uninsured and underinsured. there is enough money in the system to pay for those people who are uninsured and underinsured. in fact, we hear that families have found that nearly 7%, in 1987, 7% of their median household income was being used and dwoted for health care and now it's grown to 20%. in fact, americans spend more than any other industrialized country in health care for a working family. yet our health care, life expectancy is on par with cuba, on par with cuba. so we have got to make fundamental changes. as the gentlewoman said, to focus on prevention. four cents of every dollar is focused on prevention, yet we have some of the worst chronic diseases that continue over this period. we want to stress that folks will have more choices and bean counters won't decide, but doctors will decide the type of health care they get and there is enough money in the system to pay for itself. those are the delee guideposts and the beacons we are using as we are drafting legislation in the house. . ms. pingree: i wan

more underinsured people are dying. but at least we're not spending a lot of money. you know, if you bought an old, broken-down car and you started complaining that it doesn't work well, i would say, what do you expect? you didn't spend a lot of money on your car. and people say, canada has problems. canada has problems. the u.k. has problems, france has problems. every country has problems. but the relate it, we're spend -- but the reality is, we're spending almost twice as much as any other nation per capita on health care. we should be doing far better than every other country on earth and that is not the case. the reality is that we're spending close to $2.7 trillion on health care -- that's 18% of our g.d.p. and the skyrocketing cost of health care in america is unsustainable, both from a personal point of view and a macroecomonic point of view. at the individual level, the average american today is spending about $7,900 on -- because of medically related problems. stop and think. a million americans going bankrupt because they can't pay their medical bills. on

today 46 million americans have no health insurance and even more are underinsured with high deductibles and h and co-paymen. at a time when 06 million people do not have access to a doctor of their own, over 28,000 americans die every year from preventible illnesses because they do not get the medical care that they should. this is six times the number of people who died at the tragedy of 9/11, but this occurs every single year after year after year. in the midst of this horrendous lack of coverage, the united states spends far more per capita on health care than any other nation and health care costs continue to soar. at $2.4 trillion and 18% of our g.d.p., the skyrocketing cost of health care in this country is unsustainable from a personal and macro economic perspective. at the individual level, the average american spends abou about $7,900 per year on health care. $7,900 per individual every year. despite that huge outlay, a recent study found that medical problems contributed to 62% of all bankruptcies in 2007. from a business perspective, general motors spends more on health care

such an effort must not only address the lack of health insurance or underinsurance of more than 47 million of our citizens, as well as the high cost of care, it must also focus on the current and increasing shortage and maldistribution of forces and the need for greater diversity. all of these factors have is an advocate impact on access to healthcare, of protecting and improving the health of americans, and eliminating disparities in the health status of the nation's racial and ethnic minorities. i think you for this opportunity to present these opportunity -- to present these facts. i appreciate your comments as well as your leadership and support in these efforts. to achieve our goal of eliminating disparities in health status and access to healthcare for all of our citizens. thank you. >> thank you for letting me to address this civil-rights council. this is to improve the health of several through the developmental policies and programs that would help eliminate health disparities. we are located in the office of secretary within the office of health and science within the department

we have more who are underinsured. we have thousands who die because they can't get to a doctor. and then in many other health care outcomes, we are behind many other countries around the world, some of whom are spending far, far less per person than we are spending. now, it seems to me that as the health care debate here in congress heats up, we as a nation have got to ask two fundamental questions. different people will have different answers to it but here are the two questions i think we've got to ask. first, as a nation, should all americans be entitled to health care as a right? that's the first question. and honest people will have differences of opinion. some people will say, well, do you know what? hey, some people have big cars, some people have small cars. some people have big houses, some people have small houses. some people have good health insurance, some people have no headlight insurances. that is the way life goes. some people hold that view. i don't. i think that in america we should understand that every single person should be entitled to quality, comprehensi

such an effort must not only address the lack of health insurance or underinsurance of more than 47 million of our citizens as well as the high cost of care, it must also focus on the current and increasing shortage and mal distribution of health professionals and the need for more racial and ethnic diversity among our nation's health professionals. all of these factors have a significant impact on access to health care, on protecting and improving the health of americans, and eliminating disparities and health status of the nation's racial and ethnic minorities. i thank you for this opportunity to present these issues to the commission, and i look forward to your questions and comments as well as your leadership and your support in these efforts to achieve our goal of eliminating disparities in health status and access to health care for all of our citizens. thank you. >> [inaudible] >> good morning, mr. chairman. it's a pleasure to present to the commission on civil rights on the causes of health care disparities, populations most affected by these disparities and actions need today elimi

and importantly, even more are underinsured with high deductibles and copayments. further, some 60 million americans, including many with health insurance, do not have access to a medical home of their own. in fact, according to the institute of medicine, some 18,000 americans die each year from preventible diseases because they lack health insurance and do not get to a doctor when they should. and i can recall very vividly talking to several physicians in vermont who told me how people walked into their office quite sick, and when they asked why didn't you come in earlier, they said, well, we don't have a lot of money. we didn't have any health insurance. and the result is that those patients die. that happens every single day in this great country. and then when we talk about health care, we have to understand that access to dental care is even worse. and then on top of that, in our nation we pay the highest prices in the world for prescription drugs. my state of vermont borders on canada, and it is not uncommon for people to be going from vermont to canada to bu

half of the people who up and underinsured will be able to negotiate. what is set in? it means providers will be able to know that the government is a friend and a partner of everyone seeking health insurance. so the industry is going to provide new jobs for the providers, nurses, doctors, primary-care doctors, center so that communities that never had access to healthcare will be able to do it. it is going to mean a stronger financial country, it is going to mean a stronger health country and it is going to be a strong moral standard that we will be setting in noted to do what we should've done a long time ago. what an honor this for me to present to you john dingell, because i told him this afternoon. his dad has to be looking down on him saying, john is just about time. because, for all of the years that the spent in this congress, he can tell you the numbers of precedence that it said we are going to do it, but this time, on his watch, the dingell bill will be coming out and it is my pleasure to present my mentor to you, john dingell. >> i love you charlie. i love

and that it has to provide relief to people who don't have health insurance or are underinsured. those are the broad parameters that we've discussed. there are a whole host of other issues where ultimately i may have a strong opinion and i will express those to members of congress as this is shaping up. it's too early to say that. right now i will say that our position is that a public plan makes sense. now, let me go to the broader question you made about the public plan. as i said before, i think that there is a legitimate concern if the public plan was simply eating off the taxpayer trough. that it would be hard for private insurers to compete. if on the other hand the public plan is structured in such a way where they've got to collect premiums and they've got to provide good services, then if what the insurance companies are saying is true, that they're doing their best to serve their customers, that they're in the business of keeping people well and giving them security when they get sick, they should be able to compete. now, if it turns out that the public plan, for exampl

when a quarter of the population, 1 in every 4 of us, is either uninsured or underinsured, it's no wonder we have those statistics. we need to get the costs down, there are so many places not engaged -- so many places that are not actually in the health care delivery system that are not actually involved in providing health care itself. some of those drain money from the system and in a way that we can address and fix. the administrative costs of insurers when medicare and medicaid are 3-4 percent and some insurers are 30-40 percent, you've got to figure there's some sort of administrative waste in there that we could tap. billions in profits even in good times, perhaps, you know, taking the fiduciary obligation to the stockholders maybe a little too seriously. we're not selling refrigerators, we're providing health care. with layers of administrative health coverage people, most people have never heard of. health benefits administrators who are, in fact, managing profits for the participants in the health care system, not your profits, but the profits of the businesses involved in it. i

when a quarter of the population, one in every four of us is either uninsured or underinsured perhaps it is no wonder we have the statistics of the first thing we need to do is get healthcare costs down so it doesn't represent such a huge burden on the hour, on individuals, families and the government. there's so many places not engaged, so many places that are not in the healthcare delivery system that are not actually involved in providing healthcare itself. some of those drain money from the system, and in a blade that we can address and six. the administrative cost of insurers, when medicare and medicaid are three to 4%, some insurers are 30 to 40% you have to figure there is some way stinner that we could tap. profits even in good times, perhaps taking a fiduciary obligation to stockholders babies too seriously. we are providing healthcare. if layers of administrative health coverage in people, most people would never heard of, people like health benefits administrators were not administering health benefits but in fact your managing profits for the participants and the healthcar

the current system is disintegrating with 46 million without any health insurance, more who are underinsured and at the end of the day off we end up spending despite those results far more money per capita almost twice as much as any other country and our health care outcomes in infant mortality and longevity, disease prevention is not as good as many other countries. the reason to my mind why russia has into the fact that our system is geared toward making money for the private health insurance companies so i do want to shock any of the viewers with but the function of a private health insurance company is not to provide quality health care to all people in a cost-effective way. is to make as much money as they possibly can and when you have that paradigm if that is what the goal of the system is you end up not only with 1300 in separate private health insurance companies but to end up with thousands of different benefit packages which cause enormous amount of money to administer so the bottom line is we are the most not only the most expensive but the most peer craddock and wasteful system

those 46 million uninsured or underinsured people who can't seek access to their doctor because their health care effectively ended when they got their pink slip at their job because they can't afford a cobra payment, they are uninsured or underinsured and when they use the hospital emergency room as their primary care physician, they're costing all of us paying into the system four or five times more by using the hospital room, the emergency room, as their primary care physician. we need to cover all people. and to those americans who might be listening tonight, we need to understand that the american people -- the american taxpayer right now is paying to make sure that every man, woman and child in iraq has access to universal health care coverage. now, it's inconsistent that we would pay for iraqis to see the doctor that they want to but not americans. the second p is that we have portability. is that our workers, when they get that pink slip, god forbid, that they can take their health care from job to job to job. portability, covering all people and certainly one of the third p's

you talk about folks that don't have insurance or underinsured, they get it. we have universal health care in this country, you just got to wait until you're so sick you end up in the emergency room until you get it. president bush he stalled on health care reform for eight years famously remarked, don't worry about the uninsured, i'm paraphrasing, because they'll get health care when they need it. they just have to show up to an emergency room. i have told the story maybe even on this house floor before, i i have told it a hundred times back in connecticut. when we were debating health care reform in the state legislature, i'll never forget a woman who came and testified before us. she told this story. she said, i was working. i was employed but my employer didn't provide health care. and i didn't make enough to go and get it on my own. i think she might have had some kids and got them insured but she didn't have insurance herself. she started noticing over the course of a couple weeks she had a real pain in her foot. the pain would get worse and get better.

uninsured, an additional 2 25 million, 30 million, 35 million, as many as 40 million, americans are underinsured, and many are saddled with catastrophic medical debt. closing the health care gaps would dramatically prove the public health. it would also lead predictability to national health spending, which is essential if we are going to get health care costs under control. closing the health care gaps would dramatically reduce personal bankruptcies, more than half of which result from at that time strophi --catastrophie huge bills that go with it. think it this for a moment. most bankruptcies in this country are because people have had health insurance bills they simply can't pay. and most of those people that have those health insurance bills they can't pay, which then force them into bankruptcy, most of those people have health insurance. but it's inadequate, it's got too many gaps in it. closing the health care gaps is a short- and long-term investment in the health of americans, the health of u.s. businesses, businesses whose premiums are inflated by the cost of uncompensated care. and it'

and has to provide relief to people who did not have health insurance or who are underinsured. those are the raw parameters that we discussed. there are a whole host of other issues. i may have strong opinions and will express those two members of congress. it is too early to say that. a public plan makes sense right now. let me go to the broader question you made. as i said before, been met think there is a legitimate concern if the public plan were simply eating of the taxpayers' trough. but it would be hard for private insurers to compete. on the other hand, if the public plan is structured better they have to collect premiums and they have to provide the services. , then if what they insurance companies are is true, and they are doing their best to help their customers and keep people well and give them security, they should be able to compete. if it turns out the public plan is able to reduce administrative costs significantly, then i would like the insurance companies to take note. if the public plan can do that, why cannot we. that is good for everybody in the system. i

people who are really getting hurt, 46 million uninsured, a whole bunch of more people who are underinsured who are seeing their premiums and deductibles rise. so i think a lot of the questions you're asking, those details are exactly what trying to work out. this next eight weeks is going to be critical, though. and you need to be really paying attention and putting pressure on your members of congress to say, "there's no excuses. if we don't get it done this year, we're probably not going to get it done." and understand, even if you're happy with your healthcare right now, if you look at the trends, remember what i said. your premiums are going up three times faster than your wages and your incomes. so just kind of ex trap plate late. -- extrapolate. think about what that means for you five or 10 years from now. if nothing changes then you essentially are going to be going more deeper and deeper into your pockets to keep the healthcare that you've got. and at some point your employers may decide, "we just can't afford it." and there are a lot of people where that's happened, where their e

it is not just a personal issue with people uninsured, underinsured, or paying close to $8,000, it is an economic situation. everyone is talking about general motors going bankrupt. general motors spends more money per automobile on health care than they do on steel. small businesses cannot afford to put more money into an escalating health-care costs when they would like to reinvest in their business. as the president appropriately pointed out, it is not just a crisis of the individual level, it is a major economic crisis that we have got to address. host: john webster who agrees with you sent us this tweet. guest: let me also say this. the concept of single payer is not a friendlngey idea. 15,000 doctors in this country support the single payer system. they are sick and tired of being told what to do by the private insurance companies. doctors are spending between two and three weeks just arguing with insurance companies about the kind of therapy that they can prescribe. people go into medicine and they go into nursing and they want to practice their profession. they want to work wi

of people who are really getting hurt 3 46 million uninsured, a whole bunch for people who are underinsured or seeing their premiums and deductibles rise. i think a lot of the questions you're asking, the details are exactly what we're trying to work out. the next eight weeks are going to be critical and you need to be really paying attention and putting pressure on your members of congress to say there is no excuse. if we do not get it done this year, we're probably not going to get it done. understand even if you're happy with your health care right now, if you look at the trends cover remember what i said. unions are going up three times faster than your wages and your income. --premiums are going up three times faster. what does that mean for you three years from now, 10 years from now? if nothing changes then you essentially going deeper and deeper into your pocket to keep the health care that you have. at some point of your employers may decide they cannot afford it. there are a lot of people that is happening. their employers set in say, either we can afford it, or you have to pay a

you have a lot of people who are really getting hurt. 46 million uninsured, and more who are underinsured, who are seen premiums and deductibles rise. i think a lot of the questions you are asking, those details are exactly what we are trying to work out. this next eight weeks is going to be critical. you need to be paying attention and putting pressure on your members of congress to say there is no excuse. if we do not get it done this year, we will probably not get it done. understand, even if you are happy with your health care right now, if you look at the trends -- remember what i said. your premiums are going up three times faster than wages and income. just extrapolate and think about what that means for you five years from now. if nothing changes, then you essentially are going to be going deeper and deeper into your pocket to keep the health care that you have got. at some point, your employers may decide they cannot afford it. employers suddenly say they cannot afford it, or you have to pay a much larger share. do not think that just by standing still because you are doing ok no

so it's obvious crushing health care costs leave so many families uninsured and underinsured and drive far too many into bankruptcy or foreclosure. when we discuss our country's health care crisis with our constituents next week when we go home for the july 4th break and when we debate it with our colleagues in this chamber in the coming months, we'll talk about how to best relieve that burden. there are a lot of good ideas, but one of the best ways to bring down the cost is by preventing disease and illness in the first place. prevention and wellness is based on a simple premise: the less you get sick today, the less you'll have to pay tomorrow. part of reforming health care means making it easy for americans to make healthier choices to live healthier lives. we need to do a better job of making that possible. more than half of all americans live with at least one chronic condition. and those conditions cause 70% of all deaths in america. so it doesn't make sense to stop them before -- does it make sense to stop them before they start? the obvious answer is yes. it's not just a health

enough money in the system that's out there that we can make sure that 46 million uninsured or underinsured people have access to health care. how are we go to go do that, with the five p's. people having access to health care. when they use hospital room as their primary care physician, they will cost us more. making sure they have a portable plan that allows them to tae plan that allows them to take it from job to job to job and end this notion of pre-existing conditions. if you are working at one place and go to another job and somehow being pregnant or being difficult betic or chronic disease, somehow eliminates you from seeking health care from this new provider. and pre-existing conditions, providing incentives to physicians to not only enter the field and they are making the health care decisions. lastly, prevention, prevention. four cents on every health care dollar is on prevention. we have to do a better job. the president has called us to action. the nation has suffered for too long under a system that has excluded a few and allowed others to seek access. and this delivery system

even with this, it is clear that millions will still remain uninsured and underinsured. what are the models for health-care finance that would be consistent with the principle that healthcare is a human right? >> i think that it is worth noting that the broadening of coverage that will be foreseen when we look seriously at the effects of this piece of legislation is going to be very substantial. the proposal that i developed some years ago, healthcare for america, which is very similar to this draft legislation, would cover almost all americans. when i say almost all, my proposal would cover all but a tiny share. >> i use a invisible we have heard widely discussed, will soon be marking up the bill that has been well described? meets the test of health care as a human right? >> it meets the test of providing affordable quality coverage. >> does it meet the test of health care as a human right? >> that is a very high standard. i teach in my university the idea of democracy as an ideal. no system actually lives up to that standard. >> so you're saying some people have the r

right thing to do to start providing coverage for people who'd don't have health insurance, or are underinsured, are paying a lot of money for high deductibles. i get letters, two, three letters a day that i read of families who don't have health insurance, are going bankrupt, are on the brink of losing their insurance, have deductibles that are so high that even with insurance they end up with 50, $100,000 worth of debt or risk of losing their homes. and that has to be part of reform, making sure that even if you have health insurance now, you are not worried that when you lose your job or your employer decides to change policies, that somehow you are going to be out of luck. i think about the woman who was in wisconsin that i was with who introduced me up in green bay, 36 or so, double mastectomy, breast cancer has now moved to her bones. and she has got two little kids, a husband with the job. they had health insurance, but they are still $50000 in debt. and she is thinking my main legacy, if i don't survive this thing is going to be leading $100,000 worth of debt. so those are the things th

showing no interest in helping millions of people who have no insurance and the 20 million who are underinsured and the millions more who are paying too much for health care, that they could lose which is one accident and one illness, and the millions of people, mr. president, who are afraid they're going to lose their insurance. that's what this debate is about. it's not only about the people who have no insurance. it's about allowing people who have insurance to keep it. in the last eight years the nuer of uninsured in this country has gone up by 10 million people. 10 million people. so i remind my republican colleagues again, this is not about winning and st. louising. this is not the time for -- this is not about winning and losing. this is not the time for ideology. this is not the place for political games. for millions of americans, those with no coverage at all, it abouts a concrete and critical crisis that children, families, small businesses feel every single day. it is about the parent who can't afford to take their kid to the doctor because insurance is too expensive. it's about the

we pay for healthcare increase efficiency, reduce cost, extend health coverage to those who are underinsureded in 2007 a new benefits platform for life security that lays out an innovative national framework for health and retirement security. as we contemplate the issues that are before us the three basic principles that we think are important. first, do no harm. there's been a stated commitment to the employer-based system by the president and others. healthcare reform should build on the success of the system that serves 170 million americans and their employers not hurt it. second, control costs. spiraling healthcare costs threaten our global competitiveness as well as our national solvency. reform must focus on reducing these costs and ensure what we pay for has value. without cost containment effective cost containment we will not change the system. thirdly, expand access. access to the 47 million or 82 million, however you choose to count it, americans who do not have it must be expanded while recognizing that a chief cause of inadequate access is the high cost of care. now we recogni

our health care system is so expensive and leaves 46 million without any inshurnls and even more underinsured and close to 20,000 people a year die? do we talk about that? well, one of the reasons we need to talk about it is that we have 1,300 private health insurance systems, and what is the function of private health care insurance systems? does anyone believe it is to provide services? no, it is to make as much money as it can. i want to talk about a few issues, people talk about the problems of government and this and that and talk about some. when you talk about the high cost of health care, it is appropriate to talk about some of to salaries that people in health care are making? do we really think it is a good idea that people at a time when 46 million americans can not afford insurance there are people in the health care industry making huge salaries. johnson and johnson, a major pharmaceutical company found the cash to pay its ceo $37 million. is that a good way to spend it in ron williams the head of aetna concerned about cost effectively $38 million a year. is that a good way to be

make and we will talk about health care, it's not just a personal issue with people uninsured, underinsured or paying close to $8000 is what we are paying per person right now which is unsustainable. it's an economic issue and everyone is talking about general motors going bankrupt. general motors today spend more money per automobile on health care than they do on steel. in my state of vermont and all over this country small businesses just cannot afford to put more money into escalating health care costs when they would like to reinvest it in their business to create jobs and make money. so we have, as the president operably points out, not just a crisis at the individual level. it is a major economic crisis that we have got to address and that's why we need real health care reform. >> john webster who agrees with you is sending in this tweet saying regrettably our doctors and insurance companies are seized. we need national health care like other developed countries eklund also say this. you know, the concept of single pay is not a new idea. you have 15000 physicians in this country. 150

we need to get a system that will allow those who are underinsured and without insurance to be able to be cared for in this nation. we need to reduce the serious health disparities. we need to also ensure there is a public option, that there is universal access to health care. make it a good medicare plan that helps the young, the old and the working americans. in addition, we need to be fair to how we pay for it. we need to realize that physician-owned hospitals are not the enemy. in fact, they help to in essence bring down health disparities. many physician-owned hospitals or investor-owned hospitals are in the urban and rural areas with no other hospitals would go. let's fix this system in a fair manner that addresses the question in ensuring that the those without insurance can have a good public option, can as well have a good system of good doctors, have good hospitals and make it work for working americans and others who are in need. i yield back. the speaker pro tempore: pursuant to clause 8 of rule 20, the chair will postpone further proceedings today on motions to suspend the

no health insurance and very importantly we don't talk about this and we have even more who are underinsured and the importance this is not good enough to say everybody has insurance, you have to ask what is the quality of insurance, how meaningful is it? is a $10,000 or $5,000 deduction? for the war in the midst of this disintegrating system we have some 60 million americans who do not have access to a doctor on a regular basis because we have a disaster in primary health care. why is than ever airborne? it's important because we have close to 20,000 americans who die every single year because they don't have access to a doctor in by the time they get medical care their achievements, their problems are so far of long, their illnesses are so severe that they die when they should have lived. i know that in the coming weeks and months we're going to see a lot of tv ads about all the terrible things happening around the world, i hope some of those people will focus on families that have lost a loved one simply because that person cannot add to a doctor because of lack of health care. we lose cl

these 47 million americans who don't have health coverage, the tens of millions more that are underinsured because the only way the risk pool works is if you have the young and healthy, people who aren't going to use the services right now, today to offset the risk for those who are. as the gentleman indicates there is still going to be opposition to this concept when we move forward. when we talk about ways to move people into the system that currently don't have access, one of the ideas that we talk about which the gentleman from connecticut is very involved in is the idea of having a choice for people to join a plan that would compete with the private insurance industry. we hear a lot of talk about how the private sector always does it better than government. they're more efficient, more cost effective, the government is too bloated. i would say to those who make that case, then, what are you worried about? what are you worried about the competition from the government if the private sector always does it better than government? the difference in this case, if we do it right, and certai

why is it out for health care system is so expensive and least 46 million without insurance or underinsured, close to 20,000 a year by? do we talk about it? and one of the reasons i think we've got to talk about it is we have 1300 private health insurance systems and what is the function of a private health insurance system? does anyone think it is to provide health care? it's to make as much money as it possibly can. i want to touch on a few issues i haven't heard discussed. people talk about the problems of government and at this and that. let's talk about something. yet when you talk about the high cost of health care is inappropriate to talk about some of the salaries people in health care are making? do we think it is a good idea people at a time when 46 million americans can't afford health insurance there are people in the health care industry making huge salaries? johnson & johnson, a major pharmaceutical company found the cash to pay the ceo $31 million in 2007, not a good way to spend health care dollars. ron williams, who testified before this committee, concerned about cost effe

appreciate their coverage and like it, but we have tens of millions more who don't have coverage or are underinsured. so the challenge we have as a congress is how to fix what doesn't work, what's broken, but how to preserve what does work. we have put forward a plan and we are in the very beginning stages, there's a lot of negotiation that's going to go into this both in the house and in the other body, to talk about how we can achieve that goal. but make no mistake as the gentlewoman knows, we are not going to fail. we are going to pass a health care bill this year because the american people have demanded that we do that. and as i said it affects everybody in this country. the cost increases double and triple the rate of inflation every single year are simply unsustainable. we are never going to get ourselves out of the budget crisis that we have. our annual budget deficit and our structural debt that we have over the long term unless as the president says we bend that cost curve on health care. we have to bring costs more into line with the rate of general inflation. ms. schwartz: would the gent