[Congressional Record Volume 140, Number 17 (Thursday, February 24, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 24, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                         HEALTH CARE IN AMERICA

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
February 11, 1994, there being no designee from the minority leader, 
the gentleman from Michigan [Mr. Bonior] is recognized for 60 minutes 
as the majority whip.
  Mr. BONIOR. Mr. Speaker, not long ago I received something in the 
mail that in a funny way, sums up this whole health care debate.
  It was a resume, a resume that an enterprising young man had sent to 
my office. He was looking for a job.
  And like most resumes, this young man had listed his education, his 
job experience, and all the other things you put on a resume.
  But at the bottom of this resume, there was one line that caught my 
attention.
  One line that made me stop and think.
  Among his many qualifications, this young man wrote that he ``spoke 
two foreign languages . . . managed competition and single payer.''
  Of course, managed competition and single payer aren't foreign 
languages, they're simply two different approaches to health care 
reform.
  But to many people trying to follow this debate at home, and frankly, 
to many people right here in this Chamber, trying to wade through all 
the convoluted jargon of health care reform is like trying to learn 
another language.
  It certainly sounds like a different language:
  Preferred provider organizations or home maintenance organization?
  Employer mandates or individual mandates?
  Universal access or universal coverage?
  It's enough to make you wish that C-SPAN ran subtitles.
  Most people end up feeling like that guy who walked into the doctor's 
office.
  The receptionist asked him what he had, and the man said 
``shingles.''
  So the receptionist had him fill out a form listing his name, 
address, and insurance number, and told him to have a seat.
  Fifteen minutes later a nurse's aid came out and asked him what he 
had. He said, ``shingles.''
  So the nurse's aid took down his height, weight, and a complete 
medical history, had him fill out an insurance form, and told him to 
wait in the examining room.
  Thirty minutes later the nurse came in and asked him what he had. He 
said, ``shingles.''
  So the nurse gave him a blood pressure test, took his pulse, filled 
out a form and asked him to take his clothes off and wait for the 
doctor.
  An hour later the doctor came in and asked him what he had.
  The man said, ``shingles.''
  The doctor said, ``where.''
  The man said, ``Outside in the truck. Where do you want them?''
  Like that truckdriver, most people have very simple questions about 
health reform:
  Questions like, what is being proposed?
  How will it work?
  How will it affect me and my family?
  They know that health care affects us all like no other issue.
  They know that for health care reform to work, they must all play a 
part and take responsibility for this system.
  They're asking honest questions. And I think they deserve simple, 
honest answers.
  Because people have a right to know.
  Over the coming months, I have reserved time on this floor to talk 
about health care reform, to talk about the issues that confront us, 
and to answer some of the questions I'm receiving from people back 
home.
  As I've said before, I may not be Marcus Welby, I may not even be 
Doogie Howser, but I think I can give people some idea about how the 
President's health care plan might work, and how it compares to other 
plans.
  And it's important to recognize from the beginning that we're talking 
about a moving target here. The President's plan is likely to change in 
the months to come.
  It's got to go through the committees, and through both Houses of 
Congress, before it comes to a vote.
  This is just the beginning of the process, not the end.
  But that's what the democratic process is all about, taking the good 
ideas other people have and incorporating them to make a good plan even 
better.
  In the end, we'll have a health care paln--and a health care system--
that we can all be proud of.
  That will save money and save lives.
  And that will work for all of us.
  But as we move toward that goal, I do get a lot of questions from 
back home.
  One of the most common questions is simple: ``Why do we need health 
care reform.''
  There are a million reasons why we need health care reform--and I 
would bet that any family in America can list at least a dozen reasons 
based on their own experiences.
  But there are three basic reasons.
  First, if health care costs continue to rise at the rate they're 
going, they'll probably drive us into bankruptcy.
  In 1980, health care for the average American family cost $2,500 a 
year. This year it's about $6,500. If we don't do anything to reform 
the system, by the end of the decade, an average family will be 
spending $14,000 a year just for health care.
  If we do nothing to stop this, American workers will continue to lose 
$655 in income each year by the end of the decade. Small businesses 
will continue to face skyrocketing premiums, and a full third say they 
will be forced to drop insurance. Large employers will have to pay as 
much as $20,000 a year for each employee.
  And health care costs will devour more and more of the Federal 
budget.
  The current health care system is undermining our economy, eroding 
our competitiveness, stifling our ability to invest, and lowering our 
living standards. We simply can't afford to continue down this road.
  Second, even though we spend at least 35 percent more per person on 
health care than the next most expensive country, we're the only 
advanced country in the world that doesn't provide health security for 
all its citizens.
  We spend 14.5 cents of every dollar on health care. Only Canada 
spends 10 cents; Germany and Japan are under 9. Yet we have to compete 
with them every day.
  There's no reason why the country that beat polio, that pioneered 
prenatal care, and that has the best doctors and hospitals in the 
world, can't provide health security for all its citizens.
  Third, because of these high costs, we're paying more and more money 
for less and less care. Every year fewer and fewer Americans get to 
choose their doctors. Every year doctors and nurses spend more time on 
paperwork and less on patients because of the bureaucratic nightmare 
the present system has become.
  And worse of all, every month another 100,000 Americans lose their 
health care for good. We simply can't let this continue. We've got to 
reform our health care system now.
  Another question I get asked a lot is, ``David, how many different 
health care plans are currently before Congress?''
  Mr. Speaker, the answer is six--there are at least six major health 
care plans before Congress right now.
  Six major plans that are very thoughtful plans, proposed by very 
thoughtful people, and they all have some good qualities about them.
  But the President's plan is the only plan that has one essential 
feature.
  One essential feature that 79 percent of the American people said in 
a recent poll must be the cornerstone of health care reform.
  One essential feature that 4 out of every 5 Americans believe must be 
part of any plan that passes Congress.
  And that one essential feature is this: The President's plan is the 
only plan that provides all Americans with guaranteed private health 
insurance that can never be taken away.
  Not if you change jobs.
  Not if you lose your job.
  Not if you move, start a small business, or retire.
  No matter what happens, you can never lose your coverage.
  And the President's plan is the only plan that makes that guarantee.
  ``So,'' you might ask. ``What exactly is the President proposing?''
  In a nutshell, the President is proposing a twofold solution.
  First, to make sure everyone is covered, his plan builds upon what 
works today in the private sector, by expanding the employer-based 
system we have today.
  His plan would require employers to help pay for coverage, it would 
subsidize insurance for small businesses, low-wage workers, and the 
jobless, and it would set up insurance-purchasing pools called health 
alliances to make policies cheaper.
  He'd require that all people, at a minimum, be covered by a standard 
set of benefits as good as the benefits packages offered by most 
Fortune 500 companies, and no matter what happens, those benefits can 
never be taken away.
  Second, the President would also try to control health costs. He 
would cap the two big government health care programs so that they grew 
only about half as fast as inflation--and weed out much of the waste, 
fraud, abuse, and duplication in the system today.
  His plan would also rewrite the rules for the health-care market, to 
force private insurance companies to compete on how well they can take 
care of people, not how many people they can drop from coverage when 
they get sick.
  And, in case the competition of the free market doesn't do enough to 
restrain costs, the President's plan would impose strict limits on how 
fast insurance companies can jack up premiums.
  Mr. Speaker, by far the most common question I get is the most 
personal: ``How is all this going to affect me?''
  Here's what that means in English: After reform, almost all of us 
will be able to sign up for a health plan where we work, just like we 
do today.
  You'll get brochures that give you easy-to-understand information on 
the health plans in your area--including an evaluation of the quality 
of care and a consumer satisfaction survey. And you can choose the plan 
that's best for you and your family.
  If you're self-employed or unemployed, you sign up at the health 
alliance in your area--which is made up of consumers and local business 
owners who bargain with insurance companies for affordable health care 
for you and your family.
  Many people say to me, David, I have a good plan through my employer 
now. Will I be able to keep the plan I have now?
  The answer is yes--one of the features we are going to absolutely 
insist on during health care reform is that people don't lose the good 
benefits they may already have now.
  If your employer is currently paying 100 percent of the cost of your 
plan, he or she can continue to pay 100 percent. We're trying to 
preserve what is right with our system just as much as we're trying to 
fix what is wrong.
  Another common question is, ``How good is the standard benefits the 
President is proposing?''
  The standard package of benefits the President is proposing for all 
Americans is at least as good as the benefits offered by most Fortune 
500 companies. And you can never lose it.
  In fact, the President's plan is also the only private-based plan 
that specifies what benefits are covered.
  The other plans leave that chore to a commission to decide benefits--
only after the bill is signed into law.
  Under the President's plan, you will be covered for hospital care, 
doctors visits, emergency and laboratory services, substance abuse, and 
mental health treatments.
  And for the first time ever, prescription drugs will be covered.
  In today's system, your insurance may cover you if you get sick--but 
it won't pay a penny to keep you healthy in the first place.
  The President's plan will encourage prevention by paying 100 percent 
of the cost for regular check-ups, well-baby visits, mammogram, Pap 
smears, and other preventive care--to keep people healthy in the first 
place, so we can avoid more costly care down the road.
  But many of the people back home also want to know: Will I still be 
able to choose my own plan and doctor?
  The answer is yes--you'll always be able to choose your own plan and 
doctor. In fact, you'll probably have more choices than you have right 
now.
  Under today's system, rising health care costs have forced many 
businesses to limit the health plans for their employees. Nearly three-
quarters of small- and medium-sized businesses today offer just one 
plan--meaning you're stuck with that plan and the doctors it covers.
  More than half of America doesn't really have any choice today at 
all.
  Under the health security plan, no boss will be able to tell you 
which doctor to go to or which plan you can join.
  Every American will have the choice among a number of high quality 
plans.
  You can stay with your current doctor, join a network of doctors and 
hospitals, or join a health maintenance organization. Depending on the 
area you live in, you could be offered many choices within those three 
main areas. Your doctors can be part of any plan they want to.
  Every year, you can switch plans. And if your doctor switches plans--
you can move with him.
  Mr. Speaker, many people also ask me if premiums and copayments will 
go up under the new system.
  The answer is ``no,'' premiums and copayments will be brought under 
control.
  We aren't going through this long, painful process of reform just so 
that people end up paying more money for less care.
  You know how the system works today--you may have a plan with a $250 
premium. But if you get sick just once, you may see that premium shoot 
up to $2,500--and there's nothing you can do but pay it.
  Under the health security plan, insurance companies won't be able to 
charge you more just because your sick.
  Mr. Speaker, a lot of older Americans who are living on fixed incomes 
write me to ask if they'll be able to stay on Medicare.
  The answer is ``yes''--under the President's plan, older Americans 
who receive Medicare will still be able to receive their Medicare 
benefits exactly as they do today.
  In fact, Medicare will be made stronger--because for the first time 
ever, Medicare will cover prescription drugs; and no senior will ever 
again have to choose between the food they need to survive and the 
medicine they need to live.
  It's important to point out that the President's plan is the only 
plan that covers prescription drugs and long-term care for seniors.
  Under this plan, old people won't be made to pay more just to pay for 
health care for young people.
  And if you decide that you want different coverage, older Americans 
will be able to choose among different health plans that may offer 
fuller benefit packages and lower payments.
  But, many people ask me, what if someone in my family has a 
preexisting condition? Will They be covered?
  The answer is ``yes''--under the health security plan, it will be 
illegal to refuse to insure people just because they've been sick.
  Not long ago, a couple named Bob and Michele Peterson came to 
Washington to tell their story.
  Their 9-year-old son was diagnosed with a potentially fatal blood 
disease and needed a bone marrow transplant. So far the bills to care 
for their son have exceeded $800,000. But the family found out halfway 
through that their insurance policy has a lifetime limit--and won't pay 
more than $250,000.
  Three out of four Americans with insurance today have lifetime 
limits--and most of them don't even know it.
  This was an upper middle-class family with good health insurance--and 
now they're forced to hold community fundraisers to raise the money 
that will keep their son alive--because they can't find another 
insurance company who will cover his preexisting condition.
  Michele says with tears in her eyes, ``I thought we were safe. I 
thought we were in the clear. Now, we have $700,000 in bills--and 
nobody will cover us.''
  After reform passes, Bob and Michele's son can never be denied 
coverage again. Health plans will have to accept people--healthy or 
not. They won't be able to charge you more for being sick.
  And most important, they can't cut you off when you reach a lifetime 
limit. Because the President's plan abolishes lifetime limits for good.
  Finally, a lot of skeptical people often ask me, ``Will the 
President's plan really control costs.''
  The answer is ``yes,'' the President's plan will control costs.
  Don't just take my word for it.
  A few weeks ago, the Congressional Budget Office--which is a highly 
respected, nonpartisan office that provides budget analysis and advice 
to Congress--issued a report on the President's plan.
  The CBO found that not only will the President's plan indeed 
guarantee all Americans private health insurance with 100 percent 
effectiveness.
  But within 8 years time, it will reduce health care costs by $30 
billion.
  And in 10 years time, it will reduce costs by $150 billion.
  And that is something that is never going to happen if we let the 
present system continue down the path it's going.
  Mr. Speaker, those are just some of the questions I get. And those 
people who tell me it doesn't matter what plan we enact into law remind 
me of the old story about the veterinarian and taxidermist who shared 
the same office.
  The slogan was ``either way you get your dog back.''
  There is a difference between what plan we choose.
  The President's plan is the only plan that provides to all Americans 
guaranteed private health insurance that can never be taken away.
  It's the only plan that covers prescription drugs and long-term care 
for seniors.
  And it's the only plan that guarantees you will never be denied 
coverage or dropped from coverage again.
  Is it a perfect plan? Of course not.
  Some things will change between now and the time the President signs 
a bill into law.
  And we're going to be working with Democrats and Republicans over the 
coming months to make a good plan even better.
  Is it complicated? Of course it is--it has to be. Health care is 14 
percent of the gross national product.
  It's a difficult issue--and sometimes it seems we're dealing with a 
whole other language.
  But we all have a responsibility to get this system under control.
  And I'm going to keep coming to this floor in the days to come, and 
I'm going to continue to answer the questions I get from back home.
  Because the American people know what's at stake. They feel this 
health care crisis every day.
  They don't need any more interpretations.
  They don't need more partisan bickering.
  What they need is the truth.
  What they deserve is honest answers.
  And it's up to all of us to make sure they get them.

                              {time}  1640

  The SPEAKER pro tempore (Mr. Stenholm). Pursuant to the Speaker's 
announced policy of February 11, 1994, the gentleman from Pennsylvania 
[Mr. Walker] is recognized for 5 minutes as the minority leader's 
designee.

                          ____________________