[Congressional Record (Bound Edition), Volume 153 (2007), Part 8]
[Senate]
[Pages 11569-11571]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTHY AMERICANS ACT

  Mr. BENNETT. Mr. President, I appreciate the comments of my friend 
from Oregon. I wish to make it very clear that if it were not for his 
dogged persistence in going after the issue of health care reform in 
this Congress, we would not be where we are. Many of us talk about 
this. We talk about it in the dining room. We talk about it as we are 
waiting between rollcall votes. We sit in the cloakroom and say, 
wouldn't it be great? Yes, why don't we do it? It would be fabulous if. 
. . .
  Senator Wyden goes beyond the talk. He is determined to go after 
this. He and I have had a number of conversations, and I know he has 
had conversations with the administration at the White House and at the 
Department of Health and Human Services. He is a bulldog on this issue. 
If it gets done, it will be a tribute to his tenacity. I am beginning 
to believe it will get done. I am getting his enthusiasm.
  I want, for a moment, to spend a little time on history so we can 
understand how we got in the mess we are in, and why the proposal 
Senator Wyden has laid down--and I am proud to cosponsor--is the right 
direction in which to go. We got in the mess where we are with health 
care back in the Second World War, when the Federal Government decided, 
once again, it was going to repeal the law of supply and demand. I have 
said here many times, if I can control what we carve in marble around 
here to remind us of our duties, along with these Latin phrases I love, 
we should also have something before us that says you cannot repeal the 
law of supply and demand. The law of supply and demand is as immutable 
as the law of gravity. Because it occurs in economics, some people 
think we can get around it.
  In the Second World War, we had wage and price controls. We were 
going to prevent inflation by Federal fiat. In other words, we were 
going to repeal the effects of the law of supply and demand. All right, 
so that means if I had an employee, I could not give him a raise. All 
right. Senator Wyden opens a business and he wants my employee. Since 
it is a new job, he offers my employee more than I can pay, and I 
cannot match that because it is against the law. So in order to hold my 
employee, I say: I will tell you what I will do: instead of giving you 
a raise in dollars that you can put into your paycheck, I will give you 
a raise in value. The value will be a health insurance policy that is 
worth more than Senator Wyden is offering you in money. And here is the 
good thing about it: You won't have to pay taxes on this raise. I will 
pay the taxes on it; that is, it will be deductible. You won't have to 
pay taxes on it. So you get more value and you get a tax break. Isn't 
that a good deal? And the employee says: Yes, I will stay with you 
instead of switching jobs because you can, in fact, get around the 
Government's effort to prevent you from giving me a raise.
  That sounds innocent enough, but it started us down the road of 
having the employer spending the employee's money. They say, no, that 
is not employee money, that is employer money; the employer is paying 
for it. No, he is not. The employee earned that amount of money, 
returned that amount of value to his employer, but he didn't get it in 
his W-2. That meant the employer ultimately determined how it would be 
spent. So we started down the road to where there is a major divide in 
paying for health insurance. The employer is spending the employee's 
money, but the employer wants to hold that amount down because it will 
mean savings in his overall business plan.
  So the primary economic motive on the part of the employer is to hold 
the costs down. He will make a deal, therefore, that produces a 
temporary, short-term cost advantage for him. The consumer of the 
service, the employee, has a different agenda. He wants the best care 
he can get. But since he doesn't control the dollars, even though they 
are his dollars in terms of his earnings, he is stuck with whatever 
decision the employer makes.
  That might make a little bit of sense if the employee stays with the 
employer his entire career. But we have gone long beyond that. I tell 
graduates of the university they can expect to change jobs 10 times 
before they are 50, and they may even change careers. You may be 
trained as a veterinarian and end up as a Senator. We have two examples 
of that here in the Senate today. I thought I was going to spend my 
entire career in the glass and paint business, a business my 
grandfather founded, my father ran, and when I graduated, I assumed I 
was going to be there for the rest of my life. I was there for 4 years, 
and a change came along, and then there was another change. I sat down 
when I was 50 and discovered I had changed jobs 17 times from the age 
of 20 to the age of 50. In terms of health care, that meant 17 times I 
was exposed to having my health care canceled--17 times, when they were 
worried about preexisting conditions; 17 times when I would be in a 
situation I would not like. Indeed I was, because there was a period in 
that 30-year timespan when I had no health coverage at all. The 
employer I was working for could not provide it, or under some 
circumstances I had no employer, period.
  So I understand how the precedent set in the Second World War simply 
doesn't apply to the 21st century. If we were to have a system where 
the employee controls his dollars--not the employer--and takes the 
product he buys with those dollars with him from employer to employer, 
we could solve an enormous amount of the problems we have in health 
care.
  Let's talk about overall costs. John Goodman had a piece in the Wall 
Street Journal where he talked about quality. He pointed out a study 
that said the best quality in health care can be found in three cities 
in the United States. One was Seattle, WA; one was Rochester, MN--and 
the Mayo Clinic comes to mind--and the third was Salt

[[Page 11570]]

Lake City, UT. Naturally, that makes me feel pretty good. It pointed 
out if every American received the kind of health care that was 
available in Salt Lake City, UT, the cost would go down by one-third 
and the quality would go up substantially.
  So why doesn't everybody do that? Because they can't take their 
dollars and shop. They are stuck with whatever plan the employer 
decides to buy, and even as he is buying, the employer does not have 
transparency or information that would say to him: The best health care 
is available at Intermountain Health Care in Salt Lake City. Instead, 
the salesman who comes in to sell the employer the policy will say: I 
can save you this much money in this kind of situation. All right, I 
will buy that policy. The focus is on the dollars rather than the 
quality.
  This is an ironic situation that when quality and competition is 
focused on, cost comes down automatically. That is what happens in the 
rest of the economy. Why shouldn't it happen in health care? It doesn't 
happen in health care because of what we did in World War II, and the 
legacy of that has followed downward.
  What about Government health care? One of the problems with 
Government health care is we do it in Congress. Every private health 
care plan had a drug component decades ago. Medicare didn't have a drug 
component until the last Congress. Why? Because we in Congress couldn't 
agree as to what it should be. We always agreed there should be one, 
but we argued about it: It should be better, it should be smaller, we 
have a doughnut hole. All of the things we talked about that the 
average consumer knows nothing about or cares nothing about tied it up 
for decades.
  We finally passed Part D. There were dire predictions that it 
wouldn't work because it wasn't a Government-run plan. It let in 
private competition. It allowed the senior citizens to make a choice 
between private offerors. And what has been the consequence of that?
  We have some statistics: 2,596 different plans are now being offered 
around the United States. People are stunned at that number. They 
thought it would be a monopoly of big drug companies. But when the 
customer could choose and niche markets opened up, drug companies 
started to offer products in those niches, and the number of choices 
exploded.
  I have heard the Senator from Wyoming say: We were worried about 
Wyoming because Wyoming is so small. We didn't think there would be 
more than one or two plans in Wyoming, if anybody wanted to come at 
all. We thought Wyoming would be bypassed by Medicare Part D.
  There are now 34 Medicare Advantage plans in Wyoming--plenty of 
choice--and the polls show that something in excess of 80 percent of 
the seniors like Medicare Part D.
  What has happened to the cost? It is one of the few Government 
programs that I can identify where the cost has come in below 
projections.
  The one thing I always say on the floor of the Senate is, we know 
every projection with respect to Government plans is always wrong. We 
don't know whether it is wrong on the high side or wrong on the low 
side, but we know it is always wrong. But if you are going to bet, bet 
that it is wrong on the low side. Bet that the program will cost more 
than we project or than CBO projects. This is one that has come in 
below.
  All of these straws in the wind tell me Senator Wyden is on to 
something very significant. It is the Healthy Americans Act which says 
let the people control their own money. Let the people have their own 
plan that is going to give us better quality and lower costs.
  We look around the world and we see other countries that have tried 
the single-payer system, and they are retrenching. We look around the 
world and we see other countries that tried a consumer-driven health 
care plan, and they are prospering with respect to getting their health 
care costs down.
  With that history, Mr. President, I am proud to be the Republican 
cosponsor with Senator Wyden and salute him once again on his 
leadership and his tenacity in getting this program moving forward.
  The ACTING PRESIDENT pro tempore. The Senator from Oregon.
  Mr. WYDEN. Mr. President, I believe we have about 13 additional 
minutes to go. The distinguished Senator from Utah has given a superb 
description of the history and why it is time to break with 60 years of 
policy. I would like to, because the distinguished Senator was there 
during the last effort, the 1993-1994 debate, get his sense about how 
the approach that we have been talking about--linking together 
universal coverage with these private choices that individuals would 
make--is it the Senator's judgment that had that been done in 1993 and 
1994 with the efforts of Senator Chafee, himself, and others that we 
might well have been able to pass legislation right then, 15 years ago, 
had we taken this approach?
  Mr. BENNETT. Mr. President, I say to my friend from Oregon that some 
of us proposed that during that debate. He is right to mention John 
Chafee. John Chafee was a towering figure in this body. He was the head 
of the Republican health care task force. We talked about an individual 
mandate as opposed to an employer mandate.
  The core of the bill that was on the Senate floor, sponsored by then-
majority leader George Mitchell, was an employer mandate. And in the 
partisan nature of that debate, we Republicans organized ourselves to 
stop that bill. We divided the bill into various sections, and my 
assignment was to attack the employer mandate. I had a stack of 
material that high to help me do that with my fellow Senators. But as I 
would talk with people on the other side, I would say: Let's talk about 
an individual mandate. I think everyone should have some kind of 
coverage.
  I think it is in society's best interest to have everyone have some 
kind of coverage. We do it with auto insurance. You can't drive if you 
don't have an individual insurance plan. So that is how we get 
universal coverage.
  The political stars simply weren't lined up to deal with it. But this 
is not a new idea. It was around that long ago, and if we had done it, 
I think we could have passed legislation.
  Mr. WYDEN. Mr. President, I appreciate the Senator's comments.
  The other area I have picked up over the last 15 years where there 
has been dramatic interest and is an opportunity for bipartisanship--
and I have heard the Senator from Utah talk about it--is this area of 
prevention. We know with the Medicare Program that something like 4 
percent of those on Medicare consume over half the dollars because we 
are seeing so much of the health care money go to treatment of what are 
often preventable illnesses--heart disease, diabetes, stroke, and 
others.
  What we have tried to do in the Healthy Americans Act is to create 
some incentives for families and prevention, and, for example, if 
parents took a youngster to a wellness program--they wouldn't be 
required to do it, although we know it makes sense--the parents would 
be eligible for a discount on the parents' premium, again using these 
voluntary incentives.
  What is the Senator's sense for the opportunities for prevention? I 
have been struck by some of what the Senator from Utah has said about 
prevention in the past.
  Mr. BENNETT. Mr. President, the record is very clear that when people 
spend time taking care of themselves, their health care costs go down 
dramatically. We had examples presented to us from companies that have 
done that; that is, companies that have been very aggressive in trying 
to make sure their employees stay healthy rather than simply pay for 
what happens when they get sick.
  The CEO of General Mills was with Senator Wyden and me at the press 
conference this week in which he talked about the things they have done 
in their company. They have held their health care cost increases to 
the level of inflation. We would all be thrilled with that because 
health care costs have been going up in double digits for years now.

[[Page 11571]]

  People respond to incentives, and if there are incentives for 
parents, incentives for employees to stay healthy rather than simply 
waiting for the ultimate bill to come along, we will make a significant 
difference.
  If I can be personal for one quick moment, I once worked for Howard 
Hughes. In the Hughes organization in the 1960s and 1970s, we had 
absolutely total health care coverage. Anything that had to do with 
health care, we would send in the bill, and it would get paid 100 
percent. I sent in my kids' orthodontist bills, and they paid for 
straightening their teeth. There wasn't any concern about what was 
covered or what wasn't. I figured I could have sent in the vet bills 
for my dog and probably gotten reimbursed, but I didn't do that.
  I look back on that and the sense of security and abundance that came 
from that led me to overuse the system and to not worry about how well 
we were because they would take care of us. So I have had a personal 
experience about how important it is to pay attention to health at the 
front end.
  Mr. WYDEN. I close, Mr. President--and the Senator has been very 
gracious to do this with me this morning--with why it would be 
important to have a bipartisan initiative now. As we have discussed, 
the conventional thinking is that the Congress can't deal with 
something such as this now; that this will be for the next President. 
But I think the two of us would very much like to bring the Senate 
together behind what the country wants to do today, which is to fix 
health care.
  I have always gotten the sense that when you have divided 
Government--the President of one party, the Congress of another--that 
is the ideal time to try to bring the Congress together to tackle a big 
issue, and there is nothing bigger than health care at home. I think it 
would be appropriate.
  I appreciate the Senator from Utah for coming and for his support, to 
hear his thoughts on bringing the Congress together and the country 
together to finally deal with an issue where there has been so much 
polarization in the past.
  Mr. BENNETT. Mr. President, there is nothing that succeeds in 
politics like good programs, like good policy. Ronald Reagan didn't 
invent it, but he is known for repeating it, saying there is no limit 
to the amount of good you can do if you don't care who gets the credit. 
Far too much of the partisanship stems from the fact that we don't want 
the other party to get credit for solving the problem.
  When I have had discussions across the aisle about this and Social 
Security, I get told: Bob, we will address that right after the next 
election. The next election never comes because there is always a next 
election.
  The Senator from Oregon is exactly right in that for the first time 
since Dwight Eisenhower's election, we have an election where there is 
not an incumbent in the White House on the ballot, either a sitting 
President or a sitting Vice President. So the Democrats who control the 
Congress have a political motive to show they can do something as they 
go into the 2008 elections.
  The Republicans cannot try to take credit for that with their 
candidate because they are not going to have a candidate who is part of 
the present administration. But the Republicans want to be able to say: 
Well, at least in the last days of the Bush administration something 
important got done.
  The setting is rare. We should take advantage of it. This is the 
moment, and I join with the Senator from Oregon in an attempt to seize 
it.
  Mr. WYDEN. I thank my colleague from Utah. I see other Senators who 
are wishing to speak. We will be back to talk with Senators about this 
issue, to urge action in 2007, to support a bipartisan push in the 
Senate to deal with the premier domestic issue of our time.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Arizona.

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