[Congressional Record Volume 140, Number 109 (Tuesday, August 9, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 9, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          HEALTH SECURITY ACT

  Mr. JEFFORDS. Mr. President, this afternoon we will take up the 
Health Security Act. Hyperbole is the coin of the realm in Congress, 
but I think it is fair to say that this is the most important domestic 
legislation any of us has or will face in our careers.
  We have an opportunity to do something that no other Congress has 
been able to accomplish--to provide the means for all Americans to have 
private health insurance. This opportunity is a fragile one. As we 
found in Vermont, where there was a tremendous reservoir of good 
intentions and good will, reforming the health care system is a 
difficult operation.
  While many of us have been working on health issues for some time, 
today's debate really began with the commitment of the President and 
the First Lady to provide this country with meaningful health care 
reform which includes universal coverage. I have supported President 
Clinton in this goal for the simple reason that is also my goal, as it 
is for many of my Republican colleagues.
  Mr. President, I was a member of the Republican Task Force on Health 
Care Reform which like the President had a deep commitment toward 
obtaining meaningful reform. Our task force, led by my patient and 
esteemed colleagues Senator John Chafee, met weekly for over 4 years to 
design a comprehensive health care proposal that would lower the cost 
of health care for Americans and our Federal Government. While I did 
not embrace the entire Chafee bill I do agree with many of its 
approaches, especially in providing incentives for the marketplace to 
drive our health care delivery system.
  I have once again joined Senator Chafee, who has been heading up the 
mainstream group of moderate Democrat and Republican Senators, who are 
working toward a broadly bipartisan bill. This is no easy task under 
any circumstances, let alone the partisan warfare that has already 
infected this debate.
  I understand the concerns expressed by my colleagues who believe 
strongly that a greatly expanded Government-run system would be best 
for this country, and I understand the concerns expressed by many of my 
Republican colleagues who are troubled about the Government taking 
control of our private health care system.
  But while our differences may make the headlines, in many areas there 
is agreement between all parties.
  We all believe that people should not be excluded from coverage 
because they are sick or because they change jobs.
  We all believe that we should be moving toward a system that 
encourages wellness rather than one that merely treats illness.
  We all believe that we have to stop the senseless cost-shifting from 
Medicare and Medicaid to the private sector and then back again when 
people can no longer afford insurance.
  We all believe that we must get the spiraling costs of health care 
under control.
  And we all believe that it is unacceptable that 37 million Americans 
in this country are uninsured and millions more are underinsured.
  Wanting health care reform for all American's should not be a 
Democratic or Republican issue. When a serious illness hits a family 
they do not check the doctor's political leanings. They want the best 
care they can get, and we should seek the same for them. I do believe 
that there are legitimate philosophical differences, which we debated 
in committee and which we should debate here on the Senate floor, as 
well.
  But rather than stooping to the gimmicks that both sides have already 
employed, let us give the American people some credit. Let us give them 
our best arguments, not our best artifice.
  This debate has thus far fixated on the issue of whether or not we 
will require employers to contribute toward their employees health 
insurance. That is an important issue, but I think the more important 
question is how we reduce costs for the vast majority of employers who 
are already providing coverage. And how do we reduce costs for 
individuals, as well as Federal, State, and local governments?
  How do we design the system, provide the incentives, and 
delineate responsibilities? What should we expect from the Federal 
Government and what should we expect from State government? Most 
importantly, how do we put the right incentives in place to get the 
private marketplace to function properly?

  These are terribly important questions, yet they have barely been 
asked, let alone answered. It is no wonder that the American people are 
confused about what Congress is doing, because we have yet to present 
to them a coherent approach.
  My own view is that the Federal Government should provide the 
framework and guidance for the States to carry out the ultimate goal of 
reaching universal coverage for all Americans. If a State can develop a 
program that finances universal coverage faster than the Federal 
Government can accomplish, we should provide these States with the 
appropriate waivers for innovative use of Medicare and Medicaid funds.
  Hopefully, this type of flexibility will allow States to show us the 
way to create a seamless system of coverage that eliminates the cost 
shifting in the system due to age, ability to pay, and sickness. 
Segregating the elderly, the poor, and the sick into separate programs 
and then wondering why costs are out of control simply makes no sense.
  The Federal Government should also provide guidance to ensure 
uniformity in the delivery system for both buyers and sellers in the 
marketplace. Establishing a uniform benefits package, national rules 
for health plans, national rules for purchasing cooperatives, and 
uniform rules for large multi-State employers all are necessary 
elements for a rational health care system.
  As important as what it should do is what it should not do. The 
Federal Government should not be in the business of running health care 
plans. This is a function of the private market today and must remain a 
function of the private market. There will already be a tremendous 
increase in Government responsibility without taking on this function.
  Mr. President, the formula for health care reform is really very 
simple: universal access plus affordable private insurance plus shared 
responsibility equals universal coverage. I believe very strongly that 
we can reach our goal of universal coverage only if businesses, 
individuals, and the Government share this responsibility. Business as 
well as individuals must contribute to the cost of financing health 
care.
  The time has come to put together a blueprint for a truly integrated 
health care system in this country that can replace the piecemeal 
approach that has developed over the years. Tinkering around the edges 
will not eliminate the cost shifting that occurs between providers and 
private payers.
  We must move away from a fee-for-service system and toward a 
capitated system of payment.
  Individual mandates alone will not ensure that everyone would 
purchase a health plan. But overregulating businesses by requiring them 
to spend more time and dollars documenting that they are meeting 
Federal rules will only add costs to the system. Needless expansion of 
liability will only drive costs up.
  America needs a health care system that prevents disease rather than 
one that is designed to simply take care of someone once he is sick.
  America needs a health care system in which two and a quarter million 
people a month do not lose health benefits and go without coverage for 
often long periods of time.
  America needs a health care system in which the cost of health 
insurance will not be $20,000 for a family by the year 2000.
  Americans need to know that if a catastrophic illness hits, they will 
have health care that is always there.
  Americans need a Congress that is willing to work together to provide 
the country with health care reform that is done right. I challenge my 
colleagues on both sides of the aisle to work to pass a bill that meets 
the needs of all Americans.
  Thank you, Mr. President.
  Mr. BREAUX addressed the Chair.
  The PRESIDENT pro tempore. The Senator from Louisiana [Mr. Breaux].
  The Chair would advise the Senator from Louisiana [Mr. Breaux], that 
morning business will expire at 9:30 a.m., under the order.
  Mr. BREAUX. Mr. President, with agreement of the distinguished 
Senator from Hawaii, I ask unanimous consent to proceed as if in 
morning business for not to exceed 10 minutes.
  Mr. INOUYE. Mr. President, I have no objection.
  The PRESIDENT pro tempore. There being no objection, the Senator from 
Louisiana is recognized for not to exceed 10 minutes, and the period 
for morning business is accordingly extended.
  Mr. BREAUX. Thank you, Mr. President.

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