[Congressional Record Volume 155, Number 3 (Thursday, January 8, 2009)]
[Senate]
[Pages S195-S196]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. WHITEHOUSE. Madam President, today Senator Daschle has come 
before the HELP Committee for his confirmation hearing as our Secretary 
designate of Health and Human Services. I know that all of our 
colleagues and friends in the Senate found it moving and wonderful to 
see the distinguished chairman of that committee, Senator Kennedy, back 
in his chair leading that hearing. We are all delighted to see him back 
at work in the Senate, and we are delighted to see Senator Daschle back 
with us in this exciting new capacity.
  We know every American deserves health care that he or she can 
afford. Senator Daschle knows that to do that we need basic systemic 
reform that will improve the way health care is delivered in this 
country. Senator Daschle has already brought forward ideas, such as the 
creation of a Federal health board, that have contributed enormously to 
the health care reform debate, and I hope very much he will pursue 
those ideas further at HHS. His nomination and President-elect Obama's 
creation of a new White House Office of Health Care Reform emphasize 
their serious commitment to solving this bedeviling problem. Senator 
Daschle will bring distinguished, thoughtful leadership to the crisis 
in our Nation's health care system.
  Health care reform is the signal challenge facing our families, our 
economy, and our Government. I wish to take a few minutes today to 
speak about this great challenge and the urgent need for action.
  We all know the system is broken. The evidence lies all around us--in 
my State of Rhode Island and across the country. When a lost job is 
frightening not just because it means lost income but because it means 
lost health care, our health care system is broken. When sudden illness 
strikes and insurance will not cover the costs, our health care system 
is broken. When families wait to see a doctor until it is too late 
because they have no health insurance to pay for the visit, our health 
care system is broken.
  We see the evidence of the broken system and the staggering costs of 
health care in this country. The United States spends 16 percent of our 
GDP on health care. That is about twice what our major industrialized 
competitor nations spend. The annual cost of the system exceeds $2 
trillion, and it is expected soon to double. Family health emergencies 
have been the most common cause of personal bankruptcy, and businesses, 
large and small, struggle under the weight of ever-increasing health 
insurance costs. There is more health care than steel in Ford's cars 
and more health care than coffee beans in Starbucks coffee.
  Yet for all that money, what do we get? We still leave 46 million 
Americans uninsured; 46 million wrenching stories of health care 
foregone, of personal misfortune, even lives lost. That doesn't even 
include the experiences of our Nation's underinsured or small business 
owners struggling to provide health insurance or the many Americans who 
receive poor quality health care.
  President-elect Obama is committed to reforming this broken system, 
and he has taken swift action to engage the American people in a 
national conversation about what is wrong and what we can do to fix it. 
Last month, he and Secretary-designate Daschle asked people to hold 
meetings in their communities to discuss health care reform and to 
share their ideas.
  In the end, there is no better way to understand the deep failures of 
our health care system and the very real pain, frustration, anxiety, 
and anger it causes than to talk to the people who have experienced it 
firsthand. Over the past few years--at community dinners that I have 
around our State, in my office, as I travel around--many Rhode 
Islanders have reached out to me to share their stories and to urge 
that we work urgently to repair this broken system. I wish to take a 
moment to share a few of those stories.

[[Page S196]]

  A mother in Narragansett, RI, shared a story about her 20-year-old 
son who suffers from severe bipolar disorder and relies on therapy and 
expensive medications to remain a valued and productive member of his 
community. He is too old to be covered under her family health 
insurance plan, and his preexisting condition makes buying insurance on 
the individual market impossible--prohibitively expensive. So what did 
they do? This mother and her family came up with a surprising solution. 
They enrolled her son at the Community College of Rhode Island so he 
could participate in the student health insurance plan. He takes the 
absolute minimum course load in order to continue to work, but he 
remains a student because it is less expensive to pay for college 
tuition than it is to pay for individual health insurance. Any parent 
with a child in college knows what a burden this Rhode Island family is 
bearing to ensure that their son gets the basic treatment he needs to 
stay healthy.
  I also heard from the proud owner of a small bookkeeping and tax 
preparation business in Warwick, RI. She has worked tirelessly to raise 
five sons, go back to college, and finally she has become her own boss. 
Yet despite all her effort and all her success, she wrote me to plead 
for reform. She wrote this:

       I spend over 50 percent of my income just to have health 
     insurance for my husband and myself. The premiums are over 
     $1,000 per month, even with very high deductibles. My 
     employees need health insurance also, but I am unable to 
     provide them with any benefits because of the poor economic 
     conditions.

  Her employees are like family to her, as with so many small 
businesses, and it breaks her heart that they are uninsured. Yet she 
says she simply will not be able to keep her doors open if she tried to 
contribute toward their benefits.
  In the midst of this economic downturn, and particularly in Rhode 
Island where the unemployment rate is one of the highest in the Nation, 
this story shows all too clearly how closely linked are the tasks of 
reforming our health care system and strengthening our economy.
  Our health care system manages to fail even those who believe 
themselves to be covered. A woman who lives in Woonsocket and who has 
health insurance and was always careful to pay her bills on time, 
assumed she would be covered in the event of an emergency. Why not? She 
was current. She paid her premiums. She had insurance. But not too long 
ago, she suddenly had to have her appendix removed. Despite having 
health insurance, she left that hospital with a $10,000 bill. She is 
currently working for a temp service and she has no idea how she can 
pay off this debt. She had recently bought her own home, a longtime 
dream and an accomplishment in which she took great pride. Now, because 
of the fine print of that health insurance policy, she risks losing the 
home she worked so long to afford. As this Rhode Islander learned in 
the hardest way possible, health insurance often ends up ensuring very 
little.
  It is on behalf of these Rhode Islanders and so many others that I 
urge my colleagues to come together to support health care reform that 
will lower costs and improve the quality of care for all Americans. We 
must improve the way we deliver health care by promoting quality, 
implementing health information technology, and investing in preventing 
disease. We must, and will, protect existing coverage when it is good, 
we must improve it when it is not, and we must guarantee health care 
for the 46 million Americans, 9 million of whom are children who have 
no health insurance at all.
  We see ourselves now in darkening and tumultuous economic times. Yet 
looking beyond the immediate economic perils we face, there is a $35 
trillion unfunded liability for Medicare that is bearing down on us. It 
is bearing down on us because our population is aging, because people 
get sicker as they age, and that makes them more expensive. Unless we 
figure out a way in this Chamber to stop time, unless we figure out a 
way in this Chamber to reverse the aging process, unless we figure out 
a way in this Chamber to make elders have healthier lives and bodies 
than younger people, this is inevitable. It is coming at us, and we 
have to prepare. In order to prepare, we have to reform the health care 
delivery system. We are committed, as Democrats, to making sure every 
American has health insurance coverage, but it is not enough just to 
bring everyone into the boat. If you had a boat in the ocean and people 
swimming around it and to save them you needed to bring them into the 
boat, you would do that. But if the boat itself was sinking, if the 
boat itself was on fire, just bringing everybody into the boat is not 
an adequate discharge of your duties. It is also important that you 
repair the boat, that you get it steaming forward, that you make sure 
it is safe for the people whom you bring into it.

  That means reforming our health information technology infrastructure 
so every American can count on an electronic health record, so when you 
go to see your doctor, you don't have to fill out that clipboard one 
time after another, when at the same time you can sign on to Amazon and 
not only do they know who you are, they know what you have bought and 
they have suggestions for you based on your buying habits. There is no 
excuse for our health care system being back in the 1950s as the rest 
of the economy moves forward into the 21st century. It requires 
improving the quality of health care and it requires investing in 
prevention.
  We dramatically underinvest in prevention and quality. There are 
market failures that cause those things to happen. They are repairable. 
In addition to the cost savings, it is estimated that 100,000 Americans 
die every year--100,000 Americans die every year--because of avoidable 
medical errors. It is simply not tolerable to allow that to continue, 
particularly when it is a win-win situation, where improved quality of 
care means lower costs.
  Finally, the third leg of the reform, in addition to helping 
infrastructure technology and quality and prevention reform, is that we 
have to reform how we pay for health care to align the price signal 
that we send by those payments with what we want from health care. 
Until we do that, we will be constantly struggling uphill against our 
own financial message.
  This is all doable. This is all so doable, but it will take time. 
These are complex matters. We will have to make adjustments. The 
adjustments will take time. It is a dynamic environment which will have 
to make course corrections along the way. That means we need to start 
now. We do not have the luxury of time on our side. If we do not get 
started on a thorough-going health care delivery system reform now, 
then the alternative will be times that are even darker and more 
tumultuous than we find ourselves in right now.
  I see the very distinguished chairman of the Budget Committee on the 
floor, a man who is an eloquent voice on the dark and tumultuous times 
and the risks we face from the current fiscal situation, so I will 
gladly yield at this point, and I thank the Presiding Officer.
  The PRESIDING OFFICER. The Senator from North Dakota is recognized.

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