The need for affordable healthcare is one of the most pressing issues facing our country.  The United States has the best physicians and the best medical technology in the world.  But many of our own citizens can't afford it-including millions of middle-class families.  According to the US Census, about 46 million Americans are uninsured, including many who hold down full-time jobs, and millions more are underinsured.  Since 2000, the number of uninsured Americans has risen sharply by 22%.  A single, serious illness can send a hard-working family into bankruptcy.

In fact, medical debt following a catastrophic illness or other medical emergency is responsible for about half of all bankruptcies in the United States.  In response to medical bankruptcy reaching such epidemic proportions in our country, I introduced the Medical Bankruptcy Fairness Act of 2008 (H.R. 5138).  Currently, if a family is forced into bankruptcy, little is protected under the law. This bill would correct that by providing a safety net for the ever-growing numbers of Americans who find themselves thrown into financial crisis due to a personal or family medical catastrophe.  More specifically, it protects $250,000 in the value of a medically distressed debtor's home and prevents family caregivers from having their bankruptcy filing dismissed or referred to Chapter 11 or 13.  American families should not lose their homes just because they have to misfortune to become ill.

Some people say that we can't afford to change the system.  Yet we already spend more for healthcare-over two times more-than any nation in the world.  As a nation, we've already paid for our health care-it's just not being delivered to us.

Our health care system developed in an earlier time when most people worked for a single company for most of their lives.  Employers paid most of the cost of health care. Overall costs were lower and most families paid far less than they do today.

Since then, medical costs have skyrocketed.  Meanwhile, our economy has changed so individuals are much less likely to work in the same job for their entire career.  Companies are much less willing to pay a large percentage of the cost of healthcare.  Increasingly often, they provide none at all. Americans are in a squeeze.

As our vulnerability to medical catastrophes and the ever increasing numbers of the uninsured show, we need a system that is simple, affordable, efficient, and inclusive.  Fortunately, we have a good model-the Medicare system, which provides quality healthcare to millions of senior citizens.  It is familiar to all Americans, as our parents and grandparents use it.  Our seniors who benefit from it are healthier than ever.  Under Medicare, health care coverage is publicly-funded, yet privately-delivered.  Seniors pay a small co-payment for services and yet maintain complete control.  And Medicare is efficient - its administrative expenses are only 2%, as opposed to 32% for the private insurance industry.

The benefits would be considerable-lower costs, better care, true portability, no disqualifications for pre-existing conditions, universal access-a healthier America. People would still simply go to the health care providers of their choice, as they do now, and health care providers could continue to operate independently, as private businesses.  The difference would simply be that we would pay our insurance premiums to Medicare, instead of to a private insurance company. The savings of $350 billion in administrative expenses for our unwieldy apparatus can pay for Medicare for all.

I believe that health insurance is a right of all people, not merely of those who can afford it, and I support legislation that moves us closer to a goal of health coverage for all Americans.

In the meantime, I have strongly supported legislation that improves our current healthcare system in these difficult times.

I am an original cosponsor of the Medicare Prescription Drug Negotiation Act (H.R. 4), a cost-saving measure that requires the federal government to negotiate lower prices for Medicare prescription drugs.  Ironically, the bill passed by the last Congress explicitly prohibited the government from doing this.  This legislation, which passed the House on January 12, 2007, is still awaiting action in the Senate, and has a veto threat from the President.

In Congress, we passed legislation that would have insured millions of children who already qualify for health insurance but are not yet enrolled through the State Children's Health Insurance Program (SCHIP), called Healthy Kids in New Hampshire.  Under this bill, New Hampshire would have been able to include eight thousand additional children, and across the US four million more children.  Parents should not have to lie awake at night wondering, because they don't have health insurance, if they should now raid the rent budget, or the food budget?  Or delay and maybe the child won't be sick enough to go to the hospital?  What happens to the children of New Hampshire and the children of America?  We'll never give up until we provide health care for working families in America.
 
I also voted for the Children's Health and Medicare Protection (CHAMP) Act, which helps enroll needy children in federal health insurance programs, lowers costs to seniors who use Medicare prescription drugs, and guarantees a fair reimbursement rate to doctors which provide Medicare services to seniors.  This bill did not pass the Senate.  Fortunately Congress did extend SCHIP to the same number of children as before and prevent a 10% cut in physicians' Medicare reimbursements, a cut which would have threatened the care of our seniors.

Our small businesses have been particularly battered by the rising costs of health care. The self-employed and those working for small businesses with fewer than 100 employees make up 60% of the uninsured.  That is why I cosponsored the Small Business Health Options Program Act of 2008 (called the SHOP Act).  This bill makes health insurance more affordable and accessible for small businesses by establishing a national purchasing pool for insurance.

I have also supported legislation which is critical to finding cures for devastating diseases like Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's Disease), and to expand efforts for the prevention and treatment of Lyme and other tick-borne diseases.  Early in 2007, I voted for the Stem Cell Research Enhancement Act of 2007, which enables scientists to use discarded stem cells to research diseases that, until recently, had appeared to have no cure.  I also supported legislation which provides important funding for cutting edge research at the National Institutes for Health (NIH) and the Centers for Disease Control (CDC).  I am also an original cosponsor of the Paul Wellstone Mental Health and Addiction Equity Act of 2007 (H.R. 1424), which passed the House on March 5, 2008 and is pending in Congress while differences are worked out with the Senate. This bill would require equity in the provision of mental health and substance-related disorder benefits under group health plans, to help families deal with these debilitating disorders.

There is much more work to be done, and many smaller steps to take on the way forward. It will take innovation and determined leadership to find a solution.  I am committed to working towards the goal of making high-quality, affordable health care available to every American.