[Congressional Record (Bound Edition), Volume 154 (2008), Part 6]
[House]
[Pages 7542-7547]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    OUR WORSENING HEALTH CARE CRISIS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 18, 2007, the gentleman from Michigan (Mr. Conyers) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. CONYERS. Mr. Speaker, we are in the midst of the ``Cover the 
Uninsured Week,'' and I rise to remind the Chamber of the worsening 
health care crisis that we face as a Nation, and propose a solution to 
one of the biggest challenges of the 21st Century facing us.
  Lack of health insurance often denies necessary medical care. Forty 
seven million Americans are uninsured. This problem is not limited to 
the poor or the unemployed. Researchers have estimated that about four-
fifths of the uninsured are either employed or members of a family with 
an employed adult.
  As well, there are an additional 50 million Americans who are 
underinsured; that is, they have coverage that would not protect them 
from catastrophic medical expenses. Simply put, an increasing number of 
Americans lack adequate health insurance because they and their 
employers simply cannot afford it.
  Despite the challenges of the war in Iraq and the slumping economy, 
we all agree that the uninsured need to be covered. Even the health 
insurance companies have their own plan for covering the uninsured. I'm 
glad that we're on the same page, after all these years.
  The real question we face is, how do we go about covering the 
uninsured? And how do we ensure that every American has access to 
quality medical care when they need it?
  I strongly believe in a single-payer national health insurance, an 
approach that has been too often marginalized in debates on this issue, 
even though it has been successfully employed in almost every 
industrial nation except our own.
  Mr. Speaker, it's time for Congress to consider single-payer, not 
only as a viable option to cover the uninsured, but as the preferred 
solution to fix our broken health care system. And make no mistake 
about it, it is in very bad shape.
  According to a January 2007 article in the Journal of Health Affairs, 
France, Japan and Australia rated best, and the United States worst in 
new rankings focusing on preventable deaths due to treatable 
conditions, in 19 leading industrialized nations.
  The article revealed that if the United States health care system 
performed as well as those top three countries, there'd be 101,000 
fewer deaths in the United States each year.
  Equally disturbing, the Institute of Medicine reports that 20,000 
Americans die each year as a direct result of having no health 
insurance. How can we, in the Congress, who receive fairly decent 
health care, tell 47 million uninsured Americans that they cannot have 
access to health care?
  With the knowledge that 20,000 Americans die each year without health 
insurance, how can we, in Congress, who do have health insurance, not 
place universal health care as a front burner issue in this chamber?
  This is a moral challenge that we all must pick up. And 
incrementalism will not work. Expanding a broken system or fixing parts 
of it will not work. We must approach the health care solution the same 
way a physician approaches the treatment of disease. Doctors do not 
employ treatments only because they are easy or feasible. They choose 
evidence-based solutions based upon peer-reviewed research in order to 
employ the most state-of-the-art care available. And so I propose we 
take the same approach to crafting a universal health care plan.
  So today, I ask the following question: What further disaster must 
befall us before we face the crisis of the uninsured and the 
underinsured?
  How many more people must die due to the inability to receive care in 
the world's healthiest Nation before we, in

[[Page 7543]]

Congress, take action and create a truly universal health care system?
  For those who believe that we are not ready to have a universal 
health care system, and must delay the formation of a comprehensive, 
national health insurance program, I ask you to consider the following 
evidence that demonstrates why we can ill afford delaying action on a 
universal health care system.
  Health care horror stories are cases in which the result is so tragic 
that it shocks the conscience. We hear about them almost every day, in 
the newspapers, magazines, the Internet, television, radio, personal 
encounters with our friends and neighbors.
  In the movie ``Sicko'' we, as a Nation, saw firsthand how even those 
with health insurance suffer under the current, for profit, employer-
based private health insurance system.
  In my office, I receive scores of health care horror stories each 
month, and have binders in my office of health care tragedies that we 
have collected over the last 8 years. In fact, when Michael Moore was 
doing research for ``Sicko'' he received 25,000 health care horror 
stories himself, after he made an appeal for those horror stories on 
his website.
  I'd like to read a health care horror story sent to us by Adrienne 
Campbell from Michigan, a story, that, unfortunately, millions of 
Americans who are underinsured or uninsured can relate to. Here's her 
story.
  My sister, who is 22 years old right now, was diagnosed with cervical 
cancer, the same cancer I had at the same age. She graduated from 
college back in December, so she is off my dad's insurance.
  Jobs are hard to find here in Michigan, so she's working two part-
time jobs, and neither of them provide insurance for part-time workers.
  She has to go through what I did, but instead of actually being able 
to get medical treatment right away, then having to pay for it, she has 
to put off until she and the hospital can work out a payment plan. They 
told her the soonest they might be able to perform the surgery will be 
in April.
  We've been calling around seeking other options. She's at Stage 4. I 
was at Stage 2, when I went through my ordeal, so she's in much worse 
condition than I was; which worries me.
  This is unacceptable. It's like I am living my horror all over again, 
only this is my sister. This is why we have to fight. We have to shake 
things up this election year.
  There's nothing you can do for my sister at this point, except keep 
her in your prayers, and I hope that she can get surgery soon. But, for 
those women who may get cervical cancer down the road, let's fight for 
universal health care so they don't have to go through the money 
worries.
  I love my sister, Victoria, or as my daughter calls her, Aunt Gickie, 
because she can't say Vickie.
  Please, just keep her in your prayers and thoughts. Thanks for 
letting me vent. I love her too much to see this happen to her.
  Mr. Speaker, we do not have a health care system in this country. 
What exists is a fragmented, nonsystem of health care. It's a wasteful 
and inefficient patchwork of different plans and schemes that allow too 
many people to fall between the cracks.
  The complexity of this nonsystem is what makes it unsustainable. 
Private health insurers are in the business to make a profit. Make no 
mistake about it. In fact, the real problem is that insurance companies 
are not as much in the business to provide care as they are in the 
business to deny care. They keep profits up by avoiding high risk 
patients, limiting the coverage of those they do insure, and passing 
costs back to patients through copayments and deductibles.
  They deny coverage based on pre-existing conditions, including such 
costly diseases as athletes foot and yeast infections.
  They employ an army of adjusters who go through mountains of 
paperwork, all mostly working to figure out a way to deny a claim. We 
have the story of insurance company whistleblower, Dr. Linda Pino, who 
tells us she was paid a bonus on how many claims that she could deny, 
and threatened with demotion if she authorized payment on more claims 
than her peers.
  These practices are harmful. They're expensive. All those adjusters 
and paperwork cost a lot of money. Add to that insurance costs the 
insurance company's spending on advertising, huge executive salaries, 
and profits for shareholders, and the result is an average overhead of 
15 cents on the dollar. Compare that with Medicare's overhead which is 
between 2 and 3 cents.
  The complexity of this nonsystem not only leads to gaps in coverage 
and navigating nightmares, but it's underscored by the duplicity and 
waste created by the multitude of health insurance companies.
  Mr. Speaker, I'm pleased now to recognize the gentleman from Ohio, 
who's been on this plan for--several Congresses ago he was and is the 
original co-founder and original signer with me to this bill. He's 
worked relentlessly in the Congress and across the country in making it 
clear that we're working on a system that some day is going to bring so 
much joy and benefit to the millions of Americans in this country. He's 
a fearless, dedicated, articulate leader, and I would now yield to my 
colleague, Dennis Kucinich.

                              {time}  1615

  Mr. KUCINICH. Mr. Speaker, I'm so grateful to have the opportunity to 
work with Mr. Conyers on this important bill. Years ago, when we were 
having those meetings where the legislation was being crafted, we both 
knew what an important moment it would be for the people of the United 
States to be able to have a health care system they could call their 
own. So I want to take this opportunity, as I begin my remarks, to 
salute the work of you, Chairman Conyers, and all that you have done 
and your dedication in working to make sure that the American people 
have a national health care system, a not-for-profit system. That's 
been your dedication. It has been an honor to work alongside of you in 
this endeavor.
  As we speak today about covering the uninsured, we speak to the 
American people who are worried about whether loved ones are going to 
be able to get the care that they need. There is nothing that is more 
troubling to a family than to have a family member who is ill and yet 
cannot get the medical care that would be necessary to bring them back 
to health. There are 50 million Americans who are uninsured. This means 
that when they see others able to get the care they need, they 
recognize in their own families that they cannot sustain the health of 
loved ones or themselves.
  Why is it that people are uninsured? Well, there are many reasons, 
but the principal reason is they simply cannot afford health insurance.
  You know and I know, Mr. Chairman, that there are so many families 
that are called upon to spend $1,000 or more a month for health 
insurance. The price of gasoline going up to more than $4 a gallon, the 
cost of bread going up, milk, eggs, meat, all basic staples of an 
American diet, costs going up, up, up. People are finding that the 
costs of health insurance is becoming prohibitive. And so they simply 
can't afford it. So they remain uninsured, thereby leaving their entire 
family health open to a challenge.
  How many of us would be able to survive financially being uninsured? 
Very few, because what happens is that if you're uninsured and you have 
health care bills, you're going to have to pay those bills. And you 
know that the greatest cause of bankruptcy in the United States relates 
to people not being able to pay their hospital or their doctor bills. 
That's a fact of life. There is no other issue which touches the 
American family and touches all of us so uniquely as this issue of 
health insurance. People can't afford it.
  This is a tragic problem, and it's getting worse. About 22,000 people 
die every year because they're not insured; this, according to the 
updated Institute of Medicine Statistic. But we cannot talk about the 
uninsured without talking about the underinsured as well.
  There are another 50 million Americans who are underinsured. Now 
think

[[Page 7544]]

about it. 50 million uninsured, 50 million underinsured. 100 million 
Americans. One out of every three Americans is touched by this dilemma, 
and that means virtually every American family is either uninsured or 
underinsured. If you're underinsured, premiums are expensive, you may 
not be able to pay the premium to get the coverage you need, Co-pays 
and deductibles go higher and higher and higher. The American family is 
owned by the health insurance companies.
  What kind of a country are we becoming where the people of this 
country can't get the care they need because almost $1 out of every $3 
is taken off the top by the for-profit insurance companies for 
advertising, marketing, the cost of paperwork, corporate profits, stock 
options, executive salaries, all of those necessary things that Mr. 
Conyers has talked about in the past. $700 billion a year goes for 
expenses that are totally unrelated to the cost of health care. $700 
billion a year. Meanwhile, you have 50 million uninsured and another 50 
million underinsured. The insurance companies own us. We don't own our 
own health care system.
  And the insurance industry is the reason for the underinsurance 
problem and all that goes with it. Half of all bankruptcies are tied to 
medical bills. And of those medical bankruptcies, listen to this, 
three-quarters of those had insurance before they got sick. So even 
with insurance, people are going bankrupt because they can't handle the 
co-pays and the deductibles.
  Of all of the medical bankruptcies in the United States, three of 
every four people had some kind of insurance before they got sick. They 
fell victim to insurance companies whose only way to make money is to 
deny care. How do these insurance companies make so much money? They 
make money by not providing health care. They make money telling 
people, We're not going to pay that claim. You're not going to be 
covered. The more people they can exclude, the more money they will 
make. It is a racket. Health care is a racket. Health insurance, 
rather, is a racket.
  It is time we took America in a new direction, which is what the 
Conyers' bill, that I am proud to be a co-author of, is all about. H.R. 
676 is to provide for a universal, single payer, not-for-profit health 
care system. It finally puts health care back in the hands of the 
doctors and the patients. It eliminates the insurance companies as 
middle persons, middlemen, who are able to skim almost $1 out of $3 off 
the top while 50 million Americans are uninsured and another 50 are 
underinsured.
  We need to make a clear distinction between ``health care'' and 
``health insurance.'' The two are very different. Doctors and nurses 
are not the same as health insurance CEOs. Doctors and nurses provide 
care. Insurance companies' CEOs, they deny it. There's a difference 
between health care and health insurance. If you have insurance, it 
doesn't mean you have health care. There are increasingly creative and 
complex ways to deny health care: co-pays, deductibles, premiums, 
limits on daily coverage, caps on annual amount spent, failing to cover 
certain medical conditions, failing to cover certain accidents, failing 
to cover certain drugs, failing to cover certain total spending 
amounts, like the privatized Medicare Part D donut hole, failing to 
cover hospital stays, or minimizing the coverage.
  What has this hunt for profitability in health insurance cost us? 
Well, it's cost us a lot of money. It's driving up health care costs 
beyond the reach of most Americans. Listen to this statistic: between 
1970 and 1998, the number of doctors and other clinical personnel 
increased by 2.5-fold. During the same time, the number of health 
administrators increased more than 24-fold. There's an explosion of the 
number of people in the health care system who do not provide care. 
They instead are told to deny care.
  It boils down to this: The insurance industry is the problem. It is 
not the solution. The only way to truly cover everyone is to guarantee 
access, not to force working men and women to subsidize the insurance 
industry whose very presence forces people to pay out of pocket to keep 
the industry alive. We need health care run by doctors and their 
patients, not insurance companies. Health care is a basic human right.
  So Mr. Conyers, I just want to express to you my appreciation for the 
work that you have done to bring this issue before the American people. 
To have had the opportunity over many of the last few Congresses to 
work with you on this has really been an honor.
  And when we remember when we go back home, you to Detroit and me to 
Cleveland, and we see people who need care, our hearts break when we 
realize that they can't get it because insurance has just ended up 
being a big business and they don't care about people anymore. It's all 
about making money. All about profit.
  So Mr. Conyers and I know that H.R. 676 stands alone in an 
increasingly crowded field of ideas that are going to provide health 
care for people. And this proposal addresses the accessibility problem.
  Employer-based insurance requires people to continue to work in order 
to keep their insurance even if it worsens their health. Now, I know 
Mr. Conyers worked with the UAW for years and years before coming into 
Congress. What happens if you lose your job? People end up, after their 
COBRA benefits are gone, they lose their health insurance. Our proposal 
says if you lose your job, you're still insured. If you don't have 
money, you're still insured. If you have a pre-existing condition, 
you're still insured. This covers dental care, vision care, mental 
health, long-term care, prescription drugs. It's all covered.
  Mr. Conyers, thank you. Thank you for your dedication to the American 
people. Thank you for your willingness to lead the way, and I'm just so 
grateful that I have the opportunity to work with you.
  Mr. CONYERS. Mr. Speaker, may I say to my colleague that I am so 
flattered that he remembers the days when we started out with just a 
few Members. We're up somewhere about 90 now and growing every week, 
every month. More and more people are joining us. And in addition, 
there are growing numbers of medical professionals, doctors, 
researchers, health care experts, who are all recognizing how important 
what you have said is in terms of how we move out of the situation that 
we're in.
  Your description of the pain and suffering of so many of our citizens 
because of the lack of health care leads to situations so horrible that 
they truly shock the conscious.
  Mr. KUCINICH. Mr. Speaker, if the gentleman will yield, you 
mentioned, Mr. Conyers, that many doctors support this. When I first 
ran for Congress in 1972, doctors generally opposed this idea. But 
there is a new survey that just came out published in the Annals of 
Internal Medicine that states that of the physicians that were 
contacted in this survey, thousands of them, 59 percent of the 
physicians now support a national health care plan, which is why I 
believe when you have the physicians supporting it, the patients 
support it, all we need is to keep adding to the numbers in the House 
of Representatives; and with Mr. Conyers' leadership, we're on our way 
to creating a national health care system.
  Once again, I want to thank the gentleman for the opportunity to 
share some time with you here. And again, the people of the United 
States owe you a debt of gratitude for your relentlessness and your 
dedication on this, and I intend to keep working at your side as we 
move forward to create a universal, single-payer, not-for-profit health 
care system. H.R. 676, the Conyers bill, is the way to go.
  Thank you.
  Mr. CONYERS. Thank you, Congressman Kucinich.
  And as our numbers grow in the Congress, you know that the American 
people have already indicated in policy after policy that they want a 
universal health care plan. Many are willing to even pay more to get 
it, but they don't have to. And this is a labor of love which I am so 
proud that nearly 100 of our colleagues are now working with us.

[[Page 7545]]

  And I yield again to the gentleman.
  Mr. KUCINICH. As the Chairman is always able to do, you bring up 
another point that I think would be helpful to amplify, and that is 
that people will say, Well, how are you going to pay for this? Well, 
guess what? We're already paying for a universal standard of care; 
we're just not getting it. $2.3 trillion a year goes for health care in 
the United States. $2.3 trillion.
  And when you consider the fact that the for-profit insurance 
companies take almost $1 out of every $3 or almost $700 billion a year, 
you take that $700 billion--am I right, Mr. Chairman--you put that 
money into care and you suddenly have enough money to cover all 
Americans, the underinsured and the uninsured are covered. So how we 
pay for it is using the money that's already in the system, and that's 
how much profit is in health care insurance or health insurance these 
days.

                              {time}  1630

  Mr. Speaker, once again, thank you for bringing out that point about 
the fact that it is able to be covered without any current change in 
our system, although we have a funding formula that you've helped to 
develop that will guarantee that all Americans will be covered far into 
the future.
  So again, Mr. Chairman, I'm grateful the people of Detroit are 
fortunate to have you representing them in the United States Congress.
  Mr. CONYERS. In addition, we are creating a system of preventive 
health care. We are creating a system in which people, when they 
initially get sick, can go to a doctor instead of being forced to go to 
emergency rooms where they get temporary treatment, and then they're 
back at home or on the streets again. We will make the country 
healthier. And national health care is an ambition that is very much 
related to national security. So I'm pleased that all of these things 
can occur with the consideration of House Resolution 676.
  In the last 10 years, the cost of health care to businesses has 
increased 140 percent. We need an efficient universal health care 
system that protects American businesses from skyrocketing health care 
costs so that, as a Nation, we can remain competitive in the global 
marketplace.
  The rising cost of health care in this country has played a 
significant role in the current economic climate, specifically with 
regard to the outsourcing of labor to foreign countries. Between 2000 
and 2007, United States health premiums have risen 98 percent, while 
wages have only increased by 23 percent. The average family health 
insurance plan now costs more than the earnings of a full-time minimum 
wage worker.
  Our fractured non-system of health care is crippling our economy. But 
don't take my word for it, just ask the United Automobile Workers and 
the AFL-CIO, or even the automobile makers themselves. Health care has 
become such a central issue for General Motors that Economists magazine 
only partly in jest called the company a pension hedge fund wand health 
insurance business that happens to make cars.
  Ford and General Motors pay nearly $1,500 in health care costs for 
each vehicle they produce, while BMW pays $450 in Germany, and Honda 
only $150 per vehicle in Japan.
  A General Motors executive told former Senator Tom Daschle, a 
proponent of universal health care, that the high cost of health care 
is the single largest impediment to creating more jobs in the United 
States. An IBM executive, Senior Vice President for Human Resources Mr. 
J. Randall McDonald, recently predicted that 5 years from now this 
problem will have to be cured or the competitiveness of the United 
States will be drastically impacted.
  Small business employees are one of the fastest growing segments of 
the uninsured and now comprise about one-fifth of the total uninsured 
population. Kansas Governor Kathleen Sebelius told the New York Times, 
``Affordable coverage for small business owners and self-employed 
individuals is probably the biggest challenge that we have in Kansas 
and most states.''
  Incredibly, one-fifth of working age Americans, both insured and 
uninsured, have medical debt that they are paying off over time. More 
than two-fifths of these people owe $2,000 or more. Medical bills are 
the leading cause of bankruptcy in the United States, accounting for 
half of the personal bankruptcies. If unpaid medical bills are the 
leading cause of bankruptcy in this country, then how can we in good 
conscience delay any longer in Congress to create a truly universal 
health care system?
  High deductibles in private health insurance plans are another 
barrier to consistent care. Eleven million people with health insurance 
have per-person deductibles of $1,000 or more. One recent study found 
that 44 percent of adults with deductibles of $1,000 or more did not 
fill a prescription, declined to see a specialist, skipped a 
recommended test or treatment, or didn't see a doctor when they had a 
serious medical problem.
  There are additional sums spent by hospitals and doctor's offices to 
deal with each insurance company's rules, regulations, and forms to 
fill out. After a number of our satellite industries take a cut, we're 
looking at up to 50 cents on the dollar being spent on administration, 
marketing and profits. All this is money we could be spending on health 
care.
  Drug prices in this country are about 60 percent higher than prices 
in Canada or Britain, and this is not because Big Pharma is doing so 
much research and development. In fact, data from the pharmaceutical 
companies' own annual reports show that they spend almost three times 
as much working on marketing and administrative costs as they do on 
research and development.
  It is not because American companies are carrying the burden of doing 
research and development for the rest of the world. Drug companies in 
the European Union put out about the same number of new products each 
year that American companies do. And our drug industry's research and 
development gets huge taxpayer subsidies from government-supported 
research done by the National Institutes of Health and American 
universities. In fact, only a very small percentage of the new drugs 
produced in America are in fact innovative developments. Most are 
varieties of old drugs developed simply to extend patent protections so 
that they can keep on charging those high, excessive prices.
  The reason drugs cost more in America than anywhere else boils down 
to a single factor: Profit. The drug companies have the highest profit 
margins of all American corporations. Their profits as a percent of 
sales run about 19 percent, compared to a median of about 5 percent for 
Fortune 500 companies.
  Mr. Speaker, the American people are concerned about the direction in 
which our economy is heading. As we spiral headlong toward a recession, 
if we're not already in one, both large corporations and small 
businesses have to make difficult decisions to keep their business 
afloat. For most Americans, the loss of employment means the loss of 
health insurance.
  The bottom line: If we can streamline the operations of the health 
care system by decreasing wasteful overhead and appropriately 
allocating funds, we can not only ensure the coverage of everybody in 
the United States, but we can provide for true health care. And that is 
an important point; coverage does not equal care.
  My plan, H.R. 676, is simple. And its simplicity is the very thing 
that will allow it to succeed where others will fail. Many of the plans 
generally add an individual mandate and even more insurance options. 
Others suggest financial mechanisms like tax credits or savings 
accounts. These other plans will not guarantee coverage that is 
universal, affordable or comprehensive. They fail to do anything to 
decrease administrative costs or complexity, in fact, they add to it. 
They can't control costs, and so ultimately they will be unsustainable.
  Now, I began from the premise that health care is a basic human 
right, not a privilege, a basic human right. This is the consensus 
opinion of the international community, as enshrined in the Universal 
Declaration of Human Rights and other documents.

[[Page 7546]]

  I also believe that government has a fundamental role to play in 
guaranteeing this right to each and all of its citizens. This is the 
view of the other industrialized nations, all of which have single 
payer health care systems that cover all their people, cost far less 
than ours and, sadly, get more and better results in terms of health 
outcomes.
  I believe that health care must not be a market commodity. The market 
dictates that one's ability to consume a particular product is 
constrained by one's ability to pay for it. This approach may be 
feasible when one is talking about buying hamburgers or tennis shoes, 
but it is unacceptable when it comes to health care. Our access to 
health services should be determined by only one thing, what our doctor 
thinks we need. Profit should not be a factor.
  Let me clarify: I do not advocate socialized or government-run health 
care, such as the National Health Service in Great Britain. I propose a 
plan that is publicly financed, but privately delivered, like those in 
Germany or France or Taiwan.
  The role of the government in the H.R. 676 proposal is limited to 
collecting revenues and disbursing payments to providers. Doctors, 
hospitals and clinics will continue to be run privately. I believe they 
will be required to operate as not-for-profit organizations.
  In a single payer system, we could do just that. We will do just 
that. Revenues would flow into the system through an automatic payroll 
tax, very little paperwork required. Doctors would bill the government 
electronically and they would be reimbursed electronically, cutting out 
the middle man, and the savings would be tremendous.
  Studies by the Congressional Budget Office, the Government 
Accountability Office and consultancies such as the Lewin Group 
consistently find that the savings under a single payer plan would be 
more than enough to cover all of the uninsured. So, in fact, it's 
possible to cover all Americans under a comprehensive health plan 
without spending any more money than we do now. We would just be more 
efficient with it.
  The two other major drivers of health inflation are the increasing 
use of expensive prescription drugs and the proliferation of new and 
expensive medical technologies. A single payer system would address 
both these costs.
  By leveraging the buying power of the Federal Government, we can 
negotiate huge discounts both for drugs and for other major drivers of 
health inflation such as medical technology. We can bring down the cost 
of medical technology by allocating it more efficiently. As it is, we 
have no organizing structure to manage the distribution of health care 
resources. The result is that we have a glut of medical imaging 
machines, specialists, and other medical services which are seen as 
generating the most potential profit for their owners; hospital A has 
one MRI machine, hospital B then feels it must have two MRI machines, 
and so on. To end up with MRI machines all over town standing vacant 
while we continue to spend enormous sums on acquiring more is unwise 
and impractical and should be ended.
  Under a single payer system, we can distribute resources more 
efficiently so that we are buying MRI machines based on the need for 
them, not based on how much profit they can generate for a particular 
hospital.

                              {time} 1645

  A regional board could determine, with the input of doctors and other 
providers, what number of machines would be appropriate for the 
population based on demographics and other factors.
  Allow an explanation of how a single-payer system under H.R. 676 
would work. Existing public health care spending, including government 
spending for Medicare and Medicaid, would continue, but it would flow 
into a single trust fund. We would add a payroll tax of about 3.3 
percent each to workers and employers. In addition to the 1.45 percent 
Medicare tax, the total health care tax would be 4.75 percent. This is 
cheaper than what the private health insurance companies charge; so 
families and businesses will be spending less than what they are 
spending now if they have insurance.
  We also get revenue from other sources like one quarter of 1 percent 
tax on certain stock and bond transactions. All these revenue sources 
add up to more than enough to cover current spending. But just in case 
there are additional expenses in a particular year, we also authorize 
an annual appropriation.
  Revenue flows from the Federal trust fund into the accounts of the 
currently existing Medicare regions. Reimbursement is then negotiated 
with doctors and other providers at the regional level, with current 
levels being the starting point. Doctors are paid on a fee-for-service 
basis, while hospitals and other large institutions are paid with 
monthly lump sums known as global budgets based on current 
expenditures. Global budgets are cost-control mechanisms that are very 
effective in other single-payer systems.
  Every American would receive a national health insurance card at 
birth or would be able to apply for one at the post office or other 
government facility. The application form is limited to 2 pages. 
Everyone living in the United States would be eligible. All medical 
necessary services would be covered, including inpatient and outpatient 
care, mental health care, dental care, and prescription drugs. Patients 
can go to the doctor or health care provider of their choice.
  Private insurance companies are prohibited from duplicating the 
coverage provided under the plan. They may still offer coverage for 
nonmedically necessary services, such as cosmetic surgery. They are not 
prohibited from being hired by the government to do billing services, 
but overhead costs would be strictly regulated.
  This plan relies on the existing Medicare infrastructure for 
administration. There is no ``new government bureaucracy.'' In fact, 
there will be far less bureaucracy in health care after the role of the 
insurance companies has been limited.
  Just to let you know, there are nationally recognized health 
economists and physicians who believe that if we spent more efficiently 
the money we are already currently spending on health care, then we 
would cover every American with quality and affordable health insurance 
right now through a privately delivered, public financed, single-payer 
system.
  Mr. Speaker, I thank you for your cooperation.
  Ms. LEE. Mr. Speaker, I rise today in support of Cover the Uninsured 
Week, to highlight the deplorable fact that over 47 million Americans--
including 9 million children, lack health insurance in our country.
  Mr. Speaker, I strongly believe that health care is a basic human 
right. Yet far too many people have no access to even the most basic 
health services. Contrary to popular belief, 8 out of 10 Americans who 
lack health insurance come from working families who just can't afford 
the high cost. Minority communities also disproportionately suffer from 
a lack of health coverage. More than one-third of the Hispanic 
population in our country and more than one-quarter of Native Americans 
live without health insurance. Nearly 22 percent of African Americans 
and 20 percent of Asian Americans also lack health insurance. These 
statistics are just plain shameful.
  What's worse is that because these individuals lack health coverage 
they are more likely to wait to seek treatment until they are really 
sick, which in turn further drives up health care costs and creates a 
vicious cycle of un-insurance.
  Mr. Speaker, the sad truth is that over the last 8 years of this 
administration, the number of uninsured Americans has been steadily 
rising. Instead of supporting proposals to expand access to health 
care, however, this administration has continually supported policies 
that have driven more people into poverty, placing affordable health 
care even further out of reach.
  Perhaps the clearest example is this President's veto of the SCHIP 
bill and his refusal to provide health coverage to 10 million children. 
That is just unconscionable.
  As the only industrialized nation in the world that does not 
guarantee health care for all our people, I believe we must move toward 
a system of universal health coverage. That is why

[[Page 7547]]

I have introduced H.R. 3000, the Josephine Butler United States Health 
Service Act, to make the United States Health Service its own 
independent executive branch and establish an Office of the Inspector 
General for Health Services.
  My bill would require the Health Service to ensure that everyone has 
the right and the ability to access the highest quality health care 
available regardless of cost. Mr. Speaker, providing universal health 
care is the right thing to do and it is consistent with our values as a 
nation and the goals of Cover the Uninsured Week.
  Mr. WEXLER. Mr. Speaker, I rise to acknowledge ``Cover the Uninsured 
Week.'' We must recognize the tragic reality that 47 million Americans, 
including 9 million children, are uninsured in America. In my home 
State of Florida, the figures are even more striking, with 20 percent 
of Floridians lacking health insurance. Millions of hard-working 
Americans with full-time jobs lack affordable health care options.
  For example, a woman in my district, Florianne, has worked as a 
housekeeper for a local hospital for 3 years and is uninsured. She 
cannot afford to pay for health insurance for her children despite 
having a full-time job. In 2004, when Florianne worked directly for the 
hospital, she received health benefits. Today, the hospital 
subcontracts its housekeeping operations, causing her to lose her 
health insurance. With rent, food, gas, and utilities eating up her 
$692 biweekly paycheck, there is not a dollar to spare for her son's 
glasses or basic checkups, let alone a $768 monthly premium.
  I wish Florianne's predicament was unique. All across Palm Beach 
County, the State of Florida and throughout the United States, children 
like Florianne's miss doctor's appointments, forego needed 
prescriptions, and are denied adequate health care. Their parents work 
hard but still cannot afford health care for their families. This is 
totally unacceptable in the wealthiest nation on Earth.
  In Congress, I have sponsored legislation to fund insurance for 
millions of children across the country, introduced legislation to make 
Medicare more affordable for seniors, and voted to increase funding for 
community health centers willing to treat uninsured individuals. I am 
also a sponsor of the U.S. National Health Insurance Act (H.R. 676), 
which would reform our health care system and provide health insurance 
for every man, woman, and child. Unfortunately, many of these proposals 
have been shot down by the Bush administration.
  ``Cover the Uninsured Week'' reminds us all that America desperately 
needs leadership in the White House and in Congress to work together to 
achieve the affordable health care that all Americans deserve.

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