Health Care

Floor Speech

HEALTH CARE -- (Senate - June 23, 2009)

Mr. SCHUMER. Mr. President, I rise to discuss the necessity of including a public option in the health care legislation Congress is currently drafting. One of our top priorities, as we undertake health care reform, must be increasing competition among health insurance companies in order to get costs under control and give consumers better choices. A recent New York Times/CBS poll clearly shows that a large majority of the American people, 72 percent in fact, want a government-sponsored health care option that would compete with private health insurance companies--72 percent.

What is even more incredible, 50 percent of all Republicans in this country want a public option. There seems to be a disconnect between my colleagues on the other side of the aisle and even their Republican constituents.

Do you know why so many Americans want a public plan? Because, despite what many of my colleagues on the other side of the aisle would have you believe, they do not believe they have affordable choices. Fundamentally, this is what lies at the heart of our public plan proposal. We want to ensure all Americans have a guaranteed affordable choice when it comes to health insurance. Right now, too many of them do not.

In many areas of the country, one or two insurers have a stranglehold on the entire market, which produces costly premiums and health care decisions that often serve the interests of the insurer, not the patient. In fact, according to a study of the American Medical Association, 94 percent of insurance markets are highly concentrated. This is why a public health insurance plan is absolutely critical, to ensure the greatest amount of choice possible for consumers and provide at least one option that is patient--not profit--focused.

When you read what percentage one insurance company or two insurance companies have of a market in each State, you know that robust competition is missing from the health care market. That is why so many people are worried about the future of the plans that they now have.

The public plan is not about government-controlled health care, socialism or any of the buzz words that have been tossed around as part of this debate.

I ask my colleagues, do they consider Medicare socialism? Would they like to abolish Medicare? Probably some of them would. But Medicare--hello, my friends--is a government-run plan. It is very popular with the American people. Very few propose eliminating Medicare. So let's be real here. The public option is about offering Americans a choice in the market that, far too often, offers them none.

I will tell you the choices too many Americans face: whether to pay for health insurance or health care or to pay for other necessities of life, because health care has become so expensive. That is not a choice anyone should have to make, and maybe that explains why the American people do not agree with the critics of the public plan.

Half of all Americans think the government plan will provide better health care coverage than private insurance companies, and a significantly lower percentage disagree with that statement.

Let's be clear: A public plan may not have special built-in advantages. It would be a coverage option that would compete on an equal footing alongside private insurance plans in the market for individual and small business coverage. If a level playing field exists, then private insurers will have to compete based on quality of care and pricing instead of just competing for the healthiest consumers. In this way, a public plan will accomplish many of our most important goals. It will not waste money on costs incidental to providing health care. It will not focus on profits at the expense of the best health outcomes. Instead, it will spend money on improving health delivery and on trying innovative technologies and systems in order to save, save money. It will force many insurers that have been shielded and protected from competition for far too long to compete with a plan that provides comprehensive care at an affordable rate. It will, most importantly, give all Americans a choice. In fact, I think the thing that really scares opponents of the public option is choice, that Americans might actually choose the public plan over the plan of private insurance companies, because then the curtain might be pulled back on their friends at the insurance companies and Americans will finally see the hidden costs that have caused their premiums to skyrocket, the wasteful spending that does not improve health outcomes but fattens bottom lines, and the protection from competition that has been offered to private insurers over the last decade.

To truly reform our health care system, Congress must pass legislation that includes a public option. A figleaf public plan is no plan at all, and I will not settle for such a figleaf.

It is important to remember how we arrived here. For a long time, when thinking hypothetically about health care reform, many in this country suggested that we move to a single-payer option.

The PRESIDING OFFICER (Mr. Udall of Colorado.) I would note that the Senator has used 10 minutes.

Mr. SCHUMER. I ask unanimous consent that I be given 5 additional minutes.

The PRESIDING OFFICER. Without objection, it is so ordered.

Mr. SCHUMER. The Republicans rejected the single-payer plan. So at the onset of this debate, we met them halfway with a framework that continues
to largely rely on private insurers. So then we said: If we are going to continue to rely mostly on private insurance, can we at least introduce greater competition into the market by having a public plan as one option? The Republicans--most, at least; just about all, I think--rejected that too. We said: Well, what if we ensured that the public plan had to adhere to the same rules as private insurers, thus guaranteeing a level playing field? The Republicans here in the Senate--not in the country but the Republicans here in the Senate--still said no to even a level playing field.

So some Democrats came up with a new idea: What if we relied on a co-op model that has served rural States well? In a good-faith attempt to consider this idea, I proposed some ideas for ensuring that co-ops could do the job of keeping private insurers honest. Yesterday, Senator Conrad indicated he could go along with many of these proposals. But Senator Conrad has never been the problem here. He has been well open to negotiating on how to make a co-op plan have the kind of clout to go up against private insurance companies, be available to all Americans, be able to bargain with the providers, and be ready to go on day one to compete with the large nationwide insurance companies. Senator Conrad has always been willing to entertain all of that. He has been a good-faith negotiator with the best interests at heart. It has been those on the other side of the aisle who have not been willing to negotiate. So I am losing confidence that Senate Republicans will ever agree to the types of changes to a co-op to make it a viable alternative, a viable substitute to a traditional public plan that is nationwide and available to everybody, that can go up against the private insurers and go up against the suppliers in buying power, that is formulated so that it hits the ground running on day one of the insurance exchange.

We can only bend so much to try to win over opponents of health care reform. We cannot bend so far that we break. We cannot say we are putting something else out there and not have it do the job because a public option is what really does the job. We must not let the scaremongering about the possible consequences of a public option deter us from doing what the American people overwhelmingly want and need. It is time to put the health needs of the American people, not the insurance companies, first. It is time to move past the partisan bickering and make sure the health care reform passed by Congress includes a real public option. It is the right thing, it is the smart thing, and it is what the American people want and what they deserve.

I yield the floor.

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