[Congressional Record Volume 155, Number 29 (Thursday, February 12, 2009)]
[House]
[Pages H1289-H1295]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
COMPREHENSIVE HEALTH CARE REFORM
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 2009, the gentleman from Connecticut (Mr. Murphy) is
recognized for 60 minutes as the designee of the majority leader.
Mr. MURPHY of Connecticut. Thank you very much, Madam Speaker, for
allowing us to have the time this evening.
I am very glad to be joined by a number of colleagues over the next
hour as we start what we hope will be a fairly regular Special Order
hour here on the floor of the House of Representatives to talk about
the great need for comprehensive health care reform this year in the
United States Congress.
I think it is very appropriate that we kick off this Special Order
hour in the midst of an incredibly important and critical debate about
the economic future of this country, both in the short term and in the
long term, because one of the things we're going to talk about in this
Special Order hour is the very fact that, for millions of families out
there and businesses--small and large--this economy did not just lurch
into crisis this past summer. It happened long before that.
One of the biggest contributing factors to the economic crisis that
businesses and families have been feeling for years is the mounting
cost of health care. Businesses have not been able to expand because
they cannot afford to pay the increasing health care premiums. Our
domestic manufacturers are hamstrung by a system that burdens them with
health care costs that aren't shared by their foreign competitors, and
families who are being asked to pick up more and more of the tab of
health care simply cannot do everything they would like to do. For
potential entrepreneurs who want to go out and start those new
businesses, who have great ideas but cannot leave their current places
of employment because their health care benefits tie them to those
jobs, they cannot take the risk to go out and start those new endeavors
because they cannot take the risk that their families will not have
health care.
This economy has been held back for too many years by our current
health care system, and one of the things that I hope we will get to
talk about here is the increasing burden on our economy by our current
health care system. We have an opportunity in this economic crisis to
learn from our mistakes. One of those will be our efforts to try to fix
this very broken health care system.
We have a number of people here who may have to leave before our hour
is up, so I do want to yield some time right off the bat.
Representative Baldwin, who started doing health care hours before I
came to Congress, is going to share some letters from our constituents
over the course of the next hour.
Before we get into that, I want to yield some time to, really, one of
the great leaders for those of us who have come here to Congress in the
past several years. He has been fighting the general fight for health
care reform, but he has done yeoman's work in the past several years on
the issue of mental health care. He is my good friend, Mr. Kennedy,
from Rhode Island.
Mr. KENNEDY. Thank you, Mr. Murphy from Connecticut. Let me just say
what a tremendous honor it is for me to join you on what, I think, is
the moral question of our time.
We have gone through historic times. We have just had a swearing-in
that has galvanized this Nation, and now people are asking us: What has
the country yet to challenge us? This country is now challenged with
the most profound economic crisis that we have seen in over a century.
We are coming to terms with the very basic system of government and
what it should provide its people.
Every other single major industrial power in this country provides
its people with health care. The exception is the United States of
America even though in the United States of America, per capita, we
spend twice what every other industrialized nation in the world spends
on health care. As for our infant mortality rates, our health care
statistics fall well below that of all of our industrial competitors.
If our Nation were a patient, we would be a sick patient. Tragically,
for millions of families, this comes home to them ever so frequently
when they have a member of their family get sick, and they come to
realize that the insurance they purchased is not enough to cover the
basic health care that they need to rest comfortably at night, knowing
that their loved one is going to be cared for without bankrupting them.
Health care in this country is the single leading cause of bankruptcies
in this country. We have to change this.
It is immoral that everyone in this country has their health and no
discrimination until they get sick. Then what happens? Then they are
discriminated against because then the insurance companies start
saying, ``You can get health care, and you cannot. You are too costly
to cover, but we can cover you because you aren't as costly to cover.
We are going to provide coverage for this healthy set of people but not
for this group of people because they may be disabled; they might be
older people; they might not be a people that we want to insure.''
This is not what America is about. We have come too far to include
people in our society in order for us to continue to have a system that
excludes people in our society, and our insurance system is really
based upon the notion of exclusion, not inclusion.
So we need to demand of this Congress and of this President that they
follow through on the commitment to include all Americans in health
care and not just those who are privileged enough to have access to the
best in
[[Page H1290]]
health insurance. Certainly, that includes those of us who serve in
Congress. If it is good enough for Members of Congress, it certainly
should be good enough for all of the constituents whom we represent.
To my colleagues in government, I want to thank you for including me
in this debate. Let me say this is a moral issue, but it is an economic
issue, as you said. Far be it for us to think that we are going to pass
this stimulus package and then a banking bill but not address health
care. If we do not address health care, this economy is never going to
come out of the doldrums because double-digit interest rates and
increases of inflation every year are going to continue to drag our
economy down.
This is the time for us to address health care from not only a moral
point of view but from an economic point of view. So I am glad to join
my colleagues in this hour of debate.
{time} 1800
Mr. MURPHY of Connecticut. Thank you very much, Mr. Kennedy.
There is no more forceful advocate for the moral authority that we
lack as a Nation as we try to go out and broker compromises around the
world to try to preach to other countries about their rights and
wrongs. It's very hard to do that when they look at us as the most
affluent Nation in the world, and in our midst are 45 million people
who can't afford health care insurance, children going to bed at night
sick simply because their parents can't afford to get them to a doctor.
That, I think, cheapens our ability to go around this world and try to
set the kind of example that we would like.
Mr. KENNEDY. And very many more Americans who have insurance that is
inadequate such that they fear getting health care because the
deductible is so high that they don't go for the necessary preventative
services. And then what happens? They get even sicker. And then once
they get so sick, then they come in when it's so costly to take care of
them; when if we had a health care system rather than a sick care
system, we could have taken care of them, and it costs a fraction as
much as what we end up ultimately paying for taking care of them at the
end of the line, which is what we end up doing in paying for our
current health care system is a sick care system where we pay for it at
the end of the line.
Mr. MURPHY of Connecticut. That is the genius of health care reform
is that you are going to get a system that covers everyone for less
money, that we can do the right thing morally and the right thing
financially at the same time, Mr. Kennedy.
We're joined here by a number of Members, but I'd love to yield the
floor at this point to Mr. Boccieri for a few moments, a new Member of
Congress.
You know, I think we want to talk about the importance of health care
reform. But in our current system, the way that you get health care
reform most often is through a job. And this stimulus bill that we're
debating right now can be looked at overall not only as a jobs' package
but as a health care package. Because if we can get more people
employed, we can get them jobs.
And so I know Mr. Boccieri wants to talk about our efforts to get
health care reform generally, but also the importance of this stimulus
bill for millions of families out there who are at risk of losing their
jobs.
Mr. BOCCIERI. I thank the gentleman from Connecticut for his efforts,
as well as Congressman Kennedy for his stalwart work for making sure
that we do the right thing for Americans.
And my friends, Ohio is struggling. Ohioans have lost their jobs over
the last 8 years in record numbers. In fact, we have not crawled out of
the recession from 2001. And so many, so many Ohioans--just like so
many Americans--are one accident, one medical emergency, one diagnosis
away from complete and utter bankruptcy.
Yet we spend here in America, like Mr. Kennedy said, more than any
other industrialized country in the world on health care. More than any
other industrialized country. Yet, our life expectancy is on par with
Cuba. We, as a Nation, spend nearly $12,000 for family coverage;
$12,000 of disposable income is going for health care insurance.
My friends, this not only makes moral sense and makes sense in terms
of the right thing to do, but makes sense in economic terms.
Let me tell you this. We have to cover every American. We have to
have a system that covers every American. We need to emphasize
prevention, and we have to make sure that health care is portable
between jobs, something that has been played out so often in Ohio as
Ohioans transfer from job to job because of the downturn in our
economy. And we need to end the discrimination that's based on pre-
existing conditions.
And I tell you, Mr. Speaker, there is no issue more important than
this one because this issue alone is costing millions of jobs and
costing thousands of people from seeking preventative care. We spend 75
percent of all that health care money, nearly $7,000 per person, we
spend 75 percent responding to chronic illnesses, illnesses that could
be treated if we just saw routine visits to the doctor. Chronic
diseases like diabetes, asthma, and heart disease.
And we see that only 4 cents on every dollar, Mr. Speaker, 4 cents on
every dollar is spent to promote healthy lifestyles. There is a huge
disconnect.
And when we see the fact that big insurance companies block and
prevent people from going to see routine visits to their doctor, we are
actually costing the American taxpayer, small businesses, and larger
businesses that have huge legacy costs more money.
In fact, a recent study--my colleague from Connecticut, I'm sure he
knows this one--a recent study suggests that $84 billion a year is
spent by big insurance companies to block and deny claims. From you
going to see your doctor, whether it's for a diabetes treatment,
whether it's for asthma, or for heart condition; and that same study
pointed out that nearly 77 billion is all that it would cost to cover
the nearly 50 million uninsured or underinsured Americans in this great
country.
We must take action now, because let me give you two scenarios before
I yield back my time that has been played out in Ohio over the last 8
years.
That factory worker that worked at Rubbermaid where the plant closed
and the job went overseas, now they've got to find new work and they
also have to find new health care insurance. And when you see those
individuals struggling, those families trying to send their kids to a
dental appointment or try to send their young family to go see their
physician because they have some sort of ailment--maybe the worker
themselves, Mr. Speaker, has diabetes and they can't go see routine
visits to their physician now. So they get an ulcer on their foot. It
goes to a point where they now have to go to an emergency room to seek
care.
And it costs all of us paying into the system, four, if not five
times more by seeking emergency room care versus seeking care from a
primary care physician.
So we are actually losing money, costing ourselves more money by not
ensuring everyone. We need a robust system that allows an employer-
based system that is portable that they can take from job to job and
the like.
So if that person now who worked at Rubbermaid is working at
Wal*Mart, they should have a portable health care plan that allows them
that transition period.
But what we do now is we have to pass an extension of COBRA benefits
because the Congress--and especially our former President--did not
address this issue and take it head on. Small businesses are asking for
relief, American families are asking for relief, and it's about time we
deliver that to them.
Mr. MURPHY of Connecticut. Mr. Boccieri, thank you very much for
joining us.
You know the statistics. You just look at the auto industry. And that
statistic that we've heard over and over again, that $1,500 of every
automobile produced in the United States goes to pay health care costs.
The comparable number to our domestic auto manufacturers for their
competitors in Japan or all over the word is nearly zero because they
don't bear the full burden of paying health care costs. They pay it a
different way. They pay it through taxes to the government for a
different system, but they're paying for systems that cost 11 or 10
percent of their GDP where we're paying for a
[[Page H1291]]
system that costs 16 to 17 to 18 percent of our GDP. It's a tremendous
competitive disadvantage for small businesses that are trying to pay
those premiums and also for those large manufacturers, Mr. Boccieri.
Mr. BOCCIERI. I would submit to my colleague from Connecticut, who
has taken on this issue headstrong--and we appreciate that--that a
recent poll in Ohio from the University of Cincinnati showed that
nearly 20 percent of all Ohioans--11\1/2\ people in Ohio--nearly 20
percent, 1.4 million Ohioans from age 18 to 64 lacked health care
insurance.
So that person who is transitioning from job to job who can't provide
the health care insurance they need, it makes economic sense that we
cover them to make sure that they can seek treatment because it's going
to cost us more down at the end, four, if not five times if they have
to take their child to a hospital emergency room to seek routine care
that they could have done if they just went to their physician. It not
only makes moral sense, it makes sense for all of Americans.
And I have to tell you this. We hear the diatribe and the arguments
from the other side of the aisle, but my colleagues and the Speaker
need to know this: that in 2004, George Bush's Secretary of Health and
Human Services, Tommy Thompson, flew to Iraq with one of many billion
dollar checks in hand to make sure that every man, woman, and child in
Iraq had universal health care coverage. And what he said is that Iraqi
families and their children deserve health care, but you do not. And
we're going to spend American taxpayer dollars to make sure Iraqis can
go and seek routine care with their physicians but not American
families.
And I think that is a huge disconnect. And we need to talk about that
because we are building brand new roads and bridges and hospitals and
waste water treatment facilities over in Iraq. But when it comes time
to put Americans back to work and to ensure that Americans can seek
routine care with their physicians and with their family doctors, we
hear nothing but blocking.
And I tell you, Mr. Speaker, if we were to give a Heisman award, we
would give it today to some of the dialogue that I heard today on this
floor.
This is about putting America first, putting Americans first, putting
Americans back into their doctors' offices so that they can have
valuable health care and they can seek routine care. It's about the
American family and putting Americans first.
That's what the stimulus and economic recovery package is all about,
and that's what providing health care insurance to every American is
about.
Mr. MURPHY of Connecticut. I thank the gentleman.
We've heard the numbers on how much we've spent on this war in Iraq.
We're approaching $3 trillion if you factor everything together. We're
talking about spending a fraction of that money to put people to work
here, to give people jobs in this country to start spending our
taxpayer dollars on investing in American jobs and in American health
care.
Representative Baldwin has done just an amazing job of personalizing
this issue for years on the House floor, and I really, taking from her
example, have brought down with me a few letter to really try to tell
the stories of people from my district who are struggling with this
very issue from both a human perspective and from an economic
perspective.
And Representative Baldwin, I'd love to read one letter to start it
off and then kick it over to you.
We all have these letters piling up, they are coming in,
unfortunately, more and more often every day, every week, and every
month because as the number of unemployed grows, the number of people
without insurance grows. And in fact, more and more employers as a
means of keeping their doors open are passing on more and more costs to
their employees even if they do keep their jobs.
Let me share one letter that came from a constituent of mine, and I
will read an excerpt of it.
She talks about her inability to find a good job in Connecticut, that
she can find a job but she can't find a job with health care insurance.
She says, ``Because I cannot get a good job in Connecticut, I have no
insurance. I went to get my teeth cleaned the other day, and I had to
pay $173 out of my pocket. A few weeks ago, I was sick and I went to
the doctor, and it cost me $120. Making minimum wage, I'm getting $7 or
$8 an hour.
``These bills that are mounting are going to take a long, long time
to pay off. I shudder to think what would happen if I got seriously ill
or got in an accident.
``My family has invested so much time and energy and spirit in making
this country and this State a great place. But it's increasingly
becoming a place that I can no longer afford to live.''
Representative Kennedy talked about the largest number of
bankruptcies coming from medical costs. This is a woman doing
everything we ask. She's working a minimum wage job, dignity in the
labor she provides, and yet she knows that she is just around the
corner--one illness or one accident--from losing everything, from
having her entire life changed both from a health standpoint and from a
financial standpoint. And these are the letters that are piling up in
our office.
The uninsured sometimes get cast as people who brought it on
themselves, that they should just go out and find a job, just go out
and seek out health care insurance. Well, we know that whether the
number is four out of six or five out of six, the vast majority of
people who don't have insurance come from families with full-time
workers who have a job but just simply don't have health care for
themselves or don't have it for their families or dependents.
So at this time, I would be happy to have my friend and the leader on
this effort of bringing the human side of the story to the House, Ms.
Baldwin, to join us.
Ms. BALDWIN. Thank you.
I want to start by thanking you for your leadership. It is so
important that you bring us together to highlight the issue, and I
think it is powerful to hear what our constituents have to say in their
own words.
We all travel back and forth between Washington, D.C., and our home
districts. I represent an extraordinary constituency in south central
Wisconsin, and there is nowhere I travel in my district that I don't
hear these stories that tug on your heartstrings and tell us in no
uncertain terms that we must take action, and we must take action in
this session of Congress.
I want to share with you a sampling--and we could probably have
endless special orders and not get to all of the communications that we
receive.
Michael in Poynette, Wisconsin, in my district says, ``I am a
[Federal employee] and a member of the Wisconsin WI Air National Guard.
This past year we were granted a wage increase of roughly 2.3 percent.
At the same time, the cost of our FEHBP plan benefit increased by up to
44 percent.'' For he and his coworkers.
Michael writes, ``Along with this, many of the co-pays also
increased. This has put a tremendous strain on my colleagues in the Air
National Guard, many who have been deployed three and four times in
support of operations throughout the Middle East region.''
Ed in Monroe, Wisconsin, writes to me, ``My wife and I live in the
gap. Between our Social Security and a disability policy she had, we
get too much money to qualify for help, but not really enough to get
by. With the donut hole in Medicare D, we would only be able to get my
wife's meds for 3 months if it were not for the samples provided by one
of her doctors.''
{time} 1815
``Four of her 10 meds would take 65 percent of our total income if it
were not for the help of that doctor. I live with chronic pain because
of a cancer treatment, but as the years go by, it helps less and I have
other medical problems that are gradually getting worse.''
Ed continues: ``I have a wife and a son that I have to take care of
because neither can do it all for themselves. I am the one who battles
with Social Security and the insurance companies. I have to deal with
problems that arise with their medications, their finances and many
day-to-day things.''
Ed continues: ``Every time I hear a politician talking about cutting
Medicare and other programs for the elderly and disabled, it scares me
to death because I am just hanging on by a thread.''
[[Page H1292]]
Sue in Beloit writes about her situation. Sue writes: ``My husband
was diagnosed with lung cancer. After treatment began, we found out
that the insurance company had a small loophole for the treatment of
cancer. Under our insurance, they have a $13,000 limit per year on
radiation and chemotherapy. That amount did not even cover the first
treatment of either the radiation or chemo. I was not going to have my
husband die for lack of treatment, so we started to use our savings and
available credit to pay for medical expenses. My husband later died,''
Sue wrote. ``After having completely depleted our savings and facing
insurmountable credit card debt, I had no choice but to file bankruptcy
last year.''
Greg in Verona, Wisconsin, who owns a small business writes: ``Since
1998, we've been providing health care to our employees. Every year,
we've had double digit increases in our costs. This year, the insurance
company has informed us we'll be paying 42 percent more next year,
which will lead to one of several eventualities:
``One. We'll have to reduce what we cover as a benefit for our
employees and hopefully retain them. Reality is, many will leave and
we'll have trouble replacing them.
``Two. We'll eat the increase but offer no employee raises for the
next 3 years.
``Three. We'll raise our prices and force customers to look elsewhere
for the services we currently provide them.
``The very real possibility is we'll end up with some element of all
the scenarios and end up not being able to keep the doors open. Very
scary thought when one considers that my business has been around for
55 years.''
Michael in Burlington, Wisconsin, writes: ``My late daughter was
diagnosed with lymphangiomatosis and Gorham's Vanishing Bone disease in
March 2005. We found out how much a child with a terminal illness costs
a person. My wife and I used every amount of credit and refinanced our
house three times just to take care of her. Since her death, the bills
mounted so bad that now we will have to file bankruptcy and we already
have been foreclosed on our home.
``Secondly, my wife was born with a hole in her heart. In 1972, the
doctors repaired the hole. In doing so, through the blood transfusion
they gave her hepatitis C. Now she is preexisting at 37 and can't get
life insurance and has been repeatedly denied health care coverage. Her
mental breakdown because of the death of our daughter left the
insurance companies another reason to not let her have health care.
This needs to change.''
Carol from Madison, Wisconsin, writes: ``As someone who has had no
health insurance at all for 3 years, I can tell you that it was pretty
miserable being one of the millions of people in this country without
health insurance. Not long ago, my best friend died at age 42 because
of ovarian cancer because she did not have health insurance and waited
too long to see what was causing all of her symptoms. Yes, people in
America actually die from not having health insurance.''
Susan in Baraboo, Wisconsin, writes: ``I am writing you today
regarding health insurance coverage for single people with no children.
As of this time, I feel that I am left out of the loop in regards to
this topic. I am 42, and last September I was diagnosed with breast
cancer. In January of this year, the company that I worked for informed
us that they would be closing down. I was laid off in December while I
was out due to my cancer treatment. I have been searching for health
care everywhere because my COBRA will be going up and I am on
unemployment and barely able to pay the $244.76 for the coverage now. I
cannot get insurance because of the breast cancer. HIRSP, which is the
Wisconsin State High Risk Program, is too expensive for me to get
coverage since they want 4 months of premiums up front, and as they
only cover some things.
``What are single people supposed to do? We don't qualify for any
government assistance because we are single. We cannot go without
insurance. There are no programs to help us out. So when you are
working on health care in the House of Representatives, please remember
that there are single people out there also in my shoes. I am at a
crossroad because I have no avenue for assistance when it comes to
health care. Come November, I will be unable to get coverage when I
need it at this point in my life.''
I hope, Mr. Speaker, that my colleagues will join me, and on behalf
of those constituents whose stories I've shared, in recognizing the
absolute critical nature of our efforts to enact national health care
that covers all Americans. The crisis is only worsening at this
particular moment, and I invite my colleagues to join me in working on
this most pressing issue.
I again thank the gentleman from Connecticut, my friend, Chris
Murphy, for bringing us together this evening to give voice to the
American people who are suffering so much in the current circumstance.
Mr. MURPHY of Connecticut. I thank the gentlelady. You have some
pretty articulate constituents. We hope to come down here and do this
fairly regularly, and the unfortunate nature is that there are enough
letters that come in every week to be able to fill at least an hour
every week or every 2 weeks with their stories. So I thank the
gentlelady for joining us and being part of this and hopefully keeping
this message going forward, which is that these stories are endless,
the crisis is real, and we have an opportunity to do something about it
and do something about it now. We can't wait any longer. Our economy
can't wait. Our families can't wait. Our businesses can't wait.
This year, this session, we have an opportunity to do real health
care reform, and the ultimate consequence of that is hopefully that the
number of those letters that Ms. Baldwin read aloud will reduce over
time as people see real health care come to them and their family and
the businesses they work for.
Mr. Altmire, we normally join each other down here for a more wide-
ranging conversation amongst the 30-somethings, but I'm thrilled you
were able to come down and join us this evening.
Mr. ALTMIRE. I want to thank the gentleman from Connecticut. There's
no one in this House--a lot of us care and work hard for health care--
but that works on health care more and cares more than Mr. Murphy, and
I appreciate you putting this together.
And the reason this is an important issue is because it affects
everybody. It affects every individual. It affects every family. It
affects every business in America. Health care is something that we all
need, and health care is something that we all have a right to.
Now, there's differences of opinion on what reform should look like,
but there's no difference of opinion that our system is broken. And if
you look at the facts, we as a Nation spend almost $2.5 trillion on
health care as a country, far more than any other country in the world;
yet we still get mediocre results when compared to other countries in
some things like life expectancies and infant mortality, and Mr.
Kennedy talked a little bit about that earlier. Now, we're the not in
the middle of the pack. We're in the bottom of the pack in some of
those when compared to other countries.
Now, if you can afford to get in and if you have access to the system
and if you're one of the fortunate that has a quality health plan and
you don't have any preexisting conditions, then you might say, well, we
have the finest health care system anywhere in the world. And that's
true, too, for that segment that's able to access our health care
system.
The problem that we have is we have 50 million Americans, approaching
that number, that lack any health insurance at all; 50 million people
with no health care. As the gentleman from Connecticut talked about
earlier, it's a common misconception to say those are people that it's
their own fault, they should have health care, they should get a job.
Three-quarters of those people have a job or they live in a household
where the head of the household has a job. They don't have health care.
We passed an expansion of SCHIP in this Congress in the past 2 weeks
here, signed into law by President Obama, that extends 4 million
children access to the SCHIP program. Those are working families. Those
are kids that didn't have health care. They live in families that work
hard and play by the rules, but they can't afford health care for their
kids. Is there anything more important that we could be doing for our
children than making sure they have access to quality health care?
[[Page H1293]]
And if you look at our country, a big issue that we talked about in
the stimulus was the information technology system in this country. And
I just think it's crazy that you can go--I live in Pittsburgh. So
somebody who lives in San Diego, they might not think this is so crazy.
But if you live in Pittsburgh and you go to San Diego and you put your
bank card in the ATM machine, you can pull up all your records in a
safe and secure way, all your financial documents, get your balance.
You don't worry about it. You don't think about privacy.
But if on that same trip you show up in the emergency room in San
Diego and you need services, they can't pull up your record. They don't
have your family medical history. They don't have your allergies. They
don't have your imaging, your X-rays. They don't know anything about
you, and you start from scratch, and they're going to ask you half a
dozen times when you're there, what are you allergic to.
It's crazy that health care is the only industry in the country that
doesn't have an interconnected information technology system. You would
think that would be the most important one to have it. We don't have
it.
Now, there are some health systems in this country, including the VA,
that has done a pretty good job of putting together an information
technology system, but what we can't allow happen is that we develop a
nationwide network of small information systems that are incompatible
with each other because that doesn't solve the problem at all.
So, what we tried to do in the discussion of the stimulus package was
put together a roadmap for the future with information technology
systems so that anywhere you go in this country, if you need health
care, you can pull up your records in a safe and secure way. And with
health care changing the way that it is and treatment protocols
changing, the patient will have access to that, and in some cases, in a
safe and secure way, the patient who is a diabetic from home that does
their own self-tests can update their own record in conjunction with
their physician.
So these are things that we need to aspire to in the future. We
cannot allow our health care system to continue to languish behind the
times of technology, and we certainly cannot continue to allow 50
million Americans and growing every day to go without health care.
Because it's been said many times in this hour and many times before,
we have people that do have health care outside of that 50 million that
are one accident or injury or illness away from losing everything. The
gentleman said it a moment ago. Those are the people that are lucky
enough to have health insurance.
I hear from small businesses in my district all the time, with say 10
employees. They will say if one of their employee's kids, not the
employee, the employee's kid gets sick or injured, they get a phone
call from the insurance company, and they say, well, you're too big of
a risk, we have to drop you. What's the point of having health
insurance if you only have it until you need it, until somebody needs
to use it? That's not what health insurance is supposed to be about.
We need to find a way to allow small businesses to pool their
employees, either through their States or their regions or metropolitan
statistical areas or, moving forward, the entire Nation. Put them all
in the same community-rated risk pool and say that your individual
health status doesn't matter when setting your rates. You can still
have the same choices in the market. You can still, as an employer,
choose what coverage you're going to offer your employees. And you as
an employee have the same choice, but the insurance company can't use
your individual health status to set your rates.
{time} 1830
And that would make the system more fair. But the larger issue moving
forward, as the gentleman said, and I'll conclude, is we have to find a
way to ensure the highest quality care that is available to some parts
of our society is available to everyone, to all 300-plus million
Americans in this country, has access to the highest quality care, and
they have health care not just when they do need it, but when they do
need it. That's the key.
Again, we're going to have a long discussion about what does reform
look like. We've talked about it before. And that's an issue that this
Nation needs to come to terms with. But there can be no disagreement on
the need for health care reform which, once we get past this economic
situation that we're in now, has to be the number one course of action
for this Congress.
I thank the gentleman.
Mr. MURPHY of Connecticut. I thank you, Mr. Altmire, and I think by
focusing in on that question of quality, you really talk about the
third leg of the stool--is about coverage, is about prices, is about
quality.
I think, although all of us come from a little bit different
perspective on the ultimate path forward on the parameters of that
health care reform effort, we know that it can advance all three legs.
We can get a more affordable system that covers more people for better
quality than we have now. And I don't think it's too ambitious to
suggest that we're going to get a system of coverage that covers
everybody for less money than we're spending today.
If you shift the money from crisis care to preventative care, if you
start pooling the purchasing ability of the people that are paying, you
can drive down the cost and expand out the number of people. And that
sounds impossible. I mean, how do you get more for less? But every
other country has shown a way to do that. We're not going to copy other
countries' systems. We're going to create our own, taking already from
the best that we have. But we can do both, Mr. Altmire.
We're joined as well today by my colleague from Connecticut,
Representative Courtney. Representative Courtney and I got the chance
to chair the Public Health Committee in our respective State
legislature, and we both know firsthand how hard it's been for States
to toil under the system, as 50 different States try to cobble together
50 different systems of health care to insure their citizens in the
absence of any national strategy.
Mr. Courtney, I thank you for joining us here this evening.
Mr. COURTNEY. Thank you, Mr. Murphy. As you said, we both sat on the
Public Health Committee in Hartford, Connecticut, in the State
legislature. You did an absolutely outstanding job for the people of
the State. You were the guy that was there to implement SCHIP. We call
it HUSKY in Connecticut, for obvious reasons--because we have the best
men's and women's basketball teams in the country right now in the
NCAA.
You also did, again, a lot of other path breaking legislation during
your time there. It's very exciting to see you now on the Energy and
Commerce Committee to continue that work at the national level.
I wanted to follow up actually on a couple of comments that our
colleague from Pennsylvania brought up regarding the fact that, A, in
the short time that President Obama has been in office, he followed
through on a campaign promise to extend health insurance to 4 million
more children in this country. As the three of us know, this was an
issue that people clawed at each for 2 solid years. And then, within 2
weeks of coming into office, we were able to accomplish that historic
expansion and strengthen coverage for things like dental care and
mental health care, which anybody out there talking to the pediatric
community knows, was a real weakness in the SCHIP program that has now
been in effect for the last 10 years.
His stimulus plan, the American Recovery and Reinvestment Act,
recognizes the fact that we have lost 3 million jobs in this country
and, unfortunately, in America, when people lose their jobs, they also
lose their health care in many instances because we have an employment-
based system. And his proposal which creates a COBRA subsidy, providing
65 percent of the premium costs for unemployed individuals, is really
just a major change in the health care landscape in this country.
Like a lot of Members, I have been at unemployment offices over the
last 3 weeks or so. Connecticut has been hard hit, like other parts of
the country. And talking to the folks who are in the offices describing
the individuals coming in, who in many instances have never experienced
a layoff in their lifetime, and in many instances had very solid, upper
middle-income salaries,
[[Page H1294]]
now have all these problems thrust at them.
But the number one issue that constantly comes up for people who are
at that desk trying to contend with a blizzard of new programs that
they have never dealt with before is, How do I keep my health insurance
for my families? And the cost of COBRA extension is brutal. It averages
around $700 or $800 a month. If you just do the simple math in terms of
what an unemployment check will cover, this COBRA extension, which
President Obama has included in the Recovery and Reinvestment Act, is
just going to be a tremendous help for working families who are trying
to get through this very difficult patch.
There's another issue, though, which Mr. Altmire mentioned, which is
also in the plan, which is an investment, really an infrastructure
investment, in health IT. About $19 billion is included in the plan.
And Jason mentioned earlier that the VA and the military health care
system is actually kind of ahead of the curve in terms of the civilian
sector.
I had a chance actually to personally see that in December when I was
over in Iraq and Afghanistan. I was at Walter Reed Hospital in
December, visiting a young soldier from East Lyme, Connecticut, who was
shot by a sniper in mid November. He was being treated at Walter Reed.
Talked about the great care that he received at Landstuhl Hospital in
Germany.
And on our way back from Iraq and Afghanistan, we stopped at
Landstuhl Hospital and I was up talking to the nurses on the ward and
the doctor who actually performed surgery on him. I mentioned his name.
This was about 6 weeks after the fact. They all knew him right away.
One of the reasons why, other than the fact they're just great people
who really care about their patients, is that they have a totally
interoperable system of health IT within the military hospital system.
So the doctor can pull up on a computer the treatment files of this
soldier who's in Washington, D.C., at Walter Reed Hospital, and
interact with his doctors, answer any questions that may come up in
terms of his recuperation. It was remarkable.
And the question Jason asked is, Why can't we have this in the
regular health care system in this country? Obviously, it's because we
have a very fragmented system, and we need to overcome these issues of
interoperability.
One of the ways it does it is to build on a system that George Bush
started. He created the Office of National Coordinator of Health Care
Information Technology. That was a Bush Executive Order. And what the
recovery plan does is it basically takes that office, which is dealing
with these issues of interoperability, and pump new funds into the
program and just moving this country forward much quicker than it
otherwise might have done under the prior administration's budget.
Well, there's an urban legend already out there claiming--and it's in
the blogs and it's on some of the cable TV shows--that somehow this
National Coordinator of Health Care Information is creating a
nationalized socialized system of health care and it's going to mandate
treatments that doctors and hospitals are going to have to administer.
Nothing could be further from the truth.
This office, which was created by George W. Bush, is strictly an IT
office that is dealing, again, with implementation of computer
technology in this system which, again, as Congressman Altmire said,
needs a lot of work because it's a very fragmented system, particularly
when you're trying to bring in doctors and health care providers who
are outside of the hospital network into the system of health care
information technologies.
So, for anybody out there listening who has heard these ridiculous
claims that somehow this bill is going to create a one-size-fits-all
system of health care, nothing could be further from the truth. This
bill is about trying to, again, implement what George Bush started, and
which makes common sense for anybody. All the stakeholders and health
care systems agree that health care IT, making the system more
efficient, coordinating care by just sharing information in a safe and
secure manner, is a way to really move the ball forward in this country
towards a system of universal access and high-quality care.
So, if people are hearing those rumors--and I have had some seniors
call the office saying they don't like the idea of this--the fact of
the matter is that this is a program which the military uses, which the
VA uses, which is going to be good for care in terms of eliminating
errors in the system because of just the fact that bad information is
being shared by different providers.
It does nothing in terms of changing the doctor-patient relationship,
the patient-hospital relationship. The government is not getting
involved in the decision-making of how your health care is going to be
decided or administered.
Holding this forum on the night before the vote, Mr. Murphy, I think
is a great opportunity to clarify, again, some of the really good steps
forward that President Obama is asking the Congress to vote for.
Like yourself, I know we believe that, as folks who have worked on
this issue for an awful long time, that this is a real opportunity in a
very difficult time of our country to move forward for all Americans.
So, with that, I will be happy to yield back to you.
Mr. MURPHY of Connecticut. Thank you very much, Mr. Courtney. I
preceded him or came after him as the chair of the Health Committee.
The work that had been done under your leadership to start what really
was a model program for getting prescription drugs to Connecticut
citizens, the ConPACE program, was really an amazing piece of work due
to your great leadership. And I thank you for joining us here.
I'm glad that you brought up, Mr. Courtney, this issue of what this
new Office of Health Care Information Technology is going to do. One of
the things that has held us back as a Nation in trying to create a
sensible system of health care information technology is that we don't
have any national standards, that we don't guarantee the ability of one
system to be interoperable with another system.
It just makes absolutely no sense that someone that has been treated
their entire life at a hospital in Torrington, Connecticut, who gets
brought into the emergency room 20 minutes down the road in New Milford
Hospital, even if they want that hospital, that emergency room to have
data about their care, their illnesses, their treatment, their tests,
that that data can't be transmitted. That those two hospitals who have
spent millions of dollars building up their own information technology
and medical records system can't communicate with each other.
And ultimately as we move forward on some sensible form of
comprehensive national health care, it's going to have to have at its
foundation a health care information technology system that
communicates with each other. It's going to have to be, I think, very
strong patient protections built into that system. But it is going to
have to be interoperable. And the only way that that happens is through
a Federal effort to try to set up some basic standards to guarantee
that these systems are not just individual silos and they can
communicate with each other.
That doesn't mean that we're going to dictate one software program or
one hardware program. But we're going to have some ability for those
systems to communicate with each other. And I think of all the pieces
that many of us are excited about in this stimulus bill, the ability
for this piece of legislation to move us leaps and bounds forward on
the issue of health care information technology is just absolutely,
absolutely critical.
Representative Courtney also mentioned the issue of the expensive
COBRA system. Representative Baldwin was reading us some letters
before. And seeing that you brought it up, I figured I'd read a portion
of a letter on that very subject.
George from my district writes, I'm 63 years old and was recently
laid off from my job. I was told that I would have 30 days of
additional insurance coverage from the day that I was laid off. But
when I went in to schedule a minor operation, I was told that I didn't
have insurance coverage anymore and the operation had to be canceled. I
was given the option to continue coverage under COBRA, for a
[[Page H1295]]
price. When I looked at the cost of COBRA insurance, it was over $753 a
month. My unemployment check per week was roughly $498 a week, less
taxes and any part-time job.
``How are we as Americans able to maintain our homes and this when
things like this happen to us? I think it's a real crisis and you and
your fellow Congressmen and Senators should really make an effort to
fix these problems that we're facing.''
That story can be told over and over and over again in this current
economy as people are losing their health care insurance. They have
that option of COBRA, a great decision that this Congress made to allow
that option. And now, under President Obama's stimulus bill, people
will actually be able to afford that option. It will be a realistic
option for people that are losing their jobs as a bridge to reentering
the workforce.
I know we have a Special Order hour awaiting us so we will wrap it up
at this point. I hope that as we come down to the floor and have these
Special Order hours surrounding health care reform, that we're going to
be united by a single purpose of getting health care reform done this
year.
As Representative Altmire and I were talking about, everyone is going
to have very different perspectives from both sides of the aisle as to
what should be the component of that reform legislation. And people's
ideas may vary greatly, but my hope and I think all of our hope of
those that joined us here for this hour, is that our unity of purpose
is in getting a bill done. Getting a comprehensive piece of health care
reform legislation done this year.
This Congress and this town has been stymied year after year in that
effort. But the stars may be aligning this year to get something done.
And, in particular, I think that this economic crisis that we're going
through right now should be that final impetus to get us over the hump.
We have known for a long time that as a moral imperative we have to
step up to the plate and deal with the fact that there are too many
people getting sick for no reason except that they can't get care.
This--it's too expensive. But we now have a much sharper idea of what
the economic imperative is behind health care reform.
We can cover more people for less money. We can save jobs by reducing
health care costs.
{time} 1845
And if we set that as the very realistic goal heading into a health
care reform debate, I think we will find, despite the cacophony of
voices that will surround this hall from the outside interest groups
that have so much concern and stake in the status quo, that there is
probably much more agreement in this House than there is disagreement.
I thank my colleagues for joining us here today. I look forward to
coming down and having this hour several times over the coming weeks
and months.
With that, I yield back the balance of my time.
____________________