americans lack the fundamental reassurance they need to know that if they or a loved one gets sick, they will get the treatment they need without being bankrupted in the process. we know the statistics. 50 million people are not covered. i think it is the personal stories that i hear that affect me the most. when i go to a county of a state or in the suburbs, -- up state or in the suburbs, there is nothing worse than a month looking you in the eye and saying their son or daughter has a terrible illness and i have no way to pay for his or her treatment. it is heartbreaking. we must help them. it also affects those who are covered the d, who have health care or private insurance.

most americans are covered. they know something is wrong. they also know that they like what they have because they do not see the problem directly. seniors like medicare as they should. it is a great program. it is one the best things we have done in the federal government. . . they are getting less and paying

more. and we have to tell them what is going to happen. because private health care costs have doubled in the last six years, inevitably millions, probably 10 millions of americans in the next decade are going to be called in by the employer, and that employer will look them in the eye and say, jim, mary, you are a great worker. i want to see stay with my company as long as you can. but i have bad news for you. i am going have to change your health care policy. you're going have to pay the first 5000 or $10,000 yourself. you're going after it double your monthly payment for it. or worse, jim, mary, you are a great worker and i want to keep your but i can no longer give you health care insurance. that will happen if we do nothing. so act we must. like many of my colleagues, i

spent a lot of time talking to my state about health care. and those who are covered are worried about the future, one security and stability but do not want the system to dramatically change. and i am understand that they worried that changes will not make things better. and mr. chairman, that is something we need to remember as we go through this process. is not just making sure that most people are better off but making sure that people are not worse off. we need to recognize the age and medical dictum, do no harm. so this bill takes a giant step forward in that direction. it deals with some of the cost is used in very smart ways and i am pleased by it. value based purchasing, integrated care, and for the

first time we are beginning to move away from the for serve as models that drive much of the waste and inefficiency in our health-care system, -- fee-for- service models that drive much of the waste and inefficiencies and our health care system. there are things that we must do to make it better. i am a firm believer in the public option. i think that it is vital we have greater competition. 94% of the insurance markets are highly concentrated. we do not have a public option, and the people will like competition in the cost will not go down. just remember, you're not forced to join it. it is an option. it is like what the president said, schools, colleges. in new york we have public and private colleges. they are both good and they compete and people make their choice which is better to them.

and each is better because we have them. we also have to deal with affordability. we cannot tell the middle class and working class that here is an insurance policy that you can buy but you cannot afford it but it is too much of your income. we have to do better on affordability in this bill. and finally, there is the idea of workers in high-cost dates like me, firefighters and others, who do not get paid back great salary but their job is risky. they have high insurance costs and we have to protect them as well. these and other changes must be made in the bill. that is what the process will be in the next few days. selling short, mr. chairman, this is a very good start. but it must be improved in the committee, on the floor, and as we move to conference.

and i look forward to working with you, mr. chairman, to pass health care reform now and to provide the american people with the confidence that health care reform will work for all of them. thank you. >> i thank you very much, senator schumer. we appreciate your bigger with your dressing of the subject. senator nelson, i see that you are now here. >> mr. chairman, thank you for bringing us to this point. they do, senator hatch, for the continued input that you have, and i look forward to a very substantive discussion. this chairman's mark is a good starting place. i believe that if they -- that it needs to be massaged, and then let's see if we can get something because after this long, hot summer, where even

violence got into the debate, it simply captures the passions -- some political, some partisan, but some very substantive. everyone of us has a constituency like mine that has been done -- a constituent white mine who is been undergoing cancer treatment, and going on for a year or two, and suddenly the notice comes from the insurance company that the cancer treatment patient is going to be canceled. that is intolerable, but it is a fact. and that is what we have got to address here. what we want at the end of the day is we want health-insurance that is available but is also affordable.

and, you know, there are many different choices. senator biden and nine -- wyd en and i had a proposal that would be neutral in a couple of years. but it is a significant change from the present, because it decouples basically from a system organized around an employer group policy, even though the proposal would allow everybody to keep their employer-sponsored coverage. so we are where we are and we need to move forward. i think all of us agreed that the system that we have now is unfair, it is too costly, and in needs to be fixed, and now we have the chance to fix it.

so the reality is that before a person dies, nine out of 10 of us are going to wind up in the hospital. i think this chairman's mark will let folks happy with their insurance keep that -- keep it, and that means senior citizens on medicare and veterans, they are not going to have any change, but those who do not have insurance are going to have the opportunity -- or those that have insurance they cannot afford it are going to be able to go into a health insurance exchange, a marketplace, where you can get coverage at an affordable price. and because of the free market competition, we can hold the

insurers' be to the fire by requiring them to cover everyone in that health insurance exchange and preventing them from dropping people like the constituent that i mentioned. this marked as several measures -- bismarck has several measures -- this mark has several measures all to the good. but i think we can do more for low and middle income families while keeping the overall cost of the bill reasonable. others have warned of the importance of addressing the high health-care costs of retirees not yet eligible for medicare. it is critical that we protect and preserve health coverage for retirees not yet eligible for medicare.

and for those seniors, it is not about a cadillac or a gold- plated coverage, and i am going offer an amendment that would protect those retirees' health benefits from the high cost health-insurance excise tax. it is my understanding that you may be addressing that in some modification before we ever get to my amendment. another issue that troubles me is a potential for rapid cost increases to senior citizens on medicare and medicare hmo's which is called medicare advantage. i did not dispute high subsidy to medicare advantage said

insurers need to be adjusted. but i do not think it is the right thing to ask senior citizens to give up their existing medicare advantage benefits because there are hundreds of thousands of senior citizens who did not conceive of medicare advantage but who have come to rely on it. and i intend to offer the amendment that will shield them from benefit cuts. it will be called a grandfather, the grandfather them in. i happen to come to the table with clean hands on this issue because i voted against that medicare advantage, which was part of the prescription drug bill that was past five years ago. but it is the law, and many

senior citizens have come to rely on the coverage. and to suddenly wafted away from them -- whack it away from them is unconscionable. it changes have to be made for the future and solvency of medicare, then those seniors ought to be grandfathered in. another concern that i have is the price at the federal government currently pays for drugs. i plan to offer an amendment that would require pharmaceutical companies to provide rebates to medicare just like they do to medicaid. there are more medicaid recipients then there are medicare recipients. roughly 49 million medicaid,

roughly 44 million medicare. now that has been ala. we get rebates -- that has been a lot. we get rebates using the purchasing power of the federal government ball purchasing to get costs of drugs lower to medicaid. if that is good enough for medicaid, why is it not good enough for medicare? to bring the cost of drugs lower? it would certainly save medicare a ton of money. and this famous doughnut hole that does that never seem to get closed, we could close that hole. i have some serious concerns about state compacts, allowing one state to join with another. if you do that for the purposes

of getting larger numbers of people in a health insurance exchange, that is great. that gives more lives to spread the health risk over. but if there is some subterranean subterfuge that is trying to get away from the regulatory authority of a particular state by suddenly hitching up with another state who does not have much regulatory authority, so that bad states of party then applies -- so that that state 's authority applies, then i start to think about my old days is the insurance regulator of florida, standing up for the consumers of the state particularly when the insurance commissioner did not have the

regulatory authority to protect those consumers. and so, mr. chairman, thank you for what you have done. i will let my accolades to all of it. if we are able to achieve this goal of expanding affordable health care to nearly all americans, then we're going have to do so and not take get out of the hide of the middle class or offending their coverage. and we cannot lower the quality of health care to seniors at the same time, in the process. i commend you mr. chairman. i have been one of your advocates. i have stood by you, and this is a good first art. now let's go perfected. thank you. >> thank you, senator. you have been very active and helpful in working with us. and i compliment you for your

constructive comments and hard work. next up, jo andee wyden. you have been a leader in health care coverage for years. frankly, i cannot think of a senator who has been more time and a higher percentage of his or her time on health care they knew of the last couple of years. many of the provisions that we have here are due to your hard work and efforts. i want to thank you for it. >> mr. chairman, thank you for those kind words. i do not want to make this a bouquet-tossing contest. you had made an extraordinary effort to in all of these many months to bring us together. we would not even be here without the suburban white paper that you put out to start the discussion. let me begin by saying that i

guess you did not get the memo from the folks on the ideological extremes of american politics. they said max ought to throw in the towel on bipartisanship. you either did not get it, or you chose to ignore it. and as far as i am concerned, the country is for the better because of your focus on bipartisanship. you consistently said let's try to get here through consensus rather than confrontation. and despite a popular myth among some, it is impossible to enact comprehensive health reform with a 51-mode partisan effort. but the way that you have approached trying to reach across the aisle -- was the only responsible course of action. so despite the exhaustive efforts of the chairman, the

committee now finds itself short on both real reform and democrats and republicans having their names on this mark and this legislation. the actions of this committee from this day on are going to go a long way towards determining whether the congress will -- will remain largely empty handed on bipartisanship and real reform. my vote in the committee is going to depend to a great extent on whether we can get on that real road, meaningful reform and bipartisanship. and having spent of paramount of time, like a lot of colleagues here, in the bipartisan receipt of health care reform. my sense is that you start with three principles. the first is truth telling. you cannot truthfully argued that you can change american healthcare and then list all the

parts of the system that are going to stay exactly as they are. the trick telling and bipartisan health reform efforts means telling folks that tough choices have to be made, saying no when you would rather say yes, and above all, showing leadership, persuading people to except reforms that they would otherwise resist. the second part of bipartisanship is a acknowledging that each party has a valid point. i think our party is absolutely right -- you cannot fix this until all americans get good, quality, affordable coverage. otherwise you have too much cost shifting and not enough prevention. our party is right. you have to have coverage for all people. our friends on the other side of the aisle have valid points as well. you need to meld of those two

principles together, democrats on coverage, expanding coverage, and republicans on choice and markets and a role for the private sector, that is in my view getting real reform. and finally i believe real reform is not about bringing together a who's who of health care lobbyists to sign off on legislation. slowing in disrupting the price escalators in american health care that threaten the economy is much more important been reeling in yet another of these powerful interest groups. let me wrap up by talking a bit about the bill. the chairman's mark does some very good things. i want to repeat that. some very good things. yet there is still a lot to do to place the country on the road to real reform. first, the bill does not hold insurance companies accountable.

the bill does not force insurance companies to compete for our business. the bill denies choice of coverage to over to lenders millions americans -- 200 million americans. the president at every rally across the country said that you can keep what you have and that is great. this bill in its current form stipulates that what you can keep what you have, if you do not like what you have, if you have got to keep it. you are stuck and denied the chance to get something better. you cannot go into the marketplace. as part of a large group with real bargaining power, to force the insurance companies to give you a better deal. real reform is saying you can keep what you have the, but he is also saying if you do not like what you have, you can get

something better. and we only need to look at the automobile insurance market to see that is the way that it works. a car insurance company toward shore around when you bought your first claim, they attempt to avoid paying for the repairs, and then they went out the yellow pages and you can go to a new company. the choice amendment i will be offering is built around a magical words of the american system, competition, the marketplace, and powering the individual. it is the bottom line of health reform because in this health system, for too long the system has been shielded from the powers of choice and competition. now i know that i am taking on -- i am taking on what amounts to the status quo caucus. there are very powerful insurance lobbies who like their protection, there are a lot of

interests who feel that having a captive workforce is profitable to them, but it is up to us to choose too -- in his interest, the public's or the status quo, should shape this legislation. mr. chairman, i think that we can do better. i like a lot of what is in this bill. the wade did you go to bat for low-income people, the people who were walking on economic tightropes every single day, balancing their food bills against their medical bills, this is extraordinarily important to our country. but let us do better, and for example, rather than just saying we're going to give people an exemption from having health insurance, during this markup let's start with the principle that we will stay at any until every american is guaranteed quality, affordable coverage. i will have amendments in that regard and i close with this.

this bill, for a lot of colleagues, is not their first choice. not exactly a surprise, i am one of them. but this debate is not about any of us individually. this is not about getting a political win for one party or the other by getting a win for the help economic security of the american people. i consider this, mr. chairman, the most important bill i have never worked on. it is something i have been interested in since the days when i was the director of the gray panthers. i am committed to work with new and old colleagues on both sides of the aisle, and to stay at it until we get right. >> thank you, senator. i especially appreciate your comments about competition and choice. and not being stocked with your employer if you want to go someplace else to have good health insurance.

this legislation through the exchange is creating a competition and choice for individuals to choose a plan that they may want to have. and second, working with you to make it easier to find a way to get health insurance that you want if you want to move somewhere else. and keeping a plan that you now have. thank you very much for your efforts here. next, senator 7 upper michigan. stab -- senate or stabenow from michigan. >> thank you very much, mr. chairman, and i appreciate your patience. i very much appreciate the tremendous amount of time and effort that has gone into this. we started in the right way in order to get bipartisanship.

i find it amazing that people would talk about rushing this process, given the fact that we invent -- spent over a year and countless hearings and meetings, and the fact that i think if you have gone to extraordinary lengths to reach out to make this a bipartisan effort. i regret that he is not yet there but there is important work that has been done on both sides of the aisle. i know that we will keep working at it. i think it is important to to say thank you to the staff of the finance committee who have worked so hard and getting us information and having sleepless nights on an ongoing basis. and i want to particularly thank my on staff as well, oliver, alex, and catherine, who cared deeply about providing affordable health care and changing a broken system. and i want to thank them for their hard work. mr. chairman, this certainly is

the most important debate i have been involved with on the finance committee or sense i have been here in the senate or in my time and house of representatives. we have a serious challenge and we know that. we have a current health care crisis the health care system has great strengths, but it also has many things that are broken. they are causing tremendous challenges for people and businesses. in my state we have at 15.2% unemployment rate, the highest in the country. we know that there are skyrocketing health-insurance costs better making it hard for our companies to compete -- to compete internationally. people who have coverage are seeing their costs go up. people lost their coverage are struggling to afford coverage on their time or they are just giving up on it entirely, and going without insurance. and that is why we're here. we also know that nationally

every six seconds someone loses their health care. while we are meeting, every six seconds, someone is losing their health insurance. 14,000 people a day. every day 5000 people lose their home to foreclosure because of the help of urgency. -- a health emergency. and 40,000 people die every year because of lack of health care. that is more than the number people who died in a car crash, then the people of homicides -- and the number of homicides. this is truly a crisis and we have to ask ourselves, why in america, in the wealthiest country in the world, do we tolerate a situation where someone dies every 12 minutes because they do not have quality health care? the answer is, we cannot call -- we cannot tolerate it, not anymore.

the mark, mr. chairman, as many positive aspects and i congratulate you. i will not go through each one but let me just focus on a few. the changes on focus -- by changing the incentive to record quality, this will save lives and money. it cracked down on the worst abuses of insurance companies. it creates a real health-care safety net so that if you lose your job, and your family will not lose their health care. it also strengthens and improves medicare. it focuses on prevention and the quality of care, giving relief to seniors who fall into the doughnut hole, seniors and people with disabilities will get help paying for their medicines, and i support actually closing that gap in total.

and it helps young people, many of them to starting their careers and dealing with huge student loan debt, like my daughter, who are going to be able to keep their family insurance coverage up to the age of 26. we have a lot of work to do to improve this bill, in my judgment. and truly deliver on health care reform that the americans need and deserve. we need to make sure that insurance days affordable so that people who already have it, middle-class families, and early retirees who work hard to give up salary increases to get a health care plan for their families, cannot be subjected to an unfair excise tax on insurance benefits, and i believe, mr. chairman, we need to work to better to do better than what is in this bill. you've indicated that i've taught you about this many

times, we need to make insurance affordable for those who do not already have it. we need to make sure that those who had it see their costs go down, but they can keep it, that they do not get dropped, that they have all the protections in the bill, but for those who of not been able to find or afford insurance, this -- it is incredibly important that we put this realistically within their reach. i appreciate that the updated mark you will be offering takes a step in that direction, and i still believe that there is more work to do to make this affordable. and finally, we need to make sure families have a real choice of health insurance plans, including a public health insurance option. it keeps private insurance companies on this and keeps premiums affordable. mr. chairman, i would be less concerned about the tax credits under the bill for people that

are trying to buy insurance if i knew that they had a real choice, that in fact if the for- profit insurance companies were not giving them insurance products that they could afford, that they would add another public option that would be the true cost of providing health care in the marketplace, and they would have a choice of somewhere to go. not only will we help make health care affordable for families and it must be affordable for the country as well, and i appreciate the efforts to focus on the overall costs and of a long run in bringing down the deficit. this bill does not increase the deficit. in fact it will reduce the deficit overtime, and an enormous amount of our budget is dedicated to health care. it is crucial that we bring down

costs over time as well. mr. chairman, i got my start in public-service by keeping a nursing home open and it was quite a long time ago. i spent time at the county level, the state level, and now the federal level working on health care policy, to make it better for people. i came here to this committee to do the same thing. 14,000 americans woke up this morning without health insurance, -- with health insurance and they will go to bed tonight without it. it's time to get it done and to get it done right. i continue to pledge to work with you to do that. >> i appreciate that. next is senator barbarcarpo, ani appreciate your insistence that we stay within the budget.

>> thank you for mentioning that. as you noticed, i tried to stay gunpoint -- i tried to stay on point. and that are a lot of poise to stay on. of what i thank the senator bingaman and senator conrad who heads spent as much time as they had to get the middle of the road, trying to get a bipartisan plan that will not just look good, sound good, but will actually help to bring the health care cost down, and extend coverage to do not have it. later said it is described as keeping out of step when everyone else is marching to the wrong team. -- leadership is described as keeping out of step when everyone else is marching to the wrong tune. i think we've come to a good starting place. and i like the phrase of

churchill who used to say, this is not the end. this is not the beginning of the end. this is the end of the beginning. when we finish our work at the end of this week and report out a bill with bipartisan support, that it will be the end of the beginning. a lot of work still to be done and still to do. as most of my colleagues know, i go back and forth to washington on the train. every day i go home just about every night. i usually stop at the central ymca and work out every day of my life. i drove past the wilmington hospital today on my way to a y, and i was reminded last night and frankly every night and just about every day of the year of people in not possible using the emergency room. that is about all that they have.

this care that we provide for them is provided for charitable reasons. it turns out that we pay for that, everyone of us who has health care coverage in this country, everyone pays about $1,000 a page to provide health care for those who do not have it. i went to the y and got dressed and went to one of the bikes. as i rode the bike, i was multitasking and got into the new issue of "business week." this is an executive summary on page 5, the cost of health. what congress does not come through with sweeping health care reforms? that is the question. annual health-care costs for businesses will soar 166% of the next decade. $29,000 per worker. it looks even worse in the prior

decade when it went by 131%. an hour or so after i read that article in "does this week," i was on the train heading down here. as we pass through new worked, i looked on lsi of my window and saw -- as we passed through new work, i looked out the window and saw chrysler plant that i worked for 29 years to keep open. it is closed. 4000 people who worked there not long ago do not have jobs anymore. 12 miles up the road as a gm plant. it is closed, too. because three months ago, 3000 people do not have jobs anymore. eventually they may not have health care. it is not just big companies like gm and chrysler going bankrupt. there are little companies, middle sized companies all over this country that are finding it hard to compete and we need to do something about that. during the recess, when we have

listening sessions, town hall meetings, one of my sessions i had a guy is said to me, we have a bet -- the best health care coverage in the world. and i said, no sir, we do not. we pay more for health care than any other nation on earth can we do not get better outcome. in thousand people are going to wake up without health care coverage. -- like the senator said, 14,000 people who have held got coverage today will go to bed without a. we've got companies going bankrupt, unable to compete in the world today. instead of trying to figure out what to do about it, around here we get caught up in in inflammatory issues that do not contribute much to reining in health-care costs and extending coverage to people who do not have it. making us competitive in the

world. a government takeover, i am not interested in that and i would not support that sort of thing. abortion is not provided for. we do not find abortion in this legislation. somehow saying that we will provide coverage to illegal aliens, we do just the opposite in this legislation. widely focus on what unites us? there is plenty they can be added to this legislation that would do this. some of my colleagues are talking about being tired of being a recovering governor. i want to talk a couple of minutes about things that actually work to rein in the cost of health care costs. i've been asked a lot about the same health care coverage that i have. i say, that is not a bad idea. it is a large purchasing poll that 800,000 of us get to choose from. administrative costs are 3% of

premiums. if we cannot get everyone to join that, why don't we replicated, and that is what you have done. that works. large purchasing pools, and a lot of people on this committee have been fortunate to use that for years. i shared with some of my college what i sought and i gave a speech, [unintelligible] that focus on primary care, and it does not just cleveland, but may go, and others, of big co- op in center can wells -- senator cantwell apostate, propelled, they focused on coordinated care. managing chronic diseases, and everybody there, chronic health

care records, doctors are on salary. they are basically in business during the same thing the same way and they get better results for less money. competition can work. a great example of medicare part d, a huge fight about adding a public option in the medicare prescription drug program. if we end up with states with no competition, we will provide that competition. senator snowe and i talked about that. we never had to use the fall back plan in any state in the medicare part b prescription drug program. seniors like it, and they had been under budget four years in a row. what else works? we can do things about medicine, if a doctor said -- if i did not

like the work that she did in treating me, i can go right and assault -- into court and sue her. i cannot do that anymore. i have to go before panel of experts and make my case. a dozen states have done that. in michigan, the university of michigan, see how it works. i like the idea of a court where the doctors or medical experts. i like using the best practice guidelines, and provide a safe harbor for losses. what we're going to do is on this committee, and those who care about this issue who know the pier for defense it medicines, the fee-for-service conundrum that we iran, that you would join me and say let's use this states as a laboratory for democracy, past what becomes -- test to see what works, reduce the cost of defensive medicine, the amount of time that we use

in court rooms, and improve health care options. i am almost done, mr. chairman. what else works? get people to take better chance -- to take better care of themselves. this is to think of a grocery chain but their health care delivery system can incentivize people to take medicine for themselves and they have flat line there costs in the last four years. there are a bunch of companies that are doing the same thing. we can learn from them. prescription medicine works. they do not work for everybody, for people who do not have the ability to get the medicine, they do not work for people who take -- to get the medicine but do not take them, and by mapping the human genome we have learned that not all of us take the same medicine differently. we have to be smart enough to

figure out how to use mapping the human genome, which medicines will help us, and which ones will not, and we will not spend money. that will help to save money. senator in see is over there -- enzi is over there. as one of my favorite people. i sometimes talk about the 80/20 role. it's why you and senator kennedy were so recess or -- some successful. we don't agree -- we decided to focus on the 80% that we agree on. we need to do that here. he was on the floor talking about his core of values. and i listen to him talk about them, and i said those are my core values. figure out the right thing to do, don't do the easy thing are

the expedient thing but the right thing. and that is what we're trying to do. treated people the way that we want to be treated. the companies and taxpayers that are paying for it, put ourselves in their shoes as we debate this legislation. if it is not better, make it better. that applies the legislation and our health care delivery system. we can make it better. and just do not give up. one lady said to me, you're going to the markup in the finance committee? i said, yes, ma'am. i wanted to know that i am praying for you, she said. i said, well, that is great. i appreciate that. we all appreciate that. and i just want you to keep praying. and you know what she said to me? i am going to keep praying. i want to make sure that you keep working to fix the system and get it right. and that is what we're going to do. >> thank you very much, senator.

we appreciate that. i like to recognize senator bingaman. i don't think anyone has spent more time than this senator. is not only a senior member of this committee but also help committee, spending all of those weeks and hours working on amendments offered in committee. and on top of that, he is one of the group of six, so-called, and spent hours and hours -- i think we had 63 meetings that i am not mistaken. senator, thank you for all of your intelligence work in getting down to the details. the pragmatic way to do what is right here. >> thank you very much, mr. chairman. your the one that ought to be getting the accolades today, and you are to a substantial extent. the phrase i've heard more and more members repeater here is extraordinary effort.

and i endorse that. i think you have made an extraordinary effort to get us to this point and i very much appreciated. all are very long time, senator enzi and roberts and hatch and i all served on two committees, this committee and help committee. i think we went on for how many weeks over there, but it was quiet a while. years, senator -- the senator says. but it was a while. we spent hundreds of hours trying to get this legislation into a form that we could move ahead here in the committee, working with yourself and senator conrad, senator grassley, said enzi, and senator snowe. i appreciate your leadership. i think that the broad construct of this legislation accomplishes the objectives we all want to see accomplished.

and that is, it protect those things that work in our system, it tries to reforms the things that do not work, and there are many of those. it reduces the growth and cost of health care going forward, which is an extremely important objective. and it provides affordable coverage to an awful lot of americans who currently have no coverage, and that as much to be desired. in new mexico, we have many of these problems in spades. nowhere in the country, in my view, it is the problem more serious. we continue to be the second most uninsured stayed in the nation. we have the highest percentage of workers who aren't insured of any state in the nation. health insurance premiums continue to raise at and on the state -- continue to rise at an unsustainable rate. the projection is that new

mexico will increase the greatest increase in health- insurance premiums in the nation over the next decade is nothing is done in the nature of the reforms contained in this legislation. the average premium for a family of four in new mexico was $6,000 for the year 2000. by 2006, berate had almost doubled to $11,000, and by 2016, the amount to is expected to rise even more to an astonishing $28,000. we have a serious issue that needs addressing. i will not going to the detail of various amendments that i would like to see us adopt. i am going to endorse the comments that others have made about the need to be sure that the health care require people to attain is affordable. and you move forward in that

direction substantially, and in a modified version of this bill which were planning to present to the committee. i hope that we can do more in that regard. i also hope that we can do something to increase competition in the sale of health-insurance in the country. i know that the co-op proposal which is in the market before us today has promise and they will accomplish that objective. i had thought that a more straightforward public option, which would be organized on a level playing field, so that you would have fair competition between the public's nonprofit entity and private insurance companies would be an even better way to go. i hope that we can make that improvement as we go forward. i think senator snowe put it

well by saying that the seriousness of this issue requires that we undertake a painstaking progress -- a process here in the congress. and you have done that. this marked up promises to be a painstaking process as well. i hope that the end result is one that solves many of these problems that have plagued the country for many decades now and puts us on the road to a much healthier and more sustainable situation in the country. so, again, my compliments to you and i look forward to working with you through this markup and through the consideration of this legislation in the full senate. >> thank you, senator. and now the senator from wyoming, a neighbor to my state of montana, familiar with many subjects and also one of the group of six. i might save everybody here --

say to everyone here that during those meetings you forced us to drill down deeply by asking more precise questions, how does this work, how does that work, what about this, what about that -- and that was probably because you were once a cpa. you're very viable by forcing a second and third level of analysis. >> i appreciate your new calling us the group of six rather than the gang of six, because my mother told me never to join a gang. i want to thank you for your efforts on this issue. i think it is unprecedented and i will talk more about that in a few minutes. i want to discuss some of the key issues on the bill. i do think every american should have the right to choose the health care benefits that best meet their needs. this bill does mandate a level of benefits that will significantly increase the costs of many insurance plans being

sold in wyoming and many other states throughout the country. i believe that every american should have the choice to buy a lower cost health plan that covers basic services and offers catastrophic protection. individuals should also never be compelled to enroll in a government-run plan. this bill would enroll everyone follow when a 30% of poverty in medicare. this would be the only health care option under this bill for 11 million working class americans. the expansion of medicaid in this bill directly contradicts the goals stated in the repressive and speech by providing free choice and competition in our health-care system. every american should have the right to choose to enroll in private health insurance coverage. we also need to review -- reduce health-care costs for individuals. this bill does not do enough to lower cost and it will actually

increase the cost of health care per new caught -- through new taxes and mandates. i think that reform must address issues like medical liability reform, providing financial incentives to adopt healthy behavior is modifying our tax code to encourage more rational choices, and eliminating new taxes that will only drive up the prices patients pay for health care. medicare savings should also go to strengthen the medicare program. this bill cut billions from the medicare program and then spends the money to cover the uninsured. medicare physician fees will be cut by 25% in 2011, and an additional 5% a year for the next eight years. medicaid provides no beneficiary protection against cap, because. the president promised that everyone be discovered -- would be covered for catastrophic

costs. as with medicaid, if you cannot see a doctor, you do not have health care. today we weep -- we will be marking up this, 220 page summary, not all the legislative language. it will be many times that big. but i've noted that we have two volumes of amendments, 564 amendments to try to change that. these are in some reform as well. we have talked about the need for senators to read bills and had the actual language, because sometimes the devil is in the details. outlining some of the significant problems, and what also like to commend the leadership of chairman bought the suez worked with ranking member grassley and other republicans and democrats for months. i know the fed seems like years as well, but in an attempt to

develop a bipartisan health care reform bill, you saw all wide range of ideas and tried to develop the best possible bill they could gain broad support in the senate. this effort stands in marked contrast to see what happened to help committee where i serve as the ranking republican. the majority staff drafted the bill with no apparent input from republicans. the committee then voted down almost every single since then the republican amendment to improve the bill on a straight party-line vote. as a result, the health education and labor and pinging committee brian lee for boarded a partisan bill that is loved by liberal pundits but has no chance of passing the senate. i think they realize that because they did not print the final version until almost august so that anyone -- seven no one could look at it. chairman baucus caverefused to

give in to this. i have said for many months at health care reform should have broad bipartisan support in order to gain as the trust of the american people. health care reform will affect the lives of every single american and have a dramatic impact on our economy in the future of our nation. it is too important to be passed by narrow partisan majorities. unfortunately the efforts of chairman baucus were unable to produce a bipartisan bill in large part because of arbitrary deadlines. we are here now because he was told that all is the time did you get. that was imposed by the senate leadership and by the white house. in some circles, there is a belief that passing a bill quickly is more important than getting it right. i regret that we ran out of time and we were not able to resolve key issues that must be addressed to make comprehensive reform package. i remain committed to working in a bipartisan way.

i will continue offer constructive ideas and hope that we might have the opportunity to develop a bipartisan solution to address the health care challenges that are faced by our nation. -again, i think for the -- the chairman for his indulgence, his effort, his focus, in his desire to get something done. >> next to senator cornyn. he is not here. i move to the next senator. >> mr. chairman, i want to say that you have proved that you are truly at a distance runner, because this process has been like a marathon. you bet kept on pace, and my only request is that i hope the committee process will give the kick that we need to have at the end of this, because we need to make some changes and i appreciate your willingness to make the changes. i am notem