[Congressional Record Volume 153, Number 16 (Friday, January 26, 2007)]
[Senate]
[Pages S1247-S1252]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MINIMUM WAGE AMENDMENT
Mr. BURR. Mr. President, on this brisk day in Washington,
weatherwise, we have had a refreshing debate about minimum wage. I have
listened to the majority leader say that those who have minimum wage
amendments and would like to have votes are, in fact, against raising
the minimum wage. I introduced my amendment yesterday. I highlighted
the wonderful work of Senator Kennedy and Senator Enzi, the managers of
the bill, the fact that we were long overdue for a minimum wage
increase, and that, as a Member of the Senate, I thought it was
important we explore, as we do this, if we can make some changes that
allow us to address other areas.
Now, I happen to be the Senator who offered the amendment--and I
thank my colleagues Senator Coburn and Senator DeMint who are
cosponsors--who suggested this--that with the $2.10 increase we make in
minimum wage, we allow an employer to determine if they want to provide
that increase in wages or in health care benefits.
We have had a debate in this country for years, over the 13 years I
have been here, about the uninsured population and what we need to do.
Here is an opportunity to do something. Here is a real opportunity to
give employers the incentive to provide to the most at-risk minimum
wage workers a health care benefit that can be covered under the
umbrella of health coverage that we, as Members of the Senate and those
of us who work for the Federal Government, actually have that protects
us.
All Americans should have access to quality and affordable health
care. Under our current system, many get health care from their
employer. Let's increase the number of Americans under that umbrella of
coverage and take the opportunity, as we increase the minimum wage
rate, to allow employers to be the ones to do it.
The majority leader has filed a cloture motion on S. 2. Let me
explain exactly what that means. We are going to cut off the ability to
offer amendments on anything non-germane. Anyone listening to the
description of my amendment would have to say, clearly, that is
germane. You will use the $2.10 increase in the minimum wage to allow
employers to offer health care with that $2.10. Now, this is not a shot
at the Parliamentarian of the Senate, but this amendment is not
germane. In filing cloture without an agreement, we
[[Page S1248]]
won't be allowed in the Senate to have a vote on my amendment. I can
come here and sell the merits of my amendment to those across the
country who listen to this and they will say--that makes a tremendous
amount of sense. We want to extend health care to the uninsured. An
excellent way to do that is to use the power of the employer. As an
employer negotiated for the rest of his employees who may not be at the
lower end of his pay scale, he can use the minimum wage workers in the
group rate and access health insurance cheaper than they could as
individuals.
But no, filing cloture means without an agreement the Senate is never
going to have a vote on this. We will be denied the vote because this
is non-germane.
I am not sure where this fits in that open process I heard described.
As a matter of fact, we have actually filed cloture for a bill we have
not even called up, a resolution on Iraq. I guess that means we will
limit our debate on the war, too. Gee, that is a strange one to limit
debate on.
Let me take the time I have today to talk about my amendment. Mr.
President, $2.10; what is that on an annual basis for an individual at
the lowest end of the income scale in America? It is $4,368. Some
people will be opposed to the amendment even though they will not get
an opportunity to vote on it because they will say that is not enough
money. Let me show what it can buy.
Mr. President, $4,300 a year can buy health insurance, 100 percent
for an individual. It can buy almost 50 percent of family coverage.
This is the average as followed by the Kaiser Family Foundation of fee-
for-service insurance: $3,782. I might say that regionally, where you
live in the United States dictates the cost of health insurance, but
this is an average for the United States, fee-for-service, traditional
health care coverage, $3,782; a preferred provider plan, $4,150; a POS
plan, $3,914; and a health maintenance organization, $3,767.
The argument that you cannot provide health care with the $4,368
increase we are giving to a minimum wage worker clearly has been
demonstrated by the Kaiser Foundation to be wrong. You cannot only
provide it as an employer, you can pay 100 percent of it. A minimum
wage worker would not have to put a dime out of their pocket to have
health care coverage that is equal to what a Member of the Senate has.
But when you file cloture, when you limit debate, when you deny a vote,
you have now denied every minimum wage worker in the country of having
an opportunity for their employer to work on behalf of their group to
extend the health care benefit to minimum wage workers: a 100-percent
benefit.
The President and myself--I think we pay 25 percent of our insurance
premium for health care, and that percentage certainly changes,
depending on who you work for. But an employer assumes some percentage.
Some employers pay 100 percent, but it is rare today. Here is an
opportunity to give employers an incentive to provide 100 percent of
the premium cost and still have money left over to provide to their
employees.
I am sure there are people listening to this debate who are saying
this is crazy. If we have 47 million uninsured in this country, how
many of those might fall into this category? The reality is, it is
almost 15 million Americans whose income is $25,000 or less.
The average minimum wage worker today makes a little over $10,000.
The actual national poverty level is a little over $9,000. They are
very close to it for a full 40 hours worth of work.
When we look at 47 million Americans, I am beginning to think we like
that number more for the purposes of debate than as a target or a goal
to solve.
I said at the beginning, I believe all Americans should have access
to quality, affordable health care. My opposition only wants that
access if the Government provides it instead of the private sector.
That was the debate in Part D Medicare when we created the first ever
drug benefit for seniors in this country. And there were two sides,
those who said only the Federal Government can provide this and those
who believed that the private sector could, in fact, negotiate prices--
not just for the price of the drugs but through that, the premiums--
where seniors could be afforded choices.
Today, the majority of Medicare-eligible individuals are signed up
with the Part D prescription drug plan. Much to my amazement, for those
who are incredibly pleased with their plan, the percentage is close to
100 percent because of their choices and those who want to assume more
financial risk out of their pocket and pay a smaller premium can do it.
Those who do not want to pay out of their pocket but want to pay a
higher premium can do that. For every milestone we have seen in Part D,
drug prices have reduced because we have injected competition, premium
prices have reduced because we are now providing drugs to seniors who
are actually taking them.
What does that do to our overall health care system? It means the
more they are taking their medications, the less likely they are to
visit the hospitals. Gee, I wonder if that is applicable to what we are
talking about here? Why are health care costs going so high? Yes, we
have a lot of new technology. That technology allows us to do things in
a noninvasive way. Instead of cracking a chest open and doing a bypass
on somebody's heart because maybe they ate the wrong things for 60
years, now we can go in through their leg, we can go up through their
vein structure, we can put in a stent and we can open and eliminate the
risk of a heart attack. The quality of life is better for them because
the recovery is shorter. In some cases it can be done as an outpatient
procedure. That $70,000 average cost of a heart bypass is reduced
significantly and, consequently, with that, the overall health care
system sees savings.
Imagine if we had not been doing that what the rise in health care
costs would be. Part of health care inflation today--and I suggest it
is a large part--is the cost shift that goes on. What is cost shift?
The Presiding Officer and I have health insurance.
When we go in and access health care, the hospital, the doctor, the
lab, and the pharmacist know they are going to get paid because we give
them an insurance card. There is no question in their mind. They know
exactly what their reimbursement is going to be. If a Medicare
beneficiary at any point accesses health care, that doctor, that
hospital, that lab knows exactly what the reimbursement is they are
going to get from Medicare for the procedure they offer.
But when somebody goes into an emergency room who is uninsured and
they do not pay: What happens to the cost of the procedure they got? It
is real simple. It gets shifted to us. It gets shifted to everybody who
has insurance. And to recover that, everybody's premium in the country
goes up.
So as I stand here and talk about a very specific group, minimum wage
workers in America, what everybody has to understand is what we do on
this issue affects everybody's health care in America. It affects
everybody's premium amount in America. It affects 25 percent of all
Federal employees costs. If you want to drive some costs down in the
Federal Government, it is easy: Let's do this because we will eliminate
a significant part of the cost shifting that is going on in our health
care system in this country.
Studies have shown in order to get individuals to purchase their own
health insurance, tax incentives to individuals need to cover half or
more of their health insurance premium. We are covering 100 percent of
it. Many tax-based health care proposals to help the uninsured are
criticized because they do not meet the threshold of covering half or
more of an individual's health insurance premium. This is the first
time I have ever been criticized because we offered 100 percent of the
premium.
Now, why might other people object to this? Well, quite honestly,
they might say the employees should get wages, not health care. Well,
let me restate what I said at the beginning, so it is clear.
All Americans should have health coverage. Mr. President, 14.6
million Americans make less than $25,000 a year and are uninsured. So
if we are wondering in that pot of 47 million what makes up some of
them, here is 14.6 million of them right here. They make less than
$25,000 a year, and we know for a fact they are uninsured.
[[Page S1249]]
Mr. President, $2.10 a day can buy basic health insurance for a
minimum wage worker. On this chart is a breakdown of millions of
uninsured by household income. You notice that close to the largest
group is shown right here: $25,000 and below.
This amendment is like a laser beam on exactly where we can make a
difference. You see, we are at a real crossroads in America. We have
gotten used to the best health care delivery the world has ever seen.
As a matter of fact, if we tried to import from another country--and I
will not name one because I do not want to offend them--their health
care system into our country, the American people would rebel. They
would not wait. They would not accept half a loaf when they thought
they deserved a whole loaf. That is how our system is.
So if we want to get a handle on this incredible cost of health care,
we have to do two things. We have to provide coverage and we have to
promote prevention and wellness.
You see, if we can teach people how to control disease, then the
number of times they access health care is going to be less. That is
pretty much common sense. The problem is if we cannot create a
relationship between an individual and a health care professional, how
in the world are we ever going to complete the educational process of
what disease management is? How can we teach a diabetic that it is just
as important to get exercise and to have a diet as it is to take their
medication and check their blood sugar?
As a matter of fact, in Asheville, NC, we are in the 10th year of a
project called the Asheville Project, where it has focused specifically
on diabetes. This idea was clearly out of the box because the community
decided, with a grant, they were going to reimburse pharmacists to
counsel diabetes patients.
Think about that: A diabetes patient goes in. They are getting their
medications filled. Now in Asheville, NC, and 10 other locations in the
United States, that diabetes patient will sit down with the pharmacist,
and the pharmacist will look through their drug regimen and make sure
it is correct. They will make sure there is no interaction of different
medications that they are currently taking. They will talk to them
about exercise. They will give them suggestions if they are not getting
exercise. They will check their progress if they are. They will talk to
them about diet. They will actually weigh them. Maybe that is what we
are scared of: If we do this, they will start weighing all of us.
The reality is in Asheville, NC, and these 10 other cities across the
country, there is now data. It is not me. It is the data that proves
they save $2,000 a year per diabetic because we now provide for every
diabetic this intense relationship with a health care professional.
Now, what you have to understand is that in Asheville's case, and
these other areas around the country, this is not the traditional entry
point where we would choose to educate. This is quite creative. As a
matter of fact, we have talked about it, and it has been rejected in
this institution before, that we actually pay pharmacists to do part of
the health care education. I hope it is something we will reexamine
because I think there is tremendous merit to it. It has proven to be
successful.
But what does it prove? It proves that if prevention and wellness are
promoted, there are savings that are derived across the system, and
those savings will drive down premium costs for every American.
Well, how do you get there? You get there by making sure every
American is covered. Mr. President, 14.6 million--that is a real chunk
of people whom we have an opportunity to affect whether they actually
have health care coverage, whether they will actually have the
education they need with a health care professional on disease
management. It could be diabetes; it could be HIV/AIDS. There are a
number of things that fall into the category.
But the reality is, if we miss this opportunity, we will continue to
have 14 million people who will access health care in the emergency
room on an as-needed basis, and the likelihood is, there will be an in-
hospital patient with an average stay of over 3 days. And at the end of
that stay, they probably will not have the money to pay for it, and, in
fact, that will get cost shifted to everybody's insurance across the
country. They do not want to do that; they just do not have the money
to pay for it.
Well, here is an opportunity for them not to be put in a difficult
situation. Here is an opportunity for an individual to have 100 percent
of their insurance--let me go back to that. For an individual, $4,386,
under a traditional PPO, POS, or HMO, pays 100 percent of their premium
costs--better than we get as Senators--and for a family, $9,900,
$11,000, $10,000--$10,000 is the average across the country, based upon
the type of plan you choose. We could pay 50 percent of a family's
health care premium if we allowed employers to use the $2.10 and to
apply it to health care benefits versus wages.
One in five adults age 18 to 64 were uninsured in 2004--one in five
adults. More than 54 percent of the uninsured are in families making
200 percent or less of the Federal poverty guideline. Again, that is
$9,800 a year. Americans living in households with annual incomes below
$25,000 have a higher incidence of no insurance. Mr. President, 24
percent were uninsured in 2004, compared to 15.7 percent of the total
population. You see, this is not just the norm percentage who do not
have insurance; this is almost double the national norm.
Now, why this bill? Why the way we chose to do it? Well, employers
are the centerpiece of health care delivery in the United States today.
They may not be in the future. I am anxious to have that debate.
Personally, I believe a health policy should be like a 401(k) plan. You
should be able to take that health policy with you regardless of where
you go, that when you change employers, you should not have to lose
insurance coverage with a given company and the structure of your plan.
You should have the option to take that with you. So I am sure at some
point this year we will have that debate.
Mr. President, 174 million workers and their dependents received
health coverage through the workplace in 2004. So if you ask yourself,
why am I offering this on the minimum wage bill? it is because 174
million Americans receive their health care coverage via their
employer. We have this excellent opportunity right now, as we talk
about increasing minimum wage, where we can provide the incentive.
I might add, I said the ``option,'' that an employer have the option.
I am not mandating that an employer has to offer health care. There is
a lot of work that goes into a company providing health care for their
employees. They have to meet with plans. They have to negotiate rates.
They have to keep records. There are going to be some employers who do
not provide health care as a benefit, and they may not provide it for
their employees afterwards. But you also have a segment of America that
is minimum wage workers where companies would like to find a way for
those folks to stay with them versus to leave for a nickel-an-hour or a
dime-an-hour increase by somebody else.
I can tell you, if you offer them 100 percent of their health care,
then somebody is going to have to bid very high if, in fact, they are
not providing health care, too.
Workers, and especially low-income workers, feel more comfortable
with their employers negotiating health care benefits than going into
the individual market and purchasing it themselves. Why? It is real
simple. It is because an employer negotiates volume. When I walk in,
they see one individual, and they know I must be uninsured, if I am in
there to buy health care, and the likelihood is they are never going to
pull that sheet out of the middle drawer that says ``discounts.'' I
will never receive a discount as an individual.
And oddly enough, in this country, I have to say--and this is wrong--
the lower your income, the more the actuaries look at you and determine
you are going to cost more. It is 100-percent wrong. And part of it is
the structure of our model in this country: that we seldom promote
wellness and prevention. I do not care where your income level is, if
you provide those individuals with the tools they need, they are as
healthy as the person next to them. What these folks do not have,
because they do not have coverage, is they have
[[Page S1250]]
no relationship with a health care professional. And that health care
professional could be a primary care doctor; it could be a nurse; it
could be a hospital; it could be a community health center; it could be
a rural health clinic. And in the case of Asheville, NC, it could be a
pharmacist in a very targeted program.
More than 8 out of 10 of the uninsured are in working families. I am
not talking about isolated individuals. I am picking these folks and
not suggesting that we are doing something that just affects
individuals. These are families. That is why when I talk about the
family piece, think about a family that has never had health insurance
for their children. Think about when they go in and their employer
says: You know, we have this new requirement that we have to raise the
minimum wage $2.10. But I will offer you 50 percent of your health care
premium for your entire family, your wife and your children. It is
going to be in place until your children get out of college. Maybe that
will give them an incentive to encourage those kids to graduate from
high school and to consider higher education as part of their future.
Six out of ten uninsured individuals have at least one family member
working full time year-round. This is a huge population we are talking
about affecting with this amendment. In 2002, 42 percent of wage and
salary workers, age 18 to 64, were not offered health coverage through
their employers. Here is a tremendous opportunity, as we do something
that I have said I will support, and I doubt it will receive very many
votes in opposition--here is an opportunity for the Congress to
significantly affect the uninsured. But I remind everybody, we are not
going to have an opportunity to vote on this amendment. It is so timely
that I would come to the floor, I would wait my turn to talk about an
amendment that I couldn't talk about the other day because the
leadership was in a hurry. So I called up my amendment so it would be
pending--pending means that it should get a vote before cloture would
be filed--only to find out from the majority leader when he stood, I
think he referred to my amendment as ``silly.''
I don't think it is silly. It may be non-germane, but the health
insurance of minimum wage workers is not silly. As a matter of fact, it
is crucial to the health care change that we have to accomplish in this
country if, in fact, we are going to keep health care affordable for
all Americans, not just some Americans.
Let me talk about employers and employees. I believe my amendment is
a win-win. I challenge any Member of the Senate to tell me who loses.
Think about it. An employer is able to negotiate for minimum wage
workers at the group rate which means he might be able to negotiate,
because he is putting more people in the pool, an even lower cost for
his overall workforce than he had before. He is able to offer his
employees health care which his competitor might not. His employees
have a tendency, then, to stay with him longer because we all know that
there is a cost that is incurred by an employer, an investment to train
them, an investment to have them in the business. And the last thing
they want to do is see minimum wage workers that work a month or 2 or 6
months and keep moving from employer to employer. And by the way, the
one thing they don't have control over as an employer is the days that
employees call in because they are sick. Those are days that the
employer is planning on getting something done. That minimum wage
worker, because they are now sick, picks up the phone and says: I can't
be there.
Maybe if we get them covered by insurance, maybe if they actually go
for prevention and wellness education, maybe if they learn through that
health relationship the things they should do and should not do, maybe
they are not going to be picking up the phone and calling in and
saying: I will not be there.
The employers lose on those days, but the employees lose on those
days, too, because this is a minimum wage worker. They are paid by the
hour. They are only paid when they are there. Provide them health care,
enable them not to make that phone call, the employer doesn't have a
disruption in his business, and the employee doesn't have a subtraction
in his paycheck. This is truly a win-win for employees and employers.
Employers will spend less time and less money overall by providing
the $2.10 increase in health benefits. Let me restate that. Employers
will spend less money overall by providing it in health benefits. Why?
Because they buy in bulk. What does that mean? It is more bang for the
buck. They are able to get more benefit for a smaller amount of
dollars. That means that when they go and negotiate the structure of a
plan, they could negotiate something that had an even richer benefit,
maybe no out-of-pocket cost, maybe no copayment for drugs because they
have another $500 there with which they can negotiate. Employers get
the same deduction in calculating taxable income, if they provide
compensation in the form of health benefits or compensation in the form
of wages and salaries.
We all know because we have gone through part of the debate that when
employers and employees are covered by health insurance, that is done
with pretax wages.
My point is, the tax implication on the minimum wage worker does not
go up. They get the same advantage that we have, that their health
benefits are not only deductible for the employer, but they can access
some pretax dollars to do it.
To deny a vote on this amendment is to not give minimum wage workers
the same thing we have. Sure, there is a discrepancy in the difference
that you make and I make and they make, but now we are talking about
fairness from the standpoint of benefits. We have an opportunity to
change that. And because we are in such a hurry in the Senate and
because the majority leader is tired of people offering amendments--I
think all of them have merit. I haven't seen any that I thought were
for the purposes of delay. As a matter of fact, I would be for moving
to wrap up this bill tomorrow if the majority leader would say I could
have a vote on this amendment. He is not going to give me a vote. You
can use the Senate rules to make sure that votes don't happen. And
maybe I could have designed this in a way that it was germane. But
sometimes the best things are simple. Sometimes when you lay it out in
a way that people across the country, especially minimum wage workers,
understand, it is better for them. We could hide it and make it
confusing and make it to where employers possibly couldn't provide
everything that they could. But we decided to leave it simple.
What might be another objection to this bill? Well, can employers
truly implement this process. Let me go to another chart. I think you
have heard me say most of this except for the last one: Some coverage
is better than no coverage. Will every employer get it right? Probably
not. Will every employer get as much bang for the buck as they possibly
can? Maybe not. Some coverage is better than no coverage. You have
heard the percentages about the population that are at the income
levels that minimum wage workers are. If you only believed that this
amendment would provide some coverage, then you have to agree with me
that is better than no coverage.
Under our current health care system, employees will be better off
with health care coverage through their employers because employers get
better pricing. If they don't or they can't, then I know what is going
to happen. They are going to offer it in wages. But should we deny them
the opportunity to try to help us solve part of the health care problem
that we have in America, and that is the uninsured that are here?
I said earlier that I thought all Americans had a stake in this
amendment because it is their health care premium that is affected by
every health care policy we take up. When we add additional mandates
for coverage, we drive up premium costs. When the American people
exercise, watch what they eat, they help us to moderate health care
costs and premium costs. Health insurance, even the most basic health
insurance, gives people access to a system of health care, that
relationship with a health care professional, that primary care doctor,
the prevention and wellness programs, routine testing for chronic
diseases that keep them out of a hospital.
[[Page S1251]]
I want to relate a story. I won't mention the company. Well, I will
mention the company: Dell computers. I think it is important that you
understand that they are in one of the most competitive industries in
the world. I daresay I don't think anybody is going to wake up tomorrow
and say: I think I will get into computer manufacturing because there
is so much money to be made. Everybody globally is in computer assembly
and manufacturing. Dell does it the best. I don't say that just because
they have a plant in North Carolina. I say it because the experts say
that.
I might also say, since Lenovo has a plant in North Carolina, they do
a pretty good job, too. But Dell recognized one day that if they wanted
to be competitive in this highly competitive industry of computers,
they had to do something about health care. They were self-insured.
They had already taken the first step. They assumed a lot of the risk
as a company to drive down the cost of their health care for employees
and, consequently, for the company. What did Dell find out?
Dell tried to make available prevention tools for their employees. If
they were overweight, they would give them a dietician to work with
them. If they had diabetes, they would give them somebody who could
counsel them about diabetes. If they smoked, they paid for a cessation
program. What happened? Less than 10 percent of the Dell employees who
were affected by these things took advantage of the program. Less than
10 percent of them signed up to receive the help.
Any other corporation in America might have said: I will just accept
the fact that we are going to have this high health insurance. But Dell
realized: We are still making computers. And if we can't fix this, we
are not going to be competitive.
What did they do? Dell offered employees up to $250 cash if they
would sign up for the program. I will tell my colleagues, the American
people respond to money. They do respond to money. All of a sudden, the
enrollment in these plans went sky high. Today, some 5 or 6 years later
Dell computers can prove that they save about $1,700 for every employee
who goes into that program. Those numbers may have changed since the
last time I met with them.
My point is this: Everywhere we looked--private sector, public,
individual, group--where we have been brave enough to go out and do it
differently, where we have been brave enough to force prevention and
wellness into the system, it works. It works for the employee and for
the employer. It is job security because they are more competitive. And
every American receives the benefit of it because there is less cost
shift in the system.
Let me bring it back to where we are. All Americans should have
health coverage. We have this unique opportunity, as we debate the
opportunity for minimum wage workers to receive a $2.10 raise over a
period of time, to give the option to every employer to provide that
$2.10 increase in health care benefits versus in wages. And the Kaiser
Foundation's health research proves that, for an individual, regardless
of whether it is traditional fee-for-service insurance, point-of-
service, or health maintenance organization, that $4,368 a year pays
100 percent of the premium cost for that minimum wage worker, which is
a higher percentage than a Member of the Senate is paid for by the
Federal Government. That means a minimum wage worker is not required,
such as I am, to pay 25 percent of their health care cost, but they
would get 100 percent. If, in fact, their family is uninsured, which
the majority of them are, the Kaiser Family Foundation says the average
for family coverage--wife, kids, unlimited--that an employer for a
minimum wage worker can provide is almost 50 percent of the premium
cost.
This is a tremendous opportunity, from a standpoint of health care
policy, that I so hope we are not going to miss the opportunity to do.
But if my colleagues on both sides of the aisle allow debate to be shut
down without an agreement from the majority leader that he is going to
allow a vote--the only reason I can see not to have a vote is because
nobody has figured out how to put a second-degree amendment on it. It
is too simple. Procedurally, if they can kill it, they would.
In North Carolina, Mr. President, there are 1.3 million uninsured
individuals; 17 percent of my State's population is uninsured, compared
to the national average of 16 percent. So, listen, I feel bad. I wish
to see North Carolina do better. As a matter of fact, we have probably
more waivers in health care than any State in the country right now,
from Medicaid to the soon-to-be dual eligibles under Medicare because
we are trying to lower the costs for everybody by being creative as to
how we do it. I will tell you this: In North Carolina, the centerpiece
of our success is two words: Prevention and wellness. When we are able
to establish a relationship with a health care professional, we now
have an opportunity to bring prevention and wellness into every
person's health care regimen. I am convinced this is absolutely crucial
to the future of health care in this country and to the affordability
of health care for the future.
Eight hundred and ninety eight thousand uninsured individuals and
families are on their own with one full-time worker in North Carolina.
So when I said 1.3 million uninsured, understand that almost 900,000 of
them are in families--families who could get 50 percent of their
premium paid for by their employer, if we gave the employer the option
of providing health care versus being forced only to provide wages.
In North Carolina, we have 204,360 uninsured part-time workers. That
means they are not going to work 40 hours. So maybe they are only going
to work 20 hours, and instead of getting $4,368, they are going to get
a little over $2,000. Well, even those part-time workers--uninsured
part-time workers--if they are earning minimum wage under this program,
as much as 50 or 60 percent of the premium of their health care could
be paid for. So it is not limited to full-time workers.
It is too simple. It is way too simple. Everybody in the country gets
it. Why doesn't the Senate get it? How can anybody look at this and say
we should not do it? It is easy. The Senate rules allow you to not have
a vote. I am not trying to delay; I am trying to make the bill better.
I am trying to learn from what we are learning all across the country--
that there are smart people outside Washington who are in companies, in
States, who are involved in the health care system, and we have a real
opportunity to take what they have been telling us and apply it to the
most at-risk group of Americans, which are the minimum wage workers.
I have always shrugged it off when somebody came up to me and said:
Gee, do you guys ever listen in Washington? Do you pay attention to
what is going on? Because I thought we did. I do. But, you know, what I
am learning today is that ``we'' don't. You cannot come on the floor of
the Senate day after day and talk about the uninsured population and
how we have an obligation to take care of it, and here is a real
opportunity to do it--and what is the majority's answer? We are not
going to let you vote because we think you are trying to delay.
I am not trying to delay, I say to the majority leader; I am trying
to provide health care for minimum wage workers--for maybe 14.6 million
people in this country. You know, the sad part is, even if I get this
done, there are still 30 million Americans who are uninsured. Maybe the
fear is that it will work. Maybe they will find out that when these
guys get insurance, they are no longer going to be sick. Maybe they are
worried we are going to find out that if they are not sick, our
insurance will go down and every American's insurance will go down.
Health care continuously ranks as one of the top issues in this
country. I have devoted 13 years now to understanding health care to
the degree that I feel like I can walk into an operating room and do a
procedure, even without staying at a Holiday Inn Express. But, you
know, we are not listening to them. We are not listening to doctors,
nurses, community health centers or rural health clinics. And I can
tell you this: We are not listening to the American people. We are not
doing what we can to provide the opportunity for health care coverage
to be extended to them. Do you know what? People with high health care
costs, in the absence of having to spend that on health care, are not
going to spend it in other areas. It is those other areas that create
jobs. It is the groceries, it is the
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gas, those things they pick up on the way home to eat that fuels our
restaurants.
If you want to have good balance and growth in the economy, if you
want Americans to be at work, if you want this country to prosper, this
is a piece of it. This is a piece to make sure Americans have health
care coverage. I am confident this is not the last time we are going to
have this debate this year. We will have a debate, and it will actually
be considered germane. I have wondered for the time I sat and listened
to the majority leader, what will be the excuse then? Maybe it is
because it wasn't their idea. Maybe it is because they would like to
wrap it into something bigger.
Well, as I said, 13 years after I have worked on health care--and I
see my colleague from Iowa and I know he wants to speak, and I will
wrap up, and I don't know anybody who has devoted much more to health
care than he has. This is a real opportunity, Mr. President. It is an
opportunity for the Senate to actually do something on health care
versus sitting on the floor and talking about it. As it stands right
now, this opportunity for minimum wage workers in America will not
happen because the Senate will be denied the opportunity to vote as to
whether they would like this to be part of the plan. Again, I am sure
it is difficult for America to believe that this is not germane to the
minimum wage bill, as it was to me. But I am not here to battle the
interpretation of the Parliamentarian; I am here to suggest to you that
one of the reasons we are here is we are supposed to do what is right.
We are supposed to pay attention to what is going on across the
country, and we are supposed to do what is right to fix it.
I ask you to think that I am doing something right today. I could
walk away having a vote where I didn't win. But not getting the
opportunity to have a vote cheats America out of the opportunity to
begin to turn around our health care system. I hope that between now
and Tuesday with the cloture vote, Members on both sides of the aisle
will have an opportunity to look at this vote and to encourage the
majority leader to allow us to have a vote and, if not, to encourage
him to vitiate the cloture vote and allow us to talk some more.
This is important. We ought to spend time talking about major policy
shifts. For the 10 years I spent in the House of Representatives, I
dreamed of the fact that I could come to this floor, with the
tremendous thought and debate that goes into the work here--I am not
going to tell you I am disillusioned, but I can tell you this: To take
something of this importance and to suggest we are not going to vote on
it, or to suggest that when we are talking about ways we can improve a
bill, we haven't got time to sit and debate this, that is not the
Senate I envisioned before I got here.
That is not the deliberative process, the open and balanced and
thoughtful Senate I used to see from the other end of the Capitol. It
is my hope that, as we move forward, we will be allowed the opportunity
to debate this more. Hopefully, we will be allowed to vote up or down
on it. As I said, if I lose, I will save the debate for another day and
another bill. We are going to have an opportunity to debate health
care, I know. We are going to find more things to agree on than we
disagree on. I never envisioned the Senate saying that because this is
a tough vote we are not going to take it.
This vote is not near as tough as the fact that 14 million Americans,
who are, in all likelihood, minimum wage workers, could have the option
of health care if we did this and are not going to have health care if
we don't vote. That is not silly, and it is not a delaying tactic; it
is policy.
I yield the floor.
The PRESIDING OFFICER (Mr. Webb). The Senator from Iowa.
Mr. HARKIN. Mr. President, I thank my friend from North Carolina for
his timely speech. He knows what I mean by that. I didn't hear all of
his remarks, but I did catch the tail end of them, and I think I get
the import of his remarks, which is basically that we need to do
something about health care in America. We need to debate it, discuss
it, vote on it. But to the extent somehow some kind of blame is being
laid at the step of those of us on this side of the aisle--after all,
we just took over the Senate about 3 weeks ago--I remind my friend from
North Carolina that his party has been in charge for the last several
years, and they have had the White House. We haven't seen anything come
from the White House, nor have we seen anything come out of the
Congress to deal with this over the last several years.
Be that as it may, I say to my friend from North Carolina, the
President put forward a proposal in his State of the Union Message. We
will see what the budget looks like when it comes down next week. I
join with him. I hope we will have a good debate and discussion. It is
the most important issue we have confronting our society today. But it
is not just, I say to my friend from North Carolina, the issue of how
we pay the bills and how we pay for people who get sick. The issue is
preventive medicine. How do we make prevention pay? How do we make
prevention the incentive? How do we incentivize prevention?
I noticed a full-page ad in the Washington Post this week and also in
the New York Times talking about prevention is the answer. If we really
want to get a handle on cutting down the cost of health care in
America, just jiggling how you pay the bills is not going to be the
answer. We have to get in front of this issue and make an incentive for
people to live a healthier lifestyle, for businesses to provide
workplace settings that are healthy, helping to make sure people get
their physicals, annual checkups, mammogram screenings, cutting down on
smoking, making sure that our schools also teach kids at the earliest
age what it means to stay healthy. We are building elementary schools
in America now without playgrounds. What kind of nonsense is that?
So our whole thrust on this health care issue, I say to my friend
from North Carolina, we always just keep focusing on how we are going
to pay the bills. That is a problem, obviously, but if we want to get
out ahead of it, we have to start focusing on preventive medicine. I
look forward to that debate hopefully soon.
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