Wednesday, June 10, 2009<\/p>\n\n\n\n
Sr. Merkley:<\/p>\n\n\n\n
Mr. President, in the coming weeks we are going to be taking up what probably is one of the most vexing policy challenges of the last 50 years: How to reform our health care system and provide affordable, accessible health care to every single American. The goal couldn\u2019t be more straightforward, guarantee access for every American. And the stakes couldn\u2019t be higher. Our small businesses are collapsing under the weight of health insurance premiums. Just last month, Oregon\u2019s largest insurer announced the small business premium was going up 14.7%. That\u2019s on top of a 26% increase just the previous year. Now, large employers have the challenge as well. In a global economy, our broken health care system is a major competitive disadvantage. A greater share of the price of each car in the United States goes to health care than goes to steel. $1,500 of the cost of the car goes to health care while across the border in Canada that price is zero.<\/p>\n\n\n\n
If we\u2019re going to compete in the world we need a competitive cost effective health care system. And, of course, the biggest impact of our expensive, ineffective health care is most acutely felt around the kitchen table by our working families. With unemployment skyrocketing, virtually every family is reminded of how tenuous its connection is to health care. Just one pink slip away from losing health care for their family. Even those with insurance find health costs out of reach. Nearly half of the personal bankruptcies are by folks who have health insurance but still couldn\u2019t manage all the health care costs when they became ill.<\/p>\n\n\n\n
This is what it boils down to: working families in America, if they have health care, they\u2019re concerned about the co-pays, concerned about being under-insured and concerned about losing their insurance with the loss of a job. Those working families without health care are worried about getting sick and how they\u2019re going to get well if they\u2019re already sick. This doesn\u2019t have to be the case.<\/p>\n\n\n\n
Mr. President, health care is already devouring a large portion of our economy, 18% of our gross domestic product. Driving long-term federal deficits and crowding out important state investments in education, in infrastructure, in social services, and pretty much everything else. And it\u2019s only projected to get worse as our population ages and health care inflation runs rampant year after year.<\/p>\n\n\n\n
Put simply: if we do not reform our health care, our economy will not thrive. That\u2019s a stark choice. Our economy and health care are tied together. Now, Mr. President, I know that none of this is news to you. Nor to any members of this esteemed chamber. And, in fact, since President Truman, 60 years ago called for health care for every working American as a national priority, we\u2019ve been struggling to achieve that goal and we have not yet gotten there. We\u2019ve been periodically trying to fix up a fragmented, expensive, unfair system. But the fear of change has always overtaken the sense of possibility. Those stakes and that history make it all the more critical that we seize this moment to meet the challenge that President Obama has laid out for us and that we deliver on health care reform.<\/p>\n\n\n\n
This is the year, 2009 is the year. This is the year to deliver on the promise, to give every American access to affordable health coverage, to ensure out economy has the same potential, the engine of prosperity, the opportunity of employment in this century that it was in the last century. To make this happen, we have to find ways to make our health care system more affordable.<\/p>\n\n\n\n
We need to spend our health care dollar in smarter ways so we can put money back in the pockets of Americans and make our businesses more competitive. The good news is we have lots of examples of how to do this right now. Extensive research has documented that the regions in our country that spend the most per person on Medicare \u2013 that\u2019s 60% more than the regions with the lowest expenditures on health care \u2013 they don\u2019t end up with better health care. The lowest-spending regions actually have the same or better health care outcomes after you adjust for health history and ages and occupations. Plus, the beneficiaries are more satisfied. So if we could take the practices and change them in the high-cost regions to match the low-cost regions, we would save in Medicare alone hundreds of billions of dollars. Our job in the health care reform effort is to change the rules of the road so they encourage and enable all providers to act more like the high-performers, those providing and delivering high quality, lower cost health care.<\/p>\n\n\n\n
That\u2019s why this legislation needs to get us to start spending our health care dollars more wisely, investing more in prevention, investing in chronic disease management, building a research base about what works and what financial incentives are necessary to utilize those practices. Rewarding care delivery built around coordination and efficiency rather than fragmentation and volume. We know these things work. And we need to make them the norm, not the exception.<\/p>\n\n\n\n
Mr. President, we cannot stop the bleeding in our health care system costs without also doing something about the convoluted and broken health insurance marketplace. The first thing we need to do is end the insurance company practices that penalize you if you\u2019re old, or you\u2019re sick, or you have ever been sick. I\u2019m outraged when I hear stories from Oregonians about being turned away because of their pre-existing conditions or their potential propensity towards certain diseases. The folks who need health care the most are being turned away the most. And that is not a health care system. <\/p>\n\n\n\n
Mr. President, we have fifty million Americans without health care. That\u2019s what this conversation is about. Taking that 18% of our gross domestic product we spend currently and finding a way to provide good quality coverage to every single American, not leaving out 50 million Americans. Those are reforms that anyone can get behind.<\/p>\n\n\n\n
But I understand when we talk about other changes to health insurance, folks can get nervous and worry about the system changing in ways that are not beneficial to them and that\u2019s why I keep coming back to this point: We\u2019re going to provide the health care system we have for the people who have it, we\u2019re going to improve. We\u2019re going to improve it to make it more cost-effective so we can provide health care to the 50 million who don\u2019t have coverage. With the reforms our citizens will have more choice and choice in health care options is a good thing. Instead of leaving individuals and small groups at the mercy of insurance companies providing expensive plans with very high administrative costs, those individuals and those small businesses will be able to participate in a marketplace that groups them together with millions of other Americans so they can benefit from the larger pool of health care participants. <\/p>\n\n\n\n
Now this marketplace will resemble something very close to the list of options that federal employees have. When you become a federal employee you have an option of this plan or this plan or this plan. That\u2019s what we\u2019re going to do. We\u2019re going to provide a list of plans that citizens can choose from to be part of a larger pool. We\u2019re going to provide a list of plans that small businesses can choose from and benefit from being part of a larger pool of insured. Now, this is a structure that we\u2019re familiar with as members of Congress. What works for members of Congress, what works for U.S. Senators, will work for working Americans. These plans give apples to apples comparisons so that citizens can pick the plan that fits their family the best. It will ensure minimum standards so that our workers are not ripped off. And the access to the marketplace will come with premium assistance so that strapped consumers can get help affording the premiums to obtain health care.<\/p>\n\n\n\n
Now, given the track record of inefficiencies and cherry picking by private insurers, I think it\u2019s imperative that consumers have multiple choices including a public option. That public option is simply a way to describe what we\u2019re already providing to our seniors throughout this nation. A public organized plan, a very efficient plan, the administrative costs of Medicare are around 2%, while the administrative cost for our individual applicants to the health care system, for our small businesses is 30%. Why not let our individuals \u2013 why not let our small businesses benefit from a 30% improvement in the use of the health care dollar? Now this public option would compete on a level playing field with private plans and further expand choices for consumers and it would be a tool for keeping costs low. And it should be part of any package we put forward. Now, you would think that all of us here in this room hearing from our constituents in every corner of our state would understand that this whole conversation is about addressing one of the highest stress factors for working families in every part of this nation.<\/p>\n\n\n\n
But there are opponents of this reform. My colleagues across the aisle hired a consultant, Frank Luntz, to prepare a plan to torpedo health care. This plan came out in April. This 25-page document about how to kill any plan that\u2019s put forward. And this goes on to say it doesn\u2019t matter what the specifics of the plan are, just adopt language that attacks it and frames it the opposite of what it really is. Because what this document says is that Americans want this health care reform so you can\u2019t fight it head-on, you have to recharacterize it, reframe it. So what does this plan that\u2019s been put out to kill health care say?<\/p>\n\n\n\n
It says time is on our side. If we can slow the process down, we can kill it. Well, you know, windows of opportunity are open for a certain period of time and then they close. So I suppose that\u2019s smart advice if you want to kill health care. But if you want to do something for the 50 million Americans without health care, then we need to move quickly forward with health care reform. Now, this document \u2013 this Republican document about how to kill health care, it says: say that the plan is centered around politicians. Say that it\u2019s that it is about bureaucrats. Say that it\u2019s about Washington, D.C. Well, I\u2019m not sure what there is about providing health care options to 50 million working Americans who struggle every day to address the cost of health care and often end up in personal bankruptcy and forego all kinds of other opportunities so that their child can go to the doctor. That has nothing to do with bureaucrats. That has nothing to do with Washington. That has everything to do with family values, strengthening the foundation of our families.<\/p>\n\n\n\n
Now this document about how to kill health care, this says, bring in denial, horror stories from Canada or other parts of the world to suggest to people they\u2019ll lose their relationship with their doctor. That somehow they\u2019ll be jerked out of the arrangements that they found to be so satisfactory. Scare them. Scare the citizens of the United States. Well, I can tell you that what is scaring the citizens of the United States is they can\u2019t afford their health care. They want us to do something about it. Bringing up false horror stories that have no bearing on the plan before us to scare \u2013 to scare our citizens and make them worry even more, that\u2019s not responsible.<\/p>\n\n\n\n
What\u2019s responsible is to do something about a broken health care system. <\/p>\n\n\n\n
This plan has lots more about how to kill health care. It says: take and say that this will destroy the personalized doctor-patient relationship. Take and say that this will create waste, fraud, and abuse, and so on and so forth. Every poll-tested set of words designed to decrease support and scare people into foregoing this opportunity, this once in a decade \u2013 or perhaps this once in a generation opportunity that we have to change in our health care system.<\/p>\n\n\n\n
Now, you may think that I\u2019m raising this document before you, this \u2013 this plan for how to kill health care, and that maybe it doesn\u2019t have any bearing on the real debate here. But it absolutely does. These talking points are being echoed in this very chamber, in this very chamber in order to kill health care. Let\u2019s see. Here we go. Frank Luntz\u2019s memo, that\u2019s his memo on how to kill health care, came out in April. It says \u2013 talking point number five \u2013 \u201cHealth denial care horror stories from Canada and other countries do resonate, but you have to humanize them. We recommend the phrase \u2018government takeover\u2019 rather than \u2018government run\u2019 or \u2018government control.\u2019\u201d Why? Because government takeover sounds even scarier.<\/p>\n\n\n\n
So what did we hear in the chamber from our minority leader just recently? I quote \u2013 \u201cAmericans are concerned about a government takeover of health care and for good reason.\u201d And it goes on \u2013 so recognize that that is a point that\u2019s coming from a document about how to kill health care, not a responsible debate about the plan we have in front of us.<\/p>\n\n\n\n
Let\u2019s take a look at another example. Frank Luntz\u2019s memo. His memo, talking points three and four. \u201cTime is a government health care killer, nothing else turns people against government takeover of health care \u2013 than the expectation that this plan will result in delayed and denied treatment. The arguments against the plan.\u201d I\u2019ll note that this is about a plan that wasn\u2019t written. It\u2019s about any plan put forward. \u201cThe arguments against this plan must center around politicians, bureaucrats in Washington.\u201d Note the emphasis on saying that the plan will result in delays and deny treatment. And what have we heard on the floor of this chamber from the minority leader?<\/p>\n\n\n\n
We have heard just recently and I quote \u2013 \u201cAmericans don\u2019t want to be forced by bureaucrats.\u201d That comes right out of the talking points. \u201cTo give up the health care plan to be pushed into a Washington-run government plan.\u201d Right out of those talking points. \u201cThey don\u2019t want to wait two years for surgery. And they don\u2019t want to be told they\u2019re too old for surgery.\u201d All of this straight out of this road map.<\/p>\n\n\n\n
My friends, it is irresponsible in the face of 50 million Americans without health care, with working Americans in every one of our states going bankrupt as they struggle with health care expenses. It\u2019s irresponsible to utilize a road map of rhetoric that comes from polling about how to scare people. That\u2019s irresponsible. What we need to do today is lay out a plan on how we can create affordable, accessible health care for every single American.<\/p>\n\n\n\n
Addressing one of the biggest factors that degrades the quality of life for our citizens across this nation. Now we have a unique opportunity. We have an opportunity because small business wants help with those 26% increases and 14.7% increases in premiums that they\u2019re having to pay and they\u2019re not able to continue paying them. And large businesses are asking for help to become cost competitive so that we can restore manufacturing in our nation and put people to work and rebuild the middle class and have successful international corporations operating out of America. And families around the kitchen table are asking for help today. They know how they struggled. They know if they have health care they might lose it next week when they lose their job. They know if they have health care, they might not be able to make the co-pays if they have something serious happen with their child. And they know that if they don\u2019t have health care, that they\u2019re going to have to forego virtually everything else or perhaps forego the treatment itself because they won\u2019t be able to afford those \u2013 afford to make those payments to the doctor or to the hospital. This is the moment when families and small businesses and large businesses are coming together to paint a new vision to improve the quality of life. To strengthen the foundation for our families.<\/p>\n\n\n\n
Aprovechemos este momento.<\/p>","protected":false},"excerpt":{"rendered":"
Wednesday, June 10, 2009 Mr. Merkley: Mr. President, in the coming weeks we are going to be taking up what probably is one of the most vexing policy challenges of the last 50 years: How to reform our health care system and provide affordable, accessible health care to every single American. The goal couldn\u2019t be […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[32],"tags":[],"class_list":["post-10243","post","type-post","status-publish","format-standard","hentry","category-newsroom"],"acf":[],"yoast_head":"\n