[Congressional Record (Bound Edition), Volume 155 (2009), Part 10]
[House]
[Pages 14084-14090]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        THE PROGRESSIVE MESSAGE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Minnesota (Mr. Ellison) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. ELLISON. Good evening, Mr. Speaker. I'm about to grab some boards 
but I will claim the hour, and we'll get started.
  Well, Mr. Speaker, welcome to the progressive message. This is the 
hour that the Progressive Caucus comes forward to offer a progressive 
vision for America where we put down markers, and we signal to the 
American people that there is a progressive vision, there is a way 
forward, and that way forward does include principles like generosity, 
like inclusion, like vision, like openness, like fairness, like 
sharing, not a vision of fear, not a vision as, Oh, my goodness, what's 
going to happen, we have to throw someone off the bus, but a vision of 
saying, You know what, we can include people, we can have peace, we can 
have a society where people are treated equally and fairly.
  In fact, a few weeks ago we had a Special Order where the premise 
was, why the progressives? And we detailed how important it was to take 
note of the great contributions that progressives have made to America.
  So, with that, I just want to introduce the wonderful array of 
leaders we have with us tonight, and I have to start with the co-chair 
of the Progressive Caucus, the person who's given more 5-minute 
speeches than anybody ever on the issue of peace, including Iraq but 
not limited to Iraq, also Afghanistan, demilitarization, the whole 
nine, none other than our own co-Chair Lynn Woolsey, and I yield to the 
gentlelady from California.
  Ms. WOOLSEY. Thank you very much, and I thank you again for your 
progressive hour. Every week, the progressive hour is a gift to every 
person that watches us and wants to know what we stand for.
  And we have two new women with us tonight. So we've all heard from me 
a lot, and I'm going to stand here and be part of the dialogue, but I 
think Mazie Hirono and Congresswoman Jan Schakowsky bring something 
that is new and fresh tonight.
  Mr. ELLISON. Who do you want to yield to?
  Ms. WOOLSEY. For me to yield? I will yield to Congresswoman Hirono 
from Hawaii.
  Ms. HIRONO. Thank you very much. We are going to be focusing on 
health care tonight for this hour, and I just wanted to share with all 
of you a little bit of my background because I know what it's like not 
to have health care.
  I came to this country as an immigrant. My mother brought me and my 
brothers to Hawaii, lucky me, and raised us as a single parent. We 
didn't have much, and she worked for many years in a job that did not 
have any benefit, no vacation, no health care, and I remember growing 
up that my greatest fear was that my mother would get sick, and if she 
did, she wouldn't be able to go to work, and if she didn't go to work, 
there literally would not be money for food or rent.
  So, today, in our country over 45 million people have no health 
insurance. I know what that's like. Our current system does not serve 
these millions of people, nor does our current system serve those who 
have health insurance because of rising costs which have not kept up 
with wages.
  Our current system also does not serve our businesses well, where 
employer-based health insurance premiums have nearly doubled since 2000 
and continue to rise.
  We're spending in this country over $2 trillion annually on health 
care with no one happy, certainly not 45-plus million people without 
any insurance, certainly not the business community, certainly not 
those people who literally, many of them, in fact, many individuals who 
file for bankruptcy in our country do so because of catastrophic health 
problems and costs.
  And our current system is spending almost 16 percent to 18 percent of 
the gross domestic product on health insurance, and yet with this kind 
of expenditure are we getting the kind of results that you would expect 
for each of us, spending something like $67,000 a year on health care? 
No.
  American children are two times as likely to die by the age of five 
as children in Portugal, Spain, or Slovenia. Pretty amazing, isn't it?
  Ms. WOOLSEY. It is an embarrassment.

                              {time}  2130

  Ms. HIRONO. It is. Did I mention the costs go up and up and up? 
There's no end in sight, frankly, to rely upon the private health 
insurance carriers to resolve this problem which has been with us. 
Remember, when I came here and my mother didn't have health insurance, 
it was a number of decades ago. I won't tell you how many, but the 
problems remain.
  And this is why the Progressive Caucus is very much focused as we 
focus on reducing costs and maintaining access and choice for doctors 
and health care plans and really focusing on affordable quality health 
care, that we want to have a public option, a public option to give the 
people of our country a choice as to whether or not, if they have their 
current private carrier insurance and they're happy with it, they can 
stay with that. But for those who want to have another option, who want 
to see competition in the health insurance market through a public 
option, that's what the Progressive Caucus wants to see.
  This is why so many people from all across the country are supporting 
health care reform. It's not just top down. We have all been having 
reforms all across the country, in my own State, and I can talk about 
that a little bit more. I think I have been sort of hogging the time, 
so why don't I send it over, if you don't mind.
  Mr. ELLISON. Will the gentlelady yield back? Let me just say the 
gentlelady is right. Thank you for kicking off our subject tonight of 
health care. You did a fabulous job. None of us are surprised, because 
you always do.
  But let's get one of our great champions from the great State of 
Illinois, a fighter for justice from Chicago. Let's say that Jan 
Schakowsky has been a dedicated advocate for people for many years in 
her work, not just in Congress, but before that when she was a social 
worker.
  Ms. SCHAKOWSKY. Actually, I was a community organizer from Chicago.
  Mr. ELLISON. This public option, Congresswoman Schakowsky, do you 
have any views on it you would like to share before you launch into 
some prepared remarks you might have?
  Ms. SCHAKOWSKY. No. I have had people come into my offices--I'm sure

[[Page 14085]]

you have too--day in and day out and talk about how they're so scared. 
They can't get the health care they need. They have a child with a 
disability or a spouse who's lost his job and lost his health care. And 
also people come in and say, you know, I'm 63 years old. I hope I can 
live another 2 years so I can get Medicare, a government-provided 
health care for our seniors and for persons with disabilities.
  We know that Medicare is one of the most successful programs that we 
have had. It's something that passed in 1965 and lifted the burden of 
health care costs off of the most vulnerable people, our elderly and 
persons with disabilities. This is something that I think many young 
people are jealous of, wish they had this government-provided health 
care program that is really a universal program for people over 65 and 
persons with disabilities.
  Well, now we have an opportunity, something I have been working and 
waiting for all of my adult life, that we're going to have a health 
care program for all Americans. And what is it going to look like?
  It's going to give Americans a choice. If they like what they have, 
they can keep it. Nobody has to worry about anything being taken away 
from them that they like. But if they don't want to go back to a 
private insurance company and want something that we know is reliable 
because we have done it with Medicare and the Veterans' Administration, 
they can choose a public health insurance option.
  The good news about that is not only will it be there to provide the 
package of benefits that they want, but it's also going to be something 
that's really going to save money and make the private insurance 
industry have to compete with that and make them even better.
  Let me just read from a letter that the President of the United 
States, Barack Obama, from my home State, a former community organizer, 
sent yesterday to the chairman of the Senate Finance Committee, Max 
Baucus, and the chairman of the Senate Health, Education, Labor and 
Pensions Committee, Senator Edward Kennedy.
  He wrote, ``I strongly believe that Americans should have the choice 
of a public health insurance option operating alongside private plans. 
This will give them a better range of choices, make the health care 
market more competitive, and keep insurance companies honest.''
  The other thing he could have said is that it's also going to save us 
money by helping to reduce the costs all around for health care. In 
fact, there's been estimates that over 10 years about $3 trillion can 
be saved because there will be this choice of this health care option. 
And it is about time that the United States joined the rest of the 
industrial world and said, Yes, our people are going to get the health 
care they need, that it's going to be a right and not just a privilege 
for those who can afford it.
  Let me just tell a couple of stories before I yield back, quick ones. 
The other day, a friend of mine proudly showed me a picture of her 
daughter that just had a baby in the hospital, a darling picture of 
mother and baby and mom holding the baby in one arm and a cell phone in 
the other.
  I said, Isn't that adorable? She must be calling friends and family 
and telling about the birth of this beautiful baby. And my friend said, 
Oh, no. She was on the phone with her insurance company right after the 
birth of the baby to make sure that things are covered.
  You know, there are lots of insurance policies, private insurance 
policies, that don't cover maternity care. People sometimes aren't 
aware of that until they have a baby.
  The other is I met a farmer about a month ago who told me he and his 
family had a $10,000 dollar deductible policy. Now, this man is 
included when we count who is insured in the United States of America, 
but the truth of the matter is this family isn't insured for most 
things. Unless something horrible happens, a terrible, catastrophic 
accident on the farm, for everyday health care they are absolutely 
uninsured, paying out-of-pocket costs.
  So, Congresswoman Hirono, you talked about the 47 million uninsured. 
Over half of all Americans last year reported that they had to forego 
or postpone some health procedure or prescription drug that they 
needed. And so we know it goes way beyond those who are uninsured into 
most Americans.
  And now I got a new report today; 60 percent of all personal 
bankruptcies are due to health costs, and 75 percent of those people 
have insurance, so-called. That is, until they get sick.
  Mr. ELLISON. Will the gentlelady yield back?
  Ms. SCHAKOWSKY. Absolutely.
  Mr. ELLISON. By the way, ask anybody to yield whenever you want them 
to. We will just toss the ball around kind of quick.
  But you made a point that made me, like, leap to my feet. I just want 
to draw attention to this chart. Medical bills underlie 60 percent--I 
think, Congresswoman, that's the point you were making--of the U.S. 
bankruptcies. This is according to a recent study, Washington Reuters. 
Medical bills are involved in more than 60 percent of U.S. personal 
bankruptcies, an increase of 50 percent in just 6 years.
  Now, we've had certain kind of folks running this place over the last 
6 years, right?
  Anyway, the U.S. researchers reported on Thursday that more than 75 
percent of these bankrupt families had health insurance--another point 
that Congresswoman Schakowsky just made--but were still overwhelmed by 
their medical debts, the team at Harvard Law School, Harvard Medical 
School, and Ohio University reported in the American Journal of 
Medicine, a very, very reputable institution.
  This is a quote from the study. ``Using a conservative definition, 
62.1 percent of all bankruptcies in 2007 were medical. Ninety-two 
percent of these medical debtors had medical debts over $5,000 or 10 
percent of their pretax family income,'' the researchers wrote.
  Another startling quote, ``Most medical debtors were well educated, 
owned homes, and had middle class occupations.''
  Now, that's pretty serious. I just want to just ask one of the three 
of you, do any of you have any reactions to this startling study?
  I yield to the gentlelady from California, Cochairwoman Woolsey.
  Ms. WOOLSEY. Well, you're actually telling my story. I think we all 
remember that. I've said it so many times to all of you.
  Mr. ELLISON. We never get tired of it.
  Ms. WOOLSEY. It was 40 years ago and my children were 1, 3, and 5 
years old, and their father was emotionally ill and just abandoned us. 
I went to work. And I was like the 45 million people that are uninsured 
in this country right now; 85 percent of them are working. I mean, 
imagine that. So we can't depend on employers to provide all of the 
health care.
  Well, I was working, too, and it was going to be months before I was 
eligible for health care. And certainly my husband's health care didn't 
cover us anymore.
  And I want to tell you, I would wake up in the middle of the night 
and sit straight up and think what if one of my children got sick, what 
would I do. I mean, it would just overwhelm me.
  Now, they were too young to worry about what would happen if I got 
sick, but I never thought I would, so I didn't even worry about that. 
But I had two boys and a little girl, and the boys were always breaking 
something, their arms. They played ball and they were rough and tough. 
They didn't dare do any of that while we were uninsured because I had 
no way to pay for it.
  I was working. I was on welfare. But because of getting public 
assistance, then we were eligible for Medicaid, Medi-Cal in California. 
Then I stopped waking up in the middle of the night, frightened, so 
that I would have no breath because what if one of my children got 
sick, what was I going to do.
  So if you wonder why--first of all, I would really support a single-
payer system, and I will support nothing less than a good, robust 
public plan and a choice for every single American, even if they're 
covered by their employer. I want them to have that choice of no,

[[Page 14086]]

I'd really rather go on this public plan because it's going to be good.
  When we say ``robust''--I mean, we have talked about what does 
``robust'' mean. Of course, it's quality care and it's accessible and 
it has benefits, comprehensive benefits, from prevention all the way 
through long-term care, so there's a way of meeting the needs of every 
single American.
  Now, somebody who chooses their private plan, that's perfectly all 
right, but they get to have that choice. If they don't want their 
private plan, they have the choice of the public plan, and we're 
working on that.
  We are really appreciative of this letter from the President today. 
And Senator Kennedy is putting a lot of spirit behind a good, robust 
public plan.
  But the Progressives are defining what that means. We're not going to 
leave it up to somebody else to decide for us that this is robust 
enough because we think--there's 80 of us in the Progressive Caucus and 
we have a big voice and this is very important to every single 
American.
  Mr. ELLISON. If the gentlelady yields back, I would just encourage 
Congresswomen Schakowsky or Hirono, would you care to respond to the 
recent study? I think Congresswoman Schakowsky already made a few 
comments on it.
  Ms. HIRONO. Will the gentleman yield?
  Mr. ELLISON. I will certainly yield.
  Ms. HIRONO. I also mentioned the fact that so many of our working 
families who file for bankruptcy do so because of catastrophic medical 
expenses. And in a country that is spending $2 trillion a year on 
medical care and 45 million-plus people not insured, it's astounding 
that we continue this system, which obviously is not working for people 
who are working, middle class families, for businesses.
  We have to do something. And the great thing is that we have an 
opportunity now, looking at all of this data, to come together to make 
some changes. For the first time, we have this wonderful opportunity, 
in over 15 years, to make some changes to the system that is not 
working for anybody, really.
  Mr. ELLISON. Would the gentlelady yield for just a quick moment?
  Ms. HIRONO. Yes, I'll yield.
  Mr. ELLISON. Now, according to this study, it shocked me a little 
bit, Congresswoman, because I was under the impression that only people 
that were struggling in poverty--and the Progressive Caucus is all 
about fighting for people who are dealing with poverty, but I was under 
the impression this is just poor folks' problem. But this study seems 
to say something else.

                              {time}  2145

  I mean, what about this fact here? The medical debtors were well-
educated, owned homes and had middle class occupations.
  I would yield back to the gentlelady. Is this not a middle class 
problem?
  Ms. HIRONO. It just points out how broken this health care system is 
when people who are working, when people who are educated and when 
people who have good jobs cannot afford their health care. So, again, 
it points out that there are things we need to do.
  In fact, I had mentioned earlier in my remarks that many of us have 
been having health care forums in our communities. I had one in my 
community last week on the big island of Hawaii, and we had 
representatives from the hospitals, from the medical profession and 
from the dean of our medical school. While this whole health care issue 
is very complicated, certain common themes came out.
  First of all, of course, is the recognition that the cost is 
astronomical and that there is no end in sight. In terms of what we can 
do, I was really interested to know that there was this focus on 
prevention, on primary care. These are two areas that our current 
system does not reward, that it does not pay attention to, so we've got 
this topsy-turvy kind of a system where we're actually paying a lot of 
money for quantity, not quality, because if you really cared about 
saving cost--just focusing on the cost of health care for a moment--we 
would be spending a lot more on prevention so that people wouldn't have 
to go for long periods of time until their illnesses would be 
exacerbated and then they would have to go to the emergency rooms or 
wherever they would have to go to get much more expensive care. So 
prevention is really important, but our current system does not really 
pay attention to prevention.
  Also, if we had more emphasis and support for primary care providers, 
it would be the same thing. We would probably save billions and 
billions of dollars every year by enabling people to see their primary 
care providers. Of course, we know that we don't have as many primary 
care physicians and nurse practitioners and others as we need; but if 
we spent more time on the primary care side, then we would avoid some 
of these really expensive kinds of treatments later on. So this system 
is very topsy-turvy.
  I yield back.
  Mr. ELLISON. I thank the gentlelady for yielding back.
  Let me open the floor back up to Congresswoman Schakowsky. If you 
don't mind, I just want to pose to you a question. We have a Web site 
called www.progressivecongress.org. These are folks who want to talk to 
us, right? They posed a question. The question was: Doesn't employer-
funded health care help to make American business less competitive 
globally?
  Would you like to respond to this question?
  Ms. SCHAKOWSKY. Absolutely.
  If you think about the cost of an automobile, which a lot of people 
do think about--and we certainly want to encourage people to buy 
American cars, but there is now more cost for health care than there is 
for the steel in that car. That's how much it is.
  Now, when you want to sell your cars around the world and be 
competitive and when you're competing against countries in which they 
have a national health care system and where they control their costs 
of health care, then it's pretty hard to do when employers are facing 
these double-digit rising costs in health insurance every year for 
their employees, those employers who are good enough to provide it or 
who have negotiated with their workers to provide health care benefits.
  So, clearly, we have to find a way to get these health care costs 
under control. One of the best ways to do that is to have an efficient 
and quality public plan, and that's one of the reasons it's so 
important. Not only is the quality going to be great, but there will be 
cost-effectiveness.
  I see you've got a chart about the administrative costs of health 
care. What we know is that, of all of these public plans that we have--
Medicare, Medicaid, Veterans Administration--the administrative costs 
are very low compared to the private insurance companies.
  As a progressive and as a community organizer--and still having that 
mindset--one of the things that we do as progressives is to engage 
grass-roots support.
  Mr. ELLISON. Yes.
  Ms. SCHAKOWSKY. That is one of the great things about our Web site, 
too, is that they can talk directly to us.
  Let's face it: as we push for comprehensive health care for all 
Americans, the people who are profiting from the system as it is are 
going to be out there pushing against us. Mainly, we're going to find 
that the insurance industry is fighting tooth and nail in having to 
compete against a public plan. They're out there now and are saying 
that it's unfair and that it's not right that they should have to 
compete. Come on. They have had the market to themselves for all of 
these years, and here we are right now with a crisis in our country in 
health care.
  When people think about the economy, lots of times what they're 
thinking about is health care. If they lose their jobs, what are they 
thinking about? Health care. If they had employer plans, they don't 
have them now. So what we have to do is organize. We have to mobilize. 
We have to have people out there demanding the kind of plan that's 
going to help their families, that makes sure that they can get the 
preventative care that they need and

[[Page 14087]]

that they can take their kids to the doctor. They don't have to go to 
an emergency room and wait until the last minute until there is a 
really serious illness before they get any kind of help.
  So I think one of the things that the Progressive Caucus can do is to 
go out and help mobilize people around the country to get behind a plan 
that does have a robust public health insurance option in it, too, 
because without that, you'd better believe that we're going to see the 
lobbyists from the insurance companies and probably from the 
pharmaceutical companies, like on the Medicare part D fiasco. So we 
want to create a partnership in the Progressive Caucus with Americans 
who want real change in health care.
  Ms. WOOLSEY. If the gentlelady will yield.
  Ms. SCHAKOWSKY. Absolutely.
  Ms. WOOLSEY. Well, do you remember Harry and Louise in 1994 when the 
Clintons were proposing a national health care plan? The insurance 
companies got behind this ad about a couple, an ad that cost millions 
of dollars. It was talking about how bad this health care plan would be 
for America. Well, the insurance companies had enough industry and had 
enough funds to play that ad over and over and over. Also, the Clinton 
plan was much too complicated. Nobody could explain it to anybody. It 
never got all the way to being finished in the first place. Do you know 
what? People would not be bullied by that kind of ad now.
  Mr. ELLISON. Right.
  Ms. WOOLSEY. They absolutely have gone through enough fear of losing 
their own insurance, if they have it and if they're employed. They pay 
more and get less every year for what is offered, and they never know 
if it's going to be there the next year.
  Those are the people who were saying: No, don't fool around with my 
insurance coverage. It's good. I've got mine.
  Then there were the seniors, retired folks: Well, I have my 
retirement. It's good. I'm really worried.
  Then Harry and Louise scared them to death that we were going to take 
it away from them.
  Ms. SCHAKOWSKY. You know, we're still hearing those same arguments 
against the public health insurance option. They're saying: Do you want 
the government standing between you and your doctor? Do you want the 
government telling you when you can go to the doctor?
  That's just baloney.
  Ms. WOOLSEY. Well, they're lies.
  Ms. SCHAKOWSKY. It's absolutely baloney.
  Ms. WOOLSEY. I truly believe that they are not going to pull the wool 
over the eyes of the majority of Americans. Doctors come to me or call 
me or stop me, and they say: Look, I was really against the Clinton 
plan because I was afraid of what I might lose.
  One of my favorite doctor friends tells me that he would much rather 
deal with Medicare than with the insurance companies, point blank.
  Mr. ELLISON. Right.
  Ms. WOOLSEY. He said that they're not perfect, but that they're way 
better to deal with.
  So I think that there is going to be a whole different set of 
supporters for this when we get it down and out and when we let people 
know exactly what it is.
  Ms. SCHAKOWSKY. Let me just say one thing.
  Senator Whitehouse said that this is not a Harry and Louise moment; 
this is a Thelma and Louise moment. You'll remember in the movie that 
they were driving toward a cliff. Actually, as the President pointed 
out when he said it, they fell off the cliff . We don't want to drive 
off a cliff, but that's where we're heading right now in this country 
with health care. The kind of plan that gives the choice to Americans 
and that allows all Americans to be covered will keep us from falling 
off the cliff and more. It will make our society much more healthy.
  Mr. ELLISON. That's a very important point.
  Let me yield to the gentlelady from Hawaii.
  Congresswoman Hirono, you had talked about the forums that you've had 
and that others have had, and that makes me kind of think about what 
Congresswomen Schakowsky and Woolsey are talking about in terms of 
organizing people.
  What kind of coalitions do you see gathering at these forums? Are 
these folks who you didn't expect to see working together in the past 
but now maybe are?
  I yield to the gentlelady.
  Ms. HIRONO. Thank you for yielding.
  That's the thing. This system is so broken that you've got people 
from all segments. You have Republicans and Democrats. You have 
doctors, nurses, hospitals, and providers.
  Mr. ELLISON. Businesses. Small businesses.
  Ms. HIRONO. Small businesses. You have them all coming in, saying: 
Let's really fix this. Let's identify the problem and let's fix it.
  In our country, we like competition, but I don't think anybody could 
really say that there is competition going on among the private health 
insurance carriers. It's all very complicated. Jan talked about how, if 
you don't read the fine print, you don't even know if you're not 
covered for something that you think you're covered for. So it's all 
very nontransparent.
  That's why the Progressive Caucus is supporting a public insurance 
option that is accountable and that is transparent. Believe me, those 
two adjectives do not apply to the private insurance carriers, because 
insurance is traditionally regulated, or in a manner of speaking, very 
little regulation actually occurs at the State level. I'll use Hawaii 
as an example.
  The State of Hawaii regulates the rates for automobile insurance 
because Hawaii is a ``no fault'' State. The State regulates the rates 
for workers' compensation. I would say most States regulate workers' 
compensation insurance rates, but there is no rate regulation, and 
there is no review of the rates that private insurance health care 
carriers charge. In fact, most States, I would venture to say, don't 
even require any kind of information from their private insurance 
carriers. That is why there is no competition.
  As Americans, we like competition. We want to see competition between 
a transparent, accountable public insurance option and a private 
option. Believe me, if people like their private options, or their 
private carriers, then that's what it is. It's a choice, and they can 
keep it. If they are satisfied, they ought to be able to keep it.
  Mr. ELLISON. If the gentlelady would yield back, I want to ask a 
question of you, if I may. The question is: What do you think Americans 
say on this poll question: Do you think it is the responsibility of the 
Federal Government to make sure that all Americans have health care 
coverage or is it not the responsibility of the Federal Government?
  Does anybody want to venture a guess on what most Americans say?
  Ms. WOOLSEY. I think the Federal Government is responsible.
  Mr. ELLISON. What do you think most Americans say?
  Ms. WOOLSEY. I think they say the Federal Government is responsible.
  Mr. ELLISON. You're right. Sixty-four percent of Americans said it 
is. Thirty-three said it's not. I think most people running for office 
would like to have those kinds of numbers.
  Could I ask another question for anybody?
  Ms. WOOLSEY. Sure.
  Mr. ELLISON. Here is another poll question:
  Which comes closest to your view, that the United States should 
continue the current health care insurance program in which most people 
get their health insurance from their private employers but some people 
have no insurance? That's one option. Two: The United States should 
adopt a universal health insurance program in which everyone is covered 
under the program, like Medicare, that is run by the government and 
financed by taxpayers?
  Which one do you think Americans chose and what percentage?
  Congresswoman Schakowsky.

                              {time}  2200

  Ms. SCHAKOWSKY. I don't know the exact number. I am not going to make

[[Page 14088]]

a guess. But I think it's overwhelming that people feel that the 
government needs to be a player here in providing health care.
  Ms. WOOLSEY. Well, Keith, when one in every three Americans under the 
age of 65 was uninsured at some point in 2007 and 2008--imagine, every 
one of those people knows that they weren't being taken care of, that 
they needed something that was not available to them.
  Ms. SCHAKOWSKY. So what's the answer? How many?
  Mr. ELLISON. Well, the answer is, when it says, which comes closest 
to your view, 65 percent said the United States should have a universal 
health insurance program under which everyone is covered, and only 33 
percent said no. And as I said, there's not one person in this body who 
wouldn't feel pretty good about those numbers. I know some people win 
by a higher percentage than that, but 65 percent is pretty good for 
anything. Overwhelming, as you said. So that leads me to a question 
that I want to offer to all three of you. Do Americans want the change 
that we're talking about? Or is a public option some kind of a lefty, 
far-out-there viewpoint that doesn't have any support?
  Congresswoman Hirono, do you have any points of view on this?
  Ms. HIRONO. I think that when the American public finds out what 
we're talking about with a public option that they will support it 
because it's choice. Nobody is forcing anything down anyone's throat. 
So when the American public receives accurate information, as opposed 
to being scared to death, I think they know what the appropriate 
answers are. That's part of what we need to do here. That's what we're 
doing tonight, to talk about these options that we have to talk about, 
what kind of focus we should have in terms of how we're going to use 
our health care dollars: Are we going to use it for prevention? Are we 
going to use it for primary care? Are we going to make those kinds of 
decisions with regard to how we spend $2 trillion every year? We hope 
we can reduce that. But with accurate information, I think the American 
public is perfectly able to make the correct decisions or appropriate 
decisions.
  Ms. SCHAKOWSKY. I was on FOX News not too long ago, and they said, 
Well, how do you know that the government is going to be able to really 
provide health care and it's not going to just be another big expensive 
bureaucracy? I said, Well, you know, we don't have to guess about it. 
We can just take a look at the record of the provision of health care. 
It's not just the low overhead cost. You go into a room of older 
Americans, 65 and older--and I am proud now to have my Medicare card. I 
just got it last week--and you say, Republicans or Democrats, do you 
think that we should just get rid of Medicare and send you out into the 
private market--actually, that's what we did with the prescription drug 
program--and there isn't going to be a person in that room who would 
support that kind of idea. I mean, people are longing to get old 
enough, hoping to make it until they get on Medicare because it really 
is a very effective program. Could it be better? It could be even 
better. We could have a Medicare prescription drug plan, and that would 
be a whole lot better than a private plan.
  Ms. HIRONO. When you talk about the people who are already being 
covered by Medicare or are about to get there, the fact of the matter 
is that our country is a rapidly aging country; and, in fact, Hawaii 
has one of the fastest aging populations in the entire country. So the 
issue of health care coverage and how we're going to do it is very much 
on people's minds. When you talk about, how are people supposed to take 
care of their long-term care needs, that is a huge, huge concern in our 
country.
  So what we should be also talking about is, how are we going to help 
our elders age in place as opposed to having to be institutionalized 
where the costs are so much greater? There are just so many choices 
that we can be making that truly enables the people of our country to 
sleep soundly at night, knowing their needs are being met.
  Ms. WOOLSEY. One of the things we are going to hear, and we're 
already hearing is, Well, we can't make the insurance companies compete 
with a public plan. It won't be fair to the insurance companies. Well, 
excuse me. The insurance companies have a huge marketing budget. They 
have an overhead that's so much more than the public Medicare program.
  Ms. SCHAKOWSKY. I've heard their CEOs get paid pretty well, too.
  Ms. WOOLSEY. Oh, and their CEOs get paid so much. If they can't 
compete with a public plan, oh, too bad. They'll either, you know, plus 
up and get better and only pay their CEOs so much or more people will 
go on the public plan. And if we have a good public plan, over the 
years--and I don't know how long it will be--it can lead to a single 
universal coverage.
  Ms. SCHAKOWSKY. What we're going to have is an exchange that will 
allow for all these different choices for Americans. But let's face it, 
even the private companies now are going to have to play by different 
rules. For example, pre-existing conditions are not going to be a 
reason to exclude anyone on public or private plans any longer. There 
will be some defined benefits that have to be covered so you don't find 
out when you get sick that, Uh-oh, this wasn't covered, and we thought 
it was.
  Congresswoman Hirono, you talked about transparency and all of this 
whole industry of health care, which it really is in this country now, 
is going to be much more family-friendly, people-friendly, where you 
can understand actually what you're getting, and then you can decide 
what you want.
  Mr. ELLISON. Can I just ask the question here, what is wrong--and I 
think as progressives we do have to address this question--with just 
having single payer? Let me just say, 2,275 people wanted to know that. 
That was from www.progressivecongress.org.
  Ms. WOOLSEY. If the gentleman will yield to me, in 1993 I was 
actually a freshman, my first month, just sworn in to this House of 
Representatives. I was the first freshman to sign on to the single 
payer bill. Jim McDermott was then the author. I have been a single 
payer supporter. I would be so happy if we could move into single 
payer. The arguments I hear make some sense that by disrupting 
everything right now at once would be more harmful than putting 
together a plan that can get to the single payer. But I can tell you in 
my district--and I represent Marin and Sonoma Counties, probably as 
progressive a district as anyplace in this country--when I say what I 
just said, that we're not pushing for single payer, although the great 
majority, 90 percent of the Progressive Caucus would vote for a single 
payer right now today; but that's not 90 percent of the Congress, House 
and Senate. But when I tell my constituents that, I will tell you, they 
look like they could cry. They are so disappointed in me. I mean, it's 
like, What, you?
  Ms. SCHAKOWSKY. Actually, when you ask the American people if you 
want either all private or all public or a choice of the two, the 
overwhelming response is that people want to have the choice of a 
private or a public. And so what we're doing now is building on what 
people feel comfortable with, and we certainly don't want to have 
people worrying that they're going to lose something that they feel 
pretty good about right now. So I think that the notion of having this 
competition between the two is the kind of plan that can move us 
forward to get everyone covered right now in the United States of 
America. We'll see how this multiplicity of choices actually evolves or 
turns out, or maybe it will be the thing that can last and be 
successful in providing all Americans with health insurance. But we're 
not in the business of scaring people that they're going to lose 
something that they find really works for them. Instead, we're in the 
business of giving people rational, good, quality choices.
  Mr. ELLISON. For the record, I will not vote for any health care that 
does not include a public option. I will not do it. That's a guaranteed 
``no'' vote.

                              {time}  2210

  And I cannot be dissuaded from that. And I also want to say I am a 
dedicated

[[Page 14089]]

single-payer advocate. I am going to continue to raise this issue. I 
have before. But the fact is politics is the art of the possible, and 
we do have the limitation, as the gentlelady from California mentioned, 
of not having 100 percent of all the Congress yet being Progressives. 
And so we have to do what we have to do. And I have absolute faith that 
with the public option along the lines of Medicaid, Medicare, or the 
VA, that it will outcompete what these other guys are doing. And if 
they can't outcompete them, that is fine, but the fact is I believe 
that they will.
  Let me yield to the gentlelady. Do you want to respond to this 
question that 2,275 people asked from www.progressivecongress.org? Do 
you want to answer that question, what is wrong with just having the 
single-payer? Or do you want to pass it?
  Ms. HIRONO. I don't think there is anything wrong with the single-
payer. But as you say, we are dealing with a lot of interests and 
ideas, and as President Obama said, this is a time when all of the 
perspectives ought to be given consideration and due respect. And I 
think that moving this discussion to a consideration of a public 
insurance option is a pretty large step, in my view. And if you add 
that in addition to the promoting of the use of information technology 
for medical records, and there are a number of other things we can do 
to move the ball so that we can get quality medical care for more 
people and have it affordable, I think that what we are talking about 
right now with the public option moves that ball in that direction.
  Mr. ELLISON. We have a progressive America out there, and there are 
certain things they want answered. Another question they had was why do 
insurance companies have so much input into the health care reform 
debate; 1,704 people asked that question. Again, why do insurance 
companies have so much input into the health care reform debate?
  Do any of one of you want to grab that one?
  Ms. WOOLSEY. I will make a stab at it. They are organized. They have 
associations. They have a lot of money, and they will spend that money 
on advertising. They will spend that money on helping Members of 
Congress get elected. And I am not saying that every Member of Congress 
that takes donations from anybody or any industry votes with them, but 
I'm saying--
  Mr. ELLISON. It sure helps.
  Ms. WOOLSEY. This particular industry has wielded a lot of money and 
a lot of power around this Congress, but it is mostly that they have 
been able to choke off the information that the grassroots was not able 
to receive the first time around. That is not going to happen again. We 
are not going to let that happen.
  All the money in the world is not going to be able to close down our 
voices, the thousands of people that are e-mailing us on our 
congress.org, and they know where we are with them and we are going to 
keep this. And the Democrats are with them for the most part. We are 
going to make it happen. The President is with them.
  Mr. ELLISON. If the gentlelady would yield back, I just want to 
remind everybody by saying that, you know, President Obama did say that 
if we were starting a health care system from scratch he would be 
pushing single-payer, but we are not. You have people who have vested 
interests, who have settled expectations, and so if people are 
committed to the plan they have, they can keep that. But there will be 
a public option for people who want to do that, and under no 
circumstances can these insurance companies deny people for preexisting 
conditions and things like that.
  Do you want to take another question?
  Ms. SCHAKOWSKY. Sure.
  Mr. ELLISON. Here is an important question people have. Why can't the 
public have the same insurance that Members of Congress have? And 953 
people wanted to know that.
  Ms. SCHAKOWSKY. Actually, that is exactly what we are talking about, 
making sure that everybody has a plan at least as good as the Members 
of Congress. It can be even better. Our Federal employee benefit plan, 
we have a choice of only private insurance companies that we can pick 
from. I think maybe people think that we have--and I'm certainly not 
complaining. We can pick a good plan, but it is not like Cadillac 
insurance. We pick among a number of different insurance policies, some 
better, some that provide less coverage, depending on how much you want 
to spend.
  But what we will give people is something as good as Congress gets, 
and I think better, if there is this choice of a public option.
  Ms. WOOLSEY. I echo Congresswoman Schakowsky, so I don't have to take 
up your time. So you can ask another question.
  Ms. HIRONO. Ditto for me.
  Mr. ELLISON. I would like to put this one out to you. What is it 
going to take for you--I think they mean us--to wake up and smell the 
catastrophe that profit health care is?
  Ms. SCHAKOWSKY. Let me just say, first of all, I don't know what a 
catastrophe smells like. But I think a lot of people out there are 
getting that whiff of what a wreckage the current so-called--we don't 
really have a health care system. It is kind of a hodgepodge.
  I did want to say, talking about even our Federal plan, between 2007 
and 2008, 14 different insurance plans dropped out of the Federal 
employees plan. And so thousands of Federal employees who have a plan 
like we do had to look for new coverage. And so when you have got a 
public option, it is going to be there. It is not going to go out of 
business and you have to search around for something to replace it.
  Ms. WOOLSEY. Because for senior care, when HMOs took on senior care, 
Medicare Advantage, et cetera, I went to one of my providers in my 
district, and they were telling me about this wonderful plan that was 
very good. And I said, Well, what are you going to do when people start 
using it? And they looked at me like I was just a nut on Earth. And 
guess what? In 2\1/2\ years, when seniors started using the plan that 
they had purchased, this group went out of business, and those seniors 
had to find someplace else in the district because people were using 
the plan.
  Mr. ELLISON. Well, if the gentlelady yields back, it is a lot easier 
to make money when you're just collecting the money as opposed to when 
you actually have to pay it out.
  Ms. SCHAKOWSKY. There are a lot of people who, quite correctly, feel 
as if health insurance is for the healthy, that if you get sick, forget 
it. It is not always there for you. We all know that.
  Mr. ELLISON. The fact is that many insurance companies, I think the 
whole industry identifies when a person goes to a doctor and needs to 
actually use that coverage, they call that a medical loss. They see 
that as a loss to them. That is messing with their money when somebody 
says, Hey, I actually need to use the coverage that I'm paying you an 
arm and a leg for. That is why some of these companies go out of 
business. It is not designed to do that.
  The fact is we talked about how medical expense costs families 
tremendously and also ends up people having to declare bankruptcy so 
often. The fact is that is one side of the coin.
  The other side of the coin is the overwhelming amount of profit that 
the industry makes. And I just want to point out that in an industry 
where you have CEOs making $1.6 billion like Bill McGuire of United 
Health Group made, how can you get that kind of money unless a whole 
lot of people are not getting the health care that they should get? How 
can you have these exorbitant profits that people are turning over and 
still cover everybody? Well, you can't do it. You either have to cut 
people out of coverage, you have to deny claims, and then you can pay 
exorbitant profits. Or you have to actually run a decent system that 
extends coverage, but in that case you don't have people making googobs 
of money, and so you really do have to make a basic and essential 
choice.
  Ms. HIRONO. As I had mentioned earlier, it is generally the States 
regulate, so-called regulate, insurance companies. So most States do 
not have the kind of resources or even the laws that

[[Page 14090]]

allow them to look at what the health care insurance companies are 
doing, how they are basing their cost increases or their premium 
increases. So there really is a lack of transparency and 
accountability. And when you don't have the ability to look at the 
relationship between the rates they are charging and what the claims 
are, how can you even begin to say that people's needs are actually 
being met or that cost containment is actually occurring? You can't.

                              {time}  2220

  You can't.
  Mr. ELLISON. Well, if the gentlelady yields back, let me tell you. 
Cost containment, remember, any time I charge you and you paid me, I 
now made some money, right? I'm not against making money. This is 
America, and we have a free enterprise system. But there is such a 
thing as abuse.
  Let me point out, profits at 10 of the country's largest publicly 
traded health insurance companies rose 428 percent--I'd say that's 
pretty good--from 2000 to 2007. In 2007, alone, the chief executive 
officers at these companies collected a combined total compensation of 
$118.6 million, an average of $11.9 million each. And if it's an 
average, you know some made more and some made less. And the fact is 
that that is 468 times more than the $25,000 a year that an average 
American worker makes. So the fact is, these folks are making 468 times 
more than the average wage of an average worker in the United States. 
And we're wondering why we've got problems. There's no wonder why we 
have problems. That's why we need a universal, single-payer system. But 
if we can't get it now, let's get a system where you keep your 
insurance, and we have a public option.
  Ms. SCHAKOWSKY. You know, we've heard horror stories for years about 
how insurance companies hire people who are essentially told, at least 
on the first ask, just to deny the procedure, to just say no. And there 
was, I remember a very brave doctor who ended up working for an 
insurance company and denying a procedure for somebody who actually 
died. And she came to cleanse her soul, to essentially apologize; left 
that company with enormous amounts of guilt, and said that that's how 
the business operated.
  And what we're trying to create is a health system, a health care 
system, not one that is designed to make anybody a profit. It's to keep 
people healthy. And that's what I've said to an insurance company that 
said, well, you know, how are we going to compete?
  I said, look, the object of this policy discussion is to figure out 
how are we going to provide health care to Americans. The goal, you 
know, if companies can make money doing that and working within the 
system that we prescribe, God bless them. That's what we're heading 
toward right now. But the goal is not to figure out how to maintain 
their high profits when it's done at the expense of the health care of 
millions and millions of Americans. That's the bottom line.
  Ms. WOOLSEY. And if the gentlewoman will yield. Insurers have 
increased premiums 87 percent over the last 6 years. And the premiums 
have doubled in the last 9 years, increasing four times faster than 
wages. So, what for? To pay the high salaries of the CEOs and to hire 
more bean counters.
  Mr. ELLISON. I do have to say, let's get the last one, because we've 
got about 30 seconds to go, and I think Congresswoman Hirono is going 
to get the last word. And this has been the Congressional Progressive 
Caucus, and you're going to take us out.
  Ms. HIRONO. Health care is a right, not a privilege, and everyone in 
our country deserves quality, affordable health care with choice.
  Mr. ELLISON. And I think that pretty much does it. This has been the 
Progressive Caucus with the progressive message, and we'll see you next 
week.

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