will not only worsen our long-term financial outlook, but also negatively impact american families who enjoy the private coverage of their choice. to put this in perspective, as of this year, medicare has a liability of almost $39 trillion that's trillion dollars. which in turn translates to a financial burden of more than $300,000 per american family. in our current fiscal environment where the government will have to borrow nearly 50 cents of every dollar it spends this year, exploding our deficit by almost $1.8 trillion, let's think hard about what we are doing to our country and our future generations. the impact of a new government-run program on families who currently have private insurance of their choice is also alarming.

a recent study estimated that cost shifting from government taxpayers specifically medicare and medicaid already costs families with private insurance nearly $1,800 more each year. creating another government-run government plan will further increase these costs on our family in utah and across the country. now, let me make a very important point. a new government plan is nothing more than a trojan horse for a single pair system, a one-size fits all government mandated system where we will put bureaucrats between you and your doctors. washington-run programs undermine market-based market ability through price controls an shift costs to other purchasers. the nonpartisan leuin group have concluded that a government plan open to all and offering medicare level reimbursement

rates would result in 119.1 million americans losing their private coverage. this is almost three times the size of the entire medicare program. it's already in trouble. more importantly, this would run contrary to the president's own pledge to the american families about allowing them to keep the coverage of their choice. and so far as i know no one has disputed the leuin program. and they're well known as one of the most nonpartisan groups in the country. proponents of this government plan seem to count on the efficiency of the federal government in delivering care for american families since it is already doing such a great job with our banking an automobile industry. -- and automobile industry. medicare is a perfect example. it is on a path to fiscal meltdown with part a already facing bankruptcy within the

next decade and we all know it. it underpays doctors by 20% and hospitals by 30% compared to the private sector forcing increasing number of providers to simply stop seeing our nation's seniors. according to the june 2008medpac report, nine out of 10 medicare beneficiaries have to get additional benefits beyond their medicare coverage. nine out of 10 of them. we have a broken doctor payment system in medicare that has to be fixed every yr so seniors can continue to get care. this year alone this broken formula calls for a more than 20% cut. i can keep going, but the point here is simple. washington and a government-run plan is not the answer. talk about creating problems.

the supporters of the government plan, they know these facts, so they are trying a different approach by claiming that the government plan is simply competeing with the private sector on a so-called level playing field. give me a break. history has shown us that forcing free-market plans to compete with these government-run programs always -- always creates an unlevel playing field and dooms true competition. the medicare program once again provides an important lesson, as a political compromise medicare was set up in 1965 to pay doctors an hospitals the same rates as the private sector. faced with rising budget pressures, congress quickly abandoned this level-playing field approach and enacted price limits for doctors an hospitals. -- and hospitals. today, as i said, medicare payments are 20% less for doctors and 30% less for hospitals compared to the

private sector. now, i have been told by doctors from utah and across the country that if this continues, they will simply stop seeing patients all together. a number of them are ready to quit the profession. i can't tell you the problems that will arise if we go to a government-run program. a trojan horse to lead us to a government mandated government-run, one-size fits all massive program. and -- in his march 2009 testimony in the energy and commerce committee, the director of the congressional budget office testified that it would be -- quote -- "extremely difficult" unquote to create -- quote -- "a system where a public plan -- government plan, if you will, could compete on a level playing field" unquote against private coverage. the end result with be a

government takeover of our system taking it out of the hands of our doctors and our patients, plays -- placing them in the hands of a washington bureaucracy and inserting that bureaucracy right between them. here's the bottom line. we are walking down a path where stories like jack tang could become increasingly common in our great nation. in 2006, jack tag, a former world war ii pilot, suffered from a severe case -- a severe case of macula degeneration. the regional government bureaucrats rejected his request for treatment citing high costs unless the disease hit his other eye also. it took three years to overturn that decision. three years while he had to suffer when we could have done this in a better way. now, let's just all remember

that a family member with cancer in an intensive care unit would probably neither have the time nor the resources to appeal such an egregious bureaucratic decision. we need to remember the real implications of these policies, not simply in terms of political spin and special interest, but in terms of these policy's impact on real people who are mothers, fathers, husbands, wives, brothers, sisters, and children. just like the ill conceived stimulus legislation and the flawed auto bailout plan, health care reform has the potential of becoming another example of the democrats justifying the current economic turmoil to further expand the federal government. to enact true health care reform, we have to come together as one to write a reasonable and responsible bill for the american families who are faced with rising unemployment and out of control health care costs.

i really do look forward to working together to transform our sick care system into a true health care system. i continue to hold deep in my heart that we will move beyond the beltway games and work together in a bipartisan way to fix main street. the time is now and i'm ready and i'm absolutely positive that the way to go is not with the government-run, government-mandated health care program who will bring the lowest common denominator of health care to everybody. and not even everybody. i think you're going to find that the costs are so astronomical the way it's being formed in th the "help" committe we're leaving a burden on our grandkids and great grandkids that will be insurmountable. with that, mr. president, i yield the floor. a senator: mr. president? the presiding officer: the senator from oregon.

a senator: mr. president, before he leaves the floor, i want to tell the senator from utah how much i'm looking forward on a personal level to working with him in this five-month sprint to figure out a way to fix american health care on a bipartisan fashion. mr. wyden: some of the moments that i'm proudest of have been those moments when the two of us have been able to team up on health reform and without getting into it this afternoon, mr. president, let me say that millions of poor youngsters who use community health centers now are getting services there, scores and scores of them at no extra cost to our taxpayers because senator hatch was willing to work with this senator and a group of others, public interest groups and a wide variety of health care advocates, in order to change

the malpractice rules so as to make sure that those who had a legitimate claim got served, but that the bulk of the money went into the needs of patients. and now thousands of low-income americans get care because senator hatch was willing to stand up for low-income folks. and i just want to tell him i'm very much looking forward to working with him and our colleagues on a bipartisan basis over the next five months to get this job ton right. mr. hatch: if the senator would yield. mr. wyden: i would be happy to yield. mr. hatch: i'm so appreciative of the senator's kind remarks. i've been here 33 years working on virtually every health care bill that's come up and we've done it in a bipartisan way. and i've certainly enjoyed working with the distinguished senator from oregon. he is one of the more thoughtful people on the finance committee and in this whole body and i'm grateful for him wanting to work together and work in a

bipartisan manner. we have to do that. you can't take one-sixth of the american economy and work on a partisan basis. now, there are those at the white house who want to do that. there are some on the democrat side who want to do that. and, frankly, i'm just grateful that the distinguished senator from oregon is not one of them. i personally will do everything in my power to try and put together a bipartisan approach to this that would work and would put the best of the private sector with the best of the government sector to work for our folks in this -- in this country. and if we do it and -- and when you're talking about one-sixth of the american economy, if we do that, it will be to the betterment of our country and to the betterment of everybody. if we go partisan one-size way, and, especially in my opinion with a government-run plan, we're going to be anything but -- but good as far as health

care is concerned. i'm grateful for the senator's very kind remarks and i apologize for takin taking thish time. mr. wyden: not at all. i share the senator's interest. there are good senators on both sides of the aisle who want to get this done and get it done right. mr. president, i would ask unanimous consent to speak as if in morning business for up to 20 minutes. the presiding officer: without objection. mr. wyden: mr. president, as a young man, i got involved working with senior citizens as co-director of the oregon gray panthers. every day i got up back then and we said: we're going to make a difference. we're going to help people and particularly for senior citizens we're going to make it possible for them to have a better quality of life. mr. president, the distinguished president of the senate is, i think, close to my age, and i think we can recall back then that if a town had a lunch program for senior citizens, i

was considered a really big deal there weren't a whole lot of discount programs, people didn't know, for example, about home and community-based health care services. and most of this country back then if a town had a lunch program for senior citizens, that was considered a full-fledged program for older people. and what struck me from those early days with the oregon gray panthers was the importance of good-quality, affordable health care. and i spent hours and hours back then watching what happens when seniorseniors an their familiesd their families got exploited in the health care system. the first issue i was involved with with senior citizens was a real tragedy. we had old people who needed insurance back then to

supplement their medicare. and it was very common for senior citizens then every time some fast-talking salesman came through, to buy another policy. and when i ran this legal aid office for senior citizens and i'd go to visit older people in their homes, very often they would take out a shoe box full of health insurance policies. 15, 20 of the policies. a lot of them weren't worth the paper they were written on. in fact, they had what were known as subrogation clauses, so that if you had another policy, the first one wouldn't pay off. and it was just tragic to watch senior citizens walking on an economic tightrope every week balancing their food against their fuel and their fuel against their medical bills and getting sold all this junky health insurance.

most of which wasn't worth a lot more than the paper it was written on. and i said i wanted to do something about it. and in a few years i got elected to the congress of the united states, the other body, and i had a chance to work with democrats and republicans, a number of them in the senate today. chairman baucus, very involved in the effort. and in the early 1990's we finally drained that swamp. and today, as largely possible, for a senior to have one of these policies, not 15 or 20, have the extra money to spend on essentials and the coverage is standardized so you don't need to be some kind of houdini in order to figure it out. that is as of today, mr. president, the only tough law on the books. the only one that really has teeth in it to regulate and stop

some of these private insurance ripoffs. and i'm very proud to have been able to have a role with colleagues here in the senate in changing it. and now democrats and republicans, as part of health reform, are going to have to fix the insurance market for the nonelderly population. the insurance market today for those who aren't elderly, aren't in the veterans system, who have private coverage, is really inhumane. it's all about cherry picking. that's what the market is all about today. it's about trying to find healthy people and send sick people over to government programs more fragile than they are. that's today's insurance market. and fortunately a big group of democratic senators and republican senators are now on record as saying they want to change that.

they're actually on record as saying they want to change it. they want to make sure, for example, that people can't be discriminated against if they have a preexisting condition. they want to make sure, for example, that instead of being sent off to the individual insurance market, where you don't really have any clout, you don't have any bargaining power, people will be able to be part of a bigger group so they get more value for their health care dollar. where you have to pay out a bigger portion of the premium dollar in terms of benefits, called the loss ratio. democrats and republicans are prepared, mr. president, to, in effect, turn the current system of private insurance around completely and say instead of basing it on cherry picking, which is what it's about today, in the future private insurers

are going to have to take all comers, they can't discriminate, people are going to go into big groups and the companies will have to have price benefit and quality and there will have to be price prevention and wellness so it is not just sick care as senator hatch touched on very eloquently. so that's something democrats and republicans already are on record as coming together to support that's a fundamental part of health reform, fixing the private insurance marketplace. there are other areas where democrats and republicans can join forces, one that i care most about, mr. president, is in the future making health care coverage portable so that you do not lose your coverage when either you leave your job or your job leaves you. and this is an he especially

serious -- this is an especially serious problem for the millions of folks who are laid off today. there are millions of them, and they go to a program called cobra, which i might note, mr. president, is the only federal program named after a poisonous snake. and colleagues here have improved it certainly in the stimulus to try to provide additional assistance. but it is still part of a dysfunctional system. and part of the reason why is that that system hasn't changed a whole lot since the 1940's. much of the rules with respect to coverage, and certainly, in my opinion, has led to the lack of portability revolves around the fact that in the 1940's, when there were wage and price controls, big decisions got made that affect health care today. now back in the 1940's, the

rules made some sense for those times. people would usually go to work somewhere and pretty much stay put for 20, 25 years until you gave them a gold watch and a 20,000-calorie retirement dinner. that's not what the workforce is about today. today the typical worker changes their job 11 times by the time they're 40. so what they need is portable health care coverage, coverage you can take from place to place to place and not in effect lose your job, go out and face discrimination in the insurance marketplace, not be able to afford it even with the cobra subsidies which of course run out often before you get your next position. the current position is also antientry entrepreneur because so very often somebody works for a business, has a good idea,

they'd like to go into the marketplace and try it out. but if they have an illness, they can't leave the position they have because they aren't going to be able to get coverage at their next job. so once again democrats and republicans here in the united states senate are on record as being willing to make a fundamental change in the way the system works today. they're on record in favor of portability and guaranteeing a legal right to all americans who lose their job or want to go somewhere else to be able to take their coverage with them, and it would be administered in a seamless kind of way, so they wouldn't have to go out and reapply and have physicals and all the costs associated with it, which leads me to my next point where democrats and republicans are on board. and that is lowering the crushing costs of health care administration. this senate has begun to move in

the right direction with the leadership of the obama administration to promote electronic medical records. as far as i'm concerned, mr. president, we ought to send these paper medical records off to the museum of american history, put them next to the type writer and telegraph, and the obama administration has made good progress in moving in that direction. but much more needs to be done to lower administrative costs in health care. and once again, democrats and republicans have teamed up. let's use the withholding system. we already do that for administering much of the human services benefits that our people rely on. we'll make sure people sign up once so they don't have to go through it again and again. we'll put people into these larger groups so you don't have the excessive administrative

costs that are associated with a smaller groups. and you'll have portable coverage so that our people don't have to apply and apply and apply every time they change their job. so each one of these issues, mr. president -- the question of insurance reform, portability, lower administrative costs -- already are ones where a significant group of democrats and republicans here in the united states senate are willing to join forces. now, my own view is these aren't partisan issues, and i think there are other ones that can also be tackled together by democrats and republicans. one of the most contentious of those upcoming issues, mr. president, involve the tax rules for american health care.

the reason these are so important is, of course, they're vital to americans who are trying to have enough money to pay for essentials. and also, after the medicare program, these tax rules which are upwards of $250 billion a year, mr. president, they amount to the biggest federal health care program. in other words, medicare, number one, federal health tax rules number two. now prominent democrats and prominent republicans just in the last few weeks have said that these rules don't make sense. for example, for colleagues on our side of the aisle looking at some of the progressives who have called for reform just in the last couple of weeks, robert reich, the former secretary of

labor, certainly one of the leading progressive thinkers in our country, has talked about the regressivity of thaous rules, how they disproportionately favor the most affluent. bob green stein, head of the center for budget priorities is of the same view. both of those reflect the comments of individuals who are progressive. suffice it to say, a number of conservatives have spoken out against these rules as well. milton freedman, going back to a hraepblgdary conservative, began to speak out -- back to a legendary conservative, began to speak out against these rules some time ago. we ought to deal with these issues on a bipartisan basis. i know, mr. president, of no senator, not a single one, who is going to support taxes on

middle-class people on their health care. it's off the table. it is not going to happen. there are 100 of us. not a single one of us is going to support taxing those individuals. but i do think the democrats and republicans, just like robert reich and bob greenstein on the democratic side, conservatives going back to milton freedman on the republican side have said can come together and find a way to make sure that in the future these rules don't subsidize inefficiency and also disproportionally favor the most affluent. what is really tragic in the state of delaware, state of oregon, state of georgia is if somebody doesn't have health care coverage, doesn't have a health care plan, works in a furniture store outside atlanta, doesn't have health care coverage, they in effect have their federal tax dollar

subsidize somebody who's particularly well off who decides they want to get a designer smile on their health care plan. can't we all say in the interest of protecting taxpayers and fairness, we want that person who is interested in their designer smile to be able to buy as many of them as they want. but can't we agree, democrats and republicans, that if they're going to get a designer smile, they're going to pay for it with their own money rather than with subsidized dollars. so in each of these areas i mentioned, mr. president, there is an opportunity for democrats and republicans to come together. and what each of the areas i've touched on deals with is making health care more affordable. more affordable for individuals, more affordable for families. and more affordable for taxpayers who are getting pretty darned worried about these debts

that are being incurred and the prospect that their kids and their grandkids are going to have to pick up some of these bills. i believe one of the keys to making health care more affordable in each of the areas i've touched on addresses this, is to make it possible for the individual largely as part of a group where they can have some clout, to be rewarded for making a financially sound decision for themselves and their family and to have a choice to go to the kind of program that they think makes sense for them and their family. mr. president, the current statistics show that 85% of our people who are lucky enough to have employer coverage get no

choice. let me repeat that. 85% of those who are lucky enough to have employer coverage get no choice. now, every one of us is going to require that a final bill protects somebody's right to keep the coverage they have. 100 united states senators are going to vote for that. the requirement that you can keep the coverage you have. but can't we agree as democrats and republicans that we're also going to say you ought to have some other choices? i'd like them to be in the private sector. and if you can find one that's financially in your interest, you can take the difference between what your health care costs today around what this new health package you buy costs. you can keep the difference.