[Congressional Record (Bound Edition), Volume 155 (2009), Part 13]
[Senate]
[Pages 17371-17373]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. KAUFMAN. Mr. President, I rise today to talk about health care 
and why Congress needs to pass reform now.
  There are three simple truths to healthcare reform:
  First, if we don't pass healthcare reform this year, the stars will 
not align for another opportunity to pass a major reform bill for years 
and years to come.
  Don't kid yourself: The last time Congress failed to pass major 
health care reform, 15 years passed until today.
  If the Congress fails to enact a health care reform bill this year, 
with a new President in his first year in office who has a strong 
relationship with Congress, it simply will not be done until years from 
now when the system has collapsed into truly catastrophic shape.
  And that leads to the second simple truth: We must pass reform now 
because the consequences of failure are not that we will be stuck with 
the health care system we have today. The consequences of failure are a 
very ugly health care reality our system is quickly becoming.
  Our health care system has become a gigantic resource-eating machine 
which over time sucks in more money and yet delivers fewer options and 
decreased quality care, rising premiums, uncertain coverage, decreased 
quality.
  That is the reality.
  The comparison of failing to enact reform is not to the system we 
have today but to a very ugly destiny we will face relatively soon.
  For example, if we do nothing, by 2016 health care premiums are 
projected to grow to an average of $24,000 per family. Let me repeat, 
by 2016, $24,000 on average for health care costs per family every 
year. That is simply unacceptable.
  The third simple truth of health care reform is that if you like what 
you have today, we need health care reform so you can keep it.
  We need reform to maintain stable coverage that can't be taken away 
from you; to maintain stable costs, that will not eat away at your 
paycheck and will not put coverage out of reach; and to maintain stable 
quality, so you get the treatment you need, when you need it, and from 
the doctor you choose.
  Only reform keeps and improves on the best of our current system. 
Failure to act pleads to a catastrophic health care future. I am not 
exaggerating.
  This is where we are. The pressures on the system are building. If we 
fail to act now, those pressures will cause rising costs, decreased 
choice, the loss of access to current quality health care and basically 
worse health care outcomes across the board than we face today.
  Let me add some additional statistics and projections.
  Health care spending is swallowing up our gross domestic product, 
GDP. In 2009, health care will account for 18 percent of our GDP.
  Eighteen cents of every dollar we spend is dedicated to health care. 
If we do nothing, this will rise to 28 percent of GDP in 2030 and 34 
percent in 2040. This trajectory is unsustainable.
  Today, the average premium for family coverage is just over $12,000--
an increase of 119 percent in 9 years. As I said, if we sit by and do 
nothing, by 2016, a family premium will be estimated to cost at least 
$24,000--another increase of 83 percent. And in my home State of 
Delaware, it will be even higher, with a family insurance policy 
purchased through an employer estimated to cost over $28,000.
  Can you imagine paying for that? And that doesn't even include out-
of-

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pocket costs such as deductibles and copayments. When health insurance 
premiums grow at a rate five times as fast as wages, something has to 
change.
  There also has been an increasing prevalence of medical bankruptcies. 
A recent study published in the American Journal of Medicine showed 
that bankruptcies involving medical bills now account for more than 60 
percent of U.S. personal bankruptcies, an increase of 50 percent in 
just 6 years.
  In fact, more than 75 percent of families entering bankruptcy because 
of health care costs actually have health insurance. Most are middle-
class, well educated, and own their homes. They just can't keep up with 
the alarming rise in out-of-pocket costs associated with medical care.
  Passing health care reform is important, but not easy. But for the 
reasons I have mentioned, this year is different. This year, the call 
for reform is coming from people and organizations that in the past 
opposed reform.
  This year businesses, unions, insurers, provider groups and patient 
advocacy groups are all looking for reform.
  And why is that? Because the growing healh care dollars involved 
threaten virtually to bankrupt us all. We need reform to stabilize the 
system.
  I think it is important to keep in mind that this is not just about 
an alarming set of numbers, statistics and cost projections.
  Behind all these numbers are real people who need quality and 
affordable health care, including people who struggle every day to get 
health care or keep the health insurance they already have.
  Let me take just a few minutes to talk about some people from my home 
State of Delaware and why we need health reform for them, as well as 
for millions of Americans like them in all parts of the country.
  We need health reform because of people such as Angela Austin.
  Angela is a recent mother who lives in Dover. She works as a 
bartender. Most of her earnings come from tips. She doesn't get health 
insurance through her employer. When Angela became pregnant she tried 
to find private health insurance, but she was repeatedly denied 
coverage because her pregnancy was considered a preexisting condition. 
She applied for Medicaid--to find prenatal care for herself and the 
baby--but was denied coverage because she earned $200 more than the 
monthly income limit allowed. She called organizations and clinics and 
was unable to find a payment plan she could afford.
  Midway through her pregnancy, Angela decided to cut back her work 
hours so she could qualify for Medicaid. Thankfully, Angela was finally 
able to get services at Christiana Care's Wilmington Hospital, where 
they provide prenatal care and delivery on a sliding scale for those 
who can't afford insurance.
  She worked all 9 months of the pregnancy and delivered the baby on 
May 27. The Medicaid coverage was especially crucial because she had 
complications from hyperthyroidism and was able to get the necessary 
prescriptions to control the condition.
  The sad part of this story is that when Angela was so anxious that 
everything possible be done to insure a healthy baby, the system threw 
up road blocks. Pregnancy should not be considered a preexisting 
condition. What is more, no one should be denied coverage because of a 
prexisting condition, and no one should be forced to choose poverty to 
qualify for Medicaid.
  We also need health reform for small businessmen such as Ian Kaufman 
of Georgetown. By the way, Ian is not a relative of mine.
  Ian moved to Delaware right out of college in 1990. He was laid off 
from his job this past January and decided to start a small business. 
In the process, Ian picked up COBRA coverage to ensure that his family 
maintained their health care insurance.
  When he first signed up for the COBRA coverage, his monthly premium 
was $1,800. That is a lot of money. Thanks to the COBRA provisions in 
the Recovery Act, Ian saw his payments reduced by 66 percent--which 
made his monthly premiums much more manageable.
  However, this premium assistance will run out sometime this fall, and 
he will once again have to pay $1,800 a month.
  In anticipation of higher COBRA payments, Ian applied for coverage 
from Blue Cross and Blue Shield but was turned down. They never gave 
him a reason for denying him coverage, but he suspects it was because 
of a pre-existing condition of one of his daughters.
  Ian worries that the high cost of providing health care for his 
family, in addition to the difficulty of even finding a willing policy 
provider, will affect his ability to stick with his startup business.
  Unfortunately, Ian's health insurance predicament as a self-employed 
businessman is not uncommon. There are too many sole proprietors and 
small businesses that cannot afford health policies for themselves, 
their families and any employees they might have. It should not be this 
way.
  But it is not always just a problem of finding private health 
insurance. We also need health reform for people such as Bonita 
Sponsler from Dagsboro so they don't slip through the cracks of our 
existing safety net of Medicaid and Medicare.
  Bonita was laid off from her job in March 2007. Three weeks later she 
suffered a brain aneurysm. Bonita applied for Social Security 
disability and was awarded benefits, but as with everyone who qualifies 
for such coverage, she has to wait 2 years before Medicare coverage 
kicks in.
  Meanwhile, Bonita has suffered two additional aneurysms since her 
initial episode, and it is advised that she receive an arteriogram to 
monitor her condition. Unfortunately, she can't afford to pay the 
several thousands of dollars it costs for an arteriogram, so she is 
taking her chances until she becomes eligible for Medicare in October. 
This a considerable risk due to her propensity for aneurysms, but it is 
the only option she can afford. In fact, she has had to cancel a 
scheduled arteriogram in September because she still would not have 
coverage by then. It should not be this way.
  Finally, we need health reform for people who pile up insurmountable 
debt, many times due to accidents or injuries they never caused and 
couldn't avoid.
  Without using her name, I want to highlight the situation of a 
Delaware woman who is a victim of domestic violence.
  She suffered major eye damage and has had three surgeries. She has no 
health insurance and by late 2008 owed almost $30,000 in hospital and 
anesthesia bills, in addition to $6,000 in personal bills.
  She received lost wages from the Violent Crimes Compensation Board. 
She applied for Medicaid but was turned down. She then applied for 
Social Security disability but was also turned down as her eye 
condition was not considered to be permanent and could be repaired with 
additional surgery.
  After waiting many months, she was finally able to get the eye 
surgery she needed because the doctor who performed the procedure 
reduced the fee from $12,000 to $3,000 and allowed her to go on a 
payment plan.
  However, she still owes $20,000 to $30,000 for the prior surgeries. 
She is presently not working and does not have health insurance. She 
could have had COBRA following the loss of her job, but it was $890 a 
month and she could not afford it. She presently can see well enough to 
drive. However, she is due for yet another surgery and the financial 
arrangements for that will again be extremely difficult if not 
impossible. It shouldn't be this way.
  These stories help to show why we can no longer wait for health 
reform.
  These stories require us to put our differences aside and come 
together to make certain that Americans have access to affordable, 
quality health care when they need it.
  In my short time in the Senate, I have had the pleasure of presiding 
over the floor at the President's desk. I have listened to many of my 
colleagues give good, passionate speeches staking out their position on 
where we need to go on health reform. I can truly say I have

[[Page 17373]]

learned a lot from those speeches, many of which have helped shape my 
own views on the health reform debate.
  That said, I have also heard some speeches that give me cause for 
concern, as some colleagues seem to have prejudged the legislation 
before it has even appeared.
  I have heard about the dangers of a British or Canadian-style 
government-run health care system.
  I have been warned about rationing and bureaucrats getting between 
Americans and their doctors.
  I have listened to stories about patients from other countries that 
come here to get care they can't receive in a timely manner back in 
their own country.
  I have heard over and over about a government-run takeover of health 
care.
  I do not doubt the sincerity of my colleagues who see potential 
pitfalls in health care reform. But when I hear these speeches, I often 
wonder what legislation they are warning us about.
  So far, I have not seen any bill being discussed in committee that 
calls for a government-run, single-payer system such as Canada or Great 
Britain.
  I have not seen any legislative text that puts restrictions on what 
treatments doctors can provide or what they can discuss with their 
patients.
  I have not read any language that rations any sort of health care.
  I hope that the fears about change in our health care system do not 
hurt our chances of enacting reform this year.
  I hope the debate over the bill is centered around what is actually 
in the legislation, not extrapolations about provisions in the bill or 
frightening projections of a health care system in other countries that 
are not actually being proposed here in Congress.
  I hope that as the debate moves forward, all of us in the Senate will 
step back, take a breath, and remember why we need to reform health 
care. We are moving quickly toward a health care system that Americans 
will no longer be able to afford. The system is quickly hurtling out of 
control.
  Yes, we do need to keep what works, and we need to fix what is 
broken.
  We need to make certain that Americans can get affordable health 
insurance without worrying about preexisting conditions.
  We need to help Americans avoid bankruptcy because of out-of-control 
medical bills.
  We need to ensure stability in the system so that Americans maintain 
insurance options and their choice of doctor.
  Most important, we as a country need to take control of our health 
care destiny. We can have a future in which Americans can have stable 
coverage, with stable costs and stable quality. Or if we do nothing, we 
will have a future of rapidly increasing premiums, uncertain coverage 
and decreased quality.
  I urge my colleagues to gather their collective will, realize what is 
best for our country and do the right thing during this historic 
opportunity by passing health care reform.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Arizona is 
recognized.

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