Health Care Reform

Floor Speech

HEALTH CARE REFORM -- (House of Representatives - May 12, 2009)

The SPEAKER pro tempore (Mr. Maffei). Under a previous order of the House, the gentleman from Connecticut (Mr. Murphy) is recognized for 5 minutes.

Mr. MURPHY of Connecticut. Mr. Speaker, those of us who came to Washington to pass comprehensive and revolutionary, potentially transformational health care reform are emboldened by the realization that we now, for the first time in almost a decade, have a President and an administration who are as committed as any advocate in this country to the premise that this country must reform its health care system. We are reminded almost weekly of President Obama's commitment to health care reform that happens this year.

This week we saw the President bring together varying and diverse groups that over the course of the history of health care have normally been at each other's throats, coming together to say that the first premise of health care reform has to be lowering of cost in the system. The health insurance community, the hospital association, the medical association, PhRMA and SCIU, one of the Nation's biggest unions, all coming together and saying, listen, let's take cost out of this system. And it is the right way to first approach health care reform. We can talk all we want about coverage, but if we don't start to dramatically slow the growth of health care at a pace now that stands at 7 or 8 percent a year, if we don't bring it down to something that more resembles the general inflationary rate in this country, there will be no room, never mind to expand coverage, there will be no room to just cover the people with health care now. We have gone over the numbers over and over again: $7,400 per person that we spend on health care in this country, $2.2 trillion across the spectrum of our health care system. Twice as much of our GDP is spent on health care as we spent in 1970, and twice as much of our GDP is spent on health care than many other similarly situated industrialized nations.

Health insurance premiums over the last 10 years have gone up 119 percent, while earnings have risen only 34 percent. We know there are savings because we look out across the country and we see dramatically diverse experiences with regard to cost.

In my home market of Hartford, Connecticut, we are spending on average about $8,000 a person to treat a Medicare patient. Well, you go down the eastern seaboard to Miami, and they are spending twice that amount, $16,000 to treat a similar Medicare patient.

Now, I am sure we can come up with a list of reasons why that care is going to be marginally more expensive give the client base and the provider costs, but not twice as expensive.

As we saw in some recent work at Dartmouth University, there is no correlation between what you spend and the quality you get. In fact, it tends to be the reverse: the better you are at coordinating care and keeping costs down, the healthier your patients are. So there is an enormous amount of savings that we can achieve just by better coordinating care and learning from the areas of the country and the health care communities that have figured out that you can reduce costs and preserve quality.

But ultimately, Mr. Speaker, I don't think we can really take a whack at costs until we understand the important role that a public insurance model can play in our health reform system. I want to talk about this for 1 minute.

We have looked at comparative models, for instance on the purchase of prescription drugs via a government program like the veterans health care system and private models likes the Medicare prescription drug benefit programs, and we see example after example on how the ability of the United States Government or entities acting on its behalf can bring down the cost of health care. We have seen examples of how a government-sponsored health care initiative that has no interest in returning value to shareholders, that has no interest in paying its CEOs massive salaries, that does not have a profit motivation can get more humane and less expensive care to its recipients. That is the theory behind those that want a government-run single payer system, and I think we all acknowledge we are not going to get there.

But we are not going to achieve the savings that we hope to achieve unless we can have a robust, completely competitive market where individuals and businesses that are purchasing insurance get to choose not only between private insurance companies that might offer them the best deal, but also from a public option as well.

This is fundamentally about creating real market-based choice for consumers. If we have a diverse array of private insurance products and a public option, that more than anything we do with regard to changing reimbursement from volume to outcomes, can bring down the cost of health care.

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