Christopher Murphy

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Ryan, I think for those of our colleagues who are against this exchange, they've got to go to their constituents and the American people and explain to them why they don't believe that individuals should be able to join together and negotiate for lower rates. If they're against the public option, they have to make the argument to their constituents why they don't think their constituents should have the choice to choose the same kind of health care that Members of Congress and Medicare beneficiaries and soldiers and veterans and public employees have. This is about banding people together to get lower rates, giving people more choice. And the reason why both of those ideas, Mr. Ryan, and I'll wrap up, have broad public support, every single poll that comes back says 60, 70 percent support the idea of the insurance exchange and a public option within it is because that's what they want. That's what they want, the ability to negotiate together and the ability to have more choice.

Mr. MURPHY of Connecticut. I just was in a meeting with some of my hospital CEOs, and they are talking about having a tough year this year. And they said that they were hopeful, though, that they might see some increases from their private providers, from their private insurance companies that send them obviously a lot of money. And they said that because they were making the case to their private insurers right now, Mr. Ryan and Mr. Altmire, that because they had had so many more people coming in without insurance because the number of people that no longer have coverage has increased, and the number of people coming through their doors that don't have any source of payments has gone up, they are hopeful that they will be able to convince the private insurance companies to raise their rates by 5 percent or so to compensate for all those people that are coming in the door without insurance. That happens every day out there in the negotiations between hospitals and doctors and private insurers. The pressure is on private insurance companies to make up for all the people that show up without insurance. The insurance companies don't eat that money. They pass that along in higher premiums. So everybody out there who is on private insurance today, the 70 percent of individuals who are happy with their current coverage, need to know that your premiums are higher so that those insurance companies can help compensate and keep in business the hospitals and physicians that are caring for all the people that don't have insurance. Now to your point, Mr. Ryan, about how Medicare is taking on the cost of all these folks that are uninsured from age 55 to 65 and then show up at the door of Medicare with all sorts of problems--let me share this story. In Connecticut, our major insurer, Blue Cross Blue Shield, is walking around with a chart trying to sort of push back, as far as I can tell, on health care reform. And their chart shows, as they claim, that the cost of taking care of a Medicare or Medicaid patient is comparable or a little bit more than the cost of taking care of somebody that has no insurance today. Apparently, the reason they're showing that chart is to make an argument that you should just leave these people uninsured, because if you put them on insurance, it will actually cost you more. We know that's not true. We know that by giving insurance to people, by allowing them access to their primary care physician to get them preventative care, that's going to cost less than leaving them uninsured. But they make a totally unfair comparison. They're comparing the cost of someone who is uninsured to the cost of the Medicare and Medicaid system which have the sickest, the most expensive people on their rolls. And so I think it's a caution for all of our colleagues who look at our current government health care program, Medicare and Medicaid, and say, ooh, if you really look at the per patient cost there, those are pretty expensive programs. Well, they're pretty expensive programs because Medicare and Medicaid insure the most expensive people out there, insure the sickest of the sick, the old and the frail and the elderly. All of the end-of-life care is paid for by that.

Mr. MURPHY of Connecticut. And you know what the insurance companies call the money that they spend on health care? They call it medical loss. Medical loss, that's what it is to an insurance company. To you, it's a medical benefit. It is care that you get that keeps you alive. To an insurance company, it is called medical loss. It is a bad thing to spend money on you. That doesn't mean that there are bad people running insurance companies. It just means that in the end, if the motivation is profit, if the motivation is to return as much money to your shareholders as you can, then every dollar that you're spending on care is less money that you're getting as a return on your investment, which is why so many of us believe that there is just an inherent conflict between good business and good medicine. It doesn't mean that the two can't coexist. It means that government has to step in and try to set a set of rules to make sure that in every instance good business doesn't trump good medicine, and let me give you example of why that is. Every insurance company executive will tell you, yeah, listen, if it was up to me, I wouldn't deny care for all these people that have preexisting conditions. But if I stop doing that, then I'm going to be at a disadvantage against all my competitors. If I start accepting in all of these patients with cancer and hypertension and lupus and whatever it may be, well, then I'm going to get all the sick people, my premiums are going to go up, and I'm not going to be able to compete with everybody else. And so they tell you, listen, if it was up to me, I would do it, but you need to set the playing field even between all of us. Insurance companies, listen, we might be fighting them on a lot of things, but they'll actually come in and tell you that if the government comes in and says that we should all take patients with preexisting conditions and we're all living by the same rules, well, then that's fair; we can live with that in the end. The fact is that I listen over and over again to our Republican friends say that, yeah, we're for that, too. We think that we should stop people with preexisting conditions from being excluded from insurance. Well, they had control of this Congress for 12 years. They had the House. They had the Senate. They had the Presidency. They had everything. They didn't do it. They didn't do it. They would have had insurers with them on that. They would have the public with them on that, but they didn't do it. So it just is beyond me how we can listen to so many of our colleagues on the Republican side of the aisle come down here and tell us that they were for this all along, that they were for trying to stop these discriminations against people with preexisting conditions, because they could have done something about it. They could have done something about it. And for all those people out there that say, listen, government should stay out of health care, this is a prime example of where government needs to come in and set fair rules that insurance companies needs to play by, because if you leave it up to the private sector, they're going to push sick people off of their rolls, push sick people off to the side. I don't want a government takeover of health care, you don't want a government takeover of health care, but there are some places that government needs to step in and fix it.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Altmire, this is a remarkable debate in the sense that many players even within the health care system that potentially have something to lose off of health care reform, that 15 years ago, during the Clinton health care reform debate, were fighting from the outside with torches and pitchforks to make sure that health care reform didn't happen, are part of the debate this time around. That you have the drug companies and the insurance companies and the doctors coming to the table--not everybody being holly-jolly about what's in this bill or what's in other proposals--but everyone at this point, after 15 years since the last major debate over health care, of almost complete neglect of the ills within our system, everybody realizes that there's need for reform. Certainly our constituents do. But even those institutional players, some of which have gotten pretty fat off the existing system, know that this thing is broken and know that we have to fix it. I think that they also see some real wisdom in the approach that we are building here. I've listened to Republicans and critics of health care give me story after story of how bad the Canadian system is, and the anecdotes they've heard about people waiting in lines in England and France. I listened to all those stories. And I heard them at my town halls from people. My response is: No one here is talking about importing some system from Canada or England or Europe or any other country. We're talking about developing a uniquely American solution to what is, unfortunately, a very uniquely American problem. That means basing our solution on the marketplace, basing our solution in the world of private employer-based insurance that we have today. Now there are absolutely people out there in this Chamber and in this country who want to see a Medicare-for-all system. There are others that say we should completely divorce health care from the place of employment. But for many of us those are changes that are a little bit too radical for our constituents. So what I think we have to work on--and, again, a point in which I think we can get more agreement than you might otherwise think there could be on this issue of health care--is in making this market actually work. In half of the States in this Nation, Mr. Altmire, as you know, there's one insurer that controls more than half of the market. In 70 percent of the States there are two insurers that control almost three- quarters of the market. There's not a lot of choice out there for most people today. Maybe the greatest contribution that we can make is to take this ingenious thing that we created in this country, the most vibrant capital marketplace in the world, and make it work for health care. Now it's never going to work perfectly for health care because it's a strange system in which the people paying for health care are often not the people that are choosing the health care. So the health care marketplace is never going to work like buying a car or a gallon of gasoline. We can make it work a lot better than it does now. And so the reforms that the President has proposed to establish health care exchanges, these regional health care marketplaces where insurance companies would really have to compete against each other for the business of individuals and small businesses, the reforms in this bill to make sure that insurance companies can't try to push out of their portfolios people that are sick or people that have certain expensive diseases, those are all engaged in the process of trying to make our health care marketplace work better. And so we talked about the distortions surrounding the benefits in this bill to illegal immigrants. I say the same thing about those who come down to this floor or go out in public and talk about this proposal or any of the like proposals that we're debating as a government takeover. The CBO has been pretty clear on what the 10-year results of the bill that passed the Energy and Commerce Committee would mean. Mr. Altmire, as we've talked about, there are a lot of people, including yourself, who want to see some changes to the proposal that's out there from Energy and Commerce. So I don't want to present that as the bill that's going to come to this floor for a vote. But let's take it as a foundational point of argument. The Congressional Budget Office--again, the nonpartisan sort of analyst arm of this Congress--says that if you pass the bill out of Energy and Commerce, in 10 years more people would be on private insurance than are on it today. That private insurers in this country would have more business--not the same, not less--because we would reinvigorate that private marketplace and get more people into private insurance by helping them with tax credits both through business tax credits and individual tax credits to buy insurance. That's a concept that I want to support, using the marketplace that is broken right now as the way that we fix health care going forward. I think that that's one of the points that we can get some agreement on going forward, Mr. Altmire.

Mr. MURPHY of Connecticut. Reclaiming my time, we have example after example of where the private sector and the public sector compete pretty well side by side, and most of the examples involve public sector entities that are heavily subsidized, and they still compete side by side with private entities. Public colleges haven't run private colleges out of business despite the fact that they are heavily subsidized by the government. Public hospitals haven't run private hospitals out of business despite the fact that they are often subsidized. The same thing for even smaller, more mundane examples. Public golf courses and private golf courses, public pools and private pools. There is example after example of where public entities can coexist side by side with private entities, and they actually compete with each other. I think this is such an important point, and I go back to the CBO estimate here, Mr. Altmire. Assuming that you create that level playing field, which you and I both want, with an insurance exchange that includes a public option, the CBO tells us that not only will you have more people in private insurance when all is said and done but the number of people in the public option will be about 10, 12 million people, 2, 3, maybe 4 percent of the overall health care consumers out there. A significant number but by no means a government takeover, as some people would have us believe. This is an option for people that can compete. For me, I look at government health care and I think, well, you know, if it's good enough for our soldiers, if it's good enough for our veterans, if it's good enough for our Federal employees, if it's good enough for Members of Congress, if it's good enough for State employees, if it's good enough for every individual in this country over 65, then I think that my constituents should have the choice of whether it's good enough for them. I don't want to make that choice for them. I don't want to be like a European country that says your only choice is public insurance. But I also don't like the arrangement we've got today where our law as set by the Federal Government tells my constituents that your only choice is private insurance. I give my constituents credit. I mean, I think that they'll be able to make the best choice for them. And I think if we do that, then we will get to where I think a lot of us want to get to, which is to really stimulate and reinvigorate that market, Mr. Altmire.

Mr. MURPHY of Connecticut. I thank the Speaker for granting us this time on the House floor this evening. I hope to be joined very shortly by a few other of my colleagues who are also from the 30-something Working Group. As our colleagues know, this group comes down to this floor on a regular basis to talk about the issues that matter, not just to our constituents or to the American people but, in particular, to young families out there. We are also to be joined this evening by a few other Members who care deeply about this Congress' commitment to health care reform. This is the defining subject of this moment in Congress. It is the defining moment for our constituents when we're back home, and rightly so. Mr. Speaker and my colleagues, when I was home for August, I went out there and talked to the people I represent in every forum possible. I spent early mornings in the dew of village greens. I did town halls in the evenings. I set up a card table outside supermarkets, and talked to health care professionals, nurses, doctors, and patients. Listen, we certainly saw in Connecticut the disagreement over the solution just as we saw it all over this country, but we had an agreement that something had to be done. The current system is unsustainable. Now, there is not that kind of agreement here in Washington. I hear too many of my colleagues on the other side of the aisle and groups that are affiliated with that party talking about the system being okay as is and talking about the lack of need for any real reform. Well, in Connecticut, at the very least, we understand the need for reform. We saw it plainly earlier this year when the State's major insurer, which covers over 50 percent of the individuals in Connecticut, proposed a 30 percent increase on individuals and small businesses. Now, thanks to government, thanks to the State of Connecticut's regulatory system, it looks like we're going to be able to push that increase down to 20 percent. Think of that. Think of the impact of a 20 percent 1-year increase in health insurance premiums for individuals in Connecticut who are struggling to get by. The fact is that most people in my State and across the Nation who don't have health care insurance today and who are purchasing on the individual market, frankly, are struggling to get by. These are folks who are either running their own businesses, who are self-employed or who work for an employer who doesn't provide health care benefits. Those folks cannot take a 20 percent increase. Neither can the small businesses that are being charged those premiums as well. Study after study shows us that small businesses bear the brunt of the costs in our health care system. On average, a small business is paying 18 percent more in health care premiums than are large businesses. It's simple economics. I didn't get past econ 101 in college, but I learned enough to know if you're a small business that's purchasing anything, staples, paper or health care, on behalf of only 5 or 10 or 20 employees, you're just not going to get the same deal as a company that's purchasing it on behalf of 100 or 1,000 or 10,000 employees. So it's the small businesses in today's marketplace which are getting hurt the most just as individuals are getting hurt the most. So, in Connecticut, I think we're representative of most folks and of most businesses across the Nation. They know that this current system just doesn't work for people. We're not talking about tinkering around the edges. We're talking about comprehensive, bottom-up reform to make this market work again for families, for individuals and for businesses. In Connecticut, we have seen over the last 10 years an increase of 120 percent in the premiums that small businesses have been paying. During that same time, wages for their employees have only gone up about 30 percent. Now, that's not a coincidence. The fact is that the costs of our health care system are sometimes invisible to employees and to workers because they result in a lack of wage increases. They result in a contraction of pay for those Employees. When a business is making a little bit extra money in 1 year, too much of that additional income is going simply to pay those 10 or 20 percent increases in health care premiums. The result is that the workers of those businesses get a zero percent pay increase or get a 1 percent or a 2 percent pay increase. All the extra money the companies are making is going to health care. That's not sustainable either. On the other end, we have got to ask what we are getting for all of this money. It would be one thing if we were paying in for the most expensive health care system in the world--and it's the most expensive health care system in the world, not by 5, 10, 20 percent, by 100 percent. We are paying twice as much for health care in this country as any other industrialized nation in this world. For one thing, if we were getting the added quality, maybe, maybe my friends on the Republican side of the aisle who are so defensive of our current health care system, who are so complimentary of the current health care arrangement in this country, maybe they would have a little bit better defense if all of this money that they are so proud that we are spending on health care today got us better results. But the fact is it doesn't. Yes, if you have access to the best health care centers in this country, to the best hospitals and the best doctors, you can absolutely, absolutely get better care. You can absolutely get the best health care in the world. I don't deny for a second that there are people from all over this world that are coming to those top centers of care in this country. But the fact is not enough people have access to those centers of excellence. There are too many people who can't get into the best of our health care system. It means, when a group like the World Health Organization surveys the quality of health care in the United States and all of our economic competitors across the globe, we turn out to be in the middle of the pack. Any health care indicator you look at, life expectancy, hospitalization rates, infant mortality, infection rates, we rank 10, 15, 20. For all of the money that we are spending in this country, we should be at the top of the list regarding outcomes. Our health care system should be the best in the world. This debate around health care reform has to encompass all of those problems. This debate has to start with cost, about how we get at making sure that never again the people in my district see a 20 percent or 30 percent increase in health care costs in one given year. This debate has to get to a point where businesses can make extra money in one particular year and pass that extra income along to their employees rather than to insurance companies. This debate has to address the quality gap between those who have access to the best of our system and those that can't get there. We should be at the top of those lists that the World Health Organization puts out, not the middle or the bottom. That's why Band-Aids aren't going to work. In the Energy and Commerce Committee, my Republican friends today unveiled maybe what is one of their first detailed proposals for an alternate to the effort that the President and this Congress are putting forth. It was nothing but a series of Band-Aid fixes on our current system, slight tweaks to the system of private insurance that has gotten us into the problem that we are in today. Republicans had control of this House for 12 years. During those 12 years, that's the strategy that they employed. Empower the private market, tweak and change the current private health care system here and there. The jury is in on that approach. The evidence is set. During that time that our Republican friends controlled this House, insurance premiums skyrocketed. The number of people without insurance increased. Our health care system got more broken. It is time to reset the competitive playing field. It is time to dramatically alter the rules by which insurance companies play. That's what we are talking about here today. No more incremental changes to our health care system that have proven to be ineffective, but serious reform that protects what we like about our health care system but fixes what is broken. I hope that that's the debate that we will have here in this Chamber and in committees throughout this Congress. That's what we need. That's what the businesses in my district need. That's what the constituents in my district need. Let's have a real debate. Let's have a debate on the facts, not based on innuendo, not based on distortions, not base on outright fabrications in this bill. I listened to our Republican colleagues who had the previous hour talk about this issue regarding the access that illegal immigrants will have to the new health care system that we hope to build here. They talked about an amendment in the Energy and Commerce Committee, which I sit on, that would, in their mind, restrict the access to the health insurance exchange or to the subsidies in the bill for the lower-income people so that it wouldn't accrue to illegal aliens. They failed to mention that we passed that amendment. The Space amendment passed. Check it out, thomas.gov online, passed by the House Energy and Commerce Committee, which states in as plain English as you can make it--and I get it, a lot of the amendments in the bills that we passed here are pretty hard to understand, whether you are watching Congress or in Congress. But this thing was about as clean as you could make it, that nothing in this bill shall allow people who are in this country illegally to access subsidies, to access government programs like Medicare or Medicaid. The existing law which requires verification of citizenship remains the same. Not a lot of talk.

Mr. MURPHY of Connecticut. I yield for a moment, certainly.

Mr. MURPHY of Connecticut. Estimates are, within the next 30 years, health care costs will consume 50 percent of gross domestic product in this country. Think of that. One out of every two dollars spent in this country by the government or private sector will be spent on health care. Today, it is creeping up on 20 percent, but in 30 years things will be out of control. You are exactly right, there is no way to talk about deficit and debt reduction without talking about health care reform. We have examples of how we have been able to do that just in the last week. Last week we passed an education reform bill that modernized our student loan program, got $87 billion worth of savings, and applied a significant portion of those savings not to new student loan programs but to deficit reduction. Frankly, that should probably be a model for everything that we do here. If we can glean savings out of government programs, we need to apply all or part of that to paying down the debt. We are at the close of our hour, so if you have any closing comments, Mr. Altmire. I appreciate you joining us down here for this hour. I am optimistic by nature. We both focused on the points of agreement we think we can get here. I do make a point to call out my Republican friends when I think they have tried to lead folks out there astray on a particular point on the bill, but it is because I want to have an honest debate in the end. I think if we are all talking about the facts, we can get to a point of agreement, because our constituents out there want us to get there because the problems in our health care system dictate that we create a real solution that isn't incremental and isn't small and around the edges, but attacks the foundation and the gut and the root of our problems. So I look forward to coming back down to the House floor and continuing to push forward this case for reform.

Mr. MURPHY of Connecticut. Mr. Altmire, you've been a great leader on this question, which is to say, listen, to fix the problems with our health care system, we're going to need to spend a little bit of money up front, with tax credits to individuals or to small businesses to help them afford insurance, money to plug the doughnut hole to pay for preventative care for our seniors, expansion of Medicaid programs to cover some more people. We have got to look to savings first. And that is a point you've made to dozens of Members on this floor. To say, listen, exactly as you put it, and you're much more eloquent on this subject than I am, we can squeeze savings out of this system. And as you enunciate, it's important to remember that that 10-year cost of this bill, whether in the end it's $900 billion or $700 billion or $600 billion, that's the gross cost, not the net cost. That can be paid for in whole or in large part by the savings that we're talking about here to the current government health care expenditures. Now, listen, for those people that say I don't want the government involved in health care, guess what? It's too late. Fifty-five percent, somewhere in that neighborhood, of health care dollars in this country are spent by the government. Medicare, Medicaid, the veterans system, et cetera. We have not just the obligation but the opportunity to modernize those programs, glean real savings out of them, and turn it back around to people who are left out right now. And for those opponents of reform who go around demagoging the Medicare reductions in this bill and say we cannot touch Medicare, those Democrats had better not make any changes to Medicare, well, Mr. Altmire, as you pointed out, Medicare's going to go bankrupt. So if you don't control Medicare costs, if you're one of the people on this House floor or out there on the stump saying that Congress, whatever they pass on health care reform, can't touch Medicare, then you have only one other option in order to preserve Medicare for your kids and your grandkids, and that's to increase taxes. That's to increase the amount of money that comes out of everybody's paycheck to pay for Medicare. So I can certainly understand a disagreement about where we need to rein in costs on Medicare and where we shouldn't, but I hear a lot of commotion out there by people who say we should not touch it. I agree we should keep benefits where they are and improve them, but we do need to find efficiencies in the system. Turning to another subject, Mr. Altmire, you and I both have young children. I know in the 12 months that I have had the joy of being a parent, there is not a day, not a week that goes by that I don't think about the cost of what we are doing to my son. As someone who, frankly, voted for the stimulus bill, what I thought was a necessary means to get this economy back up and running and to stabilize what had been up to that point a free fall, I approach this health care bill with the same bottom line that the President does: We need to pass a bill that finds a way to get coverage to more people and reins in the cost of care. And to the extent that requires spending some money at the outset in order to get a better system in the long run, it has to be done in a deficit-neutral way. ``Deficit-neutral'' is kind of an inside Washington term, but the bottom line is this, we can't borrow any money to pass health care reform. I think that is a growing commitment on behalf of both sides of the aisle here. It is certainly a bottom line for the President. And again, I think a central tenet of health care reform has to be do what you push for, squeeze the savings out of the system as much as we can in order to pay for what we need to do, and then make a rock-solid commitment that we won't borrow a cent in order to pay for it.

Mr. MURPHY of Connecticut. Reclaiming my time, on this point of reforming the way that Medicare works to start paying for outcomes, start paying for systems and doctors and providers and hospitals that get results rather than just paying for volume, it is incredibly discouraging to me to watch Members of this body that proclaim to be fiscal conservatives come down here and eviscerate the efforts of the President and of the Democratic side of the aisle to try to rein in the cost of Medicare. I hear sort of arguments out of two different sides. Opponents of reform talk about the fact that the government can't run anything, that they can't run Medicare; but then they also at the same time attack the fact that this bill for the first time in a long time tries to rein in the cost of Medicare, actually tries to fix the abuses out there. Yes, in this bill there are reductions in the cost of Medicare. Nobody should apologize for the fact that we are going to rein in the abuse and waste and sometimes fraud in the Medicare system. It just doesn't make any sense, Mr. Altmire, that there are health systems with the same medical populations and one is spending $16,000 per year on every Medicare beneficiary and the other community is spending $8,000 per Medicare beneficiary. And when you actually look at it, there's no difference in the outcomes that they get. Why are we rewarding systems of health care that just add volume upon volume of care and get no added benefit out of it? Now, I'm not saying that the way that you fix that is easy. I'm not saying that there is some silver bullet that comes in here and all of a sudden finds a way to reward value over volume. But I'm saying that for those out there that have come down to this floor and have gone out in public and railed against the cuts in Medicare in this bill, they've got to pay attention to the reality. The reality is the benefits stay the same for beneficiaries. In fact, they get better. As you said, we're not going to require seniors to pay for the costs of checkups and preventative health care anymore. We're going to eliminate the doughnut hole over time. We're going to start paying their physicians more to take care of Medicare patients rather than what the Republican majority insisted on, which was an annual 4 percent cut. Are we going to say to health care systems and hospitals and providers who are just ordering tests and procedures for the sake of reimbursement and volume and not for quality that they shouldn't get paid as much as they do now? Absolutely. But that's our obligation as stewards of the taxpayer dollars, as people that care, like our constituents do, about preserving the life of Medicare. So I hope that we can join together in this conversation. I hope that my friends out there that claim to be fiscal conservatives don't spend the next 2 to 3 months out there railing against every single 10-year reduction in Medicare spending in this bill because, again, if we want to come together, there is nothing more appropriate to come together on than spending our taxpayer dollars wisely on existing government programs like Medicare. I want Medicare to be around when I turn 65, and if we don't tackle the excessive costs in some parts of our Medicare system right now, it's not going to be, Mr. Altmire.

Mr. MURPHY of Connecticut. Reclaiming my time, I thank the gentleman. My point being that you don't hear a lot of discussion about the amendment that did pass, the amendment that is attached to that bill today, which states very clearly what the law is and which, I think, is one of the things that leads the President, when he appears before groups out in the public or before this Chamber, to state that the law is very clear on that issue. I wish that we had a more honest discussion about the entirety of the debate in the Energy and Commerce Committee, which included the passage of a very clear and very restrictive amendment on that case. This is, I think, one example of many in which we have got to start matching the facts of this proposal and this debate to the rhetoric that's out there today. I think if we can do that, I think if we can get by the political jibs and jabs of this debate, there is real substance here. I will just close on this, Representative Boustany, in response to the President's speech several weeks ago, talked about the fact that there is and can be agreement on a lot more than there is disagreement over. I think that many of us who went home for the break found out amongst our constituents that folks out there were arguing around the margins of this bill. But on the guts of it, whether or not we have an obligation in some form or fashion to try to help people who don't have insurance today get insurance, whether or not we have an obligation to start holding insurance companies accountable for their actions, whether or not we have a responsibility to try to stimulate a competitive health care market that is in the majority of States today not competitive, I think there is agreement on a lot of that. If we can start talking about what's really in the bill, talking about the amendments that passed, not just the amendments that didn't pass, start talking about what the words in the bill say rather than what the words of political pundits on the evening cable news shows say, I think that we can find some agreement here. I am glad that our leadership, Mr. Altmire here, in the House, has reengaged the minority side. I am hopeful that the President is absolutely sincere in his intention to bring Republicans to the table. You see in the Senate Democrats and Republicans talking to each other about how they can forge a compromise here between the two sides. There are absolutely going to be disagreements. Maybe in the end we can all come together on something. But if we listen to our constituents, if we listen to how very broken the health care system is in their eyes, small businesses, individuals and family, I think our mandate is not to put a Band-Aid on the current system, but to make major reforms that correct years of health care neglect from this body and this government. I would be glad to yield to my friend.

Mr. MURPHY of Connecticut. I thank the gentleman. I spoke a little bit about the costs that we don't see. As my friend from Pennsylvania knows as a former hospital administrator, the folks who don't have insurance today cost us money. We have a universal health care system in this country. You just don't get it until you're so sick that you show up to the emergency room. Often, the care that you get in that emergency room when you become so sick or so ill that that's your only resort is the most expensive care that you could get. It's crisis care. And so for folks out there that have insurance--and that's the vast majority of the people in my district and throughout this country-- you're paying for the health care of those that don't have it today, and you're likely paying a lot more through taxes to your government that go to hospitals to pay for the uninsured, towards increased rates that you're paying in private insurance, that the private insurers pay hospitals to pay for the uninsured. You're paying more to pay for that crisis care than you would if we just got some preventative care for those folks.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Chair, I yield myself for such time as I may consume. I would like to first thank Chairman Miller, Representative Andrews, Representative Hinojosa, the ranking member for their work on the underlying legislation. We are debating right now landmark legislation that is going to bring more access, affordable access, to hundreds of thousands, if not millions, of college students across this country. Therefore, it is only fitting that as a component to this legislation, the Student Aid and Fiscal Responsibility Act also heavily invests in birth-to-5 education. We know investing in early childhood education creates a pathway to later success in our educational spectrum. Madam Chair, I have spent the last several months touring around my district talking with the people who make our early childhood education system work. I have hosted round table discussions in cities like Torrington and Danbury and listened to parents and providers and administrators; and there is one message I have heard loud and clear, and that is the lack of early education degree programs in Connecticut and across the country often makes it difficult to find highly qualified early learning teachers in Connecticut and across the Nation. My amendment simply seeks to clarify that the very important Early Learning Challenge Fund included in this bill would allow for States to use some of that grant money to partner with local colleges and universities to create or to expand effective education and training programs for early learning providers. I was a very strong supporter of our Head Start and School Readiness Act in 2007. That bill requires that Head Start teachers by 2011 have associate's degrees; and by 2013, 50 percent of Head Start teachers be required to have a bachelor's or master's degree. I think it is important to make sure that our Nation's kids have teachers and educators who have that academic background and education. But we need to make sure that our educational system feeds our early learning centers with those trained professionals. I appreciate the chairman's help on this bill and appreciate Representative Andrews' support, and I urge the Chamber's support. I reserve the balance of my time.

Mr. MURPHY of Connecticut. Madam Chair, I thank the gentleman for his support. There are thousands of early childhood educators in my district, and I am sure similar numbers across the country who want to go back to school and get that advanced degree. Right now the problem is there aren't slots for them to do this. This early learning challenge grant provides the opportunity to expand on programs that exist today and helps to create new ones. I would urge support for this amendment. I yield back the balance of my time.

Mr. MURPHY of Connecticut. I yield such time as he may consume to the gentleman from New Jersey (Mr. Andrews).

Mr. MURPHY of Connecticut. Madam Chair, I have an amendment at the desk made in order under the rule.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Let me just add to that, that for all of the talk we have heard on this floor from our Republican friends about fiscal responsibility with respect to health care and respect to the overall budget, when that bill came up for debate, when they made their one foray into health care, a bill written for the drug industry and the insurance industry which have made record profits off of this program and many others, they didn't pay for a dime of it. They borrowed every cent in order to fund that Medicare prescription drug benefit. You want to talk about the things that added to the deficit that Barack Obama inherited? Right at the top of that list is the only major effort that the Republican House and the Republican Senate made to health care. So not only when they constructed the Medicare benefit did they get it wrong, but for all of their talk about making sure that this health care bill is deficit neutral, which is a commitment, a commitment from this President and from the House and from the Senate, when they had the opportunity to do it, they borrowed every single dime to do health care.

Mr. MURPHY of Connecticut. I thank the gentlewoman and I thank Representative Meek for convening here tonight. Here is how I look at the issue of the public option. First of all, I think it has gotten a lot more attention in the debate than it takes up in the bill. There are a lot of very important pieces to this health care reform bill, and public option is one of them; but I look at it this way: I have faith in my constituents. I think that if we give them choice, they are going to make the right choice for themselves and for their families. And just like in countries in Europe, where you may only have one choice, you have got to buy, take public insurance, in this country we also have only one choice as well: you have to take private insurance. And this notion that we shouldn't give our constituents the choice, up to them, as to whether they want to stay on their private plan or for a variety of reasons, they think it might be better to be on a publicly offered plan, I think that shows a lack of faith in the American people. And I think if it's good enough for every single Member of Congress, if it's good enough for every Federal employee and State employee in this country, if it's good enough for our veterans, if it's good enough for our soldiers, sailors, airmen and marines, and if it's good enough for every single individual in this country over 65, well then maybe our constituents should have a choice of whether it's good enough for them or not. So to me it just comes down to choice, as was mentioned about the lack of choice that's out there right now. If you are working, odds are that you might have one choice, maybe two choices, maybe three choices. But you are lucky if you have that many. If you live in a State like Connecticut, we have one insurer that covers over 50 percent of the people in our State. That's 50 percent of the States in this Nation where one insurer has over half the market, 70 percent of States in this country have two insurers that cover 70-75 percent of the market. There is not enough choice out there as it stands right now. So I just have faith that my constituents are going to be able to make the right choice for themselves. And for all those people that say, you know, well, the government can't run anything, but the public option is going to run private insurers out of business, those arguments don't work together, right. Because if the government can't run anything, then they are not going to be able to run an insurance plan, nobody is going to join. But it should be up to people whether they do that. That's how you put competition back in a very, very broken marketplace. And so to me, to me the one unifying theme that when I was home this August, as it has been throughout the entire time that I have been doing this job for the last 2\1/2\ years, that has united the people who support this specific proposal and the people that are undecided and the people who don't like it is cost. I mean, everybody agrees that the system costs too much right now. I mean, over and over again, I hear the same story that you, Mr. Meek, Mr. Ryan heard, business owners talking about a 20 percent increase last year in their health insurance premiums, individuals looking down the barrel in Connecticut of a 30 percent increase in our major insurance plan. Employees having seen wage increases be put off year after year after year because their employers are taking all the extra money they are making and putting it to health insurance premium increases. And everybody understands that we need to tackle costs here. Well, guess what. The Congressional Budget Office, right, which Republicans and Democrats alike hate because they think it's too nonpartisan, that budget office, which we listened to, which guides our decisions here, says that the public option is going to save our health care system $100 billion, $100 billion because it's going to offer something cheaper to people and it's going to put pressure on the private insurers to bring their costs down. So if we really care about costs, and this has to be part of the discussion, there is a lot of other things we can do here. We will talk about the insurance exchange which is going to force insurance companies to compete against each other, the tax credits we are going to give to businesses to try to have them offer insurance to their employees. But when all is said and done, we should be keeping every possible tool in the tool box that can bring the costs down. That's one of the things amongst many that can unite us in this building, in this Chamber and throughout this country. And I think if there is one thing that I found when I was home, it is that when you really got down beyond some of the shouting, beyond the rhetoric, beyond the talking points that both sides were handing out, that there was actually a lot more that united us here. And I think our job here, as we hit that witching hour on this bill, is to distill that down to something we can all be proud of when we go home.

Mr. MURPHY of Connecticut. If our friends on the other side of the aisle want to have a debate about freedom, let's have a debate about freedom. Listen, we don't legislate on anecdote here. We legislate on data and statistics and evidence. But the anecdotes are powerful because they're representative of what the data tells us. And I think about the woman in my district who raised her hand at an event I had at Town Green last week, and she said, Listen. I work for an employer who's downsizing and looking to cut costs wherever they can, and I've got a child with a very serious illness. She's on this employer's health care plan, and I know that I am targeted. I know that if they can get rid of me and get rid of the expenses associated with my daughter, they've just saved a lot of money. And I know if I lose this job, I'm not going to be able to find another one because there's no way that somebody is going to pick me up if they have to cover the cost of my daughter who has an illness through no fault of her own, no fault of mine. What kind of freedom is that? I think about the guy who raised his hand and told me the story about the fact that he had been working for a new company that had just hired him in New Britain, Connecticut, a couple of years ago. He had had a good, steady income for 2 years, but he got diagnosed with gallbladder cancer and he couldn't show up for work any longer, and they fired him. They fired him and he lost his health insurance. Now he spends every single dime that he makes off of his unemployment checks to pay for cancer treatment. What kind of freedom is that? When we want to talk about freedom, health care reform, giving freedom to people who have insurance and want to keep it, giving freedom to people who lose it and need to get medical care, let's have a debate about freedom, because the proponents of reform are going to win that debate, Mr. Meek.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Speaker, I hope that our friends on the Republican side of the aisle who don't want us to fix our health care system will listen to their constituents when they go home in August because they'll hear stories like I've heard in Connecticut. A woman in Thomaston, Connecticut, contacted me about her own horrific experience. She had a pulmonary embolism and was told by her doctor that she was in danger of losing her leg, but her insurance company decided not to pay for the surgery on the grounds that it was cosmetic. Her appeal was denied, and she lost the leg. One of the biggest lies I hear about our health care system is that, if you have insurance, you're all set. Well, this woman had coverage, and it failed her. The cost of our broken system can't be measured just in dollars and cents. It's so much more. We have a system that just doesn't value keeping people healthy, and we can change this by passing health care reform.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Speaker, we're going to hear a lot of rhetoric on this House floor and throughout this city of why we shouldn't do health care reform, but we don't have to listen to people here in Washington, D.C. We need to listen to our folks at home about why we need to pass health care reform. I recently was contacted by a woman from Waterbury, Connecticut, who suffers from type 2 diabetes. She worked her entire life, paid her bills, mortgage, did everything right. But now she's on COBRA and is about to lose it. Even though her diabetes is under control, every company refuses to insure her based on her preexisting condition. She knows that getting sick and ending up in the hospital could put that home that she worked so hard for in jeopardy; and she writes to me, Somebody has to stop the insurance companies from making decisions regarding life and death. Mr. Speaker, doing nothing here in the House of Representatives as our friends on the Republican side would like says to her that her situation is unsustainable, she has no way out. We need to pass health care reform to answer her and the thousands of constituents in each one of our districts just like her.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, on July 23, 2009, I was not present for rollcall vote No. 637. If I had been present I would have voted ``aye.''

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Absolutely.

Mr. MURPHY of Connecticut. Will the gentleman yield?

Mr. MURPHY of Connecticut. I just wanted to add a statistic here. You mentioned about how a public option is going to provide competition. There have been those critics of the bill, those proponents of the ``do nothing'' strategy, who have said, Well, you know, if you have this public option, it's going to mean all of these people are going to lose their private insurance, and the private insurers are going to go out of business. Well, you know, we have this thing here in Congress called the Congressional Budget Office. Do you know what? Sometimes we like them and sometimes we don't because they play it pretty straight. They're nonpartisan. They provide analysis of the bills that we do, and they've said it pretty clearly on this issue of whether or not people are going to lose their private health care insurance. They actually show, over the course of this bill, over the 10 years that this bill will be in implementation, that more people will be insured through their employers at the end of this 10-year period than when we started and that 2 million more people will be insured through their employers than when this bill started. They also show that the price of insurance is going to come down over time. So, yes, there are going to be some people who will choose the public option, but what will really happen is that everybody's insurance is going to get less costly and that more employers are going to be able to provide it and will provide it to their employees because their costs will have been brought down. With that, I am so glad that our good friend from New Mexico has joined us on the floor. He is another new Member who has been a great champion in his district for affordable health care.