it's hard to comprehend that that every single day that number of americans are losing their health care coverage. candidly if the number was half that, it would be unacceptable or even less than that. but that is in a very real way the status quo, where we are now. people losing coverage every day. thousands an thousands. 14,000 by one count. people who might have coverage but it's hard for them to afford it or to continue to afford it. and sometimes people have coverage and it's not of the kind of quality that would ensure the best health care for them and for their -- for their families. so, really, we're at a point now where we're beginning to see a basic choice that the congress has to make and the american people have to make. it's the status quo or change. it's the status quo, where we are now, which, in my judgment, is unacceptable. that status quo or reform.

it really is coming down to basic fundamental choice. the status quo right now is the enemy of change. the status quo is the -- is the impediment in front of us. the tree across the road or whatever image you want to -- whatever image you want to illustrate it. so we have to get to work making sure that the status quo doesn't stay in place. and there are so many ways to tell this story. every member of the united states senate and every member of the house and, frankly, virtually every american could tell a story about someone they know or someone they've read about and the challenges they face. and in pennsylvania we've got a lot of examples of people that are living the reality of a lack of health care coverage or bad quality coverage or coverage they cannot afford. one letter i got stood out for me among many. it was written back in february of this year by tricia urban

from but county, pennsylvania, from the -- burkes counselee pennsylvania. the east side of pennsylvania. i will read portions of her letter that will tell the story as well as anyone's could. and unfortunately in this one in the case of a tragic circumstance. she wrote, talking about her husband andrew. he had to leave his job for one year to complete an internship to get his dock trit in psychology. and the internship was unpaid and they could not afford cobra coverage, extending health care coverage. i'm quoting from the middle of the letter. she says -- tricia urban says and i -- quote -- "because of preexisting conditions neither my husband's health machine isse had some heart problems. she mentioned that she was pregnant. that neither his health issues

nor her pregnancy would be covered under insurance. i work four part-time jobs and not available for benefits. we had a second-rate health insurance plan through my husband's universities and when the bills added up the insurance company stated the internship did not qualify us for the benefits. we were left with $100,000 of medical bills and concerned with the upcoming financial responsibility of the birth of our daughter and the burden of current medical expenses and my husband missed the last doctor's appointment less than a month ago and then the letter from there, she talks about what happened at one particular moment, after summarizing their health care situation and when i was describing the pregnancy,

"my water broke and we were anxiously awaiting the birth of our first child and half an hour later two ambulances were in my driveway. as the paramedics assessed the health of my baby and me the paramedic from the other ambulance told me my husband could not be revived." she concluded the letter this way -- and i quote -- "i'm a working-class american and do not have the money or the insight to legally fight the health insurance company. we had no life insurance. i will probably lose my home and my car and everything we worked so hard to accumulate in our life will be gone in an instant. in my story is heard, if legislation can be changed to help other uninsured americans in a similar situation i am willing to pay the price of

losing everything. tricia telling us in that poignant but tragic story of her own circumstances and the serbs surrounding the birth of her daughter and the death of her husband telling us all we need to know about this debate and posing that question, or that challenge, i should say, to all of us, especially those of us who have a vote in the united states senate: "i'm willing to pay the price of losing everything if my story can be told and legislation can be enacted to deal with health care." that's a basic challenge that tricia irving has put before the united states senate. and the congress. and the administration. it's a challenge that we must respond to. we cannot pretend it pot's there, we -- that it's not there, we cannot pretend the status quo of 14,000 people losing their health insurance

every day, so many others worried about the coverage they have, we cannot pretend that's not there. we cannot just say to tricia irving, we're sorry about the circumstances of your sister but congress cannot get it done this year. we have to get it done. we have to pass a bill in our committee. we have to get a bill law the finance committee. we have to make sure the senate votes on this legislation, this year. frankly, this summer. not late in the fall, not in the winter, not in 2010 -- right now is the time for action. and the president, president obama, has led us on this. he has attached the same sense of urgency to this issue that i know the american people feel. now what is it about? well, it's about an act that a lot of americans are just hearing about. which goes by a very simple name, the affordable health choices act, that's the act that

is presently before our committee. and it does a couple of things. it focuses on fundamentals to get at that change that should come to the status quo. first of all, it reduces costs by way of prevention. very important. we know that can reduce costs substantially. and it reduces costs by better quality in information technology. that is still hard to believe when other industries like banking and insurance and other parts of our economy have moved into the new era of technology, that our health care system isn't where it has to be, to reduce medical errors and provide better quality. by focusing on information temperature we can reduce costs. that's in the bill. also, the bill contemplates rooting out waste, fraud and abuse, another square of cost reduction. we know that the big questions on costs will be dealt with in

the other committee, the finance committee, but there are elements in this bill that, in fact, reduce cost. secondly, the bill preserves choice. if you like what you have and your insurance plan and the coverage you have, you can keep it. there's no reason why that should change and it won't change under this bill. but if you don't like the cox you have we want to give you options and we also want to give you an option in coverage if you obviously don't have any health insurance at all. so it does reduce costs, it does preserve choice, and, thirdly, it will ensure quality, affordable chair, for the american people. we believe, i believe, and i think most people in the united states senate believe, you ought to have the option of not just any health care but quality care that is affordable, that you can actually make work in your own budget. so we're going to build on the system that we have and we're

not going to throw the old system out we're going to build on the system we and have make it better. we're also going to make sure in this legislation that we protect the patient-doctor relationship. there's no reason why anyone should get between those two. this bill will not do that. finally, and this is just a quick summary, i know, but finally we will make sure at long last a preexisting condition does not prevent you if getting the kind of quality health care you have a right to expect in america today. and as we move forward on this legislation, mr. president, i wanted to make sure we highlight the fundamental obligation we have not just in the bill but especially in the bill but even beyond this legislation and that is the obligation we have to get this right for the american people but to get it right especially for our children. the presiding officer knows that the great progress we made this

year on children's health insurance. thank goodness we got that done. instead of having six million kids this america covered by the children's health insurance program we're, by way of the legislation we passed this year, we extend that to almost 11 million kids. that was wonderful, and a big success. but it is not enough. we have to make sure the other five million children out there who don't have coverage today will get it. but especially for a child who happens to be in a poor family, a low-income family or a child with special needs. here's what the rule ought to be. this is what should happen throughout this process of enacting health care reform but certainly at the end of the road, so to speak. ideally, this fall, when we pass a bill that the president can sign. the rule ought to be no child worse off and especially "no child who is poor or has special needs is worse off."

a great line from the scriptures that talks about a faithful friend. we have her this over many years in the context of friendship and the context of sometimes a reading at weddings. but i like it for today to think of it in the context of our children. this is what the scriptures say: a faithful friend is a sturdy shelter, a great image about what friendship means. there are a lot of us, day in and day out, year in and year out who talk about how important children are to us; that we are advocates for children. and we should be. that we have solidarity with our children. we're going to do everything we can to protect them. we are saying we're their friend. that those of us who are elected to public office have an obligation to be a friend, an advocate for our children. i go back to the line from scripture, if we are going to be a faith will friend to children

we better make sure we provide a sturdy shelter, not just in the context of the obvious meaning of shelter but in this case the meaning of shelter in the context of health care. what is more fundamental than that? other than making sure a child has enough to eat, making sure a child has the opportunity to learn -- other than those two, health care is essential in the life of a child especially a vulnerable child whether they're poor or have special needs or both. so if we are faithful friends in the united states senate to our children we better provide that sturdy shelter and we better make sure this the end of the day these children are thought worse off because of our -- because of our legislation. i want to conclude with a thought from an expert, not someone who's just interested in children but someone who has an area of expertise which is

probably unmatched. i'm speaking of someone who testified last week, a week ago today, it was, in front of our committee. her name is dr. judith palthrey, a pediatrician, a child advocate, and just happens to be president-elect of the american academy of pediatrics. she provided compelling testimony and i won't go through all of her testimony, but here is something she said which i think has relevance for the debate we're having on health care. she says, -- and i quote -- "some times we as child advocates find it hard to understand why children's needs are such an after-thought and why? because children are little. because children are little, policy-makers and insurers think that it should take less effort and resources to provide them health care."

"because children are little we think less effort is required," or less resources is required; less in the way of hard work. well, none of us really believe that, do we? we don't really believe that? children, the health care we provide them, the protection, the shelter we provide them, should be every bit as significant, every bit as fully resourced as the protection and help we give to adults. because i believe there's -- i disagree about a lot of details in the health care bill but i think we all believe in this chamber children may be little but in god's eyes they're seven feet tall and we must treat them accordingly especially on legislation so significant as legislation on health care reform. so the rule ought to be: no

child worse off. that simple. and i believe we can get it right. i believe we can enact health care reform that preserves choice, reduces costs, and enhances quality and affordable coverage for the american people and we can make sure every child we understand that. we understand the the difficulty this is a great challenge but it's a challenge worthy of a nation. and it's a challenge that will help us in our continuing struggle, our continuing journey to make it a more perfect union. mr. president, i yield the flo floor. mr. brown: mr. president? the presiding officer: the senator from ohio. mr. brown: i want to make a couple comments on my -- senator casey's comments. and he is -- we sit next together on the health, education, labor, pension

committee nearby the presiding officer from oregon, and senator casey reminds us almost every day that as we work on this health care bill, that he reminds us that no child should be worse off and that's something that, frankly, all of us need to hear, that every member of this body and the house of representatives needs to hear, and i appreciate senator casey's work on that because it really is -- really is our mission here to do this right. and one of the most important dictums is that no child is worse off. so i thank my friend from pennsylvania. we spend more than $2 trillion a year on health care in this country, more than double that of any other industrial nation. americans account for more than 35 million hospital visits, more than 900 million office visits every single year, more than 64 million surgical procedures are performed, more than 3.5 billion prescriptions are written. health care is in dollar terms

one-sixth of our national economy and growing. yet millions of americans -- and think about that. one-sixth of our national economy, billions and hundreds of billions of dollars, yet millions of americans are just one illness away from bankruptcy. while we cannot -- what we cannot forget as we debate health care reform are the millions of americans depending on us to do the right thing for them. we cannot forget their story. senator dodd -- chairman dodd in the "help" committee, health, education, labor, pension committee today, reminded us today that 14,000, 14,000 americans lose health insurance every single day. so as our committee meets, and some people seem to be slowing this down a little bit with -- i mean, they certainly have the right to offer amendments but people just starting to get carried away and talking some of these amendments to death. but every day we don't pass this health care bill, 14,000 americans are losing their insurance. let me tell you some of these stories that i hear from my state. christopher in cincinnati tells us, christopher and his wife are

retired but they're not yet 65. without health care reform -- which means they're not yet medicare eligible. without health care reform, they can't afford health care insurance because of preexisting health conditions. their 401(k), their -- their retirement, their 401(k) is bleeding, their small pensions don't keep up with rising premiums. chris wrote to me that he puts off going to the doctor to save money, that the annual premium increase raises his out-of-pocket expenses by 45%. our nation spends in excess of $2 trillion -- that's $2,000 billion dollars -- $2 trillion annually in health care, justice too many of our citizens are only a hospital vit away from financial -- visit away from financial disaster. we can't afford to squander this opportunity for reform nor settle for just marginal improvements at the margin. instead, we must fight for substantial reforms that will significantly improve our health care supremsystem -- health car. first of all, if whatever plan

you have, you're happy with your insurance, you can keep your health care insurance. we want to particular what's broken, we want to protect what works. that's why i'm making a case for giving americans a public health insurance option, not controlled by the health insurance industry. so of us have had fights, even the president when talking about his mother when she was dying of cancer when he talked about her during the campaign last year, about how while she was so sick, she to fight the insurance companies to get reimbursed, to get payment for her illness. the public health insurance option is important in part because it's not controlled by the health insurance industry. it's a -- it's a competitor. it can compete with private insurance plans. we must preserve access, but that's clearly not enough for -- for what we do with health care. giving americans a choice to go with a private or a public health insurance option, an option, giving them the choice, is good policy and good, common sense. a public insurance option will make health care available for americans like michelle of willaby community east of

cleveland. when michelle was first diagnosed with breast cancer, she had excellent coverage through her husband's insurance. but her husband lost her job and she lost her insurance. not eligible yet for medicare, she started a consulting business and found an insurance plan, exorbitant as it was. with the economic downturn, michelle writes that -- quote -- "the sum of her work is to pay for insurance." at a time when too many americans struggle to pay health care costs, a public health insurance option will make health insurance more affordable. a public health insurance option would make insurance affordable for americans like gary from toledo. last year, gary was laid off, he couldn't afford the more than $800 a month cobra costs. after obtaining health insurance from a company that promised equivalent payments of medicare for surgery, gary's wife underwent surgery. after a week of recovery, they received a hospital bill of $210,000 with a hospital letter saying they lacked insurance. gary talked to his provider, who agreed to pay $400.

$400 out of $210,000. fortunately -- fortunately for her family -- for his family, the hospital absorbed the remaining costs. but that shouldn't happen that way either because of what that means to the local hospital. with gary and his wife still three years away from age 5, they deserve health reform that works for -- 65, they deserve health reform that works for them now. a public health insurance option will also expand access of affordable health care in rural areas that are often ignored by private -- by a private insurance market which tends to target big cities with more of a density of population, a concentration of consumers. too often, as randall of west liberty, ohio, a small town in our state, as randall can explain, rural communities have a difficult time attracting even basic care. randall oversees ohio's only rural training track in family medicine. while his program has received awards for training excellence, he struggles to attract enough doctors for their rural residency.

randall wrote to me explaining the disincentives and misperceptions he has to overcome to attract the care needed to serve rural ohio. a public health insurance option will not neglect rural areas. insurance companies often leave rural areas. insurance companies bail out or the insurance companies that stay are so small in number that there's no real competition and they can charge far too high rates. instead, the public option would be consistently available in all markets and in rural eastern oregon, in rural western and southeastern ohio. i stand ready to work with my colleagues to design a public insurance option as part of overall health care reform. the stories of millions of americans behind spiraling costs of health care will no longer go unheard. the stories of chris and gary and michelle and randall will guide this administration, will guide this congress, will guide this nation to protect and provide health security for all americans.s. mr. president, i would yield the floor and note the absence of a quorum. the presiding officer: the clerk

will call the roll. quorum call: