Health Care
Floor Speech
HEALTH CARE -- (Senate - March 27, 2007)
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Mr. BURR. Mr. President, I commend my colleague from Oklahoma, a dear friend and somebody who has been passionate about health care for years. He and I came to Washington together in 1995. We served on the Energy and Commerce Committee, and we recognized then that changes needed to be made. Every year we have seen the same response in Washington. We have seen the end of a calendar year come, the need to find savings in health care. Administrations, Republican and Democratic, turn to Medicare and Medicaid and say we are going to extract $60 billion, $70 billion out of savings in these health care systems. We have laughed as they called it ``waste, fraud, and abuse'' because there is waste, fraud and abuse in it. We just didn't get any money out of it because we have been reluctant to fix the health care system in this country.
What are we doing? What is this plan? This plan is universal health care. Let me say it again. This plan is universal health care. This is providing affordable, accessible health care, provided by the private sector, for every American in this country.
This is change in the design of health care that has been historically, up to this point, employer negotiated, the majority employer paid for, and an employee has very little input into the makeup of the policies that cover them.
It doesn't reflect their age, it doesn't reflect their health conditions, it does not reflect their income.
What we are talking about is shifting it away from employers over time. We are talking about creating real incentives for individuals. We are talking about making sure 47 million uninsured Americans today and tomorrow have tax credits that can be used for real insurance coverage. What does that provide for them? For the first time, it creates a relationship between a patient and a health care professional.
We have talked in this institution, we have talked in this town, and we have talked in this country about the need to project wellness and prevention in health care. Well, this does it. This, for once, accomplishes that because we as individuals can negotiate our plans, not through the group plan but as 250 million-plus Americans. We can negotiate what makes sense for us from the standpoint of the scope of coverage that reflects what we are willing to pay as it relates to premium--and, by the way, provides States the capability to do the same thing with their Medicaid beneficiaries, their Medicaid patients, if, in fact, they want to begin to change the way their care is delivered, by creating the same relationship between a health care professional and them, because they now have the same insurance we do.
Medicaid beneficiaries have this big ``M'' on their foreheads. They do not want to be on Medicaid, but they are there because it is the last resort. What we want to do is integrate them into what all of the rest of us have; that is, individual insurance.
Dr. Coburn hit on a real key; that is, an attempt to bring everyone's health care costs down. It is not to pick out a group and to say, We are going to reduce yours, and pick out a group over here and say, We are going to reduce yours. This is an attempt--it is the first real attempt--to bring every-body's health care costs down.
What we learned when we created Part D Medicare, the drug benefit for 35 million-plus seniors in this country, was that when we created real competition between insurers and we brought transparency to price, two very real things happened: In the first year, premiums dropped 28 percent over what we had projected, and drug pricing dropped 33 percent.
We have a model we have already tried that seniors across this country say: Do not mess with this plan. That, in fact, exemplifies what we are trying to do. We are trying to create real competition between insurance for our insurance business; we are not letting one employer negotiate the plan and then dump it on the employees. But the question is, Can we have the same results as Part D by seeing the cost of health care reduced for all Americans? Well, you start that process when you eliminate cost-shifting. You accelerate that process when you inject what this bill does; that is, transparency in the price of health care that is delivered to you.
Imagine the day that you can go online and you can actually see what your doctor's visit is going to cost, what the lab workup is going to cost, what a visit to the emergency room at your local hospital is going to cost. In markets in North Carolina today, some choose not to go to the hospital for the nonemergency care, even though that may be their primary provider; they choose to go to the community health center because the community health center actually delivers the same if not a better level of care. But one thing is for certain: They know exactly what it is going to cost them. And these are individuals who are insured.
For the first time, all Americans have an opportunity at prevention and wellness. What does that mean? It means we can make decisions about our health care that have an impact on the cost of our health care to us and consequently have a ripple effect across the marketplace, that as more and more Americans make healthy decisions, the cost of health care overall comes down.
It means we have freed up those valuable health care dollars to make sure they are there for the individuals who are going to be susceptible to disease--chronic or terminal illness.
It means the relationship we have now established between patient and health care professionals means we have recognized we can accumulate the data we need so that Medicare reimbursements are no longer a shot in the dark where we pull a number down that may not be reflective of the cost of delivering the service, may not be reflective of the value of the service.
The reality is that when we create that relationship, we are able to accomplish the accumulation of data that tells us what things really should cost.
In health care, those healthy decisions allow individuals to make decisions about disease management. The most costly part of the U.S. health care system is the chronic diseases that exist and our inability to manage those diseases. The most expensive is diabetes.
Today, we have electronic capabilities for diabetics and for coronary heart patients where, at different periods
during the day, their vital signs can be transmitted over a telephone line to their doctor. The doctor can instantly know whether, if it is a diabetic, they are managing their insulin. If it is a coronary heart patient, they can determine whether the fluid buildup means they need to adjust their medication. What does that give us the ability to do? It means we can take a patient who up to that point got too much fluid on the heart, made an emergency room visit, and in all likelihood was admitted for 3 days as they get the medicine back in balance. Now, a doctor, 24 hours a day, as these reports come in, can change their diuretic, can work with a diabetic on checking their blood sugar and what their insulin intake is, can detect whether they took the right medication. We can extrapolate that across every disease because technology now lets us do it in a real way. If we are not able to do this, then we are not able to recognize the value of new technology.
So much technology today that would benefit us in the Medicare marketplace is not reimbursable by Medicare. It is a decision they make because it is not tested in the marketplace; therefore, it has no value because they do not know how to reimburse for it. Well, the reality is, when you have a health care system that responds to the benefits to individuals, all of a sudden you have the market that creates a value for the technologies and for the innovations.
So I am delighted to be here. There is so much to this bill. This bill is the most comprehensive transformation of the health care system in my lifetime.
One might say it is difficult to do so big a bite at one time. I made that mistake. The reality is that when you look at the timeline we are up against every year we do not adopt this type of transformation of our health care system, more Americans become uninsured, more individuals with preexisting conditions no longer can afford health care, and the cost of everybody's health care in America goes up because we have not eliminated cost-shifting.
With disease management we could do today if, in fact, people had incentives in their system to take the time to monitor their health, to take their medication, to counsel with health care professionals about changes they could make, the more money we can save not only for each one of us but for the total system.
I am convinced that if you could only pick one thing out of this plan that you highlighted for the American people, it would be this: For the first time, we are presenting a very real way to insure 47 million Americans, the people who are most at risk in this country. If all of us were the beneficiaries in some way of reduced prices, more access, the ability to have transparency in pricing, the accumulation of data, electronic medical records that enable us to find savings, if that is the byproduct of us finding a way to use savings in the system to insure 47 million Americans, I believe that is the right thing to do.
The President came out in the State of the Union and he presented a very similar plan. Our plan expands on what the President said. Our plan goes to the heart of the health care system and says: If we are going to change it, then we have to go through total transformation. This is that total transformation that at the end of the day empowers every individual in this country to have custom health care coverage for themselves, for everyone in their family, for their health conditions, for their income and, more importantly, for their security.
So I commend the Senator for his work. I now look forward to working with him as we go through what I think will be a very intellectual debate about the future of health care in this country. As some look at Europe and look at other countries and say, Maybe we ought to do that in the future, I believe if we adopt this method we are going to have every country in the world looking at this model and saying, How do we do this? How fast can we do that?
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Mr. BURR. I would only use that time to thank the Senator from Oklahoma. This is a crucial debate that this country needs to have, this institution needs to have. More importantly, we are at a point where we have to stop talking about what we are going to do and actually start doing something. The Senator from Oklahoma has stated it very well. What we can do is bring a higher level of care to all Americans--not just some Americans, to all Americans. Through that effort, all Americans receive a financial benefit. Our system prospers because we are able to take care of more, and we are able to provide an unlimited opportunity in the future because we unleash innovation and technology in health care.
I have wondered what it would be like if we had innovation at the same level in health care as, say, in cell phones; that we would have a new platform every 6 years, and that platform would provide an array of opportunities to us that we are not forced to take, but they are available to us if, in fact, we want them. Health care has been starved of innovation, in large measure because it treats every American differently. This is the first real opportunity for universal coverage, universal access, where every American has an opportunity at the best coverage available.
I thank the Senator from Oklahoma.
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