Health Care for America

Floor Speech

HEALTH CARE FOR AMERICA -- (House of Representatives - April 28, 2009)

The SPEAKER pro tempore. Under the Speaker's announced policy of January 6, 2009, the gentleman from Connecticut (Mr. Murphy) is recognized for 60 minutes as the designee of the majority leader.

Mr. MURPHY of Connecticut. Mr. Speaker, I am glad to be back here on the House floor this evening to join you and our colleagues in talking about an issue that is of rising importance to millions of Americans, and that is the issue of guaranteeing a seamless and affordable and quality health care system for the American public.

Mr. Speaker, we are here to talk about health care for America. It's a pretty simple concept, and over a number of years, the desire and the call from the American public has become more and more acute. I'm glad to be here with my good friend from Wisconsin, Representative Kagen, and others who may join us here throughout our hour or a portion thereof to talk about both the need for reform and some of the ideas that are floating around this Chamber to get us there.

I stand here with new evidence from the American public that they are more desirous of change than ever, not a preservation of the status quo, not incremental reform, not a Band-Aid fix to the problem, but real reform.

A recent survey of Americans by the Kaiser Health Foundation showed that over 60 percent of Americans believe it is more important now than ever, than ever, to pass comprehensive health care reform. Those same individuals reported that they are having more problems than ever, more problems than ever, accessing care.

Forty-two percent of Americans in that recent poll said they relied on home remedies or over-the-counter drugs to take care of their illnesses because they couldn't afford the prescription. Thirty-six percent of people reported that they skipped dental care or a visit to the dentist because they couldn't afford it. Thirty-three percent of Americans said they put off or postponed care that they knew they needed because they could not afford it. Twenty-nine percent said they didn't fill a prescription because they couldn't afford it. And 18 percent of Americans, nearly one in five, said that they cut pills in half that they were due to take because they wanted the prescription to last longer.

Mr. Kagen, Mr. Speaker, and my colleagues, this is the most affluent country in the Nation, the most free, the most powerful. What does it say about the conscience of a nation that one in five Americans are sitting at their kitchen table, sitting and standing next to their bathroom sink, cutting prescription drugs in half because they can't afford to pay for the full prescription? And what does it say in this country that forces so many Americans, most of whom are playing by the rules, doing everything we ask? We know that study after study tells us that of the nearly 50 million uninsured in this country, five out of six are a member of a family with a full-time worker. More and more often you're working, you're doing everything you're supposed to, and you can't get insurance or the insurance plan that your employer presents you puts more and more of the burden on paying it onto the employee. We know that for all these people that are playing by the rules, for all these people that don't have health care insurance, they live amidst a health care system that spends more on health care than any other country in the world. We spent $2.2 trillion on health care last year, Mr. Kagen, about an average of $7,400 per person, nearly double what every other country in the First World spends. And what do we get for it? We get a system that leaves almost 50 million without health care insurance, and we get a system that by and large ranks in the middle to lower tier with regard to health care outcomes in the world.

In fact, another new study that just came out suggests that the United States amongst industrial nations ranks last, ranks last, in addressing the issue of preventable mortality; that in preventable deaths, this health care system does worse than every other industrialized nation in the world.

The facts are clear. For too many people out there, health care has become unattainable. For too many that have health care insurance, they're going bankrupt just trying to pay their portion of the bills. And the system overall is bankrupting not just this government but is bankrupting and putting out of business too many businesses, both small and large, throughout this country. Big businesses, small businesses, families, individuals, all asking with voices louder than ever that this year right now this Congress step up and fix this problem. It's the right thing to do. It's the right thing to do from the perspective of conscience. It's the right thing to do from the perspective of health care, and it's the right thing to do from the perspective of economic recovery and revitalization. So we are here tonight to talk about this challenge that's laid before and presented to this government.

Mr. Kagen and I came here in the same class, and we got here amidst probably a record degree of cynicism about what government can accomplish but in particular what Washington can accomplish. Now, it's gotten a little bit better since the election of President Obama, but there are still far too many people out there who look at the depth and the severity of this problem, the health care problem, and doubt whether Congress and this place has the ability to rise to the challenge.

We're here to say that it absolutely does. We are here to say that this is a unique moment in time, coming fresh off of an election with a mandate on health care, with a House full of Members who want reform, with a Senate full of Members who want reform, and with an administration that has made it one of their priorities that we can do it now.

Now, we may all have, as we will probably discuss over the course of the next hour, varying ideas on how we get there. And in the end for every single one of us when we go to press that green or red button on a comprehensive health care reform bill, there is going to be an element of a leap of faith. We are all going to have to cast aside the perfect for the benefit of the good. But it is time that we stopped arguing over the perfect system and started making some real improvements, big improvements, comprehensive, transformational improvements. I think that's where we will get to this year.

And I'm glad to have some of my colleagues on the floor of the House to talk about this tonight, in particular the doctor of the House, Representative STEVE KAGEN.

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Mr. MURPHY of Connecticut. Thank you very much, Mr. Klein. I am glad you are here with us tonight.

I want to turn over the podium to Representative Olver from Massachusetts. One of the statistics that stands out, and I know Mr. Olver is going to talk a little bit about the amount of money we are spending on health care, in 1970 about 7 percent of our gross domestic product was devoted to health care. Since 1970, in 30 to 40 short years we have jumped up to almost 17 percent of our gross domestic product is spent on health care. That number is going to very quickly hit 20, and could get up all the way up to 30 in a very short time if we don't do something about it.

It is always going to be a necessary component of spending, but that kind of growth is just unsustainable

as an economy, something that the Appropriations Committee, of which Mr. Olver is a senior member, will be no doubt grappling with, and I yield to him.

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Mr. MURPHY of Connecticut. I thank the gentleman. And those charts really are instructive to let us know what we're getting for the money that we're spending. I don't think it's the worst thing that we spend a little bit more money on health care in this country than the rest of the world. You know, we have relative affluence here. We have a citizenry that very rightly has high expectations, and so I don't necessarily think anybody has a problem that we spend a little bit more on health care. But two questions are raised. One, how much more money should we be spending than other countries; and what are we getting for that money because, listen, Americans, certainly in my district at least, are value shoppers and they're willing to spend money if they're going to get value for it. And the problem is not enough Americans understand that they're not getting what they should be from those health care dollars.

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Mr. MURPHY of Connecticut. Will the gentleman yield for a point before Mr. Klein jumps in?

You know, that constituent of yours is multiplied, you know, by hundreds in all of our districts. I mean, people throughout this country have a fear of government-run medicine, in part because they hear about anecdotes from some of the countries that Chairman Olver and others talked about in terms of the wait times. And, again, I think there are moments when facts are really necessary. Study after study shows that if you really do an empirical, data-based survey, wait times are, frankly, worse off in the United States than in many, if not most of those other countries.

And with respect to the one country that does tend to have wait times greater than the United States, Canada, most of those, in fact, all of those, are really for nonessential procedures. And I think it's worthwhile to then sort of mirror back to the United States.

In Canada, one of the things that comes up all the time is that if you want a hip replacement surgery you've got to wait about 6 or 8 weeks. And that's true. And that's a long time to wait, and too long. In the United States, you've got to wait about 2 weeks to get that surgery. But you know who pays for that surgery in the United States? Medicare. The government. So our government-run health care system does a pretty good job at eliminating wait times.

And for those of us who believe that ultimately you're going to have to have some increased footprint of a government-sponsored health care option for individuals and businesses, I think we can find solace in the fact that, although Medicare may not be perfect, it actually does pretty well with regard to at least that one indicator, wait times, compared to some of our other neighboring countries.

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Mr. MURPHY of Connecticut. The stories are heart-breaking and, unfortunately, the longer you serve in this place or any other level of government, the more that you hear.

It gets back to that statistic that I started with, which is that some people have an impression that maybe folks that don't have insurance, people that don't have access to health care, well, it's their fault. You know, they are living off the dole, they are freeloaders, free riders. It's not true.

Study after study shows you that 80 percent, or somewhere in that neighborhood, of individuals who don't have insurance are part of a family in which somebody or both parents are working full time. They just happen to work for an employer that doesn't offer insurance or that their insurance is kind of 50 percent insurance. It gets you part of the way there, but not very far. These are the folks that we are really talking about.

And I think that in this moment of great economic crisis--a poll came out the other day that showed that 70 percent of Americans are fearful in the next few months that either they or their spouses will lose their jobs, that more people today are conscious of the fact that they are just one paycheck away from losing all their health care benefits. And should they get sick, as they have watched their parents or their relatives or their coworkers do, that their life could be over as they know it.

As Representative Kagen said, the number one cause of bankruptcy in this Nation is medical bills, individuals who have had an illness, a cancer, an injury, that they could not have foreseen or prevented. And it has fundamentally changed their lives. They have lost their house, their car and their livelihood.

That's who we are really talking about here. Mr. Kagen is right. Representative Kagen said you can't do this one State at a time.

I am wholly supportive of States like Massachusetts. My home State of Connecticut is endeavoring to try to produce a system of universal coverage today. I am very supportive of their efforts to do so. But their efforts should highlight the fact that ultimately this has to be a national solution. Why? Because the only way you ultimately get costs down is to use the leverage of the Federal Government, ultimately, to bring those costs to a reasonable level.

Now, we certainly do have to put the money into the Medicaid and the Medicare system to make sure that we aren't shifting money off to the private sector. But, so many of us are supportive, as Mr. Klein mentioned, of opening up the Medicare system or opening up the Federal employees' health system to more Americans because we see that as a way to try to use the purchasing power of the Federal Government to get costs down.

A poll that I referenced about Americans' support for a major health care reform bill also shows that 77 percent of Americans favor allowing the government to offer a plan that would give them an option to join a publicly sponsored program or to keep their private health care insurance. And, in fact, it pretty much cuts across all parties. We said at the outset this has nothing to do with Republicans and Democrats. Whether or not you have insurance has absolutely nothing to do with the party that you registered with or where you sit on the spectrum of our American belief system. This is a nonideological, nonpartisan problem.

And so although the numbers vary a little bit, the support for a publicly sponsored option for individuals and businesses to buy into, one that would be one of the best and I think most cost competitive options in the marketplace, show that greater than 80 percent of

Democrats favor it, greater than 50 percent of Republicans favor it or just under 50 percent of Republicans favor it. But amongst Republicans, 33 percent say they don't have any opinion, so you almost have a 2 to 1 support versus opposed ratio. So you have folks of all parties and all persuasions supporting major reform.

Just one more point before I turn it back over to you, Mr. Kagen, is your notion of having a level playing field and having transparency is so important, because there are a lot of people in this Chamber that support a single payer Medicare-for-all system, you know, go to a European style system of health care. But this is the United States of America. We have unique needs. We are not Canada, we are not England, we are not France or Germany.

We are going to create our own universal health care system here, informed by the unique needs and desires and expectations of our citizens. And I think most of us agree that that's going to maintain, maybe in not as great a percentage of our system as it is today, but it is going to maintain our private health care insurance system.

And the way to get to a system that is fairer and more equal is to allow for that health care insurance exchange, allow for a marketplace where, as you said, everyone can go and compare prices, can know when they are buying that product that they aren't going to be ruled out just because they have a preexisting condition, an issue that there is no greater leader in the Congress on than Mr. Kagen, know that if they work for a business that they are not going to cause that business to not be able to provide health care insurance simply because they are the one employee of six that has higher health care costs than everyone else, that we are going to have equal coverage, a fairness in benefit levels and a transparency in price that will give, I think, a level of surety to people as they buy that insurance product that they are going to be covered and that they are going to get the best deal.

Right now if you are an American health care consumer, you don't know either. You don't know whether you bought the cheapest product, because there is no one place to go. There is no one aisle in the supermarket where you go and compare prices. You also don't know whether you are going to keep that insurance.

Because even if you got in as the bell rung, there is a thing that happens now called post-claims underwriting where even after you get sick, a lot of insurance companies will try to kick you off your health care, claiming that you should have known that you were going to get sick when you signed up in the first place. So I am very excited about this idea of the health care insurance exchange and glad, Mr. Kagen, that you have been leading on it.

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Mr. MURPHY of Connecticut. Let's think about that soldier that comes back from serving his country overseas and goes and gets a job that pays a decent wage but works for a struggling company that just can't afford to continue to employ people and give them health care benefits.

And so he, returning from serving his country abroad, putting his life on the line, comes back and gets a decent, hardworking, fair-paying job and has no health care benefits. And then he looks to this House. He looks to the people that he sent to Congress who sit here in this nice air-conditioned Chamber with pretty decent health care.

And he wonders to himself, I fought for this country, I came back and got a job, did everything that I was supposed to. And the people that I send to Washington, D.C. get a pretty good health care plan, and what am I left with.

I think that whatever we do, whatever Federal regulatory scheme that we come up with for health care insurance, it should at least guarantee that everybody out there gets to have health care like we do. That if you are going to elect men and women to go to Congress who are going to enjoy the benefits of the Federal employee health care plan, that every American out there should have access to that, certainly those that come back from duty overseas and are playing by all the rules we ask them to when they return.

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Mr. MURPHY of Connecticut. Thank you, Mr. Kagen.

We have sort of run the gamut this evening of the problems that underlie the existing system--the lack of transparency in insurance markets, the discriminatory practices of insurance companies, the lack of cohesion in prices when you walk into a pharmacy or into a hospital, the amount of money that it puts on top of businesses that are already struggling to compete in this world.

When you talk about health care, it may be the most complex topic that we ever talk about here. It seems insurmountable sometimes. It seems like there's too much to try to take on at one moment, but there are simple solutions here, as you said: Pay for performance instead of pay for volume. Pay for prevention rather than crisis care. Give people options that they can see and understand.

I think that there are some solutions here that can cross party lines, as you said, Mr. Kagen. I think that we can achieve a real victory in health care for America, in health care for America this year, this session, that guarantees that for citizens of the most affluent and the most powerful country in the world. Just because you can't afford to see a doctor doesn't mean you're not going to get sick. I hope we get the chance to do this more often and to bring our colleagues to the realization that the time for reform is now.

I yield back the balance of our time, Mr. Speaker.

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