Remarks of Congressman John D. Dingell, Ranking Member
Committee on Energy and Commerce

FAMILIES USA HEALTH ACTION 2006
ANNUAL GRASSROOTS CONFERENCE

Thursday, January 26, 2006

Let me begin by thanking Ron Pollack for his leadership on healthcare issues. He and the other Families USA staff continue to do an outstanding job advocating on healthcare issues in Washington, and across the country. He is a great leader for a truly important cause.

I also want to thank those of you in the audience for the work you have done and are doing for better health care for Americans. I cannot tell you how critical it is to have motivated, energetic advocates advancing the cause. During my service in Congress, the one thing that remains constant is that I would be unable to do what I do without advocates such as you helping fight the good fight on the outside.

The story of our Nation’s healthcare system is one of great success but also one of great failure and missed opportunity. We have some of the finest medical institutions in the world: the best trained medical professionals, cutting-edge technology, and state-of-the- art facilities.

We also have, however, major gaps in our healthcare system. At last count nearly 46 million Americans were uninsured. Close to six million Americans lost their insurance between 2000 and 2004. More than 18,000 Americans die prematurely each year because they lack health insurance coverage. Despite the outstanding job by hospitals, community health centers, and others, our safety net is becoming threadbare. Federal spending on the healthcare safety net declined 8.9 percent between 2001 and 2004, while the need continues to grow even larger.

Sadly, things are getting worse. Next week, the House of Representatives is expected to vote on legislation -- which will move quickly to the President’s desk if it passes -- that would undo years of progress in reducing the number of uninsured and under-insured. I am referring to the Budget Reconciliation bill.

This bill will hurt children, by taking away one of the most critical Medicaid benefits that ensures all children are treated for medically-necessary problems. Parents would be forced to pay significantly more out of pocket to get health insurance for their children -- and children could be denied care if their parents could not pay for it on the spot.

This reconciliation bill will severely hinder those living with disabilities who wish to move out of institutions and into the community. New premiums and punitive co-payments for people with disabilities will make it impossible for many to live in their community. Only by remaining in an institution will they be protected from these new charges. In addition, the bill allows States to reduce, cap, or otherwise eliminate the personal care coverage that today these individuals are guaranteed -- and that they rely on to continue living with their families and working in their communities.

Basically, the Republicans would allow States to charge people more and give them less. That is, States could charge even the poorest of the poor more than they have ever had to pay before, while at the same time reducing the benefits covered in their insurance package. And, the reconciliation bill is the harshest to those who are the sickest -- they are the ones who will bear the brunt of these changes because they require more prescription medicines to stay well and more doctor visits to treat their medical conditions.

My Republican colleagues clearly had a choice when selecting the policies to meet their budget targets. The Senate chose to get savings in the budget bill by closing loopholes and overpayments to Medicare HMOs, rather than taking them out of the hides of beneficiaries. The House decided to achieve its savings by cutting health coverage for families. The final House-Senate Republican agreement ended up choosing cuts in people’s healthcare funding in the amount of $16 billion over a 10-year period, and dropping the $32 billion in savings from closing HMO overpayment loopholes.

Worse, the cuts to Medicaid are being used to finance a new round of tax cuts for the richest one percent of Americans, who have already realized on average more than $103,000 in tax benefits per person last year from President Bush’s previous tax cuts, and will gain an average of another $19,000 a year from two additional cuts that took effect this month.

My Republican friends are fans of “trickle down” theories, but they are ignoring the “trickle down” effect of this ill-conceived bill. The net effect of this legislation will be to raise costs in the U.S. healthcare system both for the safety net providers who will care for these patients and for the employers who see healthcare costs increase even more to compensate for the higher number of uninsured this bill will cause.

The cost of uncompensated care for the uninsured was expected to exceed $43 billion nationally in 2005. Premiums for employer-provided family health insurance cost, on average, an extra $922 in 2005 to cover the unpaid expenses of health care for the uninsured. These added costs account for $1 out of every $12 spent for employer-provided health insurance. The costs of depriving families of health coverage under this reconciliation bill will clearly add up.

But this reconciliation bill is not just a cost shift to our employers and the already wobbly healthcare safety net, it is also a substantial cost shift to the working families who rely on Medicaid coverage -- whether for an elderly parent in a nursing home or for their preschool child with asthma or for prenatal care for the one of every three babies whose delivery is financed by Medicaid. Cutting benefits, raising out-of-pocket costs, and denying care will make it harder for these families to make ends meet. And the health consequences will be severe.

The deciding vote on this bill will come on February 1st. In the few remaining days before this vote I urge you to keep fighting. We cannot stop working for the health of our children, our elderly, our working parents, pregnant women, their unborn children, and people living with disabilities.

But in the coming weeks, we will also need to address the implementation of the new Medicare private drug benefit. You and I both saw this train wreck coming. Families USA worked tirelessly before implementation to draw attention to the problems inherent in this new Rube Goldberg scheme. I worked with my colleagues in Congress -- not only to get a different, less complicated system adopted -- but also to point out problems that needed to be fixed.

As the first month of this new benefit comes to a close, it is clear our pleas went unheeded. The new system is failing Medicare beneficiaries, particularly the most needy. More than half of the States have stepped in to provide emergency assistance, recognizing the public health crisis at hand.

Much of the confusion results from the needlessly complex scheme, built to accommodate an ideological view of government and help favored industries rather than to help real people. Scores of private insurance companies are competing for seniors’ business. Drug companies and insurance companies are making out like bandits.

The thinking person would ask why the Republicans are clutching so desperately to these private insurance companies that have confused tens of millions of Americans, and have not produced much benefit for anyone. The answer is simple. In the President’s “ownership society” people must have some “skin in the game,” but what he is trying to do is let his cronies take their hides.

I recently wrote to Department of Health and Human Services Secretary Leavitt urging him to act to rectify the disastrous situation that has unfolded in Medicare Part D. Low-income seniors are leaving their pharmacy without needed medicines; others are being overcharged 2, 3, even 10 or more times what they should to take home their prescription – or are told that their plan does not cover their prescription at all. Seniors are not being advised of their right to appeal and the Centers for Medicare and Medicaid Services has not required a standardized system, making it more difficult for families and counselors to assist those in need.

So in the event the Secretary chooses not to act, my colleagues and I are ready to introduce legislation to ensure beneficiaries are not harmed by private industry’s failures. And, of course, I will continue my efforts to simplify this mess and allow seniors and those with disabilities to get their medicines through Medicare rather than private insurance companies.

The ever-increasing needs and costs for Medicaid and for Medicare prescription drugs continue to demonstrate the need for universal healthcare coverage. The crisis is worsening and the public is becoming more aware of the urgency of the situation as lack of coverage touches more and more American families.

Eight out of ten uninsured Americans are from working families. This statistic indicates a problem that has been brewing in this country for over six decades. These hardworking Americans have jobs and play by the rules, yet they cannot afford health coverage for themselves or their family members. For too long, they have risked personal bankruptcy if they or a loved one became sick and incurred high medical bills. This is unconscionable.

Over my last 25 terms in Congress, I have worked hard to help improve healthcare coverage for all Americans. America has had some successes through the creation of Medicare, Medicaid, and the State Children’s Health Insurance Program. Each of these programs has helped create the Nation’s healthcare safety net as it stands today. Much more, however, still needs to be done.

Ensuring health care for all Americans is an issue that has been around since the 1930s. My father faced it when he was a legislator and offered solutions. When I came to Congress, I recognized his wisdom and have worked tirelessly to see that one day all Americans receive the medical care they need when they need it.

Every Congress since I was elected, I have introduced the “National Health Insurance Act”. It is a simple bill, it is direct, and it would address the problem the uninsured face head on. My bill would provide insurance to all Americans not already in the Medicare system. This would not only provide healthcare coverage, but it would also alleviate the legacy costs on employers, making them more competitive in the global marketplace. My bill is one solution that is on the table and indeed other members have their own solutions, as well. But most importantly, this must be a priority for the President and the Congress. It is not only good economics and cost effective. It is the right thing to do. Unfortunately, at this point, crafting a solution for our uninsured has not been high on the policy priorities of many decision-makers in Washington.

Let me say in closing that I remain as committed to this fight as I was when I first took office 50 years ago. Even in the absence of universal coverage, we have had many successes in the incremental improvements we have achieved and in the ongoing fight to protect these achievements from erosion.

But it would not be possible to succeed without people such as you working across the country to effect change. My Democratic colleagues and I greatly appreciate all that you have done, but we need your help now more than ever to stave off the present danger at the door. In so doing, we will move forward towards an America that is a better and healthier place for everyone. Thank you.

For additional information, contact Jodi Seth, Press Secretary,
Committee on Energy and Commerce Democratic Staff
(202) 225-3641