[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. WOFFORD. Mr. President, quite often on these Thursday mornings, 
or on other days, I have come to the Senate floor, and often with the 
Senator from South Dakota, who is giving such good leadership in this 
fight for guaranteed health insurance, private health insurance for all 
Americans--we have come to the floor to speak about what is happening 
to people in our States under our current health care system.
  Many of our colleagues have done this in a series we have called 
Faces of the Health Care Crisis, the human faces that go with the 
figures, the statistics, and the problems that have been presented to 
us.
  Little did we expect that talking about a crisis would become 
controversial here in Washington. The crisis concept is not so 
difficult for Pennsylvanians that I have spoken with over the past 2 
years: People who have come to hearings and roundtables all over 
Pennsylvania; people whose stories I have tried to tell from this spot; 
people who are feeling in their lives the crisis we are talking about; 
people who have seen their coverage cut off when they lose a job, when 
they change a job, when they retire from a job, and--most absurdly--
welfare recipients who lose their coverage when they get a job; small 
business owners who have seen their premiums skyrocket 20 or even 30 
percent a year when they or one of their employees, or their children, 
get a serious illness; older citizens who had to spend down--what a 
word that is--spend down their life savings in order to pay for nursing 
home care and have gotten no support for home care which is the most 
cost-effective and humane way, so often, to give care for long-term 
problems and for older citizens.
  Because of stories like that, Pennsylvanians gave a verdict a few 
years ago when they sent me here on whether to reform our health care 
system. They did not know exactly what the plan should be that would 
reach the goal they knew, but they knew they wanted to have health care 
reform reach that goal.
  So now we have the great opportunity within our reach, we have the 
opportunity to go forward. We have a President and a Congress, we have 
Democrats and a goodly number of Republicans working on the question of 
how to do it. But as we have that opportunity before us, the historic 
proponents of reform are trying to change the clock back, the same 
special interests who fought against Medicare, who beat Harry Truman 
and even Richard Nixon with scare tactics about socialized medicine.
  But there is another way to keep us from moving forward. Now some 
people in Washington want to keep talking about health care reform as 
if it is another political horse race. This week, they are talking 
about polls and where the President's health care plan stands in the 
polls. It should come as no surprise to anyone who has run for office 
that the Health Insurance Association of America got its money's worth 
out of their spokesmodels, Harry and Louise.
  People in this city are experts in moving poll numbers. That is how 
they get here in the first place. So let us not act surprised that the 
Health Insurance Associations' millions of dollars in deceptive TV ads, 
financed by premium dollars paid by their own customers, have served 
their purpose: To turn skepticism into cynicism, confusion into fear.
  This afternoon, our Republican colleagues are going to Annapolis for 
a health care retreat, an attempt to reach consensus on health care 
reform. I am glad they are going to do this, and I wish them well. It 
is an important development that they are spending a weekend on what to 
do about health care. A few years ago, many Republicans dismissed the 
importance of health care reform, and I doubt that they would have done 
this. I also would not have imagined 3 years ago so many Republican 
colleagues would be supporting proposals that do go a significant, 
remarkable distance further toward Harry Truman's goal of guaranteeing 
private health insurance for all Americans. They do not go far enough 
yet, but they have gone a good distance.
  The progress we have made is real. The common ground is important. 
Many Republicans are very serious about this issue and want to be 
constructive, and I am counting on them to help us to succeed together.
  So it is good for them to leave Washington for a couple of days 
because whenever we go beyond the beltway and listen to our fellow 
Americans, wherever we are--back home or in Annapolis--we see that they 
do not share Washington's view of health care reform as a spectator 
sport. People want information, that is for sure, a lot more 
information than they can get in the 30-second ad, but they are not 
interested in which party wins, which loses. And the latest punditry in 
poll numbers--who is up and down--may have been interesting in 
Lillehammer, but the Winter Olympics are now over and it is time for 
spring planting and it is time for a crop this summer that will give 
the American people their long-sought goal of universal health 
insurance.
  I find that what citizens really want to know is whether their health 
insurance cannot be taken away, whether they can choose their own 
health plan, whether their premiums are going to continue to go up and 
up.
  Americans are justifiably confused about how any particular health 
plan will work. But they know what they want. To put it simply, they 
want what we have, what Senators and Members of Congress and 9 million 
other Federal employees have--a menu of affordable health plans in 
which both the employer and the employees contribute.
  So I hope our Republican colleagues will use this opportunity to back 
away from the confusion and the complexity of the insider's game and go 
back to the basics, to the simple questions which truly define the 
health care debate, questions which point to the key elements of any 
solution to the problem.
  To make their work easier, I offer these five key questions that they 
and all of us must answer: How do you guarantee private health 
insurance to every American? It is easy to share the goal of universal 
health care. Let us all very firmly agree that health insurance for 
every American is our goal. I think a strong majority of us in this 
body agree with that, but how are we and how do you, my Republican 
colleagues, propose to proceed, and are you ready to take the steps 
needed to reach that goal?
  The President and 31 cosponsors of the Health Security Act have 
spelled out how to make that guarantee of private health insurance a 
reality. How would my Republican colleagues do it? We would build on 
the present American system of employer-employee mutual contribution, 
which is a fact of life for a great majority of Americans with health 
insurance today. We would build on it and extend it to all working 
Americans. How do my Republican colleagues propose to do it?
  Then how do we plan and how do you, my Republican colleagues, plan to 
control the costs of health care? Many Republicans supported the 
balanced budget amendment but oppose real cost control in health care. 
I cannot reconcile those positions. We cannot end the Federal deficit 
without controlling the skyrocketing costs of Medicaid and Medicare. 
But you cannot simply cap those entitlements because all that will do 
is to shift costs on to the private sector and make the burden on 
business and families and individuals even heavier. Paying customers 
will pay more and more to cover the uninsured and the underinsured. 
That is not fair and it is not smart.
  The President's Health Security Act proposes very specific ways in 
which we will bring down the inflation in health care costs. It 
proposes a structure of competition of the private health care plans 
for purchasing pools that will be our purchasing pools. It proposes a 
structure of consumer cooperatives that put the consumers in the 
driver's seat and no longer leave the choice of health plans just to 
employers and to insurance companies.
  We propose standby backup premium caps. Insurance companies in other 
fields--automobile insurance, worker's compensation--are used to limits 
on the amount they can increase each year. We would propose some 
standby limits on how much premiums can increase each year, how much 
they can increase beyond the cost-of-living increase.
  But what do our Republican colleagues propose? What is their 
alternative? How will they bring down the cost of health insurance that 
is breaking our national budget, but, even more importantly, is 
affecting the burden and the budget of every family, every business, 
every State and local government in this country?
  Then how do we make sure that Americans have the ability to choose 
their own doctors? Many of our colleagues love to talk about the 
importance of choice of doctors. I agree with them. But like our 
friends, Harry and Louise--our friends on the other side of the aisle 
have talked about that--they do not seem to realize that more and more 
people are losing or do not have that choice of doctor today. More and 
more companies are turning to the lowest costs HMO with a limited list 
of doctors and saying, take it or leave it.
  A recent study by KPMG Peat Marwick revealed that, as recently as 
1988, 73 percent of all employer plans allowed individuals to choose 
their own doctor. But by 1993, only 49 percent of employer-paid health 
plans still give that choice, and the trend is only going stronger. It 
is going down to less and less choice of your own doctor unless we do 
something.
  Our proposed Health Security Act does something. It provides that 
every American in health insurance purchasing cooperatives, called 
alliances, will have a menu of choice that always must include a plan 
to choose your own doctor and which provides competition so that you 
are likely to be able to find your own doctor in a number of plans.
  This proposal will increase the choice of plans and the choice of 
your own doctor for Americans, and I wish to see the alternatives that 
will help stop the trend that is taking that fundamental choice more 
and more from the American people.
  So I ask our Republican colleagues to help us reverse that trend and 
tell us how they would do so, if they do not want to go the route that 
we have proposed.
  Then are you, my Republican colleagues, prepared to enact real health 
insurance reform? Under the current system, insurance companies have 
the power to jack up rates, especially on older citizens--charge them 
four times what younger citizens are charged--to cut off coverage for 
people with preexisting conditions, and establish limits on the amount 
of benefits people can receive. Are you ready to enact real insurance 
reform that not only prohibits these insurance company practices but 
establishes a system that finally puts consumers in the driver's seat 
instead of the insurance companies.
  Finally, for today, of the five questions I am contributing to our 
Republican colleagues' retreat, what will you do to protect older 
citizens? Whatever its shortcomings, Medicare is one of the most 
successful programs ever created. Every serious health reform plan 
calls for savings for Medicare.
  What will you, my Republican colleagues, do to protect the seniors 
who depend on Medicare? Will you include a prescription drug benefit as 
the Health Security Act does? What will you do about long-term care? 
Will you take some steps to make that more available? And, 
particularly, will you take steps to provide assistance for home care, 
family home care?
  I think that most of us want bipartisan action on health care reform, 
but real health care reform requires answers to these questions. I put 
proposals from Democrats like Representative Cooper to this same test, 
asking how will they advance toward the goal of guaranteed, affordable, 
private health insurance for every American.
  After all, that is really the point of a strategic retreat like the 
one our colleagues are about to have, that is going to begin in 
Annapolis. It is to figure out how to advance.
  I hope we will advance, and we will advance together. The logic of 
the facts demand it; the American people demand it, because for all the 
efforts to confuse this issue and to highlight how complicated it all 
is, the bottom line is really very simple. Complexity is often the last 
excuse of those who want to do nothing.
  So help us answer these questions, my colleagues. They will not be 
easy to answer. It is complicated, but we can do it if we move together 
and we do it with determination, and if we tap the better angels of our 
nature. To cite the great Republican who showed us how to bind up the 
wounds of the Nation and, ``with malice toward none,'' move forward to 
achieve the goals of this Union.
  The other day the head of the Congressional Budget Office, Dr. 
Reischauer, at the end of his testimony, said he hoped the facts that 
he was contributing, and the facts that we need to get together and 
look at hard, would not torpedo this opportunity for fundamental health 
care reform but instead would be used to build a reform that achieves 
what our economy and our country need.
  He said he hoped that someday those of us who have something to do 
with this legislation in these next months will be able to do what a 
congressional committee did when it visited the Lyndon Johnson Library 
and looked at the exhibit on the Medicare bill and the signing of the 
Medicare bill, and were able to turn to their grandchildren and say, 
``That is something that I contributed to, to the well-being of this 
country, to the common good of America.'' He said he hoped someday 
those of us who have this opportunity today to craft this legislation, 
with our grandchildren in tow will be able to say, ``Here is the bill 
that in 1994 we put together which made our health care system more 
equitable, more efficient, and less costly.''
  We can do it, Mr. President. Let us do it.
  I yield the floor.
  The PRESIDENT pro tempore. Under the order previously entered, the 
Senator from Utah [Mr. Hatch] has control of not to exceed 10 minutes.
  Mr. HATCH. I thank the Chair.

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