[Congressional Record Volume 150, Number 66 (Wednesday, May 12, 2004)]
[Senate]
[Pages S5248-S5250]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. WYDEN. Mr. President, I have always believed health care policy 
needs to be bipartisan, and needs to be ideas driven. So as we talk 
about health care, I come to the floor to mention an idea our colleague 
Senator Kerry has talked about which I think is especially promising 
for small business.
  The reality is, a very high percentage of the uninsured work in small 
businesses. These small businesses are dying to cover their people. The 
owners of those small businesses do not get up in the morning and say: 
We want to be rotten to our workers in not giving coverage. They are 
dying to figure out ways to help their small businesses.
  Senator Kerry has come up with an idea that I think is really 
innovative. He has said, given the fact resources are scarce, that 
dollars for trying to address the uninsured, the needs of our small 
businesses, are restricted, we ought to target those dollars where they 
are needed the most. He has proposed the Federal Government, with

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respect to small business, concentrate on instances where there are 
very large bills, bills above $50,000. He would have the Federal 
Government step in and pick up about 75 percent of those costs. The 
premiums that would be charged employers and their workers could be 
trimmed about 10 percent in this fashion.
  We know it has been documented that those who are particularly in 
need of assistance when they face these very high bills are a very 
large proportion of the health care costs in America. These health care 
costs are particularly punitive for the small businesses. Small 
businesses are always walking on economic tightropes. If one employee 
at a small business gets sick, this can devastate the entire budget of 
the company for not just health care coverage but the entire coverage 
of the business.
  I am very pleased Senator Kerry has brought forward this idea. I 
think it is one that can be supported in a bipartisan way. The 
Congress, over the years, has tried to look at ways to strengthen the 
employer-based system of coverage. I think we all understand if you are 
talking about starting scores of new programs, that would be very 
difficult at this time. I also do not think it is warranted at a time 
when we are spending $1.7 trillion on health care. If you divide that 
up by 270 million Americans, it comes to more than $17,000 for a family 
of 4. So we are spending a lot of money.
  The challenge now is to really zero in on areas where the Government 
can be best utilized. I think Senator Kerry's proposal with respect to 
trying to deal with the costs of individuals who work at small 
businesses with very high bills is particularly appropriate at this 
time. It is something I think could be built in a bipartisan way.
  I will have more to say about this and other proposals in the days 
ahead. But as we come to the floor and talk--Democrats and 
Republicans--about health care, I think we ought to make our policies 
bipartisan. We ought to make them ideas driven. The kind of idea that 
has been outlined by Senator Kerry with respect to the needs of 
individuals who work at small businesses with very large bills is the 
kind of thinking that would make a difference now. It is cost 
effective. I think it warrants support on a bipartisan basis.
  With that, Mr. President, I yield the floor.
  The PRESIDING OFFICER. Who seeks recognition?
  Mr. WYDEN. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Ms. STABENOW. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Ms. STABENOW. Mr. President, I rise to lament the fact that we have 
made no progress in reducing the uninsured since 2001. This is an issue 
we all need to be working together on because it affects everyone we 
represent, every family, every business. In fact, nearly 4 million more 
people are uninsured today than the day this administration took 
office.
  We need to light a fire. We need to have a sense of urgency about 
getting this done for people. We can do much better than we are doing. 
We live in the United States of America. We are the greatest, the 
richest country on the face of the Earth. When we have the will, we can 
make great things happen. That is what we need to do here.
  We enacted Social Security in 1935. This program now serves as our 
universal retirement, life insurance, and disability insurance system 
for millions of people. A generation later we passed Medicare, our 
Nation's universal health plan for seniors and the disabled. Even 
though I am very concerned about the recent law that we passed and 
whether it is a step backward--and I believe it is--the fact is, we put 
in place in 1965 a policy based on a set of values that said, if you 
are 65 or older, if you are disabled, you are going to receive health 
care.
  Interestingly, at that time, if we go back and read the record, this 
was viewed as a compromise, a first step. Originally in 1960, what was 
being debated was health care for everyone. Then when there was not the 
support to pass that, the compromise was to start with older Americans 
and with the disabled, to provide health care first to them and then to 
open it up to all of our citizens. Yet today we are not seeing that 
happening. It is now time to go the last mile. We need to make sure all 
Americans have the same access to health insurance that we do in the 
Senate.
  As most colleagues know, approximately 80 percent of the people who 
don't have health insurance are working--one job, two jobs, three jobs, 
working very hard to care for their families. They have jobs. They go 
to work. They play by the rules. Unfortunately, health insurance is so 
expensive, they can't afford it or the business they work for can't 
afford it. We need to value the hard work these people are doing. We 
need to recognize and ensure that if they work for a living, they have 
the health insurance they need for themselves and their families.
  Regrettably, this administration has been basically silent on the 
uninsured. When members of the administration do speak, they are 
negative and pessimistic about providing access to affordable health 
care for all Americans. For example, in January of this year, the 
National Academy of Sciences said that the President and Congress 
should work to achieve health insurance coverage for all Americans by 
2010. That is a worthy goal, although I would argue too far into the 
future.
  What was the response? The administration's top health official, 
Health and Human Services Secretary Tommy Thompson said universal 
health coverage is ``not realistic . . . I don't think, 
administratively or legislatively, it's feasible.''
  Then 2 months later Secretary Thompson went on to minimize the 
Nation's uninsured problem by saying:

       Even if you don't have health insurance in America, you get 
     taken care of. That could be defined as universal health 
     care.

  In other words, just go to the emergency room to get your health care 
coverage.
  In fact, too many people are doing that now. Sometimes you can just 
get taken care of, but by the time an uninsured patient reaches the 
emergency room, it is often too late to provide lifesaving health care. 
Many of the uninsured forgo less costly preventative care and early 
treatments, getting sicker as what money they have goes for the rent, 
the car, the kids, and food.
  Hospitals in Michigan indicate they have provided over $1 billion in 
health care for the uninsured, uncompensated care this last year. Think 
what we could do if we could capture that $1 billion and put it into a 
system that worked on the front end, that kept people healthy, that 
provided preventive care, that made sure they could see the doctor in 
his office or her office rather than having to wait for the emergency 
room.
  We can do better than this in the greatest country in the world. I do 
not think we should throw in the towel. We should not say we can't do 
it, it is not feasible. It is time to create the will. The fact is, we 
can do it, if we pick the right priorities. We can do the same thing we 
did when we passed Social Security and Medicare--two great American 
success stories that have provided economic security for people as they 
grow older and retire and health care for older Americans and the 
disabled. In my book, that was all about values, about what is 
important. This certainly is equally important. We should be 
optimistic. We should join all other modern countries and make sure all 
Americans have access to affordable health insurance.
  One of the reasons more and more families can't get health care is 
because the costs are spiraling out of control. In fact, from 2000 to 
2003, the average annual cost of premiums doubled, making health 
insurance out of reach for more and more middle-income families and 
small businesses. In 3 years, the costs have doubled. Medical problems, 
in fact, were a factor in nearly half of all nonbusiness bankruptcy 
filings. Overall, health care costs have gone up nearly 14 percent last 
year. Meanwhile, workers' earnings increased by only 3 percent. You can 
see the hole people find themselves in.
  This is the fifth year in a row premiums outpaced earnings. We all 
know that one of the reasons health care costs have escalated so fast 
is the spiraling price of prescription drugs. I

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have talked frequently about this. I speak about it and focus on it 
because it is such a driver for the costs of health care and health 
insurance.
  What has Congress done to fix this problem? Unfortunately, absolutely 
nothing. In fact, the new Medicare law failed to do anything to lower 
prescription drug prices. At the same time approximately 3 million 
retirees will actually lose their prescription drug coverage under this 
new law. This bill actually takes us backward instead of forward.
  The only major health care coverage initiative this administration 
has proposed is actually for the Iraqi people. Our country has made a 
commitment to moving forward with universal health coverage for all 
Iraqi citizens. We have provided $950 million to build hospitals and 
clinics in Iraq.
  Please do not misunderstand what I am saying. I certainly want to be 
supportive of efforts to provide health care in Iraq.
  What about us? What about Americans? I also want to help American 
families who are working hard every day, playing by the rules in this 
great country, and struggling to pay their bills and care for their 
families. I think we can help both the people of Iraq and Americans at 
the same time. It is our moral obligation, I believe, to make sure we 
are helping American families as well as others.
  Mr. President, working families deserve access to affordable care for 
themselves and for their families. It is going to take leadership to 
accomplish this. The administration has had almost 4 years to take 
action, and it has not.
  I believe it is time for bold change. I believe that when we are 
looking at the price of prescription drugs, we need to take out that 
provision in the new Medicare law that says Medicare cannot negotiate 
for group discounts. That is pretty basic. We know that one of the main 
ways you are able to lower prescription drug prices, or the price of 
any product, is to be able to get a group discount. Everybody knows 
that. Yet, in this new Medicare law, Medicare is specifically 
prohibited from doing that. Who benefits from that? Certainly not the 
taxpayers, certainly not American seniors or the disabled, and American 
families certainly don't benefit from that. The prescription drug 
industry benefits from that. What we have seen under the new Medicare 
law, rather than providing lower prices for people, we have 40 million 
seniors who are being locked into paying top dollar, and that makes 
absolutely no sense.
  We can do something about that. We can make changes in the Medicare 
law so it works for people. We can also lower prices immediately by 
simply allowing the local pharmacists at the local drugstores in 
America to be able to do business with pharmacists in Canada or other 
countries, where they can provide FDA-approved drugs and processes and 
bring the prescription drugs--actually made in America--back to America 
so we can get the same deal everybody else gets around the world.
  We have a wonderful, bipartisan bill that has been put together. I am 
hopeful that we will bring it to the Senate floor as soon as possible 
and that we are able to pass what is called reimportation of 
prescription drugs and lower prices. I am very hopeful and I am proud 
to be a cosponsor of Senator Daschle's effort and vision to say that, 
by 2006, we are going to make a commitment that every American has 
access at least to the same level of health care that we receive. This 
is one of the few instances where employees--elected officials--have 
better health care and benefits than the employers. It is time to turn 
that around. It is time to make a commitment.
  Medicare, after it was passed, was put together in 1 year. We have 
great American ingenuity. If we are bold and have a vision and have a 
right priority, we can make sure that a year from now we are talking 
about the implementation of health insurance for everyone that is 
affordable and available to every single American.
  I yield the floor.

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