[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

  Mr. MITCHELL. Madam President, as all Members of the Senate know, 
ordinarily the Senate would be in session well into the evening on 
today--a Thursday--and tomorrow as well. But as I noted in earlier 
remarks to the Senate, the Republican Senators have a meeting today and 
tomorrow on health care, and the Republican leader asked me to change 
the schedule to accommodate Republican Senators for that meeting. I was 
pleased to do so. I applaud their attention to the importance of the 
subject of health care. As I also noted in my earlier remarks, 
Democratic Senators have had a number of meetings on this subject, and 
they will have a number of additional meetings.
  My hope is that out of these respective meetings can come a genuinely 
bipartisan effort to reach agreement to reform our Nation's health care 
system. The problems that Americans face with respect to the cost of 
health care are neither Republican problems nor Democratic problems. 
They are problems that face every family, regardless of politics or 
political philosophy or persuasion. I believe it will take a genuine 
bipartisan effort, with our allegiance being first and foremost to the 
national interest, for us to resolve this matter and to reach agreement 
on what I hope will be a meaningful and bipartisan and comprehensive 
reform of our Nation's system of health care.
  There are many things we must do. First and foremost among them, we 
must see to it that every American has private health insurance that 
cannot be taken away, health insurance that is permanent, 
noncancelable, and that travels with that person for life. No longer 
should Americans have to fear the loss of health insurance if they lose 
or change their jobs, if they move from one place to another.
  No longer should a single American--a single American--have to 
choose, let alone the many thousands who now make the most basic 
decisions of life based upon health care considerations. Right now in 
this country there are thousands of people who decide whether or not to 
marry, whether or not to have children, where to live and where to 
work, based upon health care insurance and cost considerations. I 
personally have met with many such Americans.
  I held a series of hearings around the country, and I was shocked to 
hear people tell me that they are either not going to be married or not 
going to have children solely because of their concern about health 
insurance and the cost of health care.
  And, of course, we all know about the growing phenomenon of joblock, 
where millions of Americans have jobs that are not making the maximum 
use of their talents, and who could, in fact, and would like to have 
other jobs, but do not move because of their fear of losing health 
insurance. This creates massive inefficiency in a free-market economic 
system in which the highest level of productivity is when each person 
is working at the maximum level of talent which he or she has.
  So there has to be health insurance for every American. There has to 
be control of cost. We cannot continue the escalation of health care 
costs that is occurring in this country, that has occurred over the 
past several decades.
  Volumes have been written on it; books have been written on it; but 
one statistic tells the story. In 1960, Americans spent on health care 
in the aggregate $27 billion. This year, Americans will spend on health 
care in the aggregate $950 billion. From $27 billion to $950 billion. 
That is a rate of increase which cannot be sustained.
  I know there are some who say the rate of increase has moderated a 
little bit in the most recent year or two and, therefore, ought not be 
a matter of concern. These are among the no-crisis exponents in our 
society who say this is not a crisis, this is not a real problem, we 
really do not have to do very much.
  Madam President, Members of the Senate, I strongly disagree.
  We must act. We must act this year.
  I would like to make a final personal appeal on one subject which has 
been a matter of special consideration and attention for me.
  Before becoming majority leader, I served as chairman of the Senate 
Health Subcommittee, and I have been privileged to serve on that Health 
Subcommittee in all the years I have been in the Senate.
  I became aware then and have become increasingly aware of the need 
for much greater emphasis on primary and preventive care in our 
society. One of the reasons Americans spend so much on health care is 
that we spend almost all of it trying to make people well after they 
have become ill. We devote very little attention, very little effort, 
and very little in the way of resources--and almost nothing in the way 
of education--in an effort to persuade people that it is in their 
personal interest to concentrate on wellness.
  Healthy people do not need as much health care as people who are not 
healthy. That is so obvious it needs to be restated: We must undertake 
a major national effort at education, at prevention, to change the 
minds and attitudes and poor health habits of Americans, to concentrate 
our efforts on personal responsibility. Every person is personally 
responsible for his or her well-being. It is something that is so 
obvious that it is often not said. But we have to do a much better job, 
especially among young Americans, of encouraging them to discontinue 
poor health habits and to encourage the kinds of habits that will 
permit longer, fuller, more meaningful, and more healthy lives. We can 
save billions of dollars in the process, and although the examples are 
legion, I am going to take this opportunity to recite just one of them 
because I think it is an example with which every American can and 
should identify.
  I have toured every health-care facility in my State, and I have been 
in many health-care facilities in other States. Some time ago, I was 
privileged to be taken on a tour of the Tampa, FL, General Hospital. It 
is a very fine community hospital in a large urban area with a diverse 
population. As I walked through the pediatrics ward, the chief 
pediatrician pointed to a row of incubators along the wall and said: 
``Senator, those are our million-dollar babies.''
  I said, ``What do you mean by that?''
  She said: ``It is a term of affection, but the cost of keeping each 
of those babies alive has exceeded $1 million. In the case of some of 
them, it is $2 million or $3 million.''
  I went over with her to the row of incubators and walked along and 
looked at each of those babies. Some of the parents were there, and I 
talked to some of them and I inquired about the histories of the babies 
and the parents.
  They were different. This is a diverse urban area, but there was one 
common theme among most of them. Most of these babies were born of 
mothers who had received no prenatal care. In plain and simple English, 
many of these young mothers had not seen a doctor between the time they 
conceived and the time they gave birth to the child.
  That ought to be shocking to all of us. I am absolutely certain that 
every single Member of this Senate would find it unthinkable, if one of 
their children became pregnant, that she would not see a doctor during 
pregnancy. For us, it would be unthinkable.

  What is unthinkable for us ought to be unthinkable for every American 
family. It is unacceptable that what is unthinkable for us is the 
reality for many American families. It simply ought not to occur in 
America.
  Every single American woman should know that if she becomes pregnant, 
she can see a doctor. The normal, reasonable, preventive measures that 
our children would take under similar circumstances ought to be taken 
by every pregnant American woman. This simply ought not to occur in our 
country, and yet it does with distressing frequency.
  I have had many people say to me, ``Well, there really are not that 
many $1 million babies.'' Maybe there are $800,000 babies, maybe there 
are $400,000 babies, maybe they are $100,000 babies. But the reality is 
this: The rate at which babies are born prematurely and of very low 
birthweight is markedly higher among women who do not receive prenatal 
care than it is among those who do.
  That, again, is just obvious common sense. A pregnant woman who does 
not see a doctor, especially one who may not have a high level of 
education, who may not have a supportive, intact family, who may be 
frightened and under enormous social and economic pressure, that woman 
is much more likely to have a child born prematurely of low 
birthweight, therefore requiring these heroic and expensive measures, 
than one who does not suffer from those pressures, who is not subject 
to those pressures, and who has the opportunity and the means to see a 
doctor on a regular basis and to have any problems taken care of, or, 
most importantly, to take reasonable preventive measures.
  That is just one example, and there are literally hundreds of such 
examples, of how we can have a healthier society, a better society, and 
spend less money.
  Would we all not be better off if there were fewer $1 million babies 
or $100,000 babies, whatever the figure? We would have healthier 
babies, healthier mothers, healthier families, a healthier society, and 
spend less in the process.
  It is so obvious, it is so clear, the knowledge exists. The only 
thing lacking is the political will to do what we know must be done. 
And that is our task.
  Each of us sought this office. Each of us worked very hard to get 
here. And once we get here, it is our responsibility to act in the 
national interest, not merely to serve in public office for the glory 
of being in public office, but to use that limited opportunity, the 
short time that each of us has in life overall and in public life to do 
something good and meaningful and positive and beneficial to the 
country. That would be the best legacy we could leave individually and 
as a Congress.
  Our challenge this year--and it is a challenge that no other Congress 
has faced with as much opportunity in many, many years--is to pass 
comprehensive, meaningful health care reform.
  Madam President, I commit myself to that objective. Again, I express 
the determination of the Democratic Members of the Senate to get this 
job done this year. We look forward to working with our Republican 
colleagues. We do not think we have all of the answers. We do not think 
our way is the only way. We welcome discussion. We welcome dialog. We 
welcome negotiation.
  Let us keep our eye on the common objective that we share and not be 
divided by the differences on how best to get there. With good will, 
with determination, with commitment, and with a proper sense of what 
public service means, I am convinced we can reach that goal.
  So I look forward to welcoming our Republican colleagues back to the 
Senate next week with a view toward sitting down and going forward and 
working together and achieving this important national objective. It is 
the most important thing we have to do. If we do it, we will have 
performed a valuable public service.

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