[Congressional Record Volume 155, Number 135 (Wednesday, September 23, 2009)]
[Senate]
[Pages S9694-S9700]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. WARNER. Mr. President, I rise with a group of my freshmen 
colleagues to discuss an issue that is on all our minds and on the 
minds of many Americans and that is the issue of health care reform. 
The subject most of us are going to address today is what happens if we 
do nothing on this critically important issue because we, as recent 
additions to this body, are united by a simple but important truth: the 
rising cost of health care is

[[Page S9695]]

hobbling American business, stressing family budgets and, if we do 
nothing and it is left unchecked, it will explode our national debt.
  While many of my colleagues have raised important and valid questions 
about some of the health care proposals, one of the things I hope all 
my colleagues will realize is that doing nothing to reform our health 
care system is a policy choice. It would be a misguided choice, an 
irresponsible choice, but it is a choice nonetheless.
  Today, health care costs in America consume nearly 17 percent of our 
GDP. This is projected to grow to one-third of our GDP by 2040 if we do 
nothing. This chart shows this ever-escalating cost of health care and 
its percentage of our GDP. Here we see the cost in actual dollar 
amounts, $2.4 to $2.5 trillion spent on health care in the past year.
  Our per capita health care cost is double that of virtually every 
other developed nation in the world--nations we compete against every 
day. As we come out of this recession and American business has to 
compete against these countries around the world, our economy is 
hobbled by costs that, on average, include $3,000 more per employee due 
to our higher health care costs than our competing nations.
  If we look at an issue that is equally important and one that I know 
our colleagues, especially my freshmen colleagues, continue to raise--
but we hear concerns about from our friends on the other side of the 
aisle--that is the concern about our Federal deficit. The primary cause 
of our Federal deficit and our overall debt is the increasing per-
person costs of Medicare and Medicaid. We pay more and more dollars in 
the Federal budget each year to basically pay for the same level of 
care. As this chart shows, increasing Medicare and Medicaid costs alone 
will exceed all other Federal spending. Clearly, this situation is not 
sustainable.
  In my home State of Virginia, since 2000, insurance premiums have 
increased nearly 90 percent, while wages have only increased 27 
percent. If we do nothing, and this was reaffirmed by the Business 
Roundtable report just last week, nationwide insurance premiums are 
projected to double by 2016. This is of particular concern to small 
businesses. Today, small businesses are the only group that still pay 
retail for their health care services. Their size makes their 
bargaining power weak and makes them susceptible to enormous increases 
in health care premiums.
  Once again, it is a policy choice. Doing nothing means exploding our 
Federal debt and deficit. Doing nothing means doubling health care 
premium costs for American families. Doing nothing means American 
companies will be less competitive in a global market and our small 
businesses will continue to pay retail for health care.
  Mr. President, I think I speak for all my freshmen colleagues when I 
say we were not elected to do nothing. We did not run for office 
because we were satisfied with the direction of our Nation. We were 
elected to work together with willing Republicans and Democrats to help 
turn this country around. I hope this will be the first of a series of 
statements from the freshman class, who are not only here to point out 
the challenges we face but to join Senators from both sides of the 
aisle who are committed to getting things done.
  I would now like to yield 5 minutes to my colleague, the 
distinguished Senator from New Hampshire.
  The ACTING PRESIDENT pro tempore. The Senator from New Hampshire is 
recognized.
  Mrs. SHAHEEN. Mr. President, I wish to begin by recognizing and 
thanking Senator Warner for his efforts today to organize the freshmen 
to talk about why it is so critical that we get something done to 
reform health care in this country. He and I both belong to the former 
Governors caucus, and I come to this debate with the work, years of 
work that I did as Governor and the perspective we have to do something 
to improve the availability of health care for all Americans and 
certainly for the families in New Hampshire.
  Over the past several months, my office has responded to thousands of 
letters and phone calls about health care. I have traveled all across 
New Hampshire, talking to small business owners and families who are 
desperate for help. I have talked to health care providers who are 
frustrated with the current system. Time and time again, what I have 
heard is that our health care system is not working. Costs are too high 
and access is too limited. The status quo is simply not sustainable. 
Now is the time to act.
  Every day in New Hampshire and across our country, families are 
struggling with the rising costs of health care. It threatens their 
financial stability and leaves them exposed to higher premiums and 
deductibles and puts them at risk of losing their health insurance and, 
in too many cases, financial ruin. According to one study, 62 percent 
of bankruptcies in 2007 were caused by a medical condition. I have a 
chart that shows this very clearly. This is the 62 percent of those 
bankruptcies that were the result of the costs of medical care. What is 
probably even more concerning is that of those 62 percent, 78 percent 
of them were insured. So most of the people in this country who are 
going bankrupt as the result of their health care costs actually have 
health insurance.
  Health care costs are a threat to our economy, to our small 
businesses, and to our working families. The current health care system 
is simply unsustainable for our economy. As Senator Warner pointed out, 
it is estimated that in 2009 our Nation will spend $2.5 trillion or 18 
percent of our gross domestic product on health care. That means health 
care costs account for 18 percent of the value of all the goods and 
services produced in this country. If we continue on this current path, 
health care will make up over a third of our economy by 2040.
  Senator Warner showed that in a chart. This is a graph that shows the 
same thing--what happens to health care costs if we do nothing, as a 
portion of the entire economy of this country.
  In New Hampshire, our small businesses are feeling this burden 
firsthand. From 2002 to 2006, there was a more than 40-percent increase 
in the cost of health insurance premiums for New Hampshire businesses. 
For those of our smallest businesses, those with fewer than 10 
employees, that increase was almost double, to more than 70 percent--a 
70-percent increase in just 4 years for small businesses in New 
Hampshire. That means that, although our small business owners want to 
provide their employees with health insurance, many of them cannot 
afford it.
  Ultimately, it is our hard-working families who suffer. Today, the 
average family living in New Hampshire pays about $14,600 for their 
insurance premium. In New Hampshire, we have the highest premiums in 
the country for those people who have group rates.
  I wish to say that one more time because in New Hampshire we are 
paying the highest premiums in the country for group health insurance. 
If we continue on this current path, families will be paying almost 
$25,000 in the next 10 years, by 2019. Again, here is another graph 
that shows what is going to happen to New Hampshire families--$25,000 
in 10 years. This is not affordable.
  The good news is that we know how to bring down costs. At the Center 
for Informed Choice at Dartmouth, research shows that more spending 
does not translate into better outcomes. In fact, it shows that up to 
40 percent of the time, patients who are engaged in the decisions 
related to their care will choose the less invasive and less costly 
procedures. These choices produce better outcomes with higher rates of 
patient satisfaction.
  The health care industry can do better for less. We can find savings 
in our system. For example, experts have estimated that we can save 
$5,000 per Medicare beneficiary by reducing costly hospital 
readmissions. I have introduced legislation with Senator Susan Collins 
from Maine called the Medicare Transitional Care Act. This bipartisan 
legislation will reduce Medicare costs and offer better support and 
coordination of care to Medicare patients. This will not only improve 
the quality of health care for our seniors, but it will also save 
taxpayers money.
  I was very pleased to see that many of these provisions were in the 
markup that came out of the Finance Committee.
  Although the numbers and statistics are compelling, it is really the 
stories I have heard from my constituents

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which best illustrate why reform cannot wait. This is not just about 
politics, this is about real people.
  A few weeks ago I received a letter from a young woman named 
Jennifer. Jennifer and her husband had recently decided they wanted to 
start a family. They both work for small businesses that do not offer 
health insurance, so they shopped around for an individual insurance 
plan. The policy they could afford did not cover standard maternity 
care, but they were told they would be covered in case of an emergency: 
if Jennifer needed a C-section or if she had other health problems 
during the pregnancy.
  Unfortunately, Jennifer suffered a rare complication, a molar 
pregnancy, resulting in a loss of the pregnancy and requiring extensive 
followup. But the insurance company told them it would not cover 
``that'' emergency. So during their time of grieving, Jennifer and her 
husband are not only facing piles of medical bills, they are wondering 
how they will ever be able to afford a baby in the future.
  No young family should have to go through this. We have the 
opportunity to stabilize health care costs and reform our health care 
system for people such as Jennifer and her husband. We know this is not 
easy. It is one of the greatest challenges of our time. But the time 
has long passed for action. We need to act now to stabilize costs and 
provide coverage for Americans.
  I look forward to working with my colleagues on both sides of the 
aisle to achieve this goal.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia.
  Mr. WARNER. I thank my colleague, the Senator from New Hampshire, on 
her very excellent comments. We are running a little behind. I do want 
to come back, if we have time, to talk about the costs to State 
budgets, something both she and I experienced.
  I yield 5 minutes of our time to the distinguished Senator from 
Delaware.
  Mr. KAUFMAN. I thank the Senator.
  I join my freshmen colleagues this morning to discuss the Nation's 
health care system and urge Congress to pass reform legislation this 
year. I think there are two major reasons we need to enact health 
reform this year, and they both require controlling health care costs.
  First, we need to pass health care reform because failure to do so 
could literally bankrupt the country. Just look at Medicare and 
Medicaid. One of the biggest driving forces behind our Federal deficit 
is the skyrocketing cost of Medicare as well as Medicaid. In 1966 
Medicare and Medicaid accounted for only 1 percent; that is, 1 percent 
of all government expenditures. Today they account for 20 percent. If 
we do nothing to start bending the cost curve down for Medicare and 
Medicaid, we will eventually spend more on these two programs than all 
other Federal programs combined.
  Medicare spending is growing rapidly for the same reasons that 
private health care spending is growing rapidly: increases in the cost 
and utilization of medical care. Between 1970 and 2007, Medicare's 
spending for each enrollee rose by an average of 8.5 percent annually, 
while private health insurance increased by 9.7 percent per person per 
year.
  The Congressional Budget office estimates that Federal spending on 
Medicare and Medicaid was approximately 4 percent of the Nation's gross 
domestic product in 2008. If we fail to act--and we cannot fail to 
act--Federal spending on Medicare and Medicaid will rise to 7 percent 
of GDP by 2025. We must bend these cost curves down and slow the level 
of growth in Medicare and Medicaid programs if we are ever to get our 
budget situation under control.
  The second major reason we have to act is because failure to do so 
will drive more and more Americans into personal bankruptcy. Today 
bankruptcy involving medical bills accounts for more than 60 percent of 
U.S. personal bankruptcies, a rate 1.5 times that of just 6 years ago.
  Keep in mind, more than 75 percent of families entering bankruptcy 
because of health care costs actually have health insurance. I think we 
have a popular idea that the people going bankrupt are people who 
cannot manage their money, who do not have health insurance. These are 
people who have health insurance. Again, two-thirds of all Americans 
filing for bankruptcy because of medical bills already have insurance. 
These are middle-class Americans who are well educated and own their 
own homes. They just cannot keep up with the alarming rise in costs 
associated with medical care.
  We have to act so that Americans no longer have to worry about how 
they are going to afford their medical bills. We need to pass health 
care reform and give Americans more stability in these rough economic 
times so they no longer have to choose between paying their medical 
bills or paying their home mortgages or their children's tuition 
payments. Controlling health care costs is a major reason we need to 
pass health care reform today.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia.
  Mr. WARNER. I thank my colleague from Delaware for pointing out the 
enormous cost of inaction both to our Federal deficit and to families 
who are struggling with these costs.
  Now I yield 4 minutes of our time to the distinguished Senator from 
Alaska.
  Mr. BEGICH. Mr. President, I am pleased to stand with my freshman 
colleague this morning. We often share the back bench, but today we 
bring our message front and center. The time has come for action on 
health insurance reform. We represent the North and South. For me, 
everyone comes from the South. But today we see that no matter where 
you live in this country or what you do for a living the cost of 
inaction is simply unacceptable. All of us can cite alarming statistics 
from our States.
  In my State, there are now 133,000 uninsured Alaskans. The raw 
numbers may not be much when compared to Virginia, Illinois, or 
Colorado, but in Alaska that number represents 20 percent of the 
population.
  To me, and I hope to my colleagues on both sides of the aisle, this 
is unacceptable. Average insurance premiums in Alaska have doubled in 
the past decade to more than $12,000 annually. If we do not act, they 
will double again about the time my 7-year-old son starts high school. 
Families cannot afford that.
  Already, the average Alaskan family pays a hidden tax of $1,900 in 
premiums to cover the cost of uncompensated care provided to people 
without insurance, and it will only get worse as time moves forward. 
The problem is especially tough for small businesses in my State 
because Alaska has a high proportion of small business owners: 
fishermen, float plane operators, construction contractors, independent 
realtors, and the like.
  Some 52 percent of all the jobs in Alaska are held by small business 
workers or the self-employed. They know better than anyone that a 
broken health care system leads to lost jobs, reduced productivity, 
less investment, and stalled business growth. Just this weekend I met 
with a small business townhall and there was one clear message from 
them to me, to Congress: Do something. Do it now. Each one cited their 
increases ranging from 14 to 41 percent in health care costs this year 
alone. That is why one of the best ways we in the Senate can strengthen 
and grow Alaska's and American business is to pass meaningful health 
care reform not sometime down the road but this year.
  I joined the small business majority earlier this year as they 
released the compelling report on the need for reform. The bottom line, 
even with middle-of-the-road reform: American small business will spend 
$800 billion more than they need to over the next 10 years.
  If they can save that, with just the middle-of-the-road reform, we 
can save them money and put it to the best use. Considering that small 
business is driving economic recovery in America, that is huge. Eight 
hundred billion dollars saved is available for infrastructure, 
innovation, and providing stable jobs.
  It is not just small business that needs reform. The Business 
Roundtable, which has been spoken about already this morning, which 
represents much bigger companies, released a report last week that said 
health care costs will triple over the next decade to nearly $29,000 
per employee.
  There is plenty to debate about health care reform in the weeks 
ahead. I still have questions of my own. But there is one thing I hear 
from all across my State and across this country, from e-mails and 
messages we receive: support for health care reform is truly support 
for America's businesses.

[[Page S9697]]

  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia is 
recognized.
  Mr. WARNER. I thank my friend from Alaska for pointing out, 
particularly, with small businesses, that in our current system they 
are the only people who pay retail for their health care expenses. 
Reform must rectify that.
  I yield 4 minutes to the Senator from Oregon.
  Mr. MERKLEY. Mr. President, during 11 townhalls in Oregon this August 
I heard a lot of heartfelt anger and confusion from Oregonians about 
health care in our Nation. I am sure it echoed the confusion and 
frustration from voices across our Nation.
  A lot of Oregonians came out to tell me that they did not like one 
bit the description of the reform plan they were hearing on radio and 
on television. If reform means they would have to give up their 
insurance or give up their doctor, they did not want any of it.
  If reform meant that government panels would deny care to seniors, 
then they wanted me to know that was outrageous, that they would never 
support it. And I agree with them. If reform had those features, it 
sure would not get my vote. I do not think it would get a single vote 
in this Chamber.
  But as most of America now knows, those claims were lies told to 
scare the bejeebers out of citizens by folks who profit from our 
current health care system. It says a lot, does it not, that those who 
want to block repairs to our broken health care system have to resort 
to creating myths in order to whip up opposition.
  The opponents of reform have their own plan, which is continue to 
profit from the current system, our current broken system. Their plan, 
simply put, is a terrible plan for America. The opponents' status quo 
plan features shutting out folks with potential health care risks, 
those who most need health care, from our health care system. Their 
plan features denying coverage for citizens with preexisting 
conditions. Their plan involves dumping citizens out of coverage who, 
after years of paying their premiums, develop a health care problem and 
then they lose their health care.
  The opponents' status quo plan is to continue a broken system in 
which premiums double every 7 years, putting health care out of reach 
to America's working families and robbing workers of their pay raises 
that could improve their standard of living.
  The opponents' plan is to continue health care rationing by insurance 
company bureaucrats who make money denying the claims. The opponents' 
plan is to continue lifetime limits that pile massive debt on those 
unfortunate enough to get sick or injured.
  The opponent's plan is to continue a system in which health care 
costs drive more than half the bankruptcies in America, tearing the 
financial foundations out of our working families, setting them back 
decades, if, in fact, they ever recover at all.
  What I did hear from citizens back home is they do not like that 
status quo plan. They want to see those problems fixed. They want an 
individual to be able to join a pool and get a much better deal. They 
as a small business want to know that they will be able to control 
health care costs and keep providing health insurance, and maybe even 
get a better deal, and not have to pay the transfer costs of all of the 
folks who do not have health care and end up in the emergency room.
  So for small businesses to thrive in our Nation, for American 
families to thrive, for large businesses to compete internationally, we 
must fix our broken health care system. The status quo plan put forward 
by opponents is simply wrong for America, wrong for families and wrong 
for business.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia.
  Mr. WARNER. I thank my friend from Oregon for pointing out, in vivid 
terms, the challenges the status quo presents to so many American 
families. I yield 4 minutes to my friend, the distinguished Senator 
from Colorado.
  Mr. UDALL of Colorado. Mr. President, I am here with my fellow 
freshmen Senators because we are united in our determination to pass 
health insurance reform this year. Our late and giant colleague Senator 
Ted Kennedy said it best when he called health reform ``the great 
unfinished business of society.''
  We are presented this fall with a historic opportunity to finally 
succeed, and, for me, failure is not an option. The cost of inaction is 
too great, both for American families and for our economy. We have a 
bloated $12 trillion Federal debt which is being fed every day by 
growing health care costs. Every day, small and large businesses are 
laying off workers and slashing benefits to their employees. Those 
Americans who have coverage still do not have the peace of mind that 
comes from knowing insurance companies will keep their promises. 
Premiums are rising at three times the rate of wages. The number of 
uninsured is growing at a faster rate every day. In my State of 
Colorado, nearly one in four is uninsured in some areas. The Treasury 
Department recently released a study showing that one out of every two 
Americans will lose coverage at some point over the next 10 years. We 
can't allow this to become America's future, but it will if we don't 
act now.
  There are many reasons health care reform cannot wait, but there is 
one that I know strikes a chord with many Coloradans; that is, the lack 
of freedom our current system provides. Workers across our country are 
afraid to leave their jobs for fear they won't be able to provide 
health care to their families.
  That lack of freedom affects our economy because fostering the growth 
of small business is one of the keys to economic success. In our 
current system, Americans are afraid to follow their dreams and start a 
small business or travel to go to work for a new company. Small 
businesses run on thinner margins than their big-company counterparts, 
and they are being hit hardest by the rise in health care costs. In 
Colorado, we have a disproportionate share of small businesses. As a 
result, we have more citizens who are uninsured. Those who do offer 
benefits are finding themselves increasingly facing no-win decisions. 
They are faced with either hiring fewer employees or slashing benefits 
or dropping coverage completely or, in some cases, going out of 
business forever.
  The proposals in front of us are tailor-made to help small 
businesses. The ideas in place would provide tax credits and create a 
simplified, well-regulated, pooled marketplace to help small businesses 
find cheaper and higher quality coverage. It is estimated that reform 
will save small businesses more than $500 billion over 10 years or more 
than $3,500 per worker. That is real money that can be reinvested in 
business growth and adding additional jobs to fuel our economic 
recovery.
  The burden on individuals is only one of the culprits preventing 
economic growth. Our deepening Federal deficit and long-term fiscal 
outlook are also closely linked to a broken system. As President Obama 
said in his address to Congress 2 weeks ago: Our Nation's health care 
problem is our deficit problem. Just think, we spend $2 trillion on 
health care per year. That is more than $1 out of every $5 spent in the 
economy, more than twice what any other industrialized nation spends. I 
think we would all agree we are not twice as healthy for our money. If 
this number continues to grow, there is no hope for reining in long-
term deficits.
  Health insurance reform is a golden opportunity to begin to control 
our deficit. We can and we need to grab this opportunity and make 
health care the springboard from which we clean up our long-term fiscal 
mess. The President reminded us that the growth of health care costs, 
if slowed by one-tenth of 1 percent a year, would help bring down the 
deficit by $4 trillion.
  There are many excellent ideas on the table to help us get there--by 
ensuring Medicare's solvency, reforming Medicare's payment structure to 
bring down cost growth in the long-term, and discouraging overgenerous 
health plans which encourage overutilization of the system.
  As Senator Warner and others have pointed out, many of the proposals 
being discussed are politically difficult to support. But not facing 
politically difficult decisions head-on is what has caused so much of 
the inertia that has brought us to where we are today. We don't all 
agree on exactly the best way forward, but we do agree it is time for 
every Member of Congress and every Member of the Senate to think about

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health insurance reform for what it is: a huge and necessary step to 
putting our economy back on track and finally providing stability, 
security, and freedom to the people. If we do this, I know we can find 
common ground. We must because the cost of inaction is too great.
  The PRESIDING OFFICER (Mr. Bennet). The Senator from Virginia.
  Mr. WARNER. Mr. President, I thank my colleague from Colorado.
  We are hearing a common theme. These freshman Members all care about 
driving down cost, and they see health care reform as stimulative to 
the American economy and recognize that ensuring the growth of our 
economy means we have to get the deficit under control. That means 
driving health care costs down.
  I yield 4 minutes to my colleague from New Mexico.
  Mr. UDALL of New Mexico. Mr. President, I am proud to join our class 
today to talk about the cost of inaction.
  Mr. UDALL of New Mexico. Mr. President, health insurance reform is 
one of the defining challenges of our time. Every person in our country 
has a stake in what we do at this moment, in this place. And while 
there are a lot of proposals out there, there is one thing we know for 
sure: Maintaining the status quo is not an option.
  It is what has been done for years. It has been the easy choice. Kick 
the can down the road a couple yards . . . a couple of years . . . but 
never get at the root of the problem. Maintaining the status quo is the 
one coward's way out. And one doesn't need an economics degree to see 
where that approach has gotten us.
  Part of meeting the challenge of reforming health insurance is being 
honest about the consequences we face if we don't. So I rise today to 
talk about the high price of doing nothing.
  It is a price we will all pay--a human price, an economic price, a 
societal price. All equally devastating if we don't muster the courage, 
if we don't have the political will to stand up and say: Not anymore. 
Not on our watch.
  The human price is the price we feel most personally when we see our 
family, our friends, our neighbors struggling to obtain health care, to 
afford health care, or to hold on to the health care they already have.
  If we do nothing--if we maintain the status quo--more Americans will 
be uninsured or underinsured. More Americans will become sick. More 
will die because of lack of care, and more families will experience 
financial ruin.
  A new report that came out last week found that family premiums have 
already increased by about 5 percent this year. Over the past 10 years, 
premiums have gone up 131 percent. It is a vicious cycle. America's 
families, America's workers and businesses--especially small 
businesses--can't keep up.
  In New Mexico, we have been paying the human price of the status quo 
for years. In my State, nearly one in four residents lacks health 
insurance. That makes us the second-highest uninsured State in the 
Nation. And three-quarters of uninsured New Mexicans work or are from 
working families. Added to that, 80 more New Mexicans lose their health 
care coverage every day.
  People like a woman I met in Raton, NM, last month. She and her 
husband just got a renewal notice from their health care insurer. Their 
premium rose 24 percent this year alone. It is an increase they can't 
afford, and they don't know what to do. They are paying the human price 
for the status quo.
  Along with the human price, there is the economic price.
  By now it is a familiar refrain. The health care system as we know it 
is unsustainable. It is unsustainable for taxpayers, who are picking up 
the costs for those who can't afford or can't obtain insurance on their 
own. It is unsustainable for businesses which aren't able to afford 
skyrocketing costs to cover their employees. And it is unsustainable 
for our government. As President Obama said recently:

       Our health care problem is our deficit problem. Nothing 
     else even comes close.

  Without health care reform, if we do nothing but maintain the status 
quo, the problems that seem insurmountable today will look like child's 
play compared with the catastrophic news of tomorrow.
  If we fail to act, the number of uninsured Americans will increase 
from more than 46 million last year to more than 53 million in 2019. 
And that is a best case scenario. The actual number could be as high as 
almost 58 million. For New Mexico, failure to act would mean that 
insured New Mexicans continue paying $2,300 in hidden subsidies for the 
uninsured.
  If we fail to act, U.S. spending on health care will climb from 
almost $2.4 trillion last year to almost $4.3 trillion in 2017. And 
insurance companies will continue to profit at the expense of America's 
health and America's pocketbooks.
  If we fail to act, businesses will continue to flounder under the 
crushing costs of health care coverage. Fewer businesses will open 
their doors. More will call it quits for good. And, most chillingly, 
the entrepreneurial spirit that is so uniquely American could be badly 
damaged.
  If we fail to act, government at all levels will suffer. Budgets will 
continue to shrink. Priorities like education, energy innovation and 
job creation will continue to be underfunded. Americans will continue 
to pay the economic price.
  Finally, along with the human and economic costs, there is one more 
price to consider if we don't step up to our responsibilities and 
deliver on health care. That price is more figurative, but no less 
painful.
  I am talking about the price we pay as a country for not living up to 
the ideals on which America was founded.
  America is heralded as the land of opportunity. But realizing that 
opportunity should not be dependent on whether you have enough money in 
your bank account to afford health care.
  America is a place where ``all men are created equal.'' But how can 
that be true if access to something as fundamental as health care is 
divided between the haves and have nots?
  Harry Truman--who was the first President to attempt to provide every 
American with health care--put it simply:

       We are a rich nation and can afford many things. But ill-
     health which can be prevented or cured is one thing we cannot 
     afford.

  More than 60 years later, his words ring true:

       We cannot afford ill-health which can be prevented or 
     cured.

  We cannot afford to maintain the status quo.
  The PRESIDING OFFICER. The Senator from Virginia.
  Mr. WARNER. Mr. President, I know our time allotment is drawing to a 
close and we still have more Senators who wish to speak.
  I yield 3 minutes to my distinguished colleague, the Senator from 
Illinois.
  Mr. BURRIS. Mr. President, I am honored to be able to join my 
freshman colleagues as we speak on this important issue of health care 
reform. On September 9, the President stood before the Congress and 
issued a resounding call for health care reform. It is time for us to 
answer. We need to recognize, as our President does, that this is our 
moment to stand for freedom and opportunity.
  Health care reform is nothing less than a moral imperative. For 
years, costs have been rising and the quality of care has been going 
down. For the giant corporations that provide health insurance, rising 
costs have meant rising profits. They rake in millions of dollars by 
denying coverage to sick Americans. But for those of us who are not 
health care insurance executives, rising costs have become a terrible 
burden.
  In the early 1990s, when President Clinton and the Democratic 
Congress tried to pass health care reform, insurance companies brought 
costs under control. From 1993 to 1995, health care costs grew by an 
average of only $38 billion. Insurance corporations must have been 
afraid that reform would hurt profits, so they self-regulated, keeping 
costs under control until the threat of reform had passed. But when the 
Republicans took back the Congress, health care reform was dropped and 
costs skyrocketed, however. Between 1995 and 2006, costs increased by 
almost $102 billion annually. These numbers are clear. We are spiraling 
out of control, and inaction is not an option. We cannot stand by as 
millions of Americans all across the country are forced into bankruptcy 
by medical bills.
  Some say we are moving too quickly, that we need to wait. I ask, wait 
for

[[Page S9699]]

what, for more people to get sick and die because they don't have 
access to health care? The American people have been waiting far too 
long. We must not wait any longer. It is time to make sure everyone has 
access to quality care and affordable health care. It is time to make 
sure no one can be dropped because of preexisting conditions and to 
provide a public option to compete with the private insurers. It is our 
duty to stand up for what we know is right.
  Mr. President, 45 years ago another Illinois Senator saw this same 
need as Congress debated the Civil Rights Act. The bill was under fire. 
There were some who could not accept reform. But Senator Everett 
Dirksen knew equality was woven into the moral fabric of this Nation, 
and he knew America had waited long enough for change to happen. 
Standing on the floor of this Chamber, he echoed Victor Hugo, who said: 
Stronger than all the enemies is the idea whose time has come. The time 
has come. Let's vote in health care reform.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia.
  Mr. WARNER. Mr. President, I thank the Senator from Illinois. I also 
thank my distinguished colleague from Tennessee for granting our group 
4 additional minutes.
  Mr. ALEXANDER. I ask unanimous consent that each side be granted 4 
additional minutes in morning business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. WARNER. I now yield 4 minutes to the Senator from North Carolina, 
my friend.
  The ACTING PRESIDENT pro tempore. The Senator from North Carolina.
  Mrs. HAGAN. Mr. President, I rise with my colleagues to discuss the 
urgent need for comprehensive health care reform and why I believe the 
cost of inaction is simply too high for North Carolina and America's 
working families.
  As I traveled across the State during the August recess, it was clear 
that North Carolinians are concerned about the rising cost of health 
care. In the past 10 years in my State, the cost of health care 
premiums has increased 98 percent, whereas wages have increased only 18 
percent. That is a startling statistic. Just last week, the chamber of 
commerce from Dunn, NC, came to visit me in Washington. One man has a 
company that employs 600 employees. The cost of health care last year 
for his company increased 28 percent--in 1 year. That is simply 
unsustainable for America's businesses.
  The Treasury Department issued a stern warning just last week: If we 
do nothing to tackle the skyrocketing cost of health care, nearly half 
of all Americans under the age of 65 will lose their health insurance 
in 10 years. Those are frightening numbers.

  Right now, the average family's health insurance premium is $13,375. 
If Congress does not send our President a reform bill, premiums are 
expected to rise to a staggering $25,000 in 2016. Today, this average 
premium represents a little over a quarter of a family's income. But, 
by 2016, that average premium will represent almost half of a family's 
income. How are people going to able to afford to pay for mortgages and 
save for college tuition if they are paying half their monthly income 
for insurance premiums?
  This past year, North Carolina's unemployment rate rose to 11 
percent. Many of the thousands of North Carolinians who have lost their 
jobs in this recession have also lost their health care, and many more 
families are facing this frightening reality: One medical emergency 
could send them into bankruptcy.
  In 2005, nearly half of all Americans who filed for bankruptcy cited 
major medical expenses as the reason for their financial decline. 
Between 2001 and 2008, the number of uninsured in North Carolina 
increased from 1.1 million to 1.4 million people. Without action, this 
number is going to continue to grow.
  The Senate Health, Education, Labor, and Pensions Committee crafted a 
bill that ensures that people who like their insurance and their 
doctors keep them. It also expands access to health insurance for those 
without it, and slows down the skyrocketing cost of health care--the 
three critical components President Obama called for in his speech to 
Congress 2 weeks ago.
  The President has been adamant that health care reform must not add 
one dime to our Federal deficit now or in the future, which has been a 
requirement of mine all along. The exploding cost of health care has 
put our Nation's economic security at risk. We simply cannot afford 
inaction any longer.
  In 1960, health care spending was 4.7 percent of GDP. Today, it is 18 
percent. On the current trajectory, by 2030, health care costs will 
account for 28 percent of GDP.
  We need health care reform to get our deficit under control. We need 
a reform package that ensures a preexisting condition, such as diabetes 
or cancer, no longer prevents anyone from obtaining health insurance. 
We need health care reform to ensure America's families do not have to 
fear bankruptcy when a loved one gets sick.
  Thank you, Mr. President.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia.
  Mr. WARNER. Mr. President, I thank my colleague from North Carolina 
and all these freshmen Senators who have talked today about the very 
real costs of inaction.
  I would like to now call on our final colleague, my friend, the 
junior Senator from Colorado.
  The ACTING PRESIDENT pro tempore. The Senator from Colorado is 
recognized.
  Mr. BENNET. Mr. President, I thank the Senator from Virginia and the 
rest of my colleagues.
  I have a few slides I wish to go through. But the basic point is, no 
matter what one thinks about the various health care bills that are out 
there and the various prescriptions that have been suggested, the 
status quo is not an option.
  For me, this starts with fiscal responsibility. We have seen an 
unbelievable explosion in debt in our country, from $5 trillion, from 
the beginning of the previous administration, to $12 trillion today. If 
you look at what is causing it: As you can see from this slide, this is 
our revenue line. The biggest drivers of our deficit are the interest 
payments we have on this debt--that we are managing to pass on to our 
kids and our grandkids because we are unwilling to make the tough 
choices that need to be made--and rising Medicare and Medicaid costs, 
which is the red line right here. So one cost of inaction is we will 
continue to drive these insane deficits we are facing as a country.
  In my State of Colorado--and the senior Senator from Colorado is in 
the Chamber as well--our working families and small businesses are 
suffering mightily because the economy is not working for them. Over 
the last decade, median family income in the State of Colorado has 
actually declined by $800 in real dollars, and that has happened all 
across the United States of America, where we see median family income 
down by $300.
  At the same time, health care premiums have risen by 97 percent. The 
cost of higher education, by the way, has gone up 50 percent. Our 
working families are being asked to do more with less just for the 
basic necessities that are required to move your family ahead. These 
are not ``nice to haves.'' These are essential, if working families and 
the middle class are going to be able to move ahead.
  The second reason we need reform is, as the Senator from Virginia 
said at the beginning of his comments, we are spending almost a fifth 
of our GDP on health care. That is more than twice a much as what any 
other industrialized country in the word is spending on their health 
care system.
  As I have said in townhall meetings all across our State, this is no 
different than if you have two small businesses across the street from 
one another, with one spending a fifth of their revenue on their light 
bill and the other spending less than half that on their light bill. 
You do not need an MBA to know which of those two companies is going to 
be able to invest in their business plan and grow their business.
  We have a lot to do to make sure this economy can compete in the 21st 
century. I would say one of the things we ought to do is not to devote 
a fifth of our economy to health care if we expect to compete.
  This slide shows the rate of insurance premium increase in our State 
versus the rate of the increase in wages. These are absolutely related 
to each other. If

[[Page S9700]]

you talk to small businesses in any State--I am sure this is true in 
Virginia, as well as it is true in Colorado--small business owners are 
desperately trying to keep their employees insured, but the choice they 
are making is to pay them less in wages. This wage compression is 
related directly to the rate of the insurance premium.
  The other chart of this slide simply shows if we change nothing there 
are going to be families all across this country who, by 2016, are 
going to be spending 40 percent of their income on health care--that is 
before you get to higher ed; that is before you get to rent or food--40 
percent of every dollar on health care. It is absurd.
  We see that health care is bankrupting middle-class Americans all 
over this country. We know 62 percent of bankruptcies are health care 
related. What is staggering to me is, 78 percent of those bankruptcies 
are happening to people who had insurance. The entire reason people buy 
insurance is so they have stability when their child gets sick or their 
spouse gets sick or they get sick. Seventy-eight percent of these 
bankruptcies have happened to people who had insurance.
  Then, finally, no one is burdened more by the current system than 
small business and the employees who work for small businesses. In our 
State, small business pays 18 percent more for health insurance just 
because they are small. When I say that, sometimes people say: Well, 
Michael, don't you understand that is because the pool is smaller and 
it is harder to spread the risk. I say: I understand that. But from a 
business point of view--and the Senator from Virginia and I both have 
spent a lot of time in our careers working in the private sector--from 
a business point of view, that is absurd because these small 
businesses, if they are investing 18 percent more, ought to be 
expecting to be 18 percent more productive or, at a minimum, ought to 
have 18 percent better health care, and that is absolutely not the 
case.
  Mr. President, I ask unanimous consent for 1 additional minute.
  The ACTING PRESIDENT pro tempore. Is there objection?
  Without objection, it is so ordered.
  Mr. BENNET. My final point, Mr. President, is we have been having a 
healthy debate about how we should do this reform, and there are a lot 
of people who are concerned about things such as a public option, 
things such as government control over health care. I would argue that 
the status quo is what is producing that because fewer and fewer of our 
working families are covered at work--which is what this slide shows--
and for every one of those people who then goes on uncompensated care, 
it is paid for by the American people.
  So I join my colleagues today in saying, we absolutely cannot 
maintain this status quo. It is absolutely unsustainable. I look 
forward to a thoughtful, commonsense reform that works for working 
families and small businesses in my State.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Virginia.
  Mr. WARNER. Mr. President, I thank our colleagues on the other side 
of the aisle for the additional time.
  I appreciate the opportunity we have had to make our statements.
  The ACTING PRESIDENT pro tempore. The time is expired.
  Mr. ALEXANDER. Mr. President, how much time is available for the 
Republican side?
  The PRESIDING OFFICER (Mr. Bennet). Forty-nine minutes.
  The Senator from Tennessee is recognized.
  Mr. ALEXANDER. Thank you very much, Mr. President.

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