[Congressional Record Volume 155, Number 114 (Monday, July 27, 2009)]
[Senate]
[Pages S8104-S8107]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. KYL. Mr. President, what I wish to talk about today is the 
subject that probably more than any other is on the minds of the 
American people and certainly probably the No. 1 item on the agenda of 
most of us in the House and the Senate; namely, what we do about the 
escalating cost of health care in America and the need for all 
Americans to have access to coverage.
  Those two questions are animating a debate which has captured the 
time of the people in the House and the Senate, who represent to the 
American people, and, as we have found more and more--and I found out 
this weekend when I was back in my home State--the attention of our 
constituents.
  Let me begin by saying, I think that is good.
  There was a question about whether the Congress would pass 
legislation on the House floor or the Senate floor before the beginning 
of the August recess. Most of us on this side of the aisle felt it 
would be beneficial if we could go back home and take the month of 
August, when we are supposed to be home visiting with our constituents, 
to have some townhall meetings and other fora, and engage them in a 
conversation about what they think the best ideas are. Because, at the 
end of the day, legislation this important, that is going to affect 
every single American, needs to be well understood by them. And we 
need, as their representatives, to get their input on what they think 
is a good idea.
  The reality is that very few, if any, Members of either the House or 
the Senate have read the major bills yet, let alone be able to post 
them on the Internet so the American people can see them or get them in 
some kind of hard copy for other people to understand, evaluate them, 
and discuss them with the American people.
  Anything this important cannot be done quickly. It has to be done 
right. And the first principle is: People need to understand what it 
is. I have found--and I confess, first of all, I have not read the 
three House bills nor have I read the HELP Committee bill, the Health, 
Education, Labor, and Pensions Committee bill. I have read a great deal 
of what has come out of the Finance Committee. But there is no bill put 
together in the Finance Committee yet.
  The thing that strikes me is the complexity and the degree of 
government takeover involved. I can't begin, in the brief period of 
time I have, to describe all the different ways in which the government 
would take over the key decisions about health insurance and health 
care in America if these bills were to pass. They are replete with 
references to the most minute things about people's health that the 
government will then be taking over.
  There are major decisions being made here. We don't know the 
ramifications of them all. Among other things, the cost. One thing we 
are learning is ideas Members have about reducing costs don't translate 
into actual cost reduction because the Congressional Budget Office, 
which is the entity we have charged with the obligation of telling us 
how much these things cost, has come back with estimates that are very 
low in terms of savings and very high in terms of cost. For example, in 
the main bill in the House of Representatives, the deficit is increased 
by $240 billion, and in the bill that has come through the HELP 
Committee in the Senate, the deficit is increased by $600 billion.
  Nor has the CBO been able to find much savings. I think it was last 
Friday that they examined the latest idea to come to the White House; 
namely, to put a group in charge--it used to be called MedPAC, but it 
would have a different name now--and they would be in charge of 
identifying what coverage for federal programs there was and how much 
would be reimbursed to the providers. Unless both Houses of Congress 
affirmatively voted to reject those recommendations, they would 
automatically go into effect.
  Well, apart from the obvious concerns about that, CBO came back and 
said it will only save perhaps $2 billion over 10 years, which is a 
drop in the bucket when given the over $1 trillion cost of the 
legislation in the House, when it is fully implemented, $2 trillion 
cost to the Senate bill.
  I mention this simply to point out the order-of-magnitude issue we 
have facing us: a hugely complex subject; huge amounts of money to be 
spent, big increases in the deficit, lots of new taxes proposed to help 
pay for it, and ramifications that will affect all of us in terms of 
the health care we are entitled to receive. Because of the amount of 
government involvement in both what insurance can and cannot cover as 
well as what the government programs such as Medicare can and cannot 
cover, every American will be affected in terms of the health care our 
physician says our family or we need but which the government says not 
necessarily can we receive from our physician; in other words, putting 
the government between the patient and the physician. That will result 
in delay and denial of care and outright rationing of health care. This 
is something that is also of concern to the American people.
  When we take $500 billion in proposed cuts from Medicare at the same 
time we are adding a brandnew group of baby boom generation retirees, 
there

[[Page S8105]]

can be only one result: a cut in health care for seniors. So seniors 
also have a right to be concerned. Young people have a right to be 
concerned when we say that in order to reduce the cost of insurance for 
the sickest people, we are going to put everybody in the same pool, 
basically, and they will all get the same basic insurance premium or at 
least within a dictated range. The sticker shock for younger people in 
America is going to be incredible. They are going to see their premiums 
increase. So for many people, the cost of health care is not going to 
go down, it is going to go up.
  Very few people believe we can actually reduce the cost of something 
by putting the government in charge of it.
  The final issue people are concerned about after the cost of it, the 
increase in deficits, the increased taxes to pay for it, the fact that 
it will result in delay and denial of care, is the fact that it will 
not enable people to keep what they have. This is one of the reasons 
the President has said so many times that if you like your insurance, 
you get to keep it. The President is wrong when he says that. He hasn't 
read the bills. On this I will take just a little bit of time because 
he is wrong on two counts.
  First of all, the statement comes with significant conditions; 
second, it comes with an expiration date. There are two primary reasons 
why it is not true that if you like your insurance, you get to keep it. 
Let's back up a little bit. According to a Fox News survey, 91 percent 
of Americans say they have health insurance. Eighty-four percent of 
them rate their insurance as either good or excellent. This is why the 
President makes the comment ``If you like it, you get to keep it,'' 
because most Americans have it and they like it, they want to keep it, 
and they don't want to sacrifice their coverage in order to solve some 
of the other problems that are inherent in our system. But the promise, 
as I said, is not true.
  First of all, what the President and our Democratic colleagues want 
is what they call a public option--a government-run insurance company--
to compete with other insurance companies. To the extent that a lot of 
Americans don't particularly like insurance companies--and I must 
confess there are some things insurance companies do that I don't 
like--it is easy to put them out there as a target and say, as the 
President has said, we need somebody to keep them honest.
  Well, let's examine that for a moment. Do we need to have a 
government-run business in every business in America in order to keep 
the privately run businesses honest? In the first place, the health 
insurance industry is the most regulated--or one of the most 
regulated--industries in America. Every State regulates the health 
insurance that is issued in their State. They don't need to be kept 
honest by a competitor from the government. In the second place, having 
the regulator--the government--also be a competitor has its obvious 
limitations. It won't be long before the other competitors are put out 
of business. I think most people who look at this say that is exactly 
what would happen.
  But it also represents a point of view that I find very troubling. I 
know the government has now taken over our biggest automobile 
manufacturers. It has gotten into the business of other insurance. It 
has gotten into the business of banking. It has gotten into the 
business of student loans; in fact, it now has a monopoly in that. But 
I can't believe the American people want there to be a government 
business to compete with private businesses in other elements of our 
economy. That is socialism. I don't think the administration wants to 
do that. Certainly, the American people don't want to. So why would you 
have a government competitor in the private market? For one reason 
only, and most people who are honest about this acknowledge that it is 
in order to have the government take over health care. It is called 
single payer. There is a group in America that wants single payer very 
badly.
  Members of Congress have said: Well, we can't get there in one giant 
step; the American people won't stand for that. It is going to take two 
steps. First, we will create a very powerful government-run insurance 
company to compete with private business and eventually put them out of 
business and then we will have one insurance company for all of 
America. It will be a government company, and there won't be any more 
private companies, at least to speak of. So it is a two-step process. 
That is the hidden agenda of those who want a government-run insurance 
company. There is no other reason to have one.
  We have 1,300 insurance companies in America. We don't need yet one 
more competitor. They sell thousands of different kinds of insurance 
policies. We don't need yet one more competitor. Honesty is not the 
issue. We have a highly regulated industry by the States and by the 
Federal Government. The only reason to have it is to put the private 
insurers out of business.
  Is that what would happen? How does this relate to people who like 
their insurance and won't get to keep it? Well, the Lewin Group, which 
is a highly respected, nonpartisan health care think tank, says that 
within a couple years, we will have 119 million people on the 
government-run insurance plan, 88 million of whom were previously 
insured by private business. In other words, 88 million people will 
lose their coverage because it is much cheaper to have the government-
run plan take care of them than for their employer to continue to do 
so. As much as their employer likes the employees, if it is 
substantially cheaper to provide health care to them by paying the fine 
that the bills have--$750 per employee, 8 percent of the payroll tax; 
there are different fines in here--it is still cheaper for the business 
to pay the fine than it is to pay the health care they are currently 
providing. So 88 million people: Sorry; even if you like your health 
care, you don't get to keep it, according to the Lewin Group. I think 
their estimate is, if anything, conservative.

  There is a second reason why if you like your insurance you won't be 
able to keep it. Those who are not insured by larger businesses--the 
ones whom I have just been talking about--but by smaller businesses or 
who are self-insured, there is an expiration date on this promise. 
After 5 years, you don't get to keep it and probably sooner than that. 
Because if there is a change in your policy or if the insurance company 
enrolls anybody else in it, then automatically it loses its protected 
or grandfathered status and is now under the regulatory regime that is 
established by these bills. That regulatory regime will totally change 
what that insurance coverage is. They dictate what is covered, what 
isn't covered, what the premiums are, what the companies can make, and 
a whole host of other things. So even though you may like your 
insurance, you are not going to get to keep it because no plan is 
static; that is to say, it never enrolls any more people and it never 
changes any of its terms. If either of those two things happen under 
the House bill, you lose your insurance. So it is not true that if you 
like your insurance, you get to keep it.
  That is the final reason people are concerned. They are concerned 
about the huge cost: $1 trillion, $2 trillion; they are concerned about 
the deficit, the increase in the deficit, even with more tax increases. 
These numbers are not mine; these are from the Congressional Budget 
Office--nonpartisan, which is in business to tell us how much these 
things cost. So these are facts, not opinions.
  It is my opinion that based upon the language of these bills, we will 
lose the ability to determine with our doctor what health care we get. 
Secondly, even if you like your health insurance, you are not going to 
be able to keep it for the reasons I mentioned.
  Mr. President, may I inquire how much time is remaining?
  The ACTING PRESIDENT pro tempore. There is 5 minutes 40 seconds.
  Mr. KYL. Five minutes. Thank you very much.
  The American people are becoming concerned about this as well. The 
more they hear about it, the more they don't like what they are 
hearing. I resent those who say we have to do this quickly or it might 
not happen at all. It is a lot like the stimulus. We were told we had 
to do it quickly. Nobody read that bill. It was over 1,000 pages. It 
had a lot of stinkers in it. It had porkbarrel spending. It made a lot 
of promises it couldn't keep: We are going to cap unemployment at 8 
percent. Well, it is on its way to 10 percent. It hasn't created 4 
million jobs. It is not going to. And it is going to cost us over $1 
trillion.

[[Page S8106]]

  So I think fooled once, maybe that is your fault; fooled twice is my 
fault. The American people are saying we are not going to be fooled 
twice. We want time to look at this one. It is over 1,000 pages. We 
want to read it. We want you, the Senators and Representatives, to read 
it, and when you do, you will find a lot of things you are going to be 
surprised about and you do not like.
  The American people, as I said, are beginning to answer polling 
questions, and I wish to share some of the data. A majority--this is 
from the Fox Poll I cited earlier--say slow it down. We would rather 
have it slowed down and done right than moved quickly. They are afraid 
it will raise taxes and costs. By 2 to 1 they believe it will reduce 
the care they currently receive. By the way, they are right.
  I mentioned the fact that 91 percent have insurance and 84 percent 
rate it as good or excellent. Fifty-three percent, according to a 
Rasmussen Poll--and this was just at the end of last week--53 percent 
disapprove of the Obama health care plan. It is no longer true that the 
majority of Americans want this plan. Now that they know about it, they 
don't like it. They want us to deal with the deficit first. That is 
another one of the things the polls say. By the way, on this idea of a 
public plan, they oppose it by 50 to 35.
  All this has resulted in some reduced polling numbers for the 
President. His job performance now has actually gone under 50 percent. 
People disapprove rather than approve 51 to 49. I don't wish him ill, 
but if he keeps pushing proposals such as this, that approval rating 
will probably continue to decline.
  What have some people said about these bills? Representatives of the 
Mayo Clinic basically said this won't create affordable care for 
patients. In fact, it will do the opposite. In other words, it will 
increase costs. The Congressional Budget Office, in looking at the 
House bill, said it won't reduce the trajectory of Federal health care 
spending. In fact, it will increase the budget deficit by $239 billion. 
Incidentally, that assumes taxes will be raised by the amount of $583 
billion.
  Incidentally, if anybody wants to check what I said about if you like 
your insurance, you get to keep it, check the University of 
Pennsylvania Annenberg School of Public Policy Web site.
  They have a site called factcheck.org. This is a totally nonpartisan 
organization. They contradict on factcheck.org the notion that if you 
like your insurance, you get to keep it.
  The last thing I want to say about this today is that: it is not 
enough for us to say what is wrong with the bills that are before us. 
There are a lot of great ideas Republicans and Democrats have put forth 
that aren't in these bills. Unfortunately, a lot of amendments were 
offered in the HELP Committee--for example, to try to inject some of 
these Republican ideas into the bill--and they were defeated, every one 
of them. In fact, when he was a Senator, President Obama voted against 
several of these ideas.
  Let me give you a flavor of some of these things to illustrate that 
there are a ton of good ideas on how to address access and costs in 
health care. They don't require us to scrap the entire system we have 
and superimpose a brandnew system of huge government regulation or a 
government takeover of health care, which results in these huge 
expenses, deficits, and dictating what care we can get and what care we 
cannot. There are solutions that go right to the specific problems.
  For example, you never hear the President talking about medical 
malpractice reform, lawsuit liability reform, or, as some have called 
it, ``jackpot justice.'' There are a lot of estimates out there that, 
because of the defensive medicine physicians have to practice, we can 
save over $100 billion every year if we have some modest reforms in the 
lawsuit liability area.
  Two very prominent Arizona physicians were in my office this morning, 
and both of them talked at length about the specific situations that 
require the practice of defensive medicine because of the fact that 
maybe 1 out of 10,000 people who come before them may have something go 
wrong, a lawsuit is filed, and they have to, therefore, go to excessive 
lengths to protect themselves by ordering all kinds of tests, calling 
in specialists, and doing things that cost a lot of money, not because 
they are necessarily needed or provide better care but simply to 
protect against a lawsuit. Annual premiums of $200,000 are not 
uncommon. That is more than most of us make. Before you can start 
practicing medicine on January 1, you have to pay your liability 
carrier. The President doesn't even mention liability reform. Let's 
start with that.
  Next is the interstate sale of insurance. This is a great idea. Why 
do they always vote it down? Because if you actually let insurance in 
the health field be sold like home insurance, liability insurance, and 
car insurance--you can buy a State Farm car insurance policy in 
virtually every State, and it doesn't matter where you move to; you are 
still covered. Why can't you do that with health care? They don't want 
that because they want the government to control it instead of allowing 
private companies to sell it all around the country. If they were able 
to do that, they could reduce premiums and provide greater access. That 
is one of the bills the President voted against.
  Why not let small business compete like big business with small 
business plans or association health plans? Basically, you could allow 
all the small businesses in your town--the Rotary and Kiwanis Clubs--to 
associate together and create a bigger risk pool, which brings down 
premiums, just as big businesses do. If you are a small business owner 
with 30 employees and one of them gets really sick, your premiums 
skyrocket the next year. By making a 3,000-person risk pool rather than 
30, your premiums will come down. We have tried to get that into the 
bill. The Democrats say no.
  There could be greater affordability by giving individuals the same 
tax deduction businesses get. The President voted against that when he 
was in the Senate. We could expand health savings accounts so you can 
use the money saved there to buy health insurance--pay the premiums. 
Again, the President voted against that when he was in the Senate.
  These are Republican ideas, good ideas, and they have been voted down 
in these bills.
  Here is another one: require insurance companies to share the claims 
data. One big business told me they couldn't compete and get a lower 
cost because their current health care insurer wouldn't give them their 
claims data. That information ought to belong to the company. So we can 
make that requirement.
  Another thing is--the last thing I will mention--we need to encourage 
less first-dollar coverage. Our automobile insurance would be very 
expensive if we insisted that it cover every tire we have to buy or 
every battery we replace or any other thing we do. Yet with health 
insurance we complain about a $15 or $20 copayment or a deductible of 
$50. It is common to have a $500 deductible or even a $1,000 deductible 
on your car insurance. Certainly, health care ought to be more 
important to us than owning a vehicle.
  These are just some of the comments I have about the reaction my 
constituents are having to the bills being proposed out there and the 
fact that they want to slow it down and look at it carefully because 
they are concerned about the cost of it, the increase in the Federal 
deficits, the increased taxes that will result, the government 
takeover, and that the net result will be our health care will be 
rationed, we will have delay and denial of care, and we won't be able 
to keep the insurance most of us have and like.
  Those are legitimate concerns, and they should not be answered by 
simply saying we have to hurry up and get this done. No, we don't. We 
need to let the American people evaluate it and have them tell us what 
they want to be done. I think they have already spoken in some of the 
polling, and I think it is important for us, therefore, if we approach 
our duties the way we are supposed to here, by carefully considering 
what our constituents want, asking whether we can solve some of the 
specific problems with, for example, some of the ideas I laid out--good 
Republican ideas--rather than having to throw out the baby with the 
bathwater, tossing overboard what we know works for most people most of 
the time just because it doesn't work for everybody all of the time, in 
exchange for a new government takeover--it is a bad bargain.

[[Page S8107]]

  I urge my colleagues, in the last week or two before the August 
recess, we have to start planning for opportunities to visit with 
constituents over the recess, get the information together so we can 
present it to them and they can tell us what they think about these 
ideas. I suspect that, at the end of the day, they will say they don't 
want a government takeover, just fix what needs to be fixed and leave 
the rest of it, which works, alone.
  The ACTING PRESIDENT pro tempore. The Senator from Oklahoma is 
recognized.
  Mr. INHOFE. Mr. President, first, let me say I agree with the points 
of my friend from Arizona. They are significant. He saved the best 
until last, because we hear people say the Republican Party doesn't 
have any answers, when we do have answers. There are real reforms we 
have tried, and they have worked. The health savings accounts--we tried 
that on a pilot project basis, and it was tremendously successful.
  Health coverage and health services are the only things in this 
country on which individual decisions can be made that would encourage 
us to save what we are spending. There is no other product or service 
out there that doesn't have some kind of a competition.
  I think it is only natural, if you have an insurance policy that 
covers all these things and you find out you have a problem, rather 
than worry about what it is going to cost or what treatment to get, you 
go out and get it all because it doesn't cost you anything. That is one 
of the problems you have. Health savings accounts have been successful. 
In fact, we have none of this stuff.
  In the discussion they have had on socializing medicine, they have 
not talked about medical liability or malpractice. The Senator from 
Arizona did a very good job talking about this issue. Just imagine, a 
doctor has to pay $200,000 upfront before he can do anything for an 
entire year. Who pays that? It is not the doctor; it is everybody else 
whom he is treating. That is where you get into the real need for 
reform.
  We have a system that has worked very well.
  By the way, I inquire of the Chair, are we in morning business?
  The ACTING PRESIDENT pro tempore. Yes.
  Mr. INHOFE. Mr. President, I ask unanimous consent to be recognized 
for such time as I shall consume.
  The ACTING PRESIDENT pro tempore. The Senator from Oklahoma is 
recognized.

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