[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
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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
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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.
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