[Congressional Record Volume 140, Number 51 (Tuesday, May 3, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. BENNETT. Mr. President, I thank my colleague from Georgia for his 
courtesy and his leadership in helping us organize the dialog on this 
issue that has proved to be so vexing as the Congress addresses the 
challenge of health care.
  I give full credit to the President of the United States for his 
having raised the issue and putting it high on the agenda. There is no 
question that it is a problem in our country. I disagree with those who 
say there is no crisis in health care because no one is dying because 
they cannot get to a hospital. That is a very limited definition of 
``crisis,'' in my view.
  We have people who are locked in jobs that they do not like because 
they are afraid they would lose their health coverage if they leave. We 
have people who cannot get the kind of insurance that they need because 
of preexisting conditions. We have financial hardship of great degree 
because of the inability of our present system to meet every 
circumstance.
  Taken together, all of these problems create, for me, a sufficient 
difficulty as to be considered a crisis. So I do not join with those 
who attack the President for even raising the issue, and I give the 
President the full credit for the leadership he has exercised.
  At the same time, Mr. President, I want to point out the magnitude of 
the task the President has assumed. We are talking here about an 
activity that consumes one-seventh of our total economy, a number 
approaching a trillion dollars worth of economic activity every year. 
On the face of it, does it seem logical that the Congress can fix all 
of the problems in a trillion dollars' worth of economic activity with 
a single bill, in a single year? I think not.
  I think the situation is so serious, the circumstances so 
overreaching throughout the economy, that we should move with great 
caution to turn the whole present system on its head. Or, just as I 
said earlier, though there may be a crisis, there is not an emergency. 
Some people may say these are semantic differences. But the fact is 
that the present system is indeed, for all of is problems and 
difficulties, taking care of the health care needs, according to the 
surveys, of somewhere between 70, 80, maybe even 85 percent of our 
citizens. Do we want to jeopardize the health care that is being 
delivered satisfactorily to over 80 percent of our citizens with hasty 
action that is ill-considered, that would lead us in the direction, we 
would hope, of taking care of the rest? The problem is we may end up 
jeopardizing health care for everyone if we do it in too slipshod and 
too hasty a fashion.
  These are my objections to the President's proposal.
  No. 1, it assumes that the whole system can be solved with a single 
bill in a single Congress. I have addressed that.
  No. 2, it is based on assumptions that are now 2, maybe even 3 years 
old. In some industries, that would be fine, but in the health care 
circumstance, the way we deliver medicine and health care in this 
country is changing so rapidly, that a 3-year-old knowledge base on 
which to build legislation is already obsolete. Medical procedures that 
were ordinary 3 years ago have been rendered obsolete by new 
discoveries, and costs have come down that render the old cost trends 
and predictions illogical and improper. Yet, all of the assumptions 
that went into the creation of the President's plan are locked in place 
as of the time that task force first met.
  Finally, there is no acceptance in the President's plan of the power 
of market forces. Many people say: Well, you cannot deal with market 
forces in health care because people do not make market-type decisions 
when they are sick.
  That is true to a certain extent. But one of the factors that must be 
included in any such discussion is the inevitability of market forces 
on any economic circumstance.
  We have sayings engraved around this Chamber. With the help of the 
President pro tempore, I finally deciphered all four of them. I give 
each one my full support.
  What I am about to say may not be as profound as the ones that are 
here, but this, too, is a truth I wish we had engraved in stone 
somewhere, which is: ``Governments cannot repeal the law of supply and 
demand.'' Yet we try. Over and over again, we try to repeal the law of 
supply and demand by governmental decree.
  Many of the things that are in the President's bill would fall under 
this particular challenge, attempting to repeal market forces by 
Government decree and producing, as governments always do when they 
make this attempt, economic dislocations which fall to the disadvantage 
of our citizens.
  So, Mr. President, while I give the President full credit for his 
leadership in getting this issue where it belongs, at the top of the 
agenda, I ask him and those who support him to step back and take a 
look at the size of the task that has been undertaken and to realize 
that it is more important, given the size of this challenge, that we do 
it right than that we do it all at once.
  Therefore, at the appropriate time, I intend, with such allies as I 
might be able to recruit, to offer legislation that would attack this 
problem in a logical, piecemeal kind of fashion instead of attempting 
to swallow the whole elephant all at once.
  We can do this without attacking the President's motives. We can do 
this while giving the President the full credit that he deserves. But 
the size of the problem requires that we take this kind of careful 
approach. If we do not, we run the risk, as I say, of jeopardizing 
health care not only for all of those who already have it but, 
ironically, for those to whom the President is trying to extend it, 
because, if we upset the whole system in too hasty action, everyone is 
damaged thereby.
  Therefore, Mr. President, I ask this body to adopt this sense of 
judicious care in approaching this problem and hope that we can 
understand just how serious the implications will be if we act in too 
precipitous a fashion.
  I thank the Chair.
  Mr. COVERDELL. I thank the Senator from Utah.
  The PRESIDENT pro tempore. The Senator from Georgia [Mr. Coverdell] 
is recognized.
  Mr. COVERDELL. Mr. President, the Senator from Utah is a 
distinguished business person in his own right and is one of those 
fresh faces that has actually been involved with Main Street America, 
and I appreciate very much his taking time to come and share his views 
on this very important subject of health care reform, which is here 
this morning.
  As I said a moment ago, Mr. President, we have now had findings from 
the U.S. Chamber of Commerce which were revealed last week that are 
very telling. One of the points I did not make a moment ago was the 
fact that the data that the U.S. Chamber has now presented is not so 
much startling as it is corroborating. The findings that they have put 
forward fall right in line with everything we have been seeing over the 
last month with regard to public attitudes about the manner in which we 
should approach health care reform.
  It almost always breaks as the numbers that the chamber brought 
forward indicate. Just the week before a CNN-USA Gallup Poll showed 
that the general citizens, not business people in particular, but just 
the general citizenry also felt overwhelmingly that we should begin to 
focus on targeted reform and that we should not destabilize perhaps the 
most innovative, creative medical system in the history of the world 
but improve it.
  But coming back to the U.S. Chamber, I think one of the reasons you 
get such an overwhelming response from business people across the 
country is their attitudes about employees. I think anyone who has ever 
worked in a business or run a business realizes that the greatest asset 
of any business is its people.
  After visiting with business people for the last year and talking 
about the subject, I am fearful that policymakers from Washington are 
getting perilously close to taking what has always been perceived as 
the Nation's greatest asset, its employees, and turning them into 
liabilities, changing the entire equation by which employers of 
companies look across the table at a potential employee.
  Instead of seeing the energy and the creativity and the asset of 
energy and contribution, they are beginning to tally up with their 
computer what the cost and liabilities are of bringing a new person 
into the company. This is a bad, bad thing for our country.
  I want to share, Mr. President, some information with regard to the 
effects of Government management of medicine on jobs. A number of 
organizations have estimated job effects of the President's health care 
proposal. For example, a February 1994 CBO report states:

       Taking together all the provisions that might increase or 
     reduce participation in the labor force, CBO estimates that 
     eventually between one-quarter of 1 percent of the labor 
     force might prefer to stay home if the proposal was enacted.

  What does that mean? We use so many numbers up here that we get lost 
in it. But what that statement means is that between 300,000 and 1.2 
million people will not be working if the plan is enacted.
  Back to my comment about sitting across the table. That means the 
employer, looking across the table at a potential employee, says to 
himself or herself, ``If that person goes to work here, I have this 
much more burden to deal with, this much more overhead, this much more 
liability, and I choose not to do that.''
  I would not want to be a recent graduate filling out that 
application, looking for a job, if we continue to impose these kinds of 
obligations on the business of commerce in America.
  You know these just read like numbers--300,000 people. We forget 
those are 300,000 individuals who live in over 300,000 families, all of 
whom are dependent in one way or another on the person getting a job.
  Of all the things that we can do, we ought to be in the business of 
making it easier to get a job. A job is the core of personal dignity 
and worth. A job is what allows a person to seek and pursue his or her 
growth, to protect and preserve their family, to educate their family, 
and, I might add, to provide for the health of their family. Any time 
we do or take actions here that means someone cannot get a job, we 
should pause--300,000 to 1.2 million.
  That is not all. CBO goes on, and it says: ``Overall the proposal 
would probably impose greater employment-related distortions than it 
removed.'' Distortions--that means the business that goes on across the 
table between the potential employer and the potential employee.

       Competition among employers for the reduced labor supply 
     would slightly raise real wage rates, but the effect of a 
     rise in wages would not completely offset the direct effect 
     of the President's proposal. The administration's proposal 
     would bring about a major change in the nature of health care 
     costs for many workers. The cost would operate like a new 
     levy on work. The proposal would create an implicit levy on 
     work because it would make health coverage universal without 
     charging many nonworkers for the full cost of their 
     insurance.

  That means that those people working are having to pay for those who 
are not--a transfer of the result of labor from the person who conducts 
the labor to somebody who does not. That means levy, burden, waste.

       The premium would simply reduce take-home pay from the 
     point of view of the individual worker buying anything.

  According to the President's own Council of Economic Advisers in 
their 1994 report, it is estimated that about 350,000 to 600,000 
additional people will be retired--that is not being able to get a job, 
that is retired--as a result of the provisions of the Health Security 
Act.
  ``Retired.'' That is an unusual word. What does that mean? That means 
let go, terminated, fired, unemployed, without the job, without the 
dignity that the job provides, without the resources to care for and 
nurture one's own family and self; lose a job.
  The Employment Policy Institute issued a September, 1993 report 
concluding that up to 3.1 million jobs could be lost if the President's 
plans were in effect--828,000 jobs would be lost in the restaurant 
trade alone; 726,000 jobs would be lost in the retail trade alone; 
194,000 jobs would be lost in agriculture. The construction industry, 
repair services, personal services, and private household services 
would also suffer disproportionate job loss.
  But while we are creating this new Federal bureaucracy, I guess we 
can take some comfort--or some can, I do not--that, according to the 
Multinational Business Services, the administration's health care 
proposal will require nearly 100,000 new bureaucrats. So we are trading 
off hundreds of thousands of private sector jobs in exchange for 
100,000 new Government jobs whose salaries will cost $3.9 billion--$3.9 
billion.
  Mr. President, this is not a good trade.
  Mr. President, I yield to the distinguished Senator from Montana [Mr. 
Burns].
  How much time does the Senator require?
  Mr. BURNS. Five minutes.
  Mr. COVERDELL. I yield 5 minutes of my time to the Senator from 
Montana.
  The PRESIDENT pro tempore. The Senator from Montana [Mr. Burns] is 
recognized for 5 minutes.


                              Health Care

  Mr. BURNS. I thank my friend from Georgia and I thank the Chair, and 
the chairman of the committee I serve on.
  Mr. President, I just got back from Montana, and, of course, health 
care is probably the No. 1 topic we are asked about in our town 
meetings. Going around in the State of Montana, record crowds turn out 
to visit about the issues of Government. Some are saying, ``Government, 
get on out of my life.'' Others are saying, ``What about health care? 
Where is it going? What is it going to lead to, and here is our 
concern.''
  I do not think anybody was really surprised at the last survey taken 
by the U.S. Chamber of Commerce. The 40,000 of their members nationwide 
are still further proof of what we have been saying all along, that, 
yes, the Clinton plan, or the one submitted by the administration, is 
pretty much unacceptable, but the status quo is also unacceptable. So 
we know that we are in for some change. We have to seek those places 
that we can find agreement and compromise on and get on with living.
  If you live on the border of Canada, which has a single-payer, 
Government-run system, you will soon understand why that plan is not 
exactly working for all people in Canada. Yes, they have universal 
coverage. What they do not have is universal access. We have universal 
access, but we do not have universal coverage. So somewhere in the 
middle there, we have to find some way to make ours work just a little 
bit better.
  If you drive into Billings, MT, which has a very active medical 
corridor, with two of the top hospitals there in the northwest and the 
northern high plains, you will find just about one out of every five 
license plates from Canada, receiving their elective surgery and their 
medical care here in this country. Which tells me that, yes, we have 
the highest quality of health care there is in the world today. People 
come here for our health care services. You do not see long lines of 
Americans going somewhere else.
  The survey showed that anywhere from 77 percent to 90 percent of 
those responding believe that we should build on the system that we 
currently have. In my State of Montana, the figure was 88 percent. That 
is an overwhelming majority.
  And listen to this. Ninety percent of the Montanans who answered the 
questionnaire of the U.S. Chamber of Commerce felt that the Government-
run health care system is completely unacceptable. Now I do not know 
about the rest of my colleagues, but these numbers speak volumes in my 
book. And the numbers across the States are awfully similar.
  The study indicates that members want incremental reform. It does not 
mean that we should not be avoiding some very serious problems that we 
have from the industry, but yet I think we could solve some of those 
problems.
  Getting started is what I would call incremental reform that can 
actually prove to be monumental. We congratulate the President for 
stepping into the batter's box and stepping up to the plate. But now 
let us find those places where we can agree.
  The insurance companies have indicated to us that they are ready to 
come to the table and start solving some problems called preexisting 
conditions. If a national pool has to be established for catastrophic 
ailments that befall some people, then let us do that. But if we take 
care of preexisting conditions, we do a lot as far as portability, 
taking care of that problem, runouts, and also job lock; in other 
words, people locked into jobs, but they are afraid to change jobs 
because they think they will lose their health care.
  Making those incremental changes is not an easy task and it is not an 
easy way out. But it will take the steps that we need to do in a 
responsible fashion, making the change in our current system that it so 
desperately needs, yet it does not destroy the system.
  We have to always remember, we have to build on the system that we 
have now. I think we need to pay serious attention to those States that 
border on Canada, because up in my part of the country on the high 
line, we can hear Canadian radio stations, when you get up in the 
morning, as an official part of the stations, just like a traffic 
report or school closing or school openings, they will say such-and-
such hospital will not take new patients today or tomorrow because they 
have a money problem of trying to reach to the end of their current 
fiscal year. So, if you are to get caught in those times, we cannot get 
sick tomorrow or the next day because the hospital is not taking any 
more new clients, so to speak. So we hear that. I do not want to get 
locked into a situation where we are operating under the same kind of 
system.

  So, let us do the right thing. Let us do the right thing and go 
incrementally, find those issues we can agree on, and do what the 
American people want us to do. That is to pass some kind of reform this 
year.
  I thank the Chair and I yield the floor.
  Mr. COVERDELL. Mr. President, how much time is remaining?
  The PRESIDENT pro tempore. The Senator has 23 minutes and 15 seconds 
remaining.
  Mr. COVERDELL. Mr. President, I yield 15 minutes to the distinguished 
Senator from Texas.
  The PRESIDENT pro tempore. The Senator from Texas [Mr. Gramm], is 
recognized for 10 minutes.

                          ____________________