[Congressional Record Volume 153, Number 19 (Wednesday, January 31, 2007)]
[Senate]
[Pages S1363-S1364]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         HEALTH CARE IN AMERICA

  Mr. WYDEN. Mr. President, it is not breaking news that the American 
health care system is broken, even though our country has scores of 
dedicated and talented health care providers. It isn't breaking news 
that Congress has ducked fixing health care since 1994.

  What should be breaking news is that for the first time in decades 
there is a genuine opportunity for Democrats and Republicans to work 
together to fix American health care.
  A few days ago in his State of the Union Address, the President put 
forward a health care reform proposal that focuses on changing the 
Federal Tax Code. Since then, leading Democratic and Republican 
economists have joined forces to point out how Federal health care tax 
rules benefit the most affluent among us, and subsidize inefficiency as 
well.
  For example, right now under the Federal Tax Code, a high-flying CEO 
can write off the cost on their Federal taxes of going out and getting 
a designer smile while a hard-working gal in a small hardware store in 
Montana, Oregon, or anywhere else in the country, gets virtually 
nothing.
  I am of the view that Democrats and Republicans should work together 
to change this inequity and make sure that all of our citizens have 
affordable, quality, private health care coverage with private sector 
choices--the way Members of Congress do.
  The Federal Tax Code and its policies have disproportionately 
rewarded the affluent. They came about because of what happened in the 
1940s when there were wage and price controls. These policies might 
have worked for the 1940s, but they are clearly not right 60 years 
later. Democrats and Republicans can work together to change the 
Federal tax rules that grease the system and disproportionally reward 
the most affluent and subsidize inefficiency.
  In return for those on the Democratic side of the aisle supporting a 
change in Federal health tax rules and coverage through private sector 
choices, the President and Republicans should join with Democrats and 
independent health experts of all political philosophies who say to fix 
health care we have to cover everybody for essential benefits. What is 
very clear now on health care is if we do not cover everybody--and not 
for Cadillac coverage, but for the essentials--our country will always 
have a health care system where those who have no coverage have their 
costs transferred to people who do have coverage. Every night in 
Montana, Oregon, and elsewhere in our country we have folks in hospital 
emergency rooms because they have not been able to get good outpatient 
health care, and the costs for folks in hospital emergency rooms who 
cannot pay get transferred to people who can pay. Many health care 
experts have theorized that perhaps up to 20 percent of the premium 
paid by people who have coverage is because of the costs for caring for 
those without coverage.
  At this point in the debate, Democrats can say that Federal tax rules 
are inequitable with respect to health care and we can use private 
sector choices. My hope is Republicans will say to fix health care we 
have to have a system that covers everybody. Democrats and Republicans 
can come together to make that case.
  There are other areas where we can find common ground right now 
between the political parties on health care. For example, Democrats 
and Republicans in the Senate think we ought to give a broad berth to 
the States to innovate in the health care area. Surely what works in 
the State of Montana may not necessarily work in Florida, Iowa, or New 
York. They say, ``Let's give a broad berth to the States to show 
innovative approaches.'' Particularly Governor Schwarzenegger and 
Governor Romney deserve a lot of credit for being willing to lead at 
the State level. In my State, folks have some innovative ideas, as 
well. My guess is they do in Montana, elsewhere. We can take steps to 
promote them. I personally don't think the States can do it all because 
the States cannot solve problems they did not create. That is why we 
need to change the Federal health care tax rules. Because of the 
federal tax rules, the Federal Government is the big spender in health 
care. The States cannot do a lot about that. But surely, as part of the 
effort to bring Democrats and Republicans together, we can agree to 
make changes in the Federal health care tax care rules and we can agree 
to get everyone covered. We can also agree there is a lot of common 
ground between Democrats and Republicans, to give States the 
opportunity to innovate.
  Democrats and Republicans, as we look at the possibility of a 
coalition, can join together so we have health care rather than sick 
care. We do not do a lot to promote wellness and prevention in this 
country. Medicare shows that better than anything else. Medicare Part A 
will pay checks for thousands and thousands of dollars of hospital 
expenses. Medicare Part B, on the other hand, the part for outpatient 
services, hardly does anything to reward prevention and wellness. You 
can not even get a break on your premium--the Part B premium, they call 
it--if you help to hold down your blood pressure, cholesterol, stop 
smoking, and that sort of thing. Surely Democrats and Republicans can 
join hands to do more to promote prevention, and to have incentives for 
parents, for example, to get their kids involved in wellness.
  This would not be some kind of national nanny program where we have 
the Federal Government saying, we are going to watch the chip bowl, but 
sensible prevention policies on which Democrats and Republicans can 
agree.
  It also seems to me that Democrats and Republicans can join hands 
with respect to chronic health care and end of life health care. We 
know in the Medicare Program close to 5 percent of the people take 
about 50 percent of the health care dollars because those folks need 
chronic care and because of spending at the end of life. They need 
compassionate health care. We have not thought through policies that 
can bring both Democrats and Republicans together to deal with this 
area of health care where an enormous amount of the money is going.

  For example, to get Medicare's hospice benefits, right now seniors 
have to choose whether they are going to get curative care or hospice 
care. That makes no sense at all. Why should a senior have to give up 
the prospects of getting a cure for their particular illness in order 
to get hospice benefit? Let's not pit the hospice benefit against 
curative care. Let's have Democrats and Republicans work together in 
order to make changes that expand the options available for older 
people.
  The door is open right now. The State of the Union gave new 
visibility to the health care cause. Democrats, such as myself, who 
serve on the Committee on Finance, who will say these Federal health 
care tax rules are inequitable, can join hands with Republicans who 
will say we need to cover everybody and stop the cost shifting. The 
door is open right now if Democrats and Republicans will work together 
in a bipartisan basis.
  Some people are saying it can't be done. They are saying there is too 
much polarization on health care and other big issues. Let's talk about 
it, once again, when there is a Presidential campaign. I send a clear 
message on that point, as well. Of course, this country can put off 
fixing health care once more, as it has done again and again for 60 
years--going back to Harry Truman in the 81st Congress. It was 1945 
when he began to talk about fixing health care. I guess one can argue, 
let's put it off again and have another Presidential campaign where 
people go back and forth on this issue. However, I submit that whoever 
the new President is in 2009--and I am very excited about our 
Democratic candidates--no matter who is the new President--should 
address this issue. However if, heaven forbid, there is a terrorist 
attack early in the new Administration, health care would get put

[[Page S1364]]

off once more. Perhaps we would go for several more years without 
talking about health care reform.
  We have had people working to fix health care in this country for 
years and years, people on both sides of the aisle. On our side of the 
aisle, we have Senator Kennedy. No one has championed the cause of 
fixing health care for as many years as passionately as Senator 
Kennedy. Republicans have worked very hard for health care reform, as 
well.
  I hope this question of health care reform is not somehow deferred 
once again until 2009. There is a broad consensus of what needs to be 
done. I outlined four or five areas this morning, starting with 
changing the Federal health care tax rules and making sure there are 
good private sector choices for Americans, getting everyone covered, 
and emphasizing prevention and wellness. That alone would be a good 
basis for Democrats and Republicans to start in. Clearly, a system that 
was created in the 1940s ought to be modernized in 2007. As I pointed 
out, the system that came about in the 1940s was a historical accident. 
There were wage and price controls and there was no way to get health 
care to working families other than to say, maybe the employers will 
cover it.
  Today our businesses are up against global competitors that have 
their governments pick up their health care bill. The combination of 
the disadvantage our businesses face, the huge escalation of costs, the 
significant increase in chronic illness, and our rapidly aging 
population means the current system is not sustainable. It is not 
sustainable and that is why we need to act.
  I am so pleased to see the Presiding Officer in the chair, a new 
Senator from Montana, who has lots of good ideas on health care and has 
campaigned on them. I know he and many on both sides of the aisle want 
to fix the system. That is what we got an election certificate to do, 
to work together on the most important issues, not put it off for 
another couple of years and have another Presidential campaign. We need 
to sort it out right now.
  The American people know we ought to have a new focus, on prevention 
rather than sick care. We can work on that now. The American people 
know a lot of the States have innovative approaches. We can help them 
build on it. The American people know the tax system in the health care 
area disproportionately favors the most affluent and does not give a 
break to the working person and it ought to be changed. These are the 
reasons why both sides ought to join hands to do that.
  The time to fix health care is now. There are a variety of proposals 
that have been put before the Congress. I have not even mentioned my 
legislation this morning, the Healthy Americans Act, based on many of 
the principles I have discussed today. I am not wedded to every 
provision or every part of it. It is a piece of legislation that can 
bring folks together. When I introduced it, Andy Stern, the president 
of the Service Employees International Union, 1.8 million members, was 
there, but so was Steve Burd, the CEO of Safeway, with over 200,000 
employees. So was Bob Beall, the CEO of a company with 400 people. So 
was a member of the National Federation of Independent Businesses who 
was from Oregon. He spoke for himself, not for the group. He employs 
eight people. All of these employers said that the legislation would 
work for them.
  Now it is up to us in the Senate. It is up to us, with the door open, 
to get Democrats and Republicans to come together. I certainly have not 
agreed with all the details of the President's proposal, but he has 
given some new visibility to the cause. All sides ought to say, let's 
get going, let's not wait for another campaign for President to go 
forward. Let us do our job now. There is much to work with that can 
bring both political parties together to fix American health care.
  I will be spending a lot of my waking hours on that in the days 
ahead. I look forward to working with both Democrats and Republicans in 
the Senate to get it done.
  I yield the floor and suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. KYL. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Cardin). Without objection, it is so 
ordered.

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