[Congressional Record Volume 140, Number 3 (Thursday, January 27, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: January 27, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                              HEALTH CARE

  Mr. GRAMM. Mr. President, a moment ago I tried to convenience my 
colleagues by agreeing to limit my comments to 5 minutes to introduce a 
bill, something that we do around here on a regular basis. I sought to 
limit my comments to 5 minutes, not wanting to disrupt this debate.
  But, Mr. President, we are under a system where any Member can take 
the floor at any time to speak on any subject. And since our dear 
colleague from Massachusetts felt compelled to get up and say that what 
I was saying was not so, I am afraid that I am going to inconvenience 
the body by responding to those comments, though I will try to be brief 
about it.
  First of all, one of our difficulties in debating health care, which 
is the number one issue in America, is that, in order to advance their 
position, everybody tries to define words in a way that leads people to 
believe what they want them to believe.
  A perfect example was in the State of the Union Address when our 
President, on three different occasions, talked about his plan being 
based on private health insurance.
  Mr. President, Winston Churchill once came up with a test where 
someone could ask seven questions to determine whether they lived in a 
free country. The point being that all over the world people in the 
most repressive totalitarian states claim to be free. So Winston 
Churchill set out seven questions you could ask to determine whether 
you lived in a free country.
  Now, I would like to just propose a two-question test on the Clinton 
plan to determine whether it preserves the right of people to buy 
private health insurance.
  First of all, if you are happy with the health insurance plan you 
have: You work for a company in Denver, CO. It has 200 employees. They 
buy Blue Cross/Blue Shield. You have a good job, a good insurance 
policy, you are happy with it. If Bill Clinton's plan, all 1,342 pages 
of it, is adopted, can you or can you not keep your Blue Cross/Blue 
Shield policy exactly as it is?
  The answer to that question is absolutely no. Under the President's 
plan, your private health insurance policy is canceled. There is no 
debate about that. No one who has read the President's bill in any 
detail disputes that fact. The whole principle is that your private 
health insurance policy is canceled. You will be forced to buy health 
care and health insurance through a Government cooperative--alliance--
collective.
  Where did the word ``alliance'' come from? The Democratic National 
Committee spent $200,000 doing polling to try to come up with a name 
that confused people as to what the institution was. They started out 
with the name ``cooperative.'' They did not like the way it sounded. 
And after $200,000 worth of polling they found that if you call the 
cooperative, or the collective--which is the old term for it and a 
perfect term for it, the kind of term you would apply if you went to 
the dictionary and tried to find the right word--they found if you call 
it an alliance, that people do not feel so threatened by it.
  The point is, if you work for a company in Denver, CO, which has 200 
employees, if the President's plan is adopted your Blue Cross/Blue 
Shield policy is canceled. You are forced to buy health insurance and 
health care through a government-run agency, probably in Denver, that 
would probably cover half the State of Colorado.
  What happens if you are not happy with what the Government offers? 
Under the President's plan, you can take two aspirin and write your 
Congressman. You can complain. But you cannot stop giving the 
Government your money. No one disputes that. No one who has ever read 
the President's plan disputes that.
  Now, what if you are so unhappy with the Government plan that you 
want, in addition to giving the Government your money--about which you 
do not have any choice--you want to go out and buy private health 
insurance on your own? The second question to determine whether this 
plan is based on private health insurance is, once you have given the 
Government collective your money, if you are not happy with the health 
care, can you go out with your own money and buy private health 
insurance to cover the same services that you were supposed to be 
getting from the Government but you do not feel they are providing? The 
answer to that is no. Under the President's plan, on page 241, there is 
a $10,000 fine for anybody who tries to sell you private health 
insurance in competition with the Government.
  Now, it is true that if you are rich enough to give the Government 
your money through this health care collective, and if you are not 
happy with the health care they provide, you can take your own money 
and if you can find someone outside one of these Government plans--
because people inside the plan cannot take your money and give you more 
services because that is illegal and they can be penalized for that--
but if you can find someone outside the system, you can buy health care 
directly. But you cannot buy a private health insurance policy to cover 
services in competition with the Government.
  If that is private health insurance, the English language has 
absolutely no meaning.
  The basic point is this. There are things broken in the health care 
system. We need to change the insurance product so you do not lose it 
when you change jobs. We need to change insurance so it cannot be taken 
away if you get sick. Everybody agrees on that. We can fix that. I 
believe we need a system to reform Medicaid and use that money to help 
working people who make low incomes get private health insurance. 
Something is wrong in America when if you do not work you qualify for 
Medicaid, but if you do work and make low income you often do not have 
health insurance. What kind of society treats the people that are 
riding in the wagon better than the people who are pulling the wagon? 
Obviously a society that wants a lot more people riding in the wagon.
  I agree with the President that we need to deal with paperwork. But 
where does the paperwork come from? Government. Government pays 31 
percent of the bill and generates two-thirds of the paperwork.
  Where is the exploding cost coming from? Medicare and Medicaid. Let 
the Government lead the way in reforming Medicare and Medicaid, in 
reducing Government paperwork. But my point--which I tried to make and 
then sit down--is this. We do not have to have the Government take over 
and run the health care system in order to make it possible for people 
to get and keep good private health insurance. The President says that 
there can be no bill unless we have universal coverage, and I believe 
we can write a bill that establishes a system through reforms in 
Medicaid and the promotion of competition in the private sector to save 
money, which will then allow us to help low-income working Americans 
get and keep private health insurance. But what we have to do if we are 
going to give everybody universal access is, we have to come up with a 
way of paying for it.
  My bill, which I have introduced, sets out a procedure to do that. 
The President lets the Government take over and run the health care 
system and promises more new benefits than Medicare and Medicaid 
combined. And how does he pay for them? By having the Government run 
the health care system and by forcing people to buy health care through 
a Government collective in each region of the country, which will be 
the only buyer of health care for people who are not lucky enough to 
work for the Government or for companies that have 5,000 or more 
employees, the President would have us believe that he can just give 
every American health care coverage because Government is going to 
produce health care more efficiently than the private sector.
  I do not believe anybody on the planet believes that. But certainly 
the President has provided no evidence whatsoever to substantiate that 
claim.
  So, what I have tried to do here, and I will yield the floor back and 
let the debate go on, is simply to make a very small number of points.
  First, we can fix the things broken in the American health care 
system. We can provide a system whereby we can save the money through 
genuine reforms to help working people get and keep private health 
insurance. And we can do it without having the Federal Government take 
over and run the health care system.
  Second, we can provide a system that is fiscally responsible. We 
cannot do it immediately. We cannot give every American the same health 
insurance policy that the United Auto Workers have because the Federal 
Government does not have, and in the foreseeable future is not going to 
have, that much money. We can institute genuine reform, but we are not 
going to pass a bill in this Congress, in my humble opinion, that has 
the Government take over and run the health care system. And if the 
President insists on that, he is going to be the person who stops us 
from passing genuine health care reform.
  Also, I believe that when the American people understand that under 
the President's plan they are going to be denied the right to buy 
private health insurance in competition with the Government program and 
that they are going to be forced--whether they like it or whether they 
do not like it--to buy through these Government agencies, and denied 
the right to go outside them and buy private health insurance--when the 
American people understand that it is not just bankrupting the 
Government that we are talking about, it is not just employer mandates 
that put people out of work that we are talking about, but that it is 
denying people their basic freedom that we are talking about, I believe 
when people understand that, they are going to reject the President's 
plan. And they are going to start looking at alternatives.
  My purpose today was to say that a substantial number of the Members 
of the Senate have put together an alternative that tries to fix what 
is broken about the health care system without tearing the system that 
we now love, in terms of its quality, in terms of its science, and in 
terms of the miracle cures generated routinely. Instead of tearing it 
down, let us keep what we love about the system and try to fix what is 
broken. And we can in the process, with private health insurance and 
competition, help Americans get and keep good private health insurance, 
promote competition, and save money.
  I hope we can work on a bipartisan basis. I am willing to work with 
the President, but as the President says, some things are not 
negotiable with him. There are some things that are not negotiable with 
me. I am not going to support a system where the Government takes over 
and runs the health care system. And second, I am not going to support 
any system that will deny a free American the right to say, ``Thank 
you, Government, for trying to help me, but I like my Blue Cross/Blue 
Shield. I want to keep it.''
  I am not going to support any bill that takes away from people the 
right to keep their own private health insurance or, if they are in a 
Government program and do not like it, the right to get out of it and 
as a free person to go and knock on the door of Mutual of Omaha and 
say, ``I want to buy one of your policies and here is my money.'' I am 
not going to support a program that would deny them that right.
  Some people hate to admit the facts, but the facts are the 
President's bill denies people those fundamental rights. When they 
understand it, they are going to reject it, and maybe at that point we 
can all get together and fix what is broken about the system. I would 
like to do that. I think the American people would like to do it.
  I yield the floor.
  Several Senators addressed the Chair.
  The PRESIDING OFFICER. The Senator from Massachusetts [Mr. Kerry].
  Mr. KERRY. Mr. President, I will yield to the Senator from Colorado 
in a moment, but I would like to make a couple of comments. I did not 
hear all of what the Senator said. This is not the time and place for 
that debate, so I am not going to respond at great length. I look 
forward to the time when we will engage in a dialog.
  The Senator from Texas is as thoughtful and quick on his feet, as 
good as anybody around here, and he is always fun to engage in a good 
dialog. I simply will say when he refers to the system we all love, he 
``ain't'' talking about all Americans because 43 million Americans do 
not have a system to love. They do not have insurance. An awful lot of 
people who do, keep getting told they have a preexisting condition, 
this is not covered, or they lose it when they lose their jobs, as more 
and more millions of Americans are losing their jobs and all of a 
sudden they have no insurance. They certainly are not going to sit 
there and say, ``Gee, I love this system that requires me to sell my 
home and invade my savings account because I have a catastrophic 
illness I cannot afford to pay for.''
  The system we love is subject to who's got the system. We are going 
to be learning a lot about that as we go down the road.
  I could not agree with my colleague more. I do not want a Government-
run system either. I really do not. I am not a cosponsor yet. We are 
going to work with the Senator and others. I am confident we are going 
to come up with a program for the American people that will address 
their real needs and concerns. I look forward to a dialog with the 
Senator from Texas at that time.

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