[Congressional Record Volume 155, Number 134 (Tuesday, September 22, 2009)]
[House]
[Pages H9780-H9784]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             DEMOCRATIC FRESHMAN CLASS HOUR ON HEALTH CARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from New York (Mr. Tonko) is recognized 
for 60 minutes as the designee of the majority leader.
  Mr. TONKO. Madam Speaker, as you know, we have a very talented 
freshman class in the House of Representatives. And for the next hour, 
Members of the freshman class will be discussing health care. We would 
like to thank the Democratic leadership for giving us time to discuss 
this very important issue. Within the freshman class I believe is a 
diversity of work experience and work expertise, skill sets that have 
been brought to this Chamber to discuss various policies.
  Well, nothing could be more pressing, Madam Speaker, than the need 
for health care reform. Just yesterday I was pleased to welcome 
President Obama to the 21st Congressional District of New York, which I 
represent, specifically to the city of Troy, New York. He had spoken 
about the innovation economy. He had spoken about the recovery from 
this recession, which has been deep and long. He made mention that 
there is no recovery without addressing health care costs for our 
businesses, to be able to go forward with a meaningful plan that will 
allow for employer-based coverage at an affordable price.
  So this evening as we speak about health care reform, it is 
significant to our business community, it is significant to our 
families, the working families across America, and it is significant to 
government, as health care costs for government-provided health care in 
our local municipalities, in our school systems, is rising well beyond 
inflation.
  In fact, just today a report was issued by the Office of the Vice 
President that spoke to, on average, 5.5 percent increases on family 
plans across America. That average of 5.5 percent came during this 
recession period that actually saw inflation dropping by 0.7 percent. 
So this is a remarkable statistic that we're seeing this growth 
continuing.
  We have been joined, and we are joined by two of our colleagues right 
now. We have Representative Gerry Connolly from Virginia's 11th 
District and Representative Chellie Pingree from Maine's 1st 
Congressional District. Representative Connolly, if you please.
  Mr. CONNOLLY of Virginia. I thank my friend and colleague from New 
York. I just wanted to amplify the point you just made, Mr. Tonko. Last 
week the Kaiser Family Foundation issued a report. This isn't coming 
from any committee in Congress. This is an independent analysis. It 
said that the average family of four in the United States is currently 
spending over $13,000 a year for health care coverage. If we do 
nothing, by 2018, in only 9 years, that $13,000 a year will be $30,000 
a year, pushing health care affordability beyond the reach of millions 
of American families if we do nothing.

[[Page H9781]]

There are real costs to inaction when it comes to health care.
  Mr. TONKO. Absolutely. And I think that the statistics speak for 
themselves. Representative Pingree, you have long been a champion in 
your State for health care reform. Statistics in the Northeast and 
certainly in New England are what they are across America, where we see 
out-of-control costs and reduced opportunities for those who are 
holding an insurance policy in hand.
  Ms. PINGREE of Maine. Absolutely. You're right. I come from the State 
of Maine. And like many State legislatures, when I was in the 
legislature and after I was there, the State implemented a lot of 
reforms around health care. They've done a tremendous amount to attempt 
to cover more citizens, to bring down the price of prescription drugs, 
to deal with the challenges of the insurance markets. But the fact is, 
even though that is a State that has done all it can, a State can't do 
it by itself. It can't do it one State at a time. What I hear from my 
constituents when I go back is, Please, do something about the health 
care system, and don't delay. Do it now. Get it done this year.
  You talked about small businesses. Small businesses in my State and 
big businesses alike are really struggling under the cost of health 
care. It's a significant economic issue. It truly is. If we don't do 
something about the rising costs of health care, we're more 
uncompetitive as a Nation. More small businesses are finding that 
they're having to cut back on the coverage for their families or take 
away coverage completely. It's a huge economic issue in our State.
  You know, one other factor we sometimes don't talk about around the 
economic issues is the number of people who might leave their job to 
start a business. I talk to a lot of constituents who say to me, You 
know, I would like to start up my own business. I have got an idea. I 
even might employ a couple of people, but I wouldn't dare leave my job 
because I don't think I could be without a safety net.
  So you have older workers who might choose to retire, you know, go on 
to their next stage of their lives, but they don't want to leave that 
health care insurance that they currently have. Or people who have good 
ideas, who want to go do something, and they say, I just can't do it 
without the safety net of health care insurance. I don't dare be out 
there.
  Mr. TONKO. Well, it's interesting because I'm sure we hear it all the 
time. We recommend to high school students that probably their work 
stops throughout their careers will be four, five in number. It will 
not be that sustained one bit of loyalty to the employer and reverse to 
the employee that goes through an individual's work life career. And 
that is an important thing. If we profess that to be true, and we share 
that with these young minds, where we see that happening today in 
today's society where there are more and more shifts in careers, where 
there are golden opportunities to enter into another work opportunity, 
or where people are displaced, tossed to the streets, if you will, and 
lose their jobs, there should be that stability.
  While the discussion by some has been framed an issue for the 
uninsured or underinsured, it's equally about those of us who are 
insured with the policy in hand. And what is really driving the issue 
here for many is catastrophic illness, where there is perhaps a huge 
demand on a family for medical expenses, and we are seeing more and 
more bankruptcies due to medical expenses as part of an American 
outcome, unacceptable outcomes in a land of abundance, as is the case 
in America.

                              {time}  1945

  So reform here is what we need. Status quo is unsustainable, 
absolutely unsustainable, and we need to go forward with a progressive 
sort of policy reform that will enable us to prosper as a society, via 
business, via families, via individuals, via our local governments and 
school systems.
  Mr. CONNOLLY of Virginia. I would say to my friend from New York, 
Madam Speaker, that I think this whole issue of the distortions health 
care causes on the labor market really impede and constitute a 
significant barrier to the fostering of innovation and entrepreneurship 
in the United States because, as our friend from Maine just indicated, 
millions of Americans have to make decisions about where they will work 
and at what they will work, not because they think that's necessarily 
what they're going to be best at or not because they're willing to take 
a chance with a startup company, understanding it might fail but, on 
the other hand, it might be the next Microsoft, but because they can't 
afford to because they have a preexisting condition.
  Forty-five percent of us who have health care insurance have a 
previous existing condition, and you may have a spouse or a child with 
a previous existing condition on that policy. And if you move to a 
smaller risk pool or, God forbid, no risk pool at all because that 
small startup or that small company can no longer afford health care 
coverage, you risk the catastrophic illness you just talked about, Mr. 
Tonko, which drives families into bankruptcy.
  In my district, which is a relatively affluent district compared to 
many others, we had 1,430 families last year in the 11th Congressional 
District of Virginia who filed for bankruptcy because of health care 
costs. And no American family should have to face that kind of 
``Sophie's choice'' over health care in America.
  Mr. TONKO. Absolutely not.
  As I mentioned, the President came to my district just yesterday and 
talked about the innovation economy and the emergence of innovation 
that is expressed through keen intellect out there, whiz kid ideas, if 
you will, that are fostered by these very sharp individuals who know 
with precision how we can enter into a high-tech sweepstakes and win 
that global race. Well, we can't saddle these people with the costs of 
health care that is unaffordable or deny their entry into the job 
creations that they want to provide by finding that the premium is 
going to be some $13,375, as the Vice President's released study 
indicates. That is unacceptable.
  Status quo also means that insurance companies will be calling the 
shots, that they will control your destiny. They will step between you 
and the medical community. They will continue to reap great profits 
that go toward marketing and executive bonuses and various other items. 
The first 26 cents now on the dollar are assumed to go for something 
other than health care. So status quo is not sustainable.
  I know, Representative Pingree, that you have been impacted by these 
issues within your district and have created a very strong voice for 
health care reform.
  Ms. PINGREE of Maine. You know, it's interesting to come from a State 
where we have done a lot of insurance reforms and a variety of reforms. 
What I find is because we've been talking about it for such a long 
period of time in our State and because the State has moved forward on 
a variety of things, I find that the constituents in my district are 
very literate and very articulate about this. Wherever I go, they've 
got to give me a piece of their mind about the insurance company, and 
most of them have had some kind of an encounter.
  We often talk about the number of people that are happy with their 
plan, but I've also heard people say, you know, you're happy with your 
insurance plan sometimes until you have to go and use it. And I am 
amazed at how many times I meet with people who say, I thought it was 
going to be there for me. I didn't realize there was going to be a cap 
on it.
  An awful lot of people in my district are self-employed or they do a 
variety of different jobs. We have a tremendous number of fishermen. 
People work at woodcutting, a variety of different things, and they 
have $5,000 and $10,000 deductibles. Well, that sounds pretty good when 
you first sign up, but the fact is you still pay a very high premium 
and you've got to pay that first $10,000. You do an injury to your knee 
or you do a variety of other things or one of your kids gets sick, 
before you know it, you've got to pay that first $10,000 and you're 
still paying enormous premiums, and what have you got in the end? It 
sounds like kind of a way to get around the situation, but most people 
say to me in the end, you know, This idea of just catastrophic 
coverage, it really didn't work for me, or, The insurance company 
wasn't really there when I needed it.

[[Page H9782]]

  I just want to go back to that point. A number of people who I talk 
to say--it's a tough economy. Maine is 38th in per capita income, so my 
district doesn't necessarily look just like yours. A lot of people are 
really struggling to put it together. A lot of people are seniors or 
nearing retirement age. But because it's a hardworking constituency, 
they'll say, you know, We do pretty well at making ends meet. I go 
fishing. I paint houses. I cut some Christmas trees. My wife sells 
crafts. We've got this little business or we want a tourist motel. We 
can almost put it all together and have a pretty good income. The thing 
we can't afford is that $12,000 or $13,000 a year for insurance. And my 
daughter's diabetic or my husband's got a condition; we can't go 
without it. And I just want to go back to that point that the number of 
people who work hard and say, I could earn a pretty good living, but 
what I can't afford is health care insurance.
  When I look at my State, the struggling economy, the job loss--our 
unemployment numbers just went up, and we're all looking for the big 
extension today of unemployment insurance. But the fact is the single 
biggest thing we can do to revive the economy in my State is to have 
universal coverage for health care. And I don't care whom I talk to. If 
they're on the left or the right or they own a business or they work 
for a big company, that's the one thing we all agree on: If there were 
affordable health care, we could get by.
  One other fact I just want to put out there, and we're talking about 
a variety of things today, is sometimes people will say to us, well, 
you know, I don't want to have this kind of government health care. I 
don't want to have to pay for everybody else.
  Well, if you're paying the cost of health care insurance today, at 
least $1,000 of your $12,000 to $13,000 premium is in the cost shift of 
all the people who aren't covered or who don't have adequate coverage. 
I mean, thank goodness people get coverage when they get sick and they 
get to the hospital. But the fact is our hospitals are struggling under 
the weight. Our practitioners are having to cover a lot of people who 
just don't have it when they need it or the insurance wasn't there when 
they thought they did. So you're already paying at least $1,000 a year 
in a tax, in a cost shift that's going somewhere else.
  Why not make this a sensible system where everybody has early care 
and intervention and we emphasize wellness? It would make a huge 
difference in the economy.
  Mr. CONNOLLY of Virginia. Absolutely.
  In my district, I've started something called ``house calls.'' In 
fact, CNN followed me around one day actually at it, saying, you know, 
it's not that often a Member of Congress makes house calls, but this 
one did.

  What I did was sit around a kitchen table at a home with some 
neighbors in this particular neighborhood in my district and listened 
to stories. And while, obviously, there exists lots of considerable and 
legitimate fear and angst about what might constitute health care 
reform, what might be in a bill or not that we heard this summer, we 
also know there was also an awful lot of orchestrated noise to try to 
prevent the legitimate debate on health care sometimes and maybe to 
drown out these stories of average Americans and what they go through 
at the hands of the health care insurers.
  So I'm picking up on what Ms. Pingree said, but I am talking about 
those who have insurance, and yet time after time what I find when I go 
back to my district is stories, often horror stories, but certainly 
stories about capricious, arbitrary decision making.
  We heard a lot of rhetoric this summer about I don't want a lot of 
government bureaucrats standing between me and my doctor and deciding 
on my medical care, and I think all three of us would agree with that. 
We don't want that either. There is a bureaucrat, however, if you're 
insured in America, standing between you, often, and your medical care, 
and that's not a government bureaucrat. It's an insurance bureaucrat 
sitting in a cubicle somewhere, looking for ways to shave costs 
irrespective of the medical requirements you may have, and sometimes 
and all too often irrespective of what the recommendation of your 
doctor may be in terms of best treatment or testing or both. Time and 
again, we hear sad story after sad story of lack of coverage, capping 
the amount of coverage, refusal to allow testing or procedures, often 
for very arbitrary reasons.
  One of the things I hope, and I know that a number of the versions of 
health care reform legislation contain, is that we will actually 
address that. We will rein that in. We will protect health care 
consumers in America from that kind of capricious behavior by insurers 
whose only motivation isn't your health or your best interest; it is 
profit.
  Mr. TONKO. Absolutely.
  Mr. CONNOLLY of Virginia. There's nothing wrong with profit, but 
profit ought not to be the driving motivation in the most important 
part of our daily lives: our good health and well-being. And it seems 
to me we ought to be putting America's health before the insurers' 
profit motive.
  Mr. TONKO. Representative Connolly, you talk about some of the 
hardship that befalls people because of these decisions by bureaucrats 
in the industry. Well, there are also those situations where they drop 
coverage because of illness, which is a dreadful outcome. And I think 
that the insurance reforms, the health care insurance reforms that are 
required in this package would address situations like catastrophic 
illness, requiring that there be no prejudice shown against those 
suffering with catastrophic illness; that there be this portability 
that if you change jobs, lose a job, you continue to maintain health 
care coverage; that there be caps on certain situations where you're 
not draining--for the bankruptcy purposes we cited here or just the 
economic hardships that befall families, you're not draining them of 
resources unnecessarily, and putting a cap of perhaps $5,000 on an 
individual, $10,000 on a family, allowing for that cap to be placed so 
there is that benefit that comes the way of our American families.
  Putting no copayment onto wellness programs and prevention programs, 
that's a smart thing for us to do. We know that when we bring people 
into the network and emphasize and underscore the value of prevention, 
they will be all the better for it.
  So there are all these dynamics that should be responded to by the 
legislation that we do here, by the policy we develop.
  Representatives talk about anecdotes that are shared within their 
districts to them either through house calls, which I think are unique, 
and just in group meetings that are had. I can tell you recently 
someone told me of their premium going up 37 percent in a matter of 2 
years and that now, because of catastrophic illness, the wife of this 
married couple whom I reference here is unemployable at the age of 60. 
Her husband is now the single wage earner, trying to cover $18,000 
worth of medical expenses.
  Now, is that the kind of outcome that we want to protect? Is that the 
status quo that we're supposed to fight for? Or do we go forward and 
champion causes that will remove this sort of situation from the lives 
of the American families that we have the fortune to represent?
  I think that there is a better way, and this health care focus in 
this House has been strong about wringing excess costs and 
inefficiencies out of the equation and putting in those measures that 
control overimpacting our American families in cases of catastrophic 
illness and advancing the cause of wellness. That's what we can achieve 
here and not be ruled by myth or fear tactics but by facts and 
information that is fed us that is responsible development of public 
policy, I believe.
  Mr. CONNOLLY of Virginia. You know, Mr. Tonko, a lot of folks who 
have health care coverage have to look at what is the trajectory moving 
out in the next few years.
  Let me give you an example of a couple I met in one of my house 
calls. This is a gentleman with a Ph.D. His livelihood is to tutor high 
school students in our school system who need extra help trying to make 
their way in the academic career, but he's considered a contract 
employee and, therefore, has to get his own health insurance. He has no 
benefits.
  Seven years ago health insurance coverage for him and his family of 
four cost $4,000 a year. Absolutely manageable, easily fit into his 
budget. Seven

[[Page H9783]]

years later, no change in his health profile, it now costs $18,000 a 
year for that same family of four, and that includes no dental, no 
vision, and no drug coverage. He now has to look at the next few years 
of whether he has to drop that health insurance policy because he can 
no longer afford it because now it involves real tradeoffs 
economically.

                              {time}  2000

  This is not somebody who is abjectly poor; this is the middle class 
actually looking at terrible choices they never thought they would have 
to make regarding health care.
  Mr. TONKO. And we have heard real-life stories that should affect all 
of us in our process here in the House. Both of you are strong voices 
for intelligent reform; and Representative Pingree, I know you have a 
lot to add.
  Ms. PINGREE of Maine. We have a lot of colleagues who are strong 
voices for reform; and most of us, every time we go to the supermarket, 
go to somebody's birthday party, the first thing our friends and 
neighbors and constituents say to us, We need to get the health care 
bill passed. What is standing in the way?
  There is so much hard work going on here in dealing with many of the 
complicated details. This is a major overhaul of the health care 
system. I commend my colleagues in Congress who are putting in a 
tremendous number of hours to get this right, and it is not easy to 
figure out and how to make it affordable for Americans. The stories 
that you talked about earlier are exactly what we hear everywhere we 
go. What we are trying to do now is put the finishing touches on a bill 
that will get us to that place.
  I want to go back to the point you made about wellness. I have 
visited with a lot of the businesses in my district, many of which are 
self-insured. Those businesses are big enough to take on the challenges 
of health care themselves, and I am so impressed with the number of 
companies that are self-insured and say that wellness needs to be a 
critical component. What they have found as a business decision, the 
more you can emphasize wellness, good nutrition, smoking cessation, 
regular check-ups, some have fitness trainers on site, things we 
wouldn't consider as an early component, but they have realized that 
the more you can do to keep people healthy, to make sure that their 
workers and their families get tests, stay out of the hospitals, that 
is where we can cut significant costs.
  That is one of the challenges that people are spending a tremendous 
number of hours trying to sort out. What does that mean to lower cost? 
How do you make sure that we don't do unnecessary testing, and that we 
pay our practitioners for keeping people well, not for hospital 
admissions and just the times we get sick. It is a major change that we 
are talking about here, and there has been a lot of thoughtful dialogue 
and debate, not the crazy talk that is out on some of the cable news 
shows, but serious dialogue about how to do this right, how to get real 
competition in with the insurance companies, how to help our small 
businesses to increase the number of people who are covered.
  I have to say that in spite of the difficulties in making major 
change and crafting a big piece of legislation, I get excited when I 
think about it. I think about what would it be like to end this year 
and go back home to our constituents and say, We did it. We took a 
major step forward. We will no longer be the only Western nation that 
doesn't have civilized health care insurance, that hasn't worked to 
bring down costs. That it is affordable. It would be wonderful to say 
that to people.
  I have to leave the floor, but I want to say in closing about my own 
district, we have talked a lot about the economic issues. When we talk 
about individual constituents, there is a part of me that believes this 
is a moral issue. It is a patriotic issue. It is a way of making sure 
that we understand that in America, we are all in this together. If my 
small business fails because I struggle under the cost of health 
insurance, or one of your constituents goes into personal bankruptcy 
because of cancer or another illness that wasn't covered, that is not 
the kind of America that I want to live in. That is not the kind of 
place we want to be. We want to do this because it is right for our 
economy, but also because we believe it is right for America.
  Mr. TONKO. It expresses the character of our society and of our 
Nation. Obviously, there are determined individuals who understand and 
acknowledge that we can't fix this system with slogans or sound bites 
or banners that are flown at various events. It needs to get into the 
weeds of detail and make certain that people are protected.
  Ms. Pingree, you make reference to small business, some 13 million 
people, nearly one-third of America's uninsured, are employed by small 
and medium-size businesses, fewer than 100 employees. That is a huge 
number. People say to me, if we do this insurance benefit, shouldn't 
people be working? I say they are working; they are not getting 
insurance coverage.
  About 15 years ago, 61 percent of our small businesses and medium-
sized businesses offered employer-based health care coverage. Today 
that number has dropped to some 38 percent.
  So the signs are there. The patterns are being developed. We cannot 
continue with the status quo. It is unaffordable and not sustainable.
  Ms. PINGREE of Maine. Thank you for allowing me to join you.
  Mr. TONKO. Mr. Connolly.
  Mr. CONNOLLY of Virginia. Adding to what you just said, Mr. Tonko, if 
we do nothing over the next 10 years, the cost to small business for 
health care in America will climb to $2.4 trillion. And that means that 
38 percent that currently provide health care coverage will drop to 
something like 30 percent or below.
  Mr. TONKO. And I am reminded with that statistic that the $13,385 on 
average for a policy will grow to something greater than $29,000. 
Unacceptable outcomes, and it will drive business into unprofitable 
situations. And it will wreak damage and pain and suffering onto our 
Nation and onto its families. So there has to be reform here. 
Absolutely there has to be reform.
  When you look at it from our senior citizens' perspective, knowing 
there have been injustices allowed, the creation of a doughnut hole 
where constantly, we have talked about this, you hear from your senior 
citizens as constituents, where they reach in a few months the 
threshold where they are in that doughnut hole and they are paying out 
of pocket for necessary pharmaceuticals, it is unacceptable.
  Mr. CONNOLLY of Virginia. It is unacceptable. Of course, an awful lot 
of fear was engendered by misinformation spread over the summer about 
what would and would not happen to Medicare. No current Medicare 
benefits will be in any way negatively affected by any of the 
legislation that we are looking at. As a matter of fact, those benefits 
will be enhanced by the closing of the doughnut hole that you just 
referred to, Mr. Tonko. That is the hole that doesn't cover the price 
of prescription drugs at a certain expense range for senior citizens, 
meaning that their out-of-pocket cost for prescription drugs goes 
through the roof. They often have to make very difficult choices 
between food and drugs at the end of the month. We want to close that 
doughnut hole.
  Mr. TONKO. Wouldn't you have expected the voice of advocacy out in 
the streets to scream and yell about that outcome when it happened just 
5 or 6 years ago? But no one brought to the attention or carried any 
anger and expressed concern to the level that you hear today. And here 
is the situation we are attempting to correct, a wrong that was allowed 
to occur, and to close that doughnut hole to allow for more freedom and 
to have a sensible outcome.

  At one of my health care forums in my district during this August 
recess, I heard from people who were not taking medications simply 
because of that doughnut hole. I heard from a couple again who 
testified at one of our forums that indicated for cardiopulmonary 
purposes the husband needed to take medication. It was a preexisting 
condition so it denied them insurance coverage, and they couldn't 
afford out of pocket to pay for the medications. So she cheerfully 
shared with us that he simply doesn't take it. It has put undue stress 
onto the family. It has caused economic hardship, and they are without 
insurance.
  For those who would argue that that system should be maintained, I 
have

[[Page H9784]]

my insurance, you go find yours, we are all paying. As Representative 
Pingree indicated, we are paying for that uncompensated care, and I 
believe that is to the tune of some $56 billion or $57 billion in this 
country. That is a huge savings that automatically flips over to a 
benefit if we do wise health care policy reform.
  Mr. CONNOLLY of Virginia. You know, in addition, if you actually 
enumerated the benefit enhancement for our seniors, Medicare stays not 
only intact; it gets better. We close the doughnut hole, making it 
easier for seniors to be able to afford and to access the prescription 
medications that they need.
  We eliminate copayments for routine, preventive medical care, 
including screenings, saving seniors hundreds of dollars a year.
  We improve and increase reimbursement payments to doctors who serve 
Medicare patients, which is a complaint we often hear from our senior 
citizens, that because of reimbursement rates being inadequate, doctors 
put a cap on how many Medicare patients they will see. And in some 
cases they get out of business all together. Obviously, that is not a 
good thing for our senior population.
  This bill addresses all three of those reforms, making Medicare 
benefits more generous to our senior citizens, protecting the benefit 
base they have got, and augmenting it. Unfortunately, some of the 
misinformation spread in the summer would suggest otherwise, creating 
needless fear and stress in our senior population which relies so 
heavily on an efficient and effective Medicare system.
  Mr. TONKO. Right. And I think the sensitivities that we need to show 
to these various audiences are hampered when people are including in 
the discussion items that are simply not in the bill, or fabricating 
them in a way where they suggest that there are outcomes that would be 
very destructive.
  So this has been a very unique effort because you are trying to share 
information with your constituents, which I think is valuable. They can 
constructively build this package with us. And at the same time, you 
have to dispel the myths and rumors and the misinformation so we can 
stay on that page of fact not fiction and do what is best for 
Americans, for all ratepayers and for all sectors of our economy.
  We earlier talked about small businesses. When you think of the 
benefits that come if they can have better bargaining leverage as small 
businesses, there is a benefit there. Our larger companies and 
industries haven't seen the growth in premiums that our small 
businesses have. They are some 18 percent greater than the larger 
business community.
  So what we need to do here is provide that benefit by pooling these 
resources, allowing for better leverage in bargaining for health care 
premiums to stay lower. Just with the report today that was issued, we 
had a growth in the last 10 years, New York State alone, they did a 
State by State measure, and 105 percent growth in premiums and a 44 
percent growth in wages over a 10-year span.
  Now, Representative Connolly, I think we can all agree that is not a 
pattern that we can allow to continue because eventually the well runs 
dry, people become sicker, and the profit column is swelling for an 
industry that is standing between choices that should be made between a 
doctor and a patient.
  Mr. CONNOLLY of Virginia. Absolutely. I think the numbers you just 
cited for New York State actually are higher than the national average, 
and there are regional disparities here in terms of the growth of cost. 
But what we do know, based on the Kaiser Family Foundation study is 
that the average increase in insurance premiums over the last decade 
was 138 percent, far outstripping the rate of inflation and far 
outstripping, as you point out, the growth in wages and income. As a 
matter of fact, that was negative.
  So there is no lodestone to measure what is happening in health care; 
but we do know that it is fast outstripping the ability of people's 
income to support, and it is far and away above the rate of any 
inflation index, and it is going to be pushing itself beyond the index 
of affordability in the not-so-distant future if we don't do something 
in the way of health care reform.
  I need to leave the floor, but I want to thank my colleague for his 
leadership and for providing us a forum for a civil discussion about 
such an important topic.
  Mr. TONKO. Thank you, Representative Connolly, for being a strong 
voice in this Chamber so as to move us all along that path of 
progressive reform, for an industry that is representative of every one 
of $6 in the American economy. If it goes unchecked, in the short span 
of 30 years, it will be one in $3. That does not make strong sense. It 
is a situation that will be a train wreck just waiting to happen.
  Mr. CONNOLLY of Virginia. It is not sustainable. I thank my 
colleague.
  Mr. TONKO. We thank you for joining us this evening.
  As we look at the progress that we can make here, it is important for 
us to move forward with fact not fiction, for us to instill reforms in 
the insurance area that allows for catastrophic illness to be addressed 
so that it does not prejudice against American families that require 
health care insurance.
  We need to move forward so as to provide portability for our American 
families, especially at a time when we profess that there will be 
career changes, job changes many times over in the work lifetime of 
countless individuals in this country, where if you lose a job, you 
shouldn't be denied your health care. Some 14,000 Americans per day are 
losing their health care. That is unacceptable in this Nation of 
plenty.
  We can have a better plan. We need to make certain that wellness and 
prevention are underscored as very valuable, important tools in the kit 
that speak to the soundness of holding down costs. We do that by not 
allowing for copayments in that regard. We need to cap those situations 
that could be catastrophic by making certain that no more than $5,000 
or $10,000 per family, some reasonable measure be there, to restrict 
the payments that are demanded because so many families face 
bankruptcy.

                              {time}  2015

  I know that if our health care measure were approved as represented 
before the House here, some 1,200 families in my congressional district 
alone would escape the woes of bankruptcy because of medical expenses.
  These are issues that face America each and every day. The business 
community has been paying stiffly for this sort of lack of reform. Some 
40 percent of our business community is reported spending more than 10 
percent of their payroll on health care costs. That is a pattern that 
is only growing worse with time.
  And our seniors have been treated unfairly, with concepts like a 
Medicare part D doughnut hole, situations that find them in a very few 
weeks into any calendar year paying dearly for pharmaceutical needs 
that are a life-and-death choice for them. They shouldn't limit or 
fractionalize what they're taking. They shouldn't avoid the 
pharmaceutical needs that have been required of them by the medical 
community.
  Those are situations that need to be responded through in this debate 
that hopefully will be factual, that will be fair, that will be based 
on soundness rather than fear tactics; those that might divide this 
Nation unnecessarily, that may impact the chance to really reform a 
situation that for decades has been talked about.
  I applaud the President when he said he wants to be the last 
President to attempt this effort and fail. He wants to achieve success 
for the Nation. For decades we have had many an administration push for 
reform but it has failed because I think there are those who resist 
change simply to resist it rather than open up to the discussion and 
the dialogue and the debate in honest measure that needs to be had so 
as to move forward in progressive format.
  Madam Speaker, we of the freshman class thank you this evening for 
the time allotted. I now yield back the remainder of my time and 
appreciate the opportunity to discuss what I believe is a critically 
important issue, that of health care and insurance reform here in 
America.

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