[Congressional Record Volume 150, Number 116 (Thursday, September 23, 2004)]
[Senate]
[Pages S9544-S9545]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         HEALTH CARE IN AMERICA

  Mr. TALENT. Mr. President, I will take also a few minutes, putting on 
a little different hat because I had not intended to talk about health 
care today, but my friend from Massachusetts spoke with his usual vigor 
and eloquence on this subject and I thought perhaps a few words in 
response were warranted.
  I agree with my friend about one thing--there certainly is a very big 
difference between the approach of the President to resolving the 
problem of the uninsured and costs in health care and the approach of 
my friend and his colleague from Massachusetts, Senator Kerry. There is 
no question that there is a problem in this country because too many 
people do not have health insurance. I have been leading a fight on 
this issue for at least 7 or 8 years. There are about 45 million people 
who at any given time are uninsured. The interesting thing is that most 
of those people are working people, and they are working on farms or 
for small businesses.
  There is a reason why a disproportionate number of the people who are 
uninsured are working for small business. It is because health 
insurance costs more to purchase for small groups. The administrative 
costs to small businesspeople of buying health insurance for their 
employees is about three times the administrative costs of buying it 
for national pools, for the employees of big companies.
  It is interesting to note that if one looks at the people in the 
country who have health insurance, everybody, except the employees of 
small business, gets their health insurance through some kind of 
national pool, public or private. They are either employees of big 
national companies, they have it through a big labor union plan, they 
work for the Federal Government, or they are participants in Medicare 
or Medicaid. Everybody else is part of a big national pool because of 
the efficiencies and the lower costs that are available if one does 
that except the employees of small business and farmers who are 
relegated to trying to buy health insurance to cover 5-, 6-, 8- or 10- 
people units. It costs more. They do not get as much health insurance 
for it. In many cases it becomes unaffordable, so the small business 
does not provide health insurance at all to their employees.
  How many more minutes do I have? I do not want my eloquence to 
consume all of my time.
  The PRESIDING OFFICER (Mr. Inhofe). The first half hour of morning 
business has expired. We are now into the second half hour, and we are 
at the beginning of the majority's 15 minutes.
  Mr. TALENT. So approximately 15 minutes remaining. I thank the Chair.
  I have talked literally to hundreds of small businesspeople who are 
suffering with this problem. They want to provide health insurance to 
their employees. They would like to because, of course, in almost all 
cases the owner is an employee of the corporation, like my brother is, 
for example. He runs a little restaurant in Missouri. He is an employee 
of the corporation. He would love to get health insurance for the whole 
company. Then he would be able to get it, too, at better rates than 
buying it on the individual market. He cannot because it costs too much 
for small businesspeople.
  What is the President's solution? It happens to be a solution I have 
been working for for a number of years, so naturally I think the 
President is right. His solution is to allow small businesspeople to 
pool through their national trade associations to buy health insurance. 
For example, the

[[Page S9545]]

President wants to pass authorizing legislation which would allow the 
National Restaurant Association, to take an example, to contract with 
insurance companies nationally, and then any restaurant that joined the 
National Restaurant Association would become like the little division 
of a big company. If we had that in place, my brother could join the 
National Restaurant Association and his employees would get health 
insurance on the same terms and same conditions as if they were 
employees of, let us say, Anheuser-Busch, a fine company headquartered 
in St. Louis, or Hallmark, a great company headquartered in Kansas 
City.

  Why should they not be able to do it? It would reduce the cost of 
health insurance to small businesses, conservatively speaking, 10 to 20 
percent. It would make it available to millions of small businesspeople 
who currently have no insurance at all, and millions of others would 
get better health insurance because the costs would go down and the 
quality would go up. It would create competition in the small group 
market that currently does not exist.
  Here is another thing that working people in small businesses or big 
businesses will be pleased about, and it does not cost anything because 
it is not a Government program. It is empowering small businesspeople 
and farmers to do the same as their colleagues who work for big 
companies already can do.
  The President has strongly supported this measure. It has passed in 
the House by a huge bipartisan vote. We pushed it further than ever 
before in the Senate. I think next year we are going to get it, and we 
will reduce the number of uninsured by getting more people good quality 
private health insurance which reflects what they want in health 
insurance instead of what the Government condescends to give them. It 
is not going to cost the taxpayers anything. Or we could pursue Senator 
Kerry's plan, which will cost the taxpayer, by two different estimates, 
one $1.5 trillion and the other $1.25 trillion. It will not even insure 
everybody who is uninsured. It is basically a vast expansion of 
Medicaid.
  I have supported expanding Medicaid to cover people who are 
unemployed or people who cannot get insurance any other way. I believe 
that is our responsibility as a society. But if we can help people get 
health insurance on their own, why should we not do it? That is the 
President's approach.

  Something else the President wants to do is he wants to reduce the 
costs that are driving health care by passing reasonable liability 
insurance reform to prevent frivolous or abusive lawsuits. I hear about 
nothing more often in Missouri than the whole question of liability 
reform, reforming our liability system so we can prevent the frivolous 
or abusive lawsuits that are driving up costs all over my State and 
States across the country.
  I was in Chillicothe, MO, a couple of weeks ago. The last OB/GYN shut 
down, moved. You can't get a baby delivered anymore in Chillicothe 
because of the rising cost of malpractice insurance that we all pay.
  I was visited the other day by a group that is involved in providing 
services in building facilities for seniors--assisted living and 
skilled nursing facilities. They were complaining because the cost--
from the time they decided to build until the time they are building, 
the cost of their liability insurance went up, I think it was from 
$200,000 to $1.5 million a year.
  The people of Missouri know who is paying those costs. It is getting 
passed on to them. We see it in the cost of health insurance premiums. 
We see it in the pressure on the Medicare and Medicaid budget.
  We can have a reasonable reform that prevents that. It doesn't have 
to be all or nothing at all. It doesn't have to be a system where 
either we allow abusive and frivolous lawsuits that are driving up 
costs or we don't allow recovery at all. We can do what we did for 
hundreds of years, which is have a system that fully allows recovery 
for people who are injured through negligence to the extent of their 
injury but doesn't allow actions that drive up costs on behalf of 
frivolous lawsuits or huge awards or settlements that are out of 
relation to any damage that is actually done.
  The President wants reform of that. So do the people of Missouri. 
They are aware of this issue. It got filibustered. The President 
supports reform and Senator Kerry supported the filibuster.
  Let me just say, there are a lot of things we can do on a 
commonsense, bipartisan basis to reduce the costs of health care in 
this country. The more you reduce the cost of health care without 
affecting quality or access, the more people will be able to get health 
insurance, the more people will be able to get health care. That is 
what we have to do.
  It is time to stop treating this as if, depending on which side of 
the aisle you are on, you either want or do not want people to have 
health care. I have never met a serious political leader in either 
party who did not want the people of this country to have health care. 
The question is how we are going to go about it.
  One of the things I like about the President's proposal is he has 
decided to get away from deeply ideological solutions and to do what 
makes common sense, to take steps each of which will substantially 
improve the situation and put us in a better position and then open up 
options for other things we can do. It is what we need to do. I am 
convinced if we set politics aside, and we can once we get past this 
election and pursue those measures for reform, we will pass them and 
not only pass them but pass them with bipartisan majorities.
  With regard to the bill for national insurance pools for small 
businesses, small business health plans, that bill has repeatedly 
passed the House with a bipartisan majority and it can here as well. I 
am hopeful that it will, after the elections this fall.
  We live in interesting times. There are a lot of key issues we are 
confronting. I continue to be optimistic. This war in Iraq is 
difficult. Wars are always difficult--the sacrifices, the heroism of 
the people of this country and their resolve, and then the men and 
women in the America's military who are a model for us all. They are 
writing another glorious chapter in the story of freedom that really is 
the story of the American fighting man and woman. The spread of freedom 
in the 20th century was the story of the American soldier all over the 
world making a reality, for other people as well as for this country, 
the ideals on which this Nation is based.
  We saw another example of the power of those ideals today in the 
House of Representatives. It was an honor to be there and a pleasure to 
take a few minutes to recall what we all heard.
  I thank the Senate for its indulgence, and I yield the floor.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ENSIGN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Graham of South Carolina). Without 
objection, it is so ordered.
  The senior Senator from Nevada has a question.
  Mr. REID. Mr. President, will the Senator withhold just for a brief 
unanimous consent request?
  Mr. President, morning business expires in how much more time?
  The PRESIDING OFFICER. There is 7\1/2\ minutes.

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