[Congressional Record Volume 140, Number 48 (Thursday, April 28, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: April 28, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           UNIVERSAL COVERAGE

  Mr. McDERMOTT. Madam Speaker, it is my hope, legislative business 
permitting, to talk to the American people every week about one issue 
in health care reform and how it will affect them personally.
  I want to talk to the American people tonight about an aspect of 
health care reform that the President has made the measuring stick of 
every proposal--universal coverage.
  Tonight, we need to talk about why every American, not just the 
uninsured, needs universal coverage. And we need to talk about what 
exactly universal coverage means.
  Universal coverage means every American always has health insurance, 
insurance that can never be taken away. No matter how your job changes, 
or whether you are a homemaker or self-employed or work part-time or 
lose a spouse or move, your health insurance is constant. It is 
something you can count on.
  It also means that the health insurance you get is substantial enough 
to give you real security.
  If you can still go bankrupt from health care bills, it's not real 
security--and it's not universal coverage.
  Universal coverage is a two-word concept. Not only must it include 
everyone but the coverage has to be generous enough to really protect 
people.
  Universal coverage means real protection so if you lose your job or 
get sick or are in an accident or give birth to a handicapped child, 
you know you can still get the health care you need without going 
broke--and without worrying about it.
  Universal coverage means everyone--everyone--is in the system so 
there are no more games about who gets care under what circumstances 
and where.
  And no more games where you get coverage if you meet one definition 
but if you life changes, you don't get that insurance anymore.
  If everyone is in the health insurance system--and we all know 
everyone is in--then we don't have to waste any more time, and money, 
and paper trying to figure out who gets what--and for how long.
  So why do you and your family need universal coverage? Because right 
now most Americans are just one pink slip away from losing his or her 
health insurance.
  Right now, if you lose your job, you lose your health insurance. So 
you not only have to worry about getting a new job and having some 
income, but you have to worry that if your child gets sick you may not 
be able to get her the care she needs.
  If your company cancels or cuts back on the benefits it offers in its 
health insurance package--you and your family are at risk.
  Right now, if you change jobs or go out on your own in business, you 
may lose your insurance.
  Right now, very few people in this country can say with certainty 
that they absolutely will have health insurance a month from now. We 
are the only people in the industrialized world who do not have that 
certainty. Universal coverage is the only way to get that certainty.
  But there is another reason to have universal coverage. As a nation, 
we simply cannot afford to do without it.
  The poet John Donne said, ``No man is an island unto himself.'' 
Nowhere is this more true than in health care.
  Because we don't have universal coverage, everyone who has health 
insurance pays a higher premium.
  Because we don't have universal coverage, people get care too late, 
in emergency rooms, where it costs much more money than it would if 
they had had timely primary care.
  And hospitals then look for someone else to pick up the tab. Our 
whole economy is playing a shell game with health care costs, trying to 
shift them around to different people who pay.
  It's called cost-shifting--getting someone else to pay for the people 
who can't--and it costs the American people a high price.
  We will never be able to control health care costs until we have 
universal coverage. It's that simple. To slow the growth of health care 
costs, we must have universal coverage.
  Every other country in the Western world has lower costs than we do, 
many have better care, and they all have universal coverage.
  Universal coverage is the house of health care reform. We all know 
that it is better to own your own home than to rent an apartment. But 
what usually keeps people from buying their own homes? The down 
payment.
  We have to come up with a down payment--the way to get into the 
house--or, as a nation, we will just have to keep on renting this 
inadequate and over-priced apartment.
  An apartment that is too small, that doesn't suit our needs, that 
drains our resources and keeps us from ever being able to afford the 
house.
  So how do we get into the house? There is no question that the 
cheapest, the quickest, the most efficient way to get into the health 
care house is through single-payer reform.
  This is the way every other country in the industrialized world got 
into the house, and they are living there much more comfortably than we 
are in our poor apartment.
  Single-payer is the way to absolutely guarantee 100 percent universal 
coverage within 1 year. Even Senator Durenberger, who is not a single-
payer supporter, acknowledged that only single-payer could achieve full 
universal coverage with every ``i'' dotted and every ``t'' crossed.
  Only single-payer guarantees unrestricted free choice of provider and 
eliminates insurance company interference in the physician/patient 
relationship. Only single-payer guarantees that you can have a lifetime 
relationship with your doctor if that is your choice.
  Only single-payer provides complete benefits including preventive 
care, all outpatient and hospital services, prescription drugs, 
children's dental care, mental health services, and comprehensive long-
term care. It takes care of the ``coverage'' part of universal 
coverage.
  How is single-payer able to do all this? Very simply.
  If Americans paid their health insurance premiums to a single 
national health security fund instead of to all their different 
insurance companies, and then that single national fund reimbursed 
health care providers directly for their services the way insurance 
companies do now, we would save enough money on insurance 
administration to pay for universal coverage and comprehensive benefits 
for all Americans.
  With single-payer, we get to universal coverage immediately. So don't 
let anyone tell you we have to phase it in over 5 years, or to the end 
of the century, or beyond.
  We don't need to wait that long. And remember, every year we postpone 
it, we lose money because we can't control costs. Every year it will 
cost more to fix the problem. Every year more people will lose their 
insurance and we will all have more to worry about.
  And every year universal coverage is delayed, the chances are greater 
that something will intervene in Congress to just keep on pushing it 
back. We will simply lose it.
  We can have universal coverage by 1997, and the American people 
should settle for no less.
  When we look around the world and reflect on the events of the last 
few years, we see historical developments of almost biblical 
proportions. The Berlin Wall has come down and Russia is a struggling 
democracy.
  Unbelievably, South Africa has ended apartheid and is completing its 
first nationwide democratic election.
  Our fellow industrialized countries are climbing--and scaling--the 
Mount Everests of political challenge.
  Compared to the challenges these nations have embraced, the 
difficulty of reforming our health care system so that we can finally 
get everyone into it is so small. It is not Mount Everest. It is not 
even a hill.
  We are the greatest nation in the history of the world. We are the 
richest and we are the most democratic.
  To say that we cannot do something as relatively simple as to get all 
our citizens into the largest health care system in the world in less 
time than it took for DeClerk to end apartheid or Gorbachev to bring 
down the Berlin Wall is unworthy of the American people.
  Since when are the American people so weak or so small that we cannot 
meet our own challenges?
  We have witnessed ordinary people around the world in the 
transformations of recent years and weeks rise to the stature of 
giants. The American people are every bit their match and we should 
never concede otherwise.
  I urge all of you who want the guarantee of universal coverage for 
yourselves and for your families to insist on universal coverage by 
1997 so that we can finally move into the house that will give us 
security for the future.

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