[Congressional Record (Bound Edition), Volume 155 (2009), Part 10]
[Senate]
[Pages 13464-13465]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. NELSON of Florida. Madam President, I wish to talk about health 
care reform which is just about happening. We have an unprecedented 
opportunity to reform our health system. It has major flaws. It is one 
that has left 46 million people in this country without health 
insurance and millions of others are struggling to afford the cost of 
health care. It is in need of repair, and that is what this Senate, 
this Congress is going to try to tackle in the next few months. As a 
matter of fact, the majority leader has expressed his intention to have 
such a bill of monumental proportions on this Senate floor for 
consideration by next month. It is ambitious, but it is necessary. We 
have no choice but to succeed.
  The health care costs are felt by many of our fellow Americans. There 
are significant economic costs associated with this broken system. 
Those who lack insurance have few options for care, which means they 
will delay and delay treatment until the condition worsens to the point 
that what could have been treated has turned into a full-blown 
emergency. Guess what happens. Where do they go? They go to the 
emergency room, and it is the most expensive place. As a result, the 
cost of that expensive care is borne by all Americans with health 
insurance by us paying higher premiums for those who do not have any 
insurance, but they still get the care.
  This is a phenomenal statistic. According to research done by 
Families USA, our families in America with health insurance paid an 
additional $1,000, on average, last year to cover the care for the 
uninsured.
  One very important component, therefore, of this package that the 
Senate Finance Committee is going to take up pretty soon and try to 
pass--I hope we are able to do it--is bipartisanship. We keep hearing 
it is going to be done in a bipartisan way. I know the chairman and the 
ranking member of the Finance Committee are committed to trying to do 
that. But at the end of the day, the proof is going to be in the 
pudding. Are the Republicans on the Finance Committee going to support 
a committee approach? Will they support universal health insurance, 
which is what I described? It is hard to disagree with what I 
described, insuring all those 46 million so the average family does not 
pay an additional thousand bucks on their health insurance premiums to 
care for those who are uninsured. That is hard to disagree with. But 
somehow the word ``universal'' has some taint on it. That is what it 
is. So until we have everyone in the system, we are going to continue 
to see the inefficiencies and the cost shifting I described.
  In this system that I think we are going to bring to the floor, those 
who like what they have are going to be able to keep it. If you are 
happy with your insurance, with your employer, and it is affordable to 
you, you can certainly keep it. But for those who cannot afford 
insurance or those who have the very sad tales we have heard, have a 
preexisting condition and, therefore, they cannot even get insurance 
coverage, this insurance reform package is going to mean they are going 
to have access to insurance that is going to be affordable and that is 
going to be quality. In this reform system that I hope we are going to 
be able to pass, insurers are going to have to be prohibited from 
denying coverage based on a preexisting condition. The needs of those 
individuals are often the greatest, and they deserve to be met.
  We are also going to try something called a health insurance 
exchange. It would simplify the process of purchasing insurance, and it 
could be simplified in purchasing it through a Web portal that would 
present all of the available insurance options in a comprehensive 
manner and in a comprehendible manner and expedite the enrollment 
process with a standardized application.
  If you are satisfied with your employer's insurance, you stay right 
there. But all the others who want an alternative or cannot get 
insurance from an insurance company, they would have this health 
insurance exchange, participated in by the private insurance companies 
that would have a series of maybe a half-dozen standardized policies, 
that then those insurance companies would bid--make available, in other 
words--competition, get the free market competition going on for those 
who could offer the best policy at the best price for all those 
millions of Americans who would want to purchase from that health 
insurance exchange.
  As we do this package, it is also important for us to focus on cost. 
Health care costs have skyrocketed. They have been increasing at a rate 
much higher than the average American's paycheck. In addition to 
placing a prohibitive financial burden on American families, these 
costs are affecting American businesses as well and their ability to 
compete in the global marketplace. So health care reform is going to 
have to be assisting individuals, families, and businesses in managing 
what has become an overwhelming expense.
  As we consider this package, we ought to provide tax credits. We can 
do tax credits that could help small businesses to offset the cost of 
providing the insurance to their employees, if that is what they 
choose, instead of doing it through the health insurance exchange.
  Tax credits could also be extended to low-income individuals to 
assist them in purchasing coverage from that exchange.
  Along with those incentives, there would also come the responsibility 
for insurance coverage that would be shared by individuals and, in some 
cases, their employers.
  Then we always have the question of what should be the eligibility in 
the Medicaid Program. Medicaid is a joint State-Federal program for the 
poor and for the disadvantaged. One of the

[[Page 13465]]

things that will be taken up will be that coverage should be expanded 
through the Medicaid Program by increasing eligibility for parents, for 
children, and for pregnant women who otherwise cannot afford the health 
care.
  I also think it is important to have reform that promotes quality 
care by mandating coverage of the services necessary to maintain health 
and wellness. What do I mean? I mean primary care, a lot of what we 
talk about that is preventive care so you get at the root of the 
problem before it becomes a big problem, and then it becomes expensive 
to treat. Get at the root of the problem, and a lot of that is with 
primary care doctors and other health providers who provide that very 
important preventive medicine. For example, diabetes, heart disease--if 
you catch it early, you can prevent the big problems. But prevention 
requires knowledge and awareness that comes with comprehensive care, 
and it is critical that preventive care is available to Medicaid and 
Medicare recipients and, therefore, also in that health insurance 
exchange. We are going to have to bring these preventive services into 
these programs.
  I close by saying we have come in this country to feel, as we should, 
that access to a quality, affordable health insurance system is a 
right. We certainly do not have that now. The system is cockeyed. This 
is a historic opportunity to answer this need by expanding and 
improving coverage while cutting the wasteful spending and addressing 
the flaws of the system.
  The time for reform is now. We are going to start hashing it out, as 
we have been in these long roundtable sessions in the Finance 
Committee. I hope this can be bipartisan, but the proof is going to be 
in the pudding on final passage. Are there going to be votes, and how 
many from both sides of the aisle? If we are successful, it is going to 
turn around our ability to have adequate quality and affordable health 
care, which we need.
  But it is going to do one more thing: It is going to start bringing 
under control the exploding cost of Medicare and Medicaid that, over 
the next 20 to 30 years, unless we change it, the Government is not 
going to be able to afford. That doesn't say one thing about cutting 
back on access to care nor the quality of care; it simply speaks to 
bringing those costs under control by rooting out the inefficiencies in 
the system and doing a lot of the things I have just talked about.
  I look forward with great gusto to tackling what is one of the most 
enormous problems facing us. I look forward to sharing my thoughts with 
the Senate later in the week about GEN Charlie Bolden to be the next 
head of the National Aeronautics and Space Administration.
  Madam President, I yield the floor, and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ALEXANDER. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ALEXANDER. Madam President, I ask unanimous consent to speak as 
in morning business for up to 15 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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