[Congressional Record Volume 155, Number 107 (Thursday, July 16, 2009)]
[Senate]
[Pages S7589-S7591]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          ENGAGING THE ISSUES

  Mr. DURBIN. Madam President, there are many things going on in the 
Capitol today. As a member of the Senate Judiciary Committee, I left 
the confirmation hearing of Judge Sonia Sotomayor, President Obama's 
nominee to the Supreme Court. I believe this is her fourth day of 
hearings before the committee. It appears we will be able to wrap up 
today or perhaps tomorrow.
  I think she has done an extraordinarily good job. She comes to this 
nomination with a remarkable life story: rising from public housing in 
the Bronx, NY, losing her father when she was 9 years old, being raised 
by a determined and capable mother, a brother who became a doctor. She 
went on to law school after academic success in an Ivy League 
institution, and now has served for 17 years on the Federal bench.
  We have many good witnesses before the Judiciary Committee, but I 
think she has set a high standard in terms of answering questions with 
a clear understanding of the law and a clear understanding of her 
responsibility if she is given this awesome assignment of serving on 
the highest Court in the land.
  I cannot help but watch at these hearings as her family sits through 
hour after weary hour of Senators' questions. They are clearly in her 
corner and cheering her on; her mother, nodding in agreement when her 
daughter tells of their life story; others there in testimony to her 
wonderful life, her professional life as an attorney and judge.
  I hope the Senate will bring her nomination before us in a timely 
fashion so that if she is approved--and I believe she will be approved 
by the Senate--she can cross the street to the U.S. Supreme Court and 
be there in September to make certain that the Court has a full 
complement of Justices to consider important cases.
  At the same time on the floor, we have the Defense authorization 
bill, an annual exercise to authorize important expenditures for our 
national defense. There is a pending amendment relative to hate crimes, 
as to whether there will be a Federal cause of action against those who 
are guilty of physically assaulting and hurting people because of their 
sexual orientation, their gender, their race, their ethnic origin.
  And, of course, there is another major debate underway about the 
future of health care in America. I have said that I think this debate 
over health care may be the biggest domestic undertaking of Congress in 
its history. In sheer numbers, the impact of this legislation will 
touch every single American immediately.
  We have considered big issues in the past, issues such as Social 
Security, but that was a program, when it was conceived and passed, 
that would affect senior citizens at a later date and only a few people 
initially. It was passed at a time when few people lived to be age 65, 
the qualifying age for Social Security. So it was an insurance policy 
for a small group of Americans. There was a payroll tax imposed on most 
workers in the country to pay for it.
  Some 60 years later, President Lyndon Johnson considered the Medicare 
Program, another far-reaching program which today provides health 
insurance for 45 million Americans. It, too, is paid for primarily by a 
payroll tax, but it reached retirees. This debate on health care goes 
far beyond retirees. It affects all of us, every single one of us.
  There have been so many things said about this debate. Some of the 
things that have been said at the outset are plain wrong. I was sent an 
e-mail by my brother who lives in California. I don't know the source 
of this e-mail, but it is one with wide subscription. It was loaded 
with mistakes and errors, suggesting that Members of Congress have some 
elite health care policies that pay for things ordinary Americans could 
never consider.
  For the record, speaking for myself and most Members of Congress, we 
are under exactly the same health care plan as 8 million Federal 
employees and their families. But make no mistake, it is a good one. 
Because we have such a good bargaining pool, for over 40 years, private 
insurance companies have been anxious to get in and offer health 
insurance to not only Members of Congress but virtually every other 
Federal employee. It is a plan that engages us with private health 
insurance companies. My wife and I can choose from nine different 
private health insurance companies that offer coverage to residents of 
Illinois who are Federal employees. We can pick a plan that has limited 
coverage or one that has more coverage. My payroll deduction depends on 
the type of plan I choose.
  The good news is once a year there is open enrollment. If I don't 
like the way I have been treated in the plan, I can move to a different 
company that might give me different benefits or better coverage. Every 
American should be so lucky as every Federal employee and Members of 
Congress. But we don't have an elite plan.
  Other things that have been said are plain wrong. Members of Congress 
do not pay into Social Security. I can tell you when I was elected in 
1982, in the House of Representatives, that was a fact. That was 
quickly changed within a year so that Members of Congress do pay into 
Social Security, as most Americans do today. These are all things that 
need to be set aside, and we need to get to the heart of the issue.
  I listened as Republican Senators have come to the floor and talked 
about this health care debate. I cannot for the life of me understand 
how most of these Senators feel about the issue of health care.

[[Page S7590]]

  The overwhelming majority of Americans believe we need to change the 
current system. If they have a good health insurance policy, they want 
to keep it, and the law we propose will allow them to do that, but 
there is a sense that the cost of health insurance is going up too fast 
and you can't earn enough money to keep up with it. Just over the last 
several years, the cost of health insurance premiums has risen three 
times faster than the wages of Americans. I have heard about it in 
Illinois; others have heard about it as well.
  Those who want to keep the current system have to answer the most 
basic question: How will individuals and families and businesses be 
able to afford health insurance if we don't change? How can we deal 
with the deficits and debt that are being created by these inflated 
health care costs? The United States is the most expensive Nation in 
the world when it comes to health care. We spend, on average, per 
person more than twice as much as most other countries. Yet we don't 
have the medical results to point to which demonstrate that money is 
being well spent.
  Some of the Republicans who have come to the floor--for instance, 
Senator McConnell from Kentucky, the Republican leader--talk about the 
failure of a plan in Maine, a public plan called--I may mispronounce 
this; I hope I don't--it looks like Dirigo. This Dirigo relied on 
private insurance with very few health insurance companies. Maine would 
benefit from the increased competition provided by a public option that 
we are talking about in the current national health care reform.
  I think States across the Nation have done a good job in exploring 
creative innovations, but there are some limits as to what a State can 
do on its own, and many are financial. It is not realistic to expect 
them to solve health care problems State by State. States don't have 
the access to the financing levers that the Federal Government has. 
That makes sustainability difficult over the long term. And cost is 
difficult to control on a State basis. States don't have access to the 
Medicare Program, the largest buyer of health care in America. Medicare 
needs to be a leader in quality and cost control initiatives if we are 
going to make health care affordable. The States have tried to do their 
best, but without Federal leadership in addressing the skyrocketing 
costs of health care, the States are in an impossible position.
  Health care reform isn't going to be easy, but we need to do it. 
Fortunately, we have a President--President Obama--who has said this is 
his highest priority. He is prepared to spend the political capital 
necessary to make this change, knowing it has been very difficult in 
the past.
  What most Americans want to see is a system where you can walk in the 
doctor's office and not have to fill out the same form over and over 
and over again; a system where doctors give the time to see their 
patients, can make the right diagnosis, and work through the questions 
that the patient might have; a system where patients aren't surprised 
by a medical bill they thought was covered under their insurance plan 
and ends up not being covered; a current system where doctors don't 
have to hassle with insurance companies for approval of medically 
necessary treatment; a system where you are not denied coverage because 
of an illness you had 5 years ago or because of your age; a system 
where health care is affordable; where it will cost less and cover 
more.
  That is what 85 percent of the American people say they want out of 
this debate. This is what I would bet even the 77 percent of the 
American people who are satisfied with their health care today want to 
make sure is guaranteed in the future.
  Some of my colleagues on the other side of the aisle seem to agree 
with the idea of the need for change, the need for health care reform. 
Some of them have focused on medical malpractice. I know a little about 
this. Before I was elected to Congress many years ago, I handled 
medical malpractice cases as an attorney in Springfield, IL. For a long 
time, I defended doctors and hospitals. And then, with a new practice, 
I was on the plaintiff side, representing the injured--the patients who 
were suing the doctors and hospitals. I have seen it from both sides of 
the table.
  It is unfortunate when these lawsuits are filed. It is even more 
unfortunate when innocent people have become victims of medical 
negligence. There are an awful lot of them each year, and we need to do 
more to reduce the incidence of medical negligence. Many of these 
people just went to the doctor, did exactly what they were told, and 
ended up in a situation where their health was compromised and where 
they incurred massive health care costs because a mistake was made. 
Sometimes it is an innocent mistake, but other times, clear negligence 
and worse on the part of medical providers.
  Don't get me wrong. I have the highest regard for the medical 
profession. And if it is my health or the health of someone in my 
family or someone I love, I want that doctor, the very best person 
there, to help, and I want to give them the benefit of the doubt; that 
they do not work miracles; they can only do the best they can, and I am 
prepared to accept that. In some cases, though, negligence happens. 
Malpractice occurs. Terrible things happen. And to close the courtroom 
doors to those who are injured and face a lifetime of pain, suffering, 
scars, limitations, disability, and health care costs is fundamentally 
unfair.
  The Congressional Budget Office thinks that medical malpractice costs 
amount to less than 2 percent of health care spending. Government 
economists estimate that restricting all patients' rights to go to 
court would only lower health care costs less than \1/2\ of 1 percent. 
So when we talk about changing the health care system, of course let's 
have a conversation about patient safety and reducing the medical 
errors and making sure that doctors who are not guilty of malpractice 
don't face lawsuits that never should have been filed, but let's be 
honest about it. This is a very small part of the issue.
  We also need to make sure that a public option is available. Health 
insurance companies are some of the most profitable companies in 
America. A public option will make sure there is an option, a choice, a 
voluntary alternative for every American to choose a public option 
plan, a plan that is a not-for-profit, government-oriented plan--such 
as Medicare--that doesn't have high administrative costs, doesn't take 
a profit out of what they are charging you, and doesn't have a lot of 
costs for marketing. That, to me, is a way to guarantee honesty and 
more competition.
  We know if we fail to act that many millions of Americans will 
continue to have no health insurance, and others will find the cost of 
health insurance going up dramatically. The cost today is overwhelming 
for some Americans.
  If you went to Wrigley Field last weekend to watch the Cards and Cubs 
play, there were about 41,000 people seated in the stands. It is a 
great rivalry, a terrific baseball rivalry that draws people from St. 
Louis and from Chicago and all points in between. If that attendance at 
the stadium was representative of America, 2,000 of those 4,000 people 
seated in the stands are currently paying health care costs of more 
than 25 percent of their income. That is a back-breaking number. And we 
have to understand that the costs keep going up, beyond the reach of a 
lot of good people who are trying hard to provide the most basic health 
care for their families.
  I notice that my colleague is here from the State of Delaware, and I 
am going to yield in 1 moment, but I wish to say before I yield that we 
have a chance here. Some of the Members of the Senate are going to see 
these bills coming out of committees and say, this isn't the bill I 
would write; in fact, there are parts of this bill I don't like at all. 
I am sure that is the case for me, too. I know what I would like to 
write. But I understand the process too.
  I also understand one other thing. This may be the last time in the 
political careers of every Senator on the floor that we can honestly 
take on this health care issue. If we don't do it in a bipartisan 
fashion, if we don't follow the guidance of those who are telling us 
this current system is unsustainable, there may never be another 
chance. I urge my colleagues, even if you disagree with some of the key 
elements of the bill coming out of one committee or the other, keep the 
process moving forward. Let us work together, debate the issues, vote 
on the

[[Page S7591]]

amendments, and keep the process moving forward. At the end of the day, 
if we end up emptyhanded, it will be a great loss for America. We will 
have to come back again under even worse circumstances, where there is 
a lot more suffering and a lot fewer people with good insurance in 
America.
  Mr. President, I yield the floor.

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