[Congressional Record Volume 140, Number 103 (Monday, August 1, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 1, 1994]


 
                     HEALTH CARE REFORM PRIORITIES

  Mrs. BOXER. Mr. President, throughout the year, we've read about 
various health care reform plans, heard predictions of doom and gloom, 
and even seen the health insurance industry use a couple of high-priced 
actors to wage a campaign of fear against health care reform. Somewhere 
between Harry and Louise, between expensive advertisements and faxed 
lobbying letters, we seem to have lost sight of what this debate should 
be about.
  This debate should be about making our health care system the best it 
can be: accessible, comprehensive, and affordable for all Americans.
  Mr. President, I did not come to the floor today to pick apart any of 
the health care plans. I came to the floor today to talk about what 
health care reform means to the people of California.
  In my State, approximately 6 million people under the age of 65 live 
without the security of health insurance. What might surprise some 
people is that the overwhelming majority of them--83 percent--work or 
are in families headed by someone who works.
  What good is a new health care system if it doesn't apply to all 
Americans? We all know the cold truth. No one is immune from the 
failures of our current system. With terms like ``preexisting 
condition'' and ``uninsurable'' still all too common, every American 
could wake up one day and join the ranks of the uninsured.
  For health care reform to be real it must be universal. It must have 
no lifetime limits, and it must be portable--so if you lose your job or 
change your job--your health care will always be there. There is a 
bottom line in this debate: Every single American must have access to 
real health care insurance that can never be taken away.
  This is the right thing to do. It also makes economic sense because 
the more people who are covered, the easier it will be to get 
skyrocketing health costs under control. The larger the pool of 
insurance buyers, the lower the cost of the premium. So those who say 
that universal health insurance is a noble goal we can't afford, I say 
it costs far too much not to have it.
  Let's listen to Laura Tyson, head of the President's Council of 
Economic Advisers. She says: ``It is a myth''--a myth, Mr. President--
``that insured people do not need to worry about the uninsured. Under 
our current system,'' she says, ``when the uninsured face catastrophic 
costs, the insured pick up the bill.''
  Right now, according to Tyson, the uninsured pay just 20 percent of 
their health care costs while a person who has insurance pays 30 
percent more than their actual health care costs. Why? Because the 
costs of caring for those without insurance are piled onto the backs of 
those with insurance. How high? About $25 billion a year, Mr. 
President.
  Did you ever wonder why it costs $10 for an aspirin in a hospital? 
It's because the patient who pays is picking up the tab for those who 
are uninsured and pay nothing.
  Because we lack a coherent, rational health insurance system, too 
much goes for expensive emergency room visits for people without 
insurance who put off getting care until they are deathly ill.
  This emergency room approach to health care wastes resources and far 
too often, wastes lives. Child immunizations are the perfect example. 
It costs thousands of dollars to treat a child who contracts the 
measles, sometimes hundreds of thousands. Children die every year in 
America from this preventable disease. Why? Because we practice 
emergency room medicine in America instead of prevention, and the cost 
is enormous.
  By focusing on prevention and primary care, universal coverage will 
save dollars in the long run. And, Mr. President, it will save lives.
  Saving lives also means safeguarding the race for cures to today's 
most deadly diseases. Mr. President, my State is home to one-third of 
the Nation's biotech firms. They are spending billions of dollars and 
devoting countless hours to ending the AIDS epidemic, to finding cures 
for cancer and Alzheimer's and heart disease and stroke.
  These companies put more Californians to work than our computer 
industry and almost as many as our movie industry. And, like many 
Americans right now, they have their concerns. They want to make sure 
that prescription drugs are covered under Medicare. And they oppose 
granting the Federal Government the authority to exclude new drugs from 
reimbursement under Medicare. I agree with their concerns.
  Mr. President, granting this authority would have a chilling effect 
on new drug development, and it runs the risk of drying up the huge 
pools of capital that are necessary to fund innovative medical 
research.
  This path runs contrary to the fundamental goal of reform: making 
America healthier. Stunting the growth of biotechnology and slowing the 
race for cures would not bring about real health care reform. In fact, 
I believe it would contribute to a very real health care crisis.
  The same goes for prescription drug coverage. How, Mr. President, can 
we go to such effort to provide all Americans with doctors who tell 
them when they are sick, and then not help with the drugs they need to 
get well?
  Mr. President, I understand that enacting comprehensive health reform 
will take courage. It will take vision, and it involves bringing many 
different perspectives to the table so that all the issues are 
addressed.
  And, I believe that another of these issues is reimbursement to 
States for the care they provide to undocumented immigrants. Many State 
hospitals provide emergency care and essential public health services 
to those in need. This is the right thing to do. It's the humane thing 
to do. But these services aren't free, and the States hardest hit must 
be reimbursed by the Federal Government.
  I believe it should be the Federal Government that pays because it is 
the Federal Government that has failed to stem the flow of illegal 
immigration. So when we talk about overhauling our Nation's health care 
system, we have to talk about reimbursing States that provide care for 
undocumented immigrants, and we have to talk about funding their 
efforts at the real level--not an artificially low level.
  Real health care reform also has to reflect the very real concerns of 
small business. More than 99 percent of all businesses in California 
are small businesses. More often than not, they function on very tight 
budgets. More often than not, they want to give their employees and 
their families health insurance. But far too often, under the current 
system, they can't afford to.
  That is why we need a system that covers everyone, a system that gets 
skyrocketing cost under control, a system in which each of us pays our 
fair share. And in this respect, I think we can build on what we have--
a system based on shared responsibility--where workers join with their 
employers to cover the cost of insurance.
  Now, I know my opponents have spent million of dollars portraying 
this approach as wrong. But the reality is that a the vast majority of 
Americans--78 percent--purchase their insurance in just this way--
through their employer. Shared responsibility is already a way of life 
for many companies and their workers. That's way I believe this 
approach would be the least disruptive way to achieve universal 
coverage.
  And beyond the concerns of small business versus big business, we 
have to look at how geography plays into the health care debate. I 
represent an extraordinarily diverse State--a State that encompasses 
huge urban centers and extreme rural areas. I represent the people of 
Los Angeles--a large, bustling city and county--and I represent the 
people of Merced--a small, rural city and county. And in looking at 
health care reform, I want a bill that looks out for all Californians.
  While the people of Los Angeles can choose from thousands of doctors, 
many Californians who live in rural areas have just one doctor in town. 
Sometimes they have to drive many, many miles to receive care. 
Increasing the pool of primary-care physicians and providing special 
incentives to doctors who serve in rural areas will improve care and 
increase choice for our rural citizens. Also, making sure that ob-gyns 
are considered primary-care physicians is key.
  Real reform must also put an end to the inhumane practice of capping 
benefits--a problem I mentioned earlier. Whether they know it or not, 
more than three-quarters of Americans have lifetime limits on their 
coverage. This means that if you come down with a catastrophic illness, 
one that carries with it great expense, you are cut off at a certain 
dollar amount. Once you're cut off, no insurance company will touch 
you; you are too high a risk.
  A few months ago, I attended an event, with the victims of this 
financial bottom line--young, chronically-ill children and their 
strong, brave parents. One by one, the parents told us the story of 
their children--children who reached their lifetime insurance limits 
before their arms could reach all the way around their mothers' waists.
  There was not a dry eye in the room, as we heard what the families 
went through. Young couples forced to sell their dream homes to buy a 
few years of medical care. Loving parents forced to divorce, children 
given up to the State, strong families torn apart. All this, so the 
government would assume responsibility for the child's medical costs.
  These choices are barbaric. No American should have to choose between 
losing their home or losing their child. That choice is unAmerican.
  I think it is clear to everyone that America has the finest health 
care in the world. But somewhere along the line our health care system 
has failed too many of us. And none of us knows when it will fail us. 
It's like Russian roulette--when will the bullet of health insurance 
loss hit us or someone we love?
  This is why we are here today.
  Mr. President, for women, health care reform provides the opportunity 
to end our second-class status as health care recipients. We must seize 
it and put together a package that provides women with a comprehensive 
set of benefits to maximize our health. This means regular exams, pap 
smears and mammograms--so that every woman has the fighting chance 
offered by the early detection of breast cancer--the leading killer of 
women between the ages of 35 and 52.
  And by definition, comprehensive women's health coverage has to 
include the full range of reproductive health services. Anything less 
would be a step backward for America's women because real health care 
reform is about building on what we have--not stripping away our 
options.
  And, as the health care debate heats up, let me make one thing 
perfectly clear: Health care reform is about access to a full range of 
services. It's about the affordability of those services, and above all 
else, it's about improving the health of America's men and women. This 
debate is not about politics. It is not about dictating personal 
beliefs. And any effort to shift the debate away from health policy and 
toward ideology is a great disservice to the people of this Nation.
  Health care reform is about a healthier America where men get 
prostate screenings, children get their checkups and pregnant women get 
pre-natal care. Health reform is about making all of us healthier.
  I will work for comprehensive reform this session. And I see a day in 
the not-too-distant future when Americans look back to this chapter in 
their history and are appalled that there was ever a time when every 
American did not have real health security, when people could work hard 
and still not be covered, when families with insurance could still lose 
the roof over their head.
  We in the Congress today should be the ones to close this dark 
chapter of American history.
  So let us sit down at the table, work out our differences and fulfill 
our promise to the people of this great Nation. Standing at this 
historic crossroads, I believe the greatest disservice we could do 
would be to stand back and do nothing at all.

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