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Senator Blanche Lambert Lincoln
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Current Office: U.S. Senate
Seniority: Senior Seat
First Elected: 11/03/1998
Last Elected: 11/02/2004
Next Election: 2010
Party: Democratic
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BiographicalVoting RecordIssue Positions
(Political Courage Test)Interest Group RatingsPosition PapersSpeeches and Public StatementsAdditional Biographical InformationCampaign Finances
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Title: Health Care
Date: 07/27/2009
Speech
HEALTH CARE -- (Senate - July 27, 2009)
Mr. KYL. Mr. President, what I wish to talk about today is the subject that probably more than any other is on the minds of the American people and certainly probably the No. 1 item on the agenda of most of us in the House and the Senate; namely, what we do about the escalating cost of health care in America and the need for all Americans to have access to coverage.
Those two questions are animating a debate which has captured the time of the people in the House and the Senate, who represent to the American people, and, as we have found more and more--and I found out this weekend when I was back in my home State--the attention of our constituents.
Let me begin by saying, I think that is good.
There was a question about whether the Congress would pass legislation on the House floor or the Senate floor before the beginning of the August recess. Most of us on this side of the aisle felt it would be beneficial if we could go back home and take the month of August, when we are supposed to be home visiting with our constituents, to have some townhall meetings and other fora, and engage them in a conversation about what they think the best ideas are. Because, at the end of the day, legislation this important, that is going to affect every single American, needs to be well understood by them. And we need, as their representatives, to get their input on what they think is a good idea.
The reality is that very few, if any, Members of either the House or the Senate have read the major bills yet, let alone be able to post them on the Internet so the American people can see them or get them in some kind of hard copy for other people to understand, evaluate them, and discuss them with the American people.
Anything this important cannot be done quickly. It has to be done right. And the first principle is: People need to understand what it is. I have found--and I confess, first of all, I have not read the three House bills nor have I read the HELP Committee bill, the Health, Education, Labor, and Pensions Committee bill. I have read a great deal of what has come out of the Finance Committee. But there is no bill put together in the Finance Committee yet.
The thing that strikes me is the complexity and the degree of government takeover involved. I can't begin, in the brief period of time I have, to describe all the different ways in which the government would take over the key decisions about health insurance and health care in America if these bills were to pass. They are replete with references to the most minute things about people's health that the government will then be taking over.
There are major decisions being made here. We don't know the ramifications of them all. Among other things, the cost. One thing we are learning is ideas Members have about reducing costs don't translate into actual cost reduction because the Congressional Budget Office, which is the entity we have charged with the obligation of telling us how much these things cost, has come back with estimates that are very low in terms of savings and very high in terms of cost. For example, in the main bill in the House of Representatives, the deficit is increased by $240 billion, and in the bill that has come through the HELP Committee in the Senate, the deficit is increased by $600 billion.
Nor has the CBO been able to find much savings. I think it was last Friday that they examined the latest idea to come to the White House; namely, to put a group in charge--it used to be called MedPAC, but it would have a different name now--and they would be in charge of identifying what coverage for federal programs there was and how much would be reimbursed to the providers. Unless both Houses of Congress affirmatively voted to reject those recommendations, they would automatically go into effect.
Well, apart from the obvious concerns about that, CBO came back and said it will only save perhaps $2 billion over 10 years, which is a drop in the bucket when given the over $1 trillion cost of the legislation in the House, when it is fully implemented, $2 trillion cost to the Senate bill.
I mention this simply to point out the order-of-magnitude issue we have facing us: a hugely complex subject; huge amounts of money to be spent, big increases in the deficit, lots of new taxes proposed to help pay for it, and ramifications that will affect all of us in terms of the health care we are entitled to receive. Because of the amount of government involvement in both what insurance can and cannot cover as well as what the government programs such as Medicare can and cannot cover, every American will be affected in terms of the health care our physician says our family or we need but which the government says not necessarily can we receive from our physician; in other words, putting the government between the patient and the physician. That will result in delay and denial of care and outright rationing of health care. This is something that is also of concern to the American people.
When we take $500 billion in proposed cuts from Medicare at the same time we are adding a brandnew group of baby boom generation retirees, there can be only one result: a cut in health care for seniors. So seniors also have a right to be concerned. Young people have a right to be concerned when we say that in order to reduce the cost of insurance for the sickest people, we are going to put everybody in the same pool, basically, and they will all get the same basic insurance premium or at least within a dictated range. The sticker shock for younger people in America is going to be incredible. They are going to see their premiums increase. So for many people, the cost of health care is not going to go down, it is going to go up.
Very few people believe we can actually reduce the cost of something by putting the government in charge of it.
The final issue people are concerned about after the cost of it, the increase in deficits, the increased taxes to pay for it, the fact that it will result in delay and denial of care, is the fact that it will not enable people to keep what they have. This is one of the reasons the President has said so many times that if you like your insurance, you get to keep it. The President is wrong when he says that. He hasn't read the bills. On this I will take just a little bit of time because he is wrong on two counts.
First of all, the statement comes with significant conditions; second, it comes with an expiration date. There are two primary reasons why it is not true that if you like your insurance, you get to keep it. Let's back up a little bit. According to a Fox News survey, 91 percent of Americans say they have health insurance. Eighty-four percent of them rate their insurance as either good or excellent. This is why the President makes the comment ``If you like it, you get to keep it,'' because most Americans have it and they like it, they want to keep it, and they don't want to sacrifice their coverage in order to solve some of the other problems that are inherent in our system. But the promise, as I said, is not true.
First of all, what the President and our Democratic colleagues want is what they call a public option--a government-run insurance company--to compete with other insurance companies. To the extent that a lot of Americans don't particularly like insurance companies--and I must confess there are some things insurance companies do that I don't like--it is easy to put them out there as a target and say, as the President has said, we need somebody to keep them honest.
Well, let's examine that for a moment. Do we need to have a government-run business in every business in America in order to keep the privately run businesses honest? In the first place, the health insurance industry is the most regulated--or one of the most regulated--industries in America. Every State regulates the health insurance that is issued in their State. They don't need to be kept honest by a competitor from the government. In the second place, having the regulator--the government--also be a competitor has its obvious limitations. It won't be long before the other competitors are put out of business. I think most people who look at this say that is exactly what would happen.
But it also represents a point of view that I find very troubling. I know the government has now taken over our biggest automobile manufacturers. It has gotten into the business of other insurance. It has gotten into the business of banking. It has gotten into the business of student loans; in fact, it now has a monopoly in that. But I can't believe the American people want there to be a government business to compete with private businesses in other elements of our economy. That is socialism. I don't think the administration wants to do that. Certainly, the American people don't want to. So why would you have a government competitor in the private market? For one reason only, and most people who are honest about this acknowledge that it is in order to have the government take over health care. It is called single payer. There is a group in America that wants single payer very badly.
Members of Congress have said: Well, we can't get there in one giant step; the American people won't stand for that. It is going to take two steps. First, we will create a very powerful government-run insurance company to compete with private business and eventually put them out of business and then we will have one insurance company for all of America. It will be a government company, and there won't be any more private companies, at least to speak of. So it is a two-step process. That is the hidden agenda of those who want a government-run insurance company. There is no other reason to have one.
We have 1,300 insurance companies in America. We don't need yet one more competitor. They sell thousands of different kinds of insurance policies. We don't need yet one more competitor. Honesty is not the issue. We have a highly regulated industry by the States and by the Federal Government. The only reason to have it is to put the private insurers out of business.
Is that what would happen? How does this relate to people who like their insurance and won't get to keep it? Well, the Lewin Group, which is a highly respected, nonpartisan health care think tank, says that within a couple years, we will have 119 million people on the government-run insurance plan, 88 million of whom were previously insured by private business. In other words, 88 million people will lose their coverage because it is much cheaper to have the government-run plan take care of them than for their employer to continue to do so. As much as their employer likes the employees, if it is substantially cheaper to provide health care to them by paying the fine that the bills have--$750 per employee, 8 percent of the payroll tax; there are different fines in here--it is still cheaper for the business to pay the fine than it is to pay the health care they are currently providing. So 88 million people: Sorry; even if you like your health care, you don't get to keep it, according to the Lewin Group. I think their estimate is, if anything, conservative.
There is a second reason why if you like your insurance you won't be able to keep it. Those who are not insured by larger businesses--the ones whom I have just been talking about--but by smaller businesses or who are self-insured, there is an expiration date on this promise. After 5 years, you don't get to keep it and probably sooner than that. Because if there is a change in your policy or if the insurance company enrolls anybody else in it, then automatically it loses its protected or grandfathered status and is now under the regulatory regime that is established by these bills. That regulatory regime will totally change what that insurance coverage is. They dictate what is covered, what isn't covered, what the premiums are, what the companies can make, and a whole host of other things. So even though you may like your insurance, you are not going to get to keep it because no plan is static; that is to say, it never enrolls any more people and it never changes any of its terms. If either of those two things happen under the House bill, you lose your insurance. So it is not true that if you like your insurance, you get to keep it.
That is the final reason people are concerned. They are concerned about the huge cost: $1 trillion, $2 trillion; they are concerned about the deficit, the increase in the deficit, even with more tax increases. These numbers are not mine; these are from the Congressional Budget Office--nonpartisan, which is in business to tell us how much these things cost. So these are facts, not opinions.
It is my opinion that based upon the language of these bills, we will lose the ability to determine with our doctor what health care we get. Secondly, even if you like your health insurance, you are not going to be able to keep it for the reasons I mentioned.
Mr. President, may I inquire how much time is remaining?
The ACTING PRESIDENT pro tempore. There is 5 minutes 40 seconds.
Mr. KYL. Five minutes. Thank you very much.
The American people are becoming concerned about this as well. The more they hear about it, the more they don't like what they are hearing. I resent those who say we have to do this quickly or it might not happen at all. It is a lot like the stimulus. We were told we had to do it quickly. Nobody read that bill. It was over 1,000 pages. It had a lot of stinkers in it. It had porkbarrel spending. It made a lot of promises it couldn't keep: We are going to cap unemployment at 8 percent. Well, it is on its way to 10 percent. It hasn't created 4 million jobs. It is not going to. And it is going to cost us over $1 trillion.
So I think fooled once, maybe that is your fault; fooled twice is my fault. The American people are saying we are not going to be fooled twice. We want time to look at this one. It is over 1,000 pages. We want to read it. We want you, the Senators and Representatives, to read it, and when you do, you will find a lot of things you are going to be surprised about and you do not like.
The American people, as I said, are beginning to answer polling questions, and I wish to share some of the data. A majority--this is from the Fox Poll I cited earlier--say slow it down. We would rather have it slowed down and done right than moved quickly. They are afraid it will raise taxes and costs. By 2 to 1 they believe it will reduce the care they currently receive. By the way, they are right.
I mentioned the fact that 91 percent have insurance and 84 percent rate it as good or excellent. Fifty-three percent, according to a Rasmussen Poll--and this was just at the end of last week--53 percent disapprove of the Obama health care plan. It is no longer true that the majority of Americans want this plan. Now that they know about it, they don't like it. They want us to deal with the deficit first. That is another one of the things the polls say. By the way, on this idea of a public plan, they oppose it by 50 to 35.
All this has resulted in some reduced polling numbers for the President. His job performance now has actually gone under 50 percent. People disapprove rather than approve 51 to 49. I don't wish him ill, but if he keeps pushing proposals such as this, that approval rating will probably continue to decline.
What have some people said about these bills? Representatives of the Mayo Clinic basically said this won't create affordable care for patients. In fact, it will do the opposite. In other words, it will increase costs. The Congressional Budget Office, in looking at the House bill, said it won't reduce the trajectory of Federal health care spending. In fact, it will increase the budget deficit by $239 billion. Incidentally, that assumes taxes will be raised by the amount of $583 billion.
Incidentally, if anybody wants to check what I said about if you like your insurance, you get to keep it, check the University of Pennsylvania Annenberg School of Public Policy Web site.
They have a site called factcheck.org. This is a totally nonpartisan organization. They contradict on factcheck.org the notion that if you like your insurance, you get to keep it.
The last thing I want to say about this today is that: it is not enough for us to say what is wrong with the bills that are before us. There are a lot of great ideas Republicans and Democrats have put forth that aren't in these bills. Unfortunately, a lot of amendments were offered in the HELP Committee--for example, to try to inject some of these Republican ideas into the bill--and they were defeated, every one of them. In fact, when he was a Senator, President Obama voted against several of these ideas.
Let me give you a flavor of some of these things to illustrate that there are a ton of good ideas on how to address access and costs in health care. They don't require us to scrap the entire system we have and superimpose a brandnew system of huge government regulation or a government takeover of health care, which results in these huge expenses, deficits, and dictating what care we can get and what care we cannot. There are solutions that go right to the specific problems.
For example, you never hear the President talking about medical malpractice reform, lawsuit liability reform, or, as some have called it, ``jackpot justice.'' There are a lot of estimates out there that, because of the defensive medicine physicians have to practice, we can save over $100 billion every year if we have some modest reforms in the lawsuit liability area.
Two very prominent Arizona physicians were in my office this morning, and both of them talked at length about the specific situations that require the practice of defensive medicine because of the fact that maybe 1 out of 10,000 people who come before them may have something go wrong, a lawsuit is filed, and they have to, therefore, go to excessive lengths to protect themselves by ordering all kinds of tests, calling in specialists, and doing things that cost a lot of money, not because they are necessarily needed or provide better care but simply to protect against a lawsuit. Annual premiums of $200,000 are not uncommon. That is more than most of us make. Before you can start practicing medicine on January 1, you have to pay your liability carrier. The President doesn't even mention liability reform. Let's start with that.
Next is the interstate sale of insurance. This is a great idea. Why do they always vote it down? Because if you actually let insurance in the health field be sold like home insurance, liability insurance, and car insurance--you can buy a State Farm car insurance policy in virtually every State, and it doesn't matter where you move to; you are still covered. Why can't you do that with health care? They don't want that because they want the government to control it instead of allowing private companies to sell it all around the country. If they were able to do that, they could reduce premiums and provide greater access. That is one of the bills the President voted against.
Why not let small business compete like big business with small business plans or association health plans? Basically, you could allow all the small businesses in your town--the Rotary and Kiwanis Clubs--to associate together and create a bigger risk pool, which brings down premiums, just as big businesses do. If you are a small business owner with 30 employees and one of them gets really sick, your premiums skyrocket the next year. By making a 3,000-person risk pool rather than 30, your premiums will come down. We have tried to get that into the bill. The Democrats say no.
There could be greater affordability by giving individuals the same tax deduction businesses get. The President voted against that when he was in the Senate. We could expand health savings accounts so you can use the money saved there to buy health insurance--pay the premiums. Again, the President voted against that when he was in the Senate.
These are Republican ideas, good ideas, and they have been voted down in these bills.
Here is another one: require insurance companies to share the claims data. One big business told me they couldn't compete and get a lower cost because their current health care insurer wouldn't give them their claims data. That information ought to belong to the company. So we can make that requirement.
Another thing is--the last thing I will mention--we need to encourage less first-dollar coverage. Our automobile insurance would be very expensive if we insisted that it cover every tire we have to buy or every battery we replace or any other thing we do. Yet with health insurance we complain about a $15 or $20 copayment or a deductible of $50. It is common to have a $500 deductible or even a $1,000 deductible on your car insurance. Certainly, health care ought to be more important to us than owning a vehicle.
These are just some of the comments I have about the reaction my constituents are having to the bills being proposed out there and the fact that they want to slow it down and look at it carefully because they are concerned about the cost of it, the increase in the Federal deficits, the increased taxes that will result, the government takeover, and that the net result will be our health care will be rationed, we will have delay and denial of care, and we won't be able to keep the insurance most of us have and like.
Those are legitimate concerns, and they should not be answered by simply saying we have to hurry up and get this done. No, we don't. We need to let the American people evaluate it and have them tell us what they want to be done. I think they have already spoken in some of the polling, and I think it is important for us, therefore, if we approach our duties the way we are supposed to here, by carefully considering what our constituents want, asking whether we can solve some of the specific problems with, for example, some of the ideas I laid out--good Republican ideas--rather than having to throw out the baby with the bathwater, tossing overboard what we know works for most people most of the time just because it doesn't work for everybody all of the time, in exchange for a new government takeover--it is a bad bargain.
I urge my colleagues, in the last week or two before the August recess, we have to start planning for opportunities to visit with constituents over the recess, get the information together so we can present it to them and they can tell us what they think about these ideas. I suspect that, at the end of the day, they will say they don't want a government takeover, just fix what needs to be fixed and leave the rest of it, which works, alone.
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