Ted Kaufman - United States Senator for Delaware

Kaufman on floor, Discusses Why Congress Must Pass Health Care Reform Now

July 10, 2009

I rise today to talk about health care and why Congress needs to pass reform now.
There are three simple truths to healthcare reform:

First, if we don't pass healthcare reform this year, the stars won't align for another opportunity to pass a major reform bill for years and years to come.

Don't kid yourself:  The last time Congress failed to pass major healthcare reform, 15 years passed until today.

If the Congress fails to enact a healthcare reform bill this year, with a new President in his first year in office who has a strong relationship with Congress, it simply will not be done until years from now when the system has collapsed into truly catastrophic shape.  

 And that leads to the second simple truth:  We must pass reform now because the consequences of failure are not that we'll be stuck with the healthcare system we have today.  The consequences of failure are a very ugly healthcare reality our system is quickly becoming.

Our healthcare system has become a gigantic-resource-eating-machine which over time sucks in more money and yet delivers fewer options and decreased quality care.  Rising premiums, uncertain coverage, decreased quality.

That's the reality, Mr. President.

The comparison of failing to enact reform is not to the system we have today but to a very ugly destiny we'll face relatively soon.

For example, if we do nothing, by 2016:  Healthcare premiums are projected to grow to an average of $24,000 per family.  Let me repeat, by 2016, $24,000 on average for healthcare costs per family every year.  That is simply unacceptable.

The third simple truth of healthcare reform is that if you like what you have today, we need healthcare reform so you can keep it.

We need reform to maintain stable coverage, that can't be taken away from you; to maintain stable costs, that won't eat away at your paycheck and won't put coverage out of reach; and to maintain stable quality, so you get the treatment you need, when you need it, and from the doctor you choose.

Only reform keeps and improves on the best of our current system.  Failure to act leads to a catastrophic healthcare future.  I am not exaggerating.

This is where we are.  The pressures on the system are building.  If we fail to act now, those pressures will cause rising costs, decreased choice, the loss of access to your current quality healthcare and basically worse healthcare outcomes across-the-board than we face today.
Let me add some additional statistics and projections. 

Health care spending is swallowing up our Gross Domestic Product (GDP). In 2009, health care will account for 18 percent of our GDP.
Eighteen cents of every dollar we spend is dedicated to health care. If we do nothing, this will rise to 28 percent of GDP in 2030 and 34 percent in 2040. This trajectory is unsustainable.

Today, the average premium for family coverage is just over $12,000 - an increase of 119 percent in nine years.  As I said, if we sit by and do nothing, by 2016 a family premium will be estimated to cost at least $24,000 - another increase of 83 percent. And in my home state of Delaware, it will be even higher, with a family insurance policy purchased through an employer estimated to cost over $28,000.

Can you imagine paying for that? And that doesn't even include out-of-pocket costs like deductibles and copayments. When health insurance premiums grow at a rate 5 times as fast as wages, something has to change.

There also has been an increasing prevalence of medical bankruptcies. A recent study published in the American Journal of Medicine showed that bankruptcies involving medical bills now account for more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years.
In fact, more than 75 percent of families entering bankruptcy because of health care costs actually have health insurance. Most are middle-class, well educated, and own their homes. They just can't keep up with the alarming rise in out-of-pocket costs associated with medical care.

Passing healthcare reform is important but not easy.  But for the reasons I've mentioned, this year is different.  This year, the call for reform is coming from people and organizations that in the past opposed reform.

This year businesses, unions, insurers, provider groups and patient advocacy groups are all looking for reform.

And why is that?  Because the growing healthcare dollars involved threaten virtually to bankrupt us all.  We need reform to stabilize the system.

I think it is important to keep in mind that this is not just about an alarming set of numbers, statistics and cost projections.

Behind all these numbers are real people who need quality and affordable healthcare, including people who struggle every day to get health care or keep the health insurance they already have.

Let me take just a few minutes to talk about some people from my home state of Delaware and why we need health reform for them, as well as for millions of Americans like them in all parts of the country.

We need health reform because of people like Angela Austin.

Angela is a recent mother who lives in Dover.  She works as a bartender. Most of her earnings come from tips. She doesn't get health insurance through her employer. When Angela became pregnant she tried to find private health insurance, but she was repeatedly denied coverage because her pregnancy was considered a preexisting condition. She applied for Medicaid-to find prenatal care for her and the baby-but was denied coverage because she earned $200 more than the monthly income limit allowed.  She called organizations and clinics and was unable to find a payment plan that she could afford.

Mid-way through her pregnancy, Angela decided to cut back her work hours so she could qualify for Medicaid.  Thankfully, Angela was finally able to get services at Christiana Care's Wilmington Hospital, where they provide prenatal care and delivery on a sliding scale for those who can't afford insurance.

She worked all nine months of the pregnancy and delivered the baby on May 27th.   The Medicaid coverage was especially crucial because she had complications from hyperthyroidism and was able to get the necessary prescriptions to control the condition. 

The sad part of this story is that when Angela was so anxious that everything possible be done to insure a healthy baby, the system threw up road blocks.  Pregnancy should not be considered a pre-existing condition.  What's more, no one should be denied coverage because of a pre-existing condition.  (And no one should be forced to choose poverty to qualify for Medicaid.)

We also need health reform for small businessmen like Ian Kaufman of Georgetown.  (Ian is not a relative of mine.) 
Ian moved to Delaware right out of college in 1990. He was laid off from his job this past January and decided to start a small business. In the process, Ian picked up COBRA coverage to ensure that his family maintained their health care insurance.

When he first signed up for the COBRA coverage, his monthly premium was $1,800.  That is a lot of money.  Thanks to the COBRA provisions in the Recovery Act, Ian saw his payments reduced by 66 percent - which made his monthly premiums much more manageable.
However, this premium assistance will run out sometime this fall, and he will once again have to pay $1,800 a month.

In anticipation of higher COBRA payments, Ian applied for coverage from Blue Cross and Blue Shield but was turned down. They never gave him a reason for denying him coverage but he suspects it was because of a pre-existing condition of one of his daughters.

Ian worries that the high cost of providing health care for his family, in addition to the difficulty of even finding a willing policy provider, will affect his ability to stick with his start-up business.

Unfortunately, Ian's health insurance predicament as a self-employed businessman is not uncommon. There are too many sole proprietors and small businesses that cannot afford health policies for themselves, their families and any employees they might have. It shouldn't be this way.

But it's not always just a problem of finding private health insurance. We also need health reform for people like Bonita Sponsler from Dagsboro so they don't slip through the cracks of our existing safety net of Medicaid and Medicare.

Bonita was laid off from her job in March 2007.  Three weeks later she suffered a brain aneurysm. Bonita applied for Social Security Disability and was awarded benefits, but as with everyone who qualifies for such coverage, she has to wait two years before Medicare coverage kicks in.

Meanwhile, Bonita has suffered two additional aneurysms since her initial episode and it is advised that she receive an arteriogram to monitor her condition. Unfortunately, she can't afford to pay the several thousands of dollars it costs for an arteriogram, so she's taking her chances until she becomes eligible for Medicare in October.  This a considerable risk due to her propensity for aneurysms, but it is the only option she can afford. In fact, she has had to cancel a scheduled arteriogram in September because she still won't have coverage by then.  It shouldn't be this way.

Finally, we need health reform for people who pile up insurmountable debt, many times due to accidents or injuries they never caused and couldn't avoid.

Without using her name, I want to highlight the situation of a Delaware woman who is a victim of domestic violence.  She suffered major eye damage and has had three surgeries.  She has no health insurance and by late 2008 owed almost $30,000 in hospital and anesthesia bills, in addition to $6,000 in personal bills.

She received "lost wages" from the Violent Crimes Compensation Board.  She applied for Medicaid but was turned down.  She then applied for Social Security Disability but was also turned down as her eye condition was not considered to be "permanent" and could be repaired with additional surgery.

After waiting many months, she was finally able to get the eye surgery she needed because the doctor who performed the procedure reduced the fee from $12,000 to $3,000 and allowed her to go on a payment plan.
However, she still owes 20 to 30 thousand dollars for the prior surgeries.  She is presently not working and does not have health insurance.  She could have had COBRA following the loss of her job but it was $890 a month and she could not afford it.  She presently can see well enough to drive. However, she is due for yet another surgery and the financial arrangements for that will again be extremely difficult if not impossible. It shouldn't be this way.

These stories help to show why we can no longer wait for health reform.

These stories require us to put our differences aside and come together to make certain that Americans have access to affordable, quality health care when they need it.

In my short time here in the Senate, I have had the pleasure of presiding over the floor in the President's desk. I have listened to many of my colleagues give good, passionate speeches staking out their position on where we need to go on health reform. I can truly say I have learned a lot from those speeches, many of which have helped shape my own views on the health reform debate.

That said, I have also heard some speeches that give me cause for concern, as some colleagues seem to have pre-judged the legislation before it has even appeared.

I've heard about the dangers of a British or Canadian-style government run health care system.

I've been warned about rationing and bureaucrats getting between Americans and their doctors.

I've listened to stories about patients from other countries that come here to get care they can't receive in a timely manner back in their own country.

I've heard over and over about a "government-run takeover of healthcare."

I do not doubt the sincerity of my colleagues who see potential pitfalls in health care reform. But when I hear these speeches I often wonder what legislation they are warning us about.

So far, I have not seen any bill being discussed in committee that calls for a government-run single-payer system like Canada or Great Britain.

I have not seen any legislative text that puts restrictions on what treatments doctors can provide or what they can discuss with their patients.

I have not read any language that rations any sort of health care.

I hope that the fears about change in our health care system do not hurt our chances of enacting reform this year.
I hope the debate over the bill is centered around what's actually in the legislation, not extrapolations about provisions in the bill or frightening projections of a health care system in other countries that are not actually being proposed here in Congress.

I hope that as the debate moves forward, all of us here in the Senate will step back, take a breath, and remember why we need to reform health care.  We are moving quickly toward a healthcare system that Americans will no longer be able to afford. The system is quickly hurtling out-of-control.

Yes, we do need to keep what works, and we need to fix what's broken.

We need to make certain that Americans can get affordable health insurance without worrying about pre-existing conditions.

We need to help Americans avoid bankruptcy because of out-of-control medical bills.

We need to ensure stability in the system so that Americans maintain insurance options and their choice of doctor.

Most importantly, we as a country need to take control of our healthcare destiny.  We can have a future in which Americans can have stable coverage, with stable costs and stable quality.  Or if we do nothing, we will have a future of rapidly increasing premiums, uncertain coverage and decreased quality.  

I urge my colleagues to gather their collective will, realize what is best for our country and do the right thing during this historic opportunity by passing healthcare reform.

Thank you Mr. President and I yield the floor.

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