[Congressional Record Volume 140, Number 99 (Tuesday, July 26, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 26, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                 EFFECTIVE HEALTH CARE REFORM THIS YEAR

  Mr. BOND. Mr. President, I thank my distinguished colleague from 
Nebraska. I want to join with him in expressing our commitment and our 
interest and our optimism that we can have effective health care reform 
this year. A lot of us have worked a long time to identify what is 
wrong in the health care system and what can be done about it. I 
believe that a consensus has emerged in this body. I have talked with 
colleagues on both sides of the aisle, and I think we understand what 
is wrong.
  We know that we have some of the finest health care in the world 
available in the United States today, and we do not want to destroy 
that. But we have too many people who do not have health care. We have 
people who lose their health care insurance or other coverage because 
they get sick. Companies--``cherry pickers'' they are sometimes 
called--quote very low prices for healthy groups, and then when you get 
sick, they cancel the policy. That is unacceptable.
  We also have cost shifting. Hospitals and other health care providers 
have to provide care to those who cannot afford it or who do not pay 
and, as a result, they charge those who do pay for private insurance or 
for their own health care. They charge on the average something like 
130 percent of the cost to cover up the charges for the cost-shifted, 
uncompensated care.
  We have health care costs that have gone up too high because of 
medical malpractice judgments, liabilities, and lawsuits that reward 
the lawyers rather than those injured by malpractice. And that causes 
doctors and hospitals to go through needless procedures, not for the 
health benefits that they provide, but as defenses against lawsuits.
  We have an outmoded administrative system where we have, going into 
the 21st century, a 19th century quill-and-scroll type of accounting 
for health care. You file your health care claims and they are handled 
by hand, by paperwork. The burden costs billions of dollars.
  We can deal with all of those. There are a number of bills that have 
been proposed in this body. I happen to join the distinguished Senator 
from Rhode Island [Mr. Chafee], on the HEART proposal. There is a 
Durenberger- Breaux bill. There are measures that are supported by my 
distinguished colleague from Nebraska, and others, that solve the 
problems of health care but do not try to fix what is not broken.
  I join in congratulating the President and the First Lady for having 
made health care a priority. It is time that we get on with the job of 
dealing with fixing what is wrong in health care. But it is clear, as I 
have talked to people in my State and I suspect as my colleagues have 
talked to people in their States, that the American public is not ready 
and a majority in this body is not ready to turn health care over to 
Government, to have Government bureaucracies setting prices, 
establishing budgets, telling people that they must get health care, 
imposing a payroll tax. It is known as an employer mandate. It is a 
payroll tax.
  That is not the way to get universal coverage. It is a payroll tax on 
employers that would cost jobs. We need real malpractice reform. We 
need electronic filing for health care administration. And, most of 
all, we need to bring the forces of competition to work in the 
marketplace so that under a reformed health care insurance system, 
people will shop for health care. They can utilize cooperatives. They 
are not going to be forced to purchase through a Government-run 
monopoly, an HPC, a regional health care alliance. They can make their 
choices. They can buy health care coverage that is the best deal for 
them.
  We have seen where competition exists in the small market--
experiments in California, in my State, and other States, where 
cooperatives have worked--and yes, you can bring down health care 
costs. You can do it through competition. You can stop cost shifting if 
the Federal Government will reimburse hospitals and health care 
providers under Medicare and Medicaid the full cost of the service. The 
Federal Government is the culprit.
  Mr. President, I join with my colleagues in saying a mainstream 
effort can succeed, and we urge the majority leader to work with us to 
fix what is wrong with health care.
  Mr. DORGAN addressed the Chair.
  The PRESIDING OFFICER. The Senator from North Dakota [Mr. Dorgan], is 
recognized for 10 minutes.
  Mr. DORGAN. Mr. President, under the previous order, I understand I 
was allowed 10 minutes this morning.
  The PRESIDING OFFICER. The Senator is correct.

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