[Congressional Record Volume 140, Number 146 (Saturday, October 8, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: October 8, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           HEALTH CARE REFORM

  Mr. DeConcini. Mr. President, I rise today to express my profound 
disappointment that this Congress was unable to fully debate and vote 
on national health care reform. We began the 103d Congress with great 
hopes and anticipation for addressing the health care crisis through 
national reform. In the course of the past 2 years, we all learned a 
lot about the intricacies of health policy and the health care 
industry.
  From the beginning, none of us expected this to be an easy process. 
We owe a lot to President Clinton and the First Lady for focusing the 
Nation on this critical issue. They gave us the first legislative 
proposal to address the problem on a comprehensive basis. They have 
taken a lot of criticism from all sides. But, without their willingness 
to provide the leadership, I am not sure we would have gotten as far as 
we did. I command them and express my appreciation for their commitment 
to improving our national health care system. They deserve more 
recognition for what they have done than some would like the American 
people to believe. I am glad that they are not discouraged and have 
vowed to continue their advocacy of this critical national issue.
  I compliment the distinguished majority leader for his unflagging 
efforts to develop compromise legislation which would meet our various 
concerns. He did an outstanding job despite the difficult set of 
circumstances he had to work under. He put the needs of the American 
people first but regrettably his valiant efforts were unsuccessful.
  I am glad during the Senate floor debate we were not deliberating the 
question of whether our health care system needed to be fixed. We 
agreed it needed to be fixed, although we parted ways on how best to 
accomplish that goal. However, to successfully reach a compromise, we 
needed to rise above differences caused by politics and policy 
disagreements.
  The American people's health care needs must always be the single 
most important consideration. Their lives and well-being will be 
significantly affected by the eventual outcome of Congress' debate in 
the coming year. We have a tremendous responsibility to look to the 
future of our country and make sure we do what is in the best interest 
of our Nation and the well being of our citizens.
  I believe that those of us who are public servants all only want to 
do the right thing. As we struggle to understand and reconcile 
conflicting interests, we must always be mindful of the fact that the 
health care system affects one-seventh of our economy. At the same 
time, we cannot lose sight of the fact that any solution which 
increases the Federal deficit will damage our deficit reduction efforts 
and undermine the best intentions.
  At no time during the past year did I expect to satisfy every side, 
but I did strive to address the issues important to my constituents in 
a constructive manner. After the hue and cry of the battle had faded 
into the past, I wanted to be able to say that the nearly 600,000 
Arizonans who lack health insurance coverage this year would finally be 
able to get health care services due to enactment of health reform. I 
wanted to be able to say that the action of the U.S. Senate resulted in 
equal access to the standard health plan for Native American citizens. 
I wanted to tell Arizona's small businesses, the true backbone of our 
State's economy, who want to provide health coverage to their employees 
that they could do so without sacrificing jobs or their own 
livelihoods--their businesses. I wanted to reassure citizens that we 
did not simply create more bureaucracy or more unfunded Federal 
mandates for State government.
  Mr. President, these are the everyday concerns which people in my 
State raise when they talk about health care reform. National reform 
will mean very little to Arizona if critical local concerns are not 
addressed when we, as a nation, respond to the health care crisis. The 
same is true in Arkansas, in Alabama, in Albuquerque, and Atlanta. As 
we all know, national policy is only as good as it benefits local 
needs.
  For example, in Arizona, the Native American communities never know 
from year to year whether the Indian Health Service will be able to 
meet their basic health care needs. The health delivery system set up 
by the U.S. Government to provide health care to Indian tribes must 
ration care. Today our Government provides less than $2 billion 
annually for IHS programs, leaving 40 percent of the current Indian 
health needs unfunded. Solemn commitments made by our Government to 
provide health care for Indian people in exchange for the millions and 
millions of acres of tribal lands they relinquished go unhonored every 
day.
  Sadly, we have not had one single administration in the past decade 
increase funding for the Indian Health Service programs. On the 
contrary, all administrations since I have been in this body used the 
IHS budget as an easy target for funding cuts. Indian tribes must fight 
every fiscal year for the survival of their health care programs. The 
responsibility for protecting the Indian health programs has fallen on 
Congress.
  No wonder Native Americans suffer epidemic levels of diabetes and 
other chronic diseases. Their valiant efforts to improve their health 
status have been frustrated by chronic funding shortages. As one tribal 
leader said, ``Why are we always the first ones forced to make funding 
cuts and the last ones to be considered for allocation of new 
resources?''
  Regrettably, this tribal leader must now wait until next year for an 
answer. I hope that my colleagues who return next year will ensure that 
the first Americans are guaranteed health security by national health 
care reform and that they are not left behind.
  Mr. President, the statement that small businesses are the backbone 
of our economy is particularly true in Arizona. In Arizona, 87 percent 
of these businesses are small firms with 25 or less employees. These 
are the employers who make jobs available and provide the opportunities 
for Arizona citizens to be productive participants in the job market.
  They pay the taxes which government relies on to administer its 
programs. Certainly they are the ones who make communities economically 
viable and the State and Nation competitive in the national and 
international marketplace. These small businesses open the door to 
economic independence for many entrepreneurial individuals. Innovative 
technology and other commercial product development would not flourish 
without the flexible environment offered by small businesses.
  The survival of small business therefore must be safeguarded under 
health care reform. I have spoken with many small business owners 
throughout Arizona and I am convinced that their concerns about the 
impact of reform cannot be ignored. While many of them oppose the 
employer mandate, I have also heard small business owners express the 
desire to cover their workers but they are frustrated over the high 
costs of insurance coverage today.
  I have found that most small business owners cannot absorb the costs 
of a 7- or 8-percent payroll premium tax. However, some small firm 
owners will concede that a 1- or 2-percent payroll cap on their premium 
costs would ease the extra burden for them. Others stand strong in 
their objection to any form of employer mandate and oppose even the use 
of a triggered mandate as a backstop measure. This is a point on which 
I respectfully had to disagree with the opponents of expanding the 
employment-based system of insurance coverage.
  I believe that what is good for the 90 percent of the insured 
Arizonans who get their health coverage from large and small employers 
is also good for those who work for small employers and have no 
insurance. In Arizona, 488,000 of the State's uninsured are in working 
families. They represent 77 percent of all the Arizonans who are 
uninsured. They deserve the same opportunity to have access to health 
coverage as do families who are covered because someone in their 
household works for an employer who provides insurance coverage.
  At the same time, I wanted to make sure that small business was not 
overwhelmed by insurance premium costs. That is why I conditioned my 
support for the employer mandate upon the inclusion of measures which 
mitigate the adverse economic impacts associated with mandated employer 
contributions.

  I was glad the majority leader's bill proposed incentives to 
encourage all businesses to expand coverage to their workers. Only if 
this approach failed to achieve 95 percent coverage would the enactment 
of the employer mandate have been considered. Under the triggered 
mandate, however, I was concerned about requiring individuals to obtain 
insurance coverage and pay for the full costs of the premium. I believe 
most low-wage workers would find this financially onerous and may be 
forced to sacrifice other basic needs to meet their obligation. Unless 
this concern is addressed, individuals may lose more than they gain.
  In closing, let me give you 562,000 reasons why I supported 
comprehensive reform of our health system. That is the number of 
citizens in the State of Arizona who do not get the basic medical care 
they need. In just 1 year this number increased by nearly 100,000. 
Another 44,000 lose their insurance coverage each month. They are being 
squeezed out of the health care system by health care costs which are 
consuming 14.3 percent of the Gross National Product. In my State, 
those who can pay are spending 13 percent of their family income on 
health care each year. Their average annual expenditure on a per family 
basis is in excess of $7,000.
  I believe that unless we, as a Nation, commit ourselves to 
comprehensive health care reform, this erosion of our families' 
purchasing power will continue unabated. Doing nothing means our total 
national health care spending, as projected by CBO, will reach a 
trillion dollars next year. The heartbreaking stories we have been 
hearing from our constituents about their staggering medical bills will 
grow worse. The cost shifting will increase and threaten the ability of 
doctors, other providers, and hospitals to delivery quality health 
care.
  Medicare funding will be threatened, as the Federal Government 
resorts to controlling its expenditures for publicly funded health 
programs as a bandaid response to rising costs. We all know that we 
cannot continue down this slippery slope.
  There may be many aspects of the many comprehensive reform proposals 
which cause concern but I simply want to remind my colleagues that duty 
calls upon everyone to look out for the national interest first and 
foremost. For example, I was not comfortable, for example, with the 
number of boards, commissions and regulatory bodies which the Federal 
and State Governments would have been required to set up under the 
Mitchell bill. But I was determined to weigh this concern against the 
bill's intent to make the health care industry more competitive and 
efficient without hurting the quality of care.
  This is a complicated problem which does not lend itself to easy 
solutions. The leader deserved credit for proposing a bill which 
attempted to balance all interests. I hope that all my colleagues, who 
have said that they do not intend to let the current health care crisis 
go unsolved next year, will make a sincere effort to find an acceptable 
compromise. Despite my disappointment, I have faith that this great 
body will find the will and means to address this national problem in 
the coming Congress. I only regret that we were unable to do so this 
year.
  Mr. MITCHELL. Mr. President, I suggest the absence of a quorum.
  The PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. MITCHELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDENT pro tempore. Without objection, it is so ordered.

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