according to the world health organization, the united states ranks 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy and preventible death. so we are spending almost double what any other country on earth is spending. we've got 46 million without any health insurance. 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 peopl

according to the world health organization, the united states ranks 37th -- 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy and preventible deaths. in other words, we're spending huge amounts of money, but what we are getting for that investment does not compare well to many other countries that spend a lot less than we do. as the health care debate heats up near washington, we, as a nation, have got to answer two fundamental questions. first, should all americans be entitled to health care as a right and not a privilege, which is the way every other major country treats health care and the way we respond to such other basic needs as education, police, and fire protection? 100 or more years ago this country decided every young person, regardless of income, is going to get a primary and secondary education because that is the right thing to do and good for the country. but unlike every other major industrialized nation we have not come to that same conclusion that health care is a r

united health, 2009, united health paid $350 million to settle lawsuits brought by the ama state medical society and doctors and patients. the lawsuits allege that the companies shortchanged consumers and physicians when paying for medical services outside of the preferred network. wellpointe, in 2009, cms barred wellpointe from participating in medicare part d and medicare advantage stating they have demonstrated a longstanding and persistent failure to comply with the requirements of the proper dispensation of the medicare program. aetna in 2003, they agreed to settle a class action suit brought by physicians by paying a $470 million in overhauling business practices that the doctors say have shortchanged patient care. humana in 2000 paid a fine for overcharging government. and sigma paid $24.5 million for allegations of medicare fraud. all right. that is just some of what the insurance companies are doing, and them you have private hospital chains. i think that many people here are familiar with that in fact that in 2000, the hospital corporation of america agreed to pay $745 million.

united health, 20 or nine, united health paid $350 million to settle lawsuits brought by the ama state medical society doctors and patient spigot these lawsuits allege the company shortchanged consumers and physicians when paying for medical services outside of its preferred network. wellpoint, the 2009 cms board wellpoint from participating in medicare part d and medicare advantage stating they've demonstrated a longstanding persistent failure to comply with cms requirements for proper administration of medicare advantage prescription drug program. aetna and 2003, agreed to settle a class-action suit brought by physicians by paying $470 million overhauling business practices that doctors say were shortchanged patient care. amana in 2000 he managed a 14.5 million to settle federal charges of overcharging government health programs. sigma, and 20 of repaid $24.5 million to settle allegations of medicare fraud at a hospital that it owns. that is some of what insurance companies do. then you've got hospital change. many people here are familiar with. that in fact in 2000, the hospital cor

administrative costs for insurers, employers, and the providers of health care in the united states are about one out of every four health care dollars that we spend. in other words, for every dollar that we spend, one-quarter of that dollar does not go to doctors, does not go to nurses, does not go to medicine, does not go to therapies. it goes to administration. and that is at the root of the problem that we have in terms of health care costs in america. in pursuit of making administrative in california -- one example: in california, only 66% of total insurance premiums are used to cover hospital and physician services. one-third, one out of every three dollars is spent on administration, billing, claims processing, sales and marketing, finance and underwriting. mr. president, the american people want their health care dollars spent on health care. i know that's a radical idea. but when people spend money on health care, they assume that it goes to the provision of health care, not profiteering, not administration, not hiring more bureaucrats to tell us that we're not covered when we

have had their policies presented by three insurance companies who will testify today, assurance, united health group and wellpoint. per my review of case files of the committee has identified a variety of abuses by insurance companies including conducting investigation with an eye toward a decision in every case in which a policyholder simmons a claim relating to leukemia, breast cancer or in any of a list of 1400 serious or costly medical conditions. rescinding policies based on alleged failure to disclose the health condition entirely unrelated to the policyholders current medical problem. rescinding policies based on policyholders failure to disclose a medical condition after doctors never told them about. rescinding policies based on is a mistake by policyholders and applications in rescinding coverage for all families -- for rescinding coverage for all members of a family of a summit million to disclose medical condition of one family member. investigation has also found that at least one insurance company wellpoint evaluated employee performance based in part on the amount of money is si

it isn't just william maguire, the former head of the united health the several years ago accumulated stock options worth $1.6 billion. anybody have a problem with one body in the health care industry getting $1.6 billion in stock options? you have on average on the top seven companies the average is $14.2 million that is the insurance companies. the drug companies' ceos make even more money. i am not going to tell you that is a huge percentage of a $2.5 trillion health care bill but it does send the message and the message is the function of health care in our country isn't quality cost-effective health care, it is to make money and the people on top are doing just that. now, in my view, there is a solution to the crisis that we have. but a requires us to do something that in congress we don't do all that often. and that is to say all the lobbyists who are here and all the big money interests to give campaign contributions who lobbied successfully put the 32nd ads on tv that your time has come and gone. we are past that now. we can't deal with your hundreds of millions of dollars tha

and investigation by the subcommittee on investigations showed that health insurance well point, united health group and assure it canceled the coverage of more than 20,000 people, allowing companies to avoid medical claims. policy -- others were targeted for cancellation. they make money by denying care. caller: she is talking about recisions. look for any reason to dump that person. when you look at some of the insurance reform that are emerging now in some of these bills, i think they want to draw attention to that. i would say that democrats are saying at this point, that they don't want the government between you and your physician. they want you and your doctor to make decisions together on your care and keep your insurance if you like it. host: walter on the republic that linline. caller: everybody is covered. health insurance is covered by everybody. no doctor has ever said to somebody when they walk in, if you don't have the money, i can't set your broken leg. that is a fallacy. as far as this idea of socialized medicine, if we are all going on socialized medicine, and ted kennedy alo

health care. and one of the things that we've also seen is that the united states really stands out in a couple of areas that drive health care costs up. we have very little to no federal lawsuit reform in the united states for health care meaning the defense of medicine is the practice of the day in our country as opposed to other countries because doctors are so likely to be sued. another is that, yes, americans generally have a higher degree of obesity as compared to other countries. and so the president and us on a bipartisan basis, i think, will have a lot of common ground inworking and -- work -- in working and encouraging a reduction in weight by americans because this will lower health care cost but one of our key experts on how lawsuits drive health care costs up is our colleague from pennsylvania as well, congressman dent. mr. dent: i thank the gentleman for yielding. in pennsylvania, of course, we have been a crisis state for some time with respect to medical liability. my colleague, tim murphy, remembers the great debates we had in pennsylvania about the need for joint and separate lia

a fellow who was the head of united health got $1.6 billion in stock options. the goal of health care should be to provide the best quality health care to all of our people in the most cost-effective way. to my mind, the way you do that and what we have learned from other countries is that a single payer system would work. host: this is from a physician from canada who wrote this article in "the wall street journal" this morning. he concludes with this question. "why are they rushing into a system of government health care when the countries that have experienced it for so long are backing away?" guest: we are the odd guys out. if you compare the american system to canada, it is true canada has problems. so do we, but we spend almost twice as much per person. if we continue to spend that kind of money, $2.3 trillion, we can have a better system than the canadians. the correct question to ask is how does it happen that every other major countries such as health care is a right of all people? we do not do that. second of all, they come up with a much more cost-eff

collins, owned by united health group. mr. brian sassi, am i saying that right? sassi who is the president and chief executive officer of wellpoint inc. and ms. karen pollitz who is the research professor georgetown university health policy institute. welcome to all of our witnesses. is the policy of the subcommittee to take your testimony under oath. please bid bison of the right and the rules of the house to be it buys the council during your testimony. kiewit to be represented by counsel during your testimony? mr. hamm you would? any time during the questions if you want to get advice from counsel, just let us know and we will allow the. council cannot testify but the cannon fisa. mr. collins? mr. sassi? ms. pollitz? so then let me have you raise your right hand and take the oath. do you swear or affirm the testimony you are about to give is the truth, the whole truth and nothing but the truth in the matter pending before this committee? let the record reflect that the witnesses replied in the affirmative. they are now under the beginning with their opening st

, institute on care at the end of life, the national hospice and palliative care organization, united health care, aetna and others -- appear in the record immediately following my statement. the presiding officer: without objection, so ordered. mr. warner: thank you, mr. president. and i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: quorum call: mr. mcconnell: mr. president? the presiding officer: the republican leader.

the top four health insurance companies in america -- united health group, well point, aetna and humana -- made more than $7.5 billion in combined profit last year, while the bottom fell out for sreurt wastefulry other company, short of the oil industry, across the board. the goal of the democratic health insurance bill is to create health care and quality. republicans want to preserve a broken system, one with escalating costs and no guarantee that the policy is going to be there when you need it. rather than health insurance companies, democrats want to put american families first and help those who are struggling with high health care costs. i think this is a moment of truth for us in this congress. this isn't an easy issue. right now the finance committee and the "help" committee are both working hard in the senate to try to put together health care reform. but let me tell you, without this things are going to get progressively worse. the cost of health care will continue to rise to unsupportable levels. individuals will still feel that even if they have a good health insurance plan

s making $1.6 billion like the united health group made, how can you get that kind of money unless a whole lot of people are not getting something, the health care they should get? how can you have these profits that people are turning over and still cover everybody? you can't do it. you either have to cut people out of coverage, deny claims and pay profits or you have to run a decent system that extends coverage, but in that case, you don't have people making gobs of money. so you have to make a basic and essential choice. ms. hirono: as i had mentioned, that is generally the states of regulated companies. most states do not have the kind of resources or even the laws that allow them to look at what the health care insurance companies are doing, how they're basing their cost increases or their premium increases. so there really is a lack of transparency and accountability. and when you don't have the ability to look at the relationship between the rates they're charging and what the claimsr how can you even begin to say that peoples' needs are actually being met or that cost containm

ashurent, united health group and well point, the committee has identified a variety of abuses from insurance companies. including conducting an investigation in ever case in which a policy holder has leukemia or any of a list of 1,400 serious or costly medical conditions. rescission is entirely unrelated to the policy holders unrelated problem. conditions that their doctors never told them about. rescinding coverage for all families -- excuse me, rescinding for all members of the fallly based on not disclosing one medical condition of a family. well point evaluated family performance base on the amount of money the employees saved the company on retroactive decisions. according to documents, one well point official was afforded a perfect score of five for exceptional performance, based on having saved the company $10 million through rescissions. these practices reveal that when an insurance company received an expensive treatment, some of them will look for a way, any way to avoid having to pay for it. this is very eerily similar to what we found last year where unscrupulous sales people wou

you get, if you were just love blue cross or you look united health care, you love cigna, you can stay with that. there is no reason whatsoever he would have to change. honestly if i were in the middle of chemotherapy right now the idea of changing anything that seem to be working for me might scare me. you don't need to be afraid of the public provider. anybody can choose it, and anyone can say i don't want it. are choices don't get smaller. are choices get larger at least by one. and what is mark, the market works the way it should, your choices become less expensive too which is pretty important right now for a middle-class family has an average income of $80,000 the average health insurance policy for the middle class family is $12,000, making insurance cost a little bit less is pretty important as your kitchen table. if we want to solve family's economic downturn we need to remember that 62% of bankruptcies are attributable to a significant degree on crippling healthcare costs and you think the sub-prime mortgage crisis is behind all of those foreclosures? you are half right. hip

a fellow who is ahead and of united health act when $.6 billion in stock options etc. so the goal of health care should be to provide the best quality health care to all of our people in the most cost-effective way into my mind the way you do that and what we have learned from other countries is a single payer system would work. >> host: this is from a physician and from canada, the pen and editorial this morning in "the wall street journal" called a candidate obama care president and the situation in the vetted kingdom but concludes with, wire are they rushing into a system of acb0Ñ( government dominated health care when the very countries that have experienced it for so long are backing away? >> guest: i don't know that is accurate and the truth is we're the only country in the industrial world not to have a national health-care program so we are the odd guys out. a second if you compare the american system to canada it is true canada has problems and so we but we spend almost twice as much per person as the canadians do and if we spend that kind of money to $.3 trill

some say there's not a health care crisis in the united states today. if you are a mom and you have a child and you do not have health insurance, and the child is a serious disease, there is a healthcare crisis. if you have a small business any have been providing health insurance and health care costs are so high is driving you out of business, or if you look at our auto companies, there is a crisis going on in the united states. whatever you want to call it, it is a serious problem, and the need to fix it. we do not need what some of the democrats and the president want to do, and they call it a public auction. they tried to disguise the term. it basically is nationalized health care. just one quick statistic for you. they like the european or canadian model. if you or a woman in the united states and get breast cancer, your chances in survival in five years or 98%. in great britain, the chances of survival within five years are only 78%. the problem is, in those nationalized health-care system, a bureaucrat it's in the decisionmaking process between y

a fellow who was the head united health got $1.6 billion in stock options, etc. etc. so the goal of health care should be to provide the best quality health care to all of our people in the most cost-effective way. into my mind my mind the way you do that, and what we have learned from other countries around the world, is that a single-payer system would work. >> let me read you. he is a physician from canada. he attended this editorial in "the wall street journal" called candidate obama. he concludes with this question. quote, why are they rushing into a system of government dominated health care when the very countries that have experienced it for so long are backing away? >> first of all i don't know if that's accurate. the truth of the matter is we are the only country, the only country in the industrialized world, not to have a national health care program. so we are the odd man out. if you compare the american system to canada, it is true canada has problems. so the week, but we spend almost twice as much or person as the canadians do it and if we spent that kind

some say there is not a health care crisis in the united states. you are a mom with a child and you don't have health insurance and that child gets a disease of some seriousness it is a health-care crisis to you. of you have a small business and do have been providing health insurance and health-care cost is so high it drives you out of business or look at our of companies and do see the health care costs, it is a crisis what every you call it it is a serious problem and we need to fix it. we don't need what some of the democrats and the president what to do it is what they call the public option to disguise the term. it is nationalized health-care basically. just one quick statistic, they like the european for the canadian model preview were woven in the united states you get breast cancer your chances of survival in five years is 98%. great britain, if you're a woman your chances of survival only 70%, the problem in those health care system is a bureaucrat gets into the decision-making process between you and your doctor. there should not be in t

health plan are taxed but the self-employed does not have the benefit of tax deduction. host: massachusetts on our republican line. caller: my relatives are from europe. to say that the united states health care system is inadequate or lacking is totally wrong. my relatives say it cannot compare to what goes on in europe. also, why don't we just give free health insurance to those that are most vulnerable, 18 and younger and retired people. everyone else can pay. what that will do is allow the benefits to be taxed on the younger people, and use that to help subsidize the older people. and all the able-bodied people that are working can pay for health insurance. i don't know of -- if a lot of people are aware of this, if you have no insurance and you go to a hospital for an emergency and they are receiving federal funds, you will get treated, then you make payment arrangements. i have gone through that myself. host: from massachusetts on the republican line. a couple of females as well. people complain that there is a charge on the employer or taxes for medicare and medicaid. what is the difference between that charge? all countries with government controlled health care sys

of medicine has suggested that a very large share, perhaps as large as half of the health-care delivered in the united states across the board is not backed by specific evidence that what your doctor is recommending or what is being done actually works better than an alternative. we spend a very tiny share of total health-care spending in the united states trying to examine whether what we're doing works. that needs to change. we have 1.one billion dollars to expand this kind of research. the goal is to provide more information about what is likely to work in that kind of case. let me try to be directly responsive to the excellent questions that were raised during the previous session. and by mr. rubin. critically important, we do not just look at national averages. there is a huge amount of variation in what is likely to work for different types of people, what that will necessarily entail, i did read the papers for the conference last night. they were very good. we are likely going to have to adopt different types of evidence procedures for this research effort and randomized controlled try and cann

health care option. and it is about time that the united states joined the rest of the industrial world and said, yes, our people are going to get the health care they need. that it's going to be a right, not just a privilege for those who can afford it. let me just tell a couple of stories before i yield back, quick ones. the other day, a friend of mine proudly showed me a picture of her daughter who just had a baby in the hospital, a darling picture of mother and baby and mom holding the baby in one arm and a cell phone in the other. isn't that adorable, she must be calling friends and family telling about the birth of this beautiful baby. and my friend said, oh, no, she was on the phone with her insurance company right after the birth of the baby, to make sure that things are covered. you know, there are a lots of insurance policies, private insurance policy, that don't cover maternity care. people sometimes aren't aware of that until they have a baby. the other is, i met a farmer about a month ago, who told me he and his family had a $10,000 deductible policy. now this man is included when we count wh

my colleagues cast during the time that we are privileged to serve in the senate of the united states. this health care reform bill will affect the lives of every single american. it will reform a system that drives one-sixth of our economy over 16 million american jobs. it will have consequences for medical science and innovation that improves the lives of not only those of us in this great country but all across the world. when people are really sick, they come to the united states. and it will spend upwards of $2 trillion -- $2 trillion -- that our children and grandchildren will have to someday repay. if we are going to do this, we cannot afford to get it wrong. for this reason, i initiated a letter just about a week ago on behalf of all my republican colleagues on the senate finance committee, on the "help" committee, and i asked the chairman of those respective committees, the distinguished chairman, senator dodd, who is now serving in senator kennedy's absence to give this process the time and the careful consideration that it deserves. that was the message of the letter: give us the time a

as of 2006 health spending in the united states was 90% higher than other industrialized countries. health insurance premium increases consistently outpace inflation and growth in family earnings. about 30% of the poor people in america spend more than 10% of their income on health care. since the beginning of this decade, health insurance premiums have gone up by 78%. everybody knows this. no matter who you work for, private business, public entity, you know the cost of health insurance, it just keeps skyrocketing. wages have only gone up 15% in that same period. people and families in america cannot keep up. overall 46 million americans have lost their insurance and many lose their insurance for periods of time during the course of a year because of changing jobs or losing jobs. but the -- with the amount of money our country dedicates to health, the facts just don't line up. yesterday my colleague from arizona, the senate republican whip, jon kyl, spoke about the problems with our health care system. i'm glad that he agreed that there are problems to address. but i need to clarify

>> his message is he has no interest in socializing the united states health care industry, he has no interest in preventing people who like their doctors and their insurance companies and their insurance coverage continuing to receive the same coverage and going to the same doctors for treatment. all he wants to do is find a way to ensure that 46 million or so people who currently do not have health insurance and assure the people with pre-existing conditions and living to graphically out of the way price of the country and have access to the same quality of care as other people do. that was the message he was trying to send to them and he is trying to preempt the ama who started to grumble and take a look at the health care concepts coming out of the u.s. senate in particular, he is trying to prevent them from launching a full-scale offensive against the kind of health care reform he wants. >> health committee is scheduled to work on its health-care proposal later this week. what will you be watching for as a mark of that could take weeks? >> well, the health committee in my opinion

in a global economy, our broken health care system is a major competitive disadvantage. a greater share of the price of each car in the united states goes to health care than goes to steel. $1,500 of the cost of the car goes do health care and in canada that price is zero. if we're going to compete in the world we need competitive cost effective health care system. and, of course, the biggest of back of our expensive ineffective health care is most acutely felt around the kitchen table by our working families. with unemployment skyrocketing, virtually every family is reminded of how tenuous its connection is to health care. just one pink slip away from losing health care for their family. even those with insurance find health costs out of reach. nearly half of the personal bankruptcies are by folks who have health insurance but still couldn't manage all the health care costs when they became ill. this is what it boils down to: working families in america, if they have health care, they're concerned about the co-pays, concerned about being under insured and concerned about losing their insurance with the loss of a job. those

there have been many studies over the years comparing the united states -- the outcomes of the united states, health outcomes, to the outcomes in other countries in the world. we rank, in terms of victim mortality, in terms of maternal mortality, in terms of life expectancy, in terms of diabetes, in terms of obesity, the united states of america, amazingly enough, even though we spend twice as much as everybody else, we rank almost at the bottom among the rich countries of the world on life expectancy, infant mortality, child obesity, all of those things. mr. president, there is one statistic where we rank near the top. that statistic is life expectancy at 65. so these pages sitting in front of me, five decades from now or so when they turn 65 -- we're going to change the system way before then. but people who are 65 in this country have a longer, healthier life in front of them than almost all other countries in the world. that's because we have medicare, and medicare works. it's pure and simple. today, some 65 years after harry truman made the speech to the joint session i mentioned, we're still w

and% of the world's innovation in health care comes from the united states -- 90% of the world innovation in health care comes from the united states. we believe that our plan is a big improvement on the current system that will cost far less than what the administration is proposing. if you look at their plan, it is a big government run a plan that will take control of the delivery of health care in america. i do not think that is what most americans want. embassies -- families and small businesses are looking for more access. when need to work on that problem. this is a serious -- we need to work on that problem. this is a serious undertaking. we need our ideas to be taken seriously. the stimulus bill, the omnibus appropriation bill, they had ignored our views. we will continue to offer better solutions as i promised on the opening day and gave the gavel to nancy pelosi. we sometimes have to say no and oppose what our democratic colleagues are for. this is a better solution for american families and small businesses who want better access to health care. i wan>> i want to recognize one

host: you said you and your wife both have health care from united healthcare in cigna. part of this proposal circulated by the president would call for companies to provide -- part of the law would ask the companies to provide health care or face a penalty. would you be in favor of that? caller: not really, because i don't believe the government belongs to the private sector business. that is well beyond the spectrum of what the government should be doing. host: here is the view of "the baltimore sun" 01 way to pay for health care. charging for the pop in soda. slapping a tax on sugary drinks could be good for health. but dcent a 3¢ excise tax on the strings may prove to be exactly what the doctor orders, not only if it means less consumption of the stuff of dreams, but if it can help finance barack obama as health reform. it hits low-income people the hardest. but, in fact, it is just the opposite. if poor people are less likely to buy sugary drinks they stand to benefit the most. omaha, neb. on our democrats' line. caller: and a person goes to see a doctor the doctor i

health-care. that is untenable. it is unacceptable. i will not allow it as president of the united states. [applause] health care reform is not something i just cooked up when i took office. sometimes i hear people say he is taking on too much. i am not doing this because i do not have enough to do. we need health care reform because it is central to our economic future. it is central to our long-term prosperity as a nation. in past years and decades, there may have been some disagreement on this point, but not anymore. today, we have already built an unprecedented coalition of people ready to reform our health-care system. physicians and health insurers, businesses and workers, democrats and republicans. a few weeks ago, some of these groups committed to doing something that would have been unthinkable a few years ago. they promised to work together to cut national health-care spending by two trillion dollars over the next decade. that will bring down costs. it will bring down premiums. that is exactly the kind of cooperation we need, but the question now is how we finish the job five we p

they do not have a history of being forthcoming with the health information in their possession. just two weeks ago, the united states court of appeals for the district of columbia found that the tobacco companies were guilty of -- quote -- "a decades-long conspiracy to deceive the american public about the health effects and addictiveness of smoking cigarettes." i'm pleased i was able to add a measure to that bill that increased civil penalties for violations of the new law and sends a strong message that we're serious about expecting compliance from the tobacco industry. the new, larger color graphic warning labels provision i authored will do a lot to reduce smoking. everyone from the world health organization to the congressional budget office says these warnings work. research shows that these warnings have a big impact. approximately one-fifth of the participants reported smoking less as a result of the labels. only 1% reported smoking more. we should want kids thinking about taking up this deadly habit to have a bit of a shock just by looking at the package. we should want smokers to think about thee he

a greater number of minorities to enroll in clinical trials designed to the immediate health disparities. the united states also has evidence that the elect shall -- that -- is enhanced by all learning in an ethnically and racially diverse education and permit -- environment. then serving culturally and linguistically culturally diverse individuals increases the number of initial visits to hospitals, to clinics, or physicians' offices. it results in higher utilization of care, enhances high-quality counters, lowers medical errors, and reduces emergency room admissions. with the prospects for health reform on the nation's stock it, we have the challenge and the opportunity to develop a successful model to eliminate health disparities, by addressing the central issue, and that is the health care work force. the administration and congress can lead this effort for needed changes in our health-care system. 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 inc

member and chair for the department of health & human services office of minority health n. 2005 he collaborated with former united states surgeon general dr. david satcher to author and edit one of the first textbooks addressing inequalities in health care titled multicultural medicine and health disparities. next we have dr. sally satel who is a psychiatrist as the oasis drug treatment clinic here in washington, d.c. she is a lecturer at yale university school of medicine and author of the health disparities myth, diagnose nosing the treatment gap. diagnosing the treatment gap. and next -- and i will need assistance pronouncing your first name. >> next we have amitabh chandra who is a professor of medicine at harvard, and he is a research fellow in bonn, germany, and the national bureau of economic research in cambridge, massachusetts. his research focuses on productivity and expenditure growth in health care, racial disparities in health care and the economics of neonatal health and cardiovascular care. then we have dr. peter bach who is a physician at the memorial sloan kiterring cancer center. his work has fo

republicans have been discussing the state of health care in canada and the united kingdom because those countries have government-run health care and delay or deny treatment for citizens to keep costs under control. the canadian and british governments created the systems with good intentions but government-run care is not serving their citizens' need and we don't need to replicate their problems in the united states. in canada, claude, chair of the commission which recommended the quebec establish a government-run system in the 1960's declared last year the system is in "crisis," his words. private clinics are opening all over canada at the rate of one per week to treat those who are on waiting lists at the public hospitals. many canadians who have the resources to get out of the bureaucratic government have chosen to do so. as the republican leader pointed out, britain's national institute for health and clinical excellence, the entity responsible for setting guidelines on pharmaceuticals and treatment for british patients denied parents in that country access to four kidney cancer dr

overall, what we've found is that the market for individual health insurance in the united states is fundamentally flawed. one of the biggest problems is that most states allow individual health insurance policies to deny coverage to people with pre-existing conditions. so if you lose your job, and you can't qualify for a government program like medicare or medicaid, it's nearly impossible to get health insurance if you're sick or have an illness. this creates a perverse incentive. in the united states, insurance companies compete based on who is best at avoiding people who need life-saving health care. and this incentive manifests itself in a wide variety of controversial practices by the insurance companies. when we know that if people apply for insurance policies, and they put down that they have some pre-existing condition, they're going to be denied. but what we've found is that when people with individual policies become ill, and then they submit their claims for expensive treatments, that insurance company launches an investigation. they scour the policyholder's original insura

one key fact is that health care expenditures in the united states are about 18% of gdp. that is the highest of any country. we go to the first figure. the figure shows our projections of the likely path of national health care expenditures. these expenditures are projected to rise sharply, by 2014, health expenditures could be roughly 1/3 of total output in the u.s. economy. all right. how about households? rising expenditures will likely show up in rising insurance premiums. even if employers can take to pay the lion's share premium, but economic theory and empirical evidence suggests that this trend will show up in stagnating take-home wages. the next figure shows our projections of total compensation. both of these are inflation. the wedge shaped area between the two lines shows are predicted levels of insurance premiums. without reform, the non insurance part of compensation will grow very slowly and will likely fall eventually as premiums rise rapidly. all right. rising health care costs also means that government spending on medicare and medicaid will rise sharply o

health policy at george washington university. this bill comes with context. i want to give some workforce context quickly. in the united states, we have large numbers of health professionals and physicians. we have an adequate number of positions. we need to " the physicians at the population grows. -- we need to grow the positions as the population grows. rural areas and poor areas have trouble with physicians and nurses and other health workers. one of three physicians in the united states inches -- is in primary care. the commitment to primary-care is flagging in the pipeline. evidence suggests that primary care is associated with better outcomes and less cost. nurse practitioners and physician assistants are important components of our work force today. they need to be grown as this bill suggests they do. in terms of the context, we do very little planning. we have a large help work force. we do little down stream planning. we need to put more brainpower and data and thoughts of deliberation on what we invest in with regard to the work force. i want to suggest a way to look at the work force. the last rapid action

there is no rationing of health care and the united states except by price. if you cannot afford insurance, then there's rationing of health care. there's not a board that tells you what you can have and what you cannot have. for the most part, that does not exist in other countries either. there is some rationing in canada because you have to wait in line to get procedure sometimes. although, there were satisfied with their system than we are. there is some rational 9ing britain who will not pay for your expensive drugs for the end of your life. -- there is some rationing in britain. we are not going to have united states rationing in united. -- we are not going to of rationing in the united states. conservatives were against medicare. we got medicare passed under lyndon johnson with almost no republican support. they thought it every step of the way. here we are and medicare is the difference between whether seniors are dying in droves or whether they get recendays and h care. you have to put these conservative ideas aside. they get told what to say by a ver

i rise in support of h.r. 1211, a bill to amend title 38, united states code, to expand and improve health care services available to women's veterans from the department of veterans affairs and for other purposes. i appreciate the gentlelady from south dakota, ms. herseth sandlin's, hard work on this bill in bringing this forward. throughout history, women have played a vital role in our national defense. currently, women make up about 8% of the total veteran population and the v.a. estimates that by 2020, women veterans will comprise about 10% of the veteran population. women are the fastest growing segment of the veteran population and it's essential to make sure that v.a. is providing specialized programs and services to meet their unique physical and mental health needs. i want to thank again my good friend and colleague, the gentlelady from south dakota, for introducing this legislation and i am pleased to have joined with her as an original co-sponsor for h.r. 1211. this would expand and improve benefits for our female veterans, especially the newest generation of women veterans ser

united states. every state, in fact, regulation health insurance. this is an area that not only has some federal regulation, but every state regulates health insurance. in fact, one of the reasons that you can't buy a health insurance policy from the state that you don't live in, you can't go across state lines and buy a policy in another state is because we're so jealous of the state regulation of insurance. so to the question of my friend from new york, who's going to provide a check? the answer is your state. if you don't trust your state to properly regulate health insurance, then i don't know where we are. but you're not going to provide better regulation by commissioning a government insurance company to exist and compete right alongside the private insurance companies. how does that provide a check on the private insurance companies? it's not as if there aren't enough private insurance companies or that they're not providing enough different kind of plans. so that can't be the problem. it's not a matter of a lack of competition in most places

that sort of option for health care reform is before the united states senate if it can only be considered. it's been offered on one hand by senator coburn and senator burr. it's been offered at the same time by senator gregg of new hampshire. it's been offered in a bipartisan way by senator wyden and senator bennett, who have offered a proposal that would basically give these dollars to the people who need help, let them buy their insurance, and according to the same congressional budget office that said the kennedy proposal cost at least $1 trillion more, they said wyden would cost zero more. i'd like to be informed when i have a minute left. the presiding officer: without objection. the senator has five minutes remaining. mr. alexander: during the last six months the four words we've heard most in washington is more debt and washington takeover. we've seen a washington takeover of banks, insurance companies, student loans, car companies and now perhaps of health care. the president insists on a government-run insurance option as part of a health care reform plan which would inevitably l

unit. so the same thing that happens as you move from active service out to be part of the veterans health care system, works within a matter of days in a hospital setting when you come in and present to the e.d., you then aren't on the same record system when you move over to the inpatient unit. that's because we do not have a sort of nationally agreed upon platform for how systems communicate to each other. hospitals say to themselves, i've got one really good system for the emergency rooms, i want to buy this other really good system for inpatient care. we need national standards that say to any hospital or physicians office that's buying into a records office, you can be guaranteed you're getting a system that presents you with the data and tools you need and will be able to communicate with everybody else. in fact, there's no way we're going to spend that stimulus money without some national standards to guarantee that that happens. but as a sort of preview as to how politicized and how politically charged this debate can become, when we were debating that portion of the stimulus bill