[Congressional Record (Bound Edition), Volume 155 (2009), Part 12]
[Senate]
[Pages 15860-15862]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. SANDERS. Mr. President, I think most Americans understand that

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our current health care system is disintegrating. Today, 46 million 
Americans have absolutely no health insurance, and even more are 
underinsured, with high deductibles and high copayments. At a time when 
60 million people, including many with insurance, do not have access to 
a medical home--do not have access to a doctor of their own--close to 
20,000 Americans die every single year from preventable illnesses 
because they do not get to a doctor when they should. This is six times 
the number of people who died during the tragedy of 9/11, but these 
deaths occur every single year.
  I can vividly recall talking to physicians from Vermont--and I am 
sure the same is the case in Delaware and every other State in this 
country--who told me that patients walked into their office very sick, 
and they would say: Why didn't you come in here before? You are very 
ill. And they said: Well, I didn't have any insurance. I didn't want 
charity. I thought I would get better.
  By the time people ended up walking in the door, their situation was 
so bad that the doctors lost those patients--people who should not have 
died. This is happening close to 20,000 times every single year in this 
country.
  Recently, the Boston Globe had a big story--and this is in the State 
of Massachusetts, which supposedly has universal health care--which 
reported that patients with chronic illnesses, such as diabetes and 
heart disease, were not taking their medicines or not getting the 
treatments they needed because they couldn't afford the 25-percent 
copay. Yet Massachusetts has almost everybody covered.
  So when we talk about the health care crisis, it is not just the 
number of people who have no health insurance, it is people who are 
underinsured. When you add that together, we have huge numbers of 
people who are not getting the medical care they need when they need 
it. The result is not only personal suffering, the result is that they 
end up going to the emergency room, costing the system far more than it 
should or they end up in the hospital at a highly inflated medical 
cost. This makes zero sense and is a manifestation of a dysfunctional 
health care system.
  In the midst of all of this, somebody may say: Well, you have 46 
million uninsured, you have more underinsured, people are dying 
needlessly, but at least you are not spending a lot of money. If you 
bought an old broken down car and you started complaining that it 
doesn't work well, I would say to you: Hey, what do you expect? You 
didn't spend a whole lot on your car.
  The reality is--and this is an important point to make, because 
people say that Canada has problems. Canada does have problems. They 
say the United Kingdom has problems. Sure, they have problems. France 
has problems. Every country has problems. But the reality is that we 
are spending almost twice as much per capita on health care as any 
other nation. We should be doing far better in terms of health care 
outcomes than every other country on Earth, and that is certainly not 
the case. The reality is we are spending close to $2.7 trillion on 
health care, which is 18 percent of our GDP, and the skyrocketing cost 
of health care in America is unsustainable both from a personal point 
of view and a macroeconomic point of view.
  At the individual level, the average American today is spending about 
$7,900 per year on health care. Do you believe that? How many people do 
you know in Delaware who are making $25,000, $30,000 a year who are 
spending $8,000 a person on health care? That is beyond comprehension.
  Here is an important point to make. Despite this huge outlay, a 
recent study found that medical problems contributed to 62 percent of 
all bankruptcies in the year 2007. That means that this year there will 
be approximately 1 million Americans who are going bankrupt because of 
medically related problems. Stop and think: a million Americans going 
bankrupt because they can't pay their medical bills.
  On a personal level, what does it mean? Imagine dealing with cancer, 
dealing with diabetes, dealing with heart disease, and at the same time 
having to stress out and worry about how you are going to pay the bill. 
I am not a doctor, but I can't help believing that it doesn't make 
one's recovery process any better when you are sitting around wondering 
whether you are going to go bankrupt. We are the only country in the 
entire world--the entire industrialized world--where people are 
worrying about having to go bankrupt because they committed the crime 
of getting sick. This is unacceptable, and we as a nation can and must 
do much better than that.
  That is from the personal point of view. What about the macroeconomic 
point of view, the business perspective? Well, we know that large 
corporations, such as General Motors, for example, having so many 
economic problems, spends more on health care per automobile than they 
do on steel. That is a big corporation. We also have small businesses 
in the State of Vermont and around the country that are forced to 
divert hard-earned profits into health coverage for their employees 
rather than into new business investments. That is what they are faced 
with: Do they spend the money growing their business or do they provide 
health insurance to their workers?
  Because of rising costs, it is no secret that many employers, many 
businesses, are cutting back on the level of their coverage, and 
passing more of the cost on to their workers. In more and more 
instances, you know what employers are saying? Sorry, can't do it 
anymore; we are not going to provide any health care coverage to the 
workers.
  What we are looking at is a situation which is disastrous for 
millions of Americans on a personal level, and disastrous for our 
economy, making us uncompetitive with countries all over the world that 
have a national health care program.
  There is one other point that should be made and that we don't talk 
about very often. Nobody knows what the exact figure is, but there are 
some estimates that as many as 25 percent of American workers are 
staying at their jobs today. You know why they are staying at the job 
they are at today? It is not because they want to stay at their job. 
They are staying in their job because they have a good health insurance 
policy which covers themselves and their families.
  Stop and think from an economic point of view, from a personal point 
of view: Does it make sense that millions of people are tied to their 
jobs simply because they have decent health insurance policies? What 
sense does that make?
  It is important--and I am sorry to say we don't do this enough--to 
ask a very simple question: How could it be that, according to the OECD 
in 2006--the best statistics that we have--the United States spent 
$6,700 per capita on health care--we are now spending more--Canada 
spent $3,600, and France spent $3,400? France spends about one-half of 
what we spend per capita, and most international observers say that the 
French system works better than our system. So as we plunge into health 
care reform, it would seem to me the very first question we should ask 
ourselves is: How do the French, among others, spend one-half of what 
we are spending and get better outcomes than we do?
  In terms of how people feel about their own systems, according to a 
five-nation study in 2004 by the well-respected Commonwealth Fund, 
despite paying far more for our health care, it turns out that, based 
on that study, Americans were far more dissatisfied than the residents 
of Australia, Canada, New Zealand, and the UK about the quality of care 
they received. In that poll, one-third of Americans told pollsters that 
the U.S. health care system should be completely rebuilt--far more than 
the residents of other countries. Does that mean to say they do not 
have problems in Canada or the United Kingdom? Of course they do. Their 
leaders are arguing about their systems every single day. But according 
to these polls, more people in our own country were dissatisfied about 
what we are getting, despite the fact that we spend, in many cases, 
twice as much as what other countries are spending.

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  It seems to me, as the health care debate heats up--and we hope more 
and more Americans are involved in this debate--that we as a nation 
have to ask two fundamental questions. In one sense, this whole issue 
is enormously complicated. There are a thousand different parts to it. 
On the other hand, it really is not so complicated. The two basic 
questions are, No. 1, should all Americans be entitled to health care 
as a right and not a privilege--which is the way, in fact, every other 
major country treats health care. Should all Americans be entitled to 
health care as a right, universal health care for all of our people?
  That, by the way, of course, is the way we have responded for years 
to police protection, education and fire protection. We take it for 
granted that when you call 911 for police protection, the dispatcher 
does not say to you: What is your income? Do you have police insurance? 
We can't really come because you do not have the right type of 
insurance to call for a police car or to call for a fire truck. When 
your kid goes to school, we take it for granted that no one at the 
front desk of a public school says: Sorry, you can't come in, your 
family is not wealthy enough. What we have said for 100 years is that 
every kid in this country is entitled to primary and secondary school 
because they are Americans and we as a nation want them to get the 
education they deserve. Every other major country on Earth has said 
that about health care as well. Yet we have not.
  I think right now and I think what the last Presidential election was 
all about is most Americans do believe all of us are in this together 
and all of us are entitled to health care as a right of being 
Americans.
  The second question we have to ask is, if we accept that, if we 
assume all Americans are entitled to health care, how do you provide 
that health care in a cost-effective way? There are a lot of ways you 
can provide health care to all people. You can continue to throw money 
at it.
  The PRESIDING OFFICER. The Senator has consumed 10 minutes.
  Mr. SANDERS. I ask unanimous consent for 5 more minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SANDERS. You can continue to throw billions and billions of 
dollars into a dysfunctional system. That is one way you can do it. I 
don't think that makes a lot of sense.
  I think the evidence suggests that if we are serious about providing 
quality health care to every man, woman, and child in a cost-effective 
way, then our country must move to 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. The function of a private health insurance company is not--
underline ``not''--to provide health care to people, it is to make as 
much money as possible. In fact, every dollar of health care that is 
denied a patient, an American, is another dollar the company makes.
  With 1,300 private insurance companies and 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, exorbitant CEO compensation 
packages, advertising, lobbying, and campaign contributions. Aren't we 
all delighted to know our health care dollars are now circulating all 
over the Halls of Congress, paying outrageous sums of money to 
lobbyists, making sure we do not do the right thing for the American 
people? Public programs such as Medicare and Medicaid and the Veterans' 
Administration are administered for far, far less than private health 
insurance.
  Let me conclude by saying that I understand that the power of the 
insurance companies and the drug companies, the medical company 
suppliers--the medical equipment suppliers--is so significant, so 
powerful that we are not going to pass a single-payer, Medicare-for-all 
program. But at the very least, what polls overwhelmingly show is that 
the American people want a strong, Medicare-like public option in order 
to compete with the private insurance companies. That is the very least 
we can and must do for the American people.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. INHOFE. Mr. President, I ask unanimous consent that I be 
recognized as in morning business for such time as I may consume.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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