[Congressional Record (Bound Edition), Volume 155 (2009), Part 16]
[Senate]
[Pages 21042-21044]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. DURBIN. Mr. President, the last issue I wish to address for a 
moment is the August recess. August is a blazing hot month in the 
Midwest, with high temperatures and high humidity--though they were 
tempered a little this year, a little cooler than usual, a little 
wetter than is usual, but we had our hot days. But the hottest days 
were reserved for the political scene because in town meetings across 
the Midwest and across the Nation many times tempers flared, people 
were upset, there was shoving and shouting going on at these town 
meetings. If you have been on the political scene you know there are 
moments when the emotions of the American people are raised to a high 
fever pitch. Fortunately for us, the reason for this interest was 
genuine. We are talking about an issue, the changing of the health care 
system in America, which literally affects every person in our country. 
It is rare that we would tackle an issue that is that all embracing, 
that touches everybody. It is understandable that people have 
legitimate questions about what it means to their lives.
  I found the same thing in Illinois. I traveled around the State. I 
met with doctors and nurses and hospital administrators, small business 
people, average folks, patients struggling with illness and disease, 
those who had been

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turned down by health insurance companies, even people coming up to me 
in restaurants and folks at the airport talking to me about their 
life's experience when it came to health care. It is an issue we all 
share in common and an issue we all care about.
  But, sadly, there was an organized effort to disrupt many of these 
town meetings. These were not people who wanted to express their 
opposition to any pending legislation so much as to end the meeting, to 
try to raise their voices above all others and to stop the dialog that 
is so important as part of this. I don't think that point of view 
prevailed at the end of the day.
  There are still legitimate, tough questions on health care reform, 
questions that will have to be answered directly and honestly as we 
proceed in this debate. But there is no question in my mind that the 
majority of the American people understand that we need to make some 
changes in our health care system.
  There are some things that are very troubling. The cost of health 
insurance is going up three times faster than the wages of working 
Americans. We know what this means. It will reach a point where more 
and more of your take-home pay will pay for health insurance which 
sadly will not provide as much coverage next year as it did this year. 
We also know that sometimes the people who have health insurance find 
out it is not there when they need it.
  I ran into that. I had a gentleman in Quincy, IL, at one of my 
meetings the other day. He and his wife both lost their jobs. For 19 
years he had been at the local bank, with health insurance, and he lost 
his job. Because he and his wife had a special needs child, they paid 
the COBRA premium. If you understand how this works, once you have lost 
a job you can keep your health insurance if you will pay the employer 
and employee portions. Even though we have made that more reasonable in 
cost, it is still very expensive, but because of the special needs 
child he decided he and his wife had to dip into their savings to keep 
the health insurance coverage for their kids and the family, even while 
they are unemployed.
  Sadly, during this period of time of unemployment his son fell down 
the stairs and needed brain surgery. They shipped him across the river 
into Iowa where he was successfully operated on. That is the good news 
here. The father kept looking for a job, only to learn that the 
insurance company was going to deny their claim for this brain surgery. 
It would have been extremely expensive if the insurance company failed 
to pay. But now this man, unemployed, looking for a job, with a son who 
does have those special needs and a wife who is trying to find 
substitute teaching jobs to help out, has to spend a good part of his 
day fighting with the insurance company over whether his son is going 
to be covered for that emergency surgery.
  It is not rare. In fact, it is too common that the average person, 
when they need the coverage of health insurance, finds out that they 
are in a battle, not with their doctor, a battle with someone who works 
for a health insurance company who says no.
  That has to change. One of the things I hope both sides agree on, 
Republican and Democratic, is that people should not be denied health 
insurance coverage because of a preexisting condition. You should not 
be denied health insurance coverage when it turns out you are sick and 
you need it. You should also be able to take your health insurance from 
one job to another. You should not have a cap on the total amount of 
coverage in your lifetime. Your children should not be high and dry at 
23 when they have to pay for their own health insurance or they are 
completely unprotected. These are things most people agree should be 
part of health insurance reform and I hope we can make it part of a 
common bipartisan effort when we talk about this issue.
  There is another issue and it is one that I will address as I talk 
about this issue later in the week, and I think it is a fundamental 
issue of social justice, that 47 million Americans today have no health 
insurance. We have about 300 million people in our country. About 100 
million of them are under some sort of government health plan-- 
Medicaid for the poor and disabled; Medicare for those in advanced 
years, which I am soon approaching; people covered by veterans' health 
care, and those who are covered in other forms, by children's health 
insurance programs.
  So take the 100 million under government health programs aside, and 
in the remaining 200 million people in America, about 1 out of 4 has no 
health insurance. They are not the poorest people in America because 
the poorest people in America have Medicaid. They are not the fortunate 
like those of us who already have health insurance. They are people who 
get up and go to work every single day and have no health insurance.
  I met plenty of them as I traveled around the State of Illinois. I do 
not understand--I do understand, but I certainly sympathize with the 
situation where you wake up in the morning and look at those children 
in that bed as a father and realize they are one accident or one 
diagnosis away from a medical catastrophe that could threaten their 
lives and wipe out your savings. That is what people without health 
insurance face every single day.
  So in addition to the cost, in addition to whether the health 
insurance is there when you need it, is the fundamental question about 
whether if everybody in America should be drawn in under the protection 
of health insurance. I believe they should. The people without health 
insurance, when they reach a critical time in their lives and are 
desperate, show up at a hospital, and our hospitals treat them and pass 
along the expense of treating them to everyone else.
  It would be far better in America for us to provide coverage and 
protection for everyone and to help those in the lowest income 
categories pay for that protection. I think that is fundamentally just. 
It is American. It is good, sound policy so that this have and have-not 
situation would not apply to circumstances of life and death, which is 
the way it does today.
  Finally, we have to find a way to change this health care system when 
it comes to incentives. Currently, we have something called fee for 
service, which means if a doctor or hospital comes up with a new 
procedure or a new service, they are paid more. It creates an extra 
incentive to do more than may be necessary. We have to change that. And 
I think we can. We have to try to stress preventive care and wellness. 
We do not do enough of that, instead of just in rescue care and 
sickness, which is the hallmark of our current system.
  Preventive care and wellness means having access to clinics and 
primary care providers across the United States. And I want to salute 
the Association of Family Physicians. They have joined me in every town 
in my State. They fully support this. They understand that health care 
reform is essential if families are going to have a fighting chance for 
good health care.
  Well, those are the basics in the debate. There are all sorts of 
separate questions about a public option and individual mandates and 
many other issues with which we are going to have to wrestle. Senator 
Alexander of Tennessee, whom I mentioned earlier in my comments, said a 
moment or two ago: Well, it is time for us to start over when it comes 
to the health care debate and engage both sides of the aisle in the 
debate.
  I would say to Senator Alexander: We have spent a lot of time 
learning a lot of things about the health care challenges in America 
and how to reach them, the way to deal with them. We have kept the door 
open for those on the other side of the aisle who are willing to come 
forward and discuss it. Some have said, no; they are not interested for 
a variety of reasons. Today, to date, only three have stepped into the 
bipartisan conversation, three Republican Senators. I hope more will. 
It would be healthy and positive.
  The worst thing we can do is to walk away from this issue, to say 
that because some town meetings were disrupted or some people have 
strong emotional feelings about this issue we need to walk away from 
it, because the

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current health care system in America is unsustainable. It is too 
expensive. We spend twice as much per person for health care in America 
as any nation on Earth. Although there are positive things to point to 
in terms of our health care in our country, some countries spending far 
less, and get much better results in many areas. We can do better.
  Secondly, who would oppose health insurance reform? I would hope 
everyone understands that at the end of the day what needs to be done 
should be done on a bipartisan basis. I hope there are those who feel 
we should create opportunities for those who are uninsured to have 
basic health insurance protection.
  Those who criticize the cost of health care reform overlook the 
obvious: If we do not help low-income families and individuals in 
America pay for health insurance, they will not have it. If they do not 
have that coverage, we will be right where we are today, with one-
fourth of those not covered by government plans having no health 
insurance protection whatsoever.
  We need to change the system to focus on prevention and wellness. 
That means encouraging more primary care physicians and health care 
professionals to reach out to families in communities across Illinois 
and across the Nation. If we do not do something about this, I am not 
sure we can sustain the system much longer.
  Just a few years ago, one out of three people filing for bankruptcy 
in America did so because of medical costs-- one out of three. Today it 
is two out of three. Two out of every three personal bankruptcies are 
over medical costs. Listen to this: 78 percent of the people filing for 
bankruptcy because of medical costs, 78 percent of them have health 
insurance. It is not very good. It does not protect them when they need 
it. It leaves them high and dry when major medical bills come through.
  So those who are watching this debate saying: I am sorry people do 
not have health insurance, I am sorry some people are complaining, but 
I am OK, I am covered, they should pause and reflect for a moment that 
many of the people in bankruptcy court today facing bankruptcy and the 
loss of virtually all of their assets are people who also had health 
insurance and were also in the belief and security----
  The PRESIDING OFFICER (Mr. Udall of Colorado.) The Senator's time has 
expired.
  Mr. DURBIN. Let me conclude by saying that we have a chance in the 
coming weeks, after the President's speech tomorrow night, to come 
together on a bipartisan basis. I hope Republicans and Democrats who 
listen carefully at home understand that despite the anger and the 
temper and the emotions that we cannot leave the current system as it 
is. If we do not make a positive change, it is unsustainable.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from South Carolina.

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