[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Senate]
[Pages 14484-14487]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mrs. MURRAY. Earlier this morning and, in fact, for the past several 
days, I have been interested to hear the comments from several of our 
Republican counterparts on the issue of health care. They are talking 
about Canada. Now, that is interesting. I appreciate that. Coming from 
a State close to Canada, we are very interested in what Canada does. 
But the discussion about what Canada does with its health care system 
has no bearing on what we are trying to do here in the Senate and 
Congress to reform the American health care system.
  I guess, and I am only guessing, they want to talk about Canada 
because they do not want to talk about their real priority. Their real 
priority in coming out and inflating a discussion that should not even 
exist because it is not what we are talking about is simply because 
they want to protect the status quo. They want to protect the status 
quo in our health care system today. So they are out here talking about 
Canada. Well, that is not an option.
  Let me tell you what we are doing because this is a very important 
discussion and a very important piece of legislation we are beginning 
our work on in the Senate. The status quo is not acceptable. This is an 
extraordinary moment of opportunity for real reform in health care. We 
here in the Senate are working very hard to come up with legislation 
that will reduce the cost for our families, for our businesses, and for 
our government.
  Like all of my colleagues, I go home every weekend and I hear from 
individual families and people, from community leaders and businesses 
that the status quo is not acceptable. They will not tolerate a debate 
here in the Senate that goes for the status quo.
  We here in the Senate are working on legislation that will protect 
people's choice of doctors, will protect their choice of hospitals, 
will protect their choice of insurance plan. If you like what you have 
today, that will be what you have when this legislation is passed. And 
that is very important. We are also working as a goal to assure that 
affordable, high-quality health care is available for every American. 
That is not the case today. Our work really builds on the existing 
employer-based system we have. We strengthen it. Again, if you like 
what you have, you will be able to keep it. Let me say this again: If 
you like what you have, when our legislation is passed and signed by 
the President, you will be able to keep it. But if you do not like what 
you have today in terms of your health care or if you do not have any 
health care insurance at all, we are going to provide new options for 
you so you have better health care.
  Health care reform is not a luxury, it is an imperative today. Our 
health care system puts far too many Americans into crisis, and 
reforming it is an urgent necessity that demands our immediate 
attention. If we are going to restore the economy and secure our 
Nation's fiscal future, now is the time to make health care more 
affordable for American families and business and government at every 
level. Doing nothing is not an option.
  As we move forward on this debate, I remind all of us, do not be 
distracted by superfluous arguments that do not apply to the bills we 
are discussing.
  The bill on which we are going to move forward in the Senate makes 
sure that if you like what you have today, you are going to be able to 
keep it. But as you and I both know, Mr. President, too many people 
cannot afford their health care today or they are unable to get health 
insurance because their insurance company says: You have too

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many problems, we are not going to insure you, or they do not have 
insurance at all. We want to make sure health care is available to 
every American.
  I am very proud of the effort that is going on as we speak. The 
health care committee is meeting today with our Republican colleagues 
to walk through our ideas we have now been putting together and get 
their input and ask for their options. We hope to work with them side 
by side, and we are giving them every opportunity to do so, because 
health care has to work for all Americans.
  So despite the rhetoric we heard on the floor this morning about 
Canada, which I love--Canada is a great country--that is not what we 
are doing here. We are moving forward on health care reform that is 
drastically needed. The status quo is not an option. Doing nothing is 
not an option. Stopping us from moving forward is not an option. This 
is an issue we are having the courage to take up and move forward on 
because America needs us to do that.
  I yield the floor, and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. DURBIN. I ask unanimous consent that the order for the quorum 
call be rescinded.
  The PRESIDING OFFICER (Mr. Begich). Without objection, it is so 
ordered.
  Mr. DURBIN. I ask unanimous consent to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. Mr. President, we are considering a bill that would allow 
the Food and Drug Administration to regulate one of the most deadly 
substances for sale in America, tobacco, a substance responsible for 
400,000 deaths, more than HIV/AIDs, for example, each year, more deaths 
than illegal drug use, alcohol use, motor vehicle accidents, suicides 
and murders combined, a substance responsible for $100 billion in 
health care costs every single year. I am glad we have finally reached 
this point. I hope we can pass this bill with a strong bipartisan vote. 
This moment has been coming for 20 years. There are Senators who 
deserve credit for where we are today in coming to this moment in 
history, none more than Senator Ted Kennedy. Senator Kennedy has been 
our leader on this issue. Unfortunately, his personal health struggle 
prevents him from joining us regularly, and he may not be here for the 
vote today, but we wouldn't have reached this point without him. His 
dogged determination to reduce the number of tobacco-related deaths and 
illnesses in America has brought us to this moment in history. We will 
be voting with him in mind, as we should.
  I thank Senator Chris Dodd, who once again has stepped in, in an 
extraordinary way, as he did with credit card reform, passing a bill 
that had been decades in the making. Senator Dodd, at the last moment, 
has been called in by Senator Kennedy and has done a spectacular job to 
move this bill forward. I am hoping we can pass it and get it enacted 
into law. It will save lives. But we can't blame tobacco for all the 
faults in our health care system. There are many parts that need to be 
addressed.
  The United States spends about 17 percent of its GDP, gross domestic 
product, on health care. This amounts to $7,400 per person on health 
care each year. We spend more than twice as much as any other country 
on Earth when it comes to health care. As of 2006, health spending in 
the United States was 90 percent higher than any other industrialized 
country. Health insurance premium increases consistently outpace 
inflation and the growth in family earnings. About 30 percent of 
America's poor people spend more than 10 percent of their income on 
health care. Since the beginning of this decade, health insurance 
premiums have gone up by 78 percent. Everybody knows this. No matter 
who one works for--private business, public entity--we know the cost of 
health insurance keeps skyrocketing. Wages have only gone up 15 percent 
in that period. People and families cannot keep up. Overall, 46 million 
Americans have lost their insurance. Many lose their insurance for 
periods during the course of a year because of changing jobs and losing 
jobs.
  With the amount of money our country dedicates to health, the facts 
don't line up. Yesterday my colleague from Arizona, the Senate 
Republican whip, Jon Kyl, spoke about the problems with our health care 
system. I am glad he agreed there are problems to address. I need to 
clarify at least my view as to some of the things he said. Democrats in 
Congress are committed to working with President Obama to ensure that 
Americans can keep the health care they have, if that is their choice. 
Yesterday, Senator Kyl said:

       If you are an employee of a small business, for example, 
     when your insurance contract runs out--and those contracts 
     are usually 1 year or 2 years--the bottom line is, even 
     though you may like it, at the end of the next year, when the 
     contract runs out, you don't get to keep it.

  That is not accurate. I have to say Senator Kyl is saying something 
that doesn't reflect the position of the President, nor any Democrat I 
know in Congress. We believe--and we stand by this--if you like your 
current health insurance plan, you will be able to keep it, plain and 
simple, straightforward.
  Senator Kyl alluded to specific frustrations felt by small business 
owners across the country. Believe me, I understand that issue better 
than some. I have been working with Senator Blanche Lincoln of 
Arkansas, Senator Snowe of Maine, and Senator Klobuchar of Minnesota to 
come up with a plan so small business owners will be able to afford 
health insurance. I am happy to say that, at least at this moment, 
there is an indication the Finance Committee is considering our bill as 
part of their overall work product. As important as keeping your health 
plan, if you like it, if you are a small business owner, you find 
health premiums have increased 200 percent because you had one sick 
employee or one sick baby born to a family of one of your employees, we 
want to make sure you are no longer subject to the unfair practice of 
raising premiums for that situation. In today's system, at the end of 
the contract, small businesses are at the mercy of insurance companies 
that are in it for profit.
  Earlier this week, I talked about a small businessman in Springfield, 
my hometown, who, in a span of just a few years, has seen his insurance 
premiums increase by 500 percent, though he has never turned in a 
claim. He has been forced to change his health care plan repeatedly. 
Because he is a small business owner, he has no bargaining power. What 
we are trying to do is ensure Americans are protected from this kind of 
price increase and that promised services are there when they need 
them.
  My colleagues on the other side of the aisle continue to raise 
tactics of fear and concern to steer us away from the real issues at 
hand. Yesterday the Senator from Arizona talked about ``a new regime of 
regulation for the insurance companies.'' He expressed concern that 
Democrats in Congress are trying to control what health insurance 
companies are doing. If the Senator is talking about trying to take 
under control some of the practices of health insurance companies 
today, I would say it is long overdue. People know what happens when 
their health insurance premiums go up dramatically, even though they 
haven't turned in a claim. Folks know when health insurance companies 
say they are going to exclude preexisting conditions and your health 
insurance policy is virtually worthless because the problems you face 
in life can't then be covered. Folks know what it is to call that 
health insurance company and bargain or argue with some clerk over 
coverage. Changing those things, if that is what regulation is all 
about, is long overdue. It is time that customers, consumers, families, 
and businesses had a fighting chance when it came to health insurance 
companies.
  We will hear plenty of speeches in the Congress in opposition to 
health care reform from a lot of people who are speaking for the health 
insurance companies. Why don't they come up and say it. If they want to 
come to the floor and say: We like the current system; we don't believe 
it needs to be

[[Page 14486]]

changed; we don't believe there is a crisis facing us in terms of cost; 
we believe that health insurance companies are doing a great job and 
shouldn't have to change their ways, let that be their position. But it 
is a position that is indefensible with the vast majority of the 
American people. They understand we should be focusing on the best 
interests of patients and families, not the best interests of health 
insurance companies, nor the best interest of the Federal Government.
  The bottom line is, we have to come up with health care reform which 
starts to reduce the cost of health care, making it more affordable, 
preserving quality, creating incentives for good health care outcomes, 
and focusing on the family and the patient, not on the government 
agency.
  I am encouraged my colleague from Arizona raised the issue of 
insurance contracts, given his concern with small businesses and access 
to health care. I think he would want attention paid to what insurance 
companies are doing to these small businesses. Earlier this year, the 
GAO released a report showing how little competition there is and what 
a tough time small businesses have to find health insurance. The medium 
market share of the largest carrier of the small group market was about 
47 percent, ranging from 21 percent in Arizona to about 96 percent in 
Alabama. This leaves American small businesses with few choices. We 
want to change that. Those who come to the floor of the Senate 
defending the health insurance companies and saying they want no change 
in the health care system have to defend the indefensible. How do they 
explain what small businesses and families are facing now when they are 
trying to find affordable, quality health insurance?
  If my colleague from Arizona wants to help small businesses, let him 
join us in the bipartisan bill Senators Lincoln, Snowe, Klobuchar, and 
I are offering, the SHOP Act. By doing so, he will be working with us 
in committees to make a positive change.
  I also wish to clarify one thing. Time and again, Senator McConnell, 
on the Republican side, and Senator Kyl have come to argue against 
government health care. They talk about it in the most general terms. 
What they are actually arguing against is a public option. What we hope 
to see come from all this debate about health care reform is lots of 
opportunities for America's families and businesses to shop for health 
insurance from private insurance companies but to have, in some 
circumstances, the option of a government-run plan they can choose, if 
they wish--voluntary choice. Of all the criticism heard on the floor 
about government health insurance, I have yet to hear Senator McConnell 
or Senator Kyl criticize Medicare. Why? Because 40 million Americans 
count on it. They know that were it not for Medicare, they couldn't 
afford health insurance. People live a whole lifetime without health 
insurance protection. Finally, when they hit age 65, they have 
Medicare, and they thank the Lord for that day.
  Medicare does a great job. Medicare is a proven success. For over 40 
years, Medicare has provided quality care to America's seniors and 
disabled, and we have seen the longevity, the life expectancy of 
seniors increase every year and their independence increase because 
they don't end up with a mountain of health debt to pass on to their 
children or have to exhaust their savings. If the Senator from Kentucky 
and the Senator from Arizona want to come to the floor and argue 
against Medicare, I welcome the debate. I wish to be here when they say 
that government health insurance program has failed us. It has not. It 
has worked. To create a public option for those across the country as 
part of health care reform is long overdue. We need to build on and 
improve Medicare, and we can do that.
  We also have to make sure our health care system is based on science 
and the best outcomes, that we encourage preventive care, that we see 
those elements in our society where people can do things to make their 
own health care better.
  Time and again you will hear the Republicans come to the floor as if 
they are part of the Travel Channel. They do not want to talk about 
America and the problems we face. They want to talk about England, New 
Zealand, Australia, Canada. They do not want to talk about the United 
States of America.
  Well, it is time for them to come home and recognize that we can 
improve our health care system, letting Americans keep the health 
insurance they have if they want to keep it, making sure we start to 
bring costs down, making quality health insurance available, giving 
families the peace of mind that the cost of health insurance is not 
going to go through the roof and beyond their means. That is part of 
this debate.
  Democrats are working to ensure Americans have real choice when it 
comes to their health care.
  My colleague from the other side of the aisle referred to the public 
option as government-run insurance. He believes that the insurance 
industry is already regulated enough and that a public option is 
unnecessary.
  I can tell the Senator that when I am receiving hundreds of letters 
and phone calls from constituents who cannot afford health insurance 
and who are seeing their premiums increase at alarming rates then I 
know our current health care insurance industry is not working for 
everybody.
  In fact, according to a survey by the Kaiser Family Foundation, two-
thirds of Americans support a public health insurance option similar to 
Medicare to compete with private health insurance plans.
  Republicans want to preserve a broken system--one with escalating 
costs and no guarantee that policies won't be cancelled.
  Rather than help insurance companies, Democrats want to put American 
families first and help those struggling with high health care costs.
  A public option for health insurance offers the American people the 
security that the government is looking out for their best interests--
just like Medicare does for our seniors.
  My colleague is correct in that the Medicare Program needs some 
changes. I hope he will be supportive of the changes we will include in 
the health reform package.
  Yes, we need to streamline the Medicare Program, restructure the 
delivery of care, and emphasize quality. We will do it and save costs. 
But we should build on what works, and despite what my colleague says, 
Medicare works.
  According to a study by the Commonwealth Fund, 61 percent of elderly 
Medicare beneficiaries said they had received excellent or very good 
care, compared to only half of those with employer-sponsored 
healthcare.
  This health care debate is Congress's opportunity to improve what we 
have and cut costs for the future.
  Comparative effectiveness research will help us do just that. Senator 
Kyl claims that the government may misuse comparative effectiveness 
research as a tool to ration or deny health care. His use of the word 
``rationing'' is only a veiled attempt to defend the status quo no 
matter how ineffective.
  Comparative effectiveness is a tool to expand Americans' access to 
high-quality health care, not restrict it. When we know which 
treatments are more effective than other treatments, people will want 
the best and avoid what is ineffective. But we need this research in 
order to distinguish the best from the not so good.
  Our health care system rations care today based on ability to pay. If 
we reform our health system and identify which treatments are most 
effective, we can reduce that hidden rationing by making health care 
more affordable for everyone.
  We need to learn what works and empower providers and patients to use 
that information. That is rationing-- is a sensible component of the 
effort to build a high-quality, value-based, results-oriented health 
system.
  We have serious problems in our health care system. This is America, 
and America needs a uniquely American solution to our Nation's health 
care problems. This is what Senate Democrats are committed to enacting.
  Mr. Kyl told some tragic stories of individuals in Canada and Britain

[[Page 14487]]

whose experience with their country's health care system was not what 
we would define as quality health care.
  I am sure we would like to think my colleagues on the other side of 
the aisle are sincerely concerned with the quality of health care 
around the globe, but I am more inclined to believe that this is their 
scare tactics trying to cloud the important issues once again.
  In fact, Mr. Kyl is following the specific instructions of Republican 
political consultant Frank Luntz.
  Here it is, on page 2, talking point No. 5 from a memo given to my 
Republican colleagues to guide their way of framing the health care 
debate:

       (5) The healthcare denial horror stories from Canada & Co. 
     do resonate, but you have to humanize them. You'll notice we 
     recommend the phrase ``government takeover'' rather than 
     ``government run'' or ``government controlled.'' It's because 
     too many politicians say ``we don't want a government run 
     healthcare system like Canada or Great Britain'' without 
     explaining those consequences. There is a better approach. 
     ``In countries with government run healthcare, politicians 
     make your healthcare decisions. They decide if you'll get the 
     procedure you need, or if you are disqualified because the 
     treatment is too expensive or because you are too old. We 
     can't have that in America.''

  This debate is not about talking points or messaging or even other 
countries. Countries such as Canada and Britain have government-run 
healthcare and each has their unique set of good and bad aspects to the 
system. But, what we need to focus on is the people in our country. In 
our system today, insurance companies make the decisions and decide for 
people if they can get the procedure they need, or if they are 
disqualified because the treatment is too expensive. We can do better 
than that in America.
  Patients and their doctors make the best decisions for a patient's 
health and wellbeing.
  Every Senator in this Chamber can agree: Our health care reform 
efforts should be patient-centered.
  I hope my colleagues on the other side of the aisle will work with 
Democrats to ensure a strong health care package for the American 
people.
  Mr. President, I see two of my colleagues are on the floor. I yield 
the floor.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. SCHUMER. First, Mr. President, I wish to thank my colleague and 
friend from Illinois for his outstanding words once again on health 
care, and on the fact that we need some kind of check on the insurance 
companies. Our colleagues offer none. They just point to Canada and 
England, as he mentioned, which is a totally different system than we 
are focusing on.
  Second, I wish to thank my colleague from Oregon, who is doing a 
great job in his first year in the Senate, for his generosity so I 
could speak for a brief moment and share with my colleagues some words 
about an act of bravery that occurred in my State yesterday.

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