[Congressional Record (Bound Edition), Volume 155 (2009), Part 12]
[Senate]
[Pages 15558-15559]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. CARPER. Madam President, I know my colleague from Wisconsin is 
standing to speak, so I will be very brief. I just want to take a 
moment.
  While Senator Shaheen and Senator Boxer were speaking, I went over 
and chatted a little bit with one of our colleagues from Texas who was 
on the floor. We talked a little bit about the debate on health care. 
As we approach, in a week or two, marking up a health care reform bill 
in the Finance Committee, he mentioned to me something I very much 
agree with, the 80-20 rule.
  Mike Enzi, the Senator from Wyoming, likes to talk about the 80-20 
rule and why he has been so productive over the years with Senator Ted 
Kennedy. Senator Kennedy, obviously, is a liberal Member of the Senate. 
Senator Enzi is a very conservative Member of the Senate. They get a 
lot done in the Health, Education, Labor, and Pensions Committee. It is 
because they follow what Senator Enzi calls the 80-20 rule. They focus 
on the 80 percent of the stuff they agree on. They set aside the 20 
percent they do not agree on, and they really focus on where the most 
agreement is.
  We need to do a similar kind of approach as we prepare to mark up in 
the Finance Committee the health reform bill, to go along with the 
areas of work going on in the HELP Committee.
  I strongly agree with Senator Baucus and Senator Grassley. We need a 
bipartisan bill. I know many Democrats and Republicans feel we need a 
bipartisan bill. My fear is, if we do not have a bipartisan bill, we 
will not be successful ultimately.
  While most of the media coverage of the health care debate focuses on 
the conflict--should we have a public plan or not; tax exclusions; what 
portion of our benefits should be excluded from taxation; should there 
be an employer mandate or individual mandate or should there not be--
setting all of those things aside, not that they are unimportant, there 
is huge agreement on a bunch of things that are important that are 
going to save money, save lives, reduce costs, and provide better 
health care for people. Part of it is in information technology; make 
it possible for businesses--large and small but especially small 
businesses--to get into a purchasing pool to be able to take advantage 
of much lower rates and have better choices of benefits for their 
folks; moving toward chronic care to make sure for people who have 
diabetes that we do not just wait until they get really sick and they 
have to have arms and legs and feet amputated, but make sure we take 
care of them early on as we go along.
  As to these purchasing pools we are going to create under health care 
reform, if people have a preexisting condition, they do not get 
excluded. They can participate as well. We are going to be covering 
more people for pharmaceuticals. We are going to do a much better job 
of making sure people who will benefit from a particular 
pharmaceutical--whether it is a large molecule or a small molecule--
will have access to something that is going to help them. We will be 
smart enough to figure out the pharmaceuticals out there that will not 
help somebody, so then they will not be taking those.
  We are going to be focusing more on primary care, less on fee for 
service, which drives up the cost of health care. We are going to do a 
better job of coordinating care and providing medical homes for people 
as we go forward.
  We are going to take examples like that in the neighboring State 
represented by Senator Feingold. Over in Minnesota, they have this Mayo 
Clinic, and they figured out how to make the Mayo Clinic provide better 
health care, with better outcomes, at lower cost than most other places 
in this country. They took their model and they went down to Florida, 
where costs were very high for health care. They took the Mayo model to 
Florida, and they ended up with better outcomes and lower costs in 
Florida compared to other folks who had been doing business in Florida 
providing health care for years.
  But it is not just the Mayos, it is the Intermountain folks, a 
nonprofit out in Utah, the Geisinger operation in Pennsylvania. There 
are a number of good examples out there. Part of what we are going to 
do through this debate, as we move toward health care reform, is to 
learn from those examples, go to school on those examples, and be able 
to put them to work for all of us.
  With that having been said, my friend said some people say we are not 
going to get health care reform done. We have to get it done. We spend 
more money for health care in this country than any other developed 
nation on Earth. We do not get better results. If we spend more money, 
we don't get better results. We can do better than this. Democrats 
working together with Republicans, we can get there, and let's just not 
give up.
  Thank you, Madam President. I thank my colleague for his patience.

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