[Congressional Record (Bound Edition), Volume 155 (2009), Part 15]
[Senate]
[Pages 20254-20255]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. ENSIGN. Madam President, I thank the assistant leader from the 
Democratic side, the Senator from Illinois, for that courtesy.
  I rise today to talk about health care reform. It is critical in our 
system that we address the issue of cost. We have the finest quality 
health care system in the world, but it is too expensive for too many 
Americans, and because of that, many Americans are uninsured. Not only 
are too many Americans uninsured, for a lot of folks who have 
insurance, especially those who receive insurance through their 
employer, they probably haven't received the kind of raises they would 
have otherwise received simply because employers are paying more and 
more for their employees' health insurance and there isn't money left 
over to provide higher wages.
  It is critical for many reasons that we address the cost issue. We 
spend about $2 trillion a year in the United States on health care. 
Some people say we need to spend more, but I disagree with that. I 
actually think we spend plenty of money in the United States on health 
care, we just don't spend it in the right ways. We need to eliminate 
waste and the bureaucratic spending of our health care dollars and get 
that money to the patients.
  There are five different committees between the House and the Senate 
that are working on health care reform proposals--three in the House, 
two in the Senate. Let me quickly address the HELP Committee bill, 
which is one of the committees in the Senate that has passed a bill. 
The HELP bill was passed on a straight party line vote. I think the 
reasons for that, which I will point out, are the flaws that are in 
that bill.
  First of all, the bill is not paid for. Second of all, it is too 
expensive and it doesn't cover enough people, especially for the money 
it spends. Two hundred times in the bill the Secretary of Health and 
Human Services is given new powers to establish programs, parameters, 
appropriate moneys, and otherwise dictates the course of one-sixth of 
our economy--200 different times. The HELP bill is around 600 pages. If 
each one of those times where it detailed or gave powers to the 
Secretary of Health and Human Services--if that was actually written in 
bill form at that point, the bill would probably have been about 5,000 
pages. That is how incredibly complex our health care system is and how 
even more complex some people are trying to make it.
  This bill creates 50 new offices, bureaus, commissions, programs, and 
bureaucracies, with 87 new government programs created in the Community 
Transformation Grants Program alone. The Democrats rejected by party-
line vote, an amendment that would have prevented the bill from 
spending funds on sidewalks, parks, bike paths, and street lights. We 
all like those kinds of things. I actually ride bikes. I like to see 
bike paths and things such as that. But certainly there is not a place 
for that in the health care reform bill that we are trying to work out 
before the Senate and the House of Representatives.
  Furthermore, the final cost of the bill has not been released. I 
serve on the Finance Committee, and there is a group of bipartisan 
Senators trying to work together to come up with an agreement. They 
have not been able to do that, and the big reason for that is they are 
trying to finalize the details. The details are extraordinarily 
challenging because of how complex our health care system is today.
  That is why we need to take our time and get it right. You don't mess 
with one-sixth of the economy of the United States and get it wrong. 
There are no do-overs when it comes to health care reform. If we mess 
it up, we literally can mess up our country. We can mess up the economy 
of our country and potentially threaten the very existence of our 
system of government because we can bankrupt our country.
  We all know Medicare and Medicaid are threatening to bankrupt our 
system of government as it stands today. All that the HELP Committee 
bill and the other that have been introduced bills do so far, is 
accelerate how fast Medicare and Medicaid can bring economic collapse 
to the United States.
  I am working on other proposals. There are examples out there where 
things are being done right in the health care system. I have told this 
story to my colleagues many times. Safeway is a company that saw their 
health care costs skyrocketing year after year. With 200,000 employees, 
they were spending about $1 billion a year on health care expenses, 
with costs increasing every year. When a company is only making $200 
million to $300 million a year, and their costs are going up 20 percent 
a year, you can see the writing on the wall. They were going to 
bankrupt their company with health care costs alone.
  Safeway set out on a new course and focused on four areas. They 
incentivized their employees through lower premiums, if they didn't 
smoke or they would quit smoking, they provided smoke cessation 
products. They focused on the area of obesity with weight management. 
If employees were in the proper body mass index or if they lost weight, 
they would give them a lower health care premium. They also focused on 
cholesterol and hypertension. They didn't penalize employees for having 
high cholesterol, but they rewarded them for keeping their cholesterol 
under control and they rewarded them for keeping their blood pressure 
under control.
  Rewarding healthy choices actually works. Safeway is a very good 
example. What happened to Safeway in the last 4 years, compared to the 
rest of the United States, is that Safeway has been able to lower their 
health care costs by 40 percent.
  Unfortunately, the Congressional Budget Office, which is the official 
scorekeeper around here and determines how much money is going to be 
saved, does not have a model that works with something like the Safeway 
program. CBO's economic models don't work that way. The bean counters 
around here, unfortunately, don't know how to put that in application 
for the rest of the country. That is unfortunate because I believe, if 
we used some of the same modeling Safeway did for the rest of the 
country, we could save huge amounts of money in our health care system.
  We don't have to save 40 percent, such as Safeway did. Maybe we could 
save 10 percent. Actually, if we don't save anything, and just freeze 
the rate of growth, we would be so far ahead in money that we would 
have plenty left over to cover the uninsured. As I said, unfortunately, 
the Congressional Budget Office doesn't say a model like Safeway's will 
save money. It is ludicrous, though, to believe that having people quit 
smoking and rewarding them for proper weight management wouldn't save 
money. I think we need

[[Page 20255]]

to change the economic models we have around here.
  Not only would that save money, but it would also lead to higher 
quality lives. Obesity is an epidemic in the United States. Type II 
diabetes is rampant. Most Type II diabetics can actually reverse, or at 
least control their diabetes through diet and exercise. We need to 
encourage healthier behaviors in the United States. Instead of just 
having a sick care system, let's actually create a true health care 
system in the United States.
  Another thing we need to do, I believe very strongly--and this is a 
role for the government--we need to provide transparency on cost and 
quality so individuals can shop. In the bay area, a colonoscopy can 
cost anywhere from $800 to $8,000. Well, if the government were to 
provide cost and quality measurement information across the United 
States, people could set up plans and they could see what the various 
costs are. Let's say that between the $800 and the $8,0000, they might 
decide to pay $1,200. And then if they want the more expensive one, 
they have to pay the difference. If they want the less expensive one, 
they can get the difference. That will cause people to comparison shop 
and they will have the information based on cost and quality of 
outcomes to be able to make smart medical decisions.
  The one thing we don't want to do is put a bureaucrat between the 
doctor and the patient making those sorts of decisions. There is a 
precious relationship between a doctor and a patient, and we don't want 
the government making those kinds of decisions. I don't want to see a 
government-run plan that says, you know what, we are going to have 
rationing. That is how so many other countries around the world control 
their costs. They actually ration care, or there is delayed care. We 
have better outcomes in the United States on cancer, on cardiovascular 
disease, and in so many other areas than Canada, Great Britain, and 
other places that have government-run health care plans.
  I think it is critical we get together as Republicans and Democrats--
as Americans--and come up with a health care system that is lower in 
cost and even better in quality than we have today. The bills before 
some of the committees out there are not going to achieve that.
  I have done several telephone townhall meetings in the last couple of 
weeks. We have called almost 200 thousand Nevadans now and talked to 
many of them. They answered questions. We have gotten their feedback. 
The one thing that seems not quite unanimous, but from the calls we are 
receiving it is overwhelming, is that is people do not want a 
government plan. They do not want a government bureaucrat rationing 
their health care.
  Whatever plan we come up with should not include a government-run 
health care plan. I feel strongly about that. I think as more and more 
of the American people find out what the effects of a government-run 
plan will be, we will see a lot more opposition coming from them.
  I appreciate the Senator from Illinois allowing me to go first. Let's 
get together as Americans and do the right thing on health care. Let's 
join as Republicans, Democrats, and Independents across this country 
and have a health care system that has lower costs and better quality.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Illinois is 
recognized.

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