[Congressional Record Volume 140, Number 23 (Monday, March 7, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 7, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           HEALTH CARE REFORM

  Mr. COATS. Mr. President, the Republicans met in Annapolis late last 
week in a conference to discuss health care and where we were going as 
a party. I thought I would report briefly on that. I certainly was not 
the one in charge, nor did I lead the effort. But as someone who was 
there, I have some observations.
  I went with a considerable amount of skepticism about our ability to 
pull our disparate views together and unite around any consensus as to 
where we ought to go on this subject. But I was very pleasantly 
surprised that through some vigorous debate and discussion, through a 
working dinner, a working breakfast, a working lunch, listening to the 
experts, talking to ourselves, and through three private sessions with 
Members only, at Senator Gregg's suggestion, which proved 
extraordinarily effective, we hammered out some unity on a number of 
issues relative to the health care issue, and I think all of us came 
away with a feeling that we had made some very substantial progress in 
dealing with an extraordinarily complex issue.
  Thirty-seven Senators, 37 of the 44 Republican Senators, were in 
Annapolis. You do not get 37 Senators together ever unless there is a 
free lunch involved, and we had to pay for this. Six House Members 
joined us, all key members of either leadership or committees which 
deal with the health care issue. We had three Republican Governors. So 
we had, along with experts that we invited in to speak to us, a broad 
array of opinions and diversity there on the particular issue.
  I think the Republicans are much closer to a unified position than 
the Democrats, who seem to be all over the lot in terms of where they 
want to go with this. But we did come away with some conclusions. 
Again, I do not speak for the group; these are my own observations. But 
I think conclusion number one is it was clear that Republicans agree 
with the concerns of many Americans relative to their ability to find 
accessible health care at a cost that they can afford; that those 
concerns are real. Those are concerns that we identify with, and those 
are concerns that we want to address. We agree that we do need to make 
some changes and some reforms in our health care system so that health 
care is available and is affordable for every American.
  But what we also agree on is that the Clinton plan will not 
accomplish that. The Clinton plan is so appropriately diagramed by 
Senator Specter's Clinton health care chart of the new bureaucracy that 
will result if that plan were enacted, and so ably demonstrated by our 
leader, Senator Dole, in his response to the President that our 
conclusion is it is dead, and we are glad it is dead. It appears that 
it is dead not just on the basis of Republicans saying so but, frankly, 
many Democrats, many of them key leaders in the health care debate, 
have pretty much declared the Clinton proposal as a nonstarter. It is 
far too complex. It is far too bureaucratic. It is far too heavy-handed 
Government control.
  The idea that you could take one-seventh of our economy and put it 
into one neat plan is preposterous, and it is almost arrogant to think 
that any individual or group of individuals could come together and tie 
this all into one neat little package and say Government can run this 
more effectively and more efficiently than it is currently being run. 
It does not mean that we do not need reform. It simply means that what 
we have been presented by the Clinton administration is a bureaucratic 
nightmare and the more the American people know about it, the less they 
like it.
  So they can take out all the ads they want at the White House. We 
think more disclosure of what is in this plan clearly dooms it to 
failure. Any plan that makes Government the solution, any plan that is 
mandate driven is bound for failure.
  Why? Because the American people instinctively know, through years 
and years of experience, that it is based on false assumptions. The 
Clinton plan is based on the assumption--and many of the Democrat plans 
are based on the assumption--that Government is more efficient than the 
private sector. Anyone who has dealt with any agency of Government 
knows that is not true. If you absolutely have to get the package there 
the next morning, do you take it to the Post Office or do you take it 
to the private sector, to UPS or Airborne or American Express? If you 
absolutely have to get something done, you do not give it to a 
Government agency to get it done.
  Second, it is based on the assumption that Government is more cost 
effective in delivering services than the private sector. We can stand 
here all day and talk about the cost effectiveness of Government 
programs. All we know is that whatever program is enacted, whatever 
Congress says it is going to cost you, you can multiply that by a 
factor of 5, 7, 9, or 15 because Government cannot control costs. 
Bureaucracy cannot control costs. There is no competition in the 
system. When there is no competition, you get a substandard product at 
a higher price.
  The Clinton plan is based on the assumption that Government knows 
best, that Government can make a better choice of a health care 
provider when you are sick, when your family is sick or your loved ones 
are sick; Government can make a better choice for you than you can; and 
that a Government gatekeeper, a Government bureaucrat will be the first 
person you will call to determine what kind of medicine you receive, 
what kind of treatment you receive, which hospital you go into, and 
which services you are going to get.
  It is just so ironic to me that virtually every other nation's health 
system in the world is trying to privatize their system because they 
have learned that they cannot afford Government medicine, that the 
people do not want Government medicine because it does not work. Yet, 
while every other health care system in the world is trying to 
privatize, along comes the administration and many of the Democrat 
plans with an attempt to bureaucratize, turn the process over to 
Government. So if Republicans are united, we are united around the 
principle that Government is not the solution to the problem.
  The Clinton plan is also based on the assumption that they can keep 
politics out of this plan, that politics will not rear its ugly head 
and inject a political decision rather than an objective decision, so 
that the components of the basic health plan will not be influenced by 
Members of Congress up for reelection trying to add new benefits 
regardless of the cost or that different schemes will not be maneuvered 
around to favor one particular area, perhaps the area of a chairman of 
an important committee. I think we know that politics injects its head 
into about every process that we have, and you cannot have a 
Government-run plan without a political component, and that political 
component can potentially skew any kind of objectivity you would have 
in putting it together.
  Mr. President, we also, I think, acknowledge that there is a lot of 
good things about our health care system that ought to be preserved.
  The ACTING PRESIDENT pro tempore. If the Senator will suspend for a 
moment, he has used his time. I know the Senator from Kansas is there. 
I do not know whether she is waiting to speak or not. But, in any 
event, I want to call the Senator's attention to the fact that his 10 
minutes has expired.
  Mrs. KASSEBAUM. Mr. President, I am going to speak but I am happy to 
yield any time to the Senator from Indiana that he would like. I do not 
think anyone else wants to speak right now.
  Thank you.
  Mr. COATS. I would ask for 2 additional minutes.
  The ACTING PRESIDENT pro tempore. The Senator is recognized for 2 
additional minutes.
  Mr. COATS. Mr. President, I think the Republicans also understand 
that there is a lot about our health care system that is worth 
preserving. We acknowledge that there are things that need fixing. But 
we want to fix what is broken. We do not want to redo the whole system. 
Like your car is not quite running properly, and you take it in. The 
mechanic says, ``Well, I think it needs a tuneup here, we need a new 
part there, and perhaps we need a new set of tires.'' Someone else 
rushes out, and says, ``The way to fix that is to reinvent a whole new 
car. We are not going to fix what is broken. Let us just throw the 
whole thing out and we will reinvent a new car for you.''
  Well, the Clintons reinvented a new car. That is kind of what the 
blueprint looks like. That staggers the imagination. Clearly, I think 
it dooms the plan to failure because it is a State-run, Government-run 
system that Senator Dole says we are somewhere down here and we are 
going to work through this maze in order to get our health care 
provided to us.
  We have a ways to go. We clearly do not have all the answers yet. We 
do not have a one package tied up with a bow on it saying here is the 
answer. But we know that there are some basic principles upon which any 
changes in the health care system ought to be rested, that they ought 
to be the foundation for change, and that those principles are 
important when we consider the various plans and the various components 
of those plans.
  We stand ready as a party, as Senator Dole said, to get together 
again and again and again, and no matter how long it takes, to fix what 
is broken in the system and preserve what is right about this system. 
We are going to base our reform proposals on solutions that work and 
solutions that target the problems and fix the problems.
  We invite, obviously, Democrats, and those from across the aisle, who 
I think if they will go home and listen to their people, which I know 
they have been doing, will come back saying no to one-size-fits-all, 
Government-run plan, this is not the answer, and who will come across 
the aisle and say we agree with those principles, and the people we 
represent agree with those principles. And let us work to fashion a 
plan and fashion a reform that will accomplish those ends.
  So, in conclusion, we had a very productive 24 hours with almost all 
work and very little sleep. But it was very effective in getting our 
ideas on the table. Not everyone agreed. There may be some people who 
want to go in a different direction, though the vast majority of us, 
including the Governors, including Members of the House of 
Representatives, share a lot of common ground. And we look forward to 
making a very substantial contribution to this debate on health care.
  With that, Mr. President, I yield the floor.
  Mrs. KASSEBAUM addressed the Chair.
  The ACTING PRESIDENT pro tempore. The Senator from Kansas.

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