Keith Ellison

Mr. ELLISON

Mr. ELLISON. If the gentleman would yield back for a moment. I want to thank Congressman Johnson and you, Congressman McDermott, for coming here today, because what you are talking about is not just dealing with the immediate situation. We are not saying, well, we are on the Titanic, let's put the deck chairs over there. No, let's move them back over there. We are projecting a progressive vision for our Nation. We are saying we are going this way. And that is why we are here with the progressive message today. I just want to remind people, we are here with the Progressive Caucus projecting a progressive message, talking about economic prosperity for all Americans. We have talked about unemployment. And Congressman Johnson and I had a great dialogue; and when you came, Congressman McDermott, we began an important conversation about how health care has a vital role to play in the economic health of a family and a Nation. I think we pointed out, when General Mills spends more money on health care than it does on steel, we have got a problem. When Starbucks spends more money on health care than it does on coffee beans, we have got a problem. Both things are true. It is time to move forward. Medical debt being one of the major drivers in bankruptcy. This is the time. The time is now to begin universal health care. And signing SCHIP I believe was the beginning of good times to come.

Mr. ELLISON. Thank you, Congressman. I am going to yield back to Dr. McDermott because he was driving at a point that I think the American people need to hear about. Congressman McDermott, when you were there at the White House and President Obama had just given his speech, all you guys who were instrumental in getting SCHIP together probably gathered around the desk and you saw him write his name on that bill which, in effect, makes SCHIP law, as a medical professional, as a person dedicated to the health of our Nation, what did you feel?

Mr. ELLISON. Do you remember Charlie Brown, whenever he tried to kick the ball, Lucy always picks the ball up. And they picked the ball up on the President, even though they said they were going to hold it down. I yield back.

Mr. ELLISON. If I can reclaim my time. The American Recovery and Reinvestment Act. I yield back to the gentleman.

Mr. ELLISON. If the gentleman yields back. Congressman Johnson, you know, we are the progressives. We want progress. And if you say you're a conservative, what, over the past 8 years, do you want to conserve? Do you want to conserve these exploding unemployment rates they've handed us? Do you want to conserve this war in Iraq and Afghanistan? Maybe you want to conserve this regime of deregulation which has allowed businesses, and particularly in the financial sector, to do whatever they want and not have to worry about consumers. Is that what you're trying to conserve? The fact is the people of America don't want conservatism. They want a progressive vision. They're looking at things like I have up on this graph right here. They're looking at Minnesota. We have an unemployment rate in 2008 of 6.9 percent. Last year, 2007, it was 4.7. In California, they're looking at 9.3 percent unemployment this year, 5.9 percent the year before. What about our colleagues from Michigan, Congressman Johnson? We've got a serious problem. The question is if you look at these high unemployment rates, and you look at every blue line is 2007 and every red line is 2008, as you can tell, unemployment is up all across the Nation everywhere. These things did not happen by accident. They are the product of a set of policies, many of which were promulgated right in this gallery you and I are in right now. Many of the policies saying that poor people have too much money and rich people don't have enough money promulgated right here. Tax cuts for the wealthiest Americans, no accountability. As a matter of fact, it was put into legislation that the whole credit default swap market would be excluded from regulation, and now we know that these derivative products cause so much risk in the system that we don't know what to do about it. The fact is, the policies and the procedures that have brought this about were done right here during the last 8 years, and we are now going to project a progressive vision to get us out of it. Let me just say this before I turn it over to you, Congressman. America has suffered 11 straight months of joblessness, of increasing job losses, totaling more than two million in the last year, 1.3 million jobs lost in the last 3 months alone. The job losses totaled over 500,000 in November, the biggest 1-month jump in 34 years. Now that's serious business. So, facing these kinds of things, Congressman, what would be your thought as to what we should be thinking about right now? Let me yield to you.

Mr. ELLISON. Congressman Johnson has correctly pointed out that we have got people losing their jobs. Unemployment is climbing up to 10 percent in many States, and we don't want to reach that point nationally. But one of the things that I think you will agree with me, Congressman Johnson, is that when you lose your job in America, so often you also lose something else--your health care. You and I have been joined by Jim McDermott from the great State of Washington, who has been fighting the good fight for so long, knows this issue of health care, and many other issues as well. Congressman McDermott, welcome. What can you tell us about the other side of losing a job, or even folks who do have a job, their health care crisis?

Mr. ELLISON. Thank you, Madam Speaker. Tonight we're here for the Congressional Progressive Caucus, and I'm joined by my colleague, the honorable Hank Johnson, who hails from the State of Georgia. And we are the Progressive Caucus. And we're here week after week, month after month to help the American people understand that the progressive community throughout America has a group of people in Congress who are willing to stand up and stand strong and project a progressive vision for all of the Nation. The Progressive Caucus has designed something we call the progressive message. So this is what we do. We come together, and we talk about our progressive vision for our country. We started off only a few weeks ago talking about the need to hold the executives accountable and to not simply wipe things that happened in the past 8 years under the rug. Then we came back last week to talk about the economy and the stimulus package. And because we're facing a rising unemployment rate, foreclosure rate that is increasing, because people are losing their jobs, because things are getting tougher every day, we've got to stick with this issue of the economy so we can talk to people about which way forward, what do we do, what is the progressive message to help America go forward. So with that, I want to introduce my colleague, my good friend from the great State of Georgia, to introduce himself and the topic tonight, Mr. Hank Johnson. Congressman, let me yield to you. How are you doing?

Mr. ELLISON. So you think America should join the 36 other countries in the world that have a single-payer system?

Mr. ELLISON. So Congressman, we're going to begin to wrap up our hour at this time. We're going to allow somebody else to offer their views to the American people. But as we get ready to wrap up, I wonder if you have any remarks you would like to share before we hand it over.

Mr. ELLISON. Would the gentleman yield for just a moment?

Mr. ELLISON. Will the gentleman yield?

Mr. ELLISON. Will the gentleman yield? If you don't mind, if you have a few other facts and figures at your disposal, would you mind detailing for us tonight some of the other things that you believe we need to stick with and not compromise away? Do you have a list of those kinds of things?

Mr. ELLISON. And if the gentleman yields back, you can bet I will be right there with you standing behind our great Speaker, Nancy Pelosi, a leader for all America, a transformative leader, a leader with energy. The fact that she has children the same age as you and I, Congressman, doesn't undermine her energy level. She is energetic. She is powerful. She is visionary. She is progressive. And you and I are here today talking about the Progressive Caucus. We're here talking about a progressive vision for our Nation. We're making an obvious observation. In the Progressive Caucus you say, look, if you don't like government, if you believe government is the problem, as Ronald Reagan famously said, ``government is the problem,'' it stands to reason you might not be good at it. If you think government is not a good idea to begin with, you might not invest the time, energy and resources necessary to be good at it. And therefore it should be no surprise to anyone that the government, that the Republicans and the conservatives are bad at economics. They are just not good at it. And so it is not surprising to me that they would think that you could increase spending around a war, cut taxes, and then think that things are going to go well economically--they didn't go well economically--and then deregulate everything, and then neglect the infrastructure. Well, we're back to offer a progressive vision, to say to America that it is time to have an inclusive economy, to have civil rights, to have environmental protection and to make a better way forward for all Americans. This has been Congressman Keith Ellison with the Progressive Caucus with Congressman Johnson. Thank you, sir. Congressman McDermott joined us and we are very proud to be here representing the Progressive Caucus with the progressive message. [From The New Yorker, Jan. 26, 2009] Annals of Public Policy: Getting There From Here How should Obama reform health care? (By Atul Gawande) In every industrialized nation, the movement to reform health care has begun with stories about cruelty. The Canadians had stories like the 1946 Toronto Globe and Mail report of a woman in labor who was refused help by three successive physicians, apparently because of her inability to pay. In Australia, a 1954 letter published in the Sydney Morning Herald sought help for a young woman who had lung disease. She couldn't afford to refill her oxygen tank, and had been forced to ration her intake ``to a point where she is on the borderline of death.'' In Britain, George Bernard Shaw was at a London hospital visiting an eminent physician when an assistant came in to report that a sick man had arrived requesting treatment. ``Is he worth it?'' the physician asked. It was the normality of the question that shocked Shaw and prompted his scathing and influential 1906 play, ``The Doctor's Dilemma.'' The British health system, he charged, was ``a conspiracy to exploit popular credulity and human suffering.'' In the United States, our stories are like the one that appeared in the Times before Christmas. Starla Darling, pregnant and due for delivery, had just taken maternity leave from her factory job at Archway & Mother's Cookie Company, in Ashland, Ohio, when she received a letter informing her that the company was going out of business. In three days, the letter said, she and almost three hundred co-workers would be laid off, and would lose their health-insurance coverage. The company was self-insured, so the employees didn't have the option of paying for the insurance themselves--their insurance plan was being terminated. ``When I heard that I was losing my insurance, I was scared,'' Darling told the Times. Her husband had been laid off from his job, too. ``I remember that the bill for my son's delivery in 2005 was about $9,000, and I knew I would never be able to pay that by myself.'' So she prevailed on her midwife to induce labor while she still had insurance coverage. During labor, Darling began bleeding profusely, and needed a Cesarean section. Mother and baby pulled through. But the insurer denied Darling's claim for coverage. The couple ended up owing more than seventeen thousand dollars. The stories become unconscionable in any society that purports to serve the needs of ordinary people, and, at some alchemical point, they combine with opportunity and leadership to produce change. Britain reached this point and enacted universal health-care coverage in 1945, Canada in 1966, Australia in 1974. The United States may finally be there now. In 2007, fifty-seven million Americans had difficulty paying their medical bills, up fourteen million from 2003. On average, they had two thousand dollars in medical debt and had been contacted by a collection agency at least once. Because, in part, of underpayment, half of American hospitals operated at a loss in 2007. Today, large numbers of employers are limiting or dropping insurance coverage in order to stay afloat, or simply going under--even hospitals themselves. Yet wherever the prospect of universal health insurance has been considered, it has been widely attacked as a Bolshevik fantasy--a coercive system to be imposed upon people by benighted socialist master planners. People fear the unintended consequences of drastic change, the blunt force of government. However terrible the system may seem, we all know that it could be worse--especially for those who already have dependable coverage and access to good doctors and hospitals. Many would-be reformers hold that ``true'' reform must simply override those fears. They believe that a new system will be far better for most people, and that those who would hang on to the old do so out of either lack of imagination or narrow self-interest. On the left, then, single-payer enthusiasts argue that the only coherent solution is to end private health insurance and replace it with a national insurance program. And, on the right, the free marketeers argue that the only coherent solution is to end public insurance and employer-controlled health benefits so that we can all buy our own coverage and put market forces to work. Neither side can stand the other. But both reserve special contempt for the pragmatists, who would build around the mess we have. The country has this one chance, the idealist maintains, to sweep away our inhumane, wasteful patchwork system and replace it with something new and more rational. So we should prepare for a bold overhaul, just as every other Western democracy has. True reform requires transformation at a stroke. But is this really the way it has occurred in other countries? The answer is no. And the reality of how health reform has come about elsewhere is both surprising and instructive. No example is more striking than that of Great Britain, which has the most socialized health system in the industrialized world. Established on July 5, 1948, the National Health Service owns the vast majority of the country's hospitals, blood banks, and ambulance operations, employs most specialist physicians as salaried government workers, and has made medical care available to every resident for free. The system is so thoroughly government- controlled that, across the Atlantic, we imagine it had to have been imposed by fiat, by the coercion of ideological planners bending the system to their will. But look at the news report in the Times of London on July 6, 1948, headlined ``FIRST DAY OF HEALTH SERVICE.'' You might expect descriptions of bureaucratic shock troops walking into hospitals, insurance-company executives and doctors protesting in the streets, patients standing outside chemist shops worrying about whether they can get their prescriptions filled. Instead, there was only a four-paragraph notice between an item on the King and Queen's return from a holiday in Scotland and one on currency problems in Germany. The beginning of the new national health service ``was taking place smoothly,'' the report said. No major problems were noted by the 2,751 hospitals involved or by patients arriving to see their family doctors. Ninety per cent of the British Medical Association's members signed up with the program voluntarily--and found that they had a larger and steadier income by doing so. The greatest difficulty, it turned out, was the unexpected pent-up demand for everything from basic dental care to pediatric visits for hundreds of thousands of people who had been going without. The program proved successful and lasting, historians say, precisely because it was not the result of an ideologue's master plan. Instead, the N.H.S. was a pragmatic outgrowth of circumstances peculiar to Britain immediately after the Second World War. The single most important moment that determined what Britain's health-care system would look like was not any policymaker's meeting in 1945 but the country's declaration of war on Germany, on September 3, 1939. As tensions between the two countries mounted, Britain's ministers realized that they would have to prepare not only for land and sea combat but also for air attacks on cities on an unprecedented scale. And so, in the days before war was declared, the British government oversaw an immense evacuation; three and a half million people moved out of the cities and into the countryside. The government had to arrange transport and lodging for those in need, along with supervision, food, and schooling for hundreds of thousands of children whose parents had stayed behind to join in the war effort. It also had to insure that medical services were in place--both in the receiving regions, whose populations had exploded, and in the cities, where up to two million war- injured civilians and returning servicemen were anticipated. As a matter of wartime necessity, the government began a national Emergency Medical Service to supplement the local services. Within a period of months, sometimes weeks, it built or expanded hundreds of hospitals. It conducted a survey of the existing hospitals and discovered that essential services were either missing or severely inadequate--laboratories, X-ray facilities, ambulances, care for fractures and burns and head injuries. The Ministry of Health was forced to upgrade and, ultimately, to operate these services itself. The war compelled the government to provide free hospital treatment for civilian casualties, as well as for combatants. In London and other cities, the government asked local hospitals to transfer some of the sick to private hospitals in the outer suburbs in order to make room for victims of the war. As a result, the government wound up paying for a large fraction of the private hospitals' costs. Likewise, doctors received government salaries for the portion of their time that was devoted to the new wartime medical service. When the Blitz came, in September, 1940, vast numbers of private hospitals and clinics were destroyed, further increasing the government's share of medical costs. The private hospitals and doctors whose doors were still open had far fewer paying patients and were close to financial ruin. Churchill's government intended the program to be temporary. But the war destroyed the status quo for patients, doctors, and hospitals alike. Moreover, the new system proved better than the old. Despite the ravages of war, the health of the population had improved. The medical and social services had reduced infant and adult mortality rates. Even the dental care was better. By the end of 1944, when the wartime medical service began to demobilize, the country's citizens did not want to see it go. The private hospitals didn't, either; they had come to depend on those government payments. By 1945, when the National Health Service was proposed, it had become evident that a national system of health coverage was not only necessary but also largely already in place--with nationally run hospitals, salaried doctors, and free care for everyone. So, while the ideal of universal coverage was spurred by those horror stories, the particular system that emerged in Britain was not the product of socialist ideology or a deliberate policy process in which all the theoretical options were weighed. It was, instead, an almost conservative creation: a program that built on a tested, practical means of providing adequate health care for everyone, while protecting the existing services that people depended upon every day. No other major country has adopted the British system--not because it didn't work but because other countries came to universalize health care under entirely different circumstances. In France, in the winter of 1945, President de Gaulle was likewise weighing how to insure that his nation's population had decent health care after the devastation of war. But the system that he inherited upon liberation had no significant public insurance or hospital sector. Seventy-five per cent of the population paid cash for private medical care, and many people had become too destitute to afford heat, let alone medications or hospital visits. Long before the war, large manufacturers and unions had organized collective insurance funds for their employees, financed through a self-imposed payroll tax, rather than a set premium. This was virtually the only insurance system in place, and it became the scaffolding for French health care. With, an almost impossible range of crises on its hands--food shortages, destroyed power plants, a quarter of the population living as refugees--the de Gaulle government had neither the time nor the capacity to create an entirely new health-care system. So it built on what it had, expanding the existing payroll-tax-funded, private insurance system to cover all wage earners, their families, and retirees. The self-employed were added in the nineteen-sixties. And the remainder of uninsured residents were finally included in 2000. Today, Securite Sociale provides payroll-tax-financed insurance to all French residents, primarily through a hundred and forty-four independent, not-for-profit, local insurance funds. The French health-care system has among the highest public-satisfaction levels of any major Western country; and, compared with Americans, the French have a higher life expectancy, lower infant mortality, more physicians, and lower costs. In 2000, the World Health Organization ranked it the best health-care system in the world. (The United States was ranked thirty-seventh.) Switzerland, because of its wartime neutrality, escaped the damage that drove health-care reform elsewhere. Instead, most of its citizens came to rely on private commercial health- insurance coverage. When problems with coverage gaps and inconsistencies finally led the nation to pass its universal- coverage law, in 1994, it had no experience with public insurance. So the country--you get the picture now--built on what it already had. It required every resident to purchase private health insurance and provided subsidies to limit the cost to no more than about ten per cent of an individual's income. Every industrialized nation in the world except the United States has a national system that guarantees affordable health care for all its citizens. Nearly all have been popular and successful. But each has taken a drastically different form, and the reason has rarely been ideology. Rather, each country has built on its own history, however imperfect, unusual, and untidy. Social scientists have a name for this pattern of evolution based on past experience. They call it ``path-dependence.'' In the battles between Betamax and VHS video recorders, Mac and P.C. computers, the QWERTY typewriter keyboard and alternative designs, they found that small, early events played a far more critical role in the market outcome than did the question of which design was better. Paul Krugman received a Nobel Prize in Economics in part for showing that trade patterns and the geographic location of industrial production are also path-dependent. The first firms to get established in a given industry, he pointed out, attract suppliers, skilled labor, specialized financing, and physical infrastructure. This entrenches local advantages that lead other firms producing similar goods to set up business in the same area--even if prices, taxes, and competition are stiffer. ``The long shadow cast by history over location is apparent at all scales, from the smallest to the largest--from the cluster of costume jewelry firms in Providence to the concentration of 60 million people in the Northeast Corridor,'' Krugman wrote in 1991. With path-dependent processes, the outcome is unpredictable at the start. Small, often random events early in the process are ``remembered,'' continuing to have influence later. And, as you go along, the range of future possibilities gets narrower. It becomes more and more unlikely that you can simply shift from one path to another, even if you are locked in on a path that has a lower payoff than an alternate one. The political scientist Paul Pierson observed that this sounds a lot like politics, and not just economics. When a social policy entails major setup costs and large numbers of people who must devote time and resources to developing expertise, early choices become difficult to reverse. And if the choices involve what economists call ``increasing returns''--where the benefits of a policy increase as more people organize their activities around it--those early decisions become self-reinforcing. America's transportation system developed this way. The century-old decision to base it on gasoline-powered automobiles led to a gigantic manufacturing capacity, along with roads, repair facilities, and fuelling stations that now make it exceedingly difficult to do things differently. There's a similar explanation for our employment-based health-care system. Like Switzerland, America made it through the war without damage to its domestic infrastructure. Unlike Switzerland, we sent much of our workforce abroad to fight. This led the Roosevelt Administration to impose national wage controls to prevent inflationary increases in labor costs. Employers who wanted to compete for workers could, however, offer commercial health insurance. That spurred our distinctive reliance on private insurance obtained through one's place of employment--a source of troubles (for employers and the unemployed alike) that we've struggled with for six decades. Some people regard the path-dependence of our policies as evidence of weak leadership; we have, they charge, allowed our choices to be constrained by history and by vested interests. But that's too simple. The reality is that leaders are held responsible for the hazards of change as well as for the benefits. And the history of master-planned transformation isn't exactly inspiring. The familiar horror story is Mao's Great Leap Forward, where the collectivization of farming caused some thirty million deaths from famine. But, to take an example from our own era, consider Defense Secretary Donald Rumsfeld's disastrous reinvention of modern military operations for the 2003 invasion of Iraq, in which he insisted on deploying far fewer ground troops than were needed. Or consider a health-care example: the 2003 prescription-drug program for America's elderly. This legislation aimed to expand the Medicare insurance program in order to provide drug coverage for some ten million elderly Americans who lacked it, averaging fifteen hundred dollars per person annually. The White House, congressional Republicans, and the pharmaceutical industry opposed providing this coverage through the existing Medicare public-insurance program. Instead, they created an entirely new, market-oriented program that offered the elderly an online choice of competing, partially subsidized commercial drug-insurance plans. It was, in theory, a reasonable approach. But it meant that twenty-five million Americans got new drug plans, and that all sixty thousand retail pharmacies in the United States had to establish contracts and billing systems for those plans. On January 1, 2006, the program went into effect nationwide. The result was chaos. There had been little realistic consideration of how millions of elderly people with cognitive difficulties, chronic illness, or limited English would manage to select the right plan for themselves. Even the savviest struggled to figure out how to navigate the choices: insurance companies offered 1,429 prescription-drug plans across the country. People arrived at their pharmacy only to discover that they needed an insurance card that hadn't come, or that they hadn't received pre-authorization for their drugs, or had switched to a plan that didn't cover the drugs they took. Tens of thousands were unable to get their prescriptions filled, many for essential drugs like insulin, inhalers, and blood-pressure medications. The result was a public-health crisis in thirty-seven states, which had to provide emergency pharmacy payments for the frail. We will never know how many were harmed, but it is likely that the program killed people. This is the trouble with the lure of the ideal. Over and over in the health-reform debate, one hears serious policy analysts say that the only genuine solution is to replace our health-care system (with a single-payer system, a free-market system, or whatever); anything else is a missed opportunity. But this is a siren song. Yes, American health care is an appallingly patched- together ship, with rotting timbers, water leaking in, mercenaries on board, and fifteen per cent of the passengers thrown over the rails just to keep it afloat. But hundreds of millions of people depend on it. The system provides more than thirty-five million hospital stays a year, sixty-four million surgical procedures, nine hundred million office visits, three and a half billion prescriptions. It represents a sixth of our economy. There is no dry-docking health care for a few months, or even for an afternoon, while we rebuild it. Grand plans admit no possibility of mistakes or failures, or the chance to learn from them. If we get things wrong, people will die. This doesn't mean that ambitious reform is beyond us. But we have to start with what we have. That kind of constraint isn't unique to the health-care system. A century ago, the modern phone system was built on a structure that came to be called the P.S.T.N., the Public Switched Telephone Network. This automated system connects our phone calls twenty-four hours a day, and over time it has had to be upgraded. But you can't turn off the phone system and do a reboot. It's too critical to too many. So engineers have had to add on one patch after another. The P.S.T.N. is probably the shaggiest, most convoluted system around; it contains tens of millions of lines of software code. Given a chance for a do-over, no self- respecting engineer would create anything remotely like it. Yet this jerry-rigged system has provided us with 911 emergency service, voice mail, instant global connectivity, mobile-phone lines, and the transformation from analog to digital communication. It has also been fantastically reliable, designed to have as little as two hours of total downtime every forty years. As a system that can't be turned off, the P.S.T.N. may be the ultimate in path-dependence. But that hasn't prevented dramatic change. The structure may not have undergone revolution; the way it functions has. The P.S.T.N. has made the twenty-first century possible. So accepting the path-dependent nature of our health-care system--recognizing that we had better build on what we've got--doesn't mean that we have to curtail our ambitions. The overarching goal of health-care reform is to establish a system that has three basic attributes. It should leave no one uncovered--medical debt must disappear as a cause of personal bankruptcy in America. It should no longer be an economic catastrophe for employers. And it should hold doctors, nurses, hospitals, drug and device companies, and insurers collectively responsible for making care better, safer, and less costly. We cannot swap out our old system for a new one that will accomplish all this. But we can build a new system on the old one. On the start date for our new health-care system--on, say, January 1, 2011--there need be no noticeable change for the vast majority of Americans who have dependable coverage and decent health care. But we can construct a kind of lifeboat alongside it for those who have been left out or dumped out, a rescue program for people like Starla Darling. In designing this program, we'll inevitably want to build on the institutions we already have. That precept sounds as if it would severely limit our choices. But our health-care system has been a hodgepodge for so long that we actually have experience with all kinds of systems. The truth is that American health care has been more flotilla than ship. Our veterans' health-care system is a program of twelve hundred government-run hospitals and other medical facilities all across the country (just like Britain's). We could open it up to other people. We could give people a chance to join Medicare, our government insurance program (much like Canada's). Or we could provide people with coverage through the benefits program that federal workers already have, a system of private-insurance choices (like Switzerland's). These are all established programs, each with advantages and disadvantages. The veterans' system has low costs, one of the nation's best information-technology systems for health care, and quality of care that (despite what you've heard) has, in recent years, come to exceed the private sector's on numerous measures. But it has a tightly limited choice of clinicians--you can't go to see any doctor you want, and the nearest facility may be far away from where you live. Medicare allows you to go to almost any private doctor or hospital you like, and has been enormously popular among its beneficiaries, but it costs about a third more per person and has had a hard time getting doctors and hospitals to improve the quality and safety of their care. Federal workers are entitled to a range of subsidized private-insurance choices, but insurance companies have done even less than Medicare to contain costs and most have done little to improve health care (although there are some striking exceptions).

Mr. ELLISON. One of the things that I think is important to bear in mind is that as we look at the American Recovery and Reinvestment Act, it is not only stimulus. We keep talking stimulus, stimulus, stimulus. That is not really the right way to describe what we're doing. It is for long-term investment. It is to deal with an emergency issue, but it is also to invest in the long-term health of our Nation. So it is not just stimulus. It is important for the American people to know that. But I do like this chart because a conservative economist named Mark Zandi did it. And he got his computers out, did some readings and figured out what is going to stimulate the economy the most, what is going to give the economy the most punch. And he found that one of the lowest things on his chart was make the income tax cuts expiring in 2010 permanent. That is like .9 percent. That is pretty low. But the big ones, the big ones that he found were things like temporary increase in food stamps. That is 1.73. That is the highest one on here. That is going to jack up and get people, that is going to help stimulate the economy, things like extend unemployment compensation benefits, 1.64 percent, things you mentioned just a moment ago, that we have to stick with the House version and hold up. Increasing infrastructure spending, 1.59. These are things that are really going to stimulate the economy. And I think it is important that as we really focus on stimulating the economy, we don't give in to ideological matters. One thing I will say regarding the Obama administration, and you know I'm a big fan, is that President Obama reached out to the Republican Caucus, came to talk to them and tried to work with them. And they completely rebuffed him. And they told him just nothing doing. And here he is reaching across the aisle, trying to move us to this post- partisan place. And not one of them, even though they got their tax cuts, voted for the stimulus package. So in my opinion, I think we should not try to, we should put all the weight on stimulating the economy. We get the economy moving. We have proved to the American people that conservatives are bad in economics. They don't understand economics very well. When the Democratic President left office in the year 2000, we had a $288 billion surplus. It didn't take long for the Republican President to mess it all up. And the reason was because they are bad at economics. They don't understand economics. Actually they like economics where the rich people get and the poor people don't. If I may, they don't quite understand that a rising tide lifts all boats. You have to make sure that everyone is part of the economic life of the country in order to have a strong, robust economy. You can't just have tax cuts for the rich people. By definition, being rich means you don't need the money. You just stick that money in your back pocket. Maybe it can just sit in an account. But when you give moneys to the poor for things like unemployment insurance, things like food stamps, when you invest in the Nation's infrastructure, then you are really building the economy. Then you're really stimulating the economy. In my view, I will say with all due respect to our President, who I believe is a great leader, that he has tried to work with them on the other side of the aisle. They have rejected and rebuffed his overture. So skip their tax cuts. Let's get to some real stimulative stuff. And I yield back.

Mr. ELLISON. Well, Congressman, I know you and I join together in thanking Congressman McDermott, who did such a great job. But on your point, I just want to say that it is too bad that the Senate proposed to cut the provisions on HIV and STD treatment, because it is stimulative. We would be hiring people who would go out to these schools and talk to young people about the importance of proper sexual health, of respecting their bodies and respecting other people, understanding the medical situation that arises when you are irresponsible, when you are unlucky enough to be infected with these horrendous diseases, which are preventable if you know what you are talking about, if you are well armed with good information. It is really too bad. And that is one of the reasons we have to come here, because we are not here as an extension of the Obama administration. We love the fact that he signed SCHIP today. Go for it, President Obama. But if it ever comes a time when we don't agree, we will be here saying that. So it is critical today that you bring out differences that we have with the Senate package, because it is our job to project a progressive vision. And if you want to know and if folks want to know how to reach us with their progressive vision, they can send their ideas to this e- mail at the bottom of this document here. I didn't really want to interrupt you, but I just thought it would be an important time to say, don't expect the Progressive Caucus to come to the House floor saying thumbs up to everybody. Expect the Progressive Caucus to say that we agree with some things, we don't agree with others. We are projecting a progressive vision that includes all Americans, that says all Americans should have health, all Americans should have civil rights, all Americans should have a shared economic prosperity. So forgive me for that interruption, but you inspired me for a moment.

Mr. ELLISON

Mr. ELLISON. Congresswoman Edwards, I want to thank you for pointing out that this stimulus package has been heavily influenced by the work of the Progressive Caucus. But for our efforts, it wouldn't be the great document that it is. Though it may not be all that we want it to be, it's much better than it would have been without our input. It's important for people to know that the role of the Progressive Caucus is to put forth a progressive agenda to help our leadership stake out a progressive policy, and if we are not pushing, if we are not agitating, if we are not arguing for that case, then the case simply won't be made. So it's critical that the Progressive Caucus come before the American people and talk about what we are doing, talk about what we are up to, but also we do some of the work that is our job as Members of Congress to do, which is to push that agenda right in here. Congresswoman Clarke.

Mr. ELLISON. Congresswoman Edwards, I'm sure you have some thoughts on this. As Congresswoman Clarke talked about building the resource development, the workforce development, the skill of our people, I'm really happy that the Green Jobs Act, which we authorized the last session of Congress at $125 million, has now been put through and appropriated at $500 million, which is a significant increase, and we have about $4 billion in job training and workforce development. That goes to the point you were making a moment ago, Congresswoman Clarke. We are investing in our people, and it is something we have to continue to do. Congresswoman Edwards, any thoughts on this?

Mr. ELLISON. That's right, that's right. Well, thank you, Madam Chairman, for pointing out what the role of the Progressive Caucus is. I invite my colleagues to weigh in on that subject as well, as we talk about the stimulus package and our economy tonight. I think it's important that the American people know that they have a progressive voice, projecting a progressive vision. We will never lay down our role as a coequal branch of government. You know, we happen to like this President, and we will probably agree with him on a number of things, but it's not our job to agree with him. It's our job to represent the American people, to project an inclusive vision in which every American feels they can be successful where their rights are protected and where they can make a living for their family. So, with that, I would just like to throw it back to my colleagues.

Mr. ELLISON. Then the center becomes the right.

Mr. ELLISON. Well, if I may turn to our chairwoman here, you know, Congresswoman Woolsey, we are the Progressive Caucus. A stimulus package was passed through the House today. Does the Progressive Caucus still have a vital and essential purpose, given that we have a President that we happen to like nowadays? What is our role in the Congress? What do we do? Now that we have a Democratic President and a majority, what should the Progressive Caucus take on as its mandate? What's our role?

Mr. ELLISON. Yes, well, let me thank you again, Congresswoman Clarke. You are right on the mark with everything that you have said. I just want to let everybody know we are the Progressive Caucus, we are here for 1 hour. It is our plan to be here week in, week out to come project a progressive vision, whether it's on economics, whether it's on war and peace, whether it's on civil rights. We talked about civil rights last week, we are talking about the economy this week. But this is the Progressive Caucus, and we are here tonight with our chairperson, Lynn Woolsey, with my colleague, Representative Clarke and my colleague, Representative Donna Edwards from Maryland. Congresswoman Edwards, I am sure that some thoughts were occurring to you as Congresswoman Clarke was stretching forth on her ideas.

Mr. ELLISON. Yes, so in other words, we are not just giving $825 billion out, we are getting real value for these kinds of things, as Chairwoman Woolsey has said. I just want to say that I am very proud, Chairpersons, of our Progressive Caucus have been communicating with our leadership and the administration on the things that the American people who are progressive really want. Congresswoman Clarke.

Mr. ELLISON. Congresswoman Woolsey.

Mr. ELLISON. Very important point.

Mr. ELLISON. A very important observation. I think it's important to point out that H.R. 1, the American Recovery and Reinvestment Act, does spend about 75 percent of the money within the first 18 months. Much of it is on infrastructure. It will create 3 to 4 million jobs. It does give about 95 percent of American workers a tax cut. Not the people who already get one but the folks who often don't get a tax cut. If I may, I don't want to spend time on gloom and doom, but I would ask my colleagues to spend maybe 10, 20 minutes or so talking about what got us here. I don't know if you want to go back there, but I think it's important to say it is the absence of a progressive vision that got us to this point. We're talking about years of deregulation and tax cuts for the wealthy. We're talking about an economic philosophy that said that poor people have too much money and rich people don't have enough money; so what we're going to do is take from them and give to the ones upstairs. We're talking about tax cuts in the middle of a war, and we're talking about a war that never, ever, ever, ever should have been started. We're talking about an economic philosophy that really was not in favor of the average working family. And we know that when the average working family is doing well, then everybody does well, and when they're not doing well, then we get what we got. The fact is it is an economic philosophy that has been driving us. What's needed is a progressive vision for our country, an economy that is inclusive, an economy that helps lift all boats because we do believe a rising tide lifts boats but you've got to raise that tide. It's not the ocean liner but the dinghies that need to be rising up. So with that I invite you all, if you would, just to talk a little bit about what you believe got us here and what the situation is we're confronting. I think it's important for the American people to know that we are not just spending $825 billion on a whim. We're in serious financial trouble. We're talking about the loss of 2 million jobs and change last year. This is an unemployment chart in 2007 and 2008. The blue is 2007 numbers. The red is 2008 numbers. Now, if you can see, every red bar is longer than every blue bar. Can you see that? That means we had a dramatic jump in unemployment in nearly every State. Minnesota's right here, California, Florida, Illinois, Iowa. Every State has had a dramatic leap forward in unemployment, a very serious issue, and I think that it's important to point out that we are here to do something about it.