Service Members Home Ownership Tax Act Of 2009

Floor Speech

SERVICE MEMBERS HOME OWNERSHIP TAX ACT OF 2009 -- (Senate - December 23, 2009)

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Mr. SCHUMER. Mr. President, it is truly my honor to be here on this historic evening and speak in support of the bill which we will vote on early tomorrow morning, Christmas Eve morning. It is an honor because anyone who looks at this country knows the problems we have, and that two problems caused by the health care system are at the top of the list. One represents a more conservative point of view and one represents a more liberal point of view. But I am proud to say the bill we will pass tomorrow morning, God willing, deals with both.

The more conservative issue is controlling costs. The health care system costs this country a whole lot of money. By and large, we get good health care--not everybody but most people. But it is so expensive, and that has been documented.

What does that mean? It means small businesses cannot grow and actually have less money to pay for wages. It means our large businesses are less competitive globally. We have seen that in the auto industry. It means individuals often have to pay a fortune for health care. It means our government runs deficits that are perilous to the economy. Health care costs are more the cause of our deficits than anything else.

On the other hand, we run a real problem because many people are not covered or covered adequately. The heartwrenching stories told by our fine leader--and I cannot give him enough kudos for the job he has done here; and I will talk about that in a minute--but the people who are not covered or covered poorly suffer in many ways. They become not only less happy citizens--that is most important--but less productive citizens. The heartwrenching stories of people who do not have coverage for them or their children we all know about. It also, by the way, increases costs because when people delay coverage, when they are ill, it inevitably costs more.

This bill addresses both. I wish to, in my brief amount of time here--and I do not know how much time I have--address both. I wish to talk on the cost side first.

Why do health care costs go up so much more than any other product? Two main reasons. First, we do not have perfect knowledge, as the economists would say. We basically do not know what we are buying. When we go to the doctor, and the doctor says: You need this test, we do not know if we need it. Is the doctor genuinely prescribing a test we need or is there some element that he makes enough money on this test that why not? can't hurt because we do not need it?

In my family, my relatives have all had prostate cancer, and I watch very carefully. But when I go to the doctor and he says I need this kind of a test or this kind of a scan, I say: Of course. If it were a car or a house, I might investigate to see if I needed it.

The second reason costs are so expensive is because fundamentally health care deals with God's most precious gift to us, which is life. Who would not beg, borrow, or steal to find $100,000--who would not give their right arm if we were told our husband, our wife, our mother, our farther, our son, or our daughter was ill and $100,000 would give them a 25-percent greater chance of living better, of healing? We would do it. But because most of us do not have that $100,000, we buy insurance. That is the reason there is health care insurance. It is not because it is health care; it is because it is so vital and so expensive. So we are willing to pay $5,000 a year, so that, God forbid, if that time comes when we need that $100,000 to cover a loved one, it is there because we have insurance.

So when I go to the doctor and he says I need this special test, special scan, special procedure, not only do I not know whether I need it--because the training is difficult; and you can go online, but you cannot really figure these things out--but, second, I am not paying for it.

You put those things together, and the costs go through the roof. We have tried in this bill to finally get a handle on the costs. Most other countries have. In America, we haven't. We must. I believe very deeply in covering everybody, but unless we get a handle on the costs, we will not be able to afford to cover everybody. Even if we cover them today, we will run out of money in 5 years. We do it in four ways, and I am going to be very brief about them because my time is somewhat limited.

First, we deal with efficiencies. There is one form. If there is IT, as we put in the stimulus bill--information technology--we can save hundreds of billions of dollars. Just one form. You go to a doctor's office, there is a nurse, a doctor, and there are four people filling out forms. If you had one form, you wouldn't need that.

Second, prevention. Early intervention and prevention saves billions, and in this bill that is what we encourage, early intervention and prevention. Right now, amazingly enough, if you get diabetes in the later stages, Medicare or private insurance will pay for dialysis. God forbid someone needs a leg amputation, one of those serious retina operations, they pay. They don't pay for the early stages. They don't pay for the nutrition therapy, the exercise therapy that could arrest diabetes in the early stages. We do that.

The third thing we try to do in this bill is provide competition in the insurance industry, and we do provide competition in the exchanges. We do put some limits on the insurance companies with the medical loss ratio provisions that Senator Rockefeller, Senator Franken, and Senator Nelson helped craft. If we could have had a public option, it would have created more competition. That is one of my great regrets, that we don't. I worked hard for it, but we don't. Nonetheless, we still get some limitation on insurance companies and create more competition.

The fourth is the hardest: fee for service. The fee-for-service system is what drives up the costs. This bill, more than any other provision ever passed in America, begins to grapple with that most difficult issue.

You do those four things, and you will bring costs down.

It is no wonder that CBO has said that in the first 10 years, we save $127 billion, even though we are covering 31 million more people, and in the second decade, we are going to save over $1 trillion. I forget the number. I think it is $1.3 trillion. We are doing whoever becomes President in 2020 a huge favor because with the cost-control provisions in this bill, should they become law, we will get a great handle on costs. It will take a while, but it will do the job. On the other side, we don't cover everybody, but 94 percent of all people will be covered, so it is an amazing feat to both cover many more people and reduce costs, and that is what this bill does.

I wish to say, for my home State of New York, there are lots of good things in this bill. We have 800,000 seniors who would be cut from Medicare who will not be because of provisions we were able to get in the Finance Committee.

Graduate medical education, intermediate medical education--a lifeblood for jobs in New York because training doctors is probably our second biggest industry in New York City--is not cut even though it was proposed to be cut. Money for neighborhood national health services and community health centers will provide physicians in inner cities and in rural areas where they don't have health care. They will get really good health care.

This bill is far from perfect. Had I written it, I would have written it a different way. Had Senator Cantwell or Senator Casey or Senator Klobuchar written it, they would have written it differently from me. But if every one of us in this Senate insisted that the bill had to be written exactly our way, we would have 100 bills, each with 1 vote, and no progress. So great progress has been made, and this is a proud moment.

There are many people I wish to thank.

My staff--I do want to mention Meghan Taira, Katie Beirne, and all of the others who worked so hard; Jeff Hamond, who worked so hard and so diligently on this bill.

I thank MAX BAUCUS. He soldiered on and on when things looked bleak and
pursued his dream of a bipartisan bill, which would have been a better product. It wasn't to be but not because of lack of his efforts.

Thanks go to Senator Dodd and Senator Harkin on the HELP Committee and my colleagues on the Finance Committee, but at the top of the list is just one person, and I was proud to be one of his lieutenants on this, and that is HARRY REID. I was up close. What an amazing job that man did, modestly, without complaining, without looking to what was good for him. He had a mission, a job: get us 60 votes on this very difficult, complicated proposal. And he did it. He will never get the credit he deserves because he is such a modest man, but I wanted to share that with my colleagues and with the country as I am sure others have done before.

So this bill is a very good bill on both sides of the ledger. It will reduce costs rather significantly and in a smart way, without hurting patient care. It gets rid of the fraud and the waste and the abuse and duplication. At the same time, it will cover many more people.

This is a very fine day for this country, this Senate, and Leader Reid. Tomorrow morning, I will be very proud to vote for this piece of legislation, certainly one of the most important I have ever voted on in my 35 years as a legislator.

I yield the floor.

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