Energy And Water Development And Related Agencies Appropriations Act, 2010

Floor Speech

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Mr. DODD. Madam President, before he departs from the floor, I commend our colleague from Delaware, our new colleague from Delaware, Senator Kaufman.

Senator Kaufman was appointed to fill the seat of my great friend and colleague and seatmate for many years, Joe Biden. And while he has only been here about 6 months as a new Member of the Senate, what a wonderful contribution he has made. I have watched him over the last number of weeks, with his focus and attention on people who work for our country every single day but who probably will never get much credit for showing up every day and doing a wonderful job on behalf of the American people. Whether they be civil servants, police officers or others--the military--the fact he has taken as much time--almost on a daily basis, I say to my colleagues and others who may be watching these proceedings--Senator TED KAUFMAN of Delaware has made it his business to express our collective gratitude to these people who serve our country every single day to keep us safe and secure and to keep us functioning as a society.

It may not seem like much to some, but I will guarantee there are thousands of people today who are at work who appreciate it. And there are millions more, I suspect, whose family members, whose neighbors, whose coworkers, and others appreciate the recognition he has given them, as well as some ideas he has brought to the table legislatively to make a difference for people.

So I commend my fellow colleague. For a relative newcomer and a short timer, he has made a substantial contribution to our country, and I thank him for it.

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Mr. DODD. Madam President, I have been on the floor every day and speaking about health care, for a few minutes anyway, although I know there are other matters of business before this body.

I am privileged to work with the Presiding Officer on the Health, Education, Labor, and Pensions Committee--a new member who has made a tremendous contribution as well to our efforts--and as she knows, back a few weeks ago, we went through that marathon session to try to at least fulfill our obligation on the health care debate and to deal with the matters over which we have jurisdiction--things such as prevention and the quality of health care, the workforce issues, the fraud and abuse questions, as well as other matters. Obviously, the Finance Committee has to grapple with these as well. So I thought it would be worthwhile, over these last number of days, to talk about things we have done in our bill. It will be a part, I hope, of a combination of efforts when we meet hopefully in the next few weeks, depending upon the outcome of the efforts in the Finance Committee, which we are all waiting for with anticipation, and confidence, I might add, as well.

I have a lot of confidence in KENT CONRAD, and MAX BAUCUS, CHUCK GRASSLEY, and JEFF BINGAMAN, and others involved in these negotiations to try to reach some understanding that will allow us to move forward. But I thought in the meantime it would be helpful to talk about various constituencies in the country and what this means to them. Because I think we all want to know how does this affect me and my family--what we are doing here. People are saying: I know you are talking about access, and you are talking about quality of health care, talking about the cost of health care, but I wish to get some idea of what are you doing and how it affects me and my family, and where is this all heading.

So while we are only in the first stages of developing what we hope will be a comprehensive proposal on health care reform, it is important that we at least communicate with people where we are coming from and how we look at these issues.

We have all heard the numbers, that 47 million Americans have lost or do not have health care today--a statistic I bring up every day, because I think it is important to point out. We completed our work about 2 weeks ago on the Affordable Health Choices Act. Since we completed our work 2 weeks ago, 196,000 fellow citizens have lost their health insurance. About 14,000 a day lose their health care coverage. About 100 people in Connecticut lose their health coverage, for one reason or another--they lose their jobs or their employers decide to drop their coverage; all sorts of reasons that can cause someone to lose their health care. Overall, it is about 14,000 a day.

These are people who have health insurance but are losing it. These are not people who have no insurance. They are just added to the rolls. And some people get health insurance as well and come off the rolls. So it is important to point out that happens as well.

But it is worthwhile to note that every single day we go forward in this process--and it is an important and deliberative process. I am not in favor of rushing something through. We need to get this thing right. It is a terribly complex matter. We have all noted that almost every single Congress over the last 70 years, along with almost every administration over the last 70 years, has tried to solve this issue. Some have succeeded in part. But there is a reason this has not happened up to now. It is because it is not easy. I commend our colleagues for trying as well as commend the Obama administration for insisting this issue be such a high priority.

Why is that the case? It is not just because it would be nice to get it done. It is because if we do not get something done, the status quo is debilitating, to put it mildly--first, in macroeconomic terms of what it does to our country, in terms of consuming such a large part of our gross domestic product, that easily could jump to 35 percent. What does that mean to the average family? That gross domestic product number, which may not mean much to many people--what does that mean? It means the average family could, in 8 to 10 years, if we did nothing and let the status quo continue, that about 50 percent of your gross income would be consumed in paying for health care premiums if you wish to have your family covered. Obviously, that is unacceptable and unsustainable. If we were to end up consuming that much of our gross domestic product and our incomes each year, families could not survive.

Today I would like to speak for a few minutes about a group of Americans who are being cheated by the current system. Those are the very people who are affected by this number, people who have health coverage but lose it every day because of various economic circumstances or other problems they face and for whom I would also say the status quo is unacceptable. These are Americans who have insurance but are underinsured. Their numbers are roughly 25 to 30 million of our fellow citizens. Obviously, it changes every day as many lose their coverage. These are about 25 to 30 million people who cannot get the care they need. These people paid good money for health insurance, and they think in exchange they are going to receive at least some guarantee that if things go wrong--if someone in their family gets a cancer diagnosis or is hit by an automobile or some other injury occurs--at least they will not have to be concerned about whether they can afford to pay for the care they need.

They worry, obviously, about getting better, getting back on their feet. But there is that sense of stability and certainty that I have a health care plan. I am not going to get wiped out. I am not going to get ruined economically. I have insurance. It may not be great, but I am in pretty good shape. I feel pretty confident, if something tragic happens, I will be OK. That is what insurance literally is supposed to mean.

Life is uncertain. Unfortunately, things happen to all of us. People get ill, injured, people get hurt. While you expect to get better, you want to be sure you are not going to get wiped out. But in our Nation, the wealthiest in the world, of course, nobody should lose their home or their economic security because of an illness or injury, in my view. We write checks to insurance companies every month or see premiums deducted from our paycheck and what do we expect in return? We expect that if something happens, we at least will not have to worry about anything but getting better, getting back on our feet again.

Unfortunately, for tens of millions of our fellow citizens, that is not how it works at all. These are people who have insurance, but they cannot be sure about anything. There is the uncertainty of what will happen. Some find out the hard way that their insurance does not cover what they thought it covered. That fine print you kind of glazed over when you signed onto that contract, I know we all wish we had read it better, understood it better, but the reality is, when you finally are in some situation and you go to this company and say I think I am covered, they say: I am sorry, but if you had read this more carefully you would have understood that fact situation is not covered, that your preexisting condition that you didn't properly let us know about excludes you from the kind of coverage in these situations. You may have high deductibles and copays. You may have an injury that can be taken care of for $5,000 or $10,000, but your insurance doesn't kick in until after that.

Five or ten thousand dollars may not seem like much for some, but for a working family, that can also be a major economic crisis.

Some who suffer from serious illnesses, such as cancer, hit an annual or lifetime benefit cap; thus, the sickest Americans find themselves cut off entirely.

Our legislation, by the way, that we adopted, the Presiding Officer, myself, and 21 other Members of the Senate, we eliminate preexisting conditions so you never again have to be excluded from coverage because of that preexisting condition. We will not exclude you because of portability. Today if you moved you could lose your coverage. And we will not allow these caps either. Today you could find out that while you have a serious illness, your coverage will take care of you for a week or two, or three or four or five visits, but that is it. Our legislation eliminates those kinds of concerns that people have worried about for a long time.

Many of our fellow citizens, of course, have children. Children have different health care needs than adults. For millions of children who fall under insurance provided by their parents' employer, those needs are not covered. Some have that coverage taken way by a profit-hungry bureaucrat at the moment when they need it the most, and many of our fellow citizens watch as skyrocketing premiums slowly consume more and more of their family budget until they have to choose between having their kids uninsured or having them receive the kind of benefits they ought to be receiving as children.

When we talk about health care reform, we are not talking about a free gift for the American people. We are talking about keeping a promise to our fellow citizens. We are talking about guaranteeing that insurance actually insures against economic ruin for working families. As it stands today, millions of our fellow citizens with health insurance are spending their life savings on care; 50.7 million insured Americans spent more than a dime out of every $1 they earned on health care last year. That is, more than 10 percent of their income today is spent on health care; last year, more than 50 million of our fellow citizens. For almost 14 million of our fellow insured Americans it was more than 25 cents out of every $1 of their income that was spent on health care. As it stands, millions of our fellow citizens, not just the uninsured, are unable to get the care they need when they need it.

Let me share some numbers, if I can. I am always reluctant to do this because numbers can glaze over the eyes of people, but people can find themselves in these situations. These numbers affect people with insurance primarily. Some here are without insurance but primarily with insurance. Today I wish to focus on the underinsured--not the people, the 47 million without insurance, I am talking about the 30 million now underinsured or those who have insurance but have high deductibles and expect out-of-pocket expenses.

Thirty-seven percent of people insured in our country took home remedies or over-the-counter drugs instead of seeing a doctor. They decide to go that route rather than getting the kind of care that would reduce their health care problems; or 31 percent postponed getting health care they need because of cost; or they skipped a recommended test or treatment, 27 percent; or they did not get a prescription filled, around 25 percent; and close to 20 percent cut pills in half or skipped doses altogether in order to try to meet their health care obligations. Obviously, in doing so they put themselves at greater risk for even more problems medically, thus raising the cost for care when they end up going back in to treat a problem that could have been contained if, in fact, they were taking the medication as prescribed.

This gives you some idea of the kind of choices people make who are insured. These are not the uninsured now, these are insured. This is in terms of what they need in order to provide for themselves.

When we talk about health care reform, I think it is very important we talk about the many people in this country who believe they are in good shape and are not worried they are going to lack coverage if, in fact, a health care crisis confronts them. The reality is, this constituency of our fellow citizens with insurance has much to worry about with the status quo; thus, the necessity for reforming a system in areas where it is broken and leaving alone those areas where it works pretty well.

This is not just people, again, who do not have insurance. These numbers include people, obviously, who have insurance. Americans with health insurance are forced into bankruptcy, as we know, as well. The numbers are not ones I make up; 62 percent of the bankruptcies in our country over the last several years occur because of a health care crisis in that family. That statistic is alarming. The next statistic is even more alarming to me--75 percent of that 62 percent are people with insurance. Here are people with insurance who ended up in bankruptcy because of a health care crisis. That is the last thing you would assume to have happen to you. If you have health insurance and you run into a major health care problem, you are assuming because you paid those premiums you are not going to be put into bankruptcy or financial ruin. Three out of four people in that 62-percent number had health insurance and still ended up being bankrupt or put into a bankruptcy situation.

Fifty percent of foreclosures--there are 10,000 foreclosure notices every day in the country, roughly. Those have been rather static for a long time. But 50 percent of those notices went out to families who are losing their homes because of a health care crisis.

I don't know the number of how many of that 50 percent had insurance or not. I don't have the same statistic as I did for the numbers of bankruptcies. We ought to try to get that number if we can, to find out what percentage of the 50 percent actually had insurance at the time they got the foreclosure notice.

Americans with health insurance give up the financial foundation they have worked a lifetime to build because we have not taken the action to fix the system that too often is designed to deprive them of the coverage they thought they bought at the very critical moment they need it. What I discovered over the years is there are sort of two groups of people within the insured category. Everyone in that category has insurance. As long as you have never had to deal with it, then you feel pretty secure about it--and you should--because you think you are covered. If all of a sudden you find yourself dealing with it and you thought you had the coverage, that is when it drives you to frustration, to put it mildly, when you discover that condition was a preexisting condition; there were caps on how much you could get for that; that, in fact, the very illness you have was never covered under the insurance policy.

That is where an awful lot of people discover, despite that sense of security they had, that the present system is more designed to deprive them of the coverage they need rather than to help out during those crises. That is why this issue is so important.

Again, this is a complicated one. There are no simple answers to it. We are not going to resolve all those problems even with one bill. It will be a perpetual struggle for us to get this right in the years ahead, but we need to from an economic standpoint, as well as serving the needs of individual people.

This debate is not just about the uninsured. I think we make a huge mistake if we leave that impression with our fellow citizens. This is not just about the 47 million without insurance. We would all like to do something to see to it that people who are uninsured get coverage, but it is about the millions of people who have insurance, the 30 million underinsured, and the many more who have insurance but could find themselves without the kind of coverage they anticipate having.

Each one of us, of course, insured or not, is hurt by inaction. Premiums are rising faster than wages. One insurance company in my State of Connecticut the other day announced they were raising their rates by 32 percent. Imagine that, a 32-percent increase in premium cost for health insurance coverage.

The average family writes a check for $1,100 in our country, $1,100 to cover the uninsured because we in this country take care of people. If you are uninsured in Connecticut or North Carolina and something terrible happens to you and you show up in a hospital in Charlotte or Hartford, we take care of people. That is because of who we are. If you walk into the emergency room, we do not throw you out, we take care of you. I am proud I live in a country that does that. But Americans need to know it is not free when people show up without insurance, with no ability to pay for the care they get in North Carolina, Connecticut or anywhere else. That bill gets passed on.

To whom does it get passed on? To the insured who get added costs in premiums to get covered. That is a tax you are paying each year, about $1,100 to pay because of uncompensated care. We try to address that because we ought to.

That is one way to bring down the costs for the insured in our country. There are other ideas as well that our committee worked on: prevention; the quality of care; reducing some of the problems with the five chronic illnesses that consume 75 cents of every $1 in our Nation for health care. These are measures we take to try to move that curve, if you will, downward when it comes to affordability and cost, as well as, of course, improving the quality of health for all our fellow citizens.

Of course, in this body, we all have health insurance--I made that point over and over again, every Member of Congress, every Member of this body. I never had to go to bed at night with one eye open, wondering whether, if something happened to my 4-year-old or 7-year-old daughters, I would be able to pay for it in the morning with the policies we have. I am glad we do have good health insurance. I just think it is important, as we are here, to remember a lot of the people we represent are not in that situation, to remember the uncertainty and lack of stability they live with. When a crisis happens--and it happens every single day to people--when that happens, they ought not to have a sense of free-fall: I will get wiped out; I can't possibly take care of this; I can't even provide the care my child needs.

I will never forget Senator Kennedy--who is the chairman of the committee I have been asked to help, to temporarily step in and write this legislation because of his own illness. Senator Kennedy has told the story over the years of when his 11- or 12-year-old son, Teddy Kennedy, Jr., developed cancer, and it was a serious form of cancer, one that was very dangerous and could take his life. He had to have his leg amputated. But there were some protocols to determine whether they could treat that cancer. They let Senator Kennedy's son be part of that protocol because during that kind of test they welcome you into it. It doesn't cost anything.

Halfway through that test, that protocol, it was determined that treatment actually worked. It could save Senator Kennedy's son's life, as it could the lives of the other children who were utilizing that drug. The difference was, of course, once the protocol was determined to be successful, it no longer was free, and it was very expensive--thousands and thousands of dollars.

Senator Kennedy, obviously, as he tells the story, comes from a family who had the resources to be able to write that check to continue to make sure his son would get the treatment that allowed Teddy, Jr. to recover, to lead a very healthy life. Today he lives in my State of Connecticut with his wife Kiki and their children, and he got that kind of medicine.

But he tells the story of other families at that time, years ago now, who did not have the money and begged the hospitals and doctors: Could they get a quarter of the treatment, could they get a half of it, to see that their child may have the same chance to succeed and recover as Senator Kennedy's son did.

It was that moment that Senator Kennedy, some 40 years ago, 35 years ago, decided this would be the cause of his life, when his child, because they had the resources to get the treatment, could get back on his feet but some other child, through economic circumstances, could not.

In the United States of America, no child ought to be deprived the opportunity--or that family--to get back on his or her feet again. I think that is what joins us here together. I think this is hard. We realize that. It is difficult. But I believe it demands our attention and time.

So for those who are insured today, and while they are feeling pretty secure--and I hope you do--understand that these moments can happen. If you are uninsured, obviously it is a frightening feeling of what can happen in your family. I know these are difficult questions and there are not going to be easy answers. There is going to be some shared responsibility in all of this. But I believe we have an obligation, as U.S. Senators, at this moment in our history, to rise to that challenge and not to fail, as others have in years past because it is too hard.

There was a great line Edward R. Murrow once used when talking about another subject matter. He said: The one excuse history will never forgive you for is that the problem was too difficult.

I do not think history will forgive us if the answer we give is: It was just too hard. We just could not figure out how to come together. I think history will judge us harshly if that is the excuse we use for not rising to the moment and dealing with this issue in a comprehensive and thoughtful manner. It can never be too difficult. It is hard. We ought to have the ability to resolve this issue. That is my plea today.

I yield the floor, and I suggest the absence of a quorum.

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