Engaging The Issues

Floor Speech

Mr. DURBIN. Madam President, there are many things going on in the Capitol today. As a member of the Senate Judiciary Committee, I left the confirmation hearing of Judge Sonia Sotomayor, President Obama's nominee to the Supreme Court. I believe this is her fourth day of hearings before the committee. It appears we will be able to wrap up today or perhaps tomorrow.

I think she has done an extraordinarily good job. She comes to this nomination with a remarkable life story: rising from public housing in the Bronx, NY, losing her father when she was 9 years old, being raised by a determined and capable mother, a brother who became a doctor. She went on to law school after academic success in an Ivy League institution, and now has served for 17 years on the Federal bench.

We have many good witnesses before the Judiciary Committee, but I think she has set a high standard in terms of answering questions with a clear understanding of the law and a clear understanding of her responsibility if she is given this awesome assignment of serving on the highest Court in the land.

I cannot help but watch at these hearings as her family sits through hour after weary hour of Senators' questions. They are clearly in her corner and cheering her on; her mother, nodding in agreement when her daughter tells of their life story; others there in testimony to her wonderful life, her professional life as an attorney and judge.

I hope the Senate will bring her nomination before us in a timely fashion so that if she is approved--and I believe she will be approved by the Senate--she can cross the street to the U.S. Supreme Court and be there in September to make certain that the Court has a full complement of Justices to consider important cases.

At the same time on the floor, we have the Defense authorization bill, an annual exercise to authorize important expenditures for our national defense. There is a pending amendment relative to hate crimes, as to whether there will be a Federal cause of action against those who are guilty of physically assaulting and hurting people because of their sexual orientation, their gender, their race, their ethnic origin.

And, of course, there is another major debate underway about the future of health care in America. I have said that I think this debate over health care may be the biggest domestic undertaking of Congress in its history. In sheer numbers, the impact of this legislation will touch every single American immediately.

We have considered big issues in the past, issues such as Social Security, but that was a program, when it was conceived and passed, that would affect senior citizens at a later date and only a few people initially. It was passed at a time when few people lived to be age 65, the qualifying age for Social Security. So it was an insurance policy for a small group of Americans. There was a payroll tax imposed on most workers in the country to pay for it.

Some 60 years later, President Lyndon Johnson considered the Medicare Program, another far-reaching program which today provides health insurance for 45 million Americans. It, too, is paid for primarily by a payroll tax, but it reached retirees. This debate on health care goes far beyond retirees. It affects all of us, every single one of us.

There have been so many things said about this debate. Some of the things that have been said at the outset are plain wrong. I was sent an e-mail by my brother who lives in California. I don't know the source of this e-mail, but it is one with wide subscription. It was loaded with mistakes and errors, suggesting that Members of Congress have some elite health care policies that pay for things ordinary Americans could never consider.

For the record, speaking for myself and most Members of Congress, we are under exactly the same health care plan as 8 million Federal employees and their families. But make no mistake, it is a good one. Because we have such a good bargaining pool, for over 40 years, private insurance companies have been anxious to get in and offer health insurance to not only Members of Congress but virtually every other Federal employee. It is a plan that engages us with private health insurance companies. My wife and I can choose from nine different private health insurance companies that offer coverage to residents of Illinois who are Federal employees. We can pick a plan that has limited coverage or one that has more coverage. My payroll deduction depends on the type of plan I choose.

The good news is once a year there is open enrollment. If I don't like the way I have been treated in the plan, I can move to a different company that might give me different benefits or better coverage. Every American should be so lucky as every Federal employee and Members of Congress. But we don't have an elite plan.

Other things that have been said are plain wrong. Members of Congress do not pay into Social Security. I can tell you when I was elected in 1982, in the House of Representatives, that was a fact. That was quickly changed within a year so that Members of Congress do pay into Social Security, as most Americans do today. These are all things that need to be set aside, and we need to get to the heart of the issue.

I listened as Republican Senators have come to the floor and talked about this health care debate. I cannot for the life of me understand how most of these Senators feel about the issue of health care.

The overwhelming majority of Americans believe we need to change the current system. If they have a good health insurance policy, they want to keep it, and the law we propose will allow them to do that, but there is a sense that the cost of health insurance is going up too fast and you can't earn enough money to keep up with it. Just over the last several years, the cost of health insurance premiums has risen three times faster than the wages of Americans. I have heard about it in Illinois; others have heard about it as well.

Those who want to keep the current system have to answer the most basic question: How will individuals and families and businesses be able to afford health insurance if we don't change? How can we deal with the deficits and debt that are being created by these inflated health care costs? The United States is the most expensive Nation in the world when it comes to health care. We spend, on average, per person more than twice as much as most other countries. Yet we don't have the medical results to point to which demonstrate that money is being well spent.

Some of the Republicans who have come to the floor--for instance, Senator McConnell from Kentucky, the Republican leader--talk about the failure of a plan in Maine, a public plan called--I may mispronounce this; I hope I don't--it looks like Dirigo. This Dirigo relied on private insurance with very few health insurance companies. Maine would benefit from the increased competition provided by a public option that we are talking about in the current national health care reform.

I think States across the Nation have done a good job in exploring creative innovations, but there are some limits as to what a State can do on its own, and many are financial. It is not realistic to expect them to solve health care problems State by State. States don't have the access to the financing levers that the Federal Government has. That makes sustainability difficult over the long term. And cost is difficult to control on a State basis. States don't have access to the Medicare Program, the largest buyer of health care in America. Medicare needs to be a leader in quality and cost control initiatives if we are going to make health care affordable. The States have tried to do their best, but without Federal leadership in addressing the skyrocketing costs of health care, the States are in an impossible position.

Health care reform isn't going to be easy, but we need to do it. Fortunately, we have a President--President Obama--who has said this is his highest priority. He is prepared to spend the political capital necessary to make this change, knowing it has been very difficult in the past.

What most Americans want to see is a system where you can walk in the doctor's office and not have to fill out the same form over and over and over again; a system where doctors give the time to see their patients, can make the right diagnosis, and work through the questions that the patient might have; a system where patients aren't surprised by a medical bill they thought was covered under their insurance plan and ends up not being covered; a current system where doctors don't have to hassle with insurance companies for approval of medically necessary treatment; a system where you are not denied coverage because of an illness you had 5 years ago or because of your age; a system where health care is affordable; where it will cost less and cover more.

That is what 85 percent of the American people say they want out of this debate. This is what I would bet even the 77 percent of the American people who are satisfied with their health care today want to make sure is guaranteed in the future.

Some of my colleagues on the other side of the aisle seem to agree with the idea of the need for change, the need for health care reform. Some of them have focused on medical malpractice. I know a little about this. Before I was elected to Congress many years ago, I handled medical malpractice cases as an attorney in Springfield, IL. For a long time, I defended doctors and hospitals. And then, with a new practice, I was on the plaintiff side, representing the injured--the patients who were suing the doctors and hospitals. I have seen it from both sides of the table.

It is unfortunate when these lawsuits are filed. It is even more unfortunate when innocent people have become victims of medical negligence. There are an awful lot of them each year, and we need to do more to reduce the incidence of medical negligence. Many of these people just went to the doctor, did exactly what they were told, and ended up in a situation where their health was compromised and where they incurred massive health care costs because a mistake was made. Sometimes it is an innocent mistake, but other times, clear negligence and worse on the part of medical providers.

Don't get me wrong. I have the highest regard for the medical profession. And if it is my health or the health of someone in my family or someone I love, I want that doctor, the very best person there, to help, and I want to give them the benefit of the doubt; that they do not work miracles; they can only do the best they can, and I am prepared to accept that. In some cases, though, negligence happens. Malpractice occurs. Terrible things happen. And to close the courtroom doors to those who are injured and face a lifetime of pain, suffering, scars, limitations, disability, and health care costs is fundamentally unfair.

The Congressional Budget Office thinks that medical malpractice costs amount to less than 2 percent of health care spending. Government economists estimate that restricting all patients' rights to go to court would only lower health care costs less than 1/2 of 1 percent. So when we talk about changing the health care system, of course let's have a conversation about patient safety and reducing the medical errors and making sure that doctors who are not guilty of malpractice don't face lawsuits that never should have been filed, but let's be honest about it. This is a very small part of the issue.

We also need to make sure that a public option is available. Health insurance companies are some of the most profitable companies in America. A public option will make sure there is an option, a choice, a voluntary alternative for every American to choose a public option plan, a plan that is a not-for-profit, government-oriented plan--such as Medicare--that doesn't have high administrative costs, doesn't take a profit out of what they are charging you, and doesn't have a lot of costs for marketing. That, to me, is a way to guarantee honesty and more competition.

We know if we fail to act that many millions of Americans will continue to have no health insurance, and others will find the cost of health insurance going up dramatically. The cost today is overwhelming for some Americans.

If you went to Wrigley Field last weekend to watch the Cards and Cubs play, there were about 41,000 people seated in the stands. It is a great rivalry, a terrific baseball rivalry that draws people from St. Louis and from Chicago and all points in between. If that attendance at the stadium was representative of America, 2,000 of those 4,000 people seated in the stands are currently paying health care costs of more than 25 percent of their income. That is a back-breaking number. And we have to understand that the costs keep going up, beyond the reach of a lot of good people who are trying hard to provide the most basic health care for their families.

I notice that my colleague is here from the State of Delaware, and I am going to yield in 1 moment, but I wish to say before I yield that we have a chance here. Some of the Members of the Senate are going to see these bills coming out of committees and say, this isn't the bill I would write; in fact, there are parts of this bill I don't like at all. I am sure that is the case for me, too. I know what I would like to write. But I understand the process too.

I also understand one other thing. This may be the last time in the political careers of every Senator on the floor that we can honestly take on this health care issue. If we don't do it in a bipartisan fashion, if we don't follow the guidance of those who are telling us this current system is unsustainable, there may never be another chance. I urge my colleagues, even if you disagree with some of the key elements of the bill coming out of one committee or the other, keep the process moving forward. Let us work together, debate the issues, vote on the amendments, and keep the process moving forward. At the end of the day, if we end up emptyhanded, it will be a great loss for America. We will have to come back again under even worse circumstances, where there is a lot more suffering and a lot fewer people with good insurance in America.

Mr. President, I yield the floor.

Source