Statement Of Senator Patrick Leahy On The Motion To Proceed To H.R. 3590, The “Patient Protection And Affordable Care Act”

Decision time is near on health insurance reform, and I will vote today to end the filibuster so the Senate can begin this important and historic debate to improve and reform our Nation’s health insurance system. Let’s not duck the debate.  Let the debate begin.  Let’s not hide from votes.  Let’s have the courage to vote and stand up and vote on the amendments.  Let the American people know where we stand and not say, well, it never came — it never came up because of the filibuster.  We can end the filibuster today.  We can get going.  We can let every American know where we stand.

The sentries of the status quo again have spared no effort to kick the can down the road, as they have done before.  The country suffers when there is a failure to act on serious challenges that millions of ordinary Americans face in their daily lives.

This is a defining moment for the Senate and for the country, ranking alongside other major decisions such as the creation of Social Security and Medicare, and the Civil Rights Act.  We have been talking about health insurance reform for more than 70 years.  The Senate should not now prevent a real debate on health reform by hiding behind the fig leaf of a procedural filibuster.

A bill worthy of this debate has been produced after months of arduous work.  Opponents of reform unfortunately have wasted much of the public’s time by provoking arguments over their distortions about what health reform means.  Spurious rumors were spread about “death panels.”  One opposition mailing claimed reform would mean denying care to people based on their voting records.  These are the tactics of obstruction, in the service of the status quo.  Meanwhile, what the American people yearn for are constructive solutions and an honest debate, not a filibuster.  That is what they deserve, and that is what we owe them.

A Vermonter came by my office to talk about health reform, as so many have over the last several months.  A physician, he has a special perspective from inside the system.  He recalled stories about his father, also a doctor, who practiced in the days before Medicare.  He remembered the devastation his father felt when he was forced to turn away elderly Vermonters because they did not have health insurance. 

It may be difficult today to even imagine this, but before Medicare, older Americans were routinely driven into poverty during their retirement years by health expenses.  Before Medicare was launched in 1964, nearly half of seniors over 65 had no health coverage, and more than one in three lived in poverty.  Today, because of Medicare, virtually everyone 65 and older has health insurance and the poverty rate among seniors has plummeted.  More than 100,000 Vermonters have Medicare insurance.

The arguments that were made against creating Medicare may sound familiar.  Opponents then tried to demonize the plan and claimed it would never work.  But eventually, Members from both sides of the aisle worked together to pass a bill that is one of the most successful and popular programs today.  Vermont’s entire congressional delegation, all Republican at the time, supported passage of that landmark legislation.

We have a health system with contradictions.  Federal investments in research and private investments in development have produced modern medical marvels in the equipment, training, techniques and drugs that are available to many Americans.  Yet in the prices we pay, in the lack of access to basic medical care, in the loopholes and red tape that plague ordinary Americans in our health insurance system, and in overall results in many categories, we get far less for our enormous health care spending than do the citizens of countries whose health costs are a fraction of ours.  Tens of millions of American households have no health insurance at all.  Employers who want to offer health insurance to their workers are being priced out of even having the option anymore.  Self-employed Americans must pay dearly to afford any insurance, and they can lose their coverage at the whim of their insurance company’s bureaucracy.  In no modern nation except ours are families actually driven into bankruptcy by illness.  In fact medical expenses are one of the top reasons for bankruptcy.

In the absence of a fair and sensible health insurance system, families, businesses and taxpayers have been dragged along by an inflationary curve that only worsens with time.   Next year, small businesses — already suffering from skyrocketing medical costs — will see their premiums rise by an average of 15 percent -- twice the rate of last year’s increases.  Drug companies have boosted prices of brand-name drugs by about 9 percent over the last year, the steepest increase in years.

Can’t we fashion an American-made solution so our citizens can have high-quality affordable care, and access to basic health insurance?  Of course we can.

The bill introduced this week by the Majority Leader and by Senators Baucus, Dodd, and Harkin, would give millions more Americans access to quality, affordable health care and would end discriminatory treatment of those who change jobs or have preexisting conditions. 

I have pushed and will continue to push to accomplish the “three Cs” of choice, competition, and cost control as we reform our health insurance system.

I am encouraged that the Senate bill includes a public option that I have strongly supported, and I will stand with others as we make our case for keeping it in the reform plan.  At the start of this process I was proud to join Senator Brown and a core group of more than 20 other Senators in introducing a resolution affirming our support of a public option.  A public option would give consumers more choices to select affordable and quality health insurance plans, while helping to drive down overall medical costs through real competition in the health insurance market.

To further enhance the advantages of a competitive market, I have introduced the Health Insurance Industry Antitrust Enforcement Act of 2009, to repeal the antitrust exemption for health insurance and medical malpractice insurance providers.  Closing this loophole in our antitrust laws is long overdue, and I will offer my legislation as an amendment to this bill.  Antitrust enforcement promotes competition, helping to lower prices and expand consumer choice.

Another factor that contributes to the rising medical costs that all Americans face is fraud within the health insurance system.  The scale of health care fraud in our system today is staggering.  Studies estimate that between 3 percent and 10 percent of all of our health spending, both public and private, is wasted through health care fraud.  That is somewhere between $60 billion and $220 billion each year.

To help wring this waste out of our system, Senator Kaufman and I and others have proposed the Health Care Fraud Enforcement Act.  Our bill would toughen sentences for those who commit health care fraud, strengthen support for prevention, investigation, and prosecution of health care fraud, and sharpen the legal tools for going after this fraud.  It would prevent wasted spending and hold accountable those who do the stealing.  Experience shows that anti-fraud efforts give taxpayers a superb return on investment, with a payback of between six dollars and fourteen dollars for every dollar spent.  I am pleased the Majority Leader included provisions in this bill to address the issue of health care fraud, and I look forward to working with Senator Kaufman and others to strengthen our laws to prevent fraud and abuse in health care costs.

Vermont has helped pave the way for some of the reforms included in this bill, and now for the third year in a row, Vermont has been ranked as the healthiest State in the Nation.  Vermont is one of the earliest leaders in expanding the State Medicaid program, under reforms led by former Governor Howard Dean and others.  Yet under the current form of this bill, Vermont would not share the enhanced federal match that would be offered to other States.  This would amount to regressive policy with adverse practical ramifications for Vermont, a State that is a leader in expanding access to health care.  I will continue to work to correct this discrepancy.

But to make these and other improvements, first we must agree to debate the bill.  Let’s not hide under our desks because we’re afraid to stand up and debate and vote. 

The people of Vermont have given me the honor of representing them in the Senate for 35 years.  I have joined in many debates that were contentious, yet ultimately productive.  As we leaf through the pages of history, we can read of the many times when the Senate has shown its remarkable ability to rise up to reflect the conscience of the Nation.  Those moments were forged in the crucible of national need, against the anvil of the tempered will of the Senate’s membership.  The Senate can do that again.

Our dear friend Senator Ted Kennedy said it so well in the letter about the health reform imperative that President Obama read to a Joint Meeting of Congress.  This is what he reminded us:  “What we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”

This is such a time, and it is my hope and belief that the Senate again will rise to the occasion. 

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