[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. GRAMM. Mr. President, I thank our dear colleague from Georgia for 
yielding.
  There are a lot of elements that you can talk about in health care. I 
would like, today, to try to focus on the issue of the role of 
Government in the President's health care reform proposal. And I would 
like to focus on the issue of freedom.
  It is a very interesting phenomenon to me that the debate on health 
care is now moving to its most important issue. I rejoice in that fact. 
I think it is important that everybody engaged in the debate start to 
move in that direction.
  I think one can make many criticisms of our President, but no one can 
claim that the President is not smart. If you look at the President's 
health care plan, the Congressional Budget Office in its February 1994 
study entitled ``An Analysis of the Administration's Health Proposal'' 
has concluded that within 2 years, starting from nothing, if we adopt 
the President's health care plan it would become, in 2 years, the 
largest single program in the Federal budget.
  I remind those who are listening, this is not Phil Gramm, Senator 
from Texas, talking. This is the Congressional Budget Office which is 
run by a director who is, in essence, appointed by the Democratic 
chairman of the Budget Committee in the Senate, and the Democratic 
chairman of the Budget Committee in the House.
  This director of the Congressional Budget Office, which does the 
budget analyses for Congress and sets the parameters under which we 
legislate, in looking at the President's health care proposal, has 
concluded that within 2 years of its creation, the President's plan 
would be larger than Social Security, larger than Medicare, larger than 
defense, and in 10 years, if everything worked exactly as the President 
says it would work--if the Government could really run the health care 
system, if wage and price controls worked, something that they have 
never done in 5,000 years of recorded history--still, under ideal 
circumstances in a world as envisioned by our President, his new health 
care plan according to CBO will cost $750 billion a year.
  Nobody but Ross Perot knows what a billion dollars is, but let me set 
$750 billion in perspective. That is over half of the current Federal 
budget, that we will spend in 1 year in funding the President's new 
health care plan.
  You might ask why are we not debating how we are going to fund this? 
When you read through this great big, thick plan of the President's, 
when you get down to the bottom line, he says we can fund this $513 
billion a year cost now--$750 billion a year 10 years from now--with 
the savings from the efficiency and economy that he says will come from 
the Government taking over and running the health care system. Who says 
there is nothing humorous about this debate?
  You would think we would be debating whether or not this plan would 
bankrupt the Government or force rationing and destroy the greatest 
medical care system in the history of the world, but we are not. The 
reason we are not is because the President understands that Congress is 
not going to reject his plan because it bankrupts the country. In 
little installments, the Congress does that almost every day.
  Second, you might think the debate would be focused on jobs. The 
President's health care plan imposes a 7.9-percent effective payroll 
tax, a 1.6-percent salary tax on working people, thus raising the cost 
of job creation by 9.5 percent. Even the President's own numbers show 
700,000 Americans losing their jobs. Most outside groups estimate that 
2 million people will lose their jobs, tens of thousands of small 
businesses will be driven out of business, because of this increase of 
almost 10 percent in the cost of creating jobs. The bottom rung of the 
economic ladder would be sawed off, as the cost of creating new jobs 
would go up. You might think the debate on health care would be about 
jobs, but the President knows that we are not going to reject his 
health care plan because it puts people out of work, because many of 
the things the majority in Congress does every day puts people out of 
work.
  The President knows that the silver bullet issue is not bankrupting 
the country, not putting people out of work--the silver bullet issue is 
freedom. The President knows with certainty that if the American people 
believe that his plan takes away from them private medicine, private 
insurance, the right to choose their own health plan, that his plan is 
dead.
  In light of that, what we have seen, especially in the last few 
weeks, is that the President has gone to great lengths to try to 
convince people that his plan is not a Government plan. I will just 
read from his speech on Monday. He says, ``When we [meaning the 
administration] try to fix it [meaning the health care system], what do 
our adversaries say?''
  And then he goes on to quote his adversaries, people like me.
  `` `They are trying to have the Government take over the health care 
system.' False,'' he says.
  In other words, the President is saying that those who oppose his 
plan claim that it would result in the Government taking over the 
health care system. He says that is not true.
  He then goes on and says it is not true again, because the President 
knows if you repeat something long enough people are going to start 
believing you. ``That is our plan, hardly a Government takeover of 
health care,'' he says.
  If there is one thing I have learned, it is that it does not do you a 
lot of good to get into a shouting match with someone who has a bigger 
megaphone than you do. So what I want to do is let Democrats and the 
people they appoint to study these issues debate themselves. I have 
gone through this book put together by the Congressional Budget Office, 
which is controlled by Democrats and which is the official budgeting 
arm of Congress, so when the President's bill comes to the floor of the 
Senate, what its February 1994 analyses says--not what the President 
says--will dominate our debate.
  Is the President's plan a private system built on private insurance 
and consumer choice, as the President says? That is the million dollar 
question. Let us look at what the Congressional Budget Office says. The 
Congressional Budget Office says, on page 47 of its study, ``On 
balance, the new program''--which is the President's program--``seems 
to represent an activity of the federal government that relies on the 
exercise of sovereign power,'' on the power of the Government to 
mandate, to force, and to coerce--that is what sovereign power is.
  On page 49, the Congressional Budget Office says, ``Although CBO's 
analysis has concluded that the health alliances''--that is the 
foundation of the President's plan, that is where you are forced 
against your will to buy health insurance and health care--``health 
alliances would be more like federal agencies than like state or 
private agencies, it has also found that the Administration's proposal 
would be unique in its form, shape, scope, and complexity.'' That is on 
page 49. That is not me talking. That is the official budget analyses 
arm of the U.S. Congress.
  On page 47, ``Although the states and the alliances would have 
important roles and responsibilities, they would be acting largely as 
agents of the federal government.'' This is a plan the President says 
is not a Government plan. But the Congressional Budget Office says that 
these alliances--and notice the President has gone through several 
iterations of what to call these things, first it was: ``Health care 
purchasing cooperatives.'' Then they did polling and the polls found 
people did not like that term, so then they started to use the word 
``alliances.'' But no matter what you call it, the Congressional Budget 
Office says they are going to be ``acting largely as agents of the 
Federal Government.''
  On page 49, ``The flow of premiums and spending into and out of the 
alliances would dwarf the income and outgo of Social Security'' --this 
is a modest program, the President says--``which is currently the 
largest Federal program.''
  On page 49, ``The complexity of the structure would be 
unprecedented.''
  Finally on page 44, ``The Congressional Budget Office concludes that 
it''--the administration's plan--``establishes both a Federal 
entitlement to health benefits and a mandatory payment to finance those 
benefits.''
  I ask the Senator to yield me 4 additional minutes.
  Mr. COVERDELL. Mr. President, I yield 4 minutes to the Senator from 
Texas.
  The PRESIDENT pro tempore. The Senator from Texas [Mr. Gramm], is 
recognized for 4 additional minutes.
  Mr. GRAMM. Mr. President, the reason I want to point these things out 
is not that I want to say the President is not leveling with the 
American people. That is not a very productive debate. But let me tell 
you the problem.
  When this bill comes to the floor of the Senate--and when we are 
dealing not in beautiful rhetoric but in reality--the first amendment I 
am going to offer will say that no American will have any health 
insurance that they want to keep canceled by this bill and that no one 
will be forced against their will to buy health insurance or health 
care through any mandatory agency.
  My guess is that that amendment will be adopted. If you listen to 
what the President is saying, you would say, what difference would that 
amendment make? It would not make much difference to the President's 
rhetoric, but it kills his health care plan because the President's 
health care plan is very clear. His rhetoric may not be clear, but the 
plan is very clear. If you work for the Federal Government, you are 
exempt. So the Congress will be exempt, and everybody who works for the 
Federal Government, under the President's plan, will be privileged--
that is until I offer my second amendment which will require that 
everyone has to be included in the President's plan.
  But under this plan as it now stands, if you work for the Federal 
Government, you are exempt. Now, if you work for a company with 5,000 
or more employees, it can buy you out of the Government plan by paying 
1 percent of its payroll to the Government. But if you are anybody else 
working in the American economy, your health insurance is going to be 
canceled, and you are going to have to buy health care through a 
Government-run cooperative that, according to the Congressional Budget 
Office and according to the President's own bill, is run by the Federal 
Government, controlled by a seven-member board.
  An incredible thing about the President's plan is, despite all his 
efforts to convince people otherwise, the fact is that this plan 
cancels private health insurance, limits freedom and, in one of the 
most incredible positions taken in the bill, imposes $10,000 in fines 
on anyone selling private insurance--this is something that I have 
raised on many occasions, generally having supporters of the 
President's plan deny the existence of such a provision until I finally 
learned to carry a copy of the page around in my pocket. To show you 
how alien the President's plan is to consumer freedom, look at how the 
plan addresses the question of whether or not, once you have been 
forced to buy health insurance through these Government-purchasing 
cooperatives, you could still go out and buy private health insurance 
to cover your family should you desire to do so. You can do that in 
Britain, even though we call their system socialized medicine. People 
there who make enough money normally have to pay for the Government 
program but if they do not want to use it for their loved ones, they 
may go out and buy private health insurance to escape the Government 
program.
  But listen to what the President's plan says about that choice: 
``Civil monetary penalty''--this is on page 241--``an entity''--that 
would be a business or a person--``that knowingly and willfully 
violates any provision of this section with respect to offering a 
supplemental health insurance policy to any individual shall be subject 
to a civil monetary penalty not to exceed $10,000 for each such 
violation.''
  What does that mean? What that means is that if you do not work for 
the Government and you do not work for a company with 5,000 or more 
employees, your health insurance is canceled and you have to buy health 
care through a Government-run cooperative.
  Am I out of time, Mr. President? May I have 1 more minute?
  Mr. COVERDELL. Mr. President, I yield 1\1/2\ minutes to the Senator 
from Texas.
  The PRESIDENT pro tempore. The Senator from Texas is recognized for 
1\1/2\ more minutes.
  Mr. GRAMM. So, Mr. President, again, what it means is that if you do 
not work for the Government and you do not work for a company of 5,000 
or more employees, your health insurance will be canceled, you will 
have to buy health care through a Government-run collective and if you 
even had enough money left to be able to buy private health insurance 
for your family because you did not like the care they were getting 
through the Government, then anybody who tried to sell you that policy 
would be fined $10,000.
  The President says his plan is based on choice and private insurance.
  I want to conclude by posing several questions.
  No. 1: Under the President's plan, if you work for a company in 
Mexia, TX, with 10 employees and for example you have a good Blue 
Cross/Blue Shield policy--which you do if you work for Flatt Printing 
Co. in Mexia--if you like your plan, can you keep it? The answer is no, 
it is canceled and you have to buy your health care through a 
Government-run collective, probably out of Austin.
  No. 2: After you get into the Government plan, and you are unhappy 
with it, you do not like the care, can you get out of it and take your 
money? No. Unless you die, you have to pay the Government your money.
  Finally, if you want to get out and you are willing to leave your 
money, can you buy private health insurance? The answer is no.
  I thank the Chair for his indulgence.
  The PRESIDENT pro tempore. The Senator from Georgia is recognized.
  Mr. COVERDELL. I thank the Senator from Texas for his remarks with 
regard to health care reform.
  How much time is remaining, Mr. President?
  The PRESIDENT pro tempore. The Senator has 6\1/2\ minutes.
  Mr. COVERDELL. Mr. President, I want to briefly refer to the daily 
reports that are now being issued from the White House. I think that if 
we had truth in advertising that applied to Washington, sometimes I 
think we would come to a standstill. These documents are coming on a 
daily basis. I think it is incumbent upon all of us to be very 
attentive to these documents to certify their accuracy.
  Just to allude to several comments, the President's approach will 
give choice back to the people, not insurance companies. This is White 
House health care reform today, March 3, 1994. We just heard that 
statement misses the mark by a rather broad distance. Give choice back 
to the people. What we are talking about, as has just been discussed by 
the Senator from Texas, is that we are taking choice from the people 
and giving it to the Government. We are not giving choice back to the 
people.
  We are talking about freedom, more Government management, what 
benefits you can and cannot have would be decided by the Government, 
not the people: Who could go to the medical practitioner or not; who is 
too old or too young. That would not be decided by you, that would be 
decided by somebody in the Government. And yet this says ``Give choice 
back to the people.''
  Mr. President, on March 24, 1994: Outlawing unfair insurance 
practices. Let us get after those bad insurance people for the unfair 
practice of charging older people more than younger people.
  What in the world are they talking about? Has anybody in our country 
ever been confused by the fact that as you get older, your insurance 
costs are more? Life insurance or health insurance or accident 
insurance, it is always more. Younger people do not get sick as much as 
older people. Everybody in their right mind now is looking at a chart 
that shows the rates that advance with our age and the perils that come 
with age. But that is characterized here as an unfair and outrageous 
insurance practice.
  On March 23, 1994, with a health security card, Americans will be 
able to follow their doctor to any plan they choose, a plan where an 
individual can see any doctor in their community. They call this fee-
for-service plan.
  It leaves out the fact that, A, the plan may eliminate fee for 
service if the alliance chose to do so, which would mean there is no 
choice of doctor. It leaves out the fact that if anybody tried to 
engage in fee for service, they would be charged an exorbitant 
additional charge for doing that--punished, punished for that choice of 
selecting one's own doctor.
  Mr. President, this is going to be a very difficult debate, but every 
attempt by all of us, including the President, should be to discuss 
this not in the anecdotal but to do this in fairness and to describe 
what you are proposing correctly--correctly.
  I admire the Senator from Texas pointing to the Congressional Budget 
Office, pointing to people who analyze these documents and give us 
truth about what is and is not being proposed.
  Now, Mr. President, in closing, let me just say--and I believe very 
much this is true--I believe the decision we are about to make on 
health care reform in this country is as important a decision as we 
will make in this quarter century. It will affect every citizen, every 
family, every business, and every community.
  As the Senator from Utah said, it is better to be right than in a 
hurry. Everybody admits that there are improvements which can be found 
in health care in America, but we ought to improve the system that has 
given us every major medical breakthrough in the last quarter century. 
It was found right here in the good old United States. What no one 
thought possible even 5 years ago is now readily available. We have 
been engaged in the practice of making the uncommon common, the 
incurable curable, not only for our own country but around the world. 
Any look at any Government system--and I have seen them all, Mr. 
President; as Director of the Peace Corps, I went all over the world--
Government-run medicine is not a pretty picture. We should not exchange 
innovation, creativity, high capacity for mediocrity. We should be 
right. We should follow the first axiom that a doctor learns: First do 
no harm.
  Mr. President, I yield the floor.
  The PRESIDENT pro tempore. The time under the control of the Senator 
from Georgia has expired.
  Under the previous order, the hour beginning at this moment shall be 
under the control of the Senator from South Dakota [Mr. Daschle] or his 
designee.
  Mr. Daschle.
  Mr. DASCHLE. Mr. President, I thank the Chair.

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