[Congressional Record Volume 158, Number 48 (Thursday, March 22, 2012)]
[Senate]
[Pages S1957-S1959]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
AFFORDABLE CARE ACT
Mr. HARKIN. Again, Mr. President, tomorrow we celebrate the second
anniversary of the signing of the affordable care act into law. Our
Democratic leader, Senator Reid, in his opening remarks today, outlined
the tremendous progress we have made. I listened to the comments made
by our distinguished Republican leader, and all I heard was: Repeal
ObamaCare, repeal ObamaCare.
But I never heard what they want to replace it with. They just want
to go back to the old system where the insurance companies ran
everything before, where people were thrown off their policies because
they had an illness, where because of preexisting conditions people
could not get health care coverage, where we had this big doughnut hole
which we are now closing for the elderly?
The one aspect I want to focus on this morning in my brief time is an
extraordinary element of the affordable care act that is not being
talked about a lot but which members of the committee I now am
privileged to chair, the HELP Committee, worked so hard to include in
the affordable care act; that is, the array of provisions that promote
wellness, disease prevention, and public health.
Taken together, these provisions have begun to jump-start America's
transformation into a genuine wellness society. They are transforming
our current sick care system into a true health care system. I have
said this many times: We do not have a health care system in America.
We have a sick
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care system. If people get sick, they get care--one way or the other.
But there is very little out there to help people keep healthy and to
maintain wellness and to keep them from going to the hospital in the
first place. Now, that would be a true health care system, and that is
what we have begun to establish with the affordable care act, by
preventing chronic diseases, enabling people to stay healthy, and stay
out of hospitals in the first place.
Right now in the United States about 75 percent of all our health
care spending--75 percent of the Nation's health care spending--is on
chronic diseases. Only 4 percent is spent for prevention. So during the
last year we have data for--2005--the United States spent about $2
trillion on health care. Of every $1 spent, 75 cents went toward
treating patients with chronic diseases, many of which are preventable.
Only 4 cents went toward prevention. That ought to tell us something
right there. That is the old system, and that is the system the
Republicans want us to go back to: Spending more and more to treat
people after they get sick rather than trying to put something forward
to keep people healthy.
Well, in the affordable care act we have tremendous opportunities to
again move us to more prevention and wellness. We have made
historically new investments in this area of wellness, prevention, and
public health. Here is one example of that, as shown on this chart.
Before our health care reform bill, our law, was passed, just take
the issue of colorectal cancer screening; we know, if people get it
early and detect it early, their chances of survival are tremendous. If
people detect it too late, then they are going to be in the hospital,
and they are going to have cancer, they are not going to live. But we
know, by people getting a colorectal cancer screening early, we can
prevent a lot of unnecessary deaths and illnesses and treatments later
on.
Cholesterol screening: We know if people get good cholesterol
screening, they can get on either a drug or a good diet, an exercise
program, reducing the prevalence of heart disease.
Tobacco cessation: Need we keep repeating around here how much it
costs our society from the plague of tobacco use?
Well, here is where we were before health care reform, as shown on
this chart. About 68 percent were covered for colorectal cancer
screenings, about 57 percent were covered for cholesterol screenings,
and only 4 percent were covered for tobacco cessation.
After health care reform, now there is 100 percent--100 percent--
coverage for colorectal screenings with no copays and deductibles, I
might add; 100 percent coverage for cholesterol screenings, and 100
percent coverage for tobacco cessation.
That is prevention, that is wellness, keeping people healthy in the
first place. What do the Republicans want? They want to go back to what
it was. We have made too much progress in prevention and wellness to go
back to the old ways of just treating people after they get sick.
Now, again, we have been able to promote a lot of activities around
the country to promote health and wellness. For example, in Illinois,
the State made improvements to its sidewalks and marked crossings to
increase student physical activity levels. You might say: Well, big
deal.
Well, it is a big deal. Because of these improvements, the number of
students who are walking to school has doubled--doubled--and it is
expected to save the school system about $67,000 a year just on bus
costs. So kids are healthier and we save money.
In Alabama, Mobile County is using funds from this prevention fund to
support tobacco quit lines to help residents live tobacco free--again,
under the Tobacco Cessation Program.
Officials enacted a comprehensive smoke-free policy expected to
protect 13,000 of their residents--this is in Mobile County, AL--from
being exposed to secondhand smoke. All across America, more and more is
being invested in prevention. We know that, for example, a 5-percent
reduction in the obesity rate--just a 5-percent reduction in the
obesity rate--will yield more than $600 billion in savings on health
care costs over 20 years.
Again, our prevention fund is out there getting people the necessary
support and information they need to reduce obesity. So with the
misguided efforts to repeal the health care reform law, again, most
Americans know what is at stake. They are going to lose a lot of these
prevention activities that enable us to take charge of our own health
care to make sure we get our colonoscopies on time, our mammogram
screenings.
Every woman in America now over age 40 gets a free mammogram
screening--no copays, no deductibles. The Republicans want to take that
away from the women of this country. Colonoscopies, as I said, without
copays or deductibles, Republicans want to take that away. Annual
physicals. We know a lot of people do not get annual physicals because
it costs money. It costs them. Now they can get an annual physical
free--no copays, no deductibles. Republicans want to take that away.
Again, I think we have to ask the question--every time I hear the
Republicans talking about doing away with ObamaCare or the affordable
care act, we have to ask: Are we going to cut short this transformation
into a wellness society in preventing diseases, keeping people healthy
in the first place? I think the answer is clear. Americans are not
going to allow all these hard-earned protections and benefits in the
affordable care act to be a taken away. We are not going to be dragged
backward. We are going to continue our march forward to make ourselves
more healthy. We are not going back to the old system, where only a
little over half the people in this country got cholesterol screening,
68 percent got colorectal cancer screening.
We want people to get early screening, early support services for
preventive care so they stay healthy. Not only is it going to help our
family budgets, it is going to help our Federal budget if we have
people healthier and not going to the hospital in the first place. This
is one of the big aspects of the affordable care act that is not talked
about a lot. But to me it is one of the most important aspects of
moving us, again, to a society where we are not just relying on people
going to the hospital and paying for high hospital bills and things
such as that in the future.
I am going to yield the floor. I just wanted to make those comments
about one aspect of the affordable care act. Of course, we do know
there are many other benefits in the affordable care act people do not
want to lose. Right now, we ban lifetime limits, which helps more than
100 million people. They want to take that away. Republicans want to
take that away. We cover vital preventive services, which I just went
over; young people remaining on their parents' coverage up to age 26--
more than 2.5 million helped so far. Republicans want to take that
away. They want to end all that. I do not think the American people
want to end it. I think the American people want to move forward with
health care reform because we have made too much progress--too much
progress in making sure health insurance is affordable, available.
I guess I have just one more thing to say, if my friend from Rhode
Island will let me.
Everyone in this Senate body belongs to the Federal Employees Health
Benefits Program. Do you know what. We have coverage for preexisting
conditions. We have no lifetime bans in our policies. Yet that is what
we did. Remember the debate? We wanted to say to the American people:
Whatever we have, we want you to have too. We put that in the
affordable care act.
The Republicans say: We are going to take that away from the American
people but keep it for ourselves. I do not think so. I do not think so.
I do not think the American people want to say: You Senators and you
Congressmen can keep all that, but you can take it away from all of us.
We are not going to do it. We are not going to go backward.
I yield the floor for my distinguished friend from Rhode Island who
played such a pivotal role in getting the affordable care act through
on our committee and has been one of the more eloquent spokespersons on
this health care bill in the last couple years.
The PRESIDING OFFICER (Mr. Warner). The Senator from Rhode Island.
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Mr. WHITEHOUSE. Mr. President, I ask unanimous consent to speak for
15 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
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