[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Senate]
[Pages 14178-14179]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. SANDERS. Mr. President, let me be very clear. Our health care 
system is disintegrating. Today, 46 million Americans have no health 
insurance and even more are underinsured with high deductibles and 
copayments. At a time when 60 million people, including many with 
insurance, do not have access to a doctor of their own, over 18,000 
Americans die every year from preventable illnesses because they do not 
get the medical care they should. This is six times the number of 
people who died at the tragedy of 9/11, but this occurs every single 
year, year after year. In the midst of this horrendous lack of 
coverage, the United States spends far more per capita on health care 
than any other Nation, and health care costs continue to soar. At $2.4 
trillion and 18 percent of our GDP, the skyrocketing cost of health 
care in this country is unsustainable, both from a personal and 
macroeconomic perspective.
  At the individual level, the average American spends about $7,900 per 
year on health care--$7,900 per individual every year. Despite that 
huge outlay, a recent study found that medical problems contributed to 
62 percent of all bankruptcies in 2007. From a business perspective, 
General Motors spends more on health care per automobile than on 
steel--more on health care than on steel--while small business owners 
are forced to divert hard-earned profits into health coverage for their 
employees rather than new business investments. Because of rising 
health care costs, many businesses are cutting back drastically on 
their level of health care coverage or they are doing away with it 
entirely.
  Further, despite the fact that we spend almost twice as much per 
person on health care as any other Nation, our health care outcomes lag 
behind many other countries. We get poor value for what we spend. 
According to the World Health Organization, the United States ranks 
37th--37th--in terms of health system performance, and we are far 
behind many other countries in terms of such important indices as 
infant mortality, life expectancy, and preventable deaths. In other 
words, we are spending huge amounts of money, but what we are getting 
for that investment does not compare well to many other countries that 
spend a lot less than we do.
  As the health care debate heats up in Washington, we as a nation have 
to answer two fundamental questions.
  First, should all Americans be entitled to health care as a right and 
not a privilege? That is the way every other major country treats 
health care and the way we respond to such other basic needs as 
education, police, and fire protection. One hundred or more years ago, 
this country decided that every young person, regardless of income, is 
going to get a primary and secondary

[[Page 14179]]

education because that is the right thing to do and good for the 
country. But unlike every other major industrialized Nation, we have 
not come to that same conclusion that health care is a right.
  Second, if we are to provide quality health care to all, the next 
question is, how do we accomplish that in the most cost-effective way 
possible? We can provide health care to all people in a lot of ways, 
but some of those ways will essentially bankrupt this country. What is 
the most cost-effective way to provide quality health care to every 
man, woman, and child in this country?
  In terms of the first question I asked: Should all Americans be 
entitled to health care as a right, I think the answer to that question 
is pretty clear and is, in fact, one of the reasons Barack Obama was 
elected President of the United States. Most Americans do believe all 
of us should have health care coverage and that nobody should be left 
out of the system. The real debate is how we accomplish that goal in an 
affordable and sustainable way. In that regard, I think the evidence is 
overwhelming that we must end the private insurance company domination 
of health care in our country and move toward a publicly funded, 
single-payer, Medicare-for-all approach.
  Our current private health insurance system is the most costly, 
wasteful, complicated, and bureaucratic in the world. Its function is 
not to provide quality health care for all of our people but to make 
huge profits for the people who own the companies. That is what private 
health insurance is about. With thousands of different health benefit 
programs designed to maximize profits, private health insurance 
companies spend an incredible 30 percent of each health care dollar on 
administration and billing. Thirty cents of every dollar is not going 
to doctors, nurses, medicine, medical personnel; it is going to 
bureaucracy and administration. Included in that spending are not only 
general administration and billing but exorbitant CEO compensation 
packages, advertising, lobbying, and campaign contributions. Public 
programs such as Medicare, Medicaid, and the VA are administered for 
far less money.
  In recent years, while we have experienced an acute shortage of 
primary health care doctors as well as nurses, as well as dentists, and 
many other health care personnel, we are paying for a huge increase in 
health care bureaucrats and bill collectors. Over the last three 
decades, the number of administrative personnel has grown by 25 times 
the number of physicians. Instead of investing in primary health care, 
instead of investing in doctors, instead of addressing the nursing 
shortage, where our health care dollars are going is to health 
insurance bureaucrats who spend half their lives on the telephone 
telling us we are not covered for the procedures we thought we had paid 
for. That is a dumb way to spend health care dollars.
  Further, and not surprisingly, while health care costs are soaring, 
so are the profits of private health insurance companies. From 2003 to 
2007, the combined profits of the Nation's major health insurance 
companies increased by 170 percent. Health care costs are soaring; 
people can't afford health insurance. Yet the profits of the private 
health insurance companies have gone up by 170 percent from 2003 to 
2007. While more and more Americans are losing their jobs and their 
health insurance, the top executives in the industry are receiving 
lavish compensation packages. It is not just William McGuire, the 
former head of United Health, who several years ago accumulated stock 
options worth an estimated $1.6 billion, or CIGNA CEO Edward Hanway, 
who made more than $120 million in the last 5 years. It is not just 
them. It is the reality that CEO compensation for the top seven health 
insurance companies now averages $14.2 million. Forty-six million 
Americans have no health insurance, more are underinsured, and we 
apparently have the money to pay exorbitant compensation packages to 
the heads of private health insurance companies.
  Moving toward a national health insurance program, which provides 
cost-effective, universal, comprehensive, and quality health care for 
all, will not be easy. That is an understatement. It will not be easy. 
The powerful special interests, the insurance companies, the drug 
companies, and the medical equipment suppliers, among others, will wage 
an all-out fight to make sure we maintain the current system which 
enables them to make billions and billions of dollars every year in 
profits.
  In recent years, these special interests have spent hundreds of 
millions of dollars on lobbying, on campaign contributions, and 
advertising, and with unlimited resources. They can make out a check as 
big as they need. They will continue to spend as much as they need in 
order to preserve this dysfunctional health care system from which they 
profit so much.
  But at the end of the day, as difficult as it may be, the fight for a 
national health care program will prevail. Like the civil rights 
movement, the struggle for women's rights, and other grassroots 
efforts, justice in this country is often delayed, but it will not be 
denied. We shall overcome.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. FEINSTEIN. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER (Mrs. Hagan). Without objection, it is so 
ordered.
  Mrs. FEINSTEIN. Madam President, I ask to speak in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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