Christopher Murphy

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. I thank Speaker Pelosi and my colleagues for allowing us to come down for the next hour or so and speak to you. We're doing a joint hour. Occasionally, those of us who are pushing for health care reform to happen for our constituents this year have come down to the floor to share our thoughts about the urgent need for reform. We're sharing this hour with the 30-something Working Group, which I'm honored to be a part of. And I know our hope is that, at the very least, Representative Ryan will be able to join us later this evening as part of this hour. But we are here to focus our thoughts and our energies and to talk to our colleagues about the need to pass real comprehensive health care reform for this country and for our constituents. We know what the problem is out there because when we're out there at our town halls, when we're setting up our office hours at the supermarket or the grocery store, it's our constituents that are coming to us and telling us about the fact that they just can't afford this health care system any longer. If you're lucky enough to have insurance, you've seen your family have to pick up more and more of the share. As the cost of health care goes up for businesses, they're passing more of it along to individual consumers. So now, if you're a family of four out there, you're likely to be spending $3,000 to $5,000, at least, on health care, even when you have insurance. Your deductible now is in the thousands of dollars rather than in the hundreds of dollars. That copay that you have to bring with you to the doctor's office now isn't $5 or $10; it's $100 or $150. Those drugs that used to only cost you $5 or $10 when you showed up, well, if it's in the wrong tier of drug, you may be paying 50 to 70 percent of the cost of that drug. If you're a senior citizen and you happen to find yourself in the dreaded doughnut hole, not only are you paying the full cost of those drugs, and potentially bankrupting yourself in the process, but you're paying the highest prices in the entire health care market when you show up at the drug store. You're paying more than the Federal Government pays for that drug. You're paying more than Blue Cross/Blue Shield pays for that drug. You're paying through the nose for it. This health care system is broken. It's broken because the people that got it just can't afford it any longer. Now, much of the cost is very visible to people. That cost that you now bear as an employee, that you didn't used to have to pay, that increased deductible or that copay, that hurt is felt. We're feeling it for you because we're hearing those stories increasingly about people that just can't come up with the money to pay that high deductible, people that just don't have the cash to fill in the drug company doughnut hole. That hurt is visible and real for our constituents. But there is an invisible pain. There is an unseen hurt that we need to talk about here on this floor because there are a lot of businesses that are passing along the cost of health care, but there are also a lot of businesses that are eating the cost of health care, that don't want to have a high-deductible plan for their employees. So what they do is they pay it instead. The business decides that they will pay the 10 percent increase in premiums, but it just means that their employees don't get a wage increase that year. Or when they were supposed to get a 5 percent bump up, they only get a 2 percent bump up. There are millions, millions of employees in this country who should be making more in take-home wages but aren't because the businesses that they work for are paying more in health care costs than they ever have before. Now that's just not me talking; that's just not anecdotes I hear from the business owners and the employees in my district. That's data. That's data that shows that over the last 10 years the premiums charged to employers from health care insurance companies have risen by 120 percent during the last 10 years--120 percent jump. More than double--a more than doubling of health care premiums charged to businesses. During that same time, average wages have grown by only about 20 or 30 percent. During that same time, wages have grown at less than the overall rate of inflation. Guess what? That's because of the cost of health care eating into the money that people take home from their paychecks. Lastly, the invisible cost comes here. Guess what, Mr. Speaker and my colleagues? We've got a system of universal health care in this country. We're not inventing a system of universal health care. We've got one now. It's just the most inhumane, most unconscionable, most inefficient universal health care system in the world because our Federal law guarantees you health care, but only until you get so sick, you get so crippled, that you get so desperate that you as an uninsured individual have to show up to the emergency room. And so you get care, but it's too late. It's the most expensive, most inefficient way of delivering universal health care. There is a cost to that, because when that individual who could have just gotten a prescription to cover their growing infection and instead lets it get to such an extent and such a degree of severity that they have to show up at the emergency room and they have to have major surgery to cure that festering illness and infection, there's a cost to that of 10 to 20 times what the cost of the preventative service might have been. That cost doesn't just sort of evaporate in the air. It doesn't disappear into the ether. It's real. It's substantive. The hospital picks up that cost and forces private insurers to reimburse them more to help them cover the costs of the uninsured. Charges some of it back to the government. Every taxpayer in this country, a portion of your tax dollars that you send to the Federal and State government goes to hospitals and emergency rooms to cover the cost of all those 50 million people that walk in without insurance. So there are costs all throughout the system, both visible and invisible, that we cannot sustain. And so we've come down here to the House floor today to not just focus on the problem--I think you've got to talk about the disease in order to get a diagnosis--but to talk about the fact that for the first time in almost a generation we are on the verge as a United States Congress of rising to the massive challenge that confronts our health care system. We are on the precipice of passing real health care reform that lowers the cost of health care for everybody in the system whether you're an individual paying it or you're a business having to bear the burden of the cost, and at the same time makes the system more fair for people right now that are paying more for health care just because they happen to be sicker than somebody else; for those millions of people who can't find health care in the first place because they happen to have a preexisting condition. For all those senior citizens out there who are trying to decide between 20 different plans that the difference can only be deciphered in the fine print of the paperwork that they send you in the mail, we're going to make this system more transparent, we're going to make it more fair, we're going to give people more choice. And by doing that, we're going to lower the cost of the American health care system for everybody so that those very visible costs that are holding families back are controlled and those invisible costs that too often aren't seen by wage earners or by taxpayers disappear over time. So I'm really glad to be down here this evening. I see Representative Speier's joined us, so I'd love to hear from her as well. We're going to be joined later on, I know, by Representative Ryan and others to focus some attention on this problem of health care and the approach that we're going to take in this House. So I'd love to have Representative Speier from California join us to talk a little bit more about the challenges that we confront and some of the solutions that we put forth.

Mr. MURPHY of Connecticut. Will the gentleman yield?

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Thank you very much, Mr. Yarmuth. So good to see my friend, Tim Ryan, back wearing a path in a familiar spot on the House floor speaking truth to the American people. Listen, what you are talking about is this invisible cost, Mr. Ryan, to the health care system that we kind of pretend doesn't exist. We didn't get to 17 percent of our gross domestic product by accident. We did that by ignoring some fundamental problems in our health care system. And the fact is that we kind of just, you know, boxed our ears and shut our eyes and tried to sort of wish this problem away. Well, you know, every employee has started to feel this crunch, right? The percentage of their income that is devoted to health care has inched up and inched up every single year. But a lot of the costs they don't see because employers out there are eating it and are paying these 10 or 12 or 15 percent increases in health care premiums that they're getting every year; and instead of passing the cost of that in its entirety over to the employee, they just don't give as big a wage increase as they might have that year, or maybe they don't give any wage increase. Maybe they actually furlough folks 1 day a month. These health care costs that companies are taking on are causing wages to remain flat. That's what we've seen over the last 10 years. The GDP in this country is growing. I mean, we're making more stuff if you look at the 10-year window. Obviously in the last 2 years that has not been the case. But in the last 10 years, GDP is growing, but wages are staying right here. There are a lot of reasons for that. Some people up at the real high end of the income spectrum are pretty fat and happy, but a lot of that is because all of the extra money that companies are making is going to pay health care rather than going to their employees. So that's one way in which the costs of our health care system are sometimes invisible, because employees just assume that they don't get wage increases because their company didn't make as many widgets that year or didn't sell as many pieces of product line. No. A lot of the reason is that they sold more this year; they just took all of that extra profit and paid for health care. The second thing is what you guys, I'm sure, have been talking about already. It's that we've got a system of universal health care in this country. It's just the worst, most backwards, most inhumane, most inefficient, most unconscionable system of universal health care system in the world because we basically say to people, We will guarantee you health care--our Federal law guarantees you health care but only when you get so disastrously sick that you show up to the emergency room. A woman in Connecticut came and testified before one of our State legislative committees, and she told a real simple story. And I've told it on the floor before. Had a pain in her foot. Had no insurance. Worked for a living. Did everything she was supposed to. Just didn't have insurance. She knew that she had some sort of infection so she knew what she was going to have to pay for it. She was going to have to go to the doctor, she was going to have to pay probably $100 for that visit, and she was going to get an antibiotic or she was going to get some medication to make it go away. That was going to be a couple hundred more dollars. She didn't have it. She knew she didn't have it. So she decided to just live with the pain. Well, finally, one night it was just unbearable. She had to go to the emergency room. So she showed up to the emergency room, and it was too late. That foot was infected so badly it had to be amputated. And that's a terrible, terrible outcome for that woman. Changes her life for the rest of her time. But it cost the system the thousands of dollars that that surgery and all of that follow-up care required versus the couple hundred bucks we could have gotten in preventative care up front. We're paying for that. You don't see it because you never met that woman and you never see the thousands like her who end up showing up in the emergency room with crisis care that could have been prevented. That's more invisible costs, but it's all there. One last point, Mr. Ryan and Mr. Yarmuth. People are going to hear the cost of these bills when they come out. They're going to see that the cost of the bill from the House is X billion dollars; the cost of the bill of the Senate is X-plus-Y billion dollars. Here's what you have to do. You have to look at that cost versus the cost of doing nothing. And every credible survey, every credible examination is going to tell you this: that the cost of the bill that we produce is going to be half of the cost of sitting and accepting the status quo. That's why we have to pass health care reform here.

Mr. MURPHY of Connecticut. If I can just add something, Mr. Kagen brings in energy policy, and we just got through a long, hard struggle of passing an energy bill on this floor, and we're right now engaged in the muck of trying to change this health care system. I think it's just worth reminding everybody out there how hard this is going to be, right, how hard it's going to be to try to reform a health care system where, as Mr. Ryan said, a lot of money is being wasted. But that money that is being wasted, it's not like you're wasting heat in your house and it just sort of escapes into the atmosphere. When we talk about wasting money, we talk about money that actually ends up in people's pockets, right, that makes them rich and creates their fortune. So when we talk about saving money within the health care system, that involves taking on some pretty powerful institutions around this city of Washington, D.C., and around this country that are going to have to live with a little bit less in order to get average Americans a little bit more. And I think people are going to read all these stories in the paper about, boy, how long it's taken to pass health care reform and how tough it is to get the Senate and the House to agree. Listen, when you are taking on one-seventh of the economy, when you're taking on the industry which by years of Republican neglect has allowed for some big players in the health care industry to make their fortunes off of the fact that some people can't afford it, then it's going to take some time, going to take some heavy lifting to fix a problem that has festered for a long time. Now, the same thing is going to go for energy. That's why energy is going to be so hard to do. It's taking on a lot of similar interests, but health care reform is not just a nice, practical policy discussion amongst intellectual peers. This is about taking on some vested interests.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, on June 24, 2009, I missed rollcall 450, a vote on final passage of the Fiscal Year 2010 Homeland Security Appropriations bill. I was detained off the House Floor with legislative business. If I had been present for the vote, I would have voted ``aye.''

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, I object to the vote on the ground that a quorum is not present and make the point of order that a quorum is not present.

Mr. MURPHY of Connecticut. Madam Speaker, pursuant to clause 1, rule I, I demand a vote on agreeing to the Speaker's approval of the Journal.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, I hope today we are going to pass a transformational climate bill that will not only grow jobs in this country but will make us truly energy independent. And when we get back from our break, it is time to turn our attention to health care. There is a lot of controversy around these issues, but out in the American public, there is no controversy over their desire to see a public insurance option be part of health care reform: 69 percent support in a recent Kaiser Foundation poll; 72 percent in a CBS/New York Times poll; 76 percent by NBC and Wall Street Journal. And it is nonpartisan: 50 percent of Republicans support it, over 80 percent of Democrats. There might be a lot of controversy on the issue of energy or health care, but on the issue of whether or not Americans want a public option on their table as part of health care reform, the jury has decided.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Thank you very much, Mr. Chairman. I rise in support of the bill, but to encourage the committee and this Congress moving forward to better address the issue of gaps in our missing persons database system. On August 24, a 31-year-old resident of my district, Billy Smolinsky, went missing. Sadly, foul play is suspected. And to this day, his parents, Janice and Bill, still don't know what happened to their son. What they found out, when they tried to go online to find databases that helped identify remains that had been found and missing adults, was that there is no central repository of information, and the databases that do exist don't communicate with each other. In fact, up until 2 years ago, there wasn't even a database that was open to the public, there were only databases that were available to private law enforcement. Today, we have the Name Us database, which is available to individuals and families who are looking to try and find this kind of information, and yet it doesn't have enough information. The private databases that are run by the FBI don't communicate with these public databases. And so I come to the floor this evening simply to encourage my colleagues in appropriations bills going forward to make sure that we look to appropriating funds to allow for this kind of transfer of information to make sure that families like the Smolinskys all across this country have access to the best and most accurate information possible to try to press their cases going forward. I understand that there are legitimate privacy concerns regarding what kind of information the FBI might share with this public database, but I think that we can solve those problems and create a much more comprehensive public database for families going forward. I look forward to that conversation in coming appropriations bills.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Thank you very much, Ms. Baldwin. I'm always amazed at how articulate your constituents are. It really is amazing to hear the stories firsthand because, as Mr. Altmire mentioned and as one of your constituents mentioned, there is an entire industry out there that is dedicated to trying to stop people from getting care. That's what you get when you build in the type of profit motivation that we have and the pressure on shareholder return. We treat health care and the economy around it just like we treat, basically, every other industry out there. I think there are a lot of us here who believe that there is something fundamentally different about health care than the auto industry or the cereal industry or the widget industry and that, when the consequences of somebody's not being able to get that product is life or death, maybe we should have some different rules that govern it. Maybe there is no problem with having some incentive built in for innovation, for success and for all the rest. Maybe there should be a limit to that, and there should be some constraints on the system. So I thank you for joining us, and please stick around for a little while. Mr. Altmire, you are talking about the three pedestals here of access, cost and quality. I think it's just important for us to talk for a second about how we sort of have an assumption in this country that the more money you spend, the better care you're going to get, right? And what we have found, as we sort of surveyed one particular segment of the country to the next, is that isn't necessarily the case, that spending more money and just having more health care doesn't necessarily deliver better health care. There are great surveys from Dartmouth University and other places that show that, actually, if you can better coordinate care, if you can get physicians talking to each other, if you can get primary care doctors doing more work up front, you can spend more money on preventive health care, as you talked about, that you can get better health care out there. So one of the things when we talk about controlling cost is trying to actually get people to have a decrease rather than an increase in utilization. I think it will be a big central part of our discussion here about how we do that. There are very interesting ideas about how you try to encourage providers to work together, about how you invest more in primary care. But a subject that we have talked about on this House floor, which is going to be fundamental to this discussion, is giving those physicians and hospitals the tools to do that. The only way that you can try to get doctors talking to each other about complicated patients, the only way that you can try to really empower the consumers themselves to take more ownership over their own health care is to make sure that they have the ability, as physicians or providers, to track those patients through the system or, as a consumer of health care yourself, to track your care as you move through the system. Technology is really the key to that, and we have already taken a great step forward on that issue through the stimulus bill. There is $19 billion in the stimulus bill dedicated to building out the world's best, most connected, most highly technologically advanced health care information system so that as an individual walks into the emergency room, that that treating physician can immediately figure out what his medical history is, what tests he's already had, what's been ruled in, been ruled out relative to the illness that they present with. We can save billions of dollars just by having better information in the system. I am so glad that our President had the foresight to see those savings down the line by investing money in the stimulus bill to get that technology out as quickly as possible so that it can be a platform for those savings. There are going to be a thousand different ways that we talk about to save money in this system, and we know that that's how we get access. But I don't think any of it is going to be possible, Mr. Altmire, without that investment in technology, something that you talk a lot about.

Mr. MURPHY of Connecticut. Mr. Altmire, scale it down. There are thousands of hospitals, some of which are in the State of Connecticut, that have competing systems, even within their own hospitals, that don't talk to each other. There are hospitals that have one electronic records system for their emergency room and then one electronic medical records system for their in-patient unit. So the same thing that happens as you move from active service out to be part of the veterans health care system works within a matter of days in a hospital setting. When you come in and present to the ED, you then aren't on the same record system when you move over to the inpatient unit. Now that is because we do not have a sort of nationally agreed-upon platform for how systems communicate with each other. And a lot of hospitals say to themselves, well, I have got one really good system for emergency rooms, and then I want to buy this other really good system for in- patient care. We have got to have some national standards that basically say to any hospital or physician's office that's buying into a records system that you can be guaranteed that you are going to get a system that presents you with all the data and tools that you need and will be able to communicate with everybody else. In fact, there's no way that we're going to spend that stimulus money without some national standards to guarantee that that happens. But as a sort of preview as to how politicized and how politically charged this debate can become, when we were debating that portion of the stimulus bill, which really is a commonsense investment in information technology, something that there should be no reason why Republicans and Democrats should disagree. I don't want to put words in Mr. Burgess mouth. He is a Republican Member from Texas. He comes down to the floor very often to talk about the crisis in our health care system, and he talks in a very articulate way about the need to upgrade our information system. So there's a lot of potential agreement on this issue between Republicans and Democrats. But it didn't stop the sort of right wing in this country from going out and spreading lies that this investment in information technology was the Federal Government's attempt to have a Big Brother takeover of health care, and this was the Federal Government reaching in and controlling all of your health care information and knowing everything about every illness that you've had or prescription drug that you're on. It's the furthest thing from the truth. We're just simply trying to standardize private health care investments that have been made by hospitals and doctors across this country. But I think it speaks to how difficult this debate is going to become. There is a group of folks out there who are either just ideologically opposed to having the government have any role in health care, or folks who are part of the status quo who are making their fortunes off of health care today that don't want the rules of the game changed. Even when it comes to what should be fairly noncontroversial issues, like investments in information technology, I mean, my God, you know, it's boring to say, right, but it's so important. It's just not that controversial. We're still going to find a lot of people on the outside that are going to fight us on this issue, as they will on many others, Mr. Altmire.

Mr. MURPHY of Connecticut. The gentleman knows that I think this is, for me, critical to reform going forward. I really do think that if you empower consumers to have real choice, that that is one of the ways in which we're going to control cost. Right now when you decide you want health care insurance, if you are a business or an individual, it's a real cloudy picture out there. You don't know exactly what you're buying. You don't know the combination of deductibles and premiums that are going to force costs on you. You can't ever be sure exactly what the benefit plan is, whether pre-existing conditions are covered here and not here. So one of the things that we're talking about that is fundamental to this reform is really trying to standardize the market, creating some national standards for health insurance; that you've got to have this basic benefit package that covers preventive services and real catastrophic care; that you can't discriminate against people that have pre-existing conditions; that you can't have lifetime limits; to basically give people some certainty that when they go out and purchase insurance, that they're going to get insurance, that they're going to get something they can actually use. So, a lot of us say, well, you know, why not give people the option, if they don't like the private insurers who are inevitably going to take a piece of their premium and pay the CEO a big salary or pay back shareholders or turn it into profit, why not give them the option to purchase a nonprofit, government-issued plan? Now, Mr. Altmire, you are right, that that only works if that government option, that government health care option, has to finance itself; that it doesn't get a subsidy from the Federal Government to help it compete with the private plans. But if that public insurance option has to pay for itself, just like every private insurance company has to, they collect premiums, pay for care and it all has to be self- financing, then you are exactly right, what is the problem? If the government is so inefficient, then they will end up having an insurance plan that costs more than the private insurers, and nobody is going to buy that. But if our theory is correct, that by not having the profit motivation that the private insurers have, that they can run a more cost-effective product, then why shouldn't consumers have that choice? The people in this Chamber who are going to say there can be no public insurance option available to individuals are taking choice away from consumers. I would rather have my 700,000 constituents be able to have as many choices as possible. I want them to decide whether they think that private insurance or public insurance is better for them. Everybody will answer that question differently. But I think that those of us that are going to be favoring a publicly sponsored health care plan as one of the options for individuals and businesses out there are going to be on the side of consumer choice, and I think if we give consumers that choice, it is going to create a really competitive structure that will end up with some people having public insurance, some people having private insurance, but a real competition by which we lower health care costs, Mr. Altmire. Listen, I get it. The devil is in the details of making sure that you don't give a little competitive advantage to that public option, but I think that it is really a linchpin of health care reform going forward, if we can get it right.

Mr. MURPHY of Connecticut. I thank Mr. Altmire and Ms. Baldwin for joining us tonight. Let's make no mistake about this. This is going to be a fight. This is going to be a fight, because to do this right, you are going to have to take on some folks who have gotten real fat over this health care system. You are going to have to take on some ideologues that just don't believe that the government has any role in trying to get health care to people. There is a polling memo going around Washington written by Newt Gingrich's pollster essentially outlining in 28 pages how you stop health care reform from happening. That is the agenda of a lot of people in this town, a lot of folks on the other side of the aisle, that they do not want health care reform to happen. Now, some of it is for good, honest policy reasons. I believe it is an incredibly mistaken belief that the private sector can just fix this on their own. They haven't done it for the last 50 years. How can we expect they are going to do it overnight? Some of it though is very cynical politics. Some of it is due to people that look back to 1994 and the failure of the Clinton health care plan in the 2 years prior, and believe that if folks can stand in the way of President Obama or this Democratic House passing health care reform, that they will gain some electoral advantage out of that. Now, I hope that is the minority of people that are standing in the way of this bill. But make no mistake, there are people out there who simply see political advantage against Democrats in general or against the President of the United States in stopping health care reform from happening. Now, they may have succeeded back in 1993. I wasn't here, Mr. Altmire wasn't here, so we can't speak to all the reasons that happened. But that is not going to happen this time. Not because you have got smarter people in the House of Representatives or you got necessarily a better strategy moving forward, but because the American people are not going to stand for the status quo. They know this economy is tough and they feel more conscious than ever of the fact that they are just one paycheck away from losing their health care and becoming one of the tens of thousands of individuals out there who have been forced into bankruptcy because of health care costs. The status quo is not good enough for people out there, and despite 28 pages of polling telling the folks on the other side of the aisle how to stop this from happening, I believe that the will of the majority of Americans is going to bring us together to get a good bill passed. We are here as 30-somethings in the Democratic Caucus talking about that tonight, but I believe that there is going to be a groundswell of public support that is going to force us, both parties, to come to the table and do something, not small, not minor, not temporary, but something big and permanent to fix all of the underlying problems in this health care system, to make sure that more people have it and less businesses are burdened by it. So, again I would like to thank Speaker Pelosi for once again giving us the opportunity as the 30-something Working Group to come down here tonight, and remind folks that they can e-mail us at 30somethingdems@mail.house.gov. If you have any questions for us, any feedback on what you have heard this evening, www.speaker.gov/ 30something is where you find us on the Web.

Mr. MURPHY of Connecticut. Mr. Altmire, we spend so much time with our business community, our chambers of commerce, when we are back home and when they come visit us down here, that we know what the reality is out there. These folks that right now can't afford to give health care to their employees desperately want to do that. They want to do it first because it is just the right thing. They are members of their community like anybody else is, and they want to be able to provide health care to their employees, whether they have two employees or 40 employees. That is just the kind of people that are out there running small businesses by the skin of their teeth across this country. But they also need to do it from an economic standpoint. They know that to the extent that they can't offer health care or can't offer the kind of generous plan that they would like to, they are at a disadvantage against their competitors who can offer that type of health care. They are at a disadvantage against the big employers who can steal their employees away. So this is really an issue that our small businessmen are waiting to be a part of the solution, and if we can offer them, whether it is through a public option or through lower rates on private plans, a more affordable health insurance option, they are going to take it. They are going to grab it. You are right, we don't want to set up any incentives where they are going to push people off to the public plan. But we know the majority of folks are going to want to be part of the solution out there, just for reasons of conscience, but also for reasons of their own salvation as a particular business.

Mr. MURPHY of Connecticut. Madam Speaker, I thank you and Speaker of the House Pelosi for allowing the 30-Something Working Group, which has been empowered by the Speaker's office, to come down to the House floor every so often and share with our colleagues here in the House really some of the burning questions of our constituents out there, especially those that affect younger individuals and younger families, and to talk about how this House, under new leadership with a new face in the White House, is rising to answer those questions and meet those challenges. We'll put this poster up at the end of the hour as well, but we are always eager to hear feedback from people who want to know more about the 30-Something Working Group. Madam Speaker, thanks to members of your class, we have a number of new members of the 30-Something Working Group and they've been coming down and joining us occasionally in these hours. We're glad to have Mr. Altmire with us and hopefully some guests to join us this evening as we try to focus our discussion this evening on an issue of just incredible importance to our constituents. That is the issue of health care for all Americans. We sit at a moment of great economic peril for this country and the people that we represent. There is not an hour or minute, frankly, that goes by when we are back in our districts where we're not talking to a family or to a shop owner, to a factory worker, to a small business man about the difficulty that they face in this economy. It's getting harder and harder to keep businesses open. It's getting harder and harder to hold onto your job. And for the now 9\1/2\ percent of Americans that are out of work, it's getting hard to find a way back into the workforce. For those of us who believe that now is the time to pass not incremental health care reform but major structural health care reform, we support that not just because we think that it's a moral imperative, as the richest Nation in the world, that we shouldn't be the outlier in the global health care system by which we still stand as the only country in the industrialized world that has such a high percentage of our citizens without access to our health care system; not just that, as the country which claims to be the leader of the free world, we still sit in a country where children go to bed at night sick because their parents can't afford a doctor; but because we believe that it's part and parcel of how we start to get this economy back on firm footing again. For families out there that have seen their wages remain flat over the last 5 years and have seen the percentage of their income dedicated to health care costs grow exponentially, they didn't figure out that this economy was in trouble last fall when the banks collapsed. They knew it long ago. For our auto companies that have been struggling for a very long time to compete competitively on a global stage when $1,500 of every car that they sell is attributable to health care costs, $1,500 more than their competitors in Japan or Germany, they knew that the health care system was dragging this economy down long before last fall. And for small- and medium-sized businesses across this country who have seen their premiums dedicated to keep their employees insured grow by 10 or 12 or 14 percent a year, far outpacing the similar increase in revenues coming into their coffers, they knew that health care was weighing this economy down long before the newspapers discovered that this economy was in crisis and in trouble last fall. If we really want to emerge from this recession stronger than ever, if we really want to be competitive in the global stage, if we really want to recognize the strength of this economy lying in the hundreds of thousands of 2- and 5- and 10- and 20-person businesses out there in each and every one of our districts, then we have got to fix our health care this year. And we can't just do it with a Band-Aid here or there, pardon the pun. We've got to do it with real reform that at the same time lowers the cost of care and expands access to more people. I happen to think that it should be a right as a matter of being a citizen of the United States that you should get health care, but I recognize that the only way that you do that is by lowering the cost of care across the board. We spend twice as much as all of the other industrialized nations on health care, essentially, maybe a little bit less than twice as much, for a system that still leaves 50 million people uninsured. We can get access for everybody out there as long as we start spending less or, at the very least, that we start controlling the rate of growth. So I think we are going to talk about all these things tonight as the 30-Somethings come to the floor. We are going to talk about health care, health care reform as a moral imperative, as a matter of conscience for this Nation. We're going to talk about it as an economic imperative, and we're going to talk about it both from the context and the perspective of getting care to people that don't have it today and trying to lower the cost of care so that all of us, whether or not we have it or don't have it, don't continue to pay for a system that far too often provides very expensive care without having accompanying results. So I'm glad to be here on the floor today with a good friend who has joined here for a number of Special Order hours, Mr. Altmire. Ms. Baldwin has joined us as well. I'm glad to yield the floor to Mr. Altmire.

Mr. MURPHY of Connecticut. Will the gentleman yield?

Mr. MURPHY of Connecticut. I want to just put an example to one of the points you made here, which is this cost shift that happens. You talk about the folks who don't have insurance or who are underinsured. They get it, right? We have universal health care in this country. You've just got to wait until you're so sick that you end up in the emergency room until you get it. In fact, President Bush, while he stalled on health care for 8 years, famously remarked, you know, don't worry about the uninsured--I'm paraphrasing--because they'll get health care when they need it. They just have to show up to emergency rooms. Well, I've told this story maybe even on this House floor before. I told it 100 times back in Connecticut. When we were debating health care reform in the State legislature, I'll never forget a woman who came and testified before us. She told this story: She said, you know, I was working. I was employed, but my employer didn't provide health care, and I didn't make enough to go and get it on my own. I think she might have had some kids, and she had gotten them insured, but she hadn't had insurance herself. She started noticing over the course of a couple of weeks that she had a real pain in her foot. The pain would sort of get worse, and then it would get better. She knew that she should go see a doctor, but she knew that a couple of things were going to happen: one, she was going to be billed a pretty exorbitant amount for the visit; two, she was going to have to go into the pharmacy and have to probably pay for some antibiotic to treat it. She was savvy enough to understand that, when she did that, she was going to pay the highest cost in the whole system. If you were uninsured, you were going to pay top dollar for that visit, and you were going to pay top dollar for that drug. You don't get the benefit of the bulk purchasing that the Federal government gets through Medicaid or through Medicare or that the insurance companies get through similar programs. So, one night, she finally decides the pain is just so unbelievable that she can't stand it anymore, and so she goes to the emergency room. She gets to the emergency room too late to save her foot. She has a foot infection that has gotten so bad that she has to have it amputated. For her, that is a life-changing event. Her life is never going to be the same. She is never going to be the same person or the same mother. She is going to have to deal with the disability for the rest of her life just because she didn't have the money or the coverage to get some simple antibiotics that would have treated that foot infection. That just doesn't make sense in the richest country in the world. Think about it from just a cost perspective. I don't know how much that surgery cost, but it was in the thousands of dollars, I am sure. She didn't have the money to pay for it. Maybe she got billed for it, but probably, more than likely, it just sort of got sucked into the unreimbursable cost by that hospital and got picked up, essentially, by the taxpayers in subsidies for that hospital or by those people who had the insurance, through higher insurance rates, in order to help the hospital to compensate for the people like that woman who didn't have care. So we paid for that surgery. You and I paid for a surgery that didn't have to happen. There is a woman walking around now with her life fundamentally altered simply because she didn't have access to insurance. Sometimes people need to hear these examples, Mr. Altmire, of what it really means when somebody only has health care when they get so badly sick or ill that they show up in emergency rooms.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. We are going to take the next 45 minutes to an hour, myself, Mr. Kagen, Mr. Langevin, and a few others that will likely join us over the course of the hour, to talk about a subject that's on the minds of more and more Americans every day, and that is the issue of getting health care for all Americans. President Obama was swept into office with a mandate to fix what has become an unjustifiably broken health care system here in this country. It costs way too much, outpacing all of our industrialized neighbors by almost twofold. It gets care that, compared to those same nations, ranks pitifully in the middle of the pack. And it has changed the very practice of medicine for far too many physicians who went into their profession for the love of treating people and making them better and now find themselves dedicating more and more of their time filling out paperwork, dealing with red tape, and arguing with insurance companies over whether or not they should get paid for their services. We can make this health care system better for our society as a whole, for our government as a payer, for the patients who interact with it, and for the providers--the doctors and the nurses and practitioners--who perform miracles every day within that system despite the system. There are a lot of people who enter this debate from various sides, and we're, frankly, not going to have over the course of this next hour unanimity of opinion on the exact solution to this crisis going forward. What you will hear over the next hour is a group of individuals on the Democratic side of the aisle who are committed not just to reform for reform's sake, not just to a--pardon the pun--Band- Aid fix, but to comprehensive health care reform. We're beyond making little incremental fixes here or there. We've got to strip this thing down and build it back up again. We've got to learn from our mistakes. On the Democratic side of the aisle, we've heard the American people loud and clear whether it was at the ballot box last November when they voted for a President, a President who made it clear that health care reform and getting coverage to every American was going to be at the top of his priority list, or whether it's every weekend when we go home, when we talk to individuals who are facing the reality of an economy that leaves them one paycheck away, one pink slip away, from losing their health care forever. That number is going up. More and more Americans are afraid that their breadwinners may lose their jobs over the next 6 months to a year. They realize that what comes along with that is the risk of having their entire lives turned over. Half of the bankruptcies in this country are not due to irresponsible spending decisions or due to houses that they bought that cost too much or due to a couple too many plasma TVs in the basement. No, it's medical costs. It's an unforeseen illness visited upon a family who didn't have the resources to pay for it. Half of the bankruptcies in this country are due to people who got sick but who didn't have the means to pay for it. Half of the bankruptcies are due to the people who played by all of the rules and who did everything we asked them to do but who just got sick. Now, in the richest country in the world, there is no justification for the fact that somebody who has the misfortune to be diagnosed with cancer or with an expensive illness has to lose everything--his house and his car--just because his fortune was a little bit different than someone else's fortune. There is no justification for the fact that millions of little kids in this country are going to bed, sick at night, just because their parents can't afford to get them to doctors. In this country, that can't be all right. People have come to the conclusion that this is the time--this year, right now, this summer, this fall--when we finally will wake up and will fix this thing for good. You're going to hear from a lot of us as to our ideas on how we should address this crisis. We're going to talk today about the role of consumers in this debate, whereby we can make our health care customers better purchasers of health care if we give them the right information and so that we can empower them in a new, reformed health care market. You're going to hear about the role of the Federal Government in this reform and, as part of that new purchasing power that we can give to individuals, that we can give them the option to buy the same health care that I have and that Mr. Langevin may have and that others in this Chamber may have. I know Mr. Kagen doesn't take the Federal employees' health care plan, but it doesn't seem like it's so revolutionary that we should not allow regular, everyday Americans to have the same kind of health care that Members of Congress have. We're going to talk about the role of people to have choices between public insurance and private insurance. We're going to talk about reforming the way that medicine is practiced so that physicians can get back to spending their time with patients rather than with filling out paperwork and with hiring more and more people to argue over whether they will get paid or not. We're going to talk about how we make this reform centered around improving quality. It still doesn't make sense that we spend 70 percent of our gross domestic product on health care, and yet we have infection rates, life expectancy numbers and infant mortality rates that should leave us pretty embarrassed given the amount of money that we're spending. So I'm excited to be here on the floor for the next hour or so to talk about these things. I know Mr. Langevin has joined us here on the floor. I would be thrilled to turn it over in just a second to Mr. Kagen to give a couple of introductory remarks, and then I will turn it over to Mr. Langevin. So I'm glad to have you join us here, Mr. Kagen.

Mr. MURPHY of Connecticut. Thank you, Dr. Kagen. Dr. Kagen has been such a great voice on this. He highlights a growing issue that, I think, we can get bipartisan agreement on, which is that transparency of price, whether it be insurance products or physicians, is going to be so important, and empowering consumers to make these decisions can be part and parcel of what gets those costs down. With that, I am very happy to have my good friend from Rhode Island join us today. I would yield to him.

Mr. MURPHY of Connecticut. I thank the gentleman from Rhode Island. You have been such a leader in this Congress for years on the issue of health care reform, especially, as the world knows, on the issue of stem cell investment. We know that one of the ways that we're going to get savings ultimately is by stimulating the next round of breakthrough treatments and cures that are going to save lives but also save money. With that, we'll turn to my very good friend and classmate from Florida (Mr. Klein) for some wise sage words.

Mr. MURPHY of Connecticut. And giving people choice. I mean, I think that this really gets back to the fact that if consumers--and Mr. Kagen was talking about this at the beginning. If consumers know what they're buying, if they can really compare the cost of A to B, and as Ms. Schwartz said, they know the terms of what they're buying, they're going to make smart choices. And many of us here in Congress who would like for individuals to simply have the option to buy into even the plan that as Federal employees and Members of Congress we have the benefit of getting, we want them to have the option of doing that. If it costs less in their particular region of the country, great, they'll buy it. If it costs more somewhere else then maybe they won't. But no subsidy from taxpayers, no check from the general treasury, just the cost of providing that plan. And the fact is that the plan that is run or sponsored by the Federal Government, it might be cheaper for people because maybe it doesn't have the same profit motive that the private insurers have. Maybe it's found a way to get administrative or marketing costs down. Maybe it doesn't have to return money to shareholders like private plans do. But all we think is that individuals and businesses out there should have that choice, like I have the choice to buy private health care in the market or join the Federal employees health care plan.

Mr. MURPHY of Connecticut. Listening to the gentleman from Florida, I'm reminded--you were down here with us the last time we were doing this. I got an e-mail not long after from a family member who comes from the other side, both the partisan and ideological side of the aisle. And he said, you know, be careful. You keep on talking about this. You know, it makes a lot more sense to me. I am struck by the principles that you have laid out because I think that a lot of our friends on the Republican side of the aisle, either here or out in the world, aren't going to find a lot of disagreement with a lot of things that we're talking about this system doing. I just think it's important for our constituents and for the American people out there to really do a little investigation when they hear the pundits on TV or the leaders of the Republican Party talking about President Obama and socialized medicine or the Democrats' plan for a government takeover because all you've got to do is scratch the surface there, and you will find out that really what we're talking about is some pretty important and I think broadly agreed upon reform and that the bogeyman and the straw man that gets thrown out there in terms of terminology that doesn't have any place in this debate can easily distract you from what is really a pretty unifying debate that's starting to happen here. I appreciate your words. One of the things you mentioned was the importance of getting at this issue of pre-existing conditions. Representative Courtney has been a great leader, offering his own legislation on that issue. I am glad to yield to the gentleman from Connecticut

Mr. MURPHY of Connecticut. And, Mr. Klein, when you talk about it like that, it is common sense. When you talk to a small business out there and you tell them, Listen, what do you think about having the option, up to you, to purchase into a plan that is run or administered by the State of Florida? The State of Connecticut, we're looking at doing the same thing, or the Federal Government. If it costs you less, you know, people are going to raise their hands by the droves because you're giving them more choice. Right now they may be, you know, if you're in some States in this Nation and you are looking to purchase an individual policy or a group policy, you don't have a lot of choice out there. It's Blue Cross/Blue Shield or--

Mr. MURPHY of Connecticut. You know, Mr. Kagen, the discrimination finds itself in a lot of different corners. It's not just you, as an individual, who may not be able to get that insurance. But it prevents you from going out and getting employed or reemployed, because that discrimination is against you individually, but also against your employer, that if you have a small employer who's looking to go out and get health care for his five or six employees, that insurance could potentially be double for your pool of five or six employees if one of them happens to have a preexisting condition. So, you know, it's really a triple whammy for somebody that gets sick and has expensive care: one, you have to deal with the limitations on yourself through that disease; two, you may not be able to get insurance to cover it. You may have to pay for it out of your pocket; and three, you may not even be able to be employed because employers today are going to say, Forget it. Even though that guy might be the perfect person for this job, I might need that person to fill that slot. It's going to break my bank if I have to put that person on the insurance rolls. And that's another reason why we have to make sure that the elimination of preexisting discrimination is part of this bill.

Mr. MURPHY of Connecticut. I thank you, Mr. Courtney. There is, and you can feel it, I hope, from the folks that are on the floor today, an enthusiasm and an optimism that we have that I don't think we have felt in this House for a long time. The forces are aligned in a way that they have not been in a long time to get this effort done. And I think your point about people wanting to stand up the public health care system as an example of what needs to remain and then also tear it down I think is a really good comment. I'm reminded of a point made by a political columnist who talked about one of the statistics that is very often used by the side backing up the status quo, which is that in the Canadian health care system, you have to wait weeks, if not months, for a hip replacement surgery, and here in the United States you can get it pretty immediately. What they fail to point out is that 70 percent of hip replacement surgeries in the United States are paid for by Medicare, are paid for by a government-run health care system. And so we, through our public payment system, already do a pretty good job of getting people the care that they need. The fact is they spend a lot less money on health care in Canada than we do here. And we are not even talking about cutting back the amount of money we are spending. We are simply talking about trying to restrain the rate of growth. By reordering the money that we already have in the most expensive health care system in the world, we are going to be able to get good care. We will have short waiting times and access to all the people that don't have it. So with that, I'm so glad that Representative Schwartz has joined us on the floor. Whether it is standing up for primary care physicians or being a leader in this Congress on the issue of health care IT, I'm so glad to have you joining us here.