Wyden Introduces Bipartisian Health Care Legislation that Works For All Americans

October 7, 2002

Our country has been trying to find such a path since President Harry Truman's proposal to cover all Americans was voted down in 1945. I believe our proposal can succeed after 57 years of failure because we begin with the public discussing and deciding their health care priorities, followed by a guarantee that Congress will vote on the recommendations that result from these discussions.

This approach has never been tried before. Now when major health laws are written, politicians sit down and prescribe what benefits will be offered and then try to come up with the money to pay for them. After the politicians write their plans, various special interest lobbies start attacking one feature or another through shrill television commercials. Pretty soon the public gets understandably confused, the chance for building consensus is lost, and important health care needs go unmet.

The 280 million Americans whose survival depends on quality, affordable health care have never been given the chance to shape their health care future before the special interest lobbyists weighed in. The Wyden-Hatch bill changes that. Under our proposal, the public gets to jump start health reform by stating their priorities at the outset rather than being treated as an afterthought.

We believe our legislation can serve as an illuminated route to a health care system where each American has the ability to obtain quality, affordable health care coverage. We place three signposts on our roadmap to provide guidance to the American people and their elected officials as they make the tough choices inherent in tackling health care reform.

At the first signpost, the public is given an extensive opportunity, in their home communities and online, to state their personal health care priorities and how they should be paid for. In addition, the public will be asked to look beyond their personal needs to those of the commuity at large, and how those needs should be paid for.

Our legislation forthrightly asks the public those questions that must be answered to have meaningful health reform, questions such as:

"What kind of health care do you want most? How much are you willing to pay? How should costs be contained without sacrificing quality of care? Should the government or private businesses be required to pay part of your costs? How about your neighbors?"

Our national government has never directly asked the public these questions before. After asking these questions, the government should keep quite for a while and listen to the people. Because without some sense of the public's views, it will always be virtually impossible to build the nationwide consensus needed to create a health care system that works for everyone.

To ask the key questions and follow up on the suggestions given by the American people, the Wyden-Hatch legislation creates a Citizens' Health Care Working Group. The Working Group is made up of a representative cross-section of our people. It is not just another Washington, DC commission of so-called policy experts.

The Working Group directs the public participation portion of this proposal. For example, as a guide to help the public in formulating their views on the tough choices that lie ahead, the Wyden-Hatch legislation directs the Working Group to prepare and make widely available a "Health Report to the American People."

The legislation we have authored requires that this report be written in understandable language and describe the cost and availability of the major public and private health choices now available – and also contain enough information so the public can create alternatives. Here are the kinds of issues we want to address: "If covering liver transplants under government health programs requires cutting other services, what services are you willing to cut, or would you rather not have liver transplants covered? If government coverage of long-term care for the elderly would require workers to begin contributing to the program at age 40, is it still worth it to you?"

These are moral choices about what health care the public has a right to expect. These are economic choices that affect the finances of our families. These are legal and social choices that will be difficult for our people to make. The Wyden-Hatch proposal is built around the proposition that these choices are too important to duck any longer.

After establishing a sense of how the public feels about these hard choices, the legislation directs that the Working Group move to the second signpost on our roadmap. There the Working Group is to take the ideas offered by the American people, and translate these views into recommendations for our elected officials to create a health care system that works for all. With the Working Group's involvement in the public participation requirement of this legislation, we believe they are the right people to take this historic step: to synthesize the opinions and information provided by the public and then present a faithful picture to Congress.

At the third signpost, the Congress takes the recommendations from the Working Group and utilizes the legislative process to develop one or more plans from the recommendations, with a guarantee to the public that the plans will be voted on in both Houses of Congress. We believe that the assurance that Congress will vote after the public's will is expressed provides an added measure of credibility for this legislation. Simply put, people will be able to see their voices, their participation, lead to actual votes on the floors of both Houses of Congress.

With these steps I have described, our country can as never before discuss, decide and deliver on health care that works for all.

I know there will be many questions about this proposal, and I'll try to answer them in the coming days. I'd like to briefly answer just one question I've already been asked: "Why now? This is the end of the Congressional session; we are all concerned about the possibility of war with Iraq. Why are you putting this before Congress today?"

My answer is that the lack of decent health care for so many Americans, and the skyrocketing costs of coverage for insured Americans, threaten countless lives and our economic security just as tenaciously as any foreign enemy our nation has ever faced. Just as we are beginning a debate about how best to address the nation's security interests, it is high time we resumed the debate about how to address the inequities and failures of the American health care system.

On health care, our families can't afford to wait any longer. Congress is completing another session without significant progress on major health care issues. A demographic tsunami of baby boomer retirees is coming soon. It is increasingly evident that piecemeal health reform – considering prescription drugs one day, patients' rights legislation the next, something else after that – isn't working.

I have no intention on giving up on any one of those important issues when it's possible to get Congress to consider them separately. I still believe the bipartisan prescription drug bill I authored with Olympia Snowe could bring the Senate together and help seniors get and afford prescription medicine now.

Yet it is clear that because health care is like an ecosystem, with one part affecting all others, it is extremely difficult to make real progress on a single important issue without factoring in the way it will ripple through our entire health care system.

So as the Congress pushes ahead on prescriptions and other urgent needs, let us simultaneously reopen the debate about creating a health care system that works for all. That debate stopped in 1994, and needs to begin again. The Wyden-Hatch bill provides an opportunity to reopen this debate, and by introducing our bill now we believe it will be ready for full Congressional deliberation when the next Congress begins in January.

One way or another, it is urgent that Congress find a way to do better by the people's health care needs.

My constituents at home in Oregon make this case constantly. At town meetings, Chamber of Commerce lunches, labor halls, non-profit board meetings, after church coffee hours, and especially at my "sidewalk office hours" where I just set up a card table to listen, they ask, "Ron, when's Congress going to get going on health care and help us out?"

One Oregon business after another has been telling me their health premiums are going up by as much as 20 percent a year. The number of uninsured is going up, with many of these individuals working at small businesses whose owners desperately want to offer health coverage and can't figure out how to do it and keep their doors open. Many physicians have been leaving government health programs because of inadequate reimbursements. Thousands and thousands of pages of health care regulations now exist and the system is almost choking on all the bureaucracy.

We know that America's health care system is scientifically prodigious. Every day our dedicated and caring health care providers are performing miracles. Last year more than $1.4 trillion was spent on health care in America. Divide that sum by the number of Americans, and there would be enough for every family of four to receive more than $18,000 for health care. With all this money, and so much talent and creativity in America, shouldn't it be possible to create a health system that works for everyone?

Senator Hatch and I believe it is. We know it will be hard, but we believe it can be done if our roadmap is used.

For example, to achieve real reform our elected officials are going to have to reject the blame game. Republicans can no longer say the problem in health care is primarily the trial lawyers. Democrats can no longer say the problem in health care is primarily the insurance companies. All – let me repeat, all – of the powerful lobbies are going to have to accept some changes they have rejected in the past if America is to have a health care system that works for everyone. I believe that's what we'll hear from the public if they're given the chance to discuss and decide their health care priorities as the Wyden-Hatch legislation envisions.

Before I wrap up, I'd like to offer a few thank-yous.

First, to the people of Oregon. You've honored me with the chance to serve you and I get up every morning feeling like the luckiest guy around. It wasn't that long ago, as co-director of the Gray Panthers, I was driving seniors to meetings in a beat-up station wagon and I never thought I would have the privilege of serving this way. You can see I've modeled much of this legislation after the way Oregon debated health care, which still stands as the first locally driven initiative to ask the tough questions.

Oregonians began asking those difficult questions in community meetings more than a decade ago for one reason: Governor John Kitzhaber, an emergency room doctor, insisted that we do so. He deserves great credit for his efforts, his courage and his tenacity. When I told him I was going to push Congress to build on Oregon's public process, he said, "Go for it."

Senator Hatch could have easily said he wanted no part of this. He's already written important health legislation from S-CHIP to community health centers to Hatch-Waxman, and he's got about the fullest plate in the Senate with his Judiciary and Intelligence responsibilities. But he, Patricia Knight and Patricia DeLoatche have been thoughtful and patient as we went through draft after draft of this proposal in an effort to start the discussion now.

Dr. Paul Ellwood, the founder of the Jackson Hole Group, has been working for more than three decades to create a health care system that works for everyone. Now, when he could be enjoying retirement riding horses in beautiful Jackson Hole, he's still bringing together health policy makers at 7:00 a.m. on a Sunday morning in an effort to find consensus. He has been so helpful in the development of this proposal, and his own new plan called Heroic Pathways, by encouraging the use of information technologies and evidence-based medicine – a fancy way of saying medicine that actually works – has great potential. To Paul and Barbara I say, we wouldn't be here today without you two.

In my office, Stephanie Kennan and Carole Grunberg kept us tethered to reality, and Ms. Daphne Edwards, a young lawyer in the legislative counsel's office, produced eight separate drafts of this legislation alone.

I went into public life because I've always felt that if the public couldn't get quality, affordable health care they wouldn't be able to do much else. Since those Gray Panthers days, I've felt that it's wrong for people in this country to die because they can't get health care, or because it comes too late.

America is now hemorrhaging dollars into a health care system that doesn't work at all for far too many of our people. The longer people go on dying needlessly, and the longer prosperity and security elude our families, the less America looks like the America of our dreams. No one I know thinks it should be so easy to slip through the cracks in our health care system. No one I know believes America is supposed to be a place where people forfeit their well-being for doing honest work that just doesn't pay enough for good medical care.

The Wyden-Hatch legislation is a chance to move toward America as it is meant to be. People can voice their vision for health care in America. Their voices can count. Their vision can come to pass. So today I ask the Senate to give our people this opportunity. The Wyden-Hatch bill provides a roadmap. The great people of this country, working with their public servants, can use it as a guide to a health care system that works for everyone. M. President, I yield the floor.

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