this morning for our subcommittee will mark an important milestone in one of the more broadly supported and interesting solutions of the problem being considered by the subcommittee in the form of a legislation proposed by the very distinguished chairman of the judiciary committee, mr. conyers. he will be our first witness. you may apply if you would like. [applauding] .. he will be our first witness this morning and will summarize and advocate for his legislation as i'm sure he will do forcefully and articulately. we will then proceed to a panel of what you might call lay witnesses. john, i guess that implies that you're a holy person, but we'll proceed to a panel of lay witnesses, and one thing i would ask our colleagues to consider out of courtesy to the lay witnesses is that once mr. conyers -- chairman conyers has concluded his statement, those who would like to ask him

questions obviously under the rules are permitted to do so. i'm not going to avail myself of that opportunity and i believe mr. cline is not either. we urge members to consider not questioning mr. conyers, not because he's beyond being questioned, but because the lay witnesses have traveled from far >> mr. conyers has proposed a solution to this problem and argues with great passion it is a solution unlike some in the senate i think belongs on the table for consideration and vigorous and fair consideration. but is the purpose of the hearing. with that i asked my ranking member of the subcommittee mr. klein for his statement. >> good morning. we are here today as the title of this hearing implies to

examine a single payer health care and we will hear from chairman conyers and from the panel of experts single payer is certainly among the most controversial approach to health-care reform and frankly mr. chairman i am surprised to see it on the subcommittee agenda. , and democratic leaders have been very clear and public in rejecting the notion of single payer and frankly i am glad that they have procreating a new one size fits all systems based on medicare is a recipe for disaster would balloon the deficit and add to our mounting debt will drive down medical innovation and rationing care while empowering bureaucrats. of my friends on the other side of the i/o have not included republicans in their deliberations. i have been following them closely in the news. the latest reports indicate

they could formally unveiled their legislation as early as next week while the proposal reported does not include a single player scheme it seems highly likely we will see a government run option and i use that word with trepidation because it seems clear any government run the option is to undercut the private the structure of the market. maybe today is appropriate after all democrats are serious about putting the government-run option in their plan and that is designed to crowd out the private sector them the reality is we are only a few steps away from a single payer system. how else can we explain the urgency with which this hearing was scheduled? committee rules required members be given at least seven days' notice thankfully we used to receive even more but today this was announced last thursday just one day

less than the customary days in the budget is require the subcommittee to waive our longstanding rules to proceed further this hastily convened a hearing epitomizes everything that is wrong with the majority health-care reform process. the health-care system is in serious need of reform. we all recognize the shortcomings of the current system and the need for meaningful change. there's a bipartisan commitment and that is why we should have a bipartisan reform process. health care reform is far too important to get wrong. it is more important we do it right and do it faster quote a majority seems to have chosen a different path the speaker after a strategy session announced arbitrary deadline that calls for house passage of a comprehensive health-care overhaul before the august work period. it is like deja vu all over

again. just like the so-called economic stimulus package earlier, we've based complex and costly legislation behind closed doors. members to not even have the opportunity to review the stimulus before it was brought to a vote and judging by the announcement made that at the white house of this week that it is not delivering the jobs that were promised that it will not work. i will say it again health-care reform is far too important to get wrong i come to this debate in good faith and i stand ready to work with you but this during is at the wrong time. it is too fast let slowdown and a duet right. >> i think the gentlemen i also want to take the prerogative to introduce a friend and guest the health subcommittee pete stark from california is present my

understanding we discuss that he will be an observer of the hearing and does not intend to ask any questions and appreciate your indulgence and just to say to my friend who i know approaches this is a good faith, chairman miller and i intend to meet as early as today with members of the minority caucus to talk about healthcare reform before there is any markka before mid we look forward to your participation. think that was scheduled just this morning but just let you know, it is happening. also about timing, i sat in this room 15 years ago, there is an attempt to get something done about this problem and it failed. there was not a lot done after that which i think was another failure. i understand there are questions about schedules but i would simply say i don't

think the problem is we have gone too quickly but not quickly enough. that is something. we will turn on to our chairman of the judiciary committee someone i have always regarded as a model of integrity and integrity to conduct himself in such an important way in this house, the jurisdiction touches how we pay our credit cards come at whether we have the rights and a court of law, he has spent a members member for a very long time and i have tremendous respect and we are very happy to welcome to the subcommittee distinguished chairman of the judiciary committee, mr. conyers is recognized. >> thank you chairman anders for that fine introduction. ranking member kline and all of my colleagues here it is great to see peat back in the

saddle again brought by and just so privileged to be here. i want to thank you very much. fell one thing we have to do in this discussion of health care and how it is reformed, we have got to have a discussion about it. my brief comments, because i am so flattered to have with us, dr. marcia angell former editor of the journal of medicine and dr. walter tsou it, and other witnesses that you have been so kind to bring here, i just want to leave you with us what i think it is and i want to extend an opportunity for our discussions to go far beyond

the a hearing today and i want to make myself available to all of the members. first of all, we have to discuss it. the first thing that occurs to me, and i can say this to my ranking member friend, there is a notion that this single payer health care is off the table. that raises a very important question. if you take the most popular health care reform measure and taken off the table, heaven knows what it is. i guess what you are left with. the one thing i commended the 44th president about when i

met with him first after his election and, he said some things that no sitting president in my experience had ever said, he said, i want you to keep in touch with me and keep me advised. we want to know what is happening and what you are thinking about. and is so i praised him for that. he made a lot of other important statements but he wanted to keep in touch was very important to me. we have been keeping in touch and citizens have been keeping in touch. i know because i have been invited around the country some people would like me to travel less and stay in my district more. the fact of the matter is we're dealing with, and the

polls establish i have something hear that tells us through to polls that this is the most popular system in the minds of most americans. most americans. i will put all of these things in the record, but here are more than 400 local unions, 20 international unions, 39 state afl-cio unions all revolve around this question. i wish i could claim some creativity or imagination for this. but universal single payer is not a new idea. as a matter of fact every industrial country on the

planet except one, us, already have some version of it. what we're doing is developing the american version. what we're doing, then we have examined all of the systems on earth, putting this all together, we are studying the spread of we are not turning this over to government. we have another database of the myth about the systems that i will not try to go into now. we want to examine these. we will not examine them without a hearing. it is with some sadness that i report it was not easy for me to get to the first summit that the president called. it was an enormous step.

we have got to help him. here is how i will help my president. he is getting rounded vice about healthcare. to think this sad substitute about the massachusetts plan and the people from this state that can expound on that far more greatly the and i can come, will move us forward. we're at a point* now where we will either take this opportunity and move forward and have everybody in the as a matter of constitutional right to healthcare. not health insurance, not policy, health care itself from the moment they are ball

ball -- born here are the essentials, 37 pages but we are not going back to the 1994 mistake of 1200 pages. we are saying, number one, ever buy the is afforded health insurance. number two, the rate would be 3.5% of your income. it is not a government run in. it is privately administered no one would be giving up their choice of doctor or hospital or how they want their health -- health service rendered. it would break the employer connection and create one health insurance system, one

of which would be devised, we would come together whether we wind combinations of existing health insurance groups or whether we want to do something differently. i want everybody who is thinking about this to start off with number one, this is the most popular form and it would be very of light the party in the majority now to determine that the most popular system would not even be examined. i am asking for a hearing and every committee, every committee would not lead us into the senate as well, that is very important. in closing, members come with this is a great bill.

fantastic. i have some saying their father was a single player. guess what? it is impossible so we have to go to the next best thing. what is that? we're working on that and we will be back in touch with you. i have a plan of a plan be put like you to examine. okay. this is where we will test the mettle and it is not a test we cut as bringing health-care to 47 million people and 307 million who don't have anything, this country was founded on the basis one-third of the people wanted to be free, 1/3 wanted to stay with england and 1/3 did not give a darn what happens.

it could not be done. it wasn't able to happen. nelson mandela was supposed to be in prison for the rest of his life and he ended up president of the country that sentenced him to a life in a penitentiary. it could not be done. social security was supposed to be the worst thing that ever happened and i have some of the debates. you would not believe what some people said in opposition to the social security. it could not be done. it would not work. what about medicare? it was fought tooth and nail, i know, because i was here. now we have a obama's himself, you can elect, please

faults, you can elect a person of color to the highest most powerful position on earth, it is impossible. it was all possible and it was done and i am asking you to consider the political necessity of bringing up a bill that they said was off the table, then they said it could not pass, i think the american people are watching very closely. and i am saying now was the time, and i thank you for allowing me to make this introduction and include the papers that i would like to be part of the record as well. thank you for this opportunity ladies and gentlemen. [applause]

>> thank you, mr. chairman. as usual, you have contributed a great deal of substance and have given us a lot to think about which we will do right now with the witnesses coming up. i can assure you the principles you are putting forward will be very much a part of this deliberation and thought sparkle this is the beginning of the process, not the end 812 knowledge congressman what sen from california and we are happy to have her with us as well. mr. chairman, i will forgo asking any questions is there a member on either side that would like to ask the chairmen any questions? that is a very good decision. thank you very much. i appreciate that. thank you for coming and we will get to the lay witnesses. thank you very much for being here.

[applause] [inaudible conversations] >> you are on. >> and chairman andrews and ranking member decline of like to thank you for this opportunity to support a single payer health care reform on behalf of the 86,000 members of the california nurses association. the country's largest organization report representing direct care registered nurses by amoco president and i especially want to think -- thank the end

miller who was a great advocate of health care reform. in your consideration to changes you should know registered nurses are the precaution most trusted by the american public has shown consistently in the gallup poll on this question. nurses are on the front line of what economic folly patient care crisis. as a critical care nurse at san diego medical center i see patients conditions who are much worse because they avoided earlier treatment although they leave quicker than they should because insurance companies will not approve care. i can tell you from more than 34 years of experience insurance companies ration care the current system ration care based on the ability to pay. some patients do not get the life-saving treatment they need and she needed a liver transplant the signal would not approve it until i and others protested i was with

natalie's another that said they had approved the transplant but it was too late. she died one hour later. it does not have to be this way. we agree with obama's who called healthcare a basic right now we agree with a president who says health care reform is not a luxury but a necessity. the same is true of healthcare. right now and the only nation on earth that boarders human life for many we need a guarantee single standard of high quality healthcare. to make the change let's have a real policy debates on the merits. people talk about evidence based practice but we need evidence based policy if we were to have a debate on containing costs come of the single payer advantage would be clear. let's consider the principles of bond and has established. first-come reduce cost producer be of eight major countries the u.s. was the worst of out-of-pocket cost and the number of chronically ill adults going to care

because of cost even though the u.s. spends twice as much per capita. than other countries. 25% of americans escape doctors because of the cost and that was before the recession. 30 percent of americans who are ensure delay care because of out of pocket costs because premiums have risen and raising four times as fast and:pay deductibles and other transaction fees that the industry imposes runs thousands of dollars. that along with teenine the claim it is how the for-profit insurance company make money which ultimately is the job not authorizing care delivery. less you can start price gouging you either have price controls or you take them out of the equation to a single para reform. cost controls are much better under the single payer mechanism. hospitals and clinics based on

and operation negotiated reimbursement to providers kumble purchasing and negotiated prices for prescription drugs and incentives for prescription care and reliance on primary care. how many americans under 65 can go too any doctor without incurring any additional cost? very few not the 94% of u.s. metropolitan areas served by one or two insurance companies shown by the insurance markets. companies now control patient choice of provider and treatment with a terrible health results by related story of a patient seriously ill and in need of the integration who turned up in my emergency room he needed the two to save his life but because he was so worried about cost he looked at the doctors and nurses and said can you wait until next week? i will be 65. i will have medicare that is not how they should be making

health-care decisions with the way the nation should evaluate health-care decisions. one of the great sayings of single payer it at guarantees the patient the ongoing choice for dr. providing treatment and third, assuring affordable care. single there has advantage from a critical point* of view, taiwan's is the most recent entry to adopt in 1995 the percentage of people climbed 57% of the 97% and expanded coverage with little increase beyond a normal growth to to normal population and come. multi player dysfunction is broken. the need days they made the switch one decade ago although some said it could not be done. the u.s. ranks among 19 leading industrialized nations in preventable death the lead last we're last set of 19.

france and japan and australia and timely and effective care 101,000 fewer americans would die every year. in a study released this year that is included in my testimony it has been shown extending medicare to all but not only provide care to millions but also result in the creation of 2. 6 million jobs. the evidence is clear it works and best meets the principles and a best meets the needs of my patients for whom i have a responsibility to advocate. it is politically viable and we need to replace this moment with reform that would not control costs to improve karen -- or are leaving the american people feeling the moment is wasted they cannot trust their government to generally act in their interest? enact single payer and put

patients first semi thank you entire artistic and it will be made part of the record. thank you dr. >> congressmen andrews and ranking member and members of the health committee i am a public position and my name is walter tsou. if you believe every american has the right to quality affordable health care then the only affordable means to achieve that goal is to properly financed single para national health insurance program. attending to reconcile the imperative of the universal coverage and cost control through alternative methods besides a single pair is an exercise of futility purpose is clear cost-control means someone's ox gets gored either the taxpayers, physicians, hospita ls, private insurance industry. monday as a quote single payer is off the table they are saying insurance will be

protecting we've been the pain to patients, taxpayers and health-care providers. let's examine each category. for the taxpayer it is difficult to understand why we must in due or an additional 1.5 trillion dollars or more over the next decade in expenses at a time when our nation already spends 60% per capita on health care than any other country in the world. for physicians or hospitals cutting reimbursement is counterproductive that time when we need to increase reimbursement for primary care and mental health services. for the private insurance industry they have dominated over the past 50 years but it does not work. despite a supposedly competitive marketplace cost of skyrocketed 50 million americans are uninsured and the quality of care for most americans is "a suboptimal" end quote. >> choice is a misnomer for

americans 12 shoes doctors and hospitals not their health plan is to make health care system should reinforce the safety net in the face of the nation's worst recession but our profit driven system kicks millions of americans and doug got and leaves them jobless and uninsured. we have saddled our nation with the inefficient and exorbitant health-care system that drives jobs overseas with health benefit costs are low and is versus -- discourages on to burn doers from striking on their own for losing insurance coverage. we need an investment of preventive medicine and clothing -- including home visitation for newborns and chronic disease management in the community. where do we get the funds? singled there is the only reform that can control health care costs. it does by cutting insurance profs