Title: Progressive Caucus Message
Date: 05/21/2009
Location: Washington, DC
Speech
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Mr. McDERMOTT. Thank you very much, Congressman Ellison.
I think that one of the interesting things about the debate that's going on in Congress right now is that the debate seems to be that we can't have a single-payer system in this country. The people aren't ready for it, or it won't work, or whatever, there's all kinds of myths around that.
And one of the fascinating things about it is that now, as we come to the President's proposal, he's proposing that we have a public option among those choices that people will have when the national health plan is put in place.
Now, everybody immediately says, oh, we don't want a public option. We don't need that. The private industry has--they'll come up with enough options and people will have choices. The problem is people won't have money to pay the premiums.
Well, the fact is that the American health insurance industry has had full chance to do it since 1933, when Franklin Delano Roosevelt took this off the agenda. They've had more than 60, more than 70 years, almost 75 years to come up with a plan to cover all Americans, and they have not done it.
Now, there has to be a public option, and it has to be a good option. There is an interesting book, if people are interested in reading about this whole thing, it's called Do Not Resuscitate, meaning do not resuscitate the health insurance industry that's dying. But that means we've got to have a good public option out there for people to choose.
Now, people say, why do we need a public option?
You need the competition of the public option to drive the health insurance industry prices down.
What's happening today--in fact, when Mrs. Clinton tried this effort 15 years ago, in 1993, we had almost 1,800 insurance companies in this country. That industry is rapidly contracting to the point where today we have around 800. And in many States, particularly rural States in this country, they have one choice of an insurance company, not two. So you've got an insurance company, or maybe they'll have two. But there's no competition in that kind of situation. And you need the government plan.
Now, the reason? Why is that? Well, very simply, Medicare has administrative costs of about 3 percent. That means you give a dollar to Medicare, 97 cents goes out in health care benefits to older people in this country. If you give money to a private insurance company, 82 cents, on average, goes out to people. In many companies it's 70 cents is all that gets out to people who are sick.
So we need a Medicare-like, a government option to compete with private industry to drive down those costs, because costs are what are killing our health care system today. Costs are going up much faster than inflation. People are finding their deductible higher. They are finding their co-pays higher. They're spending more money out of their pocket, even though they have health insurance. They think, well, I'm covered. I've got this illness, but I don't have to worry. I'm just going to go and have it taken care of. And suddenly they find out they've got huge bills left after, and that's because the plans are simply not taking care of people's needs. And we need a government option.
Now, there are several things about a government option. First of all, it has to be one in which it takes anybody. You can't give the insurance companies or anybody else the ability to say, I'd like to take that person, but I don't want to take that person. That person's old or that person looks sick, so I don't want to take care of them. I just want to take premiums from people who are healthy.
And the government option has to be one that takes everybody, and so do all the private insurance industry. If we have a health care bill that goes out of this House that does not have insurance changes in it that requires everybody to be taken, then we haven't done what we need.
You heard the disparities in minority communities in this country, and it's also, it's just poor people. It's really not minorities as much as it's poor people who don't have the same kind of health care that people do who have a lot of money. I mean, that's the way it is. And we ought to be honest about this and say if we're going to do a national plan, it takes everybody.
Now, it also has to give the same set of benefits. Whether it's a private plan or a public plan, it ought to have the same benefits.
Now, if the private industry can compete with a government plan, that's fine. But if they can't, they're going to have to find ways to bring their prices down. They're going to either have to squeeze their profits or do something to change the way that goes.
Pre-existing conditions. I had a patient or a woman in my district who was an opera singer. She went to Germany, had a contract in Munich. The minute you go into Germany you're in the German system. You're taken care of.
Her daughter got leukemia. They spent thousands and thousands of dollars treating the child. She came back. The child had remission, and so they came back to the United States. The woman couldn't find an insurance company in the United States that would give her insurance, except at exorbitant rates, $2,000 a month.
Now, why is it that the Germans can figure a way to do that, and we can't in this country?
And my view is that you have to have no pre-existing conditions, you've got to let everybody in, and you've got to give the same set of benefits. And I think that the public option is essential for any bill that goes out of here.
Mr. ELLISON. Will the gentleman yield?
Mr. McDERMOTT. Yes.
Mr. ELLISON. I'd just like to pose a question to the gentleman. There is a Web site called feedback progressive Congress. This is a Web site. It's called feedback.progressivecongress; 250 people went to that Web site and asked the question, how will you stop denial of pre-existing conditions?
And I yield back to the gentleman. For those 250 folks who got on the Web site and want to know, what do you think?
Mr. McDERMOTT. You essentially make a decision at the Federal level that we are going to require all insurance companies to take everybody. They cannot use pre-existing conditions.
One of the things that happened back in the Forties was a bill was passed in this House called the McCarran-Ferguson Act, and that said that all insurance decisions should be made at the local level. So we gave it to the States. So you've got 50 different insurance commissioners doing 50 different things all over this country.
When we come to a national health plan that Barack Obama's going to sign, it has to have a national standard that every insurance company has to cover everybody. And you can't say, well, you know, they are this ethnic group or they're a little bit overweight or they smoke. The only thing you can make changes is on age. Obviously, as you get older, there is more likelihood that you're going to have problems. But that's the only kind of rating that there can be in a system that's going to be fair to everyone in this country.
And the insurance companies, they obviously didn't want to take care of this woman's kid because they knew that the chance was she might have a recurrence of her leukemia, and they could see her sitting right there and know she had had the disease, so they said, that's a pre-existing condition. We don't want that family.
You can't let that happen when we write this national plan. It has to be written right here on the floor. They can't trust it to 50 States because some States will have a good insurance commissioner and some will have people who are not quite so publicly spirited.
And my view is that we have to make that decision, and I think the President will support us in that.
Mr. ELLISON. If the gentleman would yield again.
Mr. McDERMOTT. Sure.
Mr. ELLISON. Forgive me for these questions, but at this same Web site,
which is feedback.progressiveÐcongress.com, the question was posed, Will you, meaning the Congress, vote against a reform plan without a public option?
And then it goes on to say, a couple of months ago, Progressive Caucus made a promise to vote against any health care reform bill that does not include a strong public option. Health reform without a public option is no health reform at all. Will you continue to stand by your pledge to the American people to insist on a public option for health care by voting against any bill that does not include it?
And this question was asked by 1,434 people. And the first person to ask the question was Mike.
Mr. McDERMOTT. Well, in my view, if we have a plan brought out on this floor without a public option in it, it is not universal coverage, because that means the insurance companies have won the whole game. And if they believe in the free enterprise system, then they believe in competition, and they ought to be able to compete with a government plan that's well done, and not given any special advantages, just the fact that it's going to be done without profit, so you're not going to be worrying about--insurance companies worry about profits for stockholders. The government doesn't worry about profits for stockholders. It worries about giving services to human beings. That's why the administrative costs in Medicare are so much less than those of an insurance company.
So I can't imagine myself voting for a plan that does not have a public option in it.
And I'll tell you one of the little tricks that people have to be watching for. In the part D in Medicare, which was the drug benefit, they said, well, if there aren't two plans in an area from the private sector, then they would go to a public option. Guess what? The industry went out there and got involved everywhere, mostly because we gave them such heavy subsidies that they could make a lot of money. So they said, yeah, we'll go in and treat, we'll deliver drugs to people in this country. And it was a false public option. It says public option in the bill, but they knew it would never happen because they subsidized the pharmaceutical industry to such an extent that it just never--they were making money so they stayed and did it, and we didn't need a public option.
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Mr. McDERMOTT. Well, first of all, the American people would be offered a plan from the United States Congress. Yet, as the President has said, if you have insurance, you can stay right where you are. If you're satisfied with it, stay right there. Don't worry. You're not going to be made to do anything, but we are going to offer you a choice of a public option. Now, if you don't like what you're in now and you want to move over to the government program, you can do it.
That is not socialism. That is not forcing everybody to do the same thing. That's saying, if you want to stay where you are, fine, that's all right, but if we put together a good public option and it looks better to you, it's your free choice.
Mr. ELLISON. If the gentleman would yield for a moment, should Americans not be afraid of some of these terms that are tossed around? Is there nothing to fear? Is that what you're saying?
I yield to the gentleman.
Mr. McDERMOTT. I'm saying that you're going to see a big campaign of
fear mongering, of trying to make people afraid by using all kinds of words. The fact is that they are simply deceptive in the worst sort of way when people are vulnerable and when they're sick. Then somebody tells them, ``Oh, you don't want that because--''
In 1993, there were some ads on there called ``Harry and Louise.'' They're sitting at the kitchen table, and Harry says to Louise, Do you know that the plan that Mrs. Clinton is putting together is going to take away your health care?
Well, that was simply to scare people, and people, since they weren't sure, decided they didn't like her plan, but we could have had this 15 years ago. We could have had a change in this country 15 years ago. Now we get a second chance. This time, the people are in much worse shape than they were then. Business wants it. Labor unions want it. Even doctors today who were sort of against Mrs. Clinton's plan now are saying, you know, you can't deal with insurance companies. So you've got a whole bunch of different people this time who are saying we need a public option that can make the system fairer and that can work for everybody in the country.
The people can choose. The American people are not stupid. They're not going to fall for this kind of advertising that they used the last time.
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Mr. McDERMOTT. Well, you know, the Republicans didn't do anything in 8 years on this issue. Nothing. Not one more person was covered than was before. In fact, the number of uninsured went from 35 million to almost 50 million during the period that George Bush and his cohorts were running this place.
The American people in November of 2008 made a decision: we want change. We want something different. And President Barack Obama has offered the leadership and has said this is the way we ought to go and has laid it out and the Congress is working on it. Anybody who opposes this in the long run is going to be taking a real risk in the next election saying, Oh, I was against that because--because why? Because you wanted to give the insurance companies everything? Is that what it was you were after? Or is it because you don't think that we can make any changes in the system; the system is perfect?
One of the things I was going to quote for you, there is a man named Zeke Emanuel. He's the brother of our President's administrative assistant. He's the head of the department of clinical bioethics at the National Institutes of Health, and he says this: the U.S. health care system is considered a dysfunctional mess. Conventional wisdom has been turned on its head. If a politician declares that the United States has the best health care system in the world today, he or she looks clueless rather than patriotic or authoritative and they run the risk of opposing--if they oppose this, they are going to look like they are out to lunch.
And I think that's not a good situation to be in when you're running for re-election.
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