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Public Statements

30-Something Working Group

Floor Speech

Location: Washington, DC


Mr. ALTMIRE. I appreciate the opportunity to be here to talk about the importance of why we need to do health care reform. And the gentleman from Connecticut has heard me talk many times about an experience that I had which alludes exactly to what the gentleman was talking about, where a woman in my district came to me and she said all the reasons that she was unhappy with the Democrats in Congress, she was unhappy with the President. And she said to me, Don't you dare take my money to pay for those people who don't have health insurance.

And I said to her, Well, the problem is you're already paying for them. As the gentleman articulately said, if you go to the hospital and you don't have insurance, you get treated. They cover you; right? You get whatever the health care you need. It's the least efficient, most costly setting. But they're going to transfer those costs to the next person who comes through the door that has insurance.

And this woman said to me, It's interesting that you say that, because I just had a procedure done at the hospital and I had to pay $18,000 out of pocket because the insurance denied part of my claim, and I asked the hospital, she said, why does everything cost more than it should? Why does an aspirin cost $10? Why does everything cost five times more than you would think it costs? And she was told, as the gentleman talked about, well, that's because of the cost shift that takes place to pay for the people who don't have coverage, a cost shift to the people who do have insurance. And that's the crux of the whole thing.

I hear all the time you guys agree on 80 percent of this; right? Everyone agrees we should do the insurance reforms, no preexisting exclusions, no caps on out-of-pocket expenses, lifetime or annual caps. The insurance companies will have to take all comers. They won't be able to drop you if you get sick or injured. They won't be able to deny you coverage for any reason. And everyone does agree on that. Yes, we should do that. The problem is we can't do that by itself.

And the reason health care reform has never happened before is because of the hard decisions that have to be made, the decisions that we're going to make in this Congress and the decisions that for a hundred years since Theodore Roosevelt, literally a century ago, first started talking about health care reform we've failed to do as both Congresses and administrations, both Republican and Democrat. And those decisions include: How do you get people into the system who aren't insured? How do you do that?

The only way that works, the only way that you can tell the insurance companies you have to take everybody no matter how sick they are and you can't use their health status to set their rates, the only way that works is if you get the young and healthy people into the system, the 24-year-olds who are currently offered insurance by their employers but they turn it down because they think there's something they can do better with the $200 monthly premium than buy health insurance. And they say, Well, I'm young. I'm healthy. I feel good today. I'd rather do something else with that money.

Well, we have to find a way to get the young and healthy people into the system. If you're going to require people to have health insurance, you have to find a way to help them afford it as individuals and as businesses. Because if you're a small business--and almost half of small businesses are unable to offer health insurance now because it costs too much. If

you're a small business that can't do that, it's not because you don't want to. It's not because you're a bad person. It's because you can't afford it. And this bill is going to help small businesses find a way to offer health insurance to their employees. It's going to offer tax credits, if we do this right, and small businesses will be able to offer health insurance. Individuals who are required to have insurance that can't afford it are going to receive some assistance to help them do that. And what that does is it offsets the risk pool. It balances out what we all know needs to be done on the insurance side with the preexisting conditions and the exclusions.

So that's what we've never done. We've never made the hard decisions on the 20 percent that we all know needs to be done but we can't agree on how to do it. But there is 80 percent that is easy. But you can't do one without the other. So that's what we're going to try to do is do both.


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