[Congressional Record Volume 148, Number 130 (Monday, October 7, 2002)]
[Senate]
[Pages S10041-S10046]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. WYDEN (for himself and Mr. Hatch):
  S. 3063. A bill to establish a Citizens Health Care Working Group to 
facilitate public debate about how to improve the health care system 
for Americans and to provide for a vote by Congress on the 
recommendations that are derived from this debate; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. WYDEN. Mr. President, today I join with Senator Orrin Hatch, one 
of the most caring and thoughtful public officials I have ever known, 
in offering a bipartisan roadmap to creating a health care system that 
works for all Americans. Our country has been trying to find such a 
path since President Harry Truman's proposal to cover all Americans was 
voted down in 1945. I believe the Wyden-Hatch proposal can succeed 
after 57 years of failure because our bipartisan plan begins with the 
public discussing and deciding their health care priorities, followed 
by a guarantee Congress will actually vote on the recommendations that 
result from this grassroots debate.
  This approach has never been tried before. Now, when major health 
laws are written, politicians sit down and prescribe what benefits will 
be offered, and then try to come up with the money to pay for them. 
After the politicians write their plans, the special interest lobbies 
start attacking one feature or another through shrill television 
commercials. Pretty soon, the public gets understandably confused, the 
chance for building consensus is lost, and important health care needs 
go unmet.
  The 280 million Americans whose survival depends on quality, 
affordable health care have never been given the chance to shape their 
health care future before the special interest lobbyists weigh in. The 
Wyden-Hatch bill changes that. Under our proposal, the public gets to 
jump-start health reform by stating their priorities at the outset, 
rather than being treated as an afterthought. We believe our 
legislation can serve as an illuminated route to a health care system 
where each American has the ability to obtain quality, affordable 
health care coverage. We placed three signposts on our roadmap to 
provide guidance to the American people and their elected officials as 
they make the tough choices inherent in tackling health care reform.
  At the first signpost, the public is given an extensive opportunity, 
in their home communities and on line, to state their personal health 
care priorities and how they should be paid for. In addition, the 
public will be asked to look beyond their personal needs, to those of 
the community at large, and how those needs should be paid for.
  Our legislation forthrightly asks the questions that must be answered 
to have meaningful health reform--questions such as: What kind of 
health care do you want most? How much are you willing to pay? How 
should costs be contained without sacrificing the quality of care? 
Should the Government or private businesses be required to pay a 
portion of your costs? How about those of your neighbors?
  Our national Government has never directly asked the public these 
questions. After asking these questions, the Government ought to keep 
quiet for a bit and listen to the people because without some sense of 
the public's view, it is always going to be virtually impossible to 
create a health care system that works for everyone, with the consensus 
that is needed to get it done.
  To ask the key questions and follow up on the suggestions given by 
the American people, the Wyden-Hatch legislation creates a Citizens' 
Health Care Working Group. The Working Group is made up of a 
representative cross-section of our people. It is not just another 
Washington, DC commission of so-called policy experts.
  The Working Group directs the public participation portion of this 
proposal. For example, as a guide to help the public in formulating 
their views on the tough choices that lie ahead, the Wyden-Hatch 
legislation directs the Working Group to prepare and make widely 
available a ``Health Report to the American People.''
  The legislation we have authored requires that this report be written 
in understandable language and describe the cost and availability of 
the major public and private health choices now available--and also 
contain enough information so the public can create alternatives. Here 
are the kinds of issues we want to address: ``If covering liver 
transplants under government health programs requires cutting other 
services, what services are you willing to cut, or would you rather not 
have liver transplants covered? If government coverage of long-term 
care for the elderly would require workers to begin contributing to the 
program at age 40, is it still worth it to you?''
  These are moral choices about what health care the public has a right 
to expect. These are economic choices that affect the finances of our 
families. These are legal and social choices that will be difficult for 
our people to make. The Wyden-Hatch proposal is built around the 
proposition that these choices are too important to duck any longer.
  After establishing a sense of how the public feels about these hard 
choices, the legislation directs that the Working Group move to the 
second signpost on our roadmap. There the Working Group is to take the 
ideas offered by the American people, and translate these views into 
recommendations for our elected officials to create a health care 
system that works for all. With the Working Group's involvement in the 
public participation requirement of this legislation, we believe they 
are the right people to take this historic step: to synthesize the 
opinions and information provided by the public and then present a 
faithful picture to Congress.
  At the third signpost, the Congress takes the recommendations from 
the Working Group and utilizes the legislative process to develop one 
or more plans for the recommendations, with a guarantee to the public 
that the plans will be voted on in both Houses of Congress. We believe 
that the assurance that Congress will vote after the public's will is 
expressed provides an added measure of credibility for this 
legislation. Simply put, people will be able to see their voices, their 
participation, lead to actual votes on the floors of both Houses of 
Congress to create a health care system that works for all. With these 
steps I have described, our country can as never before discuss, decide 
and deliver on health care reforms.
  I know there will be many questions about this proposal, and I'll try 
to answer them in the coming days. I'd like to briefly answer just one 
question I've already been asked: ``Why now? This is the end of the 
Congressional session; we are all concerned about the possibility of 
war with Iraq. Why are you putting this before Congress today?''

  My answer is that the lack of decent health care for so many 
Americans,

[[Page S10042]]

and the skyrocketing costs of coverage for insured Americans, threaten 
countless lives and our economic security just as tenaciously as any 
foreign enemy our Nation has ever faced. Just as we are beginning a 
debate about how best to address the Nation's security interests, it is 
high time Congress resumed the debate about how to address the 
inequities and failures of the American health care system.
  On health care, our families can't afford to wait any longer. 
Congress is completing another session without significant progress on 
major health care issues. A demographic tsunami of baby boomer retirees 
is coming soon. It is increasingly evident that piecemeal health 
reform--considering prescription drugs one day, patients' rights 
legislation the next, something else after that--isn't working.
  I have no intention on giving up on any one of those important issues 
when it's possible to get Congress to consider them separately. I still 
believe the bipartisan prescription drug bill I authored with Olympia 
Snowe could bring the Senate together and help seniors get and afford 
prescription medicine now.
  Yet is clear that because health care is like an ecosystem, with one 
part affecting all others, it is extremely difficult to make real 
progress on a single important issue without factoring in the way it 
will ripple through our entire health care system.
  So as the Congress pushes ahead on prescriptions and other urgent 
needs, let us simultaneously reopen the debate about creating a health 
care system that works for all. That debate stopped in 1994, and needs 
to begin again. The Wyden-Hatch bill provides an opportunity to reopen 
this debate, and by introducing our bill now we believe it will be 
ready for full Congressional deliberation when the next Congress begins 
in January.
  One way or another, it is urgent that Congress find a way to do 
better by the people's health care needs.
  My constituents at home in Oregon make this case constantly. At town 
meetings, Chamber of Commerce lunches, labor halls, non-profit board 
meetings, after church coffee hours, and especially at my ``sidewalk 
office hours'' where I just set up a card table to listen, they ask, 
``Ron, when's Congress going to get going on health care and help us 
out?''
  One Oregon business after another has been telling me their health 
premiums are going up by as much as 20 percent a year. The number of 
uninsured is going up, with many of these individuals working at small 
businesses whose owners desperately want to offer health coverage and 
can't figure out how to do it and keep their doors open. Many 
physicians have been leaving government health programs because of 
inadequate reimbursements. Thousands and thousands of pages of health 
care regulations now exist and the system is almost choking on all the 
bureaucracy.
  We know that America's health care system is scientifically 
prodigious. Every day our dedicated and caring health care providers 
are performing miracles. Last year more than $1.4 trillion was spent on 
health care in America. Divide that sum by the number of Americans, and 
there would be enough for every family of four to receive more than 
$18,000 for health care. With all this money, and so much talent and 
creativity in America, shouldn't it be possible to create a health 
system that works for everyone?
  Senator Hatch and I believe it is. We know it will be hard, but we 
believe it can be done if our roadmap is used.
  For example, to achieve real reform our elected officials are going 
to have to reject the blame game. Republicans can no longer say the 
problem in health care is primarily the trial lawyers. Democrats can no 
longer say the problem in health care is primarily the insurance 
companies. All--let me repeat, all--of the powerful lobbies are going 
to have to accept some changes they have rejected in the past if 
America is to have a health care system that works for everyone. I 
believe that's what we'll hear from the public if they're given the 
chance to discuss and decide their health care priorities as the Wyden-
Hatch legislation envisions.
  Before I wrap up, I wish to offer a few thank yous.
  The first thank you is to the people of Oregon. They have honored me 
with a chance to serve, and I get up every morning feeling like the 
luckiest guy around. It was not very long ago, as codirector of the 
Oregonian Gray Panthers, I was driving to senior citizens meetings in a 
beat-up station wagon, and I never thought I would have the privilege 
of being able to serve in this capacity.
  Oregonians can see I have modeled much of this legislation after the 
debate that Oregon has had on health care. And we are proud that we are 
the first of the initiatives to ask the tough questions.
  Oregonians began asking those difficult questions more than a decade 
ago in community meetings, for one reason: Gov. John Kitzhaber, an 
emergency room physician, insisted that we do it. He deserves great 
credit for his efforts, his courage, and his tenacity. When I told him 
I was going to push Congress to build on Oregon's public process, the 
Governor said: Go for it.
  Senator Hatch--and I note that Senator Hatch is in the Chamber this 
morning--could easily have said he wanted no part of this whole 
discussion. Senator Hatch has written several vital health care laws, 
from his S-CHIP legislation, to his community health centers bill, to 
the Hatch-Waxman legislation, to make sure there are pharmaceuticals 
available for the public, and that they are affordable. All of those 
pieces of legislation have made a huge contribution.
  Senator Hatch has about the fullest plate in the Senate, with his 
Judiciary and Intelligence responsibilities, but he and Patricia Knight 
and Patricia DeLoatche have been thoughtful and patient as we went 
through draft after draft of this proposal in an effort to start the 
discussion now. I want Senator Hatch to know how grateful I am to him.
  Dr. Paul Ellwood, who founded the Jackson Hole Health Group, has been 
working for more than three decades to create a health system that 
works for everybody. Now, when he could be enjoying retirement, riding 
horses in beautiful Wyoming, he is still bringing together health care 
policymakers, at 7 o'clock on a Sunday morning, in an effort to try to 
find a consensus on the kinds of common ground that Senator Hatch and I 
are pursuing.
  Dr. Ellwood has been so helpful in the development of this proposal 
and his own new plan called Heroic Pathways, which encourages the use 
of information technologies and evidence-based medicine, which is a 
fancy way of saying health care that actually works. I am of the view 
that Dr. Ellwood's ideas have great potential. To Paul and Barbara 
Ellwood, I say this morning, we would not be here today without you.
  In my office, Stephanie Kennan and Carole Grunberg kept us tethered 
to reality, and Ms. Daphne Edwards, a young lawyer in the legislative 
counsel's office, produced eight separate drafts of this legislation 
alone.
  Finally, I went into public life because I have always believed if 
people could not get affordable, quality health care, they were not in 
a position to be able to do much of anything else. Since those Gray 
Panther days, I have believed that it is wrong for people in this 
country to die because they could not get health care or because it 
came too late.
  America is now hemorrhaging dollars into a health care system that 
simply does not work at all for too many people. The longer people go 
on dying needlessly, and the longer prosperity and security allude our 
families, the less America looks like the America of our dreams. No one 
I know thinks it should be so easy to slip through the cracks in our 
health care system. No one I know believes America is supposed to be a 
place where people forfeit their well-being for doing honest work that 
just does not pay enough for good medical care.
  The Wyden-Hatch legislation is a chance to move toward America as it 
is meant to be. People can voice their vision for health care in 
America. Their voices can count. Their vision can come to pass.
  So today I ask the Senate to give our people this opportunity. The 
Wyden-Hatch bill provides a roadmap. The great people of this country, 
working with their public servants, can use it as a guide to a health 
care system that works for everyone.
  Mr. President, I see that my colleague is on the floor this morning. 
I

[[Page S10043]]

wrap up by again expressing my appreciation to Senator Hatch. I have 
come to the conclusion that if you want to get anything important done, 
particularly in health care, it has to be bipartisan. Senator Hatch and 
I have been talking about this health care reform for an awfully long 
time. He has been extraordinarily patient--he and his staff--in working 
with me. I think we bring to the Senate today a chance, as we end this 
session--a session where there has not been the progress the people 
deserve on health care--a chance to move forward in a bipartisan way. I 
am just especially grateful to my colleague from the State of Utah, who 
is one of the most caring people I have known in public life, for all 
his help.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 3063

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Health Care That Works for 
     All Americans Act of 2002''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) In order to improve the health care system, the 
     American public must engage in an informed national public 
     debate to make choices about the services they want covered, 
     what health care coverage they want, and how they are willing 
     to pay for coverage.
       (2) More than a trillion dollars annually is spent on the 
     health care system, yet--
       (A) 41,000,000 Americans are uninsured;
       (B) insured individuals do not always have access to 
     essential, effective services to improve and maintain their 
     health; and
       (C) employers, who cover over 170,000,000 Americans, find 
     providing coverage increasingly difficult because of rising 
     costs and double digit premium increases.
       (3) Despite increases in medical care spending that are 
     greater than the rate of inflation, population growth, and 
     Gross Domestic Product growth, there has not been a 
     commensurate improvement in our health status as a nation.
       (4) Health care costs for even just 1 member of a family 
     can be catastrophic, resulting in medical bills potentially 
     harming the economic stability of the entire family.
       (5) Common life occurrences can jeopardize the ability of a 
     family to retain private coverage or jeopardize access to 
     public coverage.
       (6) Innovations in health care access, coverage, and 
     quality of care, including the use of technology, have often 
     come from States, local communities, and private sector 
     organizations, but more creative policies could tap this 
     potential.
       (7) Despite our Nation's wealth, the health care system 
     does not provide coverage to all Americans who want it.

     SEC. 3. PURPOSES.

       The purposes of this Act are--
       (1) to provide for a nationwide public debate about 
     improving the health care system to provide every American 
     with the ability to obtain quality, affordable health care 
     coverage; and
       (2) to provide for a vote by Congress on the 
     recommendations that result from the debate.

     SEC. 4. CITIZENS' HEALTH CARE WORKING GROUP.

       (a) Establishment.--The Secretary, acting through the 
     Agency for Healthcare Research and Quality, shall establish 
     an entity to be known as the Citizens' Health Care Working 
     Group (referred to in this Act as the ``Working Group'').
       (b) Appointment.--Not later than 45 days after the date of 
     enactment of this Act, the Speaker and Minority Leader of the 
     House of Representatives and the Majority Leader and Minority 
     Leader of the Senate (in this section referred to as the 
     ``leadership'') shall each appoint individuals to serve as 
     members of the Working Group in accordance with subsections 
     (c), (d), and (e).
       (c) Membership Criteria.--
       (1) Appointed members.--
       (A) Separate appointments.--The Speaker of the House of 
     Representatives jointly with the Minority Leader of the House 
     of Representatives, and the Majority Leader of the Senate 
     jointly with the Minority Leader of the Senate, shall each 
     appoint 1 member of the Working Group described in 
     subparagraphs (A), (G), (J), (K), and (M) of paragraph (2).
       (B) Joint appointments.--Members of the Working Group 
     described in subparagraphs (B), (C), (D), (E), (F), and (N) 
     of paragraph (2) shall be appointed jointly by the 
     leadership.
       (C) Combined appointments.--Members of the Working Group 
     described in subparagraphs (H) and (L) shall be appointed in 
     the following manner:
       (i) One member of the Working Group in each of such 
     subparagraphs shall be appointed jointly by the leadership.
       (ii) The remaining appointments of the members in each of 
     such subparagraphs shall be divided equally such that the 
     Speaker of the House of Representatives jointly with the 
     Minority Leader of the House of Representatives, and the 
     Majority Leader of the Senate jointly with the Minority 
     Leader of the Senate each appoint an equal number of members.
       (2) Categories of appointed members.--Members of the 
     Working Group shall be appointed as follows:
       (A) 2 members shall be patients or family members of 
     patients who, at least 1 year prior to the date of enactment 
     of this Act, have had no health insurance.
       (B) 1 member shall be a representative of children.
       (C) 1 member shall be a representative of the mentally ill.
       (D) 1 member shall be a representative of the disabled.
       (E) 1 member shall be over the age of 65 and a beneficiary 
     under the medicare program established under title XVIII of 
     the Social Security Act (42 U.S.C. 1395 et seq.).
       (F) 1 member shall be a recipient of benefits under the 
     medicaid program under title XIX of the Social Security Act 
     (42 U.S.C. 1396 et seq.).
       (G) 2 members shall be State health officials.
       (H) 3 members shall be employers, including--
       (i) 1 large employer (an employer who employed 50 or more 
     employees on business days during the preceding calendar year 
     and who employed at least 50 employees on the first of the 
     year);
       (ii) 1 small employer (an employer who employed an average 
     of at least 2 employees but less than 50 employees on 
     business days in the preceding calendar year and who employs 
     at least 2 employees on the first of the year); and
       (iii) 1 multi-state employer.
       (I) 1 member shall be a representative of labor.
       (J) 2 members shall be health insurance issuers.
       (K) 2 members shall be health care providers.
       (L) 5 members shall be appointed as follows:
       (i) 1 economist.
       (ii) 1 academician.
       (iii) 1 health policy researcher.
       (iv) 1 individual with expertise in pharmacoeconomics.
       (v) 1 health technology expert.
       (M) 2 members shall be representatives of community leaders 
     who have developed State or local community solutions to the 
     problems addressed by the Working Group.
       (N) 1 member shall be a representative of a medical school.
       (3) Secretary.--The Secretary of Health and Human Services 
     or the designee of the Secretary of Health and Human Services 
     shall be a member of the Working Group.
       (d) Prohibited Appointments.--Members of the Working Group 
     shall not include members of Congress or other elected 
     government officials (Federal, State, or local) other than 
     those individuals specified in subsection (c). To the extent 
     possible, individuals appointed to the Working Group shall 
     have used the health care system within the previous 2 years 
     and shall not be paid employees or representatives of 
     associations or advocacy organizations involved in the health 
     care system.
       (e) Appointment Criteria.--
       (1) House of representatives.--The Speaker and Minority 
     Leader of the House of Representatives shall make the 
     appointments described in subsection (b) in consultation with 
     the chairperson and ranking member of the following 
     committees of the House of Representatives:
       (A) The Committee on Ways and Means.
       (B) The Committee on Energy and Commerce.
       (C) The Committee on Education and the Workforce.
       (2) Senate.--The Majority Leader and Minority Leader of the 
     Senate shall make the appointments described in subsection 
     (b) in consultation with the chairperson and ranking member 
     of the following committees of the Senate:
       (A) The Committee on Finance.
       (B) The Committee on Health, Education, Labor, and 
     Pensions.
       (f) Period of Appointment.--Members of the Working Group 
     shall be appointed for a term of 2 years. Such term is 
     renewable and any vacancies shall not affect the power and 
     duties of the Working Group but shall be filled in the same 
     manner as the original appointment.
       (g) Appointment of the Chairperson.--Not later than 15 days 
     after the date on which all members of the Working Group have 
     been appointed under subsection (b), the leadership shall 
     make a joint designation of the chairperson of the Working 
     Group. If the leadership fails to make such designation 
     within such time period, the Working Group Members shall, not 
     later than 10 days after the end of such time period, 
     designate a chairperson by majority vote.
       (h) Subcommittees.--The Working Group may establish 
     subcommittees if doing so increases the efficiency of the 
     Working Group in completing its tasks.
       (i) Duties.--
       (1) Hearings.--Not later than 90 days after the date of 
     appointment of the chairperson under subsection (g), the 
     Working Group shall hold hearings to examine--
       (A) the capacity of the public and private health care 
     systems to expand coverage options;

[[Page S10044]]

       (B) the cost of health care and the effectiveness of care 
     provided at all stages of disease, but in particular the cost 
     of services at the end of life;
       (C) innovative State strategies used to expand health care 
     coverage and lower health care costs;
       (D) local community solutions to accessing health care 
     coverage;
       (E) efforts to enroll individuals currently eligible for 
     public or private health care coverage;
       (F) the role of evidence-based medical practices that can 
     be documented as restoring, maintaining, or improving a 
     patient's health, and the use of technology in supporting 
     providers in improving quality of care and lowering costs; 
     and
       (G) strategies to assist purchasers of health care, 
     including consumers, to become more aware of the impact of 
     costs, and to lower the costs of health care.
       (2) Additional hearings.--The Working Group may hold 
     additional hearings on subjects other than those listed in 
     paragraph (1) so long as such hearings are determined to be 
     necessary by the Working Group in carrying out the purposes 
     of this Act. Such additional hearings do not have to be 
     completed within the time period specified in paragraph (1) 
     but shall not delay the other activities of the Working Group 
     under this section.
       (3) The health report to the american people.--Not later 
     than 90 days after the hearings described in paragraphs (1) 
     and (2) are completed, the Working Group shall prepare and 
     make available to health care consumers through the Internet 
     and other appropriate public channels, a report to be 
     entitled, ``The Health Report to the American People''. Such 
     report shall be understandable to the general public and 
     include--
       (A) a summary of--
       (i) health care and related services that may be used by 
     individuals throughout their life span;
       (ii) the cost of health care services and their medical 
     effectiveness in providing better quality of care for 
     different age groups;
       (iii) the source of coverage and payment, including 
     reimbursement, for health care services;
       (iv) the reasons people are uninsured or underinsured and 
     the cost to taxpayers, purchasers of health services, and 
     communities when Americans are uninsured or underinsured;
       (v) the impact on health care outcomes and costs when 
     individuals are treated in later stages of disease;
       (vi) health care cost containment strategies; and
       (vii) information on health care needs that need to be 
     addressed;
       (B) examples of community strategies to provide health care 
     coverage or access;
       (C) information on geographic-specific issues relating to 
     health care;
       (D) information concerning the cost of care in different 
     settings, including institutional-based care and home and 
     community-based care;
       (E) a summary of ways to finance health care coverage; and
       (F) the role of technology in providing future health care 
     including ways to support the information needs of patients 
     and providers.
       (4) Community meetings.--
       (A) In general.--Not later than 1 year after the date of 
     enactment of this Act, the Working Group shall initiate 
     health care community meetings throughout the United States 
     (in this section referred to as ``community meetings''). Such 
     community meetings may be geographically or regionally based 
     and shall be completed within 180 days after the initiation 
     of the first meeting.
       (B) Number of meetings.--The Working Group shall hold a 
     sufficient number of community meetings in order to receive 
     information that reflects--
       (i) the geographic differences throughout the United 
     States;
       (ii) diverse populations; and
       (iii) a balance among urban and rural populations.
       (C) Meeting requirements.--
       (i) Facilitator.--A State health officer may be the 
     facilitator at the community meetings.
       (ii) Attendance.--At least 1 member of the Working Group 
     shall attend and serve as chair of each community meeting. 
     Other members may participate through interactive technology.
       (iii) Topics.--The community meetings shall, at a minimum, 
     address the following issues:

       (I) The optimum way to balance costs and benefits so that 
     affordable health coverage is available to as many people as 
     possible.
       (II) The identification of services that provide cost-
     effective, essential health care services to maintain and 
     improve health and which should be included in health care 
     coverage.
       (III) The cost of providing increased benefits.
       (IV) The mechanisms to finance health care coverage, 
     including defining the appropriate financial role for 
     individuals, businesses, and government.

       (iv) Interactive technology.--The Working Group may 
     encourage public participation in community meetings through 
     interactive technology and other means as determined 
     appropriate by the Working Group.
       (D) Interim requirements.--Not later than 180 days after 
     the date of completion of the community meetings, the Working 
     Group shall prepare and make available to the public through 
     the Internet and other appropriate public channels, an 
     interim set of recommendations on health care coverage and 
     ways to improve and strengthen the health care system based 
     on the information and preferences expressed at the community 
     meetings. There shall be a 90-day public comment period on 
     such recommendations.
       (j) Recommendations.--Not later than 120 days after the 
     expiration of the public comment period described in 
     subsection (h)(3)(D), the Working Group shall submit to 
     Congress and the President a final set of recommendations, 
     including any proposed legislative language to implement such 
     recommendations.
       (k) Administration.--
       (1) Executive director.--There shall be an Executive 
     Director of the Working Group who shall be appointed by the 
     chairperson of the Working Group in consultation with the 
     members of the Working Group.
       (2) Compensation.--While serving on the business of the 
     Working Group (including travel time), a member of the 
     Working Group shall be entitled to compensation at the per 
     diem equivalent of the rate provided for level IV of the 
     Executive Schedule under section 5315 of title 5, United 
     States Code, and while so serving away from home and the 
     member's regular place of business, a member may be allowed 
     travel expenses, as authorized by the chairperson of the 
     Working Group. For purposes of pay and employment benefits, 
     rights, and privileges, all personnel of the Working Group 
     shall be treated as if they were employees of the Senate.
       (3) Information from federal agencies.--The Working Group 
     may secure directly from any Federal department or agency 
     such information as the Working Group considers necessary to 
     carry out this Act. Upon request of the Working Group, the 
     head of such department or agency shall furnish such 
     information.
       (4) Postal services.--The Working Group may use the United 
     States mails in the same manner and under the same conditions 
     as other departments and agencies of the Federal Government.
       (l) Detail.--Not more than 10 Federal Government employees 
     employed by the Department of Labor and 10 Federal Government 
     employees employed by the Department of Health and Human 
     Services may be detailed to the Working Group under this 
     section without further reimbursement. Any detail of an 
     employee shall be without interruption or loss of civil 
     service status or privilege.
       (m) Temporary and Intermittent Services.--The chairperson 
     of the Working Group may procure temporary and intermittent 
     services under section 3109(b) of title 5, United States 
     Code, at rates for individuals which do not exceed the daily 
     equivalent of the annual rate of basic pay prescribed for 
     level V of the Executive Schedule under section 5316 of such 
     title.
       (n) Annual Report.--Not later that 1 year after the date of 
     enactment of this Act, and annually thereafter during the 
     existence of the Working Group, the Working Group shall 
     report to Congress and make public a detailed description of 
     the expenditures of the Working Group used to carry out its 
     duties under this section.
       (o) Sunset of Working Group.--The Working Group shall 
     terminate when the report described in subsection (j) is 
     submitted to Congress.

     SEC. 5. CONGRESSIONAL ACTION.

       (a) Drafting.--If the Working Group does not provide 
     legislative language in the report under section 4(j) then 
     the committees described in paragraphs (1) and (2) of section 
     4(e) may draft legislative language based on the 
     recommendations of the Working Group.
       (b) Bill Introduction.--
       (1) In general.--Any legislative language described in 
     subsection (a) may be introduced as a bill by request in the 
     following manner:
       (A) House of representatives.--In the House of 
     Representatives, by the Majority Leader and the Minority 
     Leader not later than 10 days after receipt of the 
     legislative language.
       (B) Senate.--In the Senate, by the Majority Leader and the 
     Minority Leader not later than 10 days after receipt of the 
     legislative language.
       (2) Alternative by administration.--The President may 
     submit legislative language based on the recommendations of 
     the Working Group and such legislative language may be 
     introduced in the manner described in paragraph (1).
       (c) Committee Consideration.--
       (1) In general.--Any legislative language submitted 
     pursuant to paragraph (1) or (2) of subsection (b) (in this 
     section referred to as ``implementing legislation'') shall be 
     referred to the appropriate committees of the House of 
     Representatives and the Senate.
       (2) Reporting.--
       (A) Committee action.--If, not later than 150 days after 
     the date on which the implementing legislation is referred to 
     a committee under paragraph (1), the committee has reported 
     the implementing legislation or has reported an original bill 
     whose subject is related to reforming the health care system, 
     or to providing access to affordable health care coverage for 
     Americans, the regular rules of the applicable House of 
     Congress shall apply to such legislation.
       (B) Discharge from committees
       (i) Senate.--

       (I) In general.--If the implementing legislation or an 
     original bill described in subparagraph (A) has not been 
     reported by a

[[Page S10045]]

     committee of the Senate within 180 days after the date on 
     which such legislation was referred to committee under 
     paragraph (1), it shall be in order for any Senator to move 
     to discharge the committee from further consideration of such 
     implementing legislation.
       (II) Sequential referrals.--Should a sequential referral of 
     the implementing legislation be made, the additional 
     committee has 30 days for consideration of implementing 
     legislation before the discharge motion described in 
     subclause (I) would be in order.
       (III) Procedure.--The motion described in subclause (I) 
     shall not be in order after the implementing legislation has 
     been placed on the calendar. While the motion described in 
     subclause (I) is pending, no other motions related to the 
     motion described in subclause (I) shall be in order. Debate 
     on a motion to discharge shall be limited to not more than 10 
     hours, equally divided and controlled by the majority leader 
     and the minority leader, or their designees. An amendment to 
     the motion shall not be in order, nor shall it be in order to 
     move to reconsider the vote by which the motion is agreed or 
     disagreed to.
       (IV) Exception.--If implementing language is submitted on a 
     date later than May 1 of the second session of a Congress, 
     the committee shall have 90 days to consider the implementing 
     legislation before a motion to discharge under this clause 
     would be in order.

       (ii) House of representatives.--If the implementing 
     legislation or an original bill described in subparagraph (A) 
     has not been reported out of a committee of the House of 
     Representatives within 180 days after the date on which such 
     legislation was referred to committee under paragraph (1), 
     then on any day on which the call of the calendar for motions 
     to discharge committees is in order, any member of the House 
     of Representatives may move that the committee be discharged 
     from consideration of the implementing legislation, and this 
     motion shall be considered under the same terms and 
     conditions, and if adopted the House of Representatives shall 
     follow the procedure described in subsection (d)(1).
       (d) Floor Consideration.--
       (1) Motion to proceed.--If a motion to discharge made 
     pursuant to subsection (c)(2)(B)(i) or (c)(2)(B)(ii) is 
     adopted, then, not earlier than 5 legislative days after the 
     date on which the motion to discharge is adopted, a motion 
     may be made to proceed to the bill.
       (2) Failure of motion.--If the motion to discharge made 
     pursuant to subsection (c)(2)(B)(i) or (c)(2)(B)(ii) fails, 
     such motion may be made not more than 2 additional times, but 
     in no case more frequently than within 30 days of the 
     previous motion. Debate on each of such motions shall be 
     limited to 5 hours, equally divided.
       (3) Applicable rules.--Once the Senate is debating the 
     implementing legislation the regular rules of the Senate 
     shall apply.

     SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated to 
     carry out this Act, other than section 4(i)(3), $3,000,000 
     for each of fiscal years 2003, 2004, 2005.
       (b) Health Report to the American People.--There are 
     authorized to be appropriated for the preparation and 
     dissemination of the Health Report to the American People 
     described in section 4(i)(3), such sums as may be necessary 
     for the fiscal year in which the report is required to be 
     submitted.
  The ACTING PRESIDENT pro tempore. The Senator from Utah.
  Mr. HATCH. Mr. President, I thank my colleague for his kind remarks, 
especially his kind remarks with regard to me. I share a mutual 
affection for him because, as a leader in the House on health care, he 
did so many good things. We are so happy to have him in the Senate 
where he has continued his work on health care. I am very grateful to 
him.
  Mr. President, I rise to associate myself with the remarks of my good 
friend and colleague, the Senator from Oregon, Mr. Wyden.
  Last week, we were all dismayed to learn the Census Bureau figures 
indicate the number of uninsured in our country has risen from 39.8 
million in 2000 to 41.2 million in 2001.
  Of even greater concern is the fact that most of the newly uninsured 
previously had employer-based coverage.
  Obviously, this is a trend in the wrong direction despite years of 
efforts here in Washington to improve our country's health care 
delivery system.
  Clearly, we must take another approach.
  In a nutshell, the legislation that Senator Wyden and I are 
introducing today will stimulate fruitful discussion and debate on how 
we can really effect improvements to our nation's health care system--
improvements that can be accepted at all levels, from communities on up 
to the Federal government.
  We have worked on this bill for several months and are proud to have 
reached bipartisan consensus.
  Bipartisanship, it seems, is a rare occurrence these days. But, in 
our opinion, the only way to resolve our country's health crisis is to 
put politics aside and work together toward common goals.
  The Health Care That Works for All Americans Act of 2002 reflects our 
common goals on how to resolve this country's health care woes.
  We accomplish these important goals by fostering candid discussions--
in every corner of our country--through which the public can have an 
earnest discussion about our current health care system.
  These discussions will lead to recommendations on how to improve 
health care coverage which will help guide the Congress as it moves 
forward in this area.
  It is our hope that, in the end, this legislation will provide 
Americans with the proper tools to access high quality, affordable 
health care coverage.
  Basically, our legislation envisions three steps: public meetings; 
recommendations to Congress; and congressional action.
  We see this an as interactive process, which will help all of us be 
more informed consumers and which can produce real changes for the 
public.
  At this point, I would like to take this opportunity to discuss each 
of these steps in more detail.
  The first step of this bill is to stimulate community gatherings at 
which individuals from all walks of life can provide their viewpoints 
on which health benefits they believe should be covered.
  Obviously, a necessary component of that discussion will be how the 
benefits can be paid for, and by whom. Strange as it may seem, our 
government has never actually asked the American people what they want 
from our health care system. These community meetings would pose 
questions to individuals such as, ``What type of health coverage do you 
want how much are you willing to pay?''
  In addition, debate would focus on the financial responsibilities of 
the government, businesses, and individual citizens.
  I believe these issues must be discussed at the beginning of a new 
debate on health coverage, because the public's response is essential 
to building a nationwide consensus for creating a new health care 
system. It is critical to receive feedback from those who use the 
health care system on a daily, weekly or even annual basis.
  Our plan is to hear from everyone who has had first-hand experience 
with the health care system. We want to hear what people like and 
dislike about the current system and their proposals for change. And, 
we also hope to hear from those who do not use health services and the 
reasons why they have not sought health care coverage.

  We hope to stimulate a provocative discussion based on key questions. 
Is health care too expensive? Too complicated? Or is it just not 
available to certain segments of our society?
  The Wyden-Hatch legislation creates a Citizens' Health Care Working 
Group which would be charged with posing these tough questions and 
overseeing this crucial debate on how to improve upon our current 
health care system.
  The Citizens' Health Care Working Group will be comprised of 
individuals who have a deep interest in health care: patients; 
providers, community leaders; and key state and federal officials.
  The Working Group will coordinate nationwide community meetings and 
facilitate the public in expressing their views on the complex and 
often difficult choices concerning health care coverage.
  To achieve this objective, our bill directs the Working Group to 
produce a ``Health Care Report to the American People.'' This report 
will be used as a guidebook designed to describe the cost and 
availability of health choices available to Americans across the 
country--taking into account geographic differences.
  Since this issue has been visited over and over again without 
noticeable results, we believe that it is time to have an honest 
dialogue about sensitive health care issues with the public so that 
individual citizens will have a better idea of what choices members of 
Congress and key health officials are facing when health care issues 
are being debated.
  We envision asking citizens about a whole range of services and 
procedures, a ``bottom-up'' review of the health

[[Page S10046]]

care system, if you will. We hope these community discussions will look 
at current coverage issues, such as whether Medicaid should provide 
better coverage for transplants, recognizing that these are very 
expensive, labor-intensive procedures that may use scarce resources 
that might have been used elsewhere.
  Another area we hope might be explored is how to improve coverage of 
long-term care services, and how this should be paid.
  These choices--economic, moral, legal and social--will be difficult 
ones, but the purpose of our legislation is this--to start discussing 
these vital issues with those on whom there will be the greatest 
impact--the American people. We cannot afford to put off these 
discussions any longer.
  In the past, health reform debates have not included the voice of the 
people who actually need to live with these decisions. The Wyden-Hatch 
legislation will ensure that those Americans who depend on quality, 
affordable health care are at the forefront of the discussion before 
the special interests weigh in with their objectives.
  Mr. President, I ask my colleagues, given the failures of the past, 
isn't it time that we approach this problem by listening to citizens' 
viewpoints on health care coverage?
  The second step of this legislation is to direct the Working Group to 
take the ideas offered by the public and translate these comments into 
recommendations for our elected officials, specifically Members of 
Congress and the President.
  The Working Group will have substantial awareness of our citizens' 
preferences because of their involvement in the public meetings across 
the country. After the meetings are completed, the Working Group will 
highlight the issues raised by the public and provide them to members 
of Congress and the President for evaluation.

  The third step of this legislation involves drafting these 
recommendations into legislation which will eventually be voted upon by 
both the House and the Senate.
  Never before has Congress voted on a health care proposal built on a 
foundation created by the public making difficult heath care choices.
  If enacted, the Wyden-Hatch bill will provide for just such a vote.
  Senator Wyden and I both know there will be many questions about this 
proposal, but, in my opinion, the most important question is ``Why 
now?''
  The answer is simple--the American people cannot afford to wait any 
longer. The number of uninsured Americans, which had been declining for 
the past couple of years, is now increasing.
  In addition, the costs of gridlock are simply too great--on human, 
social, economic and moral grounds. Congress is on the verge of 
completing another session without significant progress on major health 
care reforms.
  Once again, we have not passed prescription drug coverage for 
Medicare beneficiaries. Once again, we have not addressed the issue of 
the uninsured. Once again, we have not approved legislation that 
includes patient protections.
  And the reason for this inaction is partisan politics--no one is 
willing to compromise so we end up doing nothing and the American 
public suffers. In my opinion, something must be done to address these 
important issues, sooner rather than later.
  One issue that must be addressed is the overwhelming cost of health 
care. Every time I go home to Utah, I hear complaints from my 
constituents about escalating health care premiums and the price of 
prescription drugs. People are having a difficult time paying for their 
health insurance premiums, their physicians' visits and their 
medicines. We were all disturbed last year to hear about a recent 
Towers Perrin survey indicating that the cost of health benefit plans 
at large companies is expected to rise an average of 15 percent--15 
percent!--in 2003.
  Some businesses, especially smaller employers, are worried that they 
will no longer be able to provide health insurance coverage to their 
employees. Utah physicians complain to me about the inadequate Medicare 
reimbursement rates and are threatening to leave the state.
  In fact, many of the federal health programs have complicated and 
over-bearing regulations that are confusing to participating providers. 
For example, is it necessary to have a book of Medicaid regulations 
thicker than the Black's Law Dictionary?
  While our health care system provides the highest quality services in 
the world and is the most technologically advanced, America's health 
system has fundamental flaws. The purpose of this legislation is to 
build on the positive components of our current system and improve the 
flaws.
  We believe that the best way to improve the current system is to 
listen to public input and implement their ideas and suggestions.
  We must get past playing the blame game. All of the powerful special 
interests are going to have to accept some reforms they have rejected 
in the past if America is to have a health care system that works for 
all.
  I believe this is what we will hear from the American people if they 
are given the chance to drive the debate on health reform as envisioned 
by this legislation. Unfortunately, there never has been a system to 
gather that public input until now.
  Mr. President, I am proud to be the lead Republican sponsor of the 
Health Care that Works for All Americans Act of 2002. I urge my 
colleagues to work with us so this legislation will be enacted into law 
in a timely manner. The American people cannot afford to wait any 
longer.
  I praise my colleague again for his leadership in so many areas, but 
especially the area of health care. He is sincere. He is dedicated. He 
is smart. He works hard on these issues. I am proud to work with him on 
this issue, and hope we can be successful in passing this bill and 
getting this very worthwhile effort started.
                                 ______