Health Care Reform

Floor Speech

BREAK IN TRANSCRIPT

Mr. WHITEHOUSE. Will the Senator yield for a question?

Mr. BROWN. Sure, I yield to the Senator from Rhode Island.

The ACTING PRESIDENT pro tempore. The Senator from Rhode Island.

Mr. WHITEHOUSE. To go back to the first point about the public option, in fact, being an option, I think everybody here understands the government is going to help pay the costs of health care, particularly for low-income families who can't work to get the funds together to pay for the cost of health care. As the Senator from Ohio knows so well, wages have increased just a tiny bit and health insurance costs have gone through the roof. The result has been that families are getting clobbered, so they need some help.

So the health care reform bill we have before us will help those families who are having such trouble affording their insurance. I think it is worth confirming the help that will come to American families does not require them to join the public option. They will get the same benefit based on their income and their family's health care needs whether they choose the public option or a private insurance carrier that is offering a program through the exchange.

As long as you show up at the exchange, as I understand it--and I would like to have the Senator from Ohio confirm this--you can take that government subsidy that is yours and your family's and you can spend it at the public option, you can spend it with Blue Cross, you can spend it with Aetna, you can spend it with any insurance company--private, for profit, nonprofit, public option--that is doing business in the exchange. You can take your subsidy and you can go there and spend it there. You are not tied to the public option by your subsidy.
Mr. BROWN. That is exactly right. Senator Whitehouse and I, his staffers and mine, wrote the language in the Health, Education, Labor, and Pensions Committee on the public option, and the whole point was to create a level playing field.

As Senator Whitehouse said, if you are low income, if you are lower or medium income, making $30,000 or $40,000 a year, with a couple children, you and your spouse are required, under this bill, to buy health insurance or, if you obviously choose to, you will get a subsidy from the taxpayers--from the government--to help pay for this insurance. You then take those subsidies, as Senator Whitehouse says, and you have a choice. You can go to WellPoint, you can go to Aetna or you can go to the public option. The public dollars will follow you into any one of these.

The public option gets no special treatment. The public option gets no special taxpayer subsidies. The public option gets no special government infusion of dollars. The public option gets what any one of the private companies do. As Senator Whitehouse said, it could be a private company, it could be a for profit, a not for profit, it could be a co-op of some sort or it could be a public option. But it is all a level playing field, so people can decide which one of these they want to go into.

I thank Senator Whitehouse for his question.

The second myth: After 5 years I won't be allowed to purchase private insurance.

This is not too different from the first myth we see out there that there is going to be some forcing of people into public insurance and into the public option. When Senator Whitehouse and I and our staffs wrote this language for the Health, Education, Labor and Pensions Committee, it was written in a way not just today for people going into the insurance exchange but 5 years from now, 10 years from now, people will have the option. You can choose a private for-profit or not-for-profit insurance company or you can choose the public option. That is the way this language will continue to be. That is another one of those myths out there that has scared people.

Some people are very distrustful of government in this country. I understand. But I think the experience of Medicare has shown that, in terms of health care, government has been a pretty good delivery vehicle for people getting insurance. In 1965, half of American seniors had no insurance. In health insurance today, 99 percent plus of Americans have health insurance and it is because of Medicare.

We know government can deliver these plans efficiently but we also are not telling people they have to have the public option. In the public plan they continue to have an option.

Mr. WHITEHOUSE. If the Senator will yield again, we are approaching Veterans Day, a time when the Nation takes a moment from our busy lives to pay our respect and our honor to those who wear the uniform of the United States and are willing to put themselves in harm's way. I think there is not a person in this body who does not feel a great loyalty and pride in our Armed Services. We want them to get nothing but the best. What do we give them for health care? If they are active, they get a government plan called TRICARE. Once they retire from active service and become veterans, they go into the Veterans' Administration. So at least one measure of the quality of government health care, in addition to the success of Medicare in reaching a population that had been deprived of adequate care for generations until Medicare came along, our seniors, is that those very people whom we are about to spend the week honoring, and for whom we insist on the very best, one of the ways we pay them honor and respect is by giving them among the very best health care in the world, government health care, TRICARE and Veterans' Administration care.

Mr. BROWN. That is exactly right. TRICARE you rarely hear a complaint about. The VA is a huge operation. Of course there are sometimes complaints about people having to wait or something that doesn't quite go right all the time, but obviously by and large veterans in this country, soldiers and sailors and marines and active duty, understand their medical needs are taken care of, as they should be. It is one of the things to be proud of in our country, that we have done a decent job of taking care of people who serve the country with TRICARE.

I sit on the Veterans' Committee and all the time we are wrestling with problems in the VA. There has been a problem with people going from active duty in TRICARE into retired status, as Senator Whitehouse said, the VA. To make that transition is not always as smooth as it should be, but it is clear people's medical care works and that is another argument for the option.

Mr. WHITEHOUSE. I suggest to the distinguished Senator from Ohio, who has come to this floor so often to share the stories of Ohioans in our health care system, which are heartbreaking, which are tragic; which involve people being thrown completely out of the program when they have the temerity to get sick, which involve families going broke who had insurance, when they find out the insurance policy had holes in it that they have fallen through, when they find out when they become sick they not only have as their adversary the illness they are fighting but also the insurance company they have to fight on the other side--over and over again you have come here with those stories.

If Senator Brown's experience is anything like mine in Rhode Island, I don't get those letters about the VA system. I don't get those letters about TRICARE. Sure, there are glitches now and then; any big system has its problems. But the massive cascade of human tragedy the Senator represents so effectively on this floor with the letters he brings from home--that is not coming out of these systems. That is coming out of the private health care system.

Mr. BROWN. That is exactly right. We don't see veterans or we don't see active-duty soldiers or people on Medicare denied because of a preexisting condition. Soldiers who are injured in the line of duty, imagine if they have a preexisting condition if we don't take care of them in Bethesda or Cleveland or Dayton or in Chillicothe in my State, in the Senator's State the same. It is absurd to think that would be the case. But it is clear these endemic massive problems with people fighting their insurance companies, denied care, come out of the private insurance system.

One of these other myths was one Senator Whitehouse has talked about, that health reform will lead to rationing of health care. It is such a peculiar charge to say about this bill, that health reform will lead to rationing of health care, because we see rationing of health care every day.

Senator Whitehouse pointed out on the floor several times, the model of the health insurance business is this: They hire a lot of bureaucrats to keep people from buying insurance if they are too sick. A large insurance company will have a bunch of employees, a bunch of bureaucrats. When people apply for health insurance, they will check and see is this person going to cost our company too much, so they will deny them, they won't even get insurance with this company--a preexisting condition or something. Then they have bureaucrats on the other end to challenge the claims once one of their insured customers gets sick. So they have bureaucrats on both ends of this health insurance model, stopping people from getting insurance at the beginning and stopping them from receiving coverage. In fact, 30 percent of the claims on the first go-around are denied. Sometimes when you appeal them you can win. But just the idea, when you are sick or you are taking care of a very sick child or spouse or parent or sister or whatever, and you are fighting with the insurance companies to pay the bill--we remember the President, President Obama, talking about that with his mother, the fights she had with the insurance companies to pay for her cancer care as she was dying. We don't hear about that in the public plans. We don't hear about that in TRICARE or in Medicare.

Mr. WHITEHOUSE. It has happened in my family as well. A member of my family whom I loved very much went to the National Institutes of Health to get the best recommendations he could for a very terrible diagnosis he had received. When he went back to New York, where he lived, and filed his claim and began the treatment that the National Institutes of Health top expert on his diagnosis had recommended, his insurance company came back and said I am sorry, no, that is not the indicated treatment. They dropped--tried to, anyway--dropped a bureaucrat between his doctor, a world expert, and the care he was entitled to.

The Senator and I hear these stories all the time. People are not making them up. They happen to us. They happen to people we know. Unfortunately, unlike my family member who fought back and was able to convince the insurance company to honor what the expert at the National Institutes of Health indicated was the standard and approved treatment for that type of condition, many people are overwhelmed by the illness, they are overwhelmed by the paperwork, they are overwhelmed by the battle with the insurance company. They believe what they are told and they allow themselves to get rolled over.

If an insurance company only gets 1 in 10, it still saves them money when they deny people that care. It is in their business model to deny their insureds the care that they paid for, once they have the nerve to get sick. That is a recurring and consistent problem that just plain never comes up in the government programs. It is unique to our very unique position as being the one country in the world that turns over our health care to the profit-making private sector for things we cannot negotiate on, for things that are not elective.

If you do not want to buy a bicycle, you don't have to buy a bicycle. They have to come to you on price. But if you need a heart transplant, there is not a lot of negotiation. We turn that over to the profit sector and as a result we have higher costs and worse results than any country.

Mr. BROWN. I would point out when the Senator said the only country in the world--not every country in the world has a government health care system; not that every country has, or even many of them that have successful health care systems are necessarily socialized medicine or public health care plans. But what they have, when they use private insurance in other countries, they are private but they are not-for-profit private insurance. So they don't have all the bureaucrats in this business model at the beginning keeping people from getting coverage and at the end denying payment for those plans.

The fourth myth we hear so much is related to rationing of care, the myth about rationing of care, and that is that health reform will interfere with decisions that should be between doctors and patients. That is exactly what we are saying again with private insurance now. You don't see that with Medicare.

The ACTING PRESIDENT pro tempore. The time of the majority for morning business has expired.

Mr. BROWN. I ask unanimous consent for 2 more minutes.

Mr. ALEXANDER. Reserving the right to object, I ask to add an equal amount of time, 2 minutes, to the Republican time.

The ACTING PRESIDENT pro tempore. Without objection, it is so ordered.

Mr. BROWN. That is the fourth myth, that health reform will interfere between doctors and patients. That is what we are seeing now. We are seeing so many cases where the doctor and the patient--the doctor puts his or her secretary or nurse on the line or the doctor herself calls the insurance company to beg them for coverage. I have heard doctors say to a patient: I will pay it out of my own pocket if I can't get this covered with the insurance company.

All these resources of the system, the patient's time, the family time, the doctor time, the doctor hiring all these people, the insurance companies hiring all these people to prevent you from getting coverage, the insurance companies hiring all these people to prevent you from getting reimbursed for your expenses--all this goes into what? It is waste. Executive salaries, profits, but certainly doesn't go into patient care.

I ask Senator Whitehouse, why don't you wrap up.

Mr. WHITEHOUSE. It provides no health care value at all and it is going in the wrong direction. Insurance company administrative expense is up over 100 percent. I go to Rhode Island and I talk to doctors and community health centers, for whom 50 percent of their personnel are devoted not to providing any health care but to fighting with the insurance company. So the notion that it is the Government that will get between you and your doctor is truly the big lie. It is the insurance companies that are the ones that, day after day--a manner of their business model--get between Americans and their doctors. We are trying to cure that and we will.

I thank the Senator from Ohio.

The ACTING PRESIDENT pro tempore. The Senator from Tennessee is recognized.

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