[Congressional Record Volume 140, Number 118 (Friday, August 19, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 19, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          HEALTH SECURITY ACT

  The PRESIDING OFFICER. The Senate will now resume consideration of S. 
2351 which the clerk will report.
  The bill clerk read as follows:

       A bill (S. 2351) to achieve universal health coverage, and 
     for other purposes.

  The Senate resumed consideration of the bill.

       Pending:
       Mitchell amendment No. 2560, in the nature of a substitute.

  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. KENNEDY. May we have order?
  The PRESIDING OFFICER. The Senate will be in order.
  The Senator from Minnesota has the floor.
  Mr. WELLSTONE. Madam President, I thank the Chair.
  The PRESIDING OFFICER. The Senator will suspend until the Senate is 
in order.
  Mr. DOLE addressed the Chair.
  The PRESIDING OFFICER. The Senator from Minnesota has been 
recognized.
  The Senator may proceed.
  Mr. WELLSTONE. Thank you, Madam President.
  Madam President, could I get order on the floor?
  The PRESIDING OFFICER. The Senator has asked for order. The Senate 
will be in order.
  The Senator from Minnesota.
  Mr. WELLSTONE. Madam President, I would like to spend a little bit of 
time talking about----
  Mr. HELMS. Madam President, the Senate is still not in order.
  Mr. WELLSTONE. I thank my colleague from North Carolina.
  Madam President, I am not going to proceed until I have an 
opportunity to speak on the floor.
  The PRESIDING OFFICER. The Senator is correct. The Senate is not in 
order. The Senator from Minnesota will not continue until the Senate is 
in order. The Chair will ask Senators to kindly take their 
conversations to the Cloakrooms or off the floor.
  The Senator from Minnesota.
  Mr. WELLSTONE. Thank you, Madam President.
  Madam President, everybody, I think, here in the Senate has been 
anxiously awaiting the unveiling of the mainstream proposal, hoping 
against hope that it might magically emerge as the proposal that will 
allow us all to win on health care reform without even having to fight.
  Madam President, on the basis of what I have heard, these sets of 
proposals move us further down the road of a further weakening of 
health care reform to the point where, Madam President, we will be 
talking about a health care policy that does not even work.
  Madam President, I just wish--and I think I make this appeal more to 
the media--could I have order on the floor?
  The PRESIDING OFFICER. Will the Senate be in order and will Senators 
kindly take their conversations off the Senate floor? The Senator from 
Minnesota deserves to be heard. He has asked to be heard and he has 
asked Senators to please come to order, and the Chair asks that the 
Senate please be in order.
  The Senator from Minnesota.
  Mr. WELLSTONE. I thank the Chair.
  Madam President, the issue is not left, right, or center. The 
question is not ideology, and the question certainly is not give and 
take and compromise. The question that each and every one of us has to 
answer as Senators is whether or not a proposal or set of proposals 
will be better for the people we represent or not. That is really the 
question we have to answer. It is not a question of whether it is 
everything we want. It is certainly not a question of anybody in here 
wanting to make the perfect the enemy of the good.
  I think all of us understand that there are 100 of us here and that 
means there has to be give and take. But, ultimately, we have to decide 
whether or not a particular set of proposals or a final reform bill is 
truly a reform bill.
  Madam President, yesterday--and I am going by what I have read and I 
am anxious to see the paper--but today there is a picture in the paper 
of Robert Reischauer, someone whom I have a tremendous amount of 
respect for because I think he has done a yeoman's job under fierce 
pressure and, quite frankly, I appreciate his rigor. He has not always 
been popular with Senators in either party, but I think he has been 
rigorous in his analysis.
  My understanding is--and I will use the labels that people have 
applied to themselves--my understanding is that the mainstream group 
found it very sobering because he talked about the failure of cost 
containment.
  Madam President, I just do not know where some of my colleagues have 
been for the past several years. At the beginning, we talked about 
making sure that each and every person was covered. We talked about 
making sure that we would have affordable, dignified, humane health 
care delivered out in the communities where people lived. That made a 
lot of sense.
  We talked about making sure that people would have choice--people did 
not want to be herded to just one plan or two plans--of their doctor 
and their nurse. And we talked about making sure it was affordable both 
for individuals and affordable for the Nation.
  But, Madam President, some of the people who are now saying that we 
have to further weaken this effort, they have said no to a cap on 
insurance premiums.
  Now, if you want to look to the CBO and what the CBO has said about 
how you can contain costs, I would say to my colleagues, they will tell 
you--and they have so stated, that you have to have a cap on insurance 
premiums. But, Madam President, that was taken off the table. And by 
the way, Madam President, the insurance industry is not without a 
considerable amount of power here.
  Then we were told that we cannot have employers paying their fair 
share. Remember, our employer pays 72 percent of the share of our 
premium. And we were finally told that we needed to take out some of 
the managed part of the managed competition which people like Alan 
Enthoven and others who first thought up the idea told us you ought to 
have at the State level to make it work.
  So, Madam President, what I now see happening here is you have 
Senators who have reached an accommodation with some power interests, 
starting with the insurance industry. They have taken off the table the 
very proposals which, by the way, were in the Clinton bill that would 
have led to cost containment, made sure we could stay within a budget, 
starting with capping the premiums of insurance companies.
  Why was that ruled off the table? Which folks had the say on that?
  So we take the very proposals that the CBO tells us we should take a 
look at in order to contain costs and stay within a budget and we rule 
them off the table, and then we turn around, after having rejected the 
very things we should do, accommodating ourselves to these power 
interests, starting with the insurance industry, and then use that as 
an excuse for not covering people.
  That is what has happened. That is my objection to the direction of 
where this is going.
  Senators have said, ``No, we can't cap insurance premiums.'' Senators 
have said, ``No, employers can't pay their fair share.'' That is how 
you raise the money. That is how you control the costs. And then the 
same Senators have turned around and said, ``Well, you see, the real 
issue is deficit reduction and since we can't contain the costs and we 
do not really know how to finance it, we are going to have to move in 
the direction of making sure that people are not covered with decent 
coverage.''
  Mr. WARNER. Will the Senator entertain a question at an appropriate 
time?
  Mr. WELLSTONE. I pleased to yield.
  Mr. WARNER. It would take maybe a minute to lay a foundation for a 
question, because I listened carefully to what you said today, and 
indeed I have followed what you have said previously.
  Madam President, I freely admit the following: My father was a 
doctor, a very prominent, a very successful physician in northern 
Virginia and the Nation's Capital. I admit, Madam President, if I had 
enough brains, I would have been a doctor, but here I am today.
  Mr. WELLSTONE. Will the Senator yield for a moment?
  Mr. WARNER. Yes.
  Mr. WELLSTONE. I disagree with the Senator from Virginia. I think he 
has more than enough brains.
  Mr. WARNER. My colleague is nice to say that, but I learned at my 
father's knee several things about medicine. I would like to pose them 
to my good friend in the form of a question.
  What we have done is transform this magnificent Chamber into an 
operating room. We are like so many physicians, bending over this 
patient ready to take scalpel and make a major incision into a system 
which has served this country for some 200 years, which has served 80-
plus percent of our people quite adequately.
  Does the system have problems? Yes, it does have some problems. And 
we have been dealing with them, ostensibly, here, for a few days. But I 
think we have done little more than a pedicure, clipped a nail here, 
and polished a little bit there. We have not gotten into the heart of 
the problem in terms of how it is to be paid for, the balance between 
further Government intervention and the private sector. Those are major 
issues. Our President and the First Lady, to their credit, performed 
their own diagnosis of the patient but we rejected it.
  Subsequently, our distinguished colleague, the Senator from 
Massachusetts, [Mr. Kennedy], and others in his committee made a 
diagnosis, reported out a bill but we rejected it in large part. The 
Finance Committee likewise reported out a bill but we rejected that 
diagnosis.
  Now we have the diagnosis of Representative Gephardt, and that is 
rejected by the House.
  Time and time again we have rejected diagnosis after diagnosis. This 
thing is becoming almost like a ``Mash'' comedy and that is not what 
the American public wants. They want answers. I say to my good friend, 
when the practicing doctors and the patients reach this type of 
situation we find ourselves in today, they go and get a second opinion. 
That is bedrock practice in medicine today, a second opinion. I ask my 
good friend, is it not time to get a second opinion? And that opinion, 
in my judgment, can only be rendered by the people of the United States 
of America.
  We are now informed that later this afternoon the mainstream group 
are about to report to this Chamber another concept and idea, followed 
by, perhaps next week, the Senator from Georgia, Senator Nunn, and 
Senator Domenici, the Nunn-Domenici plan.
  I say we should listen to each of these plans very carefully, debate 
them here on the floor, report them to the public, but then let us go 
back to the public and get a second opinion. What is the harm? And I 
will finish in a moment.
  Mr. WELLSTONE. I ask for the regular order, in all due respect to my 
colleague.
  Mr. WARNER. I just want to pose to my colleague, what is wrong with 
going back to the public, after we have debated every one of these 
plans thoroughly, and getting a second opinion? That should be brought 
about through concentrated work at home with our constituents through 
the election process in November, and come back next year, as some of 
your colleagues have said, and address this in a very serious manner.
  The PRESIDING OFFICER. The Senator from Minnesota does have the floor 
and is entitled to answer the question at some point.
  Mr. WARNER. That is correct, Madam President. I guess that is the 
message I am trying to send to my friend, that it is time we get a 
second opinion and come back next year and commit--although we cannot 
bind the next Congress--the two-thirds of us who will be here.
  The PRESIDING OFFICER. Does the Senator from Minnesota understand the 
question?
  Mr. WARNER. He understands the question, Madam President.
  The PRESIDING OFFICER. It is the Senator's right to answer that 
question.
  Mr. WARNER. Madam President, he understands the question.
  Mr. WELLSTONE. Madam President, I certainly do understand the 
question. I have been a teacher for many years. I am very familiar with 
long questions. And my colleague from Virginia is his usual articulate 
self.
  Let me just simply respond very briefly and then go on with the 
second opinion that I am now going to present on the mainstream 
proposal because I think we should have a debate about ideas and policy 
proposals.
  I would simply say to my colleague from Virginia that I smile a 
little bit to myself about ``second opinion'' because health care, 
universal health care coverage is an idea whose time has come over and 
over and over again in our country, going all the way back to before 
World War I. Since we have been debating this question as a Nation for 
well over half a century, and since we are really almost alone among 
the ranks of the advanced economies in the world in our failure to 
figure out how to finance and deliver health care for all of our 
citizens--high quality care, which I know the Senator's father would 
have insisted on--it seems to me we have had plenty of time for debate 
and discussion and second opinions. We have had many committee hearings 
here.
  There comes a time in public life where you step up to the plate. I 
agree with my colleague I would like to get to the core of this and go 
after tough issues. And you would vote. That is what we are here for, 
is to vote.
  Mr. REID. Will the Senator from Minnesota yield for a question?
  Mr. WELLSTONE. I am pleased to yield to my colleague from Nevada. I 
just want to also remind my colleague, since I know we want to get to 
amendments, I want to make sure I do have time to present an analysis 
of the mainstream proposals because I want that to be a matter of 
record. But I would certainly be pleased to yield.
  Mr. REID. The Senator has the floor and the Senator can speak as long 
as the Senator wishes under the present frame of debate.
  I ask the Senator from Minnesota, is it not true that during this 
Congress there have been over 80 hearings held on various health care 
bills by the Finance Committee and the Education and Labor Committee? 
Is that true, over 80 committee hearings?
  Mr. WELLSTONE. That is correct.
  Mr. REID. Is it not true, I say to my friend from Minnesota, is it 
not true that during this period of time there have been hundreds of 
witnesses who testified before those two committees?
  Mr. WELLSTONE. That is correct.
  Mr. REID. Is it not true that one of the basic elements that we are 
trying to establish, as indicated by the Senator from Minnesota, is the 
fact that we have been through over 50 years of debate off and on, on 
this? And during the past several years debate all year long? We have 
been through six or seven Presidents who have talked about universal 
health care coverage, is that not true?
  Mr. WELLSTONE. That is correct.
  Mr. REID. Mr. President, I reach in my wallet here and I can flip 
through this wallet and I have a card here that says, ``Government-Wide 
Service Benefit Plan, Blue Cross/Blue Shield. Federal Employee 
Program.''
  Is it not true, I say to my friend from Minnesota, that we have had 
debate on this floor for over 2 weeks, trying to indicate to the 
American public and to the Members of the U. S. Senate that we are not 
trying to do anything very difficult or elaborate. We are trying to 
give the American public the same coverage that we have. Is that not 
true?
  Mr. WELLSTONE. That is correct.
  Mr. REID. Is it not true, I say to my friend from Minnesota--although 
he may have some different plan--I have a plan that is Blue Cross/Blue 
Shield. But, because we have a retail pharmacy program under the plan 
that I have, I can go to any pharmacy that is a member--it is most all 
of them around this area and in Nevada, also--and I can get my 
prescriptions for I think $5. I think no matter what the prescription 
is, $5.
  Is the Senator from Minnesota aware that I have a plan like this and 
that I am trying to get it so the American public has the same 
opportunities I have?
  Mr. WELLSTONE. I would say to my colleague--I thank him for the 
question and I would be more than willing to take some other questions 
as well, because I think the Senator from Virginia has raised an 
important question, before I go on with the other analysis. And let me 
just respond in two ways.
  No. 1, yes, to talk about, ``We really need to slow this up, we need 
another second opinion,'' ignores almost 75 years of debate and 
discussion about this. And No. 2, of course, your perspective about 
whether or not we need to stop or we need to block or we need to 
filibuster or whatever it is that we do, depends upon the situation of 
yourself and your family. If, in fact, you have reached a point where 
you do not have insurance or you are underinsured or you are terrified 
of losing your coverage because you might lose your job, or because of 
a sickness, then from your point of view it is really important that 
this does not get put off once again.
  And finally, on the Senator's point about the coverage we have, I am 
quite well aware of that. I believe yesterday the Senator from 
Pennsylvania and the Senator from South Dakota and others, the Senator 
from Massachusetts, spoke eloquently to this. I will have an amendment. 
I am going to be on the floor all day to day until I can get my turn to 
introduce an amendment. I want Senators on record that this health care 
reform bill that we pass should provide people with a health care plan, 
high-quality care comparable to what we have. We will have a vote on 
that.
  Mr. REID. Could I ask one more question before I no longer intrude on 
the time of the Senator from Minnesota?
  Mr. WELLSTONE. I would say to my colleague that he is not intruding 
on my time.
  Mr. REID. Is the Senator aware--and I was not until recently, 
frankly--that the card we carry around, I carry around, has helpful 
telephone numbers? It is so easy for me if I have a question about my 
health care. I can call here, ``For customer service: 1-202-484-1650.'' 
I even have a toll free number right here.
  Let me pull this out of my wallet--1-800-848-9766. If I have any 
question about pharmaceuticals, about medical care for my children or 
for me, I have it right here in my pocket. How many people out in this 
public, the American public, do you think has the same benefit I have?
  Mr. WELLSTONE. I say to the Senator from Nevada that he just 
emphasizes the most important point that can be emphasized in this 
debate, which is people are saying to us over and over and over again, 
``You are our elected representatives and we believe that what you have 
decided is a really good health care plan for yourselves and your loved 
ones, that that ought to be the standard that you set in pushing 
forward a reform bill. Make that available to us. We are your 
constituents.''
  Mr. DASCHLE. Will the Senator yield on that point?
  Mr. WELLSTONE. Yes, I yield.
  Mr. DASCHLE. I think the Senator from Minnesota and the Senator from 
Nevada make a very important point. The Senator from Nevada talked 
about the back of his card. Here is my card, and the back of my card is 
the same as the Senator from Nevada. I have Blue Cross/Blue Shield as 
well. Not only does it give a helpful number, we talked a lot about the 
standard benefits package. This lists them.
  It says:

       This card shall cover all hospital, surgical, mental, 
     dental, and prescription drug benefits.

  Then it says:

       This card constitutes acceptance of the terms and 
     conditions of the service benefit plan brochure.

  The requirement that we comply with the standard benefits package. It 
says it right on the back of my card. So those who say it is so 
complicated and there are so many different ways in which the American 
people ought to be given opportunities for choice, this is my ticket to 
choice, this card.
  What is interesting is that every American ought to have the same 
ticket to choice that Members of Congress have. That is what we are 
talking about here. Mine is blue and white. Maybe theirs can be gray 
and gold or something else. It all ought to say the same thing on the 
back. It says this is your ticket to confidence. This is your ticket to 
ensure you are not going to be surprised. This is your guarantee that 
there is no fine print. This is your guarantee when you walk into a 
hospital, if you need surgical care, mental or prescriptive drug care, 
you have it. This is your ticket to ensure when we standardize the 
benefits, whether you live in South Dakota, Massachusetts, or 
Minnesota, or Nevada, or Iowa, that you are not going to be treated any 
differently.
  That is what we are talking about here. When you buy a car you have 
that confidence. You know it is going to have all the safety 
precautions that any country requires. You know that when you buy 
clothing, especially if it is for a child, that it is not going to be 
flammable if, God forbid, there is anything that should happen. It is 
your ticket to confidence. This card does that, and it is all on the 
back of a little card that is no bigger than maybe 2 by 3.
  Mr. WARNER addressed the Chair.
  Mr. DASCHLE. If I can ask a question of the Senator from Minnesota 
whether or not it is his view that all Americans ought to have a card 
like this?
  Mr. WELLSTONE. Madam President, I say to my colleague from South 
Dakota, absolutely. I am going to offer a sense-of-the-Senate amendment 
that says as we move forward on this health care bill that we pass a 
piece of legislation that reads something like ``provides every 
American with health care that is as good as the health care available 
to Members of Congress.''
  I absolutely agree, and we will have a vote on this today.
  Mr. KENNEDY. Will the Senator yield? I think if we could hold up our 
cards here, these cards----
  Mr. WELLSTONE. I say to my colleague, I feel lonely. I do not have a 
card down here.
  Mr. KENNEDY. The point about it is that every Member of this Senate, 
to my knowledge, has one of these cards. To my knowledge, no Member of 
the Senate has checked off----
  Mr. HELMS. Regular order.
  Mr. KENNEDY. Does the Senator know of any Member----
  Mr. HELMS. The Senator did not yield for a speech.
  The PRESIDING OFFICER. The Senate will be in order. The Senator from 
Minnesota has the floor. The Senator from Massachusetts is posing a 
question.
  Mr. WELLSTONE. Madam President, I have the floor and I was patient in 
listening to the question of the Senator from Virginia. I am now taking 
a question from the Senator from Massachusetts.
  Mr. KENNEDY. Is it the understanding of my good friend, the Senator 
from Minnesota, that every Member of this body has a card that mentions 
their health care benefit coverage? Is it your understanding that every 
Member of the Senate has a card either identical to this or similar to 
this that provides the kind of range of services and hospitalization 
and prevention programs and prescription drugs, is that the 
understanding of Senator?
  Mr. WELLSTONE. I say to my colleague, that is my understanding, and 
it is more than just the card. It is what the card stands for. What 
this card means, Madam President, is that I will not be denied--if I 
can finish--I will not be denied coverage for myself and my loved ones 
because of an illness I have or because of a sickness my child has. 
There is no preexisting condition, because of this card.
  What this means is that I will be able to afford health care, and 
what this card means is that even though it is not perfect by way of a 
package of benefits, this is good coverage for myself and my loved 
ones. We ought to provide the same thing for the people we represent.
  Mr. KENNEDY. Just a final question. Is it the Senator's understanding 
that the President of the United States and the First Lady, under the 
program which they introduced, and the Mitchell program will provide--
their desire is to provide cards similar to the one that I have, and I 
see my friends from Pennsylvania, from Iowa, from Nevada, and other 
Senators have, that they have the same kind of card that each one of us 
has in here and get effectively the same range of benefits? Is that the 
understanding of the Senator that this program will provide a card like 
this that will be available to all Americans as it is available to the 
Members of Congress? Is that the Senator's understanding about what 
would be guaranteed under the Mitchell program that is before the 
Senate?
  Mr. WELLSTONE. Madam President, it is certainly my understanding that 
was in the Clinton plan, and I think the Mitchell plan moves us far in 
that direction. I have to tell you, by this standard, we have to be 
very careful that we do not, in the final analysis, end up moving away 
from this very important principle. So I thank my colleague from 
Massachusetts for what he said.
  Mr. HARKIN. Will the Senator yield for a question?
  Mr. WELLSTONE. I will be pleased to.
  Mr. WARNER. Will the Senator also acknowledge that under the present 
bill----
  Mr. WELLSTONE. I first yielded----
  The PRESIDING OFFICER. The Senator has yielded.
  Mr. WELLSTONE. I yielded to my colleague from Iowa.
  The PRESIDING OFFICER. The Chair will explain the situation. The 
Senator from Minnesota has the floor. He has now yielded to the Senator 
from Iowa for a question. He has promised to then yield to the Senator 
from Virginia for an additional question to the question he asked in 
prior conversation. So at this time, we are going to hear from the 
Senator from Iowa who has a question to pose to the Senator from 
Minnesota.
  Mr. WELLSTONE. I mention to my colleague from Virginia, I will yield 
for a question from my colleague.
  Mr. HARKIN. I thank the Senator for yielding. I think it has been a 
worthwhile discussion. I feel a little naked because I do not have my 
card. I gave it to my daughter so she could get her prescription at the 
drugstore.
  That is the question I want to ask the Senator. We are all holding up 
our cards like it just pertains to us. Does the Senator know that these 
cards that we are holding up here are not just for us, but they are for 
our families, too? My daughter has the card. She went to the drugstore 
so she could get her prescription filled. Is this not what we are 
trying to get for the American people, not just a card for the 
individual but so it will cover also their families like our families 
are covered?
  Mr. WELLSTONE. Madam President, I say to my colleague, I am aware of 
that by way of some painful contrast. Our children, are older now, in 
their twenties, and away from home. But had they been younger and with 
us, it would cover them. One of them is a young farmer. I can just tell 
you right now that David and his wife and our two grandchildren would 
benefit so much from universal health care coverage, because when you 
are farming or self-employed, the rates are so high. They are lucky 
enough that she works and is able to obtain some coverage through her 
employer. But since they both need to farm to make it, they cannot do 
that because they cannot afford the insurance.
  Mr. HARKIN. I appreciate the Senator responding. Again, I wanted to 
ask that question because many times we debate and discuss out here 
about coverage. I think the Senator was trying to make the point, and I 
asked that question, that these cards do not just cover us, they also 
cover our families; is that not true?
  Mr. WELLSTONE. That is correct. I might ask my colleague whether he 
has his card. The Senator from Virginia, do you have your card with 
you?
  Mr. WARNER. I have to check, but I know for one thing, this plan will 
have every dollar I have left in this wallet. Let me pose a question to 
my friend.
  Mr. WELLSTONE. I will be pleased to answer it.
  Mr. WARNER. I have the card. Let me point out to my friends, there 
are some 16 million Americans self-insured today who will be stripped 
of that option under this plan and forced to do something else. Some 30 
percent of private insurance which are represented also by cards, those 
cards would be pulled back, I say to my good friend, pulled back from 
those current holders, unlike ours, and require it to be changed. And 
that is why I think it is so imperative, Madam President, that we go 
and get that second opinion.
  I urge my colleagues--and it is not just a partisan request. 
Yesterday and today on that side of the aisle came the same pleas for 
reason and a second opinion--let us take our time, explore all the 
plans, then go back to the American people and listen to them and come 
back obligated as the first order of business next year to handle this 
very important issue.
  I thank my friend for yielding for a question because I think this 
sort of colloquy is more helpful than a lot of repetitive, canned 
speeches.
  Mr. DORGAN. Will the Senator yield?
  Mr. WELLSTONE. I will be pleased to yield. If I could just respond 
for a moment to my colleague from Virginia, then I will yield to the 
Senator from North Dakota.
  I asked the Senator whether he had his card because it is interesting 
to look at our share. If you have a standard option, self and family--
and I would not ask what plan he has because that is a personal 
decision that all of us make--the premium that you are paying is 
$101.25. That is what a Senator is paying for that plan.
  Now, it could be a high option self only. That would be $160. It 
could be high option self and family, $343.
  By the way, Madam President, the reason that some people choose that 
is if you are in a situation--I think that is my situation, as a matter 
of fact--where you have a serious medical problem, and you are really 
afraid that you are going to require a lot of care, that is the one 
that you end up choosing. But in general the bench mark is $101 per 
month. So I think we should be clear about that.
  Now, Madam President, in responding to the other part of my 
colleague's question, and then I will yield for a question from the 
Senator from North Dakota, we are now spending $1 trillion, and it is a 
little frightening to people in this country because they see us going 
very quickly to 30 percent of gross domestic product by the year 2030. 
If we do not build some sanity into this by way of some effective cost 
containment, it will without a doubt bankrupt it. Again, that is a 
compelling reason, not for inaction but for action. The whole issue of 
exploding costs much less universal coverage--and they go together--is 
not a reason for us to put this off, block it, block it, block it, but 
for action.
  I yield to my colleague from North Dakota.
  Mr. HELMS. Will the Senator yield, before he does that?
  Mr. DORGAN. I appreciate the Senator yielding.
  Mr. WELLSTONE. Madam President, I first would yield to the Senator 
from North Dakota, and then I would be happy to yield for a question.
  Mr. HELMS. I wonder if the Senator would favor me by allowing me to 
register a unanimous consent request. I have been waiting for 3 days.
  Mr. WELLSTONE. Madam President, let me ask my colleague how long the 
unanimous-consent request will take?
  Mr. HELMS. Thirty seconds.
  Mr. WELLSTONE. Madam President, if I have unanimous consent that as 
soon as my colleague has put in his unanimous-consent request that I 
then retain the floor, I would be pleased to yield.
  The PRESIDING OFFICER. Is there objection?
  Mr. WARNER. Madam President, reserving the right to object.
  The PRESIDING OFFICER. The Senator from Virginia.
  Mr. WARNER. I likewise was scheduled to speak this morning, deliver a 
prepared speech, but I have enjoyed this colloquy, and I think it is 
far more beneficial. Could we have some indication as to when those of 
us could follow the distinguished Senator from North Carolina at the 
convenience of the managers?
  Mr. KENNEDY. Madam President, will the Senator yield for a response?
  Mr. WELLSTONE. I would be pleased to yield.
  The PRESIDING OFFICER. The Senator from Massachusetts, one of the 
managers of the bill.
  Mr. KENNEDY. Earlier, at the time after the completion of the vote on 
the conference report, there was a general understanding that there 
would be recognition both on this side over here and the following 
side, and I think it was Senator Gregg who indicated that both the 
Senators from North Carolina and Virginia wanted to speak. And he 
indicated to me that the Senator from North Carolina wanted to talk for 
about an hour or so. At least that was my impression. Since the end of 
the conference report, I ask, how much time has been taken by the 
Senator from Minnesota? It was the understanding that it was going to 
rotate back and forth.
  Mr. WELLSTONE addressed the Chair.
  The PRESIDING OFFICER. Will the Senate be in order while the Chair 
answers the question of how much time has been used by the Senator from 
Minnesota.
  The vote on the conference report was at 11:09, and since that time 
the Senator from Minnesota has had the floor. He has yielded 
extensively to the Senator from Virginia and other Senators. Where we 
are now is there a unanimous-consent pending here for the Senator from 
North Carolina to take less than a minute to make a unanimous-consent 
request and then the time will go back to the Senator from Minnesota.
  Is there objection to that procedure?
  Mr. WARNER. Reserving the right to object, is it possible for the 
Senator from Virginia to be sequenced in perhaps following the Member 
from the other side? I will be happy to take any position desired so 
long as I can have some scheduling of my own time, which I understood I 
would have that opportunity.
  Mr. WELLSTONE. Madam President, if I could just first respond--and 
the manager can certainly respond to the request of the Senator from 
Virginia--I have the floor now and I intend to take the time that I 
need to present what I think is an important policy critique of where 
this mainstream group is going. I choose not to do it in terms of 
labels. I want this to be thoughtful, and I want it to be point by 
point, so I will need the chance to do that. But we certainly can go 
forward with the unanimous-consent request of the Senator from North 
Carolina, after which, Madam President, I retain the floor, and I would 
let the manager respond on the rotation, I would say to my colleague 
from Virginia.
  The PRESIDING OFFICER. Is there objection?
  Mr. WARNER. Reserving the right to object, have we made a resolution 
of my question?
  The PRESIDING OFFICER. As I understand it, there is no resolution to 
the Senator's question. The Senator is asking when he can have the 
floor. As I understand the unanimous-consent request, it does not 
include that at this time. The request is that the Senator from 
Minnesota yield time so that the Senator from North Carolina can pose a 
unanimous-consent request. Is there still objection to that request?
  Mr. KENNEDY addressed the Chair.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. KENNEDY. As I understand the situation, it was the intention of 
the floor leaders to rotate back and forth. The Senator now has had 35 
minutes. I know of no time restriction or limitation.
  The PRESIDING OFFICER. That is correct.
  Mr. KENNEDY. There has been a good faith understanding to rotate back 
and forth. I think that is the way we ought to proceed. I have no 
objection to the Senator from North Carolina propounding a unanimous-
consent request, but I am not at this time agreeing to that request 
until I hear from him. I do not know why we just do not move ahead and 
recognize the Senators from this side and then recognize a Senator from 
the other side. That is the way we have proceeded.
  The PRESIDING OFFICER. Is there objection?
  Mr. KENNEDY. I am not going to object.
  Mr. HELMS. Madam President, I withdraw my request.
  The PRESIDING OFFICER. The Senator withdraws his request.
  The Senator from Minnesota.
  Mr. WELLSTONE. I thank the Chair. Let me yield to the Senator from 
North Dakota for a question, and then I will go on with my analysis 
unless other Senators have questions.
  Mr. DORGAN. Madam President, let me ask a question of the Senator 
from Minnesota preceded by just a brief comment.
  In the discussion here about health care cards by Members of 
Congress, I think it is very important, and I hope the Senator from 
Minnesota will concur, that we not attempt to inform the American 
people that we have something extraordinary, something special, 
something very, very generous that no one else has. In fact, we are 
part of a system of health care that covers 9 million Federal 
employees. I do not want someone from the discussion here--and several 
people in discussion have talked about Members of Congress have this 
plan. It is a cottage industry to try to destroy institutions these 
days, and there are plenty of people out there on the radio doing it, 
saying we do not pay Social Security. We do. We get free haircuts. We 
do not. We have some special health care system. We do not. There are 9 
million people in this health care system.
  The point the Senator from Minnesota makes is a useful and important 
point, and I appreciate his making it. I hope that all of us will make 
that point, not to reinforce the notion that we have somehow some 
special, unique, extragenerous health care system. In fact, the health 
care system that covers the Senator from Minnesota and all other 
Federal employees is less generous than many health care systems in the 
country, and we pay about 22 percent of the cost it.
  Notwithstanding that, I would ask the Senator from Minnesota if it is 
not the case that, even though I agree with the points he is making, 
this health care card is a card that could be held up by some 9 million 
people in the country today?
  Mr. WELLSTONE. Madam President, the Senator from North Dakota is 
absolutely correct. And I would say to my colleague that we have had 
this discussion before. The reason that I will introduce this 
amendment, sense of the Senate amendment and insist on an up or down 
vote, I would say to my colleague, is not to argue that the Congress or 
Members of the Senate or the House have a great plan. In fact, in the 
findings I point out that there needs to be improvement for us and for 
everyone. There are some real gaps. But to simply make another point, 
which is when we talk about what kind of final plan we are going to 
pass, it seems to me it does set the standard. People have the right to 
say, look, if that is what you all are able to participate in and it 
does well for you, all of you are covered--
  I heard the Senator from Pennsylvania make this point very well 
yesterday--if there is not any preexisting condition, and your employer 
contributes a fair share, and it is fairly decent coverage, then that 
should be the standard you meet in the final bill that you pass. So the 
only reason I raise it is that I hear all this discussion about, no, we 
are not going to be able to cover this, and we are not going to be 
anywhere close to universal coverage, and we are not going to be able 
to do this, that, and the other, that gets further away from this 
principle.
  I am prepared to go on with my analysis.
  Mr. WOFFORD. Will the Senator from Minnesota yield for a question?
  Mr. WELLSTONE. I am pleased to yield.
  Mr. WOFFORD. Does the Senator from Minnesota think it is possible 
that the point that he has been making and that I have been making has 
been missed and that our colleagues are confused when we say ``practice 
what you preach, support the plan you live under,'' this pretty good 
Federal Employees Benefit Plan with guaranteed health insurance, with 
your employer contributing approximately three quarters, ``support the 
plan you live under, or live under the plan you support,'' when we 
press the point to practice what you preach, and if you do not believe 
that is possible and right for the American people, then give it back 
to your employer, the taxpayer--does the Senator think they are missing 
the point? Would the Senator from Minnesota agree that we are not 
trying to do away with this plan; we are trying to say that this plan 
is a good plan, and plans like this should be available to the American 
people, and this plan should be opened up to small business and 
individuals?
  Mr. WELLSTONE. Madam President, I say to the Senator from 
Pennsylvania that that is an essential point. The idea of, well, take 
it away from Senators and Representatives is missing the point. It is 
not to bring everybody down but to make sure that the people we 
represent have the same opportunities. And in this particular case, we 
are talking about health care opportunities. You cannot talk about 
anything more precious to People's lives than health care. This says 
that it is the sense of the Senate that this act should provide every 
American health care that is as good as the health care available to 
Members of the Congress. I will, as we move along in the rotation, 
bring that to the floor for a debate and a vote.
  Mr. GLENN. Will the Senator yield for a question?
  Mr. WELLSTONE. Yes, I am happy to.
  Mr. GLENN. Would the Senator agree that this issue has been debated 
for 50 years, and there have been innumerable studies and hearings, and 
would it be correct to say that to the Senator from Virginia, with his 
analogy of the second opinion, that there have been so many second 
opinions already, and we see individuals a lot of times out seeking a 
second opinion and chasing a futile second opinion around when they 
should be getting treatment now; would the Senator from Minnesota agree 
that the reason we pushed for this health reform now is the fact that 
we do not want second opinions carried to the extent that more and more 
Americans die needlessly, and we need health reform now?
  Mr. WELLSTONE. Well, Madam President, I say to my colleague from Ohio 
that what he is focused on is--and I believe the Senator from 
Pennsylvania said this the other day, and those words come to my mind--
what doctor Martin Luther King called ``the fierce urgency of now.'' 
There is a fierce urgency of now for many people, for themselves or 
their loved ones who go without care. Health care is not delivered in 
the communities where they live which are underserved, and that 
includes Ohio, Massachusetts, Pennsylvania, North Dakota, and 
Washington.
  I say to my colleague again that I now have my card. We, I think, all 
consider this to be really important, because we hope that we can do 
our work well as Senators because we do not have to live every day with 
the fear that we are not going to be able to provide coverage for our 
loved ones. But many people in this country do live with that fear. If 
we have the card and all of us are covered and our employer contributes 
fair share, and it is decent coverage, and we do not have to worry 
about anybody in our family having to pay a higher rate because of an 
illness or condition, then I say to the Senator from Ohio we do not 
need any second opinions on that proposition. If it is good for us, it 
is good for the people in the country. If we have this card, then every 
man, woman, and child, be it urban, rural, suburban, or be it age, 
income, race, should be entitled to have this card for humane, 
dignified, affordable health care.
  Mr. KENNEDY. Will the Senator yield for a brief question?
  Mr. WELLSTONE. Yes.
  Mr. KENNEDY. I understand, then, as the Senator said so well, that 
the fact that there are 100 Members in this body, and we represent all 
the States. This is good for every community, and I imagine it is good 
for every community in my State of Massachusetts, as it is in the State 
of Minnesota, or the State of Pennsylvania, or the others. It is in 
that sense that we all here--and the Members have this one card and we 
can go to any State, any community, and this card is respected. But I 
just have a final question. Does the Senator know of any Member in this 
body--or if there is any Member, I hope they would express their 
position--any Member in this body that has checked off that little blue 
sheet that says they do not want to choose the program that we share 
with 10 million of our fellow citizens? Does the Senator know of any 
single Member in this body, many of whom have spoken strongly in 
opposition to the Mitchell proposal which, in effect, would guarantee 
this kind of a card for all Americans--does the Senator know of any 
single Member in this body of 100 who has said, no, they do not want 
this particular card that will provide protection for themselves and 
their families?
  Mr. WELLSTONE. Madam President, what I would like to do, again, 
reserving my right to the floor, is have the Senator from Arkansas 
respond to that question; and, after that, I will have the floor and I 
will go forward with what I think is an important, thoughtful critique 
of where the mainstream group is headed. Let me ask the Senator from 
Arkansas to respond to the question.
  The PRESIDING OFFICER. Is there objection?
  The Senator from Arkansas is recognized.
  Mr. PRYOR. Madam President, I thank the distinguished Senator from 
Minnesota for allowing me to address the question proposed by the 
Senator from Massachusetts.
  The Senator from Massachusetts has, I think, hit on a very important 
issue here, because we have seen, over the past 2 weeks, probably 20 or 
30 speeches from let us say perhaps the other side of the aisle talking 
about Government-run insurance programs, or Government-sanctioned 
insurance programs, or Government intrusion in our insurance policies, 
and what have you. But Madam President, to the best of my knowledge--
and I assume this is in the personnel files of each Member of the 
Senate--every Member of this body has chosen to retain their Blue 
Cross/Blue Shield coverage that 9 million other Federal employees have. 
But if they desire not to have a Government-run program or a 
Government-sanctioned program, or if they desire to get Government out 
of their decisionmaking process with their particular insurance policy, 
all a United States Senator has to do is call (202) 224-1093 and ask 
the disbursing office of the Senate to send this form, health benefits 
registration form, and to sign their name on part (e), which is the 
cancellation.
  I do not know, Madam President, of one of our colleagues who has done 
this. We have a very, I think, good program. It is a generous program. 
It is a program, as other speakers have pointed out, where 9 million 
Federal employees have this same program.
  Madam President, I really think what this debate is about, and I am 
glad the Senator from Minnesota has started this debate, it is about 
comparing what on our side of the aisle Senator Mitchell has proposed 
as compared with what is pending basically as an alternative, and that 
is something we know as the Dole proposal.
  (Mr. FEINGOLD assumed the chair.)
  Mr. PRYOR. Mr. President, if the Mitchell bill would prevail, all 
Americans would have the opportunity, all Americans would have the 
right, the same right that we have if they work in a firm and if that 
firm has 500 employees or less, to achieve or to acquire this little 
card that has been held up today. Senator Dole's proposal is a 
proposal, and I am strictly trying to compare the Mitchell proposal to 
the Dole proposal, that says that if the employer chooses, chooses this 
particular Blue Cross plan with those individual benefits that we 
receive and that we enjoy, if that employer choosing that plan and only 
if the firm is 50 employees or lower, and if the employee chooses, if 
it is 50 employees or lower, then there will be a 15 percent fee 
attached to that premium as a broker's fee or as a fee for the company 
selling the policy.
  What we have done is we have legislated a right for Federal 
employees. We have legislated, frankly, an entitlement. We now have an 
entitlement commission. We have Senators talking about entitlement 
programs, about too much Government intrusion. But what we have done 
with our proposal with our insurance plan we have legislated an 
entitlement, an entitlement for us to participate in this particular 
program, and we have a freedom of choice. It is voluntary. We can 
cancel it. I do not know of any Senators who have. I would like to ask 
if there are any Senators who have, maybe they could let us know, and 
it is a Government sanctioned relationship.
  Mr. WOFFORD. Mr. President, will the Senator from Arkansas yield for 
a question?
  Mr. PRYOR. I am glad to yield. I think I have the floor at the moment 
temporarily.
  The PRESIDING OFFICER. The Senator from Minnesota has the floor.
  Mr. PRYOR. I would be glad to yield to the Senator.
  Mr. DOLE. Mr. President, the Senator from Arkansas does not have the 
floor.
  The PRESIDING OFFICER. The Senator from Minnesota has the floor.
  Mr. WELLSTONE. Mr. President, I am pleased to yield for a question to 
the Senator from Pennsylvania.
  Mr. WOFFORD. Would the Senator from Arkansas and the Senator from 
Minnesota not want to add that it is not just the Federal employees 
benefit plan that offers Blue Cross-Blue Shield, but it offers 20 or 30 
different plans. My wife and I chose Aetna.
  Does that not make the Senator's point even more clearly? It is not 
Government running how your medical care will be reached but offering a 
menu of choices that each year Members can select from.
  Mr. PRYOR. There are two points. I would like to answer my friend 
from Pennsylvania.
  The Federal Employees Health Benefits Program, FEHBP, is the largest 
employer-sponsored health insurance program in the country. It serves 9 
million people. There are 14 different fee-for-service plans. There is 
a menu. There are 313 health maintenance organizations that participate 
in this particular program that we have as Federal employees in the 
Senate.
  I might say it is driven by competition. It is driven by employee 
plan choice. It is based on benefits and premiums. And we just think 
that all Americans out there should be given the same opportunity 
ultimately to participate in the same thing.
  Mr. WELLSTONE. Mr. President, if the Senator will yield for just a 
moment, I thank the Senator from Arkansas for responding to the 
question from the Senator from Massachusetts. I would be pleased to 
yield for a question from the Senator from Pennsylvania.
  I do want to make one point to my colleague from Arkansas, which is 
that in talking about the coverage that we have, I think if you look at 
the basic package that most of us have, and I have said I have had to 
opt out for a higher one because of back problems, on the average I 
think Senators pay about 3 percent, 3 percent of our income for our 
premium. That is about what we pay. Again, this is not a question of 
zeroing in on Senators and Representatives, and saying this is awful.
  But I mean when regular people around the country look at what we are 
doing right now, they raise the question over and over and over again 
which the Senator has raised. You have the card. You have the coverage. 
You can afford it. Your employer contributes a fair share. You do not 
have to worry about not getting coverage because of a sickness or 
illness. If it is good for you, why is it not good for us?
  I say to my colleagues we have to live up to that standard. That is 
why I am very anxious to have a vote on this amendment later on today.
  Mr. WOFFORD. Mr. President, would the Senator from Minnesota not 
think that if his proposal, his proposition that the American people 
should be assured the kind of choices that we have, fails, if the 
proposition of the Senator from Virginia that we should study this 
further and defer it until next year for further study prevails, at 
that point should we not consider putting these cards away and study 
them on the same terms, on the same level playing field as the American 
people, holding these cards in abeyance, disqualifying us from using 
these cards while we conduct that study so that we conduct that study 
with the same fear and insecurity that the American people have?
  Mr. WARNER. Mr. President, I will give the Senator that deal, if he 
will yield for a question.
  The PRESIDING OFFICER. The Senator will withhold. The Senate will 
come to order.
  The Senator from Minnesota.
  Mr. WELLSTONE. Mr. President, I respond first, and then I will be 
pleased if my colleague from Virginia wants to put a question to me 
that is sort of in a sense a question to the Senator from Pennsylvania, 
we can accommodate that.
  I would say to the Senator from Pennsylvania that my answer to his 
question is with a great sense of sadness I would say yes. That is to 
say when I was campaigning for this position to be U.S. Senator from 
Minnesota I never thought that I was campaigning for the U.S. Senate to 
be ending up with decent coverage. I am not saying Senators and 
Representatives ought not to have the card and coverage. That is not 
what I hope for. If that is where we go, then I would say to my 
colleague then I guess we will have to have a second opinion on that as 
well. That is not my preference.
  One more time, it seems to me that we have a commitment that we can 
live up to here, and that commitment is on the basis of our own 
knowledge about the Federal employees benefit package and how it works 
for ourselves and our loved ones we can at least in the final bill that 
passes make sure that bill lives up to the standards.
  By the way, I say to colleagues, and I will take the question, the 
reason I want to carefully analyze the direction in which I think the 
mainstream is going I think it takes us even farther away from that. We 
must not separate the legislation and proposals we introduce from the 
words we speak.
  I ask my colleague, does he have a question?
  Mr. WARNER. Mr. President, I have a question on the subject of the 
card.
  Mr. WELLSTONE. I yield to the Senator from Virginia for a question.
  Mr. WARNER. Mr. President, I certainly wish to commend the Senator 
who raised the point that 9 million Americans have the same card. That 
is not issued by the United States. It is a private contractor with 
whom this organization contracts.
  But, Mr. President, I repeat succinctly to my colleague, and I thank 
him as do others for engaging in a colloquy--sometimes I think the 
colloquies can be far more informative than just the reading of a 
speech. But we have had now diagnoses after diagnoses of this problem 
by first the President and Mrs. Clinton, then two committees of this 
Chamber under the distinguished chairmanship of the Senator from 
Massachusetts and the Senator from New York in the Finance Committee, 
we have had in the House the Gephardt plan, we have had the 
distinguished Republican leader's plan which is yet, in my judgment, to 
see the full light of day in this Chamber. And now we have the one of 
the majority leader, the Mitchell plan.

  At what point do we say to ourselves that we have all tried in good 
faith to diagnosis it; we have discussed it, but let us go back and get 
that opinion from that body from which we derive our strength and 
wisdom, the American people, and let them, I say to my good friend from 
Ohio, Senator Glenn, let them provide us that second opinion.
  Our duty is to explain all of the options which we are in the course 
of doing now and next week, presumably, two more plans will be 
introduced.
  Time has become our enemy. We simply cannot deal with this thing 
within the limited time constraints remaining between now and that time 
when our colleagues must depart for purposes of the election.
  So I say to my colleague, why not a second opinion, and go back and 
gain it from the American people?
  Mr. WELLSTONE. Mr. President, let me respond to my colleague from 
Virginia, and unless there are other questions, which I would be 
pleased to take, I will move on with the analysis of where the 
mainstream group is going.
  I say to my colleague, and we brought this out before, that prior to 
World War I, there was an effort to move forward with universal health 
care coverage. It was blocked. We had a second opinion. Franklin Delano 
Roosevelt wanted to have universal coverage as a part of the Social 
Security act. It was blocked. We had a second opinion. Congressman 
Dingell's father and Senator Wagner made a heroic effort in the late 
1940's to pass universal coverage. Blocked. We had a second opinion. 
Harry Truman ran on a platform much like President Clinton's. He made 
it a central issue in his campaign that we should have universal 
coverage. He could not get it through. People called it socialized 
medicine, too much bureaucracy. Same argument. New faces, but the same 
interests and same arguments. Blocked. We had a second opinion.
  Finally, in 1965, we passed Medicaid and Medicare which were 
inadequate installments on universal coverage and, if you go back 
through the debate, people were saying, ``Look, we know there are going 
to be some problems with these programs. We will fix them next year.''
  Now, here we are 35 years later. Blocked. Second opinion.
  So I say to my colleague, in answer to his question, that we have had 
plenty of second opinions for about 75 years in our country, and the 
people still are waiting for us to act on a very central issue in their 
lives.
  Now, Mr. President, the reason--and this is an honest difference of 
opinion I have with my colleague--one of the serious reservations I 
have about the second opinion argument is I just find it kind of 
interesting who has been marching on Washington every day and who has 
been able to do the blocking and who wants the second opinion. It is 
not a one-to-one correlation.
  I have made it clear that this is not aimed at individual colleagues, 
but you look in the last 6 years, the Common Cause study shows some $73 
million in business PAC money, $16 million labor. That is a 4 to 1 
margin. You look at the last 18 months, Citizen Action reports some $26 
million contriuted over 18 months; $4 million alone in large individual 
contributions, in addition to PAC contributions, to the Congress. You 
look at the 1990-92 cycle, and there are tremendous contributions from 
the health industry.
  Permit me to be a little skeptical about second opinions. New faces, 
same powerful financial interests, same clout, same blocking, same 
attacks are going on right now as 30 and 45 years ago. So I think it is 
time for us to step up to the plate and pass a health reform bill that 
will do well for people.
  Mr. President, it is in this spirit and within this framework, that 
the legislation we pass ought to be as good a health care plan as we 
have, that I would like to take a preliminary look at the mainstream 
group's proposal.
  And, by the way, I use the names people have come up with in 
describing themselves out of respect. I really wish the media would not 
cover any of this in terms of mainstream, this stream, left, right, and 
center. The goal is, is it going to be a reform bill that will do well 
for people? Will it work as a policy?
  Mr. President, I have to tell you that I think there are some 
serious, serious flaws with the direction that this group is going in.
  Let me start again with the analysis I was making before questions.
  Mr. KENNEDY. Will the Senator yield for just a question?
  I was trying to get some idea, just for the other Members, about what 
the timeframe will be.
  Mr. WELLSTONE. I say to my colleague, it will probably take me no 
more than 15 minutes.
  I have been pleased to take questions from other colleagues this 
morning. I did not have any intention of several hours on the floor, I 
think I can do this in 15 minutes.
  Mr. KENNEDY. I thank the Senator.
  Mr. WELLSTONE. Mr. President, point one: We read in the paper today 
that the mainstream group found Robert Reischauer's rigorous analysis 
to be sobering. But, Mr. President, I do not think his analysis should 
come as any surprise.
  So they are now talking about further weakening this health care 
reform bill, further stripping down benefits, doing less, no 
prescription drugs, cutting back on home based and long-term health 
care, you name it.
  But, Mr. President, I would remind some of my colleagues in this 
group, you were--at least many, many of you were--the very people who, 
number one, were not interested in single payer. But the Congressional 
Budget Office has said single payer would save up to $100 billion a 
year. CBO said if we implemented a single payer system, that between 
1997 and 2003, it had the potential of saving $700 billion compared to 
status quo projections. That was ruled off the table.
  Then the next proposal, Mr. President, was a cap on insurance 
premiums. That was in the Clinton plan. And if you go back through what 
the CBO has been telling us, they have been saying that if we would cap 
insurance premiums, that is the way we could contain costs. That was 
ruled off the table by many Senators in the mainstream group.
  Then finally, Mr. President, the idea of employers paying their fair 
share, which is one of the ways you finance this, where you get the 
resources, was also ruled off the table.
  So, Mr. President, let me first of all say to my colleagues in the 
mainstream group, one of the places where I find a serious 
contradiction in what you are suggesting is that you have ruled out the 
very steps that we should be taking, according to the CBO, to contain 
costs, operate within a budget, do a good job on deficit reduction, and 
provide people with coverage.
  I will just go with the cap on insurance premiums. You have ruled 
that out. And then on the basis of ruling that out, you now want to 
move in the direction of not covering many, many citizens in this 
country, and I want to go forward with that.
  Mr. President, as I understand it, one of the proposals deals with 
the whole idea of what we are going to do with small businesses and 
what we are going to do with individuals.
  Now, the purchasing pool in the Mitchell plan is for businesses with 
500 or fewer empoyees. My understanding is that the mainstream group 
now wants to say that in the purchasing pool, you would have only small 
businesses with under 100 employees, plus individuals, participating in 
the purchasing pool. Now, if I am wrong, I am wrong.
  But, Mr. President, I have to tell you that if it is fewer than 100 
employees, then you are not going to have much of a base to draw from 
in the insurance pool. It is going to accentuate the very problem we 
are dealing with right now, which is that small businesses and self-
employed individuals are always the ones that pay at a higher rate.
  Mr. President, if I had my way, we would limit the percentage of 
income that a family would have to pay on health care premiums to make 
sure it is affordable. And I do not mean just for low-income families, 
I mean for low- and moderate-income working families, as well.
  But if we are going to level the playing field, and now you are going 
to restrict the purchasing pool, I would just say to you, you do not 
have much of a pool to draw from. And if you are talking about 
community rating, the issue is what community are you talking about?
  So if you have a small community it can be community rating for small 
businesses and the self-employed. They will all be charged the same 
thing but they will be charged higher rates than, for example, Senators 
and Representatives and others who participate in the very large pool 
covered by the Federal employees benefit package. I do not see how the 
very people we are supposed to help are helped with this proposal.
  I cannot believe that the mainstream group is talking about passing 
incremental insurance reform without requiring that everybody purchase 
coverage. Almost every single expert that I know of, and I look forward 
to the debate on these proposals, but I want to talk about whether they 
will work or not, has said that if you think you are going to move 
toward some kind of community rating or some kind of insurance reform 
but you are not going to have everybody in the system, then what is 
going to happen is that the rate will go up for younger and healthier 
people. They do not have to purchase coverage. It is not required that 
it be offered to them. Therefore they do not purchase any coverage and 
as a result of that the premiums go up even more and then even more 
people drop out. It is referred to by actuaries as the death spiral. It 
will not work. You cannot have these incremental insurance reforms 
outside the framework of universal coverage.
  So, my second point, if we are talking about this, is that a set of 
proposals that purport to be reform proposals which say there is going 
to be insurance reform moving in the direction of community rating or 
whatever, outside of universal coverage, is going to lead to the death 
spiral. It is not going to work and your actuaries will tell you that. 
Anybody who has studied this will tell you that.
  The third point, we already have in this country the trend of 
employer-based coverage steadily decreasing. Under the current system, 
right now, it is steadily decreasing. That is one of the reasons there 
has been a hue and cry for reform. This is not just for people without 
coverage, it is for people who fear they are going to lose their 
coverage. The majority leader has said that over and over again.
  The mainstream group proposals, as I understand them, could cause 
this to completely unravel. It is not a step forward. It will be a step 
backward. Most employers that cover their employees right now do so 
because providing employer-based coverage means they are providing a 
valuable benefit to their employees. That makes sense. It is not that 
having coverage in itself is a benefit for employees, but specifically 
that having employer-based coverage is a benefit. Group purchase means 
better rates and the fact that employers can deduct the expense of the 
health care coverage for their employees makes it worthwhile.
  As I understand the mainstream proposal, employees who work for firms 
that do not provide health insurance would be better off than those who 
work for employers who do, because they would qualify for Government 
subsidies. In other words, the long-run incentives of any program that 
subsidizes individuals but does not require employer contributions 
discourages employers from covering their employees.
  I have to tell you, if this is where this group is heading this is a 
fundamental flaw. With the Mitchell plan, one of the reasons this was 
less of a problem--though I worry about this in the Mitchell plan--is 
that ultimately, if we did not reach 95 percent, there is a trigger 
that would be pulled and there would be an employer mandate. Thus there 
is an incentive to continue the coverage. But if what we are going to 
say is that we are not requiring any coverage, there is not to be any 
trigger, there is not going to be any mandate now or in the future, and 
in addition the subsidies will go to individuals if they are working 
for companies that do not cover them, what do you think is going to 
happen?
  Let me talk a little bit about this mainstream proposal and take it a 
little bit further in terms of the limited subsidies we hear are going 
to be available. If individuals who are currently insured through their 
employer begin to slide into the subsidy pool that has been designed to 
cover only the currently uninsured, these funds will be drained without 
the predicted increase in overall coverage. This plan becomes, in other 
words, a subsidized employer bailout. We are saying to the employers, 
you do not have to cover people. In fact, if your employees are not 
covered they will be eligible for subsidies. But now the mainstream 
group is saying, ``We heard a sobering analysis about deficit reduction 
and cost containment. We do not think we can do it.''
  But you cannot because you will not cap insurance premiums, which are 
bound to go up. So we are going to have a limited amount of subsidies. 
So now the very low- and moderate-income people who may be covered by 
the limited amount of subsidies, are going to be facing a competing new 
group of people who are going to be dropped by employers. That I think 
is the nightmarish scenario that could take place.
  If the mainstream program strains subsidy money and produces an 
unanticipated increase in the deficit, which of course it will because 
there is no cost control and we are giving employers every reason to 
stop paying for employees that they currently insure, the subsidies 
will then be cut.
  So I have to make this point. Understand this. Our colleagues should 
understand this. We are not talking about different labels and 
ideology. I want to know whether it is a step forward or not. Now what 
we are saying is employers do not have to worry about covering 
employees. This whole thing can unravel. That has been the trend, of 
less and less coverage. There will not be any trigger, there will not 
be any mandate, there is every incentive to drop employees, there is no 
cost containment, they do not want to do any of the things that the CBO 
tells us we really need to do to contain costs. But there would be an 
automatic way if we exceed budget to control costs. Do you know what 
that is? Cut the subsidies.
  So now what we are doing is privatizing Medicaid, telling people you 
are off Medicaid. We are promising low-income people they are going to 
have subsidies, although I think this new proposal will bring even 
these subsidies way down. And then the first thing we are going to do 
when we cannot control costs, and we will not be able to control costs, 
is cut their subsidies.
  I did not come to the U.S. Senate from the State of Minnesota to pass 
some piece of legislation called a reform that could very well put many 
working people in worse shape than they are in now, that has caved in 
to large, powerful interests like the insurance industry, and will not 
cap premiums, thus we cannot contain costs, and then has as its 
proposal to contain costs to cut into the subsidies for the weakest, 
most vulnerable citizens in this country: Women and children in the 
main; and low-income people.
  That is precisely the direction--I have not seen the detail--of this 
mainstream group.
  Mr. President, finally--and this kind of summarizes the whole debate, 
and this is an issue you will be especially interested in, we have this 
malpractice reform proposal that the mainstream group is discussing. It 
is another sellout to the insurance industry. Sellout No. 1, we dare 
not cap the premiums. Insurance companies do not want us to do that so 
we will not do it.
  Now we have what is called malpractice reform. There would be, as I 
understand it, some mandatory administrative process that insurance 
plans would be in charge of. Anybody with a problem with a rejected 
claim or with a physician in the plan, would be required to go through 
this review process first.
  If the review process found negligence, then plaintiff could continue 
to go on and go to court. If it did not, then plaintiff would be out of 
luck.
  On top of that, the proposal would place a limit on noneconomic 
damages for a plaintiff who gets to court.
  Mr. President, a cap on noneconomic damages reduces payment for what 
could be a lifetime of suffering. I wish I had the piece that Bob 
Herbert wrote in the New York Times a week ago. I do not, but I will 
later on include this in the Record. It would reduce a lifetime of 
suffering to $250,000 for low-income individuals, whereas high-income 
individuals could still be rewarded millions because there is no cap on 
economic damages.
  By the way, Mr. President, anybody who knows anything about 
negligence knows that those on the low- and moderate-income end are 
most likely to be the victims. Predictably, none of the proposals on 
the table from this group include preventive measures, such as 
strengthening State medical oversight boards, giving consumers access 
to data banks on incompetent physicians and prohibiting against secret 
settlement in malpractice cases. The money interest groups that are 
fighting on behalf of their incomes and not malpractice reforms oppose 
these preventive measures.
  I think this malpractice reform issue is really a symbol of the 
entire debate. Consumers lose when powerful interests win and the 
proposed reforms do nothing to improve the quality of care, access to 
care or limit costs.
  Mr. President, I find it particularly ironic that in many ways, we 
began this fight with Senator Wofford's campaign slogan: ``If everyone 
in this country has the right to a lawyer, then everyone should have a 
right to a doctor when they are sick,'' and instead of giving every 
American a right to a doctor, we are now talking about taking away 
their right to a lawyer or at least a day in court. That is what it has 
come to.
  So, Mr. President, let me summarize. We have been waiting as if there 
is going to be a magical set of proposals so we can do all this without 
debate, so that we can do all this without stepping up to the plate and 
casting the difficult votes. And, Mr. President, maybe it will happen. 
Maybe there is going to be some proposal that is going to have a fine 
sounding name. Maybe the Senate will pass legislation that will have a 
great acronym, great sounding name, but it will not live up to any of 
the speeches that have been given, to any of the promises that have 
been made, to any of the commitments that we have made to the people we 
represent.
  There is no effort to contain costs in the way the CBO tells us we 
should. President Clinton was willing to put a cap on insurance 
premiums. Now limiting purchasing pools, I fear, to businesses under 
100 employees where there will be no base and within that community 
they will still be charged higher rates, not requiring companies to 
provide coverage, not having any trigger that would take place, 
employees get subsidies if they work for companies that do not have 
coverage--this whole system unraveling, accentuating the horrible trend 
for working people right now of losing their coverage, ratcheting 
downward the very benefits that working low- and moderate-income people 
have right now.
  Finally, having a cost containment provision that, of course, does 
not challenge insurance companies but essentially says the very people 
who would be the first to cut if we do not live within a budget--and we 
will not because there is no cost containment in the mainstream 
proposals--will be low- and moderate-income people and people, by the 
way, that companies have probably dropped.
  Mr. President, I one more time will say, I find it sadly ironic when 
I look at this malpractice reform proposal, that once upon a time, the 
battle cry is if everyone in the country has a right to a lawyer, then 
everyone should have a right to a doctor when they are sick. Senator 
Wofford said that and he meant it. Now instead of giving everybody a 
right to a doctor, we are taking away their right to a lawyer, or at 
least a day in court.
  Mr. ROCKEFELLER. Will the Senator yield?
  Mr. WELLSTONE. I will be pleased to yield if I can just finish.
  Mr. President, if this is the direction we are going in, I think it 
is particularly important to have a vote on my sense-of-the-Senate 
resolution that the legislation that we pass should provide every 
American health care that is as good as the health care available to 
Members of Congress, because I have to tell you, this mainstream 
group's proposals move further and further and further away from that.
  I appeal to my colleagues on both sides--I know we have honest 
disagreements. I believe that and there are many people you agree and 
disagree with on policy. I also appeal to the media as well. Rather 
than all this sort of what is the center, are people being unreasonable 
by being critical, just look at the proposals and see whether or not 
they are going to work.
  Mr. President, that I think is the key issue. I will finally see some 
paper on this this afternoon. But as I understand the direction of 
these proposals, I do not believe these proposals represent a step 
forward. I believe they represent a great leap backward from the 
proposition that the people we represent should have as good a plan as 
we have--no universal coverage, no employers paying their fair share, 
community rating but not in the context of universal coverage which 
will lead again to a death spiral.
  You cannot do it, I say to my colleague from West Virginia. If you do 
not have community rating and do not have everybody in it, then the 
premiums will go up for the young and healthy and they will drop out. 
And then the rates will go up more and they will drop out, and we will 
be right back to where we are now, with all the cost shifting.
  Let us get real about the policy. Let us forget the labels. Let us 
get to these amendments on the floor that are, of course, points of 
contention where people disagree and let us vote.
  Let me yield to my colleague from West Virginia for a question.
  Mr. ROCKEFELLER. I thank my very good friend from Minnesota. My 
friend was mentioning slogans. I think a pretty good slogan is that we 
in Congress are going to vote on the American people's health insurance 
and whether they have universal coverage now, and in November, they are 
going to vote on whether we have health insurance at all. I kind of 
like that.
  Mr. WELLSTONE. I will say to my colleague, I think that it is a 
catchy slogan, and I think more important than a slogan, it makes an 
important point, which is, people will hold us accountable, one way or 
the other--one way or the other. Absolutely.
  Mr. ROCKEFELLER. Is it your understanding that half, that 50 percent 
of all workers in America today under the current system do not have a 
choice of health care plans?
  Mr. WELLSTONE. That is correct, I say to my colleague from West 
Virginia.
  Mr. ROCKEFELLER. Is the Senator also aware that in companies that 
employ fewer than 500 workers, that is, 97 percent of companies in my 
State of West Virginia, and probably the same percentage for the State 
of Minnesota, only 16 percent of employees have choice of health plans?
  Mr. WELLSTONE. I am well aware of that because you cannot go to a 
community meeting anywhere in your State where people do not say that.
  Mr. ROCKEFELLER. So we who have these enormous opportunities in 
Congress to enhance the choices people have. People talked about the 
alliances and they teased about all the paperwork in HIPC's and 
alliances. Part of the paperwork, if the Senator from Minnesota agrees 
with me, was that we were going to inform citizens of their choices, 
just as we are informed in the Federal Employees Health Benefits 
Program. They give us brochures that contains the following 
information: what the programs offer, choice of plans, cost of 
enrollment, who is eligible to enroll, types of plans available, and 
more.
  Then you get to the brochure that describes the plan you are going to 
pick in detail, and I know the Senator understands this, they also list 
the plans that are open to all and which are not. Then they go State by 
State and they tell you the range of plans in which you can enroll in 
each area if you are a Federal employee. This is, in a sense, the 
choices we want to open up to the American people, as I understand the 
Senator would like to do.
  Mr. WELLSTONE. That is correct. The Senator is correct and I think 
when I meet with people in cafes in Minnesota, I hardly hear anybody 
say single payer--I know other people want to speak, and let me finish 
up, unless the Senator has a few more questions. People never talk in 
the language of single payer, all payer, no payer. People want to know 
whether they will be covered or their loved ones covered, whether they 
will have a benefits package, they want to know whether they can afford 
it and whether they can have choice, the same choice we have.
  Mr. ROCKEFELLER. And they want to have the information before they 
have to choose in the current insurance market where you buy a policy 
and then when you submit a claim you find out you are not covered for 
pregnancy or for well-baby care. And the Senator also is aware that all 
of these choices under the Mitchell plan would be among private, not 
public, health insurance plans. They would be for private, guaranteed 
private health insurance. Only 16 percent of employees in firms of less 
than 500 have a choice now, all would have choices under the Mitchell 
plan. The Senator would agree with that?
  Mr. WELLSTONE. That is correct. I am going to wait until the Senator 
finishes his question. I would agree with that.
  I do want one quick response.
  Mr. ROCKEFELLER. The Senator may proceed.
  Mr. WELLSTONE. Let me just say--and, again, does the Senator have 
other questions as well?
  Mr. ROCKEFELLER. I do not.
  Mr. WELLSTONE. He does not. Let me say the Senator is correct.
  And my final concluding point, which goes to the mainstream group's 
proposal, I want to look at it very carefully because I do not know 
what their position is.
  That is right, it is the purchase of private insurance.
  Now, we live in a grassroots political culture, and one of the 
conservative critiques of public policy that I have agreed with for 
many years is to move away from overly centralized and bureaucratized 
public policy. We have talked about States as laboratories of reform, 
and as my colleague knows I believe that the evidence is irrefutable 
and irreducible, if you want to look at CBO and others as well, that 
those States that choose to go forward with single-payer systems with 
no carveout for employers or anyone else--I mean, it is up to the 
people in the State and their representatives to have the option to do 
it--now there is a movement afoot to essentially say large employers 
can opt out of that, which then essentially we would really deny States 
the ability to do it. Insurance companies and some large companies do 
not like it.
  But it strikes me that, while the majority leader's plan, the 
President's plan, was for private insurance, moving to one insurer, one 
single source of the payment and then everything else the private 
sector, we ought to see whether some States--if they want to move 
forward, we ought to see what happens with that. I would say I am 
interested in the mainstream group's proposal because if they have the 
large employer opt-out, they have essentially denied us of that. And 
for my own part I would fight very hard on that for a long, long time 
in the Senate because I am now convinced the only way we are truly 
going to be able to show you can provide everyone coverage and keep 
administrative cost down is going to be in that direction.
  Mr. ROCKEFELLER. Mr. President, I thank the Senator for yielding.
  Mr. WELLSTONE. I thank the Senator.
  Mr. President, I yield the floor. I do want to say to my colleague 
from Kansas that I apologize for this. Part of it was the questions and 
discussion. I wanted to have the opportunity for this discussion. I 
thank him for his patience.
  Mr. DOLE. Mr. President, I am going to use a little of my leaders 
time, and I understand the Senator from North Carolina, in the loose 
agreement, will be recognized to make a statement and then maybe 
Senator Warner. If not, then Senator Hutchison will offer the amendment 
on this side. Is that satisfactory?
  If the Senator has not seen the amendment, we will try to get the 
Senator a copy of the amendment.
  Mr. President, let me just say to the Senator from Minnesota, I may 
be voting with him, for different reasons, on the mainstream proposal. 
We have not seen it yet. We will be given a copy later today. I must 
say on behalf of all those who have been involved, they are very 
tenacious; they are very determined. They have certainly worked hard. 
And we hope to see their final product and have a chance to evaluate 
it, as the Senator from Minnesota would want to do, also. But you may 
find a rare combination coming together here if there should be a vote 
on that particular bill, one that would not happen normally around this 
place, but I think maybe for different concerns, different reasons.

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