[Congressional Record (Bound Edition), Volume 155 (2009), Part 13]
[House]
[Pages 18132-18139]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  HEALTH CARE FOR THE AMERICAN PEOPLE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Minnesota (Mr. Ellison) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. ELLISON. My name is Keith Ellison; and I am appearing on behalf 
of the Progressive Caucus, which is again coming to the House floor to 
discuss a progressive vision for America, a vision of America that has 
a central focus of the American quality of life being better for all 
people, that has a central focus of the welfare of Americans being 
better than it was before. In the Progressive Caucus, Mr. Speaker, we 
have a set of values which say that yes, we can live in harmony with 
the planet Earth; yes, we can engage in activity that will allow all 
Americans to have health care; yes, we can have civil rights for all 
people; yes, America can be a party and a member in the global village 
in which we promote peace and in which we stand with nations who are 
struggling to emerge around the world.
  The progressive vision for America, a progressive vision that says 
that the greatest points in our Nation's history were when we passed 
the law for civil rights for all people; a progressive vision where we 
said the Wagner Act, where workers will have rights, was a great moment 
in American history; a progressive vision where we put together the 
resources necessary to pull America out of the Great Depression and 
into a greater level of rights, a greater level of prosperity and a 
greater level of community.
  Tonight we're talking about health care, and I hope to be joined by 
my colleague soon. But I just want to set out that this is the 
congressional progressive message; and if anybody wants to communicate 
with us, they can do so at cpc.grijalva.house.gov. It is very important 
that folks know how to get in

[[Page 18133]]

touch with us. Mr. Speaker, this is the progressive message where we 
come every week on the House floor to talk about a progressive vision. 
Health care is the topic. Health care is the issue for the American 
people today. Health care is what everybody is talking about here on 
Capitol Hill, and this is the progressive message where we talk about a 
progressive vision for America.
  Now I'm using these boards to help illustrate a point; but the main 
concept here, as we talk about the progressive vision for America's 
health care, we want to start out with a central idea; and that is, 
care should be the watchword. We should be talking about care, not who 
pays, not who doesn't pay. Care. We should not be talking about all the 
complicated mechanisms first. We'll get to that as it's time to talk 
about that and there will be a good and appropriate time to debate 
these more complicated issues.
  But the first thing we start with, as we talk about a progressive 
vision, is care, health care. Care should be where we start. Care 
should be how we end. If we care for each other, as Americans, if we 
regard all Americans as essential and important, we will construct a 
health care system and bring forth health care reform which makes sense 
for everybody, which costs less than this system does now because this 
system is not driven by care. It's driven by something else, which I 
will get to in a moment. We also have to have in this health care 
reform package a public option. But when I use the word public option, 
what I really mean is a we're-all-in-this-together option. A public 
option is an option that says that, look, we will have a public option, 
together with private options, in which the public can say, look, I 
want to select that public option because it works for me and my family 
or my business, and that's what people can take advantage of. There 
will be private options in the system, in the exchange. But this health 
care reform starts with the idea of care and states that the public 
option, which will be included in this health care reform bill and is 
in the bill now, is really a we're-in-this-together option.

                              {time}  2000

  That is what it is about. That is the point. That is what we are 
going for. And we will talk more about that later. But I think it is 
important that when people talk about a public option, we are talking 
about an option that is available for Americans to select which really 
says, we are not going to leave you out in the cold, you're not by 
yourself, this ownership society is not a you're-on-your-own society. 
In fact, it is a society in which we are all in this thing together. 
So, Mr. Speaker, as I said before, care is what drives our vision.
  But the system, the status quo, has something else driving the 
vision. Health care reform means patients before profits. That is what 
health care reform means. Health care reform doesn't mean that there 
won't be profits. Of course, there will be. There will be private 
businesses on the exchange. There will be people making money. Doctors 
will continue to make good salaries, nurses as well; and other people 
who do good things for society will be compensated fairly, of course.
  But the fact is we will not have these insurance companies that are 
not allowed to just charge anything they want and pay their CEOs 
anything they want. We will have something where patient care will be 
what is important in this health care reform system.
  So, I want to talk tonight, Mr. Speaker, about exactly what health 
care reform must include. And so let me just get to this board, and 
then I have a chart which will simplify it. Mr. Speaker, I believe 
there are folks who want to make this thing complicated. They want to 
make it hard to understand, and people just sort of switch off their 
minds and say, well, it is really complicated, so I don't get it, and 
they seem to be talking bad about it, so I am just not going to plug 
in.
  I believe Americans really, really want health care reform. And I 
want them to know what this health care reform bill is talking about. 
As I said, a progressive vision is a vision that makes ``care'' the 
operative phrase in health care and puts patients before profits, 
although profits are not out of the picture. They are still around. But 
patient care is really what is driving the conversation.
  A health care reform bill must include guaranteed eligibility. No 
American will be turned away from any insurance plan because of illness 
or preexisting condition. Mr. Speaker, how many Americans are at home 
right now who are checking over their bills, who are perhaps anxiety 
ridden or maybe even in tears because they have just been dropped or 
denied coverage because of a preexisting condition?
  I told a story last week, Mr. Speaker, about a dear friend of mine 
who called me aside at a community forum I had on health care in my 
hometown of Minneapolis, Minnesota. She said to me with tears in her 
eyes that she had a dilemma. She didn't know what to do. Her sister and 
her mom had succumbed to breast cancer. She thinks she is at risk. She 
knows that if she goes to get the test to find out, then she will be 
presumed to have a preexisting condition and could be dropped. But if 
she doesn't, and she does have the early stages of breast cancer, she 
will not be getting the care that she needs. So she gets the test now, 
she can be dropped for having a preexisting condition. If she doesn't 
get the test now, her breast cancer could be advancing. This is the 
situation that so many Americans are in today, and it is wrong.
  The health care reform we are talking about, guaranteed eligibility, 
no American will be turned away from any insurance plan because of 
illness or preexisting condition, meaning that insurance companies just 
can't insure the people who are well and the people who never make 
claims. They have to insure everybody, comprehensive benefits.
  The new public plan, this is the you're-not-on-your-own plan, will 
cover all essential medical services including preventative, maternity, 
mental health and disease management programs. This is comprehensive 
benefits. This is different from some of those plans you get that is a 
good plan for health care only it doesn't cover anything, only it has a 
high deductible, high co-pay, high premium and doesn't offer any real 
coverage, and this is excluded, that is excluded, doesn't cover this, 
doesn't cover that. That is not the kind of plan we are talking about.
  Comprehensive benefits, affordable premiums, co-pays and deductibles, 
as I just said they got a certain version of health care out there now 
that the private market has coughed up where they have high co-pays, 
high premiums, high deductibles, meaning if you go to the doctor, you 
got to pay a lot, you got to pay a lot out of your check every 2 weeks 
or every month when you get paid; and then if you need a procedure, you 
got to cough up a lot of your own personal money because they don't 
cover everything or even nearly everything.
  So, participants will be charged fair premiums and minimal co-pays 
and deductibles for preventative services. So that means if you want to 
stay healthy by doing preventative health care, that option will be 
available to you.
  Subsidies. Individuals and families who do not qualify for Medicaid 
or SCHIP but who still need assistance will receive income-related 
Federal subsidies and keep health insurance premiums affordable. So we 
are not going to leave anybody out. Even people who are the lower 
income scale and have to have health care, have to be able to go and 
see a doctor, have to be able to get preventative services; and this 
will be covered.
  So health care reform, guaranteed eligibility, no exclusion for a 
preexisting condition, comprehensive benefits, a good plan that covers 
things that you need, affordable premiums, co-pays and deductibles and 
subsidies for people who need them.
  So this is a chart that we developed, Mr. Speaker, to try to make it 
simple for folks, because it is complicated. It is our job in Congress 
to try to boil this stuff down and make it digestible. And so we came 
up with this little chart to try to talk about what is going on. Let's 
just say, here is the path to health care for all. Up here at the top

[[Page 18134]]

of the box, Mr. Speaker, you got every American.
  What the plan will yield is basically three of these bubbles that you 
will fit into. One of them is employer-based insurance. You have heard 
President Obama say, if you like your health care, keep it. That is 
what that is. If you like your health care, keep it. It is exactly what 
you have now if you have employer-based health care, but it is going to 
cost less. There will be no more discrimination for preexisting 
conditions. There will be no discrimination for age or gender. And we 
will have a medical loss ratio of 85 percent because 85 percent of the 
premiums must go to patient care. So they won't be able to just stuff 
their pockets with those $100 million salaries some of these health 
care insurance companies CEOs make.
  This is a lot like we have now, only we will have improvement because 
of cost, because of the medical loss, what is known as the ``medical 
loss ratio'' and because of the banning of the exclusion for 
preexisting conditions. Then also we have public programs that exist 
now, Medicare, Medicaid, SCHIP, still available to children, seniors 
and families below the poverty line. This will still be there. This is 
not going anywhere. We are going to have Medicare, we are going to have 
Medicaid, and we are going to have SCHIP. That is still there.
  What is going to be new, Mr. Speaker, is a health care insurance 
exchange. This is going to be new. This bubble is going to be kind of 
new. And it is going to go into effect in a few months perhaps after we 
pass the bill, perhaps as much as 12 months; but it will be counted in 
months.
  Who is eligible for the health care insurance exchange? Individuals 
and small businesses will be able to go into the exchange. And what 
will be on the exchange? Private insurance plans that people can 
purchase, and what you will have there is a public option.
  Now, people who go into the health care exchange will be subsidized 
for up to 400 percent of the poverty level. That means if you are at 
the poverty level times four, you take that income you have at the 
poverty level times four, if you make 400 percent of the poverty level, 
meaning you make well over the poverty level but still you don't have 
enough to afford health care, you can receive some sort of subsidy to 
make sure that you can afford coverage.
  Then, you can go into the exchange, and you might be able to pick 
your policy because the policies will be standardized, and you will be 
able to pick one, be it a public plan or a private plan. And you will 
be able to get your health care policy picking the one that you want, 
guaranteeing that you will have choice, guaranteeing that you will have 
options and you will be able to select based on your needs. We are 
going to revisit this chart in a moment, Mr. Speaker, because it is 
important to go back to it.
  So I just wanted to say that tonight what we want to do with this 
Progressive hour is talk about helping folks to understand the health 
care reform plan, helping folks to understand what the public option 
is. As I said before, the public option should be understood. It is 
something that is going to help you, something that means that this is 
our commitment to each other, like Social Security is our commitment to 
each other, like other important public programs are a commitment to 
each other, our roads are a commitment to each other. It is what we all 
do together to make sure people can make it. This is what the public 
option represents.
  So, Mr. Speaker, many in Congress, the House and Senate, believe that 
any significant health care reform package must include a robust public 
option. We have seen leaders, brave and courageous legislators like 
Russ Feingold in the Senate and Bernie Sanders and Chuck Schumer in the 
Senate over in the other body talking about the importance of a public 
option. But here in the House we have heard the same commitment from 
some great leaders like John Lewis, Lois Capps and Congresswoman 
Pingree from Maine, who is new to this body, all making important 
commitments to support a public option, on both sides, of course. We 
heard the President talk about the public option as well.
  So we have people in all three, in both Houses and in the President's 
Office, talking about the public option. We have talked a little bit 
about what it means. But let me just elaborate on that a little bit. 
What it means at its heart is it means giving the uninsured the option 
to enroll in a public health care plan that is sort of like Medicare. 
That is what it means at bottom, giving the uninsured the option, the 
choice, the choice to enroll in a public health care plan like 
Medicare. A public insurance option would compete. We are talking 
competition here, Mr. Speaker. We are not talking about not competing. 
We are talking about competing.
  Under the system we have now, we don't have much competition. But 
with a public option, we will have some competition. And this public 
option will compete on a level playing field with private health 
insurers, and the uninsured individuals would get a chance to choose 
which plan is best for them.
  If you look at the health care market today, and you go into a given 
area, everybody knows that one or two firms dominate in that particular 
area, maybe three. Sometimes you just really don't have any options at 
all, Mr. Speaker. And so we have a lack of insurance right now, a lack 
of a competition now; and what we need to do is get some real 
competition.
  Why is having a public health care option important? There are many 
reasons, but here are a few. A broad number of research and a broad 
spectrum of research has confirmed that a public health insurance 
option is a key component of cost containment. To drive down the cost 
of health care, you need a public option, because what it does is it 
introduces more competition, lower administrative expenses and drives 
cost-saving innovation. Some folks don't know that our health insurance 
industry right now is exempt from antitrust legislation and doesn't 
really have to compete. But a public option will drive them to 
competition, which is a good thing.
  Also, need for a public option, according to research from the 
Commonwealth Fund, the net administrative cost for Medicare and 
Medicaid are 5 and 8 percent respectively. These are plans, Medicare 
and Medicaid, which already drive reasonable cost down so that the 
folks who participate in these programs are not being charged for a 
bunch of stuff that they don't need. They are getting low 
administrative costs.
  Now I just want to say that I have been joined now by one of my 
favorite colleagues, Donna Edwards, who by the way, is a pretty good 
softball player, that is an aside, but Congresswoman Edwards is here. 
She represents a district in Maryland. And let me just give her a 
chance to sort of jump in on this important conversation going on in 
Congress right now.
  Congresswoman Edwards, how are you doing tonight? Let me yield to 
you.
  Ms. EDWARDS of Maryland. Thank you for yielding. Good evening, Mr. 
Ellison. It is good to be here with you this evening. And I just want 
to say a few words because I don't have a lot of time, and I know 
you're really holding the fort here talking about the importance of 
health care to all Americans, the importance of a public plan option 
that really covers all Americans, gives them a choice of their doctors 
and what do they want for their services.
  I just want to say the U.S. health care system is really one of the 
most expensive systems in the world. We know that. We spend about $2.2 
trillion each year on health care services and products. At the same 
time, 46 million Americans are uninsured, and a whole bunch of others, 
80 percent who have insurance, are actually from working families. They 
have insurance, but it is not enough, and it is not the right kind of 
coverage, and premiums are going up, and deductibles are going up. And 
it has become really an unaffordable system for American families.
  Almost half of all personal bankruptcies are attributed to medical 
debt.

[[Page 18135]]

I had that experience myself. I almost went bankrupt because I had a 
huge health care bill. I couldn't pay it. I got very, very sick, and I 
needed a choice. Fortunately, I was able to pay that off and then end 
up getting good insurance. But the reality is that when that happens, 
it can almost cripple a family. I don't want any other family to have 
to face the kind of choices I did about whether to take care of myself 
and my son or to pay for health care coverage.

                              {time}  2015

  And, at the same time, we also know that sometimes people make the 
choices. Do I buy my medications? Do I go see my doctor when I'm sick, 
or do I wait till I'm really sick? Those are choices that are 
unacceptable.
  And let's look at the practices of our insurers. I mean, you know 
what happens. An insurer will say to you something like, well, you 
know, you've been a victim of domestic violence, and so we're not going 
to cover that and the cost of that because it's a pre-existing illness. 
I bet a lot of people across the country don't know that there are 
health insurers that deny coverage because of a circumstance of 
domestic violence. It's hard to believe that, and yet it's true, 
because it's considered a pre-existing condition.
  And so we need not just a public option, we need one that's robust. 
We need one that says to insurance companies, here are the dos and the 
don'ts. Let's take care of the American people, and let's give them 
some choices.
  Eighty percent of Americans have health insurance, and so that means 
that most people that you run into in your schools, your communities, 
your neighborhoods, your workplaces have health insurance. But for so 
many people, it's completely inadequate to do the task.
  I think again about another situation of an insurer where my son 
actually had a little bit of an accident. He went up, he came down on 
his head. He needed to have an MRI. We talked to the insurance company. 
And what did they say to us? You couldn't go to the 24-hour MRI center; 
you had to wait and get that coverage in an emergency room. And it 
turns out that the emergency room was more expensive than getting the 
same examination that was a critical examination ordered by a doctor in 
an MRI facility. And so these choices don't make sense for the American 
public.
  And as I said, Mr. Ellison, you know, premiums are going up. Premiums 
have gone up 114 percent from 1999 to 2007. And that's greatly 
outpacing incomes in this country. And so the high costs, what are they 
doing? They're crippling the American middle class. They're crippling 
working families, they're crippling businesses.
  Most of the small business people I know actually want to be able to 
provide health care coverage, good health care coverage for their 
employees. But I'll tell you, if you're trying to provide health care 
coverage and you're suffering the cost of $10,000 and $20,000 per 
employee for health care, you can't stay in business like that. And so 
we want to give small business, all business, a helping hand with 
making sure that they can provide affordable and low-cost coverage to 
their employees.
  We want to make sure that people who are unemployed and maybe 
uninsured or underinsured have coverage. We want to make sure that 
there's a standard set of benefits that everyone should enjoy so you 
get the advantage of preventive care, diagnostic treatments ordered by 
your physician.
  We want the patient and the doctor to have control of their coverage, 
not the patient and the insurer, not the doctor and the insurer, nobody 
in between, not the government or anybody else in between, but the 
doctor and the patient. And then we want to make sure that doctors are 
paid so that they can make a viable practice, so that they can engage 
in the kind of primary and preventive care that we think is most 
important to preserving and protecting our health and our quality of 
health over a long time.
  And so I'm excited, actually, about where we are right now. I mean, I 
am so heartened because I think we've learned a lot over the years. And 
this time the American people aren't just going to get a promise, they 
are going to get the kind of health care they deserve. And so we should 
all be both excited and proud to prepare to cast a vote for the 
American people, for small businesses, for working families, for the 
uninsured, for the underinsured, for all Americans. It is the most that 
we can do for the American public.
  And I'll have to tell you, I cannot wait to cast my vote for a public 
plan option that is robust, that covers all Americans, that ensures 
what I call the three C's. You know, we want lower costs, we want 
quality care, and we want continuity of care. It shouldn't matter 
whether you have this job or that job or another job. You keep your 
health care coverage. And when we cast that vote for the American 
people, they're going to stand with us because it's the right thing to 
do.
  And so it's so good to be here this evening in this House, in the 
People's House, saying that at last, on health care, we are going to do 
what's right by the American people.
  And I yield back.
  Mr. ELLISON. Will the gentlelady yield to a question, perhaps?
  Congresswoman Edwards, we've been hearing a lot of rhetoric about 
this health care plan. This health care plan, which I agree with you, 
we need to be excited about it because this is a great and propitious 
moment in America. But we've been hearing detractors. We've been 
hearing this government-run health care, all this kind of stuff. Have 
you heard this kind of rhetoric before? And should anyone listen to it?
  I yield to the gentlelady.
  Ms. EDWARDS of Maryland. Well, I thank the gentleman. And I've heard 
the rhetoric before. But I tell you, it rings hollow on somebody who 
has not had health care and who's also had really good health care 
coverage. And so, you know, I think the detractors, we know who they 
are. They're all the vested interests who are making a boatload of 
money off of the American people while they don't have health care. And 
so we have to just stop that.
  It's really a pretty simple formula. I think the American people 
really get that. I think the American people understand that. And we 
want quality care, and we want to lower cost for everyone, and we want 
to make sure that we engage in the social responsibility that we have 
for all of those who, at some time or another, might find themselves 
uninsured or underinsured.
  And so the detractors actually don't have anything good to say, and 
so they want to try to kill our opportunity, and a meaningful 
opportunity for the American people for health care reform.
  And I think that those of us who know what the problem is, who 
understand what the solution is, who believe that we have to have a 
public option that competes with the private insurers, we know that 
that kind of competition in the marketplace will lower cost. And so 
we've got to, you know, zone out the detractors and focus on delivering 
health care reform for the American people.
  Mr. ELLISON. If the gentlelady would yield, I hope the gentlelady 
doesn't mind me asking her a few other questions.
  My next question is, why do you think that it's been reported that 
the detractors to health care reform are spending up to $1.2 million a 
day here to lobby Congress?
  I'd yield to the gentlelady. Why are they spending so much money?
  Ms. EDWARDS of Maryland. Well, you know, I don't like this mix of 
money and politics. And what it says to me is that somebody with that 
skin in that game stands a lot to lose, and so that means that the 
detractors out there know that if the cost of doing business for them 
is to spend that $1.2 million or $3 million every day to fight against 
health care reform because they know that without reform they get to 
make billions of dollars off the backs of the American people. And so 
no more to that.
  The American people are pretty smart about this. I know the people 
out in my congressional district, the Fourth Congressional District in 
Maryland, understand health care. Many of them work and they have 
health care

[[Page 18136]]

coverage. But they know that they're being burdened by increased 
premiums and deductibles. They know that there are insurance companies 
and bean counters and people on a telephone who stand between them and 
their doctor and good medical care.
  They know that they have family members, young people like my son, 
getting ready to come out of college, will lose his health care 
coverage that's covered by his parents and will be on his own. Those 
young people need to have health care coverage. We know that they don't 
believe that they're ever going to get sick or injured. But that's not 
true.
  And so we have an opportunity here to fight all of those interests. 
And you know what I say? Stop advertising. You know, we don't need to 
advertise for good health care reform. We don't need to advertise for 
pharmaceuticals that benefit us if that's a decision that our doctors 
make. And yet billions of dollars are spent in that industry. Millions 
and millions of dollars spent in lobbying against reform. And so that 
is a clear message to the American people that those detractors do not 
stand on the side of health care reform.
  Mr. ELLISON. I agree with the gentlelady, and couldn't agree more. 
And I want to thank her for making the point she's made.
  We've been joined by Congressman Hank Johnson from the great State of 
Georgia. And we're talking health care reform tonight. The Progressive 
Caucus offering a progressive vision to care for Americans. And we were 
just speaking a moment ago about how we need a robust public option; 
that we're excited about the possibility to pass health care for 
Americans. This is a 60-year debate. Some people go back to 1994. But 
we all know this debate goes back way before that.
  This is an opportunity, equal to passing, in my view, civil rights 
legislation, equal to passing environmental protection legislation, 
equal to making a leap forward for the benefit and welfare of all 
Americans.
  And I guess my question to you, and I don't want to tailor what you 
want to share with us tonight, Congressman, but I do just want to see 
if I could get your views on why, for example, the Washington Post 
reported that the Nation's largest insurers, hospitals, medical groups, 
have hired more than 350, 350 former government and staff members and 
retired Members of Congress in hopes of influencing colleagues in 
opposition to health care reform to the tune of about 1.4, I'm reading 
now, I was going from memory before, $1.4 million a day. Why would they 
do such a thing, unless they thought that this was a reasonable cost of 
doing business?
  Does the Congressman have any views?
  I yield to the gentleman.
  Mr. JOHNSON of Georgia. Thank you Congressman Ellison. And I want to 
also recognize my great freshman colleague, when we came in--now we're 
all sophomores--Ms. Donna Edwards, who's been a real champion on this, 
as you have, Mr. Ellison.
  And Mr. Speaker, I just want to respond. It is a civil rights issue. 
It's just not racial. It is a matter of demographics. It's a matter of 
who has insurance and who does not. And you'll find, looking at it, 
you'll find that most poor people and most, at this point, I would 
venture to argue, middle class people have no health insurance 
coverage.
  And so the question is, after spending $780 billion in a Wall Street 
bailout, do we have the will to handle and to address this civil rights 
issue that is so fundamental to our country?
  And to me it's mind-boggling. We just heard reports of Goldman Sachs 
hitting the jackpot for $3 billion in profits over the last quarter, of 
the taxpayers' money. And people want to know, well how much does this 
health care plan cost?
  Well, I'm going to tell you, it's going to cost us a whole lot more 
if we do nothing, like my colleagues on the other side, if we do 
nothing, it's going to cost us a whole lot more. You know why? Because 
health care costs are going to continue to skyrocket through the roof.
  In 2005, a study by Families USA and the Center for American Progress 
showed that the cost of treating the uninsured added $330 to the 
average individual plan in Georgia, and $900 for the average family 
plan. That's close to $1,000, Mr. Speaker, every year. And high costs 
are what block access to health care because people don't have the 
insurance coverage to be able to become healthy individuals.
  And certainly, for our economy, Mr. Speaker, we can't have a majority 
of the people in this country sick with some kind of a chronic illness 
that, if left untreated, will kill them, and that, if there were 
preventive measures to keep those chronic diseases from happening, or 
if there were some treatment regimens to address and arrest these 
chronic diseases, then you would find that the American people would be 
ready to, our children would be ready to, go to school and learn and 
become great individuals who carry our economy into the 21st century. 
And that's simply one of the items that we're addressing here.
  Are we going to just continue to do business as usual, tax cuts for 
the rich and famous and wealthy, as is advocated by my friends on the 
other side? Are we going to continue to do that?
  We see where that has left us. We see where we are now, and we're in 
a bad situation.

                              {time}  2030

  And so we've got to take some important steps to address it, and 
people didn't--the same folks who supported the Wall Street bailout, 
now they're talking against our investing in the lives of people in 
this country who should be in a position to save us money by having--
everyone having health care, that demand will drive down expenses in 
and of itself.
  Mr. ELLISON. So I thank the gentleman.
  If the gentleman yields back, I just want to do a very quick update 
for the folks who may have just tuned in. We're talking about health 
care reform tonight with the Progressive Caucus, and the health care 
reform must include guaranteed eligibility. That means no American will 
be turned away from any insurance plan because of an illness or 
preexisting condition.
  The bill also includes comprehensive benefits. This is what we need 
to have. This is what the bill offers: affordable premiums, copays, and 
deductibles. Participants will be charged fair premiums, minimal 
copays, and subsidies of families who do not qualify for Medicaid or 
SCHIP but still need assistance.
  What this bill calls for--and I think it's important, and I hope my 
colleagues agree--is to try to make this thing simple so that people 
can get a grip on it. The path to health care for all, under the 
proposed bill, what would happen is under these three bubbles, if you 
have employer-based health insurance now, you will be able to keep 
that, but you will have certain things that control costs, including no 
more discrimination for preexisting conditions, no discrimination for 
gender, for issues like that.
  Also medical-loss ratio, 85 percent, so that at least 85 percent of 
the premiums must go to patient care. People who have public programs 
now such as SCHIP or Medicare or Medicaid can keep their program if 
they qualify. And there won't be much that they have to worry about. It 
will be pretty much how it is now.
  But then there will be this exchange which is new. And who will 
qualify for the exchange? People who are the uninsured--individuals and 
small businesses. And they will be subsidized for up to 400 percent of 
the poverty level. And within this exchange will be a public plan, and 
there will be private plans which have standardized benefits which they 
will have to compete for and will drive down costs.
  The fact is, it's not complicated. It's not that difficult. Of 
course, the bill has a lot of pages because there are a lot of things 
to consider. But the fact is that this is not a difficult thing, and 
we're going to be working to make sure people understand it.
  I would also like to just mention that change is necessary. Change is 
necessary, and there will be some pay-fors. The fact is only 1.2 
percent of American households will have to pay the

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American surcharge for health care reform. That leaves about 98 percent 
of American households who will not pay any surcharge.
  And people who are blessed to be at that top, tip-top part of the 
income scale, I really believe, as good Americans who care about their 
fellow countrymen and -women, that they would not mind helping to cover 
the costs of health care. I think it's an act of patriotism, and I 
think it's a good act of social responsibility to say that if we, the 
top 1.2 percent, have been able to benefit from the massive tax cuts 
that have benefited this group of people over the last number of years, 
that now that the country needs health care insurance, now that it's 
not given up a substantial part of their income, that they would be 
able to contribute this.
  But I think it's important to talk about the fact that under this 
bill, a family making up to $350,000--which is a pretty good amount of 
money--in adjusted gross income will not owe any surcharge at all. And 
a family making $500,000 a year in adjusted gross income will 
contribute about $1,500 to help reduce cost and provide access to 
affordable health care for all.
  The fact is it's important to try to keep on talking about what the 
bill calls for so people will understand it.
  We've been very fortunate to be joined by John Hall, who is out front 
on nearly every progressive issue. Let me welcome the gentleman and 
yield to him so he can get in this conversation.
  Mr. HALL of New York. Thank you and your colleagues for spreading the 
word about this health care plan, which will include, for the first 
time in the United States, a public plan, a public option, a patient 
option, as some call it, so that all Americans will have access to some 
kind of coverage.
  I just wanted to follow up on what you were just saying in terms of 
what a family of making, say, adjusted gross income of half a million 
dollars a year will be paying. It's important to recognize that the 
average American family is already paying an estimated $1,100 a year in 
extra premiums to cover those 47 to 50 million uninsured who walk into 
emergency rooms, walk into trauma centers with the flu or where the 
child is sick or with a sprained ankle, something that should be 
handled by primary care physicians. But because they don't have health 
insurance, they go to the ER instead, and those bills don't get paid. 
And the costs get spread over the rest of the population, and all of us 
wind up with higher premiums as a result. We're paying more than any 
other country in the world.
  In fact, 16.2 percent of our GDP is going to pay for health care, but 
we're not getting the best results. We're not at the top in terms of 
lifespan. In terms of infant mortality, we're not even close to the 
top. And I think that it's also important to realize that, first of 
all, this plan is still being tweaked. The bill is still being worked 
on.
  There are those who have questions about one aspect or another. I'm 
particularly, in my district, concerned that small businesses be 
protected as well as possible. Although many small businesses have come 
to me, including the chambers of commerce in my district have come to 
me and said the number one issue for their member businesses is health 
care; the cost is spiraling out of control, the cost of providing 
health care to their employees. They want to do it. They're just going 
to be broken by doing it.
  But the other question I hear is, well, a couple of things. I hear 
some people say, and they've heard this from TV, from the ads that are 
running already against this, I don't want the government between me 
and my doctor. Well, neither do I. But I also don't want your insurance 
between you and your doctor, and that's the situation we have now.
  People say, I don't want rationing. We already have rationing. People 
say, I want to have my choice of doctor. You don't. If you have an HMO, 
they give you a list of doctors, and if you're not in the system, you 
know, you wind up paying for yourself and filing for reimbursement. And 
good luck, it won't be the same rate if you do get it at all.
  But the main myth that I would like to dispel is the idea that the 
government can't run a health care program well. This isn't going to be 
government-run health care. It's going to be a standard set of plans, 
the exchange into which any business or any individual can go and 
choose from among private choices, and one of those choices will be the 
public option.
  But just think about our military, for instance. All of the many 
members of the military and folks I know who work at West Point, which 
is in my district, are covered by TRICARE. TRICARE is a single-payer, 
government-funded, one-source health care plan. Same goes--Medicare is 
another one, and the Veterans Administration. There are certainly 
problems with veterans getting into the system. Once they're in, 
they're very happy. Matter of fact, don't talk to a veteran about 
taking away their VA care because most of them, once they get that card 
that's so portable--it goes anywhere in the country. Their records pop 
up instantly on computer.
  So, there are several examples already of--my parents are quite happy 
with their Medicare coverage. They buy supplemental sometimes if they 
need it, and that option would be available under the bill that we're 
talking about.
  But I mainly just wanted to thank you and add my voice to the chorus 
of those that are saying it's time for this change to happen for us to 
join the rest of the G-20, the rest of the industrialized, developed 
world in having some kind of universally available, accessible health 
care.
  Mr. ELLISON. Now let's hear from the Congresswoman from Maryland, Ms. 
Edwards.
  How do you react to these claims?
  Ms. EDWARDS of Maryland. I thank the gentleman.
  I was listening to my colleagues, Mr. Hall and Mr. Johnson, and I 
want to say particularly something about that the critics charge that 
we don't want government running health care and government is going to 
choose your doctor.
  I grew up in the United States Air Force. My father was in the 
military. So when we were young children and had to get health care 
coverage, we called, made an appointment, got the tonsils checked, got 
whatever medication was needed and went home. We saw primary care 
physicians. It's a government-provided system.
  My father on his retirement was in the VA system, got excellent 
coverage through the VA system. My brother retired from the United 
States Air Force, excellent service and care through the VA system. 
Those are government-provided systems. Medicare. Medicare is one of the 
most efficient health care systems that we have.
  And so what are we talking about here?
  The critics can say what they want, but they know that when it's 
Medicare or veterans' coverage or coverage through these systems that 
people get quality care, that it's low cost, that it's a very efficient 
system.
  Now, do we need to make some changes and tweaks? Absolutely. And you 
know what? In this bill that we are going to be voting on, those tweaks 
and changes are made to Medicare, to reform it so that it actually 
saves taxpayers money.
  So I just thank my colleagues for pointing out that while government 
can provide the mechanisms for health care, you still get to choose 
your doctor. Under a private system, you choose your doctor. Under the 
public system, you will choose your doctor, and then you can decide 
what works best for you. And that's the beauty of this.
  For people who believe in the marketplace, they need to believe in a 
public plan option because the public plan option is all about making 
the marketplace work for the American people, making it work for health 
care.
  So I thank my colleagues because I think that we are going to do 
something very special for and with the American people, and at the end 
of the day, we will celebrate because all of us will have quality, 
affordable, and accessible health care.
  And as I close, I want to say to the gentleman, as well, that quality 
and affordable and accessible health care

[[Page 18138]]

can't be just for that top 1 percent. It has to be for the other 99 
percent. And the same choice that I get here in the United States 
Congress for my health care where I can look at an array of plans and 
make a choice we want to deliver to all of the American people.
  Mr. ELLISON. I thank the gentlelady for yielding back.
  Let me now go to the gentleman again from Georgia. And I actually 
have a question I would like to pose to the gentleman, although the 
gentleman will talk about whatever he wants.
  And the question that I would like to pose to the gentleman is: Is 
this thing that we're embarking on, this health care reform plan which 
includes the public option, historically, is this a small thing or is 
this a big deal? Is this a time for rejoicing? Is this a big moment in 
history that people should be excited about?
  I yield to the gentleman.
  Mr. JOHNSON of Georgia. Like I said earlier, to quote you, this is a 
civil rights issue, and 100 years from now people will be looking back 
and seeing what a fundamental change in the delivery of health care in 
this Nation was accomplished by the 111th Congress.
  And so we cannot continue as things have gone in the past--17.7 
percent of Georgians do not have health insurance, and those that do, 
their premiums have increased 88 percent since the year 2000. This is a 
big number that cannot be sustained, Congressman Ellison, and we just 
simply must do what is right. And I will feel proud about being on the 
right side of this issue, along with my fellow Members of the 
Congressional Black Caucus.
  You know, we've got rising bankruptcies across the Nation; 62 percent 
of those involve medical bills that have resulted from a catastrophic 
illness or even just--not even catastrophic, but an illness, and more 
people going into bankruptcy because of this. Bankruptcy courts are 
overwhelmed with new bankruptcies.
  I would like to also address this issue of small businesses. As small 
business is defined by the broadest definition, which means basically 
any individual with as little as $1 of small business income, those 
people will not be impacted by a health care surcharge whatsoever. In 
fact, 96 percent of small businesses will not have to pay any surcharge 
at all, and those that make basically $250,000 or less, they won't pay 
anything.

                              {time}  2045

  If you make over $250,000 in payroll, then you would have, I believe 
it's $500, those employers who don't offer health insurance would have 
to pay about $500 per year, and it goes on up. The folks that make $1 
million or more would sustain a responsibility of--it's close to $1 
million a year, like $900,000 a year. If you have payroll, you're going 
to pay that much.
  And so those are the same folks who got the tax breaks back in 2001, 
a cut in their capital gains taxes with more spending in this Congress 
by my colleagues on the other side of the aisle which caused the 
humongous deficits that we are experiencing today, and we have nothing 
to show for them except for the people suffering.
  Mr. ELLISON. I want to thank the gentleman. Again, this is the 
Progressive Caucus coming with our weekly progressive message on the 
floor tonight with three progressive leaders who have been speaking up 
for health care reform.
  Let me turn now to Congressman Hall for a moment. We've only got 
about 10 minutes left. So I'd like to see the three colleagues share 
this time equally, and I don't need much time to close, but I'd like 
the public to hear, Mr. Speaker, from these three leaders in our 
Congress, and I guess I will just hand it right on over to Congressman 
Hall.
  Mr. HALL of New York. Thank you, Congressman Ellison, and I'll just 
tell you a brief story about my mother who was on a trip to the Slovak 
Republic with my dad and my brother, the priest, going back to see her 
great grandparents' hometown. And she's a very friendly person, 
talkative, and as she was leaving a restaurant one night, she turned 
around to say good-bye and thanks in Slovak--by the way, the language 
came back to her when she was there--and she tripped and fell down the 
stairs of this restaurant and broke her right femur just below the hip. 
And it was too much pain for her to get on the airplane and fly back to 
the United States and have her leg repaired here.
  So she went into a hospital in a little town in what was 
Czechoslovakia back when her relatives lived there and now is the 
Slovak Republic, a post-Soviet country that we think of as a backward 
nation. Probably most Americans who think of the Slovak Republic think 
of a backward nation.
  She went in the hospital, spent 2 weeks, had pins put in through the 
marrow of her leg to hold the bones in alignment, plate put in the side 
of it, screws put in. It's an elaborate operation. Spent 2 weeks in the 
hospital, and at the end of that time, my father went down to the 
office of the hospital and asked if he could pay the bill because they 
were leaving to get on the plane to go home. And the administrator 
said, What bill? Send us a postcard, tell her to do her exercises, and 
have a good trip.
  Now, I'm not sure that we're going to be able to do that, certainly 
not for, you know, every visitor to this country, but we ought to 
certainly try to do that for our own people, for those who can't afford 
it. For people who can afford it, they can pay for it. The people who 
can afford the insurance, they can buy it. For those who can't afford 
it because they're living at or below the poverty level, then we have 
found ways and are still addressing ways to fund that.
  But for the first time in this country we will do what Israel, 
Canada, the Slovak Republic, Sweden, Holland, France, Taiwan, you can 
read on the list of all our allies and all of the industrialized 
developed countries in the world what they do for their citizens and 
that is make sure that every one of them can go to bed at night and 
have that certainty, not worrying that they or their children might get 
sick or injured and not be covered by some kind of health care.
  Mr. ELLISON. I want to thank the gentleman, and that was a very 
important story for us as we wind down, and now I turn to the 
gentlelady from Maryland, Congresswoman Edwards.
  Ms. EDWARDS of Maryland. I thank the gentleman for yielding.
  You know, each time Mr. Hall has spoken, he reminds me of something 
else, and I have to tell you, I, too, left my appendix in Spain in a 
clinic, but I didn't get a bill. Now, that is not what we're doing 
here, but we are doing something really important for the American 
people.
  And I believe that the strongest health care reform that we can pass 
out of this Congress also embraces a robust public plan option that 
gives people choice, that's competitive in the marketplace, a bill that 
makes certain that we don't have exclusions for preexisting conditions 
like domestic violence or any other so-called preexisting condition.
  And so I think that, in order to meet the test for real reform, we 
have to have a system in which patients choose their doctor, doctors 
and patients choose their care, and insurers and government bureaucrats 
alike stay out of those decisions.
  And so I say to the American public, we're ready to cast a vote for 
real reform, and so let's bring on the choice, let's bring on the 
competition, and let's bring on the care for patients.
  Mr. ELLISON. I thank the gentlewoman, and let me yield to the 
gentleman from Georgia.
  Mr. JOHNSON of Georgia. I thank Congressman Ellison.
  We're having or they are having a TEA party outside one of my 
district offices on Friday, and I would venture to speculate that many 
of those people who will come don't have health insurance or recently 
lost their health insurance and they are frustrated. They feel like 
this is going to cost them some money, but actually, when you stop and 
think about it, some folks have only the choice of going into the 
emergency room when their illness becomes so dire that the family makes 
them come, and that's the only health care that they have.

[[Page 18139]]

  But with this bill, with a strong public option, those folks will be 
able to choose whether or not to be enrolled in that program or not. 
And if so, then they will get coverage for their medical throughout 
their lives. And that's exactly what we need in this country because 
this plan that would enable a public option will keep the insurance 
companies honest because it will be competitive, and so we're talking 
about lowering the cost of health care, taking some of that 88 percent 
of health insurance, rising cost, off the backs of the middle class.
  Mr. ELLISON. Well, let me thank the gentleman, and let me remind 
everybody that this is the Progressive message, the Progressive Caucus 
coming together; and I just want to leave us with this.
  Mary from Minneapolis says, My daughter needed her wisdom teeth out. 
At the time with insurance we were told to pay $375 and we did. Then we 
got billed over a thousand. Resubmitted, eventually the amount was 
reduced to 750. In the meantime, my husband had no paycheck.
  Her second story was, she had calcium deposits in her back which make 
it difficult for her to walk, and yet she's having to delay her 
treatment until such time that it gets to be an emergency.
  There are health care nightmare stories all across America. This 
Democratic Caucus is hearing the cries of the American people and 
bringing forth reform, with a bill that includes a robust public 
option, will stop people being dropped and denied for preexisting 
conditions; and we hope, Mr. Speaker, that people all over America talk 
about the fact that hope is on the way, change is on the way.
  And I'm looking forward to pushing green on this bill, just like my 
colleague from Maryland talked about, feeling good about this change 
that's coming. Not that we don't have some tweaks to do, but, hey look, 
any tweak is nothing compared to the hope that this bill represents to 
the American people.
  So, Mr. Speaker, I want to thank you and the Congress.

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