[Congressional Record Volume 155, Number 136 (Thursday, September 24, 2009)]
[House]
[Pages H9920-H9924]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  THE PROGRESSIVE CAUCUS MESSAGE HOUR

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Minnesota (Mr. Ellison) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. ELLISON. Mr. Speaker, I am Keith Ellison, here to claim the time.
  The Progressive Caucus message hour, which comes to the House floor 
every week, week after week, with a Progressive message will be short 
tonight. We want to let our Republican colleagues know that. Tonight, 
though short, it will be a very potent and effective message because it 
is a Progressive message.
  Obviously, everything these days is health care. Health care is a 
crucial issue, but it's important to understand that, from a 
Progressive standpoint, health care reform is part of an overall 
package of reform for middle and working class people in America.
  How are you doing with your family budget when you see, over the last 
10 years, that health care premiums have increased, that deductibles 
are increasing and that copays are increasing? How is it going when you 
see your neighbors are foreclosed upon and when the houses in your 
neighborhood are seeing a reduction in value? That's real wealth you're 
losing with this foreclosure crisis.
  In a Progressive vision of this world, we see middle class people and 
working class people--people who are making only a little bit, who are 
making only minimum wage--who are actually seeing their wages rise, who 
are seeing their health care costs level off and go down, who are 
seeing their home values go up, and who are seeing the doors to the 
universities remain open so that young people can have real 
opportunities in this America.

[[Page H9921]]

  We have a vision where everybody counts, where everybody matters, 
where we're not constantly looking for the next person to throw under 
the bus. With the Progressive vision, we know that it doesn't really 
matter what your economic station is in life. You still have an 
opportunity to do well in America. You still should have that 
opportunity. You should still have an opportunity to have your civil 
and your human rights respected. As we move forward in this health care 
debate, we must remember from a Progressive message standpoint that it 
is a part of a network of things that American middle class and working 
class people need--people of all colors, people of all cultures and 
people of all faiths.
  The Progressive message: We don't believe that it makes sense to rail 
against and to demonize people who come from other countries. We 
welcome new Americans. We think it's a good idea. Immigration has been 
good for the United States.
  We have a Progressive message which says that we believe that 
everybody's health care in the United States ought to be covered and 
that your health should not be a commodity which is bought and sold on 
Wall Street, which is bought and sold on commodity markets, where 
people basically look at you and your health as an economic entity to 
make themselves richer and wealthier.
  So it is with that opening remark that I talk about our short 
presentation tonight: the Progressive message about health care. It is 
in this context that we talk about health care, not so much about the 
technicalities of health care at this point, but really focusing on 
health care reform--patients before profits. We believe in this.
  Thirty-six other nations in this world provide some form of national 
health care. Our country does not. We are the richest country in the 
world. We have a GDP bigger than any other country in the world by 
double, and still we say we don't have enough to go around to cover the 
49 million who are left uninsured or to make sure that we hold prices 
down and have quality care for the 250 million who do have employer-
based health care and government health care but who are seeing their 
premiums rise.
  Tonight, though our friends on the other side of the aisle constantly 
bang on government and talk about government-sponsored health care, we 
are here to say that the government is a good thing. There is nothing 
wrong with government. From a Progressive standpoint, we say that, yes, 
government must be efficient, that, yes, government must be effective 
and that, yes, government must not be too intrusive. Yet, just to make 
blanket statements about how government is bad, this is not part of the 
Progressive mission, because we know the GI Bill is part of government; 
we know that Medicare is part of government; we know that Medicaid, 
which covers the poor, is part of government; we know Social Security 
is part of government. We don't look at the government as the enemy in 
a country that is by, for and of the people. The government is us. So 
what are people talking about when they rail on government-run health 
care as if it's some horrible thing?
  The fact is that we're here to stand up and to stand out for real 
health care reform as a part of an overall package to make middle and 
working class people better off, with a higher quality of life and with 
more opportunities for themselves and for their families.
  So, as we discuss this issue and as we keep it in context, it's 
important to also bear in mind that a key element of reform--an 
essential element of reform--is the public option. The public option is 
an essential element of reform, and I want to talk to you about it 
tonight for just a few minutes because we're not going to be here long. 
We're going to be here for a while. Most doctors support the public 
option.
  We have this chart here--and I hope I can get a nice, wide camera 
angle--of both the public and private options.
  Sixty-three percent of all doctors--they call it ``doctors/
providers'' nowadays, but they're really doctors. Sixty-three percent 
of doctors support both a public and a private option. Sixty-three 
percent. That's a lot. Now, you have another 10 percent of doctors who 
say, You know what? Get profit-based health care out of our American 
system. We want public-only options.
  If you put all of the doctors who believe in both public and private 
options and doctors who believe in public-only options, that's 73 
percent of doctors.
  Doctors say they know the public option is better. You might have 
some folks who are accountable to industry interests in the insurance 
industry who don't want a public option, but you don't have doctors 
saying it. Doctors are for the public option--63 percent-plus more.

  I am very pleased to be joined right now by my dear friend from the 
great State of New York, Anthony Weiner.
  Anthony, how are you doing tonight?
  Mr. WEINER. I thank you very much.
  I am an honorary member of the Progressive Caucus. I am not a member 
of the caucus, but I am very interested in the work that you've done on 
this issue. I just want to pick up on a point that you just made.
  Part of the reason doctors understand the need for the public option 
is that they deal every day with insurance companies. You and I, when 
we get sick--and God willing, that's not often--and when our 
constituents get sick, they have to deal with their insurance 
companies. They deal with them every day. They've got six or seven 
different in-boxes on their desks. About 20 percent of their overhead 
is dealing with insurance companies, and I don't mean dealing with them 
as in, ``Hey, how are you doing? Let's have a doughnut and coffee 
together.'' I mean sitting on hold, getting approval, trying to find 
out when they're going to get reimbursed, spending months and months 
and months waiting for insurance companies to give them money for 
services they've already provided.
  So when doctors look at this debate, they say, You know what? Having 
some level of competition is helpful to them as well. Just so we 
understand the context of this, we swing wildly between people who say 
the public option in this health care debate is going to transform the 
world and people who say it's not really going to do anything. 
Somewhere in between is probably right.
  When this health care plan goes into effect under the President's 
proposal we have here in the House, for most Americans, they're not 
even going to have the ability to go sign up for the public option 
because they get health insurance at their work. If they decide to 
leave their employers, they're going to leave whatever the employers 
are putting into the kitty, so they're probably not going to do that. 
They effectively are not going to go into the public option. If you're 
on Medicare, Medicaid, the VA, or the Department of Defense, you're not 
going to be even eligible to go into the public option.
  So the people who are going to benefit are a small group of people, 
an important group of people who are underinsured, meaning their 
employers don't provide even the basic health insurance we believe they 
should, or those who have no coverage at all. They're going to be able 
to shop. Even for those people, it is going to take a while for this 
public option to get up and running.
  The reason it's so important--and you've made this point continually 
during the debate--is that we should have at least some experiment with 
how it might work. We should have some way to look through the lens and 
say, You know what? Here's a private insurance company that's paying 
for advertisements and that's paying bonuses. The CEO of the public 
option will probably make--I don't know--$190,000 a year, whatever it 
is, versus an institution, a public option, which might say, You know 
what? Maybe we can do it for less because we don't have to look out for 
shareholders. That sliver of competition has the insurance companies 
mortified.
  The question is why. Why are they so afraid?
  Because, I say to my colleague from Minnesota, at the end of the day, 
it could just be that these insurance companies say, You know what? If 
I'm going to compete, maybe I'll have to turn a little bit less over to 
profits, a little bit less over to advertising and over to bonuses. 
Now, for them, that might not be so good, but for the rest of us and 
for the country as a whole, that is actually, probably, a pretty good 
thing.
  Mr. ELLISON. If the gentleman would yield briefly--and I'll hand it 
right back to the gentleman from New York--I just want to throw this 
out there:

[[Page H9922]]

  I propose that the people who support the public option and the 
people who oppose the public option do so for the same reasons.

                              {time}  1345

  One is that the public option will be competitive. Because we don't 
have to funnel monies into these things that don't really go to care, 
we will be able to provide cost-competitive products for people to be 
able to purchase.
  Mr. WEINER. Well, let me make one other point. First, that's funny, 
you made that observation, great minds think alike or average minds 
think alike.
  I had written an op-ed a month ago, made the same exact point that 
actually the two sides agree on this. But what's interesting about some 
of my Republicans friends who have fought so vehemently against it is, 
at the end of the day, we are introducing another market player. That 
is, you always want more market players because that's where 
competition comes from.
  We are introducing another one. Now we have tied its hands behind its 
back a bit more than I would have liked, but we are introducing another 
market player. It's fascinating because the argument seems to be, wait 
a minute, if you give my constituents choice, they might take it. Now, 
it's fine that--we apparently believe that our constituents are smart 
enough to choose us to be their representatives, but, oh, no, we can't 
trust them to be smart enough to choose the health insurance plan.
  By the way, I already see the TV commercials. Don't go with them, you 
don't want government-funded health care. Yes, the private insurance 
companies are going to do everything possible to compete in that way. 
But at the end of the day, we are trying to introduce market forces 
where they don't exist today.
  Let me just make this one final point. We hear all the time from the 
other side. Let the marketplace work. There is no marketplace for 
health care as a commodity the way we know it.
  If I have an appendix burst right now standing here, I am not going 
to say, You know what, I am not going to get an appendix, I am going to 
shop for a liver instead. Or I am not going to say, You know, I am 
going to wait. I understand appendix goes on sale in December, I am 
going to wait. Or I don't have the ability to say, I am going to go buy 
some books and learn how to sew up my own appendix. That doesn't 
happen.
  If I am like 80 percent of all people that get their insurance from 
an employer, I have one option. My employer walks in and says, 
Congratulations, everyone here at the supermarket. We have Blue Cross 
or we have Oxford, and here is the coverage.
  I don't get to say, Hey, boss, uh-uh, give me my money, I am going to 
go shop around a little bit more. That doesn't happen.
  So the idea that we have some kind of a free market guaranteed choice 
doesn't exist. Now we are introducing a little bit here, but at the end 
of the day, this is not a commodity, like a suit of clothes that you 
can say I am going to buy or I am going to not. It's also true when 
people say, Why should I have to get insurance, I am not sick.
  Well, you might not be sick today, but if, God forbid, you get hit by 
a car and you have $170,000 worth of insurance, of health care costs, 
and $100 in your pocket, you know who is paying? You and I are.
  But what happened to the idea of letting us all make free choices? 
The right of your choice stops where it starts impacting me. As my 
father would frequently say to me when he was explaining to me the law, 
the right of my fist stops at your nose. You can't have this kind of 
conversation that--but if you really believe in the marketplace, 
introduce more players.
  That's what Mr. Ellison has talked about, and that's what the 
Progressive Caucus talked about. That's what, frankly, overwhelming 
numbers of Americans and overwhelming numbers of doctors are talking 
about.
  If you are interested in making sure that we have a marketplace that 
is not just dominated by the idea if you can afford to pay, you do, and 
let me make this final--I know I keep saying final point. There is one 
other thing. You know, I have made the point that insurance companies 
for health care at the end of the day are not like insurance companies 
in any other walk of life.
  Your car insurance company, since we all have automobile insurance 
coverage, they are apportioning risk. They are trying to figure out how 
you spread risk around. Health insurance companies don't do that. They 
are not covering anyone over 65. They are not covering anyone that has 
a preexisting condition. People like my father who tried to get health 
insurance before he was 65 were charged so much he effectively couldn't 
get it. So they are not doing that either.
  So the question becomes what are the insurance companies doing? They 
are taking our money and giving it to doctors, giving it to hospitals, 
giving it to clinics. But they are putting 20 percent in their pocket.
  So why don't we, if we are trying to figure out savings, not that I 
have anything--I mean insurance companies aren't venal people; they are 
doing what we frankly have allowed them to do and they have risen up 
for natural reasons. Let's start with that 20 percent. Let's start with 
that 350 or so billion dollars out of a $2.5 trillion pot. You know 
what, let's put that back into health care, let's put that back into 
tax cuts. Let's put that back into other service.
  Frankly, that's the argument behind the public option, and it's 4 
percent overhead, compared to the health insurance plan that I have, 
which has about a 25 percent overhead.
  Mr. ELLISON. If the gentleman would just hang with me for a minute--
well, tonight, we are short here tonight, we are going to be handing it 
over in a little while.
  But I just want to explore this issue of competition with the 
gentleman from New York one more time. Now you pointed out how we have 
real problems with competition. We have real issues with flexibility 
within the market because, when you need the operation, you need it. 
There is not much opportunity for shopping around.
  But what about the number of health care insurance companies that are 
in markets as they exist today? As you look around the cities of our 
country, are we seeing health insurance companies proliferating 
throughout these cities where you have multiple companies to choose 
from or are you looking at large markets being dominated by one to five 
actors?
  I believe 75 percent of all the major markets are dominated by no 
more than five actors. Even if you could go shop around for that 
policy, do you have a lot to choose from?
  Mr. WEINER. It's an interesting point. One of the most common things 
we hear from people who oppose this comprehensive health plan is they 
pick a reed of information and say, Why don't we do this? Why don't we 
let all insurance companies around the country compete in every market?
  Well, I am open to the idea, but I have got to tell you they don't 
seem to want to. We have 50 States that have 50 State insurance 
commissions, and you can knock on the door of any one of them and say, 
I am an insurance company, I want to apply to provide insurance here in 
Minnesota or New York.
  Now you know we have a grand total of zero applications from 
insurance companies in New York who want to operate in Maine. I tell 
you why, for an obvious reason. If you are a health insurance company 
in New York, you don't know any of the doctors in Maine. What your 
patients and your customers are going to want is my doctor in your 
network.

  So they have to go organize all these doctors, create a whole new 
network. It's hard to do. I honor health insurance companies for trying 
to do it. They make a lot of money. Maybe it's because they were able 
to do that. But you want to know, there is one insurance entity that 
has been able to do it for the entire country. It's called Medicare. 
Not only have they have been able to do it, but they have been able to 
do it at 3.5 percent overhead compared to a 30 percent overhead.
  Mr. ELLISON. Wait a minute, isn't this a government-administered 
program?
  Mr. WEINER. Well, not long ago on this floor, my colleagues on the 
Republican side of the aisle, who thump their chest and beat the 
rostrum about being against government-funded single payer health care 
plans, all voted for it. I mean, maybe not all of them; most of them 
voted for it.

[[Page H9923]]

  They are the defenders of Medicare? Well, that's a single-payer, 
government-funded, government-controlled health care. Now it is not one 
thing, though--that really needs to be clarified. It's not socialism, 
and I will tell you why. Socialism means that government controls the 
means of production.
  Government doesn't run the doctors or the hospitals any more than 
Oxford, Blue Cross or Aetna does. Now it's a common thing to say--and 
never or hardly ever do my colleagues on the other side of the aisle 
actually try to figure out the literal sense of what they are saying. 
It's not that.
  It is, in a way, trying to figure out a way that we as a society 
figure out how to deal with the society problem, but the problem that 
we have here is the private insurance companies pick and choose markets 
the same way they pick and choose customers. I have got to tell you 
something. We can pass a law tomorrow saying that everyone can compete, 
all over the 50 States. You won't have people applying to go into Idaho 
and set up a--or probably going into Minnesota.
  We have in New York a pretty rich--because we have a lot of 
customers, a lot of senior citizens. But we also have some of the 
toughest regulatory regimes because of many of the abuses that we have 
seen.
  Look, I want to tell you something. It is my view we should have 
something like Medicare for all Americans. We should treat health care 
like we treat the fire department. Hopefully we don't need it very 
often. We all pay taxes so that when there is a fire they will come and 
put out the fire. It's good for our economy that our neighborhood shoe 
store should worry about selling shoes, not health care.
  Under a vote that I am going to be offering, and I think it will have 
your support----
  Mr. ELLISON. Absolutely.
  Mr. WEINER. We are going to take the shoe store guy and say, You 
focus on that. We, the government, have an infrastructure that we know 
that works for health care. It has a financing problem like all health 
care does. Actually the curve for health care is not as severe as it is 
for private insurance. That's the way we should do it.
  We should make it less expensive, not more expensive for citizens, 
because we shouldn't say, Your State taxes are going to go up, your 
local taxes are going to go up, your hospitals are going to close. We 
are going to run it the way we run Medicare, which is efficiently, and 
we will provide it as a service.
  But putting that aside for a moment, at the very least, if we're 
going to have insurance companies be the primary place we get it, how 
about a tiny reed, a tiny sliver of competition. If you don't do it 
because you think you should have choice, do it because you think we 
should save money.
  The Congressional Budget Office says that if we take a public option 
and we link it to Medicare plus 5 percent, we will save another $100 
billion. If you are a fiscal hawk, you want the public option. If you 
want choice, you want the public option.
  If you are a doctor, you want a public option. If you are uninsured, 
you want a public option. If you have insurance, you may not know it, 
but you want a public option too.
  I thank the gentleman for just about every day talking about these 
important issues.
  Mr. ELLISON. I want to thank the gentleman for being as eloquent as 
he has been. We turn on the TV screen and the gentleman has been on 
national news talking about these critical issues from the standpoint 
of the numbers, the logic, but also from the standpoint of the person 
who really, really needs the change.
  Congressman, you have done a great service. I have told you on the 
floor one-on-one how proud I am of the work that you have done. I think 
that you are going to keep doing it. You can count on me to support the 
Weiner amendment, which is a single-payer payment.
  Mr. WEINER. Let me say very briefly what the single payer--consider 
it Medicare fraud. Ask your neighbor, if you are not old enough to have 
Medicare, ask them how their service is.
  Every year they do a survey of all Medicare beneficiaries; 96 percent 
say they are satisfied with it, which any program or any business would 
be glad to have that. They also ask the providers, the hospitals, the 
doctors: Rate it on a score of 1 to 6. Last year the average score was 
4.5. That is pretty good. That is essentially an A minus.
  What it does is say, Look, we are not going have high overhead. We 
will not pay you the bust-out top of the market. For every single 
person you are going to get prompt payment. Everyone is going to be 
covered. You are going to have customers all around the neighborhood, 
and we will try to do some smart things to contain cost.
  Now make no mistake about it. The canard that's raised--wait a 
minute. Medicare is a successful program. We don't like it, but there 
are costs to it. It's true. We have more older people. To some degree 
Medicare's success is why it's having trouble financially.
  We are living 10 years longer today than we were when Medicare was 
passed. By the way, it's not 10 years in our teenage years, we get 10 
years at the end of life when we have more health care costs.
  But if we want to solve a problem in Medicare, you call your 
Congressman. You get on the phone. The taxpayers employ those people. 
If you want to fix your private insurance, if they shut you down, they 
kick you out, you get on an 800 number or you buy shares in their 
company. Those are the two ways you influence it.
  What we are saying is, let's have a more efficient model, let's have 
a model that's lower cost, let's have a model that you know works. If 
you don't think it works, ask our Republican friends how come they keep 
voting for it over and over and over.
  I offered an amendment in the Energy and Commerce Committee. I see my 
colleague from the Judiciary Committee, but the Energy and Commerce 
Committee--I said, You don't like single-payer health plan, put your 
money where your mouth is. I offered an amendment on the day of the 
44th anniversary of Medicare to eliminate the program. They say they 
don't like government-run health care. Eliminate the program.
  Not a single one of those people--and I am prohibited on the floor 
from calling them phonies--not a single one of those people voted 
``no''--or voted ``yes'' to eliminate Medicare. Oh, no, no, no, we love 
Medicare. You like Medicare if you are 65 but not if you are 64?

                              {time}  1400

  Not if you're 60, not if you're 45. Why? What's the intellectually 
honest explanation of that? If you believe the program that you're 
going to fight and defend--you should have it when you're 65--what's 
magical about that?
  When my dad retired at 60, he wasn't eligible to get Medicare, and he 
went to the private insurance market. They said, Fine. For $15,000 a 
year, a retired guy, why not give that guy Medicare? And then maybe in 
a couple of years we give younger guys Medicare. And we get down to the 
twenties, where you are, we give you Medicare.
  The point is, we know what works. You want simple? We got simple. 
Medicare for all Americans. You want inexpensive, you want low 
overhead? We got that. Medicare for all Americans. You want something 
that every doctor accepts? Medicare for all Americans. You want 
complete, 100 percent choice of what doctor you go to? Medicare for all 
Americans.
  Now, one thing it doesn't do. It doesn't skim off 20 percent for 
profits. You won't see TV commercials with people sitting in rocking 
chairs saying, Boy, I'm glad I got Medicare. No, they're going to put 
that money into health care.
  Does it need some fixing? Yeah. We do some dumb things. We'll put 
$900 for someone to be in a hospital bed. We won't pay $50 to put up a 
handrail when one-third of all seniors get into a hospital emergency 
room because of slips and falls. We do some dumb things, and we need to 
fix it.
  But I've got to tell you something. As a Member of Congress 
representing 650,00, 660,000 people in Brooklyn and Queens in New York 
City, in God's country, I would much rather fight with CMS, fight with 
the Federal bureaucracy which, by the way, I get far fewer complaints 
about them than I do about private insurance companies, than having to 
hope that I get a good response from my insurance company.
  So that's basically the philosophy behind the single-payer thing. I 
have to

[[Page H9924]]

take exception to one thing the President said in his speech. He said, 
Some people in this Chamber want a single-payer system like they have 
in Canada. No. I want a single-payer system like we have in the United 
States of America. I want a single-payer plan that my father has. I 
want a single-payer plan that my mother has.
  I want a single-payer plan that took my grandparents, whose 
generation had a 30 percent poverty rate before Medicare, and is now at 
8 percent. That's the American single-payer.
  So don't let people distract you by, Oh, it's Europe; it's socialism; 
it's Canada. It's the United States of America. We know how to do 
health care in the United States, and it's called Medicare. The 
Democrats created it. The Republicans now embrace it. It's got 
bipartisan support. Let's expand it.
  I appreciate it. Let me just yield on this point. First of all, I 
appreciate it. I'm not a member of the Progressive Caucus. The final 
stage of the application, as you know, is the talent competition, and I 
was never able to make it through that last threshold.
  But the fact that you, in hour-long blocks, have real thoughtful 
conversation--this present company excluded--but real thoughtful 
conversations about this issue that explore the actual facts and the 
underpinning is exactly why this has been, I believe, a proud moment in 
our American civic life.
  You put aside the people yelling, call people names, put that aside 
for a moment. This is something all Americans see through the lens of 
their own experience. They feel very compassionate about it.
  So I ask all of the people watching today and all of the people here 
observing this debate, ask someone about their experience with Medicare 
and you'll see it's a pretty good ambassador for a government program 
that works pretty well that we should try to expand to more Americans.
  I thank you for your kindness.
  Mr. ELLISON. I do thank the gentleman. This will be the conclusion of 
our Progressive message tonight. The Progressive Caucus, appearing with 
Anthony Weiner, who did such a fine job, we will be back next week, 
everybody.
  This has been Keith Ellison with the Progressive message, and we 
yield back.

                          ____________________