[Congressional Record Volume 140, Number 100 (Wednesday, July 27, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 27, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
 HEALTH CARE REFORM: PIZZA HUT, McDONALD'S, AND THE FAST-FOOD INDUSTRY

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
February 11, 1994, and June 10, 1994, the gentleman from West Virginia 
[Mr. Wise] is recognized for 60 minutes as the designee of the majority 
leader.
  Mr. WISE. Mr. Speaker, I am joined by Ms. DeLauro in taking out this 
special order today. The gentlewoman from Connecticut and I want to 
talk some about something that I know both of us enjoy a lot, in fact I 
believe every American does, and that is pizza, certainly one of 
America's most common meals.
  But in enjoying pizza, we need to know something, that while it might 
not be the best for preventive medicine or preventive health, it is 
still very enjoyable to eat, of course, the problem with pizza is that 
it often does not provide for health, provide for health care.
  So in talking about pizza--incidentally, I note with interest that 
during the health care debate for some reason I have become the expert 
about health care and pizza, mainly because the first claims made by 
Godfather's Pizza and then the study that came out in the health care 
reform project about the practices of Pizza Hut in purchasing health 
care, that I have chosen to focus on pizza and the fast-food industry 
and pizza particularly.
  Now, I think in pizza--always, of course, subject to a good pie 
chart--I think in pizza there is often told the story of health care 
because pizza reflects what is often said about health care and it also 
reflects what is not true about health care.
  So I am going to be quoting extensively during this discussion from 
the health care reform project study as well as some of my own 
analyses.
  First of all, what the health care reform project looked at was the 
practices of Pizza Hut and McDonald's, two of our largest fast-food 
producers, and how they were treated in other countries. And what they 
found was that in four other nations where both these companies serve, 
that they paid health care costs. Why? Because the Governments require 
them to.
  There is a concept of shared responsibility, the employer and 
employee are expected to contribute to health care, and the goal is to 
have everyone with guaranteed private insurance that cannot be taken 
away.
  So the health care reform project looked at Belgium, Germany, Japan, 
and the Netherlands. What they found out was that Pizza Hut--doing 
quite well in those countries as it is, I might add, in the United 
States--what they found out was that in those nations, that these 
companies, Pizza Hut and McDonald's, paid for health care insurance 
because the Government requires them to. They do not pay in the same 
way in the United States.
  And yet they argue that if they are forced to pay in the United 
States, that somehow this is going to cause the loss of tens of 
thousands of jobs. I think it is worth looking at some of the claims 
that Pizza Hut and McDonald's make.
  Incidentally, as I get to that, I am not necessarily singling out 
Pizza Hut or McDonald's. I happen to be a patron, my family and I are 
patrons of both. We like the breadsticks, which come a little slowly to 
the table, but otherwise it is a pretty good pizza.
  But what we do not appreciate is the fact that those who work in 
Pizza Hut, those who work in McDonald's, and those who work in many 
other fast-food chains do not have the same health care coverage as 
many of the customers that come in the door.
  So this is not to single out two companies in particular but to use 
them as examples and to say that it is most likely true in the fast-
food industry and in many other small businesses.
  Now, let us look at some of the facts: First of all, in response to 
the Health Care Reform Project study, what Pizza Hut and McDonald's 
said was that--particularly Pizza Hut--was that if you force us to 
provide health insurance in the United States in the same way that we 
are paying in other countries, in other words, we are willing to treat 
employees in other nations better than we treat employees in this 
Nation, in our Nation, in the United States of America, but if you 
force us to do that, then what you will see is a loss of thousands of 
jobs and one reason is because of skyrocketing prices. ``We will have 
to charge more,'' they say. In fact, if you look at Germany and Japan, 
the price of pizza is much higher. An $11 pizza might be as much as 
$19,'' and I believe the figure was used, ``$23 in those countries.'' 
Well, yes, that is true.
  What they do not point out is this: That because of the difference in 
the yen, deutsche mark and dollar and the fact that the yen and 
deutsche mark are going stronger as the dollar grows weaker, that that 
means that anything priced in dollars overseas becomes more expensive 
everyday. So the exchange rate is causing some of that difference.
  The second thing they are not pointing out is their prices are higher 
in those countries mainly because those countries have a higher per 
capita income. So there is no real correlation.
  In fact, if you look, I think it is interesting to note in the 
practices in other countries, in Germany and Japan--I do not think, 
while they are going through some recession at this point, no one 
thinks their economy is ready to bottom out--Germany and Japan both 
charge the employer 50 percent of the premium cost for insurance and 
the employee pays 50 percent. In Belgium, one of the other countries 
studied, the employer pays almost 4 percent of wages and the employee 
2\1/2\ percent. In the Netherlands the employer pays almost 5 percent 
of wages and the employee about 3.15 percent.
  So let us look at the economics behind pizza. I have spent some time 
studying pizza. I regret that I do not have my pie charts with me, but 
another day perhaps.
  Most acknowledge that labor costs in making pizza are about 25 to 30 
percent. So that means whatever the cost of that pizza, remember that 
cost is built into it advertising, marketing, food acquisition, 
management, administration and wages and labor. Labor costs around 30 
percent for Pizza Hut, 30 percent for most fast-food industries. In 
some cases it is actually lower. That means then that on a $10 pizza--
and, yes, you can still get a $10 pizza--on a $10 pizza that means 
about $3.35 is labor. That means then that under the original Clinton 
bill--and, of course, the Clinton bill is not with us anymore, and the 
assistance that it provided to small business is even better now under 
the new proposal--but let us take the Clinton bill. The Clinton bill 
says that the employer would be responsible for 80 percent of premiums. 
What many people have chosen not to focus on, particularly the 
opponents like Pizza Hut, while 80 percent of the premium was to be 
paid by the employer, in no event was that premium to exceed 7.9 
percent, and in some cases, for small businesses under 25 employees, it 
would be as low as 3.5 percent.

                              {time}  1430

  Three and a half percent of payroll; what that means then is, if you 
have a $10 pizza, and a third of the cost is roughly $3.35, then what 
you have is you have about $3.35 times--round it off to 8 percent--you 
got about 24 cents, 20 to 24 cents, of that would be reflected as an 
increase resulting from health care legislation. That is without, of 
course, factoring in some offsets. First of all, it is that every 
insurance policy has built into it, that you and I pay for and every 
working person, every insurance policy has built into it, about 25 
percent of its premium cost is not going to our health care. It is 
going to pay for the health care of people who do not have insurance, 
namely the fast food employees and a lot of people like them, so Pizza 
Hut could save some money on the insurance it provides by providing the 
insurance for everyone.
  Second thing is that it is very likely that workers compensation 
costs, which are often a large factor in many businesses, would be 
significantly lower were this legislation to pass because, instead of 
using the workers comp system, the employer would be able to then send 
that employee who is injured on the job to get medical care, health 
care, based upon their health plan, not upon the workers comp plan. So, 
let us do some factoring then.

  Ten dollar pizza. We estimate that, at the most, the increase in cost 
would be 20 to 24 percent. I priced new toppings incidentally at a 
pizza restaurant the other day and found out that a new topping or an 
additional topping is about 60 cents, so that for about one-third the 
cost of a new topping, Mr. Speaker, we have got health care for 
everybody who works in that restaurant.
  But I do not want to make it sound like I am just singling out pizza, 
so let us move on to the land of the Happy Meal, to the land of Ronald 
McDonald, or to any other burger that may be your pleasure. We happen 
to spend a lot of time, having two young children, with Happy Meals. I 
say, ``You get the burger, small burger, you get the drink, and you get 
the fries, usually for around $3.'' Well, let us price that out.
  That means for that fast food employer, that $3 meal, one third the 
cost is labor. So that is about a dollar. Under the original proposals, 
that would have meant a limitation of no more than 8 percent. So, for 8 
cents on that $3 meal, every employee in there would have had health 
care. Indeed once again you also would have saved workers comp costs 
and cost shifting, so the Happy Meal apparently is happy in everything 
but health care.
  Mr. Speaker, these are the kinds of put-your-pencil-to-the-paper 
calculations that are so essential. If I hear one more business person 
who says--actually let me back off. If I hear one more person who says 
they speak for the business community, talk about the thousands of jobs 
that will be lost, the massive unemployment if health care legislation 
passes, and yet is not willing to take their pen or pencil, and put it 
to the paper, and see how it affects their business--I grow quite 
disturbed at this phenomenon because what 9 out of 10 businesses find 
is that, when they do this exercise, what they find is they come out 
better than they are today. They have a better policy because they 
would have a comprehensive policy at a cheaper rate.
  Now Pizza Hut has stated in some of the news accounts that that is 
all right because 70 percent of their employees have insurance 
somewhere else. they are covered some other way. Well, how is that? 
They are covered because in most cases the employee is either working 
another job someplace else that does cover, or the employee's spouse, 
or some other provider in the family, is covered. But what they are 
saying is:

       It's all right for the business down the street, which 
     probably isn't as large as Pizza Hut or McDonald's it's all 
     right for the mom and pop restaurant to do everything 
     possible to provide insurance for its people at a much 
     greater cost while Pizza Hut and McDonald's ignore their 
     shared responsibility.

  It is alright, for instance, to have General Motors pay more for 
insurance, health insurance, than the cost of the steel that goes into 
every car. That is all right, to shift that cost to somebody else, 
because that is what we are talking about. We are talking about 
shifting costs.
  If Pizza Hut employees do not get it at Pizza Hut and they are 
covered by insurance, they are getting it someplace else, usually 
through the spouse's employer, and that means, once again, somebody 
else is pricking up the tab. I say, if you don't pay for it here, it 
gets paid for over here.
  Finally, Mr. Speaker, let me make the last argument for a while. What 
about if they do not pay? What about why should we ask our businesses 
to pay? Because eventually everybody who is not covered is going to get 
health care, but the way they get it is the most expensive way. It 
means that you put off doing the basic health care that is essential. 
You put off the primary care. You put off the prenatal care. You put 
off the early intervention care. You wait until you are the sickest, 
and you go into the emergency room of our local hospital where care 
will be administered to you, and it will cost four times as much, and 
if you are not able to pay, the cost gets spread out to everybody else 
who comes into that hospital that year. So once again we all pay.
  Mr. Speaker, I just urge people, when they go to a fast food 
restaurant, to put their own pencil to the napkin. I say to my 
colleagues, take a look at that menu when you order it, and when they 
tell you that they would have to increase the price dollars 30 to 40 
percent. figure it out. Say, ``Well, the most that anybody has talked 
about has been 8 percent of payroll.'' Take a third of what's on that 
menu, and then multiply that by percent, and in most cases the only 
increase you're going to see, if any, is a very insignificant one, and 
then factor in what would it mean if I didn't in my insurance, if I 
didn't have to pay 30 percent on my premium for cost shifting? What 
would it mean to this employer if he or she did not have to pay as much 
worker comp? What would it mean to our society as a whole if everybody 
were covered?

  That is why we have to be careful when we go into a fast food 
restaurant and see the sign that says ``special today,'' or perhaps, 
``We are going to throw bread sticks in free with the pizza.'' There is 
no free lunch around here. The bread sticks cost. They are costing the 
health care, unfortunately, of the employees there. There is no bonus 
for anybody in that situation.
  Mr. Speaker, I appreciate the chance to talk about pizza, always a 
popular subject. I now yield to the gentlewoman from Connecticut [Ms. 
DeLauro].
  Ms. DeLAURO. Mr. Speaker, I want to thank the gentleman from West 
Virginia [Mr. Wise] for initiating this discussion this afternoon and 
for his outstanding role throughout the health care debate and as we go 
into the final weeks of this debate and the final passage of health 
care reform in this country.
  Over the last several months, as we have debated this issue of health 
care reform and the merits of health care reform, and it has been a 
national debate, we have found ourselves taking a look at other 
countries who provide health care for all of their citizens, and the 
logical question here arises, and a number of my constituents have 
asked me this question: ``If Germany and Japan can give their citizens 
health care coverage, why can't we?'' It is a good question. That 
question is made all the more disturbing when we consider that some of 
this country's largest corporations in fact provide health insurance 
for their employees in Germany and Japan, but not for their employees 
who work in the United States. This in my view is a double standard, 
and in fact it is a double standard.
  So, Mr. Speaker, if Pizza Hut and McDonald's, as the gentleman from 
West Virginia [Mr. Wise] has pointed out, can provide health insurance 
for their workers overseas, again a logical question: ``Why can't they 
provide insurance for their workers here in the United States?'' The 
response from Pizza Hut, and McDonald's and others has consistently 
been that providing health insurance for all U.S. employees will hurt 
business, will force them to raise their prices and will lead to a job 
loss.

                              {time}  1440

  We truly do understand in this body, and my colleague from West 
Virginia and myself and others who will participate here today, that 
Pizza Hut and McDonald's and other fast food chains, and, for that 
matter, other businesses, are concerned about the costs of covering low 
wage, part-time employees. But the assertion that costs covering 
employees will hurt business, lead to massive job loss, or cause a rise 
in food prices, is nothing more than a scare tactic, and we need to 
look at the facts, some of which my colleague has already pointed out.
  In Japan, where employers are required to contribute to their 
employees' health care, Pizza Hut intends to boost the total number of 
Pizza Huts in Japan by more than 300 percent within a 5-year period of 
time.
  In the Netherlands, McDonald's now has 100 stores, a 17.6 percent 
increase over last year. Clearly employer responsibility is not hurting 
U.S. business in their countries.
  Employer responsibility does not hurt job growth either. Employment 
at Pizza Hut in Germany increased 23 percent from 1992 to 1993. Also in 
Germany, employment at McDonald's is thriving. In 1992, it had 27,000 
employees and revenues of nearly $1 billion. Employer responsibility is 
not hurting job growth. It is not hurting job growth in Germany and in 
Japan.
  What of the charge by Pizza Hut that the higher costs for their 
products overseas is a reflection of their requirement to provide 
health care? One problem that they failed to mention is virtually 
everything costs a bit more in Germany and Japan than in the United 
States. But they fail to talk about that.
  But this is not to say what we are doing here this afternoon is not 
to say that requiring the company to cover employees will not have some 
impact on the price of its product. That is not the point. However, 
Pizza Hut's claim that their prices would soar from $11 a pizza to $25 
a pizza if they have to pay for health insurance is a gross 
exaggeration. Most estimates, as my colleague has pointed out, will see 
a likely increase in the cost per pizza of closer to 40 cents a pizza, 
not $8 as this company has claimed.
  What this debate is all about is shared responsibility between 
employer and employee. Fast food chains should know better than anyone 
that there is no such thing as a free lunch. If they are not paying for 
the health insurance for their employees, who is? The answer, of 
course, is everyone else is picking up that cost.
  When a Pizza Hut or McDonald's abdicates its responsibility to pay 
for employee health coverage, it does not keep their employees from 
getting sick. They get sick the way everyone else does. Working 
Americans still must attend to the health care needs of their families, 
their children still need to have vaccinations, they still need 
prescription drugs, and their parents need long-term care. But the cost 
of that health care is more expensive, because working families who are 
left without insurance by employers tend to put off seeking care until 
they find themselves in need of emergency care. Emergency room 
physicians have become the primary care givers for too many of the 
uninsured working families, and you and I pay for those costs. What we 
have found is that those who are uninsured are not those who are 
unemployed. Most of the uninsured are working in small businesses, with 
under 25 people, whose employer does not have the wherewithal to 
potentially provide the opportunity for a shared responsibility between 
employer and employee.
  Many unisured workers are hourly employees, like those who work at 
Pizza Hut and McDonald's and other service industry jobs. And the rest 
of us with health insurance pay to cover 86 percent of their hourly 
employees through cost shifting and uncompensated care.
  So whose responsibility is it to cover Pizza Hut's employees, or 
McDonald's employees? Is it Pizza Hut's, or is it ours?
  Pizza Hut says that they meet their responsibilities by offering 
employees health insurance. But offering is not the same thing as 
providing insurance. And offering something that is out of the reach of 
most of their employees is an empty gesture at best. They have a plan, 
they make it available, but they do not pay for anything, and, in fact, 
only 14 percent of hourly restaurant workers at Pizza Hut participate 
in the company's insurance program, because those employees cannot 
afford to pay 100 percent of the costs.
  McDonald's does not cover its hourly or part-time workers at its U.S. 
restaurants. However, they do in fact cover hourly or part-time workers 
in Belgium, Germany, Japan, and in the Netherlands. And for a company 
that has wooed the American public for years with the slogan ``You 
deserve a break today,'' we believe that McDonald's workers deserve a 
break today on the cost of their health care.
  Like McDonald's, Pizza Hut does not cover its hourly or part-time 
workers at its U.S. restaurants. However, they do cover hourly or part-
time workers in Germany and in Japan.
  Now, in response to the threat of health care reform in this country 
that will ask employers to pay their fair share, Pizza Hut has launched 
a public relations campaign to scare the American public into believing 
that the Congress is out to take away their pepperoni pizzas, and 
nothing could be further from the truth. We want them to keep 
delivering pizzas to the American people, and we want them to deliver 
health care to the American people.
  Providing health care for every American will not come at the expense 
of American business. In fact, it is our current health care system 
that is bad for business, and particularly for small businesses. And 
that is why the CEO's of the big three auto companies came to 
Washington to make the case for a system of shared responsibility 
between employer and employee. Why? Because they are doing the right 
thing by providing health insurance for their employees, but they are 
also paying for Pizza Hut and McDonald's employees every time one of 
those employees has to go to the hospital.
  So we need to reform our current system. Nobody is talking about 
rebuilding it, but reforming it, and that is why we need health care 
reform that builds on our current system of shared responsibility 
between employer and employee. Nine out of ten people today in this 
country who are covered by health insurance get it through their place 
of employment. It is a system that works for employers and employees, 
and only by bringing everyone into the health care system can we 
achieve public, private guaranteed health care insurance for everyone 
at a cost that businesses and working families can afford and that can 
never be taken away from people.
  We need to ask these corporate citizens to play fair in the United 
States. They are doing their responsibility in other countries, but 
come home and play fair with the people in this Nation, give them a 
break on their health insurance costs today. The American public 
deserves no less.
  Mr. WISE. If the gentlewoman will yield, let me get this straight. If 
I am an American, and I do what society asks me to do in this country, 
no matter how difficult, I go to work at a low wage job in a fast food 
outlet, I stand on my feet 8 to 10 hours a day, I don't have much take-
home pay, but I am doing what society asks, and I don't have health 
insurance through my employer, but if I happen to be the same worker in 
Japan or Germany or Belgium or the Netherlands working for the same 
company, I get health insurance?
  Ms. DeLAURO. That is absolutely right, and that is because there is a 
system in those nations that says that every employer must provide 
health care. And, as you pointed out, there are shared 
responsibilities. No one is saying that the employer has got to pick up 
the entire tab for the employee. But it is shared responsibility. That 
is essentially what the debate is about in the United States. If they 
can do it there, they can certainly do it here in this country, and not 
put Americans' lives in jeopardy, because that is in fact what is does, 
because people get sick in this Nation.

                              {time}  1450

  And many are going without health care because they cannot afford it. 
And they are not in a situation in their employment where they have 
that opportunity to share their health care costs with their employer.
  Mr. WISE. The real irony in this situation is that the best thing an 
American Pizza Hut or McDonald's worker could do is to see if it could 
get one of the German, Japanese, Dutch subsidiaries to open a facility 
here and thus they would be covered.
  Indeed, I have heard that story of a person who was working for a 
French company that was a French corporation. They were working in the 
United States. And when they became ill, they were covered by the 
French company but they could not have gotten insurance working for the 
American company.
  I thank the gentlewoman from Connecticut for her very, very eloquent 
statement.
  Another gentleman who has been very active on this issue is the 
gentleman from Texas [Mr. Green].
  I yield to the gentleman from Texas [Mr. Green].
  Mr. GENE GREEN of Texas. Mr. Speaker, I thank the gentleman from West 
Virginia and also the gentlewoman from Connecticut for those words.
  I have been active in the health care debate. Coming from Houston, 
TX, because of serving on the Education and Labor Committee, but also 
the district I represent has 148,000 families who are working, who are 
working at those jobs and their employers do not provide it, one of the 
highest in the country.
  These are people who are out working, and they are not on welfare. 
But they are working and yet they do not have it.
  I rise this afternoon along with my colleagues to bring attention to 
the issue of universal coverage as the essential component of any 
health care reform that we do.
  Universal coverage is the key to lowering the cost and eliminating 
the cost shifting that has caused the sky-rocketing of health care 
insurance premiums. The people of the district that I am honored to 
represent are some of the hardest working people in this country. Yet 
that alarming 148,000 of working Houstonians and working Texans are 
from working families without health care coverage. This is from the 
census data that we received from 1990.
  This is a prime example of what is wrong with our current system. 
These people work and yet have no coverage. We provide them with a 
system where it would be easier to stop working and qualify for 
Medicaid. Yet these people continue to work because they know that 
their work is the way to have a better future for their families.

  We should reward their work with health care and not punish them for 
working by saying, you should go on Medicaid, an additional cost to 
both States and the Federal Government.
  In a recent survey, 74 percent of Americans stated they support 
universal coverage. The AFL-CIO, the AARP, the AMA, with a combined 
membership of 46 million Americans, all agree that universal coverage 
is an essential component of health care. Along with that 74 percent, 
almost three-quarters of Americans support universal coverage.
  Since we have reached some reasonable consensus that whatever bill 
passes needs to have universal coverage as its goal, we must now look 
at the methods on how we can reach that care and how we can reach that 
goal.
  First of all, we can do nothing. We can, Congress can adjourn in 
September or October and say, let us leave the current system as it is 
and see what we can do and let the system correct itself.
  Well, for many years, Presidents from Harry Truman to Richard Nixon 
have suggested national health care. The problems were apparent then, 
and all of a sudden the market changed a little bit and then Congress 
went home and did not do anything. So the problems continued, because 
the only reason we have any health in the last year is because of the 
threat of additional government intervention.
  So we can do nothing. We would continue to see skyrocketing premium 
increases. People would still risk losing their coverage. And our 
national debt would continue to grow under the strain of increased 
health care spending.
  We could enact a government-sponsored plan, whether it be called a 
single payer or any other government plan that would be provided. And 
the Federal Government, like in some of the countries that my 
colleagues have talked about, would provide that insurance.
  I have received so many calls, like a lot of us in Congress from our 
districts, saying, ``we know the system is broke, but we do not want 
the Government to provide it. We don't know if the Government can do 
anything right. So we do not want to trust it to the Government.''
  So we are not even advocating a single payer system, although there 
will be a vote in the next few weeks on that here in the House, because 
we do not want that Government intervention because people do not 
necessarily trust the Federal Government. The proposal has some 
distinct advantages though. It would cover universal care. It would 
take care of everyone universally. But we also know the distrust that 
people have. So let us discount the second mechanism for doing it.
  We can require an individual mandate. That is one of the proposals 
that was considered in the Education and Labor Committee. We could 
require everyone in the United States to provide their health care.
  Well, before I was elected to Congress in 1992, I served 20 years in 
the Texas Legislature, and we tried to deal with automobile insurance 
with an individual mandate. Like most States in this country, including 
West Virginia, it is a mandate that you have automobile liability 
insurance. Today on the roads in Texas, we still have 30 percent of 
those people who are on the road who have no liability insurance 
because of the high cost, because of the availability, for lots of 
different reasons.
  So an individual mandate has not worked in automobile insurance even 
though we have criminal penalties in the State of Texas. And in some 
States, you could lose your automobile for not having liability 
insurance. But we still have a lot uninsured motorists. So the 
individual mandate that is being proposed and will be voted on in the 
next few weeks here just will not work because it has not worked in 
other areas of insurance.
  What we come back down to then is to continue the system we have 
today, the success that we have and to build on the success we have of 
the employer/employee cost sharing that is fairness that we have now. 
Almost 9 out of 10 of the people who have insurance in the United 
States today, through the free market, get it through their employer. 
It is not with a mandate. That would require some fair sharing between 
employers and employees. Even Pizza Hut that was talked about a few 
minutes ago, they offer their employees now some type of health care. 
They just do not want it mandated.
  Well, I would like to see those minimum wage workers, those part-time 
workers, whether it be at Pizza Hut or McDonald's or any other place, 
be able to have that health care, because 9 out of 10 of the people who 
have it now get it through their employers. This keeps the free 
enterprise system that we have, the benefits of it. We have some of the 
highest quality health care in the world here in the United States. We 
have people come from all over the world to our health care centers. 
And particularly in Houston, TX, people come from all over Latin 
America to Houston for health care. They can pay for it though, and 
they come. And they pay very top dollar to come to the University of 
Texas, M.D. Anderson, or to many of our hospitals and our medical 
centers. What we need to do is build on our current system and expand 
that for the people I represent, that 148,000 families who work and do 
not have it, to be able to access that high quality care that we can 
offer in Houston and all over across the country. It opens up our 
quality health care system we have now to those hard working Americans 
that need it.
  Today most people who have their insurance get their insurance 
through their employer, including Members of Congress and the 
President. If we want to make sure that the system we provide also 
includes Members of Congress and the President, we need to have some 
type of employer/employee fair share. We have a 70/30 system now in 
Congress.
  I will be honest with you, before I was elected to Congress and was 
in a business, we had a union contract that required our employer to 
pay 100 percent. So I may be one of the Members of Congress who had 
better health care before I was elected to Congress. But we had 100 
percent coverage for dependents. And we have a lot of quality care in 
the United States today, but this builds on even the system that 
Congress has and the President has. It is cost sharing system.
  This system for all Americans was created by the market forces, by 
free enterprise. No one is mandated that requirement but it was 
created. What we need to do is expand it to those other few people who 
have not been the beneficiaries of our quality system we have now. It 
is very attractive to the best workers. We want to make sure that it is 
attractive to all the workers. By creating a system that is an 
extension of the market-created system we have now, we are retaining 
the best of our current system, the fairness.
  Let us make this work for all the health care system for every one in 
America.
  In closing, I would like to remind my colleagues who may be watching 
and also the American people that this is the last great people-
oriented debate we may have for this century.

                              {time}  1500

  The social policy we talked about, Social Security in the thirties 
and Medicare in the sixties, now we are going to talk about health care 
for everyone in the nineties--hopefully by the time we leave here, we 
will have it on the President's desk--that will cover all Americans. 
When we talk to our children and our grandchildren, 30, 50 years from 
now, maybe they will look back on it just like we today look back on 
the sixties and say how did Congress have such a hard time passing 
Medicare for our senior citizens, or passing a basic pension system in 
the thirties for our senior citizens.
  We cannot imagine 50 years later not having that, or 30 years later 
not having it. I think that 30 to 50 years from now we may be in the 
same situation. My children and my grandchildren will be saying, ``I 
can't believe that it took Congress so long to do something.''
  We need to make sure that Congress leaves with success; that we do 
not simply make history, that we make history on health care fairness, 
not just a big political squabble we have here, and we leave Congress 
in October with some success, and not just with a lot of hot air here.
  Other industrialized nations of the world, as my colleagues have 
pointed out, have taken this step because it is the right thing to do 
economically and politically. There is a great future for all 
Americans. If we vote for health care reform that covers everyone, if 
we pass a plan that contains universal coverage, it will be a better 
life for all Americans.
  Mr. WISE. I want to thank the gentleman. In so many ways he has 
touched on so many points: Universal coverage, big word, but what is 
important that the American people understand is that universal 
coverage is simply guaranteed private, stressed private, health 
insurance that cannot be taken away, and that it has certain elements 
to it.
  The bills we are looking at, you and myself and the gentlewoman from 
Connecticut [Ms. DeLauro] and so many others, these bills would say 
``guaranteed private health insurance that cannot be taken away,'' 
freedom of choice to choose your provider, your doctor, and your plan; 
you want an HMO, you want a provider option, you want a fee-for-
service, choose your provider, choose your plan.
  Medicare as senior citizens know it and have fought for it would be 
preserved. They do not need to worry about Medicare, it is intact.
  There would be true insurance reform. You could not be denied because 
of preexisting illness. There would not be discriminatory pricing. You 
would have rates spread out over the entire population, instead of 
focused just on a few, often who are sick, and therefore the rates rise 
sharply.
  Finally, there would be shared responsibility. The employer, the 
employee, and the Government all would share the responsibility for 
providing this health care.
  Mr. Speaker, the gentleman made another point that I think is very, 
very significant. He spoke about President Nixon, Richard Nixon. I have 
never heard anyone suggest that Richard Nixon was a rank liberal, 
someone that was high on the Americans for Democratic Action rating 
list.
  Yet, it was Richard Nixon, President Richard Nixon, who in the early 
1970's proposed the first shared responsibility, the first employer 
mandate. Interestingly enough, it was in much the same way; it would 
have worked much the same as what has been proposed today.
  The gentleman also brought up another very tender subject: Members of 
Congress. In my town meetings I have heard the refrain coming back to 
me, ``I want to make sure Members of Congress are covered, as well as 
Members should be covered by the plans that everyone else is subject 
to, but more importantly, I demand the same care that Members of 
Congress get.''
  I want people to have that care. As the gentleman points out, it is 
not something special. Nine million Federal employees have that policy. 
Members of Congress pay into the Federal employees' health benefit pool 
the same way that 9 million others do.
  To those afraid of Government bureaucracy, I might add that 9 million 
Government employees or their dependents have their choice of plans, as 
many as 300 nationwide. Every year they can change it if they wish. The 
employer pays and the employee pays. Presently we pay somewhere between 
28 and 30 percent of the premium cost.
  I know that in our family, we have opted for a fee-for-service plan. 
You can buy an HMO. You can buy a PPO. You can buy many different 
varieties.
  Out of all this, how large a role does Government have? What kind of 
giant, awesome bureaucracy is set up to administer this? For 9 million 
people, there are 145 people involved in administering the Federal 
employees' health benefits plan, at a cost of one-tenth of 1 percent of 
what these plans pay out.
  I want the American public to have the kind of coverage that Members 
of Congress and, yes, 9 million other Federal employees and dependents 
have. Incidentally, it is very likely that the plan that will be on the 
House floor will permit some kind of buy-in, particularly for small 
businesses, into that system.
  I thank the gentleman very much for the points that he has made.
  Mr. GENE GREEN of Texas. If the gentleman will continue to yield, if 
I could respond just in brief, when I first was elected in 1992 and 
came to Congress and health care was an issue, I did not agree to vote 
for the President's plan or any of the plans, or co-sign any of them.
  However, I voted for one after working in the Committee on Education 
and Labor for many months on that, to address some of the things you 
talked about. The freedom of choice of physicians, we have that freedom 
of choice. I don't want to go home and tell my constituents that we do 
not have that freedom of choice.
  Whatever plan Congress passes, we will have that freedom of choice, 
probably more so than they have currently, under the current system, if 
they are out in the marketplace, because we will expand some of those 
HMOs and those pools where they will have more physicians and more 
health care providers.
  The prescription medication, I receive, like the gentleman does, a 
lot of letters in my office from senior citizens who are worried about 
Medicare, worried that they will lose their flexibility on their plan. 
If Congress does nothing, if Congress does nothing this time, we will 
lose the benefit that we need for some type of copayment on 
prescription medication from Medicare, for some type of long-term care 
for Medicare patients. That is what is in the bill that came out of the 
Committee on Education and Labor, came out of the Committee on Ways and 
Means. I'm sure it will come out of the House when we start working on 
it in the next week.
  We need to take care of senior citizens and their concerns because 
again, like you, I have senior citizens who are on minimum benefits, 
Social Security. Often their prescription medication right now is the 
same amount of money they receive per month from their minimum benefit 
on Social Security. We have to change that. We have to make some 
changes.

  That is part of this bill. It is a major reform. It is a lot to take 
up but it is not something that we just dreamed up the last year. As 
the gentleman said, President Nixon in the early seventies actually in 
his 1969 inaugural speech, Harry Truman in the forties, so it is not 
something we can say, ``Let us put it off until next year. Let us look 
at it some more.''
  We can study health care forever, but we need to address it now, 
because the next session of Congress, sure, we will have to fine tune 
it. We will have to make some changes, because the health care system 
is not a block of granite that we can leave in place. It is something 
we will have to continually mold and work and adjust, and we will have 
to do that. But we need to get off of dead center where we have been 
for the last 30 years since we passed Medicare for senior citizens.
  Ms. DeLAURO. Will the gentleman continue to yield for a moment?
  Mr. GENE GREEN of Texas. I yield to the gentlewoman from Connecticut 
[Ms. DeLauro].
  Ms. DeLAURO. I'm sure you hear the same story. Seniors do one of 
three things with prescriptions. They will go to the pharmacy and they 
will ask the cost. One of three things will happen. They will decide 
that it is too expensive and they will not get the prescription 
covered; or they will get the prescription half covered; because that 
is all that they can afford to do; or, if they do get it covered, then 
they may go without eating for a day or two, or they cut back on what 
they are eating for a day or two.
  In all three instances, we are looking at a vulnerable population 
becoming more vulnerable, because of cost of prescription drugs. My 
colleague is absolutely right. If we sit here and do nothing, and do 
not do what is in some of the plans that we are looking at, which is to 
provide a prescription drug benefit, we are going to find that more and 
more people are going to be in the situation of deteriorating health 
because of the increasing costs in prescription drugs.
  Mr. Speaker, I might add that, in terms of what we started to talk 
about earlier, that often pharmaceutical companies will charge four 
times as much for prescription drugs in the United States than they 
will for drugs in other countries, where there is some sort of a 
commission or board or some law that says that that cannot occur. In 
the same way, we are talking about covering people who are workers, not 
covering workers in U.S. companies but American corporations covering 
workers in foreign countries, the same thing.
  We have an opportunity here, Mr. Speaker, to pass a piece of 
legislation that will have a tremendous impact on seniors, as the 
gentleman pointed out, and others, but also to do something about that 
people who are not now covered, and to do something about the costs of 
some of these services.
  Mr. GENE GREEN of Texas. Some of the other options I have had seniors 
do in their prescriptions is that, one, they will get a prescription, 
and maybe they should take one pill a day, and because they know they 
only have so much money, then they will say, ``I can't afford one pill 
a day, but I know I need to take it because my doctor said to, so I 
will only take one every 2 days.'' They are doing self-diagnosis to 
spread out that cost.
  In Houston we have seniors who drive 6 hours to Mexico to take 
advantage of some of the cost differences the gentlewoman talked about 
from foreign countries. I know in the Northeast, in the Northern 
States, they also can go to Canada, but people will drive 6 hours to go 
to a pharmacy in the Republic of Mexico to take advantage of, in some 
cases, 20 to 40 percent of the costs that they are paying for it in 
Houston, TX, and yet it is the same prescription.
  In fact, I joked with our colleague from Puerto Rico, we have some of 
the prescription medication that is made in Puerto Rico with our 936 
tax benefit, which you can buy cheaper in the Republic of Mexico than 
you can here because it is exported from Puerto Rico to Mexico.

                              {time}  1510

  So we have a lot of seniors who are trying to make the system work, 
with their limited resources. We have to be sensitive and remember that 
those are people who fought in World War II, those are people who have 
built America to what it is today and we need to respond to that and 
not make them make that decision on self-diagnosis, or in Houston 
today, there are people who are cutting off their air-conditioner 
because they want to save on their electric bill so they can buy their 
prescriptions. We do not need them to make that choice.
  Mr. WISE. As the gentleman points out, Houston, too, I had the 
privilege of spending 2 years in Houston in law school. Houston is a 
major medical center, and the problem is that many of those people will 
put off the prescription drug or the checkup or whatever until it is 
late in the game. Then they go into the hospital, to one of the major 
medical centers, they get the best care in the world, the problem is it 
is the most expensive care. I also note something else. I have heard we 
do have the best health care system in the world. We have the highest 
quality. Houston epitomizes it. We have other major centers across the 
country, such as Los Angeles.
  I note with interest that on Sunday, I was in a fast-food restaurant 
in Clarksburg, WV, I think I am pretty safe in saying that none of the 
employees in there had health care. But while I am paying for my food, 
I look over and there is a jar, a glass jar. There is a picture of a 
little girl in a white party dress that says, ``My name is Misty Lewis 
and I have'' in this case a certain kidney disease. ``I need money for 
dialysis.'' She said, ``I need it to save my life. Thank you for your 
support.'' We have the best health care system in the world, we have 
people that fly whether it is to Houston or to Ruby Hospital or travel 
hours to Charleston Area Medical Center to get the best medical care in 
the world. In many cases fly hundreds, thousands of miles. Yet we also 
have children who cannot get 20 miles to get to the care they need 
because of finances. It is just incredible to me.
  The gentleman from Texas mentioned automobiles. West Virginia has 
been through much the same experience as I think Texas and every other 
State with compulsory coverage. I find it passing strange that in this 
country that we have accepted, whether or not it is totally lived up 
to, but we have accepted the concept of compulsory auto coverage. We 
have not accepted the concept of universal health coverage. Our cars 
get far better treatment and coverage than we do, which leads us to 
this image of a scene in an automobile accident, a couple, Harry and 
Louise, hit a tree while they are driving, talking about how they do 
not want Government health care. They hit a tree and tumble out of the 
car. Ambulance and tow truck arrive at the same time. Ambulance driver 
goes over and says, ``Whoops, they don't have insurance.'' Tow truck 
driver goes over, looks at the car, and says, ``The car is covered in 
this State. Get out of my way.'' The car gets the coverage. The couple 
do not. It is a ludicrous situation. My hope is that as the gentleman 
has well expressed it, this is the year for health care.
  Ms. DeLAURO. I think that the American public needs to be clear. They 
are receiving a whole lot of information today about what is going on 
in health care, what this plan is, what that plan is. Listening to 
people like Pizza Hut and McDonald's and others, fast-food chains 
talking about how this is going to bankrupt the system, that people are 
going to be thrown out of jobs. I think we can help to provide a little 
bit of clarity. Some in the press have done that. The public really 
should know the truth. In The New York Times in July, the last 
paragraph of an editorial that says Pizza Hut's Double Standard, it 
reads that Pizza Hut and others like it do perfectly well in the 
countries where shared responsibility for medical care is a matter of 
law. Why not here? The notion of trying to really pull the wool over 
the American public's eye in saying that business is going to go out of 
business if they do this is unfair. That is one of the reasons why we 
are here tonight. The other is that the public should know that both 
Pizza Hut and McDonald's, they sit on a steering committee of the 
Health Care Equity Action League which is an organization that contends 
that employer responsibility is unacceptable, that they do not want to 
move in that direction and that they have been working very closely 
with another organization called the National Federation of Independent 
Businesses which has been one of the leading proponents against shared 
responsibility and they have been at the head of that lobby, to try to 
not have businesses be able to provide health insurance. The fact of 
the matter is that what we ought to be engaged in is a truthful dialog. 
as I said earlier on, no one believes otherwise, that in fact they need 
to have an opportunity to assist business and particularly small 
businesses with helping them to cover their employees. We are trying to 
do that with discount assistance for small businesses. The Clinton 
bill, which is no longer the operative plan, talked about capping the 
cost for small business as well as large business. The other plan, some 
of the other plans, the bill of the Committee on Ways and Means, the 
Labor and Human Resources bill in the Senate talks about assistance to 
small businesses in doing this. This needs to be a partnership. What we 
cannot do is to try to trash health care reform on issues that untruths 
are being told about these issues. We need to have a cooperative 
partnership relationship with business in enabling them to be able to 
cover employees so in fact we achieve that private guaranteed health 
insurance for everyone in this Nation, because only then will we be 
able to bring the cost down. Only then is it portable, only then will 
we be able to provide the kind of prescription drug benefits and the 
beginning of long-term care that we are talking about.

  The issue is, let us be truthful with the public. If you can provide 
this kind of service in other countries which demand that you do it, 
please do it for the American public.
  Mr. WISE. Exactly. And I think the gentlewoman points out something 
else, too, which is this that may be Pizza Hut and McDonald's, two very 
large corporations, but by the same token much business in this country 
supports universal coverage, supports guaranteed private insurance that 
cannot be taken away, whether it is IBM, the Big Three auto 
manufacturers, grocery store chains, because they know that it is good 
for health care but it is good business in economics, too. They also 
know that when somebody does not pay, then they end up paying even 
more. That is why our goods that we ship abroad, whether it is an 
automobile or whatever, can become less competitive because they pay 
more for health care in the cost of making that car than do those in 
another country where the cost is spread out. I think that is also why 
they have supported this concept of guaranteed private health insurance 
that cannot be taken away, from everybody, because they want universal 
coverage. That is the only way this system works.
  Ms. DeLAURO. There is an entire listing of Fortune 500 companies that 
do in fact support employer-employee cost sharing: A&P, Food For Less, 
Acme Steel, American Corn Growers, American Auto Manufacturers. As the 
gentleman said, IBM, H.J. Heinz, Hechinger Co. The list goes on. So 
there can be a debate and dialog about this and its value in terms of 
getting everyone in this Nation covered.
  Mr. GENE GREEN of Texas. Let me add to that, because we could go over 
that list. A great many of those companies in my area, from Texas, a 
great many chemical and oil companies, Arco is a good example that is 
on that list that came and lobbied, said, ``We want some type of 
universal coverage because we see what the cost shifting is doing to 
us.'' Sometimes we get to talking about small businesses, and I know 
you mentioned the National Federation of Independent Business people. I 
have a constituent who is a member of that who called my office 2 
months ago and talked about how he is a member but he covers his 10 
employees because it is fair, but he cannot continue to compete with 
his competitors unless they are all in the same boat. Same way with 
wages. If he did not have to pay minimum wage or some type of 
competitive wages, his competitors did not, we would see that burden 
shifting, that cost shifting that we see today in health care. That 
person whether they be a memorial monument company or whether they be a 
restaurant or anyone else cannot continue to provide health care with 
the ever-increasing costs we have unless we broaden that coverage to 
everyone so we do not see that cost shifting. That is why I think we 
see a lot of those Fortune 500's saying we need to change that.
  Let me talk a little and say something about something which was 
said, often people get so many different versions about what is 
happening here in Congress. They listen to Harry and Louise and 
everyone else. Free enterprise and freedom of speech is the greatest 
thing this country has been founded upon. We also need to recognize 
that the people who listen to that need to say, kind of wonder, that 
they are expounding on their issue and sometimes they may not be 
telling you the whole truth. They may not be wanting to say that sure 
they have coverage now and they are happy with it but their employer 
may drop them tomorrow, or they may have a deductible that's $1,000.
  So sometimes in the commercial free speech we see or in the 
noncommercial free speech or even in the letters a lot of people get 
from the computers here in Washington saying Congress is going to do 
damage to you, well, sure Congress every day we are in session can do 
damage.

                              {time}  1520

  But we can also do good if those people are constructive and are 
working with us to identify prescription medications, identify the way 
we can help with people, and health care is one of those, and not 
necessarily believe just what you happen to hear on radio talk shows.
  Mr. WISE. The irony too is the Pizza Huts, the McDonald's, and other 
organizations like them taking the position they do is they have the 
ability to buy insurance, negotiate from strength, for thousands of 
employees. The small companies the gentleman mentioned that are 
supplying insurance do not have that bargaining power.
  The legislation we support gives small businesses that bargaining 
power. But there are some that already have it, and choose not to 
exercise it.
  That is why so many businesses, separate corporations do support the 
health care legislation that all of us here support, because they 
understand that it makes it fair, that it levels the playing field, and 
the one who is supplying health care is not put at a competitive 
disadvantage to those who are not.
  My one hope is out of this debate and discussion that the Pizza Huts 
of the world will come forward and recognize their responsibility. I 
want to be able to think next time I walk into a Pizza Hut that it is 
not just a Pizza Hut, but that it is pizza health, and that they are 
living up to their share of responsibility to make sure their employees 
are covered, just the way some other business people are, and want to 
make sure their employees are covered.
  Ms. DeLAURO. The gentleman was talking about his constituent who was 
a member of the NFIB. I had a wonderful experience which I mentioned on 
the floor of this House before of a constituent who has a small 
cleaning business, whose name is Harry Pappas. I have known Harry for a 
long time. I used to bring cleaning to his establishment years ago. I 
had not heard from him since I have been a Member of this body. But he 
called and he said, ``Rosa, I never make a call like this, but,'' he 
said, ``I received a package of information and it told me to call you 
to tell you to vote against health care reform because, in fact, this 
was going to hurt my business. It would put me out of business.'' And 
he said, ``They also included for me a worksheet to put down the facts 
and figures in my business to see how much more it would cost if we 
went this route.''
  The fact of the matter is that Harry did that, he took the time, as 
the gentleman said, took the pencil to the paper, took the pencil to 
the paper and to the worksheet and laid it out, and lo and behold, what 
he found is that it was going to cost him 17 percent less than he was 
paying now, and he was trying to take care and he is trying to cover 
his employees.
  So the purpose of his call would up being to encourage me to move 
forward in voting on health care reform.
  The point again is let us give the American public a fair break, the 
public, small business, and let us be honest with them about what this 
system means to them. This is an issue that is much too important to 
have it get clouded over with rhetoric and with falsehoods and with a 
variety of other kinds of comments on it. Let us provide the data, and 
let the American people decide whether or not this is something that 
they want to do.
  Mr. WISE. In closing, I would just urge all business, small and 
large, before they react to the rhetoric, take this pencil or pen, put 
it to the paper, and they are going to find out that health care is 
good economics and good sense.

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