Health Care

HEALTH CARE -- (Senate - September 07, 2007)

Mr. WYDEN. Mr. President, Senator Bennett of Utah and I have brought to the Senate the first bipartisan universal health care coverage legislation in more than 13 years. I thought today I would open my remarks on health care in something of a light fashion. There is a brand new study that has recently found Americans are no longer the tallest people in the world. Over the past 50 or so years, the U.S. population has lost that status and now ranks among the shortest among industrialized countries. The Netherlands now holds the honor for the tallest nation. The authors of this new study speculate this change may stem from the fact that most other affluent countries have health care systems that cover their entire population and that particularly healthy lifestyles and healthy diets are also significant factors.

Senator Bennett is 6 foot 6. I am 6 foot 4. We would like our country to get its rightful position back as the leader among nations in the height department. We think part of what is going to be necessary to do that, in all seriousness, to make our health policies more health focused rather than just spending on health care, is to adopt some fresh policies. We have been particularly interested this week because the Wall Street Journal, which colleagues know displays a preference for private health care sector solutions, has written a fascinating front page article this week on the special accomplishments in Holland with respect to health care. I have long been of the view that as we look finally to accomplishing what this country has not been able to do for 70 years, which is to get all Americans good quality, affordable health care, we are going to have to devise our own system. It is not going to be possible to import some other country's system of health care to our Nation and pretty much plop it down on the United States and say: This is the way to go.

But as the Wall Street Journal said in their article this week, there are some important lessons to learn as it relates to the experience of other countries.

I ask unanimous consent to print in the Record this front page article from the Wall Street Journal with respect to health care.

There being no objection, the material was ordered to be printed in the Record, as follows:

BREAK IN TRANSCRIPT

Mr. WYDEN. I am going to read one paragraph at the outset of the article:

Since a new system took effect here last year, cost growth is projected to fall this year to about 3 [percent] after inflation from 4.5 [percent] in 2006. Waiting lists are shrinking, and private health insurers are coming up with innovative ways to care for the sick.

What struck Senator Bennett and I is, there is an awful lot of comparison between our bipartisan legislation and the experience of the Dutch. For example, both in Holland and in the United States under our proposal, there would be a requirement that individuals would have to purchase their own health insurance. Insurers under our proposal, as in Holland, would not be able to discriminate against individuals who have had illnesses. We saw in the movie ``Sicko'' that wonderful scene with the ``Star Wars'' music describing all the various conditions that individuals might have that would exclude them from insurance coverage. That would be illegal under what Senator Bennett and I are advocating. It is illegal, according to the Wall Street Journal, in the Netherlands.

Finally, in the Netherlands and under our legislation, there is a sharp and specific focus on prevention and wellness. The tragedy in our country is, we don't have health care at all. What we largely have is sick care. Medicare shows this probably more clearly than anything else. Medicare Part A will pay huge expenses for senior citizens' hospital bills. The check goes from the Government to the hospital. But Medicare Part B, on the other hand, will pay for virtually nothing for prevention and keeping people well. Senator Bennett and I seek to change that. For the first time under our legislation, Medicare would be authorized to discount the premiums for seniors who lower their blood pressure, lower their cholesterol, practice good health in their individual lives. I am struck by this Wall Street Journal article, where insurers in Holland are adopting much the same kind of approach. The article states on the front page that insurers now are offering discounts to customers who buy low cholesterol versions of yogurt, butter, and milk.

The point is, worldwide the message is getting out. Prevention works. Wellness, a new focus on personal responsibility, and keeping our citizens healthy makes sense. They are doing it in Holland. The Wall Street Journal describes the positive benefits there. I and Senator Bennett, along with our cosponsors, Senators BILL NELSON, LAMAR ALEXANDER, and JUDD GREGG, are trying to build a bipartisan coalition in the Senate to do exactly the same.

Our legislation, the Healthy Americans Act, would require that everyone not on Medicare or in the military would have to purchase private health insurance. But to make sure that is doable, we fix the broken marketplace. Under our legislation, private insurance companies wouldn't be able to cherry-pick. They wouldn't be able to take just healthy people and send sick people over to Government programs more fragile than they are. They couldn't discriminate against those with illnesses. They would have to spread risks through large groups of people. Right now essentially much of the private insurance business is about filtering out those people who have illnesses and finding a way to cover just those who are healthy. Our legislation would change that.

We also take critical steps to make sure that if you are going to require that people purchase coverage, you have generous subsidies for folks with modest incomes. What Senator Bennett and I propose--and apparently they are doing something along these lines in Holland--is to subsidize those up to 100 percent of poverty completely and for those between 100 percent of poverty and 400 percent of poverty, there would be a partial subsidy. The most generous subsidies of any program anywhere in our country would be offered under this legislation that we are offering, with Senators ALEXANDER, GREGG, and NELSON of Florida.

How do we pay for it? The Lewin Group, which is kind of the gold standard for looking at health policies, scored the administration's approaches, many of the States and ours and said we can find a lot of the savings under our legislation through an administrative process that establishes that once you sign up in Ohio, once you sign up in Oregon or anywhere else in the country, you are in for life. You don't have to sign up again and again and again. In my State, my guess is it is very similar to the situation in Ohio, if you are on Medicaid, there is something like 31 or 32 categories of coverage. A poor person has to try to squeeze themselves into one of those boxes in order to get coverage. It is degrading to the poor and a big waste of money.

What Senator Bennett and I have offered is a one-stop process so you sign up once, and everything else from that point on is essentially accomplished through the magical world of electronic transfers. An individual's contribution would be taken out of their paycheck while they are working. Ours is fully funded.

There is an opportunity for bipartisan cooperation, particularly should the Bush administration want to assist in this effort. For example, every single economist who has come before the Finance Committee, before the Budget Committee, has talked about the Tax Code as it relates to health care disproportionately favoring the most affluent and rewarding inefficiency at the same time. To put it another way, if you are a high-flying CEO in the United States, if you want to go out and get a designer smile put on your face, you can write off the cost of that service on your taxes. But if you are a hard-working woman without any health plan and a local furniture store, you get nothing. So I and Senator Bennett redirect the current tax expenditures. They are the biggest part of private health care spending.

The Lewin Group establishes in their analysis of our report that would ensure we could expand coverage over the next few years without any additional cost to taxpayers. The Lewin Group has said the proposal now being sponsored by five Members of the Senate would slow the rate of growth in health care spending by $1.5 trillion.

I know the distinguished Presiding Officer has a great interest in health. We are so pleased he is here because we have worked together on these issues often. It is clear this is the premier domestic issue of our time. A combination of today's demographics with a rapidly aging population, escalating costs, the huge increase in chronic illness, our current health care system is not sustainable. It is not one we can put on automatic pilot and say: Let us run it this way for years and years in the future.

The tragedy is with all the wonderful doctors and hospitals and nurses in Ohio and Oregon, all across the country, we are spending enough money on health care to do this job. We are simply not spending it in the right places.

To give an idea of how out of whack American health care spending is, for the amount of money we are spending today, $2.3 trillion, 300 million of us in the country, you divide 300 million into $2.3 trillion, and you could go out and hire a doctor for every seven families in the United States and say: Doctor, your job will be for this year to take care of seven families, and we will pay you $200,000 a year.

My experience, I say to the Acting President pro tempore, is that when I bring this up to physicians at home in Oregon, they say: Ron, where do I go to get my seven families? It sounds pretty good to be able to get back into the business of practicing medicine again and advocating for my patients rather than going through all this paperwork and bureaucracy and redtape.

So we are spending enough on health care today. We are not spending it in the right places. That is what they have begun to change in Holland, according to the Wall Street Journal this week. That is what I and Senator Bennett and our colleagues on both sides of the aisle are seeking to do in the Senate.

One last comment, Mr. President. I know there is a hectic schedule for all Senators, and certainly the Senator from Ohio.

The question is whether there should be action now or the Congress should simply wait for another Presidential election. Here are the consequences of waiting for several more years. The Census Bureau reported last week that 2.2 million additional Americans were without health insurance between 2005 and 2006. If this Congress waits a couple of years more, we can expect that number to increase and the number without coverage in this country to hemorrhage further.

That is a moral abomination, No. 1; and it is going to be costly to taxpayers, No. 2, because those people very often will have to go to hospital emergency rooms to get their coverage. Of course, those bills will be passed on to businesses in Ohio and Oregon and across the country and to our taxpayers. So the costs of delay are very direct and immediate.

Second, with respect to employer-based coverage, the new numbers indicate the number of employers offering coverage has now fallen below 60 percent. It is pretty easy to see why, with these double-digit premium hikes, Price Waterhouse says health costs are going to average, this year, a little over 11 percent. A lot of our employers want to do the right thing by their workers and simply cannot offer coverage.

If this Congress decides to stand down on the question of overhauling health care and say, ``Let's just wait until 2009,'' you are going to see more businesses in Ohio, in Oregon, and across this country lose coverage. I do not think we ought to sit by and just let our coverage continue to melt away along the lines of these statistics that I mentioned.

Finally, on the question of prevention and what Holland is doing, and what we are seeking to do in the Healthy Americans Act, there is a very significant cost with respect to chronic illness as it relates to doing nothing to change our policies. The new numbers with respect to chronic illness indicate that in 31 States over the last year obesity has risen once again; of course, there is a direct link here between heart and stroke and diabetes and so many illnesses. Not one State--not one--experienced a decline.

So if the Congress says: Well, we will pass on overhauling American health care until 2009, we can expect to have missed another opportunity--yet another opportunity--for doing something about enacting health care policies that put a new focus on prevention and wellness.

So this question of waiting for 2 more years and saying: Let's just spend our time looking at what the various candidates for President from both political parties are saying about health care--certainly it is getting a lot of attention in terms of debates on TV and all of us trying to look at the various merits of the candidates' proposals; and they are good people; and they have good suggestions--but I want to make it clear to the Senate there are very real costs of waiting to fix health care.

I think the question of fixing health care is so urgent we ought to get on with it, and we ought to get on with it in a bipartisan way, which is what I and Senator Bennett are trying to do. We are very proud to have been able to get the support of business and labor leaders.

When we offered the initial proposal, Andy Stern, the president of the Service Employees International Union, stood on one side of me, and Steve Burd, the CEO of the Safeway company, a very large Fortune 500 company, stood on the other side. We had individuals such as Ron Pollack, of Families USA, and advocates for compassionate end-of-life health care with us as well.

The last time Congress looked at this--and the Acting President pro tempore, I think, remembers this--during a period in the early 1990s, the people who stood with me for the kickoff of the Healthy Americans Act were spending millions to pretty much beat each other's brains out. That was the last time the Congress and the President, during the Clinton years, debated health care.

So this is a different climate, certainly a different climate for businesses in Ohio and Oregon. What I hear from businesses at home--unlike in 1993, the Clinton years, when they said: We cannot afford fixing health care--they are now saying: We cannot afford the status quo. That is why they are joining Senator Bennett and I and others on these proposals.

My hope is as Congress looks at the evidence, whether it is the Wall Street Journal reporting on promising developments--very often people think of Europe and socialized countries--the Wall Street Journal is putting on the front page of the paper--a publication that clearly favors private health care coverage--an example of a country in Europe where they seem to be making great progress.

So as we devise our own system, one that is uniquely American, I and Senator Bennett want to work with every Member of the Senate--I think I can speak for Senators Bill Nelson, Lamar Alexander, Judd Gregg, and the others we have been talking to--that we think this is the premier domestic issue of our time. Certainly, the conflict in Iraq is the premier national security issue. But the premier domestic issue at home is fixing American health care.

I think based on the evidence that comes in every day, we know what needs to be done. Now the question is making sure there is the political will to go forward. I look forward to working with the Acting President pro tempore, who has a great interest in these matters, and all our colleagues.

Mr. President, I yield the floor.

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