[Congressional Record Volume 140, Number 145 (Friday, October 7, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: October 7, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
              REFLECTIONS ON THE HEALTH CARE REFORM DEBATE

  Mr. ROCKEFELLER. Mr. President, as the final hours of the 103d 
Congress near, I rise to share some thoughts on the subject that so 
many of us thought would be the defining accomplishment of this 
challenging year. We were not able, it turns out, to arrive at a 
conclusion on health care reform. Many of the problems that sparked the 
drive for reform still exist and will continue. It is my deep and 
abiding hope that the experiences and lessons of these past 2 years 
will help guide a more successful course in the next year.
  Lyndon Johnson used to say that other nations are confused by the 
nature of our democracy. He was referring to observers that mistake 
dissent for disloyalty, restlessness for a rejection of policy, and 
individual speeches for public policy. That could apply to our recent 
debate on health care. But the heated, tumultuous stage on health care 
was, yet again, democracy in practice. This legislative body took a 
serious problem on its broad shoulders and struggled to mend it. And 
while we have yet to conclude our work, we have seriously begun our 
push.
  For too long, American families have struggled under the weight of 
health care. Medical bills have become more and more expensive while 
health insurance paid less and less. The same is true for American 
businesses--they have spent more and more to insure workers with 
policies that covered less and less.
  My reason for deciding to focus on health care reform years ago was 
very simple. Over my many years in public life, I saw more and more 
harm being done to the people of my State. West Virginians--families, 
small businesses, providers--asked for help. They said they could not 
solve these problems on their own no matter how hard they tried.
  Whenever I am back home, I meet a worried mother or father, a devoted 
son or granddaughter looking for a way to cope with burdens caused by a 
health care crisis or need. People who work, who pay their taxes, who 
play by the rules. But people who individually just can not stop an 
insurer from raising its rates or cutting off coverage at the moment it 
is needed the most.
  As much as we can explain the reasons that Congress did not agree on 
a health reform bill this year, as much as we have learned from one 
another, one fundamental and simple truth remains: too many working 
American families are still falling through the cracks every single 
day, unable to pay their health care bills or get the treatment a loved 
one needs.
  We must persist in the search of a solution. I am disappointed that 
health care reform did not happen in this session--there is no denying 
that. I try to find comfort in the fact that getting Social Security 
into place took 10 years.
  Important ground was covered in the feisty, fiery debate that lasted 
over this entire Congress. If enough of us remain committed to 
solutions, Congress and the American people have much to draw on to 
chart the path to health care reform. We did not finish our work, and 
there should not be a competition for partisan trophies. There is no 
win here for Democrats or Republicans.
  We dare not find ourselves satisfied. We dare not claim the moral 
high ground on what became of health care reform. Because, in America, 
people still lose their homes, parents still deplete college funds, and 
businesses still shutter their doors because health care costs are 
spiraling out of control. We have brought health care reform closer to 
happening than ever before in American history, but that means very 
little to the people hurting from the problems of our system and the 
bottom line that saddles our economy. Our heated exchanges did achieve 
one thing: it moved health care reform from a whisper in a few rooms 
into the national conversation.
  Around lunch counters, on front porch stoops, in factory cafeterias, 
Americans now discuss the pros and cons of managed care, purchasing 
cooperatives, single payer, and mandates.
  The debate of the past 2 years helped educate all Americans. Every 
single Member of Congress talked to and wrote to constituents about 
health care reform. I held town meetings in many counties in West 
Virginia where 8 out of 10 questions I was asked were about health care 
reform. And I bet my experience was the norm. When reporters from home 
started to pick up on this, I eagerly exchanged thoughts and 
information about health care reform with them. I know every Member of 
Congress did the same. As the questions got tougher and more detailed, 
I worked harder, researched more, tried to explain the issues as I 
understood them in greater length.
  We saw the dividends. Our newspapers and talk shows, our radio 
programs and magazines gave more and more time, more and more space, to 
health care. We moved the country from arguing about whether or not 
there even was a health care crisis to how best to respond to the 
crisis. That does not happen easily in this country. That was the 
result of patient, committed work.
  We had more partners than we can count. Whether people supported 
President Clinton's plan or not--whether they wanted a single payer 
system or some form of mandates or their very own prescription--they 
weighed in and got active. Involvement in health care reform spanned 
the entire American population. Union members, small business owners, 
seniors, handicapped, farmers and so many others rallied their 
membership, educated themselves, and took an active role. Phones here 
really did ring off the hook with input. There was no apathy on health 
care reform. No time that America lost interest. I still get calls from 
people in West Virginia and from all over the country telling me ``to 
keep on working on reform.''
  Even with this to be proud of and take solace in, far-reaching, 
meaningful health care reform will have to wait another day. Because 
fear and confusion, in the end, stalled our work.
  After all our hours of deliberation, after caucusing and studying and 
hearing from constituents back home, the problems of our system are not 
retreating. Insurance companies will not be forced to change a thing. 
Consumers will still be buried under more paperwork, fine print, and 
bureaucratic waste. The $100 million spent to stir up a blinding 
sandstorm of bedlam and bewilderment overwhelmed our push to help 
Americans.
  And that bedlam reigned, despite the fact that there are some basic 
reforms that we all agree are desperately needed, like the need to stop 
insurance companies from refusing to insure people with preexisting 
conditions--or the need to make home- and community-based care 
available for those in need of long-term care. Or, to make sure that 
all of our children have a health insurance card.
  Real people lost out because we could not get a compromise agreement 
on even a scaled-back reform package, real people whom I was sent here 
to represent, like the Saunders family from Charles Town, WV, lost. The 
Saunders' story is not uncommon in today's system, and it will happened 
again and again without action on basic insurance reforms. Michael 
Saunders is an assistant pastor at a Baptist Church. The family lost 
their health care coverage suddenly when their church had to switch 
plans to an insurance company that then went broke. Now, the Saunders 
are faced with thousands and thousands of dollars of unpaid bills that 
make each day a struggle. I firmly believe that a majority of my 
colleagues would have ultimately voted to change that, but that vote 
never came.
  A few early votes, like the bipartisan vote for the Pryor Rockefeller 
long-term care amendment during the Finance Committee's markup of 
health reform, or the Senate floor vote in favor of the amendment I 
wrote with Senator Daschle to help rural areas, did prove there is a 
strong, bipartisan base of support for some important pieces of reform.
  In the Veterans' Affairs Committee that I am proud to chair, a 
substantial proposal was approved to both preserve a health care system 
for America's veterans and extend the choices and quality services that 
they deserve. This effort must resume, and Congress cannot ignore the 
obvious needs for improvements in the health care system dedicated to 
veterans.
  I appreciate the thought and effort devoted to the need for reforms 
in our current system of financing medical education. Market changes 
and fiscal realities are forcing lawmakers and medical educators to 
adapt our policies. My hope is that we can build a consensus to 
generate the primary care doctors and health care workforce that 
Americans so clearly need.
  With the few votes on health care cast in committees and on the 
Senate floor, they showed that Members were willing to make a 
commitment to new spending if it met serious needs and if the programs 
were designed to be fiscally responsible. Democrats and Republicans 
alike agreed on the need to act to provide some assistance to the 
families who want the ability to care for their own at home as they 
deal with the financial, physical, and emotional burdens of coping with 
chronic illnesses. But, on this issue, as on so many others, I regret 
to say that the real life needs of the people we represent were not 
elevated beyond gestures of support.
  Here is what is so sad: It was easy to be stubborn, to draw lines in 
the sand and pull one objection after another out of the air when a 
$100 million blitz smothered the basic nuggets of truth. Confusion and 
hysteria about health care went hand-in-hand with calls for help. Those 
endless and divisive Harry and Louise ads, and others on radio and in 
newspapers, played fast and loose with the truth in an effort to scare 
people into believing that health care reform--any reform--was so 
complicated, so revolutionary, and so expensive that it would ruin us 
all. Well, that was not the truth, period. But a $100 million sky-is-
falling media blitz was tough to drown out.
  The nature of the American media only fueled the fire. At a time when 
everything from Michael Jordan's baseball career to O.J. Simpson were 
headline-grabbers, something as critically important in the real world 
as health care reform had to share precious airtime and ink. Now health 
care isn't very sexy and it won't sell many newspapers--unless it's 
a controversial story. So health care was reduced to a political horse 
race.

  I am not faulting reporters for the fact that we did not get health 
care reform done. Most did us a great service with detailed and 
insightful work. But the American media is a very different entity than 
it used to be. Not so long ago, major newspapers and a few networks 
essentially served as a check on misleading and irresponsible 
information. The public gained perspective by how a restrained and 
cautious media covered subjects. That discrete judgment is just about 
gone. What the mainstream media rejects as trivial or simply 
titillating is delivered by the feeding frenzy of the alternative 
media.
  So the ability to deliver an inaccurate message is easily found. And 
opponents of health care reform seized this chance--their hype, 
hysteria, and half-truths were broadcast far and wide. Take Harry and 
Louise. Actors who pretended to have health care worriers took on a 
life of their own. They pushed scary ideas like big government and 
bureaucracy without ever having to prove anything. They were 
unchallenged critics. yet they were as fake as the sets for their home 
and office built on some back-lot soundstage. And the tabloid press 
treated them as real when they were products of the health insurance 
industry's Public Relations machine.
  Factor together a $100 million blitz and news priorities skewed by 
the need to compete for audience share with the explosion of tabloid 
journalism, and it is no wonder the important elements of health care 
reform were drowned out.
  This confusion helped to stall health care reform. It bogged reform 
down in so much uncertainty and fear that it made having to take a real 
stand on health care reform utterly avoidable.
  We are sent to Washington by our constituents to act on their 
behalf--to take on the important issues and problems of a nation. Yet 
millions of dollars and thousands of column inches and hours of airtime 
make it harder to cut through--it takes more time, more education, to 
make a case for reform. That helped run the congressional clock down. 
And that came at the expense of virtually every single middle class 
family and every single small business in America. The people who 
really do drive this country, the people who work in our factories and 
on our farms, who pay taxes and play by the rules, who give their time 
and money to build their communities, are the people on the losing end 
of this score.
  Sadly, I believe our falling short could have been avoided. We could 
have put as much time and effort into constructive negotiation as we 
did to fighting over labels. But that never really seemed an option. No 
one ever said the Bill Clinton's plan was perfect. No one ever said 
Senator Mitchell's bill was a take-it-or-leave-it proposition. I was an 
advocate for both those bills, and I myself saw them as starting 
points. But the notion that health care reform had to start somewhere 
and would be an evolutionary process never seemed an option to some 
here--and that is a shame. So health care reform is something we all 
have to keep on pushing for.
  I have not given up for West Virginia. Not unless and not until the 
problems that saddle our people and economy go away.
  As frustrated as I am with what transpired on health care, I am still 
moved by the good-faith, sincere, and honorable efforts of individuals 
far, far too numerous to mention. I think of many Senators and members 
of the other body. I think of the hundreds and hundreds of 
congressional staff, like my own, who sacrificed time with their 
families and gave their hearts and souls to the effort of the past 2 
years. I think of the President and First Lady, and their own troops, 
all clearly trying to make life better for the American people. I think 
of the people from my State and across the country who did all they 
could to help achieve reform for themselves and their fellow citizens.
  In the closing days of this Congress, Senate Majority Leader George 
Mitchell and Republican Senator John Chafee tried mightily to create a 
blueprint for health care reform. Together, they represented Senators 
from both parties who wanted to put the concerns of the American people 
ahead of partisan politics. They wanted to make a real effort to 
achieve universal coverage. The conviction they represented will not 
die, and it is one of the starting points we have to press on.
  Health care reform should be bipartisan. It should represent what 
most Americans want, and not just for one faction or one theology. But 
it also has to be about dealing with real problems and achieving real 
results.
  I do not see the endeavor getting any easier. The special interest 
money and the confusing claims will form their torrent when we try 
again next year or the year after or the year after.
  Without reform, this nation's deficit will balloon just when we have 
put it on a downward slope. Without reform, businesses and families 
will continue to struggle with an impossible choice: spend more for 
coverage or gamble on doing without. Without reform there will be no 
peace of mind for parents and no thoughts of a secure future for young 
people. So the stakes remain high, and the need remains undiminished. 
Our debate is over for this year, but the health crisis continues to 
grow.

  We can succeed only if we stop listening to the voices for partisan 
wars and those that win when the status quo prevails. And success means 
relief for real people and the stability that our budget so clearly 
needs.
  For those of us who will not give up on trying for our people, we 
have to look on the past 2 years as the foundation to build from. 
Before the 103d Congress, health care reform was something like the 
Loch Ness monster--sighted every few years, heard about, but never 
produced. President after President during the past 60 years had an 
idea of the importance of health care reform, only to be outdone by 
political inertia. This time, reform came closer to reality than ever 
before. And it is now a vivid issue, etched clearly onto the American 
agenda. People in rural and urban America young and old, regardless of 
ethnicity, income, or geography all see the need for reform.
  At its very core, health care reform has been about offering real 
hope for resolving the real problems that weigh down too many of us. 
For me, it has been about helping West Virginians put their heads on 
their pillows at night with the peace of knowing that their families, 
their businesses, their jobs, and their homes will not be devastated by 
health care costs. For me, it has been about freeing my State from the 
exhausting burdens of out-of-control health care costs.
  Let us not forget what health care reform was really about. It was 
about giving the American people the same security that they give 
Congress. It was about giving them the same reliable, affordable, 
flexible coverage we have. I have in my wallet a Blue Cross Blue Shield 
card. Because I am one of 9 million Federal employees in a common 
program, I get to choose from among dozens of different insurance 
plans. I chose this one because it suits the needs of my family best. I 
pay almost a third of the monthly premium, and my employer, the Federal 
Government and taxpayers, pays the rest. I have very good, very 
comprehensive health benefits. I don't wait in lines and I deal with 
doctor, not a bureaucrat.
  In fact, just a day or so after the reality that health care reform 
was not going to happen this year, the Washington Post ran a front page 
story detailing how the health care benefits of Congress and of all 
Federal employees were about to get better and less expensive. How can 
we watch the success of the health program that covers us and our own 
staff, and then endure the failures that plague the people we 
represent. There is no way to rationalize this, no way to spin or 
filibuster it into acceptability. Allowing Americans to get the same 
affordable, reliable coverage was what we fought for.
  I know other think the same way, and I know I have Senate colleagues 
just as hopeful and determined to do right and pass reforms that 
Americans want from us. We've come so very far, but more trying and 
exhausting steps await us when the 104th Congress convenes next year. 
The growing interest in entitlement reform, and what that means for 
Americans relying on Medicare and Medicaid, will require serious 
attention.
  My greatest hope is that the needs of our Nation and our own States, 
in the end, will ultimately outweigh the $100 million hype and hysteria 
that have put obstacle after obstacle after obstacle in our path.
  During World War II, the Army Corps of Engineers--the people who 
helped bridge the Rhine and clinch the defeat of Germany--had a motto: 
The difficult we do immediately, the impossible takes a little longer. 
That should be our rallying cry for health care. It's a major 
undertaking, and I have acknowledged that from day one. But it's an 
undertaking we must resume. We have taken a long time, and well take a 
little longer. If we have the integrity and the committee to do right 
by the American people, well get to work with renewed vigor and 
determination and repair the health care system. We can and we must 
turn one of our Nations's more trying episodes into a moment of great 
effort and achievement.

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