Health Care Reform

Floor Speech

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Mr. MERKLEY. Mr. President, I thank the Senator very much for his presentation and leadership on health care.

The Senator was just talking about Medicare, and when our HELP Committee was meeting, I heard a very interesting statistic; that is, while Americans spend 17 to 18 percent of our GDP on health care--more than any other country on the planet--our health outcomes overall are significantly less than several dozen other nations in the world. That is part of the puzzle we are addressing. But then I heard another piece of the puzzle; that is, for American citizens who are 65, their health prospects are among the best in the world. The question was posed before the committee: What is the difference? The difference is very simple, as the Senator from Connecticut has so described, and that was the creation of the Medicare Program. All of our citizens 65 and older have health care. If we can take it and make it a nation where all of our citizens 65 and under have health care, wouldn't it make a tremendous difference?

Mr. DODD. My colleague is absolutely correct. This is the point. People probably know, but the younger generation may not realize it. Prior to 1965, the poorest population of our country were our elderly. It was a great tragedy--the generation that grew up and then contributed so much. The 20th century--of course, by 1965, those were the veterans of World War I. They were the people who had lived through the Depression and held us together as a nation time after time, and here they were reaching their retirement years, and, as we all know, when health care problems become pretty routine.

A generation that came before us sitting in this very Chamber decided we could do better than that, and so crafted Medicare. The leadership again began with President Kennedy and culminated with the work of Lyndon Baines Johnson putting a package together with Hubert Humphrey and others, putting together that Medicare Program and taking a substantial portion of our population and giving them the assurance and the confidence that as they grow older and face health care problems, the Nation would be there to back them up and to say thank you as a gesture of gratitude for the contribution they made.

Also, there was a note of selfishness in that it relieved that younger generation from the burden of financially caring for parents beyond their economic means, in many cases. So it freed up their children to provide for that generation's grandchildren. In so many ways we have benefited from that.

So while we talk about the recipients of Medicare--and that is extremely worthwhile--we all benefited from that. It was a great economic relief to an entire Nation, not just the recipients of Medicare's assistance and support.

Mr. MERKLEY. Mr. President, if I could carry on a second point related to the Senator's comments, and that is simply as you address small business and Kevin Galvin, your constituent, to help organize small business, whereas we did a tremendous job in regard to our seniors 65 and older, we haven't done such a good job for our small businesses.

I know that over the past many years, small business owners have been coming to me and saying: JEFF, we just can't afford these double-digit increases we are getting every year in health care premiums, and we are having to shift some of the cost to our employees. We are having to consider shutting down our insurance program completely. We as small businesses can't get the same good deal the large businesses are able to get. Can't you do something about that?

I think with the bill the Senator from Connecticut has steered through committee, he has done such great work in laying out a plan that will help our small businesses in several different ways.

First is to create a pool where they will have the negotiating power of hundreds of thousands of individuals rather than having to go as a small business of 5 or so or 25 employees to the health care market, because when you go by yourself with 5 or 10 or 25 employees, it is like leading a lamb to slaughter. Now they will be able to go to the health care marketplace where they will be able to be a part of a larger pool and negotiate a much better deal.

The second is, they will have so many options when they get to that health care marketplace, whereas now there may be only one company that will hear them out and give them a possible plan, and then they will have many more to choose from.

So I think those pieces are a tremendous improvement to what I think has been a long neglected part of the health care puzzle.

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Mr. MERKLEY. I thank the Senator very much.

The distinguished chair, Senator Dodd, mentioned earlier that this bill is not just for the uninsured; this is for the insured because we have a broken health care system for the insured. My colleague from Oregon made this point, that we need to close the deal for insurance in this country.

I can tell you that folks with insurance have been telling us lots of stories about the challenges they face under our current broken status quo health care system. The first is that right now, their insurance is largely tied to their job, so if they should lose their job, it is a huge calamity--not just because they lost their job but also because they lost their insurance.

It is a double whammy. This bill would change that for our families who currently have insurance.

Second, our families who currently have insurance, their costs are being driven up, in part because they are covering the costs of the emergency room treatment for those who don't have insurance. In the last couple of years, we have had more and more people without insurance transferring more costs in the emergency room and, therefore, more costs to the insurer. Therefore, more companies--particularly small ones--are saying we cannot afford health insurance anymore.

This is a downward cycle, a death cycle in insurance that we break with this bill--helping out those who have insurance by taking away the burden of paying for the emergency room for those who don't.

A third factor is that other pieces are driving up health care more than 10 percent a year of health care premiums. That means health care is going to double every 7 years. That is unsustainable in this country for those of us who are fortunate enough to have insurance.

Then, also, citizens have been recognizing that they would like to have portability--to be able to take the insurance they have and, should they change jobs--as Americans do, on average, every 3 years--be able to have the same insurance plan, the same set of choices, the same doctors, the same doctor for themselves and their spouse and their children. That portability becomes an inherent feature of the bill, helping those who have insurance.

The list goes on. Those who currently have insurance sometimes get it at a very poor deal. As the chairman pointed out, it is 18 percent more for an individual than a small business. Now they will be able to be part of a larger pool and get a much better deal.

Finally, many of those who currently have insurance don't have existing conditions covered. If they have a bad back or a heart condition or cancer or diabetes, and they cannot have that fundamental health care issue covered by their insurance, then they don't have any form of health care insurance that matters for the issue they are wrestling with.

So in so many ways, the plan the committee has put together profoundly improves on our broken health care system for those who have insurance today in America.

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