[Congressional Record Volume 140, Number 136 (Monday, September 26, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: September 26, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                              HEALTH CARE

  Mr. SPECTER. Mr. President, earlier this afternoon, Senator Mitchell, 
the majority leader, made a statement about health care, concluding 
with the sentence: ``It is clear that health insurance reform cannot be 
enacted this year.''
  That is a very sad day for the American people on the substantive 
subject of health care, and it is a very sad day for the legislative 
process in the U.S. Congress.
  I believe that no Republican has taken the floor to comment on this 
statement by the majority leader, but a number of Democrats have spoken 
and have blamed the Republicans and the special interest groups.
  I would suggest, Mr. President, that the American people are going to 
blame all of us in Washington, DC, for this conclusion. The American 
people are really fed up with fingerpointing in the Congress, with 
everyone blaming everyone else, when the reality is that there is 
enough blame to go around for everyone, and that it is not, as Senator 
Mitchell has said in this statement, the responsibility of the 
Republicans.
  I do not seek at this time to blame the Democrats. But I think that 
it is important to review the bidding on what has happened here, 
because I think that it is a failure of our system which we have an 
obligation, as elected Senators and elected Members of Congress, to 
correct. That responsibility rests largely on the Congress and rests in 
part on the executive branch for what has occurred here, so that we are 
concluding the 103d session of the Congress without health care 
legislation having been enacted.
  Permit me to start first with what Senator Mitchell said in his 
statement today, on page 2:

       Under the rules of the Senate, a minority can obstruct the 
     majority. This is what happened to comprehensive health 
     insurance reform.

  And on page 3:

       Even though Republicans are a minority in Congress, in the 
     Senate, they are a minority with a veto. They have the 
     ability to block legislation and they have chosen to do so on 
     health care reform.

  I suggest this is not in accordance with the facts. When health care 
legislation was finally brought to the floor a few weeks ago by the 
majority leader, there was no objection to proceeding to the 
consideration of Senator Mitchell's bill. There was never a vote to 
stop debate because debate did not proceed to any extent before the 
majority leader took the bill down. The majority leader withdrew the 
bill because, after he introduced it on the first occasion, he changed 
it to a second bill, and then he changed it to a third bill. It was 
obvious that there was not support for the bill either on the 
Democratic side of the aisle or on the Republican side of the aisle 
because of the enormous bureaucratic substance of the bill.
  Like the bill introduced at the request of President Clinton on 
October 27, 1993, the bill introduced by Senator Mitchell had more than 
100 new agencies, boards, and commissions and had assigned new jobs to 
about 50 existing agencies. So that it was a massive bureaucracy making 
revolutionary changes in the health care system which were unpalatable 
to the American people and unpalatable to the Congress. There was never 
a cloture vote taken where the Republicans amassed the necessary votes 
to defeat cloture.
  So that I believe it is factually incorrect for the statement to be 
made that the Republicans obstructed the bill.
  Senator Mitchell went on to say:

       I had hoped that agreement with the mainstream group would 
     produce the 60 votes needed to defeat a filibuster.

  I do not know about the 60 votes. There was never a cloture vote 
taken. The majority leader goes on to say, ``Regrettably, very few 
Senate Republicans took this view. The overwhelming majority opposed 
any health care legislation, even a modest bill to extend health care 
insurance to children and reform some industry practices.''
  Mr. President, a reform bill was offered by the Republican leader, 
sponsored by 40 Republican Senators, in an effort to have some reform 
this year. There were bills introduced by other Senators, including 
myself. There were sincere efforts, and I will speak about the efforts 
that I personally made on this subject. So I think it is just not in 
accordance with the facts for the Democrats to point the finger at the 
Republicans and to say the Republicans killed this legislation.
  I am not going to reciprocate in kind by saying the Democrats are at 
fault because I think the American people are fed up, sick and tired of 
hearing blame assessed, always on the other side; finger pointing, 
always at the other side. But I think if we review the history of what 
has happened on health care reform, we can find a way to handle this 
job next year.
  The issue of health care and the need for reform has long been 
evident, at least for 4 years, going back to 1990 when Senator Chafee 
led a task force to consider legislation. It was apparent in 1992 that 
this was a pressing issue on the minds of the American people. And in 
the 102d Congress, in 1992, there were some 1,500 health care bills 
pending in the U.S. Congress.
  I took the floor on January 29, 1992, to offer health care reform 
legislation as a starting point. The core of what I offered on that day 
had been agreed to by all parties. No. 1: Full deductibility for the 
self-employed and, second, insurance market reform. The majority leader 
came to the floor that day and said this amendment does not belong on 
this bill. I responded and agreed with the majority leader that if he 
would give me a date certain for health care legislation to be taken up 
I would withdraw the amendment. The majority leader, Senator Mitchell, 
declined to do that saying he could not give a date certain. I reminded 
the majority leader he had given a date certain, the day after Labor 
Day, to take up product liability, which was on the calendar and was 
taken up on the date certain. But the majority leader declined to give 
a date certain and my amendments were defeated, largely along party 
lines.
  Then President Clinton was elected, and in the early days of his 
administration he announced he would have health care legislation on 
the floor within 100 days. Soon it became apparent that commitment 
could not be fulfilled because of the complexity of the subject.
  I am not attaching any blame. The statement was made, the goal of 100 
days; too complicated, could not be done. First Chairman Rostenkowski, 
then-chairman of the House Ways and Means Committee, said we were not 
even going to have health care legislation in 1993. Then the House 
majority leader, Mr. Gephardt, said we were not going to have health 
care legislation in 1993. And each time there was a slip in the days, 
as the Congressional Record will show; I came to the floor and said we 
ought to move ahead at this time. Finally, on April 27, 1993--I should 
not say ``finally'' because that was pretty early in the process--I 
offered health care legislation which was a combination of legislation 
which had been prepared by Senator Cohen, Senator Kassebaum, Senator 
Bond, Senator McCain, and myself.
  On the first legislative day of the 103d Congress, the day after the 
State of the Union speech on January 21, 1993, I introduced Senate bill 
18, which I believe was a reform package leaving intact the essence of 
the current system, which covers 86.1 percent of the American people. 
It had been targeted to specific problems: targeted coverage for the 37 
to 40 million people now not covered; targeted the problem of 
portability, when people change jobs; targeted the issue of coverage 
for preexisting conditions; and dealt with the spiraling health care 
costs by looking at terminal health care costs and by looking at low-
birthweight babies and a comprehensive reform plan.
  President Clinton introduced, or submitted, his bill on October 27, 
1993. We in the Senate were ripe to take up the bill at the beginning 
of 1994, but we awaited committee action. There were enormous problems 
in the House of Representatives. The distinguished chairman of a major 
House committee, Congressman Dingell, could not get the report out of 
committee and finally abandoned an effort in that committee.
  In the Senate, finally, laboriously late, a bill was produced by the 
Senate Committee on Labor and Human Resources. And also late, a bill 
was produced by the Finance Committee. And then much later, a bill was 
produced by the majority leader and submitted a few weeks ago.
  The legislation that was submitted, Mr. President, was so cumbersome, 
along the lines of bureaucracy, that it simply could not gather much 
support and was abandoned.
  There has been an effort in the last few days by a number of 
Senators, this Senator included--and I worked with the mainstream group 
where representatives were present for both the Democratic and 
Republican parties--trying to find a bill that would make sense, and 
then more limited bills were proposed by a number of Senators trying to 
work it out. Finally, it became apparent when Senator Mitchell, the 
majority leader, made his announcement today that health care 
legislation was dead for this year.
  There are many ways to point the finger of blame at many, many people 
all along the process. When I introduced the legislation in 1992, the 
conclusion was by those who wanted broader reform, ``We are not going 
to take piecemeal reform now because that will defeat an effort for 
broader reform.'' Then when I introduced legislation from five 
Republican Senators, it was defeated again largely along party lines: 
``Too early, let's await the President's bill.''
  Finally, when the President's bill came, it was not introduced; we 
had to have hearings on it. The Presiding Officer, the distinguished 
Senator from West Virginia, has been heard to say we have had hearings 
until they come out our ears, maybe not those exact words--the 
Presiding Officer is smiling--but we have had hearings in sufficient 
number to know what we are going to do.
  But the necessity has always been, I submit, to bring the bill to the 
floor and to offer amendments. Then to deal with mandates to see if it 
is the will of the Senate to pass them, to deal with the issue of caps 
on coverage, to deal with the issue of preexisting conditions, to deal 
with the issue of portability, and let the Senate vote and let us see 
where we are going.
  It is my firm conviction that we are only going to achieve health 
care reform if we take it a step at a time, to see what the 
consequences are, and that there is confidence in the current system by 
most people and, I think, most of the American people and, I think, 
most of the Members of Congress, but recognizing that there are areas 
which have to be corrected.
  If we had passed tax reform to give full deductibility to the self-
employed, we would have picked up additional coverage. How much? Well, 
nobody knows for sure--3, 4, 5 million people? If we had insurance 
market reform to allow small businesses to get together to cut the 
cost, we would have picked up additional coverage. How much--7, 8, 9, 
10, 11, 12 million people?
  We could have picked up very significant coverage taking it a step at 
a time. And through managed care, which is an element of my bill, 
Senate bill 18, there were substantial savings that could have been 
achieved. We have a tremendous problem of people getting health care at 
emergency wards. We could have taken steps to try to deal with that 
problem, which involves a great deal of cost shifting.
  I believe that when we have a health care delivery system in America 
which approximates $1 trillion there is evidence to support significant 
savings for managed health care without destroying choice--my wife 
recently enrolled us in a managed care system, with a little 
trepidation on my part, but there is an option to pay more if we are 
not satisfied--managed health care can produce savings. Substantial 
savings are available also if we deal with terminal health care costs 
and low birthweight babies and emergency care service if we take it a 
step at a time.
  So it is my hope, Mr. President, that we do not conclude this session 
and this work on health care by pointing the finger of blame. I think 
that a long, detailed speech could be made pointing the finger of blame 
in every direction, but that when you take a look at the hard facts, we 
did not get far enough on Senator Mitchell's bill to have a cloture 
vote or even to consider the legislation which was forthcoming. And in 
the context where the Republicans had offered legislation with 40 
cosponsors and no inquiry was made about who was going to vote how--at 
least nobody asked me how I was going to vote--and no cloture vote was 
sought, it is simply not correct to point the finger of blame at 
Republicans on this side of the aisle when there is a pending bill with 
40 Republican cosponsors. I am not saying it goes far enough. I think 
additions were needed to it, but if you started with that bill, you 
could have votes to see how far we could go.
  So it is my hope, Mr. President, that next year this is the first 
item of business, whether we have a Senate controlled by the Democrats 
or Republicans. So that we can say to the American people that when you 
elect Senator Rockefeller, from West Virginia, who is presiding now, 
who has done a tremendous amount of work on health care, and when you 
elect Senator Arlen Specter, from Pennsylvania, and 98 other Senators--
they will have elected Senator Rockefeller and me because we are not up 
this time, and so we know, God willing, considering our health this 
year, we will be back next year so we can sit down and work this out in 
the interest of the American people and essentially learn from the 
mistakes of the past 2 years at least; that it is not realistic to have 
a massive bureaucracy, illustrated by the chart which I have shown so 
often on the Senate floor that I will not bring back, with the Clinton 
plan with 105 new agencies, boards, and commissions and 47 existing 
agencies with new jobs, and Senator Mitchell's plan with even more new 
agencies and more jobs for existing agencies.
  But the lesson is we know how to take it a step at a time, and I call 
it trial and correction, not trial and error, because it is not error 
to see how we do with it but take it a step at a time to see how it 
will progress, and that we work in a bipartisan way and stop the finger 
pointing. I think we can craft health care reform which will meet the 
objective of health care for all Americans and will meet the objective 
of holding down the costs.
  I thank the Chair. I thank the staff which has waited this extra few 
minutes for my presentation.
  I yield the floor.


                     RECESS UNTIL 10 A.M. TOMORROW

  The PRESIDING OFFICER. The Senate, under the previous order, stands 
in recess until 10 a.m. Tuesday, September 27.
  Thereupon, at 6:40 p.m., the Senate recessed until Tuesday, September 
27, 1994, at 10 a.m.

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