[Congressional Record (Bound Edition), Volume 155 (2009), Part 15]
[Senate]
[Pages 20287-20288]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. WHITEHOUSE. Mr. President, I met in my office today with Donna, a 
Rhode Islander who suffers from vascular disease. Donna's condition 
forced her to give up her job, and therefore her insurance. She cannot 
afford to buy it on her own, since it would cost her $650 a month--
money she does not have. So she pays for her medications out of pocket. 
They should be $2,000 per month, but her doctor got them down to $450. 
But even this is no walk in the park. Donna read me a laundry list of 
procedures and services she needs but cannot afford, so like so many 
Americans, she sits waiting, struggling, hoping she does not get worse.
  I want to tell my colleagues what I told Donna today: the Affordable 
Health Choices Act, the bill that the HELP Committee passed out last 
Wednesday, would mean hope and change and help for Donna. It would mean 
that insurance companies could not deny her a policy because of her 
vascular disease, as they can, and do, right now. It would mean that 
insurance companies could not charge her sky-high rates because of her 
vascular disease, as they can, and do, right now. It would mean that if 
Donna needed financial help to purchase a health insurance plan, she 
would get it. No preexisting condition exclusions, affordable premium 
rates, and subsidies for those who need help purchasing a plan. That is 
what the HELP Committee's plan offers every American in this country.
  I also have heard from Madeleine, a Pawtucket resident who cannot 
afford health coverage despite working two jobs. Her family has a 
history of colorectal cancer; both her sister and mother lost their 
fight to this disease. Tragically, Madeleine cannot afford to get a 
colonoscopy. Without insurance, Madeleine waits and hopes that she 
doesn't get sick, because that is the only option she has.
  Under the Affordable Health Choices Act, Madeleine would have the 
financial help she needs to buy a comprehensive, affordable plan. But 
even before she did that, even before everything is in place for 
Madeline to go to a gateway and buy a plan, she could sign up for the 
Right Choices program. Under Right Choices, even without insurance, 
Madeline would have access to all basic preventive services. She would 
get a chronic disease health risk assessment, a care plan, and 
referrals to community-based resources. Most importantly, she would get 
the colonoscopy she needs, so that she is not another victim of the 
terrible disease that took her mother and her sister. It goes without 
saying that preventing this disease and treating it early would, in the 
long run, save money for the healthcare system as well as preserve 
Madeleine's health.
  I recently had coffee with Shirley, a Middletown resident who 
described her relief at turning 65. For the past 20 years, she and her 
husband did not have insurance. As self-employed business owners in 
their fifties, finding affordable insurance options was impossible, so 
they went without. They took their chances. Now 65 and eligible for 
Medicare, they finally have peace of mind. Shirley admits she and her 
husband were lucky to make it through those 20 years without serious 
health problems. During our meeting, she urged us to pass health care 
reform for the millions of hard-working Americans--hard-working, 
middle-class Americans--who are not as fortunate as she and her 
husband.
  Under the bill passed by the HELP Committee, Shirley would not have 
endured 20 years of fear and uncertainty without health insurance. As a 
self-employed, small business owner, Shirley would be eligible for tax 
credits to either continue to offer health insurance to her employees, 
or to offer it for the first time. Shirley could also take all of her 
employees to the health insurance gateway, which will give small firms 
a choice of multiple insurance plans at a lower cost and of a higher 
quality than what currently exist in the small group market. If you are 
a small business owner, this bill is for you.
  Judith from Warwick, has shared with me a story about her brother-in-
law, whose lungs collapsed during an outpatient procedure. After 
staying in the intensive care unit for 28 days, he contracted a 
hospital infection and was rehospitalized four times. Thankfully, a 
year later, he is symptom free. However, the costs stemming from the 
treatment totaled over $500,000. Like her brother-in-law, Judith and 
her husband are retired and live off of their monthly Social Security 
check. She reflects that on such a limited income, if she or her 
husband faced a catastrophic health issue like her brother-in-law, they 
would be in ``dire straits.''
  The HELP Committee bill creates a Patient Safety Research Center at 
AHRQ, which will support research, technical assistance, and process 
implementation grants to local providers to teach and implement best 
practices. No one should go through what Judith's brother-in-law did. 
No one should contract a hospital infection that leads to not one, not 
two, not three, but four rehospitalizations. We know how to prevent 
hospital-acquired infections; we have seen tremendous results in places 
like Michigan and

[[Page 20288]]

Rhode Island for years. The HELP Committee bill finally creates a 
national infrastructure to support the dissemination of these proven 
techniques so that we can drastically improve the quality of care in 
our system, and in doing so, drastically lower the cost.
  Finally, I recently met David, a self-employed resident from Central 
Falls, who described the astronomical rise in the cost of health 
insurance for him and his waif. Years ago, he paid $85 per month for 
their plan; today, he pays approximately $19,000 a year for their 
health insurance. Despite the dramatic jump in price, their health 
insurance plan does not cover as much as it used to. To keep their 
premiums and overall health costs down, David has been forced to drop 
dental coverage and increase the out-of-pocket expenses he and his wife 
pay on their plan. He noted, ``I'm almost afraid to get sick, because 
today's health plans have so many holes in them, they can nickel and 
dime you to death.''
  The Affordable Health Choices Act would do two important things to 
help David. One, it would require that plans sold in the gateway offer 
a truly comprehensive set of benefits so that ``affordable'' does not 
mean ``skimpy.'' Affordable will mean inclusive, available, and 
accessible. Two, the bill would not allow insurance companies to 
``nickel and dime you to death'' as David fears now. Insurance 
companies would be prohibited from imposing lifetime or annual limits 
on the dollar value of benefits for any enrollee. So David will not be 
forced to pay out-of-pocket once he exceeds certain levels of benefits, 
as he does now.
  There is some uncertainty both in this building and around this 
country right now about the future of health reform. I want to remind 
everyone--my colleagues on both sides of the aisle, my colleagues in 
the House, Rhode Islanders back home, and Americans across the country, 
the Senate has already put forth a health reform plan that will work 
for you. It will work for sill-mil businesses. It will work for 
Americans with pre-existing conditions. It will work for Americans 
struggling to pay health care premiums. It will work for Americans who 
are in small businesses. It will work for Americans who are one illness 
away from their family going into bankruptcy. It will work for 
Americans who are uninsured. It will work for Americans who have been 
victims of hospital errors. It will work for Americans who need 
preventive services they cannot afford.
  Most importantly, it will work for Donna, for Madeline, for Shirley, 
for Judith, and for David, and it will work for their fellow Americans 
all over this country whose stories are all too similar. Heartache, 
frustration, exhaustion, and disgust with a health care system that 
has, at best, disappointed them, and at worst, turned its back on them. 
The Affordable Health Choices Act offers these Americans a hand up when 
they need it most, and I am proud to support it.
  Before I yield the floor, I want to take one moment to thank the 
distinguished senior Senator from Iowa for his courtesy in allowing me 
to proceed. I know he has substantial remarks he wishes to deliver. I 
hope it was not too much of an inconvenience.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Iowa.

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