[Congressional Record Volume 140, Number 21 (Wednesday, March 2, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 2, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                              HEALTH CARE

  Mr. DOLE. Mr. President, tomorrow afternoon, about 33 out of 44 
Republicans will go to Annapolis, MD, where we will discuss health care 
from tomorrow afternoon through tomorrow evening at around 10 o'clock, 
and then early Friday morning, from about 7 o'clock until 2 o'clock.
  The purpose of the conference--it will be the third conference we 
have had on health care--is to determine how many areas we can agree on 
in health care, how many areas Republicans can agree on in the health 
care area and, if we can, explore our disagreements and find out if 
there is any way to resolve those disagreements. We are not going there 
to put together a plan. We are going there to see where we are in the 
process.
  There is no question about it; no single plan has the votes here to 
pass. We would hope in the final analysis there would be some 
bipartisan consensus reached that would attract a great many, a 
majority of Members on each side of the aisle.
  In my view, health care is not an issue where you want to win by one 
vote or two votes or three votes. It ought to be an issue that has 
overwhelming support.
  So that will be the purpose of our conference this next day and a 
half. We do not expect to come out with total unanimity. This is a very 
difficult issue. We do expect to have some good discussions, Member-to-
Member discussions without staff, without anybody else, to see 
precisely where we are in the process and where we think we need to be 
going.
  Now, having said that, I think there is no question about it; if you 
pick up the morning papers the President's plan is in deep trouble. It 
says, ``Health Care Reform Proves To Be Tough Sell.'' That is in USA 
Today. Then, in the Washington Post, ``President's Health Plan Falters 
in Poll; 80 Percent Say They Fear Decline in Care Under the President's 
Plan.''
  The President's plan is too complicated. We held up a chart in 
response to the President's State of the Union Message with 207 boxes--
a chart prepared by a member of Senator Specter's staff--just to 
indicate that these were new, either new or expanded bureaucracies that 
are going to be created by the President's health care plan. And we did 
not list them all.
  Even people who may benefit from the President's health care plan are 
skeptical of the big, big Government turning one-seventh of the total 
economy over to the Federal Government, $900-some billion in the first 
year.
  Yesterday, we debated and, unfortunately, lost the vote on the 
balanced budget amendment by four votes.
  The President's plan creates three new entitlement programs--they 
sound great: Long-term care, prescription drugs, and taking care of 
early retirees for big companies who have made sweetheart deals with 
labor unions and now they want the Government to bail them out. The 
total cost of all these programs would be $200 or $300 billion. Nobody 
knows for certain.
  Again, how do we pay for it? Well, we pay for it some by cutting 
Medicare and Medicaid and taxing cigarettes. Some would say, 
particularly seniors, that you cannot touch Medicare, you cannot get 
that much out of Medicare. Others, low-income Americans who rely on 
Medicaid support, say you cannot take away Medicaid; you ought to be 
expanding Medicaid.
  I guess the point is that the President's program is losing support 
and will continue to lose support because the American people cannot 
recall the last thing the Government operated that they thought was 
satisfactory or that they wanted more of. And this is a big, big 
program. This is the biggest program we have had around here for 25, 30 
years, maybe as big as since we started Social Security.
  Many of these programs have been different, though. Social Security, 
we talked about it for years before it happened. Medicare, we talked 
about a program. Some called it elder care, some called it Medicare. 
That went through the mill for several years before it passed.
  My view is that Members of Congress in both parties understand there 
are very serious problems in our health care delivery system. We want 
to address those problems. But we are a little skeptical about it when 
everybody is going to get more out of this program but nobody is going 
to pay more. We are going to save money by giving people more. That is 
a hard sell.
  So the President's support has dwindled and dwindled and dwindled. It 
is down from 59 to 46 percent in one poll in just the last couple of 
months, and in the other poll it is down to about the same; 48 percent 
disapprove, 44 percent approve--and that has been a big drop--8 percent 
have no opinion.
  But it seems to me that they are concerned about big Government, the 
American people are concerned about rationing. If you have global 
budgets, if you only spend so much money on health care and you run out 
of money, you either have to ration, or raise taxes, or find some way 
to find more money.
  I must say, I am a Member of the Senate Finance Committee. I have 
attended every Finance Committee hearing. We are having outstanding 
witnesses. I do not know their political affiliation. They are not 
there because they are Democrats, Republicans, or Independents. They 
are there because they are experts in health care.
  I think I could say safely that many who supported health care, maybe 
even the President's plan, are now backing away from it. They are 
backing away from it because they are beginning to study it more 
carefully. They are reading these 1,432 pages in the President's plan 
and they are seeing things that they did not fully understand or they 
did not fully recognize at the time. And now I think we are finding a 
number of people who are very skeptical who have gone from a favorable 
position to a neutral position or a negative position.
  Now, the President's plan is dead. I said yesterday it is probably 
dead. Dead in its present form. I do not think anybody in the House or 
the Senate who can count would say that we are going to have these new, 
big bureaucracies in Wisconsin or Kansas or California and you are 
going to have to buy all your insurance through this big bureaucracy 
called a health alliance.
  It is not going to happen. Mandatory health alliances, like mandates 
or anything else mandatory, scare a lot of people, and a lot of people 
in the health care business plus a lot of consumers are going to have 
employer mandates? I do not think so. I do not think so.
  In the State of Kansas, for example, about 90 percent of our 
employers have 10 or fewer employees. We are a small business State, 
and many States have about the same percent. We do not have many big 
employers in our State. We are proud of everybody we have, and we do a 
good job. But we do not have the big, big business that some industrial 
States have.
  Again, it is not that the small business man or woman does not want 
to provide health care for everybody, nor that everybody who works for 
them does not want it. Sometimes they cannot do as much as they might 
be required to do under the Clinton plan, or any other plan, for that 
matter. So I do not believe employer mandates will be around when we 
consider this bill, either.
  Price controls: Republicans are experts on price controls because 
they were last imposed when President Nixon was in the White House. I 
happened to have been chairman of the Republican Party at the time. I 
remember that I was in San Diego. I received a call from the White 
House saying: ``We are going to put price controls on.'' It sounded 
like a great idea: Put on price controls; nobody pay any more. Then we 
started making exemptions, exceptions. They took the price controls off 
and the prices went through the roof. Plus, it discouraged competition. 
It was bad policy.
  So we have learned the hard way that price controls are not really 
the way to try to regulate anything, whether it is on insurance, 
whether it is on drugs, whether it is on doctors, or whether it is on 
hospitals. It does not work. The marketplace will work, and the 
marketplace is working. In fact, many people are telling us that if 
Congress does not hurry and get to this health care problem, it is 
going to solve itself and we will not be able to bring it up because 
there are changes being made. Insurance companies are making changes, 
pharmaceutical companies are making changes; doctors, hospitals, 
providers up and down the line are making changes.
  So it seems to me that the President--they have had a whole year to 
sell this plan to the American people. I heard prominent Democrats say 
this morning on the radio that we need more time to sell the program. 
My view is the more time this program is around, the lower it is going 
to sink in the polls.
  This program is not going to pass. It is not going to pass with big 
Government price controls and mandates. Mandates are taxes. If I 
mandate anybody in this room that they have to pay x dollars, that is a 
tax. And small businessmen and small businesswomen understand it is a 
tax. We pass mandates back to the States. We tell the State they have 
to do x. That is a tax on the people in those States, because the 
States have to go out and raise money because we passed a law and we 
did not send the money.
  So for all the reasons I can think of--and I just suggest that the 
administration spent a great deal of time arguing whether or not we had 
a crisis or a serious problem. If that is not an utter waste of time. 
The Democratic National Committee even ran ads saying the Republicans 
do not think this is a crisis, that we only have a serious problem. If 
you want to dissipate your energy and get nothing for it, you can 
engage in those little games. This is a big problem; it ought to be 
addressed. We ought to stop the theatrics, the politics, and the 
semantics. ``Crisis,'' ``serious problem,'' look it up in Webster's. I 
do not know what the difference is. It is not very much.
  I am not prepared to say our system is ready to collapse. We have the 
best health care delivery system in America today. People come here 
from all over the world to study, for research, for treatment. I do not 
know how many Americans go to Germany or some other country; maybe a 
lot. I do not get many requests for information on that. But I know a 
lot of people come to America. I know that a lot of people in the 
Midwest go to the Mayo Clinic because they believe it is a good place, 
and it is a good place. They go to the Kansas University Medical 
Center. They go to other places because we have a good health care 
delivery system.
  Some people in America have fallen through the cracks. Some people in 
America are not covered. Everybody in America can receive treatment. 
But some people do not have coverage. So we ought to make certain they 
have coverage. We ought to make certain that through vouchers or tax 
credits, that low-income Americans have a good benefit package for 
themselves and their families. And we ought to do what we can to make 
certain that these--I do not know how many millions; I do not believe 
it is 37 million. That is the figure used. It is probably closer to 
maybe 12 million. There are children and there are elderly people. We 
ought to reach out and determine how to do that.
  I would just say, finally, when I go to meetings in my State and in 
other States, people say, ``Bob, why are we changing 100 percent of 
this system when only 15 percent of it is broken?'' It is a good 
question. I asked the President that question in a dinner meeting that 
he was generous enough to invite us to last week to talk about health 
care reform. I said, ``Mr. President, I get this question when I go 
out: Why are we trying to change everything when only 15 percent or 20 
percent, whatever it is, needs fixing?''
  So there has to be a better way; there has to be a better way. Maybe 
it is a bit too early. I told my colleagues it is too early to try to 
put together this package. We are still in the hearing process. The 
Finance Committee, the Labor Committee, and the House committees are 
going through the hearing process. Let the hearing process run its 
course. But sooner or later, it is going to be up to us, Members of 
Congress, Democrats and Republicans, to see if we cannot come together. 
If not, we will come out here and we will have a big debate. Something 
will pass, and we will keep our fingers crossed and hope it is not to 
the detriment of the American people, the people who need health care.
  Let me just say one other thing because for months and months, 
Republicans have been ridiculed, saying that, ``Well, the polls show--
'' In fact, in December, this is what the polls showed: 64 percent of 
the people thought the Democrats could do a better job on health care; 
21 percent thought the Republicans could do a better job. At the end of 
February, just 3 short months, that number is now that 45 percent think 
the Democrats could do a better job and 40 percent think Republicans 
could do a better job.
  My point is this: We have not changed our position. We have said from 
the start that mandatory alliances, employer mandates, and price 
controls are not going to happen. Not many people agreed with us at the 
time. But then we had a lot of small business people, farmers, and 
others all across America--providers, nurses, doctors, whatever--and a 
lot of consumers who are concerned about maybe losing some of the 
benefits they have now, start listening to Republicans. And I think the 
poll demonstrates--I am not a great believer in polls; they can change 
quickly, too--that as of now, the parties are about even on who can 
best provide health care.
  What does that mean to me? It means we ought to try to get together. 
It means there ought to be some bipartisanship, Republicans and 
Democrats. And, if not, the Democrats will have a bill and we will have 
a bill; we will vote; and the majority party will win. So it seems to 
me that we have a long way to go.
  Mr. President, I ask that the poll numbers in the USA Today article 
entitled ``Health Plan Support Falls'' and also the numbers in the 
Washington Post be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                     [From USA Today, Mar. 2, 1944]

                       Health Plan Support Falls

       The past month, President Clinton has lost support for his 
     health-care plan among baby boomers (ages 30-49) and even 
     among the youngest voters, his strongest backers:

------------------------------------------------------------------------
                                                     Jan. 30,   Feb. 28,
                                                      1994       1994   
------------------------------------------------------------------------
Age:                                                                    
  18 to 29........................................         64         56
  30 to 49........................................         56         40
  50 to 64........................................         56         46
  65 plus.........................................         53         47
Liberals stand by Clinton:                                              
  Conservatives...................................         42         29
  Moderates.......................................         64         51
  Liberals........................................         74         72
                                                                        
                Parties MOVE Closer                                     
                                                                        
How Congress should deal with Clinton plan:                             
  Pass as is......................................         24         20
  Pass with changes...............................         55         47
  Reject..........................................         16         28
Majority still sees health care as a crisis:                            
  Crisis..........................................         57         53
  Problem.........................................         42  .........
  Not a crisis....................................  .........        46 
------------------------------------------------------------------------


Men, elderly doubt crisis:                                              
  Men........................................................         44
  Women......................................................         60
    Ages:                                                               
      18 to 29...............................................         54
      30 to 49...............................................         54
      50 to 64...............................................         59
      65 plus................................................        41 

       Percentage that say a specific political party can best 
     deal with health-care policy:

------------------------------------------------------------------------
                                                     Dec. 6,    Feb. 28,
                                                      1993       1994   
------------------------------------------------------------------------
Democrats.........................................         64         45
Republicans.......................................         21        40 
------------------------------------------------------------------------

       Percent saying ``big concern'':

------------------------------------------------------------------------
                                                     Oct. 10,   Feb. 27,
                                                      1993       1994   
------------------------------------------------------------------------
The quality of your medical care will decline.....         64         80
You might not have good choices of doctors or                           
 hospitals........................................         72         75
The cost of your medical care will increase.......         70         74
People who need it most won't get adequate medical                      
 care.............................................         56         72
Some kinds of expensive medical services will not                       
 be available to all who need them................         69         70
There will be a lot of fraud and abuse under the                        
 plan.............................................         67         70
Employers would eliminate existing jobs...........         64         69
The plan will cost too much.......................         66         68
Taxes will have to be increased to pay for the                          
 plan.............................................         68         62
The plan would create another large and                                 
 inefficient government bureaucracy...............         59         62
The plan will pay for legal abortions.............         43        47 
------------------------------------------------------------------------
NOTE: The most recent figures are from a Washington Post/ABC News       
  national telephone poll of 1,531 adults conducted Feb. 24-27. Other   
  data are from Washington Post-ABC News polls of approximately the same
  sample size. Margin of sampling error for all polls is plus or minus 3
  percentage points overall. Sampling error is, however, only one of    
  many potential sources of error in these or any public opinion polls. 
  Interviewing was conducted by Chilton Research services of Radnor, Pa.
                                                                        

  Mr. DOLE. Mr. President, the final point I make is that the more the 
American people learn about the Clinton plan, the less they like it.
  So those who say we need more time to explain it, I think that is a 
loser, because every poll demonstrates that the more people find out 
about it--how big the Government is, how big the mandates are, and 
about the penalties. For example, you might go to jail if you ask the 
doctor to perform the operation early. Say you are scheduled for June 
and the operation is in May; you pay the doctor a little extra, and you 
can end up in jail, it says. Not so bad, if you go with your doctor. It 
is a penalty. There are a lot of penalties in this bill.
  We have a lot of work to do. I just say to the President and Mrs. 
Clinton, I will give you credit for getting health care on the agenda. 
I do not give you credit for the plan you put on the agenda because I 
think it is a bad plan for America.
  But we will have our retreat this next day and a half. We will not 
come out with a plan. But we will come out, I hope, closer together 
than we are now. We have a lot of good ideas on our side. We have at 
least three or four plans on the Republican side. We need to try to 
come together. Democrats have as many plans. They need to try to come 
together.
  So in the final analysis, the President's plan is slipping away, and 
it is time for leadership in both parties to see if we cannot deal with 
this issue this year. If not, we may be doing what we had to do in 
1983: We may have to appoint a commission, a commission composed of 
bipartisan experts to take a look at health care and to give Congress 
some guidance if we cannot resolve it ourselves.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mrs. HUTCHISON. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.

                          ____________________