taking a hit in the marketplace. in other words, madam president, we need insurance company rules on preexisting condition, on changing the way we do community rating, on a whole host of -- of rules to make insurance companies behave better for -- and serve the public better. we also need this federally-backed insurance option because all too often, insurance companies are a step ahead of the sheriff. they always can figure out how to -- how to stay ahead of the rules that try to make them behave in a way that's -- that's more in the public interest. the purpose of establishing a federally-backed insurance option -- it's an option -- is to give america's -- americans more choice and to give the private industry -- private insurance industry an incentive to play fair with their enrollees or the enrollees will look elsewhere, perhaps in the public plan. private insurers have a system of winners and losers. a system that ensured that americans can be bankrupted and other insured americans can die

far to young because they can't get the health care they need. insurance companies have always been a step ahead of the sheriff. they've given us no reason to believe they will behave any differently. they have come to congress and said you can put new rules on us, but when they've done that in the past, they find a way -- it is their bottom line. i don't blame the insurance companies for acting the way they do. i say that we need a set of rules to make sure they act in the public interest. private insurance market reforms coupled with the federally backed health insurance option, it's an option just like there will be an option once we pass health insurance that anybody today can stay in the insurance plan they have. nobody's going to be forced to do anything they don't want to do. private insurance market reforms represent, coupled with the creation of the federally backed health insurance option, represent our best hope in achieving health reforms so vital to the health of our citizens and future of our nation. last week president obama sent a letter to chairman kennedy of

the health, education, and labor in which i sit and to senator max baucus, chairman of the finance committee, the other health care committee, which the president stated, i strongly believe that americans should have the choice of a public health insurance option operating alongside private plans. this will give them -- will give americans the -- the american citizens will give them a better range of choices, it will make the health care market more competitive and the president added it will keep insurance companies honest. a public health insurance option not administered by a private for-profit insurance company, but a public insurance option is a necessary component, one of the necessary components of health reform. there is no better way to keep the private health industry honest than to make sure they're not the only games in town. publicly health insurance outperformed private health insurance in providing access to stable and reliable health care, in rening in costs, a public

insurance option will not neglect sparsely populated and rural areas as insurers too often too. the -- do. the presiding officer represented a rural congressional district in new york and knows the problems of insurance availablity in more rural eamples it will not disappear, a public insurance option will not disappear when an american loses her job or a marriage ends. a public health insurance option, the pages sitting in front of me when they finish school and go into the workplace, they would have an option once they're no longer dependent on their parents, they will have that public option as other americans will. public health insurance option will not deny claims first and ask questions later as insurance companies too often do. it will not look for any and every loophole to ensure -- insurance the health andy avoid the sick as private insurance

companies too often do. these are the fundamental reasons why a public plan option is the key at arriving at a health insurance system that better serves every american, insured and uninsured alike. what is the point of health care reform if we don't do it right and make sure that every american citizen is better served than they are now in this health insurance market. i yield the floor and i -- the presiding officer: under the previous order the senate stands in recess until 2:15 p.m. on-csp.

host: we want to wreck -- wecsp. want to welcome bernie sanders. . guest: our system is geared toward making money for the private health insurance >> i don't want to talk any other viewers, but the function of a private health insurance company is not to provide quality health care to all

people in a cost-effective way. is to make as much money as they possibly can. and when you have that paradigm, if that's what the goal of the system is, you end up not only with 1300 separate private health insurance companies, but you end up with thousands of different benefit packages which cost an enormous amount of money to administer. so the bottom line is, we are the most, not only the most expensive, the most bureaucratic and wasteful system in the world. we are spending hundreds and hundreds of billions of dollars in the administration, and profiteering from the insurance companies whose profits are doing very, very well getting an exorbitant and compensation packages to ceos a couple of years ago. a fellow who was the head united health got $1.6 billion in stock options, etc. etc. so the goal of health care should be to provide the best quality health care to all of

our people in the most cost-effective way. into my mind my mind the way you do that, and what we have learned from other countries around the world, is that a single-payer system would work. >> let me read you. he is a physician from canada. he attended this editorial in "the wall street journal" called candidate obama. he concludes with this question. quote, why are they rushing into a system of government dominated health care when the very countries that have experienced it for so long are backing away? >> first of all i don't know if that's accurate. the truth of the matter is we are the only country, the only country in the industrialized world, not to have a national health care program. so we are the odd man out. if you compare the american system to canada, it is true canada has problems. so the week, but we spend almost twice as much or person as the canadians do it and if we spent that kind of money, continue to spend that kind of money, two-point recruiting dollars, we

can have a better system than the canadians. i think the correct question to ask is how does it happen that every other country, major country on earth says health care is a right of all people, we don't do that. and second of all, they end up coming up with a much more cost-effective approach, and three, their outcomes in many cases, infant mortality, life expectancy, preventable deaths are better than we do. i think the evidence is overwhelming. our current system is not working and we have to move in a very, very different erection. we have to have the courage to take on the private insurance companies that spent hundreds of millions of dollars lobbying, campaign contributions, the drug companies that charge is the highest prices in the world, and also powerful lobbying here in dc. >> there has been a lot of discussion over the single-payer plan and what senator baucus will not put on the table. is it on the table?

>> you. what baucus did is i arranged for a meeting between a number of positions and a nurse organizations with baucus. i think what he said is a month ago he said single-payer is not on the table. what he indicated to us that he regretted saying that, that he should have held a hearing, he should have listened. he apologized. but the truth of the matter is in my view, i speak only for myself now, the power of the insurance companies make so much money out of our current health system and the drug companies are so strong that it's very hard for us to get the kind of hearing and the kind of success that we need to move to a single-payer system. >> so you are saying special interests are influencing the debate? >> influencing the debate, no. i think special interest on the debate. i don't want to shock you, but in fact, these guys have spent hundreds and hundreds of millions of dollars to make sure we do not have a cost-effective comprehensive universal health care system that guarantees health care to all people. >> so what does that tell the

version out there who doesn't have insurance and wondering what's going to happen next? >> and tells him there's a lot of debate. after i leave this interview and in a couple of hours i will be meeting with the health education committee and we will be talking about this. we don't know what in result will be. it is possible we will make some progress in terms of primary health care, in terms of disease prevention, in terms of making health care more affordable to people who today don't have any health insurance. my concern is, look, is that we are going to be touring huge amounts of money into a system which is largely dysfunctional. and that means it's like a leaky bucket. you keep pouring water into it, you can have some good success in keeping or in the bucket, but you have to keep putting more and more in it rather than understand it, why the system is so wasteful and an efficient. in california, my understanding is that about one out of three health care dollars goes not to

doctors, not to nurses, not to medicine, not to making us well or keeping us from getting sick, it goes to administration. that is basically the crux of the problem right now. our system is designed to make money for the drug companies and insurance companies, not to provide quality health care to all people. i think we have to change direction and a very substantive way. >> one of the subjects in the washington post by paul mccain on the cusp is senator democrats also referenced robert byrd who is 91 years old but senator kennedy was battling brain cancer and a quote from your colleague in the piecing it's hard to imagine a senate without them. also a story this morning inside "the new york times" and a quote from senator jack reed of rhode island saying i think we would all like to see senator kennedy here for many, many reasons, but we are going to move forward, forward without them. will he be at all part of this debate? >> i don't know. we heard he was part of a

telephone conference call a week ago and he sounded good. we're going to be meeting today. my understanding is he probably will not be there. the other point that i want to make and we will talk about health care, it's not just a personal issue with people uninsured, underinsured or paying close to $8000 is what we are paying per person right now which is unsustainable. it's an economic issue and everyone is talking about general motors going bankrupt. general motors today spend more money per automobile on health care than they do on steel. in my state of vermont and all over this country small businesses just cannot afford to put more money into escalating health care costs when they would like to reinvest it in their business to create jobs and make money. so we have, as the president operably points out, not just a crisis at the individual level. it is a major economic crisis that we have got to address and that's why we need real health care reform. >> john webster who agrees with you is sending in this tweet

saying regrettably our doctors and insurance companies are seized. we need national health care like other developed countries eklund also say this. you know, the concept of single pay is not a new idea. you have 15000 physicians in this country. 15000 who support a single-payer system. we have the largest nurses organizations in this country that supports single-payer. do you know why? they are sick and tired of being told what to do by the private insurance companies. there was a study a few weeks ago where doctors are spending between two and three weeks just arguing with insurance companies about the kind of therapy that they can prescribe. nurses are doing the same thing. people go into medicine and go into nursing they want to practice their profession. they want to work with people, not scream at insurance companies. which prevents them from doing what they were trained to deal. >> jr on the phone from kansas

city. good morning. >> caller: a few things i would like to talk about if i could. watching c-span i found out, we found out that there are continued patent rights on medicine. in america we have a 20 year patent right. why is it that our congress hasn't done something about that? you give the pharmaceutical companies the right to charge as much as they can for medicine for 20 years. it takes away from anything we could possibly do, and then the other thing is i have a nephew who just became a chiropractor. i was talking to him, his education is costing more than a quarter of a million dollars before he ever gets a chance to work as a chiropractor. >> let me ask two questions.

i live an hour away in vermont from the canadian border. i was a member of the united states congress when i was in the house to take americans over the canadian border to purchase prescription drugs in montréal. and i will never forget as long as i live, the expression on the face of women, many of those who were with me were struggling with breast cancer. and they bought a drug at that point, this is a number of years ago, they paid a 10th of the price. a 10th of the price in canada for the same exact medicine they were buying in the united states. and i should call them right now, as many of us are fighting for a program, so that americans do not continue to get ripped off by the drug companies and have to pay the highest prices in the world. in terms of education, again, one of the problems that we have is that many people who graduate from medical school today are very, very deeply in debt. and the university of vermont

medical school, it's about 150,000, if you go to dental school it's even more. what we are trying to do and haven't succeeded doing in the stimulus package is greatly expand the program called the national health service corps which helps provide debt forgiveness for those doctors in and it does the work -- serve underserved medical areas. we need you more doctors out into the areas where people need them for primary health, more nurses out, more dentists out. we are making some success in that but we have a long way to go. but the cost of medical education as such that the average person graduates a hundred $50000 in debt. they go to become a specialist in order to make the kind of money they need to pay off their debt. that's a real problem. >> former member of the house and his first term of the u.s. senate. patrick is on the phone from atlanta. good morning. >> caller: good morning. senator sanders, i just wanted to thank you for your honesty and your service. you always talk truth and

there's never any special interest money around behind her campaigns. you always represent the people, and i just wanted to thank you for your service. my question is, what are we going to do against the insurance companies when the bill is going through the congress and they tried to strangle it as they did in 1994? >> let's be clear where we are right now. against single-payer for the moment. there is no republican, not one, that once a public plan. at the very least a medicare plan for all americans. you have some conservative democrats who are also wavering on that issue. i think what we need is to answer patrick's question, does a very strong grassroots movement which says that health care in america must be a right of all people. that it doesn't make any sense

that a working person who may work at a company that doesn't provide good quality health care and go bankrupt if they end up in the hospital while somebody else has good care. it doesn't make any sense that we spend almost twice as much as any other question on health care. health care has got to be a human right for all people, and we need to mobilize in the same way, patrick, that we dealt with civil rights. it was a struggle that went on for decades, that we dealt 40 women rights, and other injustices in america. this is a civil rights issue of our time. it is wrong that families are going bankrupt. it is wrong that families because they can't afford health care, it is wrong in my view that millions of people. we have 60 million people in america today who do not have a doctor of their own. and we have almost 20000 people who die every year from diseases which were preventable because they never went to the doctor. that's over six times every single year the people we lost on 9/11. this is a moral issue.

is a civil rights issue. and our position must be health care for all people, regardless of income, and we can do that in my view. if we take on the private insurance companies and the drug companies without spending any more than the amount of money than we are spending today. that's the struggle we are in right now. >> and he who is a democratic lobby has, and this piece from david drucker in roll call. he is quoted as saying this, a potential challenge looms to the washington leadership of these trade associations with reference to association. how do they maintain the relationships and commitment to a process and what happens if, when the details come out, their membership is not convinced that the process is worth participating in. >> don't get. >> he's talking about the role of lobbyists. >> i'm not sitting around worrying about lobbyists. lobbyists are the bloody problem. whenever you take on -- getting back to the question about restriction drug.

we pay by far the highest prices in the world for prescription drugs. the pharmaceutical industry over a period of years have spent hundreds of millions of dollars lobbying congress. huge amounts of money of campaign contributions, advertising. they never lose. they have never ever lost in a battle with congress. so i don't sit around worrying about the lobbyist. we have too many lobbyists. guys are making hundreds of thousands of dollars a year representing big money interests. i think maybe we need a little more energy for ordinary people, for the middle bass and the working people. >> this goes along your life because of the essence of the story is that republican allies are mounting about public relations offensive to put on the brakes of public obama's health care. >> of course they are. their job is to represent the insurance company to make sure that ceos can make tens of billions of dollars a year, that copies are very, very profitable. and they could care less that millions of americans are paying five more than they can afford. we are spending about $7800 per person on health care can you imagine that?

what is a family that makes $30000 a year to do? you can't afford to. it's going up and up and that. these guys are worried about the profits of the insurance companies? that is just an outrage and we have to have the courage to stand up to them. >> from the republican line, eddie is on the phone. >> caller: good morning, senator sanders. the information or the conversation that you are having, a majority of it is true. the previous representative from georgia was not telling the truth as it relates to the insurance. information. i have three insurance policies. i'm a retiree, and one is through my job which i contribute. one is through my husband, which he pays nothing. and that is because his was

through a union. he pays their union dues and what have you. and the other is medicare. i am still paying through the nose for my share of health coverage. i have two types of drug coverage. one is through my own personal, through my retirement plan that i had, you know, before and went to my husband at i have a chronic illness of -- with my drug company. i pay $10. no, twentysomething dollars. through my husband is a medication costs me 10. and they are interludes. >> here's the point. health care is expensive. any system in the world is expensive but it makes no sense for us to be spending an estimated 350 or $400 billion a

year in wasteful administrative costs. we have an enormously compensated system. all of us will whenever during a campaign, i happen to think it's one of the reasons that barack obama won the election. he was talking about his mother who was dying of cancer, trying to summon up or energy to be strong, having to fight with the insurance company for coverage. and all over america that is what is going on. here's the story. in the last 30 years, we have seen 25 times more jobs created for health care, bureaucrats, who argue with us about whether or not we are covered and we have seen an increase of physicians. we need more doctors, especially primary-care. we need more dentist. we need more nurses. we're not getting that you know we are paying for? through the nose. we are paying for health care bureaucrats who are out there arguing with is about whether or not. we have an enormously collocated system. so the way you save money is to come up with a simple system.

franca, no system is perfect, but at the end of the day you say, you know what, you're an american, you're going to have all of the health care that you need. is going to be paid for out of the public system, it will be paid for out of tax is. you about the bank part of it out of health insurance. you will not be having 16 different programs. everyone will have the same quality health care, and if we move in that direction we save hundreds of billions of dollars of administration. we put that into coverage for all americans, and i think we have the best system in the world. >> jim henson in this week. senator sanders, why not propose a bill to ban insurance companies that seems to be your goal to put them out of business. >> it is michael. and we have introduced legislation. it's called single-payer. >> garrison is next from the state of wisconsin. good morning. >> caller: good morning. senator, thank you very much for the fight you are putting on. i am 70 years old, retired and just had three major surgeries, two heart surgeries and prostate

cancer surgery. my wife has been forced out of having health insurance, and we are at the brink of bankruptcy. i fought very hard to get president obama elected, and i have become very bitter and very disillusioned when you have somebody like senator baucus who will not give single-payer people pc at the table. and he is taking hundreds of thousands of dollars in contributions from the people that are creating the situation we have in this country. i would very much like you see a bill passed if it's possible that no one in congress take a dime from this people. not one dime. they are ruining our country. they could care less about

anything that is good for the people for this country. >> you raise a very, very important issue and it has to do not just with health care. not just with the quest of prescription drugs. not with the deregulation of wall street so that those crooks could lead us into a major recession. what we're talking about is the impact that big money has on the political process in washington. i think the caller is absolutely right, it is an extremely negative impact. in my view, that is why we have to move toward public funding of elections. candidates and incumbent members should not be the ban on big money interest as i'm afraid that dependence leads to legislation which does not work for ordinary people. the gentleman talked about bankruptcies, and here's an interesting point. in 2007, 62% of bankruptcies, personal bankruptcies in this country were related to medical bills. 62%. and the majority of those people

had health insurance. so even if in many cases you have health insurance, if you have a large deductibles, if your insurance policy doesn't cover all of your needs, you can go bankrupt and large number of people are doing that. >> john had e-mailed this question. currently health care is a regulatory and bureaucratic mess. how would government make this any better? how would a single-payer system and all the corporate cronyism that comes with it help? >> nothing is perfect that this is what we have so far. you've got a veterans administration, does it have its problems? sure it does. but i'm on the veterans committee and what i can take is that veterans throughout this country by and large are very supportive of the va system which is run far more cost-effectively by the way that most other hospital and medical programs. you have medicare. does medicare have problems? it sure does, but the administrative costs of medicare are a fraction of what private

health insurance costs are. it runs more smoothly. i think that's the goal we have is to create a simplified system, because the complexity of the current system has to do with insurance companies among other things, cherry picking saint we want to cover you because you just won the marathon and a you're 20 years of age and we are quite sure that you're not going to get sick. you're a good guy to cover. on the other hand, if you are 50 years of age and had a cancer operation, we really don't want to cover you at all because we're going to lose money on you. it becomes a very complicated process to cover you, not cover them. but we have got to say we are all in this together, we are all going to get coverage and we are going to do that delivery system in the most cost-effective way. we're going to put more money in disease prevention. were going to put more money into primary care. 60 million americans today, 20% of our population, if you can believe it, do not have access to a doctor on a regular basis.