Health Care Reform
Floor Speech
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Mr. WELCH. Thank you very much. It's a pleasure to be here. It's an incredible debate that we have. It's long overdue. We have to have affordable, accessible health care for all our citizens, and we have to have it be affordable for our employers and our taxpayers. We don't have that now. You know, right now in 2009, health care spending eats up about 19 percent of every family's income. Under present trends, that would go up to 31 percent in 2019, and anybody who is working for a paycheck, a wage or a salary, has faced over and over again year in and year out that grim choice of accepting a very small raise--if they're lucky enough to get a raise--in exchange for hanging onto the health care benefits that they have.
So the real challenge of health care is to make it affordable and accessible for the people who have it, but for whom the quality of health care and the cost of health care is slipping beyond their reach.
Now, there are three elements to the health care bill: one is insurance reform, two is extension of coverage to the uninsured, and three is a public option. As my friend from Connecticut (Mr. Murphy) mentioned, insurance reform is overdue. The insurance companies make their money, and a lot of it, not by paying claims, but oftentimes by rejecting claims. Not by covering everyone who needs coverage, like my friend from Colorado's daughter who has a preexisting condition, but by writing policies to exclude folks who have a preexisting condition or illness or by refusing to continue insurance for somebody that was covered but gets sick and then needs it.
You can't have a health insurance system that operates that way because at some point each and every one of us is going to need health care coverage. And if health care insurance companies that are supposedly getting paid to provide coverage reject us when we need it so they can pad their bottom line, it's good for them, but it's not sustainable for us.
So health insurance reforms are immensely important. Anybody who has had to use their health care coverage has probably run into the hassles that they've had to deal with, with the pages and pages of billing, with the disputes about whether a particular service is or is not provided, even though it was recommended by your physician; and anybody who's talked to their own physician about the frustrations in that office, all the back-office personnel that they have to have just to process these claims, knows that it's a nightmare of confusion, incredible inefficiency and very, very expensive.
Now, the sad truth is that this system is as inefficient and frustrating for doctors as it is frustrating for fathers, mothers and families. It works great for the insurance companies. What we've seen with insurance companies is that they're making a lot of money. The head of Aetna one year made $24 million in 1 year. And for what? It's to process claims. The work is done by the medical providers, by the nurses, by the hospitals; and the insurance companies are processing claims. It's something that needs to be done.
But $24 million for the head of the company, where much of what they're doing is slicing and dicing who they'll insure in order to boost up those profits? We've got to change that. We have got to have a system where your health care dollar is paying for your health care needs, not for the $24 million salary of the head of Aetna.
You know, even in my own State of Vermont, which is very small, and we don't have these huge executive salaries, by and large, the head of Blue Cross/Blue Shield, who was there for 9 years, when he walked out the door, he left with $9 million. That's unbelievable in Vermont.
Our farmers are struggling to hang onto a way of life, our workers are working a second and third job to try to make ends meet. When they have to use health care, the can't afford the copay and deductible. Oftentimes they are pulling back from getting the care they need.
So one of the major elements of this health care reform is really cracking down on insurance company practices that, yes, work fine for them but are digging a deep hole for the American economy, families, and businesses. Health care reform is going to require that all insurers compete on a level playing field, that they offer policies regardless of preexisting condition, that they don't have a lifetime cap on what your benefits are if you get an illness that requires significant care, that they can't yank your insurance because you need it.
Then you're going to have insurance companies competing for your business on the basis of the service and the value, not on the basis of how cleverly they can write their policies to surprise you when you think you're going to get it. So insurance reform is a major component. Second is extending coverage to the uninsured. More and more folks are becoming uninsured. Obviously, if we can extend affordable coverage to them, it's very good for them. But, Mr. Speaker, it's very good for any of us who have coverage because it means about an $1,100 savings for each and every one of us.
Finally, is the public option. There has been a lot of debate about that, but what it's about very simply is extending choice to you and me so that if we want to select a public option insurance program that competes on a level playing field with the private insurance companies, we can. It also is not a cram-down for our providers. Our doctors, our hospitals, our medical care folks, they can decide yes or no to be in that public option. So this is a choice. It's adding a choice for us. It's adding a choice for our medical providers, and it's going to create some competition for the insurance companies who, in all candor, have been running roughshod over the American consumer and our small businesses for years.
So I thank my friend from Connecticut for bringing us together, and I yield back to you.
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Mr. WELCH. If the gentleman will yield, one of the things that I hear from a lot of Vermonters is that they're frustrated that in Vermont there are only two or three insurance plans that they can choose from. And a lot of times people say what they'd like to do is buy, or have the opportunity to buy insurance from out of State. And the reason that many States don't do that is that the private insurance companies, including some so-called nonprofits, by and large dominate their local market areas. So the frustration that many Vermonters have, very limited choice about what insurance they can buy, that's a frustration folks have in Texas, in Colorado, in New Hampshire, in Connecticut, all over the country.
Now, we regulate insurance with a set of rules that levels the playing field that applies to them and to the public option. So when you as a consumer purchase a policy, you can have some confidence that you actually are going to get coverage for your wife, for your daughter, for your husband. Then that will create the circumstances where we will have competition. And you know what? The insurance companies don't like competition, and they have been very good at restricting it. And then when you deny that choice and you deny competition, the prices, in fact, do go up. The market power of the insurance companies to boost prices, the pharmaceutical companies to boost prices beyond what the competition would allow if there were a freer market is costing the American people an awful lot of money.
So we add a level playing field, a new choice of a public option that's the choice of you from Colorado, me from Vermont. It's going to create competition that is, as many people know from their own experience, going to drive down costs and we hope improve quality, Mr. Perlmutter.
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