[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[House]
[Pages 18951-18957]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        THE PROGRESSIVE MESSAGE

  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. Mr. Speaker, what a pleasure it is to claim this hour, 
this Special Order, on behalf of the Congressional Progressive Caucus. 
The Congressional Progressive Caucus is the body of Members of Congress 
who believe that we're all better off together than we are separated 
and apart. We believe that we need a mixed economy, in which, yes, 
people are entitled to pursue their private dreams and make their 
money, but also there are certain things that we should do together, 
things like take care of the water, things like provide for 
transportation, things like provide for education and things like 
health care.
  The Progressive Caucus is the body of people here in the Congress who 
stand by the idea that the civil rights movement was a great moment in 
American history, that FDR and the New Deal was another great moment in 
American history and that the steps forward to end slavery was a great 
moment in American history.
  And yet the greatest moments of American history have not yet been 
written but are really still in front of us. We still have more people 
to bring into the ambit, bring into the embrace of this great American 
ideal, the progressive ideal, this idea that America has not yet done 
the best it can do. We have more people to include, more people to help 
find that internal light of their own and that this is the time to walk 
forward into that history.
  We have the Congressional Progressive Caucus that comes together 
today. We started out, Mr. Speaker, as a group that said, we would like 
to see in

[[Page 18952]]

the area of health care a single-payer system. This was our position. 
But we've compromised, because we're practical progressives. We said we 
can have health care reform if we have a public option, but we can't go 
any further than that. There must be a public option in the health care 
plan. And it looks like we are going to have one. We are excited about 
the prospect of seeing this public option. It appears as though it is 
moving forward, Mr. Speaker. And it's a good thing because it's what 
America needs. It's what America needs.
  This is the Progressive Message, and we are here to talk about health 
care tonight. Health care, Mr. Speaker, is the boiling issue. It is the 
issue that is all the talk around the Congress; it is the issue that is 
all the talk around America. The fact of the matter is, Mr. Speaker, it 
is a fact, it is a belief and a firmly held belief of my own that 
health care is a movement that is essentially a civil rights movement. 
It has the same level of intensity as that movement. And it has the 
same urgency as that movement.
  I'm inspired by the words of Martin Luther King, Mr. Speaker, who 
said that we have the fierce urgency of now, the fierce urgency of now, 
that we can't say that somebody else can get their freedom at some 
other time, at a more convenient time, at a time when it makes sense 
and is comfortable for everybody.
  No, he said civil rights now, not later, and not have to say today we 
have got to have health care for all, right now, not later. The fierce 
urgency of now, Mr. Speaker.
  I want to let you know, Mr. Speaker, that when I was watching 
television last night, I was tuned into President Barack Obama. And I 
want to let you know that I was very proud of President Obama last 
night, Mr. Speaker. President Obama came before the American people and 
articulated a case, as skillfully as any arguer or orator ever could, 
for health care, health care now.
  The thing that really grabbed my attention, Mr. Speaker, is when he 
was asked by a reporter, why does it have to be now, and the reporter 
asked in somewhat of a challenging and slightly derisive tone of voice, 
why does it have to be now? Can't it just be some other time? Mr. 
Speaker, President Obama said, you know, I can't delay it when I read 
the letters that I get. The letters tell me that we have got to act 
now. We can't put it off another day. We've got to do it now. And I 
actually was cheering at the television screen as President Obama was 
saying these things. It's so nice to have a President that you truly 
agree with and believe in and think is a real champion for the people 
who elected him.
  So in that spirit of President Obama saying that the letters and the 
stories that people are going through propel him toward action, let me 
share a few stories of my own, Mr. Speaker, because my constituents 
write me letters too, and those help move me and motivate me toward 
action for true health care reform. Instead of my hitting you first 
with the facts and figures and all those things, I just want to start 
out tonight, Mr. Speaker, with stories and letters from my 
constituents.
  Let me talk about Mary from Minneapolis, Minnesota. Mary says, my 
daughter needed her wisdom teeth out. At the same time, with insurance, 
we were told to pay $375, which we did, then got billed over $1,000, 
resubmitted, eventually the amount was reduced to $750. In the 
meantime, my husband got no paycheck. I have calcium deposits in my 
back which make it difficult to walk, and I can't afford the copays, so 
I'm waiting until it's so bad that I can't walk.
  Mr. Speaker, Mary needs help. Mary needs a caring, committed 
government that is listening to her and is going to help bring forth 
legislation which can allow her to work with her doctor and her health 
care provider with the solutions that she needs. No government official 
in the middle between Mary and her health care provider. That's nothing 
but spooky, scary stuff, and it's not true.
  Let's hear from Denise: I find more and more often that my family and 
I are skipping doctor visits for preventive care, and when we would 
have made a visit to the doctor in the past, but now can't afford the 
copayments to be seen. This is especially true for childhood illnesses 
such as allergy visits or medication, dental problems that could 
potentially be serious, and injuries that, in reality, should be 
checked out by a doctor. My family is insured. Yet because of our 
current employment situation, combined with rising health care costs, 
it has come out of reach to have the kind of health care we have 
enjoyed in the past. I feel that we are being left behind for an 
inability to be able to bear the burden of the cost. This may mean that 
we will pay dearly in the future for things that could have been 
prevented or less serious had they been able to see a doctor initially.
  As I listen to Denise from Minneapolis's story, I'm thinking, Mr. 
Speaker, about the global, the larger trends in our society that are 
sweeping her up and affecting her. She's talking about being insured, 
having a job, but having to go without because of the costs of copays 
and premiums. Well, Mr. Speaker, one of these startling facts that you 
might want to know is that over the last 9 years, premiums have doubled 
for people who have insurance, and while wages have been flat, premiums 
have been increasing much faster than wages have, and this has made a 
squeeze on the American household budget. Denise needs a hand, Mr. 
Speaker. Denise needs somebody to care.
  Janice from Golden Valley, Minnesota: I've worked every day since I 
turned 15, and I'm currently 51. I'm married with two teenage children. 
I have a college degree. We have always lived a balanced and frugal 
life. We do not take exotic trips and mostly buy generic groceries and 
thrift or discount store clothing. I do not and never have smoked or 
drank, and I have been in my job for 20 years, yet I bring home less 
and less each year due primarily to health care premiums and costs. 
Health care premiums and copays cost about 25 to 30 percent of my 
income. Health care premiums cost me more than my Federal, State, 
Social Security, union dues and retirement plan deduction combined from 
each paycheck.
  The increase has been so great that we have stopped being able to 
contribute to savings for 4 years. The one thing I fear more than 
anything is me or my family member getting sick because of what 
treatment will cost even beyond the premium costs. When I have a 
strange new sensation in my eye or a vein hurting in my leg or a dull 
pain in my chest, I just pray it will go away on its own because I'm 
afraid of what it will cost me.
  We pay out so much for health care insurance, yet we cannot afford to 
really even use it. And I feel even worse for those who have no health 
insurance at all. This reflects badly on what America has become, a 
place where only the wealthiest survive and profit by a few takes 
priority over the basic needs of all.
  Mr. Speaker, let me tell you about the story of Anita. I'm armed with 
statistics tonight, Mr. Speaker, and I have them. But they don't mean a 
thing next to these stories of these citizens, these good, honest 
Americans from my State of Minnesota whose stories I want to bring to 
you tonight.
  Let me talk to you about Cynthia from Minnesota. Cynthia says: As an 
asthmatic and a mother of an asthmatic, I would think the insurance 
company would be happy that we go for our annual check up and would be 
willing to cover our medicines so that we stay healthy and don't end up 
costing them more. Much to my surprise, the insurance company would not 
cover our asthma checks, and the cost of our prescriptions has gone 
through the roof. Unfortunately, our meds are not part of the formulary 
drug list. What ends up happening is I cover my child's meds, and I 
don't get any. I just hope we are near each other if I have an attack.
  Mr. Speaker, that is no way to treat Americans who are trying to make 
it in this society.
  How about this one. Maria from Minnesota: My daughter is 24. She has 
had a polycystic ovarian disease since she

[[Page 18953]]

 was 15 requiring three surgeries, five hospital visits and many, many 
office calls. This is a chronic condition which will probably result in 
infertility or at the least difficulty in achieving pregnancy. This is 
physically draining, as she is often in pain and has been on many 
narcotic pain meds, including Vicodin, Percocet and OxyContin.
  In addition, the idea of not having children is a tough thing to face 
as a teenager and young adult. If that wasn't enough, she also has a 
degenerative disk disease in her cervical spine. This has resulted in a 
herniated disk and chronic constant pain. Again, there is no cure for 
this and no real treatment. Since she is an adult, she no longer is 
eligible to be under our insurance plans. She has a BA degree, but has 
not been able to find long-term employment in her field which would 
offer benefits. Rather, she is managing a bar restaurant, which is a 
good job, but it's not what she went to school for.

                              {time}  2145

  She's working as a bartender at least 60 hours a week, on her feet 
all the time. She pays her own bills, lives on her own, but because of 
her chronic condition, has not been able to get COBRA insurance and, 
instead, has a policy through a private insurance company paying over 
$200 a month, which doesn't cover many of her needs. This is 
outrageous.
  Please, please understand she is not sitting at home waiting for a 
handout. She's so motivated and such a hard worker, but the insurance 
costs are eating up her paychecks. She's my hero, as I can't imagine 
facing these conditions and then having the minimum coverage while 
paying the maximum bill.
  Mr. Speaker, I just thought I'd start off this Progressive Hour with 
some real stories from real people, real stories for real people who 
are dealing with a very difficult situation. Mr. Speaker, let's not 
relegate them to the status quo.
  My colleagues, many of them on the other side of the aisle, are 
essentially saying let's keep it how it is. Let's stop moving so fast. 
Let's not let this process move along too quickly. And some have been 
caught offhandedly making the comments that they think that they can 
take President Obama down. Is that what this is about, taking somebody 
down?
  This should be about lifting somebody up, the American people, 
lifting them up, not trying to score a partisan point in a political 
game. This is real life people are going through, real life like the 
Minnesotans that I just talked about. But as I speak here tonight, Mr. 
Speaker, I can assure you that in every State in this Union and in 
every territory of this country, there are stories exactly like these.
  Mr. Speaker, I want to talk about what the bill actually does a 
little bit, but before I do, I want to talk a little bit about the cost 
of this health care reform because, you know, first of all, there is 
this big fear thing around cost, and this is one of the major ways that 
some detractors are trying to stop things. So first let's talk about 
the individual cost, the cost to the person.
  Without reform, the cost of health care for the average family of 
four is estimated to rise $1,800 every year for years to come, and 
insurance companies will make more health care decisions. Okay. Status 
quo, hand the insurance companies 1,800 bucks every year. In 2 years 
that's 3,600, in 4 years it's more than that. The fact is this is the 
status quo. And I was so proud to hear President Obama last night 
saying, if somebody offered you a plan that was going to double, that 
was guaranteed to double in cost and was going to push more people into 
the ranks of the insured, would you want that, because that's what we 
have now. Again, another brilliant oratorical flourish rooted in the 
truth.
  So one cost is the 1,800 bucks every year estimated to increase, but 
let's talk about the individual costs a little bit more. If we have 
health care reform, if we have health care reform, Mr. Speaker, no more 
copays or deductibles for preventive care. That will help a family 
budget. No more rate increases for preexisting conditions, gender or 
occupation. That will help the family budget. No more annual cap on 
out-of-pocket expenses. That's going to help the family budget. Group 
rates of a national pool, if you buy your own plan, that should hold 
costs down. Guaranteed affordable oral, hearing and vision care for 
your kids, that will definitely help the family budget out.
  The fact is that this bill is designed to help families deal with the 
escalating costs of health care. It's not about increasing costs or 
increasing debt or anything like that. It's about helping the family 
budget stay in a place where families can actually get ahead a little 
bit for the first time in a long time, for the first time under a 
budget, under an economic philosophy where the rich didn't have enough 
and the poor had too much in the minds of some people.
  The fact is, Mr. Speaker, we need to talk about costs tonight. We 
need to talk about it, and I want to go now to the recent--the CBO 
budget scores have been tossed around a lot. We've been hearing a lot 
about what the CBO says. The CBO says this, the CBO says that. Let me 
talk about what the CBO actually says, really says.
  On July 17, the Congressional Budget Office released estimates 
confirming that the health care insurance reform policies of H.R. 3200, 
America's Affordable Health Care Choices Act, are deficit-neutral over 
a 10-year budget window. That means that they don't add to the budget. 
They're deficit-neutral, even producing a $6 billion surplus.
  CBO estimated that the cost of the bill's insurance reforms was 
$1.042 trillion, while the bill's cost savings and revenues totaled 
about $1.48 trillion. This is over a 10-year period. CBO estimated that 
these reforms will provide affordable coverage for 97 percent of 
Americans 2 years after the program starts. Now, that's really 
something, Mr. Speaker.
  It was also reported in the press, CBO also estimated that the 
overall bill has a net cost of $239 billion over 10 years, but this is 
entirely due to additional provisions in the bill to maintain current 
Medicare physician payment rates costing $245 billion over 10 years by 
preventing scheduled draconian cuts.
  The House agreed earlier this year that this $245 billion cost would 
be exempt from PAYGO. The President's budget acknowledged the flawed 
Medicare physician payment formula and allotted money to address it. 
Then, in voting for the budget resolution in April, the House voted to 
exempt Medicare physician payment provisions from PAYGO. The statutory 
PAYGO bill to be considered by the House this week, passed through this 
House this week, also exempts these provisions from PAYGO.
  Mr. Speaker, let me also add that this bill preserves and increases 
options, plan options. Those eligible for the exchange--and I'll talk 
about that in a moment--choose from all options, private and public. No 
one can steer them to any particular plan.
  CBO projects that by the year 2019 about 9 to 10 million Americans, 
or a little more than 3 percent of Americans, will choose the public 
option. CBO projects that the most of these using the exchange will 
choose private sector plans. This confirms that the bill creates a 
level playing field where the public option will compete with private 
plans on a fair basis and that the public plan will not necessarily 
push them out of existence.
  Again, I'm a single-payer advocate, but I wanted to talk about, just 
a little bit about this cost, because this is the very thing that 
detractors are using to try to scare Americans away from real health 
care reform with, and I think that Americans deserve better. They 
deserve the truth, and they should know that this plan is one that's 
designed to help save them money. Let's talk a little bit more about 
health care costs.
  Health care costs for small businesses have grown 30 percent since 
the year 2000. The average family premium costs $1,100 more per year 
because our health care system fails to cover everyone. The average 
individual premium costs $410 or more.
  The fact is we're joined here tonight by one of the great, great, 
great stalwarts and heroes of health care reform,

[[Page 18954]]

none other than John Conyers, chairman of the Judiciary Committee, 
second-most senior Member of the House of Representatives.
  Good evening, Congressman Conyers.
  Mr. CONYERS. Would the distinguished gentleman yield to me?
  Mr. ELLISON. Certainly I will yield to the distinguished gentleman 
from Michigan.
  Mr. CONYERS. Thank you, Mr. Ellison, and to our colleague and friend, 
Steve King, who is also on the floor enjoying the proceedings.
  I came down merely to let you know how much I admire and respect your 
determination to make sure that every American can listen and learn 
about the importance of health care, the issues as you see them 
developing, and what it means for all of us to come up with the best 
possible result that we can.
  The 44th President of the United States brought his case to the 
public last night, a brilliant explanation, very persuasive, very 
intellectual, and then he answered more than a dozen questions from the 
press. It was very instructive. I was moved by that last night, and I'm 
moved by the gentleman from Minnesota (Mr. Ellison) this night as well, 
because what you're doing is so very, very important.
  I get calls in my office, and I have the unique tendency to answer my 
own phone. And people are very surprised when I answer the phone and 
they're telling me what to tell the Congressman, and I explain to them 
who I am, and they're pleased and flattered by that. But a lot of those 
calls are about health care. Some of them are very moving, like some of 
the stories that you've related here tonight. Other people are not 
happy about health care, and some hope that we don't come up with a 
bill, a few. But most people realize that this struggle has been going 
on for 30, 40, 50 years.
  Harry Truman began talking about universal health care, and then 
Lyndon Johnson was able to come through with Medicare. And in respect 
to Harry Truman's determination, although unsuccessful, he went to the 
Harry Truman Library in Missouri to sign the Medicare bill.
  There's a rich history, a legacy about how we've gone through these 
different changes. And now the President, after only a few months, 
calls us together in the White House at a White House summit to declare 
his determination to do more about this system--we call it a system. 
It's a broken-down, nonworking system--about health care. And so it's 
so interesting to study what all of our Presidents, what our leaders 
have done and why it's so important when we think of the millions and 
millions of people that don't have health care.
  I'm going to say something here tonight that, to me, I want to put in 
perspective the issues. The plan, as I understand it, that's being 
proposed does not relieve everybody of the threat of not having health 
care. It is not a universal system.
  Let's put these things on the table. I am for a universal system of 
health care. I've worked with doctors, medical scholars, nurses for 
years now, and they say that that's the only way we're going to reduce 
costs. And for anybody that's talking about--it's bad enough that we 
don't have single-payer health care involved in this, except for the 
tremendous efforts of the gentleman from Ohio, Dennis Kucinich, who's 
got it in one of the committee's bills that would allow States to 
develop health care if they chose an option.

                              {time}  2200

  But we don't even know what the public option is finally going to be. 
There are those that don't even want to give the opportunity of 
Americans to choose between their health care plans, and the controls 
of the insurance industry have been legendary. It's been written, 
spoken about, people's own experience.
  And then if I hear anybody talk about the government controlling 
medicine, it's the health insurance companies that are controlling 
medicine, not the doctor.
  So I just want to listen, take in the wisdom that you have brought to 
this body and enjoy this discussion. I hope any other of our colleagues 
that want to join in this can participate as well if they choose, and 
I'm just so proud you're doing it tonight and that I can just add my 
comments to this decision of yours to once again take out a Special 
Order to discuss this subject.
  Mr. ELLISON. Well, I want to thank the gentleman from Michigan, 
Chairman Conyers, for coming down here. We have a chance to do a little 
bit of give-and-take. Actually, I'd like to ask the gentleman a few 
questions if the gentleman would take a question.
  And my question is for you, Mr. Chairman, is why do you author H.R. 
676, the single-payer bill, and why did you work so hard to try to get 
so many authors in the House? And you ended up getting about 80-plus 
authors. And why did you go all over the country, to my State of 
Minnesota, and talk to so many people? Why did you work so hard to push 
this idea of single payer forward?
  I yield to the gentleman.
  Mr. CONYERS. Well, improving our health care system is the most 
single fundamental domestic issue that we can deal with. The second 
most important is creating a full employment society. And both go 
together, because if you've got your health and don't have any 
employment, I don't know if you're in worse shape than a person who has 
employment and doesn't have any availability for health care. They're 
both fundamental rights that are inherent in a constitutional system of 
democracy, and we've been working on this for so long.
  I remember when the First Lady then, Hillary Rodham Clinton, called 
us into the White House and asked us to hold back on our push for 
universal single-payer health care when her husband became President, 
because she, with Ira Magaziner, was going to work on health care 
reform. We did. We met. I remember and said, look, we should honor her 
request. There had never been a First Lady in the White House 
designated by the President to work on an issue this momentous, and so 
we pulled back. It did not succeed. It wasn't her fault. She had no way 
of estimating how powerful the corporate medical sources in health care 
were and that were determined not to make this universal or to make any 
changes at all.
  And so this, to me, is one of the highest issues that all of us in 
the Congress can repair to, and I'm so proud that we now have a total 
of 85 Members of the House now on H.R. 676. I'm proud that we have it 
in the health care reform as an option for States so that we can 
overcome some of the restrictions that will be relieved through the 
Kucinich amendment to allow States that want to begin this global 
experiment.
  That's how it started in Canada. It was a province in Canada that 
first passed it, and then another, and yet another. And of course, 
Canadians are overwhelmingly, extremely proud of the system that they 
have. No, it's not perfect, but very few things in this life are. 
They're working on it, and we're not copying it. We're looking at 
health care systems from around the world, everywhere, all countries 
that have them and the problems in countries that don't have them, and 
so this is an exciting global setting.
  I was even in China not too long ago examining their system, which 
sometimes they're very efficient, and in other places, they don't exist 
at all. But we're putting the study together so that the plan that we 
create is an American plan, created by us, benefiting from all the 
improvements and problems of other countries that have universal health 
care systems.
  And so even though my primary concerns are the Judiciary Committee 
issues, some of which tie into health care, the bankruptcies caused by 
health care are in our committee, and now we're having hearings on 
medical bankruptcies next week in the Judiciary Committee, and I know 
my colleagues on both sides of the aisle will no doubt attend these 
hearings.
  And so there's a relationship. There's a relationship in creating a 
full employment program. I will be talking to some of the Caucus 
members tomorrow morning about unemployment and the importance that we 
sever the link between unemployment and health care,

[[Page 18955]]

because what has happened in Detroit is that, as the plants are closed 
and people laid off and no longer have employment, guess what? They no 
longer have health care either.
  So the relationship of employment-based health care to unemployment 
is profound, and a person without employment needs health care 
guaranteed and assured, needs health care, whether he's working or not. 
He needs it even perhaps more than when he is working.
  And so as the unemployment continues unfortunately to rise, more and 
more people who once enjoyed health care from the employer-based system 
don't have it anymore.
  Mr. ELLISON. If the gentleman will yield for another question, do you 
think, Chairman Conyers, that your advocacy for single-payer health 
care, H.R. 676, which was widely supported, wildly supported in my 
district when you showed up to talk about it in Minnesota--we packed 
the house. Everybody was so excited. We've had several other hearings 
on health care since then. People always mention that hearing because 
the spirit was so high. Do you think that that effort for a single 
payer actually helped gain enough momentum to at least make sure we had 
a public option for consideration in the current version of the bill?
  Mr. CONYERS. I think a distinct relationship, and there are many 
people that have told me--and I'd like to compare it with your 
experience and our colleagues'. There are those who have said, first of 
all, they're disappointed that a single-payer system, which is the most 
popular in the country and has the most numerous supporters in the 
Congress of any other plan, did not get more consideration. But they 
said, well, at least we ought to have a strong public option at a 
minimum, and so, yes, there is a relationship between those who still 
seek a single-payer system who demand that there be a public option.
  Unfortunately, there are some of our colleagues who are still not 
persuaded that we need a public option even.

                              {time}  2210

  There are reservations in the other body. And so it still remains to 
be seen what is really going to happen in that regard.
  Mr. ELLISON. If the gentleman would yield back, I wonder if the 
gentleman would offer another question. As the Chair of the Judiciary, 
the chief author of H.R. 676, we're talking about a public option. 
Could you offer your opinion as to why anyone who claims to be in favor 
of free markets would be afraid of having the public option included in 
other private insurance offerings in the exchange?
  The health care proposal is that if you have your health insurance, 
employer-based health insurance, you can keep that and that some 
improvements would be no exclusion for preexisting condition, no 
discrimination for age and gender. And then, the second thing, if you 
have a government program now, like Medicare, you can keep that. And we 
try to get more people enrolled in Medicaid who are eligible for that.
  And then, of course, the third option, the new option, would be the 
exchange standardized benefits, which would include eight private 
insurance offerings, together with a public option.
  And so my question to you is: Why are the free marketeers afraid of a 
public option? What are they scared of? I thought they were in favor of 
competition.
  I yield to the gentleman.
  Mr. CONYERS. Well, it's clear that many in the insurance field--
remember, there are over 1,200 or 1,300 different insurance policies 
for health care, dozens and dozens of companies writing their own 
policies and plans, creating huge administrative overhead for doctors 
who are practicing, who frequently have to hire more and more 
administrative people just to sort through all of the policies of 
patients that come to visit them.
  So they don't want competition. They don't want a free market. They 
want a market in which the ones that have the business and have been in 
it for a long time don't have to share it with anybody. And they 
certainly don't want to have to face the competition of an effective 
public option, which almost surely would be less expensive and perhaps 
more efficient than most of the private insurance systems. Why? Because 
they won't have the advertising costs, the overhead costs, the 
administrative costs--all of these things that burden and raise the 
cost of private insurance.
  The same way with Medicare. Medicare costs have an overhead of 3 
percent. In the private sector, the insurance policies run 10, 15, 17 
percent or more in cost. All the advertising we see, at least in my 
area, these huge billboards, Come to this hospital because we're better 
at this particular health service. Another hospital, Come to this 
hospital; we're specialists in this particular service. And so on.
  MRI equipment, the overuse of equipment. And doctors tell me if 
they're in a hospital and another hospital nearby gets new MRI 
equipment, they have to go get it to compete with theirs, and they 
don't really need it, but they want to have state-of-the-art, the 
latest thing.
  And so this fee-for-services notion keeps raising the cost of health 
care. Many of the people that complain about these costs don't realize 
that the public option will almost surely lower the cost of health 
care.
  Mr. ELLISON. Well, if the gentleman yields back, if the cost of 
health care is lower for families, will this allow them to be able to 
meet more of their basic needs and put food on the table, send kids to 
school, buy adequate amounts of clothing? Will this allow them to 
escape having to rely on credit cards and payday lenders just to be 
able to make it through the week?
  I yield to the gentleman.
  Mr. CONYERS. The answer is yes. No question about it. This is what 
the goal of health care reform is about, to lower the costs, which, by 
the way, each year the costs keep increasing and we have to find ways 
to deal with it.
  There are other reasons that costs go up. We have got to tackle this 
on a realistic basis. This isn't about emotions or whether a capitalist 
system is being challenged or not. We have plenty of examples in 
which--your highway systems aren't run by different companies, your 
water systems, your electricity.
  Health care is a matter of having it available to every citizen, 
regardless of their ability to pay. Of course, many of the people that 
end up in bankruptcy, they had health insurance. They didn't know that 
what they needed it for wasn't covered by the health insurance that 
they have.
  And so, for me, it's been such an interesting field of endeavor to 
meet and talk with these really wonderful doctors in different parts of 
the country, at the medical schools, and to have made their 
acquaintance and then to learn of all the innumerable citizens who are 
so grateful to us for dealing with their problems.
  By the way, this isn't some kind of circumstance that applies in 
rural areas as opposed to urban areas or in conservative areas as 
compared to liberal areas. These people are in the same fix all across 
the country in every one of the congressional districts.
  I yield.
  Mr. ELLISON. That's an interesting point. Do people who live in 
conservative areas where their Representatives are fighting for the 
status quo, are these people exempt from these escalating health care 
costs, these escalating premiums? And do people who live in the so-
called ``red'' States, folks who are being excluded for preexisting 
conditions, being dropped, do people who have Representatives who fight 
for the status quo get some sort of a pass under our current health 
care system?
  Mr. CONYERS. Not on your life. We're all experiencing much the same 
thing. I had hearings around the country on this subject. And I 
remember going to the Upper Peninsula of Michigan. Our good colleague, 
the gentleman from Michigan, Bart Stupak, had invited me up there for 
hearings.
  I thought the urban areas were in trouble. I got a lesson. The rural 
areas were in even more difficulty in some respects.

                              {time}  2220

  Let me explain what I mean. They were of the opinion that they 
couldn't

[[Page 18956]]

get doctors or nurses to come up there to serve their population. I 
remember their telling me about one doctor whose wife had said, At the 
end of this year, I'm leaving. I'm going back. I just don't fit in 
here. I'm not comfortable.
  And there are people that would love to be in the Upper Peninsula of 
Michigan. It's beautiful. I have people rhapsodic about the beauty of 
the outdoors. But this wasn't for her. This was the only doctor. They 
were begging the doctor not to leave, and his wife. They knew if she 
left, he would leave, too. They were flying people from upper Michigan 
to Wisconsin because they didn't have any way to serve people who 
needed serious hospital treatment.
  So we find that in Minnesota, up there at the Canadian-Michigan 
border, in that State, I remember distinctly talking with farmers who 
called their health insurance agents and said, Please. I'm a successful 
farmer. Please come out and help me get insurance. I remember 
distinctly this one farmer said, The insurance agent said you don't 
want me to come out to quote you a price because I know you can't 
afford it. We don't even want to bother even trying to sell you 
insurance because I don't care how successful a farmer you are, because 
with you and your family, you won't be able to afford it, so we don't 
even need to try to sell you the policy.
  There are all sorts of circumstances going on that I learn of as I 
accept invitations around the country to meet with health care experts 
in hospitals, in medical schools, in town hall meetings where people 
are trying to get some relief from this terrible fact that originally 
37 but now 50 million people are without any insurance at all. And more 
people who are losing their jobs end up going into that column as well.
  Mr. ELLISON. Well, if the gentleman yields back, I just want to point 
out that you mentioned Medicare has an administrative fee of about 3 to 
5 percent. The fact is, however, that if you look at the top five 
health insurance companies, their administrative costs are 17 percent, 
and if you look at the average overall private insurance, it's about 14 
percent.
  What do they spend all that money on? How come they can't get down to 
a reasonable percentage of medical loss ratio? Does the fact that some 
of these CEOs just get exorbitant pay have anything to do with it? And 
if there was a public option--the CEO of the public option, I guess, 
would be Governor Sebelius, who is the Secretary of HHS, Health and 
Human Services. She is not making $10 million a year as a public 
servant. I guess my question is what are they spending all that money 
on. How come they can't be more efficient?
  Mr. CONYERS. Well, exorbitant salaries to the chief executives and 
the managers of the company, as you imply, runs into millions of 
dollars annually, and many of them are the precise people who, through 
their lobbyists on K Street, are fighting any kind of serious health 
care reform. It's not a pretty picture.
  Mr. ELLISON. Well, if the gentleman would yield, it was recently 
reported that the lobbyists are spending $1.4 million a day to try to 
stop health care. Why would they want to spend so much money? And does 
this amount of money, $1.4 million a day, how does that compare to the 
profits that they reap by, say, excluding people? They are excluding 
their enrollees and are not covering medical procedures.
  Mr. CONYERS. Well, there is a relationship, and that's what makes it 
so difficult for us to come to a conclusion and to do something about 
this. Notwithstanding the great intellect of the President and his 
determination to correct the situation, there are people that put 
profits before health care. I'm sorry that that's the case, but that's 
what it really comes down to.
  Mr. ELLISON. I just want to say that in this last 5 minutes that 
we're here tonight with this Progressive Hour that the goal and the 
purpose and the soul of our efforts to reform health care should focus 
on the word care, health care. We should act like we care. This is not 
widgets; this is people.
  At the beginning of this hour, Mr. Speaker and Congressman Conyers, I 
shared stories about people from my district. I know you could have 
done the same thing. You get letters. The President gets letters. We 
all get letters. But care should be what drives us. I believe that you, 
Mr. Conyers, have worked so hard and done so much to start with a 
single payer, but because of your advocacy, we have gotten to a point 
where a public option is a real option, and I thank you for that.
  But public option is not the best name. It could be called patient 
option or a we're-in-this-together option, an option that says that 
we're going to have a public plan that could compete with the private 
plans, that could have some real cost drivers; not just drive down 
cost, but can offer best practices so that we really put an emphasis on 
health care and wellness, not just on processing people, fee-for-
service, overutilization, which, as you know, has been a very serious, 
serious problem.
  I think as we close up, Mr. Speaker--and I want to leave the 
gentleman from Michigan time to make some closing remarks, and we'll 
give him the final word since he's so eloquent--I just want to say that 
it's important for us to understand that if Americans want real health 
care reform, the time is now, I think, Mr. Speaker, to raise your 
voice. I'm not saying what people should or shouldn't do, but I'm 
saying that if you want health care reform, this is not the time to be 
silent. It's a time to raise your voice. And if you happen to live in 
an area where you have a Representative who is not for reform, I think 
that this is an especially important time to have something to say 
about that and exercise your constitutional right and offer your views 
on that.
  I just want to say that we've fought hard here, and this piece of 
legislation that we're fighting for now is every bit of a civil rights 
issue as the 1964 Civil Rights Act. The 1964 Civil Rights Act was 
passed just a few years before you came to Congress, Mr. Conyers, so 
you really were in the ambit and in the aura of this great triumph of 
American democracy. You were a friend of Martin Luther King. In fact, 
Rosa Parks worked in your office for many years and was a dear friend 
of yours throughout her life.
  I think I feel something like what you must have felt then, that we 
are on the doorstep of seeing great change in the American democracy, 
but it's going to take the energy and the prayers and the voices of 
everyone to get us over the line. When the President comes out on the 
television here at prime time, it's not just because he doesn't have 
anything else to do.
  It's serious. It's important, and it's very essential that everybody 
click in, raise their voice and make sure that if you want health care 
reform, if you want an end to being dropped and kicked off and denied 
for a preexisting condition, that if you're tired of discrimination 
because of gender and because of age, if you feel that a public option 
should be able to compete with a private insurance to drive cost down, 
and if you really believe that in our country that a health insurance 
company should be able to operate with a 4 or 5, 6 or 7 percent 
administrative cost as opposed to 17, 18, 19 percent, completely 
inefficient, then it's time to step up and do something about it. It's 
time to step forward.
  If you want to do something about health care disparities between 
people of color and other people, it's time to step up and do something 
about it. This is not the time to sit back and figure, Well, Conyers 
will probably save us. Obama will save us. Somebody will do the right 
thing. No, this is time for everybody to step up and demonstrate their 
own leadership.
  With the moments remaining, I just want to yield--I think that's it. 
The gentleman from Michigan has yielded to me. Therefore, what I'm 
going to do is thank the Speaker for allowing us to come to the floor 
tonight and talk about the Progressive Caucus, arguing for a public 
option, starting out our debate for single-payer health care, but being 
reasonable and being practical and saying that we've got to have a 
public option, that that is where we stop compromising.
  We've done our part already. We are proud that people like 
Congressman

[[Page 18957]]

Kucinich have made it possible for States to be able to pursue single-
payer. We're practical Progressives. We're not doctrine here. We're 
practical. What we want is good results for the people of the United 
States so we can join the 36 other countries in this world who have 
national health insurance.
  With that, Mr. Speaker, I yield back the balance of my time.

                          ____________________