[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[Senate]
[Pages 18807-18812]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. DODD. Mr. President, I rise on this early evening in July to 
spend a few minutes to talk about health care. I know it has obviously 
been a subject of great interest over the last number of days, having 
been asked to fill in for my dear friend, Senator Ted Kennedy, the 
chairman of the Health, Education, Labor, and Pensions Committee, who 
as we all know is struggling with his own health issues.
  I was asked to fill in for him to mark up the HELP Committee's 
legislation on health care, and I was fortunate to have as my allies in 
that effort some remarkable Members of this body--both Democrats and 
Republicans--who, we are told, spent as long a time, maybe longer than 
for any other markup in the history of that committee and one of the 
longest in the history of this body. There were some 23 sessions over 
13 days, covering nearly 300 amendments that were offered on behalf of 
the 23 Members of the Senate--almost a quarter of this body--serving on 
that committee.
  After that lengthy period of time, we drafted a bipartisan bill. It 
did not end up being a bipartisan vote. It was a partisan vote coming 
out of committee, regrettably. But that doesn't mean it will end up 
that way. I have often been involved in legislative efforts where the 
committee action would have a partisan conclusion, only to find that 
after further work, those efforts can attract a broad base of support 
and develop the kind of broad-based backing that is, I think, an 
important feature of good legislation.
  So while I regret we didn't have any Republican votes in that 
committee, I am deeply grateful to my Democratic colleagues for their 
efforts--and also to my Republican colleagues for their efforts--which 
I will talk about. I intend, in the coming days, to talk about this 
issue through the remaining weeks we are in session--and possibly even 
beyond that, if we stay in session in August to work on this issue.
  This is not any ordinary issue or ordinary time. I have been around 
long enough now to have witnessed the debates on this issue going back 
30 years. Every single Congress and every single administration 
predating my arrival here has grappled with this issue--Republicans and 
Democrats alike. Since the days of Harry Truman in the 1940s, literally 
every administration has tried to come up with an idea to reform our 
health care system.
  In years past, those efforts were talked about in terms of describing 
the present condition of health care as being an unacceptable 
situation; that it was wrong, unethical, immoral that we weren't 
serving people who should be served. The debate has now changed because 
it is no longer just unacceptable--which has always been the case--but 
we are now in a situation where the present conditions are 
unsustainable. Yesterday and again this morning the Chairman of the 
Federal Reserve Board, Ben Bernanke, testifying on monetary policy, was 
asked the question in both the other body as well as in the Banking 
Committee, which I chair, how important health care was as a matter of 
economic recovery. In both forums, in different language, the Chairman 
of the Federal Reserve--while not getting into the details of the 
various plans--pointed out, once again, if there was any doubt about 
this, that unless we resolve the health care issue, the economic issues 
we are grappling with today will be unresolved and only grow in their 
complexity and in their depth.
  So this issue of health care is obviously one that affects real 
people every day. As we conclude the work day here on the east coast, 
and will do so in a few hours across America, remember this: Today, and 
every day, as we grapple with this issue, 14,000 of our fellow citizens 
will lose their health care. That is 14,000 today, 14,000 tomorrow and 
the next day and the next day and the next day. Every day we wait and 
delay on this issue, that many more of our fellow citizens and their 
families can fall into that abyss, that free-fall of wondering whether 
some accident, some injury, some diagnosis will tell them and their 
families they are in deep trouble, from a health care perspective.
  If they lack the kind of coverage and insurance or lack the kind of 
personal wealth, that family will not only face the hardship of 
confronting a health care crisis without the adequate quality of care 
to provide for them and their families, but they may very well find 
themselves in economic ruin as a result of the situation that persists 
today.
  I am not talking about the uninsured alone. I am talking about the 25 
or 30 million who are underinsured in this country. They struggle every 
single day, wondering whether those deductibles are going to be low 
enough to pay when crisis strikes and, even if they have a policy, 
whether there are going to be an adequate number of doctor visits, 
prescriptions covered, and the like that provide them with the 
necessary protection to recover from their health care situation and 
avoid the economic crisis that can befall them.
  To put it in perspective for you, Mr. President, consider this: Of 
all the bankruptcies that occur in the country, and there are many in 
economic times such as this, 62 percent of those bankruptcies are 
directly related to a health care crisis in that family; that they 
would not be in that situation except for the fact that they are 
suffering through a health care crisis that has forced them into 
financial bankruptcy. Consider this, if you will: 50 percent of all 
home foreclosures--and there are 10,000 of those every day, today 
10,000 families got a foreclosure notice--50 percent, one out of every 
two foreclosures that occurred in this country occurred because of 
health care costs for that family.
  Eighty-seven million of our fellow citizens every year find 
themselves in some period when they lack health insurance. Yet, as I 
say all of that from this Chamber, all 100 of us here have a great 
health care system, the Federal Employees Health Benefits Plan. All of 
the Federal employees in the Capitol and across this country have a 
good health care program, the Federal Employees Health Benefits Plan. 
Maybe if we were in the same situation as our fellow citizens, being 
uninsured or underinsured, maybe there would be a heightened sense of 
urgency about this issue. But as long as we are OK and have nothing to 
worry about because of the jobs we hold, the titles we have, because of 
the good health care at relatively low cost that we have, none of us 
have to worry about that. We hope nothing happens, we hope we do not 
get sick, we hope a child of ours or a grandchild doesn't face a health 
care crisis, but if they do, Lord forbid, we have the resources to 
protect our family. That is not the case for millions of our fellow 
citizens.
  So this issue demands our attention. It is an issue that cries out 
for solution. It is one that we must address. This is not one we can 
delay on, it is not one we can postpone for some future Congress. In 
fact, the American President, Barack Obama, who will address the 
country about 55 minutes

[[Page 18808]]

from now on this subject, has made the case publicly: There is no other 
issue more important to him than this one. He has announced he is 
willing to expend whatever political capital he has in order to resolve 
the health care issue. He has made it the central issue of his 
Presidency, and we in this body, regardless of what political label we 
wear, bear a similar responsibility and should be sharing a similar 
cause--and that is to address this issue in a way that will increase 
access, will reduce cost, and create the kind of quality health care 
all Americans ought to have.
  Every American ought to have at least as good health care coverage as 
their Member of Congress. Every American ought to be able to go to bed 
at night with the security that if their spouse or their children or a 
loved one in their family were to face a health care crisis, they would 
not be facing economic ruin, that they would not be wiped out because 
of it. Every American ought to have that sense of security, that 
something in this great Nation of ours ought not to be depending upon 
the wealth you have in your family or the job you hold. It ought to be 
a basic right to be able to have access to affordable quality health 
care in America. That is the charge. That is the obligation. That is 
what stands before us as the issue of, not only the day or the hour, 
but I think of our time here in this Congress.
  President Obama has said he is willing to expend every bit of his 
political capital. That is an extraordinary statement made by an 
extraordinary President at an extraordinary moment in our Nation's 
history. In my 35 years in Congress serving with seven Presidents, I 
have never heard another President on any issue make a similar 
statement of their willingness to expend their capital on a single 
issue. This President has made that statement. That ought to inspire 
all of us to join him in that effort.
  The President recognizes, as I hope my colleagues recognize, that we 
have been given a mandate by the American people to deliver on health 
care reform. I hope my colleagues will join in this effort.
  Already we have made significant progress toward legislation that 
cuts costs, protects consumer choice, and guarantees access to 
affordable quality care for every one of our citizens.
  The American Medical Association, the American Nurses Association, 
the organizations representing America's hospitals and pharmaceutical 
companies, have all come to the table and agreed to support strong 
health care reform. Three of five congressional committees responsible 
for health care have already approved strong legislation. I was here in 
1994. Those organizations which I just mentioned, believe me, were not 
at the table urging that this Congress pass major health care reform. 
They are today. That is a fundamental change that has occurred in the 
last decade and a half.
  Even the notorious Harry and Louise, those actors who once were used 
in commercials to kill health care reform, stood with me last week in a 
group of our colleagues when we announced the first piece of health 
care legislation to emerge from the Senate. They stand strong for 
health care reform and change and intend to do everything they can to 
assist in that effort.
  This bill, the one that passed the HELP Committee, the Affordable 
Health Care Choices Act, is a strong and sensible piece of legislation. 
It forbids insurance companies from cherry-picking applicants based on 
their gender, based on their health care status, or any preexisting 
conditions. Never, ever again, under our legislation, if adopted, would 
an American citizen be denied coverage of health care because he or she 
is a cancer survivor or the victim of domestic violence. Never, ever 
again under our bill would an American citizen who thought they had 
insurance find their coverage cut or taken away just at the moment they 
need it the most because our bill, if it is passed, not only eliminates 
caps on benefits, it bans insurance companies from cutting or taking 
away coverage after a policy has been signed.
  Our bill, if adopted into law, cracks down on waste and fraud, 
focuses on preventive care, reduces the crushing burden of 
administrative costs, and has been scored by the Congressional Budget 
Office at $611 billion over 10 years. That is a savings of more than 
$400 billion from the original estimate by the Congressional Budget 
Office.
  I am very proud we came in on time and under budget in the HELP 
Committee. We are not being talked about much these days because we got 
our job done a week ago today, but I am even more proud that with real 
contributions from each of the 22 of my colleagues who serve on that 
committee--a quarter of the Senate--we were able to craft a uniquely 
American bill for the American people.
  In the United States of America, we already find much we like in our 
health care system. We like our family doctors and compassionate 
nurses. We like our world-class hospitals and technology--and we 
should. They are remarkable. We like having the freedom of choice as 
Americans of our own health care and the ability to get it fast, if we 
can. Our bill will not touch these things that work in our health care 
system in the United States today.
  In the United States, we hold the relationship between a doctor and 
his or her patient to be sacrosanct, and our bill, if signed into law, 
guarantees nothing can ever come between you and the doctor of your 
choice--not the Federal Government, not an insurance company, not a 
bureaucrat from the private or the public sector. In the United States 
of America, we believe in shared risk and shared responsibility. Our 
bill, if signed into law, lowers costs for everyone by ensuring that 
everyone is insured. The bigger the pool, obviously the broader the 
risk and the lower the cost.
  In return, our bill asks individuals, employers, the Federal 
Government, all of us to share responsibility, not just for treating 
people when they get sick but hopefully for preventing them from 
getting sick in the first place.
  In the United States of America, we know in our committee, as we 
drafted the bill, that good companies are not afraid of competition. 
Our bill includes a public insurance option that is just that--it is an 
option, purely voluntary, for consumers and providers to decide whether 
they want to participate, nothing mandatory, just a voluntary option, a 
little healthy American competition to give consumers and providers 
some choices in the health care system of our Nation. That is an 
outrageous and radical thought to some, I know. In my communities, it 
is pretty basic, pretty common sense, pretty traditional, and it is a 
red-blooded American idea--a little competition. It doesn't hurt 
anybody. In fact, we suspect it actually helps most.
  In the United States of America, we have the best treatment and 
research facilities in the world, facilities that regularly produce 
remarkable advances. Our bill, if signed into law, ensures that those 
advances translate directly and efficiently into better outcomes and 
lower costs for our fellow citizens.
  Most of all, in our United States of America, we have learned the 
hard way that we need health care reform. For nearly 70 years now, 
Democrats and Republicans, Presidents and Congresses alike, have all 
tried this. Every one of them has made a Herculean effort to deal with 
this issue. Here we are, close to a century later, still in the same 
ditch, unable to dig ourselves out of it as it gets deeper and deeper.
  So this is the moment. This is why we are here. This is our 
opportunity now to step up or to step back, and history will judge 
which of the two directions we took at this moment; whether we have the 
intestinal fortitude and determination to sit down for the long, hard 
hours and hammer out something, to deliver not because it is good for 
us but because it is good for the people we seek to represent. That is 
why we are here.
  We talk about these debates as if no one else existed. Who is working 
on this, who is bipartisan, who is not, what coalition or group, who is 
a Blue Dog or Red Dog. It must drive the American people nuts watching 
us acting as if we were the only people on the

[[Page 18809]]

face this planet wrestling with this issue. We don't have to worry, 
none of us. Tonight you can sleep soundly, as a U.S. Congressman or 
Senator, because if you wake up in the morning with a health care 
crisis, there is nothing to worry about financially. We are well 
protected and taken care of. Unfortunately for millions of our fellow 
citizens all across this country, they cannot sleep as soundly as we 
do. They are the ones we ought to be thinking about in this debate--not 
whether we have some coalition that is going to produce some magical 
result. Keep our eye on the ball. The American people are expecting 
nothing less from us.
  For far too often, of course, we have failed in these efforts that 
have been defeated by nothing more than cheap politics in too many 
instances. The well-being of our citizens is left to drown in today's 
political current, all the while we have paid, of course, a deep, deep 
price for that ditch we are in, a ditch that is growing.
  American families pay an average of $1,100 extra. If you bought 
insurance and you have an insurance policy, by and large you are paying 
$1,100 more every year in premiums to cover the costs associated with 
the health care for the 47 million of our fellow citizens who are 
uninsured. It is not that they don't get health care. They show up. 
Where do they show up? They show up in emergency rooms. The most 
expensive health care in the country is in emergency rooms. So when you 
are paying tonight, as many Americans will be, that quarterly or 
monthly premium, or whatever the timeframe is for the premiums you pay, 
look at a percentage of what you are paying. On average, you are paying 
$1,100 more every year to cover the uninsured, whose health care gets 
paid for. You are paying for it. When people say we cannot afford any 
more cost on all of this, you are already paying an exorbitant amount.
  One of the efforts in this bill, in our bill along with the efforts 
being made by others, is to see to it that the 47 million, a number 
that expands to 87 million at one point or another during the year, of 
our fellow citizens who are without insurance at all, is reduced.
  But that is the pricetag, $1,100 on average for our covering the 
uninsured among our fellow citizens.
  Three out of every five bankruptcies, as I mentioned already, in the 
United States of America are caused by high medical bills. More than 75 
percent of those forced into bankruptcy because of medical bills had 
insurance, by the way. That number is not the uninsured, 75 percent of 
people who fall into bankruptcy are insured.
  Of the 62 percent of the bankruptcies that are created by this health 
care crisis, 75 percent of those people had a health insurance policy. 
So do not assume this only happens to those people who have no health 
insurance. If you are insured tonight, and you run into a major health 
care crisis, then you can very well find yourselves in the same 
position millions of our fellow citizens have who fall into bankruptcy. 
It is not the destitute, it is average American families.
  In many cases, half our Nation's foreclosures are a direct result of 
our broken health care system, as we now know. But it is not just 
families and businesses being bankrupted, health care costs have come 
to consume a simply unsustainable portion of our budget. The other day 
the Congressional Budget Office answered the question in the Budget 
Committee: Are we bending the curves up or down for these various 
health care plans. I have a lot of respect for the people who work at 
the Congressional Budget Office. I know they work very hard.
  But I will do a little wager that no one on that committee, the 
Budget Committee, nor did the CBO in their calculations of cost, ask 
the question of whether bankruptcies or foreclosures were calculated 
into the costs, one way or another, that were part of their 
conclusions.
  But why are they not? If 62 percent of all bankruptcies occur in the 
country because people who are insured could not afford the health care 
needs they had for their families, why is that not a cost to be 
calculated in bending curves? What about those foreclosures, 50 percent 
of which occur because of a health care crisis in that family.
  Did the CBO write that number into its computer models to figure out 
costs? Why not? Is that not a cost to our country? If a family goes 
into bankruptcy or loses their home because of a health care crisis 
that is created by the present situation in this country, where are the 
calculations and computer models that will tell us the impact of those 
crises on families?
  So we talk about this issue, and we are told now in these 
macroeconomic terms by actuaries and accountants and the ``green visor 
crowd'' that 16 percent of our gross domestic product is spent on 
health care and that number could quickly climb to 35 percent.
  What does that mean? It means, we are told, in the next 8 or 10 
years, if we do not act, if we listen to those who do not think the 
last 70 years or the last number of Congresses that we wrestled with 
these issues is somehow wasted time, that we can end up with the 
average family paying 50 percent of its gross income on health care 
premiums. That is not an exaggeration, that is not a phony projection. 
The very same economists who are telling you about the 16 percent of 
our gross domestic product consumed today are the ones who predict, 
based on the present trajectories, unchanged, that 35 percent of our 
GDP can be consumed by health care costs.
  You might be curious to know the next nation that is closest to us as 
a percentage of its gross domestic product is Switzerland, and 
Switzerland spends a little over 10 percent of its GDP on health care. 
Then the next country is us, around 16 percent and growing.
  To give you some idea around the world how we rate and compare on a 
per-capita basis, pretty staggering numbers. By the way, you might say: 
Well, look, I am sorry, Senator. I know it is a lot of money, but you 
know what? We have great outcomes. We have remarkable outcomes. So we 
are paying more than Switzerland. But, by golly, our people here get 
great outcomes.
  Well, I wish I could tell you that is the case. The fact is we rank 
37th in the world in outcomes. What a great statistic, the United 
States of America, the wealthiest nation on the face of this Earth, we 
spend more, $2.5 trillion a year, than anybody, a larger percentage by 
almost double, with the closest of any other nation in the world, and 
we rank 37th in the world in medical outcomes.
  There is something staggeringly wrong with that number--with that 
amount of money being spent and those outcomes coming in. If you wonder 
why people are frustrated by the subject matter, and they may not know 
these numbers, all they know is what they are going through and their 
family.
  If we continue on this path, it only gets worse. By the way, to add 
additional shame to that number, we rank at the bottom of all 
industrialized nations when it comes to infant mortality, the bottom of 
industrialized nations, when it comes to infant mortality in the United 
States of America. I find that shameful, those numbers.
  We like to think of ourselves as doing so many things so well as a 
country because of who we are and how we govern ourselves and the 
opportunities we create in the United States of America. We like to 
believe that this is not some Third World country, that we would take 
good care of our newborns. To rank at the bottom of the list in infant 
mortality is shameful, to come in 37th in medical outcomes is shameful, 
to spend almost double the percentage of our gross domestic product as 
our nearest competitor nation is also shameful.
  We have reached a point where no Senator can, with a straight face, 
come on the floor of this body and argue for the status quo. That 
status quo is not only unacceptable, as I have said, it is 
unsustainable.
  Of course, some will stand on this floor and argue that the best 
thing we can do when confronted with a house on fire is to walk around 
it a few more times and argue about how high the flames have grown. 
Well, when we began writing this legislation out of

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the HELP Committee, we did not forget that each of us were born with 
one mouth and two ears.
  We started with a blank page. Long before I was asked to pinch-hit 
for Ted Kennedy, Senator Kennedy and his staff and others invited the 
minority, early on, to share their ideas. You are going to hear 
otherwise, that we got drawn into this, we were not informed. That is 
not the case. They were not drawn in. They were invited. They had no 
idea what they wanted to offer, only that they got nervous about this 
plan going forward.
  That started, I am told, at the end of last year, not when the 
President was inaugurated after January 20. So we began by listening. 
We listened to stakeholders, providers, hospitals, pharmaceutical 
companies. Anyone we could gather who had an interest in the subject 
matter was invited to come and talk about what they thought a Federal 
health care reform package ought to look like. The culmination of that 
effort was to draft a bill. Why did we draft a bill? Well, because the 
rules of the Senate require it. You cannot begin a markup in the HELP 
Committee unless you have a product on the table. There has to be 
legislation written. The rules require it. So we wrote a bill and put 
it on the table and invited our colleagues on the committee to come and 
comment on it, talk about it, amend it, change it, do whatever they 
thought might improve it.
  That is what took us to 54 hours, over 13 days and 23 sessions and 
nearly 300 amendments; a rather long and elaborate process. It was good 
work. Frankly, the bill got a lot better because of the effort. It got 
better because my Republican colleagues offered terrific ideas.
  Contrary to what some may think, they did not come and just shove 
their hands in their pockets, put their heads in the sand and refuse to 
participate or walk away and not show up. Mike Enzi, Judd Gregg, Lamar 
Alexander, I can go down a long list of the Republican members who were 
there day after day, sat in that committee room and contributed 
mightily to our effort.
  I was blessed to have Tom Harkin and Barbara Mikulski and Jeff 
Bingaman and Patty Murray, who were asked by Senator Ted Kennedy months 
ago if they would each take on a separate piece of the bill.
  Tom Harkin grappled with prevention issues; developed a staff with 
expertise and knowledge. Barbara Mikulski worked on quality issues; did 
the same as Tom Harkin. Patty Murray did it on workforce. Jeff Bingaman 
did it on coverage. They had 12 hearings themselves on this subject 
matter even before a word was written on the bill, to bring people 
together, to listen to ideas and how we could shape those ideas as part 
of the structure of reform for the health care system.
  Then that culminated with us sitting down in the beginning, back 5 or 
6 weeks ago now, to actually mark up this bill, as we are expected to 
do. True, the Republicans on the committees did not vote for the bill, 
I have said that, regrettably. That was pretty clear to me that was 
probably going to happen no matter what we did. But they contributed 
and they made significant contributions. Of the 161 amendments that we 
accepted were offered by the Republican side--of the nearly 300 
amendments that we considered, 161 amendments offered by the minority 
are very much a part of the bill that I have been talking about this 
evening. Some were technical amendments, clearly. But many were very 
substantive.
  They do not want to admit it maybe because they voted against it in 
the end. You can define bipartisan any way you want. But I define it by 
contributions made to the product. They made a bipartisan contribution 
to the product and a better bill, not a perfect bill, was the result. 
It obviously needs more work. But we think it is a good, sensible bill 
that ought to enjoy the support of our colleagues.
  Senator Gregg, for instance, and a number of his fellow Republicans 
were concerned about the long-term fiscal impact of our provisions on 
long-term care. So Judd Gregg offered an amendment that would require 
the Secretary of Health and Human Services to set and adjust premiums 
based on a 75-year outlook of the program's solvency.
  We had a robust debate for an hour on this issue. The committee 
recognized the tremendous value, frankly, of what Judd Gregg was 
proposing. So his amendment was accepted unanimously, and the bill is a 
better bill for it. Johnny Isakson, my very good friend from Georgia, 
brought to the table the issue of end-of-life care, drawing on his own 
family's experiences. He gave very moving remarks in our committee 
about the importance of end-of-life care issues. He was able to talk 
about the importance of planning for the last days of one's life, how 
difficult that can be.
  I just went through that with my sister who was diagnosed on May 22 
with lung cancer, and she was gone in 6 weeks. She died on July 6, the 
first of my siblings to be lost. She was 68 years of age, with 5 
children and 17 grandchildren. She knew in the last 9 days of her life 
what the outcome was going to be.
  So she insisted upon each of us spending an hour or so alone, every 
one of her 17 grandchildren, every one of her children and their 
spouses, every one of her siblings, every one of her close friends. Her 
best friend in the world was a woman she met on the first day of 
college when she was 18 years of age. Her name is Nancy Pelosi, Speaker 
of the House. She was there for the funeral.
  Joe Biden came up. Joe and my sister were great friends, and he came 
up for the wake the night before. So I knew she was thinking, my 
sister, in planning what she wanted to have happen those last nine days 
of her life. A lot of families go through that. Senator Isakson made a 
very substantial contribution, nothing technical about what he was 
talking about. Our bill is a better bill because Johnny Isakson's ideas 
were incorporated in it.
  Mike Enzi and Judd Gregg and Lamar Alexander wanted to increase 
employer's flexibility to offer work-based wellness programs with 
incentives for employees. Some of my fellow Democrats had reservations 
about their proposal. But Senator Tom Harkin of Iowa and myself and 
several others on the committee worked with our colleagues on the 
Republican side to craft a compromise, a version we were able to pass 
on a bipartisan basis unanimously.
  As a result, today, employers at some point can offer as much as a 
50-percent reduction in premiums to employees who have engaged in 
lifestyle behaviors that will reduce their threat of illness and thus 
bring down the cost to those people. It was a great idea. We attributed 
a lot of it to Steven Burd, the CEO of Safeway, who brought the ideas 
to the table.
  But our fellow Democrats, working again with Mike Enzi and Judd Gregg 
and Lamar Alexander came up with those ideas in that compromise. That 
is not technical. The bill is a better bill because of their efforts. I 
can go on and talk of the rest of the members who made contributions--
but I will not tonight. Every one of them have contributions in this 
bill. But let me be clear: If we deem bipartisanship more important 
than timely and effective health care reform, the only thing that will 
be bipartisan will be our collective failure as an institution. I have 
introduced a lot of bills over the years, and passed a lot of 
legislation. On every major bill I have written in this place, I have 
had a Republican partner, going back to the earliest days when I 
arrived here and offered the first child care legislation since World 
War II.
  My ally on that was a guy named Orrin Hatch from Utah, who stood with 
me and we passed it. I offered the Family and Medical Leave Act. That 
took 7 years, two vetoes. Today there are some 50 million Americans who 
take leave without pay without losing their jobs. My partner on that 
was Dan Coates of Indiana, and Arlen Specter at the time was a 
Republican, obviously, along with people not here who were involved. 
Kit Bond played a very important role in developing the Family and 
Medical Leave Act.
  I could go on with a list of bills, and on every single one of them I 
had bipartisan support. So I understand the value of it. It is a very 
important

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means by which to get a job done. But let me suggest to you at this 
hour, while bipartisanship is a means to get to an end, what really is 
missing right now is leadership in all of this--leadership from each 
one of us.
  The President is leading as strongly as he can, and is deeply 
involved in this issue. Members of various committees are also leading. 
But in this institution everybody can be a leader, if they want to be.
  Right now, I think what the country is looking for is leadership on 
this issue. Yes, bipartisanship is a nice quality, an important 
element, to pass bills. But leadership is what is most missing in all 
of this--the willingness to understand the moment, the unique 
opportunity to address a crippling issue that faces our country.
  Every single one of our citizens will be adversely affected if we 
fail to act. There are very few bills that can ever make that claim, 
and yet health care issues affect 100 percent of the Nation. Most bills 
we deal with deal with percentages. Family and medical leave--50 
million benefited by it, far short of the 300-plus million in our 
country. Health care affects every single one of our citizens and is 
why, again, it demands our attention and our resolution.
  So to those who are not ready to join in this effort, we invite your 
suggestions, your improvements, your thoughts to come to that table. 
Listening to some of our colleagues say this is all about defeating the 
President or making sure no one has a political victory, I have to ask 
what planet are they living on to believe this debate ought to be about 
who wins and who loses a political contest on this issue?
  Again, it is not about us. It is about people across this country who 
are expecting a lot more from us who do not wake up and wonder what 
political party they belong to or what section of the country they live 
in. If their child gets sick, if their spouse is sick and struggling 
and needing help, the last thing they want to hear about is whether you 
are a Democrat or a Republican or an Independent or live in a blue 
State, a red State, or whatever other color you want to attribute to 
them. They want to know if we have the sense to deal with this issue.
  The truth is, we have waited too long. We have waited far too long. 
We have waited decades now. And the American people have been waiting 
even longer. Their wait is much more painful than ours. There is no 
cause for delay.
  Yes, you have to examine the bill. We have to look at it, consider 
suggestions, but that only happens when you sit down and work together.
  We spent those 60 hours in the HELP Committee, and it was not easy 
and it was not comfortable, and people got tired and frustrated at 
various moments, and there were times I thought it was going to fall 
apart. But I knew if we ever stopped and walked away, then those who 
wanted no result, no answer to this, would win. So day after day I 
asked my colleagues to come back and sit at that table and work.
  What I said earlier I mean deeply: There were those who, frankly, 
might have decided not to show up, and that might have had a political 
conclusion; but they did show up. My Republican colleagues, as well as 
my Democratic colleagues, showed up every single day and worked to make 
that a better bill, even though there were those who voted against it. 
So there is no cause for delay. There is no cause for obstruction. And 
there is no excuse for inaction, in my view.
  In a few weeks, we will return to our various States for the so-
called August break, although, frankly, I am prepared to stay here and 
work. That may not be a popular idea, but I cannot think of anything 
more important than this issue, including whether we take some time off 
in August to go to the beach and go to the mountains or go to the lakes 
or wherever we go to visit with our constituents. Remember that every 
day we are on our break, another 14,000--every day in that August break 
we will take--will be without health care at the end of that day--every 
day; 14,000 a day--while we are drifting off instead of engaging in 
what we ought to be doing, in my view, and coming to terms with this 
issue.
  Some will be among the ranks of the uninsured. Some are struggling 
and scared, bearing the emotional and physical scars that come with 
delaying the foregoing needed care, worrying that one car accident, one 
diagnosis could mean bankruptcy, foreclosure, or, in fact, the 
inability to get any care at all. Some will have insurance, but they 
will share the same worries because their insurance costs are much too 
high and covers far too little. They will be thinking about the jobs 
they wish they could leave to maybe start a small business but cannot 
because they would lose their insurance lifeline. They will be 
wondering whether their plan will decide to cover cancer screening when 
they are told by their doctor they actually need it. They will be 
wondering how many visits to the doctor, how many visits to the 
hospital will be adequate. Some will not be worried about their 
insurance today, but they will be among the millions who will lose 
their insurance if they do not step up to the plate and take some 
action.
  But everyone we see when we go home will be watching us over the next 
3 weeks. You better believe they are going to ask us about health care. 
They are going to ask us whether we are up to the job of passing a bill 
this year. They are going to ask us why we have not made more progress. 
They are going to ask us fundamental questions, ones we will have to 
answer for ourselves based on what we do in these coming days and 
weeks.
  At this very moment, we stand at the cusp of history--one of those 
unique moments. It does not happen very often around here, but every 
now and then it happens, and we are in one. And it is not going to last 
long. It is only going to last a few more weeks, maybe a couple of 
months, as to whether, in this moment, we have the ability to rise up 
and do what we should be doing--even though it does not meet our 
ideals; it is not the bill each one of us would write on our own--but 
that moment when we recognize our failure to act at all is a moment 
missed and not likely to be recaptured during our tenure.
  I know for newer Members here that may seem like an exaggeration, but 
to those of us who have been here a while, we will tell you, these 
moments do not come very often. Most of the time we go through the 
routine of reauthorizing bills, reappropriating money, and that 
consumes about 95 percent of our time--not unimportant business, I will 
be the first to admit, but fairly routine.
  And every now and then--every now and then--in our Nation's history, 
there have been moments of critical importance: in the early 1960s, the 
Civil Rights Act, the Voting Rights Act, Medicare; going back in the 
depression years; the Eisenhower years, with the Federal Highway System 
in our country. You can point to various times through the 20th century 
when Congress, contrary to what everyone else thought--this 
institution--decided to take on an issue that made a difference in our 
country.
  I suspect Barack Obama, in part, had a chance to be elected President 
of the United States because people he never knew and who never knew 
him sat here day after day, week after week, and engaged in the debate 
on civil rights--back long before any of us were ever here, except for 
Bob Byrd, who was here, and Ted Kennedy, who was here. Those two 
Members actually were in this Chamber in those days in the early 1960s, 
and today we are a lot better country. We are a lot better country 
because of it.
  And that was one heck of a fight, let me tell you. I was a young page 
sitting on the floor here in the summer of 1961 and 1962, when Lyndon 
Johnson was sitting where the Presiding Officer is, watching the all-
night debates on civil rights. And they were raucous, and they were 
wild, and they were tough. There was no bipartisanship on that, I can 
tell you. It was down right tough and nasty. Those memories fade. What 
remains is the fact that this institution had leaders who stood up and 
said: We are going to get this done. And they achieved those results. 
And today we celebrate those moments.
  We have forgotten about the bitterness that occurred in the debates. 
No one is asking whether it was bipartisan or whether coalitions got 
what they wanted. The response was: the United States got closer to 
that more perfect union that our Founders described more than two 
centuries ago.
  Well, we are in that moment again. And in many ways this is a civil 
rights debate about health care, because too many of our fellow 
citizens are denied that right of health care based on economic 
circumstances beyond their control. The issue is very simply this: Will 
we come together and decide, at a moment like this, to get a job done 
or will we take the easier path and step back because it is a little 
too tough?
  Others have failed at it. It means I might lose some votes back home. 
But there are certain issues that are worth losing an election over. 
That is not the worst thing that ever happened to someone. Watching 
your family go

[[Page 18812]]

bankrupt, losing your home, watching a child or a spouse suffer because 
you do not have enough money to buy health care, that is a problem. 
That is a real problem.
  So the issues here are complicated. I know that. I know they are 
difficult. I know if they were easy, they would have been solved a long 
time ago. But I have a lot of confidence. I listened to 22 of my 
colleagues over 5 weeks in a markup become educated and grapple with 
these issues. We did not resolve all of them, but we educated ourselves 
and made a difference and produced a bill--a bill that is now the only 
one in this Chamber that is before us. We hope our colleagues will 
examine it, take a look at it, make whatever recommendations they could 
as we move forward. I know the Finance Committee is wrestling with 
this. Senator Baucus and I arrived on the same day in Congress in 1975. 
We have been friends for 35 years. I know he is struggling to get the 
right kind of bill to come out of that committee. I wish him the very 
best and have offered whatever help we can to assist in that effort. I 
hope we can get a product that moves forward, that we can embrace and 
be proud of, and that will make a difference.
  So for the coming days, I won't take as much time as I have this 
evening, but I want to talk about this bill in detail. I want to engage 
in the debate. I want to get away from the cheap politics, the bumper 
sticker slogans about things that don't exist, the fear that is so easy 
to arouse in people--the easiest emotion to appeal to is people's fears 
and hates--and talk constructively and positively about what we can do 
together to overcome this issue that is a scourge on our society and 
worthy of this Chamber's efforts.
  I thank my colleagues for their the patience this evening and for 
listening to all of this, and I thank the Chair for his patience. I 
look forward to the hour when we will come together as a body here--not 
as Democrats and as Republicans, but as United States Senators--at this 
moment and pass a major health care reform bill that moves our country 
to accessibility, to affordability, and equality of health care.

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