[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]

 
                           UNIVERSAL COVERAGE

  The SPEAKER pro tempore (Mr. Hinchey). Under the Speaker's announced 
policy of February 11, 1994, and June 10, 1994, the Chair recognizes 
the gentleman from Washington [Mr. McDermott] for 60 minutes.
  Mr. McDERMOTT. Mr. Speaker, as you know, I have made an effort almost 
every week to talk to my colleagues about one issue in health care 
reform and how it will affect the American people personally.
  I want to talk tonight about an aspect of health care reform that the 
President made the measuring stick of every proposal--universal 
coverage.
  Tonight, we need to talk about why every American, not just the 
uninsured, needs universal coverage. We need to talk about what exactly 
universal coverage means. And we need to talk about why we need 
universal coverage now.
  Universal coverage means every American always has health insurance, 
insurance that can never be taken away. No matter how your job changes, 
or whether you are a homemaker or self-employed, or work part time or 
lose a spouse or move, your health insurance is constant. It is 
something you can count on. One hundred percent universal coverage is 
attainable, and contrary to the propaganda you may hear, every other 
country in the Western world has a system of absolute, guaranteed 
universal coverage and has for decades. Everyone in other Western 
countries who needs health care gets it, and those who provide the care 
get paid for the care they give, period. That's 100 percent universal 
coverage. Germany has had a system of absolute, complete, guaranteed 
universal coverage for over a century. Now what are our leaders saying 
when they suggest that the United States can't really achieve universal 
coverage? I'll tell you what they are saying. They are saying that 
Americans aren't as good as the Germans or the French or the Japanese.
  They are saying that the American people don't have the will to solve 
their problems the way the people in other countries--our competitors--
do.
  They are saying that the American people don't deserve the same 
protection that people in every other industrialized nation in the 
world have.
  Mr. Speaker, the doubts about whether America can achieve universal 
coverage or whether it can even occur in this century are unworthy of 
the American people.
  The reality is that we can have universal coverage starting in 
January, 1996--full, complete, total, guaranteed universal coverage.
  And the reality is that every American needs it just as soon as we 
can pass it.
  Let me share a story with you about what having the kind of security 
our trading partners have means to people who live and work in those 
countries. I have a friend in my home district of Seattle who is an 
opera singer with the Seattle Opera Company. She occasionally is a 
guest performer with a German opera company. From the minute she sets 
foot on German soil, she and her family have full health insurance in 
Germany without any concern about what the state of their health 
insurance is in this country or whether her policy will cover foreign 
work or travel. Her daughter contracted leukemia and when the mother 
was performing in Germany, her daughter received full treatment in 
Germany or her leukemia without any question about when she contracted 
the leukemia or where her residence was.
  There was simply no anxiety about her health coverage or her health 
care. She had better protection because her mother occasionally 
performed in Germany than she does in her own country. And Germany 
spends about half of what we spend per person on health care.
  Universal coverage means everyone--everyone--is in the system so 
there are no more games about who gets care under what circumstances 
and where. And no more games where you get coverage if you meet one 
definition but if your life changes, you don't get that insurance 
anymore.
  If everyone is in the health insurance system--and we all know 
everyone is in--then we don't have to waste any more time, and money, 
and paper trying to figure out who gets what--and for how long.
  So, Mr. Speaker, why does every person and family in America need 
universal coverage? Because right now most Americans are just one pink 
slip away from losing his or her health insurance.
  Right now, if you lose your job, you lose your health insurance. So 
you not only have to worry about getting a new job and having some 
income, but you have to worry that if your child gets sick you may not 
be able to get her the care she needs.
  If your company cancels or cuts back on the benefits it offers in its 
health insurance package--you and your family are at risk. Right now, 
if you change jobs or go out on your own in business, you may lose your 
insurance. Right now, very few people in this country can say with 
certainty that they absolutely will have health insurance a month from 
now.
  We are the only people in the industrialized world who do not have 
that certainty. Universal coverage is the only way to get that 
certainty. But there is another reason to have universal coverage. As a 
nation, we simply cannot afford to do without it. The poet John Donne 
said, ``no man is an island unto himself.'' Nowhere is this more true 
than in health care. Because we don't have universal coverage, everyone 
who has health insurance pays a higher premium. Because we don't have 
universal coverage, people get care too late, in emergency rooms, where 
it costs much more money than it would if they had had timely primary 
care. And hospitals then look for someone else to pick up the tab. Our 
whole economy is playing a shell game with health care costs, trying to 
shift them around to different people who pay. It's called cost-
shifting--getting someone else to pay for the people who can't--and it 
costs the American people a high price.
  We will never be able to control health care costs until we have 
universal coverage. It's that simple. To slow the growth of health care 
costs, we must have universal coverage. Every other country in the 
Western world has lower costs than we do, many have better care, and 
they all have universal coverage. Every year universal coverage is 
delayed, the costs of health insurance and health care go up.
  A study performed for the Catholic Health Association shows that if 
proposals for insurance reform such as ending the practice of denying 
health insurance because of a preexisting condition are enacted without 
universal coverage, health insurance premiums for families earning 
between $20,000 and $29,000 will go up almost $500 a year. In other 
words, universal coverage is essential to keeping the cost of health 
care down.
  In New York State, they tried to do insurance reform without 
universal coverage. The result was that health insurance costs 
increased and more people lost their insurance after insurance reform 
than before. If everyone had been in the system, then insurance reform 
would have worked. The lesson is clear. Universal coverage is the house 
of health care reform.
  We all know that in most cases it is better to own your own home than 
to rent an apartment. But what usually keeps people from buying their 
own homes? The down payment. We have to come up with a down payment--
the way to get into the house--or, as a nation, we will just have to 
keep on renting this inadequate and over-priced apartment. An apartment 
that is too small, that doesn't suit our needs, that drains our 
resources and keeps us from ever being able to afford the house.
  So how do we get into the house? There is no question that the 
cheapest, the quickest, the most efficient way to get into the health 
care house is through single-payer reform. This is the way every other 
country in the industrialized world got into the house, and they are 
living there much more comfortably than we are in our poor apartment. 
Single-payer is the way to absolutely guarantee 100 percent universal 
coverage within 1 year. Even opponents of single-payer acknowledge that 
only single-payer could achieve full universal coverage with every 
``i'' dotted and every ``t'' crossed. Only single-payer guarantees 
unrestricted free choice of provider and eliminates insurance company 
interference in the physician/patient relationship. Only single-payer 
guarantees that you can have a lifetime relationship with your doctor 
if that is your choice. Only single-payer provides complete benefits 
including preventive care, all outpatient and hospital services, 
prescription drugs, children's dental care, mental health services, and 
comprehensive long-term care.
  How is single-payer able to do all this? Very simply. If Americans 
paid their health insurance premiums to a single national health 
security fund instead of to all their different insurance companies, 
and then that single national fund reimbursed health care providers 
directly for their services the way insurance companies do now, we 
would save enough money on insurance administration to pay for 
universal coverage and comprehensive benefits for all Americans. With 
single-payer, we get to universal coverage immediately. So don't let 
anyone tell you we have to phase it in over 5 years, or to the end of 
the century, or beyond. We don't need to wait that long. We can't wait 
that long.
  Remember, every year we postpone it, we lose money because we can't 
control costs. Every year it will cost more to fix the problem. Every 
year more people will lose their insurance and we will all have more to 
worry about. And every year universal coverage is delayed, the chances 
are greater that something will intervene in Congress to just keep on 
pushing it back. We will simply lose it.
  That's what happened in Massachusetts. They set up universal coverage 
in 1988 to go into effect in 1993. And it still hasn't happened. 
Americans need universal coverage that is guaranteed now so that 
Congress can't undo it once its done. We can have universal coverage by 
1997, and the American people should settle for no less.
  When we look around the world and the events of the last few years, 
we see historical developments of almost Biblical proportions. The 
Berlin Wall has come down and Russia is a struggling democracy. 
Unbelievably, South Africa has ended apartheid and has implemented a 
democratic government. Our fellow industrialized countries are 
climbing--and scaling--the Mount Everests of political challenges. 
Compared to the challenges these Nations have embraced, the difficulty 
of reforming our health care system so that we can finally get everyone 
into the system is so small. It is not Mount Everest. It is not even a 
hill.
  We are the greatest nation in the history of the world. We are the 
richest and we are the most democratic. It is an outrage to say that we 
cannot do something as relatively simple as get all our citizens in the 
largest health care system in the world in less time than it took for 
de Klerk to end apartheid or Gorbachev to bring down the Berlin Wall.
  I urge my colleagues to take the small step--not the big step--of 
guaranteeing universal coverage for American families and to insist on 
universal coverage by 1997 so that we can finally move into the house 
that will give us security for the future.

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