[Congressional Record Volume 155, Number 72 (Tuesday, May 12, 2009)]
[House]
[Pages H5452-H5453]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore (Mr. Maffei). Under a previous order of the 
House, the gentleman from Connecticut (Mr. Murphy) is recognized for 5 
minutes.
  Mr. MURPHY of Connecticut. Mr. Speaker, those of us who came to 
Washington to pass comprehensive and revolutionary, potentially 
transformational health care reform are emboldened by the realization 
that we now, for the first time in almost a decade, have a President 
and an administration who are as committed as any advocate in this 
country to the premise that this country must reform its health care 
system. We are reminded almost weekly of President Obama's commitment 
to health care reform that happens this year.
  This week we saw the President bring together varying and diverse 
groups that over the course of the history of health care have normally 
been at each other's throats, coming together to say that the first 
premise of health care reform has to be lowering of cost in the system. 
The health insurance community, the hospital association, the medical 
association, PhRMA and SCIU, one of the Nation's biggest unions, all 
coming together and saying, listen, let's take cost out of this system. 
And it is the right way to first approach health care reform. We can 
talk all we want about coverage, but if we don't start to dramatically 
slow the growth of health care at a pace now that stands at 7 or 8 
percent a year, if we don't bring it down to something that more 
resembles the general inflationary rate in this country, there will be 
no room, never mind to expand coverage, there will be no room to just 
cover the people with health care now. We have gone over the numbers 
over and over again: $7,400 per person that we spend on health care in 
this country, $2.2 trillion across the spectrum of our health care 
system. Twice as much of our GDP is spent on health care as we spent in 
1970, and twice as much of our GDP is spent on health care than many 
other similarly situated industrialized nations.
  Health insurance premiums over the last 10 years have gone up 119 
percent, while earnings have risen only 34 percent. We know there are 
savings because we look out across the country and we see dramatically 
diverse experiences with regard to cost.
  In my home market of Hartford, Connecticut, we are spending on 
average about $8,000 a person to treat a Medicare patient. Well, you go 
down the eastern seaboard to Miami, and they are spending twice that 
amount, $16,000 to treat a similar Medicare patient.
  Now, I am sure we can come up with a list of reasons why that care is 
going to be marginally more expensive give the client base and the 
provider costs, but not twice as expensive.
  As we saw in some recent work at Dartmouth University, there is no 
correlation between what you spend and the quality you get. In fact, it 
tends to be the reverse: the better you are at coordinating care and 
keeping costs down, the healthier your patients are. So there is an 
enormous amount of savings that we can achieve just by better

[[Page H5453]]

coordinating care and learning from the areas of the country and the 
health care communities that have figured out that you can reduce costs 
and preserve quality.
  But ultimately, Mr. Speaker, I don't think we can really take a whack 
at costs until we understand the important role that a public insurance 
model can play in our health reform system. I want to talk about this 
for 1 minute.
  We have looked at comparative models, for instance on the purchase of 
prescription drugs via a government program like the veterans health 
care system and private models likes the Medicare prescription drug 
benefit programs, and we see example after example on how the ability 
of the United States Government or entities acting on its behalf can 
bring down the cost of health care. We have seen examples of how a 
government-sponsored health care initiative that has no interest in 
returning value to shareholders, that has no interest in paying its 
CEOs massive salaries, that does not have a profit motivation can get 
more humane and less expensive care to its recipients. That is the 
theory behind those that want a government-run single payer system, and 
I think we all acknowledge we are not going to get there.
  But we are not going to achieve the savings that we hope to achieve 
unless we can have a robust, completely competitive market where 
individuals and businesses that are purchasing insurance get to choose 
not only between private insurance companies that might offer them the 
best deal, but also from a public option as well.
  This is fundamentally about creating real market-based choice for 
consumers. If we have a diverse array of private insurance products and 
a public option, that more than anything we do with regard to changing 
reimbursement from volume to outcomes, can bring down the cost of 
health care.

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