[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[Senate]
[Pages 26243-26245]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. JOHANNS. Mr. President, I anticipate speaking about 10 minutes, 
and I rise to speak on the health care bill that is making its way to 
the Senate floor. Today, I wish to talk about just two topics relative 
to that health care bill, and those two topics are transparency and, of 
course, the all-important topic of taxes.

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  We all have been through elections. We know elections lead to 
promises. We say things out on the campaign trail. We make promises to 
the American people and to the people of our State. Well, last 
election, by any measure, was a historic election. Over and over again, 
the American people were promised change. They were promised middle-
class protections. Very specifically, our President promised increased 
transparency. There would be no tax increases on the middle class. We 
can all quote that language--not one dime. But I have to tell you, 
everything I see about the health care debate at this point leads me to 
the conclusion that campaign promises are about to be broken.
  Without a doubt--without a doubt--the American people clearly support 
more transparency in Washington. Yet health care has the same old 
politics. There isn't any transparency at the moment. I remember that 
famous tape of the President where he said: You know, we are going to 
do this in front of C-SPAN. We are going to see who is with the big 
insurance companies and who is with the people. Well, what is happening 
now? We are in the process of bills being merged--hugely different, 
monstrous bills--and we don't even know exactly what is going to be in 
those bills, and it is all happening behind closed doors. I just 
fundamentally ask the question: If this is good for America, then why 
be secret about it? It is altering one-sixth of our economy. It simply 
should not be happening behind closed doors. There is too much at 
stake.
  Everyone should support the 72-hour transparency bill. It simply 
requires that legislation and a CBO score be available at least 72 
hours before consideration. That is a commonsense idea and I think kind 
of a minimal idea, actually. A 1,900-page bill came out of the House--
1,900 pages. Yet they are talking about a vote on that next week. I 
think most people would say: What is the rush? But we should at least 
get 72 hours, with a score, so we could talk to the American people 
about what is in the bill and what is not.
  This leads me to the next piece of what I wished to talk about today, 
and that is taxes. A signature promise of the President's campaign was 
no taxes on families making under $250,000. Wow. What an important 
promise to the middle class. Let's look at the taxes in the Finance 
Committee's bill. There are over $500 billion of new taxes and fees. 
That is a very big number. Who is going to be hit with that? We have 
had studies done on it. The Joint Committee on Taxation analysis says 
this. It concluded that for 2019, roughly 77 percent of these taxes 
will be borne by middle-class tax payers; three quarters of the tax 
burden falls on those the President promised would not be impacted with 
higher taxes. What are the taxes? For anyone with a higher priced 
insurance plan, a 40-percent excise tax will be passed through to the 
worker. Higher health care costs, lower wages, I think. Any taxpayer 
who refuses to buy government-approved insurance will be penalized. 
These numbers could change, but right now it looks like $750 for 
singles and $1,500 for couples.
  The CBO says this: Almost half of those paying this penalty tax would 
be between 100 percent and 300 percent of the Federal poverty level--or 
a family of 4, earning $22,800 and $68,400 in 2013. Clearly they are in 
the middle class. Clearly they are under $250,000. Call it what you 
will, to the people paying this, to them it will be a tax.
  If you do buy insurance, prepare to be taxed by the new insurance 
industry fees. If you use a medical device, you will get hit with a new 
medical device fee. If you contribute more than $2,500 to a Flexible 
Spending Account, your taxes go up. Many taxpayers who purchase over-
the-counter medicine will now see them taxed. Taxes and transparency--
two issues.
  I will continue, in the weeks ahead, as will my colleagues, to 
discuss the dangers of health care reform done wrong. Health care 
reform is needed, no doubt about it, but not rushed legislation with no 
transparency and so many new taxes on the middle class.
  I will wrap up with this. I think overhauling 16 percent of the 
economy is too important to do fast and to not do right, so I 
respectfully suggest that we take the time to do it right and honor the 
pledges made.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Illinois is recognized.
  Mr. BURRIS. Mr. President, over the last few months I have addressed 
this Chamber many times on the need for a strong public option as part 
of our health reform legislation. The need, I believe, is quite clear, 
but the controversy remains. There are some who continue to attack the 
public option as a ``government takeover,'' or an unnecessary intrusion 
into the free market. We must not be deceived by these baseless 
attacks. They are the instrument of a political opposition that cannot 
win this argument on the merits.
  The American people know this better than anyone. They recognize that 
our health care system is broken and that they must not settle for 
anything less than comprehensive reform that only a public option can 
provide. They know that the insurance companies maintain a virtual 
monopoly over regional markets and that large corporations are 
squeezing families and businesses for extraordinary profits. Those who 
oppose reform see no problem with this lack of competition and 
accountability and that is why their arguments fall short. That is why 
their talking points seem tired and disingenuous, because they are out 
of touch with what is going on in America today.
  Let's reject the constraints of partisanship. Let's shut out the 
lobbyists and special interest groups that stand to profit from the 
poor health of hard-working Americans. Let's talk about why we 
desperately need a strong public option in this country right now.
  The key problem with health coverage today is that American consumers 
do not have any options. The principles of competition and choice have 
always been at the heart of our economic system. They have driven 
innovation and they have served as the foundation of so many great 
ideas and achievements throughout our history. In many ways, these 
principles are uniquely American. Yet the health industry is somewhat 
exempt from their influence. Private insurance companies are free to 
fix prices, monopolize local markets and deny coverage to almost anyone 
for almost any reason. We have seen unprecedented consolidations in the 
insurance market and that has led to a lack of competition and choice 
for American consumers.
  In the past 13 years, there have been more than 400 corporate mergers 
involving health insurers. As a result, 94 percent of our Nation's 
markets are now considered ``highly concentrated,'' meaning that they 
are post-antitrust concerns. In my home State of Illinois, just two 
companies control 69 percent of the market and, sadly, Illinois is far 
from alone. In Alabama, a single company controls more than almost 90 
percent of the market and in Iowa, Rhode Island, Arkansas, Hawaii, 
Alaska, Vermont, Wyoming, Maine, and Montana, the two largest health 
insurance companies control at least 80 percent of the market. In fact, 
there are only three States in the entire country where the largest 
three companies control less than a half of the insurance market.
  This is a staggering statistic. In that kind of highly concentrated 
environment, there is no incentive to compete. There is no reason to 
improve service, expand access, or work with patients and doctors to 
achieve better health outcomes. In fact, there is every incentive to do 
just the opposite. These companies continue to look for new, innovative 
ways to deny coverage to sick Americans. They increase premiums, they 
cap lifetime benefits, they increase corporate earnings at the expense 
of families and businesses that are already stretched to the breaking 
point. While the rest of us suffer the effects of recession, they post 
record profits. That is why health care premiums are growing four times 
faster than wages. That is why profits are up and, relatively, health 
outcomes are down.
  In the last quarter, one major insurance company reported profits 
that had more than doubled when compared to

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the same quarter last year. In fact, between 2000 and 2007, 10 of the 
country's top insurance companies increased their profits by an average 
of 428 percent.
  Today, $1 out of every $6 spent in this country goes to pay for 
health care. This is wrong. This flies in the face of every value our 
Nation holds so dear.
  It is time to stand up for the American people and restore the 
American values of competition and choice to the system. It is time to 
hold insurance companies accountable. It is time to create a strong 
public option that will make insurers compete for your business, like 
any other corporation in America.
  There is nothing wrong with making a fair profit. I understand that. 
I have been in business myself. They have to make a profit. But there 
is nothing fair about creating a monopoly and then wringing money from 
the sick Americans who are counting on you in their hour of need.
  That is why we need a strong public option. We cannot have real 
reform without competition and we cannot have competition without a 
public option. A strong public option would be a self-sustaining, would 
provide a low-cost alternative to private companies, and would force 
them to improve their product or risk losing customers. The public 
option would give people a choice for the first time in many years. No 
one would be forced to change their coverage, but if their current 
provider isn't treating them right, they deserve the opportunity to 
choose something better and more affordable.
  The American people deserve the chance to shop around, to compare 
options and pick the plan that is right for themselves and their 
families or small businesses. That is what the public option would mean 
for Americans. That is why I will not settle for anything less. I will 
not compromise. I will not stop fighting. The good hard-working people 
in Illinois and across America demand the real reform that a strong 
public option would provide.
  Now is not the time to back down. Now is the time to act with 
conviction. I urge my colleagues to join me in standing up for choice 
and competition in the health insurance industry. Let us rise to this 
challenge and include a strong public option in the reform bill we send 
to the President.
  Mr. President, I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  The PRESIDING OFFICER (Mr. Udall of New Mexico). The Senator from 
Tennessee.
  Mr. ALEXANDER. 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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