Health Care and Making it in America

Floor Speech

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Mr. TONKO. There you go. Always a pleasure to join you on this House floor. And thank you for leading us in a very important discussion this evening here on the floor.

It's important for us to recognize that for our business community to compete, and compete effectively, they need to be able to contain costs; they need to be able to have predictability and stability in their day-to-day routine. And I think that the Affordable Care Act takes us toward those goals. It is a predictable outcome. It enables our small business community to have a sound and well workforce.

I know that that is in the ether of the mind-set of our business community in that they know a productive workforce begins with the soundness of a health care plan. We are the last industrialized nation to come to the table to begin to resolve that dilemma, and it has held back our business community. What we will have with this important Affordable Care Act is the opportunity for exchanges to be developed, either along the State line or in a national setting, that enables us to provide for the opportunities for business and to do it in a way that is vastly improved over present situations. Status quo, just about everyone agrees, will not cut it. It is unsustainable to continue with a system of health care delivery that we currently operate under.

This, I believe, will be welcome news for our business community. They will have the opportunity to address this dilemma which has found the business community, the small business community, to be paying anywhere from 18 to 20 percent more than industrial settings and getting reduced services, or a smaller bit of service package, than the industrial setting would get. This allows for better services at reduced premiums that will enable them to have that affordability factor addressed. To go to the marketplace with that operational motif is going to be, I think, a very strong enhancer for the competitive edge of the American business community.

So underpinning, supporting the small business community, is important because, as we know, it is the driver; it is producing the great majority of new jobs in the private sector in America today. If we can take that outcome and enhance it by addressing an Affordable Care Act that impacts soundly and progressively and positively the small business community, then we are doing something to increase America's growth in jobs. We do it also by having the ability to provide for various tax credits that go toward the small business community, especially for those that have 50 and fewer employees.

We have seen what an economic engine the small business community is. Since time beginning for this Nation, the small business community has been that pulse of American enterprise. It has been that predictor of soundness, of job creation, and of economic recovery. If we treat the small business community with the respect and the dignity and the assuredness that it requires, we have done something. We will be doing something.

So, Representative Garamendi, I think it is important to understand and to outline that the Affordable Care Act is the beginning of providing that foundation for the small business community to have a sound workforce, which is essential in this very competitive sweepstakes for jobs and landing contracts in that international scenario where we all compete for the right to serve the general public.

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Mr. TONKO. I was going to say, too, that many people will say, well, if the option is made available, which it is, why would they choose that? Why would they want to spend even if there is a tax credit made available?

Think about it. The sound business community leader is going to want to recruit, and when you recruit and get the best employees, you offer the best package, and you have, as a result, a soundness in your workforce.

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Mr. TONKO. So the management style is driving that sort of benefit so that you will reach to the program so as to recruit and retain quality workers. I think that driving element will influence it more than anything, and then the tax credits will become part and parcel to that package, which, as you suggest, can be as great as 50 percent. This is a huge cost savings and a sound policy to which they're attaching. So I think it's a benefit.

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Mr. TONKO. If I might add, I know that we want to get into the talk of job creation, but if I might add some of the dialogue that has been developed in the district I represent--and I'm sure it's not unique to the 21st District of New York.

Again, there is this proliferation of small business that has been the driving force and that has really built our economic recovery from this painful recession. What you will hear time and time again is, if I'm a small operation of 10, 15, 20 people, one person--just one person--in that workforce impacted by a catastrophic illness will throw the actuarial science into a frenzy. That means that your premiums will be adjusted in a way that makes it difficult as the employer to continue to afford that insurance or to have the copayments from the employees.

So, as you're suggesting, if you enter this large collection called an ``exchange,'' in which many more numbers than 10, 15, or 20 work in this concept together, it shaves those peaks, and the shock--the premium rate shock--that is dulled is a good thing.

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Mr. TONKO. I just wanted to speak to the issue that Representative Altmire raised with the doughnut hole--such a sweet label thrown onto a hidden attack on our senior community, asking them to dig into their pockets when they hit the threshold of $2,930 and up till they hit the threshold of $4,700.

I can tell you painful, heart-wrenching stories that many of the seniors I represent--and again, I have a huge proportion of seniors in my home county of Montgomery County, New York. Many will reach that threshold early in any fiscal year. It's a phenomenon with the prescription drugs. Those prescription drugs are their connection to quality of life. It's not only keeping them well and healthy; it may be keeping them alive. There are far too many heart-wrenching stories of people who will cut their prescription or their pills in half so that they can balance their budget. That is not the way to respond to their medical needs. They are told by their physician what that prescription drug intake is to look like for their wellness or their getting well. We ought not cause them to be pushed to the brink where they actually adjust their intake of prescription drugs just to meet a budget.

This closing of this doughnut hole, making prescription drugs more affordable, where we finally in 2020 close it completely--I mean, people have realized already billions of dollars of savings. There have been 5.3 million seniors that have received $3.7 billion in savings.

Is that something you want to take away? So when this House, with the majority, the three of us obviously said no, but when the majority said repeal, why? What's the replacement? We didn't hear replace, we heard repeal, and it left many stunned in this Chamber because the progress just begun to be tasted was attempted to be pulled away, and it's regrettable.

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Mr. TONKO. Thank you, Representative Garamendi. Let me also thank our military, our active forces out there as we speak who are defending us in some
very far-off places, deserted deserts and mountains that extract great courage and commitment to this Nation and her cause.

You know, again, so many veterans returning are looking for work. There ought not be a battlefield in their homeland to find a job, and it's why the American Jobs Act makes it possible for businesses to realize benefits when they hire our veterans, when they hire the active military that are returning, and that's a commitment that ought to be understood by all of us. That's a commitment that should be part and parcel to unanimity in this House. Let's go forward with something like the American Jobs Act.

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Mr. TONKO. But the full package could have been done, which allows for even more opportunity for our veterans if we're hiring police officers and firefighters and educators, teachers. We're building the fabric of the Nation and the infrastructure, the human infrastructure that's required to educate our young, protect our neighborhoods, make certain that we're there in response efforts when tragedy hits. These are the things that can also in a broader sense affect positively the employment factors for our veterans. That full package offered the greatest hope.

The fact that we would nitpick and that we would be pushed to pressure points and finally acknowledge the work getting done is not the way to achieve what we know has to happen out there. We've seen the growth, Representative Garamendi, of private sector jobs, 29 consecutive months of private sector job growth, well beyond 4 million jobs.

It is a wonderful number, but still a lot of work to do when we think of the Bush recession and the loss of 8.2 million jobs. Now people want to take us back to those failed policies that saw us losing as many as 800,000 jobs a month and say that's the way to move forward. That's moving backward. We need to move forward with efforts like the American Jobs Act.

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Mr. TONKO. Yes. We are, in fact, very proud of their efforts and very proud of the training they endure to be able to be the greatest force on the globe, and so we thank them for that.

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Mr. TONKO. Representative Garamendi, you're offering a very powerful statement, a powerful challenge, the what-if.

When you take that statement and failure to commit to our Nation's children and then contrast that with what's happening in competitor nations, where they're investing in education, investing in higher education, investing in research, investing in advanced manufacturing, these are the challenges that are facing us as a government, as a body, as a House of Representatives.

And if we do not respond accordingly, we're holding back the Nation. We're actually pushing us backward. This discussion here in this House ought to be about moving us forward--moving us forward with progressive policy and investments of human infrastructure.

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Mr. TONKO. Representative Garamendi, as you're speaking, I'm thinking of those ``golden moments'' in our history replete with those statements made by the Nation--this Nation--of investing, especially in tough times.

You know my district. I've described it several times. It's the confluence of the Hudson and Mohawk Rivers and the donor area to the eastern portions of the Erie Canal. In very tough times, Governor DeWitt Clinton proposed--

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Mr. TONKO. Right. He proposed a canal system, in tough times, saying we need to invest our way through this. There's a way to grow a port out of this town called New York. And there's a way perhaps that there will be a ripple effect, which there was, with the birthing of mill towns, a necklace of mill towns that became the epicenters of invention and innovation. And it drove a westward movement so that it headed toward California. It drove an industrial revolution, sparking all sorts of opportunity and activity, driven by a pioneer spirit that is unique to this Nation.

And our collection of stories of journeys to this Nation with people embracing nothing but this noble dream--an American Dream--that transitioned a rags-to-riches scenario, that's what it's all about. It's us in our finest moments. And why not today, as we have these inordinate needs to invest in the people, invest in jobs, understanding the dignity of work, underpinned by the effervescence of the pioneer spirit that is, I think, part and parcel of our DNA. It is within our fabric as a Nation to have that pioneer spirit. We're denying it. We're denying that spirit.

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Mr. TONKO. The reach that we ought to make to our history, to let it to speak to us, the reach we ought to make to the boldness that we embraced in times that preceded us ought to speak to us, ought to feed our soul, ought to feed our mindset. The courageous steps that we were asked to take that we took together as a Nation, committed to a cause, this is the sort of leadership that I think is required. The President is asking us to respond in very challenging times to these orders of investment.

Now, I can tell you in my district, the birthplace of the Erie Canal, mill towns that have achieved and changed the quality of life of peoples around the world, we're watching nanotechnology, semiconductor science, advanced battery manufacturing, chips manufacturing, a growth area happening within the capital region of New York, all built upon, I think, a public-private sector partnership, government inserted in a way that provides for the priming of the pump that goes where you absorb risk which, perhaps, the private sector won't take. And we're now seen as a global center of operations in certain areas. And it's growing and it's expanding. Now is not the time to walk away from that progress. Now is the time to invest in these dreams--these American dreams that people have always seen as the nobleness of the American saga.

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Mr. TONKO. Absolutely. And I see the order of progress, Representative Garamendi, that we've achieved in that private sector that you just outlined. And it's regrettable that the solution for which the President is calling to provide for the public sector side, which would speak to greater numbers of employment, because we've taken that 4 million-plus in the private sector and reduced the overall results by losing some public sector opportunities which speak to soundness of community, public safety, educating the young, and providing for public protection out there. These are important aspects of quality of life. They ought to be embraced.

So we've denied part of the President's agenda. We've recognized the success and strength part of his plan, but there's been this partisan divide, there's been this holding back on progress because perish the thought if the White House should look good in this comeback from a recession.

Well, you need to place--we need to place the public good, the Nation's good, ahead of partisan divide. It is absolutely essential. And to then criticize the President by restraining some of the progress that he's been trying to cultivate and saying he's not cleaning up the mess quick enough, well, there was a huge mess delivered just before he assumed office--8.2 million jobs is a tough situation from which to walk forward from. And I think that there is a solution there, and we ought to work and put America first, the needs of this Nation first so as to be able to continue to walk forward and not negate any of the progress that we're achieving.

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Mr. TONKO. Let me tell you, that is welcome news to my manufacturing base. I hear it all the time. They support the efforts of the President to reward those who produce jobs here in the U.S. and where we provide benefits for returning jobs, onshoring them as you suggest. That is welcome news. That is welcome news to the manufacturing base, as is the call for action by the President for investments in advance manufacturing. And I know that's compete and compete effectively, and to allow for job growth to come via the private sector base.

We need to invest in that new day of manufacturing. It is not dead. I refuse to submit to this notion that manufacturing is dead in this country. It is alive, it is well, and it needs to be retrofitted so as to be advanced in nature and in character. Let's get moving forward, and let's, again, reward those job creators, not paying people to offshore or send out of this Nation. Our hugest export was jobs in the decade preceding this administration.

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Mr. TONKO. Let me do this quickly, Representative Garamendi. We're the greatest nation in the world. I believe our greatest days lie ahead of us. Let us take our golden moments in history when we were faced with heavy challenges, where we responded accordingly with the belief in the worker, belief in the American way, the pioneer spirit, and did it in an order of investment.

Let those solutions-oriented moments speak to us today. We need the soundest of solutions, we need the respect for the American worker, and our greatest days lie ahead. It's a spirit of optimism that we should embrace, a history that ought to challenge, feed us, and inspire us. With that, I thank you for yielding this evening.

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