[Congressional Record Volume 152, Number 9 (Tuesday, January 31, 2006)]
[Senate]
[Pages S371-S373]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KENNEDY:
  S. 2229. A bill to provide quality, affordable health care for all 
Americans; to the Committee on Finance.
  Mr. KENNEDY. Mr. President, in this century of the life sciences, 
medical miracles have the potential to improve the health and extend 
the lives of millions of Americans and millions more across the world.
  But for too many of our citizens, quality affordable health care is a 
distant dream, and the promise of the century of the life sciences 
rings hollow.
  Forty-six million Americans have no health insurance. Under the 
current Administration, the number has climbed every year of this 
Administration, from 40 million in 2000 to 46 million today. That's 
equivalent to the population of 24 States and the District of 
Columbia--combined.
  That's 46 million Americans who wonder whether a cough or fever will 
turn into a serious illness that brings financial ruin, and 46 million 
Americans who have to make the impossible choice between paying for a 
visit to the doctor or paying the rent to keep a roof over their heads.
  Even these figures understate the problem. Over a two year period, 82 
million Americans, one out of every three Americans under 65, will be 
uninsured for a period of at least two months.
  The burden of lack of health insurance falls most heavily on minority 
populations. Less than 13 percent of white Americans are uninsured, but 
over 20 percent of African Americans lack health insurance. For 
Hispanic Americans, the figure is even more appalling--over a third of 
Hispanic Americans lack coverage.
  Over 80 percent of the uninsured are members of working families. 
They work 40 hours a week, fifty-two weeks a year--but all their hard 
work can't buy them the health insurance they need to protect 
themselves and their families--because they can't afford it and their 
employers don't provide it.
  In any given year, one third of the uninsured go without needed 
medical care. Eight million uninsured Americans fail to take the drugs 
their doctors prescribe--because they can't afford to fill the 
prescription. 270,000 children suffering from asthma never see a 
doctor. 27,000 uninsured women are diagnosed with breast cancer each 
year. They are twice as likely as insured women not to receive medical 
treatment until their cancer has spread. As a result, they are 50 
percent more likely to die of the disease.
  The list of grim examples goes on and on.
  Some argue that despite the lack of health care coverage, the 
uninsured get the care they need. But that's a myth. The facts prove 
otherwise.
  Thirty five percent of the uninsured--over 15 million Americans--skip 
recommended treatment because of cost. Over a third of the uninsured 
need care but do not get it, and nearly half postpone care because of 
its cost. Millions of Americans are at risk of ignoring serious 
illnesses, because they can't afford to see a doctor for a needed test.
  Whether the disease is AIDS or mental illness or cancer or heart 
disease or diabetes, the uninsured are left out and left behind. In 
hospital and out, young or old, black or white, they receive less care, 
suffer more, and are 25 percent more likely to die than those who are 
insured.
  But the large and growing number of the uninsured is only part of the 
health care crisis. Costs are rising out of control, making health care 
coverage less affordable for businesses and individuals, and 
undercutting American industry in the global marketplace.
  There is no doubt that America has the finest health care 
professionals, the best hospitals and the most creative medical 
researchers in the world. But having the best components is no 
guarantee of success for the health care system as a whole.
  In the amount of money spent on health care per person, America is 
first in the world by a large margin. By that standard, we spend 49 
percent more than the Swiss, 88 percent more than the Germans, 150 
percent more than the British, and 160 more than the Japanese. Despite 
this enormons expenditure, America's health care system fails all too 
often to deliver quality health care. Among the world's leading 
industrialized countries, the United States ranks only 22nd in average 
life expectancy and 25th in infant mortality.
  The most significant difference between the American health care 
system and those of our economic competitors is that these other 
nations regard health as a right, not a privilege. They make certain 
that their citizens have access to good health care. By establishing a 
national system of care, they have been able to hold down costs and 
keep quality high.
  In the United States, we have refused to commit to quality health 
care for all Americans.
  As a result, those who can afford the best care receive it, but 
millions of other Americans are left by the wayside.
  Because of our fractured system of care, America's health care system 
is the most economically inefficient in the industrial world. The 
administrative costs alone of our system are nearly double those of 
Canada. Reducing our administrative costs to the low level of the 
Canadian system would save about $250 billion every year.
  The difference between the way health care is financed in Canada and 
the U.S. saves the Canadian auto industry $4.00 an hour in worker 
compensation compared to the U.S. The Canadian branches of the big 
three automakers have released a joint letter with the Canadian Auto 
Workers Union stating that the Canadian system is a ``strategic 
advantage for Canada'' and ``has been an important ingredient'' in the 
success of Canada's ``most important export industry.''
  Wise investments have helped contain health care costs here at home 
too. Since 1996, costs per patient in the Veterans medical system have 
actually decreased 7 percent, while private sector costs per patient 
have increased by 62 percent. The VA system did not achieve these 
savings by stinting on patient care or denying needed services. The VA 
has been widely praised for improving its quality of care through 
investments in information technology and a strong commitment to 
quality for all.

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  As a result of America's failure to focus on comprehensive care and 
cost reduction, costs are soaring out of control. Health care premiums 
have gone up over 70 percent in the last five years--over 5 times the 
overall rate of inflation in the economy. More and more small 
businesses can't afford to offer health care to their employees.
  Health care costs mean that working Americans who have health 
coverage through their job are increasingly worried that their employer 
will eliminate the coverage on which they rely. Those who obtain 
coverage on the individual market must often pay huge premiums and 
accept large gaps in their coverage if they have any history of 
illness, no matter how slight. Many cannot obtain coverage at any 
price.
  Even those who have health insurance have little security. Millions 
of Americans have seen health care costs eat away their savings and cut 
into their paychecks more and more every year.
  Since the year 2000, the average cost of a family health insurance 
policy has increased by over $4,500, so that it now costs the average 
family nearly $11,000 for a health care policy. Family earnings have 
not kept pace. According to the Kaiser Family Foundation, health 
insurance premiums climbed by 73 percent over the last five years--but 
earnings increased only 15 percent.
  The costs keep climbing higher and higher. Almost one in five working 
families have seen their premiums go up over 15 percent--and one in ten 
have faced increases over 20 percent.
  These out-of-control costs are devastating for both individuals and 
businesses. Working families often face the agonizing choice between 
paying for health insurance and paying rent or buying groceries. Or 
they compromise by buying a meager insurance policy that provides 
little refuge when big danger strikes.
  It's no wonder that unpaid medical bills cause nearly half the 
bankruptcies in America.
  It's no wonder that practically every business leader in America 
cites rising health care costs as a top concern. When General Motors 
has to spend more on health care than it does on steel, it's time for a 
change. When ten percent of the total cost of a ton of steel 
manufactured in the United States is consumed by retiree health 
benefits alone, it's time for a change. When Starbucks spends more on 
health care than it does on coffee, it's time for a change.
  In world markets, American businesses have to compete with foreign 
firms whose health costs are heavily subsidized by the government. 
American workers are the best in the world, but we give other nations 
an unfair advantage, because we refuse to enact long overdue policies 
to reduce health costs and ease the heavy burden of health care for 
American employees.
  To say that this Administration and its Republican allies in Congress 
have stood idly by as this crisis has worsened would be untrue. To say 
they have taken no action as 3,000 more Americans have become uninsured 
during every single day of the Bush Administration would be inaccurate. 
They have taken action--by making the health care crisis worse.
  Tomorrow, the House of Representatives will vote on a budget bill 
that will make the health care crisis worse for the 50 million 
Americans for whom Medicaid is literally the difference between life or 
death. The Republican bill makes them pay more and more for the health 
care on which their lives depend. I urge the House to reject these 
distorted priorities.
  Currently, communities across the nation are struggling to cope with 
the disaster caused by the Republican Medicare drug ``plan''. Millions 
of seniors have faced a baffling array of choices, instead of the 
certainty of Medicare in getting the medications they need. Millions of 
persons with disabilities, or those facing the challenge of HIV/AIDS or 
living with mental illnesses have been denied the prescriptions they 
require, or have been told to pay exorbitant fees by the insurance 
companies that Republicans put in charge of the drug benefit. Try 
telling those who have been denied their medicines that they are in 
charge of their health care.
  Tonight, the President will try to make the American people believe 
that the solution to rising health costs is to shift more and more of 
those costs to patients, or to deny care to those in need. That's the 
wrong prescription for health care.
  The President's proposal will let the wealthiest Americans rack up 
billions of dollars in tax giveaways, while shifting the costs of 
health care to working families and those least able to pay.

  Our people deserve true health care reform--not gimmicks and 
giveaways that worsen the crisis. They deserve a guarantee that when 
they get sick, they'll be able to obtain decent health care at a price 
they can afford.
  Medicare has meant quality health care for millions of senior 
citizens for forty years. The time has come to make Medicare available 
to every American who wants to enroll in it. It's the best way to bring 
the enormous promise of this new century of the life sciences to every 
American.
  America's failure to guarantee the basic right to health care for all 
its citizens was one of the great public policy failures of the 20th 
century, and we must not allow that failure to continue in this new 
century.
  There is a better way. Our goal should be an America where no citizen 
of any age fears the cost of health care, and no employer stops 
creating jobs because of the high cost of providing health insurance.
  We should build on the tried and true and trusted model of Medicare. 
Administrative costs are low, patient satisfaction is high, and 
patients have the right to choose any doctor and hospital they think is 
best--not the one an insurance company thinks is best for them.
  Today I am introducing legislation to extend Medicare to all 
Americans, from birth to the end of life. Those who prefer private 
insurance can choose any of the plans offered to members of Congress 
and the President. I call this approach Medicare for All, because it 
will free all Americans from the fear of medical expenses and enable 
them to seek the best possible care when illness strikes. Nothing is 
more cynical than a Member of Congress who gives a speech denouncing 
health care for all, then goes off to see his doctor for a visit paid 
for by the Federal Employees Health Benefit Plan.
  To ease the transition, Medicare for All will be phased in by age 
group, starting with those 55-65 years old and children up to the age 
of 20.
  The plan contains a number of provisions to reduce costs and improve 
quality, including more effective use of health information technology. 
It also puts new emphasis on preventive care, because preventing 
illness before it occurs is always better and less expensive than 
treating patients after they become ill.
  My proposal will be entirely voluntary. Any American who wishes to 
stay in their current employer-sponsored plan can do so, and employers 
can tailor their health plans to provide additional services to their 
employees that wrap around Medicare coverage.
  As we implement this reform, financing must be a shared 
responsibility. All will benefit, and all should contribute. Payroll 
taxes should be part of the financing, but so should general revenues, 
to make the financing as progressive as possible.
  We can offset a large part of the expense by a single giant step--
bringing health care into the modem age of information technology. By 
moving to electronic medical records for all Americans when they go to 
the hospital or their doctor, we can save hundreds of billions of 
dollars a year in administrative costs while improving the quality of 
care. Equally important, we should pay for health care based on value 
and results, not just the number of procedures performed or days in a 
hospital bed.
  We all know that Medicare is one of the most successful social 
programs ever enacted. It makes no sense to make it available only to 
senior citizens. I have no doubt that if we were enacting Medicare 
today, we would not limit its benefits to seniors. The need for good 
health coverage is as urgent today for all Americans as it was for 
senior citizens 40 years ago, when Medicare was first enacted.
  The battle to achieve Medicare for All will not be easy. Powerful 
interests will strongly oppose it, because they profit immensely from 
the status quo. But no battle worth fighting is easy--and the struggle 
to fulfill the promise

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of this century of the life sciences for all our citizens is as worthy 
as any in American history.
  I urge my colleagues to make good on the promise of America, and see 
that all our citizens receive the quality health care that should be 
their birthright. I urge the Senate to support Medicare for All.

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