[Congressional Record Volume 155, Number 79 (Thursday, May 21, 2009)]
[House]
[Pages H5993-H5999]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       PROGRESSIVE CAUCUS MESSAGE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Minnesota (Mr. Ellison) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. ELLISON. Madam Speaker, let me just signal that again tonight we 
come before this body as the Congressional Progressive Caucus with the 
Progressive Message.
  The Progressive Message, this idea of coming before the American 
people, projecting a progressive message, so that the people of the 
United States can say, you know what, there are people in Congress 
today who are willing to stand up and say that ideas about generosity, 
of justice, of peace, of inclusion, of universal health care, of 
providing access for everyone, these are principles, there are people 
who are in that Congress who will stand up for these ideas, and that is 
the Congressional Progressive Caucus.
  And we come and we talk about the Progressive Message where we talk 
about the importance of this message of saying we will remember great 
advances of our country of the past, like the civil rights movement, 
the women rights movement, the idea of coming together for Social 
Security, standing up for peace, getting us out of Vietnam, standing up 
against the rush to war in Iraq and Afghanistan. And today, that charge 
has not failed. That charge has not gone unnoticed, and we're here 
today to keep the call going.
  And tonight for the Progressive Message, I'm really pleased to have 
join me a leader who never fails to stand up for the people, never 
shrinks from the call of the people, a progressive, dynamic leader who 
hails from the great city of Houston, the great State of Texas, none 
other than Sheila Jackson-Lee. I thank Congresswoman Jackson-Lee for 
joining me tonight for the Progressive Message. Do you want to get us 
started a little bit as tonight we talk about health care?
  Ms. JACKSON-LEE of Texas. Let me first of all thank the distinguished 
gentleman, Congressman Ellison, for his leadership and to applaud the 
effort of, if you will, recording, reporting, enforcing, and educating 
individuals on the importance of a holistic approach to health care 
reform.
  Certainly, I want to congratulate the Progressive Caucus, of which 
I'm a member and my distinguished colleague is, because we have been 
spending time, Madam Speaker, on working on these issues, constantly 
seeking to find common ground around a very important issue, and that 
is, of course, the public option.
  Some of us are concerned and interested in single payer, and in our 
meetings that we have had, which is a number of legislative 
initiatives, one happens to be H.R. 676. But what we are speaking about 
is to keep all doors open, all voices open, because as you can see, the 
idea of coming together around fixing the health care system is going 
to ensure that we have the kind of baseline of service that will help 
all Americans.
  And let me just make a point to my distinguished colleague. We were 
just in a hearing on the collapse or the bankruptcy of Chrysler and 
General Motors, and I call it a collapse, and I call it a crisis. And 
why? Because we're putting people out of work. Even with the bankruptcy 
structure they're closing dealerships. They are closing minority 
dealerships. They're laying people off work.

[[Page H5994]]

  Well, it was projected in a hearing by some of our colleagues on the 
other side of the aisle that it was this labor union health care cost 
that brought the industry to its knees. I refuted that by saying it was 
the lack of health care in America, and thank goodness for labor unions 
who are willing to protect their retirees and the workers and give them 
health care.
  And so just take the example of having this access to health care, 
this public option, this new reform that would help ensure the 47 
million uninsured or give companies an option. That would have helped 
General Motors and Chrysler, not putting the burden on labor unions.
  And let me digress for just one moment, and I appreciate the 
gentleman yielding to me, and I just have to do this because it has to 
do with focus. It has to do about what is important for this Congress 
to go forward on.
  And today, as you well know, there was an individual that stood up to 
offer a privileged resolution regarding our Speaker, and I just for a 
moment have to champion her cause and say that these are the kinds of 
distractions that take us away from focusing on the needs of the 
everyday men and women of America. There's some representation about 
comments regarding the briefing that our Speaker received as it relates 
to torture. I was there during that period of time, and I am well aware 
of the atmosphere.
  First of all, we should note the Speaker has indicated to have all 
files released, one point. The second point is in the 1990s, or let's 
say after 9/11, we had the presentation being given by the Bush 
administration at the United Nations, and the backbone of that 
presentation happened to be the Agency. Of course, we seem to be living 
in an atmosphere of being misled.
  So, to my friends on the other side of the aisle who don't look at 
the real facts of this case, I ask them to do so, but then I ask them 
to wake up and ask the question of themselves: What do Americans want 
us to do? They want us to address the question of recession. They want 
us to address the question of mortgage foreclosure. And they want us to 
address the question of health care.
  And so, for that reason, let me thank you for allowing me to be here. 
We will be having town hall meetings in my congressional district. I 
look forward to travelling to other districts, joining my colleagues to 
talk about the public option, the value of the single payer.
  And the message that I leave here is I don't believe any aspect of 
health care reform should be left out. I frankly believe that under the 
public option designation, which means that there is something similar 
to Medicaid and Medicare in a more efficient manner, you could in 
essence put a single payer choice under that particular structure so 
that just as people are arguing for individuals to keep their own 
doctors, you could in fact say, well, you want choice in this way, I 
want a choice in public option, and we can come to the table and meet 
ourselves head-on and find the kind of relief that the American people 
need.

  So I'm delighted to be here with my good friend and colleague, 
Congresswoman Watson, and you have my confidence and support on how we 
move forward in the evidence of your great works in bringing to the 
American people what we need to do for good health care reform.
  Mr. ELLISON. Let me thank the gentlelady. We hope that she can stick 
with us because we'll be here for a little while, but I want to turn 
right now to another champion of the progressive values around health 
care, around diplomacy, around so many critical issues. Congresswoman 
Diane Watson's been a stalwart champion, and so I want to invite the 
gentlelady right now to just give some opening comments and reflections 
on this critical health care debate that's going on right now in our 
Nation's Capital and across America.
  Ms. WATSON. Thank you so much for yielding, and Madam Speaker, thank 
you for presiding this evening.
  I wanted to join my colleagues because it's important that we speak 
on such a critical issue as health care, and as we all know the United 
States is the only industrialized Nation to not offer universal health 
care to its citizens. Currently, there are only 47 million people 
without health insurance, and as a Nation we're facing a real health 
care crisis.
  Did you know that blacks are far more likely than whites to die from 
strokes, diabetes and other diseases? Six million African American 
adults are uninsured or experiencing gaps in their coverage, and one-
third of all adult African Americans are without health care. Sixty-one 
percent of African American adults who are uninsured during the year 
reported medical bills or debt problems, compared to 56 percent 
uninsured white adults and 35 percent uninsured Hispanic adults.
  About one-third of African American adults visited an emergency room 
for a condition that could have been treated by a regular doctor if one 
had been available, compared to 19 percent of Hispanics and 19 percent 
of whites. Hispanics and African American working age adults in the 
United States are at greater risk of experiencing gaps in insurance 
coverage, lacking access to health care and facing medical debt than 
white working age adults, and usually when African Americans come in to 
a health facility, they come in more acutely ill. They go into 
emergency and end up in the surgical suite at a great cost.
  Uninsured rates for working age African American adults are also 
high, with one-third, or 33 percent, more than 6 million adults 
uninsured who are experiencing a gap in coverage during the year. 
Sixty-two percent of Hispanic adults, age 19 to 64, an estimated 15 
million adults were uninsured at some point during the year, a rate 
more than three times as high as that for white working age adults.
  Minorities are less likely to be given appropriate cardiac medicine 
or to undergo bypass surgery. Studies show significant racial 
differences in who receives appropriate cancer diagnostic tests and 
treatments.
  Mr. ELLISON. To the gentlelady from California, the statistics you've 
laid out are excellent, and I'm sure we all need to hear more of that. 
But I just want to ask you for a moment, if I may, in all the 
statistics that you have read--and they're startling--as you walk 
around your district in California and you talk to people, just regular 
folks like at the grocery store, do they tell you stories about their 
lives, which really are reflective in some of the statistics that you 
have been sharing with us? I yield.
  Ms. WATSON. Absolutely, and I just want to mention the demographics 
of my district. I have a third African American, a third other people 
of color, and a third majority, and I have some very wealthy real 
estate and some very poor real estate in my district. And what I do to 
accommodate their concerns is send out a questionnaire, and I have five 
regional advisory groups that come maybe every quarter to my office in 
the conference room, and I list their concerns. And then we go over 
each one of the concerns, and what comes at the top is education.
  But health care depends on the area that you're in. The very wealthy 
people can pay for their 50-minute hour with their psychiatrist. So 
health might come in the middle or down in the lower area of their 
responses. But in the lower socioeconomic areas, you can always find it 
near the top. Education is at the top but health care would follow.
  Mr. ELLISON. So as you walk your district and you talk to folks, just 
regular folks, whether they be from the rich district you're talking 
about or the not-so-rich district, you're saying that people are 
concerned about this issue of health care?
  Ms. WATSON. Yes, they are, and particularly in this era when we have 
a critical economic crisis they are really concerned about health care. 
They're out of a job. They don't have any insurance. They don't even 
get their retirement. Some of them worked for, I would say one of those 
discount master store. I won't call any names.

                              {time}  1945

  And they work part-time and there are no benefits. And these are the 
people that fall at the end of that spectrum.
  Mr. ELLISON. Well, I thank the gentlelady for yielding back. We're 
going to be right back with the gentlelady in a moment.
  But at this time I'd like to get into the conversation one of the 
very fine physician who happens to be a Member

[[Page H5995]]

of this esteemed body, and we're so happy that he is a member of the 
Progressive Caucus too, and that is Jim McDermott, a physician, Member 
of Congress, a long-term practitioner of medicine, who is going to give 
us a thought on his reflections on where we are in health care, and as 
a member of the Progressive Caucus.
  And I yield to the gentleman from Washington.
  Mr. McDERMOTT. Thank you very much, Congressman Ellison.
  I think that one of the interesting things about the debate that's 
going on in Congress right now is that the debate seems to be that we 
can't have a single-payer system in this country. The people aren't 
ready for it, or it won't work, or whatever, there's all kinds of myths 
around that.
  And one of the fascinating things about it is that now, as we come to 
the President's proposal, he's proposing that we have a public option 
among those choices that people will have when the national health plan 
is put in place.
  Now, everybody immediately says, oh, we don't want a public option. 
We don't need that. The private industry has--they'll come up with 
enough options and people will have choices. The problem is people 
won't have money to pay the premiums.
  Well, the fact is that the American health insurance industry has had 
full chance to do it since 1933, when Franklin Delano Roosevelt took 
this off the agenda. They've had more than 60, more than 70 years, 
almost 75 years to come up with a plan to cover all Americans, and they 
have not done it.
  Now, there has to be a public option, and it has to be a good option. 
There is an interesting book, if people are interested in reading about 
this whole thing, it's called Do Not Resuscitate, meaning do not 
resuscitate the health insurance industry that's dying. But that means 
we've got to have a good public option out there for people to choose.
  Now, people say, why do we need a public option?
  You need the competition of the public option to drive the health 
insurance industry prices down.
  What's happening today--in fact, when Mrs. Clinton tried this effort 
15 years ago, in 1993, we had almost 1,800 insurance companies in this 
country. That industry is rapidly contracting to the point where today 
we have around 800. And in many States, particularly rural States in 
this country, they have one choice of an insurance company, not two. So 
you've got an insurance company, or maybe they'll have two. But there's 
no competition in that kind of situation. And you need the government 
plan.
  Now, the reason? Why is that? Well, very simply, Medicare has 
administrative costs of about 3 percent. That means you give a dollar 
to Medicare, 97 cents goes out in health care benefits to older people 
in this country. If you give money to a private insurance company, 82 
cents, on average, goes out to people. In many companies it's 70 cents 
is all that gets out to people who are sick.
  So we need a Medicare-like, a government option to compete with 
private industry to drive down those costs, because costs are what are 
killing our health care system today. Costs are going up much faster 
than inflation. People are finding their deductible higher. They are 
finding their co-pays higher. They're spending more money out of their 
pocket, even though they have health insurance. They think, well, I'm 
covered. I've got this illness, but I don't have to worry. I'm just 
going to go and have it taken care of. And suddenly they find out 
they've got huge bills left after, and that's because the plans are 
simply not taking care of people's needs. And we need a government 
option.
  Now, there are several things about a government option. First of 
all, it has to be one in which it takes anybody. You can't give the 
insurance companies or anybody else the ability to say, I'd like to 
take that person, but I don't want to take that person. That person's 
old or that person looks sick, so I don't want to take care of them. I 
just want to take premiums from people who are healthy.
  And the government option has to be one that takes everybody, and so 
do all the private insurance industry. If we have a health care bill 
that goes out of this House that does not have insurance changes in it 
that requires everybody to be taken, then we haven't done what we need.
  You heard the disparities in minority communities in this country, 
and it's also, it's just poor people. It's really not minorities as 
much as it's poor people who don't have the same kind of health care 
that people do who have a lot of money. I mean, that's the way it is. 
And we ought to be honest about this and say if we're going to do a 
national plan, it takes everybody.
  Now, it also has to give the same set of benefits. Whether it's a 
private plan or a public plan, it ought to have the same benefits.
  Now, if the private industry can compete with a government plan, 
that's fine. But if they can't, they're going to have to find ways to 
bring their prices down. They're going to either have to squeeze their 
profits or do something to change the way that goes.
  Pre-existing conditions. I had a patient or a woman in my district 
who was an opera singer. She went to Germany, had a contract in Munich. 
The minute you go into Germany you're in the German system. You're 
taken care of.
  Her daughter got leukemia. They spent thousands and thousands of 
dollars treating the child. She came back. The child had remission, and 
so they came back to the United States. The woman couldn't find an 
insurance company in the United States that would give her insurance, 
except at exorbitant rates, $2,000 a month.
  Now, why is it that the Germans can figure a way to do that, and we 
can't in this country?
  And my view is that you have to have no pre-existing conditions, 
you've got to let everybody in, and you've got to give the same set of 
benefits. And I think that the public option is essential for any bill 
that goes out of here.
  Mr. ELLISON. Will the gentleman yield?
  Mr. McDERMOTT. Yes.
  Mr. ELLISON. I'd just like to pose a question to the gentleman. There 
is a Web site called feedback progressive Congress. This is a Web site. 
It's called feedback.progressivecongress; 250 people went to that Web 
site and asked the question, how will you stop denial of pre-existing 
conditions?
  And I yield back to the gentleman. For those 250 folks who got on the 
Web site and want to know, what do you think?
  Mr. McDERMOTT. You essentially make a decision at the Federal level 
that we are going to require all insurance companies to take everybody. 
They cannot use pre-existing conditions.
  One of the things that happened back in the Forties was a bill was 
passed in this House called the McCarran-Ferguson Act, and that said 
that all insurance decisions should be made at the local level. So we 
gave it to the States. So you've got 50 different insurance 
commissioners doing 50 different things all over this country.
  When we come to a national health plan that Barack Obama's going to 
sign, it has to have a national standard that every insurance company 
has to cover everybody. And you can't say, well, you know, they are 
this ethnic group or they're a little bit overweight or they smoke. The 
only thing you can make changes is on age. Obviously, as you get older, 
there is more likelihood that you're going to have problems. But that's 
the only kind of rating that there can be in a system that's going to 
be fair to everyone in this country.
  And the insurance companies, they obviously didn't want to take care 
of this woman's kid because they knew that the chance was she might 
have a recurrence of her leukemia, and they could see her sitting right 
there and know she had had the disease, so they said, that's a pre-
existing condition. We don't want that family.
  You can't let that happen when we write this national plan. It has to 
be written right here on the floor. They can't trust it to 50 States 
because some States will have a good insurance commissioner and some 
will have people who are not quite so publicly spirited.
  And my view is that we have to make that decision, and I think the 
President will support us in that.
  Mr. ELLISON. If the gentleman would yield again.
  Mr. McDERMOTT. Sure.
  Mr. ELLISON. Forgive me for these questions, but at this same Web 
site,

[[Page H5996]]

which is feedback.progressive
congress.com, the question was posed, Will you, meaning the Congress, 
vote against a reform plan without a public option?
  And then it goes on to say, a couple of months ago, Progressive 
Caucus made a promise to vote against any health care reform bill that 
does not include a strong public option. Health reform without a public 
option is no health reform at all. Will you continue to stand by your 
pledge to the American people to insist on a public option for health 
care by voting against any bill that does not include it?
  And this question was asked by 1,434 people. And the first person to 
ask the question was Mike.
  Mr. McDERMOTT. Well, in my view, if we have a plan brought out on 
this floor without a public option in it, it is not universal coverage, 
because that means the insurance companies have won the whole game. And 
if they believe in the free enterprise system, then they believe in 
competition, and they ought to be able to compete with a government 
plan that's well done, and not given any special advantages, just the 
fact that it's going to be done without profit, so you're not going to 
be worrying about--insurance companies worry about profits for 
stockholders. The government doesn't worry about profits for 
stockholders. It worries about giving services to human beings. That's 
why the administrative costs in Medicare are so much less than those of 
an insurance company.
  So I can't imagine myself voting for a plan that does not have a 
public option in it.
  And I'll tell you one of the little tricks that people have to be 
watching for. In the part D in Medicare, which was the drug benefit, 
they said, well, if there aren't two plans in an area from the private 
sector, then they would go to a public option. Guess what? The industry 
went out there and got involved everywhere, mostly because we gave them 
such heavy subsidies that they could make a lot of money. So they said, 
yeah, we'll go in and treat, we'll deliver drugs to people in this 
country. And it was a false public option. It says public option in the 
bill, but they knew it would never happen because they subsidized the 
pharmaceutical industry to such an extent that it just never--they were 
making money so they stayed and did it, and we didn't need a public 
option.
  Mr. ELLISON. Well, if the gentleman would yield, I want to get 
Congresswoman Lee involved in the conversation. We'll be right back 
with the gentleman in a moment because I know the gentleman has plenty 
more to go, the good doctor from Washington State.
  But we do have with us Congresswoman Barbara Lee, who is wearing a 
fabulous blue suit tonight, but more importantly than that, has been a 
fighter for people for so many years on so many issues; currently, the 
chairperson of the Congressional Black Caucus.
  Congresswoman, give us your thoughts on the progressive vision for 
health care in America, the debate going on right now and all across 
America.
  I'll yield to the gentlelady.
  Ms. LEE of California. Thank you very much. I want to thank the 
gentleman for yielding, for his generous comments, and for your 
leadership.
  And a couple of things I'd just like to say as I was listening to the 
discussion tonight.
  First of all, and Doctor, Congressman McDermott, I'm very pleased and 
delighted that you laid out why a public option is necessary to reduce 
health care costs. That fact, I think, is often missed in this health 
care reform debate.
  I personally think that single-payer--and I have to applaud 
Congressman Conyers and all of those who are supporting H.R. 676.
  Mr. McDERMOTT. Me too.
  Ms. LEE of California. That's where we should start. That's where we 
should start. And whether one agrees or disagrees with single-payer, 
that option has to be on the table for us to even move toward universal 
affordable health care for all. But I hope that we end up with single-
payer.
  And when you look at Medicare and when you look at single-payer, it 
works. It has worked for many of our veterans in terms of cost 
containment of medical costs. The VA is allowed to purchase 
pharmaceuticals and drugs at a price that is lower than on the open 
market, and so it just makes a lot of sense. So a public option is 
absolutely necessary, and I'm very proud of the fact that the 
Congressional Black Caucus has gone on record calling for a public 
option.
  Also, let me just mention the importance of closing health care 
disparities. I was listening to Congresswoman Watson earlier talking 
about that. When you look at the disproportionate rates, for example, 
of HIV and AIDS or of diabetes or of other diseases in communities of 
color and, of course, on top of that, we have the poor, and rural 
communities.

                              {time}  2000

  So, if we don't look at closing health care disparities and look at a 
strategy for that and at health care reform, we're going to end up with 
another two-tiered system. We will have health care reform for those 
who can afford it, but we'll have the millions of people who have 
historically had these disparities, because of the economics of their 
lives and because of the circumstances of their lives, who won't be 
included at all in any new health care reform effort.
  I, personally, don't believe health care should be an industry. I 
mean profits should not be made off of sicknesses and illnesses. We 
should begin to understand that, as we keep health care as a profit 
motive only, we'll never have the type of system that's affordable and 
accessible for all.
  Prevention: What is it? An ounce of prevention is worth a pound of 
cure. We have to focus on prevention in any health care reform. Many of 
us have ended up in emergency rooms with our families, and we see what 
happens in emergency rooms. Many people, especially in communities of 
color, end up going to emergency rooms for primary care or they go to 
emergency rooms when it's really too late and when they could have had 
some form of preventative treatment. So we have to look at prevention 
as key in this reform debate.
  Also, community clinics: Community clinics provide access to the poor 
and to rural communities as well as to urban communities and to 
communities of color. So I hope, in any debate and in any health care 
reform we have, that community clinics become central in that effort.
  Mental health care: Congressman McDermott, you are a psychiatrist by 
trade, by profession. I'm a clinical social worker. We've fought for 
years for mental health parity. Now mental health parity, thanks to 
Congressman Patrick Kennedy and to Senator Kennedy, it's the law of the 
land. In any health care reform efforts, we have to include mental 
health as being as important as one's physical health.
  So, Congressman Ellison, I'm really pleased that you're continuing to 
beat the drum for the Progressive Caucus on the issue of health care 
reform. You are putting forth our vision of health care reform, which 
is really a vision that addresses the majority of Americans in our 
country. It actually affects all Americans and it impacts all 
Americans. So the progressive promise, which the Progressive Caucus 
laid out several years ago, is a promise for the entire country.
  Tonight, once again, we're talking about that promise. Hopefully, 
that promise and that dream will be realized as we move forward and 
provide health care for all.
  Mr. ELLISON. Will the gentlelady yield for a question?
  Ms. LEE of California. Yes, I will yield.
  Mr. ELLISON. The Progressive
Congress.org asked for questions for the Progressive Caucus and for 
other progressive legislators on the issue of health care. Fifty-nine 
people want to know: What about the chronically ill?
  There is a lot of talk about subsidizing ``those who can't afford 
it.'' What about subsidizing the chronically ill, who have to pay 
outrageous fees for minimal access? What will you do for them? Is it 
the sick who need health care subsidies, those who truly cannot afford 
it at any income level?
  You mentioned HIV/AIDS. You mentioned other chronic illnesses. I 
wonder if the gentlelady has any views on that topic.

[[Page H5997]]

  Ms. LEE of California. Sure. The chronically ill should be a priority 
in our health care reform effort. Unless one has health care 
insurance--which, of course, in any health care reform plan, one can 
maintain one's health insurance. So, if one has the insurance to cover 
chronic illness, that's great and that's fine. That coverage will be 
maintained. For the chronically ill who have run out of funds and who 
don't have any money and who don't know what to do next, we have to 
include the chronically ill in our health care reform package. We have 
to include long-term care and other types of provisions and policy 
initiatives for our senior citizens, for example, or for the disabled, 
who deserve long-term care. This has got to be covered. This is a must.
  I believe the Progressive Caucus gets it, and I think the rest of the 
country gets it. So we have to make sure that this is part of our 
effort and of our legislation.
  Mr. ELLISON. I thank the gentlelady for yielding back. I hope the 
gentlelady can hang on with us for a little while longer.
  Mr. McDERMOTT. Could I just say one thing?
  Mr. ELLISON. Yes, the gentleman from Washington.
  Mr. McDERMOTT. Representative Lee raised the question of profits for 
insurance companies.
  Between 2000 and 2007, the insurance companies profits in this 
country went from $2.4 billion to $12.9 billion.
  Mr. ELLISON. If the gentleman would yield, would you repeat that?
  Mr. McDERMOTT. $2.4 billion to $12.9 billion. That's an increase of 
428 percent.
  Mr. ELLISON. Wow.
  Mr. McDERMOTT. Now, you're going to see ads on television saying, oh, 
this government option is the worst thing that has ever happened to 
this country and that we need to save the poor, struggling insurance 
companies. Just remember those figures.
  The average collective salary of the executives, the CEOs, is $118 
million. That's an average of $11.9 million a piece. If you're running 
an insurance company and you're making $11.9 million, what do you think 
your real interest is in taking care of people? Your interest is in 
getting as much money as you can. Give it to the stockholders and keep 
it for yourself. That's why we have to have a public option where the 
public good is the driver in what we try to do.
  Mr. ELLISON. Will the gentleman yield for a moment?
  Mr. McDERMOTT. Yes.
  Mr. ELLISON. In Minnesota, we have a health care company where a 
particular executive, who is no longer there, made $100 million every 
year. If he made $90 million one year, he'd have to chalk that up as a 
bad year for him. Here is my question:
  If this hypothetical but real gentleman only made, say, $10 million a 
year--just $10 million a year--wouldn't there be at least another $80 
million to $90 million a year just out of his salary alone to extend 
coverage to more people?
  Mr. McDERMOTT. Of course.
  Mr. ELLISON. Would the gentleman or the gentlelady like to address 
this issue?
  Mr. McDERMOTT. I mean the answer is so obvious that I know you're not 
asking me a question, because it's clear that the money that people are 
paying in premiums is not going to pay for health care. It's going to 
pay for a whole lot of other things. That's why we want a strong public 
option that takes the money that people pay and has it pay for health 
care.
  Mr. ELLISON. Would the gentlelady like to weigh in?
  Ms. LEE of California. Health care is big business. It's profit-
driven. It's big business such as any corporate entity in our country. 
In any health care reform package, we have to make sure that it is not 
the profit motive that's driving health care reform. All of us have 
instances where we know of either constituents or of family members who 
have to wait on an account executive to make a medical decision for 
them, and that account executive has to go back to the corporate 
officials to determine whether or not this individual will be allowed a 
certain medical treatment. That is wrong. It's really unethical. It's 
hard to believe that that is still happening in our own country.
  Let me just say that I lived in England for 2 years, and I'm not 
saying there is any system that we need to look to as a model, but I 
have to just tell you that I lived in Great Britain. My first son was 
born in Great Britain. I've lived under a different health care system, 
and I know what that system provided, not only to British citizens but 
to me, and I was a U.S. citizen who was living there for 2 years. It 
was a system that was much further advanced than, I think, we have ever 
had in our own country.
  I say that because there are other ways to do this, and we need to 
look to see what the best ways are in terms of health care systems 
throughout the world. It's being done differently, and people are 
benefiting in other countries, and we just need to know that there are 
other options.
  Mr. ELLISON. Will the gentlelady yield just for a moment? I just want 
to ask you a question. I pose this question to both the Members of 
Congress who are with us tonight.
  Aren't you talking about socialized medicine? Aren't we supposed to 
be scared of this?
  I yield to the gentlelady.
  Ms. LEE of California. Well, let me just say that, by any stretch of 
the imagination, I don't believe that England is a socialist country, 
and I'm not talking about socialized medicine. I know what ``socialized 
medicine'' is.
  What I'm talking about is making sure of our values as American 
people, as people who care, the least of these being ``I am my 
brother's keeper;'' ``I am my sister's keeper.'' I'm talking about the 
most powerful, the most wealthy industrialized country in the world 
having 47 million people uninsured, and it's growing. There are 10 
million more now as a result of this economic downturn that has 
resulted from these last 8 years of Bush's economic policy.
  So come on. We have to begin to look at how we begin to reflect our 
values as Americans in this great democracy, and we have to begin to 
say that we're going to be concerned about everyone who deserves health 
care but who does not have health care. So, no, that's not socialized 
medicine. Trust me. I know what socialized medicine is, and I don't 
think anybody on this House floor would want to see our country enact a 
socialized medical system.
  What we want is a universal, accessible, affordable health care 
system for all regardless of one's ability to pay, regardless of one's 
disability, regardless of preconditions, regardless of one's ethnicity, 
regardless of one's economic status. As long as people don't have the 
money to purchase a large health care policy, then they should at least 
be provided with a public option so they can live. This is about, you 
know, life. This is not about counting beans. This is about life and 
death issues.
  Thank you.
  Mr. ELLISON. If the gentlelady would yield back, I just want to pose 
a question to the gentleman from Washington, Congressman McDermott.
  Before you make your point, could you just address this issue? I 
think, as we go through this debate, there will be people who will say 
that a public option is nothing but socialized medicine. In fact, I've 
heard this word ``socialist'' thrown around already in this Congress. 
What do you say to this?
  I yield to the gentleman.
  Mr. McDERMOTT. Well, first of all, the American people would be 
offered a plan from the United States Congress. Yet, as the President 
has said, if you have insurance, you can stay right where you are. If 
you're satisfied with it, stay right there. Don't worry. You're not 
going to be made to do anything, but we are going to offer you a choice 
of a public option. Now, if you don't like what you're in now and you 
want to move over to the government program, you can do it.
  That is not socialism. That is not forcing everybody to do the same 
thing. That's saying, if you want to stay where you are, fine, that's 
all right, but if we put together a good public option and it looks 
better to you, it's your free choice.
  Mr. ELLISON. If the gentleman would yield for a moment, should 
Americans not be afraid of some of these terms that are tossed around? 
Is there nothing to fear? Is that what you're saying?
  I yield to the gentleman.
  Mr. McDERMOTT. I'm saying that you're going to see a big campaign of

[[Page H5998]]

fear mongering, of trying to make people afraid by using all kinds of 
words. The fact is that they are simply deceptive in the worst sort of 
way when people are vulnerable and when they're sick. Then somebody 
tells them, ``Oh, you don't want that because--''
  In 1993, there were some ads on there called ``Harry and Louise.'' 
They're sitting at the kitchen table, and Harry says to Louise, Do you 
know that the plan that Mrs. Clinton is putting together is going to 
take away your health care?
  Well, that was simply to scare people, and people, since they weren't 
sure, decided they didn't like her plan, but we could have had this 15 
years ago. We could have had a change in this country 15 years ago. Now 
we get a second chance. This time, the people are in much worse shape 
than they were then. Business wants it. Labor unions want it. Even 
doctors today who were sort of against Mrs. Clinton's plan now are 
saying, you know, you can't deal with insurance companies. So you've 
got a whole bunch of different people this time who are saying we need 
a public option that can make the system fairer and that can work for 
everybody in the country.
  The people can choose. The American people are not stupid. They're 
not going to fall for this kind of advertising that they used the last 
time.
  Mr. ELLISON. I thank the gentleman for yielding back. I'll yield to 
the gentlelady from California.
  Ms. LEE of California. Yes. I would just like to say that the 
question has to be asked of the public:
  Why would companies with big bucks run these advertising campaigns? 
It's to try to scare people. This money that's going to be put out 
there is very, very--I would say--wrong. Again, Congressman McDermott 
said that it's almost preying on the most vulnerable when they need 
help, when they need something. So it's sinister to mount that type of 
a campaign and to believe that any of us would want socialized 
medicine. It's a scare tactic. I think we all have seen this before.
  I thank you, Mr. Ellison, for having these Special Orders, because 
we've got to sound the alarm and beat the drum and let people know that 
no one is talking about socialized medicine.

                              {time}  2015

  I hope the country hears us loud and clear. No one is talking about 
socialized medicine. We're talking about affordable, accessible health 
care for all with choice as being central to that policy.
  Mr. ELLISON. I thank the gentlelady.
  Let me point out as we walk into this new round of debate in health 
care, there is a pretty well-accomplished Republican adviser and 
consultant who has come out to be heard on this issue. And the 
gentleman, Frank Luntz: ``Warns GOP Health Reform is Popular.'' This 
has been published. This is a headline. Mr. Luntz is telling his 
constituency that health reform is popular, and he's warning the GOP 
what they should do if they ever want to come out of the cold.
  Dr. Frank Luntz, a top Republican consultant on the language of 
politics is warning the GOP that the American people want health care 
reform and that lawmakers need to avoid directly opposing President 
Barack Obama. ``You simply must be vocally and passionately on the side 
of reform,'' Luntz advises in a confidential 26-page report--I guess 
it's not so confidential now--obtained from Capitol Hill Republicans. 
``The status quo is no longer acceptable if the dynamic becomes 
President Obama is on the side of reform and Republicans are against 
it. Then the battle is lost and every word in this document is 
useless.''
  I think it's important to bring this out because we, of course, care 
about our Republican colleagues. We're all in the same body. And I 
think the advice to them is to avoid the fear stuff, because as Frank 
Luntz, a man who knows this stuff, has said, health reform is popular.
  I wonder--I mean, do either one of the esteemed Members have any 
views? Is this health reform that is talked about all over the Nation, 
is it popular? Do people really want it, and does a politician who 
stands against reform run the risk of paying the price at the polls?
  I offer the question to either Member.
  Mr. McDERMOTT. Well, you know, the Republicans didn't do anything in 
8 years on this issue. Nothing. Not one more person was covered than 
was before. In fact, the number of uninsured went from 35 million to 
almost 50 million during the period that George Bush and his cohorts 
were running this place.
  The American people in November of 2008 made a decision: we want 
change. We want something different. And President Barack Obama has 
offered the leadership and has said this is the way we ought to go and 
has laid it out and the Congress is working on it. Anybody who opposes 
this in the long run is going to be taking a real risk in the next 
election saying, Oh, I was against that because--because why? Because 
you wanted to give the insurance companies everything? Is that what it 
was you were after? Or is it because you don't think that we can make 
any changes in the system; the system is perfect?
  One of the things I was going to quote for you, there is a man named 
Zeke Emanuel. He's the brother of our President's administrative 
assistant. He's the head of the department of clinical bioethics at the 
National Institutes of Health, and he says this: the U.S. health care 
system is considered a dysfunctional mess. Conventional wisdom has been 
turned on its head. If a politician declares that the United States has 
the best health care system in the world today, he or she looks 
clueless rather than patriotic or authoritative and they run the risk 
of opposing--if they oppose this, they are going to look like they are 
out to lunch.
  And I think that's not a good situation to be in when you're running 
for re-election.
  Ms. LEE of California. You can't tell me that the 47 million 
uninsured in our country are all in Democrats' districts. You can't 
tell me that it's only Democratic Members' constituents who are 
uninsured. The lack of health insurance is an equal opportunity 
destroyer. So just as with the economic recovery package, I said over 
and over again, people have lost their jobs not only in Democrats' 
districts but in Republican districts. And so the public wants health 
care reform. I don't care what party they're registered with and who 
represents them.
  We have to also remember that given this economic downturn, the first 
reason for bankruptcies, the top of the list, health care. Health care. 
That's the reason people are filing bankruptcy. The first reason, the 
cost of health care.
  Mr. ELLISON. Well, you've opened up an issue that I would like to 
explore for a moment, and that's an issue of cost and expense, how much 
is it costing. I think the gentleman from Washington already talked 
about the exorbitant expenditure. And this chart I have to the right--
projected spending on health care as a percentage of gross domestic 
product--what this chart shows is that we are nearly approaching 50 
percent of gross domestic product when you add up all of health care. 
This big shaded area, the light blue-gray area here is all other health 
care. This little thin slice is Medicaid, and this low slice down here 
is Medicare, which we all know is one of the most efficiently run 
health care systems that we have--by the way, a single-payer system.
  And we've seen, as the percentage of GDP that if we add it all up, 
it's getting up to 50 percent. And my question is--and by 2082, it will 
be 50 percent. Here we are back here. It's been crouching up. And now 
we're in the realm of approaching 15, 14 percent. But if it keeps on 
growing, we will be paying 50 percent of our gross domestic product in 
health care by 2082, which, quite frankly, is not that long from now.
  These numbers are going in the wrong direction.
  I also want to bring up another chart very briefly. And this chart 
talks about net insurance program administrative costs as a percent of 
total spending. The fact is, if you look at Medicare, administrative 
costs are pretty low, about 5 percent or less. Medicaid, a little 
higher, 8 percent. Top five private companies, 17 percent. Small group, 
29 percent. Individuals, 41 percent. Average private insurance, 14 
percent.
  My question is, can we continue to see administrative costs be so 
high?

[[Page H5999]]

When we talk about having an insurance program, what are the 
implications for the average citizen trying to get health care?

  I yield to the gentleman.
  Mr. McDERMOTT. Let me give you just one figure out of that.
  When we looked at that in 1993, the administrative costs were--we 
could save $140 billion by going to a single-payer system. The 
administrative costs in that system are totally out of control.
  I'll give you another way to look at it, to really think about it. 
France has been judged to have the best health care system in the world 
by the World Health Organization. They spend one-half as much per 
person as we spend in the United States, and they have one doctor for 
every 430 people. And in the United States, we have one doctor for 
every 1,230 people.
  Now, you can't tell me that the French are that much smarter than us, 
that they could figure out how to get the best health care system--
we're rated 37 when you look at infant mortality and maternal mortality 
and longevity and morbidity for hypertension and for diabetes and all 
of these other things. We are not in the best health care system in the 
world despite of what we're spending.
  Mr. ELLISON. But are we number one in any particular aspect?
  Mr. McDERMOTT. We're number one in how much money we spend.
  And my view is there's plenty of money in this system if we were more 
efficient and had more primary care physicians. I put in a bill that 
would make medical school in public medical schools free. In exchange 
for that, a medical student coming out would serve 4 years in primary 
care in underserved areas or inner-city areas--areas where people are 
underserved, whether it's the urban or the rural area. And we would 
take the debt load off our students. That would cut down the costs of 
medical care in this country.
  We can do some things that would be real game changers if we were to 
change. Right now, most medical students go through and go into a 
specialty because they have to pay off their debts. And we can stop 
that. There are a lot of ways we can cut costs if we start thinking 
about those issues.
  Mr. ELLISON. I thank you.
  If I could yield to the gentlelady from California
  Ms. LEE of California. It doesn't take a rocket scientist to 
understand that the billions of dollars going for administrative cost 
that drive up the cost of health care is what I'm talking about when 
we're talking about the profit motive and the fact that there are big 
bucks being made in the health care industry. And that is what is 
driving up the cost of health care in many respects.
  So we have to get to a system that allows for, yes, profits for those 
who want to make profits, for those who have those types of health 
care, you know, who can afford those types of health care premiums. But 
also we've got to have some fairness and some justice in this health 
care system for those who can't afford those kinds of plans.
  And, in fact, single-payer, as Congressman McDermott said earlier, 
it's been shown that you drive down the cost of health care if you have 
single-payer. And I think the American people need to believe this and 
understand this, and if they just look at what you just showed us 
earlier in terms of the cost of health care and if you have a system 
that is fairer, then you will drive down those costs and then everyone 
will be able to afford health care. And that has nothing to do with 
running any company out of business. I support companies, the business 
sector, making money, making profits. I was a business owner for 11 
years. So I get it. But I don't get how in the world can you do that at 
the disadvantage of 47 million-plus who are desperate for some kind of 
health care coverage.
  So we have to deal with this quickly.
  Mr. ELLISON. If I could ask the gentlelady a question. You just noted 
that you were a business owner for 11 years. How does a public option, 
single-payer impact small business people? Is this going to put them 
out of business as we've heard, the scare tactics and so forth? Or 
would this, perhaps, help them out?
  Ms. LEE of California. I will tell you as a former small business 
owner, had we had single-payer, my business would have thrived a little 
more. Small businesses need help. Small businesses want to insure their 
employees because they know that a happy workforce, a workforce that 
has good benefits, good wages, decent wages, living wages, that's how 
productivity is ensured. When you have businesses that are struggling 
to survive because they can't afford the cost of health care, they need 
some help.
  A single-payer system would help small businesses with their health 
care costs. And I have talked to many, many, many small businesses 
about health care reform, and many of them agree they need some help 
because they know that health care reform could drive their costs up 
and they don't want that, they don't need that. And we have to make 
sure that our small businesses are treated fairly and that the 
employees have health care coverage. And the single-payer system would 
certainly help small businesses move forward and insure their 
employees.
  Mr. ELLISON. I thank the gentlelady for making that clear about small 
business because it is important that for people to know that we have 
this burgeoning coalition of people who want to see single-payer, at 
least want to see a public option. Clearly, we know that the forces of 
labor would like to see this public option and many of them call for 
single-payer. We know that the Chamber of Commerce has said we need 
health care reform. They may not be calling for single-payer, but some 
are. We know doctors are. But also as you pointed out, it's critical to 
know small business people would benefit from single-payer or at least 
a public option, which is critical.
  And I just want to say, as we begin to wrap up the night, that the 
need for health care reform in a public plan is essential. Reform will 
alleviate the burden on families by lowering costs, ensuring timely 
access to affordable health care, making sure that everybody has access 
to preventative care to help keep people healthy so those people that 
you were referring to don't have to worry about their employees being 
sick and not coming to work. They got a plan so they're coming back to 
work every day.
  And allowing workers to change jobs without worrying about losing 
health care. In this age of increasing unemployment, should a person 
lose their job and lose their health care? It's a scary prospect, and I 
suppose I pose that question to the gentlelady as well.
  As you talk to your constituents and you walk around the City of 
Oakland and you're in the grocery store, and you're in the park and in 
the community meetings, what are you hearing about people's fears as it 
relates to how they might lose their job--I mean, lose their health 
care if they should happen to become unemployed?

                              {time}  2030

  Ms. LEE of California. You know, right now people are worried. First 
of all, in a country as great as ours; in a country that spends over 
$600 billion for defense, and more; in a country that spent close to a 
trillion dollars on wars that should not have been fought, it is a 
shame and disgrace that a person has to fear and worry about losing a 
job and health care. I can't understand this. I can't believe that our 
values are there.
  I think that this is a debate that has ethical and moral dimensions 
for us as a people. And I can't imagine any Member on this House floor 
wanting to see a person lose a job, and then health care, and not want 
to do something about it immediately.
  So I want to thank you for your leadership. I want to thank the 
Progressive Caucus for their leadership. And we're going to stick with 
this public option. We want disparities closed. We want community 
clinics, we want prevention. There's big, big pieces of this health 
care reform bill that we're insisting on.
  Thank you, Mr. Ellison.
  Mr. ELLISON. Let me thank the gentlelady for yielding. That will 
close us out for the night.

                          ____________________