[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[Senate]
[Pages 25311-25317]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mrs. SHAHEEN. Mr. President, as you well know, being one of the 
freshmen Senators, along with me and a number of others of us, we have 
been coming to the floor for the past several weeks to talk about the 
need to address health care reform.
  We are here again this morning for the next hour to talk about why 
this is so imperative. I am going to yield my time, about 5 minutes 
initially to Senator Warner, who has another engagement and needs to be 
off. So at this point I yield 5 minutes to Senator Warner.
  Mr. WARNER. Mr. President, I thank my colleague, the Senator from New 
Hampshire, for leading the freshmen Senators here this morning as we 
once again take the floor to talk about health care reform.
  I also commend my friend, the junior Senator from Florida, for his 
comments today. I share his views about the necessity of bringing our 
Federal deficit in line.
  In the Commonwealth of Virginia, we have a balanced budget 
requirement and we meet our budget every year. I am proud of the fact 
that Virginia has been named the best managed State in America. So I do 
have to take issue with some of the comments made by my colleagues, who 
I think understand States' needs. The fastest growing costs in my 
State, as well as the State of Colorado, New Hampshire, and I would 
assume the State of Florida, are health care costs.
  Medicaid is going to bankrupt virtually every State in the Nation by 
2025 if we do not act. I hope for, and welcome, my colleagues' efforts 
to try to reach a bipartisan consensus on health care reform.
  I will again make the point I have made repeatedly over the last few 
weeks: What happens if we don't act? What happens if we simply kick the 
can down the road another 10 years? That is the appeal I make to my 
colleagues on the other side. Join us. Particularly join the freshmen 
Senators, who don't come to the Senate with the same background of the 
last 20 years and experience of past battles. Join a group who does, 
however, come to this body wanting to do the people's business. That 
means driving down health care costs, expanding coverage, and making 
sure our health care system is financially sustainable.
  If we don't act, not only will States' increasing Medicaid costs go 
unmet, State budgets will not be balanced. If we don't act, the Federal 
deficit will explode. The largest driver of the deficit is not the TARP 
spending or stimulus spending; it is health care spending. If we don't 
act, the current Medicare Program, which seniors depend on, will go 
bankrupt by 2017. That is not a political statement; that is a fact.
  If we don't act, American companies will not be competitive in the 
global economy. We have the most productive workforce in the world. But 
no American company can compete when they have built in health care 
costs of $3,000 to $4,000 more per worker than any other competitor in 
the world. If we don't act, for the 65 percent of us who get our health 
care coverage through the private insurance market, an average Virginia 
family will be paying 40 percent of their disposable income on health 
insurance premiums within the next decade.
  I ask my colleague from Florida and others on the other side of the 
aisle to join us in this bipartisan effort to reform health care. This 
morning we will lay out how we think health care reform can both expand 
coverage and drive down costs. We will look at some of the models 
currently being used by large employers who have had the flexibility to 
design their own benefit plans. These models have successfully driven 
down costs by putting in place prevention and wellness activities, 
negotiating better prices with providers, and restructuring a financial 
incentive system which currently rewards hospitals based on higher 
readmission rates, rather than quality care.
  I thank the Senator from New Hampshire for organizing the freshmen 
one more time. As a former Governor, I know she has been a leader on 
issues like Medicaid and health care costs. I call on my colleagues on 
the other side of the aisle to actually join in this effort to make 
sure we do achieve bipartisan health care reform.
  I yield the floor.
  Mrs. SHAHEEN. I thank the Senator from Virginia for his comments. As 
he said, our health care system is on an unsustainable path. Now is the 
time to fix it.
  Health care has not been working for families, for workers, for 
businesses, and for the Nation's economy. Today we are actually going 
to talk about some of the good news we know we can accomplish with 
health care reform. We are going to talk about what health care reform 
can do to help those families, workers, and the economy. It is our 
opportunity to control costs for Americans and to improve quality.
  Let me be clear: We can control cost and improve quality at the same 
time. When we do this, we have to remember to keep patients at the 
center of the debate. The truth is, in so many cases the health care 
industry can do more for less. Usually I like to tell a story about 
what is going on with my constituents. It helps us keep people at the 
center of the debate.
  Today I want to talk about some of the innovative health quality 
initiatives happening in New Hampshire. We

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all know hospital readmissions are a costly problem in the country. We 
have an exciting program going on in Manchester, the State's largest 
city, at the Elliot Senior Health Center. They recognized what was 
happening with readmissions. They recognized that hospital discharges 
can be confusing and sometimes overwhelming for seniors and that 
providing a little extra attention to help those seniors as they are 
transitioning out of the hospital can help keep them from being 
readmitted. They developed a program they call the TRACE Program. TRACE 
provides seniors with a health coach who helps patients with the tools 
and support to take a more active role in managing their medical care. 
The support those patients receive improves their understanding not 
only of their own health care, of the health care system in general, it 
helps keep them out of the hospital.
  Senator Collins and I have introduced a bill that would help do this 
systemwide called the Medicare Transitional Care Act. It builds on 
successful programs such as the one at the Elliot Senior Health Center. 
Our legislation would improve the quality of care, reduce hospital 
readmissions, and lower costs. Research shows we can save $5,000 per 
Medicare beneficiary if we enact this kind of a program systemwide to 
deal with hospital readmissions. I am happy the key provisions of this 
idea are included in the Finance Committee bill. It will give us an 
idea of how this is going to work systemwide. It is one example of what 
we can do to improve the quality of care while we control cost.
  There is another initiative we have been working on. I know all of us 
have been forced to wait in a crowded emergency room sometimes. 
Emergency room overcrowding is a problem that has become all too 
common. It is a symptom of what is going on in our health care system. 
Frequent users of health care services are a small but very costly 
portion of our population. They contribute to overcrowding in emergency 
rooms, and they raise costs for everyone. These individuals often have 
multiple chronic conditions. Sometimes they have mental illness. 
Sometimes they are faced with issues such as poverty and homelessness. 
They are among our most vulnerable but most frequent users of emergency 
rooms because they have nowhere else to go.
  In one study, one individual used the emergency room 115 times in 1 
year. This was in Camden, NJ. Another patient accumulated $3.5 million 
in hospital charges over 5 years. These are charges for which the 
American taxpayer paid the bill. Our health care system is not 
adequately dealing with frequent users of emergency rooms. The good 
news is, we can change this. Through increased outreach and 
coordination, we can reduce utilization. We can save costs. Research 
shows that after 2 years of participation in a program that provides 
this kind of coordinated care for people who use emergency rooms, usage 
of emergency rooms was cut by over half. This translates into 
significant savings for the taxpayer. It is the kind of reform we must 
continue to look at if we are going to change the health care system 
and make it work for taxpayers, for businesses, and for families.
  These are only a few examples of how health reform can benefit 
Americans. We can improve the quality of care available to people, and 
we can control health care costs at the same time. I believe we can do 
this. Now is the time to pass meaningful health reform for the citizens 
of New Hampshire and for all Americans so we can achieve these changes 
in our system.
  I now yield the floor to Senator Merkley for 6 minutes.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. MERKLEY. Mr. President, it is a pleasure to talk about health 
care following upon the remarks of Senator Jeanne Shaheen and Senator 
Mark Warner, both of whom, as Governors, had the opportunity to know 
firsthand how important health care reform is to taking our Nation 
forward. They come from very diverse States, but the observation is the 
same. Health care reform is essential to putting our Nation back on 
track, and now is the time.
  I wish to direct my comments specifically to the benefits of health 
care reform to small business. We all know the current system doesn't 
work for small business employers or their employees. Without numbers 
behind them, they have no ability to negotiate rates with insurance 
companies. They are like lambs led to the slaughter. More often than 
not, they have to take whatever deal is offered. Those deals are not 
very good. On average, small businesses pay 18 percent more than large 
firms for the same health insurance policies. Because of this, they are 
far less likely to provide health insurance. Just 49 percent of firms 
with 3 to 9 workers and only 78 percent of firms with 10 to 24 workers 
offer health insurance to their employees, as compared to 99 percent of 
firms with 200 or more employees in the same year.
  When small firms do offer health care, rising premiums force owners 
to make hard choices between keeping health coverage, expanding their 
operations, or increasing wages. In the last decade, health care 
premiums for the average Oregon family more than doubled, while median 
earnings rose only 23.8 percent. It is no coincidence. Employers are 
spending more in compensation, but that compensation is going to higher 
insurance premiums rather than higher wages.
  Last month I talked to small business owners in Medford and Portland, 
OR, who share strikingly similar stories about the problems rising 
health care costs are causing for them. Dave Wilkerson runs a Medford 
architectural firm that has 12 full-time employees. He is dedicated to 
providing a family-friendly work environment, and he provides full 
medical, dental, and vision coverage to his employees. The company has 
had to deal with large annual increases in health care premiums and has 
had to change carriers several times in order to try to keep costs 
down. Health care costs are the second highest expense for David's 
firm. Only payroll exceeds them.
  This year rising health care costs forced David and his partners to 
look very closely at either eliminating health care benefits or laying 
off employees.
  Jim Houser and his wife Liz Dally tell a similar story. They operate 
the Harthorne Auto Clinic in Portland. When they opened their doors 26 
years ago, they made a commitment to offer those who worked for them a 
good benefits package, including comprehensive health care. Jim and Liz 
are still able to provide health insurance to their employees, but 
premiums have gone from 9 percent of their payroll to 18 percent in 5 
years. As a result, they have had to cut back on benefits. These and 
otherwise successful small businesses have been hamstrung by health 
care costs.
  Will reform help these small businesses? Yes, it will. It will help 
them a lot.
  First, it will allow them to enter health care exchanges, where they 
will be part of a much larger pool. With their increased market clout, 
they will be able to negotiate lower premium costs. These rates will be 
much more stable than in past years. One sick employee will no longer 
make an entire group uninsurable.
  Second, the exchanges will offer more and better policies from which 
to choose. Currently, many small businesses struggle to find any 
insurers that will offer policies. But through health care reform, and 
as part of the exchange, they will be able to choose from a number of 
different plans. Because these plans will have to meet certain 
standards, small businesses will have higher quality policies from 
which to choose.
  Finally, better choices at a lower price will mean small businesses 
can dedicate more revenue to increasing wages--more money in the 
pockets of their employees--have more opportunity to invest in new 
equipment or hire additional employees. This is good for these owners, 
it is good for our economy, and it is good for the employees.
  Health care costs have become a millstone around the neck of our 
small businesses, dragging down our economy. Health care reform will 
help

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small businesses thrive by lowering cost, improving service, and 
enabling small business owners to focus on making their businesses more 
successful.
  I yield back the floor to my colleague from New Hampshire, and I 
thank her for conducting and managing this set of conversations from 
the freshman Senators today.
  Mrs. SHAHEEN. Mr. President, I thank very much Senator Merkley for 
pointing out what a difference health care reform can make for small 
businesses.
  I will now yield 6 minutes to the Senator from Alaska, Mr. Begich.
  Mr. BEGICH. Mr. President, I thank the Senator.
  I say to Senator Merkley, I am going to follow up on your points as 
to small businesses, and they are very good points. In Alaska, 52 
percent of our population is self-employed, in some form or another, or 
they are self-employed and employ many individuals.
  Again, I am pleased to be back here with our freshman colleagues to 
talk about why America needs health insurance reform and why we need it 
now.
  Last week, we busted myths being pushed by the opponents of reform. 
Today, we join forces to describe the undeniably positive aspects of 
reform--how it will help our friends, our neighbors, and our loved 
ones.
  I rise to address the unquestionable link between health insurance 
reform and economic recovery in America. All of us on this floor have 
heard from those who say we should not do health reform now, that with 
the economy still hurting, we should wait. Some of that commentary 
comes from loud and angry naysayers looking for any excuse to kill 
reform.
  But that concern has also been raised by average Alaskans at our 
townhall meetings. It is a legitimate question, and here is how I 
answer my constituents: If we want to do this right, economic recovery 
and health reform have to go hand in hand. You cannot have one without 
the other.
  There are already signs in this country of our economic turnaround in 
progress. That is welcome news for American breadwinners going back to 
work, for businesses racking up new sales, and for manufacturers 
ramping up production to fill new orders.
  But there is more work to do, more progress to make. That is where 
health insurance reform comes in because the status quo is directly at 
odds with the possibility of continued economic growth. Here are a few 
examples. Businesses, big and small, have been saddled with 
skyrocketing health care costs for their workers. You have heard many 
examples this morning. The average health insurance premium in Alaska 
has risen 102 percent in the past decade--more than doubled.
  No matter which State you are from, those premium increases take a 
toll on business. Money that could go to innovation, investment, pay 
raises or added staff is going instead to insurance. Today, employer-
provided family premiums in Alaska average more than $14,000, about the 
annual pay of one new minimum wage job.
  Household budgets are also strained. In this decade, health insurance 
costs for Alaska families have risen five times faster than wages. That 
is a loss of purchasing power that could be going instead into our 
local economy or to education to improve individual earning power.
  Of course, my Alaska examples are happening in States all over this 
country. The statistics are troubling. Today, one-sixth of the entire 
American economy is devoted to health care costs. Think about it. That 
is more than $2 trillion each year that does not go to job creation or 
business innovation or investments in infrastructure.
  If we do nothing to reverse this trend--if supporters of the high 
cost of insurance manage to kill this reform--this problem will get 
much worse. By the time my 7-year-old son is raising his family, one-
third of the entire U.S. economy could be consumed by health care.
  Yesterday, on the floor of the Senate, one of our colleagues in 
opposition to health care reform put up a prop--which we will see over 
and over again--a large bill that was put on the desk. It is about 
1,500 pages of the Finance bill, and over time that will change. But 
when you think about it, one-sixth of the economy will be decided by 
that bill--1,500 pages. To me, that is a small amount of work, in the 
sense of the legislation, to deal with one-sixth of our economy. But, 
again, we will see that prop over and over again. But I hope the 
American people will see through that and see how important dealing 
with one-sixth of the economy is and how having a bill of that length 
is important.
  How can we expect American businesses to shoulder such costs and be 
truly competitive in a global economy? Here is one example. Right now, 
General Motors reports that health care spending adds $1,500 to the 
cost of every car it produces. Of course, its chief overseas 
competitors do not have to worry about health care costs because their 
countries dealt with this years ago.
  We can and must do better. Economic peace of mind is fundamental to 
our democracy. It is the goal of every family in this country. It is a 
cornerstone of the American dream.
  Let me say again, if we are serious about economic recovery in this 
country, then we must be serious about health insurance reform. It is a 
package deal.
  Mr. President, I thank you and yield back the floor to the Senator 
from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I say to Senator Begich, thank you very 
much and thank you for pointing out how important health care reform is 
to our economy.
  I now yield time to Senator Kaufman from Delaware.
  Mr. KAUFMAN. Mr. President, I thank Senator Shaheen for her 
leadership in putting this together and thank her for her leadership on 
health care and so many other issues.
  I appreciate the opportunity, once again, to join my colleagues in 
calling for the passage of meaningful health care reform.
  This morning, we are answering the question: What can health care 
reform do for you?
  I wish to take a couple minutes to talk about how health care reform 
can help Americans stay active and healthy by enhancing prevention and 
wellness services for all Americans.
  As I have said many times on the floor, the present health care 
system is out of control. It has become a gigantic resource-eating 
machine which, over time, sucks in more money and delivers fewer 
options and poorer care.
  As odd as it sounds--and it does sound odd--health is not always the 
top priority in the present health care system. The current system, all 
too often, waits to treat illness and respond to health problems until 
they become particularly acute and costly to treat.
  Promotion of health, both physical and mental health, is not given a 
top priority in the present health care system because, frankly, it is 
not rewarded. Because of this lack of emphasis, our present health care 
system is weighed down by Americans who battle one or more chronic 
diseases every day.
  Despite all we spend on health care--and in 2009 this figure will 
approach $2.5 trillion--almost one in two Americans suffers from 
common, costly, and often preventable chronic diseases.
  The Partnership to Fight Chronic Disease estimates that almost 80 
percent of American workers have at least one chronic disease, and 55 
percent have more than one chronic condition. In fact, treatment of 
chronic disease accounts for approximately 75 percent of every dollar 
spent on health care today.
  The spending rate is even higher in the Medicaid and Medicare 
populations, with 83 percent of spending in Medicaid and 98 percent in 
Medicare going for the treatment of chronic disease.
  The rapid growth of chronic disease increases insurance costs for 
Americans, undercuts U.S. competitiveness, and threatens Medicare and 
Medicaid viability. Our present health care reform effort gives us the 
opportunity to finally reverse this trend.
  By empowering and motivating Americans to be physically active and

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giving them a financial stake in maintaining their day-to-day health 
status, health care reform can put the focus back on healthy living.
  An example we can build on is the recent success Safeway Corporation 
has had in reducing health care premiums for many of their employees by 
providing them incentives to change their behavior.
  The CEO of Safeway, Steven Burd, created a program that rewards 
employees with lower premiums if they reduce their tobacco use, lower 
their blood pressure and cholesterol levels, and achieve a healthy 
weight. The completely voluntary program tests for these four measures, 
and employees receive premium discounts for each test they pass.
  Aided by this program, obesity and smoking rates at Safeway are 
roughly 70 percent of the national average, and their health care costs 
for the last 4 years have remained constant. Let me repeat that: Their 
health care costs for the last 4 years have remained constant.
  Right now, discounts for healthy behaviors such as Safeway's are 
limited to 20 percent of the regular premium. Recognizing the success 
of the programs such as these, the health reform bills moving through 
Congress include provisions to expand the premium discounts for healthy 
behaviors from 20 percent to 30 percent.
  Another attempt to bring increased wellness to the workplace through 
health reform is a measure that provides grants to small businesses to 
provide access to comprehensive, evidence-based workplace wellness 
programs that would help employees make healthier choices.
  These are both positive steps to promote healthy behaviors and give 
incentives to keep premium costs under control.
  Also, by authorizing and expanding school-based health clinics, 
health care reform gives America's children more opportunity to learn 
about the merits of healthy behaviors at a young age, giving them the 
tools they need to make healthier choices throughout their lives.
  In addition to promoting healthy lifestyles among American workers 
and children, health care reform will make it easier for those enrolled 
in Medicare and Medicaid to gain access to preventive services and 
wellness programs. This is incredibly important not only for the 
individual health of the enrollees but also to reduce the long-term 
costs of chronic disease in these programs.
  For instance, health care reform will provide Medicare beneficiaries 
with a free visit to their primary care provider every year to create 
and update a personalized prevention plan. These plans can address 
health risks and chronic health problems and design a schedule for 
regular recommended preventive screenings.
  Health care reform will also eliminate out-of-pocket costs for 
preventive services for Medicare beneficiaries, making these services 
more affordable and increasing the likelihood they will seek early care 
before the cost of treating a disease is prohibitive.
  For those enrolled in Medicaid, health care reform will offer tobacco 
cessation services to pregnant women, create a new State option for 
providing chronically ill individuals with a health home aide to 
coordinate care, and encourage States to cover preventive services 
recommended by the U.S. Preventive Services Task Force.
  Again, these are all steps that begin to reward preventive medicine 
and give people the incentive to utilize such services.
  The PRESIDING OFFICER. The Senator has used 6 minutes.
  Mr. KAUFMAN. Mr. President, may I have 1 more minute?
  Mrs. SHAHEEN. Yes, 1 minute.
  Mr. KAUFMAN. In short, the long-term financial viability of the 
health care system requires a focus on improving health and addressing 
the burden of chronic disease.
  Health care reform gives us the chance to facilitate our health 
system's transition from one that focuses on just treating illness to 
one that is more designed to prevent or delay disease onset and 
progression.
  It is time to 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.
  Thank you.
  Mrs. SHAHEEN. Mr. President, I thank very much Senator Kaufman for 
giving us one more reason why we need to address health care reform.
  I now yield 6 minutes of my time to Senator Udall of New Mexico.
  Mr. UDALL of New Mexico. Mr. President, I thank very much the Senator 
from New Hampshire. I thank her for her leadership on the floor and for 
the hard work she has done on this issue. I know everybody back in New 
Hampshire very much appreciates that. This is the fourth time the 
Senate's freshman class has gathered on the Senate floor to talk about 
health reform. Already we have talked about why maintaining the status 
quo is not an option. We have talked about how reform will contain 
costs and dispel the myths about reform. We have talked about how 
reform will mean many things to many different people. What I wish to 
talk about today is what reform will mean for rural New Mexicans.
  Our rural areas are the backbone of America. It is where we grow our 
food. It is where the values and traditions that make our country 
unique continue to thrive. It is where the potential for a clean energy 
future grows brighter and brighter every day. Unfortunately, our rural 
areas are also places where the disparities in America's health care 
system are the most startling.
  It shouldn't matter whether one lives in a vast metropolis such as 
New York City or a frontier town in New Mexico. All Americans, 
regardless of where we choose to call home, deserve access to quality, 
affordable health care.
  However, the reality is that right now, where one lives does have a 
big impact on whether they have access to quality, affordable coverage. 
Americans living in rural areas are more likely to be uninsured, and if 
they do have insurance, it can be very difficult to find a doctor. As a 
result, rural Americans end up getting sicker, they have higher rates 
of chronic disease, and they are often forced to travel hundreds of 
miles for preventive or emergency care, if they are able to find any at 
all.
  I have seen these disparities firsthand, as a Member of the other 
Chamber and now a Senator for one of the most rural States in the 
Nation. Geographically, New Mexico is the fifth largest State in the 
country with more than 120,000 square miles of some of the most 
beautiful land that God created. Of the 2 million people who call New 
Mexico home, about 700,000 live in rural areas. Several places in New 
Mexico are so sparsely populated they are classified as frontier areas 
with less than six people per square mile.
  Many of New Mexico's rural residents are farmers and ranchers, and 
they run their own businesses. Their only access to health insurance is 
often through the individual market where coverage can be extremely 
expensive, difficult to obtain, and nowhere near as comprehensive. As a 
result, rural Americans pay nearly half of their health insurance costs 
out of pocket, and one in five farmers lives in medical debt.
  With health care reform, we must ensure that America's farmers and 
ranchers, as their small business counterparts in more urban areas, 
have more affordable choices for coverage. I believe the best way for 
making this happen is through a health insurance exchange that includes 
a strong public option. Inserting more choice into the market would 
keep insurers honest and allow consumers to compare plans and prices 
and decide what works best for them.
  With health care reform, we must also address the growing doctor 
shortage in rural America. In my State, for example, 30 of 33 counties 
are categorized as ``medically underserved.'' Americans should not have 
to travel hundreds of miles for health care. Whether it is lifesaving 
treatment for a heart attack or a basic preventive service such as a 
mammogram, people are more likely to get the help they need

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when they need it if the services are close to home. Through incentives 
such as low-interest student loans, loan repayment programs, and 
scholarships for students and midcareer professionals, we can encourage 
more doctors and nurses and specialists to establish and grow their 
medical careers in rural America.
  Finally, with health care reform, we must better support rural 
hospitals that serve large numbers of low-income and uninsured 
patients. This could be through initiatives such as expanded drug 
discount programs, increased Medicare payment caps for rural health 
plans, increased National Health Service Corps doctors, and expanded 
demonstration programs to test reasonable cost reimbursement for small 
and rural hospitals.
  We will never achieve true reform in our country if we don't address 
the very real health care challenges facing rural Americans from the 
deserts of New Mexico to the mountains of Maine and everywhere in 
between. The improvements I have outlined are a good start, but there 
is more left to do, and I plan on talking about how we can accomplish 
this in the coming weeks.
  We have traveled a long way over the past few months. I applaud my 
fellow freshman Senators for standing up each week and making sure 
their voices were heard in this process. I believe, working together, 
we can create a system where all people can find and afford quality 
health insurance that provides the care they need. We can guarantee 
quality, affordable health insurance to every American, and we must do 
that.
  Thank you, Mr. President. I yield to the distinguished Senator from 
New Hampshire.
  The PRESIDING OFFICER (Mr. Kaufman). The Senator from New Hampshire.
  Mrs. SHAHEEN. I thank Senator Udall very much for giving us another 
reason health care reform is going to be good for our families and for 
America.
  Now I wish to yield 6 minutes to the Senator from Colorado, Mr. 
Bennet.
  Mr. BENNET. Mr. President, I wish to thank the Senator from New 
Hampshire for yielding, as well as the Senator from New Mexico for his 
excellent comments.
  I am a father of three little girls who are 10, 8, and 5. One of the 
things I miss most in being here and not being in Colorado is being 
able to read to them at night or be with them. Over the years, we have 
moved from one story to another. Harry Potter is now being read. But I 
heard a story from Colorado this morning that I couldn't believe that 
reminded me so much of ``Goldilocks and the Three Bears.'' So that is 
what I wish to talk about today.
  In Colorado, we have a young boy named Alex Lange who is 4 months 
old. He is 17 pounds. Several weeks ago he was denied insurance because 
of his ``preexisting condition'' which, in his case, is obesity. Bernie 
and Kelli Lange, his parents, tried to get insurance and were told by 
an insurance broker that their baby was too fat to be covered. As his 
father said:

       [I] could understand if we could control what he is eating, 
     but he is 4 months old. He is breastfeeding. We can't put him 
     on the Atkins diet or on a treadmill.

  So that was one story of a child who is too fat to be covered.
  Today we have the story of Aislin Bates. By the way, in the Lange 
case--and I want the record to reflect this--the insurance company did 
the right thing, which is to say: We made a mistake, and we need to 
cover this young man.
  Today comes the story of Aislin Bates who is 2 years old, 22 pounds, 
denied insurance because of her ``preexisting condition,'' which is 
that she is underweight. Rob and Rachel, her family, tried to get 
insurance and they received a letter saying:

       We are unable to provide coverage for Aislin because her 
     height and weight do not meet our company's standards.

  Her pediatrician wrote a letter in support of the family's request to 
appeal the insurance company's decision, but the company stuck by its 
decision. The Bates family has said it costs as much to cover Aislin 
under COBRA as it costs to cover the remaining three family members.
  So in Colorado we have children who are too big to be insured; we 
have children who are too little to be insured. The reason this 
reminded me of Goldilocks was that it looks as though you have to be 
``just right'' to get insurance, even if you are an infant.
  We can do better than that as a country, and we are proposing to do 
better than that as a country. One of the most important parts of this 
insurance reform is to get rid of denials of coverage based on 
preexisting conditions. I have spoken to many people who work for 
insurance companies that are tired of having to deny claims for this or 
for that or relying on the fine print when they know the right thing to 
do is to provide coverage.
  I am tired of living in a country where 62 percent of bankruptcies 
are health care-related and 78 percent of those health care-related 
bankruptcies are happening to people who have insurance, working 
families who have insurance. I am tired of the fact that we have public 
hospitals in Denver that 2 or 3 years ago spent $180 million of 
taxpayer money on uncompensated care for people employed by small 
businesses.
  So I think what we are talking about at the end of the day is trying 
to create some stability for our working families, trying to create 
some stability and some fairness for our small businesses that, after 
all, are paying 18 percent more to cover their employees just because 
they are small.
  Politics has gotten in the way of reform of our health care system 
for more than 20 years. It has been longer than that. In the last 10 
years alone, the costs of health insurance premiums have gone up 97 
percent in my State, while median family income has declined by $800 
over this same period. This is unsustainable for our working families. 
It is unsustainable for us as an economy, for us to spend more than 
twice what any other industrialized country in the world is spending on 
health care. We can't hope to compete in this global economy when we 
are devoting more than twice what anyone else is spending on health 
care.
  We can do better. The commonsense reforms that are in front of us and 
that I am sure are going to be improved upon in the coming weeks are a 
big step forward for working families and small businesses. It is going 
to be a big step forward for these young children in Denver, CO, and in 
the rest of our State who can't be denied coverage because they are not 
``just right,'' because they are too big or they are too small or there 
is one other issue that nobody anticipated.
  Our families need help. They need stability in order to get ahead. 
That is why I support this health care reform effort.
  I wish to thank, again, the Senator from New Hampshire for her 
leadership this morning and throughout the months as we have been 
talking about this issue. I look forward to working with her in the 
coming weeks as we finally bring this matter into its safe harbor.
  Thank you, Mr. President. I yield the floor.
  Mrs. SHAHEEN. I thank Senator Bennet very much for yet another reason 
we must pass health care reform.
  Now I wish to yield 6 minutes to Senator Burris from Illinois.
  Mr. BURRIS. I thank the Senator from New Hampshire.
  Mr. President, this week my freshman colleagues and I have come to 
the Senate floor to answer a simple question. It is a question we have 
been hearing from ordinary Americans across the country. They want to 
know: What can health care reform do for me?
  I believe this question deserves an honest answer. Opponents of 
reform have resorted to lies and distortions to try to scare the 
American people into siding with the big insurance corporations. They 
talk about death panels and government takeovers and a lot of redtape 
between ordinary people and their doctors. These myths have been 
debunked many times. They have had no basis in reality.
  I believe the American people are tired of the scare tactics and the 
dishonesty. They are too smart to fall for

[[Page 25316]]

this kind of tactic. They are interested in the truth behind our reform 
proposals. They just want to know: What can health care reform do for 
me?
  This is what reform with a public option can do for all Americans: It 
can make insurers compete for their business. Reform with a public 
option will restore choice to an insurance market that is currently 
dominated by only a few companies. In my home State of Illinois, two 
companies control 69 percent of the insurance market. In some places, 
the market is even more concentrated. As any businessman will tell us, 
as competition shrinks, profits soar. That is bad for the consumer.
  Between 2000 and 2007, profits increased by an average of 428 percent 
among 10 of America's top insurance providers. Other insurance premiums 
are rising four times faster than wages. Big corporations have the 
American people in a vice grip, and they are squeezing them for 
extraordinary profits. It is time for this to end.
  If we reform the insurance industry and create a not-for-profit 
public health option, it will force private companies to improve their 
prices and their products. It will restore choice and competition to 
the market and will help make our insurance more affordable.
  If you like your current plan, no one will force you to switch to a 
public option. Understand: If you have your doctor, you have your 
providers, and you have insurance coverage today, we are not going to 
impact you. But if your insurance provider isn't treating you right or 
is not giving you the coverage you need, you will have the ability to 
shop around. You can buy a better private plan that is guaranteed to be 
affordable for someone of your income level or you can choose the 
public option which will set its premiums at an affordable rate. Then 
it will rely on those premiums to remain self-sufficient.
  These are the facts. This is what health insurance reform with a 
public option means to the American people: competition, choice, and 
affordability. That is why I refuse to compromise on the public option 
because it is the only way to give the American people the quality 
affordable care they deserve.
  Let me be as clear as I possibly can. I will not vote for any health 
reform bill that does not include a public option. I ask my colleagues 
to stand with me. We have been debating reform for almost a century. 
Now is not the time to back down. Now is the time to act on our 
convictions. Let's do this for the American people. Let's make a public 
option a reality.
  I yield back my time to the distinguished Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I thank Senator Burris for pointing out 
that we need health care reform to get competition in our health care 
industry.
  I yield 6 minutes to the Senator from North Carolina, Mrs. Hagan.
  Mrs. HAGAN. Mr. President, I am joining my colleagues on the floor 
today to discuss the need for health care reform and what it means for 
Americans with preexisting conditions.
  Millions of Americans live today with what insurance companies 
describe as preexisting conditions. They range from something as common 
as asthma or diabetes to diseases such as cancer or MS. Some insurance 
companies, believe it or not, even consider a C-section to be a 
preexisting condition.
  Under our current system, if you are shopping for insurance on the 
individual market and you have a preexisting condition, you are faced 
with one of three frightening choices: One, you could be denied 
coverage altogether; two, you could be charged an exorbitant premium; 
three, you could be granted insurance with a rider that stipulates your 
insurance company is not required to cover your preexisting condition.
  Recently, I received an e-mail from a family in Mooresville, NC, that 
truly underscores why millions of Americans living with preexisting 
conditions simply can no longer afford inaction on this issue.
  Seven years ago, Tim became disabled and lost his job. Because he 
lost his job, his wife Marilyn also lost her coverage under his 
employer-provided plan. Tim's health care, which requires his wife 
Marilyn to provide constant home care, is covered by Medicare. But 
Marilyn has Osler's disease, which is a blood disease considered to be 
a preexisting condition by her insurance company. Marilyn is only able 
to purchase a high-cost, high-deductible plan. Compared to Tim's 
illness, her condition is relatively minor. But over the last 7 years, 
they have racked up more than $72,000 in debt for her health care. And 
this past year, her health insurance premiums cost more than the 
mortgage on their home.
  Unfortunately, there are millions of Americans all across our country 
such as Tim and Marilyn who are literally one medical emergency away 
from bankruptcy. This couple is sick and stuck.
  Over the last 10 years, medical premiums in North Carolina have 
skyrocketed, increasing 98 percent, while wages, on the other hand, 
have increased only 18 percent.
  The Health, Education, Labor, and Pensions Committee, of which I am a 
member, crafted a bill that ensures a preexisting condition never again 
prevents anyone from obtaining health insurance. It also provides 
security and stability for people with insurance, expands access to 
health insurance for people without it, and it will stop draining the 
finances of American families and the Treasury. The Finance Committee's 
bill also includes these critical elements.
  My goal is to send the President a bill that gives people the peace 
of mind that if they change or lose their job, as Tim did, they will no 
longer have to fear losing their health insurance too.
  Every single day I hear from North Carolinians who are looking for an 
opportunity to purchase quality affordable health insurance and protect 
their families. Hard-working Americans, such as Tim and Marilyn, simply 
cannot afford to wait any longer.
  I yield back my time.
  Mrs. SHAHEEN. Mr. President, I thank Senator Hagan for yet another 
reason why health care reform is going to make a difference for 
Americans.
  This morning, the freshman Senators have again talked about why we 
must pass health care reform. We have heard nine very important reasons 
why health care can make a difference for American families.
  We heard from Senator Warner that health care reform is going to be 
critical to States as they look at the rising costs of Medicaid in 
their budgets and how to get those health care costs under control.
  We heard from Senator Merkley why health care reform is critical to 
help small businesses as they are trying to cover their employees and 
deal with the costs as they get out of this recession.
  We heard from Senator Begich about why health care reform is critical 
as we are looking at economic recovery. Health care costs are 18 
percent of this economy, one-sixth of this economy, and we cannot allow 
those costs to continue to grow at this rate and expect we are going to 
be able to recover robustly from this recession.
  We heard from you, Mr. President, about why health care reform is 
going to improve prevention and wellness. The goal is to make us a 
healthier population, and health care reform can help spur that.
  We heard from Senator Bennet about why health care reform is going to 
help people who already have health insurance, to make that health 
insurance better provide for families who need it.
  We heard from Senator Burris about why health care reform is going to 
be critical to making health insurance companies compete for business 
and, therefore, better accommodate the health issues families have.
  We heard from Senator Udall about why health care reform is going to 
make a difference for rural areas, places such as the north country of 
New Hampshire where we have too many people who have to spend too much 
and go too far for their health care.
  We heard from Senator Hagan about the importance of health insurance 
reform and health care reform to address things such as preexisting 
conditions.
  I talked about the fact that health care reform can both lower costs 
and improve quality for Americans.

[[Page 25317]]

  Those are nine critical reasons why health care reform is going to be 
important to help American families, American businesses, the American 
economy.
  The time to act is now. Hopefully, we can act in a bipartisan way. 
But we must act to make a difference for this country and for families.
  Mr. President, I yield back the remaining time in morning business. I 
yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. JOHNSON. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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