[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Senate]
[Pages 14711-14712]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. McCONNELL. Madam President, the American people are frustrated 
with the U.S. health care system. But they are also increasingly 
concerned about some of the proposals coming from Washington. Now the 
alarms are beginning to sound. As reported in today's New York Times, 
the Nation's doctors are strongly opposed to the so-called government 
plan that appears to be gaining steam in Washington. The American 
Medical Association says the government plan threatens to restrict 
patient choice by putting out of business existing health plans that 
cover nearly 70 percent of Americans.
  One estimate suggests that 119 million Americans could lose the 
private coverage they have as a consequence of the government plan. 
Moreover, the AMA, in its statement from yesterday, notes that ``the 
corresponding surge in public plan participation would likely lead to 
an explosion of costs that would need to be absorbed by taxpayers.''
  Republicans and Democrats alike agree that health care reform is 
needed in this country. But a government plan is not the kind of reform 
the American people want. They want real reform for a system that's in 
serious need of it. Unfortunately, what some in Washington are 
proposing instead is the illusion of a reform that will replace what is 
good about health care in America with something that is far worse.
  Instead of making health care more affordable and accessible, these 
proposals could make treatments and procedures that everyday Americans 
currently take for granted less accessible or even impossible to 
obtain--even as these proposals would add to the colossal and 
unsustainable debt that already burdens the Federal Government.
  I have spoken repeatedly on the Senate floor about the dangers of a 
government-run health plan. By drawing on the experience of countries 
that have already adopted these government-run system I have pointed 
out the serious problems government-run health care creates for 
millions around the world. I have noted that a common defect of these 
government-run plans is that they deny, delay, and ration health care. 
And I have noted that the primary culprit in almost every case is the 
so-called government board that these countries have established to 
decide which treatments and medicines patients in these countries can 
and cannot have. This morning I would like to focus again on these so-
called government boards, so people have an idea of what they could 
expect from a government-run plan here in the U.S.
  Britain's government board, the National Institute for Health and 
Clinical Excellence, or NICE, is responsible for setting guidelines on 
the use of drugs and treatments for patients in that country. The 
government bureaucrats at this agency are supposed to weigh the 
effectiveness of a medicine or a treatment against its cost to the 
government. If the government thinks that a drug is too expensive, it 
can refuse to make it available to patients, regardless of any 
potential benefits.
  Last summer, the board in Great Britain denied patients in that 
country access to four kidney cancer drugs that have the potential to 
extend life. Here's the chilling explanation it gave to justify the 
move.

       Although these treatments are clinically effective, 
     regrettably the cost . . . is such that they are not a cost-
     effective use of . . . resources.

  After a public outcry, NICE reversed its position on one of the drugs 
but affirmed its ban on the other three.
  In New Zealand, a government board known as Pharmac reviews potential 
drugs and treatments and decides whether they should be prescribed to 
patients in that country. Pharmac says its goal is to use its 
``expertise'' to ``help . . . decide which new hospital medicines are 
cost-effective.'' And like the government board in Great Britain, if 
Pharmac does not think a drug's cost justifies its benefits, it can 
refuse to make it available to patients or doctors who want it.
  One drug that Pharmac did not think was worth the cost was Herceptin, 
which had proven to be effective in fighting breast cancer. Although 
Pharmac began covering the drug for advanced breast cancer in 2002, it 
refused to fund the drug for early stage breast cancer. After a public 
outcry and a reevaluation of the decision, Pharmac finally relented and 
decided to allow the drug for early stage breast cancer in 2007, but 
only for a limited amount of treatments.
  These kinds of decisions about which drugs should or should not be 
covered are based on a method commonly known as ``comparative 
effectiveness.'' Comparative effectiveness is not alien to the U.S. 
health care system. Indeed, the stimulus bill Congress passed earlier 
this year included significant funding to lay the groundwork for just 
this kind of research in the United States. In my view, the more 
research we do on the effectiveness of drugs and treatments the better. 
Doctors should have as much good information as possible in dealing 
with their patients.

[[Page 14712]]

  What Americans strenuously oppose, however, is the government using 
this information to deny access to treatment or procedures that 
patients and doctors choose to pursue--just as government agencies such 
as NICE and Pharmac do in Great Britain and New Zealand. Americans 
oppose this kind of government-mandated limitation on health care. They 
simply will not allow it.
  That is why my friend, Senator Kyl, will propose a bill that will 
prohibit the government from ever using comparative effectiveness in 
this way. It is a wise bill, and it should be included as a part of any 
health reform we consider. Americans want their doctors to have 
clinical information on which treatments work best and which ones do 
not. But government bureaucrats should not be able to use that 
information to determine what treatments Americans can or cannot get. 
That is a decision we currently leave between a patient and his or her 
doctor, and that is where it should remain.
  Americans want to see changes in the health care system, but they 
don't want changes that deny, delay, or ration care. They want reforms 
that control costs, even as they protect patients. They want us to 
discourage frivolous medical liability lawsuits that limit access to 
care in places such as rural Kentucky. They want prevention and 
wellness programs that cut costs by helping people quit smoking, 
overcome obesity, and diagnose illnesses early. And they want us to 
address the needs of small businesses without imposing new mandates or 
taxes that kill jobs.
  All of us want reform, but the government-run plan some are proposing 
in the United States is not the kind of change Americans are looking 
for. We should learn the lessons from problems we have seen in 
countries such as Great Britain and New Zealand. We should learn a 
lesson from the nightmares so many people in these countries and their 
families have endured as a result of government-run health care and the 
bureaucratic government boards that almost always come with it.
  Madam President, I am about to yield the floor, but before I do that, 
I see my friend from Arizona is on the floor. I want to express to him 
my gratitude for his leadership on this very important issue. The most 
important issue we will be dealing with this year is the question of 
whether the government should literally take over and run 16 percent of 
our economy. We have seen the government take over banks, insurance 
companies, and automobile companies. Now it appears as if there is an 
effort underway to take over health care as well.
  I thank my friend from Arizona for the contribution he has made on 
this important issue in the past and say we are looking forward to 
working together on this in the future.
  Madam President, I yield the floor.

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