vision are of health care, doctors and patients will make medical decisions, not insurance companies or the government. i cannot overstate this point enough, medical decisions should always be left to the patient and his or her health care provider. that's what we're going to ensure under this system. . one that offers stability for families where coverage is not lost because someone changes or loses their job or becomes unexpectedly ill. these are as we know without a doubt challenging times. we face extraordinarily high unemployment in this country. my home state of rhode island right now the unemployment rate has reached 12.1%. this is on my mind every single day when i come to work, when gi to sleep the first thing i wake up with in the morning. it is this on my mind and how do we fix that, getting our economy back on track? we are fixing health care is going to be vitally important to

do that because the current status quo is unacceptable. even more unacceptable is that every job loss places access to even the most basic health care coverage at even greater risk. just as i conclude here tonight, let me just say this. in a nation that's led the world in health care innovation, every citizen should have access to affordable high quality care. i believe this to be true not only for moral reasons, but because this is what will ensure that we remain the global leader in health care innovation in the 21st century and also make sure that our workers and our businesses will continue to be competitive in this global economy in which we now live. i urge my constituents and americans from across the nation to engage in a real honest, clear discussion on health care reform and to demand a universal health care proposal that puts the american people first.

i'm proud to be able to join this special order tonight. talking about the need for health care reform. i again want to thank and commend the gentleman from connecticut, mr. murphy, for organizing this event. pleased to be here with you. and with mr. ryan. with all of our colleagues who compassionately -- care passionately about health care reform. this is our time. this is the year when we are going to fix health care in america once and for all for the american people. i thank my colleagues and i yield back. mr. murphy: i thank the gentleman, mr. langevin. such a great leader on this issue for a very long time. i think he's right, this is our moment. it's no coincidence that it's taken a long time to get here because there are a lot of force that is are aligned against health care reform happening here. for whatever reason for a long time they had control to the levers of power down here, the folks that have been doing very well off the status quo have stopped health care reform from happening here for a long time. there are a few individuals out there who are run aring some of

the big health care companies who are down on wall street who have made they are fortunes off this health care system. what's happened is that they priced their products, whether it be a drug or medical device or insurance plan, to such an expensive degree people can't afford to get it. so the cost of their fortune ends up being people's life's, people's health. so it is no coincidence it's taken us this long to get here. there are powerful interests aligned against getting health care to people who don't have it. mr. ryan: one of the reasons is the projection for costs if we do nothing, this plan here, if we implement or just let the republican health care plan continue, that means an $1,800 increase next year. and down the pike. so the reason mr. langevin thinks about this before he goes to bed and before he gets upp is because we know the cost of

inaction. you don't have to explain to people in the heartland what the cost of inaction is. it's an increase of $1,le00 -- $1,800. it's more people being knocked off the rolls. more people calling our offices saying, can you help us? i just got denied coverage. it says in my policy i got covered now aim not getting covered. all of this happens. and it is a cost to all of us. and so i think the reason we have to act now and why it's so important is because the cost of inaction is $1,800 a year increase. mr. murphy: it's absolutely right. as i was saying earlier, some of that cost is sort of invisible to people because it's buried in their tax bill. all the money we send to emergency rooms to cover the uninsured. all of the extra medicine that's being practiced out there that doesn't need to be practiced that we are paying through our medicare and medicaid systems.

the wages that people never got because their employers took all the tax breaks money they earned that year and sent it to the insurance company to pay for increased premiums. that increase in the health care system we are going to see if we don't enact health care reform is visible in someplaces to some people out there and is invisible in other places. i just see no way to get this economy back up and running unless we take on the high cost of this health care system. now, it's one thing to sort of before cutting costs in our health care system, we heard a lot of people on the republican side of the aisle talk in unison with us about cutting costs. it's another thing to be for the things that cut costs. i want to talk for just one second about the element of the democratic plan that saves our health care system about $100 billion over the next 10 years, and that is giving small

employers and individuals the option if they want to to buy into a government health care plan, not unlike the one that you and i have access to or the medicare plan that lots of other folks have access to. all we are saying is that people in businesses should have the choice to go out there and buy a not-for-profit government-sponsored health care plan. if they think their private insurance is better, stay there. if they think maybe they'll do bert on a government plan which costs less because it doesn't have to pay the big c.e.o.'s salaries, it doesn't have to return big returns to shareholders, if they think they would be better off there let them go there. our nonpartisan budget office has told us that's going to save the health care system about $100 a year. -- $100 billion year. the commonwealth fund, a nonprofit research group, estimates an individual might be able to save $1,100 a year by

choosing that government sponsored health care option. now, it's up to them whether they want to do that. but we are hearing from both our budget experts here and our budget experts outside of this building that there are real cost savings. mr. ryan, that's why when we are looking at surveys on this issue of whether or not the public wants to have the option to buy into a public health care plan, every single survey that's done shows that 65%, 83%, 76% , want that option. the most remarkable thing is the highest survey here, survey that shows 83% of people wanting the option to buy into a government sponsored health plan, that survey was done by a group called edri, essentially all of the major institutional health care companies research arm. so even when the groups out there that are a little bit more skeptical of health care reform

do a survey, they find the same thing everybody else finds. i think that there could be some real bipartisan agreement here on cutting costs. but it's one thing to stand up on the house floor if you are a republican and say that you want to cut costs. it's another thing to actually be for legislation that does it. that actually implements cost cutting measures. mr. ryan: that's the money that we reinvest back in, those cost saving measures that we reinvest back in to preventive care. so that kids will have dental, kids will have oral, which could be the same thing. kids will have hearing checkups. all of these things will be included for young kids. vision. these are all things that as we save this money and steer it back into the front end of this program, we are going to have healthier citizens. i was reading an article last night that it hit me about

energy and it also makes a good point about health care. we are in a direct competition, mr. speaker, with china. i don't think anybody will deny that. i think we all know that we are in a direct competition with asia and with china. and in china they lose 400,000 people a year that die because of air pollution in china. so the point on the energy bill is clearly not doing enough and at some point those people are going to say we want clean air and once we jump ahead in the energy field and start making these products and exporting them to china, we now have created a massive export market. but the philosophy is different. because we are saying that our values, our priorities here are

about putting the money on the front end, making sure everybody's covered. this chart here, the difference in the 6,000 we spend per citizen and the 3,000 and some change that canada, france, and germany spend and have a higher life expectancy is because they cover everyone. they allow people to get preventive care so they are healthier. so they could go to work. so they don't miss weeks at a time at work. they get the prescription and they could go back to work. i mean we heard a lot over the last decade or two about family values. what is a deeper value than the health of your kids and the health of our families? there is not one because if you don't have health, you don't even have happiness. there are very few unhealthy happy people. when you are unhealthy, you are unhappy. so this is fundamental to the values that we have as a

country. and it will unleash a level of productivity in this country. there will be all of the anxiety that people have will be channeled and unleashed into more positive endeavors. and at the same time begin to move us in a direction where we are not going to bankrupt the country. we are going to make the country healthier, more productive, create more wealth, and at the same time contain our health care costs which will probably end up saving us a lot of money in medicare. i mean one of the things people forget is all of these people who don't have health care that are older, that think, i'm going to wait, i'm going to wait, i'm going to wait until i get on medicare, and then once they get on medicare, the problem is exacerbated, the cancer has spread, and a variety of other problems ensue. so this is an opportunity for us to say that as we try to compete

in a global marketplace, mr. murphy, we have the opportunity to enhance the intellect, enhance the productivity, and the health of our citizens. mr. murphy: there ryan, there are a the lot of really great mpanies out there who have figured this out. i think of a company in my state, pit any bows -- pit knee bows, who has -- pitneybowes figured out how much productivity they were losing because they had a health care plan somebody else was administering out there that had a financial incentive to deny care. so they decided that they were going to take on their health care plan themselves. that they were going to put health care clinics in their facilities. they were going to put health care close to their employees. they were going to give rewards to employees that worked out, that invested themselves in

keeping themselves healthy. there are companies out there that have figured out really great models to provide better health care, more immediate on site care for their employees and they have benefited not just because they feel good about keeping their employees healthy, but because their bottom line has been strengthened by the fact that their employees are healthier, showing up for work more often, and ready to produce and ready to compete. you mentioned the fact that this health care system is going to bankrupt this economy. right now we are spending 70% of our g.d.p. on health care and economists are telling us in the not so distant future one out of every $3 we are spending in this country will be on health care. that's unsustainable. on a local level this is personal bankruptcies, too. we think of bankruptcy in this country as being somebody that went out there and bought too many snake oil securities or

made a real bad bet in a real estate investment and all of a sudden they have gone belly up. no, mr. ryan. you know this. half of the bankruptcies in this country, half of the families that have to go into bankruptcy, do so because they had an unexpected medical cost. a cancer or a term nibble disease that bankrupt their lives. families devastated through no fault of their own because they gosick and either didn't have insurance or they had insurance that wouldn't cover the full extent of the illness. dirty little secret out there is a lot of insurance plans, you may not know this because it's in the fine fine print, have a lifetime limit on the amount of money they spend on you. you are ok until you get really sick. for that 1% or 2% of people that are spending millions of dollars on their care over their lifetime, your insurance runs out even if you think that you have it. this is about individual people

whose lives are shattered, shattered by having expenses that they can't control. that's what this health care reform is about as well, mr. ryan. mr. ryan: you look at the -- like the company you were mentioning no co-pays on prevention, no rate increases for pre-existing condition. there will be a big sigh of relief in this country when this is passed. . an annual cap on out of pocket expenses. we're saying to people in america, in 2013 or whatever the date is that this gets implemented, you will not go bankrupt because of a health care condition that you may have or a member of your family may have. said and done. that's what this bill is about. mr. murphy: not that we're not

going to ask people to contribute to the cost of health care. we're talking about caps on the amount of money you're going to contribute but we're still going to expect people to step up to the plate and pay for part of health care to have a little bit of exposure and scratch in the game themselves. that's important. that's important to have shared responsibility. nobody's talking about the government coming in here and either taking over our health care system in general or paying for everybody's health care or even asking insurance companies to pay for 100% of health care. we want individuals to have some scratch in the game we just don't want it to end their lives. mr. ryan: exactly and flip their families and send them out of their homes and the whole ripple effect that happens. there's another point to this, it's in here but it's not in here. as we talk about prevention and there's great sections in here about community health clinics and different preventive measures going on and that we're going to continue to promote, preventive medicine

and public health training grants and those kinds of things we think are important to what we're trying to achieve here. it's sending a signal and i think president obama has been sending a signaling people have got to take care of themselves as well. this is not just, ok, you can do whatever you want, you're going to be covered. like congressman murphy said, each citizen will have skin in the game and their health care decisions will -- at some level will affect what they pay. but what we're saying is, we will be helpful, you will contribute, there will be share responsibility here. at the same time, you have to do what you need to do to take care of yourself and we all have that responsibility now. we have the demographic train come do you think the pike with baby boomers going into medicare, going into social security, and all of these issues, we have got to be a lean, mean, productive, economic force in the world so

that we can drive you are our economy and help -- drive our economy and help pay for a lot of this debt accumulated over the course of the last eight to 10 years and move us forward. but again, we know the cost of doing nothing. we know exactly what will happen. health care bills will go up another 1,800 bucks on average next year and as far as the eye can see, again, this is not a plan. this is the -- our friends on the other side, this is their republican health care plan, a bunch of lines going to a bunch of question marks and back again and maybe, you know, at some point, maybe off the chart somewhere there's a solution there. it hasn't worked. and they had an opportunity here when they controlled the house and senate and white house to implement whatever it is they've come up with. whatever it is they came up with, they had the chance to implement it. knew it's johnny come lately and we're going to get this done.

every time i go home and i meet thousands of delphi employees who have been left behind in the g.m. bankruptcy, both salaried and union and steelworkers who have lost their jobs and lost -- had their pensions cut in half, go to the pbgc, lose their health care, this is what -- this is what this is about. those are the people that will benefit from thising mr. murphy and i want to thank you as we wind down here for the opportunity to do this. we'll be here tomorrow and possibly friday and next week, day in and day out because it is that important for us to pass this. i really believe the health and welfare of our country depend on it. with the energy bill and with this, i think this is transformational for us. i think it's great opportunity for places like northeast ohio. i yield back to my friend.

mr. murphy: i thank you for joining us. we will be down here talking about this because it's so important to get health care for america. as you said, our friends on the other side of the aisle had eight years to get this done. people may say, mr. president, you're taking on a lot really quickly, but we are paying for the costs of inaction. we are paying for the costs of a republican party which for forever reason decided not to do much about the cost of our health care system. and we are going to get this done. we are going to get this done so nobody loses their livelihood, nobody loses their access to the apparatus of opportunity because they get sick. we're going to l they are cost of doing business and we're going to do it this year. with that, i yield back the balance of our time. the speaker pro tempore: the gentleman yields back, the gentleman's time has expired. under the speaker's announced policy of january 6, 2009, the chair recognizes the gentleman

from iowa, mr. king, for 60 minutes. mr. king: thank you, mr. speaker. i appreciate being here. i'd like to borrow the chart from mr. ryan, i have the one here with all the democratic solutions. i have here something that looks like the basis of it, which was hillary care. if i go back to my office in iowa and i dig through my archive from my construction company that was seeking to thrive during the clinton administration, i have in there the very poster that was laminated that showed the entire flow chart of hillary care which was presented to the american people and rejected by the american people. it's got to be, i think, once i compare the two, the template for what we have here that's produced off of this bill. you know, there aren't question marks with what republicans want to do.

we have more ideas than we can agree upon, i will concede that much. we have sought to improve health care but we fought democrats every step of the way. it's clear when you look at the differences between the proposals we have and what it is that they are poised to vote for, here's what will happen. you'll hear all kinds of platitudes about how we can't stimulate the economy and grow our way out of this situation we're in unless magically the solution that arrives is, let's go to socialized medicine and that's going to fix our economic woes. somehow when i hear that said, i can't connect it, mr. speaker. i'm listening to the dialogue that comes out and with such great self-confidence it flows, let me see, i wrote it down, i was listening to mr. murphy from connecticut and he said, let me see, i see no way to get this economy back on track unless we fix health care. fixing health care means nationalizing health care.

it means turning it into socialized medicine. what goes on if we look at the flow chart here is the health choices administration, h.c.a., just a moment. let me get this back where i can read it too, mr. speaker. the health choices administration, h.c.a., sets up a commissioner. there's a health insurance exchange that would presumably broker health insurance through this exchange, kind of like where you might trade on the board of trade for a commodity like corn or oil or beans or gold. and they want to trade traditional health insurance plans would be in there and a public health plan matched up against it. that's the centerpiece of this proposal. what it really says is that they want to establish a government health insurance program that would compete directly with the private health insurance programs that are out there.

and we have hundreds and hundreds of those insurance programs that are out there and if i remember correctly, the number that i saw was 1,300 different companies competing in health insurance in the health insurance business. that's a lot of competition. that's not a little competition, it's a lot of competition. if you believe competition brings out the best in us, then you have to know that there are a lot of different models that have been tried and there may be some good models marketed very well or bad models marketed well, maybe there are some other alternatives out there, but this i can guarantee you, if there's a better idea of how to ensure health care in the united states of america, it will not come from government. government doesn't provide solutions. the creativity is not there. this proposal that comes from the democrats that was just unleashed on america yesterday has within it a series of

presumptions on how they are going to save money on health care. one if we listen to the gentleman that made the presentations here within the last hour, they would tell you they're going to squeeze the profit out, that there are people actually making money by providing us the very best health care in the world. and we surely couldn't have that we couldn't have people making money doing this. i don't know where people get their incentive, we have good hearts, we're altruistic people, but it's nice to have a little profit to justify going to work every day, otherwise you might stay home, raise the kids, work in the garden, go golfing, whatever you do squeeds the profit out, people will quit going to work. that's what they suggest is going to happen. squeeze the profit out, take it out of whatever might be there for the insurance companies, take whatever might be in the profit for the health care providers, doctors, nurses, administrators and the people who work sod well in the health care industry, and by the way,

let's acknowledge the volunteer this is a are the -- the e.m.t.'s out there on a daily and nightly basis, they deliver more regularly than the mail does, rain or snow or sleet or hail, nothing stops them from going out to save people's lives and increase the quality of our life. but into all of this mix, they propose that we upset the very -- the largest and the best health care system in the world. to what purpose? fix the economy? mr. murphy would have you think that. he says that he can't imagine getting our economy back on track unless we fix health care. here it is. i see no way to get this economy back on track unless we fix health care. this is something that was amazing to me, mr. speaker. i listen to, at the time, it was senator obama, candidate obama, arguing to the american people that they should elect

him because he's going to fix the thing this is a aren't working with government and the economy will work better for we simply nationalize our health care plan. now, i will concede this point. this nation spends too high of a percentage of its g.d.p. on health care. it's too high if you compare it to other countries in the world. but it's not too high when you're someone who needs that care. when you've got cancer in the family. when you need some emergency heart surgery. we are not a country that waits in line for health care. but the countries that are mentioned here do wait in line. the canadians wait in line for health care. the europeans wait in line for health care. those in the united kingdom wait in line for health care. one of the gentlemen, i believe it was -- it was mr. ryan, from ohio, said that people delay getting health care services until they qualify for medicare, then the cancer

spreads and presumably it's a bigger problem. the cancer spreads because people wait until they qualify for medicare is what the statement was. but it's a fact that if one is diagnosed with cancer in the united kingdom, your life expectancy is on average 18 years less than if you're diagnosed with cancer in the united states. now i wonder how the gentleman who gave the presentation in the last hour would reconcile that, and i'll use that, that dirty little secret about how much better our care is for cancer patients here in the united states and how much longer our life expectancy is than it is in a place like the united kingdom and presumably they have a similar health care plan to those in the european union and their answer will be, the life expectancy of canadians and europeans is one or two or three years longer than the life expectancy of those in the united states. that's typical liberal logicing

mr. speaker. they would look at one statistic and if that statistic can support the argument they want to make they don't look underneath that to ask the question, why would the life expect tan soif a canadian be longer -- longer than the life expectancy of an american? by a year, i think the data was. i didn't get to see the chart. the first thing you need to do when you hear some data like that is ask other questionsing like, why is it -- how could it be if one is diagnosed with cancer and lives to be 18 years longer in the united states than if you're under the socialized medicine program of the united kingdom, then how can you equate that the life expectancy of someone in the united kingdom will be longer than that in the united states because they have access to health care when that health care supposedly cures their cancer, but they're dying 18 years sooner. so could it be, mr. speaker, that there are other factors involved that reduce a life exapt tancy here in the united

states? how many of us die violently to accidents, for example, compared to those in canada. how many of us die of addictions like abusing illegal drugs or from alcoholism? what are the ratios of that? how many die of ideas? -- suicide? i wouldn't think that's a situation to be solved by a social medicine problem, except i'm willing to bet there's something in the flow chart to expand the mental health that i might have overlooked in this nasty looking, modern techny color hillary version. it's here somewhere, i'm confident, about how they'd address the mental health situation. it's an issue. when you carve all these of -- carve all of of these things out of the system, life expectancy of americans that take care of themselves he the way canadians do is equal to or better than that of canadians

or europeans. otherwise, what's the variable sf if they're dying 18 years sooner from cancer in europe, then would there be another illness that counterbalances that? maybe it's diabetes here in the united states because we may be heavier or have diabetes more snauven put those factors into place but don't just throw a blanket number out here and tell us you have to upset the best health care system in the world because you have one data point you can point to without looking underneath that data point to draw a legitimate conclusion from that data. . if gi on the dirty little secret from mr. murphy. there is a secret limit what insurance will spend on you. i don't know that that exists and it implied it exists in every health insurance policy of the united states. i expect it exists in some of them. i'm confident it doesn't exist in all of them. here's the real dirty little secret that is in this bill and

this broad exploded techny color -- tech technicolor flow chart. part of the secret is this, they intend to tax the middle class workers in america and some of the working poor in america n. fact probably all of the working poor in america, to fund this outrageously high priced socialized medicine plan. and how will that work, mr. speaker? here's how it will work. there will be a surcharge according to this bill that will be imposed upon the payroll of employees. now, the employer is asked to pay the tax, 8% that would be put upon the payroll -- be calculated off the wages of the employer's workers, in order to fund the health insurance plan for those employees if the employer doesn't provide the health insurance for them. to make it simple, they want to

tax the employer who doesn't provide health insurance for the employees. now, that may sound good to people who don't have health insurance. it may sound good to someone who is a little berudge grudges -- begrudges their loss and lack of generosity on the part of their boss. here's what happens and i'll just draw this comparison so we can think of it in relative terms. the social security that we pay, the payroll tax we pay, all of us on our payroll up to whatever the cap is, is considered by economists to be, even though it's 50/50, i many times have sat down and done the math formula making out payroll for my own employees, i multiply .0765. that's half of the payroll tax. and that came out of the employee's side. and then that same .0765% which adds up to 15.3%, employers half came out of my side. i would look at that and say

that 7.65% out of the employer is something i'm actually paying to the employee. it's a cost of hiring that employee. it's a fixed cost that comes with it. and so regardless of whether i take it out of his check or take it out of my check, it's all money that i would be paying that employee if it weren't going to the government. it is a tax on his earned wages. his or her earned wages. so i have always viewed it that way as the payroll tax being a tax on the earned wages of the employee and the limiting factor on how much i can afford to pay the employee. let's just say you can hire someone who will return for you $30 an hour. and if you pay them in total cost of their wages, their overtime wages, the payroll tax, the benefits plan that you have whether it be health insurance, retirement plan, whatever else

it might be all of those costs including the lost time that's in in transition, the lost time in production in coffee breaks and all of of those things that have to be added in, the inefficiencies added in, let's say that adds up and it costs you $20 an hour to have this employee hired. and you can make $30 an hour off of having that employee. now, there is a little margin there to work with. of course you have other factors involved to take that profit to apply to such as the overhead of the company and the list goes on. let's just say you are at -- it costs you $20 an hour to have this employee working for you, and he's making you $30 an hour, and you can make that work and have a little margin for profit and apply some of that overall margin to your overhead, your own administrative costs. and along comes the government and says i'm going to tax you $10 an hour for this employee. now they have taken entirely all of the cushion that was there

and the necessary profit that you have to have to fund other parts of the company from that and the profit you have to have to build enough capital so you can offer somebody else a job, and government takes it all away. what's an employer do? i'll tell you exactly. he has to lay off the employees that cost him more money than they are making him. you can't sustain yourself that way. you can bridge these gaps over time. things go up and down. over time this will all be reduced down to can you afford to have the employee or can't you? and one of the ways that you adjust that affordability is if the federal government adds $10 on to the cost of keeping the employee, you have toe look -- to look at that in terms of if that eats up all you have to work with, you have to look at looking at the employee's wages, more often you simply don't offer the raises at the same time you might have otherwise. this comes off the backs of the worker.

democrats want to tax the working poor and the working middle class and the middle and upper class americans to pay for a health care plan that i believe is completely misguided, that doesn't fix what it's designed to fix, and surely will not fix this economy. we have to know that their approach to the economy is so far off that more of the same is not going to solve the problem. these are a bunch of keynesian economists here in charge of this country today at the white house, in the house of representatives, and in the senate. and they believe like f.d.r. believed that if you could just borrow enough money and pour it into this economy and replace jobs in the private sector with government jobs in the public sector, that somehow you could stimulate this economy and get the engine -- this economic engine running again. mr. speaker, i can find no empirical data out there that

consistently supports the idea that we can borrow money from our children and grandchildren's future, actually borrow it directly from the chinese and the saudis while we are at it, and dump that money into this economy and stimulate the economy so that it grows. back to the 1930's, i thought and i believe, there is been a definitive experiment that's taken place with keynesian economics this borrowed money, government jobs, and grow government to compensate for shrinking that has taken place in the private sector. if we go back to henry morganthau who was the treasurer for f.d.r. back in the 1930's, he objected and he said, what have we to show for this? we borrowed money, we spent money like nobody has spent it before, and we haven't created any jobs. we have nothing to show for all the money that we have spent. now, that was -- he was a believer. he was the mouthpiece for

f.d.r.'s keynesian approach to the new deal. the new deal that i was taught was a good deal was -- when i went to school and i went back and studied the data and came to an informed conclusion rather than just simply a cursory statement that reinforced the f.d.r.'s new deal program. the father of of this of course was john keynes the father of keynesian economics. he throughout those years he was very influential in the 20's and 1930's and less so in the 1940's although america was distract interested economics during that period of time. but keynes said he could solve all the unemployment in america, all we needed to do was go find an abandoned coal mine and go out there and drill a lot of holes down in that abandoned coal mine and fill those holes full of american cash, greenbacks, the dollar, drop

cash down int those holes, fill them up again, and then fill the old coal mine up full of garbage, this is his story, and turn the entrepreneurs of america loose to go dig up the money. it would create these jobs and digging through the garbage, digging down through the holes, finding the money. keeping everybody busy and the entrepreneurs would find that money eventually and probably all of it somehow and it would keep everybody busy and they would have a job and money. i know it was a facetious model. i know that he drew that description as -- let's just say a facetious model that would illustrate how ridiculous it can be, i think he began to realize this in his career, how ridiculous it could be to put government in to make work and put government into the business of intervening in the private sector. what's going on here in america. the dirty little secret to use the phrase used by mr. murphy from connecticut is not that

there is a limit on what insurance company will provide that they'll shut off your health care, what the dirty secret is, democrats have committed to taxing the working people in america to fund their trillion and a half or poor -- or more health insurance plan that is designed to crowd out the private sector insurance companies in america, the hundreds and hundreds of them providing such a good job and such a highly professional service, and it comes down to the health insurance exchange. and those qualified health benefits plans that exist today competing against a proposed and newly created public health plan that would crowd out our private health insurance here in america as we know it. we have a model we can look at to learn from this. business mark established a national health care plan in

germany before the turn into the 20th century. my guess is 1898, i suspect it was before that. i know it's the oldest national health care plan in the world. and then it didn't cost very much because medicine hadn't developed very far. but they do have private health insurance in germany. but what it is it's 10% of the market. and the national plan, the required plan, has crowded out all of the private health insurance in germany except for about 10%. and the people that have that 10% are those who are self-employed, that run businesses, that have found a way within their business to go out into the marketplace and buy some health insurance that provides them perhaps a little better care than they get out of the government plan. so that's what we can expect to happen with the insurance companies here in the united states. should the democrats in this congress and the house and senate and white house get their way, mr. speaker, we will see

these proud, important, independent health insurance underwriters, their companies, these people that are doing this business, this service, on main street in many small towns in america and across this country, we will see them shrink down, drop off one by one, companies dropping off one by one. some will go in one ffelp swoop, but they are looking at almost the death knell of their industry if this socialized medicine plan gets passed by this congress. and, yes, they'll try to find a little niche in the market. but there -- that isn't going to happen in the end. some will find their way. but they'll be narrowed down like they were narrowed down in germany. and we won't have the people that are answering the phone at 7:00 at night, going over to someone's house to sit down and talk through their health insurance plan with them, helping to nurture them, and helping inform them as to the situation. it will be a government bureaucrat that bunches the clock and thereby a line up

outside the door, we know how this works in government agencies, there will be a line up outside the door, and that bureaucrat will take the appointments at the appointed time, usually, and when it's time for the coffee break, in the middle of the conference, they will get up and go off into the break room, they'll have their little coffee break, and it will ask all of 15 minutes and when it's time for the lunch hour, at noon, the closed sign goes on, the bureaucrat walks out the door, and goes off down to the bistro or wherever to have lunch with his other bureaucrats. he or she shows back up again at one minute to 1:00 and opens up the door again and starts through this process. and the american people will not be able to compete, they will not be able to go someplace where they are treated like a real human being customer, they'll be treated by a government bureaucrat. don't we have 300 million americans who have experience with bureaucrats?

don't we know what that does to the attitude, bureaucrats have an attitude. it's the nature of it all. they aren't any different -- it's because they have a monopoly. people that have a monopoly have an attitude. whether they are in the private sector or whether they are in the public sector, if it cashes out the same for being nice as opposed to being not so nice, for being the same for providing happy, friendly service compared to providing that grumpy reluctant service, we know the result. people like that often gravitate towards the government. . we create this great big massive techny color flow chart of interrelated government agencies, and the ones in color are the new one the ones in white are existing. medicare, schip, medicaid, they're existing.

private health plans, they're exist, but they get shoved into the qualified health plans, but they have to write a plan that qualifies. here are the departments, treasury, health and human service, veterans administration, labor department, here's congress, the president, institute of medicine exists, there's the national health service corps, they're there. states, all these programs, and this is -- the ones in white are existing, the ones in color are created new. all of those in color, that's thousands and thousands and thousands, mr. speaker, of new bureaucrats. new bureaucrats who will be handed this monopoly and they'll be in the business of not only taking customers in and writing their insurance plans and the pace they see fit, because they're government, after all, what government office stays open after 5:00 on any working day?

what government office would think of coming in on a national holiday? what government office would take a look at how to retool their service so they could expand the size of the -- compete with higher competition so they could expand because they could compete bet her they won't do that because they're handed a monopoly. if they can't compete, they'll be subsidized more by the taxpayers in america. we will be trained, as a people to line up outside the door, patiently wait our time, take what we can get, not be able to shop around because these -- these qualified health benefits plan this is a come from our traditional health insurance providers will be squeezed out and by the way, that squeeze out that will come will not be an accident that's the result of people who really didn't think through what they were doing to the american people. it will be the willful, premeditated result of the people who happen to have the

gavels in this congress now and the pow ein the white house now. who believe in socialized medicine. they want to adopt a policy that is a socialized medicine policy and kill the private sector because they don't believe in it. they believe government provides better than individuals, competition, free markets, and people provide. that's the great divide in our two approaches here. not a chart with question marks on it, those must be things that were confusing to mr. ryan. the chart with all these new bureaucracies on them, i would say, mr. speaker, it's a chilling thought to think that my children and my grandchildren and their children and every generation beyond them might be receiving their health care standing in line. in front of a government agent who hangs the closed sign on the minute the clock ticks past the appointed hour regardless of how long the line is. we're a people that will -- we

will be conditioned to a lot of things. but standing in line is not one of the things americans do well. we have to do that when we get on an airplane now to go through security at t.s.a. and i look at that and i watch that and the security line and sometimes i wonder, how did they ever get americans to stand in line like that? we don't do that? we'll stand in line to get into a ballgame, to get into a concert, we'll stand in line to vote, now we'll stand in line to get on an airplane and if this broad, exploded, techny color, hillary expanded plan gets signed by the congress, it will be signed by the president, he wants a bill to sign, i don't think it matters what's in it, americans will be standing in line for health care, not just in offices to be part of the public health plan but lined up in emergency rooms, clinics, hospitals, all across this country, or in a

queue that doesn't show up so much, not one that's tangible until the long lists that will be there. because it's an inevitable result that socialized medicine produces rationing of care. it's been a fact wherever it's been tried. it's a fact today wherever it exists and it will become a fact in the united states of america should this program that was unleashed on us yesterday be made law. here's another place where they think they're going to save. they're going to save money by rationing care, getting you in a long line, places like canada, united kingdom, europe, people die when they're in line. there are plenty of examples of that. i listen to the gentlelady talk about anomaly this is a justify to her socialized medicine. well, they would describe those who die in line in canada or the united kingdom or europe of being just simply anomaly this

is a somehow the system let them fall through the cracks. the family this is a lose members don't think it is just the system that fell through the cracks. it's a real life. a real loved one. someone whose health care is rationed by formulas that are created by bureaucrats. the bureaucrat this is a will close their door at the appointed time. could be the health choices administration commissioner. could be coming from the bureau of health information. could be the national priorities for performance improvement. when i see national priorities, we know that some of the national priorities will be, they want to spend less money on certain types of care. that will mean that people will die because they weren't a high enough national priority. they've already got it here in their bureaucracy, national priorities for performance

improvement. here's how they want to improve performance. by the way, i endorse some of these things as being good ideas, i just don't think government can run it and make it work. they want to expand the information technology in our health care. i agree with that. i think we ought to have interconnected health -- the health records so that if someone gets sick from my district who happens to be in speaker pelosi's district in san francisco, they can put their health care card into the internet-connected security database and find out what prescription drugs a person might be own on, find out what they've been treated for and be able to save lives accordably and provide efficiencies accordingly. i think it could reduce the numbers of people going around and shopping for prescriptions if we had a central database. i believe that's being developed within the health care industry and not fast enough to suit any of us, i don't think, including the

people developing it. but info tech is a good thing. it can be used in a lot of good ways. you don't have to have socialized medicine to have information technology. the second item they'd save money with is comparative research. good. we're doing a lot of comparative research. they're earmarking comparative research. we're earmarking comparative research, this floor, there's not really legitimate debate on this floor because the house has been shut down by the speaker and the rules committee, i have to inject that in, special order and one-minutes is the only opportunity you have to have these kinds of discussions, mr. speaker, comparative research is good. the other countries can do a little more research and that would be great but what happens is, we do the research in this country. all of the progress, put it this way, much of the progress that has been produced by the pharmaceutical companies and the innovations that have come about the health care markets within the last generation have

dramatically transformed the way we provide health care in this country. the research and the development is predominantly paid for by american users of pharmaceuticals and the beneficiaries of that research are the people in the countries like canada, united kingdom and europe where they do negotiate for a cheaper rate and where here in the united states we're paying too much of that. we can fix that without socialized medicine. and i'd like to see them pay a greater share of the costs of the research and development that go into making these wonder drugs we have today that do extend people's lives. and i would add that those people in those countries that have a longer life expectancy are probably using american research and development pharmaceuticals. they may be made in a foreign country, but a lot of them are produced by the r&d here in the

united states, and they're beneficiaries of it as well. third thing they'd do to save money on health care is more prevention and wellness. mr. speaker, you don't need to socialize the health care system in the united states of america in order to have more prevention and wellness. that's something that's emerging. it's emerging in our culture, it's emerging with some of the health insurance providers we have in this country. who are packaging up proposals in different ways to provide incentives for the insured to live a healthier lifestyle to get regular checkups to go across the scales and watch their weight and maintain, let's say a void -- avoid, some of the vice this is a shorten our life exapt tennesseecy and letting that be reflected in premiums being paid. i can guarantee you, mr. speaker that this public health plan of the health insurance exchange is not going to have those incentive nuances in there.

it's the private sector going to produce those things. we need to encourage them to do that. so they've borrowed some ideas from the private sector, but the idea that they've borrowed that is the center priest of this is the idea of expanding medicare to reaching across the generations and reflecting the model of socialized medicine that exists in canada, united kingdom, europe, we could keep going further east, i think, mr. speakering and might end up with something that's a little closer to what they're talking about. so we're a country that's thrived on free enterprise. we need to continue to thrive on free enterprise and the idea of socialized medicine is abhorrent to americans. waiting in line far bureaucrat to approve your premium is abhorrent to americans. i visited russia earlier this year and as i traveled around moscow, mr. speaker, i saw

something there that was kind of a phenomena that exists in russia that i'm afraid might exist in the united states. if they pass this socialized medicine. and that is that if you're watching the russians they walk around, moscow, i didn't go much beyond moscow so they walk around out there with their shoulders hunched looking down at the sidewalk. i see people in the streets of washington, d.c. do that all the time but they're looking out for all the cracks and bumps and holes we have and it's a matter of survival here. where i come from, we look people people in the eye when we walk down the sidewalk, bid them good day, good morning, we're friends and neighbors working together. doesn't happen in that country. they look down. and their shoulders are hunched and they wander around and if you sit and watch them, they'll wander around, you can follow one of those fur coats and a hat and it'll lead you to a line. they go get in line and stand there.

and then the line moves slowly, i stood in line for nearly two hours even as a member of congress to walk into the -- into their legislative duma. and they knew we were coming. i see the other rugs standing in line a lot longer than i was, but it looks to me like they find a line and stand in it. then they get to the front of the line, find out why they're there. do whatever it is, buy their toothpaste or whatever it is, and then go find another line and stand in it. it looks like the russians are conditioned to go from line to line, stand in line. it reminds me of the story where somebody will go out in the street, it's a comedy routine from the 1950's or 1967 s, someone will go up into the street and look up scoo the inty. someone else would come along and look, and the original person looking at nothing steps back, smiles, well he's drawn a crowd by doing that. just standing in line in russia draws a line behind you,

doesn't really -- without regard to what's in the front of that. i know they have to talk to each other, figure out if they're wasting their time, human nature is human nature. we're going to create line standers in america, people who capitulate to the system. i'll argue that the health care system we have in the united states, some of the problem we have is because we have too much government and submit too much to the system and the individual whors receiving the health care don't have enough vested interest in, not enough skin in the game to be able to use their incentive this is a should be there to do a better job of evaluating the costs. so what should we do? and i'll provide some answers here, mr. speakering on what we should do for health care. first and foremost, take a look at our health savings accounts. we did that. we put that in place as republicans, as a republican majority in the house and in the senate and it was signed by

president bush. who comes out against health savings accounts today? well, they don't comport well with socialized medicine, mr. speaker, that's something that's probably going to go. probably not going to be in this flow chart here that i've -- i don't see the health savings account. i haven't read the whole bill, i don't know that i'm going to put myself through that. but we created health savings accounts. if you were a young couple at age 20, i do this because round numbers i can figure. you're at age 20, put in thet 5,150 into the savings account, grows each year since then, we're in about year six, i think we are, maybe year five, you put that money, the maximum amount in the health savings account every year, and spend $2,000 out for reasonable health care costs, and grow this account at around 4% and

when i did the math on this, that made sense. today it doesn't quite make sense. it will again. grow it at about 4%. if that couple would work and put the maximum into their health savings account every year from age 20 to age 65, they arrive at medicare eligibility with about $950,000 in their health savings account. now that's a pretty good deal. but i can tell you what the democrats in this congress want to do with that if they get their hands on the money. they want to tax the $950,000 in the health savings account. they'll tax it then, before you can take it out, because you won't need much of it, if any of it, anymore. or they'll take it out of you in inheritance tax when you die. you are not going to be able to avoid democrats increasing taxes on you. that's one of those dirty little secrets as your health savings account will be taxed, they'll be taxed by the ideas of democrats, either when you die or when you try to take the money out when you retire.

. let's increase that amount to the point where that couple can arrive at age 65 with enough money to buy paid up medicare replacement insurance policies, policies they own or maybe transition a policy they have owned throughout their working lives that's theirs, that is transportable, that can go with them, policy that they own, and let them transition into a lifetime health insurance plan and be able to use their health savings account to purchase that full up. that's one thing we should be able to do to give people back some freedom. and i can tell you what it costs today if you wanted to buy a medicare replacement policy at age 65, the liability, the current value of -- the present value of that liability of medicare replacement at age 65 is around $72,000 this year. that's about where we are. it gives you an idea if that $950,000 were in a 65-year-old

couple's health savings account today, they could write a check for $144,000 and buy paid up medicare replacement policy and take the difference, let's just call that $800,000, and i would want them to have that tax free and go off and retire, travel the world, will it to their children, buy a new convertible, whatever they want to do. give them their freedom because they have earned it by being responsible. but the problem that we have is the democrat plan takes away the responsibility of the insured of the individuals in this country and it puts it on somebody else. it puts it on the employer that says regardless of whether your employee wants to sit down and market his way through a health insurance plan, his or her, regardless of that, if they don't have health insurance provided by you, then we are going to tax you 8% on that payroll and i just -- i said earlier that comes out of the worker. that's wages he is not going to get. the employer has to crank it out

of the worker because he's paying all the market can stand on the wages that are there. so, we tax small business, tax the workers, there was the issue raised pre-existing conditions. we can do some things with pre-existing conditions without socialized medicine. here's a point that was made by the gentleman from arizona yesterday, john shadegg, who is a leader on this health care policy that we have. he said, if you like your health insurance, over 70% of americans like the health insurance plan that they have, if you like it, then get ready to lose it because you will lose it under this democrat plan in this flow chart is the trap that you'll be be sucked in from here over here to the public health care plan. when president obama says, if you like your health insurance, if you like the plan you have, don't worry. you get to keep it.

well, mr. speaker, you get to keep it for the first minute that president obama signs such a bill. and probably the first hour, day, month, maybe even a year. but maybe not. maybe not because most of the health insurance in this country is provided through people's jobs, through their employer. who brokers it and there are long deep reasons for that that i won't go into tonight. but the president can't say you get to keep your health insurance plan because he doesn't make that call. if the government model, this public health plan here, if that model is financially advantageous for the employer, if the policies that the employer are paying for cost the company more than the policy that's offered by the public insurance plan, an employer will almost always then drop the

private payer health insurance plans. these that are in this circle, which would become the qualified health been fit plans, drop them and adopt the public health plan. now, how is president obama going to tell some company they can't do that? if you don't quite follow this yet, mr. speaker, i put it this way. wal-mart announced last weekend that they are supporting an employer mandated health insurance plan. they announced that policy over the weekend and i thought, why would wal-mart do that? i have the press release here. let's see. aim going to say this, they would do that because it looks like it would help their bottom line. here's what they said, the company says it supports the employer mandate because all businesses should share the burden of fixing the health care system. i don't know what the basis is for that statement except that there must be be some advantage to this. are we to believe that a huge

company a. company that i applaud for the business model that they have creatively put together, but are we to believe that a huge company like wal-mart that is everywhere would propose and support an employer mandated, employer mandated health insurance, employer mandated health care system is the language they used, would wal-mart support that? and then not adopt the public health plan? because they already have the traditional health insurance plans provided to 52% of their employees. would they then move into a qualified health benefit plan for all of their employees because of the mandate that they have endorsed? or would they opt into the public health plan option? would wal-mart still support the president's proposal, which is

basically what has been presented here in this congress, would they still support it if, if the health insurance -- if they had to guarantee they were going to keep the qualified health benefits plan. would they still support it? if it was in the bill that they couldn't drop the private provider and could not opt into the public plan, into the government plan, socialized medicine plan, i think not. i think they want the best option of the two. they will fight to preserve that. so will a lot of companies. but i think this is about something that puts pressure on some of their competition that doesn't provide as much health insurance for their employees as wal-mart does for theirs. less responsible employers some might call that. there still remain a lot of uninsured in that group. some are in medicaid. that's true for a lot of companies that are more entry-level wages. i don't take so much issue with that. i just point out that the idea

is this. the employees of wal-mart won't get to decide that they get to keep the private plan that they have today, the traditional health insurance plan in this white box that will transition into a qualified health benefit plan most likely if it does qualify, unless a bureaucrat says it doesn't, they'll write some new rules for that, those employees will make that decision, wal-mart will make that decision. when the president says if you like the plan you have, don't worry you get to keep it, in truth you should worry. john shadegg's right. if you like your plan, get ready to lose it. because you will lose it. the public plan will crowd out the private plan and everybody will fall under the same category and we'll have health care that is rationed in america. we'll have lines. and we'll have bureaucrats with their nose in the air deciding making life and death decisions on the health care that will be provided to american people. it is inevitable. it's resulted in that every time that it's been found.

now, i draw another comparison. the canadians are forbidden by law to jump ahead in the line. now, if they didn't have a line, you wouldn't have to have a law that forbid you from jumping ahead in the line and accessing health care. so when you need a hip replacement, i have seen the data on this and i actually have to guess, but i believe what i saw for hip replacement number was 171 days of waiting. something in that category is pretty close. i don't know how long you wait in the united states, not at all if you're in a hurry. somebody will get you in. they'll find way to schedule it. we have that service here in this country. i talked to an individual in my district a year and a half or so ago who had emigrated to the united states from germany and he had had hip surgery over there under their socialized medicine plan, a german, but he didn't get his surgery in germany, he had to go to italy

to get his hip surgery. the european union has queues, longer lines in some places, certain times you can get into a line and move closer to the front of the line. i suppose you try to get yourself in as many lines as you can. this individual happened to be -- ran into him when he was out piing up some things for home improvement as i was, and he told me the story about how long had he to wait in line and what he had to do to go from germany to italy, get in that line, then get his hip replacement and hip surgery. here in the united states you are not going to have a measurable line. you might be able to get in one if you're not in a hurry and let it schedule for convenience. if you want in a surgery you are going to get that quickly. canadians have an innovative thing. what is it against the law for them to jump ahead of line, those laws are not enforced equally across the provinces in canada, so some people with more money, some people with more influence get ahead in the line.

mr. speaker, if you have ever had the experience of standing in line and one of the easy ways to think of this is in the airport, are you standing in line waiting to try to make a flight, and you see one or two or three flight crews arrive late, and they go get in line in front of you and they start going through the security. now they are actually pretty efficient at it. i want to get them on the plane and get the planes going. the lines will be longer if the crews done show up. i stood in that line and had to back up. and the result is this. when someone gets in line in front of you, you have to back up. the line gets longer. you have stepped in a line and watch the line get longer, you know it isn't paying your time very well to stand in that line. the lines get longer in places in canada and europe because you have people that have money and influence and poler that -- power that get preferential treatment over those who don't have the influbse and power. -- influence and power.

some of the employers who offer a good employment package pay the wages and benefits to their plowees. the employees who have full access to the canadian socialized medicine plan, but also as part of the package let's just say for example if they need heart surgery, and you're working in toronto, just say you are wearing a suit and tie working for some company in toronto who puts together a good health care package, a good employment package, here will be the wages, vacation time, retirement benefits, they don't get to save the health care plan for canada, but they do get to say you can opt out and go to the united states. in their employment package will be an insurance plan that will put them on a plane in toronto and fly them to houston for heart surgery so that they can cut ahead of the line. they don't have to wait. now, what kind of a country has a health care plan that we would want to emulate that would have employment packages that fly

people all the way across the continent to give them heart surgery quickly because the line's too long in canada. and it's worse than this, mr. speaker. there are companies that have sprouted up in canada that turn key these things. sometimes within the health insurance plan that's part of the employment that says we'll opt you out of the country to get you fast health care services to the united states. and sometimes it's someone in canada who can't wait in line to get the service and so there are companies there like tour companies, travel agencies, travel/health care agencies that put together the package. let's just say that you are in quebec, and you want to go to let's say the mayo clinic in rochester, minnesota, to get a hip replacement, and the hip rae replacement line in canada is long. the travel/health care agency in canada that's sprouted up because of entrepreneurs, you can go contact them and they'll

set that up and say let me see. you arrive at the airport, here in quebec, at this time and this is your flight number and ticket. and you can fly down to the mayo clinic. here's the hotel that you can go check into this hotel. you'll arrive at this time. transportation to the hotel is a shuttle bus from the hotel airport to the hotel that you'll be be staying at. .iaort, airport to the hotel you'll be saying at. here's your examination from the doctors and surgeons and they'll do that examination and later on in the day or overnight they'll start the surgery and give you the hip replacement. here's the package on the rehabilitation therapy, here's your trip back and your plane ticket back to quebec. turn key, i don't know how long it takes, i'm guessing three or four days turn around, give you a little therapy, send you back home again, all of that, you write one check to the travel/health care agency that sprouted up to meet a demand that exists because of the

lines and the rationing that necessarily result in government-run plans, and always have. mr. speaker, i'll go back to 1948 and 1949, i had a world war ii vet hand me a stack of collier's magazines. he fought in europe, second world war. he'd saved these magazines all of those years from 1948 and 1949. 1948 was the year that the united kingdom established their national health care plan, their socialized medicine. and in the magazine, each issue of the magazine had a story about the health care that was unfolding in canada. and you just range through some of them. i can remember pictures of people lined up outside doctor's offices, nurses that were frazzled, doctors who were speaking into the record, quoted as saying i have to see so many more patients now in order to provide enough income because i'm being paid so much

less per patient, i have to spend less time with the patients, and i have to run them through and see too many patients an hour, i'm missing diagnosis, i'm not able to treat the patients the way i should be, the relationship between us is so fast there is no doctor-patient relationship. people that are leaving the health care industry because the stress was turned up and the margins were turned down. and we have a good lot of highly talented people in this country that stepped forward to go into the health care industry, good doctors and nurses and other providers, that are highly educated and takes a long time to train a doctor, roughly a decade to turn one out that can start to take charge and teachers. -- and teach others. that takes time and money. they need to be paid what it's worth to attract them to the profession and be able to be on call in the middle of the night and on weekends and everything they do and that won't happen in a country that rations health care and squeezes down

the prices, mr. speaker. i would just suggest that -- excuse me. i would just suggest that we should think long and hard before we should leap into this abyss, as i listen to the gentleman from connecticut, mr. murphy, i would suggest he should know this if anyone does, and that is when you turn government loose to do something that private sectors should be doing, murphy's law always applies. murphy's law, of course, is what can go wrong will go wrong. the incentives will not be in place to provide the quality of care, the timely service, and we don't have rationing of health care in the united states today. we don't have lines that exist in a measurable way. we don't have long lists on paper of people that are waiting their turn to get their service. we have the best health care

system in the world, and it's getting better. and we can do more with competition. we can do more with addressing the medical malpractice litigation we have in this country that they don't have to a measurable extent in the other countries. we can do better with health savings accounts. we can do better with bringing in competition. we can allow people to expand their health savingings accounts and allow them to have enough money in that to bargain down a higher co-payment and lower deductible in order to get a lower premium. you roll this together, if you give people freedom, if you give them responsibility, if you believe in the free market system and you let the markets do what they will without interference, without the intervention of some fraudulent medical malpractice suits that are driving up these premiums and causing doctors to do tests that are unnecessary except to protect them from litigation, we can bring this health care down and we can see the quality of it go up, and we can also be an inspiration for the rest of

the world, and creating socialized medicine is not a solution for an economic problem. that will make the problem worse, not better. and we are, on one side of us, we are adam smith, free marketeers on the republican side of the aisle and these are the keen economists on the democratic side of the aisle, those who want to grow government and nationalize eight huge entities in america and that will happen on the watch of president obama, the nationalization of eight huge entities. and with that in mind, the nationalization -- there is no exit strategy there. there will be no exit from socialized medicine and cap and tax will crush this economy as well. we must draw a line. this is it. this is the rube con-- the rubicon. i'm not going across in the irrevocable policy and those that do i believe will regret it the rest of their life. for that, mr. speaker, i would thank you for your indulgence and yield back the balance of my time.

the speaker pro tempore: the chair recognizes the gentleman from iowa for a motion. >> mr. speaker, i do move the house to now adjourn. the speaker pro tempore: the question is on the motion to adjourn. those in favor say aye. those in favor say aye. those opposed say no.

spnspn republican and not all of them were directed to spending lue platform and message amendments to give republicans an opportunity to revisit that debate. >> and there have been several protest votes, are you saying that's what's underlying that? >> the protest votes are actually a slightly different matter. the republicans want a chance to air their grievances about the climate debate and grife their anger home about that. but what's going on this year in the appropriations process, there are 12 annual spending bills that funds government, traditionally, those are brought and debated to the house floor with unlimited amendments. something called an open rule. this year house democrats have decided it's a top priority to really move those spending

bills through briskly and get them done in time for the august recess. that hasn't been done in years. >> and let's get to the bottom line about that. how does this bill compare with years past in terms of the money proposed in the bill and what the president has requested. >> it's a dull bill and flat lines spending. part of the reason for that is that a lot of programs that are funded in this bill, particularly renewable energy, alternative energy, water infrastructure projects, those got a huge cash infusion from the stimulus. so this bill doesn't even really cover those. which is another reason why it's just thought -- you know, the bill itself is sort of in some ways secondary to the debate about climate change, you know, to the anger of republicans that democrats are trying to limit their ability to influence bills.

for example, in this year's bill, the energy department gets $28 billion which is less than a 1% increase over the year before. however, energy and water -- energy programs got about $38 billion in the stimulus. so, you know, larger than the side of -- size of the entire energy department. >> and so the bill being debated today, and bottom line is you think it will pass? >> oh, it will pass very easily but not without a lot of heated debate over issues that aren't quite related. >> coral davenport of "congressional quarterly." thanks for joining us today. >> coming up on c-span, some of today's governments on health care legislation. first, the senate health committee finishes its work on a health care bill. president obama's remarks on health care at the white house. and then some of today's house debates about the democrats' bill.

now that senate health committee markup session today on their 13th day of meetings, they finished with a final vote on the committee report. >> let me welcome all our colleagues here this morning and those who gathered in this historic room, the russell caucus room which as i mentioned the first day of our markup, seems like about five years ago, it was actually about five weeks ago, that there were many important events that occurred in this room over the years. i mentioned -- in fact, the hearings on the examination of what had happened to the titanic which is not maybe the best example to use considering the effort we're undertaking. but it was in this room the mccarthy hearings were held, the watergate hearings were

held. and happier moments where john fitzgerald kennedy, announces candidacy for presidency, his brother announced the presidency in this very room. and over the years has been the site of numerous hearings and gathering of one kind or another including dinners we had together as members of the senate where we come together once or twice a year with our spouses and family just to enjoy each other's company in the absence of everyone else. in room is at a source of some of the most dramatic moments as well as the most happiest and pleasant moments of those who had the privilege of serving in the united states senate, so i thank all of you for the tremendous effort and work you've engaged in over these last number of days. it's been a tremendous undertaking and i'm very grateful for all of you. what i'm going to do is turn to my colleague and friend from wyoming, senator enzi, for any statement he has this morning. i will then make a brief statement as well. there's a statement from

senator kennedy which i'm going to put in the record to include it. we just got off the phone with vicky kennedy and i talked to senator kennedy over the phone and he wished he could be here. mike enzi. >> thank you, mr. chairman and i want to thank both sides of the aisle, all of the staff both sides of the aisle for all of the work that everyone's put in on this bill and other bills we've orked on but particularly this bill. a lot of people don't know about the weekend work that's been done by members and staff. staff has stayed around in the evenings after we left and worked out details. they stayed through the lunch hours and worked out details. they stayed through the dinner hour and worked out details. i think it's pretty much been

an all day, all week effort for them. that they should be congratulated for hanging in there and remaining civil to each other. i want to thank all the members for being civil to each other as well. i think it's been, as far as markups on a very difficult bill, i think it's been very cleagily -- collegial and there's been a lot of patience and i really appreciate that. but i do have to say we've been working to reform our nation's broken health care system since i entered the senate 12 years ago. i did have high hopes that this would be the year the democrat and republican members on the committee on health, education, labor and pensions would work together to provide health insurance for every american. i urge my colleagues to work on a blank piece of paper and develop a bipartisan bill that up to 80 members of the senate can support and i still think

that's an absolute criteria. if america is going to believe in what we do it cannot be a bill just put together by one side. there has to be solid support from both sides. and that means we probably got it right. if just one side has the votes and writes the bill and wins, america won't win. i know that the majority had some other am wigses and the bill the committee will -- -- committee will bill be 20-10 that's occurred on every one that's been blocked. but in the 14 days markup we had 45 roll call votes on republican sponsored amendments and two prevailed. president obama has repeatedly called for a health care bill that will reduce costs and called for a bill that will help every american get access to quality health care.

a bill that allows people who like the care they have to keep it. a bill that will not increase the deficit. republicans strongly support those goals. and fortunately, this bill does not meet them. don't meet the goals and the bill has some old solutions for problems that aren't stated. i wonder what candidate obama's reaction in the campaign trail would have been had this bill passed out of committee last summer rather than this summer. i wonder how the former senator from illinois would have voted given the stark differences between this bill and his campaign proposal goals. in my view and graded on the criteria specified by the president, the bill before this committee fails on all of those counts. this bill breaks the president's promises and falls short on achieving the common sense goals that republicans, democrats and the president share. instead, this partisan bill adds $1 trillion to the deficit

despite the president's promise that health care reform must and will be deficit neutral, the bill increases the deficit by more than $1 trillion over 10 years. this on the heels of news last week from the nonpartisan congressional office that the federal budget deficit was $1.1 trillion for the first nine months of the fiscal year 2009. we were asked -- in fact, we were instructed to bend the cost curve downward. this bill will bend the cost curve the wrong way. it will drive up the cost of health insurance for most americans and increase in the total spending on health care. the first word in the title of the bill is "affordable." unfortunately with a trillion dollar price tag this bill is anything but affordable. most people insured now will pay more. this bill breaks the president's promise, if you like the care you have now, you can keep it. c.b.o. has reported the bill

would force millions of americans to lose the health care plans they have and like now. this bill kills jobs and cuts wages. the congressional budget office concludes this bill will result in high -- lower waynes and higher unemployment. it would hit women and minorities hardest. it's hard to believe with unemployment at a generational high that the democrats on this committee would even consider putting more jobs on the chopping block. but if you look at the front page of today's "wall street journal" you'll read the ominous title, referring to the house -- the house proposal, small business faces big bite. house health bill penalizes all but tiniest employers for not providing insurance. despite passage of the stimulus bill earlier this year americans are facing the highest unemployment rate in 26 years. at the same time this committee and the house democrats are attempting to impose new taxes on small employers that will

eliminate jobs for low income minority workers. this bill raises taxes at the worst possible time despite several amendments offered by republican members which the democrats defeated on party line votes. the bill breaks president obama's promise not to raise taxes on individuals earning less than $250,000 a year. the bill would impose a new tax on people without health insurance. this bill will allow washington burets -- bureaucrats to ration care. they tried amendments to prevent that. the bill lays the groundwork for a government takeover of health care giving washington bureaucrats the power to prevent patients from seeing the doctor they choose and obtaining new and innovative medical therapies. this bill traps low income americans in the second tier health care program. despite several amendments, the other side refused to give medicaid patients the choice to access higher quality care. the other side claims giving

patients choices when the choices of a new government run health plan. at the same time they refuse to give low income americans the chance to get out of the worst health programs in the country. instead of giving the lowest income americans the choice to enroll in private churns with generous subsids it forces them to stay in a program where 40% of physicians refuse to see them and the care received is worse than what's available through private health insurance. instead of reducing health care costs this bill spends billions of taxpayer dollars on new pork barrel spending. made a point of that through several amendments. the bill would build new sidewalks, jungle gyms and farmer's markets and create an $80 billion slush fund for additional pork. that's just in the first 10 years. continuing program after that. this bill preserves the costly, dangerous medical malpractice system. again, despite several blocked apartment -- attempts by many republican members the bill

fails to reduce medical lawsuits which drive up health care costs and force doctors to order wasteful tests and treatments to cover liabilities. this bill worsens doctor shortages according to an analysis by the department of health human services. the bill would worsen the primary care physician shortage by providing fewer medical students with financial assistance and working with those in underserved areas. mr. chairman, this bill probably breaks the record for the most markups and amendments filed but that's because republicans were shut out of the drafting process. we were forced to do hundreds of amendments to try and get the corrections we thought ought to be in there. i appreciate the flexibility of the majority and of course we reciprocated some flexibility by the way we're able to do the second half of the bill. without it being second-degree

amendments which are not allowed in the committee and getting half the bill and then another half of the bill. and i do appreciate the acknowledgement of senator dodd and his acceptance of republican amendments. but those amendments were largely filled with technical corrections. we kind of got to tinker around the edges, so all of the substantial bright idea amendments suffered a party line vote. mr. chairman, i hope between now and the merging of the finance and going to the floor, we can correct some of these things. i have a lot of hope for that. i know that there are a lot of ideas that have been suggested here and have been suggested in the finance committee. i'm on that committee as well. and i think there is a bright future for health care reform in america. it cannot be this bill.

it can have parts of this bill but i do passionately want to reform the health care system to improve quality, reduce costs, increase access, and i also like the goal that if you like the insurance you've got now, you can keep it. but i think that this legislation at the moment, meaningfully fails to address those and sticks the american people with a bill we can't afford. i understand the finance committee is the the one that's supposed to take care of paying for it but what we did is add programs and increase costs and make it very difficult for the finance committee but we have that chance at the end of the finance committee process to merge the two bills and come up with a bill that will meet the president's goals -- all of our goals, and so for the reasons i've mentioned, i'd ask my colleagues to oppose this bill. i thank the chairman and am ready to proceed to a vote. >> thank you very much, senator enzi.

and i appreciate your participation and cooperation over the last number of weeks. let me begin -- i'm going to submit for the record because the list is rather long but the staff members last night, judd greg appropriately asked for a round of applause for the staff in the room here, that have not only been here during this markup but as all of us around the table know, on literally every weekend we've been involved in this process, they've worked true the weekend. long nights, emails back and forth in the middle of the evening to try and resolve a lot of the issues we've grappled with over the last 15, 13 days, some 23 sessions of markups, and so i'm going to submit the names from senator kennedy's staff on down through the republican staff as well and i'll go over and check the names but we're grateful to all of you for the time and effort you put in to get us to the point where we have the first bill coming out of either body of the united states congress to grapple with the issue

that's defied resolution through seven presidents and as many congresses through the 1940's, some 65 years. while we haven't crafted the perfect piece of legislation we've now put on the table a piece of legislation that will serve as the basis for us addressing the crippling issue of health care reform in our country. so i thank all of the staff. i also want to recognize our colleague from rhode island, sheldon white house who got thrown into this as a fill-in here in our committee, after the vote here today he will be leaving us and this committee but made a significant contribution to our process and we're very grateful to you. i know our republican friends would love to hear this, you were very instrumental in crafting what i thought was a very creative proposal in public option as well as a number of other suggestions in the process. so we thank you very much, sheldon, for your participation and look forward to working with you in the years ahead on

these issues. let me just share some general thoughts. first of all, as all of you know, in fact i put these little blue bracelets on the table here just to say thank you to senator kennedy, and it was a wonderful program the other evening on hbo called "in his own words" which i'd hoped to have for each member this morning but make sure you all get copies of it before the day is out, sort of teddy talking about his life in the senate over the years. and as i said, i spoke with him this morning and despite my good friend mike enzi's characterization of our efforts here, he is ecstatic about the process here we have in place and thrilled with the effort that we're about to -- and hopefully endorse and that is to send this bill out of committee and to begin the work to begin to work with the finance committee and others to try to meld together a piece of legislation that hopefully in the end we can all embrace and endorse and is a goal i hope all of us would have. we begin this process, as all of you know, with pretty much a

blank sheet, a mandate from our fellow citizens around the country. the american people demanded legislation that protects their choice of doctors, hospitals, insurance plans, cuts costs for families, businesses and the federal government and ensures in the wealthiest nation on the face of this earth and throughout history that everyone have access to affordable, high quality health care. that was the charge we've all received. our fellow citizens urge us to produce a smarter, more efficient health care system, one that would eliminate waste and fraud and abuses and focus on keeping people well instead of just taking care of them when they're sick. and would rely on the expertise of our dedicated health professionals to improve outcomes for every citizen. the american people ask us to recognize the urgency of this moment and the impact our health care crisis is having on them, american businesses across the nation, and to fix things that are broken without ruining the things that aren't broken. most of all, the american people wanted us to act, to set

aside politics and find the health care reform solutions that have eluded presidents and congresses for more than six decades. when we began this process i spoke about the history and marked with too many disappointments and said this time i hope would be different. it is different this time. we've produced a piece of legislation i think americans by and large want. this time we've delivered on the promise of real change. this committee stands ready to take the first step, a giant step, i might add, towards america and america where our health care system lives up to the lofty standards set by our talented health professionals. towards an america where health care is about the patient, not about profits, towards an america where no parent lies awake at night hoping their child's fever goes down because there's no money to take that child to see a physician. towards an america where no grandmother unable to afford the prescription drugs she needs to stay well has to cut

those prescriptions in half to try and stay healthy. towards an america where no one fails or falls into bankruptcy or loses their home just because they get sick and their insurance won't cover their bills. towards an america where health care decisions are made by doctors and patients, not government bureaucrats or h.m.o.'s. and towards an america where you get sick your ability to receive quality affordable care isn't determined by your job, your income or your zip code. and towards an america where people don't have to live in fear that if they lose their jobs, they might lose the insurance they rely on or that it might be taken away from them by an insurance company at the very moment they need it the most. if you don't have health insurance, this bill is for you. it stops insurance industries from denying coverage based on preexisting conditions. it guarantees that you won't be able to find an insurance plan that works with you including a public health insurance option if you want it.

and it makes quality care affordable and accessible to every american family. if you have health insurance, but you still worry about how you'll be able to afford the care you need, this bill is for you. it eliminates annual and lifetime caps on coverage, it stops insurance companies from jacking up premiums and ensures your out of pocket costs won't exceed their ability to pay them. if you have health insurance that works well for you and your family, this bill is for you, too. because it makes -- it will make sure you won't lose it, good coverage isn't good coverage unless it's stable coverage, coverage that can't be taken away, coverage that doesn't slowly eat up your family budget, coverage that guarantees you'll always be able to get that treatment that you need from the doctor that you choose. this bill, this is the bill we've been waiting for and fighting for for a long time, in my view, and i'm proud this has come from this committee because it's only right the bill for which americans have waited 60 years should come

through the committee chaired by ted kennedy who fought for it for decades. by the way, i spoke with senator kennedy this morning and he's very excited about the prospects of us moving forward. when senator kennedy asked me to chair these hearings in his markup in his absence, i decided on two things, one, that i would not let us fail here, that we'd listen to each other, that we'd be civil with each other, that we'd engage where we could to find and add the contributions each and every member could make to this effort. every single member of this committee has contributed to this bill. and i can cite chapter and verse and particular provisions that have included in this legislation because of the contributions of all 22 of you from around this table and every single instance, from the amendments offered by mike enzi to the work of judd gregg in helping us to come the resolution of solvency issue of long-term care and encouraging people to engage in the behavior that would reduce the cost of this legislation by taking responsibility for their own behavior.

lamar alexander and what he's offered in areas of trying to achieve that same result, talking about medicaid issues, richard but, what you've done on education efforts, johnny isakson on numerous pieces of the bill that reflects cost and life decisions people have to make down the road, john mccain obviously in his efforts on prescription drugs, orrin hatch in biologics, lisa makowski in small business concerns and i think had an impact on the decisions we made regarding smaller employers in this country, tom cochran was endless in his offering of ideas and amendments over the last 15 days. when in doubt we had a gap and no amendment could be offered i could count on tom kolb burn -- tom coburn. and pat we thank you on the issues as well and my democratic colleagues, obviously, with tom harken working on the prevention issues in this bill, holding hearings beforehand, helping

develop the ideas, barbara mikulski and the extended bait on how to improve health care qualities and jeff bingaman and pat roberts on the issue of coverage, making a huge difference for us here coming up with the ideas on the pay or play for employers that i think has worked out to provide a reasonable impact as well as making sure that everyone is going to be covered or at least most americans will be. patty murray and the efforts on the work force made a significant contribution and we thank you immensely for the efforts to ee see people get the help they need in the nursing profession and the primary care needs of our nation. jack reed you made a number of contributions yesterday, specifically in a number of areas that have been worthwhile and you're working on orrin hatch on the follow-on biologics issue and so forth and was able to achieve what he wanted despite the differences in the committee, bernie sanders obviously on what he offered in quadrupling the number of penalties that would be imposed on those who engage in the fraud and abuse, to try

to discourage that behavior in our country. sherrod brown on biologics and a number of other areas. while we didn't prevail with your ideas specifically this process will go forward and i'm sure there will be a compromise. bob casey, you made significant contributions on small business ideas along the way, kay, your work, being involved earlier on some of these problems in how we deal with the public opposite or how we deal with the pay and play issues and your work yesterday on providing for the part-time workers and seeing we don't discriminate against smaller employers with part-time employees and jeff hurricanele with the idea with the -- jeff murkle to provide the support to have intelligent people making the decisions that are needed. and sheldon, the work you provided in dealing with the public option, dealing with liability questions and the like have been a significant contribution. every member of this committee has made a significant contribution. we considered 200 amendments

offered by my republican friends, 160 of them were adopted this committee and some were technical and substantive. almost a 1/4 of the united states senate has been engaged almost 60 hours in a discussion about this critical issue and this is a far better bill, even if you don't vote for it, you've made a significant contribution, and obviously the process is not completed yet. this goes forward now to begin to work with others to try to fashion this. there's a reason why every other congress and every other administration has failed at this. this is hard. this is hard. it's 1/6 of our economy. it's no longer unacceptable, it's unsustainable and we've got to figure it out and why we're sent here. despite our differences we need to come up with a common answer. as difficult as it is, and it is hard, but i believe based on the determination i've seen around the table the last five weeks we can achieve that result in the coming weeks. we have a president who is

deeply committed to this, has suggested publicly he's prepared to literally expend every bit of political capital he has. i never heard an american president say this about any issue, he's willing to expend every bit of political capital he has in order to achieve a reform of our health care system in this country. that's an incredible commitment by an american president. i'm very grateful to all of you for the contributions you've made. i got saddled with this responsibility obviously at a late hour and you've made my job easier because of the civility, the decency, the common determination to sit around this table despite other obligations and other committees you have to come to this point where we are and the position to adopt even by a partisan vote. and i wish it were otherwise but i know worry not done with this. and as i said, orrin hatch and i were together earlier this morning. our goal is to write a good bill. if it's a bipartisan bill, it's even better in my view. but it's a good bill. it's got to be a good bill. and i know there are

differences here but we've made significant process. we think we've crafted a good bill dealing with prevention and quality and work force issues, dealing with bringing down costs, increasing accessibility and doing so at a price the american people i think can live with. it's not inexpensive but a lot less expensive than the predictions were earlier. so again, my thanks to all of you for allowing us to come to this moment. we owe it to our fellow citizens, 14,000 people a day lose health care coverage. it's a staggering cost. and we bear responsibility to try and relieve these burdens and fierce that too many people have in our country because they worry about the ability to take care of themselves and their families on this issue. so with that my fellow colleagues, i'm prepared to stay around after the vote for those to add comments of their own but i want to move along because the judiciary committee and other obligations people have. >> mr. chairman, before we vote, there was one member that was not mentioned for an expression of thanks. i think on behalf of the

committee we'd like to thank you. you stepped in for really an enormous job under significant stress. you are the chairman of the banks committee which in and of itself is a 36-hour day. so -- and with your usual loyalty to the institution, your friendship with senator kennedy that you stepped in here to the task, you stepped in here with enormous skill and self-sacrifice. so i think on behalf of all of us on both sides of the aisle, we'd like to thank you for the leadership that you provided, you provided both in forum, almost unlimited debate and opportunity to offer ideas and showed that if we function with civility, focus on content and remember we have a duty to our

country, we can prevail and you provided that. leadership is about creating a state of mind and the state of mind you created in this committee, we had a big job to do and needed to work hard to get it right and we needed to act right with each other, so we want to thank you. >> thank you. i appreciate that. [applause] >> ok. the clerk will call the role. >> senator dodd. >> aye. >> senator harkin? >> jie. >> nor mikulski? >> aye. >> snore murray? >> jie. >> senator sanders? >> jie. >> senator brown? >> aye. >> senator hagan? >> aye. >> senator americaly? >> aye.

>> senator enzi? >> no. >> nor greg? >> no. >> senator alexander? >> no. >> senator isakson? >> no. >> senator mccain? >> senator mccain is on the floor doing the defense authorization, no by proxy. >> senator half? >> no >> senator mckowske >> no. >> senator colbrunn? >> he's in the judiciary committee getting his opportunity to do the questions on the supreme court justice, by proxy, no. >> senator roberts? >> no. the vote is 10 ayes. >> for all the obvious reasons, here in spirit. both aye and spirit. >> chairman kennedy? >> aye by proxy. >> the vote is 13 ayes, 10 nays. >> i thank my colleagues. i move to report the bill as amended.

[applause] >> thank everyone. john ward and upward. i was going to invite the members to come up here and get one photograph of this committee. we won't meet again on this issue as a committee. lamar, before you run off. get the members to gather and we'll take one committee photograph.

>> i authorize the staff to make technical changes. how are we doing? ok. all right. very good. ok. thanks again. >> one more. >> one more. all right. >> come to the center here. yeah. >> thanks. >> ok. very good. committee stands adjourned. that was great.

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republican amendments. even though this wasn't a bipartisan vote, it's a bipartisan effort to produce this bill and every member of the health committee made a contribution to this product and i'm grateful to them. particularly i want to thank senator bingaman, hart, and murray who took on the responsibility crafting the ideas dealing with prevention, quality, coverage and work force issues and did a fantastic job. we miss ted kennedy. he was here in spirit. i talked to him this morning earlier. and he was very excited about

this fact that his committee would be the first to mock up a bill and send it to the floor. obviously we need to mail a bill to the finance committee as we move forward. but most important, beyond the relief we feel, for millions of americans, those who have too high a coverage, too high an out of pocket suspense, this is a response to them. they deserve better in a country of this great affluence, of this great ability, with the professional class we have in our health care area we ought to be able to do a lot better than we've been doing. we spend more and get less for a health care system than americans deserve. this bill, because of what we've done, they think is -- we think the -- is going to increase access, reduce costs to individuals and improve the quality of health care in our country.

we're going to have to make some investments to achieve those results but we're prepared to do that. this is an important moment. we may never get another chance to do it. it's not only unacceptable, the health care system, it's unsustainable and we're determined to get it done in this country -- congress and we have a president who's prepared to spend whatever political capital is required to get this accomplished. that makes us give the synergy and the opportunity to do what every other congress has been unable to achieve for almost seven decades. with that, let me turn to senator harken and the rest of my colleagues. >> mr. chairman, thank you very much on your great leadership on getting us over the finish line. it's been a long side but we all worked hard and we all stuck together. we now have a bill that does

four things. it reduces costs. it accepts choice, it ensures coverage for all americans and also begins to change our system to be a health care system rather than just a sick care system. as president obama has said many times, that prevention and wellness and public health is the one way we can change the system so we can keep costs down in the future. and in this bill we have made great strides forward in putting more emphasis on prevention, keeping people healthy in the first place and keeping them out of the hospital. i think this is a good bill for maersk. it is the right prescription for what ails this country right now and i want to thank all my colleagues for all the great work they did in sitting here through all these hours and drafting a bill that i believe will get a lot of

support in the senate and i believe we'll get it over the finish line sometime this fall and we're going to have this on the president's desk sometime early this fall. >> well, today we meet our responsibility to the american people by now providing universal health care coverage to all americans. health care coverage that is available, undeniable and affordable. available to all without any discrimination on the basis of a previous condition, a no discrimination on the basis of gender. if you are a mother dealing with an autistic child, you will be able to have the doctor that you need when you need it and no one can then deny that care. we make it affordable by focusing on new thinking in

prevention and quality that we know through our quality initiative, whether reducing needless errors, needless hospital readd admission -- -- readmissions, we can save over $5 billion in our health care system. if you have something you like you get to keep it but if you need something knew -- new, you can find a new gateway. we regret that the republicans did not support this bill, even though we gave them hours of debate, opportunities to offer unlimited amendments and to be able to speak their mind, vote their will, but at the end of the day, they did not want to support universal health coverage for all americans. so it's a question of on whose side are you? we stand here today on the side of the american people.

we stand here on the side of american providers, where we want to get rid of their hassle so they can do value-based care. we stand on the side of history that says we, the democrats, know how to do a social contract with the american people that provides them with a safety net in terms of the health care they need. and i want to thank senator chris dodd for the leadership that he provided. he stepped in when needed. he provided the leadership that was called for and he provided the skill and openness and transparency of the debate that i think truly honors this committee and the senate. chris, we thank you and i thank my colleagues for all of their hard work and their great contributions. >> well, i want to join everybody in glatting senator dodd on his leadership and success in this process. i do think that as part of this

mock-up, we have had to make tough decisions on the key design elements in a health care reform bill, and that includes the design of a public option, it includes what kind of a responsibility we'll put on individuals, what kind of responsibility we'll put on employers, what will the impact be on small employers, all of those decisions, i think, have been made very well in this legislation and this is one piece of legislation that will now compete with others that are working their way through the committee process, both here in the senate and in the house, and i think when our colleagues look at the different places you can come out on these issues, they will find that we have made a very balanced and wise decisions in many of these areas, so i particularly congratulate all my colleagues. i think this is a good work product and the process that

senator dodd set out for us was a fair one-and-one that got us to this point. >> first let me thank senator dodd for the tremendous work that he has done over the last months putting this bill together and bringing together everybody's ideas about health care reform. i know he did it with senator kennedy sitting on his shoulder and we truly thank you for the great job you've done. a few months ago health care reform was hundreds of different ideas and bills. today this committee has brought together an inclusive bill that really focuses on the needs of our families out there, from prevention to quality care to coverage to the work force, to make sure that our families that are out there today, who don't have access to health care, who can't pay for it when they do or don't feel they have a choice about the personal decisions they make, this is a major step forward. i was very proud to work on the work force side of this because

providing access is critical but without the doctors and nurses and health care providers to provide that care, we'll never achieve access. this has a major component to make sure that all americans do have access to the health care work farce -- work force they're going to need. we look forward to see that the finance committee does, to get to the floor of the united states senate and tell the people we respect across the country that the united states senate and congress is dealing with the most important issue of the day -- making sure that people in our states have access to health care. today i stand here and think about a young boy that i mentioned at the very beginning of this mark-up, a little boy named marcellus, who lost his mom. she lost her health care because she lost her job. she couldn't see a doctor, and this young boy lost his mom.

today we are a step closing to ensuring young boys like marcellus and americans everywhere that they will not be denied health care coverage. >> any questions we have? >> can you give an example of something that -- [inaudible] >> there are numerous things. i went through and identified every republican contribution. judd gregg made a contribution dealing with the solvency of the long care professional. the issue that tom harken worked on to see to it that there would be rewards for employees who took on the responsibility of reducing the exporsche of the health care problems. working with greg, obviously orrin hatch. the work that benjamin did with moscow ski on small issues. there were numerous contributions. and the republicans made it a

better bill and that's the way it's supposed to be. i regret they didn't feel it was significant enough for them to support our bill at this point but i've been around long enough to know that isn't always the case in the final analysis. i still believe we can achieve that bipartisanship, but the important thing is a good bill. getting a bipartisan bill that doesn't do anything for the people who are depending on us is not going to be well-received. a good bill that is bipartisan has a chance of being achieved. but i will not sacrifice a good bill for that. the people we're working for are not our colleagues but the american public. as members of the united states congress we have very good health care. it's for the millions of our citizens all across the country who either have little coverage

or no coverage, who are losing jobs, losing health care coverage. there's the issue that needs to be addressed. >> crowd you sebringing this -- could you sebringing this bill to the floor and perhaps adding some provisions to it? >> i'm confident max and baucus will get a bill. he's a -- he's a good friend. he's got a tough job in the finance committee. i have a lot of confidence in max, who will go get the job done. we'll bring our two bills together. we've dealt with the major structural matters of health care that will work with the finance committee and put together a strong bill for our colleagues to support. >> you don't see this coming to the floor on its own? >> i don't think it will be necessary. >> you said the president is willing to spend his political capital. has he or his staff given any indication of what that means?

what is he going to be doing? >> he already has, beginning the summits. i'll be leaving here and going down with him later this morning. he'll be talking with nurses about their contribution. he's been deeply involved and i have every confidence the president is going to be deeply engaged with this process. supporting our efforts, bringing us together to get the job done. that's the job of a president and this president i think is deeply committed to doing everything he can to achieve this result. he cares deeply about this issue. i've listened to him over and over again saying how much this means to our country and on his watch he's determined to dealt get this done. >> you said a good bill is more important than a bipartisan bill. do you think it will take republican votes to get it through the senate? >> it may. again, we have 60 votes. but the ideal thing is to have all of us working together on

this. and that's certainly my goal. i'm not opposed to that idea but i don't want to lose sight of what our important objective is, and that's a good bill. a good bill will pass but it's going to be better if we have bipartisan support. that's what we've done over the last 15 days. that's why there are between 250 amendments of the 500 or so we considered that came from the republican side what that we dealt with. 161 were accepted. some were technical, many were very substantive. while that wasn't enough to bring them across the finish line i think we have a better bill because of it and i'll continue to work with them to bring more of them on their side. that would be the ideal goal. >> [inaudible] the senate health care bill -- [inaudible]

>> we addressed in the committee and we like the idea that people have choices. here the law of the land permits the people to make those choices. we respect that and we're going to pursue that. we don't want to discriminate people who have convictions, moral and lidge use. but also in states of emergency we don't want someone to be denied health care. i think we handled the issue well. >> senator, is there any particular area where you're confident that fighting -- as it stands now? >> i don't know. i haven't had that conversation yet. obviously the most conversations will begin now that we finished our work.

but i'm confident given what we've done that a good part if not all of our bill here would be adopted by the finance committee. >> what is your feeling on the tax that the house democrats are -- >> the responsibility of this committee is obviously we have to try to fix ways to pay for all of this. a lot of it we tried to achieve with our bill dealing with the waist -- waste and fraud issues. obviously we'll have to grapple with other funding mechanismses for it and i want to defer to the committees that have the responsibilities of doing that. we finished our job. our job was not to come up with that answer. ultimately we'll have to engage in it but partnership pep -- at this point i don't want to prepreclude any idea that would provide the resources necessary to finish the bill. >> thank you.

>> got a road ahead. maybe three or four. you ok? [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> the senate health committee today passed health care legislation voting 13-10 along party lines. the measure must be combined with the health care bill making its way through the finance committee before moving to the full senate. republican a-- reaction. >> the president said that we needed to drive down the cost of health care and that it should be paid for. that bill gets an f. it does not cover any of those things. it's a tragedy because haveg affects 1/6 of the american economy. it affects every single american, every single business, every single provider. this is the most comprehensive thing that we have ever addressed in the united states

senate because we've never had anything that affected everybody. it's important that we get it right. that bill got it wrong. we tried through a long process of amendments to get it right. we had to do it through amendments because the democrats drafted the bill and i do remember in the election they said we won the election, we get to draft the bills. but that's not bipartisan. the only way we had any input was to do amendments and we did a bunch of them to point out the flaws in the bill. i hope people will look at that and we'll talk about that some this morning because this bill will not meet any of the presidential goals. we've had speed in the drafting process, we allowed the bill to come to committee with only half of it drafted and later we got the other half. the reason the other half didn't come is because it drove up costs even more. we're talking about a

trillion-dollar problem this bill will cause and cover less people. it's a travesty for small business. i have some other people here that will cover a number of these issues. but the bill fails what it was set out to do. i hope there's still a chance to correct it for the sake of americans. they need to be coverage, they need to have portability. we had five republican bills that answered all of the things the president said, all of the goals that we set out. we had to do those through amendments and they are virtually turned down. the impression kind of we got was if it was suggested by a republican it has to be bad and that's bad for maersk. i'll call on senator gregg for some comments. >> thank you, senator and thank you for your leadership during these last few weeks. the president, throughout the first -- threw out the first pitch last night for the all-star game but today the

democratic committee struck out on the president's initiatives of health care. he said all americans should be covered this. bill leaves 34 million people uncovered. second, the out-year cost curve should be bent and we should get it another another -- under control. this bill adds over a trillion dollars potentially to the debt of the united states. and thirdly he said nobody should lose their health care if they wanted to keep it -- their health insurance. this bill doesn't reach that issue either. in fact, people are going to lose their insurance under this and actually lose their job. according to the study, small business will be massively impacted by this and lots of jobs will be lost in maersk. there are ways to accomplish what the president has proposed when we can cover all americans, bend the out-year costs of health care and make

sure that americans who like their health insurance get to keep it. it's regrettable we were not allowed to be at the table when this bill was drafted. it was equally regrettable that when he -- we dimmed offer amendments which in many ways addressed the issue that the president has raised, they unfortunately failed because they came from our side of the aisle. >> thank you, mike. the president stated very clearly at the start of this process that health care was unsustainable on its current path. today it's 17% of our gross domestic product. we agree with the president, it is unsustainable today, and the goal was to produce a health care system that reduced the cost of health care over a period of time and made the future sustainable and predictable. well, we have anything but that today. tom coburn and i did offer a

complete substitute to the bill, one that checked all the boxes that senator gregg just talked about it. it assured that every american was covered. it ashoulder that the right investment was made in prevention, wellness and disease management, the only things that bring the costs down in the future. and yes, it passed the test of being financially sustainable well into the future. not only did us the bill passed today fall 34 million americans short of full coverage, it is unsustainable forly and it actually will -- financially and it will penalize americans that are happy with their health coverage now that will affect their future and possibly who their provider of

choice might be. we're headed in the wrong direction dr. -- direction. there are only two numbers you need to remember from the whole process and that's 13-10. when it was a republican amendment it was defeated 13-10. when it was a democrat amendment it was passed 13-10. >> thank you. senator isakson? >> thank you, senator lindsey and thank you for your work. i want to focus on one specific point to talk about, how we did not put all the patient nor all the issues on the table. the president stated fully one of the things he wanted this to accomplish was to begin a downward curve on the cost. one of the factors is frivolous lawsuits and the tort issue. on four different cases in the committee. members talked about our offered amendments that dealt with frivolous lawsuits and runaway verdicts.

not to keep someone from being rewarded to the full extent of damages if they were injured, but to give the judge the authority to lift caps only if the evidence in court proveed that there were bad damages. no chance to even bring that up or talk about it. so one of the more significant contributors to cost, something we could have really done something about to level that curve was rejected unanimously. >> senator? >> we're going in order of seniority? >> i would -- >> you always have to defer to that seniority level there. i think as we look at the process that we just went through in this health committee, it's important to recognize what happened and what didn't happen. we're kind of having competing press conferences here this morning and on the democratic side they're saying that this

was a bipartisan process, that many republican amendments were accepted, and that while the vote may have been 13-10 that there was a level of fairness throughout. let me just give you an example of the amendments that were accepted from my self. we had about 20 amendments accepted. that's pretty impressive for a republican, but they were all technical amendments that spoke to -- in my situation -- making sure that the language within this legislation allowed for indian tribes to be participants whether they be in health care grants or what have you. so we had gone through the draft and ensured that there was a level of "equity" provided for our tribes across the country. each one of those was counted as accepting a republican

amendment and now somehow or other this is a fair process, a bipartisan process. the other -- some of the other points that need to be raised with this legislation, and my colleagues have done a good job in outlining them, but when we talk about the impact to small bids, i think it's important -- business, i think it's important to recognize that things can go on on one side of the hill and through our laws of unintended consequences we can really foul things up on the other side. right now the administration recognizes with small businesses that where this economy is going is having a very, very painful impact on small businesses around this nation, the businesses that keep this nation going. so they're looking at possibly using tarp funds to provide for a level of bailout. whether or not you know that's right or wrong, that's one of the considerations. here in this committee, we've said, ok, small businesses, we're going to assess a pretty

substantial tax to you. if you are an employer that has less than 25 employees, you're ok, but if you're a small business that has, say, 50 employees, you're going to be taxed about an additional $20,000 to you. on the one hand they're saying we're going to give you a temporary bailout but we're going to impose on you a tax for the long term. if the small businesses can't pay that, they're going to lose their jobs, they're going to shut their doors, we're not helping. one of the things i've been encountering is the access issue in rural maersk. about 17% of individuals in this country, according to medpac has limited access to a primary care provider. they're just not there. and what we're doing through this legislation is squeezing it down. we're saying that the

reimbursement rates under a government run plan may be even less than what medicare is paying now. my doctors in alaska are saying we can't participate in that. so where do our people do -- go for care? we might be giving you a card that says you're covered but if you don't have a provider that can't see you and address your medical needs, we haven't provided anything for americans. >> all of us republicans are committed to the prospect that we need to reform health care in maersk, but our principle and our fundamental belief is that health care has to be available and affordable. the problem with health care is not the quality in maersk, it is the cost. let me point out that this legislation has not one single provision that is aimed as reducing the cost of health care. glaring in its absence is any

medical liability reform. not one provision, and everybody knows that one of the major contributors to the increasing cost is the requirement of doctors to practice defensive medicine for fear of appearing in court and having high legal bills and the cost of their health insurance. there's not one provision in this bill that reduces the cost of health care in maersk. and -- in aamericana. we have to consider what we've just done, by the way, when the committee passed this bill out, without knowing the cost of billions and billions of dollars in provisions that we passed by a 13-10 vote. here we are with the highest deficit in history in peacetime with a bill that is going to top over a trillion dollars

with no way of paying for. the bill will tax small businesses who can't afford to pay more and will lead to job losses. the c.e.o. says pay or play. it could reduce the wages of workers. the bill employees a government plan that c.b.o. says will force million of americans out of their current coverage, out of the coverage that they now want and believe in and into the governor -- government plan. that's not keeping what you have if you like it and it will leave millions of americans un ininsured. elections have consequences. this is a glaring example of that. we have now committed another act of generational theft. of laying an unsustainable fiscal burden on futures of americans. and the whole procession we've just been there is -- through is one of the least savory and

most bizarre that i have been involved in this my years in the united states senate. >> senator hatch? >> i think my colleagues have summed this up pretty good but let me just take, with senator gregg's permission, a copy of a letter from senator gregg to mr. el men defensive, the head of our congressional budget office. i won't reeled the whole thing but i thought i'd read just a couple of -- part of one paragraph that i think kind of sums this up and backs up senator mccain 100%. it says c.b.o. has not yet had time to produce a full estimate of the cost of incorporating any specific medicaid expansion in the health committee's legislation. however, our preliminary analysis indicates that such an expansion could increase

federal spending for medicaid by an amount that could amount to over $500 billion over 10 years. that's what they haven't told you. they haven't told you that intend to go with this medicaid expansion that will cost $500 billion more or even more. along with that, would come a substantial increase in medicaid enrollment, amounting to perhaps 15 million to 20 million people. this would have some impact on the number of people obtaining coverage from other sources, including employers. all told, the number of nonelderly people who would maintain uninsured would probably decline to somewhere between 15 million and 20 million. for comparison, c.b.s. analysis found that absent any expansion of medicaid or other change in the legislation, about 33

million people would ultimately remain uninsured if it were to be enacted. i don't care who you are. they're spending too much, taxing too much to get us there and they're writing legislation that is totally partisan that isn't going to work. you know, you're talking about moving people into a government plan like medicaid and medicare. medicare alone it's estimated is 33 trillion dollars in unfunded debt. 33 to 39 trillion dollars. even the president has said these medicaid and medicare are -- and social security are unsustainable in their present form and yet they're adding even more of a burden to those costs. and let me tell you, this isn't some republican making this point. it happens to be the head of

c.b.o. who's a straight shooter. i've been very impressed and i have to tell you this -- health care reform is not a democrat nor a republican issue. it's an american issue. but from the start of the debate, democrats have -- yes, they've taken a lot of amendments, mainly technical amendments. and there have been some amendments that they've had to take because we've gotten enough votes to put them in. but when we turned our efforts to offer valuable amendments, by and large, most have them were turned down by straight party line sthrote -- vote. our national dealt tripling within the next decade and with 50 cents of every federal dollar of spending being deficit financed, here we're going to spend another 1.5 to two trillion, if we're lucky to, fix a system that's already

way overpriced. medicine care right now is the future cost of $39 trillion or almost $300,000 per family. this bill creates another washington-run bureaucracy. to make matters worse, the employer mandate will without a doubt kill jobs at a time when our unemployment rates are approaching 10%. i'm extremely disappointed and sad to say that it is not the people in this stage who will be hurt by the democrats' partisan approach. it's all americans. if this bill becomes law, americans will not only see a government borrow accurate step in between them and their doctors, they will see their health care costs rise and there is a strong chance they could lose their current coverage. i'm disappointed that the obama administration may give up on a

bipartisan solution too. while they say it's a priority for the president, he may not roll up his sleeves. i think it's high time he does, make his objectest clear and work with us on a bipartisan solution. i believe we can asheaf a bipartisan bill to ensure quality coverage for american families. hi amendment on follow-along bionics was a great example for bipartisan accomplishment when we put our differences aside and passed rather overwhelming in the committee after a really tough debate. let's not just get it done. let's get it done right. i and the other members here today are committed to bipartisan health care reform to assure quality, affordable and quality health care for every american. it's the least that our fell americans deserve. >> this is getting to be an

unfortunate and familiar refrain. more washington debt, another washington takeover. we republicans had several proposals on the table, including a bipartisan proposal that would have gone in a completely different direction. our goal is to reduce the cost of health care for every american and when we're finished to also give americans a government that they can afford. this bill doesn't do that. the gregg proposal, the proposal by senator burr and senator coburn, the bipartisan proposal that 14 senators, the widen-bend proposal, which i'm a co-sponsor of, would have created dollars for low-income americans to buy more of the same kind of insurance the rest of us buy. it would have done it without adding to the government debt, without creating a government program. that was rejected in favor of this proposal, which is the first step to medicare cuts to,

higher state taxes, to more federal debt to, higher income tax to, expanding one failed governments program and creating another. the medical proposals that senator hatchell talked about will bankrupt states from fully limp -- imply yetted. the idea is going to be dump another 15 or 20 million americans into a failed program and after five years shift the amount of the states. the amount it will cost the state about equals a 10% income tax. that will will discovered as time goes along. the president has said we need to watch our entitlement spending. he said in early june we need to pay as it goes. he said two weeks ago let's make thure that health care is paid for. for us to know exactly what this costs will take several

weeks of work by the budget offers. if we take the president's advice, we won't move ahead until we know exactly what wall of these programs cost so the american taxpayer can know before we vote. >> thank you. we've -- you've got on the hear from a number of members of the health education and pensions committee. you heard what just passed out of committee on a partisan line covers too much, covers too few and kicks people out to have to coverage they have right now. senator gregg raced an interesting point from the budget committee that there was a long-term care provision, that was going to provide $59 billion in extra revenue. an accounting trick. they only count the revenue that comes in because nobody could use the long term care another after the budget window closed. at the end of the wroiled

there's a $two trillion cost. so we did have an amendment that they were embarrassed not to pass. so the front end covers the $2 trillion in costs. that's just one example of the things in this bill that drive the costs up. there's a provision in there for health care prevention. yeah, i guess you could call it that if you really stretch things. it provides a slush fund, a slush fund, man -- mandatoryly, each year of $10 million -- billion. that money could be used for jungle jimmings and buying farmer's markets. it's something that has been dreamed of for earmarks for a long time and it's going to be instituted through this bill. we're going to drive doctors out of the system and we're going to have a little thing

called the government option. the way that fails is we're going to have 119 million that are going to be forced out of the insurance they have now into a government plan. in fact, if it's worked the way i suspect it will be, everybody will be forced into the government option if that continues to exist. we have something new in this bill called the clinical effectiveness research. that's health care rationing. that's cost effectiveness, not clinical effectiveness. we tried a number of measures. the united kingdom has a system with quality of life year. that means the older you are the less care you get. the long -- older you are the longer you have to wait to see a doctor, the longer you have to wait for tests, the longer you have to wait for team. the people buy. that's not the system that we'll buy in maersk. we will not settle for our older people dying. we will not settle for long waiting times for anybody.

we're not used to that. it's culturally impossible. that's just a few of the things that this bill does. there's a long process yet. we hope that there can be some corrections in this, that can move to some of the solutions we have. there were five republican plans. 10 months ago i won't -- went on a tour of rhyme wyoming with my 10 steps for health care. it would have covered everybody, driven the costs down. gregg had one. coburn had one. i should mention that senator wideen and senator bennett had won two. all of those meet the president's criteria, none of those are used. so we appreciate this opportunity to bring our case to the nation and we know that the american people already understanding. they're understanding at greater rate every day and this bill will have to meet the

criteria that's been set out by everybody because it affects everybody. so we thank you. are there any questions? >> for and you senator hatch. you're now in bipartisan negotiations over the finance committee and i wonder if you would comment on the status of those negotiations -- and then also if any of you want to comment on president obama's -- on this house tax on wealthier americans to pay for haveg. >> in the finance committee nothing is going to be final until everything is final. there are a lot of proposals being thrown out for ways to pay for it. we have some criteria for how that has to work. it cannot be at the expense of medicaid can and medicare. it does have to be paid for. we want it paid for out of health care items, not by a general tax to the people.

and that's a good possibility if we don't keep it to health care. again, a lot of ideas there and we don't try and negotiate those through this kind of a situation, but i'm hopeful that in the finance committee we'll have a better hearing than we had in the health committee. senator? >> well, i'm -- i really question whether there's that amount of money in that 1% surcharge for people earning over $350,000. 3% over 500,000 and 5.4% additional over people earnening over a million dollars. they use that money to expand their businesses and create more jobs and so forth. in the end if they get socked, you're going to lose more jobs. then they have this pay or --

play or pay thing they're trying to get over. there are so many things wrong with what they're proposing it's unbelievable. we do have a number of republican plans that have not received the notoriety, naturally, that these two committees have in their efforts, but which would be much less expensive, do the job a lot better without bankrupting the country and keeping, you know, keeping the current programs at least alive and running. so, you know, i agree with the distinguished chairman of this committee, that they're just going to tax us right into olive onif we allow them to have this kind of bill and they're going to spend us even more than they're taxing us. that's why i read that just one paragraph. he's a straight shooter and i can tell you right now that they're hiding a lot of the

costs with budget gimmickry. and it's not fair. senator alexander is 100% right. this medicare expansion -- medicaid expansion is going to be left to the states because the federal government cannot afford to keep it going once they implement. so the states are going to get hung with it and it's going to bankrupt almost every state in the union if that's what happens. that's not good government. that's not good legislation, and we want to work with our colleagues on the other side but when you keep talking about the central point of this as a government plan that basically is going to dictate one size fits all form of government health care from washington, we know that we're not going to have the innovative and great ideas it will take to have a great health care system. >> senator hatch offered a high-tech method -- talked

about it -- >> imes, i couldn't hear you. >> last week we offered a high-tech amendment? >> the way the bill is written right now they can ignore -- which has been law now since 197 and pretty much settled law. in other words, almost everybody has said this is what it should be. now the language of this bill is a way of circumventing that law and having the taxpayers pay for abortion. i don't care who you are, that is not the right policy. and let me tell you, we start down that road, the bipartisanship is going to be even less in both lobbies. and in the end, we'll have less effective health care.

now some said well, it doesn't really affect the hyde language. of course it does. if you read it very carefully it's a way around the hyde language. i think it's a terrible mistake. we've been able to get along because the hyde language said taxpayers shouldn't have to pay, especially those who don't believe in abortions should not have to be paying for abortion for those who do. it's a pretty almost irrefutable argument. at least one of the polls show that finally now a majority are oposed to abortion in this country. whether that's true or not i don't know. i know that it's narrowing for sure. i can tell you, people are getting awfully tired of this mass slaughter of innocent children. i think what brought that to moat -- most people's attention happened to be the partial abortion debate. when people realized that a

fully grown infant capable of living outside the mother's womb is pulled out. they ram scissors into the back of the head, extract the brains and pull that child out and say it's not a living human being, it's immoral. that's why that particular bill didn't pass but it brought home to everybody how brut some of these approaches are. >> senator, how confident are you that the finance negotiations are going to produce a bill that republicans can sign on to and if republicans object to that bill the way they have with the health bill that -- does that mean that reconciliation is the only avenue available to the democrats? >> actually, i don't think reconciliation is an avenue available at all. it leaves holes bigger than swiss cheese. i'm hoping that the finance

committee bill will be more bipartisan. i appropriate the -- appreciate the openness that senator back us has had. i don't know if he's going to be allowed to take the time to actually make it bipartisan. if he doesn't then the health bill will be the bill. i'm also very concerned about how the merger of the two bills will work. we did a pensions bill. that was a two-committee i.b.m. finance and help committee. we worked that through in committee and then we had to merge the two and when we did, it took the approval of both the two chairmen and the two ranking members before the bill could be put together. i suspect this won't be the case on this one in light of what we just did in the help committee. but how they merge and whether any of the provisions that were able to put into the finance bill ever make it into the final bill we don't know.

but if this is going to be bipartisan, if the american people are going to be convinced, it needs to be bipartisan. it needs to have the support of about 80 people. that will show that we've covered the goals, filled the loop heels and it will work. fit winds up just 60 votes or 61 votes, it will be the most liberal bill that this country has ever seen and it may do things that we will never be able to correct. thank you. >> the senate finance committee must also complete work on its health care bill, which is estimated to have a $1 trillion price tag. no date has been set for those meetings. senate and house leaders have both said that they hope to pass each of their haveg bills

before the august recess. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> live coverage of the confirmation hearing or scrout justice nominee sonia sotomayor -- and coming this fall, tour the home of maersk's highest court, the supreme court on c-span. >> at the white house today, president obama praised senate democrats on the health committee for passing health care legislation. none of the republicans on the committee voted for the bit be -- bill. it must be combined with a different bill making its way through the finance committee before heading to the full senate. from the white house rose garden. this is about 10 minutes. >> hello, everybody. good afternoon. i am pleased to be joined by not only some of my former

colleagues and outstanding legislatures but also by nurses and i think i've said this before. i really like nurses. and so to have them here today on behalf of such a critical issue at a critical time is extraordinary. let me introduce a few of them. we've got becky patton, who's the president of the american nurses association here. raise your hand back this. we have dr. mary wakefield, who's a nurse and happens to be the administrator of the health resources and services administration at h.h.s. our highest ranking nurse in the administration. we've got keisha walker. an r.n., currently a senior research nurse as johns hopkins. we have dr. rebecca wiseman, nurse and assistant professor of adult health at the university of maryland school of nursing.

i'm also joined by representative johnson, representative capps, representative mccarthy, chairman george miller and my friend chris dodd. i am very pleased to be joined today by the representatives from the american nurses association on behalf of 2.9 million registered nurses in maersk. men and women who know as well as anyone the urgent need for health reform. as i said before, i have a long-standing bias towards nurses. when sasha, our younger daughter, was diagnosed with a dangerous case of meningitis when she's -- she was just three most old. we were terrified. we were appreciative of the doctors but it was the nurses who walked us through the entire process. when both my daughters were born, the on city tradition was

one of our best friends but we saw her for about 10 minutes in each delivery. the rest of the time what we saw were nurses who did an incredible amount of work in not only taking care of michelle but also caring for a nervous husband and then later for a couple of fat little babies. so i know how important nurses are. and the nation does too. nurses aren't in health care to get rich. last i checked. they're in it to care for all of us, from the time they bring a new life into this world to the moment they ease the pain of those who pass from it. if it weren't for nurses, many americans underserved in rural areas would have noack says to health care at all. that's why it's safe to say that few understand why we have to pass reform as intimately as

our nation's nurses. they see firsthand the heartbreaking costs of our health care crisis. they hear the same stories that i've heard across the country, of treatment deferred or coverage denied by insurance companies -- companies of insurance premiums that are so expensive they consume a family's entire budgets. or americans forced to use the emergency room for something as simple as a sore throat audience: boo! they can't afford to see a doctor. and they understand that this is a problem that we can no longer defer. we can't kick the can down the road further. deferring reform is nothing more than defending the status quo and those who would oppose our efforts should take a hard look at what it is they're defending. over the last decade health insurance premiums that risen three times faster than wages. deductible and out of pocket

costs are skyrocketting and every day we wait to act, thousands of americans lose their insurance. some turning to nurses in emergency rooms as their only recourse, so make no mistake, the status quos on health care is not an option for the united states of maersk. it's threatening the financial stability of families, businesses and government. it's unsustainable and it has to change. i know a lot of americans who are satisfied with their health care right now are wondering what reform would mean for them. so let me be clear -- if you like your doctor or health care provider you can keep them. if you like your health care plan, you can keep that too. but here's what else reform will mean for you. and this is for people whomp health insurance. you will save money. if you lose your job, change your job or start a new business, you'll still be able to find quality health insurance that you can afford. if you have a preexisting

medical condition, no insurance company will be able to deny you coverage. you won't have to worry about being priced outs of the markets, one illness leading your family into financial ruin. that's what reform means, not just for the unsure is but for the people who have health insurance right now. the naysayers and the cynics still doubt that we can do this. but it wasn't too long ago that those same naysayers doubted that we'd be able to make real progress on health care reform and thanks to the work anke committees in congress, we're now closer to the goal than we've ever been. yesterday the house introduced its health reform proposal. today, thanks to the unyielding passion and inspiration of our friend ted kennedy and to the bold leadership of senator chris dodd, the senate help committee reached a major milestone by passing a similarly strong proposal for health reform.