[Congressional Record (Bound Edition), Volume 155 (2009), Part 18]
[Senate]
[Pages 24543-24545]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. DURBIN. Mr. President, I listened carefully to the Republican 
leader of the Senate, as I have every day, waiting for one thing: the 
Republican health care reform plan. We did not receive it today. We 
have never received it because there is no Republican approach to 
health care reform.
  I know we have tried to engage the Republicans in this debate. We 
waited weeks--make that months--to bring over just three Republican 
Senators who would sit down and negotiate with us. In the end, they 
walked away. One Senator from Maine is still possibly going to vote for 
this. We hope she will. I hope others will join her. But it is not for 
lack of effort that we do not have a bipartisan approach at this 
moment.
  What the Senator from Kentucky failed to mention when he said we have 
dismissed commonsense Republican proposals is when the HELP Committee--
which is the Health, Education, Labor Committee--sat down to write 
their health care reform bill--it went on for weeks--day after weary 
day, amendment after amendment was considered by this committee because 
of the gravity of this challenge--we are literally talking about a 
health care system that affects every one of us--and at the end of the 
weeks of hearings and the hundreds of amendments offered, 150, maybe 
more, Republican amendments were adopted to this bill. The committee 
decided on a bipartisan basis to accept these Republican ideas and make 
them part of the final product that was going to be voted on by the 
HELP Committee.
  Well, wouldn't you believe, at the end of that long process--
bipartisan process--with Democrats and Republicans working together, 
after 150 Republican amendments had been accepted, at least 1 
Republican Senator would have voted for the health care reform bill 
reported by the committee? It did not happen. There were 150 amendments 
from the Republican side of the aisle, and still not 1 Republican 
Senator was willing to stand up for health care reform.
  So when the Republican leader says, we have dismissed commonsense 
Republican proposals, we took 150 of them and could not get a vote out 
of it--not a single vote. The reality is this. The Republicans have no 
alternative to health care reform. They come to the floor and they 
quote as their sources the health care insurance industry.
  For the longest time, the Senator from Texas, Mr. Cornyn, came and he 
would quote the so-called Lewin study. Well, it turns out that the 
Lewin study about the cost of health care reform had an element to it 
which he did not disclose: The Lewin company that did the study is 
owned by the largest health insurance company in America. So they 
quoted as their source on how much this bill would cost the critics of 
health care reform, the people who want to maintain the current system.
  Today, the Senator from Kentucky very carefully avoided saying the 
obvious. This PricewaterhouseCoopers study he is talking about was 
commissioned by the health insurance industry. That is why they have 
come out with it the night before the critical vote in the Senate 
Finance Committee.
  What did they say? They predicted if health care reform went through, 
health care insurance premiums would go up. Well, there are those who 
disagree, people with the Congressional Budget Office and others, who 
believe that more and more Americans with insurance--not showing up in 
emergency rooms for charity care, where the cost of their care is 
passed on to all the rest of us--is going to mean there is going to be 
a downward push on premium costs.
  They estimate each of us with a family plan pays $1,000 a year in 
premiums to take care of the charity work that is given out at our 
hospitals every single day. If there is less charity work, it means 
less money is going to be needed from all the rest of us who have 
health insurance, and that will help bring premiums down as more and 
more Americans have health insurance protection.
  But what do we make of the health insurance industry telling us that 
premiums are going to go up? I will tell you what I think. I think it 
is a self-fulfilling prophecy. I think when health care reform passes--
and I think it will--the health insurance companies, unless we do 
something about it, will raise premiums, and they will point at 
Congress and say: You did it. See, we told you not to change the 
system.
  Can they make good on their promise of higher health insurance 
premiums? You bet they can. There is something called the McCarran-
Ferguson Act. It is a law that was passed decades ago that said two 
industries in America were exempt from antitrust laws. The two were 
organized baseball and the insurance industry. What it means is, unlike 
other businesses making products such as cars and computers, which are 
prohibited by law from collusion and conspiracy in putting together the 
cost of their product, the insurance industry is exempt. That is right, 
it is the only industry, other than baseball, exempt from the antitrust 
laws of America.
  So when the health insurance companies tell us: We are going to raise 
premiums, you ought to listen up, they have the power to do it. They 
can literally meet in the same room and decide to do it--legally in 
America. I think it is an outrage. I think that law should change. But 
the fact is, it will not change unless there is a force to change it.
  What is the force that would keep the health insurance companies 
honest, stop them from this collusion, create real competition to 
protect consumers, stop them from raising premiums in a fit of pique 
over health care reform? It is called the public option. It says there 
ought to be for every American at least one not-for-profit insurance 
company available to sell you health insurance. You do not have to take 
it. You may decide you do not want any part of it because it is a 
public option or a not-for-profit option, but it ought to be your 
choice. If you have that not-for-profit option--that does not have 
dramatic overhead costs because they hire scores of people to say 
``no'' when you turn in a claim, that does not have significant amounts 
of money they spend each year for advertising, that does not have 
multimillion-dollar CEO bonuses and huge health insurance policies for 
the people in the boardroom--we believe the costs would be lower and we 
believe that competition will force the health insurance companies that 
are exempt from antitrust laws to play it straight and give consumers 
across America a fighting chance.
  Well, you know where the public option is today. Let me tell you who 
supports a public option. Two out of three Americans consistently 
through this debate--although they have heard both sides of the story 
and they have been confused by some allegations and others--two out of 
three have consistently said: Give us that choice, give us a choice, 
like Medicare, something that is not profit driven that can be a low-

[[Page 24544]]

cost alternative that we can consider--two out of three Americans.
  But what about the health care professionals? What about the doctors 
across America? What do they think about a public option for health 
insurance? Do not take my word for it. Go to the New England Journal of 
Medicine. They surveyed 2,000 doctors across America and asked them 
basically: What do you think about a not-for-profit, public option 
health insurance plan? Doctors, professionals, medical professionals--
10 percent of them said: We think we ought to have single payer like 
Canada; 10 percent of the doctors said that. Sixty-three percent of 
them said: We think it ought to be a blend of public and private so 
there is a public not-for-profit option available to people. What it 
comes down to is three out of four doctors in America, when asked, 
believe this is a reasonable alternative, to have a public option of 
some kind. So it is not a radical idea.
  Who opposes the public option? The health insurance companies do 
because it means competition in places where they do not have it today. 
In most of the markets in America, private health insurance companies--
just two or three of them--dominate the market. There is very little 
competition. And the other health insurance companies there cherry-pick 
healthy people to try to make money, leaving the rest of the people, 
obviously, paying higher premiums.
  So when I hear criticism from the Republican side of the aisle of the 
current plan, the obvious question is: What do you offer as an 
alternative? Continuing this current system where the cost of health 
insurance premiums is going up three times faster than wages in 
America, where fewer businesses are offering health insurance?
  I was home in Springfield, IL, over the weekend. I went to a grocery 
store, the County Market. There was a lady there. She was offering 
samples of food. I did not know her. She recognized me. She stepped 
away from the counter, where people were grabbing these little samples, 
and came up to me. She said: Please pass health care reform. I said: 
How does it affect you? She said: I work for the city of Springfield. 
We don't have very good health insurance. She said: My health care 
costs are such that I had to take this job on the weekends out here at 
the grocery store giving out samples to try to keep up with health care 
costs.
  She said: I'm just one person, Senator, but think about me when you 
get back to Washington. Well, I do, and I will. And I will think about 
what has been said on the other side of the aisle. When they say they 
do not want to expand government, listen, we are not talking about the 
government running a health insurance plan. We are talking about a not-
for-profit plan that is an option for people. But for those who are 
keeping score, one out of three Americans today is covered by some kind 
of government health insurance--about 40 million on Medicaid, another 
40 million on Medicare, tens of millions on veterans health care, and 
how about all the Federal employees and Members of Congress--please 
hold up your hands--8 million of us in a government-run health care 
plan. I don't see a lot of my colleagues running for the exits to get 
out of the Federal Employees Health Benefits Program. It is one of the 
best insurance programs in America. It has been for 40 years. It offers 
us, in my case, nine different private health insurance plans to choose 
from; open enrollment every year. My wife and I pick the plan best for 
us. Our employer, the Federal Government, pays a portion of it. If we 
want a bigger plan, we pay more. It is administered by the Federal 
Government. It has been for 40 years. It is wildly successful. I don't 
hear a lot of people coming to the floor criticizing that approach. It 
turns out to be a good one and a good model to expand, which is what we 
are trying to do in health care reform.
  When the Republican leader comes and says health care reform is going 
to slash Medicare, open the book and take a look at what is really 
going on.
  There are private health insurance companies that came to the Federal 
Government years ago and said: We can do Medicare better than the 
government. We can save the government money. So let us offer the 
Medicare policy as a private health insurance company and we will run 
rings around the government.
  Well, you know what. It turned out some of these insurance companies 
did, and it turned out to be cheaper, but too many of them didn't. They 
ended up overcharging us for basic Medicare, up to 14 percent more than 
the cost of Medicare--a subsidy to private health insurance companies 
out of the Medicare system, taking money away from seniors who need it. 
So when the Senator from Kentucky says we are slashing Medicare, what 
he doesn't say is what we are going to do is eliminate that subsidy 
over time to these private health insurance companies that are frankly 
taking money out of Medicare, under false pretenses. They were supposed 
to save us money, and they haven't.
  The Senator from Kentucky laments the fact that pharmaceutical 
companies are going to have to pay more and that medical device 
companies are going to have to pay more. Can I tell the Senator from 
Kentucky that most of them agreed to this? Why would they agree to take 
less money for health care over the next 10 years? Because they realize 
that if the 40 million uninsured Americans now have insurance and they 
are showing up at the hospitals and the doctors' offices with that 
insurance, more of their products, medical devices, and pharmaceuticals 
will be sold and paid for. So they are willing to take a cut in their 
profits, realizing their consumer base is going to expand. That is the 
so-called slashing he is speaking about.
  The ACTING PRESIDENT pro tempore. The Senator's time has expired.
  Mr. DURBIN. Mr. President, I ask unanimous consent for 3 additional 
minutes. I see the Senator from Georgia in the Chamber.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. DURBIN. Mr. President, let me address this notion that what we 
are doing happened behind closed doors, which was said by the Senator 
from Kentucky. I know some don't want to leave the broadcasting of the 
floor of the Senate, which is broadcast by C-SPAN, but one of the other 
channels is carrying the Senate Finance Committee. It is not behind 
closed doors. It is right in front of the television cameras. It is 
going on right now as they consider the bill they will be voting on 
this afternoon.
  The Senator from Kentucky said the administration doesn't want the 
people to know what is in this bill. Before this bill is voted on, it 
will be up on the Internet for everyone to read, as it should be. 
Members of Congress will have the time and the responsibility to read 
it as well. That is the way it should be on something this important.
  So I would say the bottom line is this: The Senator from Kentucky is 
critical of what we are trying to do. We have tried to engage the 
Republicans in achieving this goal. We haven't had many volunteers on 
their side of the aisle. I hope that changes. They don't have a 
Republican approach to health care reform. The arguments they make 
primarily come from health insurance companies that don't want to see 
change.
  But Americans know we need change. We need to stabilize the system, 
get people security, making sure they can afford good health insurance, 
that the costs don't go through the roof. We have to end the abuses of 
health insurance companies that turn down people when they need them 
the most, finding deep in some application form the failure of a person 
to disclose they suffered from acne as a teenager, so they are going to 
disqualify them from health insurance coverage later in life--and I am 
not making this up. We know what happens when they put caps and limits 
on the amount they will spend in a lifetime, and then people find 
themselves with a catastrophic health situation, not covered by their 
health insurance policy. We know more than twice as many people are 
filing bankruptcy in America today because of medical bills, and over 
three-fourths of them have health insurance that isn't any good. That 
is the reality of staying

[[Page 24545]]

with the current system. The Senator from Kentucky may want to defend 
that. I think it is indefensible. If he wants to hear it firsthand from 
a real person, I suggest he go to the county market and look for the 
food sample lady. She will tell him what is really going on in America 
today as we face health care reform.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Georgia is 
recognized.
  Mr. ISAKSON. Mr. President, are we in morning business?
  The ACTING PRESIDENT pro tempore. We are.
  Mr. ISAKSON. I ask unanimous consent to speak for up to 10 minutes.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.

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