[Congressional Record Volume 155, Number 83 (Thursday, June 4, 2009)]
[Senate]
[Pages S6174-S6175]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. KAUFMAN. Madam President, I would like to speak on reforming our 
health care system. Simply put, health care reform has been delayed for 
far too long, and it cannot wait any longer. Most Americans are 
satisfied with the health care they receive today.
  Let me repeat this. Most Americans are satisfied with the health care 
they receive today. But if we want to sustain and improve the quality 
of health care, we need to act now.
  What they are concerned about is what future health care is going to 
be about, and they are also concerned about the cost of health care. We 
must get health care costs under control while preserving choice.
  If we do nothing and allow the status quo to persist, it has been 
estimated that the share of gross domestic product devoted to health 
care will rise from 18 percent in 2009 to 28 percent in 2030.
  If health care premiums continue to rise at 4 percent per year, which 
is actually less than the historical average, then by 2025, premiums 
for family coverage will reach $25,200 a year--over $2,000 a month. 
This trajectory is simply unsustainable.
  We have attempted to reform our health care system several times in 
the past to no avail. But this year is different and has to be 
different. This time the call for reform is coming from people and 
organizations that previously opposed reform. This time businesses, 
along with unions that represent their workers, are asking for reform.
  Businesses in America have to compete against companies from other 
countries. Many of them do not pay anything for health care for their 
workers or retirees. Others pay far less than what many of our larger 
corporations pay. This puts many of our businesses at a disadvantage in 
the global marketplace.
  In addition, people in my home State of Delaware and Americans across 
the Nation are struggling to keep up with the crushing and seemingly 
constant increase in the cost of health care.
  Over the last decade, Americans have watched as their health 
insurance premiums and deductibles have risen at much faster rates than 
their wages, threatening their financial stability. It also puts them 
at risk for losing their insurance as employers struggle to provide 
adequate health care coverage.
  Americans rightfully value their relations with their doctor and the 
care they receive. We must--and I say must--preserve these 
relationships. In addition, as costs rise and insurance benefits erode, 
Americans are also asking to protect what works and fixes what is 
broken.
  Our current health care system--the status quo--is rampant with 
bureaucracy, inefficiency, and waste. It is time for reform. It is time 
to reform health care for Americans so everyone has access to quality, 
affordable care, regardless of preexisting medical conditions. It is 
time to reform health care so we

[[Page S6175]]

place a higher priority on prevention and wellness, saving lives as 
well as money. It is time to reform health care so all Americans can 
compare the costs and benefits of different health care policies. It is 
time to reform health care so Americans have more choices, not less, 
and can choose their own doctor.
  I applaud the members of the Finance Committee and the Health, 
Education, Labor, and Pensions Committee in the Senate, as well as our 
counterparts in the House, for their sincere dedication, their 
thoroughness, and their commitment to crafting legislation that truly 
will transform the health care system in this country.

  It is clear this is not an easy task and is one that will require 
true compromise from everyone across the ideological spectrum, but it 
is a task that must be done. Our country and the health of its 
citizens, as well as the economy, cannot afford to maintain the status 
quo.
  As the members of these committees gather to discuss and ultimately 
mark up legislation, I encourage them to include a viable public option 
in a menu of insurance options from which Americans may choose. It will 
be--and let me stress this--it would be a purely voluntary option.
  If you like your current plan, you keep it. But a public health 
insurance option is critical to ensure the greatest amount of choice 
possible for consumers. There are too many Americans who do not have 
real choices when it comes to health insurance, especially those who 
live in rural areas.
  In addition, many large urban areas are dominated by one or two 
insurers that serve more than 60 percent of the market. In fact, there 
are seven States where one insurer has over 75 percent of the market 
share.
  A public option can help Americans expand their choice of insurance 
provider. A public option could take various forms, and I think the 
committees are the proper place to determine the appropriate contours 
of a public option.
  I think a good starting point for discussion is the proposal put 
forward by my colleague from New York, Senator Schumer. It delivers all 
the benefits of increased competition without relying on unfair, built-
in advantages for the federally backed option.
  This public option would not be subsidized by the government or 
partnered with Medicare. It would not be supported by tax revenue. It 
would compete on a level playing field with the private insurance 
industry. If a level playing field exists, then private insurers will 
have to compete based on quality of care and pricing, instead of just 
competing for the healthiest consumers.
  This is just one proposal for public option. There are others we can 
debate as we move forward.
  Right now, more than 30 State governments offer their employees a 
choice between traditional private insurance and a plan that is self-
insured by the State. Some of them have had them for more than 15 
years.
  In these States, the market share of the self-funded plans within the 
market for State employees typically ranges from 25 to 40 percent. This 
shows a healthy competition between the public option and private 
insurers, not domination by either type of insurer. The States provide 
these options because they believe it adds value to competitive 
offerings they give their workers.
  These arrangements do not seem to be a problem or incite ideological 
issues at the State level. Why should it be so when discussing health 
reform on the national level?
  A public option can go a long way in introducing quality advancements 
and innovation that many private insurers do not now have the incentive 
to implement.
  Medicare and the veterans health system have spearheaded important 
innovations in the past, including payment methods, quality of care 
initiatives, and information technology advancements.
  A new public option could also help lead the way in bringing more 
innovation to the delivery system and introducing new measures to 
reduce costs and improve quality.
  A public option can serve as a benchmark for all insurers, setting a 
standard for cost, quality, and access within regional or national 
marketplaces. It can have low administrative costs and can have a broad 
choice of providers.
  Simply put, Americans should have a choice of a public health 
insurance option operating alongside private plans.
  A public option will give Americans a better range of choices, make 
the health care market more competitive, and keep insurance companies 
honest.
  The key to all this, however, is that a public option will be just 
that, as I said--an option, not a mandate.
  Some people will choose it; others will not. If you like the 
insurance plan you have now, you keep it. If you are happy with the 
insurance you get with your employer, or even the individual insurance 
market, you stay enrolled in that insurance plan. And if you are 
unsatisfied with the public option, you have the option to switch back 
to private insurers.
  Americans firmly support the ability to choose their own doctor and 
value their relationships with their providers. So do I.
  An overriding goal of health reform is to increase patients' access 
to affordable, quality health care, and offering a public option can 
help increase Americans' choices.
  I am heartened that I was joined by 26 other Senators several weeks 
ago in cosponsoring a resolution introduced by Senator Brown calling 
for the inclusion of a federally backed health insurance option in 
health care reform.
  Senators who have been involved in health care issues for decades--
Senators Kennedy, Dodd, Rockefeller, Harkin, Bingaman, and Inouye, just 
to name a few--have all agreed that a public option should be included.
  As I said before, I admire the efforts of my colleagues on the 
Finance and Health, Education, Labor and Pensions Committees who will 
be drafting our health reform legislation.
  They have an important responsibility, and I recognize that they will 
be debating many options regarding coverage, financing, regulations, 
and so on.
  I simply encourage them to consider seriously a public option as a 
choice for Americans in any new health insurance exchange.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER (Mr. Begich). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. SANDERS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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