[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 CARE REFORM

  Mr. BREAUX. Mr. President, as we begin the historic debate this week 
on the question of health care reform, I rise on this occasion to ask 
the question that perhaps many Americans asked over the past several 
months.
  The question is: Why are we here? What are we doing? Why is it 
necessary for the Congress of the United States to be debating a health 
care reform program or plan when we, in America, already have the 
finest health care system in the world?
  (Mrs. MURRAY assumed the chair.)
  Mr. BREAUX. Let me make two points in trying to respond to that 
question. The first point, I think, is clearly shown by the question of 
health care cost--how much it costs each and every citizen in this 
country to have health care in what is clearly the finest system known 
to man.
  In 1970, Madam President, we, in America, spent about the same amount 
of money on health care as we spent on education in the public and 
private sector; dollar for dollar, health care spending equaled what we 
spent on education.
  Last year, Madam President, we, in America, spent the same amount of 
money on health care as we spent on all of education; but in addition, 
combined with what we spent on all of national defense, what we spent 
on running all of the prisons in America, what we spent on all of the 
farm subsidy programs in America, what we spent on all of the food 
stamp programs in America, plus what we spent on all of the foreign aid 
programs combined. That occurred in a relatively short period of time 
in our country's history. So, No. 1, we are here because the cost of 
health care in this country is out of control. Health care costs were 
climbing at a rate nearly twice the rate of inflation since 1981. If we 
do nothing, the long-term economic stability of our entire Nation will 
be adversely affected in a very serious way, unless we address the 
question of health care costs.
  The second point is this. Madam President, 85 percent of Americans 
have health insurance so they would question the Congress, ``Why are 
you messing with what I already have? Are you not planning to take away 
something that I have in order to give it to the 15 percent of the 
people who do not have health insurance and need help and assistance?''
  In my State of Louisiana we have one of the highest rates of 
uninsured people in the Nation--second highest, to be exact. But we 
have a large percentage of people who, in fact, do have health 
insurance. Those people who have health insurance, No. 1, pay too much 
for it. Everybody in America who has a plan is paying more than he or 
she should pay for health insurance because they are paying in their 
premiums for everybody else who does not have health insurance. That is 
wrong and we need to fix it.
  Second, those people have their health insurance canceled when they 
get sick. How many of our colleagues do not know of a family somewhere 
where the mother or the father or a child got sick and they get a 
notice in the mail that their health insurance has been canceled? Why? 
Because somebody got sick. That is what health insurance is for, to 
take care of people who get sick. We need to do better, and health care 
reform can address that problem and help fix it.
  Madam President, the third point is the people who already have 
health insurance lose it when they change jobs. In today's mobile 
society in this country, where people change jobs several times in a 
lifetime of trying to find the best type of work suitable for their 
intelligence and their endeavors, they change jobs. They improve their 
conditions. But, when they do that, many times they lose health 
insurance because the employer says you cannot take your policy with 
you. If you are changing jobs, you are going to lose health insurance. 
And guess what; if you had a preexisting condition, when you get to the 
new job, they are not going to sell you health insurance in the first 
place.
  So I say to the 85 percent of Americans who have health insurance, 
you have a lot of problems with it and they need to be addressed. You 
pay too much; it gets canceled when you get sick; and you lose it when 
you change jobs. Health care reform is about helping make better the 
conditions of the people who have health insurance in America, as well 
as it is about taking care of the 15 percent who have no health 
insurance whatsoever. The question becomes, how do we do it? I think 
there are two basic ways we could approach the problem of how do we 
address health care reform.
  First, and some have advocated this, is that the Government should do 
a lot more. We should have Government-run health care. We should have 
more mandates, more regulations, more bureaucracies; we should have 
price controls, we should make sure everything works right, and we 
ought to have it all done in Washington. That is one way. I do not 
think that is the best way. In fact, I think history tells us in many 
areas, we have not done very well with Government-run types of 
programs, particularly when it comes to cost control. Medicare is a 
good example of that point.
  The other alternative, which I think is a better way, is improving 
the marketplace, getting rid of those impediments in the marketplace 
that have not allowed the health care system in this country to work 
very well, those impediments that have restricted competition from 
really working in the area of health care. That is the approach I 
prefer.
  Several years ago, the Congressman from Tennessee--perhaps soon to be 
Senator--Jim Cooper and I introduced the Managed Competition in Health 
Care Act, which relied on improving the marketplace as a way of trying 
to bring about this reform we all can agree on.
  I think the President and the First Lady have done a tremendous job 
of bringing this issue to the attention of the American people. They 
have said they want to assure that all Americans have adequate health 
care, at an affordable price, that they will never lose. Who is against 
that? Nobody I have ever spoken to is against the concept of all 
Americans having quality health care at an affordable price. How we get 
there is the issue here today. I have suggested a way of doing it that 
I think is the proper way.

  Many liberals say we should do everything; we should do it all at 
once, and hope we get it right. Then there are some conservatives who 
say we do not want to do anything, and we want to take a long time in 
doing it. I think both of those two positions are unworkable and are 
not the best way of addressing this problem. I suggest we take it one 
step at a time to make sure we do it right as opposed to trying to do 
it all at once and just hoping we get it right.
  We have suggested, and the concept we are embracing, is major 
insurance reform: Take care of those 85 percent of the people who lose 
their health insurance when they change jobs or have it canceled when 
they get sick. We need to make sure that insurance reform is part of a 
package. We need to have purchasing cooperatives so the individual 
person in Louisiana running a small business has the opportunity to buy 
health insurance as if he or she were General Motors or Xerox or a 
multinational company, which gets a much better deal than the average 
American who has to rely on buying insurance by themselves. Purchasing 
cooperatives give them purchasing power so they have the opportunity to 
buy as if they were a large company and get a good deal. They should 
get the same good deal a big company gets. They are not getting it. 
Purchasing cooperatives take care of that.
  And the people who do not have insurance--again, if you have 15 
percent of the people who are uninsured, we have to help them pay for 
their premiums. Right now, we are paying Medicaid for them, which is 
not the best way to do it. We should take the money from Medicaid and 
give it to the people who cannot afford to buy insurance in the form of 
subsidies, and we have a way of helping them. They should buy 
insurance. Poor people should have access to health care just like 
somebody who is wealthy. We need to lower the costs of the people who 
have health insurance, as well as giving poor people a much better deal 
than they have now.
  We need to standardize the benefit package. We have 2,000 health 
insurance companies with 20,000 exceptions. Did you ever look at a 
health insurance policy and try to understand it? I have, and I cannot. 
I am sure most Americans are like I am. It is too complicated, too 
confusing, too many exceptions. Madam President, 25 or 30 percent of 
the doctor's work in his office is filling out forms or processing 
redtape. You fill out a document and submit it. They send it back to 
you because you did it wrong. You do it again, resubmit it. That is 25 
to 30 percent of the cost of doing business, and nobody is being 
treated when all that money is being spent filling out forms and 
processing redtape, bureaucratic requirements. So we need to 
standardize the plans and I think that would go a long way.
  We need malpractice reform. Doctors should do tests to treat people, 
and not have to worry about whether they are going to be sued or 
litigated against. But still the individual's right to the courts would 
be preserved, of course. We make sure we try to improve the system in a 
way I think makes a great deal of sense.
  The final thing is this: Universal coverage. Is anybody not for that? 
Is anybody willing to say, ``I am against some people having insurance 
and I do not think everybody should have insurance?'' Of course not. I 
have not met an American in Louisiana or a Member of Congress who is 
willing to stand up and say, ``I don't think everybody ought to have 
coverage.'' Everybody thinks everyone ought to have coverage. How we 
get it is what is at question right now; what process do we use.
  George Mitchell, our majority leader, the distinguished Senator from 
Maine, I think, has come a very long way toward reaching a plan that I 
think makes a great deal of sense.
  The PRESIDING OFFICER. The time of the Senator from Louisiana has 
expired.
  Mr. BREAUX. Madam President, I ask for two additional minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BREAUX. I thank the Chair for the indulgence, and conclude by 
saying the majority leader's plan, I think, is a major move toward 
getting a bill everybody can support. Do you know why I know that? 
Because everybody is criticizing it. It is getting criticized from the 
left as not being enough, being criticized from the right as being too 
much. I think that means it is in the middle somewhere, which I think 
is how we have to solve this problem: From the middle out instead of 
from the left in or from the right in. It is a plan that moves in the 
right direction.
  I am concerned about the mandates because the plan that is before the 
Senate now, or will be, says that in 1994 we are going to make a 
decision about what is the best way of getting it in the year 2001. I 
suggest we have enough problem deciding what is best to do today, 
rather than trying to decide today what is the best answer in the year 
2001.
  I will suggest that work in that area will give us a solution that 
will present a package to the Senate that we can adopt in a bipartisan 
manner, as all major legislation, like Medicare, Social Security, have 
been adopted in a bipartisan fashion over the years.
  We can do this. It is important. We should do it. The American people 
expect Congress to act. They are tired of the political debate that 
they hear about whose fault it is and which party is going to get 
credit, which party is going to get blamed. It is time the American 
people win one. This is an opportunity to make all Americans winners in 
the question of health care reform.

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