[Congressional Record (Bound Edition), Volume 150 (2004), Part 1]
[House]
[Pages 144-145]
[From the U.S. Government Publishing Office, www.gpo.gov]




              SOLUTIONS FOR SKYROCKETING HEALTH CARE COSTS

  The SPEAKER pro tempore (Mr. Bishop of Utah). Under a previous order 
of the House, the gentleman from Illinois (Mr. Emanuel) is recognized 
for 5 minutes.
  Mr. EMANUEL. Mr. Speaker, last year's 9\1/2\ percent increase in 
health care spending and costs was the largest in 11 years. Our health 
care spending per capita doubles that of European nations; yet 43 
million Americans have no health care coverage and millions more 
receive inadequate care.
  Many Americans listened to the State of the Union address last night 
in hopes of hearing solutions to skyrocketing prescription drug costs 
and insurance costs, driven largely by the uninsured who show up in 
hospitals and emergency rooms seeking care, forcing

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all of us who do have health care to pay what I call an uninsured 
premium, which is one of the great causes of our health care inflation 
in this country.
  Unfortunately, the President's speech did not propose new ways to 
tackle these problems. The President touted his Medicare bill but 
ignored the fact that that bill does nothing to address skyrocketing 
prescription drug prices. We pay in this country 40 to 50 percent more 
than Canadians and Europeans pay for the same prescription drugs.
  To address the worsening problem of the uninsured, the President 
referred again to a refundable tax credit worth $1,000. The reality is 
in the marketplace it is impossible to find plans, individual plans, 
for $1,000 worth of any health care coverage, coverage none of us in 
Congress would take at all.
  Until we commit ourselves to market-based solutions that embrace the 
principle of competition and choice, we will not bring down health care 
prices and costs. Access problems will only get worse for the uninsured 
and insured.
  By asking our taxpayers to spend $400 billion on a Medicare 
prescription drug bill while paying the most expensive prices in the 
world, we are shortchanging our seniors, and we are shortchanging our 
taxpayers. They deserve the common decency and courtesy to get the best 
prices in the world, not the most expensive prices.
  By not taking steps to lower all health insurance costs through 
market-based, cost-effective solutions, we are compromising the care 
all Americans receive who are struggling to try to pay for the premium 
increases and cost increases in their health care system.
  Prescription drug spending increased by 15.3 percent in 2003. In 
Europe, where there is competition and choice for medications, prices 
on average are 40 percent below what they are here in the United 
States. In every other industry, food, software, cars, consumer 
electronics, worldwide competition keeps prices down here in the United 
States; yet for pharmaceutical drugs, we have a closed market, and we 
pay the most expensive prices in the world.
  Polls show that more than two thirds of Americans think they should 
be able to purchase drugs from Canada and Europe; yet the final 
Medicare bill did not include these provisions. President Bush should 
work with Congress this year to lower prescription drug prices through 
greater reliance on competition and market forces and not threaten to 
veto such legislation. To do this, we should continue to work for 
market access legislation similar to the Pharmaceutical Market Access 
Act, which passed the House last year.
  We should also expand the limited provisions in the Medicare bill to 
increase access to generics. We should remove the provision on the 
Medicare bill that prohibits the Secretary of Health and Human Services 
from doing both negotiation, setting up a Sam's Club-like entity of 
Medicare and using the 41 million seniors who purchase prescription 
drugs to reduce prices, just like the Veterans Administration and just 
like private plans.
  The other major skyrocketing health care cost for the rest of us is 
the uninsured, and this is not just a problem for the poor. The 
fastest-growing group of people who are working without health care are 
people who earn $50,000 to $75,000 a year. The uninsured in this 
country who work is a middle-class problem.
  Today, all insured Americans pay an uninsured premium in their taxes 
and their insurance policies, but all the while the uninsured go 
without coverage. By addressing the health care needs of the uninsured, 
the entire system will work more efficiently, more cost effectively. 
Instead of trying to solve this problem with a tax credit that forces 
the uninsured to shop in the inefficient and expensive individual 
market, we should shape a policy for the uninsured around the 
principles of market competition.
  I will propose legislation this year that provides the uninsured a 
voucher, a health care voucher, to purchase health insurance through a 
subsidiary of the Federal Employees Health Benefit Program, the same 
program where Members of Congress and the United States Senate and 
members of the administration get their health care. This plan will use 
the efficiencies of the group health insurance market to provide 
comprehensive insurance and reduce prices, while giving people a 
voucher. It also will keep the prices in a competitive range to the tax 
credit the President proposed.
  There is nothing wrong with the health care system that competition 
and choice cannot fix.

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