[Congressional Record (Bound Edition), Volume 155 (2009), Part 14]
[Senate]
[Pages 19106-19107]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. WYDEN. Mr. President, I came to the floor this morning to take a 
few minutes to reflect on this week's developments on the issue of 
health care reform. For me, the week began with an inspiring essay by 
the man who has led the crusade for fixing American health care for 
more than 40 years, the man who continues to lead this body in our 
efforts to fix health care. I am referring to the wonderful essay by 
Senator Kennedy. I encourage all Senators to read his article because, 
as usual, Senator Kennedy lays out the challenge ahead. He says on the 
front page of the magazine, ``We're Almost There.'' That might be a 
little much for some folks, given the developments of the week, but as 
usual, there is a lot of validity in what Senator Kennedy has written 
in Newsweek magazine.
  There is widespread agreement on some very significant areas of 
health care policy. For example, we have bipartisan support in the 
Senate for fundamentally changing the inhumane model of private health 
insurance.
  Today, private health insurance is essentially about cherry-picking. 
It is about going out and finding the healthy people and sending the 
sick people over to government programs more fragile than they are. 
There is widespread agreement that needs to be changed. For example, 15 
Senators are on legislation that would make it illegal to discriminate 
against those with preexisting illnesses. That is a fundamental change, 
a dramatic change in the way the insurance industry does business. 
Democrats, Republicans, both major committees--the committee Senator 
Kennedy chairs, the committee led by my chairman, Max Baucus--Democrats 
and Republicans support fundamental changes in the way private health 
insurance operates. If someone had told me 3 years ago that there would 
be such strong bipartisan support for fundamentally altering the model 
of how private health insurance is sold in our country, I probably 
would have asked them what hallucinogenic substance they were smoking. 
But it is an indication, as Senator Kennedy writes in his article, that 
we have made a lot of progress.
  Suffice to say, as Senator Kennedy notes again, there is a lot of 
heavy lifting to do. In particular, if we go to the President's Web 
site, the three areas he is focused on are lowering costs, increasing 
choices, and maintaining quality. Those are the three areas the 
President has focused on, very correctly. Those are the three areas on 
which our President has made clear he is going to spend his political 
capital. This is what he is going to use his bully pulpit for. This is 
what he is going to put in these killer hours for. Having met with him 
recently, I can tell my colleagues that President Barack Obama is 
making that kind of effort with his political capital, using the bully 
pulpit, and putting in the hours to get the job done.
  With respect to lowering people's premiums and lowering costs, one of 
the areas the Congressional Budget Office has said will generate real 
savings in the next few years is increasing individual choice, giving 
all Americans the opportunity, as we have in the Congress, to choose 
from a variety of plans--big plans, where we spread cost and risk, 
where they can't discriminate. When an individual makes a wise 
selection from one of those plans, the individual puts that money in 
their pocket. That is what the budget office folks have said they will 
score as real savings for the system, for people's individual premiums 
in the next few years.
  The challenge for our committees is that in many respects, these 
bills don't give all Americans free choice. They don't give all 
Americans the choice the Senator from Virginia has--I note the presence 
of the distinguished leader from Kentucky--these bills don't give all 
Americans the kinds of choices we have as Senators. Choice and the 
requirement that companies compete for people's business is what 
competition is all about. It is what holding premiums down is all 
about.
  I have developed legislation called the free choice proposal. It 
protects the employer-based system on which we know well over 150 
million Americans rely. It also gives us a chance to improve on it. It 
creates more options for employers and for employees to hold costs 
down. For employers, our free choice proposal gives them more leverage 
with their insurance company so they can tell their insurer: I have 
done business with you for a lot of years. You better give me a better 
deal or I will take my business somewhere else.
  It also says to an employer--hypothetically, in Virginia, Oregon--if 
you want to take all of your employees to what is called the insurance 
exchange, kind of a farmers market arrangement, the employer would have 
the ability to take their workers to the exchange, and the employer 
could get a discount for doing that against strengthening the 
employer's role in the effort to hold down cost.
  For the worker, what it means is, for example, in Virginia or Oregon, 
if your employer's share of your health care coverage is, say, $13,000 
and you can find a plan on the insurance exchange for $12,000, the 
$1,000 goes into your pocket. Again, you get a financial reward for 
shopping. Members of Congress get to shop. I would like to see 
everybody get to shop, everybody have those individual choices.
  It is also good for the system because right now, really since the 
1940s, since the middle of the last century, the individual has been 
disconnected from the health care system. The individual does not get 
many choices. Eighty-five percent of the employers who offer health 
care coverage do not offer choice--not because they are evil. They 
would love to do it. They cannot afford it. The administrative costs 
are too crushing.
  So, again, if we get employers and employees into these larger 
systems, where they will have clout in the marketplace, there will be 
the ability for everybody to choose, not just folks who are unemployed 
or uninsured or small business, but give everybody, over the next few 
years, the ability to have these choices and be in a position to help 
drive more competition and more accountability and hold down their 
premiums in the private sector.
  We can do that on a bipartisan basis. We have 15 Senators of both 
political parties on legislation that does it now. It could fit with 
the structure of several of the bills that are being considered. We can 
do this, as Senator Kennedy suggests in his wonderful essay, on a 
bipartisan basis. Both Democrats and Republicans have a good point.
  I believe my party is right on the issue that you cannot fix this 
system unless you cover everybody. The reason that is the case is, you 
cannot build a market unless you cover everybody. Unless you cover 
everybody, there is too much cost shifting. The people who are 
uninsured shift their bills to the insured.

[[Page 19107]]

  But my colleagues on the other side of the aisle--the distinguished 
leader from Kentucky and I have had this conversation on a number of 
occasions--they have valid points too. The Congress ought to be very 
careful about freezing innovation, about restricting private choice, 
about setting up price controls.
  There is the sweet spot for a bipartisan bill: Democrats with good 
ideas, as Senator Kennedy lays out in his wonderful essay, about 
expanding coverage; Republicans bringing creative ideas to the table 
about innovation and choice. Both sides have some valid points. That is 
what Senator Kennedy is saying in his wonderful essay.
  I see the leader on the floor. I hope colleagues will go to our Web 
site. That is where we lay out this free choice proposal. I think it is 
consistent with the idea of not blowing up the employer-based system 
but not saying we cannot improve on it. It gives new tools to both 
employers and employees to hold down costs. It ensures that all 
Americans will have choices, not just some.
  I submit to colleagues, if folks in Virginia and Kentucky and Oregon 
come away from this and say that only some people got choices, that is 
not going to go down very well. Let's do what the President says on his 
Web site and give all Americans choices--choices such as we have in 
Congress from these big insurance pools, where you cannot discriminate 
and you have some leverage in terms of holding costs down.
  It has certainly been a tumultuous week on this health care issue. 
But I hope colleagues, this weekend, will pick up a copy of Newsweek 
and read the inspiring essay by Senator Kennedy, who has led our body 
for more than 40 years--led the country--on this issue, and continues 
to lead us because there is a lot for us to build on now to finally end 
this injustice that we have not been able to fix our system so we hold 
costs down and all Americans get good, quality, affordable coverage. We 
can do it. We can do it this year, on the President's timetable, by 
working together.
  Mr. President, with that, I yield the floor.

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