[Congressional Record (Bound Edition), Volume 155 (2009), Part 15]
[Senate]
[Pages 20292-20296]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. DODD. Mr. President, what I have done every day over the last 
week or so is to take the floor to talk about health care, and I do so 
again this evening, with a note of some sadness. I have just been told 
there has now been a statement issued that there will be no markup of 
the Finance Committee bill next week on health care. I know Senator 
Baucus has worked hard at that. I know other members of that committee, 
in that effort, have been working to try to reach some understanding in 
all of that. I regret we will now leave here, I gather, next week, at 
the conclusion of the nomination process for Judge Sotomayor, for a 
month-long recess to our respective States, or whatever other 
obligations our colleagues may have. So I am saddened by that.
  Let me try to find a good note in all of this--there are five 
congressional committees between the House of Representatives, the 
other body, and ourselves that have some jurisdiction over the health 
care debate. Three of those committees reside in the other body, the 
House of Representatives; that is, the Energy and Commerce Committee, 
the Education and Labor Committee, and the Ways and Means Committee. I 
am told that by tomorrow those three committees will have completed 
their jobs. They will have reported out a bill. There are two 
committees in the U.S. Senate with jurisdiction. Jurisdiction over some 
of the most major components of health care resides in the committee 
chaired by our colleague from Massachusetts, Senator Kennedy, who is 
not with us, as most Americans know, because of his ongoing battle 
today with brain cancer. In his absence, I have been asked to act as 
the acting chair of that committee. Two weeks and 2 days ago, we 
completed our work in that committee. So the only committee remaining 
to do some work is the Finance Committee. So of the five committees, 
four, by the end of business tomorrow, will have completed their jobs.
  That does not mean the work is completed. Obviously, a lot of work 
remains in melding these bills together to try to come up with answers 
to the thorny questions that remain on how we structure the health care 
system in our Nation to go from a sick care system, which it is today, 
to truly a health care system, to deal with the issues of cost, to try 
to manage these issues so we bend that cost in the coming decades and 
beyond in a different direction than we are headed today--I will talk 
about that in a minute--obviously, to improve the quality of health 
care, which all of us care about. And while we have great quality of 
health care in many areas of our country, there are still numerous 
areas where the outcome, the overall health condition, the life 
expectancy of our fellow citizens, is far less than it ought to be. So 
accessibility, quality of care, and affordability are still the primary 
goals. We are all working very hard to try to reach that point.
  So four out of five committees will have acted. The fifth, we hope, 
will achieve that result at some point here or in some manner in which 
we can move forward with this critical debate in our Nation.
  So this evening, I want to spend a few minutes talking about where we 
are on a couple of these issues. I have discussed, on previous 
gatherings, my thoughts on aspects of the legislation. Let me share 
where this debate is.
  There is a strong case to be made--we know the economic argument. I 
am going to get to that in a minute. But there is a moral case to be 
made as well for health care reform, and it is a very strong one.
  Maybe that impresses economists or actuaries, but there is a moral 
obligation, it seems to me, in a nation as blessed as ours, with great 
resources and wealth and abundance of resources, natural and otherwise. 
We live in the wealthiest Nation in the history of mankind. Our 
generation is an inheritor of incredible work that was done by those 
who have come before us, who sacrificed greatly, including their very 
lives, to produce the kind of Nation we live in today. It has been a 
remarkable story for little more than two centuries, which has resulted 
in one of the great miracles in world history--to produce a nation 
where the vast majority of our population can live with financial 
security, with job opportunities, with the ability to raise families 
with security, despite what we have gone through in recent years in 
certain instances. Nonetheless, there is a sense of stability and 
security about being an American.
  In many ways, we are the envy of a good part of the world. So it is 
important, as we think of the debate on health care, to remind 
ourselves what others have given to produce the kind of results that 
leave us with a level of lifestyle that is unmatched anywhere around 
the globe. In spite of that great news, we should note that also 45 
million of our fellow citizens, many of whom are children, go to bed 
every night without health care coverage. In the wealthiest Nation in 
the history of mankind, nobody should be denied coverage for health 
care because they have some preexisting condition. What is that? That 
is some determination that you had a problem, a healthcare problem, 
before. Therefore, that insurance company will deny you coverage 
because of that preexisting condition, especially when that excuse is 
used by so many insurance companies to avoid covering victims of 
domestic violence, for instance, or those suffering from the most 
painful of long-term illnesses--those preexisting conditions.
  In the wealthiest Nation in the history of mankind, nobody should 
have to choose between paying their electric bill or taking a sick 
child to the doctor. I wish that were just in minor cases, small 
anecdotes. It is not. Regardless of which State we represent, every one 
of us represents families who, every single day, make those kinds of 
choices, such as paying that electric bill or cutting back on the 
family budget because they have to make a choice about whether they can 
care for that sick family member.
  Nobody should have to lose their home and go into bankruptcy because 
their medical bills are too high. I know the Presiding Officer has 
heard me on previous occasions in recent times talk about the 
statistics. Let me repeat them quickly: 62 percent of all bankruptcies 
in the last several years are health care crisis related--62 to 65 
percent. Of that 62 percent, 75 percent of those people had health 
insurance. When I first saw those numbers that 60 to 65 percent of 
bankruptcies are due to the health care crisis, I assumed that the 
overwhelming majority of people in that situation must be those without 
health care coverage. It pained me to learn that 75 percent of those 
people actually had health care coverage. Despite that, they ended up 
in financial ruin, having to go into bankruptcy to survive 
economically.
  In the wealthiest Nation in the world, the one that spends far more 
on health care than anybody else--some $2.5 trillion a year, and we now 
rank 37th in the world in medical outcomes--that is in terms of our 
overall condition, healthwise, as a people, life expectancy. We now 
have the first generation of Americans who will live shorter, less 
healthy lives than their parents. That has never happened before in the 
history of our country. Each generation of Americans has been able to 
improve the quality of the health

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care of their children. Even in that 19th century and throughout the 
difficulties of the 20th century, every generation did better on that 
score. We are about to be the first generation whose children will be 
less well off--not financially, although that may be the case, but in 
terms of their health care.
  I don't know of anyone in this generation who wants to leave a legacy 
like that, where because we could not figure out how to deal with 
health care we left our children in a condition where they will have 
less healthy lives than we have had. I don't think any one of us--I 
don't care what our politics are, or where we are from--wants to be 
part of a generation that gets referred to in history because we could 
not take better care of our children.
  There is a moral case for health care that I know gets dispelled by 
some because people don't want to take it seriously or don't want to 
talk about that. Let's just talk about the economics. I think, as a 
people, we ought to talk about it. I think it motivates us. I think all 
of us share that common concern that we believe in this great country 
of ours we ought to be able to do a better job taking care of our 
fellow citizenry when it comes to the basic right of being provided for 
when a health care crisis comes.
  Today I want to make the case for reform, in addition to being the 
right thing to do, is also the smart thing to do, the very smart thing 
to do. It is the smart thing to do for our Federal deficit--and my 
colleague from Iowa talked about the deficit. I think he is right that 
we need to confront that issue. Six months ago, an American President 
assumed office--how quickly we forget--having inherited the largest 
deficit accumulated not just by any President but by every previous 
President combined. That is a remarkable track record. It is one thing 
to have a larger deficit than your predecessor, but over the previous 8 
years the administration that just left town, and the Congresses that 
supported them, accumulated a deficit in 8 years that exceeded the 
deficits accumulated by all previous 42 Presidents in our American 
history.
  All of a sudden, President Obama arrives in town on January 20 and he 
gets handed this ``gift'' from the previous administration: a mountain 
of accumulated debt. All of a sudden, now this is the big issue we hear 
about. Where were those voices over the past 8 years as that debt 
accumulated day after day? All of a sudden they want to lay this at the 
doorstep of a new President arriving in town.
  If they are concerned about it--and I believe my colleagues are--then 
one certain way to add to it is to do nothing about health care. Let's 
just leave town for another month, without having addressed this issue 
in any concrete and thoughtful manner because, clearly, if we do that, 
the amount of deficit this country will accumulate--Mr. President, we 
spend 16 cents of every dollar on health care today. I don't know of a 
single expert who would tell us that by 2040 we will be spending as 
much as 30 to 40 cents out of every dollar on health care if we do 
nothing, with inaction, if the status quo dominates. There is a danger 
of that. We are all painfully aware of that.
  The bill that passed our committee 2 weeks and 2 days ago--by the 
way, it took a long time, 5 weeks. We had 23 sessions and went through 
some 60 hours--it was 4 weeks from start to finish, actually, almost 60 
hours, 23 sessions, on 13 days. We actually considered 287 amendments 
over that month-long process day in and day out. We accepted 161 
amendments offered by our friends on the Republican side. Many were 
technical and many were substantive amendments.
  So we went through a long process and considered it at length, with 
long debates, with 23 of us, one-quarter of the Senate, sitting on the 
committee chaired by Senator Kennedy to consider various ideas within 
our jurisdiction.
  Under that bill we established a very large and robust marketplace 
where small business owners can go to comparison shop for various 
health care packages for their employees or themselves. Our bill is the 
smart thing to do for businesses which often today find themselves 
choosing between reducing coverage for their employees or laying off 
workers because they cannot afford to provide it.
  In our bill--the one we passed--if our bill would be adopted, as I 
believe it will be, no longer will small businesses in our country be 
forced to act as health insurance experts. No longer would they be 
denied affordable insurance options. No longer would small businesses 
be discriminated against because they employ someone with a preexisting 
condition or one who suffers a sudden unexpected health crisis, thus 
driving up the premiums for every employee, either making it too costly 
or making it impossible to provide them coverage.
  In our bill we passed not only do we give small businesses somewhere 
to turn for insurance options, we give them the financial assistance to 
pay for it--$1,000 for individuals and $2,000 for families. Every small 
business could get that to assist them in that very business of trying 
to provide for their families.
  That has been in our bill. It is written in there. If we can pass 
that bill, I am confident the other body would adopt it.
  We give employers a healthier, more productive workforce. I point out 
in many parts of our country employers only have one choice or two 
choices for health care coverage for their employees. That is all that 
exists for them, and they want to shop to find out what is available. 
Under our marketplace in the bill, they would have a wide range of 
options to choose from of private carriers offering different packages 
and different levels of cost, allowing the employer to shop on behalf 
of their employees, and we give them the credit to make it available, 
financially, to do so. Our bill does more than anything else--
certainly, when it comes to small businesses.
  Importantly, for those employers who are happy, as many are, with the 
insurance they have--maybe they are a large employer who has invested 
heavily in prevention, or they have negotiated low prices and a wide 
network of providers as exists in some parts of our country. Under our 
bill nothing changes for them. They can keep the insurance as long as 
they choose to renew it. That is their business. We change none of 
that.
  If you like what you have, you keep that. If you are a smaller 
employer and you want to change that and you want better plans, we 
provide the credits to do so and the option for you to have more 
choices.
  Most of all, we believe reform is the smart thing to do for the 
American consumer, for those employers and employees. Some of our 
fellow citizens are getting a good deal when it comes to their 
insurance. They like the doctor they have, they like the hospital they 
go to when they need one, and they like the insurance plan they have. 
They don't want anything about their health care to change. They should 
not have to worry about that. Our bill protects that. If you like your 
doctor, your hospital, and your health care coverage, you can keep 
that, just as that business who wants the plan they have, they can keep 
that under our bill, which we wrote 2 weeks and 2 days ago--the 900 
pages we worked on for almost 5 weeks and on which we considered 300 
amendments.
  Some of our colleagues have tried to scare our fellow Americans into 
believing our bill would force change upon them. That is just not true. 
That is a falsehood. It is being dishonest with the American people. 
The bill that was crafted in the HELP committee won't make anyone 
change their doctor or their insurance plan. If they like what they 
have, they get to keep it. The only change they may see is that there 
may be more money back in their pocket as a result of what we provided 
in the options available to people to make better choices at lower 
costs.
  Here is what our opponents won't tell you: If we don't take action--
if it is just the status quo and we go back to our States and walk away 
from all of this and never deal with this issue, you may very well lose 
the ability to see the doctor you like. That is at risk with inaction. 
If we don't take action,

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you may lose that good insurance plan you have. If we don't take 
action, you may well find yourself unable to get the kind of care you 
need when you need it.
  If we don't take action in the Congress, families with insurance will 
continue to pay that hidden tax of $1,100 that the average family pays 
every single year to cover the costs of the uninsured who show up at 
hospitals.
  In our country, you will get care. If you walk into the emergency 
room, we take care of you. But there is a cost for doing so. The cost 
is, on average, $1,100 per family a year. That is the tax we pay today 
because of the failure to provide the kind of plans we adopted in our 
bill. So that cost falls on families.
  Further, Mr. President, if we don't take action, premiums will 
continue to rise faster than wages. If you don't believe me, look what 
happened to my State of Connecticut a few weeks ago when an insurance 
company proposed to raise their rates by 32 percent. I wish that were 
uncommon. The rates in my States in the last 6 years have gone up 45, 
46 percent, and since 1996 in the country, they have gone up 86 
percent, vastly outstripping the rate of inflation, with no end in 
sight.
  For those who say we can wait, we don't need to do this now, we ought 
to postpone all this, it is not necessary, we ought to deal with the 
deficit or other issues, then consider what is going to happen if we 
don't move and if we don't come together and get this job done. On 
every one of these issues, if we don't take action, no matter how 
secure you may feel today, you may lose that insurance, you may lose 
that coverage, you may find yourself unable to go to that doctor or 
hospital you believe you would like to and you continue to pay a rising 
cost in premiums to cover the uninsured.
  Mr. President, 2 weeks and 2 days ago, since our committee acted, 
210,000 of our fellow citizens have lost health care coverage. These 
are people who had insurance 2 weeks ago. Every single day we delay 
taking action on legislation, 14,000 of our fellow citizens lose health 
care coverage--every day. So since 2 weeks and 2 days ago, 210,000 of 
our fellow citizens lost their health care coverage, and we are about 
to leave for another month. Do the math on a daily basis.
  While we as Members of this body go back to our respective States, we 
have our health care coverage, we have very good health care coverage--
very good health care coverage. None of us have to worry about that as 
we go back and walk away, unfortunately, from a set of issues with 
which we should be grappling. But we can do so with the assurance, the 
certainty, and the stability as elected officials in this body that if 
something happens to any one of us, we are going to be fine because we 
have great health care coverage. But, unfortunately, for 210,000 of our 
fellow citizens in the last 2 weeks, that is not the case.
  Imagine tonight that you are one of those 210,000 and you wake up in 
the middle of the night because your child is very sick and you rush 
them to the hospital, or a spouse or loved one who needs that kind of 
care because of an accident. These things happen with the least 
predictability. Every one of us knows what happens. We have all had it 
happen to us with a child, a spouse, where all of a sudden there is a 
tragedy, an accident, an injury, there is an illness, and all of a 
sudden we need that coverage to protect us. Tonight there are 210,000 
more people since 2 weeks ago who are in that free-fall hoping that 
nothing happens until they get back on their feet again, maybe get that 
new job, find that insurance company that will cover them and provide 
those benefits.
  Imagine yourself being in that spot--think about that--that lack of 
stability, that lack of certainty, that lack of comfort knowing that if 
something happens to my family, I cannot help them.
  I hope we can get them back on their feet again. I hope they get to 
see a good doctor, and they will have the drugs they need or care they 
need to restore their health. But you never get to that question if you 
cannot even approach it because you don't have the coverage any longer 
to pay for it.
  Those 14,000 a day are going to continue to mount up under the 
present circumstances. I am disappointed, to put it mildly, that we 
find ourselves leaving here without continuing to do work. Not that we 
are going to solve all the problems in the week before we leave, and no 
one, of course, argues that we shouldn't do this right and we shouldn't 
be careful to make sure we are doing it right. It is a silly argument 
to suggest there are people here who don't care about crafting 
responsible legislation. I will not accept the argument it is too hard 
and that is the reason we cannot get it done. That is why reforming our 
health care system is so important, for all those reasons.
  Even if you are satisfied with your personal health care situation, 
you ought not have too much comfort and believe it will be there when 
you may need it the most.
  The bill we passed provides stability so that care that is available 
to you stays available day after day and provides cost savings that you 
will see in your family budget. Our bill eliminates entirely the annual 
and lifetime caps on benefits. So even if you suddenly develop a 
serious illness or get into a bad accident, you will be able to get the 
treatment you need, and it does put limits on how much money out of 
your income you could be forced to spend on insurance.
  Today there are no limits. Our bill provides those limits so your 
expenses will never be more than you can afford to pay.
  Our bill we passed prohibits insurance companies from discriminating 
against people with preexisting conditions. That is gone forever in our 
bill. That argument about preexisting conditions is absolutely gone. If 
we do nothing, it is still there, and so that certainty you think you 
have is not certain at all with preexisting conditions that exist 
today. Our bill eliminates those.
  You don't have to stay in a job just because you have an illness that 
would keep you from getting coverage elsewhere. I cannot tell you how 
many stories I have heard about that, where people have miserable jobs 
with miserable pay, but they don't dare leave it because they know if 
they do and they have a preexisting condition, they will be denied the 
kind of coverage they need to have.
  Our legislation also prohibits insurance companies from changing or 
dropping coverage or refusing to renew it if you get sick. It mandates 
that these companies cover the things that will help you stay well, 
such as mammograms or annual checkups, at no additional charge to you 
as a patient.
  The truth is that too many Americans are getting a bad deal, even 
those who are operating with a comfort that they believe that what they 
have will be there whenever they need it, and the ones who are getting 
a good deal might not be able to keep it unless we take action to 
provide the kind of stability people are looking for.
  Even those who somehow are able to ignore the urgent moral imperative 
of reform I think should support the legislation we crafted simply 
because it is a better deal for American consumers, and it is the smart 
thing to do.
  It has now been, as I said, more than 2 weeks since our HELP 
Committee passed its legislation. It is a good bill. It is not a 
perfect bill, and more work needs to be done. All of us acknowledge 
that. But it is one that I think every Member of this body can get 
behind. Every single member of that committee, all 23 of us, every 
single member added contributions to the original draft. Every 
Democrat, every Republican added amendments that were adopted to our 
bill.
  By the end of this week, as I pointed out earlier, four of the five 
committees with health reform bills will have completed their work. I 
know the Finance Committee, as I said earlier, is working hard to 
produce a bill as well. When their work is complete, I look forward to 
sitting down with them to merge our efforts, which is clearly going to 
happen. We are going to merge our efforts. We are going to take what we 
have done and merge it with what the Finance Committee has done. So the 
Senate will have two committees on equal footing dealing with health 
care

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issues. I know the leaders guaranteed that, the President has spoken 
about it, and I am sure my colleagues will support that effort.
  I heard some of my colleagues mention that now is not the time to 
plow ahead. I disagree. I can't think of a more urgent issue for all 
the reasons I mentioned this evening and how important it is. I said it 
may not be as much an urgency for those of us with the stability and 
certainty of our own health care policies, but for so many of the 
people we represent--those who are uninsured or underinsured--they have 
a right to insist we do the job, face the difficult questions, and have 
the courage to lead on this issue, to be leaders. That is what we are 
asked to be when people chose us to represent them.
  I know it is the case in my own State, as it is across the country. A 
lot of the choices we have to make are tough ones and hard to explain, 
in some cases, because they will involve the shared responsibility that 
all Americans must be involved in if this is going to work. That is why 
we get sent here. Occasionally, there are matters that require us to 
stand and make tough choices. We are at such a moment. For us to do 
less, to walk away from this, I think, will be one of the great 
tragedies of our time.
  I regret we will not be working on this legislation in the coming 
weeks, although we will in our own way--our staffs will be working and 
we will be back in our respective States listening to our constituents. 
I hope when we come back in September, we will have a renewed sense of 
purpose and get the job done. We have a President who cares about this 
deeply. We have Members of both bodies who were elected and ran on this 
issue of reforming our health care system. Major industries, the 
insurance industry, the providers, the doctors, nurses, the 
pharmaceutical industry, all today are on the side of getting something 
done. There are disagreements on how to do this, but wonderful people 
in public and outside public life are committed to this. It is 
different than it was 14 years ago. We ought to be able to take 
advantage of that new alignment, if you will, and get this job done.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Mr. President, I appreciate the opportunity to speak after 
Chairman Dodd, who has probably, more than anybody else this year, led 
the health care effort. As he pointed out, in our committee, it was the 
longest markup of any bill I have ever seen in my years in the House 
and Senate.
  I spoke today to a Washington Post reporter who said she had never 
seen a markup so thorough. We faced 160 Republican amendments, either 
passed or accepted, many of them substantive, some of them not but 
certainly a major bipartisan effort. In the HELP Committee, we went 
over it section by section. This is a very good work product.
  We are joined by three committees in the House of Representatives--
the Ways and Means Committee and the Education and Labor Committee, 
which have already completed their work on a similar bill, and another 
committee is working on it tonight, the Energy and Commerce Committee, 
a committee on which I sat in my years in the House of Representatives.
  All four of these bills are similar. They all protect what works in 
our health care system, and they fix what is broken. They all provide 
that, if you are happy with your insurance, you can keep what you have. 
But in addition, your premium is much more likely to stabilize because, 
as Chairman Dodd said, you are no longer subsidizing to the tune of 
$1,100, $1,200 a year uncompensated care for others. You are paying for 
your health insurance, but others in society will be paying for their 
own health insurance rather than what is called cross-subsidies. This 
legislation obviously covers millions of Americans who are not insured.
  All that aside for a moment, I have come to the floor to read letters 
from people, which I have done every day for the last several days and 
will continue. We use words such as ``market exclusivity, gateway, 
exchange, cross-subsidies,'' and all these kinds of terms. When it gets 
right down to it, it is how this affects people individually in our 
country and our State. Whether they are in West Haven or Hartford, 
whether they are in New London, CT, or New London, OH, people are 
hurting, and these are some letters from constituents I have received.
  I would like to share five, six letters with my colleagues and with 
the Presiding Officer.
  Diana from Seneca County in Ohio writes:

       I am a middle-aged widow who returned to college. Next 
     month, I will graduate. I have no health insurance and have 
     been seeking employment for a year. Please help the good 
     citizens of Ohio get health care, many of whom have found 
     themselves in a terrible predicament through no fault of 
     their own. Please help me help myself.

  This is an example of people working hard, doing the right thing. 
Chairman Dodd said 14,000 Americans lose their health insurance every 
day now, and people such as Diana from the Tiffin area in northwest 
Ohio cannot get ahead of the game, cannot get ahead of the curve, 
cannot get insurance, has not found a job. In economic times such as 
these, there are an awful lot of people similar to Diana from Seneca 
County. That is why it is so important we pass legislation when we come 
back in September.
  Ian from Franklin County--that is central Ohio, the Columbus area:

       I am a 31 year old without health insurance. I have a 4-
     year degree but work part time. I have no sick days, no 
     vacation days, or personal days. I'm sick and tired of being 
     scared of getting sick. . . . Health care should be based on 
     need rather than ability to pay. Enough.

  Just think of how many people in this country live that way. They 
think about being sick. They think: What happens if I am sick? I am 
barely making a living. I know if I get sick, I will have to choose 
between my medical bills and paying my rent or choose between my 
medicine or sufficiently heating my home in the winter.
  Those kinds of choices are very real choices to hundreds of 
thousands--more than that--Americans every single day.
  Lee from Cuyahoga County writes:

       I have worked in health insurance in some form or another 
     since 1973. I know Medicare and Medicaid as well as private 
     health insurance. I have seen health insurance from just 
     about all angles and could probably write a book on it. Many 
     times I have told potential clients that ``shopping around 
     for health insurance is like going to a casino and betting 
     against the house--where the house is making up the rules, 
     changing the rules, and not letting you know that the rules 
     have been changed.''

  This is an expert who made his living by dealing with health care 
issues. He knows what happens with insurance companies. That is why we 
did consumer protection in this legislation--no more preexisting 
conditions, no more dropping coverage indiscriminately, no more caps on 
coverage, no more gaming the community rating system, no more 
discrimination. That is what this legislation is all about.
  If you have insurance and you like what you have, you can keep it. 
Absolutely our bill guarantees that. But you also will have these 
consumer protections because plenty of people who are satisfied with 
their insurance get sick and find their insurance has been canceled. No 
more of that under this legislation.
  Susan from central Ohio, from Franklin County, writes:

       I am in my mid-50s and have been unemployed for over a 
     year, looking for a new job the entire time. Living without 
     health insurance at this point in my life is terrifying.

  I am 56. This woman is in her midfifties. She has been unemployed for 
a year. She is living without health insurance. It sounds like she is 
healthy but always thinking about it, always scared.

       My father was a physician in private practice in Columbus 
     from the 1950s through the 1980s, in the days when the 
     physicians made the diagnoses and the health care providers 
     trusted them to do so. Please fix the health care system, and 
     make it possible for everyone to have access to good medical 
     care.

  Susan is somebody who understands the health care system from within. 
She is the daughter of a physician and understands, in her words:

       . . . living without health insurance at this point in my 
     life is terrifying.

  Think about that. With all the worries someone has when they are in

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their mid-fifties and thinking about what happens if they get sick.
  Libby, also from Franklin County, says:

       I need a follow-up CT scan for kidney cancer, but I can't 
     afford the co-pay. I have to take early retirement, but can't 
     wait 2 years for disability. I hope having to wait doesn't 
     kill me, but I am one of many. Please fix our broken health 
     care system.

  We hear stories every day about health care denied and health care 
delayed--which really is health care denied--and what happens to people 
when they have to delay. Libby, from this letter, sounds to me as if 
she is hoping, hoping, hoping that we can move quickly so she can get 
insurance and can have the follow-up CT Scan for her kidney cancer.
  Claudia, from Franklin County in central Ohio, says:

       My husband and I have owned our own successful business for 
     21 years. Our health insurance costs have escalated to the 
     point where we barely can pay the bill and our coverage is 
     truly awful. With a $5,000 deductible per person, we are 
     insuring against catastrophic illness only. Little money is 
     available for regular checkups, recommended annual tests, or 
     dental care. I never thought we would be in this position and 
     there is no relief in sight. Many self-employed people are 
     now discontinuing health care because of the cost. We need 
     help.

  Claudia and her husband are like small business owners all over this 
country--people who are self-employed, who have maybe 5 to 10 
employees. They can no longer afford health insurance, particularly if 
they are a business of 30, 40 or 50 people and 2 or 3 of those 
employees get very sick and they need Remicade or they need Perceptin 
or one of those biologic drugs that cost $10,000, $20,000, sometimes 
$50,000 or even $100,000 a year. What happens to that small business, 
if they have 20 or 30 employees and a couple of those employees end up 
with drug costs of $50,000 or $100,000 a year? That may cause the 
employer to have to cancel their insurance because the insurance 
premiums go so high as a result of three or four or five sick people.
  This legislation, as Chairman Dodd points out, has specific 
provisions to help small business. It lets them go to the health 
exchange so they can spread out their costs among the larger numbers of 
people than the small employers of 10, 15 or 20 people--or in the case 
of self-employed people such as Claudia from Columbus and her husband--
who simply don't have any chance of getting insurance. They know people 
with insurance in small businesses will no longer have to pay the cost 
of the uninsured--the extra $1,100, $1,200 a year they have to pay. 
They will get additional tax credits so they can insure themselves and 
insure their employees.
  Almost every employer I know wants to insure their employees. They 
want to insure their employees. So many simply can't afford it. This 
bill will make a difference for small business. It will make a 
difference with the consumer protections that will help those people 
who are happy with their insurance but are always anxious about perhaps 
their insurance being canceled or caps being put on their insurance or 
all of those issues that happen to people.
  That is why this legislation is so important. That is what is 
reflected in these letters from individual people, whether they are 
from Zanesville or Mansfield or Urbana or Youngstown. People all over 
my State are hurting. People all over this country are hurting. People 
in the State of the Presiding Officer--in Boulder, in Denver. Anywhere 
in Colorado or in Connecticut we know these problems are every bit as 
severe as they are in my State. That is why we need to take action.
  We have 14,000 Americans every day losing health insurance, and I am 
hearing from a lot of them. I am hearing from people who are looking 
for work and can't find work and can't find insurance. It is time we 
move forward.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Bennet). The Senator from Connecticut.
  Mr. DODD. Mr. President, I thank my colleague from Ohio. He has been 
a member of our committee, and as I mentioned earlier, he has done a 
tremendous job, as others have as well. Sherrod Brown brings a wealth 
of experience. He has been dealing with these issues, obviously, in the 
other body.
  And I think in talking about real people with these issues, there is 
a tendency of all of us to kind of discuss these matters from about 
30,000 feet, using the language we are familiar with to describe what 
is going on, and too often I think for people across the country, they 
wonder if anybody is talking about them. I think by reading letters 
from citizens in Ohio and what they are wrestling with every day, it 
brings this back down to a level that we need to think of more often 
when we debate these issues, and that is that every single day, of 
those 14,000 people who are losing their health insurance, there are 
many who do confront a health care crisis and lack the ability to 
respond to it other than showing up in an emergency room or hoping 
there will be free health care for them because they do not have the 
capacity to pay for it.
  So I appreciate tremendously Senator Brown's contribution, not only 
during those long days we spent day in and day out crafting the 
legislation that is now before us, but now, when we need to do more 
talking about what is in that bill. Because from a small business 
perspective, as well as the insured, the prevention, the quality of 
care, or workforce issues, they are all very significant contributions 
to our debate.
  The Class Act, which allows individual people, at no government 
expense, to contribute to their own long-term care needs is one of the 
most innovative and creative ideas in our bill. That will provide not 
only substantial resources, but the ability of people to lead 
independent lives who have disabilities under what might otherwise 
force them to live under more expensive care or tapping into Medicare. 
In fact, the projections under the Congressional Budget Office is that 
we have saved $2 billion in Medicare costs just by having the Class 
Act--that is the long-term care provisions in the bill.
  I invite all my colleagues to read the bill and to go to the 
briefings. I spent a little more than an hour today with my colleague 
from California, Dianne Feinstein, who requested that I come by with 
staff, with her staff, and go through the various sections of the bill 
and how it would work; how it would affect people in their State; how 
these various provisions would work.
  I don't want to speak for her, but I think she was pleased to hear 
what we had done. Obviously, there is more to be done out of the 
Finance Committee, and I don't have answers for that because there is 
no bill out of the Finance Committee as yet, but on the part of the 
effort we have made, as our Members and colleagues look at what we have 
done, I think they will be pleasantly pleased about the efforts we have 
made to assist the insured with preexisting conditions, the caps, as I 
have mentioned, the credits we provide to small businesses to allow 
them to make that health care insurance available to their employees--
as many would like to be able to do--at a cost they can afford, without 
crippling them because one employee ends up with a serious health 
condition thus raising the cost of every other employee and the cost of 
overall health care. That is gone as a result of what we have written 
in our legislation.
  So I urge my colleagues to read the bill, to talk with us, to raise 
the questions you have, particularly over these weeks between now and 
the time we come back. I think you will again be pleased at the effort 
our colleagues have made to vastly improve the status quo and, I think, 
contribute significantly to where we need to be going with regard to 
health care reform.
  So I am very grateful to Senator Sherrod Brown of Ohio for his 
contribution.
  Mr. President, I yield the floor.

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