[Congressional Record Volume 155, Number 87 (Thursday, June 11, 2009)]
[Senate]
[Pages S6530-S6531]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. KAUFMAN. Mr. President, I wish to speak today about reforming our 
health care system. As I said last week, most Americans are satisfied 
with the health care they receive, but if we want to maintain and 
improve the quality of affordable health care, we need to act now. We 
must get health care costs under control while preserving choice. We 
must reform health care to make it more affordable for businesses and 
patients and less cumbersome for providers. Health care reform has been 
delayed for too long, and it cannot wait any longer.
  If anyone needs reasons as to why health care reform is necessary, 
all they have to do is read some of the studies that have been released 
recently that show the dire consequences for our health care system and 
our economy if we refuse to act. For example, if we allow the status 
quo to persist, the White House Council of Economic Advisers has 
estimated that the sheer gross domestic product devoted to health care 
will rise from 18 percent in 2009 to 28 percent in 2030 and 34 percent 
in 2040. This trajectory is simply unsustainable.
  Businesses in America have to compete against companies from other 
countries. Many of these foreign companies pay nothing 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.
  A recent report by the Robert Wood Johnson Foundation and the Urban 
Institute reiterates the pressure that American businesses face in 
supplying health care benefits to their employees. These researchers 
prepared analyses using a simulation model estimating how coverage and 
cost trends would change between now and 2019. Looking at three 
different scenarios, the worst case would be where there is a slow 
growth in incomes and continuing high growth rates for health care 
costs; an intermediate case where there would be some faster growth in 
incomes but a lower growth rate for health care costs; and the best 
case would be where there is full employment, faster income growth, and 
even slower growth in health care costs.
  Under all three scenarios, the report showed a tremendous strain on 
business owners and their employees over the next decade if no reform 
is enacted. If health care reform is not enacted, the report projects 
that within 10 years, the cost of health care of a business can double 
from approximately $430 billion for employee premiums in 2009 to $885 
billion in 2019. Even in the best case scenario, employer spending on 
health insurance premiums would rise by 72 percent.
  This would most likely result in fewer Americans being offered 
employer-sponsored insurance, with a likely drop from 56 percent of 
employees getting coverage through their employer in 2009 to as few as 
49 percent by 2019.
  If no changes are made, and the number of people with employer 
sponsored insurance continues to decrease, that also means the ranks of 
the uninsured will increase. And the projections are not pretty.
  Under the same scenarios, the number of uninsured will reach just 
over 53 million under the best case and as high as 66 million under the 
worst case.
  Unfortunately, when those without insurance do receive care--most 
likely in an emergency room--the costs for treating them are passed on 
to those of us who are fortunate enough to have health insurance.
  Providers and hospitals charge insurers more for the services 
provided to patients who do have health insurance to make up for the 
cost of treating the uninsured.
  These cost shifts result in a ``hidden tax'' of higher premiums for 
patients and businesses.
  Right now, this hidden tax results in an increase of about $1,000 for 
premiums for family coverage.
  It is time for reform.
  Over the last decade, Americans have watched their health insurance 
premiums double at a growth rate six times faster than their wages, 
threatening their financial stability.
  If we do not reform health care, if health care premiums continue to 
rise at 4 percent per year, in 2025 premiums for family coverage will 
cost more than $25,000 per year.
  Can you imagine how that dollar amount will affect American families?
  On top of this, a recent study published in the American Journal of 
Medicine showed that bankruptcies involving medical bills now account 
for more than 60 percent of U.S. personal bankruptcies, an increase of 
50 percent in just 6 years. And it is not the uninsured that is driving 
this increase.
  In fact, more than 75 percent of families needing to enter bankruptcy 
because of health care costs actually

[[Page S6531]]

have health insurance. Most are middle class, well educated, and own 
their homes.
  They just cannot keep up with the alarming rise in out-of-pocket 
costs associated with medical care.
  It is time for reform.
  Our current health care system is rampant with bureaucracy, 
inefficiency and waste.
  An example of this is the amount of time physicians must spend 
filling out various forms required by insurance plans.
  A national survey of physician practices found that, on average, 
doctors are spending 3 hours per week--the equivalent of 3 workweeks 
per year just on administrative tasks required by health plans.
  The study showed that the cost of interacting with insurance plans 
amounts to $31 billion annually and approximately 7 percent of all U.S. 
expenditures for physician and clinical services.
  More importantly, on a personal level, this is 3 weeks less time 
annually that physicians have to spend with their patients discussing 
their treatment options, explaining the pros and cons of various 
procedures, learning the fears and anxieties of their patients, 
furthering the patient-doctor relationship.
  It is time for reform.
  We have attempted to reform our health care system several times in 
the past to no avail. But this year it is different.
  This time, the call for reform is coming from people and 
organizations that previously opposed reform.
  This time, because of the reasons I have mentioned, businesses, along 
with unions that represent their workers, are asking for reform.
  This time, patient advocacy organizations and provider groups are 
calling for health reform.
  Make no mistake, reforming health care is not an easy task, and it 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.
  Next week, the members of the Senate Health, Education, Labor and 
Pensions Committee and the Senate Finance Committee will begin 
deliberations on legislation to reform health care.
  As the members of these committees gather to discuss and ultimately 
mark up legislation, I want to take this opportunity to again voice my 
support for a public option in a menu of insurance options from which 
people may choose.
  I believe a public option is imperative in providing a true choice 
for all Americans.
  Let me stress: this would be a purely voluntary option.
  If you like your current plan, you keep it.
  But 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 an 
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.
  But I want to point out again that right now, today, there are more 
than 30 State governments that offer their employees a choice between 
traditional private insurance and a plan that is self-insured by the 
State. Some States have had them for more than 15 years.
  In these 30 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.
  And I want to point out that these arrangements do not seem to be a 
problem or incite ideological issues at the State level.
  Why then, should it be so when discussing health reform on a national 
level?
  A public option can go a long way in bringing more innovation to the 
delivery system and introducing new measures to reduce cost 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. It can give Americans a better range of choices, make the 
health care market more competitive, and keep insurance companies 
honest.
  And again, the key to all this is that a public option will be just 
that, an option, not a requirement.
  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. It is key to 
any health care plan that Americans have a right to choose their 
doctor.
  An overriding goal of health reform is to increase a patient's access 
to affordable, quality health care--offering a public option can help 
increase Americans' choices.
  Mr. President, it is time for reform that protects what works and 
fixes what is broken.
  It is time to reform health care so that American businesses can 
afford to offer health care to their employees.
  It is time to reform health care so that all Americans have access to 
quality, affordable care, regardless of preexisting medical conditions.
  It is time to reform health care so that physicians and other 
providers have less redtape to deal with and more time to spend with 
patients.
  It is time to reform health care so we 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 insurance policies.
  And, it is time to reform health care so Americans have more choices 
and can retain the right to choose their own doctors.
  For all these reasons and more, it is time for health care reform.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Merkley). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. ALEXANDER. Mr. President, I ask unanimous consent for the quorum 
call to be rescinded.
  The PRESIDING OFFICER (Mr. Burris). Without objection, it is so 
ordered.

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