[Congressional Record Volume 155, Number 122 (Thursday, August 6, 2009)]
[Senate]
[Pages S9012-S9015]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BENNET:
  S. 1613. A bill to reduce the Federal budget deficit in a responsible 
manner; to the Committee on the Budget.
  Mr. BENNET. Mr. President, I cannot tell you how much I appreciated 
your remarks--I was sitting in the chair--and those of Chairman Dodd as 
well. The hour is late. The idea that you would be here at that hour to 
talk about something as important as health care is appreciated, I 
know, by the people in your State, but also by the people in my State 
as well. So I say thank you for that.
  I also want to talk about health care. I want to talk about health 
care in the context of fiscal discipline in this country. As you know, 
our Nation's annual deficits are staggering, and our

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national debt is absolutely unsustainable. For the future of our 
country and for our children's sake, as we recover from this 
devastating blow to our economy, we have to stand together and begin to 
start the difficult, but essential, work of putting our fiscal house in 
order.
  Health care reform must help solve this Nation's fiscal problems, not 
make them worse. To accomplish this, effective reform must bend the 
cost curve in health care spending both in the private and public 
sectors.
  In part because of years of neglect and inaction, this Congress has 
reached a defining moment of reckoning. Rising health care costs, 
especially Medicare costs, are now the largest driver of our deficits. 
Our Nation's health care spending, as you were just saying, is 17 
percent of our Nation's gross domestic product and is expected to grow 
to over 20 percent of GDP in 10 years, on its way, as you said, to 35 
percent.
  Health care alone--just health care--will soon account for one-fifth 
of our economy. This represents a greater share of the GDP than our 
manufacturing, agricultural, forestry, mining, and construction 
industries combined.
  As we emerge from this terrible recession, the worst since the Great 
Depression, we cannot commit one-fifth of our economy to health care 
and expect to compete effectively in the global marketplace.
  Adding to the urgency of the problem, this recession has made 
rocketing health care costs even more painful for families and 
businesses in the last 15 months. Both large businesses and small 
businesses have cut some 5.1 million jobs, and 2.4 million of these 
newly unemployed workers have lost the health coverage their jobs once 
provided. Now the same people must try to find insurance in the 
individual market where they can be rejected by private insurance 
companies for preexisting conditions such as asthma, diabetes, or even 
cancer.
  Health care costs are strangling opportunities for working families 
and small businesses all over my State and the country. As health care 
costs rise, families are forced to make choices no one should have to 
make between insuring their families or their employees and sending 
their kids to college, taking lower paying jobs with less 
responsibility just for the medical benefits and defaulting on their 
mortgage payments to pay for their medical bills.
  Every one of these examples springs from the experiences of people in 
my State. And it is no mystery why people are having to make these 
terrible choices. Middle-class wages are not even close to keeping up 
with these rising insurance costs. While median family income in this 
country fell by $300 during the last decade--staggering, by the way; 
over a decade in real dollars, median family income in the United 
States actually declined by $300--health care costs increased over the 
same period by 80 percent.
  The cost of health insurance is eating into family budgets faster and 
faster. Over the past decades, premiums for Colorado families, as this 
chart shows us, have more than doubled, growing four times faster than 
wage increases. The cost of premiums for a Colorado family is over 
$13,000 today. If we do nothing, by 2016, Colorado families will be 
spending over $25,000 on their premiums, a 90-percent increase. We have 
come out of a period with an 85-percent increase, and if we do nothing, 
we are going to end up in a period with a 90-percent increase, with no 
real increase in wages.
  Left unaddressed, this imbalance, which is the creation of our 
catastrophically inefficient health care system, will destroy the 
middle class in this country. If we do nothing, if we continue on with 
the status quo, by 2016, just 7 years from now--and I believe these 
numbers are very similar to the ones you quoted for Rhode Island--by 
2016, 40 cents of every dollar a typical Colorado family earns will be 
eaten up by health care costs, leaving just 60 cents for everything 
else.
  Think about it. That is almost half an average family's income. Money 
spent not to educate their children, not to feed them or house them, 
but just to cover the cost of the family health care plan. And that is 
just paying for coverage. Never mind if you actually get sick.
  In 2007, 62 percent of the personal bankruptcies in this country were 
due to medical costs. Traditionally, most people's employers help pay 
for cost increases. That has been the case for over many years. But I 
heard from employers all over Colorado having to make tough choices--
cutting back on benefits and laying off more costs to their employees.
  In the coming years, copays for Coloradans will go up double digits. 
More Coloradans are being forced into health plans with higher 
deductibles, and more employers are getting out of the business of 
providing health insurance for their employees altogether.
  Mr. President, we won't be able to completely flatten the health care 
cost curve in the short run, and we should be careful not to 
overpromise, but we have to make the rising cost of health care 
something our economy can plausibly absorb.
  Part of the solution is reducing waste and curbing overpayments to 
insurance companies, and part of the answer is encouraging patients to 
seek preventive care. Small businesses may not see health costs go down 
immediately, but we sure can slow their rise. And we have to work hard 
to make sure they do not rise this quickly. Reforming our health care 
system could save over 100,000 small business jobs in the coming years 
that would otherwise be lost if we do nothing.
  I agree with bipartisan voices saying that our first health care goal 
has to be to drive down costs, and we must start with Medicare. As I 
travel throughout Colorado, I have met countless physicians, nurses, 
and hospital workers who tell me about the perverse incentives in 
Medicare. Instead of being paid to spend time with patients and produce 
better quality care, doctors and nurses are paid for the number of 
patients they see in the shortest amount of time and the number of 
procedures they perform. This is no way to produce patient-centered 
care, and it is no way to reduce cost.
  Medicare doesn't just influence, as you know, the care of the elderly 
and disabled. As the largest health care program in the United States, 
Medicare influences every level of health care. Private insurance and 
employer-based health care look to Medicare as they make decisions on 
what to pay doctors, nurses, and hospitals. Owing to the perverse 
incentives in Medicare, however, since 1970--since 1970--every year for 
almost 40 years, year-in and year-out, Medicare spending per person has 
risen by over 8 percent each year, and private insurance spending per 
person has risen by over 9 percent each year.
  If we expect reform to begin to gain any traction, we must drive cost 
down at the Federal level first. We can start by paying doctors and 
nurses to actually do what they are supposed to do and what they want 
to do--be focused on patients. We have to reform the system so that we 
are paying for quality and not volume. We must improve care, produce 
savings, and slow down cost growth by bundling payments, paying for 
performance and outcomes, and providing better coordinated care for 
patients and providers.
  The burden is on us to meet the public expectation that we will drive 
down costs in the health care system and make it more efficient, that 
we will make the health care marketplace more competitive, and that we 
will provide affordable, stable health care coverage to the American 
people that can't be taken away because they lose a job, have a 
preexisting condition, or have reached some arbitrary cap.
  Controlling health care costs would help our fiscal situation a great 
deal, and that is one of the fundamental reasons health care reform is 
needed. But this alone will not be enough to fill the deepening hole of 
national debt that threatens America's prosperity. The fiscal decisions 
we make today matter so much because they will dictate the well-being 
and range of choices of the generations that follow us.
  Sometimes, with the daily hail of press clippings, these issues may 
seem overly complex, but I like to use a pretty simple analogy. The way 
we run our government is not different than if you or I were to buy a 
house--probably a bigger one than we reasonably could afford--and then 
we tell the bank to please send the mortgage documents to our kids. 
Imagine how that burden--paying for mom and dad's house--would 
constrain our children's choices. What dreams would they have to defer

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because their first obligation was a debt they didn't even incur.
  My three daughters, ages 9, 8 and 5, have never had an economics 
class, but I can tell you that as much as they love their mom and dad, 
if asked, they would never do that deal--especially my 5-year-old, 
Anne. Whether we are taking her blanket away or telling her to stop 
sucking her thumb or putting a mountain of debt on her, she knows a raw 
deal when she sees one.
  We in Congress owe the next generation much more than this, as the 
chairman, Senator Dodd, was saying. We ought to be able to build on our 
roles as parents and community leaders to respect our children, come 
together, and plan America's way back to fiscal health. The longer we 
wait, the more difficult the choices become. If we wait 10 years, we 
will face a massive gap between our spending and the revenue the 
government collects. If we wait 10 years to take action, we would have 
to increase individual income taxes by almost 90 percent to keep pace. 
That is an unacceptable outcome for Colorado's families. If you don't 
like tax increases, fine, then we would have to slash Federal spending 
by almost one-half. That would mean massive cuts to Medicare, our 
Nation's defense, and other critical initiatives that keep our country 
strong. No one wants to be put in a position to make those kinds of 
choices either. These outcomes are unacceptable, yet we can see them 
coming. That is why inaction is so unacceptable on health care and also 
on returning to policies of fiscal discipline. It is long past time to 
put in place the policies that will reverse this condition. And as with 
any deep hole, the first order of business is to stop digging.
  The good news is that we have a tried-and-true way to stop making 
matters worse. In the 1990s, we had Pay-Go, which effectively forced 
the shovel from Congress's hands and made Congress stop digging. Pay-Go 
means that before Congress can create new spending on permanent 
programs, it needs to figure out how to pay for that new spending, just 
as every family in the States we represent.
  Pay-Go helped turn 1980s deficits into 1990s surpluses, and we 
actually began to pay down our debt. Pay-Go is commonsense budgeting. 
It is not any different, as I just said, than what a family does when 
its spending gets out of hand. When that bad credit card statements 
comes in the mail, a parent knows it is time to sit down at the kitchen 
table and plan how to stop the spending. Pay-Go is what Congress and 
President Clinton did to respond to Washington's bad credit card bill.
  Pay-Go was smart lawmaking because it imposed a culture of fiscal 
responsibility--and I would say discipline--on the Congress. Yet, for 
some reason, early in this decade a new administration let Pay-Go 
expire. That played a part in how these surpluses all of a sudden 
turned back into big annual deficits. This is how America incurred 
years of new debt.
  The frustrating reality is that we are not getting enough out of 
borrowing all this money in the end--fighting an expensive war with 
tremendous unseen long-term costs to follow, ignoring the staggering 
costs of our health care system and entitlements, paying huge interest 
costs on our debt, in large part to foreign countries. These are hardly 
worthy uses of deficit spending.
  In 2003, the Bush administration and Congress passed a new 
entitlement program called Medicare Part D. It is very popular, but we 
never paid a dime for it. They also chose two tax cuts for people who 
needed them least over fiscal discipline. They ignored skyrocketing 
mandatory spending. They created a brandnew bureaucracy and just 
saddled all of this heavy new weight on America's national debt.
  In short, Washington was unwilling to ask the American people to pay 
for any of its investments--they put it on our children's shoulders 
instead.
  And the tragedy of this incredible mismanagement is, it didn't work. 
Our economy plunged into its deepest hole since the Great Depression.
  Fortunately, earlier this year, the House rightly passed new 
statutory Pay-Go. The Senate should pass Pay-Go too. That's why today, 
Senator McCaskill and I introduced Pay-Go. We believe that Pay-Go is 
one important way to make sure that our fiscal situation doesn't get 
any worse. Pay-Go is not a magic bullet, but it is part of the answer 
to our fiscal woes.
  Once Pay-Go is in place though, we cannot stop there. Pay-Go will 
help us stop digging. But we also need to budget for the future, stop 
running large deficits and fill this fiscal hole completely. I am 
optimistic that this can be done, and it will take bipartisan 
commitment and discipline.
  One place to start is with the growth of our yearly spending. Like 
Pay-Go, the yearly spending of Congress has also been done before, and 
it has worked.
  That is why today I am introducing separate legislation, the Deficit 
Reduction Act of 2009, that would create yearly limits on discretionary 
spending. By pairing these discretionary spending limits with Pay-Go, 
we can start to make a substantial change in how Washington does 
business.
  But it is not enough just to limit new spending across the board. 
Much of the reason that we are running such large deficits, is that we 
have made long-term spending commitments, called mandatory spending. To 
truly reverse the totality of our disastrous fiscal course, we must be 
willing to address rapidly expanding mandatory commitments too.
  The best way--you know, it is funny, when you use the word 
``mandatory.'' It is the word that should be used to express what this 
debt burden is we are putting on our kids. It will be mandatory that 
they pay that back before they make decisions about how to educate 
their own children; before they make decisions about how to provide 
individual health care in this country or make other kinds of 
investments all across the United States, in transportation or in new 
economies. What will be mandatory as we fall farther and farther behind 
in this global economy--what will be mandatory for them is to pay the 
bill left behind by their mothers and fathers.
  The best way to get Congress to take a hard look at mandatory 
spending, is to place a flexible cap on our annual deficits. That's the 
other main component of what my new legislation would do. The cap in 
the Deficit Reduction Act is realistic--it would impose limits that are 
consistent with what economists believe we can sustain. This deficit 
limit is flexible--providing an exception when we are in a recession.
  Here is how the deficit limit would work. Whatever the gross domestic 
product is in a given year, Congress must limit the deficit to 3 
percent of the GDP or less. Economists tell us that this 3 percent 
number is sustainable over time, and that is a reasonably healthy 
ceiling. Now of course we should push to do better than running a 
deficit that is 3 percent of GDP. But this is a good starting point at 
setting and adhering to a budget. We would all clap if the deficits of 
today--12 or 13 percent of GDP--were 3 percent, and no one would clap 
louder than our children.
  Under my legislation, if Congress failed to meet these deficit 
control requirements, the government would have to impose an across the 
board cut called a sequestration. Certain programs such as Social 
Security and veterans programs would not be subject to cuts. Yet most 
of the government's functions would be. The goal, of course, is to 
avoid this drastic measure by forcing Congress to plan ahead, and 
forcing Congress to pay attention to the deficit when it makes its 
spending choices.
  Deficit limits make perfect sense during most years. But, as we have 
learned during this recession, an infusion of public funds can jolt a 
frozen economy and help turn that economy around. Running temporary 
deficits can kickstart a stagnant economy. But this only works if 
during healthy economic times, you also reduce government spending. The 
deficit limits I am proposing in this legislation would put Congress on 
a gradual track back to solid fiscal footing.
  We should immediately enact budget reform proposals like Pay-Go 
discretionary spending limits and deficit limits. The CBO has concluded 
that after 2019, the rate at which we accumulate debt will continue to 
accelerate due to the aging of the population and increased health care 
costs. As angry as we all are with the excessive leverage in the 
private marketplace over the past decade that contributed to the market 
crashing, it is also obvious that Washington set a very bad example.

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  Let's put an end to these unsound fiscal practices. Let's not put our 
kids in the kind of situation we have inherited. Let's not make matters 
even worse, and the policy decisions regarding the national debt even 
harder for our kids.
  What we need now is leadership and cooperation; not more shifting 
costs to our kids. The Congressional Budget Office estimates that if we 
remain on our current course, the total debt owed by the public will 
stand at over $17 trillion by the end of fiscal year 2019--only 10 
years from today.
  The point is that linked with our growing debt are the dreams and the 
plans of millions of American families. There is nothing fun about 
tightening our belt and cutting popular programs. I don't like it any 
more than anyone else who is here. Yet there are plenty of encouraging 
signs that this Congress and this President can stand together and do 
exactly that. Recently, just a couple of weeks ago, the Senate stood 
with the President for fiscal discipline and slashed nearly $2 billion 
from an outdated weapons system. That is a good start that I gladly 
supported. But so much more is left to do.
  Coloradans already know we are in a bad way. People in my State are 
well aware that the excesses in recent years are catching up to us, and 
they know that Congress and the President have to make hard fiscal 
choices, reform health care before it eats up our entire budget, and 
pay for our reform efforts.
  This challenging outlook may be just what it takes to bring both 
political parties to the negotiating table. Paired with Pay-Go, it is 
my hope that this new legislation can be a real starting point for 
meaningful fiscal negotiations. It is time we come up with an 
intelligent framework of fiscal management, that keeps Congress 
thinking ahead each time it makes a decision, and each time it puts 
together an annual budget, and each time it is faced with America's 
long-term fiscal trajectory.
  Washington's fiscal mess was created over many years, and we won't 
solve the problem overnight. But this bill would give Congress and the 
President a guidepost to make the decisions necessary to get our budget 
under control. It would set a strong and binding standard for us to act 
responsibly.
  We must start with what unites us. When I worry about what type of 
country we will leave my daughters and all of our young people, I know 
that others who vote differently than I do have the same worries. We 
owe more to our kids than to leave them a huge national debt and no 
plan to get out of it.
  If we don't start making difficult decisions soon, we will be 
limiting our children's ability to make our country a better place, 
before they even get started. We will be limiting their ability to 
invest in education, life-saving scientific research, or new 
technologies that form the foundation of economic growth. We will be 
limiting their ability to defend the Nation during future times of war 
that we can't even think of today. And we will be limiting their 
chances of having a quality of life even better than what our parents 
and grandparents left to us.
  If we fail to confront the tough issues so we can control the cost of 
health care, we will have squandered this narrow window of opportunity. 
If we fail to step up to the plate and pass a fiscally sound health 
care reform bill, this Congress will be remembered for years to come as 
having let down the country. If we fail--not just to stop digging this 
deep fiscal hole, but to put a process in place for climbing back up to 
solid fiscal footing--we will have failed to perform as the stewards of 
our children's dreams.
  Let's stand together, with our President and with American families. 
Let's get health care reform done responsibly, let's take action to 
reduce the deficit and debt, and let's put this economy back on track.
                                 ______