[Congressional Record Volume 140, Number 89 (Tuesday, July 12, 1994)]
[Senate]
[Page S]
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]

 
                           HEALTH CARE REFORM

  Mr. DOLE. Mr. President, health care is a big problem, no question 
about it. It is going to be a big issue. I understand the majority 
leader indicated earlier today we are going to take it up in late July 
in the Senate. That may be or may not be, because I am not certain what 
will be coming up.
  There is a piece by Robert J. Samuelson, who is a Democrat economist, 
in this week's Newsweek. It is entitled: ``Our Health Care. Start 
Over.'' He gives you good reasons why we ought to start over. He just 
says at the start, ``A bad bill would be worse than no bill at all.''
  I think he is exactly right, and I would certainly recommend this for 
the reading of all my colleagues on both sides of the aisle. Mr. 
Samuelson does not always agree with me; he has been a critic of some 
of the things I have done. But in this case, whether it is the Finance 
Committee bill or whether it is the so-called Kennedy bill, the Labor 
Committee bill, or the two or three bills the House passed out of 
committees, I think he is right. What he suggests is we ought to do it 
right. The American people want us to do it right. They are not 
interested in deadlines. They are not interested in who gains or who 
loses in politics in November 1994. They want to get it right. And they 
want us to take care of preexisting conditions that affect millions of 
people. They want us to take care of portability so they can move from 
one job to the other without losing their benefits.
  There are a lot of things, probably 20 things we could have a voice 
vote on here today and pass, where everybody agrees. And if we do not 
do that, then we are denying literally millions of people opportunities 
they should have. Let small businesses go together, small businessmen, 
business women, pool their resources, get better deals from insurance 
companies, better coverage for their workers. Do not tell the American 
people you can only have one standard benefit package, as the 
administration does and as the Finance Committee bill does. One size 
fits all. You cannot buy any less. If you are a 22-year-old and do not 
have a family and want to buy a catastrophic plan, you cannot do that 
because that is less than the standard plan. The Government is going to 
tell you what you can buy. You cannot buy any less. You can buy more, 
but you cannot buy any less. And all that is discussed in this article 
by Mr. Samuelson.
  Now, I have had an opportunity to travel some here lately, and there 
is no doubt about it: The opposition to the President's plan is growing 
in all parts of America, whether you be Democrat or an Independent or 
Republican, or whether you really do not care about politics at all. I 
guess when the President first announced his plan, he probably had 74 
percent support. That is what a poll showed. The same poll shows 32, 33 
percent now; some maybe 38, 39. So the President is now saying, well--
he does not say it, but he says, well, my plan is not any good, but the 
other plans are not any good either.
  Last week, or 10 days ago, 40 Republican Senators out of 44 said OK, 
let us put a plan out there so the American people know where we stand. 
We are not doing it in any partisan way because we are trying to attack 
Democrats. In fact, we were in touch with 14 of our Democrat colleagues 
and in touch with Democrats and Republicans in the House.
  So I introduced, with Senator Packwood, a bill that we think does the 
very things that Mr. Samuelson and other people talk about.
  Preexisting condition. If somebody has cancer in the family, should 
you be denied coverage for the family? The answer is no. Take care of 
it. If you do not have the money, should somebody subsidize coverage? 
The answer is yes, and we take care of it. But we do not have employer 
mandates. We are not trying to put people out of work. The employer 
mandate is an employer tax. It is a tax on business. And in the State 
of Kansas, where 90 percent of your employers have 10 or fewer 
employees, small businessmen and small business women are the backbone 
of our economy; they are doing all they can for their employees, but 
there are limits.
  So in the Dole-Packwood plan, there are no mandates, no new taxes, 
and no price controls. We think that is important. I have not had 
anybody write in and say to me, ``We want more taxes,'' after the $265 
billion tax increase imposed on the American public last year. And some 
say that is why the dollar is falling apart, because of the big tax 
increase.
  The President said the Dole-Packwood plan does not do anything for 
the middle class. Well, I guess what I should say is the President is 
wrong. I want to take just a few minutes to set the record straight and 
list some of the ways in which our proposal helps average, hard-working 
Americans whose primary interests are keeping a job and providing for 
their families.
  First of all, as I said, taxes. If there is one thing middle-class 
America is tired of, it is taxes. The Dole-Packwood plan does not 
contain 1 cent of new taxes, nor does it raise any existing tax. The 
same cannot be said about the President's plan or about the plan passed 
by the Senate Finance Committee 10 days ago. No one knows for certain 
what actually passed in the Finance Committee, but some estimates on 
the new taxes in the bill are as high as $500 billion over the next 5 
years.
  Quality. Quality is very important to the American people. Polls show 
that 85 percent of Americans are satisfied with the health care they 
receive. And the American health care system, while certainly not 
perfect, is the best in the world. The Dole-Packwood plan would 
maintain that quality by leaving control in the hands of the American 
people and their doctors. The President's plan would compromise that 
quality through more Government, more regulations, and more mandates.
  No. 3, we do not increase the deficit, which also affects the middle 
class and everybody else in America. Americans are concerned about the 
future of their children, and if there is one thing that endangers that 
future, it is the Federal budget deficit. The Dole-Packwood plan 
provides a fiscal ``fail-safe'' mechanism to assure that reforms are 
implemented on a pay-as-you-go basis. If you do not have the money, you 
do not increase the benefits. And you do not raise taxes.
  The Clinton plan, on the other hand, promises everything to everyone. 
Even the nonpartisan Congressional Budget Office has estimated the 
Clinton plan will add at least $70 billion to the deficit by the year 
2000. And we always underestimate things around here, so who knows what 
the real figure is?
  Choice is another thing I think affects the middle class, and 
everybody else. In today's market, people buy the insurance they think 
best fits their needs, as it should be in a free country. The 
President's plan makes it illegal for Americans to buy anything less 
than the standard plan the Government approves.
  Can you imagine that? In a free country like America, you have to buy 
their plan. You cannot buy anything less in America. Nothing less. You 
have to take it. That is it. Now, to me, that is not what the American 
people may have voted for in 1992. If you took a survey now and asked 
the American people: Do you want a choice of plans; do you want the 
same choice that Members of Congress have--where we have 20 different 
options, you only get one. You can only have one. If you do not like 
it, that is tough. Oh, you can buy more, but you cannot buy any less.
  Some of these standard benefit packages are very rich, and some of 
the benefits in those packages are never going to be used by some 
people in America. But you cannot say, well, I do not want this or I do 
not want that, because that is in the benefit package. You have to buy 
it. That is one size fits all.
  As I said, you may be single; you may be 22 years of age; you may 
have a job; you may not have a lot of money; you may want catastrophic 
coverage; you may want a medical savings account where, if you put more 
money in a medical savings account, your employer does, and you do not 
spend it all, you get it back at the end of the year. It is yours. You 
do not have to pay tax on it. You put it in. If it is $2,000 and you 
only spend $1,000--it is first-dollar coverage--you get the other 
$1,000 back at the end of the year.
  Not bad. You cannot do that in the administration's plan. We do not 
have any job-killing employer mandates. Americans want health care. But 
they do not want to pay for it with their jobs. My colleagues keep 
saying, ``Oh, 73 percent of the American people said they want employer 
mandates.'' How many? They did not take the poll just with employers. 
If anybody said, ``Do you want somebody else to pay for your 
insurance?'' you probably would say, ``Sure. Why not?'' So 73 percent 
of the American people said let somebody else pay for it. I guess the 
other 27 percent must be the employers. It must be that small 
businessman and that small businesswoman in Kansas, California, or 
South Carolina or somewhere else. ``You pay for it.'' So I am not 
surprised at that poll.
  But the Clinton plan and many of the other plans contain employer 
mandates. Now they have a new thing they call trigger. It is a trigger. 
It says if we do not have employer mandates, if we do not reach a 
certain percentage of coverage by the year 2002, then we just 
automatically trigger a mandate. A mandate is an employer tax. It is a 
tax on your business.
  In fact, I spoke this morning by phone with the National Restaurant 
Association. They are having town meetings all across America. They 
create a lot of jobs, lot of part-time jobs for a lot of young people 
who work after school and who are not out on the streets. They are 
worried about employer mandates. They want to provide all the coverage 
they can. But they do not want to have people have to leave their job 
because they cannot afford to pay. So mandates whether they are 
triggered or untriggered are bad. They are taxes. They ought to be 
called taxes.
  Portability: Many Americans find it impossible or expensive to obtain 
health insurance if they have a family member who is already sick or 
who has health care problems. This is called a preexisting condition. 
And it is one of the reasons people get locked into a job and is 
because they do not want to leave. If somebody has a preexisting 
condition, you are covered in your present job. You do not dare leave 
because you cannot get coverage again. We are going to guarantee in the 
Dole-Packwood bill that you be able to get insurance at an affordable 
price and not risk losing that insurance if you change jobs which is 
very important.
  A lot of people call it job lock. ``I cannot leave my job because of 
the insurance.'' If you watch some of these programs, all of the 
anecdotes, these terrible stories about tragedies, about people who 
have preexisting conditions, or do not have portability, it ought to be 
fixed.
  Fairness: The Clinton plan says that everyone should pay the same 
amount for health insurance, the process known as community rating. The 
Dole-Packwood plan sees this practice as unfair to younger people who 
most often use less health care. That is why Dole-Packwood allows 
variations in the price of insurance based on age.
  Let me give you an example. New York, a great State, the Empire 
State. They tried this community rating. They tried what we call pure 
community rating. They tried it not long ago. The increased costs led 
about 25,000 young New Yorkers to drop their insurance in the first 9 
months of enactment because they are paying 4, 5, or 6 times what they 
ought to be paying. Somebody has to defend the young people in America. 
They are the ones out there that are going to be the leaders of 
tomorrow and the workers of tomorrow--in fact, they are the workers of 
tomorrow. Why should a young American just starting out making $15,000 
a year subsidize the health care of middle-aged professionals making 
$50,000 a year? It does not make any sense. That is what happens under 
the President's bill.
  Small businesses. Small business men and women are the backbone of 
America's economy. The Dole-Packwood plan helps small business in many 
ways and here are three.
  First, small businesses can join together in pools to provide more 
coverage at better rates with their employers.
  Second, small business and those who are self-employed can enroll in 
the Federal Employees Health Benefit Program. We give those people the 
same choice that Members of Congress and the President now enjoy. If it 
is good enough for us, it ought to be good enough for them. Why cannot 
they have that right? To ensure that they should have that right, it is 
in our bill.
  Third, if you are a self-employed small business person or individual 
who buys his own insurance, you cannot deduct health insurance costs. 
You can deduct up to 25 percent. Under our provision, the bill phases 
in tax deductibility up to 100 percent. If you are a rancher, if you 
are a small farmer, if you are a self-employed business man or woman, 
you will be able to deduct 100 percent of your insurance costs like 
everybody else. We are going to give you the same treatment as that 
received by anyone whose employer contributes to their health care 
insurance costs.
  So does the Dole-Packwood proposal help the middle class? You bet it 
does. That is one of the reasons I am proud to cosponsor the 
legislation, and why it has earned the support of 40 Republican 
Senators and many outstanding organizations across America.
  Madam President, I think my leader time has probably expired. But I 
would like to now speak briefly on the striker replacement motion.
  The PRESIDING OFFICER. The Senator has that right.

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