Urgent Need for Health Care Reform
URGENT NEED FOR HEALTH CARE REFORM -- (House of Representatives - July 15, 2009)
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Mr. MURPHY of Connecticut. I thank Speaker Pelosi and my colleagues for allowing us to come down for the next hour or so and speak to you. We're doing a joint hour. Occasionally, those of us who are pushing for health care reform to happen for our constituents this year have come down to the floor to share our thoughts about the urgent need for reform.
We're sharing this hour with the 30-something Working Group, which I'm honored to be a part of. And I know our hope is that, at the very least, Representative Ryan will be able to join us later this evening as part of this hour.
But we are here to focus our thoughts and our energies and to talk to our colleagues about the need to pass real comprehensive health care reform for this country and for our constituents. We know what the problem is out there because when we're out there at our town halls, when we're setting up our office hours at the supermarket or the grocery store, it's our constituents that are coming to us and telling us about the fact that they just can't afford this health care system any longer.
If you're lucky enough to have insurance, you've seen your family have to pick up more and more of the share. As the cost of health care goes up for businesses, they're passing more of it along to individual consumers.
So now, if you're a family of four out there, you're likely to be spending $3,000 to $5,000, at least, on health care, even when you have insurance. Your deductible now is in the thousands of dollars rather than in the hundreds of dollars.
That copay that you have to bring with you to the doctor's office now isn't $5 or $10; it's $100 or $150. Those drugs that used to only cost you $5 or $10 when you showed up, well, if it's in the wrong tier of drug, you may be paying 50 to 70 percent of the cost of that drug.
If you're a senior citizen and you happen to find yourself in the dreaded doughnut hole, not only are you paying the full cost of those drugs, and potentially bankrupting yourself in the process, but you're paying the highest prices in the entire health care market when you show up at the drug store.
You're paying more than the Federal Government pays for that drug. You're paying more than Blue Cross/Blue Shield pays for that drug. You're paying through the nose for it.
This health care system is broken. It's broken because the people that got it just can't afford it any longer.
Now, much of the cost is very visible to people. That cost that you now bear as an employee, that you didn't used to have to pay, that increased deductible or that copay, that hurt is felt. We're feeling it for you because we're hearing those stories increasingly about people that just can't come up with the money to pay that high deductible, people that just don't have the cash to fill in the drug company doughnut hole. That hurt is visible and real for our constituents.
But there is an invisible pain. There is an unseen hurt that we need to talk about here on this floor because there are a lot of businesses that are passing along the cost of health care, but there are also a lot of businesses that are eating the cost of health care, that don't want to have a high-deductible plan for their employees. So what they do is they pay it instead.
The business decides that they will pay the 10 percent increase in premiums, but it just means that their employees don't get a wage increase that year. Or when they were supposed to get a 5 percent bump up, they only get a 2 percent bump up.
There are millions, millions of employees in this country who should be making more in take-home wages but aren't because the businesses that they work for are paying more in health care costs than they ever have before.
Now that's just not me talking; that's just not anecdotes I hear from the business owners and the employees in my district. That's data. That's data that shows that over the last 10 years the premiums charged to employers from health care insurance companies have risen by 120 percent during the last 10 years--120 percent jump. More than double--a more than doubling of health care premiums charged to businesses.
During that same time, average wages have grown by only about 20 or 30 percent. During that same time, wages have grown at less than the overall rate of inflation. Guess what? That's because of the cost of health care eating into the money that people take home from their paychecks.
Lastly, the invisible cost comes here. Guess what, Mr. Speaker and my colleagues? We've got a system of universal health care in this country. We're not inventing a system of universal health care. We've got one now. It's just the most inhumane, most unconscionable, most inefficient universal health care system in the world because our Federal law guarantees you health care, but only until you get so sick, you get so crippled, that you get so desperate that you as an uninsured individual have to show up to the emergency room. And so you get care, but it's too late.
It's the most expensive, most inefficient way of delivering universal health care. There is a cost to that, because when that individual who could have just gotten a prescription to cover their growing infection and instead lets it get to such an extent and such a degree of severity that they have to show up at the emergency room and they have to have major surgery to cure that festering illness and infection, there's a cost to that of 10 to 20 times what the cost of the preventative service might have been.
That cost doesn't just sort of evaporate in the air. It doesn't disappear into the ether. It's real. It's substantive. The hospital picks up that cost and forces private insurers to reimburse them more to help them cover the costs of the uninsured. Charges some of it back to the government. Every taxpayer in this country, a portion of your tax dollars that you send to the Federal and State government goes to hospitals and emergency rooms to cover the cost of all those 50 million people that walk in without insurance.
So there are costs all throughout the system, both visible and invisible, that we cannot sustain. And so we've come down here to the House floor today to not just focus on the problem--I think you've got to talk about the disease in order to get a diagnosis--but to talk about the fact that for the first time in almost a generation we are on the verge as a United States Congress of rising to the massive challenge that confronts our health care system.
We are on the precipice of passing real health care reform that lowers the cost of health care for everybody in the system whether you're an individual paying it or you're a business having to bear the burden of the cost, and at the same time makes the system more fair for people right now that are paying more for health care just because they happen to be sicker than somebody else; for those millions of people who can't find health care in the first place because they happen to have a preexisting condition.
For all those senior citizens out there who are trying to decide between 20 different plans that the difference can only be deciphered in the fine print of the paperwork that they send you in the mail, we're going to make this system more transparent, we're going to make it more fair, we're going to give people more choice. And by doing that, we're going to lower the cost of the American health care system for everybody so that those very visible costs that are holding families back are controlled and those invisible costs that too often aren't seen by wage earners or by taxpayers disappear over time.
So I'm really glad to be down here this evening. I see Representative Speier's joined us, so I'd love to hear from her as well. We're going to be joined later on, I know, by Representative Ryan and others to focus some attention on this problem of health care and the approach that we're going to take in this House. So I'd love to have Representative Speier from California join us to talk a little bit more about the challenges that we confront and some of the solutions that we put forth.
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Mr. MURPHY of Connecticut. Thank you very much, Representative Speier. Thank you for drawing attention to what this reform effort that we're talking about here tonight means, not just to these people that you're talking about that have been denied coverage for preexisting conditions, but what it means to all the folks that have insurance out there.
If I had a dime for every person I've run into that has talked to me about the fact that, you know what, they're not really happy in the job that they're in. They want to go do something else, or that they really have a great idea, a business that just has been germinating in their mind and they want to go out and start it, but they can't leave their current job. They can't go out and start that business because they're going to lose their health care because their daughter is sick and they've got some health care for her now, but if he leaves or she leaves and goes out and does what they really want to do with their life, or starts that small business, that they're going to lose that health care coverage. There are millions of Americans who have health care today and are trapped, are trapped in their job, are trapped in their place of employment, because they can't dare lose the coverage that they have.
Now, in the most powerful country in the world, in the beacon of freedom from around this globe, that kind of servitude to your employer, just because you have insurance that you can't leave, just doesn't seem right.
But it also is just absolutely silly economic policy. Think of all of the innovation that we're stifling. Think of all of the great entrepreneurs who never get to go out and invent, who never get to start that business because they can't leave the insurance that they have. So this really is fundamentally about trying to make health care for those that have it more meaningful, more real, but also more flexible. And I thank you for drawing attention to this issue.
Well, we are blessed to have with us on the floor Representative Ryan. We were talking earlier. This is kind of a hybrid health care hour/30-Something hour, and one of the things we're talking about here, Mr. Ryan, is that this is hard; right? This is a big problem. We've got one the most confusing, most complicated health care systems in the world, and we're going to take on a very complex and convoluted system at a lot of different angles.
So the bill that is going to come out is going to be big. It's going to have a lot of pages to it, because in order to tackle a really complicated and confusing health care system, you have to have the guts to think big. You've got to take on all of the various problems that have been created in this system, whether it be high cost health plans, preexisting condition exclusions, post-claims underwriting, all of the various tricks of the trade that insurers and others have used to try to make money and exclude people we've got to take on and do things with.
But it also makes it really easy for folks who are critical of health care to just sit back and say, Well, what you're proposing isn't any good, and we're just going to sit back and criticize rather than propose alternatives. And that seems to be the dynamic once again that's playing out on this floor, that the Democrats are going to offer real solutions, real opportunities for this country to move forward on health care, and we're going to be met with opposition that defends the status quo and really doesn't offer alternatives. So we're here tonight to----
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Mr. MURPHY of Connecticut. Let me go back to a number that I used at the outset of this hour.
Over the last 10 years, a time during which the Republicans had control of this House and the Senate and during which the Republicans had control of the White House, the employers in my district saw health care costs go up by 120 percent. Now, they've had a lot of things increase during that time.
Frankly, Mr. Ryan, the only thing that competes for that are energy costs, probably during that same time, depending on what oil was costing from coming abroad. Energy prices might have gone up by 120 percent, but nothing else has increased by 120 percent. That is an unsustainable rate of growth for our employers, and it puts them at a tremendous disadvantage vis-a-vis the rest of the world. We live in a global economy today.
If we want to go back and diagnose all of the reasons that our economy, essentially, went into a free fall at the end of last year--and that were abated at the beginning of this year, in part, by the actions that this Congress took--you've got to look at health care costs. You've got to look at the fact that $1,500 of every car produced in this country can be accounted for just with regard to retiree health care benefits. That number is essentially zero for their competitors in Asia or in Europe. This economy is weighed down by a health care system that costs twice as much as every other health care system in the rest of the world.
So, if we want to talk about economic revitalization, if we want to talk about making this country globally competitive again and about coming out of this recession stronger than we were when we went back into it, then we've got to do something about costs.
We spent some time today in our committee, Mr. Ryan, with the nonpartisan Congressional Budget Office. They outlined for us the economic effects of our bill, and they made it very clear: The reforms that are outlined in our bill are going to lower the costs of health care insurance for individuals and for employers, that the menu of options that we are going to present, an increased menu of affordable options for businesses and for individuals, is going to lower the costs of health care. In an era where most businesses are crossing their fingers and are hoping and praying that this year's premium increase is only 10 or 11 percent, a decrease in cost is almost unthinkable for those businesses, and it's central to why we're doing health care reform.
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Mr. MURPHY of Connecticut. I thank the gentleman who has been such a great leader on this for a very long time. I think he is right. This is our moment. But it's no coincidence that it's taken a long time to get here because there are a lot of forces that are aligned against health care reform happening here. For whatever reason, for a long time they had control of the levers of power down here. The folks that have been doing very well off the status quo have stopped health care reform from happening here for a long time. There are a few individuals out there who are running some of the big health care companies, who are down on Wall Street, who have made their fortunes off this health care system. But what's happened is they've priced their products, whether it be a drug or a medical device or an insurance plan, to such an expensive degree that people can't afford to get it; and so the cost of their fortune ends up being people's lives, people's health. So it is no coincidence that it's taken us this long to get here. There are powerful interests that are aligned against getting health care to people that don't have it.
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Mr. MURPHY of Connecticut. That is absolutely right. As I was saying earlier, some of that cost is sort of invisible to people because all of the money that we send to emergency rooms to cover the uninsured, all of the extra medicine that is being practiced out there that doesn't need to be practiced that we're paying for through our Medicare and Medicaid systems is buried in the people's tax bills. The wages that people never got because their employers took all of the extra money they earned that year and sent it to the insurance company to pay for their increased premiums. So that increase in the health care system that we're going to see if we don't enact health care reform is visible in some places, to some people out there, and it is invisible in other places. I just see no way to get this economy back up and running unless we take on the high cost of this health care system.
Now it's one thing to sort of be for cutting costs in our health care system. We heard a lot of people on the Republican side of the aisle talk in unison with us about cutting cost. It's another thing to be for things that cut cost. I want to talk for just one second about the element of the Democratic plan that saves our health care system about $100 billion over the next 10 years and is giving small employers and individuals the option, if they want to, to buy into a government health care plan--you know, not unlike the one that you and I have access to or the Medicare plan that lots of other folks have access to. All we're saying is that people and businesses should have the choice to go out there and buy a not-for-profit government-sponsored health care plan. If they think that their private insurance is better, then stay there. But if they think that maybe they'll do better on a government plan which costs less because it doesn't have to pay the big CEOs' salaries, it doesn't have to return big returns to shareholders, if they think they'd be better off there, let them go there. And our nonpartisan budget office has told us that that's going to save the health care system about $100 billion a year. The Commonwealth Fund, a nonpartisan research group, estimates that an individual might be able to save $1,100 a year by choosing that government-sponsored health care option. Now it's up to them whether they want to do that. But we are hearing from both our budget experts here and our budget experts outside of this building that there are real cost savings. That's why when we're looking at surveys on this issue of whether or not the public wants to have the option to buy into a public health care plan, every single survey they have done
shows that 65, 83 percent, 76, 72 percent want that option. In fact, on this chart the most remarkable thing is that the highest survey here, the survey that shows 83 percent of people wanting the option to buy into a government-sponsored health plan, that survey was done by a group called EBRI, which is essentially all of the major institutional health care companies' research arm. So even when the groups out there that are a little bit more skeptical about health care reform do a survey, they find the same thing that everybody else finds. So listen, I think that there could be some real bipartisan agreement here on cutting costs. But it's one thing to stand up on the House floor if you are a Republican and say that you want to cut costs. It's another thing to actually be for legislation that does it, that actually implements cost-cutting measures.
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Mr. MURPHY of Connecticut. You know, there are a lot of really great companies out there who have figured this out. I think of a company in my State, Pitney Bowes, who has been a leader in health care reform because they've figured out over time how much money they were losing to sick workers, how much productivity they were losing because they had a health care plan that somebody else was administering out there that had a financial incentive to deny care. So they decided that they were going to take on their health care plan themselves, that they were going to put health care clinics in their facilities, that they were going to put health care close to their employees, that they were going to give rewards to employees that worked out, that invested themselves in keeping themselves healthy. There are companies out there that have figured out really great models to provide better health care, more immediate onsite care for their employees; and they have benefited not just because they feel good about keeping their employees healthy but because their bottom line has been strengthened by the fact that their employees are healthier, showing up for work more often and ready to produce and ready to compete.
You mentioned the fact that this health care system is going to bankrupt this economy. Right now we're spending 17 percent of our GDP on health care, and economists are telling us that in the not so distant future $1 out of every $3 that we're spending in this country is going to be on health care. That is just unsustainable. But on a much more local level, these are personal bankruptcies too. We think of bankruptcy in this country as, you know, being somebody that went out there and bought too many snake oil securities or made a real bad bet in a real estate investment and then all of a sudden they've gone belly-up. No, Mr. Ryan. You know this. Half of the bankruptcies in this country, half of the families that have to go into bankruptcy do so because they had an unexpected medical cost, a cancer or a terminal disease that bankrupted their family. Lives, families devastated through no fault of their own, just because they got sick and they either didn't have insurance or they had insurance that wouldn't cover the full extent of the illness.
The dirty little secret out there is that a lot of insurance plans, you may not know this because it is in the fine print, have a lifetime limit on the amount of money they will spend on you. So you're okay until you get really, really sick. But for that 1 or 2 percent of people that are spending millions of dollars on their care over their lifetime, your insurance runs out even if you think that you have it
So this is about individual people whose lives are shattered, shattered by having expenses that they can't control. That is what this health care reform is about as well, Mr. Ryan.
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Mr. MURPHY of Connecticut. Mr. Ryan, it is not that we are not going to ask people to contribute to the cost of health care. We are talking about caps on the amount of money that you're going to contribute. But we are still going to expect people to step up to the plate and pay for part of health care, to have a little bit of exposure and scratch in the game themselves. And that is important. It is important to have shared responsibility.
Nobody is talking about the government coming in here and either taking over our health care system in general or paying for everybody's health care or even asking insurance companies to pay for 100 percent of health care. We want individuals to have some scratch in the game. We just don't want it to end their lives.
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Mr. MURPHY of Connecticut. I thank you for joining us here. We will be down here talking about this because it is so important to get health care for America. As you said, our friends on the other side of the aisle had 8 years to get this done. And people may say, well, Mr. President, you're taking on a lot really quickly. But we are paying for the costs of inaction. We are paying for the costs of a Republican Party which for whatever reason decided not to do much about the cost of our health care system.
And we are going to get this done. We are going to get this done so that nobody loses their livelihood, nobody loses their access to the apparatus of opportunity just because they get sick and can't afford to treat themselves. We are going to lower the cost of doing business. We are going to lower the burden of the cost of living for families, and we are going to do it this year.
And with that I yield back.
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