Health Care Reform
Floor Speech
Mr. SANDERS. Mr. President, I think the American people are aware that our country is in the midst of a major health care crisis. That is not a secret to anybody. Forty-six million Americans have no health insurance and, importantly, even more are underinsured, with high deductibles and copayments. Further, some 60 million Americans, including many with health insurance, do not have access to a medical home of their own. In fact, according to the Institute of Medicine, some 18,000 Americans die each year from preventable diseases because they lack health insurance and do not get to a doctor when they should.
I can recall very vividly talking to several physicians in Vermont who told me how people walked into their office, quite sick, and when they asked why they hadn't come in earlier, they said: Well, we don't have a lot of money; we didn't have any health insurance. The result is that those patients died. That happens every single day in this great country.
When we talk about health care, we have to understand that access to dental care is even worse. On top of that, in our Nation, we pay the highest prices in the world for prescription drugs. My State of Vermont borders on Canada, and it is not uncommon for people to go from Vermont to Canada to buy the prescription drugs they need at far lower cost than in America.
In the midst of all of this--the 46 million Americans without health insurance, people being underinsured, and people paying outrageously high prices for prescription drugs--at the end of the day, our Nation pays far more for health care per person than any other country on Earth. Far more. It is not even close. Yet despite the enormous sum of money we spend, our health care outcomes--what we get for what we spend--lag behind many other countries in terms of life expectancy--how long our people live, in terms of infant mortality, and other health indices.
According to a recent report from the National Center for Health Statistics--this is just one example--the United States ranks 29th in infant mortality in the world--29th in the world. We are tied with Poland and Slovakia for 29th in the world in terms of infant mortality. In all due respect to our friends in Poland and Slovakia, we should be doing a lot better than that because we spend a lot more on health care than they do in Poland and Slovakia.
Further, according to a study published in the London School of Hygiene and Tropical Medicine, the United States has the highest rate of preventable deaths among 19 industrialized nations. Although our rate has declined over the past 5 years, it is doing so at a slower rate than other countries. According to that study, if the rate of preventable deaths in the United States improved to the average of the top three countries, which are France, Japan, and Australia, approximately 100,000 fewer residents of the United States would die annually.
When we talk about health care, we are not just talking about individuals who suffer and die because they do not have health care. What we are talking about is that the high cost of health care--as President Obama makes clear all of the time--is a major economic issue as well. In our country today, we are now spending about 16 percent of our GNP on health care, and the cost of health care is continuing to rise at a very high rate, which becomes economically unsustainable. The fact is, General Motors, which recently declared bankruptcy, spends more money on health care per automobile than they do on steel, and that creates an economic climate in which America--our companies--becomes noncompetitive with other countries around the world. But it is not just large corporations such as GM. Small business owners in Vermont and throughout this country are finding it harder and harder not only to provide health care for their workers but even for themselves.
In addition, a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007 and that between 2001 and 2007, the proportion of all bankruptcies attributable to medical problems rose by nearly 50 percent. Interestingly, 78 percent of those who experienced bankruptcy as a result of illness were insured. They were insured. These are not people who did not have any health insurance. But it speaks to the inadequacy and the lack of coverage, comprehensive coverage, in many health insurance programs.
We as a Congress, for whatever reason--and I will suggest the reason in a moment--do not really spend a lot of time discussing why the American health care system is so expensive, why it is so inefficient, why it is so complicated. We do not talk about that very much. I fear that has a lot to do with the role private health insurance plays over the political process in this country. Let me be very clear. In my view, the evidence is overwhelming that the function of a private health insurance company is not to provide health care. The function of a private health insurance company is to make as much money as it possibly can. The truth is, the more health care a private health insurance company denies people, the more money it makes. If you submit a claim for coverage and they deny it, from their perspective that is a very good thing because they make more money.
Further, in pursuit of making as much money as they can, private health insurance companies have created a patchwork system which is the most complicated, the most bureaucratic, and the most wasteful in the world. According to a number of studies, we are wasting about $400 billion a year in administrative costs, in profiteering, and in bureaucratic billing practices. That is enough money to provide health care to all of the uninsured.
I know that is not an issue we are supposed to be talking about here on the floor of the Senate because we are not supposed to take on the insurance companies or the drug companies because of all of their power. But I believe, if we are serious about moving toward a universal, comprehensive, cost-effective health care system in this country, we have to talk about the very negative role private health insurance companies are playing in that process.
Administrative costs for insurers, employers, and the providers of health care in the United States are about one out of every four health care dollars we spend. In other words, for every $1 we spend, one quarter of that dollar does not go to doctors, does not go to nurses, does not go to medicine, does not go to therapies; it goes to administration. That is at the root of the problem we have in terms of health care costs in America. In California--one example--only 66 percent of total insurance premiums are used to cover hospital and physician services. One-third, $1 out of every $3, is spent on administration, billing, claims processing, sales and marketing, finance and underwriting.
The American people want their health care dollars spent on health care. I know that is a radical idea, but when people spend money on health care, they assume it goes to the provision of health care, not profiteering, not administration, not hiring more bureaucrats to tell us we are not covered when we thought we were covered. What the American people want is close to 100 percent of that dollar to go to health care and not bureaucracy.
While health care costs in America have soared, as everybody knows, from 2003 to 2007 the combined profits of the Nation's major health insurance companies increased by 170 percent. Health care costs are soaring, profits of the major health insurance companies have gone up by 170 percent from 2003 to 2007, and CEO compensation for the top seven health insurance companies averaged over $14 million per CEO. To add insult to injury, some of these health care profits are going directly into campaign contributions and into lobbying to make sure, in fact, the Congress does not move forward toward real health care reform, which, in my view, means a single-payer health care system.
That is where we are right now. We have the most inefficient, wasteful, bureaucratic system of any major country on Earth. Our health care outcomes, despite all the money we spend, are way below many other countries in the world. And we are not discussing the most important issue with regard to health care spending; that is, the role private health insurance companies are playing.
We are now in the beginning of the debate on health care. I am going to do my best to make sure that issue of the role private health insurance companies are playing in the system, the very negative role they are playing, is something that, in fact, we talk about.
With that, I yield the floor.
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Mr. SANDERS. Would the Senator from Ohio yield?
Mr. BROWN. Yes.
Mr. SANDERS. I wish to thank him for his cogent remarks, talking about one of the most basic issues facing this country and that is health care. We are on the Veterans' Committee as well, and I know you spend a lot of time talking to veterans in Ohio. Has the Senator heard a veteran in Ohio tell you they want to privatize the VA?
Mr. BROWN. I have heard mostly conservative Republicans say they want to privatize the VA.
Mr. SANDERS. Every time that issue is raised, the veterans say no.
Mr. BROWN. One of the things we noticed about the Veterans' Administration is that the VA has found a way to buy, at the lowest cost possible, some of the least-expensive but good-quality prescription drugs. Because what the VA does--there are millions of veterans--they negotiate on behalf of veterans with individual drug companies for individual prescription drugs, individual pharmaceuticals, and they get a rate at about one-half of what you would pay if you went to Drug Mart or Rite Aid or any of the other stores.
The Medicare bill, when it came through the House and Senate--President Bush pushed that bill--they did not allow us to negotiate drug prices. We know what this is about. We know if we follow the lead of the drug industry and the insurance industry, which this Congress did through most of the first part of this decade with President Bush, we end up with special interest laws that protect the drug companies or insurance companies.
Or we can now pass health care with a public option plan, give the public the option of going to a Medicare-like plan instead of a private insurance company plan, if they want to, or stay in the plan they are in and then they decide on what kind of care they would like.
Mr. SANDERS. My friend from Ohio is exactly right. If you talk to the people of this country, if you talk to the veterans and say: Do you want VA health care to be privatized? Overwhelmingly, no.
In recent years, the Senator from Ohio, I, and others, have worked to substantially increase funding for federally qualified community health care centers all over this country. These are the most cost-effective ways of providing quality health care, dental care, low-cost prescription drugs, mental health counseling.
The people of this country want those. I hope we have success in expanding that program. But I get a little bit tired of hearing from some of our friends on the other side who tell us: Oh, people do not want government involved in health care. Well, you tell that to seniors. Tell them you want to privatize Medicare. Tell that to the veterans, that you want to privatize the VA.
The fact is, as the Senator from Ohio indicated, we are wasting tens and tens of billions of dollars every year in bureaucracy, in billing, in excessive CEO salaries through private health insurance companies. At the very least, the people of this country are demanding, and we must bring forth, a strong--underline ``strong''--public option within any health care reform program we develop.
Mr. BROWN. I thank the Senator from Vermont. It is pretty clear, and I think this Congress is going to do the right thing. The President, when he met with us last week, as he promised in his campaign, was strongly in favor of purchasing insurance from the Medicare look-alike plan or private plans or either one or keeping what they already have.
The President has spoken strongly on it for months. The majority of this Congress wants to do the same. I am hopeful that is what we will do in the months ahead.
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