[Congressional Record (Bound Edition), Volume 155 (2009), Part 16]
[House]
[Pages 21675-21680]
[From the U.S. Government Publishing Office, www.gpo.gov]




        THE MAJORITY MAKERS: WHAT WE DID ON OUR SUMMER VACATIONS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Kentucky (Mr. Yarmuth) is 
recognized for 60 minutes as the designee of the majority leader.
  Mr. YARMUTH. Mr. Speaker, it's a great honor to be here tonight to 
join with at least one of my colleagues from the class of 2006, the 
Majority Makers, to discuss the theme: What we did on our summer 
vacations.
  As everyone knows, it has been a very fascinating few months, as we 
in Congress and people throughout the country have talked about how we 
can solve one of the great problems that this country has been trying 
to deal with for generations, and that is a health care system that 
serves every one of its citizens.
  I, like all of my colleagues in the House, have spent the greater 
part of August talking with my constituents. We have had town hall 
meetings, we have had telephone town hall meetings, we've met with 
groups, we've met with providers, we've met with individual citizens to 
talk about the problems facing Americans--the challenge of finding 
quality, affordable health care for every citizen.
  I think what was most revealing to me as I spent all of this time 
talking about health care with my constituents is how receptive they 
were and are to comprehensive health care reform once they understand, 
first of all, the need for reform; secondly, the direct benefit to them 
and their families of the reform that we're proposing in the House; 
and, third, the relevance of health care to our economic future.

                              {time}  1845

  President Obama, in this Chamber last Wednesday night, discussed 
those very themes, and he did it in a very compelling way. I think 
anyone who watched that speech would have to have left it feeling, one, 
we can wait no longer to make major reforms in our health care system, 
that the trajectory that we're on now is an unsustainable one, that we 
are facing extraordinarily high costs for insurance, we are facing 
extraordinarily high deficits in Medicare, and that we have to act now 
in order to mitigate the disaster that we face if we don't act.
  Secondly, the absolute challenge--and I think the national shame--
that we have that 18,000 Americans die every year because they don't 
have health insurance or access to care, the absolute shame in this 
country that almost 1 million people are forced to file bankruptcy 
every year because they either have no health insurance and are facing 
enormous medical bills or they have inadequate health insurance, that 
even though they had it, it was not sufficient to pay for the cost of 
their care.
  I mean, this is not what should happen in the wealthiest country in 
the world, a country that has met every challenge it has faced in its 
220-year history. I think the President clearly defined that challenge 
for us last Wednesday night.
  And then there is the question of how this all relates to our 
economic challenges, the fact that employers who are now insuring, at 
least partially, 160 million of our citizens are going to be facing 
such high costs--they face them now, and even higher costs in the 
future--that their ability to compete in the global economy is severely 
impeded because of these high insurance costs. We have enormous 
challenges in this area. And again, once I met with citizens and was 
able to discuss with them their situations and their challenges

[[Page 21676]]

and how what we're proposing to do in the House would address them, 
they change their opinions almost instantaneously.
  And I just have to relate one story which was extremely meaningful to 
me. I was at what's called a ``district dialogue'' one of our metro 
council members in Louisville put on. And there were 35 or 40 citizens 
there to address issues with him. I was invited as a guest. And when I 
walked in the room, I would say that the body language that I saw was, 
to put it lightly, very cold. And they were very skeptical because they 
knew I was going to talk about health care.
  Well, I spent 1 hour and 15 minutes there explaining the need for 
reform, the cost of doing nothing, the benefits to citizens with and 
without insurance, and answering all their questions about our 
legislation in the House and many of the myths that had developed 
around it. And I will never forget one couple sitting down to my left. 
At the beginning of the meeting, the husband asked me a very 
challenging question--wasn't quite hostile, but it was very 
challenging, and you could tell that he was extremely skeptical about 
what we were trying to do here. And I answered the question very 
respectfully and factually.
  About 10 minutes later his wife said, Congressman, let me tell you 
about our situation. We're 55. Eight months ago, my husband lost his 
job and we lost our insurance. We finally got insurance; it cost us 
$750 a month. So they're paying $8,000 a year, after-tax income, 
unemployed, $8,000 a year. She said our deductibles, our copays are 
very high. And 2 weeks ago, my husband had to go to the emergency room, 
I had to take him. Our bill was several hundred dollars and our 
insurance policy wouldn't pay for it.
  And I said, Ma'am, you are exactly why we're doing this reform 
measure. You are one of the case studies about what's important about 
what we're doing, because there are so many people in your category, 
middle-aged individuals who lost their jobs who really can't afford the 
insurance that's available to them, if it's available at all, in the 
individual private market. And while you're paying $8,000 now, under 
our proposal you would probably pay something like $2,000 a year. You 
could never be denied coverage because of a preexisting condition. If, 
heaven forbid, you got a serious illness, the insurance company 
couldn't take your benefits away.
  And I went through the list of all these ways in which our plan would 
help this couple. And she looked at me and said, Wow, that sounds 
pretty good. And that's what I found throughout our community when I 
talked about health care.
  And it was very gratifying as we went through all of these meetings 
and we encountered hostility, we encountered passion, we encountered a 
lot of people who are frustrated at a lot of the things that are going 
on in the world. But when it boiled right down to it, when you talked 
about what this plan that we're considering in the House would mean to 
them, their objections seemed to melt away. And I think they began to 
believe, for the first time probably, that we were truly working to 
help them and not to in any way harm them or take away what they have.
  So I thought my summer vacation was terrific in that regard because I 
know I was reassured that we are on the right path, that the American 
people are receptive to the type of reform we're trying to provide. And 
I'm energized and look forward to the next few months when we actually 
refine our legislation and bring a package to the floor and hopefully 
deliver one to the President that will accomplish what we've been 
trying to accomplish--again, for generations--and that is to provide 
security and stability in the health insurance lives of every American.
  With that, I take great pleasure in introducing my colleague from the 
class of 2006 from Colorado, the great State of Colorado (Mr. 
Perlmutter).
  Mr. PERLMUTTER. I thank my friend, Mr. Yarmuth.
  And I want to follow up on that. The last few months, in Colorado as 
well as every place else in the Nation and other places in the world, 
we've been talking about how do we finance health care? How do we 
finance it in Colorado, in Kentucky, wherever it might be? But that 
subject really leads to so many other conversations because the health 
care system touches every life in America, 300 million plus people.
  And I can tell you from the Perlmutter family, from my family, the 
passion really has been evident because there are some things in the 
system that are broken and we have to fix them. There are some things 
in the system that are working, but they can be better. And we need to 
do this in a way that's affordable to all Americans.
  Let's start with what's broken, because that's something that affects 
my family and I know thousands and thousands and thousands of families 
across the country, and that is the discrimination that is suffered by 
people with prior illnesses. One of my kids has epilepsy. And if she 
doesn't have a job where there is group health insurance she is going 
to be denied coverage or be placed in a situation where the cost of her 
health care is going to be way beyond her means. Thank goodness she has 
a job where there is group health insurance, but if she were ever to 
leave that job or lose that job, she would be in trouble.
  And she's like so many other people around the country who face this 
discrimination--and from my point of view, that discrimination is just 
wrong, and it's probably unconstitutional under the 14th Amendment to 
the Constitution, which guarantees all of us equal protection of the 
laws of this great country.
  So there's a place where we really have a problem in the health care 
system where people who have prior illnesses, prior conditions, can't 
get coverage or they can only get coverage at prices that are out of 
sight.
  Now, I don't fault the insurance companies on that; they're insurance 
companies, and they want to insure individuals and people who aren't 
sick. I don't blame them, that's how insurance works. If you insure 
somebody who is sick and you know it's going to cost you, then that 
doesn't help the shareholders and that doesn't help the company as a 
whole. But that is what's wrong with this, and that's why we've got to 
change it.
  I compliment the President and the Members of this House who have had 
the guts to step up and deal with this issue because it is a major 
issue and a major change to policy that we have here in the United 
States, which is to cover people with prior illnesses. That's number 
one. And I can tell you, in my district in Colorado, almost everybody 
thinks that that needs to be changed. So we're dealing with something 
that is fundamentally wrong within the system, and it's something that 
almost every family can understand and relate to because they either 
have somebody within the family or they have a close neighbor or friend 
who has some kind of illness, number one.
  Number two, we've got to fix something that every small business and 
individuals are seeing, and that is the increase in premiums year after 
year, and deductibles increasing so that the cost of your health 
insurance just keeps going up without any end in sight. And so we're 
trying, as part of this legislation, to put some restraints on this so 
that we slow these increases down so that businesses and individuals 
can afford insurance.
  This is part of the menu, the choices that we want to bring as part 
of the legislation so that there is competition and choice and 
availability to small businesses and to individuals so that they can 
acquire insurance so that, God forbid, something bad happens medically 
or within the health of their family or their employees, that there's 
coverage.
  So we're trying to deal with two very fundamental problems with our 
health care system today: One, denying people or discriminating against 
people with prior illnesses; and two, trying to put some lid or 
restraint on the ever-increasing premiums that we see to small 
businesses and to individuals so that they have a place they can turn 
to get

[[Page 21677]]

insurance that isn't going to break them in half.
  Now, we can improve things that are working. And one of those places 
where we really do have some great success stories and we can build on 
those is in the research that the country and our medical universities 
are conducting throughout the Nation. We are on the cusp of some 
tremendous breakthroughs when it comes to heart disease and cancer, two 
of the things that are so expensive to both individuals and businesses 
and the Nation. So if we can continue to really develop this research 
and continue to provide resources for research, there is hope and 
promise on some very difficult diseases that ultimately we can 
overcome.
  And so it's with these kinds of things in mind--righting a wrong that 
comes about with discriminating against people with prior illnesses, 
helping small businesses and individuals find affordable insurance 
where there is competition and choice, and three, advancing the 
research that is ongoing in the Nation today where we really are going 
to have some tremendous breakthroughs that will be good for people's 
quality of life, but also for their personal pocketbooks and for the 
national pocketbook. There is real opportunity here.
  We have to change this health care system. We can't continue to say, 
``No, we can't.'' We have to say, ``Yes, we can.'' And that's what I 
want to see as we move forward with this health care debate.
  With that, I would yield back to my friend from Kentucky.
  Mr. YARMUTH. I thank the gentleman. And I want to pick up on his 
conversation about small businesses because this is one of the very 
interesting reactions I got when I was home during the month of August. 
And of course I have some experience in that regard as well. I ran a 
small business for a number of years. We struggled very, very hard to 
provide health coverage for all of our employees. We had somewhere 
between 20 and 23 employees the entire life of my involvement in that 
business, and they were generally young, very healthy men and women. 
Unfortunately, we had a middle-aged woman who had cancer, and because 
we had that one unfortunate situation among our employees, everyone 
suffered financially because of her misfortune.

                              {time}  1900

  Every year, we faced premium increases of 20, 25, 30 percent. We'd 
have to shop around as best we could. We'd have to increase co-pays and 
deductibles, things we had to do to be able to afford to provide 
coverage for everyone. Yet it wasn't just the business that was 
struggling; it was all of the individuals, again, all of whom had to 
pay dearly because of the misfortune of one person.
  Under our health care reform, that would never happen. Everybody--
every small business, every individual, regardless of their health 
histories or their health situations--would be guaranteed the lowest 
rates that anybody else could find. This is the way that America should 
function. The misfortune of one person should not adversely affect 
other people. In this particular case, the misfortune, through no fault 
of this woman's, should not put her in the situation of being 
discriminated against. So the gentleman is absolutely right.
  We had a session back in Louisville during the break, and we invited 
about 20 to 25 small business people because we wanted to take the 
opportunity to talk with them and to get their questions because, 
again, a lot of the discussion surrounding this bill has been, oh, 
there's going to be a huge employer mandate and we're going to impose 
this huge tax on small businesses. A lot of people, when they hear 
those types of headlines, understandably get very concerned.
  So we met. We spent 2 hours with this group of small business people, 
and what we found was exactly the situation that I described with my 
prior experience with small businesses. Every one of them was facing 
annual increases of double digits, sometimes approaching 30 percent.
  Just today, for instance, I had a small business in the office. 
They're paying now $7,200 per person for every one of their employees. 
They have about 35 employees. The quote for their policy that's up for 
renewal is a 30 percent increase. So they're spending now about $2.5 
million a year. The increase alone would add $750,000 to their expense 
to keep the same level of coverage for their employees. I don't know 
many businesses that can experience a 30 percent increase in any aspect 
of their cost structure and survive for very long, and that's what all 
of these small business people were facing.
  One of the things that we talked about was--they said, Well, you have 
an incentive in this bill that we're covered, which most small 
businesses aren't because we exempt 95 percent of the small businesses 
from the employer mandates. But if I'm over there, why wouldn't I just 
drop my coverage and put my employees into the public market, the 
exchange, where they would again have these choices, but they would 
give up their coverage with me?
  I said, Well, you know what? You might very well have that financial 
incentive to do that. On strictly a dollars-and-cents basis, it might 
make sense for you to do it, but you know what? Your employees may be 
better off because, under our plan, they'll have far more choices than 
they will under your plan. They don't have a choice under your plan. 
It's whatever you can negotiate for your group, and they're stuck with 
that. It may not be the provider network they want. It may not have the 
terms that they want. They're stuck with it.
  Under our plan, if you decided to drop your coverage, they could shop 
in the exchange. They could pick the provider network, the plan that 
fits them best; and because of the subsidies that we provide, they're 
probably going to be out of pocket less money overall than they are 
with you. So it's not necessarily a bad thing that you would drop your 
coverage.
  They said, Oh, well, that's interesting.
  I said, Furthermore, under our plan, if you get someone who has a 
high cost of insurance--somebody who has a cancer or a condition that 
puts someone at a disadvantage--he's not necessarily locked in. I mean, 
he's not job-locked at all. If you were to drop your coverage under 
today's terms, he'd probably have to go to work for a big company to 
make up for it.
  Mr. PERLMUTTER. Will the gentleman yield?
  Mr. YARMUTH. I'll yield.
  Mr. PERLMUTTER. One of the stories that I came across when I was home 
a couple of weeks ago--and this occurred at my neighborhood filling 
station where I'm pumping gas because I've got to go to a couple of 
events on a Saturday morning. One neighbor came up, and he was on the 
other side of the pump right across from me.
  He says, This health care thing, Ed, you know, I really want you to 
go slow and make sure that this thing is financially sound.
  As he was saying that, the neighbor who was pumping gas at the island 
just behind me came over and said, Ed, you guys aren't doing enough, 
and you're not going fast enough.
  So the two of them, as I started pumping gas, started having this 
conversation. It was a great conversation. Both of them have very, very 
legitimate points; and we need, as we go through this, to make sure 
this is financially sound and that we try to predict as much as we can 
on an ongoing basis. We do know that there are problems with the 
system. We do know that we pay, as a nation, a lot more than almost any 
other industrialized country around; and, competitively, that puts us 
at a disadvantage. So we know we have to do something.
  The gentleman who said we're not going fast enough was, you know, a 
young father--I think probably 35 years old. He works for a roofing 
company. He'd like to start his own roofing company, but he can't 
because his wife has Crohn's disease; and because she has Crohn's 
disease, if he were to go out and set off on his own, be a real 
entrepreneur and really try to make a go of it, which is what we all 
want to do in this country--and it's the opportunity that this country 
provides so

[[Page 21678]]

many people--he can't because of his wife's medical condition, and the 
probability is that he won't be able to get anything to cover her if he 
sets out on his own.
  So these two gentlemen, both of whom are neighbors of mine, had this 
great conversation--both of them with legitimate points--but there is 
an urgency here, and there is a restriction on people really going out 
and doing things the American way by setting out on their own to see 
what they can do for themselves, for their families and, ultimately, 
for their communities and this Nation.
  So I clearly had an event, or a conversation, where the system today 
prevents entrepreneurship of young men and women who really want to, 
you know, try some new opportunities for themselves and for their 
families.
  So, with that, I would yield back to my friend.
  Mr. YARMUTH. I had another case just like that.
  I was at an actual event that was saluting many of the benefits of 
the summer jobs program that we provided as part of the Recovery Act. 
It was called YouthBuild where they build homes. They get teenagers who 
are at risk; they're from the at-risk population. They give them jobs; 
they give them training, and they have them spend a summer 
productively.
  I walked out to this construction site, and here was a young man, 
probably about the same age as yours, probably mid-30s. He said, May I 
talk to you a minute about my situation?
  I said, Absolutely.
  He said, My wife and I pay for the two of us, plus our one child, a 
$900-a-month premium. So that's almost $11,000 a year.
  I asked, And your employer pays part as well?
  He said, Oh, yeah. The $900 a month is my part. My employer pays 
more.
  So I don't know what the whole policy cost, but it was a lot of 
money.
  He said, I've got a preexisting condition. I've got a very bad 
allergy situation. I've had it all my life, and I can't get insurance 
in the private sector. I would love to go out and start my own 
construction company, but I'm locked into this job because of health 
care, because I would be stuck without it if I had to leave it.
  Interestingly enough, he was not supportive of what we're doing.
  At the outset, he said, I really wish you wouldn't do this. You know, 
I don't like the Federal Government's getting involved in coverage--all 
of the standard arguments that we hear sometimes.
  Again, he was someone whose problems with health care would have been 
solved, whose ambition to form his own company would have been 
restored, and yet he was still kind of blinded by a lot of rhetoric 
that's out there. I think I comforted him some in the conversation, but 
these stories are found throughout the country. We know that there are 
so many thousands and thousands of people who are in this situation, 
and this is the type of situation which has, I think, motivated all of 
us to work so hard to create reform that will be meaningful for the 
American people.
  Just quickly back to the small business issue: so we spent 2 hours in 
this meeting with the 20 or 25-or-so small business people answering 
all their questions. At the end of the meeting, about half of them 
said, Go get it. Go get it. Go for it. We're with you. There were still 
two or three holdouts who just didn't think that the Federal Government 
should get involved in any way. When they're eligible for Medicare, 
we'll have to ask them if they still feel that way. These small 
business owners, for the most part, understood finally that this was 
something that would free them from a problem that they have been 
trying to work out.
  So when you work it through, whether it's with senior citizens, with 
small businesses or with young families who have a situation where one 
of them might have a preexisting condition, this is exactly what we are 
trying to do--to create the opportunity for every American, regardless 
of their conditions or their situations, to have access to affordable 
health care.
  You did make reference to kind of the global situation. My colleague, 
Mr. Perlmutter, talked about the fact that we are the only 
industrialized Nation in the world that does not provide a certain 
level of benefits, that is, guaranteed health care benefits for its 
population, and that we spend twice as much per person as any other 
country and a much larger percentage of our gross domestic product than 
any other country does. Right now, we spend about 17 or 18 percent of 
our GDP on health care. I think the next highest level in the world is 
about 11 percent.
  While we do have some of the best health care anywhere available, 
it's just not available to enough people; and because of that and 
because of the fact that many people have virtually no health care and 
have no insurance and get very little care, we have poorer outcomes in 
this country even though we spend so much more. The World Health 
Organization ranks us 37th in the world. In their entire picture of 
health care outcomes, which includes infant mortality, life expectancy 
and survivability with certain diseases, we're 37th in the world 
overall.
  That's something that should be a challenge and a motivation for all 
of us to do better because, again, America has always been the problem-
solving Nation. Whenever we put our minds to it and our collective 
will, we have been able to solve any problem that has confronted us.
  People say, Well, we don't want to be Canada. We don't want to be 
Great Britain. We don't want to be Japan, or whatever it is.
  I say that we don't have to be any of those countries. We're not 
those countries. We can do better than those countries; and we can 
create a health care system that is uniquely American, one that, again, 
provides security and stability to every American citizen, because 
that's what we're all about.
  Before I yield back to my friend, it's interesting--as we talk about 
the world situation--and we have to confront issues like the myth that 
illegal immigrants are going to be covered under our bill. Now, we know 
there are people who are out there who will say anything to undermine 
this effort; but to me, the discussion about the illegal immigrants is 
intriguing because on the one hand it's very clear in section 246 that 
no undocumented aliens will receive Federal payments under this plan; 
but the opponents say, Well, but they'll still have access to care in 
the emergency rooms.
  Yes, because President Reagan pushed for a law that requires 
hospitals and emergency rooms to treat anybody who goes there without 
regard to insurance or citizenship.
  What's intriguing to me is that people don't necessarily take the 
next step, which is to ask, for instance: Do you really want people, 
doctors and nurses in the emergency rooms, to be worried first about 
checking somebody's citizenship when somebody is lying on a gurney or 
when your child or a child, any child or any adult, is mortally injured 
or has a very serious disease or is having a coronary? Do you want the 
doctor or nurse to say, Oh, wait a minute. I've got to go check your 
citizenship before I can treat you?
  People don't think about the fact that it's not just that they would 
check Hispanic citizens or Hispanic people who would go to the 
emergency rooms or Asian people or whoever it is. They would have to 
check everybody. They would have to check everybody who would come in, 
and they would have to check senior citizens who would come in with 
grave illnesses. So we don't necessarily think through that.
  The opponents would also say, Well, they can still buy insurance if 
they pay for it.
  The answer of course is yes. Why is that a problem? Wouldn't you want 
people to have insurance rather than to go to the emergency rooms where 
all of us would subsidize their care? If they're illegal immigrants and 
can afford insurance, wouldn't you rather they have it so their kids, 
if they're in school next year, are not spreading a contagious disease? 
Wouldn't you rather they get the health care they need?

                              {time}  1915

  I mean, some of the arguments really just don't hold water once you 
think

[[Page 21679]]

through them and understand that health care is a very specific 
category in society and humanity. And I am always amused when we say, 
well, illegal immigrants can still get care. Yes, I think we want them 
to still get care, but there is nothing in the legislation that we are 
proposing or that's being proposed on the Senate side, nothing in that 
law which would add a benefit, a Federal benefit, to illegal 
immigrants, and that is clearly spelled out.
  So it takes a lot to work through these arguments, as my good friend 
knows, but it's worth working through them, because once you do, again, 
people feel much more comfortable and supportive with what we are 
doing.
  Mr. PERLMUTTER. My friend, Mr. Yarmuth, mentioned Medicare, and one 
thing where there has been another myth is that there were going to be 
cuts in Medicare or things like that. In fact, it's just the opposite.
  There are additional benefits, and one of the benefits that is very 
important, I know, to my district, and certainly when I was out talking 
to people, was getting rid of the doughnut hole in prescription drug 
costs. So that if you get to a certain level, all of a sudden, instead 
of the Medicare benefit paying for it, now you have got to pay for it 
out of your pocket.
  And many people run into this, and it is financially just difficult 
and, in some cases, devastating to them because of this doughnut hole. 
And this bill, part of it is to eliminate this doughnut hole so that 
the benefits cover prescription medicines.
  I think the bottom line for me here is that the status quo is not an 
option, that there has to be real change to the way this system 
operates, for individuals who are discriminated against because of 
their physical health and conditions to small businesses who see the 
costs going through the roof, and to the Nation that sees its costs 
going through the roof.
  We can't stand idly by. We can't allow failure to reign. We must act. 
And it's a difficult subject. It's a very complicated system, and it 
touches 300 million people across this country, so everybody has a 
perspective on it.
  But looking at it in the whole and trying to deal with it as a whole, 
we must make changes. And that's what I hope will occur over the next 
few months here in this House of Representatives and in the Senate and 
ultimately signed by the President so that we can get on with this and 
start making the changes that are so desperately needed before the 
system continues to get worse, premiums continue to go higher, people 
who shouldn't be discriminated against are.
  We need change, and I am ready for it now.
  Mr. YARMUTH. It's important to reemphasize the point that Mr. 
Perlmutter just made was that this is an incredibly complicated 
endeavor. And that's one of the problems we have in terms of a 
communications effort, that there are so many things that need to be 
explained. And as I have described it before, this is the biggest 
Rubik's Cube that anyone has ever tried to solve because there are so 
many moving parts.
  And one of the things that I have heard from a number of people in my 
district is they say, well, why don't you do it piece by piece? Why 
don't you do it incrementally? And the answer is, of course, that 
because of the system we have in this country, you can't really 
approach this problem piecemeal, because you could say, for instance, 
we are going to address the problems in Medicare. You could do that, or 
you could say we are going to address the private insurance system. The 
problem is that they use the same provider networks. The same doctors 
service the private system and the public system, Medicare, Medicaid. 
The same hospitals service them, the same home health care companies, 
the same skilled nursing facilities service both.
  So there is so much cost shifting going on, so that because Medicare 
pays less to providers, they charge private insurance companies more, 
which drives rates up. And they are always trying to balance their 
overall business to provider networks with the compensation they get, a 
reimbursement from both sides. So unless you deal with it holistically, 
you are going to basically push the finger in one side of the balloon 
and push it out the other end. We know that game.
  And so incrementalism, while it might be desirable, it might be 
easier to achieve a comfort level in the country because people might 
be able to digest what we are proposing to do a little bit better, the 
fact is that reform that doesn't touch all of these areas is not going 
to be effective, and we will just distort the system even more and 
probably have more and more people fall through the cracks.
  So nobody said this was going to be easy. I think it was Teddy 
Roosevelt 100 years ago who talked about providing universal health 
care, and we are still struggling with a way to bring health care to 
all our citizens. But we can do it. It's important work. I don't think 
there is anything we will ever do in this body at least domestically 
that will be as important as this effort.
  And as I look around the world and see what other countries have 
done, see both the positive aspects of many other systems, some of the 
negatives, again, I don't think there is anywhere else in the world 
where I would say we can take that system and plop it down in the 
United States and it would be the perfect system for us.
  There are elements of everybody's system around the world that could 
be useful in, again, creating that uniquely American solution.
  There is a new book out called ``The Healing of America'' by a 
Washington Post journalist named T.R. Reid, and he traveled around the 
world examining the health care systems, and he said there are three 
universal laws about health care reform or health care around the 
world. One is that no matter how good the system is for so many people, 
for as many people as possible, some people always complain about it. 
Secondly, doctors and hospitals will always complain that they are not 
being paid enough. And the final point was, the last reform always 
failed.
  So we are in an imperfect arena, and we know that whatever we do here 
in this Congress, hopefully this year, will be far from perfect. We 
know that we will be working on this for as long as we are all alive, 
because there will be thousands of unintended consequences and 
unpredictable consequences of what we do.
  But as my friend said, we have to start somewhere, and this is the 
time because we are looking at a very, very bleak picture moving 
forward, with tens of trillions of dollars of added debt in Medicare, 
with insurance premiums that are projected to increase by $1,800 a year 
for the next 10 years for a family policy, which would take it in the 
range of $30,000 by the end of the next decade.
  And we know that the American economy, certainly not American 
businesses, and definitely not American families can afford that type 
of cost. So this is the biggest challenge, but also the biggest 
opportunity we have ever faced in this country.
  And I am so glad, not just to be in Congress being able to work on 
this incredible endeavor, but also that the American people are so 
engaged in the process, because when the American people pay attention, 
the American people will respond, and they are responding with their 
input, with their reactions, and I think, ultimately, they will respond 
with their wholehearted support with the reform effort that we are 
engaged in.
  So I would just offer the floor to my colleague, if he has any 
closing remarks, and then we will surrender our time.
  Mr. PERLMUTTER. I thank my friend, I thank him for hosting this hour. 
I think for me the status quo is not an option. We have to act because 
there are things in this system, the health care system and the way we 
finance it. We need insurance reform, because there are things that are 
broken. We need to fix what's broken. We need to improve what's 
working, and we need to have a system that is affordable and accessible 
to all Americans. And now is the time to act. We can't fade into the 
woodwork and hope this all makes itself better. Sometimes you have to 
tackle tough subjects, and people aren't going to be always right in 
line with you.

[[Page 21680]]

  Now is the time for us to tackle a very tough subject, to bring the 
change that's needed for generations to come, to save money and provide 
care for individuals, for businesses and this Nation.
  Mr. YARMUTH. I thank the gentleman and thank him for his 
participation tonight. As I said a moment ago, we are involved in an 
incredible historic endeavor here, and I am very appreciative of the 
fact that we in the class of 2006, the Majority Makers, most of whom 
campaigned on a platform that included affordable quality health care 
for all, are able to participate here with the cooperation of the 
American people.

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