[Congressional Record (Bound Edition), Volume 155 (2009), Part 12]
[Senate]
[Page 16869]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. JOHANNS. Madam President, I spent several days during the recess 
hosting a series of discussions on health care. I met with doctors and 
hospitals, underwriters, small business owners, and uninsured 
Nebraskans. Many of them feel as if they are one illness away from a 
crisis. The economic slowdown has only heightened this fear as they 
worry that they may lose their job and the health insurance their 
family depends upon to stay healthy.
  Their concerns are real, and Congress should act carefully to address 
them. We need to create a health care system that protects patient 
rights, let's them see their doctor, and is affordable.
  But I am concerned about the discussion that is occurring today. The 
American people deserve true solutions and should not be led down a 
path that is fraught with shadowy numbers and unfulfilled promises. 
Specifically, I have reservations about a government-run public plan. 
Some have attempted to sugar-coat this new bureaucracy as simply an 
option. However, the more you learn about it, the more you realize 
there is nothing optional about it. In my judgment, it is a one-way 
ticket to a single-payer, government-run health care system, one that 
will compromise patient access to quality care.
  It is impossible for private industry to compete with the government. 
The government can fix the prices and pick the rules that make only one 
plan feasible--the government plan. When the government acts as both 
the player and the umpire, it's not a level playing field. That close 
call at the plate will never go to the runner and the foul ball 
magically will become a home run.
  Some will say the government-run option will increase competition and 
keep the private insurers honest. Left unsaid is that government 
underpayments on Medicaid and Medicare are creating enormous cost 
shifting and increase the health care costs for others. Underpayments 
for Medicare and Medicaid are estimated to shift about $89 billion onto 
people who have private insurance. Each family pays an additional 
$1,800 annually to make up for the government's flawed payment system. 
Hospitals and doctors literally told me they could not keep their 
businesses open on the Medicaid and Medicare reimbursement rate. So the 
creation of another plan, a government plan, will only rob from Peter 
to pay Paul. Eventually, there will be no private insurance companies 
left to bear the burden.
  Bottom line is that government does not balance the books, and it 
views itself as not having to. Washington seems happy to keep on 
printing money and raising taxes. How can private business compete with 
that?
  If a government-run public plan was truly going to compete, it would 
face the same regulations and the same risks that the private industry 
feels. No bailouts if it becomes insolvent. Does anyone think the 
bill's proponents would honestly let that happen? The Administration 
would probably claim it is too big to fail, like AIG, Citibank, General 
Motors.
  A system with a competitive government option, I fear, is a fairy 
tale. A government-run plan will undercut the private market and 
ultimately drive them out of business. I am not defending the private 
insurance industry. Far from it. But we need to be honest with the 
American people. An uneven playing field is not right, and it will not 
benefit Americans.
  The effect, I fear, will be longer waiting lines, less innovation, 
and rationing of care. In Canada, the average wait time for radiation 
treatment is 7 weeks. I cannot imagine asking Americans diagnosed with 
cancer to wait that long. There are some in Washington who have their 
heels dug in on a single-payer plan. It contradicts the President's 
promise. He has said over and over that people will be able to keep 
their health care. But Americans beware. One study estimates 119 
million people will shift to the government plan. They will not choose 
that; their employer will choose it for them. We cannot fault employers 
that are trying to save money.
  In the committee draft, businesses that employ 25 or more employees 
would be required to pay an annual penalty of $750 per employee. When 
you do the math, this is no penalty compared to the cost of private 
insurance.
  In 2008, the average employer's cost for an individual health care 
plan was $3,900. Putting their employees on the public plan option 
would save them over $3,200 a year for each employee. So you can see 
why this shift would occur.
  Ultimately, people will not have a choice. Their employer will make 
the choice, and they will be forced onto the government plan. To 
promise otherwise is misleading. Even the President has recognized that 
shift is going to occur.
  I conclude my comments today by saying: Don't be fooled. A government 
plan that does not compete on a level playing field means people will 
migrate to the government plan, and the choice to keep private 
insurance will not be a viable option.
  The PRESIDING OFFICER. The Senator from North Carolina.

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