operating alongside private plans. a public option will give americans a better change of chases and keep insurance companies honest. the key to all of this, however, is that a public option will be just that. as i said before, an option, not a phab date. some people would choose it -- not a mandate. some people will choose it. others will not. if you like the insurance plan you have now, you keep it. if you're happy with the insurance you get from your employer or the individual insurance market, or you may be he be rolled, stay enrolled in that insurance plan. if you're unsatisfied with the public option, you have the option to switch back to private insurers. americans firmly support the ability to choose their own doctor and value their relationship with the providers, and so do i. an overriding goal of health reform is to increase patients access to affordable, quality health care and offering public

option can help increase america's choices. i am heartened that i was joined by 26 other senators several weeks ago in cosponsoring a resolution sponsored by senator brown calling for the inclusion of the federally backed health insurance option and health care reform. senators have been involved in health care issues for decades: senators kennedy, dodd, rockefeller, bingaman, just to name a few have all agreed a public option should be included. as i said before, i admire the efforts of my colleagues on finance and health, education, labor and pension committee who will be drafting our health reform legislation. they have an important responsibility, and i recognize they will be debating many, many options regarding coverage, financing, regulations and so object. i simply encourage that to consider seriously a public option as a choice for americans in any new health insurance exchange. thank you, mr. president. i yield the floor and suggest the absence of a quorum. the presiding officer: the

clerk will call the roll. quorum call:

the presiding officer: the senator from vermont. mr. sanders: mr. president, i ask unanimous consent that privileges of the floor be granted to a fellow in my office. the presiding officer: the senate is in a quorum call. mr. sanders: i ask that the quorum call be vitiated. the presiding officer: without objection. mr. sanders: -- consent that the privileges of the floor be granted to a fellow in my office, gail henson. the presiding officer: without objection. mr. sanders: mr. president, i think the american people are aware that our country is in the midst of a major health care

crisis. that's not a secret to anybody. 46 million americans have no health insurance. and importantly, even more are underinsured with high deductibles and copayments. further, some 60 million americans, including many with health insurance, do not have access to a medical home of their own. in fact, according to the institute of medicine, some 18,000 americans die each year from preventible diseases because they lack health insurance and do not get to a doctor when they should. and i can recall very vividly talking to several physicians in vermont who told me how people walked into their office quite sick, and when they asked why didn't you come in earlier, they said, well, we don't have a lot of money. we didn't have any health insurance. and the result is that those patients die. that happens every single day in this great country. and then when we talk about health care, we have to

understand that access to dental care is even worse. and then on top of that, in our nation we pay the highest prices in the world for prescription drugs. my state of vermont borders on canada, and it is not uncommon for people to be going from vermont to canada to buy the prescription drugs that they need at far lower cost than in america. and in the midst of all of this, of 46 million americans without health insurance, people being underinsured, people paying outagesly high costs for prescription drugs, at the end of the day our nation pays far more for health care per person than any other country on earth. far more. not even close. and yet, despite the enormous sum of money we spend, our health care outcomes, what we get for what we spend lags behind many other countries in

terms of life expectancy -- how long our people live -- in terms of infant mortality and other health indices. according to a recent report from the national center for health statistics, for example, one example: the united states ranks in infant mortality 29th in the world. 29th in the world. we are tied with poland and slovakia. we're 29th in the world in terms of infant mortality, in all due respect, to our friends in poland and slovakia. we should be doing a lot better than that, because we spend a lot more on health care than they do in poland and slovakia. further, according to a study published in the london school of hygiene and tropical medicine, the united states has the highest rate of preventible deaths among 19 industrialized nations.

and although our rate has declined over the past five years, it is doing so at a slower rate than other countries. according to that study, if the rate of preventible deaths in the united states improved to the average of the top three countries -- france, japan, and australia -- approximately 100,000 fewer u.s. residents would die annually. mr. president, when we talk about health care, we're not just talking about individuals who suffer and die because they don't have health care. what we're talking about is that the high cost of health care, as president obama makes clear all of the time, is a major, major economic issue as well. in our country today, we are now spending about 16% of our g.n.p. on health care. and the cost of health care is continuing to rise at a very high rate, which becomes

economically unsustainable. the fact of the matter is that general motors, which recently declared bankruptcy, spends more money on health care per automobile than they do on steel. and that creates an economic climate in which america, our companies, become noncompetitive with other countries around the world. but it's not just large corporations like g.m. small business owners in vermont and throughout this country are finding it harder and harder not only to provide health care for their workers, but even for themselves. in addition, a recent study found that medical problems contributed to 62% of all bankruptcies in 2007 and that between 2001 and 2007, the proportion of all bankruptcies attributable to medical problems

rose by nearly 50%. and interestingly 78% of those experience bankruptcy as a result of illness were insured. they were insured. this is not people did not have any health insurance, but it speaks to the inadequacy and the lack of coverage, comprehensive coverage in many health insurance programs. mr. president, we really as a congress, for whatever reason -- and i'll suggest the reason in a moment -- don't really spend a lot of time really discussing why the american health care system is so expensive, why it is so inefficient, why it is so complicated. we don't talk about that very much. and i fear that that has a lot to do with the role that private health insurance have and play

over the political process in this country. so let me be very clear. in my view, the evidence, the evidence is overwhelming that the function of a private health insurance company is not to provide health care. the functions of a private health insurance company is to make as much money as it possibly can. and the truth is the more health care a private health insurance company denies people, the more money it makes. so if you submit a claim for coverage and they deny it, from their perspective, that is a very good thing because they make more money. further, in pursuit of making as much money as they can, private health insurance companies have created a patchwork system which

is the most complicated, the most bureaucratic and the most wasteful in the world. and according to a number of studies, we always think about $4 -- we are wasting about $400 billion a year in administrative costs, profiteering and bureaucratic billing practice, and that is enough money to provide health care to all of the uninsured. now i know that that's not an issue we're supposed to be talking about here on the floor of the senate, because we're not supposed to take on the insurance companies or the drug companies because of all of their power. but i think if we are serious about moving toward a universal comprehensive, cost-effective health care system in this country we have got to talk about the very negative role that private health insurance companies are playing in that

process. administrative costs for insurers, employers, and the providers of health care in the united states are about one out of every four health care dollars that we spend. in other words, for every dollar that we spend, one-quarter of that dollar does not go to doctors, does not go to nurses, does not go to medicine, does not go to therapies. it goes to administration. and that is at the root of the problem that we have in terms of health care costs in america. in pursuit of making administrative in california -- one example: in california, only 66% of total insurance premiums are used to cover hospital and physician services. one-third, one out of every three dollars is spent on administration, billing, claims processing, sales and marketing,

finance and underwriting. mr. president, the american people want their health care dollars spent on health care. i know that's a radical idea. but when people spend money on health care, they assume that it goes to the provision of health care, not profiteering, not administration, not hiring more bureaucrats to tell us that we're not covered when we thought we were covered. the american people want as close to that dollar, 100 cents on that dollar to go to health care and not bureaucracy. while health care costs in america have soared, as everybody knows, from 2003 to 2007, the combined profits of the nation's major health insurance companies increased by 170%. health care costs are soaring. the profits of the major health insurance companies have gone up by 170% from 2003 to 2007.

and c.e.o. compensation for the top seven health insurance companies averaged over $14 million per c.e.o. mr. president, to add insult to injury, some of these health care profits are going directly into campaign contributions and into lobbying to make sure in fact that congress does not move forward toward real health care reform which, in my view, means a single-payer health care system. so, mr. president, that's where we are at right now. we have the most inefficient, wasteful bureaucratic system of any major country on earth. our health care outcomes, despite all the money we spend, are way below many other countries in the world and we are not discussing the most

important issue with regard to health care spending, and that is the role that private health insurance companies are playing. so, mr. president, we are now in the beginning of the debate on health care and i'm going to do my best to make sure that that issue of the role that private health insurance companies are playing in the system, the very negative role they're playing is something that, in fact, we talk about. and with that, mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from ohio. mr. brown: thank you, mr. president. i commend my friend, the senator from -- the junior senator from vermont for his words about this critique of the health insurance system. you know, what's right about it and what's wrong with it, we know that for those with insurance, we can get good medical care in this country we know that many people don't have any insurance.

we know that many others have inadequate insurance, and we know that so many americans are in a situation where they're just anxious about the future of their -- of their health -- the future of the quality of health care that they -- that they have. too many americans have seen their health care premiums go up, their deductibles go up, their co-pays go up. they end up with a private insurance company that finds ways to delay paying them, to, in many cases, to not reimburse them at all for their health care insurance. it is insurance that doesn't really deliver. that is really no insurance at all. what senator sanders said is exactly right, the behavior of health insurance companies have mentd that we have huge anyone -- meant that we have huge administrative costs. we remember what the president of the united states said when he was a candidate for president, senate sanders mentioned that to president obama, how moved people in this country were when they heard

about the president talk about his own mother who was dying who was fighting with insurance companies over paying for her cancer treatment while she was dying. and she had to advocate for herself, her son was advocating for her too. but thee went through the trauma and pain of cancer and the trauma and pain of dealing with insurance companies. we know that. yet, some in this body want to increase the role of private insurance and allow them to continue to gain the system. we also know that private insurance companies, in many ways, are simply a step ahead of the sheriff. that they will ensure -- that they don't mind insurancing someone who is 50 and healthy, but they would rather not insurance someone who is 63 and healthy. someone who is has a preexisting continue they will find a way to not insurance them or not pay off to them when that person gets sick. we know about the inefficiency

of the health care system, we know about the inefficiency of the private insurance. we know about the difficulty of the private insurance and the administrative cost of private industry. the private administrative costs run from 15% to 30%, depending in you're in a big group plan or small are group plan or individual plan. we know that medical care, which is -- medicare, delivered for years, we know that medicare is delivered very well in the great majority of cases for the american people, for the elderly, but we also know that medicare has a 2% or 3% administrative cost, again, contrast to the 15% to 30% with private insurance companies. interestingly, there was a statistic -- there was a study several years ago that medicare -- that of the major -- of the -- a study of the richest

industrial democracies, france, germany, japan, israel, italy, canada, and the united states. and they rated all of these countries according to several indices, life expectancy, faint mortality, the inoculation rates for the children. the united states ranked 12th. even though we spend twice as much as any other country on ert per capita, our outcomes were not as good. we were 12th out of 30. one area that we -- if you get to be 65 in this country, the chances are you're going to live a longer, healthier life than almost any other country in the world. why? because we have a health care system, medicare that provides health insurance for everybody

over 65. there are polls and gaps in coverage in medicare, the premiums can be pretty hard for some to reach. the co-pay and deductible can be a problem. overall people know when they have medicare, they are pretty well darned taken care of and that is not the case for people under 65. i came it the floor tonight for a few more moments, mr. president, as i was listening to senator sanders talk so eloquently to share a couple of stories. sherry in albany, ohio, she is not medicare eligible, she is forced to consider borrowing from the equity in her home to pay her $1,070 premium through cobra. she had a job. she lost her job. she has to pay the employer and employee side to pay for her health insurance. that's the way cobra works. a good program, but a bit of a cruel hoax, if you lose your job, it is pretty hard to pay your premium and your employer's premium at the same time.

she's considering borrowing against her house to pay for her health insurance for cobra for 18 months, she will get a little bit of help now, because in the stimulus package, we took he care of some of that. she that's to find a way until 65 to cobble together insurance. terry, a small business owner nearby in columbus, expects to pay 35% more this year to cover his employees. he wants to cover his employees, but he has a 30% increase. what's he supposed to do? especially when his business, i don't know a lot about his business, but so many small businesses are squeezed more and more because of the economy. so we know these stories, and that's why it's so important, mr. president, that we -- that we address health care reform this year. now, we want to do several things. first of all, anybody that's in a health care plan that they're happy with, that they're satisfied with now, they can stay in that plan. if they want to make that choice, they stay in the plan.

second, we're going to do a lot of cost. we need to -- we need to stop the huge increase in premiums, co-pace, deductibles, we have to do a better job to constrain costs in the health care plan than this government or the private sector has been able to do for decades. third, we need to give people full choice. that means that they can stay in their plan, as i mentioned earlier, number one, but they also will have a choice of private insurance plans and a public plan, a public option, so they can choose a private plan with aetna or a private plan with united health or a private plan with blue cross blue shield or they can decide to join a public plan, a public plan that might look like medicare, which they can decide, perhaps they would save money or better preventive care or a plan with lower co-pays or deduct ibles, they can -- deductibles. they can make the choice. a great majority of the democratic caucus, and i hope

republicans will join us. an overwhelming sector wants that option a public plan and private plan that they can choose that might be similar to medicare. anything that we tried in health care, every time that health care reform was introduced, the across of government takeover and socialized medicine were heard by conservatives who don't think that government should have a role in health care. we're the only country in the world that -- that thinks that, it seems like, because every other country they have a major part of their health care plan, a major, major part is involved with the government, if not the whole plan. we're not asking for a government takeover. we're not doing socialized medicine. that's what they always say. we heard in 1948 when harry truman tried to -- tried to push through medicare. we heard it in 1965, when lyndon johnson and the overwhelmingly democratic house and senate passed the medicare law we heard it in 1993, my first term in the

house, senator sanders' second term in the house. that's what insurers are claiming today. they're saying government takeover of medicine. that's not true. we want a government option plan. we want the government to provide a medicare plan that people can choose from. you can choose a private plan or public plan. americans deserve no less. our country can afford no less. the president asked us to move on this as quickly as we can and to do it right. this is our chance and i think we're going to do it. mr. sanders: will the senator from ohio yield for a moment? mr. brown: yes. mr. sanders: i want to thank him for his cogent remarks talking about one of the most basic issues facing this country, and that is health care. we're on the veterans committee as well, and i know that you spend a lot of time talking to veterans in ohio. you have heard a veteran in ohio

tell you that they want to privatize the v.a.? mr. brown: i have heard mostly conservative republicans say that they want to privatize the v.a. mr. sanders: every time that issue is raised, the veterans say no. mr. brown: senator sanders, one of the things that we noticed about the veterans administration, is that the v.a. has found a way to -- to buy at the lowest cost possible some of the least expensive, but good-quality prescription drugs. because what the v.a. does is there are millions of veterans, they negotiate on behalf of veterans with individual drug companies for individual prescription drugs, individual pharmaceuticals, and they get a rate at about one half of what you would pay if you went to drug part or rite aid or any of -- drug part or rite aid or any of the other stores.

the medicare bill when it came through the house and senate, president bush pushed that bill. they didn't allow us to negotiate drug prices. we know what this is about. we know if we fl the lead of the drug industry and the insurance industry, which this congress did through most of the first part of this decade with president bush, we end up with -- with special interest laws that protect the drug companies or insurance companies. or we can now pass health care with a public option plan give the public the option of going to a medicare-like plan instead of a private insurance company plan if they want to or stay in the plan that they're in and then they decide on what kind of care they would like. mr. sanders: my friend from ohio is exactly right. if you talk it the people of this country, if you talk to the veterans and say, do you want v.a. health care to be privatized, overwhelmingly, no.

in recent years the senator from ohio, i and others worked to substantially increase funding for federally qualified community health care centers all over this country. these are the most cost-effective ways of providing quality health care, dental care, low-cost prescription drugs, mental health counseling. people of this country want those. i hope that we have success in expanding that program. but i get a little bit tired of hearing from some of our friends on the other side who tell us, oh, people don't want government involved in health care, well, you tell that to seniors, tell them you want to privatize medicare, tell that to the veterans that you want to privatize the v.a. the fact of the matter is as the senator from ohio just indicated, we are wasting tens and tens of billions of dollars every year in bureaucracy, in billing, in excessive c.e.o. salaries through private health insurance companies. and at the very least -- at the very least, the people of this country are demanding panned we

must bring forth a strong -- are demanding and we must bring forth a strong, underline strong, public option within any health care reform program that we develop. mr. brown: i thank the senator from vermont. and it's pretty clear and i think this congress is going to do the right thing. the president when he met with us last week, as he promised in this campaign, was strongly if may never of purchasing insurance from the medicare look-alike plan or private plans or either one or keeping what they already have. the president has spoken strongly on it for months, the majority of this congress wants to do the same and i'm hopeful that is what we do in the months ahead. i yield the floor and i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: