Health Care Reform

Floor Speech

Mr. DURBIN. Mr. President, this morning the Republican Senate leader, Mitch McConnell of Kentucky, came to the floor to talk about health care. It is a timely conversation among Members of the Senate about the future of this important issue. I know Senator Wyden of Oregon is going to address it as well.

Yesterday, in Chicago, IL, which I am honored to represent, the President came to speak to the American Medical Association, a gathering of doctors from all over the United States, to address this same issue. It is an issue of paramount importance to these medical professionals. They understand, as we do, that we want to maintain the best quality health care in the world. In order to do that, we have to face the realities of the shortcomings of our current health care system.

Although we have many of the best hospitals and doctors and some of the best technology, we lead the world in the development of pharmaceuticals, we also know the cost of this system is spinning out of control. People feel it; whether it is individuals buying health insurance, businesses, governments--State and local and Federal governments--all understand that if the cost of health care continues to rise as it is currently going up, it will literally break the bank, not just for the Federal Government and all the health care programs we have but for individuals and families and businesses. That is the reality.

If we do nothing, if we ignore this reality, we are doomed to face a situation where more and more of the dollars we earn as employees will go toward health care protection and health care insurance and the protection itself will diminish each year--because that is the other reality. As the cost of health insurance goes up each year, the coverage goes down.

People know what I am talking about. When the health insurance company says we have a great plan for you but, incidentally, remember the cancer test you had last year, we will not cover anything related to cancer in the future, that is not much when it comes to insurance or protection or peace of mind.

They also know that many health insurance companies make this a deadly game of a battle between what your doctor says you need and what some insurance company bureaucrat is going to negotiate. You end up on the phone with some clerk in a distant location debating as to whether there is coverage and whether they can go ahead with the procedure they think is important for you or someone you love very much in your family. That is the reality of where we are today. We have to deal with cost and deal with it in a fashion that is appropriate.

How do we deal with it? First, this system has a lot of money in it. We spend twice as much as any other country on Earth when it comes to health protection and health care. Yet when you look at the results, the actual survival rates for many of the serious illnesses that face us, it turns out that countries that spend a fraction of what the United States spends get better results. There is a lesson to be learned. There is waste in this system.

One of the articles that is making the rounds on Capitol Hill was written in the New Yorker magazine on June 1 by a Boston surgeon named Atul Gawande. He went to McAllen, TX, and tried to understand why the cost per Medicare patient there, at $15,000 a year, was so high, dramatically higher than many other comparable cities in the State of Texas and around the Nation.

What he found, to his surprise and disappointment, was that the doctors and hospitals in those areas were bundling up and charging people as much as possible, ordering procedures that were unnecessary, doing things that were not called for. The reason was obvious: there was money to be made. As long as they kept piling the medical bills on the patients through Medicare, they received more reimbursement. They didn't have healthier people. They didn't have an outcome that justified it. But they made a lot more money in the process.

What the President has said to us is, with all this money in the system, we have to find ways to bring in more efficiency. It is one thing to say that 48 million Americans currently uninsured will receive protection. I think that is basic. That is moral. That should be one of our primary goals. But that costs money.

When the Republican leader comes up and argues this is going to be an expensive undertaking, what he is saying is we cannot afford to insure people in America. I think he is wrong. I think there are ways to do it, and we must do it because, honestly, if they don't have health insurance, they are still going to get sick. They are still going to a doctor or hospital and all of us are going to pay for it.

Right now we estimate that for an ordinary family in America, we are paying about $1,000 a year more in health insurance premiums to cover those who are uninsured. In other words, the health insurance policy I have through the

Federal Government with the Federal employees costs $1,000 more than it ordinarily would so there is more money in the system to cover those uninsured. If we can bring those uninsured into insurance coverage, it gives them peace of mind, it relieves this hidden tax on families across America, and it means, frankly, that providers--hospitals, doctors, and others--are going to be adequately compensated for the care they offer to currently uninsured people.

When President Obama comes to the AMA and talks about covering the uninsured, there is usually a cheer. That is 48 million more paying customers, people who will actually pay into our system. But he also talks about something that is not as popular with many health care providers and that is reducing the cost of this system.

What happened in McAllen, TX, is unacceptable; that you can have health care providers trying to run up the bill in an effort to make more money for themselves at the expense of the government, at the expense of health insurance companies but, frankly, not to the benefit of those who are being treated.

The Senator from Kentucky frequently comes here and talks about how much he dislikes--I will use that word--government-related health care. Let's make it clear. I do not know of anyone, including the President or leaders of Congress, calling for a government health care plan to cover everyone. That is not what we are asking for. We want to make sure there is private health insurance that is held accountable and is competitive so we can help bring down the cost. But to argue there is something fundamentally wrong with government-sponsored health care, even if it is just an option, a voluntary option for customers across America, is to ignore the obvious. There are 40 million Americans today protected by Medicare. Forty million seniors and disabled people who have quality health care because of a government plan that has been in place now for over 40 years. There are also a large number of our men and women who serve in the military protected by the veterans health care system, another government health care system, who believe--and I think rightly so--that they are receiving some of the best medical care in America. I do not believe the Senator from Kentucky is opposed to the Veterans' Administration and the health care it provides, but it is a government plan.

The same is true when it comes to the Children's Health Insurance Program. That is health insurance for individual children through private companies, but the Government has stepped in to make sure these kids are covered, and I, frankly, am very proud of the fact that when President Obama took office, we extended that coverage to 11 million uninsured children in America. That was a government effort to make the private health insurance effort in our country work better.

We have to get down to the bottom line here. Are we going to succeed or fail when it comes to health care reform? If we ignore the obvious and ignore the challenges, there is a genuine chance we may come up short. But if we accept this historic challenge to come together on both sides of the aisle, I think the American people will cheer us on. They want to maintain what is good about the current health care system and fix what is broken. They want to make sure, at the end of the day, if they have health insurance they like, a plan they think is right for them and their families, that they can keep that. They want to make sure the health care reform is centered on patients and families and the doctor-patient relationship, not on a government bureaucracy. They want to end the health insurance company bureaucracies that are so frustrating and so expensive for families across America.

When the Senator from Kentucky, the Republican leader, comes to the floor and comes up with a series of criticisms about any attempt at reform, I have a question to ask him: What is your option? What would you do? Do you accept the status quo? Do you think this is as good as it can be? I do not. I agree with President Obama. We can do better.

The President said one last thing that I am going to say; that is, he said: If this were easy, it would have been done a long time ago. It is hard, and it will take bipartisan cooperation for it to succeed. I encourage my colleagues to join in that conversation at the Finance Committee, as well as at the HELP Committee, and I hope we can produce a product this year that shows we are going to move forward together to make sure we have affordable quality health care for every American.

I yield the floor.

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