Omnibus Appropriations Act, 2009

Floor Speech

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Mr. WYDEN. Madam President, I thank the distinguished chairman of the committee for the chance to speak at this time. I am going to talk a bit about the cause of health care reform, and I know the chairman has been a leader in this area lo these many years.

For some time, the planets have started to align for the cause of health reform, and today the President put in place some stars in Kathleen Sebelius and Nancy-Ann DeParle for key assignments in this health reform effort. Both of them bring extraordinary qualifications to their positions.

Kathleen Sebelius is a renowned expert on the cause of insurance reform. This is going to be especially important because the insurance model today is fundamentally flawed. It is all about cherry-picking--taking healthy people and sending sick people over to government programs more fragile than they are. Under Kathleen Sebelius, I am of the view we will reinvent that insurance system. Private insurers will compete on the basis of price, benefit, and quality.

I believe we will have bipartisan support for that effort. The President has talked about it. Chairman Baucus has it in his white paper. Chairman Kennedy has long advocated this very different model of private insurance. I am pleased to say in our bipartisan Healthy Americans Act, which Senator Bennett and I have sponsored, we include it as well. With Kathleen Sebelius and her expertise in the insurance field, we will be in a position to get it done and get it done with bipartisan support.

Nancy-Ann DeParle brings the same qualifications to the task of fixing health care. She is an expert in health care numbers. She was involved what was then the Health Care Finance Administration. But what I like the most about Nancy-Ann DeParle is that she has always understood that enduring solutions to big questions--such as fixing health care--are going to require that we bring together bipartisan support for those efforts.

To his credit, the President has emphasized how important it is to have bipartisan support for this challenge. I believe at this point Democrats and Republicans can come together and end the gridlock over health care reform. I think we are now seeing emerge a bipartisan consensus that each party has been right on fundamentals with respect to health care.

Democrats have been right about the proposition that you cannot fix the system without covering everybody. If you don't cover everybody, the people who are uninsured shift their bills to the insured, and they shift the most expensive bills. So my view is my party has been right on the question of coverage, and it is time to get all Americans good quality, affordable health care.

I also believe Republicans have contributed significantly because we do need a strong private sector, one that encourages innovation, one that steers clear of price controls and a one-size-fits-all Federal solution. So I think there is opportunity now for private sector choices as well as expanding coverage. Again, President Obama has included that kind of thinking, Chairman Baucus has, Chairman Kennedy has, and we have it in the Healthy Americans Act as well.

Some are saying--and we have heard this repeatedly in recent weeks--that our country, with our fragile economy, can't afford health care reform. I am of the view that our economy can't afford the status quo. If you think about what is going on in North Carolina, the reason people's take-home pay doesn't go up is because it is all going to health care. The fact is that fixing the economy and fixing health care are two sides of the same coin. The Obama administration--particularly Peter Orszag, the Budget Director--has long recognized this.

The President was right to say that after 60 years of talking about health care, he didn't want to wait until year 61 to get something done; he wanted to do it this year. Today, by appointing Kathleen Sebelius and Nancy-Ann DeParle, he got these efforts off to a very strong start.

This Thursday we will have a health care summit. Proponents, opponents, and those of differing views will be around the table. Again, the President has made the right call by inviting some who haven't been advocates for health care reform in the past. But I think we are seeing a dramatic departure from a lot of the positions of the past, and that is what is going to make Thursday's session very exciting and I believe very productive.

For example, in 1993 and 1994, when our country debated health care reform under the Clinton plan, the business community said, We can't afford to fix health care. Now the business community--businesses small and large and of all philosophies--are saying, We can't afford the status quo. Chairman Baucus and Chairman Kennedy and their ranking minority members, Chuck Grassley and Mike Enzi, have a long record of being able to work in a bipartisan fashion to build on those new sentiments coming from the business community.

I believe Senator Bennett and I, with the 13 Senators who are part of the Healthy Americans Act coalition, can bring to the President, can bring to our chairs and ranking minority members, some ideas that can pick up bipartisan support. They know we are anxious to work with them and to work with them quickly. To stick to the President's timetable is going to require that kind of bipartisan goodwill, and I believe it is now there.

I believe that the health care challenge in this country, with exploding costs and demographics that are relentless, requires a lot of the old thinking be set aside. I believe it is doable. In the course of the last 2 years, I have had a chance to visit more than 80 of our colleagues in their offices, to listen to them, to get their thoughts on what needs to be done in health care, and to a person, I found a desire to act and to act now.

I think, as the President knows, you can't have a town meeting--whether it is North Carolina or Oregon, or anywhere else in this country--without health care dominating the discussion. So this Thursday provides an opportunity to bring people together. We will have the nominations of Kathleen Sebelius and Nancy-Ann DeParle going forward. I am certain they are going to be approved with very substantial bipartisan support, and then we will be down to the task of writing legislation.

On the key issues there is agreement among reformers. Clearly, you have to cover everybody to stop cost shifting. You have to change the insurance model so that instead of spending time scouring out the bad risks and taking only healthy people, there is a different model of private insurance where plans compete on the basis of price, benefit and quality. We are going to come together and make sure we are purchasing value for our health care dollar.

Dr. Orszag has pointed out on many occasions that something like 30 percent of the health care dollar goes for services of little or no value. That is these services don't help patients get healthier. Chairman Baucus and Chairman Kennedy have some good ideas for changing that as well.

I think, finally, there will be a very sharp new focus on prevention and wellness. When Senator Bennett and I were talking about the Healthy Americans Act, we thought there were a number of key areas we felt strongly about. But what we felt most strongly about was getting a new emphasis on prevention and wellness. That is why we called it the Healthy Americans Act--because to a great extent, Madam President, we don't have health care at all in this country. We have sick care.

Medicare Part A, the biggest health care program in our country, will pay thousands of dollars for senior citizens' hospital bills, and Medicare Part B, on the other hand, will not do anything to award prevention and to keep people healthy. So in the Healthy Americans Act we say seniors who make efforts to lower their blood pressure or lower their cholesterol will get lower Part B premiums.

The fact is, the entire health system does little to encourage prevention. For example, with the typical workers changing their jobs every few years--right now the workers, by the time they are 40, change their jobs 11 times--there is not a great incentive for private insurers to invest in prevention. So what the President seeks to do--and Chairman Baucus, Chairman Kennedy, Senator Bennett, myself, distinguished chairman of the Appropriations Committee who is part of our legislation--we are saying let's make health coverage portable so you can take it from place to place as you change your job, and in the future private insurance companies will have an incentive to invest in wellness and prevention and good health care because people will be staying with them. In today's system, when workers jump from one job to another every year or year and a half there is no incentive for the insurance company to invest in your health.

Madam President, I said the planet was aligning for the cause of health reform. With the appointment of two true stars, Kathleen Sebelius and Nancy-Ann DeParle, the President took another significant step toward achieving our goal today. I believe, after 60 years of bickering about this subject--it literally goes back to the 81st Congress with Harry Truman--there is new momentum for an enduring fix for the challenges of American health care. To make an enduring solution to those challenges requires that Democrats and Republicans come together. I think that is going to be possible with both parties having the ability to secure major objectives they have worked for in the past.

With Thursday's summit coming up, I think the American people will see that now the hard work is going to go forward. This time, after years and years of polarizing debates, there is going to be an opportunity to come together. I believe the Congress, with the leadership of President Obama, is going to take that opportunity.

I yield the floor.

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