[Congressional Record (Bound Edition), Volume 155 (2009), Part 9]
[Senate]
[Pages 11893-11894]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. NELSON of Nebraska. Madam President, 19 years ago, after narrowly 
winning my first statewide race for Governor in Nebraska, I was 
concerned about the significant budget challenges and economic downturn 
we faced. Today, the United States is confronted by financial troubles 
on a much larger scale.
  Among them, we are suffering from the compounding economic impact of 
years of steadily rising health care

[[Page 11894]]

costs and millions of uninsured Americans. This crisis is strangling 
businesses and throwing sand in the gears of our economic engine, but 
the most troubling impact is on families.
  From 2001 to 2007, premiums for family insurance coverage surged 78 
percent while income increased just 19 percent. Wages are lagging 
behind not only premiums but also out-of-pocket costs which families 
must pay for health care services.
  In my view, meaningful health care reforms are within reach and 
should be achieved in a bipartisan fashion without stifling minority 
views or using reconciliation.
  Although there are signs of progress in the reform debate, some seem 
ready to stir partisan tensions. We should play down the divisions 
which ideologies present and focus instead on areas of consensus.
  What could this middle ground look like?
  I believe that two of the highest priorities should be reducing the 
cost of health care and improving efficiency in our delivery system.
  Despite state-of-the-art treatment, some studies still show that 
Americans receive appropriate care just 55 percent of the time.
  The American Recovery and Reinvestment Act Congress approved this 
year made a downpayment addressing health information technology and 
comparative effectiveness research. As a result, doctors and patients 
will receive access to improved health records and better evidence 
about which medical treatments may best serve a patient's needs.
  Senator Baucus and the Finance Committee have laid out a series of 
additional delivery system reforms which I applaud them for. These 
cost-containment measures are the first order of business and a 
mission-critical component of reform which will immediately pay 
dividends on affordability and access.
  In an additional sign of progress in covering the uninsured, 
America's health insurers have agreed to guarantee health care coverage 
to all Americans and transition away from charging higher premiums to 
those who are most ill, if Congress agrees to support a requirement to 
obtain coverage.
  While I have an aversion to mandates, I recognize that we all have a 
responsibility to obtain health care coverage because we all pay higher 
premiums when providers are forced to write off expensive, 
uncompensated care.
  We often focus on the 45 million or more Americans who are uninsured, 
a crucial problem to be sure. However, we also must make sure we are 
not destabilizing care for the 200 million Americans who have private 
health insurance.
  Some have called for establishing a public plan, but I think it would 
undermine health care services for millions of Americans and squander 
this unique opportunity for substantial reform.
  Here are some of my concerns about a public plan run by the 
Government:
  Washington runs our Medicare system which is already on its way to 
insolvency.
  Our delivery system could collapse if it had to rely more heavily on 
Medicare-like reimbursement rates. Today, one-third of physicians limit 
the number of new Medicare patients they see.
  A Government-run plan would further limit payments to doctors, 
nurses, health care workers and hospitals, and they would over time 
refuse patients covered by this system.
  That would worsen the current cost shift to private payers, which can 
run in the neighborhood of 30 to 40 percent.
  The result? Patients would lose access to health care, services would 
decline for millions and competition would disappear.
  In my State of Nebraska, uncompensated care and the cost-shift from 
low Government reimbursements account for 15 percent of the average 
health insurance premium.
  In sum, a one-size-fits-all Washington-run health care plan expands 
Government but will not fix the main problems people face every day: 
affordability, access and high quality care.
  Several years ago, we debated whether private competition could 
deliver affordable choices to cover seniors' prescription drugs. I was 
not convinced there would be enough competition.
  Well, the jury is in. The verdict? A recent independent poll showed 
that 87 percent of Medicare beneficiaries are satisfied with their 
prescription drug coverage. And, vigorous competition among drug plans 
will save taxpayers $243 billion over 10 years.
  I believe private competition can work. I would suggest we empower 
consumers and demand that private insurers compete on service to 
restore a true marketplace for insurance. We need to make it easier for 
Americans to compare health plans and the co-pays, networks, provider 
quality measures and access to medical records the plans offer.
  In fact, President Obama has said Americans deserve the same health 
insurance that their members of Congress receive. Well, Federal 
employees and Members of Congress choose between a wide array of 
coverage options offered by private health insurers, selecting the plan 
that best fits their needs.
  Ultimately, I want consumers, not Washington, to be in charge of 
their health care and to give them the ability to demand more from 
insurers through the marketplace.
  In the coming weeks, America will see a debate that tests our ability 
to confront this enormous challenge yet still preserve bipartisanship 
and reason. We can meet in the center on a reform plan making major 
improvements in our health care system that puts us firmly on the path 
toward cost containment, universal coverage and, ultimately, fairness 
for all Americans.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from New Hampshire.
  Mr. GREGG. Madam President, I understand now is the time for the 
majority. If somebody appears, I will be happy to yield the floor. I 
ask unanimous consent to proceed in morning business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. GREGG. I congratulate Senator Nelson for his excellent statement. 
His statement was very appropriate and on point on the issue of health 
care and health reform and the need for a bipartisan effort in this 
Chamber. He is one of the leaders in the ability to bring people 
together, and I congratulate him for a strong and thoughtful statement.

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