Service Members Home Ownership Tax Act Of 2009
Floor Speech
SERVICE MEMBERS HOME OWNERSHIP TAX ACT OF 2009 -- (Senate - December 21, 2009)
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Ms. KLOBUCHAR. Mr. President, late last night, as my colleagues are aware, the Senate took the important step to move forward on health care reform. After all the work, the debate that has gone on for this entire year, we owe the American people a vote on this issue. We can't afford to ignore this situation anymore.
I know some of my colleagues on the other side of the aisle have been talking about a lack of debate. I think anyone who has turned on C-SPAN for the last few months will tell you there has been a lot of debate--not only that, a number of Republican amendments were actually included in the original bill, the HELP Committee bill. When it came out, I believe it was something like 130 amendments that were included that came from their side--and the Finance Committee as well.
I remember the first bipartisan meeting we had on health care reform was something called Ready to Launch that the Finance Committee put together. I remember Senator Whitehouse and I were there. It was literally a year and a half ago. So many of the ideas that are now incorporated in this bill that Senator Bennet from Colorado just so eloquently went through are in this bill, so many of the bipartisan ideas to kick off cost reform, to start rewarding high-quality care, to start bringing down those costs in a way that gives us the high-quality care.
We all know that rising costs are not sustainable. If we don't act, these costs are going to continue to skyrocket.
So what was the vote about last night? The vote last night was to say we are not going to put our heads in the sand anymore. We are not going to keep letting these costs go up.
Ten years ago, the average family was paying $6,000 a year for their health insurance. Now they are paying $12,000 a year. Well, 10 years from now, if we don't do anything about this, they are going to be paying $24,000 to $36,000 a year for their health insurance. Just look at these numbers. Look at where we are. In 1999, a single person was paying about $2,100 for their health care. They were paying for a family, $5,790 for their health care. Where are we now? Last year, in 2008, a single person was paying $4,700 for their health care and then a family was paying $12,680. Especially during this difficult economic time when wages haven't been going up, people have been losing their jobs, cutting back on their hours, and look what their health care costs have been. It has been a higher and higher percentage of their family budget, a higher and higher percentage.
At the same time, health care expenditures are going up and up and up. In 1995, we were spending something like $12 billion and now it is way up to $2.5 trillion. This is the kind of money we are talking about when we look at why we have to do something to bend the cost curve. When people at home hear this term ``cost curve'' and they don't know what it means--well, this is exactly what it is: The cost curve has been going up and up and up for health care in America.
So $1 out of every $6 spent in our economy is on health care. Over 20 percent of our economy, by 2018, we believe, will be spent on health care. American families can no longer afford it.
Who has been taking it the worst? Small businesses. They are paying 20 percent more than large businesses for their health care. In a recent survey, nearly three-quarters of small businesses that did not offer benefits cited high premiums as the reason.
These are little companies such as Granite Gear up in northern Minnesota and Two Harbors. I went up there and visited them. They are a thriving little company. They now have 15 employees. They are making backpacks for our Nation's soldiers because they make such high-quality backpacks. Do you know what the man who started that company told me? That if he had known how much his health care would cost with his family of four--he did not have kids when he started the business--he would not have started it today. He is paying $24,000 in Two Harbors, MN, for a family of four.
This is what it really means when you look at the numbers. Inflation usually raises the cost of most goods and services between 2 and 3 percent a year. What have health care premiums been doing? Health care premiums have been going up close to 8 percent a year, and that is an increase Americans simply cannot afford.
What does this bill do? I was listening to some of the commentary and taking part in it myself over the weekend. There seems to have been a lot of talk about these delayed benefits. Why don't we talk about the benefits that are taking place right when the President signs this bill, within the first year of this bill?
The first thing is, if your kid loses their coverage because something goes wrong--if they get diabetes or if they have some childhood disease--guess what. They are going to be able to get health care. There is no longer a ban on preexisting conditions immediately, and then in later years that applies for adults as well but immediately for kids.
Immediately, by 2011, within the first year of the bill, our seniors are going to be covered in that doughnut hole for their prescription drugs. So many of them for so long--I know my own mother would complain about this doughnut hole where they fall off a cliff and are not able to pay for their drugs because they do not have enough money. That will be covered.
A number of the small business tax credits take effect by 2011. These are real benefits for the people of this country--real benefits.
The thing I care most about in this bill which Senator Bennet discussed is this idea of getting our money's worth for our health care dollars. What does this bill do? This new bill--we have taken a lot of the good from the original bill and made things even better: $132 billion off the deficit in the first 10 years and in the next 10 years, $1.3 trillion off the deficit. That was the most important thing to people in my State when I went around. They said: We want to get rid of these preexisting conditions, we want to make things better so we have better health care, but we want to make sure we do something about the deficit, start doing something about costs.
As you know, Mr. President, Minnesota is a mecca for health care. We have one of the high-quality, cost-efficient, low-cost States in the country. In fact, when we look at some of the numbers, one of my favorite ones--and
maybe this will be the last time I will say this before the end of the year--is Mayo Clinic. They did a study out of Dartmouth, and they looked at what Mayo did with chronically ill patients. What they found was this: If other hospitals in the country simply use the same high-quality care Mayo uses--bring the family in, talk to them about what the care should be for the patient--they talk to the patient and then figure out what is the best course. They work as a team, like a quarterback with a team working with that quarterback. They do not have 20 specialists falling all over each other; they work as a team. What this study showed was this kind of health care for that subset of chronically ill patients in the last 4 years of their lives, the quality ratings were sky high for the Mayo Clinic. The families felt good about how their loved ones were treated.
What Dartmouth found is if all the hospitals in the country followed the same protocol, we would save, for this subset alone, $50 billion every 5 years in taxpayer money, giving patients that Mayo health care, giving them high-quality health care. It is counterintuitive to people. If you go to a hotel and you pay the most, you are going to get the best room with the best view. That has not been the same in American health care. In fact, there is an inverse relationship.
I see my friend from Ohio. Ohio has the Cleveland Clinic, and there is Geisinger. Those places that offer high-quality care also tend to have some of the lowest costs.
Those are the incentives we are putting in this bill--incentives for accountable care organizations, incentives for that integrated care I talked about instead of people running around with x rays to 20 specialists, getting charged every single time, but then one specialist does not know what the other specialist is doing. They don't know what kind of drugs you are allergic to when you go in for surgery. This is because there is no communication. This bill promotes that integrated care where you put the patient in the driver's seat so they have their pick of a doctor. That is what we want--bundling of payment so you start rewarding outcomes instead of the number of tests and procedures.
My favorite example of this came out of the Geisinger Clinic in Pennsylvania, where they said: We are not that happy with how we are treating diabetes patients. So instead of having everyone wait to see an endocrinologist, a doctor, we are going to have some of the routine cases see nurses, and the nurses will report to the doctors, and the patients will be happier because they will be able to see a nurse more often. The most difficult cases will be treated by endocrinologists.
They did that for about a year and looked to see what the results were. Guess what. The patients were much happier because they were able to communicate one-on-one with the nurse. The doctors were able to handle the most difficult cases and monitor the other cases. They saved $200 a month per patient with this kind of system. Higher quality care and better patient outcomes.
What does our system do when they see this kind of smart, cost-effective result for the doctors and for the system and for the taxpayers? They actually are told: You get punished for this under our system. You are going to get a lot less money if you do something like this. That is what I am talking about.
On hospital readmissions, we could save $18 billion a year. If you go in the hospital and you are treated, you want to go home. You don't want to go back into the hospital because someone made a mistake or they gave you an infection. Let's provide incentives--that is what this bill does--so that we reduce those hospital readmissions, make life better for the patient and at the same time reduce taxpayer money. That is what this bill is about.
Right now, fraud is $60 billion. I don't think anyone would believe this. A senior who just depends on Medicare, right--we have to tell our seniors today that $60 billion a year is wasted on Medicare fraud, going to con men, going to people who set up storefronts and they get fake checks and they are not even real. That is where the money is going right now--down the tube, siphoned off by fraudsters. What this bill does is give the tools to improve that situation so that will not happen anymore.
That is what we are doing with this bill. It is about reducing costs, it is about raising quality, and it is about saving Medicare so it does not go in the red by 2017, giving it 10 more years and beyond because of the delivery system changes.
I am proud to support this bill. We continue to work for reform. As you know, this is not just an end, this is a beginning. There will be more work to do in the future, but we cannot put our heads in the sand. We have to vote on this bill. We have to get this done.
I yield the floor.
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