[Congressional Record Volume 154, Number 159 (Wednesday, October 1, 2008)]
[Senate]
[Pages S10337-S10338]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. CLINTON:
  S. 3674. A bill to amend the Public Health Service Act to establish a 
Wellness Trust; to the Committee on Health, Education, Labor, and 
Pensions.
  Mrs. CLINTON. Mr. President, reforming the healthcare system is a top 
priority for me. I have been on the frontlines in the fight for 
healthcare for every single American for as long as I have been in 
public service. And every passing day, and year, the task becomes both 
more urgent and more difficult--success more expensive and failure more 
costly.
  The United States spent about $2.1 trillion on healthcare in 2006, 
twice what we spent 10 years ago, and half of what we're projected to 
spend 10 years from now. Preventable and chronic diseases are this 
century's epidemic. The number of people with chronic conditions is 
rapidly increasing and it is estimated that if we do not intervene now, 
by 2025 nearly half of the population will suffer from at least one 
chronic disease.
  The wellness gap also affects health care costs. About 78 percent of 
all health spending in the United States is attributable to chronic 
illness, much of which is preventable. Chronic diseases cost the United 
States an additional $1 trillion each year in lost productivity, and 
are a major contributing factor to the overall poor health that is 
placing the Nation's economic security and competitiveness in jeopardy.
  Unlike some health care challenges, proven preventive services and 
programs exist. If effective risk reduction were implemented and 
sustained, by 2015 the death rate due to cancer could drop by 29 
percent. Improved blood sugar control for people with diabetes could 
reduce the risk for eye disease, kidney disease, and nerve disease by 
40 percent. Similarly, blood pressure control could reduce the risk for 
heart disease and stroke by 33 to 50 percent. Yet, only half of 
recommended clinical preventive services are provided to adults. About 
20 percent of children do not receive all recommended immunizations, 
with higher rates in certain areas. Nearly 70 percent of people with 
high blood pressure do not now control it. And racial disparities in 
the use of prevention exist.
  The country faces low use of preventive services because of the low 
value placed on prevention, a delivery system bent toward fixing rather 
than preventing problems, and financial disincentives for prevention. 
Insurers have little incentive to invest in preventive services today 
that will benefit other insurers tomorrow. This is especially true for 
those preventive services that reduce chronic diseases that develop 
over a period of several years or decades. The costs of prevention are 
incurred immediately but most of its benefits are realized later, often 
by Medicare. The United States spends only an estimated 1 to 3 percent 
of national health expenditures on preventive healthcare services and 
health promotion.
  In addition, the workforce to deliver prevention is also 
insufficient. The supply of providers who are trained to emphasize 
prevention is shrinking. Between 1997 and 2005, the number of medical 
school graduates entering family practice residencies dropped by 50 
percent. There is an acute shortage of community health workers. 
Between 25 and 50 percent of the existing Federal, State and local 
public health workforce is eligible for retirement in the next 5 years. 
Today, more than 75 percent of the existing public health workforce has 
no formal public health or prevention training. There is no national, 
uniform credentialing system for public health or prevention workers 
that would ensure that these workers are trained in the basics of 
preventive care.
  A system that promoted full use of high-priority prevention could 
save lives and reduce costs. For example, complete, routine childhood 
vaccination could save up to $40 billion in direct and societal costs 
over time. Promoting screenings and behavioral modifications in the 
workplace can lower absenteeism and, in most cases, health costs to 
firms. Preventive health care services could reduce government spending 
on health care. If all seniors recommended to received a flu vaccine 
did, health costs could be reduced by nearly $1 billion per year. Over 
25 years, Medicare could save an estimated $890 billion from effective 
control of hypertension, and $1 trillion from returning to levels of 
obesity observed in the 1980s.
  So today, I am pleased to introduce The 21st Century Wellness Trust 
Act. This legislation is a critical part of the broader effort we will 
undertake next Congress to cover every single American and bring 
reforms to our delivery system that make it more efficient and improve 
health outcomes.
  The 21st Century Wellness Trust Act would create a Wellness Trust at 
the Centers for Disease Control and Prevention at the Department of 
Health and Human Services to refocus the efforts of our healthcare 
system on prevention and wellness. Through the Trust Fund Board, the 
Wellness Trust will become the primary payer for priority prevention 
services, as well as ensure an adequate and appropriately trained and 
credentialed prevention health workforce. The Trust will also serve as 
a central source of prevention information and ensure the inclusion of 
prevention and wellness in the development of a nationwide, 
interoperable health IT infrastructure.
  We cannot afford to wait any longer and I am proud to introduce The 
21st Century Wellness Trust Act which will be an important part of the 
solution. We must undertake reforms that move us from a system of 
sickness to a system of wellness. From a system that is tilted towards 
institutional and emergency care to one that not only covers everyone, 
but is designed to promote prevention of disease and wellness.

[[Page S10338]]

      By Mr. KERRY:
  S. 3675. A bill to amend the Internal Revenue Code of 1986 to provide 
for the treatment of certain excessive employee remuneration, and for 
other purposes; to the Committee on Finance.
  Mr. KERRY. Mr. President, today I am introducing the Compensation 
Fairness Act of 2008 to tighten the rules for the amount of 
compensation that is deductible as an ordinary and necessary business 
expense. The recent financial crisis has brought the issue of executive 
compensation to the forefront.
  We have all read about the outrageous salaries that many of the chief 
executive officers of troubled companies have earned over the past few 
years. Some have increased their pay by increasing the risks their 
companies take. According to Equilar, a compensation research firm, the 
CEOs of the 10 largest financial services firms in a survey of 200 
companies with revenues of at least $6.5 billion were awarded a 
combined total of $320 million last year, even though the firms 
reported mortgage-related losses that totaled $55 billion and that 
wiped out more than $200 billion in shareholder value. That is 
unacceptable.
  It is not just the financial industry where executive pay has become 
excessive. For 2006, the CEOs of large U.S. companies averaged $10.8 
million in total compensation, more than 364 times the pay of the 
average U.S. worker. We can learn from what led us to the current 
situation and one way to make CEOs more accountable is to limit the 
taxpayer subsidy for executive compensation.
  I am pleased that the bailout legislation places limits on the 
executive compensation of the firms that participate in the Treasury 
program. I commend Chairmen Dodd and Baucus for their efforts for to 
place limits on executive compensation part of the solution. However, I 
believe that executive compensation for all public companies should be 
reexamined.
  Under current law, the allowable deduction for the compensation of 
the top five highly paid individuals, including the CEO and the chief 
financial officer, CFO, is limited to $1 million per year. This 
limitation does not include commissions and performance-based pay. I am 
concerned that these exceptions have weakened the effectiveness of the 
limitation and encourage performance-based pay arrangements which could 
cause executives to manipulate earnings.
  The Compensation Fairness Act of 2008 would make several changes to 
the limitation on deduction for compensation. It would repeal the 
exceptions for commission and performance-based pay. Under current law, 
an employee that is covered by the limitation has to be an employee the 
last day of the year. The legislation would change this to make a 
covered employee one who is employed at any time during the year. This 
legislation would retain the $1 million limitation and index it for 
inflation.
  The Compensation Fairness Act of 2008 would not limit the amount of 
salary an executive can receive, but it would just limit the tax 
subsidy. Taxpayers should not have to bear the cost of excessive 
compensation. Warren Buffett, one of the most successful businessmen of 
all time, has annual salary of $100,000.
  Limiting the deduction of executive compensation is just one part of 
addressing compensation. Earlier this Congress, the Senate passed 
legislation which would limit the amount of compensation that can be 
deferred to $1 million. Senator Obama has introduced legislation that I 
cosponsored and the House has passed which would require annual 
shareholder approval of a public company's executive compensation plan.
  Once we address the current crisis, we need to have a serious debate 
on executive compensation and the deductibility of compensation should 
be part of the conversation. I urge my colleagues to consider changing 
the current tax treatment of compensation.
                                 ______