[Congressional Record Volume 140, Number 29 (Wednesday, March 16, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 16, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           HEALTH CARE DEBATE

  Mr. CARDIN. Mr. Speaker, tonight, instead of special orders, this 
House of Representatives will be holding its first Oxford-style debate. 
Oxford-style debates give the American people an opportunity to hear 
details, fundamental discussions of important issues.
  This debate will be the first of a series of debates scheduled for 
the House floor. The second debate is scheduled for April 20. The third 
debate, which is scheduled for May 11, will include bipartisan teams. 
After review of the first three debates, the House will decide whether 
or not to continue debates on the House floor.
  Most appropriately, the first debate is on health care. I want to 
congratulate both the Democratic and Republican leadership for their 
persistence in bringing us to this moment.
  In developing this debate format, the joint leadership has sought 
ways of elevating the value and effectiveness of debate in the House of 
Representatives. Together tonight, we institute a reform that all of us 
hope will improve the quality of debate in this legislative Chamber.
  When referring to debates, the French moralist Joseph Joubert, known 
as Pensees, said:

       The aim of argument or discussion should not be victory but 
     progress.

  In that spirit, one can hope that tonight's debate will help us 
reconcile differences in the House and lead towards the enactment of 
health care reform. We will both better understand each other's 
position.
  I want to thank those who have studied the congressional process and 
come forward with reform proposals and pushed for congressional reform 
for the Oxford-style debate, including Norman Ornstein of the American 
Enterprize Institute and Thomas Mann of the Brookings Institution. In 
addition, I would like to thank C-SPAN and National Public Radio for 
covering these debates so that the American people can watch and listen 
to this debate.
  I would like to thank my counterpart from the Republican side, the 
gentleman from Pennsylvania [Mr. Walker], for his help in bringing 
about these debates.
  This debate will be in the Oxford-style format. An Oxford-style 
debate differs from the American-style two person debate, because it 
allows teams to speak in sequence, allowing different members of the 
team to focus on different issues. By expanding participation, we 
encourage a more comprehensive discussion of the subject.

  Oxford-style debates encourage instant and continuous rebuttal from 
the participants. It is just as important for a team to question the 
other team as to expand its own arguments.
  Each debate will last 90 minutes. The moderator will open the debate 
with an introduction of the topic and the members. After the 
introduction by the moderator, one member of each team will make a 3-
minute opening statement, laying out the position of their team. A back 
and forth debate between the teams will follow the opening remarks with 
time and recognition controlled by the moderator.
  During this time, the remaining six debaters will also be able to 
make brief statements. Also, each debater will have 5 minutes in which 
to question and later be questioned by a member of the other team. In 
addition, each debater will be subject to 5 minutes of interrogation 
from any member of the opposing team.
  During the questioning and interrogation portions of the debate, 
questions will be limited to 30 seconds. I ask the debaters' 
cooperation on that point. And answers will be limited to no longer 
than 2 minutes.
  After the back and forth debate between the teams, one member of each 
team will make a final point summarizing his team's position.
  For the help of the debaters, we have cards that will give Members 
notice when there is certain time remaining, depending on how long the 
period involved. The cards will be held at the front.
  We would ask Members to please strictly comply with the time limit.
  We would hope that we will have as much back and forth as we can. The 
purpose of this debate is to be free flowing, but we do ask you also to 
please be courteous.
  We had some guests today from England who participate in Oxford 
debate regularly, and they also give one more bit of instruction. And 
that is for the debaters to please have fun.
  The topic for this debate tonight will be introduced in the form of a 
statement to be resolved. The position statement for the first debate, 
which will be argued in the affirmative by a four-member Democratic 
team and in the negative by a four-member Republican team, is, 
resolved, that the Clinton health care plan best represents the 
elements that should be included in health care reform.

  The Democratic Members participating in the health care debate are 
Majority Leader Richard Gephardt, Chairman Henry Waxman of the Energy 
and Commerce Subcommittee on Health and the Environment, Chairman Pete 
Stark, Ways and Means Subcommittee on Health, and Congresswoman Rosa 
DeLauro, a member of the Appropriations Committee.
  The Republican Members participating in tonight's debate are Minority 
Whip Newt Gingrich, ranking Republican Member Thomas Bliley of the 
Energy and Commerce Subcommittee on Health and the Environment, ranking 
Republican Member William Thomas of the Ways and Means Subcommittee on 
Health, and Congresswoman Nancy Johnson, a member of the Ways and Means 
Subcommittee on Health.
  At this point, I will yield time to debators in conformity to the 
time limits established by the agreed format that has been filed at the 
desk.
  I yield to Mr. Gephardt for his opening statement.

                              {time}  2010

  Mr. GEPHARDT. Mr. Speaker, I want to thank the Republican leadership 
for their help in bringing this debate about, and I want to thank all 
of my colleagues who have worked so hard to make this evening happen. I 
hope this is the first of many Oxford-style debates.
  I want to start tonight by saying that this debate is not about 
charts, it is not about statistics, and it is not about graphs. It is 
not even about philosophy. It really is simply about people. It is 
about the elderly women in my district that I saw the other night whose 
husband died soon after he retired, leaving her without health 
insurance. She wound up with a very serious form of cancer, and now she 
needs an operation, and she has no idea how she is going to pay for it, 
because she does not yet qualify for Medicare.
  It is about the truck driver who came to one of my town hall meetings 
and finally stood in frustration in the middle of the meeting and shook 
his hand at me and said:

       Congressman, I have to go to work, but you have to do 
     something about health care costs. I cannot afford to pay for 
     my family's policy, and I'm worried I'm going to lose it.

  It is about small business people that we have all met who want to be 
able to give their people health insurance as part of their 
compensation, but they simply can't figure out how to afford to do it.
  The truth is, in doing health care, as I hope we will later this 
year, we have to listen to these people. This is about them. It is not 
about lobbyists, it is not about organized groups, as legitimate as 
they may be, as legitimate as their views may be. When we go to work on 
health care tonight, in debating, and later in the year in working on 
it, we have to listen to these people.
  I think we have the best health care system in the world. I have 
benefitted from it. My family has benefitted from it. However, it can 
be better. We have got to fix what is wrong and we have got to keep 
what is right. In my view, the Clinton plan represents the best 
elements that we have got to get in any health care plan we do.
  First, we have got to make it affordable for every American. Second, 
we have to guarantee private health insurance for every American 
family. Third, we have to guarantee choice. People have got to go to 
the doctor they want, pick the plan they want. Finally, we have to 
protect the elderly and Medicare and the benefits of that program.
  In my view, all of the Republican plans except one are deficient. We 
cannot toy around and tinker around and nibble around the edges, we 
have to have a plan that accepts and embodies the principles, the goals 
that I just talked about. The choice tonight is, are we going to do 
something or are we going to do nothing?
  Finally, let me say this. Back in 1935, 1965, Republicans came 
together with Democrats to pass Social Security and to pass Medicare. 
We reach out our hand tonight to the Republicans to join with us in 
passing real national health care reform.
  Mr. CARDIN. Mr. Speaker, I yield to the gentleman from Georgia [Mr. 
Gingrich] for an opening statement.
  Mr. GINGRICH. Mr. Speaker, let me say first that I appreciate very 
much this chance to be here, and I enjoyed immensely the opening by the 
Democratic majority leader, which was wonderful, about goals, and with 
which we agree. We all go home and we all have problems. My own 
daughter had a problem with a precondition and had to spend a year 
without coverage.
  That is why the Michel bill and, to the best of my knowledge, every 
Republican bill, eliminates preconditions and says you are going to get 
coverage.
  I have had relatives who have had problems losing jobs and not being 
able to have health insurance, and that is why the Republican bill and 
virtually every bill I know guarantees portability.
  As my good friend knows, there is bill after bill after bill already 
introduced, attempting to solve the problems, but the resolution that 
my Democratic friends agreed to defend tonight was not about good 
goals, it was not about good anecdotes. It was the elements of the 
Clinton plan.
  I am excited by this debate, first because it is good for the House, 
and second, because we finally get to talk about H.R. 3600, a bill, a 
piece of legislation, and we get to talk about the elements.
  It is a little unfair, but I cannot quite resist. Let me cite what 
some Democrats have said about this plan, because we are talking about 
the Clinton plan.
  I agree with my friend, the gentleman from Missouri [Mr. Gephardt]. I 
want to reach out in a bipartisan way to pass the bill. I praise the 
gentleman from Florida [Mr. Bilirakis] and the gentleman from Georgia 
[Mr. Rowland] for a bipartisan bill. I praise the gentleman from Iowa 
[Mr. Grandy] and the gentleman from Tennessee [Mr. Cooper] for a 
bipartisan bill. They are starting in the right direction to reach out.
  However, let me cite the Clinton plan, which is the goal of tonight's 
debate, and which the gentleman has agreed to defend.
  One of our debate Members on the gentleman's side said, ``The health 
alliance and the Clinton plan is a beautiful animal in fairyland, but 
unseen on Earth.'' One of your Members said, ``I don't know of any 
Republican or Democrat who would support mandatory alliances like the 
President's. I have heard a thousand objections and virtually no 
support.''
  One of your Members said, ``I kissed a frog, but it's still a frog,'' 
referring to the Clinton plan. I am not going to refer to the Clinton 
plan as a frog. That was a Democrat. We are not going to be nastily 
partisan on our side tonight.
  One of the gentleman's Members defending the plan tonight said of the 
President's plan, ``It is amazingly complex. It creates many new 
bureaucracies. It is confusing. It eliminates traditional fee-for-
service medicine as we know it.''
  A Democrat in the Senate pointed out that, and I quote, ``Literally 
hundreds of thousands of small business people in this country might 
have to close their doors under the President's proposal, and that is 
unacceptable.''
  Our focus tonight is to focus on the elements of the Clinton plan, 
which is the topic of this debate, elements which include a global 
budget by which politicians and bureaucrats will decide the health of 
all Americans and inevitably lead to rationing, elements which include 
a National Rationing Board appointed and controlled by politicians, 
with the power to decide what health care you can receive; elements 
which include government-controlled and designed health bureaucracies 
you may be required to join, which will control which doctor and which 
hospital you can go to.
  Mr. CARDIN. Mr. Speaker, I yield to the gentleman from California 
[Mr. Waxman] for an opening statement.
  Mr. WAXMAN. Mr. Speaker, this is a debate about one basic issue: Will 
all Americans have health care coverage? Right now they don't. Almost 
39 million Americans are uninsured. Eight million of them are children. 
Think about that. In this, our rich country, 8 million children are 
without insurance coverge, and the fact of the matter is they are the 
children of working parents, because sadly, most Americans without 
insurance are working. They play by the rules, but they are still left 
out.
  Being uninsured matters. Women who don't get mammograms die more 
often from breast cancer. People with diabetes who don't get home care 
end up in hospitals, and families without health insurance worry that 
they will go bankrupt if a child gets sick.
  There is much that is good in our health care system, but there is 
much that is wrong and must be fixed. What we need to do is subject any 
health proposal, Democrat or Republican, to one simple test: Does it 
guarantee that all Americans will have health care coverage? That is 
real reform.
  Mr. CARDIN. I recognize the gentleman from Virginia [Mr. Bliley] for 
an opening statement.
  Mr. BLILEY. Mr. Speaker, all of us complain about some parts of the 
health care system, but all of us, I think, would agree that Americans 
have the finest health care system in the world, and the best 
practitioners in the world. The Clinton plan would change all of that. 
We would have rationed care. The spending caps in this bill are more 
severe than they are in the United Kingdom or Canada. Specialists would 
be rationed by government bureaucrats to decide what promising students 
go on to study for a medical specialty. The elderly and the poor would 
be rationed under Medicare and Medicaid, $200 billion worth, and 
research would be rationed, because there would not be venture capital 
there to explore promising new areas of medical discovery.
  Republicans have a better way to solve the plan. Republicans want 
choice, so that you can choose your doctor. Republicans want you to 
have your insurance when you transfer jobs or you lose your job. In 
short, we would fix what is wrong with the system, but we would keep 
what is good with the system, and that is where we differ from the 
Clinton plan, and that is why the Michel plan is the best plan.
  Mr. CARDIN. The gentleman from California [Mr. Waxman] is recognized 
to question Mr. Bliley.
  Mr. WAXMAN. Mr. Speaker, I say to the gentleman from Virginia [Mr. 
Bliley], you said you want to fix what is wrong with the American 
health care system, and one thing that is wrong is that we have 39 
million Americans without insurance. I have looked at the Republican 
alternatives and they don't guarantee universal coverage. They don't 
guarantee every American a health insurance policy. How long, under 
your proposal, will be have to wait before every American is covered?

                              {time}  2020

  Mr. BLILEY. The Michel plan is not under discussion, I would remind 
you tonight, Henry. We are discussing the elements of the Clinton plan. 
And, yes, you will get the universal coverage by 1998.
  Mr. WAXMAN. Under your proposal?
  Mr. BLILEY. Under the President's proposal, you will get there, but 
you will still have 5 to 12, and please let me answer the question. I 
did not interrupt you when you asked the question. So do not interrupt 
me.
  Mr. WAXMAN. Please answer the question, because I have some more to 
ask.
  Mr. BLILEY. I am answering the question. And you are here to defend 
the President's plan and the elements that are in it, and you get to 
universal care in 1998.
  Mr. WAXMAN. You are not answering my question. When will you say to 
the American people that they will know that they will be covered, and 
if you are not going to cover them, who are you going to leave out, and 
how long is it going to take? There are 39 million Americans, many of 
them may be watching tonight, and they would like to know, and I would 
like to know, when can they expect to be able to buy a health insurance 
policy they can afford?
  Mr. BLILEY. They can buy health care policies that they can afford 
now under the Michel plan, and we would like to work with all people to 
improve it as we go to 1998, but the problem with your plan is that in 
order to achieve your coverage you destroy the system as we have it 
now. You will cost 900,000 to 3 million jobs.
  Mr. WAXMAN. We have people who are working people. If their employers 
do not provide that benefit for them at their work where most people 
get their insurance----
  Mr. BLILEY. Well, a lot of them will not be working after this bill 
becomes law, I can tell you that.
  Mr. WAXMAN. Well, there are a lot of people working now.
  My question to you is: Can you tell working people they will be able 
to afford a policy? Because most of them cannot, and if their employers 
do not help them pay for that policy like you and I have our 
employers----
  Mr. BLILEY. Absolutely.
  Mr. WAXMAN. Of the U.S. Government, pay for our policy, how can they 
expect to get coverage?
  Mr. BLILEY. They will have a basic plan that will guarantee them 
coverage, that they will be able to buy. It will be affordable, and 
they will be able to take it with them if they leave their job or they 
lose their job.
  Mr. WAXMAN. One of the problems is health insurance is not 
affordable. Health care costs are going up so rapidly.
  President Clinton tries to tackle this issue by putting some limits 
on what insurance companies are going to charge people. You do not have 
that in your proposal.
  How do you plan to hold down health care costs?
  Mr. BLILEY. By reforming malpractice, which you do not even attempt 
to do. We would say before you go to court you must go to dispute 
resolution, and if you go to court after that, if you are not satisfied 
with the dispute resolution, you may go. But you go with the 
understanding that if you lose the case, you pay the defendant's court 
costs.
  Mr. WAXMAN. Do you really believe that malpractice is the reason why 
we have health care costs that are so rapidly increasing that small 
businesses have to pay 30 percent more and, therefore, cannot afford to 
cover their employees? Would it be your solution to say that anybody 
hurt in a malpractice just should not be able to sue? Would that make 
health care affordable to all Americans?
  Mr. BLILEY. No. We do not do that.
  We say, if you read the Michel bill, we reform ERISA to allow small 
groups to pull together to get the advantage that large groups have in 
purchasing health care. We do that. We do not say that malpractice is 
the only answer, but it certainly is a major factor in the costs of 
health care insurance today.
  Mr. WAXMAN. The Michel plan does not spell out what benefits anyone 
will get.
  The Clinton proposal does.
  What I would like to know is, and I think others would like to know, 
what is it that you would like to drop from the Clinton plan? Would it 
be mammograms, prescription drugs? Do you think that those ought to be 
in? How about dental benefits for kids or catastrophic costs? Would all 
of those be in the benefit plan guaranteed to all Americans in any 
goals you would hope to achieve?
  Mr. BLILEY. We believe that you should not have one size fits all. 
People should have choice, choice of their doctors. People should be 
assured of quality, and people should not have to put up with rationing 
which you destroy all three. You destroy quality, you destroy the 
choice, and you ration care.
  Mr. WAXMAN. I disagree with all of those statements.
  Mr. CARDIN. Mr. Bliley is recognized to question Mr. Waxman.
  Mr. BLILEY. How can you be here, Henry, in support of this bill when 
you are quoted in the New York Times as saying the Clinton 
administration has relied too heavily on cuts in Medicare and Medicaid 
to finance changes in the rest of the health care system; it is going 
to be politically unacceptable, ``and I do not think the financing 
proposal is realistic. I do not think they can make the cuts of that 
magnitude without doing harm to Medicare and Medicaid and the people 
those programs serve,'' and this bill that you are defending, it cuts 
$200 billion out of Medicare and Medicaid?
  Mr. WAXMAN. As you well know, I am a strong supporter of the Medicare 
program. I would not want us to take any cuts that are not wise. But 
the fact of the matter is that the Clinton administration proposal 
would cut Medicare less than what some of the Republican proposals 
would do, and the Clinton proposal would take----
  Mr. BLILEY. That is not the question. We are not talking about the 
proposals. We are talking about the Clinton----
  Mr. WAXMAN. My answer to you is that we--the Clinton proposal would 
take the Medicare savings which they can legitimately accomplish, and 
give them back in benefits to elderly people through prescription drugs 
and home health care.
  Mr. BLILEY. You are rationing care under this bill.
  Mr. WAXMAN. You would take away benefits from the elderly.
  Mr. BLILEY. Under this bill, you ration care. How do you propose to 
control the rate of growth in health care costs to no more than the CPI 
when none of our trading partners in the Western World are able to do 
that? In Canada and Great Britain, both are 3 or 4 percent above the 
CPI.
  Mr. WAXMAN. Give me time for an answer.
  Mr. BLILEY. I will give you time for an answer, but you took plenty 
of time before, so I am going to finish. Three or four percent above 
the CPI. And they ration care. How are you going to reach that goal 
without rationing care?
  Mr. WAXMAN. I hope you will permit me to answer the question, because 
you are trying to scare people about rationing, and there is no 
rationing in the Clinton proposal.
  Second, we are trying to legitimately hold down health care costs by 
telling the insurance companies to be able to hold down----
  Mr. BLILEY. Please answer my question. How are you going to hold it 
down?
  Mr. WAXMAN. I am trying to answer your question, if the gentleman 
would permit. I would like to answer your question if you would listen.
  We will hold down health care costs by using market forces, by 
limiting what insurance companies can charge people. There is none of 
that in the Republican proposal at all.
  The only way Republicans seem to hold down costs is asking people to 
pay more out of their pockets, and not everybody can afford to pay more 
out of their pockets, because they find health insurance unaffordable, 
and I do no think you have an answer to them in your proposal.
  Mr. BLILEY. Henry, you know better than that.
  The Clinton plan rations care. It is the only way that you are going 
to be able to achieve those goals. When you run out of money just like 
in Canada, they go to close hospitals to all but emergency treatment. 
The elderly are going to have to wait for their hip transplants and 
their other routine procedures.
  Mr. WAXMAN. I will tell you who is rationed now: the millions of 
people who have no insurance. The people who are rationed out of health 
care services are the 2 million who are added to the list of uninsured 
every month.
  People have to be worried. If they have insurance now, they may lost 
it, and if they lose it, they are going to be thrown into the cold, 
because there is rationing against them.
  The President proposes that everybody be covered. They get a choice 
of their doctor, their insurance plan.
  Mr. BLILEY. Let me reclaim my time.
  Mr. WAXMAN. And they get a basic benefit package. The Republicans 
promise none of that.
  Mr. BLILEY. I would say to you that we had a plan. Senator Bentsen 
came up with a market reform in 1992. It passed the Senate on March 12 
the first time and the second time on March 29. It was stripped out in 
conference.
  Mr. WAXMAN. Is this a question or a statement?
  Mr. BLILEY. You were in the conference. Why was it stripped out? Why 
did you strip it out if you were interested in people keeping their 
health insurance if they were out of a job? It was in this bill. We 
would have it now. Why did you strip it out?
  Mr. WAXMAN. The gentleman does not understand fully what happened in 
that example, but the fact of the matter is----
  Mr. BLILEY. Are you denying that it did not happen, that it was 
stripped out?
  Mr. WAXMAN. I am denying a lot of things did not happen. We had a 
President named Reagan who did not even know there was a problem about 
people without coverage. We had a President named Bush who never came 
forward with any proposal. Now we have a President named Clinton who is 
taking the courageous stand of saying let us do something for the 
American people, not for the insurance companies, but for the people, 
and let us make sure working people get their insurance where they 
work. That is the way most people in this country get their coverage.
  Mr. BLILEY. I do not think you meant to include Secretary Bensten as 
a tool of the insurance people.
  Mr. CARDIN. I now yield to the gentleman from California [Mr. Stark] 
for his opening statement.

                              {time}  2030

  Mr. STARK. I thank the gentleman.
  I am pleased to be here tonight to explain the goals of the 
President's plan. What is America about? It is about being a family and 
taking care of each other in troubled times.
  Our goals are: permanent health insurance for everyone, affordable, 
quality, and individual choice. Our plan builds on our country's 
history. We have social security, and it is the time, gentlemen, for 
health security. It builds on the Old and New Testaments. We are called 
upon to help the sick. On the day of judgment we will be judged for our 
service to the sick.
  I ask any of you who contest the question: Who in our Nation would 
you leave uninsured, afraid, and unable to seek care in their hour of 
sickness? Who, might I ask, gentlemen, in our Nation would you deny the 
same quality and choice and level of care that you yourselves as 
Members of Congress enjoy today?
  And since the big insurance companies and drug companies and for-
profit hospitals have brought us to this present dismal state, why, why 
would you question the need for the Federal Government to demand 
fairness and price restraint so that health care can be affordable to 
every American?
  I do not have to defend the question. The Republican Members must 
defend caring so little about their fellow citizens that none of their 
proposals and none of their bills provide universal coverage, choice, 
or affordability.
  Mr. CARDIN. I now yield to the Republican team to question Mr. Stark.
  Mr. THOMAS of California. I than the moderator.
  It seems to me that I think we can stipulate at this point in the 
debate that all of us share these laudable goals that have been 
repeated over and over again.
  Mr. STARK. I don't intend to stipulate.
  Mr. THOMAS of California. We are all for life, we are all for taking 
care of all Americans. That is not the----
  Mr. STARK. Well, no----
  Mr. THOMAS of California. Well, I would tell the gentleman the first 
thing out of his mouth was that he wants to talk about the goals of the 
Clinton plan. The debate is about the elements of the Clinton plan.
  Mr. STARK. The principal elements.
  Mr. THOMAS of California. And I would ask the gentleman: Today, 
rather than the Federal Government, States and the private sector, 
driven by the increased costs of health care, are the engines of change 
and health care reform. In our State, as you know, California has 
changed its malpractice law, changed the way insurance can be sold, 
created voluntary purchasing cooperatives to let the little guy 
voluntarily achieve the same buying power as large corporations. Our 
Republican plans build on these reforms. We keep them, and we expand 
them.
  The Clinton plan, the plan that you are defending, would outlaw these 
kinds of changes taking place in the States and force them into a 
structure dictated by the non-elected national health board that would 
have the power, in addition to controlling that, of setting and 
enforcing a national budget for the entire U.S. health system.
  Mr. STARK. That is not the question.
  Mr. THOMAS of California. The question is: Do you believe that this 
key element, this non-elected board with vast powers----
  Mr. STARK. What is the question? Would you repeat the question, 
please? I did get the question.
  Mr. THOMAS of California. Well, I understand your confusion, since it 
is about an element of the Clinton health care plan. I understand your 
confusion.
  The question is: The national health board, dictatorial, stopping all 
of the change that has been made in the States, controlling the prices, 
is it really the best choice for the American health system?
  Mr. STARK. The best choice for the American health system are the 
goals of the President's health plan, which are to provide----
  Mr. THOMAS of California. I would like to tell the gentleman we do 
not vote on goals, we vote on elements. What about this element of the 
President's plan, do you like it or not?
  Mr. STARK. The gentleman is incorrect in stating the President's 
plan. But I would suggest to you----
  Mr. THOMAS of California. Do you like the national health board in 
the President's plan, as you define it?
  Mr. STARK. There is no--there are now several national health boards. 
There are those who recommend----
  Mr. THOMAS of California. The board that is in H.R. 3600.
  Mr. STARK. If I could finish my statement. There are now national 
health boards that provide quite well for advising Congress for what we 
need.
  Mr. THOMAS of California. I would ask the gentleman, on page 92 of 
H.R. 3600, part V, ``Role of the National Health Board,'' does he agree 
with the specific language in the President's plan?
  Mr. STARK. No.
  Mr. THOMAS of California. The scope and the breadth?
  Mr. STARK. No.
  Mr. THOMAS of California. No, you do not. Thank you.
  Mrs. JOHNSON of Connecticut. Most doctors believe that women need to 
have a baseline mammogram at the age of 35 and should have one every 
year thereafter from the age of 40 on. Now, the document to which my 
colleague referred, the President's health plan, denies women coverage 
for mammograms until they reach age 50 and then provides every 2 years 
until age 65.
  Many, many women in America enjoy much better insurance benefits than 
that. Does the gentleman who says that he supports the goals of the 
President's plan, which is choice and quality, support such a 
restrictive benefit plan?
  Mr. STARK. Well, I, as a matter of fact--the benefit plan that I 
introduced today provided those goals, and the gentlewoman just voted 
against it.
  Mrs. JOHNSON of Connecticut. My colleague, on pages 44 and 45----
  Mr. STARK. At age 35. And the gentlewoman just voted against it this 
afternoon.
  Mrs. JOHNSON of Connecticut. On pages 44 and 45 and on throughout, 
the President is very specific about denying benefits.
  Mr. STARK. Why did the gentlewoman vote against it this afternoon? I 
am confused by her inquiry.
  Mrs. JOHNSON of Connecticut. The question is----
  Mr. STARK. The gentlewoman had a chance this afternoon to vote for 
that very same benefit, and she voted against it.
  Mrs. JOHNSON of Connecticut. That is right, and you bet I did, for 
the very same reason the President is wrong. When you vote something 
in, you vote something out. I want a system that allows the private 
sector to choose exactly----

  Mr. STARK. I thought you wanted mammograms. Let us stay on 
mammograms. You want mammograms, but you vote against it.
  Mrs. JOHNSON of Connecticut. Now the people in America have that.
  Mr. STARK. I am sorry?
  Mrs. JOHNSON of Connecticut. The point is, if you vote mammograms in 
because of the money cost and the global budget, you have to say they 
can't have them early on when they need them.
  Mr. STARK. Did you say you wanted mammograms or not? I am confused. 
You cannot have it both ways.
  Mrs. JOHNSON of Connecticut. I want mammograms, and I want women to 
choose plans that give them all the mammograms they need.
  Mr. STARK. You just voted against it this afternoon.
  Mrs. JOHNSON of Connecticut. I want them to have all that they need.
  Mr. STARK. You just voted against it.
  Mrs. JOHNSON of Connecticut. I voted against Government having the 
power to define in or out, and you, sir, submitted a plan that will 
deny to America's women, men, and children innumerable health care 
services that they currently enjoy under their current insurance plan.
  Mr. STARK. The question, if there was a question in that, I would----
  Mr. CARDIN. Mr. Stark will have half a minute to respond.
  Mr. STARK. I am just suggesting that the lady had a chance to vote 
for the mammograms that the Democrats provided this afternoon in 
markup. She voted against it. She cannot have it both ways.
  Mr. CARDIN. The Chair now yields to Mr. Thomas for an opening 
statement.
  Mr. THOMAS of California. I thank the moderator.
  It seems to me that it is evident tonight, based upon the initial 
opening statement of the gentleman from California, Mr. Stark, and his 
attempt to evade the questions, that either he has not read the resolve 
clause of this Oxford debate or he is very uncomfortable with the 
question that is supposed to be in front of us. I will repeat it:
  Resolved that the Clinton health care plan best represents the 
elements that should be included in health care reform. Nowhere do we 
see goals; it is the elements of the President's plan. And I believe we 
have heard several responses tonight which indicate that they are far 
more comfortable talking about general ephemeral goals than they are 
about the elements of the President's plan.
  Frankly, when the American people are going to be required to live 
under this plan, they are not going to be living under ephemeral goals, 
they are going to be living under a national health board that has the 
ability to set the prices for the entire health care delivery system of 
the United States. They are going to be told they can no longer have 
the insurance plan that they currently have. And at some point in this 
debate, I do hoe we begin talking about the elements of the President's 
plan.
  There has been waltzing outside these chambers for 6 months. I 
thought this would be an opportunity to engage on the elements of the 
President's plan and bring to the American people a better 
understanding so that they can make real choices. It is pretty obvious 
the opposition does not want to close on the elements of the 
President's plan.
  Mr. CARDIN. I now yield to the Democratic team for questioning Mr. 
Thomas.
  Mr. STARK. I am reminded of ``waltzing Matilda,'' and I would direct 
our first question, because it was again today that the gentleman, Mr. 
Thomas, pontificated about helping medical teaching hospitals, to 
promote quality in health care. Last Friday you voted to cut $13.5 
billion out of teaching hospitals in the next 5 years. Again, a 
question: Which way would you have it? Would you help quality medical 
care, or would you continue to cut the very heart of the medical 
education system and use it to spend on defense or some other item?
  Mr. THOMAS of California. First of all, I would tell the gentleman he 
is totally mistaken. The vote on the health--the teaching hospitals, 
was on a tobacco tax. I did not speak on that bill. In fact, it was 
voted to be tabled.
  Mr. STARK. The gentleman voted----
  Mr. THOMAS of California. May I answer the question? If you will take 
a look at the Republican plans and most specifically the plan that I 
carry as a sponsor in this House, we not only engage the problem of 
making sure that these teaching hospitals are adequately financed but 
we create incentives so that we move toward strengthening primary care 
doctors rather than specialists. In addition to that, we turn to the 
tax code and we tell these people who are willing to go to rural areas, 
we give them a tax incentive of $1,000 a month to try to get these 
people out into the structure.

                              {time}  2040

  Not only do our plans encourage and promote teaching hospitals, we 
nurture in a positive, incentive way----
  Mr. STARK. Excuse me----
  Mr. THOMAS of California. The direction that allows them to create a 
stronger base.
  Mr. STARK. Cutting 13 billion out of teaching hospitals helps them. 
On the same day that the gentleman did that he voted to cut $45 billion 
out of Medicare. Did that help the seniors in their Medicare in the 
same way?
  Mr. THOMAS of California. The gentleman, the gentleman is talking 
about, the Republican budget. Would you tell me how $45 billion in 
Medicare equates----
  Mr. STARK. The President----
  Mr. THOMAS of California. With the President's cut in Medicare in his 
plan? It is $124 billion over 5 years in the President's plan----
  Mr. STARK. This was all----
  Mr. THOMAS of California. And what does he do with those cuts? He 
turns around and gives millionaires taxpayers' money to pay for 
prescription drugs.
  Mr. WAXMAN. I would like to ask the----
  Mr. THOMAS of California. Does the gentleman think that's the 
appropriate way to deal with Medicare cuts?
  Mr. STARK. We're asking a question.
  Mr. WAXMAN. I read Mr. Thomas' own bill on health care reform, and he 
would cut the Medicare program more than President Clinton, but he 
wouldn't use that for benefits for the elderly. He would give vouchers 
to low-income people, a worthy goal, but why do you take from seniors 
in this country to help poor people? That's hardly fair.
  Mr. THOMAS of California. Why does the President take from seniors? 
He has repeated over and again the Medicare structure is full of 
waste----
  Mr. WAXMAN. Does----
  Mr. THOMAS of California. May I answer the question or not?
  Mr. WAXMAN. If he did----
  Mr. THOMAS of California. Can I answer the question?
  The President cuts $124 billion from Medicare. He says he gets it 
from waste, fraud, and abuse, and what does he do with that money? He 
turns around and gives millionaires additional benefits----
  Mr. WAXMAN. Are you willing----
  Mr. THOMAS of California. Would the gentleman support, would the 
gentleman support means testing on Medicare?
  Mr. WAXMAN. The gentleman wants to misrepresent the President's----
  Mr. THOMAS of California. I'm not--how do I misrepresent the 
President's bill?
  Mr. WAXMAN. Even if you were right, and you're not----
  Mr. THOMAS of California. How did I misrepresent----
  Mr. WAXMAN. To take the money----
  Mr. THOMAS of California. The gentleman said I misrepresented the 
President's bill. It's $124 billion he's going to cut in Medicare?
  Mr. WAXMAN. Gentleman answered the question? I don't blame you 
because I'd be embarrassed to answer that question.
  Mr. THOMAS of California. You said I misrepresented the President's 
bill. Was it the $124 billion that the President is going to cut?

  Mr. WAXMAN. Am I misrepresenting your----
  Mr. THOMAS of California. Do you dispute----
  Mr. WAXMAN. Obviously----
  Mr. THOMAS of California. $24 billion----
  Mr. WAXMAN. I actually dispute----
  Mr. THOMAS of California. Billion that the President----
  Mr. WAXMAN. That you say about the President, but you don't seem to 
be willing to dispute what I'm saying about your own legislation.
  Mr. THOMAS of California. No. I am more than willing to share the 
reductions in Medicare squeezing out waste, fraud, and abuse just like 
the President does.
  Ms. DeLAURO. Mr. Thomas, let me ask you. You support the plan, the 
Cooper plan, that you do not define----
  Mr. THOMAS of California. Excuse me, Ms. DeLauro. I do not support 
the Cooper plan. I am not a cosponsor of the Cooper plan.
  Ms. DeLAURO. Well, let me ask you this then. There is no definition 
in any of the Republican plans of a comprehensive benefit package. The 
notion is that we will leave that decision to some national board, one 
in which a few minutes ago you said you don't like, but a national 
board will decide a comprehensive benefit package. You tell the 
American public to trust you and that you'll come up with a benefit 
package after the legislation is passed.
  Mr. THOMAS of California. Yes. First of all, I have a choice of 
asking for you to ask the American people to trust you because under 
the President's plan Congress will log roll, pork barrel, play to 
lobbyists and create a national benefits plan.
  Ms. DeLAURO. Not true.
  Mr. THOMAS of California. That is what the President----
  Ms. DeLAURO. Not true.
  Mr. THOMAS of California. Congress doesn't create the benefit plan 
under the President's plan.
  Ms. DeLAURO. Do you ask----
  Mr. THOMAS of California. The President's plan, the President's plan 
allows Congress to create the national benefits package. It is log 
rolling and pork barreling at its worst.
  Ms. DeLAURO. You ask the public to buy a pig in a poke, Mr. Thomas.
  Mr. CARDIN. Ms. DeLauro is recognized for a minute and a half. I 
yield a minute and a half.
  Ms. DeLAURO. Thank you. I am honored tonight to rise in support of 
the resolution that the Clinton plan best represents the elements that 
should be included in health care reform. It is the only plan before 
the Congress that assures that everyone is covered by private health 
insurance, every day, no matter what, and it's the only plan that 
attacks the core problem.
  Insurance and medical costs are rising through the roof. Those costs 
rob working people of their wages and increases in wages and businesses 
of their competitiveness, and for many good people it has meant 
personal bankruptcy.
  We're debating health care reform tonight because Bill Clinton had 
the courage to tackle the issue for more than a decade. The leaders of 
this country through two administrations did nothing while the 
insurance crisis worsened.
  I come to this health care debate as a cancer survivor. I have seen 
the best in our health care system, and it saved my life. But I also 
saw the enormous costs. I don't begrudge the doctors and the doctors 
their fees, but imagine if my family had to face those tens of 
thousands of dollars of bills without insurance. What if I had been 
between jobs? What if I had worked for a small business that couldn't 
afford insurance?

  The Clinton health care plan includes the essential elements of 
reform. Expanding the pool of the insured will control costs. 
Guaranteeing universal coverage ends cost shifting. Emphasizing 
preventive care lowers costs. Our experience teaches us that these 
methods will work, and we dare not falter before this challenge.
  Mr. CARDIN. Yield to the Republican team to question Ms. DeLauro.
  Mrs. JOHNSON of Connecticut. Ms. DeLauro, we would certainly agree 
that Connecticut's No. 1 problem is jobs. Do you know what percent of 
Connecticut's residents are uninsured at this time?
  Ms. DeLAURO. Connecticut has the highest rate of insured, lower than 
the national average which is about 15 percent.
  Mrs. JOHNSON of Connecticut. No, it has 17.6 percent uninsured in 
Connecticut right now.
  Do you know what percent Hawaii with an employer mandate has 
uninsured at this time?
  Ms. DeLAURO. Hawaii has been the--has come in below the average on 
what the national numbers are on employment, and, as a metter of fact, 
with regard to Hawaii----
  Mrs. JOHNSON of Connecticut. The answer----
  Ms. DeLAURO. With regard to Hawaii, and you're a person, Mrs. 
Johnson, who believes that we ought to try what works.
  Mrs. JOHNSON of Connecticut. That's right.
  Ms. DeLAURO. If you do take the example of Hawaii, they have seen 
their unemployment----
  Mrs. JOHNSON of Connecticut. That's right. The uninsured rate, my 
colleague, is 8 percent. Connecticut's is 7.6 percent. For one-half of 
1 percent why is it necessary to impose on the employers of Connecticut 
a mandate that you know will cost jobs in the short term and, worse 
yet, in the long term will slow the growth of jobs in a very----
  Ms. DeLAURO. Let's talk about small business, and I'm delighted that 
you talked about small business.
  Mrs. JOHNSON of Connecticut. You bet. That's what----
  Ms. DeLAURO. I won't support a plan that doesn't have small 
business----
  Mrs. JOHNSON of Connecticut. This will kill small business. Did you 
read the amount----
  Ms. DeLAURO. May I answer the question?
  Mrs. JOHNSON of Connecticut. Yes because I've got questions.
  Ms. DeLAURO. Let me tell you--if you allow me to tell you, I will do 
it.
  Small businesses today have doubled the cost of health insurance 
since 1985. Smaller businesses today spend 35 percent more than the 
larger firms for health care.
  Mrs. JOHNSON of Connecticut. Congresswoman----
  Ms. DeLAURO. Let me finish.
  Mrs. JOHNSON of Connecticut. Congresswoman, don't you go home? When I 
go home----
  Ms. DeLAURO. I go home----
  Mrs. JOHNSON of Connecticut. Small businesses tell me they are barely 
surviving, they don't have any margin, they're not able to provide 3.5 
percent of payroll. How can you think----
  Ms. DeLAURO. You asked me a question----
  Mrs. JOHNSON of Connecticut. That small business----
  Ms. DeLAURO. I'd like to answer it.
  Mr. CARDIN. One moment. This has certainly been spirited back and 
forth through all the questioners, but I would like to ask that we 
would please allow the person to finish the question and at least give 
an answer before we follow it up.
  Ms. DeLAURO. I'd like to answer the question on small business 
because I believe it is a critical question. Let me address the issue.
  Forty percent they pay in administrative costs in small businesses 
today. The current system is killing small businesses, and what we 
attempt to do with the Clinton plan is to allow small businesses to 
have the purchasing power to deal with the insurance companies to get 
lower costs and, secondly, what it does is it builds on the current 
system that we have in extending insurance in this country.
  Mrs. JOHNSON of Connecticut. All kinds----
  Ms. DeLAURO. Extending----
  Mrs. JOHNSON of Connecticut. If you had endorsed my bill 3 years ago, 
we could have given small business access to health care, health 
insurance----
  Ms. DeLAURO. Mrs. Johnson----
  Mrs. JOHNSON of Connecticut. Would not have had----
  Ms. DeLAURO. Mrs. Johnson, you support a plan that would put a 34 
percent tax on businesses who do more for their employees in terms of 
being good business people and try to provide more benefits. It would 
put a 34 percent tax on those businesses. You support that bill which 
would put most small businesses into a pool that would raise their 
rates sky high.
  Mr. THOMAS of California. OK, Ms. DeLauro, under the Clinton health 
plan, under the Clinton health plan employers pay 80 percent of the 
costs----
  Ms. DeLAURO. Average----
  Mr. THOMAS of California. Can I finish the question, please?
  Ms. DeLAURO. Yes.
  Mr. THOMAS of California. They are forced to pay the 80-percent fee. 
The employees are supposed to pay the 20 percent. What happens if they 
don't under the President's plan?
  Ms. DeLAURO. What the Clinton plan says is that employers----
  Mr. THOMAS of California. No----
  Ms. DeLAURO. Will pay the average, 80 percent of the average cost of 
the health care plan. Employees will pay the----
  Mr. THOMAS of California. Twenty percent.
  What happens if they don't?
  Ms. DeLAURO. That's right.

                              {time}  2050

  Mr. THOMAS of California. What happens if they don't? What happens if 
they don't?
  Ms. DeLAURO. What will happen, if you will let me answer the 
question, there are several things. First of all, employers will be 
able to----
  Mr. THOMAS of California. No, employees, if they don't pay the 20 
percent, what happens under the Clinton bill? A simple question.
  Ms. DeLAURO. Well, if they are out of a job----
  Mr. THOMAS of California. No, we are talking about employees. Not 
unemployed. The employers pay 80 percent. Employees, workers of the 
employer, pay 20 percent. What happens if they don't pay their 20 
percent under the Clinton bill?
  Ms. DeLAURO. What is meant to happen is that the----
  Mr. THOMAS of California. Not is what is meant to happen. What 
happens under the bill?
  Ms. DeLAURO. There are discounts to those who qualify for the 
discount.
  Mr. THOMAS of California. The answer very clearly is everybody else 
pays, because there is no compulsion under the President's bill.
  Ms. DeLAURO. Everyone pays now. They pay for those businesses----
  Mr. THOMAS of California. I appreciate your knowledge of the bill you 
are defending, because you don't know it.
  Ms. DeLAURO. I know the plan very well.
  Mr. CARDIN. Ms. DeLauro is recognized to answer the question if she 
knows the answer. The time in this round has expired, but Ms. DeLauro 
may answer the question if she wishes to answer the question at this 
point, before she is recognized. There was a question asked and she did 
not have an opportunity to respond. At the end, the Republican team was 
using the time.
  Mr. THOMAS of California. Excuse me, Mr. Moderator, that question was 
asked with 2\1/2\ minutes left. It was a simple question and it was 
asked with 2\1/2\ minutes left in the timeframe. If she was unable to 
answer it within that time, that is her problem, not ours.
  Mr. CARDIN. There were interruptions back and forth.
  Ms. DeLAURO. Employees will be able to pay the cost of their plan 
because the premiums are going to be less than what they are today, and 
if they need assistance----
  Mr. THOMAS of California. If she is going to answer the question, she 
needs to respond to the question that was asked, not how they are going 
to pay it. What happens if they don't pay it. The question is what 
happens if they don't pay it.
  Mr. CARDIN. On the exchange back and forth, we are trying to give as 
much leeway as possible. Under the agreed rules, if time expires at the 
end of the 5 minutes and it is my judgment, the moderator's judgment, 
that there is need for time for a response, that I have the option of 
giving the respondent the extra 30 seconds. It will be uninterrupted at 
this point.
  Ms. DeLAURO. If the employees are unable to pay for their health 
insurance, if they qualify for a discount, they will be able to get a 
subsidy in order to be able to do it. That is what the Clinton plan 
says. In addition to which, as I said, what will happen is that the 
cost of premiums comes down. You may say it is wrong, but that is the 
way it is.
  Mr. CARDIN. I now yield to Mrs. Johnson for a statement.
  Mrs. JOHNSON of Connecticut. The majority leader opened this debate 
by talking about portability, about guaranteeing private insurance, 
choice, and security.
  Four years ago, I talked with a young woman in front of a grocery 
store who had two beautiful children uninsured, and out of that 
experience I introduced insurance reform legislation, that if we had 
passed it 3 years ago, and not one of you cosponsored it, there would 
be no one today excluded for preexisting conditions, no one today the 
victim of job lock. And I also introduced--the Republicans introduced 
purchasing cooperatives, that would have lowered the cost of health 
insurance for all Americans. We expanded the infrastructure of health 
care. And we did something to control skyrocketing costs through 
administrative reform and the smart card that the President talks 
about. We have introduced all those ideas, and we are proud of it.
  We want health care for all Americans that is affordable and high 
quality. We just don't want an employer mandate that costs jobs and 
slows the economy. He--we don't want global budgets and price setting 
that is going to result in rationing. We know that through the systems 
that we already have in place that the Government runs.
  We don't want mandatory alliances that force every individual in 
America to give up the plan they have and go buy some other plan that 
the Government is giving them through their health alliances. We don't 
want to lose all those jobs in Connecticut and export them to other 
States, just because the Government decided that instead of purchasing 
nationally, we have to purchase state-by-state. So let's get back to 
the real issue, action on health care today.
  Mr. CARDIN. The Democratic team may question Mrs. Johnson.
  Ms. DeLAURO. Mrs. Johnson, tell me: You don't want to have people 
forced into mandatory alliances, small businesses having mandates. Then 
explain to me how you can support a bill that would force small 
businesses into the highest risk pools, businesses of 100 or less, into 
a risk pool that would have the uninsured, Medicaid recipients, and 
small businesses, thereby causing small business premiums to continue 
to skyrocket, as they will, and how can you support a tax, a 34 percent 
tax on businesses?
  Mrs. JOHNSON of Connecticut. As the Member of this House that 
introduced the first insurance reform bill, I know a good deal about 
pooling, and I can tell you that that pool is large enough so we can 
keep the low cost premiums of large pools, the low administrative costs 
and the low marketing costs.
  If you look at the legislation that I personally promoted as the lead 
sponsor, you will see that we reduced the cost of insurance through 
providing a good, solid plan developed by the private sector on the 
basis of the kind of average plan that Americans have come to consensus 
about, that they want, not by a Government defining benefits in and 
out, not saying you, mammogram now, not later. You can have this and 
not that. But letting the public choose from plans, some of which 
provide mammograms and some of which don't, because if you are young 
you don't need mammograms. If you are older, you certainly do. I don't 
want the Government controlling that.
  Mr. WAXMAN. You are letting insurance companies make choices for 
people, not people making choices for themselves. Let me ask you----
  Mrs. JOHNSON of Connecticut. People have choices of what plan they 
buy. My reform legislation guarantees that choice in the public and 
private sector.
  Mr. WAXMAN. I know you would like to give another speech. My question 
to you is with insurance reform, you can do some good, 200,000 people 
may get covered. But there are 39 million. Why not have shared 
responsibility of employers and employees? That is the way most people, 
9 out of 10, have their coverage today. If we adopted your proposal, 
what assurance do you have that the uninsured will ever really get 
insurance if they can't afford it?
  Mrs. JOHNSON of Connecticut. I will give you the insurance. The 
Republican side introduced the first bill that would have exploded the 
infrastructure to guarantee all 37 million of those uninsured access to 
our good community health systems, and, in addition, we lowered the 
cost of insurance so they could have their choice. We provided options 
choice so that everyone in America would have access to affordable 
care.
  Mr. WAXMAN. Who would pay for that insurance? Individuals?
  Mrs. JOHNSON of Connecticut. Individuals would pay for the insurance.
  Mr. WAXMAN. If they can't afford it, they go without. If their bosses 
don't help them, they can't afford it.
  Mrs. JOHNSON of Connecticut. Listen to this. In the community health 
center, they pay according to a sliding scale. For the insurance they 
would pay on their own, unless they were low income, and then they have 
vouchers to help subsidize the cost. So we provide universal access to 
affordable care for all Americans.
  Read our stuff. Read our stuff. But we don't have health alliances 
that will export jobs from my State. We don't have mandates on small 
business that will retard the growth of the very good venture capital, 
little companies, that our future as a nation depends on. And we don't 
go to global budgets and price setting and state budgets.
  Mr. GEPHARDT. Mrs. Johnson, why don't you want to do something about 
costs? Eighty percent of the American people are covered, have health 
insurance. Their problem is they are not going to be able to afford it. 
Nothing in your plan does anything to hold costs down, to give people 
affordability.
  Mrs. JOHNSON of Connecticut. No, three things do. There are lots of 
things about holding costs down. First of all, the cost driver is the 
increased ability to diagnose and treat illness. We know a lot more 
about diagnosing. We can do a lot more tests and treatment. I want a 
solution that guarantees you will still get the diagnosis and treatment 
you want. I don't want arbitrary global budgets that will deny you 
treatments or care when you need it. I want to change the system so it 
makes better decisions, doesn't duplicate tests, doesn't provide 
inappropriate care, doesn't give you stuff you don't need just to make 
a profit, and that is what the Republican system does.
  Mr. STARK. The gentlewoman's expertise is known far and wide in the 
medical area.
  Mrs. JOHNSON of Connecticut. I earned it on my own.
  Mr. STARK. How would the system improve on the system known as 
Medicare?
  Mrs. JOHNSON of Connecticut. How would I improve Medicare? I would 
improve Medicare by allowing all Medicare patients in all States, not 
just 15, to have access to the Medicare Program that is a managed care 
program, and for the same premium gives you prescription drugs. But we 
haven't been willing in Congress to open up Medicare to the private 
sector, God forbid, even though seniors could get more care, 
prescription drugs, and more options.
  Mr. WAXMAN. I find that very peculiar. Medicare people go in the 
private sector.
  Mr. CARDIN. The time for this section has expired. The Republican 
team is now yielded time to question Mr. Gephardt.

                              {time}  2100

  Mr. GINGRICH. Let me say that I am delighted that finally we can now 
get to what I believe the Democratic side agreed to defend, which is 
the bill introduced by Mr. Gephardt for himself and a host of others in 
the title H.R. 3600 which I think was the topic of the debate, not what 
Mr. Stark decided to replace the bill with, because he did not like 
this one, not with what Mr. Waxman will later on replace the bill with, 
not the various versions that Ms. DeLauro decided to have but, rather, 
the bill you were supposed to be defending, H.R. 3600.
  I want to go back to the topic of mammograms for a second, because my 
good friend, who is a very modern and wise person. knows that we are in 
the middle of a biological revolution. He knows that there is genetic 
research. He knows that there are many things going on.
  Do you really think it makes sense, from page 40 to page 47, to write 
into law which tetanus shots, which inspections, which mammograms at 
which age, to have the Congress of the United States writing into law 
with the cumbersome, slow, politicized procedures we have, to lock into 
law these kinds of situations, and in the Clinton bill, which you are 
defending, to block mammograms for women who are, I believe, under 45.
  Mr. GEPHARDT. I would rather have mammograms between 40 and 47 than 
not at all, which is most of your plans. You do not have any benefit 
package that is described. You do not. There is nothing in the Michel 
plan that you all endorse, there is absolutely no benefit package. You 
turn it over to the insurance board. I would rather have the Congress, 
the elected Representatives. make those kind of decisions.
  Let me say this, if you want to have more mammograms, as Mr. Stark 
said earlier, we would be happy to have your support to work with us to 
get the mammograms for women at a much earlier age.
  Mr. GINGRICH. Let me just say to my good friend, first of all, that 
what you just said about the Republican plan is not true, unless the 
only things that every count in life are mandated and required by a 
Federal bureaucracy. Our plan allows women and their doctors to choose. 
I realize that if you believe in only government and bureaucracy, our 
plans seems invisible.
  But let me carry you back again to page 43 and 44 of the Clinton plan 
you are defending, which says you have got to be 50 years of age. Do 
you really believe in the plan that you are defending in this 
particular debate that that is a wise provision? Are you prepared to 
defend to every woman under 50 that her government by law, by law would 
block her from getting that mammogram?
  Mr. GEPHARDT. Let me say again, Mr. Gingrich, something is better 
than nothing. What you are offering the American people is nothing. You 
do not have a described benefit. You are buying pig in a poke if you 
buy the Republican plan.
  At least with the Democratic plan, we have described benefits. And 
again, we welcome you to work with us. We need your help.
  Mrs. JOHNSON of Connecticut. We gave them the right to choose it. And 
half the managed care plans provide mammogram reimbursement for women 
of all ages.
  Mr. GEPHARDT. You say, yes, you can all have health insurance like 
you can have it today, if you can afford it, if you can continue it.
  Mrs. JOHNSON of Connecticut. We make it affordable.
  Mr. BLILEY. I would like you to comment on the letter I received from 
one of my constituents, Ed Gooding. He operates a small data processing 
company in Richmond, VA. He has 70 people on his payroll, and he is 
fortunate in that he had been doing well enough to be able to purchase 
health care for his people.
  Can he continue on his way with the Clinton plan? No; his costs for 
health care will rise from $162,000 to $253,000 under the Clinton plan.
  Where will he get that money?
  As his letter points out, this means more of his money will come to 
Washington and will go out of the local economy. Couple that with the 
fact that ``my employees will also end up with inferior coverage to 
what they have now.''
  Do you have a response for Mr. Gooding? How this plan of the 
President's is going to help him?
  Mr. GEPHARDT. First, Mr. Bliley, I think maybe you misdescribed the 
Clinton plan to your constituents, because if he really understood what 
is going on here, he would know that it is the Clinton plan that 
finally gets his colleagues in small business and other businesses to 
be involved in health care.
  The reason his health care costs are going through the roof today is 
that he is trying to do the right thing, and that is to obtain 
insurance for his employees, while about 30 percent of employers simply 
are not doing it.
  Mr. BLILEY. He has got to pay the $253,000. The difference between 
$162,000 and $253,000, that is his problem. He has already got the 
insurance. He loses his insurance and his people are going to get less, 
and he is going to pay more.
  Mr. GEPHARDT. I think his problem today is that the plan we are 
operating under today, and what you would persist under your plan, 
simply leaves people who do not provide it out there to do it. They are 
getting by with something that others are not doing. Let us get 
everybody involved in health care. Everybody ought to be responsible, 
everybody, every employer and every employee.
  Mr. CARDIN. I now yield to Mr. Stark to question Mr. Thomas.
  Mr. STARK. Thank you.
  Bill, I know that you, too, are an expert, probably the Republican 
expert in the area of health care.
  Mr. CARDIN. I have to interrupt. I want to make sure we go in the 
right order. It should now be up to the Democratic team to question Mr. 
Gingrich. I do not want to let Mr. Gingrich lose that opportunity.
  Mr. GINGRICH. I was willing to allow the moderator to leap onto this.
  Mr. THOMAS of California. I loved that flattery. I thought it was 
going to go somewhere.
  Mr. GEPHARDT. We would have missed our opportunity.
  Mr. GINGRICH. We now know that I am not the leading expert on health 
care on this panel. I feel the burden is lowered.
  Mr. GEPHARDT. Mr. Gingrich, you mentioned in your opening statement 
your daughter, who had to wait a year to get health insurance, and that 
is precisely the kind of problem that we think the Clinton plan solves.
  The plan you support, the Republican plan, the Michel plan, would 
keep your daughter waiting 6 months, if she had a condition 3 months 
before she bought health insurance.
  Further than that, if she got sick while she had health insurance, 
under the Michel plan that you support, her premiums could triple, 
quadruple.
  Is that the kind of plan you support?
  Mr. GINGRICH. Let me say to my good friend, first of all, there are 
several Republican plans that I have supported, and they have evolved 
over the last 2 years. They would guarantee that you would have 
portability, and they do guarantee that you would be protected against 
this kind of precondition.
  But let me tell you, in the context of Ms. DeLauro's earlier comment, 
which I respect a great deal, about the cancer that she had recovered 
from, why my daughter and I, my daughter is a small businesswoman who 
is afraid she would have to lay off some of her employees. She runs a 
small coffee company in Greensboro, if I can get a plug in for her. I 
will tell you why she and I both fear the Clinton plan.
  In the process of creating these large bureaucratic alliances, our 
fear is that 10, 15 years from now, as is happening in Canada and 
Britain, you would not have the cures for cancer. We just saw a news 
report from Canada over Christmas where they closed the hospitals for 3 
weeks, including the cancer therapies, including the AIDS therapies. 
And they said, if your child is 4 years old and has got a high 
temperature but is not vomiting, do not bring them in.
  Now, we look ahead and we say, what price are you charging us for 
this ephemeral hope of universal coverage the way you do it?
  Mr. GEPHARDT. We are not talking about the Canadian plan. We are 
talking about the Clinton plan, and what we are saying is that we get 
rid of preexisting conditions. The plan you support does not. It would 
not help your daugher. Our plan does.
  Mr. GINGRICH. That is not true. We are not here to defend the Michel 
plan. We would be glad to have the debate, if you would like to choose 
that topic, to defense any of the Republican plans: Gramm, Nichols, 
Stearns, Michel, Thomas. There are a number of good Republican plans.
  But let me come back to the comparison, because I think what you 
said, I would say to my good friend from Missouri, is just not right.
  The Clinton plan and Mrs. Clinton's testimony guaranteed a lower rate 
of increase in budget than any Western country has ever gotten, a lower 
rate than Canada, a lower rate than Germany. And the only way, the only 
way you can get to that lower rate is, in fact, to ration health care.

  And my fear is, and I have been told, by the way, by many medical 
hospitals, research hospitals, that now that they have read the Clinton 
plan, they are terrified of the Clinton plan because it will destroy 
medical research and lead to rationing of all sophisticated care.
  Mr. WAXMAN. Mr. Gingrich, you quoted a number of people this morning. 
I would like to cite back to you your statement to the press. You 
called the Clinton health care proposal socialism.
  A lot of us remembered that being said about Medicare. We remember 
the Republicans saying that about Social Security. And now that 
President Clinton is trying to make sure that every American gets a 
private health care insurance policy, you call it socialism.
  Do you really believe it is socialism?
  Mr. GINGRICH. That is a very good question, Mr. Waxman. I will cite 
two sources. One of my sources is the book ``Reinventing Government,'' 
by David Osborn, who was the Clinton's advisor, who said, flatly, the 
West German socialist model is the model, not Canada, West German 
socialism.
  Second, I would say to my good friend, if you will turn to page 109 
of the bill you are supposed to----
  Mr. WAXMAN. You are quoting the page number from the Clinton bill. 
But then you want to disassociate yourself from the bill that all the 
Republicans are for.
  Mr. CARDIN. Let Mr. Gingrich have a chance to respond.
  Mr. WAXMAN. Do you not think that is a scare tactic, referring to it 
as socialism?
  Mr. GINGRICH. I certainly hope that Mr. Waxman's introductions are 
not taken out of our time.
  If you look at page 109 of the bill you are supposedly defending, the 
Clinton plan, you will see a provision that allows a State government 
to take over all health care in a State. If you turn to page 110, you 
will see that it says at the top, ``at the option of the State, the 
system may sign up everybody on Medicare.''
  At the option not of the citizens on Medicare, not at the option of 
the senior citizen, ``at the option of the State.''

                              {time}  2110

  Mr. GINGRICH. I would say to my friend--
  Mr. WAXMAN. Do you think people on Medicare are on the Socialist 
health care plan?
  Mr. GINGRICH. No. This allows the State of Louisiana----
  Mr. WAXMAN. It is funded by taxes.
  Mr. GINGRICH. If I might, let me go back and just repeat my 
statement. This allows the government of a single State, Louisiana, 
Arkansas, Maryland, Georgia, a single State, to decide to control all 
the health care in the State.
  Mr. GEPHARDT. I thought Republicans were for a Federal system, and 
Federalism, and wanted States to help out.
  Mr. GINGRICH. Republicans are certainly not for the Federal 
Government taking away your health control, giving it to a local 
Governor and State legislature to plan it the way they want to and then 
saying, ``You have no choice, you must do what that State government 
wants.'' I think that is fairly close to socialism.
  Mr. GEPHARDT. If the people in the State do not like it, they can get 
rid of the government.
  Mr. CARDIN. I now yield to the gentleman from California [Mr. Stark] 
to question Mr. Thomas. You don't have to go through all of that.
  Mr. THOMAS of California. Where were we when we were interrupted?
  Mr. STARK. I would ask, Mr. Speaker, for the very poorest and those 
for whom medical care is not available, who would you suggest is 
responsible in the final analysis, who should provide the safety net 
for the unemployed or the poor in this country?
  Mr. THOMAS of California. I think without question that the ultimate 
provider and supporter of those who have no support would be the 
Government. The question, I think, is why----
  Mr. STARK. I asked the question. I'm sorry, you can ask me----
  Mr. THOMAS of California. I'm going to answer the question.
  Mr. STARK. You just said it. Your answer is fine. You think it should 
be----
  Mr. THOMAS of California. I would then like to say the question is 
when, how much, under what circumstances, who pays, and what are the 
consequences of all of those decisions.
  Mr. STARK. Now answer your own. You said it quite well. You said it 
should be the Federal Government and the question is when. When do you 
think that should come into effect for the 37 million uninsured? Do you 
have a time in mind?
  Mr. THOMAS of California. First of all, tell me, the universe is 
going to be the current 37 million?
  Mr. STARK. Uninsured.
  Mr. THOMAS of California. First of all, the 37 million----
  Mr. STARK. Who are poor. I defined them earlier.
  Mr. THOMAS of California. Please, please, please. The 37 million 
uninsured are those that you said Government should support.
  Mr. STARK. And you agreed.
  Mr. THOMAS of California. I think you need to look at that 37 
million, and they are not the poorest of the poor.
  Mr. STARK. I defined that and I just asked you when.
  Mr. THOMAS of California. There are a majority of people who are 
earning above the poverty level.
  Mr. STARK. Excuse me.
  Mr. THOMAS of California. They are young people who did have 
insurance today----
  Mr. STARK. The gentleman did not understand it.
  Mr. THOMAS of California. I understood it. You did not ask it right, 
I think.
  Mr. STARK. I said the poor and the uninsured who in no other way 
could get insurance, and I think you answered. You answered that.
  Mr. THOMAS of California. No, that is the question. They can get 
insurance. It is not that they cannot get insurance.
  Mr. STARK. When should that group get insurance who are poor, poor 
uninsured, unemployed, and who in the final analysis the Federal 
Government should support? I agree with you. At what point in time 
should we have that in place? By the end of this decade or when?
  Mr. THOMAS of California. The first thing you do is examine those 37 
million to find out who could afford it, but given the failure to 
change insurance laws in the country today on a uniform basis, they 
refuse to do it. Find out those who are more than willing to pay 
catastrophic insurance----
  Mr. STARK. When should they be covered when we find that out, what 
time?
  Mr. THOMAS of California. If we are talking about 12 or 15 million, 
which is really a high number to begin with----
  Mr. STARK. I will stipulate to that.
  Mr. THOMAS of California. Let us do it tomorrow. Let us take all of 
that money you are saving under the President's plan in cutting 
Medicare and pay for those people's coverage instead of giving 
millionaires prescription drug benefits, then,
  Mr. STARK. What level of benefits--we are making progress. The 
gentleman has agreed, if I could identify it, the gentleman has agreed 
that there are a group, perhaps as many as 10 million, maybe not, that 
the Federal Government should finally----
  Mr. THOMAS of California. I would say 7 to 9 million, if you are 
going to boil it down to the smallest group.
  Mr. STARK. The Federal Government should provide it immediately. 
Would the gentleman now like to say what level of benefits--should they 
receive benefits as generous as you and I receive from the Federal 
Government?
  Mr. THOMAS of California. I think if the gentleman is going to 
argue----
  Mr. STARK. I just asked the question.
  Mr. THOMAS of California. Yes. Yes. They should.
  Mr. STARK. We are making progress. We are making progress.
  Mr. THOMAS of California. How is the gentleman going to pay for it?
  Mr. STARK. For those for whom it is unavailable, the Government 
should do it immediately, if possible, with benefits about as generous 
as we have. Now, how would you suggest we all pay for that?
  Mr. THOMAS of California. I suggest that we take a look at the way in 
which win money is currently spent today for those people who could 
otherwise afford their insurance but have Government subsidies for 
them. Let us begin with means testing Medicare, so that millionaires 
don't get prescription drugs. Let us not talk about providing long-term 
benefits for people who are more well-off than the average American. 
Let us take that money immediately and transfer it to the poorest of 
the poor, so that instead of a subsidy to millionaires, we do pay for 
the health care costs of the poor.
  Mr. STARK. If that is not sufficient, then what?
  Mr. THOMAS of California. It is sufficient. Let me tell you, it is 
more than sufficient. The President has identified the money, $124 
billion to provide new benefits for the entire Medicare population. All 
we are doing is taking that money and directing it to the 7 or 9----
  Mr. STARK. You don't disagree with that, then, is that correct?
  Mr. THOMAS of California. If you promise me that that is what we will 
do tomorrow morning in the Health Care Subcommittee, we can lock that 
up right away.
  Mr. STARK. The Federal Government----
  Mr. THOMAS of California. Let us means test Medicare and give it to 
the people who really need the money. I am with you on that.
  Mr. STARK. First you will have to agree to the Federal Government 
providing the care. If that is what the gentleman agreed to, there 
could be some progress.
  Mr. THOMAS of California. What I agreed to was means testing 
Medicare, taking money away from people who are getting it now, who 
really don't deserve it, and giving it to the people who do, and I 
agree with the gentleman that those people need it. It is available. 
You folks simply refuse to do that.
  Mr. STARK. Is the gentleman opposed to other forms of progressive 
taxation?
  Mr. THOMAS of California. I didn't hear the gentleman.
  Mr. STARK. Is the gentleman opposed to other forms of progressive 
taxation?
  Mr. THOMAS of California. Other forms of oppressive----
  Mr. STARK. Progressive.
  Mr. THOMAS of California. Of course.
  Mr. STARK. You were opposed to them?
  Mr. THOMAS of California. I'm not opposed to them.
  Mr. STARK. We could use other forms of progressive taxation to 
achieve these ends.
  Mr. THOMAS of California. If the gentleman refuses to means test 
millionaires for getting prescription drug benefits. I guess you have 
to look to other sources. I would prefer looking there.
  Mr. STARK. I thank the gentleman.
  Mr. CARDIN. Mr. Thomas, I now yield you the time to question the 
gentleman from California [Mr. Stark].
  Mr. THOMAS of California. Mr. Stark, in today's Washington Post there 
was a full page ad, an open letter to President Clinton from 565 
economists from all 50 States. They say, ``Mr. President, price 
controls produce shortages, black markets, and reduced quality. Your 
plan,'' the Clinton Plan, the plan we are discussing tonight, sets the 
fees charged by doctors and hospitals, caps annual spending on health 
care, limits insurance premiums, and imposes price limitations on new 
and existing drugs. These controls will hurt people and they will 
damage the economy. We urge you to remove price controls in any form 
from your health care plan.
  You have 2 minutes to tell me why these 565 economists from 50 States 
are wrong.
  Mr. STARK. Mostly, I read through the list, they were mostly second-
rate economists, and so I can understand, they wouldn't get their name 
in print any other way than to buy it.
  Mr. THOMAS of California. Mr. Stark, I did not ask you to cite their 
credentials. I asked you to tell me why.
  Mr. STARK. I saw the ad. I took the trouble to vet them out. They are 
not worth the paper that ad is printed on.
  Mr. THOMAS of California. Are they wrong?
  Mr. STARK. Of course they are wrong. They were put up to it by some 
right wing think tank.
  Mr. THOMAS of California. Does the President's plan limit insurance 
premiums, yes or no?
  Mr. STARK. That group was put up to that nonsense by some right wing 
think tank.
  Mr. THOMAS of California. No. Does the President's plan limit 
insurance premiums?
  Mr. STARK. Wait a minute. We are talking about that nutso group who 
put up----
  Mr. THOMAS of California. Yes or no, yes or no.
  Mr. STARK. They bought their own billboard because nobody else would 
pay any attention to them, and the gentleman got suckered into that.
  Mr. THOMAS of California. The question is, does the President's plan 
limit insurance premiums, yes or no?
  Mr. STARK. The President's plan would control costs through two 
methods, if the gentleman----
  Mr. THOMAS of California. Does it limit insurance premiums?
  Mr. STARK. The gentleman at the end of the table is reading it. I 
mean that the President limits coverage in two ways, controlling----
  Mr. THOMAS. He does limit insurance premiums. He does. Why are they 
wrong?
  Mr. STARK. The President limits fees for doctors and hospitals, and 
limits amounts paid as we do now under Medicare, as the gentleman well 
knows, for premiums for plans. It it a very good cost containment 
system, the same one the gentleman uses and helps me legislate with, 
over Medicare.
  Mr. THOMAS of California. Does the President's plan impose price 
limitations on new and existing drugs?
  Mr. STARK. I should certainly hope so, after the experience we have 
had with the ripoff of this AmGen Co., which is making unconscionable 
profits on people who need dialysis, unwilling to bargain with the 
United States, while we throw the taxpayers' money away at these 
unscrupulous profiteers in the drug industry. I should hope that the 
gentleman would have the wherewithal to want to protect the taxpayers--
--
  Mr. THOMAS of California. The gentleman agrees with these second 
class economists.
  Mr. STARK. The gentleman does not care about the taxpayer's money, it 
is obvious.
  Mr. THOMAS of California. You found something to agree with the 
second class economists.
  A key element of the Clinton plan is the herding of Americans into 
something called alliances. As you well know, the alliances are 
mandatory health plans, making illegal virtually all of the current 
health plans for Americans.
  If this is necessary, and first of all I would ask you if you believe 
the mandatory alliances outlined by the President are necessary, then 
why should people be forced into these plans? Do you believe they are 
necessary?
  Mr. STARK. The gentleman correctly states my position. I support 
alliances such as the CalPers plan in California, but not----
  Mr. THOMAS of California. That is not the President's plan.
  Mr. STARK. I do not find that it is necessary to mandate them, and I 
find that alliances, like managed care, grow quite well by themselves, 
thank you.
  Mr. THOMAS of California. So you agree, then----
  Mr. STARK. I would support making alliances and coops available to 
people to help them do what the President does. I don't think it is 
necessary to mandate them.
  Mr. THOMAS of California. So you don't support the President's plan 
forcing all Americans into alliances?
  Mr. STARK. I support the concept of collective buying and I support 
the concept of consumer empowerment. I don't think it is necessary to 
make it mandatory.
  Mr. THOMAS of California. And you don't support the President's plan 
in that regard?

                              {time}  2120

  Mr. STARK. That is correct.
  Mr. THOMAS of California. That key has controls, the structure which 
controls the flow of money, through which every American will be buying 
their health plans, you believe, is not a key element of the 
President's plan?
  Mr. STARK. I believe the key element is what is missing in your plan, 
and that is that every American gets health insurance, and you do not 
do that.
  Mr. THOMAS of California. In my plan----
  Mr. STARK. I believe it should control costs, and you do not do that.
  Mr. THOMAS of California. You are wrong; you are wrong.
  Mr. STARK. I believe that we should control quality, and you do not 
do that.
  Mr. THOMAS of California. You are wrong. I would love to take an hour 
on the floor discussing the Thomas-Chafee plan.
  Mrs. JOHNSON of Connecticut. I would love to take an hour on the 
floor to explain your plan does nothing.
  Mr. THOMAS of California. You are wrong.
  Mr. STARK. Which is at least what it would take.
  Mr. THOMAS of California. It seems to me that you would spend a 
little more time on the President's plan looking at the key elements 
like these compulsive, mandatory alliances which will force all 
Americans to give up their current insurance even if they are not part 
of the problem. But I am pleased to know the gentleman agrees with me.
  Mr. STARK. I skipped right over the mandatory alliances and looked at 
his goal, which is to provide health care to every American at a price 
they can afford and at a date certain with a benefit level that we all 
understand, which no other plan does.
  Mr. CARDIN. I now yield to the Republican team who may question the 
gentleman from California [Mr. Waxman].
  At this point, it might be good for me just to ask both teams, if 
they would, the time belongs to the questioning team, but if we could 
allow a little bit less interruption when the questions are being given 
and the responses are being made, it may facilitate the debate.
  The Republican team is recognized.
  Mr. BLILEY. Thank you, Mr. Moderator.
  Mr. Waxman, under the Clinton plan, every American who is currently 
insured will have to give up his or her health plan no matter how 
satisfied he or she may be with it. They will then have to go to this 
bureaucracy called an alliance and get their health insurance from the 
Government.
  Why should most Americans have to give up what they have in order to 
provide coverage for those that are uninsured?
  Mr. WAXMAN. The gentleman is absolutely incorrect about the 
circumstances for most Americans.
  All Americans under Clinton's proposal will have choices, and one 
choice they will have is to stay in the plan they now have if it meets 
the minimum benefit package, but people will have choices, because they 
will have an opportunity to go to a number of different plans, and 
those choices are evaporating quickly for the insured as they are 
forced into managed care, which is maybe not where they would like to 
have themselves and their families receive medical care; and people who 
do not have insurance, I can assure you, have no choice at all.
  Mr. BLILEY. If I have a plan with the Prudential Insurance Co. today 
under the Clinton plan, and I am satisfied with it, I would have to 
give that up and purchase a plan, one of the approved plans, from the 
alliance?

  Mr. WAXMAN. If your plan----
  Mr. BLILEY. Why should I have to do that?
  Mr. WAXMAN. If your plan meets the specifications of the benefit 
package, and there are a lot of plans out there now that are really 
pretty skimpy, but if your plan meets that benefit, then you may choose 
that plan. I think it is your right to choose.
  Mr. BLILEY. Let me----
  Mr. WAXMAN. People do not get a choice today, and President Clinton 
will give them that choice.
  Mr. GINGRICH. What you just said, let me say to my friend, and I 
notice what you just said, and it goes to the core, I think, of one of 
the major differences between our two sides.
  That is not if the plan is the one I want, not if the plan is the one 
my family likes, not if the plan is the one our doctor and hospital and 
we have created, if the plan happens to meet what the bureaucrats have 
decided under the National Health Board is OK, so is it not true that 
if they do not meet that criteria, every American, even if they are 
satisfied, would have to give up their current plan if it does not meet 
the criteria of the bureaucrats.
  Mr. WAXMAN. I am amazed how Republicans want to tell the American 
people to be afraid of something when they are so wrong about what the 
proposal would do.
  The American people should understand that they will have a choice. 
They will have the insurance plan that they want. They will have more 
than one choice. The Republican idea----
  Mr. THOMAS of California. No. Not that they want. No.
  Mr. WAXMAN. The Republican idea--and it will be affordable, but the 
Republican idea is that they should have to pay more out of their 
pockets in order to receive insurance coverage; if they do not have it, 
they still will not have it. There is nothing you will do for them.
  Mr. GINGRICH. Let me ask you, is it not true that in this bill, a 
State could establish by a vote of the State legislature a single-payer 
plan in which you would have no choices except those given you by the 
State legislature?
  Mr. WAXMAN. The gentleman is absolutely incorrect. The single-payer 
plan----
  Mr. GINGRICH. Have you read the plan?
  Mr. WAXMAN. I tell you, you are incorrect. You may not want to hear 
it, but you are wrong. A single-payer plan is Medicare. Medicare will 
pay to see any doctor you choose. If you want to sign up in an HMO, you 
can do it. It is a single-payer plan if the State chooses.
  Mr. GINGRICH. Wait a minute, page 108, if the State chooses, the 
State has chosen for you.
  Mr. WAXMAN. By the vote of the State legislature, duly elected 
legislature and Governor, may decide they can have everybody enrolled 
in a plan, enrolled in a system, where they would then choose whatever 
doctor or plan they want.
  Mr. GINGRICH. Let me suggest here, page 109, just so you know that I 
am not making this up: ``State law provides for mechanisms to enforce 
the requirements of the system. The system is operated by the State or 
a designated agency of the State.''
  Mr. WAXMAN. Do not get bogged down in reading words and 
misinterpreting them.
  Mr. GINGRICH. Let me finish.
  Mr. WAXMAN. If you agree with my principles----
  Mr. GINGRICH. Mr. Moderator----
  Mr. CARDIN. The time belongs to the Republican team.
  Mr. GINGRICH. Let me finish. Page 110, ``Mandatory enrollment of all 
regional alliance individuals.'' I am just pointing out to you the 
words, and here are not the words: ``choice,'' ``you control your 
own,'' ``you have any kind of control.'' The words in here are your 
Governor and your State legislature can take over your health and your 
insurance and define for you; what if, by the way, they decide not to 
contract with the Mayo Clinic; what if they decide not to contract with 
the Cleveland Clinic; what if they decide that you only get to go in 
your State to your local hospital? Would that be possible?
  Mr. WAXMAN. If the gentleman would permit me, let me clarify, there 
is a clear specification that all of the teaching hospitals and 
tertiary care centers will be a part of every plan. There are 
protections in there for needed community facilities to be in every 
plan.
  The alliances, which the President has as his proposal as to how to 
accomplish his goals, let us accomplish his goals any way we want, and 
his goals are to let every American get coverage for an affordable 
health care plan, and they will have choices, not the insurance company 
choosing for them, but choices that they make for themselves and their 
families.
  Mr. CARDIN. I now yield to the Democratic team to question the 
gentleman from Virginia [Mr. Bliley].
  Mr. GEPHARDT. Mr. Bliley, you were talking before about the question 
of choice. You were talking also about costs, and I would simply like 
to ask why it is that none of the Republican plans, except perhaps the 
plan by the gentleman from California [Mr. Thomas] and the gentlewoman 
from Connecticut [Mrs. Johnson], really tries to get everybody involved 
in health care, really makes an attempt. I do not agree entirely with 
the way they do it, but at least they have made an attempt. Why are you 
not for that?
  Mr. BLILEY. Why are you refusing to debate the question which is 
today the Clinton Health Plan? Why are you wanting to talk about the 
Republican plan? The Clinton plan is--we will take some time later and 
discuss any plan you want, but tonight we are discussing the Clinton 
plan.
  Why do you run away from it at every opportunity?
  Mr. GEPHARDT. We are not at all running away from it. I am very proud 
of it. I am happy to talk about it. But I get to ask you a question, 
and my question is: We are talking about elements of plans that get the 
job done.

  Mr. BLILEY. The elements of three plans.
  Mr. GEPHARDT. Why are you not for a plan that gets everybody involved 
with their responsibility to have health care?
  Mr. BLILEY. We are interested in getting everybody involved, but we 
do not believe that one size should fit all, that people should have 
the choice of who their doctors should be. We think people should not 
lose their insurance when they leave their job. They should be able to 
carry it with them.
  We believe that they should not have their insurance denied for a 
preexisting condition, or if they get sick. We believe that we should 
have serious malpractice reform.
  Mr. GEPHARDT. Mr. Bliley, you are a sponsor of the Michel plan. The 
Michel plan does not take care of preexisting conditions. It limits 
them, but it does not get rid of them. If you get sick while you, under 
your insurance policy----
  Mr. BLILEY. Well, I do not think, I say to the majority leader, I do 
not think any plan gets rid of a preexisting condition.
  Mr. GEPHARDT. The Clinton plan does.
  Mr. BLILEY. It does?
  Mr. GEPHARDT. It does.
  Mr. BLILEY. It cures people?
  Mr. GEPHARDT. It does. It gets rid of it.
  Mr. BLILEY. What is the cure for AIDS? Is it in here?
  Mr. STARK. The gentleman is brighter than that. The gentleman is 
listening to the chorus behind him. You are being confused by these 
people throwing answers at you. You are brighter than that, Mr. Bliley. 
No, sir, you know that a preexisting condition refers to an insurance 
term. The gentleman is hiding behind a corn pone vernacular that does 
not do him justice. He is a brilliant scholar, and I know that he knows 
that preexisting conditions refer to an insurance condition. Your plans 
do not eliminate preexisting conditions, and the President's plan does.
  Now, do you believe that we should limit insurance companies from 
using preexisting conditions to deny insurance, and if so, why do not 
any of your plans do that?
  Mr. BLILEY. The Michel plan does that. Read it.
  Mr. STARK. No. It does not. It simply does not.
  Mr. GEPHARDT. It does not. You can quadruple premiums if you get sick 
on the plan, while you are on the plan. Nothing in the Michel plan 
stops an insurance company from doing that. If there is one thing we 
need to do----
  Mr. STARK. The man behind you said page 13----
  Mr. BLILEY. Page 13, Mr. Majority Leader. Read it.
  Ms. DeLAURO. It furthermore allows you to charge more for older 
workers than for younger workers.
  Mr. BLILEY. Do you have a question, Ms. DeLauro?
  Ms. DeLAURO. It furthermore charges more for older workers, older 
people, than younger people. I am just saying that you make statements 
about the Michel plan that are absolutely wrong. You do not know what 
bill you have signed on to.

                              {time}  2130

  Mr. BLILEY. Page 13, it says no limit on preexisting condition. You 
cannot deny insurance for a preexisting condition.
  Mr. GEPHARDT. But it does not say they are prohibited from raising 
premiums on the people.
  Mr. BLILEY. We do not believe in price controls, you are exactly 
right.
  Mr. GEPHARDT. We believe that they should not be able to do it.
  Mr. STARK. There is a case of a woman in my district who is 8 months 
pregnant, had her policy canceled, and the company said, ``You may 
continue that policy for another month for $17,000.'' Is that what the 
Michel bill does? Is it not?
  Mr. BLILEY. No, no. Now, wait a minute, let me answer. May I answer 
the question.
  Ms. DeLAURO. Under the Michel bill, as a cancer survivor I could not 
be covered.
  Mr. BLILEY. Mr. Moderator, I ask for regular order, if you please. 
Mr. Stark asked me a question. Do I not have the right to answer before 
Ms. DeLauro interrupts? Thank you, Mr. Moderator.
  It does limit how much premiums can increase. So the sky is not the 
limit.
  Mr. STARK. But that is, in effect, not providing a limitation on 
preexisting conditions, is that not the case?
  Mr. BLILEY. Repeat the question.
  Mr. STARK. That does not limit preexisting conditions? That says you 
charge more for them, does it not?
  Mr. BLILEY. But it doesn't--it says you cannot deny. It certainly 
does, it says you cannot deny insurance.
  Mr. STARK. But charge more.
  Mr. BLILEY. It says you cannot deny, and it limits how much you can 
increase the premium.
  Ms. DeLAURO. Mr. Bliley, let me just quote the AMA to you, which 
says, ``The Michel plan will lead to lower-quality care because people 
will have a financial incentive not to use preventive care,'' that it 
threatens the quality of care, and in fact what it does is puts the 
burden on that individual.
  Mr. BLILEY. Well, what is your question?
  Mr. CARDIN. The gentlewoman will have the time to repeat the 
question, and Mr. Bliley will have 30 seconds to answer.
  Ms. DeLAURO. Do you agree with that? Mr. Bliley, do you agree with 
putting in danger people's health care, which is what the AMA says the 
Michel plan will do?
  Mr. CARDIN. Mr. Bliley will have an opportunity.
  Mr. BLILEY. That is why I am against the Clinton plan, because it 
rations care. It is the only way you can meet those caps. I believe 
your time has expired, and I am just using mine to respond to your 
question.
  It does not allow the rate to go above the CPI. No country in the 
Western world is able to control prices to that extent.
  Ms. DeLAURO. Mr. Bliley, that is not true.
  Mr. CARDIN. I now yield to Mr. Gephardt to question Mr. Gingrich.
  Mr. GEPHARDT. Mr. Gingrich, two of your colleagues who are debating 
here tonight are for a plan that I do not think you endorse, but it is 
a plan that at least tries to see that everybody gets covered. They 
have a family mandate to see that everybody is covered with insurance. 
I know there is a debate raging in your party, it probably was raging 
in Annapolis in your meeting with Members of the other body about 
health care about this issue.
  Can you come out for and work with us for a plan that insures that 
everybody is guaranteed private health insurance?
  Mr. GINGRICH. I would love to see the Clinton plan change so 
dramatically that we are talking about private health insurance and we 
are giving up the States that have single-payer and giving up the 
Government's mandatory allowances. But if you would be willing to back 
off from the Clinton plan and approach the issue of private insurance, 
I can assure you, just speaking for myself--and I can't speak for my 
good colleagues--but for myself I absolutely want to see that every 
American has coverage. I said in Annapolis I believe we should do 
everything we can to get coverage.
  But I would make this point to my friend: When you say to us the only 
way--and by the way, you are the first Democrat I have heard who has 
admitted that there are Republican plans which get us to universal 
coverage, that there are Republican alternatives that do not have a 
national health board, do not have a mandatory Government bureaucratic 
alliance, do not require the Clinton multiple-page complexity but in 
fact get to universal coverage. I appreciate your recognition of the 
Republican contribution. We would be delighted to work in a bipartisan 
manner to try to write a genuine free-market bill with personal 
responsibility and with families having a real choice which sought to 
get every single American an opportunity to buy health insurance. I 
would be glad to start that tomorrow.
  Mr. GEPHARDT. Mr. Gingrich, we are making progress now.
  Let us tease it----
  Mr. GINGRICH. I am not sure that that is part of your debate program.
  Mr. GEPHARDT. Let's go a little further because I think this gets to 
the heart of the matter. We are here tonight to talk about goals and 
elements of the plan that we think are very important. I know you want 
us to defend every word on every page of the bill. And that is fine, 
that is a great debate technique. But let us get down to what this is 
about. We care, and I know you care, about getting every American 
family to have guaranteed private insurance that cannot go away. We 
care about it, and I think you care about it. Two of your colleagues 
have had the courage to come forward with a plan that has unpopular 
features in it in order to get that done. And we have got what I am 
sure can be unpopular features, in order to get that done in our plan.

  The truth is, if we are going to get this done, leaders like you in 
your party I think have to come out for plans like that so that we can 
begin this discussion to get down to brass tacks. Are you willing to do 
that?
  Mr. GINGRICH. But I am so shaken when I see, as I did in the morning 
paper, your assertion that you would have to pass the plan with only 
Democratic votes. I am so disheartened when I see your side not willing 
to work with us on a bipartisan basis, that it is hard for me to 
respond to that the way I would like to.
  But I can assure you that if you would really like to work together, 
I am prepared to say let us start with, I think, the plans that are 
already out here that I think are bipartisan.
  I look at the Bilirakis/Rowland plan, I look at the Cooper/Grandy 
plan. I certainly look at the Thomas/Chafee plan. If you are willing to 
start with those plans as a beginning point, I think together we could 
be creative in finding a solution.
  What I cannot do, I say to my friend, it is not just that these are 
little points; the American people have learned painfully that big, 
thick bills become even bigger and thicker regulations and they need to 
long jail terms. This is not always obvious to everybody in public 
life, but you are actually supposed to obey these laws. In that 
context, it is dangerous for the Congress to just pass lots and lots of 
regulations that even very well-informed lawyers may not fully 
understand and be able to obey.
  Mr. GEPHARDT. Mr. Gingrich, are you for compulsory auto insurance, do 
you think those are good laws?
  Mr. GINGRICH. I think in the average State which has compulsory auto 
insurance, 40 percent of the people do not in fact have auto insurance. 
I think that is a fact. I think in the District of Columbia, which 
theoretically has compulsory auto insurance, 40 percent do not have 
auto insurance. We have to quit lying to ourselves about the power of 
Government to play King Canute and tell the waves to quit coming in, 
because the States that have had compulsory auto insurance, their 
insurance costs have gone up and the number of people who fail to get 
insurance has gone up.
  Mr. GEPHARDT. Are you for the Medicare plan? Do you want to get rid 
of it, or do you think we ought to keep it?
  Mr. GINGRICH. I think we should keep the Medicare program, and I 
think we should increase the opportunities for Americans under Medicare 
to get even better care with even a broader range of choice with less 
red tape and less bureaucracy, which is why I oppose going in the 
opposite direction and adding more red tape and more bureaucracy.
  Mr. GEPHARDT. I think we are out of time.
  Mr. CARDIN. The time has expired.
  I now yield to Mr. Gingrich, who will question Mr. Gephardt.
  Mr. GINGRICH. Let me start, I guess, with what I find to be the most 
puzzling part of the whole experience. You and I in a couple of weeks 
will be going to Russia on a second trip to try to say to the Russians 
less bureaucracy, less centralization, less Government control, more 
marketplaces, more incentive, more entrepreneurship.
  In that context, beyond the debating points, does it not worry you to 
be setting up a national health board--I do not have the exact number 
at my fingertips--with something like 17 new mandates in this bill? I 
could cite them if you doubt it. Does it not worry you that the 
design--and I sympathize with the goals and I know it is hard to come 
in as a brand-new Administration with all the paperwork and confusion 
to try to actually write a bill like this. But doesn't it worry you 
that the Clinton bill is in fact everything we are telling Boris 
Yeltsin to quit doing?
  Mr. GEPHARDT. Mr. Gingrich, I have said many times that what we have 
got to look at here are goals. There are certain things we have got to 
try to get done. What we need to talk about more honestly, I think, 
with one another is how it is best to do that. How can we get certain 
things to actually be accomplished?
  Back in 1978 I agreed with Republicans and together we defeated Jimmy 
Carter's hospital cost containment. We said at the time that we ought 
to have competition. I led the effort with Republicans to defeat a 
Democratic President's plan because I thought it was not the right 
plan. What has happened in the last 15 years since we did that?

                              {time}  2140

  Prices have skyrocketed, competition hasn't been fair and equal, we 
haven't been on a level playing field, and now we come back to these 
questions, and I'm willing to criticize a stand that I took 15 years 
ago. I think I made a mistake. I think we have got to look at ways to 
do these things, and all I ask you to do--how do we get prices down? 
How do we actually get people involved in health care?
  Mr. GINGRICH. I'll give you an answer.
  There are a lot of ideas that are market oriented. The medical 
savings account, for example, lowers the cost by some 30 percent when 
tried by Forbes magazine and Golden Insurance Co. The Steel Case Co. in 
Michigan did a 5-year effort in preventive care. They lowered their 
costs by 35 percent. There are many ways to have a free market with 
free people making free choices because I think the American people are 
pretty smart.
  Mr. GEPHARDT. Mr. Gingrich, we had a free market for these 15 years--
--
  Mr. GINGRICH. We haven't had a free market----
  Mr. GEPHARDT. We have had a free market. Your bill doesn't do 
anything, so----
  Mr. GINGRICH. We certainly do. We move in exactly the direction of a 
fair market, but let me ask you a question about the plan you're 
supposedly defending tonight.
  If you look at this plan, and particularly pages 25 and 109, 110 and 
674, it spells out how senior citizens can be forced out of Medicare 
and be forced to buy this new alliance insurance even if it would be 
different in their State than it would be in the rest of the country. 
So, if you happen to be in one State, and the State government adopted 
this new system for that one State, you could be getting totally 
different care if you moved across the State line.
  Do you really think we should adopt a bill which coerces senior 
citizens in a single State and gives them no choice about what would 
happen to them?
  Mr. GEPHARDT. I just think your characterization of what the bill 
calls for is completely wrong. Medicare recipients gain under the 
Clinton plan. Medicare recipients today can choose the doctor they 
want, they can choose the plan they want. If a State decided to have an 
alliance, and they were going to choose through the alliance, they 
would have the same choices available they have today.
  Mr. GINGRICH. That's completely inaccurate.
  Mr. GEPHARDT. You use scare words like coercion. Nobody is coercing 
anybody to do anything, plus we're trying to help people have 
prescription drugs paid for by the plan, something that none of the 
Republican plans do.
  We enhance Medicare. We increase the benefits of Medicare. We make 
Medicare better than it is today. What's wrong with that?
  Mr. GINGRICH. What I'm saying to you is, if you read starting on page 
109, a single State can design a system totally different than the 
State next to it and could say that you have much fewer choices as a 
senior citizen.
  Mr. GEPHARDT. That's just not true. It's not true.
  Mr. GINGRICH. I'm reading from the plan.
  Mr. GEPHARDT. Well, you're reading it wrong.
  Mr. GINGRICH. It says--I'm reading it wrong?
  Mr. GEPHARDT. You're reading it wrong.
  Mr. GINGRICH. It says operate a single payer system. It establishes 
how they set us, and it says again--let me read the key line, page 110. 
Quote. And notice whose option it is.
  All right; I'm quoting now so I'm not reading it wrong:

       At the option of the State the system may provide for the 
     enrollment of Medicare individuals residing in the State.

  Mr. GEPHARDT. That's the same thing they have today. If you're in 
Medicare, and I know you hate the word government----
  Mr. GINGRICH. Nobody can be forced by the Governor of Georgia to 
leave Medicare and join----
  Mr. GEPHARDT. You're for government. You say you're for our 
Government. Medicare is a Government single payer system, and that's 
what it is, and people like it, and you're for it, and you say you're 
going to appeal it----
  Mr. GINGRICH. I said the senior citizens of America, over 50 State 
governments, 50 State legislatures, particularly given, frankly, what 
we know about corruption in some States, why should we turn people over 
to those State governments?
  Mr. CARDIN. The time expired.
  I now yield to Ms. DeLauro to question Mrs. Johnson.
  Ms. DeLAURO. Congresswoman Johnson, you propose that we reform health 
care to reward, and I quote, wellness actions. It's what I think you 
call it. You want variable premiums that promote healthy behavior, and 
I'm quoting you. So, substance abuse, tobacco, overweight, 
underexercise, those are measurable things that, if we develop this 
approach sufficiently, we ought to be able to check on whether people 
are, in fact, doing what they say. To me this sounds like big 
government and, if you will, government at its worst, a real invasion 
of privacy that I don't see how any person can tolerate.
  But I believe, and I just ask you, isn't it really the logical 
extension of a philosophy that blames people for their health care 
problems and does not blame industry for the problems that we have 
today?
  Mrs. JOHNSON of Connecticut. I'm delighted to answer that question. 
In fact only a Democrat could possibly read that statement of mine and 
assume that I wanted government to set those premiums on that basis.
  Absolutely I don't want government to set the premiums. I want the 
private sector to have the right to say if you're a nonsmoker, you pay 
less for health care. You bet I do. And that Steel Case example that he 
just gave where they cut health care costs by 35 percent; you know how 
they did it? They gave individual members, employees, the option to 
participate in wellness programs, and, if they did, they got not only 
direct bonuses, but they also got lower premiums.
  Ms. DeLAURO. I think----
  Mrs. JOHNSON of Connecticut. That's----
  Ms. DeLAURO. I think your point on tobacco is good.
  How would you deal----
  Mrs. JOHNSON of Connecticut. My point on wellness was----
  Ms. DeLAURO. If I might, how would you deal with overweight and 
underexercise? How would you find, how would you find----
  Mrs. JOHNSON of Connecticut. I--Rosa, the difference between you and 
me----
  Ms. DeLAURO. Look around this Chamber.
  Mrs. JOHNSON of Connecticut. The difference between you and me is I 
wouldn't dictate it. I would allow companies to say, ``You participate 
as Steel Case did. You participate in exercise class once a week, and 
you get lower rates before that''----
  Ms. DeLAURO. So we'll have an exercise police and an eating police to 
find out who is doing what and how----
  Mrs. JOHNSON of Connecticut. No, that's not government doing it, 
Rosa. It plans on offering it and people taking up the options to 
voluntarily lower their health care costs through their own wellness 
actions.
  Ms. DeLAURO. But, as I say, it is a philosophy that says that people 
are to blame for the problems of health care----
  Mrs. JOHNSON of Connecticut. Oh, no, it's a philosophy----
  Ms. DeLAURO. And not the industry today.
  Mrs. JOHNSON of Connecticut. And people have power.
  Now the reverse side is that you don't want people who are nonsmokers 
to pay lower premiums when they are willing not to smoke. You want them 
to carry the burden----
  Ms. DeLAURO. To talk about the people who are overweight and 
underexercised.
  Mrs. JOHNSON of Connecticut. You want young people to pay higher 
premiums because what you're saying, this is an important element of 
the plan. You support community rating. I supported tests of community 
rating. Community rating says young people have to pay higher premiums 
so their parents can pay lower premiums. They have a tough enough time 
as it is, Rosa. Why don't you give them a break because----
  Ms. DeLAURO. Mrs. Johnson, every plan that you are on does--deals 
with--continues to have lifetime limitations, does not exclude 
preexisting conditions----
  Mrs. JOHNSON of Connecticut. Absolutely.
  Ms. DeLAURO. Discriminates against older workers versus younger. 
There's even a plan that by occupation the premiums can be rated.
  Mrs. JOHNSON of Connecticut. Congresswoman DeLauro, for the public's 
information, in the past we have allowed rates to vary according to 
about five factors, one of which has been a place of work which we now 
exclude, one of which has been medical risk which we now exclude, but 
we don't want rates to vary by age because otherwise young people have 
to get the cost shifted on to them of older people. They are carrying 
Medicare and Social Security already. Why should they carry their 
parents----
  Ms. DeLAURO. Mrs. Johnson, a primary element of the Clinton plan is 
to provide guaranteed private insurance to everyone----
  Mrs. JOHNSON of Connecticut. You bet it is.
  Ms. DeLAURO. Private insurance to everyone where the insurance 
companies cannot discriminate against anyone based on age----
  Mrs. JOHNSON of Connecticut. Right.
  Ms. DeLAURO. Gender, occupation, illness, or anything that they can 
come up with----
  Mrs. JOHNSON of Connecticut. And it's typical----
  Ms. DeLAURO. To say no in terms of coverage.
  Mrs. JOHNSON of Connecticut. In answer to your question do I support 
body rating, it's big government telling us that the private sector can 
say to people, ``If you don't smoke, you can pay less; if you're 
younger, I'm not going to shift costs''----
  Ms. DeLAURO. Mrs. Johnson, anyone who would want to monitor people's 
eating habits and their exercise habits, have government doing it, is 
really going to talk about----
  Mrs. JOHNSON of Connecticut. I'm saying rewards, incentives----
  Ms. DeLAURO. And in order to----
  Mrs. JOHNSON of Connecticut. You bet----
  Ms. DeLAURO. And I would like to see who it's going to be when 
government has the eating police and the exercise police to monitor----
  Mrs. JOHNSON of Connecticut. Typical Democrat, you can't imagine that 
anybody could do this without government. I'm not setting the rates for 
the private sector. I'm just saying you can't medically underwrite, you 
can't exclude people with preexisting conditions, you can't increase 
the rates more than a very modest amount from year to year, and you 
have to take anyone who wants to buy your plan for the very same 
premium. That's insurance----
  Ms. DeLAURO. Time is up.
  Mrs. JOHNSON of Connecticut. And, by gum, if you had supported me 
then we could have solved those problems.
  Mr. CARDIN. We are not going to switch. In case people did not 
recognize it, now we are going to have Mrs. Johnson question Ms. 
DeLauro.
  Mrs. JOHNSON of Connecticut. Well, she asked me my first question, so 
that makes it real easy.
  The President's plan recognizes that small businesses are going to 
have a tough time paying the premiums and offer subsidies. How does the 
gentlelady from Connecticut rationalize supporting a plan that will not 
offer subsidies to Connecticut's small businesses because there isn't 
any small business in Connecticut that has an average wage of $12,000 
so we are cut out of the 3.5-percent premium subsidy category?
  Ms. DeLAURO. Well, as a matter of fact, in terms of Connecticut 
business people because----
  Mrs. JOHNSON of Connecticut. Answer the specific question. Do you 
support small businesses not getting subsidies because the Federal plan 
isn't structured to recognize Connecticut's needs?

                              {time}  2150

  Ms. DeLAURO. Mrs. Johnson, let me answer the question of small 
businesses. The issue is Connecticut in fact, and we have a good State 
that we both come from, that has a lot of our businesses today who do 
cover their workers.
  Mrs. JOHNSON of Connecticut. All but 7.6 percent.
  Ms. DeLAURO. And they are terrific at that. Which means in fact that 
when you can provide an opportunity for those businesses, who in fact 
now are subsidizing those businesses that are not covering their 
employees, you are going to provide these businesses and these 
employers with an opportunity to see their rates lowered, their 
premiums lowered, and in fact save money.
  Mrs. JOHNSON of Connecticut. We have been devastated by a recession. 
Our small businesses need subsidies if they are going to have to 
provide better benefits. The President's bill will check them out of 
the subsidy plan, and you support that bill.
  Ms. DeLAURO. Employers who already offer insurance, this is in the 
State of Connecticut, will pay $1.1 billion less in premium payments in 
the year 2000 than they would without comprehensive reform, $805 less 
per worker for 1.8 percent of payroll. I think I have answered your 
question.
  Mrs. JOHNSON of Connecticut. Isn't it odd that study didn't use the 
Congressional Budget Office figures? It used some weird model no one is 
familiar with? If we use Congressional Budget Office figures, we don't 
save money. We cost money.
  Ms. DeLAURO. I would be happy to use Congressional Budget Office 
figures in reference to small businesses, which is very, very clear in 
saying in fact employers are going to see health costs go down, and in 
fact that employers might be able to provide increased wages and we 
will see even a creation of jobs. And you know and I know how important 
that is to the State of Connecticut.
  Mrs. JOHNSON of Connecticut. And, of course, Congresswoman DeLauro, 
since small businesses in Connecticut will not be qualified for the 
subsidies, they will have to close, rather than expand. Let me just 
finish. You had quite long time.
  Ms. DeLAURO. You are supposed to be asking me a question. Let me 
answer.
  Mrs. JOHNSON of Connecticut. Small businesses in Connecticut won't 
qualify for the subsidies in the President's plan. That is the subsidy 
structure that you support. And we won't qualify because our average 
wages are too high. But our profit margins are zero, because we are in 
such a recession.
  Ms. DeLAURO. I got a call about 2 days ago from Harry Pappas. And you 
can call Harry up. He runs a cleaning business in New Haven, CT. Harry 
received a package from the National Federation of Independent 
Businesses. The sole purpose of him giving me a call was to say Rosa, 
do not support the President's plan. They also sent him a worksheet. 
Wait a minute, let me finish.
  Mrs. JOHNSON of Connecticut. It is my questioning time, and you are 
taking it from me. You are taking so long. Get to the point.
  Ms. DeLAURO. Harry filled out the sheet, and, lo and behold, he found 
out he was going to save 37 percent on his health care cost. He called 
me and said Rosa, support the Clinton health care plan.
  Mrs. JOHNSON of Connecticut. A whole chain of small businesses from 
Connecticut testified before the Ways and Means Committee 3 days ago.
  Ms. DeLAURO. We are talking about different small businesses in 
Connecticut.
  Mrs. JOHNSON of Connecticut. It would push his costs up 
extraordinarily and send five of his companies at risk out of business. 
When the President says small businesses can't afford this, that is why 
we have to subsidize them, and when Connecticut small businesses won't 
qualify for any of those subsidies because of the way the President 
structured them, don't you believe for a minute that our small 
businesses making zero profit are going to increase their insurance.
  Mr. CARDIN. Let Mrs. Johnson please complete the question.
  Mrs. JOHNSON of Connecticut. You support a bill with mandatory health 
alliances. Mandatory health alliances will force the purchasing of 
insurance to move on to a State-by-State business basis, individual-by-
individual. This will cause Connecticut to lose clearly and quickly 
thousands of jobs, because we have thousands of people who are doing a 
very efficient job of purchasing insurance for millions of Americans in 
a very quick and efficient fashion.
  How can you support a bill that not only will hemorrhage jobs out of 
Connecticut, but will increase the overall cost of the purchasing 
operation of insurance?
  Ms. DeLAURO. Let me talk about the whole issue of alliances, which 
has been referred to tonight over and over again.
  Mrs. JOHNSON of Connecticut. I asked you about the job impact in 
Connecticut. That is my question, and you have 30 seconds additionally 
to answer it.
  Mr. CARDIN. We are well beyond the 5-minutes of this section. Ms. 
DeLauro may respond.
  Mrs. JOHNSON of Connecticut. The time is out. The question is jobs in 
Connecticut from the health alliances. They will be hemorrhaging.
  Ms. DeLAURO. You are wrong. You are absolutely wrong. I don't care 
what you call it. You can call it Rural Electrification, the Grange, 
Farmers' Co-op, you can call it whatever you want. Let us focus in on 
what the purpose is of having a mechanism that says small businesses 
gather together so in fact they have a better purchasing power. You let 
the little guy have more buying power.
  Mrs. JOHNSON of Connecticut. Jobs in Connecticut, the health 
alliance, but purchasing alliance, which I introduced 3 years ago.
  Mr. CARDIN. Everybody can relax a little bit now. We have finished 
the portion of the debate in which teams or Members will question each 
other. We will now have the closing arguments. I would first yield to 
Mr. Gingrich for the closing points.
  Mr. GINGRICH. Let me thank our friend from Maryland for being the 
moderator tonight. I think this has been a useful experiment, and we 
will find out over the next day or two if our colleagues think it is 
useful to have eight of us down here doing this sort of thing.
  I wanted to make three points. The first is I was on a college campus 
in Georgia. A women got up, a student, who was a native American, and 
she said she had to speak out, that if every American understood how 
bad Government health care is on the Indian reservations, they would 
not tolerate the idea of extending Government medicine to everyone 
else.
  It was a very moving and very powerful point, that here we are, not 
able to have public schools that work in the inner city, not able to 
provide safety to our children, not able to have Government that 
functions in all of its current duties, and we have a proposal in a 
massive bill to extend to every American a Government bureaucracy 
controlled from Washington, with decisions made by people appointed by 
politicians.
  Second, I wanted to make the point that this is all real. This is not 
a debate at Oxford. This is not a set of nice resolutions or goals. I 
can agree to most of the goals my Democratic friends have. This bill 
would put into place some truly bizarre things.
  If you take a look at the details, and I keep citing the bill because 
that is what becomes law. On page 120, it says that none of the board 
of directors, none, can be a health care provider, an individual who is 
an employee or member of a board of directors of a health care 
provider, a health plan, a pharmaceutical company, a supplier of 
medical equipment, a person who derives income from provision of health 
care, a member or employee of an association, law firm or other 
association. It goes down through for a page saying that if you know 
anything about health care, you can't serve on the boards.
  Later they develop this brand new monstrosity called a National 
Council on Medical Education, totally appointed by the Secretary of 
Health and Human Services, who is of course appointed by the President. 
So they are all political appointments. This national council will be 
able to decide how many black doctors, how many Asian doctors, how many 
women doctors, how many Polynesian doctors.

  This is a level of Government control that is just wrong. It is not 
what America is about. We want to work on a bipartisan basis for a bill 
that has the private sector, personal choice, personal responsibility, 
and a chance to create a better America, not a chance to turn America 
into a giant German Bureaucracy.
  Mr. CARDIN. I now recognize Mr. Gephardt for a closing.
  Mr. GEPHARDT. I want to start my closing with a story tonight. 
Twenty-one years ago, almost this month, my son was diagnosed with 
terminal cancer, and I remember talking to the doctors in the hall that 
night when he was diagnosed and thinking that we didn't have a chance. 
But in the months ahead, because of their work and their dedication and 
nurses and doctors in hospitals all over the country, we worked with 
him, and he prayed. And tonight he is alive. He graduated from college 
last May.
  We were lucky. We had insurance. We were covered. There are so many 
people that were in the hospital with us had kids with cancer who 
didn't have coverage, because they couldn't afford it.
  I have thought many times if he had gotten cancer today, would we 
have been able to afford it? I was a young lawyer in St. Louis. I 
didn't make a lot. Could we afford it today? Would he have had 
coverage?
  Would he have been able to get treatment under the preexisting 
conditions rules that are in many policies today?
  I am not sure he would. He called me the other night. He still has 
lots of problems from his cancer. He got a job after he graduated from 
college, and he was telling me he was afraid to go to the doctor to get 
these problems taken care of because there was a preexisting condition 
clause in his policy now. He has got to wait 6 months before he is 
covered.

                              {time}  2200

  We can do better than this. Back in the time of the Depression, the 
Democratic Party came forward and said, we have to have Social 
Security; people have to have a pension.
  We came forward with, yes, a government program, and you called it 
socialism and a dictatorship.
  But when the votes came here, you joined with us and a majority of 
Republicans voted for this program. The same thing happened in 1965. 
You are a great party, and you are good people. And you want this 
country to do well. You are better than this. You can do better than 
this.
  Let us have plans like the Thomas and the Johnson plans. Let us talk 
about a compromise. Let us do this for the America people. We can do 
it. It is the right thing to do: Affordable health care, guaranteed 
private insurance that never goes away, choice, and protecting 
Medicare.
  Let us join together and make it happen for the American people.
  Mr. CARDIN. First, let me congratulate the eight participants who 
were willing to subject themselves to this debate. This is an 
experiment. It is the first of its kind on the floor of the House. 
Obviously, we are feeling our way in certain respects.
  I want to thank all eight of you for your participation. There will 
be those will speculate as to who won this debate.
  I think in a very real sense the House of Representatives has won 
this debate, because this type of spirited debate can only improve the 
way in which we do the people's business here in the House of 
Representatives. I also think that the American people have won in this 
debate, for they have had a opportunity to witness different views on 
health care reform in a very democratic setting, and that can only help 
in raising the image of this body in the eyes of public.
  Last, I think the issue of health care reform has been advanced by 
this type of a debate in which the differences can be explained. And 
hopefully, we will be able to find a common ground for the enactment of 
health care reform.
  So on behalf of all the Members of the House of Representatives, I 
would like to thank the eight participants for living up to the highest 
traditions of the Members of the House of Representatives.

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