Travel Promotion Act Of 2009 - Motion To Proceed - Continued

Floor Speech

BREAK IN TRANSCRIPT

Mr. SANDERS. Mr. President, I think virtually everybody in our country understands that America is in the midst of a major health care crisis. We have 46 million Americans without any health insurance. We have even more who are underinsured, and we have, in addition to all of that, some 60 million Americans--20 percent of our population--who do not have access to a doctor on a regular basis. The result of that particular fact is that we lose over 18,000 Americans every year, Americans who die needlessly--who should not die--because they do not go to the doctor when they should and get the treatment they need. That is six times every single year the number of people we lost on 9/11--people who should not die because they do not have access to a doctor.

Mr. President, in the midst of this horrendous lack of coverage--unique, I should mention, among major nations on Earth--the United States spends far more per capita on health care than any other nation, and those costs continue to soar. So when people make international comparisons of the United States with other nations on how well or not well we are doing--and that is good to do--we should always remember we are spending almost twice as much per capita on health care as any other country. There is certainly something wrong and dysfunctional about a system which spends so much and yet leaves so many people uninsured, underinsured, or without access to a doctor or a dentist or other preventive health care.

At $2.4 trillion and 18 percent of our gross domestic product, the skyrocketing cost of health care in this country is unsustainable both from a personal point of view--the needs of individual Americans--and also from a
macroeconomic perspective of what is happening to our entire economy. At the individual level, the average American today spends about $7,900 per year on health care. Can you believe that? Close to $8,000 per person on health care?

We all know folks who are out there making $20,000, $25,000, or $30,000 a year, and we are spending, on average, almost $8,000 per person.

Despite that huge outlay--unprecedented in the world--a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. I should add that most of the people who went bankrupt had health insurance. They had health insurance. But what they had was inadequate health insurance.

From a business perspective--as opposed to the needs of an individual--General Motors spends more money on health care per automobile than they do on steel--more money on health care than on steel--which might lead us to understand why they are where they are today.

Small business owners in the State of Vermont and around this country are forced to divert hard-earned profits into health coverage for their employees rather than new business investments. Many small businesses are trying to do the right thing for their employees, spending more than they have for health coverage so they do not have the money available to make the investments they need to make their businesses grow. The result of that, of course, is as a result of soaring health care costs--going up 10, 15, 20 percent a year--many small- and medium-size businesses are cutting back drastically on their level of health care coverage or, in some cases, they are doing away with it entirely.

More and more businesses in America are simply saying: I cannot afford to provide health insurance to my workers. Despite all of that--that we spend almost twice as much per person on health care as any other country--people will say: Since you spend all that money, the results must be great. But that is not the case. The bottom line is we get poor value for what we spend.

According to the World Health Organization, the United States ranks 37th in terms of health system performance. We are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths.

So we are spending almost double what any other country on Earth is spending. We have 46 million without any health insurance, we have more who are underinsured, we have thousands who die because they cannot get to a doctor, and then in many other health care outcomes we are behind many other countries around the world--some of which are spending far less per person than we are spending.

It seems to me, as the health care debate in Congress heats up, we as a nation have to ask two fundamental questions. Different people will have different answers to them, but here are the two questions I think we have to ask: First, as a nation, should all Americans be entitled to health care as a right? That is the first question.

Honest people will have differences of opinion. Some people will say: You know what. Some people have big cars, some people have small cars. Some people have big houses, some people have small houses. Some people have good health insurance, some people have no health insurance. That is the way life goes. Some people hold that view.

I do not. I think in America we should understand that every single person should be entitled to quality, comprehensive, affordable health care. In fact, I think most Americans believe the same thing.

Second, if we are to provide quality health care to every man, woman, and child in this country, how do we do it in a way that does not bankrupt the Nation? How do we do it in a cost-effective way? Those are the two questions that we have to ask ourselves.

I think the answer to the first question is pretty clear and, in fact, it is one of the reasons Barack Obama was elected President of the United States. Most Americans do believe all of us should have health care and nobody should be left out of the system. We have a hard time understanding that Joe Smith who works for one company has good health care, and his neighbor, Mary Evans, who works for another company, does not have any health insurance at all. What sense is that?

I think as a nation we are coming to understand all of our people are entitled to health care as a right, as Americans, and the challenge we face is how do we do it in a cost-effective way. In that regard, I think--and I obviously speak just for myself--the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly funded, single-payer, Medicare-for-all approach. I think the evidence is overwhelming that if you want universal, comprehensive, quality health care for all people, that is actually the only way you can do it.

Our current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Just today--not yesterday, just today--I spoke to an individual who has a law degree, a very smart guy. His wife has a Ph.D. They went through the Federal employee benefit package. Between a Ph.D. and a lawyer, they spent hours trying to figure out what particular program could work best for them.

All over America, people are spending countless hours trying to figure out: Is it this program? Is it that program? I am young; I might not get sick but, you know, I have a history of cancer in my family. Should I get comprehensive? Should I get a high deductible? If I am a small business I can only negotiate this, if I am General Motors I can self insure. What should I do?

The answer is, there are 1,300 separate private insurance companies in America peddling thousands and thousands of different plans. Let's be very clear, if in fact, anybody has not caught on yet; the function of a private health insurance company is not to provide health care. It is to make as much money as possible. That is what its reason for existence is about.

In fact, when a private health insurance company denies health care, it makes more money. In fact, the record is pretty clear that private health insurance companies have given bonuses to people, their own employees, who are successful in throwing people off of the insurance policy because those people were running up high health care costs. Thus, we have the insane phenomenon of something called a preexisting condition.

What a term that is, preexisting condition--meaning a person cannot get coverage for the illness they need to be covered for most. The person who had cancer 3 years ago and is worried about a recurrence of cancer--sorry, we can't provide insurance to you.

Then you have other circumstances where somebody gets really sick, runs up a high medical bill, and the insurance company says: Oh, we don't want to continue your policy because we had to pay out so much money. We want to go to some young guy who can run the marathon and promises us never to get sick. Those are the guys we want to cover.

This is an insane system. It is a wasteful system. It is a bureaucratic system. How many people are spending half their lives on the telephone, arguing with insurance companies to cover the claims they thought they were covered for? So people on one end of the phone are spending huge amounts of time and money doing that, and at the other end of the phone we are paying someone to tell us we don't have coverage for what we thought we did have coverage.

With thousands of different health benefit programs designed to maximize profits, not provide health care, private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions.

One of the lovely things the insurance companies do and the pharmaceutical companies do is, after they rip you off and they make huge profits, they take some of that money to hire all these fancy guys in Washington, DC, to protect the status quo.

The bottom line is--and all of the evidence makes this clear--public programs such as Medicare, Medicaid, the SCHIP Program, and the Veterans' Administration are administered for far less money than are private health insurance companies.

In recent years, while we have experienced an acute shortage of primary
health care doctors, nurses, and dentists, we are paying for a huge increase in health care bureaucrats and bill collectors. Here is the insanity, the dysfunctionality of the current system: We do not have enough primary health care doctors, we don't have enough dentists, we do not have enough nurses, we do not have enough medical personnel--we don't have enough of those people, but over the last three decades we have seen an explosion in the number of health care bureaucrats and people who are bill collectors.

To my mind, I would rather see somebody hired who can help somebody get well or prevent disease, not somebody on the telephone billing or arguing about what we owe or do not owe. The fact is, over the last three decades the number of administrative personnel has grown by 25 times the numbers of physicians--25 times more bureaucrats than physicians. We do not need health care bureaucrats pushing paper. We need primary health care doctors delivering babies, taking care of the elderly, and taking care of those people who are sick.

Not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. 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 health insurance companies are also soaring, and while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It is not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion.

OK, $1.6 billion a few years ago for the CEO of United Health and we do not have enough money to provide health care to people who are uninsured? It is not just the head of Cigna, Edward Hanway, who made more than $120 million in the last 5 years. The fact is, CEO compensation for the top private health insurance companies now averages over $14 million apiece.

Moving toward a national health insurance program which provides cost-effective, universal, comprehensive, and quality health care for all will not be easy. It is the major political struggle that we face right now. The powerful special interests--and they are all over Capitol Hill. The lobbyists are here. In the midst of the recession, I would suggest that while unemployment in general is soaring, my strong guess is that unemployment for health care lobbyists and pharmaceutical industry lobbyists

is going down. Those guys have plenty of work, and they are making plenty of money. I am quite confident that those lobbyists will wage an all-out fight to make sure we maintain the current dysfunctional system which enables them, the insurance companies and the drug companies, to make millions and billions of dollars in profits.

In recent years they have spent hundreds of millions on lobbying, campaign contributions, and advertising with unlimited resources. We have no reason to believe they will not continue to spend as much as they need. But at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Decade after decade, all over this country people fought for a civil rights movement which said we will judge human beings not on their color but on their character, who they are as a human being. The struggle for women's rights went on decade after decade before women had the right to vote or had a seat at the table.

In my view, the struggle for health care is the civil rights struggle of today, and I believe 30 years from now, 50 years from now, people will look back and say: I don't believe there was a time in America where people who got sick couldn't find a doctor, where people went bankrupt because they committed the crime of being sick or having cancer. I do not believe that.

Our job is to bring that day when every American has health care as a right in a comprehensive, cost-effective manner. Our job is to make that day come sooner rather than later. If we work together and if we have the courage to stand up to the big money interests who want to maintain the status quo, we, in fact, can do that.

Mr. President, I yield the floor.

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