[Congressional Record Volume 140, Number 22 (Thursday, March 3, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 3, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                        HEALTH CARE LEGISLATION

  Mr. KERREY. Mr. President, I come today to discuss briefly the health 
care debate.
  The Republican Members of this body are having a retreat. I think 
those of us on the other side of the aisle need to listen very 
carefully when they come back from their retreat as to what they are 
willing to do. The one thing that I believe strongly about health care 
today is that the American people cannot afford in 1994 for us to do 
nothing; that we have to have the wisdom and the perseverance necessary 
to put together a piece of legislation that has both Republicans and 
Democrats on it.
  We ought to give some on this side of the aisle, and they ought to 
give some on their side of the aisle in an effort to enact legislation.
  Mr. President, since the President introduced his legislation which 
he presented to the American people last fall, I have made an effort to 
learn what is in that bill. I view the President's bill as the vehicle 
for action. He, after all, is the President. He has spent a great deal 
of take time looking at that issue.
  He has presented a very thoughtful piece of legislation, frankly not 
as confusing as described. There are 11 sections in it. Yes, the 
legislation is long. It is 1,300 or 1,400 pages. But it seems to me on 
an issue this important, we should not expect to get three or four 
pages of law. It is long; it is thoughtful; it is detailed; and it 
specifies how the bills are to be paid. And it provides for universal 
coverage.
  I have found, in my own presentations to audiences, that when they 
are presented with the facts of what is in the bill, No. 1, they say, 
``Gosh, this is not as confusing as I thought.'' And, second, they say, 
``I am sort of comforted by the language. It is not as obscure as I 
thought.''
  I heard the distinguished President pro tempore, the occupant of the 
chair, talk at length about the need for us to understand the law. And 
thus I think it is very important in this debate for Americans really 
to become familiar with this proposal.
  I myself want to amend the bill, want to make changes in this 
legislation. But it is rather difficult for me to make changes unless I 
know what is in it.
  It is interesting as you watch the critics. I see in one week the 
Business Roundtable says, ``We won't support the President's bill 
because it does too much.'' The next week, the American Association of 
Retired People says, ``We will not support the bill because it does too 
little.''
  That, it seems to me, sort of frames the argument. We are going to 
have people opposed to the legislation because it does not do enough, 
or we will have people opposing it because it does too much. We have to 
figure out how to change this piece of legislation so we can pass it. 
We cannot allow the status quo to continue. We know that, Mr. 
President.
  The mandated spending on health care, Medicare, and Medicaid will 
increase another $30 billion from last year to this. The principal 
reason we are struggling to find money for crime and transportation and 
economic development and education is that these health care programs 
are squeezing out these other spending items. The domestic accounts 
will all go down in total this year; whereas, the mandated programs are 
all going to go up. We have no change. We know that.
  People are still out there with preexisting conditions. Individuals 
are rationing their care. Americans at age 55 are praying that nothing 
happens to them for the 10 years before they become eligible for 
Medicare. People are confused about the current system. There are 
businesses that are unable to purchase a product, and there are all 
kinds of freezes beyond our own budget for us to take action.
  We do not have to wait for a problem to affect a majority of us; it 
need not affect 60 percent or 51 percent of the American people. This 
affects every one of us, in my judgment, through the increased cost of 
taxation. But it affects a sufficient number of Americans in a very 
terrifying and real form who wonder whether or not they are going to 
get care for us to act as well.
  Mr. President, there are four areas where I am going to focus my 
attention. The first is in the area of insurance reform. The insurance 
industry has changed dramatically from 3 years ago. They are saying: We 
will accept the need for community rating and accept the need for 
comprehensive uniformity in benefits at the national level. We need to 
lock that reform in. I believe we can get agreement between the 
Republicans and Democrats on that issue and find common ground so the 
American people can begin to get a little less confused about what it 
is that we support.
  Second, the welfare system is broken. The Medicaid system traps 
people, makes it difficult for people to get back into the work force 
and encourages the wrong kind of behavior. We need to reform that 
system, Mr. President, and disclose to the American people that all of 
us pay for health care through our tax system; and disclose to the 
American people that if you have household income of, say, $30,000 a 
year, it is apt that you are already paying $3,000 or $4,000 through 
your tax system. We need to disclose that so that we can design a means 
to allow individuals who are receiving State and Federal payments for 
health care in low-income categories to move back into the work force. 
It is relatively easy to envision a way to do that with merely a 
sliding scale, using the tax system to adjust the subsidy as an 
individual goes back to work.
  I do not like the idea, Mr. President, of having somebody sit out 
there and say that you have to meet this arbitrary guideline of 100 
percent or 200 percent. Use our tax system. It is relatively easy for 
me to imagine a compromise between Republicans and Democrats on 
Medicaid reform. There is an urgent need to do it. Because it has long-
term care in it, we can address that rather difficult problem 
simultaneously, I hope.
  The third area is that I think there is generalized agreement that 
rather than having the Government regulate price and do cost control, 
we need to move in a direction where individuals are taking more risk, 
where individuals are getting information about price and quality and 
making decisions based on that information. That is what the President 
has talked about over and over again. His critics say he wants to have 
the Government do it. That is not true. There is an agreement between 
the Republicans and Democrats that we need to move away from Government 
regulation of health care and in the direction of having individuals 
make more decisions about price and quality. A relatively small number 
of adjustments in our Tax Code would provide those incentives. And, 
again, I see consensus emerging between Democrats and Republicans to do 
it.
  The last area is the area of accountability. The system is not very 
accountable, whether the issue is an individual that has been injured 
and wants damages through a tort system that is difficult, or whether a 
provider is trying to defend against some very unreasonable and silly 
lawsuits, or whether, Mr. President, you are talking about the 
accountability provided by us as politicians by telling the American 
people how we are paying the bill, there is an urgent need to provide a 
simplified way for individuals to come and appeal a decision that is 
negative, either by an insurance company or by Federal payer benefits. 
We cannot have Americans flying to Baltimore, Maryland, or to some 
insurance company headquarters, to appeal. We know accountability is 
something we can lock in with Republican and Democratic support.
  In conclusion, Mr. President, I really think there is consensus in 
this body, and I will listen with a great deal of interest when the 
Republicans come back off of their retreat. I know a majority of 
Republicans want to enact legislation this year. Our job is to write 
law, Mr. President. This Senate sometimes does not do that. We have an 
opportunity, I think, to lead now--to lead by doing the hard work of 
looking at the law, ignoring the rhetoric, and looking at the detail of 
this legislation and coming together to try to provide the American 
people in fact exactly what they want, which is comprehensive coverage 
for every single American, and a system they can understand.
  Several Senators addressed the Chair.
  The PRESIDING OFFICER (Mrs. Murray). Under the order, Mr. Wallop is 
to be recognized for up to 10 minutes.
  Mr. REID. Parliamentary inquiry, Madam President.
  Mr. WALLOP. I am happy to yield for that purpose.
  Mr. REID. Madam President, I have had a number of people come to me. 
The Senator from Colorado has a couple minutes he would like to speak, 
and Senator Daschle wants to speak. We will raise that after the 
Senator completes his.

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