[Congressional Record (Bound Edition), Volume 157 (2011), Part 1]
[House]
[Pages 371-372]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 IN SUPPORT OF THE AFFORDABLE CARE ACT

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Oregon (Mr. Blumenauer) is recognized for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, we are having debates about health care 
because Americans are nervous about changing something so important to 
their families, and that, of course, makes politicians nervous about 
reform.
  This skepticism is understandable. Attempting to adjust policies and 
programs that comprise now 17 percent of our economy, the biggest 
driver of the Federal deficit that literally touches every American 
family, poses daunting challenges. Yet, as people begin the analysis, 
the appropriate comparison is not some idealized, magical state but the 
comparison to the path we are on, which everybody agrees is 
unsustainable.
  Medical costs, left unchecked, will literally bankrupt the country. 
The Department of Defense will spend more on health care this year than 
China uses to run its entire military operation for 7 months. Every 
objective, independent expert acknowledges and laments the fact that 
the United States is the world's health care underachiever. We pay more 
for health care than our major allies and competitors in Europe, Japan, 
and Canada, but our people get sick more often; they die sooner, and 
unlike any other country, people are bankrupted by medical costs--about 
2,000 people per day. All the while, we have a record number of 
uninsured Americans--now over 50 million.

[[Page 372]]

  Sadly, we are getting exactly what we paid for: more procedures, 
multiple providers, an emphasis on specialty care rather than someone 
who can help us with our own efforts to negotiate this complex, 
fragmented health care system. America actually spends more 
administering our health insurance system and finding ways to deny care 
than any other country in the world spends on providing care.
  Starting from scratch, we could give better care for less money, but 
we are not starting from scratch. We are starting with an economic and 
structural behemoth, encompassing, as I said, 17 percent of the 
economy. It is the largest employer in most communities, and it has 
evolved over two-thirds of a century of public and private investment 
and government legislation. Today, our hybrid system is largely 
administered through hundreds of agencies, programs, and large 
providers, with the Federal Government paying half the bill directly.
  The good news is that we have proven that we can get better results 
for less than we are spending, and the health care reform legislation 
provides this framework. First, we don't need more money. In fact, if 
we implement the existing legislation, it can be a source of savings in 
the future.
  The good news is we don't have to deal with unproven techniques or 
technologies. We know what to do. We don't even have to look at foreign 
models that are more successful than ours. We can look right here in 
the United States. My community of Portland, Oregon, delivers better 
health care for Medicare, for instance, to its recipients than other 
communities where costs are twice as high. It's not just Portland. This 
can be found in areas in the West and the upper Midwest. There are also 
innovative health care practices in the Mayo Clinic, the Cleveland 
Clinic, and Gunderson Lutheran.
  The government, itself, has proven how to be more efficient. The 
Veterans Administration has a practice model for older citizens with 
complex health problems that face our veterans. The VA has automated 
its medical records system. It pays its doctors for performance, not 
procedures, and they figured out a way to get better prescription drug 
costs for millions of our veterans.
  Many of the techniques for reducing the number of unnecessary 
hospital admissions, for bundling services, for having accountable care 
organizations are known and actually supported by my Republican 
friends. They've been embraced by Republican Governors.
  This is not foreign territory. We know it can work. The path forward 
is clear. It is important not to lose 2 important years in reforming 
our medical system, giving better health care, and starting to reduce 
these massive future deficits.
  After having identified weak spots in the implementation, let's work 
to hold people accountable. Don't attack the CBO for scoring the bill 
as written, which is their job. Attack efforts to undermine the cost-
saving elements of the bill. If States can more creatively provide 
health care envisioned in the exchanges, let them do it. Give them the 
waivers, and encourage them to experiment as long as they meet minimum 
national standards.
  Absolutely allow people to purchase insurance across State lines to 
improve competition and choice, but only after everybody agrees to 
provide insurance according to the same quality standards of 
accountability. That prevents gaps in coverage. We don't want massive 
marketing budgets while denying the money for essential treatment. We 
need not to have long protracted battles over if we understand and 
agree upon the terms.
  We've reached a critical point where we cannot continue on the path 
that we've been headed. We do have reform legislation that encourages 
much of what has bipartisan support. We are spending more money than we 
need to and there are huge opportunities to improve the quality of 
service. I would hope that this exercise would be the last of the 
political ritual on health care. Instead let's turn to working with the 
Administration to figure out how to achieve the objectives, so critical 
for our citizens.

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