Health Care Reform

Floor Speech

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Mr. WYDEN. Mr. President, I wanted to come tonight as a member of the Finance Committee and particularly highlight the extraordinary contributions that those on the HELP Committee have made in the prevention area. This is going to be a landmark bill. This is going to be an absolute turning point in American history when we finally say that instead of spending loads of money on various health care services, we will start keeping people healthy. You look, for example, at the Medicare Program. Medicare Part A will pay thousands and thousands of dollars on senior citizens' hospital bills. And then Medicare Part B, the outpatient portion, can't do anything to reward somebody for staying healthy. Along comes Senator Harkin, who has consulted very extensively with the private sector, worked on a bipartisan effort. Senator Enzi and Senator Gregg were very involved.

And you found the sweet spot. Prevention.

What you all were able to do in the preventive area is to show that you could give very dramatic incentives to reward people for staying healthy, lowering their cholesterol, lowering their blood pressure, picking up on some of the good work that is being done in the private sector but not getting into where one could, in effect, be said to be discriminating against an individual who would have a lot of health problems and would have difficulty just with an incentive-based system.

That is a very thoughtful approach, in my view, to moving this country forward. I hope we will be able to pick up on it in the Senate Finance Committee. There is a lot of bipartisan support for it. I came to the floor tonight to particularly highlight that.

There is time, perhaps, for one other thought. I was struck--as we talk about the lack of choice in this country--the distinguished Presiding Officer and I woke up this morning to our statewide newspaper, the Oregonian, which described, in great detail, our health insurance as Members of Congress. Senator Harkin and I have talked about this, Chairman Dodd as well. It described how Senator Merkley and I have access to 23 health care packages, which, by the way, understand the HELP lesson. They cannot discriminate against you if you have a preexisting condition. You go into a big group so you can play hardball with the insurance companies.

What is striking about this--and Senate MERKLEY and I heard about this on the front page of our newspaper--is most of the country thinks this is some kind of ``Cadillac,'' gold-plated operation. But, as the newspaper pointed out today, that is what somebody who works for the Forest Service gets in central Oregon, that is what somebody who is a janitor, for example, the paper said, gets at the Bureau of Engraving.

I very much look forward to working with all of you on the HELP Committee, as Chairman Dodd and I have talked about, to make sure everybody can have a wide array of choices, have a lot of clout to take on the insurance companies, get reduced administrative costs, which is what you get with the big groups, and, by the way, have a financial incentive to choose one of these Harkin-type packages that reward prevention.

One of the things that is troubling about this debate is if we do not get the choice issue right, a lot of Americans are not going to be able to choose those kinds of packages. I think, under the Senator's leadership, we will be able to do it.

The last point I would make is--and I thank the Senator for all the time--I think working together over the next few months we can close the sale with folks who have insurance. This is going to be the key to getting health reform passed.

Mr. President, 150 million-plus people say: Not only do I want to make sure I am not worse off, I want to be better off. Well, we want to make sure they are going to be able to choose a package such as Senator Harkin has been able to advance in the HELP Committee, where they get rewarded for prevention. We want to make sure they can choose a package where they can get lower premiums. We want to make sure everybody can keep what they have, but if they do not like what they have they can go somewhere else, which is what we can do as Members of Congress.

So I think tonight's program, particularly focusing on prevention and the incentives you all have laid out--and as Senator Whitehouse has talked about, changing this insurance model, which in many respects is inhumane to reward all this cherry-picking and, in effect, sending the sick people over to government programs more fragile than they are--you all have done some very good work, particularly in prevention and making sure the consumer gets a fair shake with the insurance industry.

Working together, particularly by adding choices, we are going to be able, over the next few months, to show we can close the sale with those who have insurance in this country and come back in the fall and win bipartisan support to go where this country has not been able to go for 60 years; that is, quality, affordable coverage for all Americans.

We have already made it clear that in any legislative effort we are a part of, we will mandate good health for the Dodd household because we are all thinking about you, and we want you to know how much affection we have for you and how much support both personally and professionally we have for you from all of us in the Senate.

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Mr. WYDEN. If the chairman would yield on that point, the reason I wanted to speak at this point is, in fact, today there is an entrepreneurship tax in America. What it means is, if you have a health care problem and you work in a small business and you have a good idea and you would like to go out and set up your own small business, you are not going to be able to do it because you have a preexisting illness. You are locked into your job. What your insurance reforms do in the HELP legislation, and what I think a lot of Senators want to do, is lift that entrepreneurship tax.

This is very appropriate that you talk about taxes because that is what
this always comes down to. Your insurance reforms specifically, as a result of making sure that person who has a good idea--perhaps that gentleman's business the Senator just described--they are going to be able to do what makes America great, which is use their ingenuity and talent because when they go to their next job, they are not going to face insurance discrimination.

I appreciate the Senator bringing up the entrepreneurship tax. I am looking forward to working with the chairman over the next few weeks. I think there is additional work we can do on the exchanges. The Senator from Oregon, Mr. Merkley, my colleague who is doing such a good job, talked about some of those options. I think we can get additional people more bargaining power, and in effect build on the good work done in the HELP Committee.

Thanks for all the time tonight. You have done a first-rate job on prevention. Again, I appreciate lifting that entrepreneurship tax. That is why I wanted to take a minute to point that out.

I look forward to working specifically with my colleagues on the HELP Committee. Let's expand those exchanges because that makes the system work for us and Members of Congress.

I checked the other day. My pool--put on the front page of our paper--is 1 million people. That is a lot of folks to spread costs and risk among. Senator Harkin and I have talked about it. It is not possible to replicate that exactly, for a variety of reasons. We can get close. We can get pretty close because we can build on the good work Senators have done in the HELP Committee, expand the exchanges, and give more people choices and more opportunities to lower their premiums and, in my view, close the sale with the insured people over the next few months.

I thank the Chairman for all the time.

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