[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[Senate]
[Pages 26236-26237]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. CARDIN. Mr. President, soon we will have a historic opportunity 
to take up the most significant change in our health care system in 
many decades, a bill that will help Americans deal with their health 
care needs, that will reform our health care system so we have 
affordable, quality health care for all Americans. This bill will help 
middle-income families who currently have health insurance. Because we 
are going to build on the current system, protect those who have good 
health care coverage so they are able to keep that coverage in the 
future, we base it on building on what is right in our health care 
system and correcting the problems that currently exist.
  For a family who has health insurance today, they are paying a large 
amount of money for those who don't have health insurance. The number 
of people without health insurance has grown dramatically, to over 46 
million Americans. The cost to a family who has health insurance for 
those who don't have health insurance is $1,100 a year. That is a 
hidden tax on middle-income families today. Health insurance reform 
will help correct that inequity to help middle-income families. It will 
also reform the practices of health insurance companies dealing with 
preexisting conditions and caps put on the amount of coverage and with 
making sure that prevention is available without copayments and 
deductibles. All that will help middle-income families today who have 
health insurance.
  But the critical factor, why this is so important for middle-income 
families today, is because of the escalating cost of health care. 
Health care is growing three times greater than wages. That means for 
the typical family, every year they are falling further and further 
behind on their standard of living, because more and more of their 
income needs to be devoted toward health care costs. Whether your 
employee pays it or you pay it or a combination of both, it comes out 
of your compensation package. For many families, they are actually 
receiving less income every year because so much more is devoted toward 
health care costs.
  In Maryland, 10 years ago the cost for a family was about $6,000 for 
health insurance. Today that is $12,000. By the year 2017, it is 
projected to be $23,000. We are spending in America today $7,400 per 
person for health care, $2.4 trillion. Health reform will help middle-
income families because we are going to bring down the cost of health 
care.
  First, we invest in wellness. We know that if people take care of 
their own health care needs, if they deal with their diabetes, high 
blood pressure, high cholesterol, with keeping themselves healthy 
through exercise, if they don't smoke, all of that will bring down the 
cost of health care. The health care reform that we will be taking up 
invests in wellness programs, gives incentives for wellness programs to 
bring down the cost. What we also do is invest in health information 
technology. The amount of money we waste every year because of the 
administrative inefficiencies of the system is staggering. Also we have 
unnecessary tests that are given in the emergency room because they 
don't have medical records. We have the technology. Let's use it. We 
can use technology to keep people healthy by sharing information so 
that your health care provider knows what medicines you are taking. And 
managing care, we can save money by managing diseases much more 
effectively than we do. For all those reasons, health care reform will 
help control the escalating costs, and that will help middle-income 
families. It will also help small businesses.

[[Page 26237]]

  Small businesses need more competition among health care insurance 
companies. Today, if you are a small business owner, there are very few 
options available as to who you can choose as your health insurance 
company. As a result, you are subjected to unpredictable annual 
adjustments in your premiums. We already know that health insurance is 
too expensive. We already know that it increases every year by too high 
a percentage rate. But for a small business owner, it is worse than 
that. They can be subjected to a 20, 30, 40-percent increase in any 
given year because they are not in the large pools that larger 
companies are. Health insurance reform helps small businesses by 
providing larger pools that small businesses can get into, more 
competition. The State exchanges provide information that is critically 
important for small businesses to get a competitive product, to get the 
product they want. It makes it more affordable.
  Let me give one example. We all have received letters. I have 
received lots of letters from my constituents. I want to read one I 
received. It comes from Keith, a Maryland small business owner. He 
writes:

       Currently, I have what is considered a ``Cadillac'' health 
     plan. It is an old CareFirst Blue Cross Blue Shield plan that 
     does not cover vision or dental [and has] a moderate 
     deductible. It only covers general health and drugs. My wife 
     is disabled and is unable to work. She is under age 50 and 
     has Medicare as a primary insurance and is on my family plan 
     as secondary where she gets drug coverage.

  This person is a small business owner involved in a plan.

       I have one child with some health issues on the plan as 
     well. Based [on] my situation, my health insurance options 
     are limited.
       I am a small business owner and have had significant 
     increases in my insurance costs over the last 20 years. 
     Currently, I pay $29,000 for family coverage thru (sic) my 
     company and last year I had $9,900 in out of pocket expenses, 
     which is ``normal'' for my family. My income is above 
     $100,000, but well below the $250,000.
       At one time I considered myself part of the middle class, 
     but with my ever increasing health care costs, I now have 
     second thoughts. . . .
       It is unbelievable to me that a family like mine could be 
     in this situation. I know there are others far worse than 
     mine and can empathize with their plight. . . .
       How can I be spending about $40,000 a year [on health care] 
     with no end in sight?

  Well, help is on the way. The bills that have been reported out of 
our committees that the majority leader is now merging to bring to the 
Senate floor will help my constituent Keith, who finds that he cannot 
afford health care today even though he has certainly a reasonable 
income.
  This legislation will also help our seniors. I mention that because 
there is a lot of concern about how we can strengthen the Medicare 
system, which is so important to our seniors. Well, the problem with 
Medicare today is that health care costs are going up. Medicare is a 
pretty efficient program. We know its administrative costs are far less 
than private insurance. But we cannot bring down the government cost of 
Medicare unless we bring down health care costs in America. That is 
exactly what the health care reform proposals will do.
  It will also, by the way, use those savings to help our seniors by 
improving their prescription drug benefit so we can certainly make 
improvements to mitigate the doughnut hole on prescription drug 
coverage. It strengthens dramatically the preventative health care 
services that are offered our seniors under the Medicare system.
  Well, the uninsured are also helped under this bill and those who are 
in danger of losing their health insurance by the State exchanges, 
where there will be more competition, more availability. The bill deals 
with affordability, providing subsidies for those who otherwise could 
not afford the health insurance.
  One of the prime ways that is done is through the public option, so 
let me talk a moment about it. There has been a lot of discussion about 
it. I saw that it is going to be included in the bill in the House of 
Representatives. The majority leader is looking to include that in the 
bill that is going to be brought forward on the floor of this Senate.
  A public option is nothing strange to Americans. It is not that the 
government takes over health care; it does not. Health care is provided 
by private doctors, private hospitals. The most successful public 
option program in America in health care is Medicare, and I do not see 
anyone coming and saying we should do Medicare in a different way. 
Medicare has worked well, with the government providing the way we 
collect the premiums and collect the dollars necessary to pay the 
doctors and hospitals that are private, and where the Medicare 
beneficiaries can choose their own doctor or hospital. That is the way 
it should be.
  The reason it is important to include a public insurance option in 
the bill that is being brought forward is to make sure we have an 
affordable option for those who cannot find insurance, so we have an 
affordable product in every part of America. If you live in rural 
America, it is tough to find an insurance company that is interested in 
insuring you if you are in the individual market. That is just a fact 
of life.
  So the public option provides an affordable option and provides more 
competition. In my own State of Maryland, two insurance companies 
represent 71 percent of the private insurance market. We do not have 
effective competition in our State of Maryland. The public option 
offers more competition. If we have more competition, it is going to be 
less costly. That is the reason we want to make sure it is included in 
the bill that is brought forward and the bill we hope will be 
reconciled with the House and sent to the President of the United 
States.
  Mr. President, as I said when I took the floor, we have a unique 
opportunity. We have a unique opportunity in taking up health care 
reform and health insurance reform to help the people of our Nation. We 
have to make sure we get it right. I agree with my colleagues, we need 
to take the time to make sure we get this bill right, but we need to 
act. We need to act in order to protect middle-income families so they 
have affordable health care coverage in America.
  We need to act to help small businesses so they have more choices, 
more competition, so they can afford to provide health insurance for 
their employees. We need to act for our seniors and those who are 
disabled in the Medicare system to make sure we strengthen Medicare for 
future generations and can expand the benefits that are covered under 
Medicare.
  We need to act for the sake of our economy. We need to act for the 
sake of our Nation. I encourage my colleagues to get engaged in this 
debate so that, at the end of the day, we pass a bill that is going to 
be in the best interest of the people of this Nation.
  With that, Mr. President, 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.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. BAUCUS. Mr. President, I ask unanimous consent that I be allowed 
to speak for up to 20 minutes in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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