[Congressional Record Volume 140, Number 81 (Thursday, June 23, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: June 23, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                              HEALTH CARE

  Mr. WELLSTONE. Mr. President, I was going to propose an amendment to 
the Department of Defense bill which reads as follows:

        Congress should enact health care reform that guarantees 
     everyone health care as good as the health care that will be 
     available to Members of Congress under that reform.

  Mr. President, it is very rare, at least in my 3\1/2\ years in the 
Senate--I have not quite had the long, distinguished career that the 
President pro tempore has had--that I have proposed a nongermane 
amendment. I really do not like to do that.
  But I wanted to propose this amendment for a couple of reasons.
  One, I am impressed with the strength of the President and the First 
Lady and what they have been saying, especially this last week, about 
the importance of universal coverage, decent coverage for people.
  I have been listening to my colleagues on both sides of the aisle on 
the floor, and in reading reports back in their communities. It seemed 
to me that there was a consensus here that really, in the final reform 
bill that we pass--and I believe we will pass a health care reform bill 
that will be historic, and I am optimistic it will be a step forward 
for people in our Nation--that however our plan in the Federal 
employees benefit package is configured or reconfigured, basically, we 
want to use that as a yardstick and make sure the people we represent 
have the same quality plan in terms of what is covered, and in terms of 
making sure it is affordable and that the copayments are not too high.
  So I thought this amendment, given the intensity of the debate and 
where we are in the debate, would be a real contribution with Senators 
really going on record saying: Yes, we agree with this principle, 
absolutely. When we look at our plan, we want to say to the people we 
represent that in the final reform bill, you should have the same, 
comparable quality plan.
  Now, Mr. President, this is treading on sensitive ground. I do not 
want people who are listening to believe that our coverage right now, 
for example, is by any means great or perfect. It is not. It is not 
good on dental or vision care. Long-term care is not covered, at least 
institutional long-term care. It is by no means 100-percent 
comprehensive coverage for benefits.
  On the other hand, when you look at inpatient and outpatient 
benefits, and look at well-child care, offering delivery at birth 
centers, coverage of care by nurses and midwives, prescription drugs, 
pap screening, home health care, and mammograms, and other such 
features, we have very good coverage, better, probably, than most 
people in the country.
  So actually, Mr. President, I did not think this would be 
controversial.
  I hear some of my colleagues talking about how we need to water down 
the benefits, saying that we really should not make decisions exactly 
what the coverage will be; we really cannot have universal coverage, it 
should be 91 percent. And I have to ask: Who is not covered? People 
with a disability? The poor? People who live in rural communities? 
Older people?--I worry about those kinds of comments.
  So I thought what a positive statement for the Senate to make, just 
to go on record.
  Mr. President, my colleagues on the other side of the aisle said that 
they would second degree this amendment, I think probably with a very 
specific amendment that would get us right into the specifics of the 
legislation that is now moving through committees.
  I do not want for us to have that kind of long debate right now on 
the floor of the Senate when we are dealing with the Department of 
Defense bill. That, to my mind, just simply crosses the boundary, and I 
think it probably is not the direction we should go.
  So with the understanding, Mr. President, that basically we are all 
going to operate within this framework of not really zeroing in on the 
health care right now, that that debate will take place in July--the 
majority leader has made it clear to all of us that bill will be on the 
floor in July--I am not going to put this amendment forward at this 
time. I think if I do so and then there is this second-degree 
amendment, we are going to get into a long, long debate about all sorts 
of specifics in health care, and at this point in time that would be a 
mistake.
  The Finance Committee, I believe, is going to report out a bill and a 
bill will come to the floor.
  So with the understanding that that is our framework and that these 
health care amendments are not going to be part of DOD, with that 
understanding, then, I am not going to put this amendment forward. 
Although I must say there will be a time to do so, certainly between 
now and July or maybe when the bill comes to the floor in July or maybe 
before, because this is such a--no pun intended--healthy statement for 
us to make.
  I think we should, again, avoid all the sort of temptation to say, 
``Well, everybody in Congress has everything perfect.'' That is not 
true. There are places where our coverage should improve and could 
improve for ourselves and our family and loved ones.
  But the real point, in the final reform bill, is let us just make 
sure, as all of this is reconfigured, whatever plan we have, that the 
people we represent have as good a plan.
  So what do we have in general by way of summary? We have universal 
coverage. All of us are covered. Our employer, the Federal Government, 
contributes a significant percentage and we contribute. That seems to 
me to be fair. So you have, if you will, an employer mandate. All of us 
can afford the health care coverage that's available. There is no 
preexisting condition exclusion, which I think is extremely important. 
That is one of the things that outrages people in Minnesota--and I am 
sure in West Virginia--most, that because of a prior illness or 
condition of sickness you cannot even receive coverage and, if you can, 
the premium rate is so high you cannot afford it. And the final thing 
we have is a very good package of benefits.
  That, I think, is a commitment we made to the people, that in the 
reform bill that is what we will include.
  Mr. President, just on two other subjects, very briefly.
  I do want to submit as a part of this statement a letter from many 
different health care consumer and provider organizations around the 
country to President Clinton, making it very clear to the President 
that we support universal coverage; we do not see how you can do it 
unless you have employers making a contribution, some kind of mandate; 
we want to make sure it is affordable; we want to make sure it is out 
in the communities; and, Mr. President, we want to make sure--and this 
is really, I think, a part of the consensus here, as I understand it--
that States in our grassroots political culture will have the option to 
implement a single payer plan.
  I ask unanimous consent to have this printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                  U.S. Senate,

                                    Washington, DC, June 23, 1994.
       Dear Bill: Last week several senators and I sent you a 
     letter urging continuing firm support for universal coverage 
     as a key feature of health care reform.
       Several organizations of health care consumers and 
     providers expressed their interest in communicating the same 
     message to you.
       I am pleased to present you with a list of the groups that 
     offered to sign the letter. I'm certain we are both 
     encouraged that this impressive list of groups support 100% 
     universal coverage, employer mandates, affordable care, cost 
     containment, and the option for states to implement a state 
     single payer system.
       Even more encouraging to me was the signal that so many 
     groups and individuals are ready to respond to requests from 
     Washington to show their support for these key issues.
       Many of us in Congress, and millions of Americans around 
     the country, are ready to stand up and make sure that health 
     care reform will not be hijacked by big ticket special 
     interests.
       We know that we need health care reform, and we need it 
     this year.
       All of us appreciate the most recent comments you and Mrs. 
     Clinton have made on the importance of passing a bill that is 
     unequivocal on the issue of universal coverage. I know that I 
     speak for us all in offering any help we can provide in 
     assuring that we accomplish that goal in the 103rd Congress.
           Sincerely,
                                             Paul David Wellstone,
                                                     U.S. Senator.
                                  ____

                                                    June 23, 1994.
     President Bill Clinton,
     The White House,
     Washington, DC.
       Dear Mr. President: Our organizations have always shared 
     with you a commitment that universal coverage must be the 
     cornerstone of health care reform. That commitment cannot 
     waver as we continue our progress in Congress to enact 
     comprehensive health care reform legislation.
       We are troubled by comments from the press and some Members 
     of Congress that universal coverage is not a realistic goal.
       Universal coverage is impossible unless it meets several 
     critical tests. First, it must include meaningful, employer-
     based financing. Unworkable proposals that would put the 
     burden on individuals to pay most of the costs of their care, 
     or project employer contributions into some distant future, 
     cannot achieve the health care reform that Americans are 
     counting on.
       Second, all Americans must be covered. Suggestions that 
     universal coverage should be defined as something less than 
     total coverage, such as 90 percent or 95 percent, would 
     continue to leave millions of Americans vulnerable to the 
     double plagues of illness and impoverishment. Anyone could 
     lose the lottery: people who work and those at risk of losing 
     their jobs, the elderly and people with disabilities and 
     their families, people with cancer and people with AIDS, 
     people in rural areas, women, men, children.
       Third, coverage must be affordable. Meaningful cost 
     containment must be included to protect businesses, 
     individuals, and government entities contributing to the 
     system.
       Finally, states must have the ability to adopt a single-
     payer system if they determine through their own legislative 
     processes that would be a fairer or more cost-effective 
     approach to universal coverage.
       Universal coverage is not only a humane goal, one which 
     most industrialized countries have attained. It is also key 
     to making health care affordable because it would end 
     wasteful and inflationary cost-shifting, encourage preventive 
     care, and allow more appropriate use of resources. 
     Suggestions that we waste more years and more lives tinkering 
     around the edges of almost covering everyone, trying to 
     make health care almost affordable, are a diversion from 
     the fair and workable framework you have presented. In 
     addition, it would send an unwelcome signal to the country 
     that its elected leaders are unwilling to take the long 
     overdue step of guaranteeing that every American enjoys 
     health security.
       We ask that you remain strong in your commitment to 
     universal coverage, affordable for all and fairly financed. 
     While there will be areas for compromise during the 
     legislative process, assuring universal and affordable 
     coverage must not be among them. We will assist efforts 
     toward the goal of true universal coverage for health care in 
     any way that we can.
           Sincerely,
       Actors' Equity, Ron Silver, President.
       ACTUP Washington.
       AIDS Action Council.
       American Association of Children's Residential Centers.
       American Association for Marriage and Family Therapy.
       American Association of Pastoral Counsellors.
       American Association of Physicians for Human Rights.
       American Association of University Women.
       American College of Physicians.
       American Counselling Association.
       Americans for Democratic Action.
       American Federation of State, County and Municipal 
     Employees.
       American Medical Students Association, Terrence Steyer, 
     National President.
       American Psychological Association.
       American Public Health Association, Eugene Feingold, 
     President.
       Association of Maternal and Child Health Programs.
       Association of Mental Health Administrators.
       Judge David L. Bazelon Center for Mental Health Law.
       Califronia Society for Clinical Social Work.
       Campaign for Women's Health.
       Children's Defense Fund.
       Churchwomen United.
       Citizen Action.
       Consumers Union.
       Creative Coalition, Blair Brown, Co-President.
       Family Service America.
       Gray Panthers.
       Health Care for the Homeless.
       InterHealth, St. Paul, Minnesota.
       International Association of Psychosocial Rehabilitation.
       International Brotherhood of Teamsters.
       Internatinal Union of Electronic, Electrical, Salaried, 
     Machine and Furniture Workers (IUE), William H. Bywater, 
     International President.
       Legal Action Center.
       Lutheran Medical Center, Brooklyn, N.Y., Jim Stiles, 
     Executive Vice President.
       National Association of Community Health Centers.
       National Association of Homes and Services for Children.
       National Association of Protection and Advocacy Systems.
       National Association of Public Hospitals.
       National Association of Social Workers.
       National Association of State Alcohol and Drug Abuse 
     Directors.
       National Community Mental Health Care Council.
       National Council of Churches of Christ in the U.S.A.
       National Council of La Raza.
       National Education Association.
       National Federation of Societies for Clinical Social Work.
       National Mental Health Association, Mike Saenza, Chief 
     Executive Officer.
       National Rainbow Coalition.
       National Women's Health Network.
       New York StateWide Senior Action Council, Inc., Ruby Sills 
     Miller, Member of the Board.
       Oil, Chemical and Atomic Workers International Union.
       Older Women's League.
       Protestant Health Alliance.
       Screen Actors Guild, Barry Gordon, National President.
       Service Employees International Union.
       Sigerist Circle of Medical Historians, Elizabeth Fee, 
     President.
       Unitarian Universalist Association of Congregations.
       United Automobile, Aerospace & Agricultural Implement 
     Workers of America International Union.

  (Mr. KOHL assumed the chair.)

                          ____________________