June 16, 2009

Wyden Spells Out Health Reform Challenges

Washington, D.C. - U.S. Senator Ron Wyden (D-Ore.) spoke on the Senate floor today, laying out what he sees as the key components required to enact true health care reform. The text of the speech follows:

Mr. President, many senators on both sides of the aisle are working constructively to fix American health care, and for several years I have spent time listening to colleagues - going to the offices of about 85 Senators and at least that many in the House - and also listening to thousands in the public and private sectors, about their ideas for fixing American health care. My aim has been to try to help find common ground and to chart a path so that this Congress and this President can go somewhere that this country has never gone before: and that is to real health care reform.

Today I come to the floor to lay out the specifics of what real health care reform is all about. The President said yesterday there has never been a better opportunity to get the job done: specifically, to improve the lives of all Americans, to guarantee quality, affordable coverage to all people. The question now is: Will Democrats and Republicans here in the Senate rise to this challenge? Will this Congress and the President overcome the fear tactics that have derailed past efforts? And equally important: Will this Congress and our President dare to pass real reform? The pitfall as I see it is, too often, we've been too afraid of failure - if we draft legislation with an eye only on what you think we can get through - or what the American people will buy - if you play it too safe -- my fear is you will miss the opportunity for real reform. And I believe that passing a reform bill that doesn't really reform the health care system is just about as wrong as not passing any bill at all.

The President said yesterday he is going to support legislation that "earns the title of reform." I agree with the President, which is why I am going to use this morning to lay down a similar marker for what I believe is necessary to "earn the title of real reform."

First, real reform means that all of us, and especially the powerful, moneyed interest groups in our society, all accept changes they have resisted in the past. Insurers are going to have to change the way they do business. Pharmaceutical companies will have to be more responsive to purchasers who insist on more value and transparency. Doctors and hospitals will be held accountable for the quality of care they provide. And malpractice suits would be held to stricter standards. And individuals would have to take greater responsibility for their health.

Real health reform means changing the way business is done in the private insurance market. It means, Mr. President, an end to insurance company cherry-picking, where the companies take the healthy people and send the sick people over to government programs more fragile than they are. That's wrong, and this Congress - Democrats and Republicans - will make it illegal. Real reform means everyone is guaranteed coverage by their choice of insurer. Under a new system, insurance companies must be required to cover all comers and they'd be required to price with fairness so you don't get discriminated against because of your gender or your health status or your age. It means that you no longer will be denied coverage or charged more because you were sick years ago or you might be sick five years from now.

Real health reform guarantees that all Americans can choose their doctor and their health plan. As the President said yesterday, real reform will give every American access to the insurance exchange where they can choose to keep the care they have or pick a better plan that meets their families' needs. That means if you like the care you have - you can keep it. But it also means that if you don't like the care you have - you can reject it. You can reject it and choose a better plan. Real reform will not only cover the uninsured but it will make the lives of all those who have insurance coverage better. Right now the majority of Americans, Mr. President, who are lucky enough to have employer coverage get no choice. I believe - and the President said it yesterday - those Americans deserve choice too.

Now, some might say that this undermines the employer-based system. No, it doesn't. Rather, it makes the employer-based system more accountable at the same time that it makes health care more portable. Real health reform means that if you leave your job or your job leaves you, you don't lose your health care coverage. Real reform would end once and for all the entrepreneurial tax in which Americans are afraid to go into business for themselves because they can't take their health care with them. The President himself said it best when he wrote in 2006, "With Americans changing jobs more frequently, more likely to go through spells of unemployment, and more likely to work part time or to be self-employed, health insurance can't just run through employers anymore it must be portable."

Mr. President, real reform has to guarantee that all Americans can afford quality health care. No longer should families be forced to pay more for their health insurance premiums than they pay for their housing. Our goal should not be to exempt those Americans who can't afford to pay - our goal should be to guarantee that all Americans can afford the health care that they need. Real reform will be affordable for our nation and for our taxpayers. It will reduce current costs and bring the rate of health care inflation in line with economic growth. Failure to meet this test would result in massive new government obligations - without means to pay for them.

Mr. President, real reform must end the health care caste system in which low-income Americans are treated as second-class citizens. No longer should low-income Americans have less access to doctors than their Member of Congress or other Americans. Today, 37 million adults and 10 million children effectively lack access to primary care physicians. Those are Americans who have health insurance but who cannot find a doctor to care for them. Real reform means ending the caste system in America that, in my view, discriminates against the most vulnerable and most impoverished among us, and it means with reform, they will be able to get a doctor when they need to see one.

Real reform rewards Americans for making smart choices. Americans ought to be rewarded for choosing the right insurer for their families and they ought to be rewarded for choosing a healthy lifestyle. This means a new health system that no longer focuses primarily on sick care but puts the priority on prevention as well. Real reform would change the incentives that drive behavior in the American health care system. It would reduce the demand and desire for unnecessary health care services. Health care institutions would no longer profit from the quantity of procedures they run up, but will instead, Mr. President, be rewarded for quality care.

Real reform takes an axe to administrative costs. Americans ought to sign up just once for health care. They ought to have their premiums taken from withholdings so they don't have to worry about making payments. They ought to go into larger, efficient groups so they are no longer left on their own on what can often be a cruel individual market. In today's non-system, people are an afterthought to the self-perpetuating bureaucracy of medical billing, reimbursement fights, coverage fights, and outright fraud, waste and abuse. The President said yesterday real reform will: "Replicate best practices; incentivize excellence; and close cost disparities." In effect, he wants to see health care dollars go and pay for health care and quality, efficient health care. And that is what I have described today.

Real reform that provides care, it gets all of us under the tent for good-quality, affordable coverage, coverage that's portable coverage that ensures that we end the caste system so that all Americans can see doctors when they need one, and a system that is more intent on keeping people healthy rather than profiting from illness.

So the central question when it comes to real reform is not who pays but how we pay. Every American knows that ultimately the taxpayer foots the bill. It is now Congress's job to create an accountable system that puts the focus where it belongs - not on misguided incentives, not on shedding risk, not on quarterly profits - but on quality, efficient care for all our people. That's what Americans want from this debate about health care reform. That's what I think can bring Democrats and Republicans together, working with the President under the banner of real reform. The country deserves it. It is time for this Congress to give it to our people.

Mr. President, I yield the floor.