[Congressional Record (Bound Edition), Volume 155 (2009), Part 18]
[Senate]
[Pages 24913-24919]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. BENNET. Mr. President, I am pleased to be here today, as we were 
last week and the week before that, with other freshman colleagues to 
talk about the need for health care reform in this Congress. Today, 
what we want to focus on is the effect of health care reform on small 
business.
  When I am in Colorado, what we always start with is a conversation 
about what problem is it we are trying to solve. When it comes to small 
businesses, they are the biggest losers in the current health care 
system we have today and, by extension, the people who work for small 
businesses.
  Today in my State, small business pays 18 percent more to cover their 
employees than large business does. Some people say to me: Michael, 
that is obviously because they have a smaller pool of people; it is 
harder to spread the risk. And that is true, but from a business 
perspective, that is ridiculous. From a small business perspective, if 
you are going to spend 18 percent more on something, you ought to 
expect to get 18 percent more productivity out of your company or you 
ought to at least expect to get 18 percent better coverage for your 
employees. Of course, every small business owner in this country knows 
the reverse is true--coverage is worse, deductibles are higher. It is 
just an illustration of how challenging the status quo is for small 
businesses that, after all, employ most of the people in our economy 
and are going to be responsible for carrying us out of this recession.
  One can see on this chart the extraordinary effect this has had on my 
State. Even before this current recession, we saw a huge drop in the 
number of people who were getting coverage at

[[Page 24914]]

work and many fewer small businesses. Now we are almost at 40 percent--
I guarantee that number is well below 40 percent today after this 
recession has occurred. Even fewer smaller businesses are able to offer 
their employees coverage, which is heartbreaking for small business 
owners all over my State and all over the other States represented here 
today. Many of these businesses are family-owned businesses. The 
businesses feel like a family. People feel responsibility and care for 
one another and take responsibility for, among other things, health 
care. But they are not able to do it anymore. They are making very 
tough choices as a result.
  By the way, one of the choices they are making is to not raise wages. 
Median family income in Colorado went down by $800 over the last 10 
years, and in the country it went down over $300 in the same period, 
while in my State health insurance premiums went up by 90 percent. 
Small businesspeople say to me that those things are directly related 
to each other. In other words, people have to make a choice between 
covering their employees and paying them a living wage, and more often 
than not they are having to choose to compress wages just because of 
the skyrocketing costs of health insurance.
  Health care reform done right is going to make an enormous difference 
for small businesses and for the people employed by small businesses. 
It will lower premiums and the cost of health insurance coverage; 
provide tax credits for small businesses that provide health 
insurance--that do the right thing; exempt most small businesses from 
employer responsibility requirements; subsidize health insurance for 
employees in small businesses that do not provide health insurance; 
increase entrepreneurship to expand the pool of workers available to 
small businesses; and eliminate job lock. Job lock means having to stay 
in a job because you are so scared of losing your insurance.
  The estimate is that the administrative costs for small businesses, 
when it comes to health care insurance, will drop by over 50 percent. 
Most small businesspeople I know, who are skeptical sometimes of the 
reform we are talking about, will tell me this administrative burden is 
extraordinary for them today. Today, it is a paper-and-pencil system of 
trying to root out and sort out the health insurance market for their 
employees. Tomorrow, what we are going to have is an exchange where 
people can easily compare prices, compare coverage, and get the best 
deal for their employees, not to mention the fact they are going to be 
able to pool their purchasing power and drive down cost as a result.
  The estimates are, small business will save billions of dollars over 
the course of this reform--$432 billion by 2013, $855 billion just 9 
years from now. That is money that can be put into wages. In fact, the 
estimates are that of those savings, what we will see is small 
businesses being able to increase wages for their employees by almost 
$300 billion by the end of this period of time.
  So today we are here to talk about why reform is important for small 
business. We are at a very perilous moment in our economy for small 
businesses that do not have access to the credit they need to help get 
us where we need to be. They are facing an incredible credit crunch out 
there, which is making it hard for them to hire again, which is driving 
up our unemployment rate. Over the medium and long term, what is 
critical to the success of our small businesses is that we reform our 
health care system, we make it more transparent, we make it more 
efficient, we make coverage more available to small businesses and to 
the millions of Americans who are employed by small businesses in their 
communities.
  We are going to go through a series of colleagues today from the 
freshman class, as we did last week and the week before, and I will now 
yield the floor for the Senator from Alaska to give his perspective on 
why, as a former small businessperson himself, health care reform is so 
critical to keeping our small businesses competitive.
  The PRESIDING OFFICER. The Senator from Alaska.
  Mr. BEGICH. Mr. President, I thank the Senator from Colorado for his 
presentation, especially on small businesses and the impact health care 
reform will have on them. The Senator from Colorado has done a great 
lay of the land on the impact to small business, and I wish to step it 
up and talk about what I heard as I sat here and listened to several of 
my colleagues on the other side, the Republicans, talking about what is 
going to happen if we don't do something or if we do health care 
reform. In that regard, I wish to talk about at least one myth that I 
hear over and over from the other side that will impact not only small 
business but impact everybody.
  I am pleased to join my fellow colleagues and talk about the 
importance of health insurance reform in general, but the myth I wish 
to talk about today, which I have heard stated over and over, involves 
scare tactics and, in particular, a word which I think belongs in the 
soup lines of the Great Depression--``rationing.'' Opponents of health 
insurance reform have resurrected the word to suggest that Americans 
will get less care when reform legislation passes.
  Is there anything more cynical than telling Americans their health 
care will be rationed because of reform; that they will lose or get 
less care when Congress and the President finally take action? 
Defenders of the status quo ought to be embarrassed. They know the 
opposite is true--that more Americans will have access to more health 
care when reforms are finally adopted.
  Rationing is not some roadblock waiting down the road for the vast 
majority of Americans, it is what is happening right now. Let's use my 
State as an example--a State where 52 percent of the folks employed are 
from small businesses. When I came into the Senate at the start of this 
year, the Census Bureau said 123,000 Alaskans were uninsured. But new 
data came out last month--just a few months after the earlier 
statistic--and that number is up to 133,000. In other words, 10,000 
more Alaskans have been rationed out of their coverage. Insurance 
companies no longer cover them.
  Unable to pay the skyrocketing insurance premiums, or maybe their 
employers can no longer afford it--as laid out so well by the Senator 
from Colorado--people and businesses are struggling to make sure they 
can afford their insurance premiums for their employees or they are 
rationed out of the system because they have switched jobs. Then, when 
they apply for new insurance, they are disqualified because of a 
preexisting condition or perhaps the annual cap on how much their 
insurance company will pay is so low people get sick and hit their 
limit early. From that point on, they can't afford to see a doctor for 
the rest of the year or ensure their coverage or their quality of care 
is maintained. This is another form of rationing, and it is real.
  By one estimate, 14,000 Americans lose their health insurance every 
day. These are friends and neighbors and loved ones and it is 
inexcusable. Maybe the reasoning for rationing is even more 
outrageous--the cases where insurance companies revoke coverage by a 
process of rescission. Unfortunately, that is very real. A report by 
the House Ways and Means Committee says insurance companies saved 
themselves $300 million over 5 years through this practice of 
rescission.
  So, again, let's put the word ``rationing'' in proper context. It is 
the status quo, and the insurance industry is making lots of money 
because of it.
  Let's talk about what will change when we pass health insurance 
reform. As you can see on the chart, reform will easily take care of 
many of the issues Americans face: Tell insurance companies they can no 
longer deny coverage because of preexisting conditions; stop them from 
setting low annual or lifetime caps and refusing to pay the care after 
that; reform will offer Americans more choices by creating health 
insurance exchanges--as so well described by the Senator from Colorado. 
As I like to call it, it is health insurance Expedia. As we do with 
travel, we can do with health insurance. It will require insurance 
companies and Medicare to pay for more

[[Page 24915]]

preventive care so people can have regular checkups and screenings. 
This means we can recognize and even prevent oncoming chronic illness. 
Of course, this is better for the patient, and it saves us money.
  Let me say it again: The scare tactic of so-called health care 
rationing is just that, a tactic trotted out by those who want to kill 
reform. The truth is, health insurance reform will give Americans 
more--more people have more access to more health care.
  Mr. President, I yield the floor.
  Mr. BENNET. Mr. President, I thank the Senator from Alaska, and I 
think he raises such an important point because so much of the debate 
has been about dividing one set of Americans from another set of 
Americans. Health care reform is something that needs to be of concern 
to 300 million Americans--if you are concerned about the double-digit 
increases every year of your premiums; if you are concerned about 
spending almost 20 percent of our GDP on health care, when every other 
industrialized country in the world is spending less than half that; 
concerned, as the other side is and this side is, with the fiscal 
condition of our government, when we know the biggest drivers of our 
medium-term deficits are rising Medicare and Medicaid costs, and the 
biggest drivers of those are health care costs. We are all in this 
together.
  It is a great pleasure for me to turn now to the Senator from Oregon, 
who will talk about the fact that this isn't just about trying to cover 
one small group of Americans, it is about all 300 million Americans in 
this country.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. MERKLEY. Mr. President, I am delighted to join my colleagues from 
Colorado and Alaska to tackle some of the myths being printed about 
health care reform. It is startling to stand on the floor and hear 
increasingly shrill presentations from those who wish to defend the 
status quo broken system of health care in America. I wonder to myself, 
do they not hear what I hear from my constituents about the challenges 
they encounter each and every day if they do not have insurance; who 
are worried about getting sick or, if they have insurance, are worried 
about losing that insurance; worried about the problems and challenges 
faced with utilizing that insurance?
  I rise to talk about one of the most prevalent myths--that health 
care reform is only about expanding access to those who don't have 
health insurance. Because here is the truth: Health care reform is 
about improving health care for those who already have insurance. Those 
with insurance in the United States live in a precarious state. Their 
rates often go up by double-digit increases every year, so 
affordability is hanging by a thread. Those who have insurance through 
their jobs can change jobs and lose that coverage. They could get 
dropped from their insurance because they become sick or injured or 
they could find that their insurance has lifetime or annual limits that 
block them from obtaining the medical care they need if they do become 
injured or ill. We want to make health care insurance more stable and 
secure for those who have it, and that is what health care reform will 
do.
  First, health care reform will make insurance portable. If you lose 
your job, you often lose your coverage. That is a terrible double 
whammy for American families. Health care reform will make sure your 
coverage goes with you if you lose your job or if you choose to take on 
a new career.
  Second, health care reform will end dumping--the terrible practice of 
insurance companies canceling policies when those citizens become 
seriously ill. That is wrong. What kind of health care system is it 
when you pay insurance premiums for 15 years and then your child or 
your spouse or perhaps yourself becomes seriously ill and you get a 
letter from your insurance company saying they are canceling your 
insurance? That is not health insurance. That is a scam. Health care 
reform will end that scam in America.
  Finally, health care reform will get rid of annual or lifetime limits 
that drive people into bankruptcy, even when they have coverage. Here 
is an example from my home State of Oregon.
  Alaya Wyndham-Price lives in Oswego. She had insurance through her 
previous job as an event planner and is currently on COBRA. Six months 
ago, Alaya developed a tumor the size of a golf ball just below her 
brain, and she has had numerous tests performed by a neurologist to 
determine the best course of treatment. Her insurance caps treatment 
costs at $20,000 annually, and she has already approached $30,000 of 
expenses with the diagnostic tests over the last few months.
  Through COBRA, Alaya's insurance will renew in January, but the 
surgery to remove her tumor will cost about $50,000--or $30,000 over 
the amount her insurance will pay in 2010. So she is trying to work as 
much as possible--doing freelance writing, taking on projects--but on 
many days is too ill to do much of anything. She is scheduled to see a 
doctor again soon to have an expensive MRI test in November, but with 
every single medical visit she goes deeper into debt.
  This is not right, but it is common. More than half of bankruptcies 
in America are due to medical bills and in more than half of those 
situations where medical bills drive people into bankruptcy, the 
individuals had health insurance. No American should be driven into 
bankruptcy because he or she becomes sick or injured. Health care 
reform will end arbitrary annual and lifetime limits to make sure 
Americans get the care they need when they need it, not having to delay 
care to the next year in order to benefit from a new annual ceiling.
  In conclusion: The myth is that health care reform is simply about 
extending coverage. The truth is this: Reform will mean better, fairer, 
and more affordable coverage for the millions of Americans who already 
have insurance.
  Mr. President, I yield the floor.
  Mr. BENNET. Mr. President, I wish to thank the Senator from Oregon 
for pointing out the incredible lack of stability that exists in the 
system today. The bankruptcy numbers are unbelievable. In my State, I 
think roughly 62 percent of all bankruptcies are caused by health care 
issues. Of those health-care-related bankruptcies, 78 percent, nearly 
80 percent of them, are bankruptcies involving people who actually were 
covered by insurance. We are not getting done the job that needs to get 
done. That is why we are here today to talk about these issues.
  I am going to call on the Senator from Virginia to talk a little bit 
about how, under the current system, we pay for the uninsured in our 
country today, but we do it in the most inefficient way possible. Just 
one fact from my State: We have a public hospital in Denver called 
Denver Health. It is an incredibly well-run hospital, run by a person 
named Dr. Patty Gabow. She told me they did a study a couple of years 
ago that showed they spent, in 1 year, $180 million for uncompensated 
care for people employed by small businesses who could not get 
insurance at work.
  I will yield for the Senator from Virginia.
  The PRESIDING OFFICER. The Senator from Virginia is recognized.
  Mr. WARNER. Mr. President, first of all, I thank my colleague, the 
Senator from Colorado, for organizing this effort today and leading 
freshmen Senators this week as we, once again, come down to the floor, 
as some of the folks who are newest to the Senate, most recently hired 
in most cases, to talk about the need for health care reform. I 
particularly thank my colleague, the Senator from Colorado, for raising 
the very important issue of the cost of health care to small 
businesses.
  The remarkable thing about small businesses is they are basically the 
only people who pay retail for their health care costs in America 
today. Those who have Medicare, those who have Medicaid, large 
employers--they all can leverage their purchasing power. But small 
businesses are the folks who take it on the chin, and I am grateful for 
my colleague's comments today, describing how health care reform can 
benefit small businesses.
  My colleagues, the Senator from Alaska and the Senator from Oregon, 
have also pointed out some other

[[Page 24916]]

myths, as the Senator from Colorado indicated. The one I am going to 
take on today, because we hear a lot from our friends on the other side 
of the aisle about the problems with reform, and sometimes they do 
actually dispel some of these myths--but one of the myths I have dealt 
with for 18 years, as somebody who founded the Virginia Health Care 
Foundation in the early 1990s, is, how do we deal with the uninsured? 
Yes, part of our health care reform is about extending coverage to the 
uninsured. There will be some additional cost to do that, but I think 
it is very important to recognize that under our current system, right 
now we pay for the uninsured. We pay for the uninsured through 
uncompensated care, as my colleague from Colorado mentioned. We pay for 
the uninsured in higher health insurance premiums for all of us who buy 
private insurance. We pay for the uninsured, candidly, in higher costs 
to our Medicare and Medicaid system.
  Our uninsured end up on the emergency room doorsteps, oftentimes 
receiving care in the most inefficient way possible and oftentimes 
without good quality care.
  We have seen, on average, 8 percent of families' 2009 health care 
premiums--about $1,000 a year for all of us who purchase private health 
insurance--we pay in effect a $1,000-a-year tax to compensate and pay 
for the cost of the uninsured.
  As my colleague mentioned, and I know from my experience in Virginia 
18 years ago, we started this Virginia Health Care Foundation to deal 
with how we could provide health care coverage for the uninsured. We 
saw folks ending up, as I mentioned, on hospital doorsteps. We saw 
folks waiting too long before they could access the health care system. 
Oftentimes, if they had a chronic disease and then waited to get that 
health care coverage, the cost of covering that person was not only 
much higher--obviously, the person has to deal with a much more serious 
illness--but they too ended up in the emergency room, which is an 
inefficient delivery mechanism.
  If we are going to truly start to bring down the cost of insurance, 
if we are going to do the right thing in giving the uninsured in this 
country a chance to receive a medical home and make sure they access 
health care through a more affordable and more long term, healthier 
way, we must pass health care reform this year.
  A lot of numbers have been bandied about concerning what kind of 
extended coverage we are talking about in this health care reform. 
There have been arguments that we are talking about covering 30 million 
additional people. I believe the Senate Finance bill covers 25, 26 
million. One of the things that is often absent from this debate is 
that while these are the numbers we are trying to deal with right now, 
literally triple that number, about 87 million Americans during a year, 
at one point or another, through either being unemployed for a while or 
moving off one plan to another, go through some period of being 
uninsured and uncovered.
  On top of that 87 million, we also have the problem of literally tens 
of millions of people who are stuck in dead-end jobs, who want to 
change jobs, who want to become more productive, but they are afraid to 
make that change because of concerns over losing their health care 
coverage. If we can provide the kind of health care reform we are 
talking about, if we can provide the kind of coverage we are talking 
about, those kinds of problems will go away. We will become a more 
effective and cost-effective society.
  I know we have other colleagues who want to speak, and I want to come 
back to where we started, at least the freshmen did a few weeks back, 
and why some of our colleagues on the other side who seem to be this 
``caucus of no,'' who seem to say: Let's take more time, let's put it 
off, let's wait a little bit longer before we take on health care 
reform--why that policy choice is so wrong.
  If we do nothing, if we choose not to act this year, our current 
health care system is financially unsustainable. If we do nothing, 
Medicare, under the current projections, will go bankrupt in 2017. Many 
of us on this side of the aisle share the concerns of some of our 
colleagues on the other side of the aisle about the exploding deficit 
our Nation faces. The largest single driver of our Federal deficit is 
not the stimulus program, it is not the TARP program, it is not some of 
the other things we debate back and forth, it is the rising cost of 
health care that we pay for with Federal dollars in Medicare, Medicaid, 
and the VA.
  If we do nothing, our deficit and those health care costs will 
continue to explode, undermining the dollar, undermining our ability 
for economic recovery. If we do nothing, an average family in 
Virginia--and I would argue probably an average family in the State of 
Colorado--will see literally 40 percent of their disposable income go 
to paying their health insurance premiums within the next decade. Those 
costs are unaffordable and unsustainable.
  Finally, as a former business guy and somebody who believes, as my 
colleague from Denver does, that the heart of what keeps our economy 
growing is the business community, and particularly the small business 
community, if we can't lower our health care costs, then American 
business will not be competitive in the global economy. No matter how 
productive American workers are, America builds into our cost 
structure, for almost every business, about $3,000 to $4,000 more per 
employee because we have so much higher health care costs than any of 
our competitors around the rest of the world. We cannot maintain that 
competitive disadvantage in a global economy.
  The time is now. There are ways we can continue to improve these 
bills. We are looking forward to the melding of the Finance bill and 
HELP bill, and I know myself and some of my fellow freshmen colleagues 
will have some ideas about how we can improve programs even in that 
package.
  I thank my colleague from Colorado for his leadership on this issue, 
and I look forward to working with not only my freshmen colleagues but 
all colleagues on this side of the aisle, and hopefully those on the 
other side, to make sure we do get health care reform this year.
  I yield my time.
  Mr. BENNET. I thank the Senator from Virginia. I particularly, on 
behalf of all the colleagues here today, thank him for his leadership 
over the last couple of months on the question of personal 
responsibility: how do we incentivize people to make sure they are 
doing a better job to take care of themselves; how do we work with some 
of the corporations in this country that have done an extraordinary job 
of lowering health care costs by incentivizing folks to take personal 
responsibility for their health care. I have enjoyed working on those 
issues with him and look forward to continuing to work on it.
  Next, we have the Senator from New Mexico who is here to talk about 
another myth, which is the idea that our health care system always 
works well for everybody.
  We have great things in our health care system. We have some of the 
best health care technology in the world. We have some of the greatest 
treatments in the world. If you are going to get sick, a place you want 
to get sick, depending on what you have, is the United States. But we 
are not perfect by any stretch of the imagination, and the Senator from 
New Mexico is going to comment on that.
  The PRESIDING OFFICER. The Senator from New Mexico is recognized.
  Mr. UDALL of New Mexico. Mr. President, it is good to see our 
Presiding Officer, the new Senator from Massachusetts, here, who has 
joined us within the last couple of weeks, Mr. Paul Kirk.
  Today we are talking about myths, inaccuracies, deliberate 
exaggerations, and outright lies that have abounded over the months we 
have been debating health care reform. Some have been dreamed up by 
those who stubbornly cling to the status quo. Others reflect fears 
lying just beneath the surface.
  If we step back, it is easy to see these scare tactics for the lies 
they are, but

[[Page 24917]]

for Americans who will be most impacted by this reform, it may be 
difficult to separate fact from fiction. The myth I would like to talk 
about today is a bit different from the others being discussed by my 
colleagues. It is a myth that existed long before the current debate 
but is being used in a new way by people fighting this reform. They are 
using it as a weapon against change. It is a myth we have all heard 
about. It is the myth that reform is not necessary because we have the 
greatest health care system in the world.
  What makes this myth different from the others is that parts of it 
are absolutely true. Americans are blessed with some of the best 
doctors and nurses and health care professionals in the world, hard-
working men and women who have dedicated their lives to the health and 
healing of others but often work in difficult situations.
  Our technology is unmatched. Our emergency care system is repeatedly 
cited as the best of the best, and we rank highly regarding the levels 
of dignity and respect with which patients are treated. But all these 
achievements, as great as they are, do not add up to the best health 
care system in the world for all Americans--not as long as we are 
spending $2.4 trillion a year on medical care but continue to rank near 
the bottom when it comes to premature deaths from diseases such as 
diabetes, stroke, and pneumonia; not when we spend twice as much of our 
GDP on health care as Japan and the UK but have lower life expectancy 
at birth; not when we rank last in infant mortality among 
industrialized countries; and not when half of the personal 
bankruptcies in the United States are related to medical bills.
  Right now in America, if people have the money, they have access to 
the best health care money can buy. For the vast majority of Americans, 
that access is not there. If a person is a small business employee or 
laid off from a job or someone with a preexisting condition, the ``best 
health care system in the world'' is much harder to come by. When 80 
million people are either uninsured or underinsured, there is no way a 
country can lay claim to that title.
  But there is something we can do about it. With this reform, we have 
the opportunity to build on the strengths of the U.S. health care 
system while also addressing its weaknesses. Comprehensive health 
reform will go a long way toward remedying these and other inequalities 
and reducing the health care disparities between rich and poor, the 
majority and minority.
  The solution is not always spending more money. Sometimes it is about 
making better use of the money we are already spending. It is about 
finding ways to achieve better returns on our investment. The reforms 
we are proposing would allow us to do that by ridding the system of 
waste, by increasing our investment in prevention, by helping small 
businesses afford insurance for their employees, and by covering more 
individuals whose only medical option right now is expensive emergency 
room visits.
  The status quo is unsustainable, but that is what reform opponents 
are hoping to continue with, myths like those we are discussing today. 
America has the potential, the talent, the technology to achieve the 
best health care outcomes in the world. Whether we reach that goal 
depends on the actions we take now.
  I yield the floor.
  Mr. BENNET. Mr. President, I thank the Senator from New Mexico, and I 
am reminded of the trips I made around my State during recess when 
everybody settled down and we could actually get into a conversation 
about how well the status quo was working for people. It took about 40 
minutes into the meeting before people would stand up and start to say: 
Let me tell you my story about how I was laid off from a company or 
lost my insurance, had a preexisting condition, couldn't get new 
insurance and, therefore, can't get the health care I need.
  That is the kind of conversation we need to have about what we are 
facing. I was left with the impression from people in Colorado that 
while they don't like the status quo, they are worried that we are 
going to make it worse. We can't blame people for thinking that, as 
they watch what is on TV every night or on the Internet. Our obligation 
is to make sure as we go through this legislative process, we deliver 
something that builds on our strengths, as the Senator said, but also 
fills in gaps that are clearly present and disrupting the lives of 
working families.
  I turn now to the Senator from Illinois to talk about the public 
option and choice. It is apparent to me, as people have begun to see 
there might be a requirement that they have insurance, what I am 
hearing from people is they want more choices, not fewer. They don't 
want to necessarily be forced into a private insurance plan. They want 
their family to have choices. Today the Senator from Illinois will talk 
about the public option.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. BURRIS. Mr. President, to my colleagues who are making this 
presentation on behalf of the people on health care, it is my pleasure 
to join them and speak briefly about what will take place if we do not 
pass, as part of insurance reform, a public option. When it comes to 
health care reform, we have all heard the myth that a public option 
would amount to a government takeover of the health care system. This 
is completely false and has no basis in the legislation under 
consideration by the Senate.
  Let's examine the facts: 45,000 Americans die each and every year 
because they do not have health insurance and cannot get quality care. 
That is 1 death every 12 minutes. Clearly, the system is broken. The 
time for action is long past. I believe we need to restore choice and 
accountability to the health care system. The only way to accomplish 
this is with a public option. It would increase the availability of 
care. It would help fight the disparities that plague our current 
system.
  At the moment, people of color represent half of the Nation's 
uninsured, even though they make up only a third of the total 
population. A low-cost public option would meet the needs of these who 
are at a disadvantage, regardless of background or skin color. The 
public option would restore competition to a market that is currently 
monopolized by only a few corporations. Take my State. In the State of 
Illinois, two companies dominate 69 percent of the insurance market. 
That is why their profits are growing four times faster than wages. 
This is unsustainable. It is breaking America's businesses and 
bankrupting American families.
  We talked about businesses earlier. My colleagues mentioned what this 
will do for small businesses.
  We must make sure there are choices for them to have an exchange 
where small businesses can shop for their insurance. If these companies 
have to compete with a public plan, everyone's premiums will go down. 
It will bring about competition in the marketplace. If you like your 
current insurance providers, nothing will change except that you will 
save money, and you won't have to worry about losing coverage when you 
need it. No government bureaucrat will alter your insurance plan, your 
doctor, or the level of care you receive. But if you can't afford 
insurance or your coverage has been denied due to a preexisting 
condition, you will be able to get quality care at an affordable rate. 
Just like any business, a not-for-profit public insurance option would 
require initial capital to get off the ground. But afterwards it would 
rely on the premium it collects to remain self-sufficient.
  The current system is a drain on American taxpayers. The public 
option would not be. The public option would complement private 
insurance providers, not drive them out of business. In fact, it will 
result in an increase of 1 to 3 million additional customers for 
private companies. In other words, by bringing all those persons into 
coverage, insurance companies will benefit when all these uninsured 
people will now be covered. There will be no government takeover, no 
death panels, no rationing, and no redtape between you and your doctor.
  It is time to reject these myths and to take decisive action. The 
only way

[[Page 24918]]

to achieve meaningful health care reform and bring costs down is 
through a public option that creates real competition in the system.
  Let it be clear to all of my colleagues in this august body: I will 
not vote for any health care bill that does not include a public 
option.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Colorado.
  Mr. BENNET. I thank the Senator from Illinois for his eloquent 
discussion about trying to provide more choice rather than less to our 
working families. A lot of what we are trying to do with health care 
reform--and I hope the bills will improve over the coming weeks--is 
give people more control over choices with respect to their doctors and 
their medical care, to make sure that it is doctors and patients making 
decisions about treatment and not insurance company bureaucrats or a 
government bureaucrat.
  Next I will yield for the Senator from Delaware to talk about why 
this is such an urgent problem and why we need to address it now and 
not wait, as we have over the last 20 years. As the President said, the 
first President to call for health care reform was Teddy Roosevelt. 
Here we sit in 2009, confronted by the same sorts of arguments about 
why today is the wrong time to do this and why we ought to kick the can 
down the road for another generation of Americans.
  I turn the floor over to the Senator from Delaware.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. KAUFMAN. Mr. President, I thank Senator Bennet for organizing 
this event today. He has been a leader in our effort to try to achieve 
meaningful health care reform. I am looking to him, as we move down the 
road on health care reform, to continue to show leadership to make sure 
we achieve meaningful health care reform.
  I appreciate the opportunity once again to join my colleagues and 
show our united support for health care reform. I want to address one 
of the biggest myths reform opponents have spread throughout the 
debate, the myth that America cannot afford to change the health care 
system. They say our country has too much debt and the health care 
reform would only increase the Nation's deficit. They say we spent too 
much money on TARP and the stimulus package. They say we must rein in 
spending and push off health reform until we straighten out our fiscal 
house. When we hear this kind of criticism, especially during this time 
of economic downturn, it is reasonable to ask if now is the time for 
reform of the health care system. The answer is: We need health care 
reform now. We need health care reform now because economic recovery 
for the long term is completely dependent on controlling health care 
costs.
  We cannot afford to wait for reform because the status quo is 
absolutely, positively unsustainable.
  Medical costs account for one-sixth of domestic spending and are 
headed upward. They are handcuffing families and workers, strangling 
Federal and State Governments. In 2000, the average premium for family 
health care in Delaware was just over $7,500. In 2008, that number 
jumped to $14,900, almost doubling in only 8 years. If we do not enact 
health care reform now, the same premium for family coverage is 
expected to reach $29,000 in 2016, another doubling in price.
  The status quo is unsustainable because of health care spending on a 
national level. In 1979, we spent approximately $220 billion as a 
nation on health care. In 1992, we spent close to $850 billion. In 
2009, we will spend $2.5 trillion on health care. That trajectory of 
health care expenditures is totally out of control. We must begin to 
bend the cost curve down on the health care system. We need to do this 
now. We cannot wait any longer. We cannot afford to wait for reform 
because failure to do so will place even more pressure on the Federal 
budget and on taxpayers to continue support for Medicare and Medicaid.
  Clearly, one of the major driving forces behind our Federal deficit 
is the skyrocketing cost of Medicare and Medicaid. Combined, these 
programs account for 20 percent of all government expenditures. If we 
do nothing to start bending the cost curve down for Medicare and 
Medicaid, we will eventually spend more on these two programs than all 
other Federal programs combined.
  Let me say that again: If we do nothing to start bending the cost 
curve down on Medicare and Medicaid, we will eventually--and not that 
far off--spend more on these two programs than all other Federal 
programs combined. Because of this, people who are concerned about 
deficits should welcome health care reform now. The plans being 
considered by the Congress would require some upfront cost, but reform 
done the right way will mean savings for families and businesses, money 
that could be pumped into the economy.
  We all know in the short term the cost of expanding coverage to 
Americans will temporarily increase government spending. Quickly, 
however, the net impact of the cost containment provisions will 
accumulate, and there will be a reduction in government spending. It is 
important to remember that while we are awaiting the cost containment 
provisions to take hold, the President and congressional leaders have 
insisted that health care reform be deficit neutral. In other words, 
the administration and Congress are committed to responsible health 
care reform that reduces the deficit over 10 years and major reductions 
over the long term. We will not be able to get the major reductions we 
need to sustain the budget and sustain the Government if we don't do 
these things now which will only begin to benefit us in the long term. 
For this reason we cannot afford to wait for health care reform.
  Finally, if we lose this opportunity to pass health care reform, we 
will not have an opportunity to reform our health system in the 
foreseeable future. We will be stuck with the unsustainable status quo. 
This Congress, this President is not about to return to this issue if 
we do not pass it because it is so incredibly difficult and so 
traumatic and takes everyone's concern. I have been around Congress for 
36 years, and I have learned something about how Washington works. 
Trust me, we have truly a unique window of opportunity for health care 
reform. The window is now open. It will soon close. We have a new 
President in his first year in office who has a good relationship with 
Congress. There is major support for reform among providers, patients, 
business, labor, and everyday Americans. With the major players in 
health care seeking reform, this could be our chance. I believe it is 
our chance, and this will be the only chance for a while.
  Mark my words: If we don't take this opening and enact health care 
reform this year, it will not be done until the health care system 
crashes down around our ears. We cannot continue the status quo for one 
more day. We cannot wait to enact health care reform. We must gather 
our collective will and do the right thing during this historic 
opportunity by passing health care reform. We can do no less. The 
American people deserve no less.
  Mr. BENNET. I thank the Senator from Delaware for pointing out that 
maintaining the status quo, being unwilling to act, in fact, is making 
a choice.
  It is making a choice about having another decade of double-digit 
cost increases every year. It is making a choice about devoting a fifth 
of our economy to health care when every other industrialized country 
in the world is devoting less than half of that. It is making a choice 
about having increasing and mounting and rising deficits in the 
outyears.
  I thank the Senator from Delaware for pointing out that we have a 
once-in-a-lifetime opportunity right now to try to address a number of 
these issues at the same time.
  Mr. President, our closer today is the Senator from New Hampshire, 
who is here to talk about what this reform is about versus what some 
have claimed it is about. I welcome her here this morning.
  Let me turn the floor over to the Senator from New Hampshire.

[[Page 24919]]

  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I thank very much Senator Bennet for 
coordinating this effort today.
  As you have all heard for the past few weeks, the freshmen Senators 
have joined together to deliver a very simple message: We need to act, 
and we need to act now, on health care reform.
  As people have been pointing out all morning, there is a lot of 
confusing and, unfortunately, some false information that has been 
going around about who is going to be included in health care reform 
legislation and what that is going to mean for people. So as everyone 
has said, we are joining together today to try to dispel some of those 
myths and to focus on what really matters, which is making our health 
care system better for our families, for our businesses, and for our 
Nation's economy.
  One common myth we have heard is that health reform is a government 
takeover of our health care system. This is simply not true. The truth 
is, health care reform is being driven by consumers who are concerned 
about the cost of health care and about their coverage, and it is being 
driven by the market because health care costs are so high that too 
many businesses and too many people cannot get the health care they 
need when they need it.
  Under the current legislation, everyone will have the freedom to keep 
their health care plan if they like it. But for the millions of hard-
working Americans who cannot find affordable coverage or who have been 
discriminated against because of a preexisting condition or for women 
like me who too often are discriminated against in the costs of health 
care, health reform will give them a choice.
  Last week, my office heard from a man named Andrew from New Boston, 
NH. Sadly, his story is all too common. Andrew and his family had 
employer-sponsored insurance coverage through his wife's job. 
Unfortunately, she was laid off recently. Now not only is she out of 
work, but her family has to find another source of health insurance 
coverage. The fact is, the individual market simply does not provide 
sufficient affordable options for families. The coverage they managed 
to find--Andrew and his family--puts a significant financial burden on 
their family.
  The good news is, health reform legislation offers a solution for 
families such as Andrew's by offering more choice. The health insurance 
exchange creates a marketplace where insurance companies must compete 
for our business. Individuals and small businesses will be able to shop 
for the most affordable plans in a way that is transparent and easy to 
understand--similar to the way Members of Congress get their insurance, 
and Americans should have the same choice.
  Increased competition and transparency do not sound like a government 
takeover to me. Rather, it sounds like the markets acting in a way that 
best serves the American people.
  My health reform reality check is that health care reform is consumer 
based and market driven. You can keep your insurance if you like it. It 
will increase choices for families. It will promote competition.
  We need to move past the rhetoric and the myths. We need to rise to 
the occasion in this pivotal moment in our Nation's history. We must 
pass meaningful health reform for the citizens of New Hampshire and all 
Americans.
  Mr. President, I yield the floor.
  Mr. BENNET. Mr. President, I wish to thank the Senator from New 
Hampshire for closing in such a perfect way today. I agree with her 
that for far too long Washington special interest politics has gotten 
in the way of fixing this system, and the result has been enormously 
unfortunate for working families all across the United States of 
America.
  When your median family income is going down by $300 over a decade, 
and the cost of health insurance is doubling over the same period of 
time--by the way, in my State, it has gone down by $800--and the cost 
of insurance has gone up 97 percent, the cost of higher education has 
gone up by 50 percent over the same period of time, essentially what we 
are saying to working families is: You are going to take home less, but 
you have to pay more for, not ``nice to haves'' but things that are 
critical to move your family ahead to have the kind of stability that 
is essential for everybody to have a shot at the American dream, and 
for some reason we in Washington cannot figure out how to make some 
changes that would help working families and small businesses all 
across the United States.
  That moment has come now, and we are here. We have the next few weeks 
to figure this out. I believe we will. I am enormously optimistic we 
can pass a bill in this Senate and in the Congress that the President 
can sign that will make a material impact, an improvement in the lives 
of working families and those employed by small businesses all over 
this country. In fact, anything less than that should be unacceptable 
to all of us.
  I hope we can do that in a bipartisan way. I hope we can have 
cooperation across the aisle and the best ideas from both parties as we 
design it. But, to me, the most important thing is to make sure people 
who live in my State do not need to endure another decade of double-
digit cost increases every single year, do not need to endure another 
decade where they lose their health insurance because they lose a job 
or because they have a preexisting condition or because, as happened in 
my State last week, a baby was born who was deemed to be too heavy to 
insure--fortunately, the insurance company did the right thing in the 
end--to not have another decade where people are wrestling with their 
insurers to get paid, so that doctors and people providing health care 
do not have to spend 30 percent of their overhead or more trying to get 
reimbursed for services they provided to their patients.
  I am optimistic in part because of all my wonderful colleagues who 
were here this morning. I thank them for joining me today.
  Mr. President, with that, I yield the floor and suggest the absence 
of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. SHAHEEN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Burris). Without objection, it is so 
ordered.
  Mrs. SHAHEEN. Mr. President, I ask unanimous consent that I be 
allowed to speak as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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