From the Desk of Carl Levin U.S. Sen. Michigan (D-MI)
Washington D.C. – Madam President, in a few hours we will, I hope, take an important step on the road to health care reform. Our vote will come after months of analysis and debate, and years of growing concern on the part of our constituents that the American health care system is in need of fundamental reform. Two Senate committees have approved reform legislation, and we will vote later today on whether to open debate on a third bill, which merges the two produced by the Senate Finance and HELP committees.
Much time and attention has been focused on the provisions in this legislation which will expand the number of Americans who are covered by health insurance, a goal I wholeheartedly share. But a compelling reason for reform, and a major reason to vote in favor of allowing the Senate to debate health care reform, are the serious and worsening signs that for those Americans who have health insurance, our healthcare system is no longer working as it should. Increasingly, Americans with health insurance are at catastrophic financial risk if they get sick. Increasingly, working families with insurance are unable to afford the escalating premiums that they face to maintain their often inadequate coverage. Increasingly, businesses large and small that offer health insurance to their employees are buckling under the crushing weight of spiraling costs for their employees. Increasingly, families find that caps on their coverage leave them exposed to devastating medical bills. And increasingly, arbitrary insurance company practices that boost their own profits are shortchanging Americans, denying coverage because of pre-existing conditions and searching for ways to deny patients the treatments that they need and have paid for through their premiums.
Madam President, Democrats are not alone in pointing out these problems. The Republican leader himself has said, “every Republican in Congress supports reform.” That’s the Republican leader who said that every Republican in Congress supports reform. He did not say “many Republicans.” He did not say “most Republicans.” Every single Republican in both chambers of Congress, the Republican leader tells us, wants to reform the health care system in this country.
How will any reform happen – reform proposed by Democrats or by Republicans or by anybody? Only when this body can bring a bill to the floor of the Senate for debate and amendment; only when we work with our colleagues in the other chamber to resolve differences between legislation approved by the Senate and that approved by the House; only when Congress sends to the president a bill he is prepared to sign into law. Speeches will not reform health care. Polls and cable television shout-fests – none of them will reform health care. We, the members of the United States Congress, and we alone can reform health care. We must listen to constituents, advocacy groups, physicians, insurers, health care experts, economists, and anyone else with constructive ideas. But ultimately, it is we who must act.
And to do that, we must begin to debate here, on the floor of the Senate, the many complex issues that must be resolved. That is all today’s vote will do: give the members of the Senate the chance to come together in a sincere effort to work together, resolve our differences, and address an issue on which there is, we are told even by the Republican leader, that there is general agreement on the need for reform.
Two Senate committees have already spent months seeking the proper ways to reform the health care system. The Senate Finance Committee has held over 50 meetings on health care reform legislation in the last year. The Senate Health, Education, Labor & Pensions Committee spent thirteen days marking up its legislation.
So we have made progress. We are at least in position to do what this body was designed to do, and is supposed to do: deliberate and decide. Now the minority opposes the legislation we are trying to bring to the floor for debate and amendment. They say don’t like the bill. But why deny the Senate the opportunity to debate the subject of health care reform? Why prevent us from considering it? Why not offer amendments to the bill if you don’t like it, or a substitute measure for it?
Mr. President, there are parts of this bill I would like to see changes in. I’d like to make health insurance even more affordable for working families, and I’m willing to require that those earning more than $250,000 a year pay a higher, and in my view a more fair and more appropriate tax rate, to make that greater affordability for working families possible. Income data shows that in recent years, only the wealthiest ten percent of Americans have seen any real increases in income, and that those increases are concentrated in the wealthiest one percent of the country, while the vast majority of Americans have lost ground. At the same time most Americans are coping with falling income, they have been hit with massive increases in health insurance premiums. So I am willing to support an increase in upper-income tax brackets to end that unfairness. Other sources of revenue, such as ending the abuse of offshore tax havens, can and should go toward doing other things we need to do in this bill.
For instance I am concerned that the annual fee on insurance providers contained in the merged bill would treat nonprofit and for-profit insurers the same way. Millions of Michigan residents receive their insurance from Blue Cross Blue Shield of Michigan, a nonprofit company which is the insurer of last resort in our state, providing coverage to residents who cannot find it elsewhere. We need to find ways to reform the insurance market without negatively impacting the not-for-profit insurance companies who are the insurers of last resort and who provide high levels of coverage in return for the premiums they collect.
On these and other issues, I will continue to study the details of the legislation, discuss them with colleagues and constituents, and seek and support improvements where needed. What I will not do is vote to block efforts to reform a system that simply isn’t working well for those who have health insurance as well as for those who don’t. The need for reform is generally acknowledged. How can we not open debate? How can we not discuss, offer amendments, consider alternatives, make changes, and vote on reform legislation? That is the only path to health care reform; there is no other way. And for those who proclaim their belief in the need for reform to stand in the way of that debate is, at best, starkly inconsistent. A vote against even opening debate is a vote in favor of the status quo which my constituents, and the vast majority of Americans, can no longer afford.
They can no longer afford it because it is bankrupting them – in many cases, literally bankrupting. A study this year published in the American Journal of Medicine found that in 2007, 62 percent of all individual bankruptcies in the United States involved medical costs. That’s a tragedy. You shouldn’t be forced into bankruptcy because you get sick. But it gets worse. Three-quarters of those bankruptcies involved people who had health insurance when they got sick. Let me repeat that, Madam President: In the United States, almost two-thirds of all bankruptcies are linked to medical costs, and three–quarters of those bankruptcies occurred even though the debtor had health insurance. That’s adding absurdity to tragedy – and demonstrates the inadequacy of health insurance for those who are covered.
We must act to reform a health care system so broken that it crushes Americans under a mountain of debt. One of my constituents, a Kalamazoo man, had what he thought was adequate health care coverage when, three years ago, he needed surgery to replace two sections of his aorta. But his coverage left him an out-of-pocket cost of nearly $40,000. Madam President, that is the sum that stood between this man and life-saving surgery. Financially devastated by the costs, he declared personal bankruptcy. He wrote to me: “No one should die because they cannot afford health care, and no one should go broke because they get sick.” And he’s right.
We must act to reform a health care system so broken that it leaves the mother of a young Michigan State University student worried her daughter won’t get the care she needs. This 24-year-old student has insurance, yet when she began to have unexplained seizures, her coverage would not pay for all the tests needed to determine their cause. Even after declining some prescribed tests because she couldn’t afford them, the young woman’s doctors eventually discovered the cause of her seizures: a brain tumor. This mother worries that her daughter will lose her insurance, will be forced to declare bankruptcy, and that the family will have to find some way to cover the massive expense of her life-saving care, all while coping with the other financial strains hitting her family and so many others. The mother writes: “We will lose too many bright young people … if something is not done.” And she’s right.
We must reform a health care system so broken it sent a minister from Jackson, Michigan, on a weeks-long odyssey to keep her insurance because she became pregnant – a joyous event for most families, but apparently just another pre-existing condition to the insurance companies. When this expectant mother moved from a church in Massachusetts to one in southern Michigan, her new church immediately sought for their new minister to find her health insurance. But company after company declined to cover her because of her pregnancy. She and her church spent weeks researching the issue, changing insurance agents, providing document after document, pleading with insurance companies. She wrote me that “I had two volunteers, myself, and two insurance agents working on the situation constantly for over a month.” And she says, “If you have the time and energy, and some good help, and are willing to spend a month hassling with the system pretty much continuously … then you can sometimes, with a great deal of luck, work the system.” Reflecting on her experience, this minister writes, “It is clear to me that we are desperately in need of health care reform.” And she’s right.
Mr. President, the legislation the majority leader has brought forward would do much to ease the hardship on millions of Americans. It has benefits for those who already have insurance through their employer, with steps to rein in skyrocketing premiums and to reduce the risk of financial ruin for those who have health insurance.
In addition to helping those with private insurance, this legislation provides important benefits for seniors covered by Medicare. Medicare beneficiaries will receive free preventive care benefits, and the bill will reduce the enormous costs many seniors face when they fall into the “doughnut hole,” so-called, in the Medicare Part D prescription drug program. Because of these important improvements in care for seniors, AARP has recommended that senators vote in favor of beginning debate on this bill tonight.
The legislation also contains important provisions to improve information technology in the health care sector, pushing for uniform billing practices and developing standards that will lead to the computer systems of health care providers being able to talk to the computer systems of insurance companies, reducing mountains of paperwork and other inefficiencies that drive up health insurance premiums. And Americans who move from one employer to another will no longer face the risk of being denied coverage at their new job because of a pre-existing condition.
We must allow debate to begin. If we act, millions of those who already have insurance at work will benefit. If we act, millions without insurance will get it, along with help to pay for it, so that we can end the current wasteful situation in which emergency-room care, vastly more expensive than primary care through a family doctor, is used for nonemergency purposes by those without health insurance.
We can only accomplish these things if we vote today to begin debate on this legislation. We can only accomplish these things if we are willing to honestly and vigorously debate the best ways to achieve them. So I urge our colleagues not to close the doors of this chamber to debate of one of the most urgent problems Americans face. I ask our colleagues to allow the Senate to begin deliberations on health care reform, and not to turn away from the opportunity – and the responsibility – before us.
