[Congressional Record (Bound Edition), Volume 150 (2004), Part 15]
[Senate]
[Pages 20986-20988]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Ms. STABENOW. Mr. President, I appreciate those comments. I actually 
would not be here asking to do this if it were not for the earlier 
comments of the Senator from Pennsylvania, speaking as in morning 
business, as it relates to Senator Kerry's health care plan. I felt in 
fairness, as someone who works extensively on health care, that it was 
important to come down and speak to the errors that were presented 
earlier as my colleague spoke on the other side of the aisle.
  First, it is important to know that it does not matter who we talk to 
today, it does not matter who comes into my office or what conversation 
I have with people throughout the great State of Michigan, the issue of 
health care always comes up.
  Right now the big three automakers, struggling to compete 
internationally with their business competitors around the world, are 
talking about the need to address the high cost of health care. They 
have indicated to me on more than one occasion that this needs to be 
one of our top priorities of the Congress and the President of the 
United States: to tackle the explosion in health care costs.
  We also know that half of those costs is the explosion in 
prescription drug prices, and that specifically needs to be addressed. 
We have proposals we have been consistently bringing to this body and 
bringing to the President of the United States that will bring prices 
down. So when we talk to our manufacturers in Michigan, this is a huge 
issue. If I talk to the workers who work for our manufacturers, it is a 
huge issue for them. They are being asked to pay more copays, more 
premiums, to take pay cuts, in some cases layoffs, as a result of the 
high cost of health care and the fact that there has been no action to 
address this while premiums and costs continue to go up faster and 
faster.
  I could talk to a group of seniors in Michigan and certainly talk 
about medicine and the fact that the bill that passed this last year 
for Medicare is more about helping the prescription drug industry than 
it is about helping our seniors in this country. They know what we need 
to be doing. They want to see the pharmacists be able to do business 
with pharmacists in Canada, be able to bring prices down, cut them in 
half or, in some cases, 70 percent.
  Seniors understand we have a crisis as it relates to the cost of 
medicine and health care in this country, and they certainly know when 
we look at the fact that this administration has announced the largest 
Medicare premium increase--17\1/2\ percent--in the history of the 
program since 1965 when it was instituted even though it is estimated 
that Social Security will go up possibly only as much as 3 percent. I 
have a bill that has been introduced with colleagues of mine to cap 
that Medicare increase at the cost of Social Security increases, and up 
to now we have not been able to get a vote on this. Yet this will be 
taking effect in January and taking more out of the pockets of our 
seniors.

[[Page 20987]]

  We know that one of the major reasons for the increase--it is not 
just normal inflation--is because of the costs that are being rolled 
into the premium increases relating to privatization that was part of 
the prescription drug bill. We were told privatization would save 
money. The reality is, we have the highest Medicare increases in the 
history of the program.
  So we can talk to seniors. We can talk to families who are struggling 
every day and seeing their costs go up. We see the real household 
income in 2000 has gone down $1,535. Family health care premiums have 
gone up, $3,000 on average, to $3,599. This is not what ought to be 
happening. We have a crisis going on in our country.
  I can talk to young people getting out of college who find themselves 
no longer eligible to be on their parents' insurance, who now go into 
their first job and maybe do not have health insurance on their first 
job. This is a very real story for me in my own family. Young people 
are hoping and praying they remain healthy, that nothing happens to 
them until they can get into a job that has some health care.
  We know that the majority of people, about 80 percent of the people 
who do not have health insurance in this country, are working. We are 
not talking about people who are not working; we are talking about 
people who are working one job, two jobs, three jobs, working for small 
businesses. I can go to any small business in Michigan and, I would 
guess, across our great country, and they want to talk to me about what 
is happening in health care and health insurance, an explosion in 
pricing. The average premium for small businesses has more than doubled 
in the last 5 years.
  This is a crisis, and I am proud of the fact that John Kerry and John 
Edwards are stepping up to say this will be one of our highest 
priorities, to address this crisis. Everybody knows we have it. 
Everybody, from manufacturers to small businesses to seniors to workers 
to young families to students right out of college, everybody 
understands that we have a crisis in this country. I believe it is one 
of the major moral issues of our time. In the last 4 years we have seen 
this over and over again. Whenever it was a choice between the 
pharmaceutical lobby and the people of our country, the pharmaceutical 
lobby has won. Whenever it was a choice between the insurance industry 
and the people of this country, the insurance industries have won, the 
HMOs have won.
  Frankly, on behalf of the people of my great State, we want somebody 
fighting for us, for the people of our country. The proposals that are 
put forward by Senator Kerry and Senator Edwards address the costs of 
health care and the access to health care. It is overdue for families. 
Again, this chart shows incomes going down, family health care premiums 
going up. We can do something about this. A big piece of this is the 
cost of prescription drugs. Frankly, the rest of the premiums that we 
see going up are because of folks who do not have insurance.
  Our Secretary of Health and Human Services said, when asked about 
why--I believe it was in the context of why our Government is 
supporting the development of a health care system in Iraq with 
American tax dollars, but why we did not see the administration having 
the same sense of passion and urgency about Americans and health care. 
The Secretary of Health and Human Services said: Well, we kind of have 
universal health care coverage in our country because if someone is 
sick and goes into an emergency room, they get treated.
  Well, that is true. When folks go into the emergency room and they go 
in sicker than they should be, go in instead of going to the doctor or 
instead of getting preventive care, they get treated. And what happens? 
The hospital then is forced to turn around and put those costs back on 
folks with insurance, resulting in family health care premiums 
skyrocketing.
  This is not by accident. Part of this is a result of the fact that we 
have folks walking into the emergency room sicker than they should be 
or inappropriately getting care that should be in a doctor's office, 
that should be on the front end where it is more effective, more 
efficient, costs less.
  In Michigan alone, last year my hospitals tell me that they spent 
over $1 billion in uncompensated care for folks walking into the 
emergency room. We now see it materializing in requests to expand 
emergency rooms. I have all kinds of requests from hospitals that are 
bulging at the seams to expand their emergency rooms. So we are paying 
for this on the back end. Families are paying through family health 
care premiums rising more. We all pay because of emergency rooms being 
expanded. Businesses are paying in loss of competitiveness. Seniors are 
paying.
  What John Kerry and John Edwards are saying is we need to face that, 
we can do better than that, and we need to tackle it on the front end. 
So what are they suggesting? Well, I will mention just a few things. 
First, half of the premium increases are prescription drugs. It is very 
simple. They say Medicare, first, ought to be able to negotiate group 
discounts. Everybody else can. The VA can on behalf of veterans. Any 
other insurance system negotiates group discounts, but Medicare is 
prohibited under the new bill. We know why. The insurance lobby did 
their job. The prescription drug lobby did their job. So they are going 
to go back and change that. We negotiate group discounts. We can 
actually close the gap in coverage so it is a better benefit.
  We also have seen from both John Kerry and John Edwards a complete 
commitment to allow us to do, on a bipartisan basis, what we have the 
votes to do in the Senate if we could ever get this up for a vote, and 
that is to open the border to Canada and to other countries where it is 
safe, under strict FDA rules and regulations, to allow our pharmacists 
to do business with pharmacists in Canada and in other countries to 
bring back prescription drugs to the local pharmacy at half the price.
  I am tired of putting seniors on a bus. Just a week ago I was 
involved, again with AARP, out at the Ambassador Bridge in Detroit. We 
had people at the other two bridges in Michigan, talking about and 
demonstrating the difference in prices. I am, frankly, tired of seeing 
in my State people who have to drive across the bridge or through the 
tunnel in order to be able to demonstrate lower prices or be able to 
purchase at lower prices. The Kerry-Edwards administration will bring 
back those prices to the local pharmacy. It will make a major 
difference.
  What else are they suggesting? I hear this all the time. We know one 
of the major problems right now under the insurance system is, 
particularly for a small business, for example, a small business may 
have 10 employees, and they may have low rates. Then one person gets 
very ill--gets cancer, has a car accident, something else happens--and 
they have a tremendous amount of costs for their care. That one case 
throws the insurance rates of the business up dramatically. What the 
Kerry-Edwards administration is talking about is having the Federal 
Government come in and, when the costs exceed $50,000 for an 
individual, the Federal Government would serve as reinsurance, to cover 
those few cases that are very expensive and throw the entire cost off 
for the business. It makes sense. We can do that.
  We have also indicated we need to make a commitment to cover all 
children in our country--and we do. This is a moral obligation. It is 
all about priorities. It is always about priorities. It is always about 
our values and priorities. If we make the right choices, we can make 
sure every child has the health care they need.
  Then they have also said that every person in this country ought to 
have the same ability to buy into the Federal employee health care 
system as we do. In our country we have the employer, meaning taxpayers 
or American citizens, who have less health care than the employees--us 
or other Federal employees. They want to change that. They can do that 
through an umbrella, allow people to buy in, businesses to buy in. They 
can choose either traditional programs or HMOs, but they would have the 
benefit of sharing administrative costs and bulk

[[Page 20988]]

purchasing and sharing other efficiencies to bring costs down.
  They have a number of very specific proposals that will allow greater 
access, that will allow costs to come down, and will directly tackle 
the stranglehold that has been occurring in this country, where a few 
special interests have been able to stop this body and this 
administration and others from making choices about what is best for 
American families.
  We know there are folks who benefit by the current system. The 
pharmaceutical industry and insurance industry do well. They control 
what the price will be, what the access will be, and they don't want to 
change. They and their spokespeople will come forward and scare people, 
that somehow to do any change at all means some big, bureaucratic, top-
down government system and socialized medicine, and they use all these 
other words, but it is used to scare people and to stop us from moving 
together and doing what needs to be done.
  We need to be working together, partnering with business, with 
communities, with local governments and State and Federal Government to 
create a system where we make better decisions, provide health care to 
people on the front end rather than when they are very sick and walking 
into an emergency room, and bringing prices down by designing a system 
that works for us.
  There is no doubt in my mind that we are capable of doing that. If we 
have the will, the political will and the right leadership in this 
country, there is no question that we cannot sit down, figure out a 
system that provides and maintains the best of what is great about 
American medicine and American health care, and also create some new 
opportunities to benefit from what is the best and yet create a better 
system for everyone.
  We can do that. But first we have to have the right leadership, which 
is why I am supporting John Kerry and John Edwards. They understand. 
Senator Kerry has said his first initiative to come forward to the 
Congress as President of the United States will be on health care. My 
biggest concern since coming here, related to health care, has been 
there is not the sense of urgency we need to sit down and get this 
done. We need the political will to stand up to folks, the special 
interests with a lot of money who benefit from the way the system is 
today. We need to have the courage and the leadership to be able to 
design a system and tackle this in a way that makes sense for people.
  There is absolutely no doubt in my mind that this can be done. There 
is also absolutely no doubt in my mind that it must be done. If our 
businesses are going to survive in a global economy, if our families 
are going to survive, in terms of providing health care for their 
children and moms and dads and grandpas and grandmas, if we are going 
to survive in terms of older care and care for the disabled in this 
country, if we are going to continue to have the quality of life 
Americans need and deserve, we have to tackle the health care issue and 
have more than just slogans and scare tactics for people.
  We have to do better than the last 4 years. Real household income is 
down. Family health care premiums are up. This is the wrong direction. 
We can do better and with a change in administrations, working together 
in a bipartisan way, we will do better.

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