[Congressional Record Volume 155, Number 85 (Tuesday, June 9, 2009)]
[Senate]
[Pages S6332-S6333]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            HEALTH INSURANCE

  Mr. BROWN. Madam President, in 1945, President Truman delivered a 
speech to a joint session of Congress, in which he declared:

       Millions of our citizens do not now have a full measure of 
     opportunity to achieve and enjoy good health. Millions do not 
     now have protection or security against the economic effects 
     of sickness. The time has arrived for action to help them 
     attain that opportunity and that protection.

  That was said by President Truman, 10 or 11 Presidents ago, perhaps 
six decades ago, and 64 years later we are still fighting to provide 
that opportunity and that protection.
  A severely weakened economy, growing unemployment, rising health care 
and health insurance costs, and declining employment-based insurance 
are all factors contributing to the current health care crisis. Today, 
47 million Americans are uninsured. An additional 25, 30, 35, as many 
as 40 million Americans are underinsured and millions of Americans are 
either underinsured or uninsured and are saddled with catastrophic 
medical debt.
  Closing the health care gap will dramatically improve the public's 
health. It will also lead predictability to national health spending, 
which is essential if we are going to get health care costs under 
control.
  Closing the health care gap would dramatically reduce personal 
bankruptcies, more than half of which result from catastrophic illness 
and the huge bills that go with it.
  Think about that for a moment. Most bankruptcies in this country are 
because people have had health care bills they simply cannot pay. Most 
of those people have those health care bills which they cannot pay 
which then force them into bankruptcy. Most of those people have health 
insurance, but it is inadequate and has too many gaps in it.
  Closing the health care gap is a short-term and a long-term 
investment in the health of Americans, the health of U.S. businesses--
businesses whose premiums are inflated by the costs of uncompensated 
care. It is an investment in the health of our economy, which benefits 
from the health care industry but not from already too high health care 
costs, further inflated by needless red tape, needless duplication, 
needless indifference to health care needs that become more serious and 
more costly when they are not caught early.
  Per capita health care spending in the United States is 53 percent 
higher here than that of any other nation in the world, and we are the 
only nation

[[Page S6333]]

in the world without an insurance system to cover everyone. In other 
words, we are paying at least half again as much--at least--as any 
other country in the world per person. Yet millions, tens of millions 
of Americans, do not have health insurance. Life expectancy, infant 
mortality, maternal mortality, immunization rates--we are not among the 
world leaders in any of those categories.
  Interestingly, the only place we are a world leader is life 
expectancy at 65. If you get to be 65 in this country, the chance that 
you will live a longer, healthier life is greater than in almost any 
other country in the world.
  In Ohio, $3.5 billion is spent each year by and on behalf of the 
uninsured for health care that meets about half their needs. For the 
first time, we are on the verge of meaningful health care reform that 
will make a difference in the lives of Americans who have, for too 
long, put up with less than they deserve when it comes to health care. 
Our health insurance system does some things very well, but we have let 
the industry, the health care industry, forget its own core central 
purpose.
  The insurance industry is supposed to bear risks on behalf of its 
enrollees, not avoid risk at the expense of its enrollees.
  The insurance industry is supposed to protect the sick, not throw 
them overboard.
  The insurance industry is supposed to offer affordable coverage to 
every American, not expensive coverage to some Americans and no 
coverage to the rest.
  The insurance industry is supposed to cover the reasonable and 
customary costs of health care, not a fraction of that.
  The health insurance industry is supposed to cover the doctors you 
need, not the doctors the insurer chooses for you.
  The insurance industry is supposed to pay claims on a timely basis, 
not as slowly as they possibly can.
  Who can forget, when Senator Obama was talking about his mother in 
the last months of her life, how as she suffered and was dying from 
terminal cancer, she spent much of her time on the phone trying to 
figure out how to collect on insurance, how to pay, how to simply get 
by and not leave debt for her soon to be very famous son.
  The health insurance industry does some things pretty well, but it 
gets away with too much. What do we do about it? First, we put stronger 
insurance rules in place. Second, we introduce some good old-fashioned 
competition into the insurance market. That is the purpose of a 
federally backed insurance option, one the Presiding Officer from New 
York has spoken out for, as has the other Senator from New York and a 
majority of people in this body. It is to set the bar high enough for 
private insurers that they can't slip back into their risk-avoiding 
ways without taking a hit in the marketplace. In other words, we need 
insurance company rules on preexisting conditions, on changing the way 
we do community rating, on a whole host of rules to make insurance 
companies behave better and serve the public better.
  We also need this federally backed insurance option because all too 
often insurance companies are a step ahead of the sheriff. They always 
can figure out how to stay ahead of the rules that try to make them 
behave in a way that is more in the public interest.
  The purpose of establishing a federally backed insurance option--it 
is an option--is to give Americans more choices and to give the private 
insurance industry an incentive to play fair with their enrollees, or 
their enrollees will look elsewhere, perhaps in the public plan.
  Private insurers have helped to create a system of winners and 
losers--a system in which insured Americans can still be bankrupted by 
health expenses and uninsured Americans can still die far too young 
because they cannot get the health care they need.
  Insurance companies have always been one step ahead of the sheriff. 
They have given us no reason to believe they will behave any 
differently. They have come to Congress this year and said: You can put 
some new rules on us. But when we have done that in the past, we know 
they have always found a way to avoid some of those rules that do not 
serve their bottom line. And it is their bottom line, and I do not even 
blame the insurance companies for acting the way they do. I just say we 
need a set of rules to make sure they act in the public interest.
  Private insurance market reforms, coupled with the creation of a 
competitive, federally backed health insurance option--it is an option, 
just as it will be an option, once we pass health insurance, that 
anybody today can stay in the insurance plan they have. Nobody is going 
to be forced to do anything they do not want to do. Private insurance 
market reforms, coupled with the creation of a competitive, federally 
backed health insurance option represents our best hope at achieving 
the health reforms so vital to the health of our citizens and the 
future of our Nation.
  Last week, President Obama sent a letter to Chairman Kennedy of the 
Health, Education, Labor, and Pensions Committee, on which I sit, and 
to Chairman Max Baucus, chairman of the Finance Committee, the other 
health care committee here, in which the President stated:

       I strongly believe that Americans should have the choice of 
     a public health insurance option operating alongside private 
     plans. This will give them--

  Will give American citizens--

     a better range of choices, make the health care market more 
     competitive and keep insurance companies honest.

  A public health insurance option--not administered by a private for-
profit insurance company but a public health insurance option--is one 
of the necessary components of health reform.
  There is no better way to keep the private insurance industry honest 
than to make sure they are not the only game in town. Historically, 
public health insurance has outperformed private insurance in 
preserving access to stable and reliable health care, in reining in 
costs, in cutting down on bureaucracy, and in pioneering new payment 
and quality-improvement methods.
  A public health insurance option will not neglect sparsely populated 
and rural areas, as insurers too often do. The Presiding Officer 
previously represented a rural congressional district in New York. She 
knows the problems of insurance availability in rural areas. It will 
not disappear.
  A public health insurance option will not disappear when an American 
loses her job, when a marriage ends, or when a dependent becomes an 
adult. And the pages sitting here in front of me, when they finish 
school and go into the workplace, they would have an option. Once they 
are no longer dependent on their parents, they will have that public 
option, as other Americans will.
  A public health insurance option will not deny claims first and ask 
questions later, as insurance companies too often do. It will not look 
for any and every loophole to insure the healthy and avoid the sick, as 
private insurance companies too often do.
  These are the fundamental reasons why a public plan option is the 
key--is the key--to arriving at a health insurance system that better 
serves every American, insured and uninsured alike. What is the point 
of health care reform if we do not do it right and make sure every 
American citizen is better served than they are now in this health 
insurance market?
  Madam President, I yield the floor.

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