[Congressional Record Volume 140, Number 106 (Thursday, August 4, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 4, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           HEALTH CARE REFORM

  Ms. MOSELEY-BRAUN. Madam President, I rise in behalf and I would like 
to speak for a moment regarding the monumental health care debate that 
we are about to engage here in the Senate. We are at an historic moment 
in our country.
  We are about to have the battle of the century, if you will, between 
health care reform or the status quo. The reasons for health care 
reform should be by now evident to everyone. We have in this country, 
unfortunately, a health care nonsystem, a nonsystem that wastes money, 
that costs more, than anywhere else in the industrialized world that 
leaves some 37 million people without health care coverage, health care 
costs are still the No. 1 cause of bankruptcy in our country.
  And that, as the Senator from Nevada rightly pointed out, is about to 
break the bank in terms of cost.
  We have, with this initiative by Senator Mitchell, a chance for 
reform. We have an opportunity to put some rationality and fairness 
into the health care system.
  Right now, with 1,500 different health care plans, not to mention 
Medicare and Medicaid, we are wasting almost 25 cents on every dollar 
just in administrative costs alone. The reason for those administrative 
costs, really, is the fact that this is a nonsystem. There is no 
rationality to it. That is why we have so much waste. That is why we 
are getting such little bang for our buck, if you will.
  We have a chance for reform, an opportunity to help working Americans 
achieve health care security that could never be taken away, as the 
President has talked about. No more preexisting illnesses. And I know 
everyone listening to the debate knows of horror stories of people who 
have been denied insurance coverage because of a preexisting illness. 
No more job lock, stuck in your job and unable to move for fear that 
you will lose your health care coverage if you do. No more 
discrimination based on age or where you live in terms of access to 
health care coverage.
  This opportunity for reform will help us correct the imbalances and 
the dysfunctions of the nonsystem that we have.
  Madam President, it is very important that we not lose this chance 
for reform. The initiatives to reform health care in this country go 
back in my own experience as a young person when I started out 
practicing law some 20 years ago, almost. There was legislation then, 
an attempt to try to reform health care. They tried to bring some 
rationality to the system then, but the big money interests killed that 
initiative and we continued with the feeding frenzy and with the 
spending frenzy.
  We have now a health care system that looks like nothing so much as a 
Rube Goldberg contraption with system on system on system and plan on 
plan and different plans. It is a system that has no sense to it. It is 
gobbling up some 15 percent, almost, of our GDP, our Gross Domestic 
Product.
  We spent almost $850 billion last year on health care. And yet, 
again, there is hardly a person that cannot tell a story of someone who 
fell through the cracks, slipped through the cracks, had some tragedy 
and was unable to access health care in this, the greatest nation on 
Earth. This system has been patched and patched time and time again.
  Again, following my own career and my involvement with health care 
issues in this 20-year period, I started off in litigation around 
reform efforts some 20 years ago. When I went to the State legislature, 
we worked on issues and passed the first PPO legislation, the preferred 
provider option. We passed legislation having to do with setting up 
managed care plans and the HMO's and all these terms I am sure most 
Americans are familiar with now, having tried to shop between the 
various options and opportunities and Catch-22s that are out there in 
terms of health care now.
  And even though we patched and patched, the system still does not 
work. It has been referred to on this floor as one that is very 
complex. Well, it is complex for a reason, Madam President. It is 
complex because, on the one hand, health care has macroeconomic 
implications. It affects our international competitiveness. It affects 
our budgetary processes. It affects billions of dollars. It is a major 
segment of our economy.
  On the other hand, it is still as personal as whether or not your 
daughter, your son, or your neighbor can get health care, can access it 
when they need it. It is as personal as the ads we have seen and the 
tragedy Senator Mitchell mentioned in his speech the other day of 
people who have to go to their friends and neighbors with hat in hand 
in charity campaigns to pay for cancer treatments or to pay for an 
illness that strikes unexpectedly when health care insurance is not 
available. It is as personal as those people.
  And we all hear the stories, and I know we will hear them time and 
time again on this floor, of people who are forced onto welfare or 
forced to stay on welfare because they cannot afford health care 
insurance otherwise.
  Madam President, this is our chance. This is our opportunity to rise 
to the occasion to correct this problem, to fix this system, to provide 
health care to Americans in a system that is rational, that is fair, 
that works.
  I have maintained all along in this debate that, from my perspective 
for my State of Illinois, there were essentially four cornerstones of 
reform that I would want to see met in any health care reform 
initiative.
  As a mattersad of fact, I have asked to cosponsor the Mitchell plan. 
I was a cosponsor or asked to sponsor the single payer plan. I am 
convinced there are a number of initiatives and a number of different 
ways to get down this road to reform. But the real battle is between 
staying with what we have now or changing it. And I believe that the 
initiative that we have with the proposal of the Senator from Michigan 
is a real opportunity for us to change it. This is our chance.
  The four cornerstones of reform that I have talked about all along 
are: Maintaining the quality of care that we have. We have the greatest 
health care in the world here in America, if you can afford it, and if 
you can access it. We want to make certain that everyone is entitled 
and eligible and capable of accessing that high quality of care that is 
available to those who right now have the means and have insurance.
  We ought to have universal coverage. It seems to me not to ask too 
much in a country as great as this one, with the kind of money that we 
are spending on health care, that every person have access to health 
care coverage.
  We want to maintain freedom of choice of providers. I think Americans 
want to be able to go to a doctor or a hospital, the provider of their 
choice, instead of being forced to go to somebody else's choice. 
Freedom of choice of providers is a very important element and is one 
of the four cornerstones of reform that I have talked about all along.
  And, of course, there is the cost containment aspect; making certain 
that, if we are going to spend 15 percent of our GDP, we have the 
highest quality health care in the world for every American and that we 
rein in the rise of health care cost so that it does not threaten to 
rob our children, frankly, of their opportunities for the future.
  Right now the cost of health care so far outstrips the cost of 
anything else that we do that it is threatening to break the bank and 
to foreclose our options for growth in this economy.
  The Mitchell plan, Madam President, meets the four cornerstones of 
reform.
  With regard to quality care, it sets up a research trust fund. It 
talks about academic health centers and basic health centers. It talks 
about health services research. It talks about capital improvement for 
development of rural and inner city health care, which, as you know, in 
a State like mine, I have two options in Illinois, it is rural 
communities and big cities. Well, there are a number of smaller towns, 
as well. But in my State, there is a real challenge to see to it that 
the needs of rural communities are met and, at the same time, the needs 
of the urban centers are meet. This bill does both.
  Provider incentives, wellness incentives, and an increase of coverage 
for children and pregnant women. These are all quality imperatives in 
this plan that I believe the American people have every right to 
expect.
  With regard to freedom of choice of provider, the Mitchell plan 
provides us with the opportunity to choose either a traditional fee for 
service or point of service or an HMO. So the options remain for people 
to access the kind of coverage, the kind of plan that they want to 
participate in. I think that is important.
  And, at the same time, specialty care insurance is assured in this 
bill and long-term care is addressed and assured in this bill. And so 
freedom of choice, home-based care, all of these things are addressed 
in the Mitchell plan.
  With regard to cost containment, we have a system and a plan that 
will put some rationality into the way that we fund health care. This 
is a major step forward. Frankly, I applaud the majority leader for his 
almost Solomonic accomplishment here, because he manages to fund this 
plan without going to the mandates which are such an object of 
controversy.
  I do not know how he managed to do it--we are waiting now to see the 
CBO analysis--because it is nothing short of Solomonic, nothing short 
of miraculous because the thinking has always been that you had to have 
some sort of employer mandate in order to fund health care. The 
Mitchell plan says we are going to turn it around, do it slowly, do it 
in a 6-year period. But by the year 2000 we will have 95 percent 
coverage. And any State that has not achieved 95 percent coverage by 
then will have to come up with a plan as to how they are going to meet 
universal coverage thereafter. So it is a gradual approach, a gradual 
approach that will allow us to fund health care reform without going to 
the mandates that have been such an object of controversy--I daresay 
mistaken in many instances.
  There has been an awful lot of propaganda and an awful lot of 
conversation about employer mandates. I am digressing now, Madam 
President, but I do not believe half of what has been said out there, 
that employer mandate was as bad as suggested. In fact, if anything, 
the system that we currently have requires small businesses, those that 
provide coverage for their employees, to pay more for health insurance 
by virtue of the fact that other small businesses do not pay at all. 
That is one of the reasons why the system so badly needs to be changed.
  The financing of health care in this country really has not had any 
rationality to it. And the Mitchell plan, I believe, will bring us the 
opportunity to have real cost containment, cost containment that will 
provide an opportunity for working families to have health care 
coverage at a reasonable rate. That, it seems to me, is nothing short 
of an enormous step forward.
  I believe insofar as the four cornerstones of reform are met, insofar 
as this plan is an innovation, insofar as this plan represents a major 
step forward, bringing the various people and interests together, I 
believe it gives us a wonderful starting point for this debate. I 
support the Mitchell plan. I support the leadership. I am going to 
engage with others, frankly, to try to see if we cannot try to reach 
that 100 percent coverage sooner. I think it is important to talk about 
the critical aspect of universality of coverage. But I say, Madam 
President, the challenge now is to achieve reform; not let the forces 
of status quo win the day again; not allow this nonsystem that we have 
continue to strangle our economy and hurt our people; not allow our 
country to lag behind the rest of the industrialized world with regard 
to health care because we cannot get our act together.
  We have a chance in this Congress, in this Senate, to get our act 
together. We have a chance to achieve reform. I encourage my colleagues 
to engage in this debate, to engage with this initiative, to support 
this initiative and to help us achieve in this Congress of the United 
States health care security for Americans that can never be taken away.
  The PRESIDING OFFICER. The Senator from California is recognized.


                         Privilege of the Floor

  Mrs. BOXER. Madam President, first, I ask unanimous consent that 
Krisma Martinelli, a Senate intern, be granted the privilege of the 
floor this evening.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Health Care Reform

  Mrs. BOXER. Madam President, it is indeed a pleasure to take to the 
Senate floor to talk about an issue that means so much, I think, to all 
America. I compliment the Senator from South Dakota [Mr. Daschle]. I 
also see on the floor Senator Rockefeller. Senator Kennedy was here 
before. I thank these gentlemen, and, of course, the majority leader 
and others, for their steadfast commitment to health care reform.
  Madam President, I join in the sentiments expressed by the Senator 
from Nevada [Mr. Reid], when he said how important it is that we set 
aside our political differences here in the U.S. Senate and stop 
thinking about who is going to get credit for what health care bill and 
really sit down around the table and get it done. We need to fix the 
health care system, and we have to do it soon. The clock is ticking on 
too many Americans.
  It is clear that no Democrat is going to get everything he or she 
wants in this bill. And no Republican will get everything he or she 
wants in this bill. That is the beauty of the legislative process. We 
all could write our own bill, and I know, Madam President--you and I 
have discussed this--we have ideas on how to write it so it is the best 
for California, and we are going to make sure it is the best it can be 
for our State. But we all come together here from all the States and we 
try to work together and come up with a plan that is going to give real 
security to the people of our Nation.
  I was so pleased when the majority leader made his first speech right 
before he introduced his bill because he spoke about a young man that I 
knew who came to see me when he was about 17 years old, who was 
suffering from cancer, a cancer that had lain dormant since he was just 
a little boy. He was a strapping football player. He needed a very 
serious operation, and he was denied it by his insurance company.
  But what was so important to Andy Azevedo when he came to see me was 
that he knew that when he turned 21 and was out of school--and he was 
optimistic that he would live well beyond the age of 21 --that he would 
no longer be able to get health insurance because he would have 
finished school, he would have been on his own, and, yes, he would have 
had a preexisting condition.
  I had never heard of that before. When Andy came to me years ago I 
was in the House of Representatives. He really taught me firsthand 
about the fears that he felt, the way his family felt, how he knew if 
he lost his insurance his family would go broke because they would 
always stand by him. And this is a hard-working family, a ranching 
family in the northern part of our State.
  Andy Azevedo never made it. His mother and I have kept in touch. I 
have to tell you, I promised her on this floor of the Senate a long 
time ago--and I remember, when I made the speech months ago, Senator 
Rockefeller was there, and he came up to me afterwards and he said, 
``That is what we need to do. We have to keep telling the American 
people the real stories of what happens to people. And that is the 
focus.'' So, I promised her then, and I promise her now in Andy's 
memory, that we will enact health care reform.
  Madam President, I want to tell you about another story. I remember 
it so well because I was campaigning for the Senate and it was a warm 
day out on the road. I ran into a woman named Mrs. Jan Fish. She came 
all the way from Jackson, CA, to Stockton, and she talked to me about 
health care reform. She drove a long way. That may not seem unusual, 
but Mrs. Fish had just turned 79 and the hour drive was not something 
that she was used to. She had a mission, just as we have a mission 
concerning health care reform. And she had a message and a story that I 
would like to share with you, Madam President, with my colleagues, and 
with the American people.
  We like to think if we are responsible people and we make responsible 
decisions and we have insurance, that it will be there when we need it. 
It was not true for Mrs. Fish and it was not true for her husband, 
Colonel Rue Fish. When Colonel Fish was in the Army stationed in the 
beautiful Presidio in San Francisco in 1968, he and his wife attended 
an Army-sponsored lecture on health insurance. The offer of private 
insurance that would always be there for them sounded good, and Colonel 
and Mrs. Fish signed up, along with many other Army families. They were 
told they would never, ever have to worry about a hospital or a medical 
bill again.
  Until they left the Army in 1970 they did not because they were taken 
care of by the military. The few things they needed were taken care of 
at Letterman Hospital. Mrs. Fish told me how healthy the colonel always 
had been. She said the only thing that was ever wrong with him was he 
had his tonsils out. He never had anything more complicated than that. 
But to be safe and secure, they paid their insurance premium every 
month, just in case they would ever need that coverage.
  In the late 1980's, Colonel Fish began sleeping a lot. He 
occasionally lost his balance and he seemed distant from Mrs. Fish and 
their friends. She attributed it to retirement and getting older. But 
in 1990 they went on vacation, and when they came home, Colonel Fish 
seemed worse than usual so they went to the doctor. After a hushed 
conversation with her husband's doctor--and we have all gone through 
something like this in our lives--Mrs. Fish took the colonel to the 
admitting room, and that was the last day she saw him out of the 
hospital.
  At first, the doctors thought it was Alzheimer's but more tests 
revealed that the colonel had suffered six or seven strokes that had 
never been diagnosed. So Colonel Fish, who was a proud man, went from 
being a retired Army colonel living at home to a long-term care, 
chronically ill patient. The doctors refused to let Mrs. Fish care for 
her husband at home. She wanted to, but her age, her bad back, her bad 
knees would never let her do the daily tasks needed to take care of her 
husband. But they had insurance, did they not? Insurance that would 
make sure they never had to pay a lot for medical care ever again. That 
is what they were promised.
  That first year of care at Amador Hospital cost $59,000. The 
insurance company rejected every single claim.
  Yes, the same company Mrs. Fish had been paying every month for 
years, the same company that said, ``Don't worry,'' when they made 
their presentation, now sent them, every time they sent in a claim, a 
rejection letter, a form letter. And where was Medicare? Medicare does 
not cover long-term care.
  Just a short time ago, I met with a number of people from California 
who came to talk to me about the importance of long-term care. They 
brought me drawings and poems done by children who have lost someone 
they love to Alzheimer's and other long-term illnesses.
  Charlotte deKohning, who is 8 years old, wrote on her drawing:

       I lost something vere speshel--

  And she spells special s-p-e-s-h-e-l.
  She said:

       I lost something vere speshel--my grama.

  And 11-year-old Elizabeth Turner wrote:

       When you lose someone, when you cherish someone, then you 
     lose them. It hurts more than you can say.

  What are we giving our children as a future? Another generation at 
the mercy of insurance companies who put their bottom line before the 
lives of their policy holders? I hope not.
  Are we asking our children to grow up in a world of insurance forms, 
not reform? I hope not. Of preexisting conditions and the threat of 
bankruptcy just because you dared to get sick, like my mother or your 
mother or Senator Rockefeller's mother?
  I asked Mrs. Fish if she sued the company. She said, ``I couldn't go 
through all that. I'd have to get an attorney and I can't afford one 
and, anyway, all I cared about was taking care of my husband.'' That is 
the kind of person she is, and that is the kind of people we have in 
the United States of America.
  All she really wanted was to be able to take care of her husband. She 
was not screaming about spending all of their life savings, she did it. 
She wanted to make sure the man she loved for so many years was 
receiving the best possible care.
  When she came to see me on that day, she said: ``I'm not here to 
complain. We're lucky we had savings and pension that could all go to 
medical bills. It's the other people, the young people, the little 
guys, the little guys. You have to do something for them.''
  I told Mrs. Fish that I understand, and I do. I told her about how my 
own mother, who thought she had everything right, all the insurance she 
could need, wound up in a nursing home, spent her last dollar there, 
lost all of her dignity, could not leave a penny to her grandchildren. 
I told her that story.
  This cannot continue in this country, Madam President, where we strip 
the dignity away from our people who have worked so hard and saved and 
served their country. We have to make sure that people do not go broke 
fighting to get health care that they deserve, or fearing that they 
will die alone and broke.
  Mrs. Fish had to move her husband to a less expensive care facility 
after the first year. They were out of savings. Colonel Fish died in 
May 1992. Mrs. Fish said: ``The care was good. The insurance company 
was horrible.''
  We cannot allow such pain to continue. We cannot allow people in 
America to have this done to them on a regular basis. We cannot stand 
around arguing whether health care is a crisis, not a crisis, a 
problem, not a problem. We have to act.
  In closing, I want to say to you, Madam President, and to my friends, 
we have to let the American people know that the time for politics on 
this is over.
  I ask unanimous consent to print in the Record an article written by 
William Kristol. It is entitled, ``Memorandum to Republican Leaders 
from the Project for the Republican Future.''
  There being no objection, the article was ordered to be printed in 
the Record, as follows:

               [From the Washington Times, July 27, 1994]

        Health: Congress Is Now More Dangerous Than Mr. Clinton

                          (By William Kristol)

       The fate of health care reform is now out of the hands of 
     Bill and Hillary Clinton. The intellectual case that once 
     justified the Administration's health care campaign has 
     collapsed so completely that even its onetime supporters are 
     embarrassed by it: ``It smacks of excess government and the 
     smell of socialism,'' says Senator Max Baucus (D-MT), an 
     original sponsor of the Clinton legislation. Hill Democrats 
     are now hard at work writing their own legislation. Mr. and 
     Mrs. Clinton, meanwhile, are reduced to the function 
     equivalent to cheerleading party chairmen, addressing hand-
     picked crowds at pep rallies and bus stops.
       The End of Ideology. Indeed, what is so striking about this 
     final stage of the health care debate is how shallow it has 
     become. We recall that this effort began with the loftiest 
     motives to ``accomplish what our nation has never done 
     before,'' as the First Lady put it last September. And for 
     all its big-government madness, the Clinton plan was at least 
     a consistent and coherent attempt to overhaul the way health 
     care is financed and delivered in the United States. Based on 
     European social-democratic models, the mandates, the taxes, 
     the alliances, and the premium caps were all aspects of a 
     single vision: sweeping federal control of American medicine. 
     It was public policy consciously designated after the wide-
     ranging transformations of American society achieved by the 
     New Deal and the Great Society.
       It has been a spectacular failure. What the Clintons have 
     painfully learned over the past ten months is that the public 
     will not embrace government-supervised health care. White 
     House pollster Stan Greenberg's theory that Democrats would 
     be well-advised to ``once again become the party of 
     government'' and to relegitimize government to the American 
     people has been disproved: American skepticism of the federal 
     government runs too deep. The White House committed itself to 
     a far-reaching, big-government health care reform strategy 
     and has thereby made itself irrelevant to the final debate.
       The Mitchell-Gephardt Farce. Sometime before the end of 
     this week, Acting Presidents Mitchell and Gephardt will 
     unveil a new Democratic health care bill. Senator Packwood 
     has correctly pointed out that it is ludicrous to begin 
     immediate debate on a bill that no one has read, as the 
     majority intends. But the problem is not that the Democratic 
     timetable does not permit adequate study of their bill; we 
     believe their bill neither requires nor deserves careful 
     study. No one can accurately predict what precise mix of 
     triggers, subsidies, phase-ins, commissions, exemptions, and 
     regulations will emerge from the Mitchell-Gephardt cauldron, 
     but the actual details of this not-quite-universal-coverage 
     bill don't matter. Sight unseen, Republicans should oppose 
     it. Those stray Republicans who delude themselves by 
     believing that there is still a ``mainstream'' middle 
     solution are merely pawns in a Democratic game. Mitchell 
     and Gephardt have finally dropped all pretense of concern 
     for American health care per se; their interest is now 
     exclusively with passing something--anything--so as to 
     forestall electoral disaster in November. Health care 
     reform is now about politics, and absolutely nothing else.
       Our message this week should therefore take the form of a 
     preemptive strike: whatever the Democratic leadership 
     produces in the next few days is certain to be politically 
     motivated, intellectually incoherent, and substantively 
     dangerous. If Mitchell and Gephardt have their way, this 
     final stage of the national debate over health care will be 
     conducted through the crude and ordinary means of normal 
     Democratic politics: highstakes interest-group lobbying and 
     the steady incantation of evocative but now meaningless 
     phrases like ``universal coverage.'' That's why we don't need 
     a few more days to ``see'', what kind of bill the Hill 
     leadership comes up with, much less the rest of August to 
     engage in futile debate with an insincere Democratic 
     leadership.
       The Path Toward a Bad Bill. The intellectual defeat of 
     Clinton's ambitions, however, has not guaranteed a political 
     defeat over Democratic health care legislation. Our enemy is 
     no longer Clinton, it is Congress. Mitchell and Gephardt, we 
     suspect, have correctly concluded that even the Clinton-style 
     bills that passed three House and Senate committees cannot 
     survive a floor vote. But rather than explicitly abandon 
     their pursuit of compulsory universal courage, they will seek 
     to ``delay'' or otherwise disguise it. They are acting in bad 
     faith. Federally mandated universal coverage cannot pass: 
     good riddance. And the only other meaningful and principled 
     approach to health care possible this year, the conservative 
     reform embodied in the Dole and Rowland-Bilirakis bills, is 
     unacceptable to the Democratic leadership for purely partisan 
     reasons.
       Instead, we will be offered a classic, eleventh-hour, 
     disingenuous potpourri of half-baked health care reform 
     ideas, and the process for enacting that plan will be 
     lobbyist heaven. The president and Mrs. Clinton, self-
     described crusaders for the middle class, have effectively 
     yielded control of health care to every special interest 
     group imaginable, each of which will spend the next three 
     weeks busily carving out its own piece of the health care 
     pie. There will be no principles at stake, only spurious 
     genuflecting to the ``shared goal of universal coverage''; 
     Congressmen and Senators will boast about their willingness 
     to compromise; no one will be able accurately to predict the 
     effect of the changes they endorse. With the grand promise of 
     sweeping reform having been abandoned, interest group 
     liberalism will be triumphant again. Why bother?
       The Fraud of the Finance Bill. The best existing model for 
     this likely outcome is the disconnected jumble of health care 
     notions that passed the Senate Finance Committee, a bill 
     fraudulent even by current Washington standards. Without 
     requiring mandates immediately, this bill nevertheless 
     establishes much of the bureaucratic machinery necessary for 
     a more expansive government role in health care in the 
     future. Eight years from now, a politically appointed 
     commission would tell Congress what methods of government 
     coercion it must use to mandate universal insurance coverage. 
     Debate on the commission's ``recommendations'' would, by 
     statute, be brief and limited.
       In the meantime, the bill establishes a board in the 
     Department of Health and Human Services responsible for 
     defining an approved standard benefits package that applies 
     to every health insurance policy in America (with a phony 
     abortion exemption that opens the door to federal funding of 
     the procedure). The bill taxes all health insurance plans and 
     adds a 25 percent surtax to arbitrarily determined ``high 
     cost'' policies, which include many existing plans that have 
     long been part of labor-negotiated compensation packages. 
     Fee-for-service physicians and specialists will be prohibited 
     from ``balance billing,'' a price control prohibition that 
     will drive most doctors into HMOs. The inflexible insurance 
     reforms the bill proposes will drive up premium costs. Every 
     state will have to establish a health purchasing alliance. 
     COBRA, the successful transition program that permits people 
     to purchase the same health insurance plan for 18 months 
     after they leave a job, will be truncated to six months. And 
     Medical Savings Accounts, the one truly innovative free-
     market idea to emerge this year, will be prohibited 
     altogether.
       It's not the ``Clinton plan.'' It may not even qualify as 
     ``Clinton lite.'' But the Finance bill is still plenty bad, 
     just the same: it unmistakably moves the country toward 
     health care by government commission, and for the more than 
     80 percent of Americans who are satisfied with their current 
     health care arrangements, the Finance bill would make things 
     worse, not better, and right away.
       Why was the Finance bill passed? Because it was the only 
     bill that Finance could pass, and for no other reason. How 
     was the Finance bill constructed? A series of lobbyist-
     friendly special interest provisions were glued together 
     without concern for overall consistency or effect: academic 
     health centers for Senator Moynihan; purchasing alliances for 
     Senator Chafee; tax-exempt state risk pools to please Senator 
     Breaux. And why are we so confident that Mitchell and 
     Gephardt are moving in Finance's direction? Because they, 
     too, are concerned only to pass something--and they don't 
     care what it is or how it happens.
       Opposition Without Apology. At bottom this debate is now a 
     political one. In the final, frenzied Democratic rush to 
     produce any legislation, Republicans should stand steadfast. 
     We cannot allow a Democratic Congress to throw together, for 
     their own selfish political ends, legislation that has 
     profound consequences on the medical care that every American 
     receives. What George Mitchell is fashioning on the second 
     floor of the Capitol is not a health care bill; it's a fall 
     campaign gimmick.
       If our analysis is correct that no principled, conservative 
     reform bill is likely to prevail this year, then the 
     appropriate Republican response is to take the noble road of 
     opposing any alternative the Democrats offer and insist on 
     starting over in '95. We should do so with pride and without 
     a speck of guilt. Health care is not like the annual budget 
     bill that must be passed before Congress adjourns. Robert J. 
     Samuelson's column in the July 18 issue of Newsweek 
     persuasively demolishes the case for the phony Finance 
     committee bill--and by extension, any other bill the 
     Democratic leadership is likely to produce: ``What should not 
     be forgotten in the inevitable clamor to `do something' is 
     that a bad bill would be worse than no bill at all. Opposing 
     such a bill is prudence, not obstructionism.''
       We have reached the point where the initial Clinton plan 
     has become a policy failure of historic proportions. Case 
     studies of its demise are already being prepared at public 
     policy schools. But we remain in a precarious period when 
     Democratic loyalists in Congress, bereft of leadership or 
     ideology but spurred by November politics, are making a last, 
     desperate effort to salvage enough from the wreckage to claim 
     a victory.

  Mrs. BOXER. I am going to quote briefly from this, just two 
sentences, and I say to my colleagues, listen well. This is what the 
Republicans are saying:

       Sight unseen, Republicans should oppose--

  The Democrats' bill.

       Sight unseen, Republicans should oppose it * * *. Our 
     message this week should [be] a preemptive strike; whatever 
     the Democratic leadership produces * * *.
       We should oppose.

  And in closing this article, saying of the Democrats:

       We should send them to the voters empty handed.

  In other words, Mr. President, the theme of this article is that the 
health care issue is not about health care at all, it is about who gets 
the credit for what we do here.
  I beg the American people, I urge the American people to forget about 
whether you are a Republican or a Democrat, whether you voted for Ross 
Perot or George Bush or Bill Clinton, whether you voted for Barbara 
Boxer or Tom Daschle or Jay Rockefeller, or Senator Levin. Forget about 
who you voted for and come together around this issue of health care.
  The majority leader's bill is a commonsense approach to reform. It 
will mean that we are on the road to coverage for all our people, that 
we will all have access to an insurance policy that we can afford, and 
it will not be taken away from us when we change our job; it will not 
be taken away from us when we get sick or a member of our family gets 
sick. And with the long-term care provisions, we begin to make sure in 
our country, in our great country, that stories like the one I told 
about a decent, hardworking, patriotic, Army family, that those stories 
will be a thing of the past and some day, we can look at our great 
grandchildren or our grandchildren and say, ``Can you believe there was 
one time in America where people went bankrupt because they couldn't 
get health insurance?''
  Let us say, Mr. President, to all of America--Republicans, Democrats, 
independents, people who do not vote, people who do vote--that we are 
going to come together and we are going to turn this country around and 
we are going to make sure that every American has the security that 
will come to them when they know they can have health care insurance 
that can never be taken away.
  It has been a privilege to participate in these floor statements with 
my colleagues. It is going to be a rough-and-tumble road ahead. But I 
believe from the bottom of my heart that we are correct to pursue this.
  In the old days when they fought about Social Security and Medicare, 
there were always those naysayers: ``Oh, we can't do it, there are 
reasons not to do it, I don't like this, I don't like that part of the 
bill.'' None of us will be perfectly satisfied with the product, but I 
think all of us will be proud when the President signs the bill and our 
people have a real sense of security that they never had before.
  Thank you very much, Mr. President. I yield the floor.
  The PRESIDING OFFICER (Mr. Levin). The Senator from South Dakota.
  Mr. DASCHLE. Mr. President, let me compliment our colleague, the 
Senator from California, for a very eloquent, passionate statement. She 
spoke for many of us when she articulated so well the consequences of 
failure of health reform and the importance of success. I thank her 
very much for participating in the colloquy this evening.
  Mr. President, this Saturday marks the first anniversary of the 
passage of the President's economic reform package, and I think it is 
appropriate that as we mark the first anniversary, we recall that very 
divisive debate, that we remember, the unfortunate partisanship 
demonstrated during that debate; that we recognize, in spite of the 
fact that the President pleaded for bipartisanship and made an earnest 
attempt to reach across the aisle, there was very little cooperation 
and absolutely no assistance from our Republican colleagues in the 
passage of that legislation.
  I recall that debate very vividly because of the extraordinary 
predictions about what would happen if that legislation were to pass.
  A Senator from the South, one of our Republican colleagues, said, 
``We are buying a one-way ticket to a recession.''
  One of our Republican colleagues from the Northeast said, ``It will 
flatten the economy.''
  One of our Republican colleagues from the West said, ``This plan 
cannot help the economy in the short term.''
  Instead, we all know now the results of that legislation--4 million 
new jobs, an economy growing faster than anyone would have imagined, 
deficit reduction way beyond the goals set out by our own budget 
process.
  Alan Sinai of Lehman Bros. in a recent report called this, ``The 
healthiest American economy in 30 years.''
  The Federal Reserve Chairman Alan Greenspan reported, ``The outlook 
for the American economy is as bright as it has been in a decade. 
Economic activity has strengthened. Unemployment is down. And price 
trends have remained subdued. In addition, unlike earlier periods, 
business spending on new plant and equipment has been an important 
contributor to growth. The strength in investment will enhance economic 
efficiency and lay the foundation for the productivity gains that will 
bolster the economic welfare of our Nation.''
  So obviously, Mr. President, the predictions made by many of our 
colleagues were just wrong.
  I also recall the predictions they made about jobs. A Senator from 
the Southeast said, ``This bill will cost American jobs, no doubt about 
it.''
  One of our Republican Senators from the West said, ``Make no mistake, 
these higher rates will cost jobs.''
  But in the first 18 months of the President's term, 3.8 million new 
jobs have been created. We are creating jobs at a rate of 77,000 per 
day. In 1\1/2\ years, the economic plan has helped create 1\1/3\ 
million more jobs than were created during the entire 4 years of the 
Bush administration. The unemployment rate, which was 7.7 percent when 
the President took office, has been reduced by almost 2 full percentage 
points.
  Mr. President, I repeat all of these statistics and dire warnings 
because, in a sense, it is ``deja vu all over again.'' We hear many of 
the same dire predictions now as we begin the debate about health 
reform. The economic consequences of health reform again are the 
subject of debate, and again our Republican colleagues make very 
similar dire predictions about the consequences of this piece of 
legislation.

  A Senator from the Midwest, from the Republican Caucus recently said, 
``America will pay a predictable price for heavy-handed Government 
control in the quality of health care, in more Government bureaucracy, 
in higher taxes, and in lost jobs.''
  A Senator from the South: ``Mandates kill jobs, but even worse, they 
cost Americans freedom.''
  A Senator from the Great Plains, ``The job loss estimates from this 
employer mandate will run from 600,000 to 3.1 million.''
  Dire predictions, Mr. President. But in my view these predictions 
sound more like politics than analysis. In my view, again, it is a 
regurgitation of the dire, and mistaken predictions we got last year 
about the economy.
  But before we get caught up in politics and lose sight of the 
analysis, perhaps it is important to draw attention again to more 
objective analyses provided to us by those who are knowledgeable about 
this issue. The Employee Benefit Research Institute is a nonpartisan, 
nonprofit institute, that provides objective information on the 
tradeoffs inherent in all of the health care reform proposals. Here is 
what they said, ``Health reform could result in the creation''--you 
heard me, the creation, not the elimination--``of as many as 660,000 
new jobs.''
  Using a variety of assumptions, they produced a range of estimates on 
the employment effects of the Health Security Act, the original Clinton 
health reform bill, ranging from 660,000 jobs created to about 168,000 
jobs lost. But they show how sensitive these estimates are to the 
assumptions one makes when setting up a study. This suggests we have to 
look very carefully at the assumptions that opponents use in claiming 
job loss.
  EBRI has issued their analysis. They are not Republican. They are not 
Democrat. They have looked at all the data provided to them in as many 
ways, shapes, and forms as can be considered, and they have concluded 
that health reform actually could mean an additional 660,000 new jobs.
  The Economic Policy Institute, again, a nonpartisan organization, 
suggests that the net result of health reform will be an increase of 
76,000 jobs by the fifth year and $18 billion in savings to the 
manufacturing sector in 1994 alone. The Council of Economic Advisers in 
concert with the Department of Labor reported they, too, believe that 
over 600,000 new jobs could be created.
  The Brookings Institute reported in a recent study that health care 
reform could lead to the creation of 750,000 jobs in home health care 
alone. Tremendous new opportunities in various sectors of health care 
that do not exist today.
  But you know, Mr. President, as so many of my colleagues have 
demonstrated again tonight, these statistics sort of wash off the 
shoulders of listeners. It is the faces, it is the human experience 
that perhaps has the greatest effect in the debate that we will have in 
the coming weeks.
  Gary Sprague is the owner of an independent trucking company in New 
Mexico. Gary Sprague makes it very clear. He said he cannot afford 
health insurance today. As much as he would like to provide it, he 
simply cannot do it under the current system. ``If you give me the 
ability to offer health care to my employees, I'll create a job 
tomorrow--my business will grow.''
  That is experience talking. Gary Sprague knows. He confirms that 
these independent studies are right, that jobs can be created. And so I 
hope, Mr. President, that as we again hear all of these dire 
predictions, we recognize how far off the mark they were just a year 
ago. We can now compare results with predictions. And I hope that we 
could use that as some gauge by which to carefully consider the 
accuracy, the veracity, the real expectations of the predictions made 
again during this debate.
  I am very concerned, frankly, that the same partisanship that was so 
clearly evident in the debate about that economic plan is again evident 
as we debate health care, something even more critical, this year.
  I am concerned, as the Senator from California indicated, that our 
colleagues on the other side of the aisle are continually getting 
advice to delay health care reform, to do little, or to do nothing; 
that the country can benefit if they can paralyze this institution once 
again. I am concerned about the polarization that continues to be so 
evident as we get into the heart and soul of this debate.
  I am concerned about the semantic evolution of the debate on 
mandates. I say ``semantic'' because I believe in my heart that there 
are many people on the other side of the aisle who understand the 
importance of a mandate, who understand truly when we say that 
universal coverage is important, that we can only achieve it in one of 
two ways: taxes or a mandate. Twenty of our Republican colleagues  felt 
so strongly about a mandate less than a year ago that they put their 
name on a bill requiring one; over 20 Senators.

  My good friend, the Republican leader, has indicated time and again 
that he, of course, would not support the repeal of Medicare, and I 
doubt he would support the repeal of Social Security, two mandates we 
have in law right now. He voted against the Medicare bill in the 
1960's, but supports the mandate today. Somewhere between the time he 
voted ``no'' and now, he changed his mind about Medicare. He was wrong 
in the 1960's. He is right now, with regard to Medicare. I believe that 
he is wrong now on health care and would be right to change his mind.
  So I hope, Mr. President, that during this debate we can reach out 
across the aisle to our Republican colleagues who have been on record 
in the past in support of approaches to ensure universal participation 
in Medicare, in Social Security, and even in health reform.
  There has been so much partisan criticism of the Clinton bill. Of 
course, in the last couple of days there has also been extraordinary 
partisan criticism of the Mitchell bill. Republicans praise the Dole 
bill. Yet, there is no Dole bill. In fact, perhaps we should call it 
the stealth bill. We are still looking for it. I hope that at some 
point in the not too distant future we will see a Dole bill so we can 
compare side by side the Dole bill and the Mitchell bill. Let us try to 
examine in a realistic way what the Republicans would suggest as an 
alternative to the Mitchell approach. It is not too much to ask. We 
have waited now for weeks and weeks in an expectation that along with 
the criticism of the Mitchell plan will come some constructive 
suggestion about what we do to accomplish the goals we say we all have. 
Mr. President, the Republicans ought to be concerned about the 
devastating consequences of the failure to achieve meaningful health 
reform this year, of failure to take advantage of an opportunity now 
that we have had on only a few occasions throughout this century. I 
think it is safe to say this will be the last opportunity we have this 
decade, in this century, to achieve what we have all indicated we want.
  But there is also a political consequence of action. That was 
indicated again just this morning in the Wall Street Journal. My 
colleague from Pennsylvania, who is on the floor this evening, pointed 
this out to all of our colleagues earlier today. I think it really 
bears  some discussion because the American people are beginning to see 
through all of this partisanship. They are beginning to understand that 
gridlock may be here once more. In spite of the fact that this has been 
one of the most successful sessions of Congress that we have had since 
the early 1950's, in spite of the fact that over the last couple of 
years we have made remarkable progress with this administration, 
gridlock again may be on the horizon.

  The poll asked: ``Do you think Congress will pass or will fail to 
pass some type of major health reform this year?'' Sixty-three percent 
indicated that they do not think a bill will pass this year; 31 percent 
suggested otherwise. That is the cynicism. That is the skepticism 
evident among the American people today.
  They do not think we will act for good reason. They hear these daily 
suggestions of delay, and the constant criticism. They hear these 
suggestions that perhaps we ought to hold off until next year, that we 
cannot do anything this year.
  Yet, as this article indicates, this is more than just a political 
question. This is a fundamental problem affecting millions of people 
across this land. The article is datelined ``York, Pennsylvania,'' 
obviously a community my colleague from Pennsylvania is very personally 
familiar with. In surveying a number of people in York, the article 
says:

       The people here, most of whom have health insurance, many 
     of whom have been without it before, and all of whom worry 
     about rising medical costs, urgently want Congress to pass 
     some health care legislation this year. All want universal 
     coverage. But nearly all would rather accept a bill that 
     falls short of that aim rather than wait for Congress to act 
     next year. Their anger suggests that Members of Congress from 
     both parties may face a backlash if Congress fails to act on 
     health reform this year.

  A backlash, anger from our constituents--if we have not seen enough 
of it yet, it is about to increase unless we are prepared to do 
something.

       The people disagree about a number of things: whether small 
     business should be required to help pay for their workers' 
     health insurance, whether government programs are the right 
     solution to the country's health care problems. But waiting 
     to resolve these issues will only make the problem worse, 
     most say. And hardly anyone buys the argument often put forth 
     by Republicans these days * * * that taking longer to study 
     the problem will lead Congress to a better solution.

  Mr. President, I do not need to remind anyone, in this Chamber 
certainly, of the cynicism so evident in the American people today 
about Congress' ability to do the right thing. I hope, in spite of the 
fact that 63 percent do not think we can do the job, that we can prove 
them wrong.
  It is interesting that on the same page in the Wall Street Journal 
there is another headline that responds to the skepticism expressed in 
the first article. The headline reads: ``Mitchell's vision of the 
health reform bill may offer the best hope to pass this year.''
  That is the answer. Mitchell's vision of the health reform bill may 
offer the best hope to pass this year--the best hope, not the only 
hope, but certainly a recognition that it is a doable plan that there 
is a consensus in this Chamber that we must act and that it is the 
minority who would keep us from acting.
  So I hope as we begin this debate--and it will begin in earnest 
within the next couple of days.
  I would hope we could declare a 3-week truce. We see so much divisive 
partisan politics. We saw it last year on the economic plan. We have 
seen it now for the last 8 months on the health reform. How nice it 
would be if we could just declare a 3-week truce--Republicans and 
Democrats saying let us forget politics for just 3 weeks; let us put 
our best minds to work on health reform. There will be philosophical 
differences, let there be no mistake. But what a tremendous opportunity 
it is for both sides of the aisle to work together to accomplish 
something we know the vast majority of the people of this country want.
  Mr. President, today, I believe, was the final rally involving those 
who participated in the Health Security Express. It took place on the 
West front of the Capitol. I had the opportunity to be with them 
briefly this afternoon. As you looked out over that audience, you saw 
people who had come from all over the country, people in wheelchairs, 
people on crutches, people who are disabled, people with stories to 
tell that chill us to the bone. They were here with a message. That 
message was: We are counting on you; we need you; we must pass health 
reform this year.
  Among those in the audience this afternoon was a man quoted 
frequently this morning, and quoted earlier this evening, His name is 
John Cox. John Cox was involved with a religious broadcasting company. 
His wife encouraged him to get on the Health Express. He was reluctant 
at first, but he did it after some encouragement. He was on the Health 
Express, and as it rolled toward Washington, his wife passed away. And 
now he is here with a message. The message is very simple: Until we get 
health reform, the pursuit of life, liberty, and happiness is only a 
dream that cannot be realized.
  It is up to us, if we want to accomplish that dream, to respond to 
those who were out on the west steps this afternoon. This is a fight 
for freedom. It goes beyond just health care. On top of the Capitol 
dome is the Statue of Freedom, symbolizing that we hold freedom as one 
of the highest virtues. As we join in the fight for freedom, we 
recognize that 200 years ago, there were those who fought for freedom 
from oppression; and 80 years ago, there was a tremendous fight in this 
country for the freedom to vote for all women; 30 years ago, there was 
a fight for freedom to acquire fundamental civil rights. So this, too, 
is a fight for freedom, recognizing that there cannot be real freedom 
until every man, woman, and child has health care that cannot be taken 
away. Again, we hear the dire predictions; we hear all of the  problems 
associated with health reform. But the bottom line is that unless we 
achieve meaningful health care reform, a bad situation will get even 
worse.

  Mr. President, our task in the next 3 weeks is to put partisanship 
aside, to recognize that there are those who are watching right now, 
who will watch and join in this debate for the next 3 weeks, who 
recognize the cost of failure, who believe as we believe, that this is 
an issue fundamentally affecting the freedom of every American today. 
Let us respond by telling them at long last that they, too, will enjoy 
their freedom, that the result of this fight is their freedom. They 
will be free at last.
  Mr. President, there are many others who wish to speak tonight, and I 
know my colleague from Pennsylvania has listened and is prepared to 
speak.
  I yield the floor.
  Mr. WOFFORD addressed the Chair.
  The PRESIDING OFFICER. The Senator from Pennsylvania [Mr. Wofford], 
is recognized.
  Mr. WOFFORD. Mr. President, I thank Senator Daschle for giving such 
leadership in this effort. I salute Senator Mitchell, who said that the 
greatest challenge of his life in this body would be to pilot a 
successful health reform bill through, for which he said he turned down 
the Supreme Court appointment.
  Under Senator Mitchell's leadership, we in the majority have now come 
to the health care table with a strong hand and an open mind. Having 
listened to the voices of the people, we have crafted a deliberate and 
moderate approach that provides a common sense, common ground for 
achieving universal, affordable private health insurance that cannot be 
taken away. Not more Government-run medicine, but less. Not less choice 
of your own doctor and your own preferred plans, but more choice. We 
will see that as this debate moves forward over the next 3 weeks.
  We need to hear further from the American people who are concerned 
about achieving health security. We will hear a lot from the special 
interests, but now is the time for the American people to speak, to 
speak up and to be counted.
  The question now before this body is whether our Republican 
colleagues will reject gridlock and put the working families they 
represent ahead of party politics, and whether they will focus more on 
the needs of the next generation and not the next election. The vast 
majority of people in this country support the idea of employers 
contributing something to their employees' health insurance, as most 
working people find their employers doing today. That is the American 
private health insurance system.
  It is incredible to me that the very same Members of Congress who 
oppose having private employers contribute to their employees' coverage 
have arranged to have their employer--the taxpayers--contribute to 
their private health insurance.
  They are going to have--if they pursue this course of total 
opposition--a very hard time going back to the people and saying that 
they blocked a plan to give working families the kind of affordable 
coverage, employer contribution, and choice of private health plans 
that they as Members of Congress have arranged for themselves.
  If they think that gridlock is great because health care no longer 
ranks high on the list of public concerns, believe me, they are living 
in an inside-the-beltway fantasy world. That is like saying that 
domestic violence was not a big concern before the O.J. Simpson case, 
or will not be after the media spotlight shines somewhere else. The 
reality is that issues like crime, or jobs, or health care, are life 
and death issues that are always central to the quality of life for 
working families in this country. Each may rise and fall in this week's 
polls, depending on the numbers of network news stories or magazine 
covers, but the political establishment, like the media, would be 
unwise to mistake its own short attention span for the daily, ongoing 
concerns of American families.
  It is easy for people in this Capitol to say go slow, wait until next 
year. It is easy for them to say that because they have health 
insurance paid by the taxpayers. But look at what has been happening 
out there to most American families. It is not just the tragic stories 
which are legend, it is not just John Cox, grieving over the death of 
his wife who lacked health insurance in crucial moments that might have 
saved her life. It is also the grinding daily reality that working 
families face of losing coverage they thought was secure and paying 
ever higher premiums and deductibles they can no longer afford.
  I have met those working families all across Pennsylvania and they 
know this has been the experience of their lives. They do not need to 
read reports or hear statistics about it, they have seen it happen year 
after year and on a greater scale.
  But let us look at some of the numbers. More and more employers are 
dropping coverage altogether. According to the current population 
survey, in 1983 two-thirds of American workers were covered for health 
insurance through their employer. Today only 60 percent of workers 
receive coverage at work. As a result, 71 percent, nearly three-
quarters of the uninsured today are not out of work they have jobs. 
They just do not have any health insurance. And those who are lucky 
enough to have coverage at work are losing increasingly their choice of 
doctor and health plan.
  According to a Kaiser/Peat, Marwick June 1994 survey, today 84 
percent of firms offer only one choice of plan to their employees. It 
is not reform that is taking choice away, it is the system we have 
today and where it is headed, headed down to less and less coverage and 
less and less choice of plans and doctors.
  Those numbers should tell you why the latest New York Times poll 
showed last week that health care is now moving ahead of crime on the 
issue hit parade.
  Those numbers should tell you why most Americans want to see this 
Congress take action on health reform this year. Read today's Wall 
Street Journal which my colleague and partner from South Dakota 
reported on, this account of a focus group of middle-class citizens in 
York, PA.
  Mr. President, I ask unanimous consent that the article from today's 
Wall Street Journal entitled ``Survey Group Wants Some Form of Health 
Coverage This Year,'' be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

              [From the Wall Street Journal, Aug. 4, 1994]

       Survey Group Wants Some Form of Health Coverage This Year

                           (By Hilary Stout)

       York, PA.--Debbie Rudisill comes from one of those middle-
     class working families President Clinton says a system of 
     universal health coverage will help the most.
       Her family lost its medical insurance last December when 
     her husband was laid off from a job that paid more than 
     $35,000 a year. Today he is in business for himself and can't 
     afford a health policy. Mrs. Rudisill wants Congress to pass 
     legislation that meets the president's goal of health 
     coverage for all.
       But she'll accept something less--as long as Congress 
     approves it this year. If Congress keeps stalling, or Mr. 
     Clinton vetoes a bill that falls short of universal coverage, 
     ``it will never be put into place,'' Mrs. Rudisill says. 
     ``You've got to start somewhere.''


                        confusion turns to anger

       Mrs. Rudisill's view is shared by most of those in a group 
     of middle-class residents of this midsize southern 
     Pennsylvania city convened at The Wall Street Journal's 
     request by Peter D. Hart Research Associates Inc. to discuss 
     health-care reform. When these people first met last March, 
     they were mostly confused about the issue. Today they're 
     mostly angry.
       ``If they pass something they can improve upon it, but you 
     can't start from nothing. Nothing from nothing is nothing,'' 
     says Susan Mayer, a 51-year-old automobile saleswoman, who 
     didn't have health insurance earlier this year because she 
     was unemployed. She now has coverage through her new job.
       The group here wasn't a scientific sampling, and a recent 
     Wall Street Journal/NBC News poll found that 61% of the 
     public thinks Congress should debate health care and act next 
     year. However, the people in York are deeply skeptical that 
     Congress will be any better able to act next year. And an 
     even larger majority in the national poll, 70%, think 
     Congress and the president should continue their efforts to 
     fix the health system, echoing the sentiments in the York 
     group.


                       doubts on action this year

       More than anything the people here see a health-care reform 
     debate run amok by politics and increasingly unresponsive to 
     the wishes of average citizens. As Congress readies for votes 
     on major health-care bills this month, passage of any health 
     legislation this year is very much in doubt. The Democratic 
     leadership in both the House and Senate has substantially 
     rewritten President Clinton's original proposal in an effort 
     to win support, but Republicans and many moderate and 
     conservative Democrats still are balking.
       ``The longer this thing goes on, the more I see this as 
     being divided along party lines, and I see it as an example 
     of our country not working together for the benefit of the 
     people,'' says Jahan Bashir, a 44-year-old secretary and 
     mother of seven who works largely so her family can have 
     health insurance. Her husband is self-employed, and they 
     can't afford coverage any other way.
       Both parties are to blame, most say. Fred Bingaman, a 
     customer service representative whose employer recently 
     switched him to a managed-care network, asserts: ``I think 
     the whole thing boils down to the issue of Republicans vs. 
     Democrats, and I think that if they could forget about that 
     for a while--which they probably can't--maybe we could have a 
     good health plan.''
       But Republicans seem to come under the harshest criticism. 
     Robin Doll, a 45-year-old financial specialist who receives 
     health coverage through her employer, doesn't believe in 
     party affiliation. But she has particularly angry words for 
     the Republicans. ``They are not even trying to make it 
     happen. You know, `Let's not make it happen before the next 
     election and give Clinton credit for anything.' I think 
     they're really holding up the process.''
       Echoes Ms. Mayer: ``They need to do something, but are they 
     looking at the overall picture of what's best for us or--is 
     it, `I'm a Republican, and I'm not going to vote for this 
     bill because Clinton wants it?'''
       The people in this room disagree about a number of things--
     whether small businesses should be required to help pay for 
     their workers health insurance and whether government 
     programs are the right solution to the country's health-care 
     problems.
       But waiting to resolve these issues will only make the 
     problem worse, most say. And hardly anyone buys the argument, 
     often put forth by Republicans these days, that taking longer 
     to study the problem will lead Congress to a better solution.
       ``Unfortunately they're going to come back with the same 
     mentality as this year,'' says Ms. Doll.
       Linda Baumer, a 42-year-old computer programmer who has 
     health coverage through her husband's employer, is one of the 
     few who disagrees. She worries that the momentum for passing 
     a system of universal coverage will collapse if President 
     Clinton signs a partial solution this year. ``If he goes half 
     way the issue will die down,'' she says.
       As it was five months ago, the group is bewildered abut not 
     only President Clinton's health-care reform proposal but the 
     other bills under deliberation in Congress. Most of those 
     here say they don't think much of the president's plan, which 
     even Mr. Clinton's allies in Congress say is dead. Yet, when 
     presented with written descriptions of the president's 
     health-care bill, a proposal by Senate Republican leader Bob 
     Dole, and Democratic leadership bills in the House and 
     Senate--without identifying who is behind each proposal--the 
     Clinton plan is the first choice of six of the nine people in 
     the group. The House leadership bill, which includes the 
     president's core proposal of requiring all employers to help 
     pay for their workers health insurance, comes in second with 
     two votes.

  Mr. WOFFORD. Mr. President, these people in York, PA, do not think 
that gridlock is great. They do not think it is acceptable to do 
nothing. They are angry at the thought that we will not rise to this 
occasion in this Congress this year, and those who try to block health 
reform are going to face the wrath of the American people.
  So let us cut the game-playing and the gridlock. Let us ask why so 
many Republicans have done a total flip-flop on their own constructive 
Chafee plan. Let us have no more song and dance about how long and 
complex the Mitchell bill is.
  We do not even have a Dole bill yet to pick up and to handle. Where 
is it? People are waiting. Waiting. And people do not believe that 
complexity in this matter should be an excuse for doing nothing. They 
do not believe that it should be an excuse for delaying further. They 
know that justice and health insurance, like justice delayed, can be 
for people like John Cox and his wife, justice and health insurance 
denied.
  Do you want to see something that is long and complex? Let us see. 
These are five volumes of the North American Free-Trade Agreement, 
popularly known as NAFTA. There it is. This is the treaty that Senator 
Dole, Senator Gramm and a lot of other people voted for last fall.
  I was against it because I did not think it was the right treaty at 
the right time for Pennsylvania workers. But I did not sit there and 
demand that every page be read on the Senate floor. Neither did the 
American people. They understood very well the choices this magnum opus 
represented.
  And here is the Uruguay round of GATT, which will be before us pretty 
soon, supported by some of the Members of this body who are saying that 
Senator Mitchell's bill is too long for them to handle.
  As a matter of fact, I have a question for Senator Dole and Senator 
Gramm and the others who really want to delay and seem to want to do 
nothing. Did you did you read every page of these five NAFTA volumes of 
the NAFTA treaty before you voted for it? Did you read every page? Are 
you reading every page of this GATT agreement before you support it?
  Do you think those people in York, PA, and all over this country 
cannot tell what this argument about the length of the bill, the need 
for delay adds up to?
  Let me tell you those people in York and all over Pennsylvania, and I 
believe all over America, are tired of the political games and the 
special-interest gridlock. Fifty years since Harry Truman started this 
fight, they want the buck to stop with this Congress. Because if we do 
not, the people will not forgive us. Not only the people of York, PA, 
but the people in Atlanta, GA, and Russell, KS, and Fort Worth, TX.
  Let us do the job the American people sent us here to do. It is what 
the people of Pennsylvania especially sent me here to do. Let us give 
other Americans the kind of affordable coverage and choice of private 
plans that Members of Congress have arranged for themselves.
  ``If you build it, they will come.'' So said the film, ``Field of 
Dreams.'' Between the Mitchell bill in the Senate and the Gephardt bill 
in the House, we are on the way toward building a moderate, careful, 
deliberate, reform bill that the American people will demand we pass.
  It will not, as I said in the beginning, be more Government-run 
health care. It will, as we look at the details of this bill, be clear 
to the American people it will be less Government-run medicine.
  It will not be a one-size-fits-all system, but a consumer choice 
system in which consumers, workers, and working families are in the 
driver's seat with more choice in fact than most of them have today.
  How can the opponents of universal coverage go back to the people and 
say they would block such a plan that would give working families the 
kind of affordable coverage and choice of private plans that they, as 
Members of Congress, enjoy themselves?
  By the way, Mr. President, as we get into this debate I am not 
interested only in how we phase it in over a longer period of time or 
how we drag it out beyond the turn of the century, beyond the year 
2000. I am interested in how we do the major steps forward toward 
insuring every American with private health insurance choices. I am 
interested in how we do those steps sooner, rather than later. And I am 
convinced that many of the key elements of this can start in year one.
  I urge my colleagues to not only look at to how you slow it down, but 
how we get the savings out of the system and bring costs down so we can 
speed it up.
  I also want to pay tribute to Senator Mitchell for including in the 
bill a number of the key items that I have been fighting hard for.
  First, opening the Federal Employees Health Benefit Program to 
private citizens.
  Here is the plan that I was given when I had the honor to come to 
this body and discover the kind of guaranteed choice, no preexisting 
conditions, portability of plan from State to State within the Federal 
system, and the contributions from your employer. In this plan no 
medical examination can be canceled, and a range of 25 or 30 choices 
that every year Members of Congress can make for themselves.
  It works for 9 million Federal employees and their families and the 
Members of Congress. I am glad that the Mitchell bill not only has this 
as a model of the kind of private health insurance, but in fact 
proposes ways that for many Americans will be actually opened for them 
to be part of this plan.
  Second, changing mandatory Government-run health alliances into 
completely voluntary, consumer-run purchasing cooperatives for those 
who choose them.
  I do not know if Harry and Louise on the television ads are going to 
flog the horse of mandatory alliances. That horse will be gone for long 
time. A lot of us said there should not be mandatory unduly Government 
regulatory alliances, but consumer-run voluntary purchasing 
cooperatives, open to small business, independent entrepreneurs, 
farmers, individuals who need that choice of plan with reasonably low 
premiums.
  Third, including protection for early retirees whose promised health 
benefits so often in recent years become broken promises.
  There are significant provisions in this bill that will give vital 
protection to some of those workers who have found themselves out in 
the cold in health care after having for many, many years worked hard 
days' to pay their dues on the assumption the projects made for health 
care and retirement to would be there, before they were entitled to the 
Medicare security that was provided for Americans in 1960's.
  Fourth, providing coverage for prescription drugs and long-term care 
in the home and community.
  And that is one of the items, Mr. President, that it is vital that we 
start sooner rather than later and that we show the ways to get the 
savings to make that possible.
  Fifth, a fiscal discipline, stay-within-the budget, do-not-increase-
the-deficit provision, with teeth in it, as in the other matters that 
we are now taking action on that have led now to the third year of 
actual deficit reduction, the first three years since Harry Truman's 
time that that has been a fact. That must be one of the key elements of 
this bill. And Senator Mitchell has included those provisions we 
developed in the Labor Committee and also the Finance Committee.
  Sixth, creating a voluntary self-financing insurance option to help 
older people pay for long-term nursing home care without giving up 
their life savings or their dignity.
  I hope my colleagues will look at this provision that I pressed for 
and we developed in the Senate Labor Committee that will give 
assistance and relief to millions of Americans. It is voluntary and 
self-financing. I think people will see, as those who looked at it with 
care, that it will work and it will help and that should begin in year 
one.
  Finally, simplifying the administration of the billing and data 
collection system through the private sector, instead of creating a new 
Federal bureaucracy.
  We will talk more about that. But this was a step forward that we 
made in our Labor Committee and I am glad that Senator Mitchell has 
pressed it forward to this body.
  And then there is one general principle that I think is in the 
structure of Senator Mitchell's bill that is very important, and that 
is to allow maximum State flexibility, so that different States can 
create their own unique ways to extend coverage and control costs--so 
that States like Pennsylvania, which have worked hard to develop State 
alternatives, can move ahead sooner, rather than waiting for a Federal 
deadline.
  So, Mr. President, I think this is a test for us as to whether we can 
govern, whether we the people of the United States through our 
representatives in Congress and with the support of our President can 
win that battle that Harry Truman started.
  I came out of World War II from the Army Air Corps in time to cheer 
Harry Truman on when he started this battle. I am one of those who 
cheered him when he was alive. Many revere him now, but he did not have 
that kind of support when he started this battle.
  And he did not have that kind of support when he pressed for the 
Marshall plan. He made the comment, at one point when he was at the 
bottom of his popularity and nobody thought he had any chance of 
reelection, he essentially said, ``Thank God that this was not the 
Truman plan.'' It was the Marshall plan, named after a distinguished 
son of Pennsylvania, from Uniontown, PA. George C. Marshall, one of the 
founders of the Civilian Conservation Corps and our leader in World War 
II.
  Mr. President, it is time for this Congress this year to see through 
the cause and to win the battle that Harry Truman started and--to give 
him credit--Richard Nixon carried on nearly 20 years ago. We can do it. 
We can do it if we rise to the occasion, inspired by the first great 
Republican. And if our Republican colleagues will remember that first 
great Republican, Abraham Lincoln, who called on the American people to 
return and to tap the better angels of our nature.

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