[Congressional Record Volume 140, Number 89 (Tuesday, July 12, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 12, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
               CONCERNING THE HEALTH CARE REFORM PROCESS

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Missouri [Mr. Emerson] is recognized for 5 minutes.
  Mr. EMERSON. Mr. Speaker, as the elected representative of the Eighth 
District of Missouri, I feel constrained to make a statement concerning 
my view of the health care reform process that is currently the subject 
of widespread attention and activity here in the House of 
Representatives and in the Congress at large, not to mention the 
country.
  Several fundamental impressions loom large with me, and I am anxious 
to talk about them, because they deeply concern me and my constituents; 
and I hope, and my constituents hope, that some order may be injected 
into the process so that we all, Congress and constituents alike, can 
be singing out of the same hymnal and collectively have a common 
understanding of how this thing is to work, because the financial 
impact and personal security concerns of all citizens are real, and 
should not be treated in cavalier fashion.
  First of all, as one who has followed the subject very closely since 
the President's speech to Congress last September, I do not see a 
proposal that is currently on the table around which I believe a 
consensus exists. That is not to say that there isn't a proposal on the 
table around which a consensus may be built, but it is not there at 
this point in time.
  The President spoke to Congress last September; and in a very fine, 
rhetorical statement outlined for the Congress and the country his and 
Ms. Rodham Clinton's view of where he and she wanted to take the 
country. Almost immediately hearings were held on the rhetorical 
statement. There was a highly orchestrated TV/media performance related 
to hearings in the Ways and Means Committee, but all that was really on 
the table was the President's speech to Congress. There was not a plan. 
There was no blueprint. There was no calculation as to what this 
rhetorical statement if implemented would cost. There was no detail 
about how this proposal would work in practice, no detailed plan about 
how to get from where we are now in health care to where the President 
and Ms. Rodham Clinton want to take us.
  Details were not forthcoming and were not forthcoming and were not 
forthcoming.
  Finally, along about Thanksgiving a document was received by Congress 
purporting to be the President's and Ms. Rodham Clinton's plan. Yet, 
there were whole sections of the plan missing--with notations appearing 
where sections of the plan should have been--stating section reserved.
  Then, during the winter holiday season there was much media 
speculation and dissection and attention given; but not until Congress 
convened this year was there any parceling out of the plan.
  Given the complexity of the subject, here in the House of 
Representatives three major committees were given jurisdiction over the 
plan, told to hold hearings, and report what they may achieve. The 
Education and Labor Committee was the first to report, the Ways and 
Means Committee finally reported just before the Fourth of July recess, 
and the Energy and Commerce Committee reported that it was unable to 
arrive at a point in its deliberations that anything could be reported 
to the House.

  Earlier, the Senate Labor and Human Resources Committee had reported 
a bill; and about the time of the July 4 break, the Senate Finance 
Committee reported a bill. So, what we have now are two bills reported 
by House Committees and two bills reported by Senate Committees, and no 
bill in particular that is slated at this time to come to the House. 
So, at this juncture, it is fair to say the House does not know the 
parameters of a measure that will come to the House for consideration.
  The majority leader of the House and the majority leader of the 
Senate are now to meet behind closed doors and assemble a bill from the 
four bills that are now reported, but their deliberations are not 
confined to those four bills. So, what is likely to come before both 
the House and the Senate is a measure that will have been pasted 
together and on which no hearings will have been held per se and about 
which budget impact data will not be available and about which there 
will be many questions in the implementation, should the measure pass.
  From what I have heard from my own constituency, several matters 
stand out. There is a high level of concern that it is very important 
that Congress take the time to do well whatever it does on health care 
reform, rather than it do it quickly. Cost and impact data are of vital 
concern to every American, most especially to those who currently have 
health insurance, but even to a large percentage to those who do not 
have health insurance.
  Second, what all of this is going to cost in terms of dollars, and 
potentially jobs, is a matter of great concern. The President in his 
rhetorical statement of last September indicated that all of the reform 
that he wishes to accomplish could be achieved with minimal tax 
implications. No one believes this. The respective committees of the 
Congress tell us this is not true, but neither can they tell us what it 
will cost. In casual discussions here on the floor with members of the 
Ways and Means Committee immediately prior to the July 4 break, members 
of the committee itself said that they were not dealing with any 
numbers that they consider reliable. How then can a measure that is 
going to be pasted together and on which no hearings are going to be 
held be able to give us any idea as to the cost and impact on the very 
citizens this measure is purported to help?
  There are a lot of issues related to health care reform about which 
there is a broad concern in the Congress, reflecting the concerns that 
are at large in the country. These are mainly cost containment, 
administrative simplification, portability, preexisting condition 
issues, tort reform, and access either to the insurance system or to 
the medical system. I believe a bipartisan consensus could be built to 
address these specific issues. I also want to emphasize that there are 
some concerns related to rural areas that are unique, and there is 
thought that what may work on a larger scale for a majority of the 
population may not work so well in rural areas where the sparseness of 
population and difficulties of consolidating resources obtain.

  I am concerned that the Congress at this juncture not proceed with a 
public relations effort to pass just anything in order to say it has 
done something. I do not believe the broad implications of health care 
reform either as to cost or to the implications that lie in the 
administration of many ideas contained in health care reform are well 
understood by us collectively; and I think this whole subject is one 
about which we should proceed with a good, collective understanding not 
only among ourselves, but with our constituencies. That is to say, 
given the fact that we will be taking action that will have serious 
impact on one-sixth to one-seventh of our entire economy, we had better 
know very well among ourselves what we are doing and make sure that our 
constituencies understand with us what it is that we are doing. This is 
too broad and deep and profound an issue to be dealt with cursorily or 
lightly or with more of a view to public relations impact than to 
substance.
  I am also alarmed, if present reports and work-of-mouth scuttlebutt 
is true, that the objective of the majority is to put together a plan 
excluding any minority input, posturing to make the minority seem 
obstructionist if it does not swallow the concepts being pasted 
together by the respective majority leaders. This is an issue that 
affects all Americans, and through their elected representatives all 
Americans should have input to the process.
  I would be remiss if I did not note that my understanding of 
bipartisanship in the Clinton era by the Clintonians is if Republicans 
sign on without question to the ideas put forth by the administration, 
then we are acting in a good, bipartisan way. My view of a bipartisan 
product is that both parties and different points of view come together 
to work out what is doable and attainable. Thus far, there has been a 
genuine attempt at bipartisanship, but with no real success. The 
Republicans have been largely shut out of the process here in the 
House--the Republicans not being at the table until the majority caucus 
of the pertinent committees have decided what they want to do, the 
committees than ratifying what the caucuses agreed they could 
respectively pass. Of course, that did not happen in the Energy and 
Commerce Committee because not enough members of the majority would 
vote with the majority to make a majority in the full committee. So 
what we have here in the House, at this juncture, are two bills, each 
of which have been reported by the narrowest of margins, which will 
probably be used for guidelines for the larger measure to be introduced 
in the future but not exclusively so. I reserve judgment as to whether 
anything that has been reported by the two Senate committees could 
serve as a basis for a measure that could go forward in a bipartisan 
way.
  I am very frustrated by how the process relating to health care 
reform has worked thus far, and I hope the mechanism may be found by 
which a truly bipartisan measure may be reported, to the benefit of the 
American people and not for partisan gamesmanship.

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