[Congressional Record Volume 140, Number 13 (Thursday, February 10, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 10, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
           FACES OF THE HEALTH CARE CRISIS ``LIFE CARE ACT''

  Mr. WOFFORD. Mr. President, I have been listening to the reaction 
here in Washington to the very forthright and helpful report on health 
care reform from the Congressional Budget Office. And it is hard to 
believe--or to excuse--what I am hearing.
  Because so many of the people I hear doing the talking about the CBO 
report do not seem to have done much listening to Dr. Reischauer's 
testimony. If they had, then they would know that the Congressional 
Budget Office has found that the Health Security Act, in its current 
form, would save our economy $337 billion dollars in health care 
spending over the next decade, while providing guaranteed coverage for 
every American.
  And CBO found that if we do nothing, our Nation will have to spend 
$150 billion a year more 10 years from now and millions of people will 
still be without health insurance.
  The CBO did find that the Health Security Act would, in short term, 
add to the Federal deficit. And we should work together--as the Senator 
from Missouri proposed--to change that in the months ahead. And we can 
do that. The differences are not very large. The gap is not too large 
to close. But at the same time, Dr. Reischauer made it clear that the 
savings in private health spending--the savings for business and 
individuals and families and the savings for State and local government 
would begin immediately and would grow to reaching $650 billion a year 
within a decade.
  That is our whole national health care spending, and that would 
happen to it. But the most important thing Dr. Reischauer said was not 
about numbers. It was about us.
  He said that he hoped the CBO analysis would be used only for its 
intended purpose: To help us achieve comprehensive health care reform. 
Not to provide ammunition for those who only want to torpedo reform.
  Dr. Reischauer urged us to put aside partisanship and come together 
in a spirit of cooperation, as we did when we passed the Medicare Act 
in the 1960's.
  He said: ``An even more profound opportunity lies before the Congress 
today. I wonder whether any of [you] someday will be able to tour a 
Presidential archive and say to a grandchild [you] might have in tow: 
`That is my signature on the legislation that helped make America's 
health care system more equitable, more efficient, and less costly.' I 
hope so.''
  I hope so, too.
  But I am not sure the Washington insiders were listening. When are 
the pundits going to figure out that this is not the winter Olympics? 
That is not about gold, silver, and bronze medals for people in the 
White House or Congress. It is about what happens to millions of 
Americans where they live and work. It is about whether people in 
Washington can come around a table and work together to find solutions 
to the problems facing our families and communities.
  Since 1991, I have made the point that health care reform is the 
critical issue of our time not because of an election, or because of 
any politician's rhetoric, but because of the reality of people's 
everyday lives.
  And I hope my colleagues will keep that in mind when they start 
wielding numbers like swords, when they are meant to be plowshares. 
Because the goal is not to slash and burn but to plant a seed.
  Because our job here is not finally to win debating points, but to 
take action. And the CBO report gives us an excellent starting point 
for action that will achieve guaranteed, affordable, private health 
insurance through nongovernmental, nonprofit, consumer-run cooperatives 
that offer a choice of health plans to every American.
  Those who say we cannot or should not try to reach that goal must 
already have health insurance themselves. Maybe there is no health care 
crisis for TV commentators, newspaper columnists, and Members of 
Congress; they are already covered. But try telling the Pennsylvanians 
I have met and heard from over the past 3 years that there is no real 
crisis and no need for serious action.
  Tell it to the millions of older Americans who have worked hard their 
whole lives to earn a secure retirement, but whose families are being 
bankrupted by the staggering cost of long-term care.
  Tell it to the Winiarski family of Pittsburgh. When Stanley Winiarski 
retired from the steel mills at age 65, he and his wife Esther sold 
their home and moved to Florida. Eight years later, when Stanley began 
having health problems, they came back to Pittsburgh and moved in with 
their son's family.
  Four years later, Esther suffered a stroke. After being released from 
the hospital, she spent some time in a nursing home. But when Esther 
had another stroke about a year later, she went back to the nursing 
home and has been there ever since. She is confined to a wheelchair and 
struggles to speak.
  Like so many older Americans, the Winiarskis have had to find a way 
to pay for long-term nursing home care. Medicare does not cover it. And 
Stanley's Blue Cross/Blue Shield policy from his former employer, like 
most private insurance plans, does not cover it, either.
  Every month, all but $50 of Esther's Social Security check goes to 
pay for her nursing home. The Winiarskis have had to spend most of 
their life savings on Esther's care before they could get any help. 
Some of the money went to pay in advance for Esther's funeral. That is 
absurd; that is unfair.
  The wealthiest Americans can afford private insurance plans which 
cover nursing home care. And the very poor get help from Medicaid.
  But the Winiarskis, like so many others, have been caught in a 
middle-class squeeze--not wealthy enough to live well after pay 
expensive bills, but not poor enough to qualify for aid. This is until 
the system forced them to spend down their savings, so they could 
finally get some help.
  For years, the Winiarskis worked hard and played by the rules, so 
they could enjoy their retirement. But our health care system--which, 
according to some, is not is crisis--has robbed the Winiarskis of the 
security they have earned. It has made their retirement one of trauma 
and anxiety rather than peace and comfort.
  As the Winiarskis' daughter-in-law, Mary Jean, said in her letter to 
me, the strain on her family has been emotional as well as financial. 
She describes her husband's parents as proud, independent people, who 
feel demanded by being forced to give up what they worked so hard for.
  The story is the same at the other end of Pennsylvania. Aldona Zenker 
of Scranton is 90 years old. She was very active until just a few years 
ago when she lost her sight to glaucoma. Her son Jack says that the 
family could no longer give her the treatment she needed. So in October 
1991, they admitted her to the Lackawanna County Health Center, where 
Jack works.
  Aldona did not have any private health insurance. And Medicare did 
not cover her nursing home costs. She did have some money saved. She 
and her husband had owned a small grocery store. But the nursing home 
cost $115 a day, and in less than 6 months, all of Aldona's savings, 
except for $1,000 were gone. Only then, only after spending herself 
down to $1,000 in assets, was she able to get assistance.
  Jack Zenker says that he is grateful for the high quality of care 
that his mother has been able to receive at the nursing home. But it is 
unfair that his mother had to exhaust almost her whole life savings 
before being able to get any kind of nursing home coverage.
  Others who have written to me feel the same way. One man wrote:

       ``Forced impoverishment to qualify for welfare as a 
     solution strips the responsible citizen of dignity. When that 
     is added to the wallop of ill health to that person, life 
     becomes a bottomless pit of depression.''

  A few months ago, my colleague Tom Daschle and I compiled a health 
care reform consumer checklist. We rated the various reform proposals 
on the table to see if they included the provisions that we felt must 
be a part of any serious comprehensive reform package.
  When it came to long-term care, there were not very many high marks. 
The Gramm, Chafee, and Cooper plans do not even begin to deal with the 
issue of long-term care, though I am encouraged that Congressman Cooper 
now says he wants to add a long-term care provision to his plan.
  Even the Health Security Act, which I have cosponsored, does not go 
far enough. As Hilary Clinton and I explained last Friday at the 
Chandler Hall Adult Center in Bucks County, our plan is the only one 
that offers support for home and community-based care, the kind of care 
that is more humane--and often more cost-efficient--than placing an 
older relative in a nursing home. It is the kind of care that 
Pennsylvania helps provide today through its Family Caregiver Program.
  But even the Health Security Act does not fully address the cruel way 
we now pay for long-term nursing home care, which forced the Winiarskis 
and Aldona Zenker to spend themselves onto welfare.
  That is why this week I introduced the Life Care Act with Senator 
Kennedy. The bill would give middle-class families like these access to 
affordable long-term nursing home care. It would establish a voluntary, 
nonprofit, public insurance program. Families would have the 
opportunity to purchase a nursing home coverage plan--at an affordable 
premium--at one of three benefit levels--$30,000, $60,000, or $90,000.
  Each of these benefit levels would be combined with an equal level of 
asset protection.
  What that means is that if you take the $30,000 option, and you use 
up the $30,000 in coverage, you can retain $30,000 in assets and still 
qualify for Medicaid.
  Under our bill, families like the Winiarskis and Zenkers would have a 
choice of nursing home plans which would protect them from going 
bankrupt from the cost of care.
  The bill would be self-financing. It would require no new spending 
and would not add to the deficit.
  Here in Washington, we often get caught up in the political game of 
who is up and who is down? Which health care reform plan is in and 
which one is out?
  And when we are not following the horserace, we are buried in reams 
of statistics and complicated jargon.
  Maybe that is why some have decided that there is no health care 
crisis. Because they have forgotten the far more important bottom line, 
they have forgotten what is behind the polls and the committee reports: 
the real faces of this very real health care crisis.
  Those who have lost coverage they thought was secure. Who are 
overwhelmed by staggering costs. Who are forced to cope with 
bureaucracy, paperwork, and redtape. Who are forced to spend their life 
savings on long-term care.
  It is easy to whip up fear about potential change, as the Health 
Insurance Association and its allies are doing. But I do not think 
families like the Winiarskis and the Zenkers will buy the argument that 
the status quo is not so bad.
  To those who say there is no crisis, that we cannot afford to change, 
the Winiarskis, the Zenkers, and the other faces of the health care 
crisis answer that we cannot afford not to.
  Mr. WELLSTONE addressed the Chair.
  The PRESIDING OFFICER (Mrs. Boxer). The Senator from Minnesota.
  Mr. WELLSTONE. Madam President, I guess I ought to check with the 
manager of the bill. I wonder whether I might have 5 minutes to 
proceed. If not, I can come back later on.
  Mr. INOUYE. Madam President, the managers would be most pleased to 
accommodate the Senator.
  Mr. WELLSTONE. Madam President, I ask to speak for 5 minutes.
  The PRESIDING OFFICER. The Senator is recognized for 5 minutes.

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