Wednesday, December 2, 2009

I rise today to share a few thoughts about our health care proposal and also to address the amendment of my good friend from Maryland, Senator Mikulski.  We’ve heard the word “arrogant” echo in this Chamber. “The bill before us is arrogant.”

   And, I come to it with a somewhat different perspective.  For 10 years, as a Representative of a working class neighborhood back in Oregon, as a State legislator, I have heard a lot of stories from America’s working families–from the working families in my House district back home, a lot of stories regarding health care.  A lot of concern that they can’t afford health care.  A lot of concern that their children do not have appropriate coverage.  A lot of concern that their health care is tied to their job, and if they lose their job, they are going to lose their health care.

   There is a huge amount of stress for America’s families who understand that if you have health care you have to worry about losing it, and if you don’t have it, you have to worry about getting sick. That is why we are here today in this Chamber debating health care, because so many of us have heard from our constituents, so many of us know from our personal experience what a dysfunctional, broken health care system we have in America.

   Now sometimes, listening to this conversation on the Senate floor, you would think this is a rather complicated debate.  But the heart of this bill is not that complicated.  The heart of this bill is that every single American should have access to affordable, quality health care, and that we can take a model that has worked very well for the Federal employees of our Nation, a model that encourages competition, a model that says let’s create a marketplace where every individual, every small business that currently struggles to get health care –  has to pay a huge premium for health care–enable them to join a health care pool that will negotiate a good deal on their behalf.

   I think every American who has tried to get health care on their own, every small business that is paying a 15 to 20-percent premium because they don’t have the clout of a large business, understands if they could join with other businesses, if they could join with other individuals, they would get a lot better deal.

   Americans understand if there is a large pool of citizens who are seeking health insurance that insurers are going to be attracted to market their goods. We have seen that in the Federal employees system, where insurers come and compete.  It turns the tables.  It takes the power away from the insurance companies and it gives the power to the American citizen because now the citizen is in charge.  Now the citizen gets to choose between health care providers instead of having to search for anyone who they can possibly get a policy from.

   I do not find that it is arrogant to try to create a system in which individuals and small businesses get health care that is more affordable health care.  I don’t find that a bill that says we are going to invest in prevention – that’s not arrogant, that’s smart.  I don’t find a bill that says we are going to create incentives to do disease management so someone suffering from diabetes has the disease managed rather than ending up with an expensive amputation of their foot.  That is intelligent, that is not arrogant.

   I don’t find that having a bill that says that every single American is going to find affordable health care, and if they are too poor to afford it we will provide a subsidy to assist them – get everyone in the door, that is not arrogant. That is saying we are all in this together as citizens and that health care is a fundamental factor in quality of life.  It is a fundamental factor in the pursuit of happiness.  It is not arrogant to find for fundamental access to health care.

   I rise specifically to address the amendment offered by my good friend from Maryland, Senator Mikulski.  The legislation we are considering has many parts that make health care more affordable and available, expand access; many parts to hold insurance companies accountable.  But a big part of health care reform also deals with helping people avoid illness or injury in the first place.  That is what Senator Mikulski’s amendment does and why it is so important that it be included in this package.

   Preventative screening saves lives.  That is a fact.  Early detection saves lives.  That is a fact.  Too many women forgo both because of the cost.

   I want to share a story from a physician in Oregon.  The physician is Dr. Linda Harris.  I am going to quote her story in full.  It is not that long.  She says:

   I work one day a week at our county’s public health department.  There I met Sue, a 31-year-old woman who came in with pelvic pain and bleeding.  She proved to have extremely aggressive cervical cancer that was stage IV when I diagnosed it.

   She continues:

   When Sue was 18 she had a tubal ligation after she gave birth to her only child.  As a single mom she did not have the financial resources to have more children.  She concentrated on raising her daughter. Sue always worked, sometimes two jobs at once, but never the kind of job that offered health insurance.  But because she had a tubal ligation she did not qualify for our state’s family planning expansion project that provides free annual exams, pap smears and contraceptive services to many of our clients.

   The doctor continues:

   Cervical cancer is an entirely preventable disease.  Pap smears almost always find it in its pre-invasive form, but Sue never came in for a pap smear or an annual exam.  Her lack of affordable access to basic health care proved fatal. When Sue died of cervical cancer her daughter was 13.

   That is the completion of the story that the doctor shared.  Sue should not be viewed as a statistic in a broken health care system.  But, instead, we should take her story to heart, about the importance of preventive services.  Sue is one of 44,000 Americans who die each year because they lack insurance, according to a recent Harvard Medical School study.

   Let me repeat that statistic because I think it is hard to get your hands around–44,000 Americans die each year because they lack insurance. I don’t think it is arrogant to say we should build a health care system that gives every single American access to affordable, quality care so that 44,000 of our mothers and fathers, our sons and brothers, our daughters, our wives, our sisters–so that 44,000 of them do not die each year because they lack insurance.

   Senator Mikulski’s amendment will help keep this tragedy from happening to our families.  To put it plainly, it will save lives.  It does this by allowing the Health Resources and Services Administration to develop evidence-based guidelines to help bridge critical gaps in coverage and access to affordable preventive health services–the same approach the bill takes to address gaps in preventive services for children.  This will guarantee women access to the kinds of screenings and tests that can prevent illnesses or stop them early.

   As the American Cancer Society Cancer Action Network notes:

   Transforming our broken “sick care” system depends on an increased emphasis on prevention and early detection, enabling us to find diseases when they are easier to survive and less expensive to treat.

   That last point is also important.  Treating illnesses also saves money.  With so much emphasis on the cost of health care, we should all agree that it is common sense to include reforms that lower health care costs for all Americans.

   I was noticing that her amendment has a long list of organizations stating how important this is–the National Organization for Women, the National Partnership for Women and Families, the Religious Coalition for Reproductive Choice, the American Cancer Society-Cancer Action Network, the National Family Planning and Reproductive Health Association.

   I applaud Senator Mikulski for offering this amendment.  I urge my colleagues to remember the 44,000 Americans who die every year because they do not have access to insurance, they do not have access to preventive services, and vote to include this important reform.