Christopher Murphy

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Of course.

Mr. MURPHY of Connecticut. Mr. Kagen, as a closing comment I will just say that, as much agreement as we've had over the last hour, there's going to be disagreement. There are going to be people that try to stand in the way of this change happening. And there's a memo circulated by a Newt Gingrich pollster going around Washington now and around the circles that want to stop reform from happening, and it sort of lays out the case for how you can stop health care reform. But it's interesting because one of the underlying points of that memo, based on the polling that this pollster had done around the country, was that this year you can't be for nothing. This year you have to be for something. Now, he undergoes a very cynical analysis of how, in the end, you stop reform from happening. But the message, even through this conservative Republican pollster, is clear: People want change. And I think they're going to get it this year. I thank the Speaker for giving us this time, and we yield back our balance.

Mr. MURPHY of Connecticut

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

Mr. MURPHY of Connecticut. I yield myself such time as I may consume. I'd like to thank Chairman Oberstar and Chairman Costello and the minority members on the committee for allowing this amendment to come before us today. Every year, the FAA works with local communities and local airports to address and try to remediate noise and safety issues. In my district, that's happening with respect to the Waterbury-Oxford Airport, which has changed over time: a lot more jet traffic, a lot more noise and increased safety concerns for, in particular, a neighborhood, the Triangle Hills neighborhood, which sits in the town of Middlebury. We are undergoing a process right now to potentially purchase and relocate some of the people who live in that neighborhood. A problem, though, potentially arises in that during the process of notifying the neighborhood and the community about a relocation effort, the value of those homes is going to normally drop. It is standard practice in the FAA to make sure that in assessing the value of those homes that you do not allow for the decrease in value due to the notice regarding a potential relocation. This amendment simply seeks to take that standard practice issued in guidelines to local Departments of Transportation and put it into statute. This is going to make sure that these processes of relocation ensure that people in the Triangle Hills neighborhood and like neighborhoods around the country get the fair market value for their homes, but also, I think it will allow this program to work more efficiently as it goes forward. I think residents will be much more willing to enter into these type of noise remediation and safety remediation plans if they have some assurance that they are going to get a fair price for their homes. So I thank again the chairman and the ranking member for working with us on this amendment; and on behalf of the dozens of residents of the Triangle Hills neighborhood, we thank you for allowing us to bring this amendment before us. I reserve the balance of my time.

Mr. MURPHY of Connecticut. I yield back the balance of my time.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Speaker, those of us who came to Washington to pass comprehensive and revolutionary, potentially transformational health care reform are emboldened by the realization that we now, for the first time in almost a decade, have a President and an administration who are as committed as any advocate in this country to the premise that this country must reform its health care system. We are reminded almost weekly of President Obama's commitment to health care reform that happens this year. This week we saw the President bring together varying and diverse groups that over the course of the history of health care have normally been at each other's throats, coming together to say that the first premise of health care reform has to be lowering of cost in the system. The health insurance community, the hospital association, the medical association, PhRMA and SCIU, one of the Nation's biggest unions, all coming together and saying, listen, let's take cost out of this system. And it is the right way to first approach health care reform. We can talk all we want about coverage, but if we don't start to dramatically slow the growth of health care at a pace now that stands at 7 or 8 percent a year, if we don't bring it down to something that more resembles the general inflationary rate in this country, there will be no room, never mind to expand coverage, there will be no room to just cover the people with health care now. We have gone over the numbers over and over again: $7,400 per person that we spend on health care in this country, $2.2 trillion across the spectrum of our health care system. Twice as much of our GDP is spent on health care as we spent in 1970, and twice as much of our GDP is spent on health care than many other similarly situated industrialized nations. Health insurance premiums over the last 10 years have gone up 119 percent, while earnings have risen only 34 percent. We know there are savings because we look out across the country and we see dramatically diverse experiences with regard to cost. In my home market of Hartford, Connecticut, we are spending on average about $8,000 a person to treat a Medicare patient. Well, you go down the eastern seaboard to Miami, and they are spending twice that amount, $16,000 to treat a similar Medicare patient. Now, I am sure we can come up with a list of reasons why that care is going to be marginally more expensive give the client base and the provider costs, but not twice as expensive. As we saw in some recent work at Dartmouth University, there is no correlation between what you spend and the quality you get. In fact, it tends to be the reverse: the better you are at coordinating care and keeping costs down, the healthier your patients are. So there is an enormous amount of savings that we can achieve just by better coordinating care and learning from the areas of the country and the health care communities that have figured out that you can reduce costs and preserve quality. But ultimately, Mr. Speaker, I don't think we can really take a whack at costs until we understand the important role that a public insurance model can play in our health reform system. I want to talk about this for 1 minute. We have looked at comparative models, for instance on the purchase of prescription drugs via a government program like the veterans health care system and private models likes the Medicare prescription drug benefit programs, and we see example after example on how the ability of the United States Government or entities acting on its behalf can bring down the cost of health care. We have seen examples of how a government-sponsored health care initiative that has no interest in returning value to shareholders, that has no interest in paying its CEOs massive salaries, that does not have a profit motivation can get more humane and less expensive care to its recipients. That is the theory behind those that want a government-run single payer system, and I think we all acknowledge we are not going to get there. But we are not going to achieve the savings that we hope to achieve unless we can have a robust, completely competitive market where individuals and businesses that are purchasing insurance get to choose not only between private insurance companies that might offer them the best deal, but also from a public option as well. This is fundamentally about creating real market-based choice for consumers. If we have a diverse array of private insurance products and a public option, that more than anything we do with regard to changing reimbursement from volume to outcomes, can bring down the cost of health care.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, a recent Consumers Union Poll states that 71 percent of Americans support health care reform that provides health care to all Americans. They also told us why. Sixty-four percent of those polled had concerns that they weren't able to afford a doctor in the last year. Sixty percent of them were afraid they were going to go into bankruptcy because of unforeseen medical expenses. And they also had a good idea as to the path forward because out of 66 percent of those polled, two-thirds supported the ability to choose a public insurance option, the ability to choose whether they want to stay on their private plan or whether they want to go on to a potentially better quality, more affordable public plan. They have told us they don't want politicians making the choice for them, that they themselves want to choose whether they are better off in the private or public market.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Speaker, I rise today in support of legislation that I recently introduced, along with several cosponsors, the Juvenile Justice Improvement Act. Mr. Speaker, every day in America, 90,000 youth are incarcerated in our juvenile correctional facilities. Seventy percent of these youth are held for noncriminal acts like running away or violating curfew. Instead of working with these youth and these families to identify the root of their problem and help them find alternatives to their negative behavior, our policy in too many places around this country is to simply lock them up. Even more shocking, 7,500 of our Nation's young people sit in adult jails on any given day, even though study after study has proven that that practice of putting youth in adult facilities only increases the likelihood of recidivism and puts them at risk amongst that sometimes very dangerous adult population. Sadly, these are not the only consequences of putting juveniles in the adult system. Keeping children safe in the adult juvenile justice system is extremely difficult. All too often, physical and sexual assault become commonplace. According to the Department of Justice's statistics division, 21 percent and 13 percent of all substantiated victims of inmate-on-inmate sexual violence in jails in 2005 and 2006 respectively were youth under the age of 18. That number is disturbingly high when you take into account that juveniles account for only 1 percent of all inmates. Thirteen percent of all sexual violence in our prisons is against these young people. They represent 1 percent of the total population. Moreover, and not surprisingly, youth have the highest rate of suicide in our jails. And as we know too well in Connecticut, placing juveniles with adults only exacerbates that problem. However, I'm hopeful that with this legislation, H.R. 1873, the Juvenile Justice Improvement Act, we can start to reverse these dangerous trends. Mr. Speaker, by keeping youth out of the adult criminal justice system and by using rehabilitative programs and services that are proven to try to help stop that cycle of crime, youth involved in these systems can emerge as proactive, positive and productive members of our community and of our workforce. Specifically, this bill would protect youth prosecuted as adults from being held in adult jails or lockups while awaiting trial except in very limited circumstances. In these limited circumstances, youth prosecuted as adults must be sight and sound separated from adults in that facility to help protect their safety. Fortunately, some States already allow youth who have been convicted as adults to serve their sentence in juvenile correctional facilities. H.R. 1873 would remove a provision in current law that penalizes these States for choosing to house youth convicted as adults in more appropriate settings while not endangering other youth in the facility. The Juvenile Justice Improvement Act would also work to keep youth out of locked facilities for noncriminal status offenses like running away or violating curfew. It would do this by closing a loophole in the Juvenile Justice and Delinquency Prevention Act. This vital legislation would also encourage States to take steps to eliminate the use of dangerous practices such as choking youth or restraining them to fixed objects for the purpose of coercion, punishment or the convenience of staff. These steps would include collecting data on the use of these dangerous practices in prisons, providing training to staff on effective behavior management and creating an independent monitoring system to oversee conditions across the country at juvenile facilities. Finally, Mr. Speaker, the Juvenile Justice Improvement Act would reward States through incentive grants that are implementing ideas that are research and evidence based. Such reforms would include making juvenile justice facilities safer based on this research, improving public safety in the rehabilitation of juvenile delinquents based on research, and better addressing the mental health needs of juvenile justice inmates based on research. Mr. Speaker, these changes to the juvenile justice system are critical to ensure that all of our youth become law-abiding, contributing members of society. There is not always political utility in government to stand up for youthful offenders, Mr. Speaker. It is not an easy thing for Members of this House or State legislatures to stand up and fight for. But we need to fight for these kids under the age of 18 who may have made a mistake, maybe a big mistake, to try to give them a second chance or at the very least to try to make sure that when they are in prison, when they are locked up behind bars that they are safe from the ravages that can be associated with incarceration. If we can do those things, we are a better Congress and we are a better society. With that, I urge my colleagues to join me in cosponsoring H.R. 1873.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. The stories are heart-breaking and, unfortunately, the longer you serve in this place or any other level of government, the more that you hear. It gets back to that statistic that I started with, which is that some people have an impression that maybe folks that don't have insurance, people that don't have access to health care, well, it's their fault. You know, they are living off the dole, they are freeloaders, free riders. It's not true. Study after study shows you that 80 percent, or somewhere in that neighborhood, of individuals who don't have insurance are part of a family in which somebody or both parents are working full time. They just happen to work for an employer that doesn't offer insurance or that their insurance is kind of 50 percent insurance. It gets you part of the way there, but not very far. These are the folks that we are really talking about. And I think that in this moment of great economic crisis--a poll came out the other day that showed that 70 percent of Americans are fearful in the next few months that either they or their spouses will lose their jobs, that more people today are conscious of the fact that they are just one paycheck away from losing all their health care benefits. And should they get sick, as they have watched their parents or their relatives or their coworkers do, that their life could be over as they know it. As Representative Kagen said, the number one cause of bankruptcy in this Nation is medical bills, individuals who have had an illness, a cancer, an injury, that they could not have foreseen or prevented. And it has fundamentally changed their lives. They have lost their house, their car and their livelihood. That's who we are really talking about here. Mr. Kagen is right. Representative Kagen said you can't do this one State at a time. I am wholly supportive of States like Massachusetts. My home State of Connecticut is endeavoring to try to produce a system of universal coverage today. I am very supportive of their efforts to do so. But their efforts should highlight the fact that ultimately this has to be a national solution. Why? Because the only way you ultimately get costs down is to use the leverage of the Federal Government, ultimately, to bring those costs to a reasonable level. Now, we certainly do have to put the money into the Medicaid and the Medicare system to make sure that we aren't shifting money off to the private sector. But, so many of us are supportive, as Mr. Klein mentioned, of opening up the Medicare system or opening up the Federal employees' health system to more Americans because we see that as a way to try to use the purchasing power of the Federal Government to get costs down. A poll that I referenced about Americans' support for a major health care reform bill also shows that 77 percent of Americans favor allowing the government to offer a plan that would give them an option to join a publicly sponsored program or to keep their private health care insurance. And, in fact, it pretty much cuts across all parties. We said at the outset this has nothing to do with Republicans and Democrats. Whether or not you have insurance has absolutely nothing to do with the party that you registered with or where you sit on the spectrum of our American belief system. This is a nonideological, nonpartisan problem. And so although the numbers vary a little bit, the support for a publicly sponsored option for individuals and businesses to buy into, one that would be one of the best and I think most cost competitive options in the marketplace, show that greater than 80 percent of Democrats favor it, greater than 50 percent of Republicans favor it or just under 50 percent of Republicans favor it. But amongst Republicans, 33 percent say they don't have any opinion, so you almost have a 2 to 1 support versus opposed ratio. So you have folks of all parties and all persuasions supporting major reform. Just one more point before I turn it back over to you, Mr. Kagen, is your notion of having a level playing field and having transparency is so important, because there are a lot of people in this Chamber that support a single payer Medicare-for-all system, you know, go to a European style system of health care. But this is the United States of America. We have unique needs. We are not Canada, we are not England, we are not France or Germany. We are going to create our own universal health care system here, informed by the unique needs and desires and expectations of our citizens. And I think most of us agree that that's going to maintain, maybe in not as great a percentage of our system as it is today, but it is going to maintain our private health care insurance system. And the way to get to a system that is fairer and more equal is to allow for that health care insurance exchange, allow for a marketplace where, as you said, everyone can go and compare prices, can know when they are buying that product that they aren't going to be ruled out just because they have a preexisting condition, an issue that there is no greater leader in the Congress on than Mr. Kagen, know that if they work for a business that they are not going to cause that business to not be able to provide health care insurance simply because they are the one employee of six that has higher health care costs than everyone else, that we are going to have equal coverage, a fairness in benefit levels and a transparency in price that will give, I think, a level of surety to people as they buy that insurance product that they are going to be covered and that they are going to get the best deal. Right now if you are an American health care consumer, you don't know either. You don't know whether you bought the cheapest product, because there is no one place to go. There is no one aisle in the supermarket where you go and compare prices. You also don't know whether you are going to keep that insurance. Because even if you got in as the bell rung, there is a thing that happens now called post-claims underwriting where even after you get sick, a lot of insurance companies will try to kick you off your health care, claiming that you should have known that you were going to get sick when you signed up in the first place. So I am very excited about this idea of the health care insurance exchange and glad, Mr. Kagen, that you have been leading on it.

Mr. MURPHY of Connecticut. Thank you, Mr. Kagen. We have sort of run the gamut this evening of the problems that underlie the existing system--the lack of transparency in insurance markets, the discriminatory practices of insurance companies, the lack of cohesion in prices when you walk into a pharmacy or into a hospital, the amount of money that it puts on top of businesses that are already struggling to compete in this world. When you talk about health care, it may be the most complex topic that we ever talk about here. It seems insurmountable sometimes. It seems like there's too much to try to take on at one moment, but there are simple solutions here, as you said: Pay for performance instead of pay for volume. Pay for prevention rather than crisis care. Give people options that they can see and understand. I think that there are some solutions here that can cross party lines, as you said, Mr. Kagen. I think that we can achieve a real victory in health care for America, in health care for America this year, this session, that guarantees that for citizens of the most affluent and the most powerful country in the world. Just because you can't afford to see a doctor doesn't mean you're not going to get sick. I hope we get the chance to do this more often and to bring our colleagues to the realization that the time for reform is now. I yield back the balance of our time, Mr. Speaker.

Mr. MURPHY of Connecticut. Mr. Speaker, I am glad to be back here on the House floor this evening to join you and our colleagues in talking about an issue that is of rising importance to millions of Americans, and that is the issue of guaranteeing a seamless and affordable and quality health care system for the American public. Mr. Speaker, we are here to talk about health care for America. It's a pretty simple concept, and over a number of years, the desire and the call from the American public has become more and more acute. I'm glad to be here with my good friend from Wisconsin, Representative Kagen, and others who may join us here throughout our hour or a portion thereof to talk about both the need for reform and some of the ideas that are floating around this Chamber to get us there. I stand here with new evidence from the American public that they are more desirous of change than ever, not a preservation of the status quo, not incremental reform, not a Band-Aid fix to the problem, but real reform. A recent survey of Americans by the Kaiser Health Foundation showed that over 60 percent of Americans believe it is more important now than ever, than ever, to pass comprehensive health care reform. Those same individuals reported that they are having more problems than ever, more problems than ever, accessing care. Forty-two percent of Americans in that recent poll said they relied on home remedies or over-the-counter drugs to take care of their illnesses because they couldn't afford the prescription. Thirty-six percent of people reported that they skipped dental care or a visit to the dentist because they couldn't afford it. Thirty-three percent of Americans said they put off or postponed care that they knew they needed because they could not afford it. Twenty-nine percent said they didn't fill a prescription because they couldn't afford it. And 18 percent of Americans, nearly one in five, said that they cut pills in half that they were due to take because they wanted the prescription to last longer. Mr. Kagen, Mr. Speaker, and my colleagues, this is the most affluent country in the Nation, the most free, the most powerful. What does it say about the conscience of a nation that one in five Americans are sitting at their kitchen table, sitting and standing next to their bathroom sink, cutting prescription drugs in half because they can't afford to pay for the full prescription? And what does it say in this country that forces so many Americans, most of whom are playing by the rules, doing everything we ask? We know that study after study tells us that of the nearly 50 million uninsured in this country, five out of six are a member of a family with a full-time worker. More and more often you're working, you're doing everything you're supposed to, and you can't get insurance or the insurance plan that your employer presents you puts more and more of the burden on paying it onto the employee. We know that for all these people that are playing by the rules, for all these people that don't have health care insurance, they live amidst a health care system that spends more on health care than any other country in the world. We spent $2.2 trillion on health care last year, Mr. Kagen, about an average of $7,400 per person, nearly double what every other country in the First World spends. And what do we get for it? We get a system that leaves almost 50 million without health care insurance, and we get a system that by and large ranks in the middle to lower tier with regard to health care outcomes in the world. In fact, another new study that just came out suggests that the United States amongst industrial nations ranks last, ranks last, in addressing the issue of preventable mortality; that in preventable deaths, this health care system does worse than every other industrialized nation in the world. The facts are clear. For too many people out there, health care has become unattainable. For too many that have health care insurance, they're going bankrupt just trying to pay their portion of the bills. And the system overall is bankrupting not just this government but is bankrupting and putting out of business too many businesses, both small and large, throughout this country. Big businesses, small businesses, families, individuals, all asking with voices louder than ever that this year right now this Congress step up and fix this problem. It's the right thing to do. It's the right thing to do from the perspective of conscience. It's the right thing to do from the perspective of health care, and it's the right thing to do from the perspective of economic recovery and revitalization. So we are here tonight to talk about this challenge that's laid before and presented to this government. Mr. Kagen and I came here in the same class, and we got here amidst probably a record degree of cynicism about what government can accomplish but in particular what Washington can accomplish. Now, it's gotten a little bit better since the election of President Obama, but there are still far too many people out there who look at the depth and the severity of this problem, the health care problem, and doubt whether Congress and this place has the ability to rise to the challenge. We're here to say that it absolutely does. We are here to say that this is a unique moment in time, coming fresh off of an election with a mandate on health care, with a House full of Members who want reform, with a Senate full of Members who want reform, and with an administration that has made it one of their priorities that we can do it now. Now, we may all have, as we will probably discuss over the course of the next hour, varying ideas on how we get there. And in the end for every single one of us when we go to press that green or red button on a comprehensive health care reform bill, there is going to be an element of a leap of faith. We are all going to have to cast aside the perfect for the benefit of the good. But it is time that we stopped arguing over the perfect system and started making some real improvements, big improvements, comprehensive, transformational improvements. I think that's where we will get to this year. And I'm glad to have some of my colleagues on the floor of the House to talk about this tonight, in particular the doctor of the House, Representative Steve Kagen.

Mr. MURPHY of Connecticut. Thank you very much, Mr. Klein. I am glad you are here with us tonight. I want to turn over the podium to Representative Olver from Massachusetts. One of the statistics that stands out, and I know Mr. Olver is going to talk a little bit about the amount of money we are spending on health care, in 1970 about 7 percent of our gross domestic product was devoted to health care. Since 1970, in 30 to 40 short years we have jumped up to almost 17 percent of our gross domestic product is spent on health care. That number is going to very quickly hit 20, and could get up all the way up to 30 in a very short time if we don't do something about it. It is always going to be a necessary component of spending, but that kind of growth is just unsustainable as an economy, something that the Appropriations Committee, of which Mr. Olver is a senior member, will be no doubt grappling with, and I yield to him.

Mr. MURPHY of Connecticut. I thank the gentleman. And those charts really are instructive to let us know what we're getting for the money that we're spending. I don't think it's the worst thing that we spend a little bit more money on health care in this country than the rest of the world. You know, we have relative affluence here. We have a citizenry that very rightly has high expectations, and so I don't necessarily think anybody has a problem that we spend a little bit more on health care. But two questions are raised. One, how much more money should we be spending than other countries; and what are we getting for that money because, listen, Americans, certainly in my district at least, are value shoppers and they're willing to spend money if they're going to get value for it. And the problem is not enough Americans understand that they're not getting what they should be from those health care dollars.

Mr. MURPHY of Connecticut. Of course.

Mr. MURPHY of Connecticut. Will the gentleman yield for a point before Mr. Klein jumps in? You know, that constituent of yours is multiplied, you know, by hundreds in all of our districts. I mean, people throughout this country have a fear of government-run medicine, in part because they hear about anecdotes from some of the countries that Chairman Olver and others talked about in terms of the wait times. And, again, I think there are moments when facts are really necessary. Study after study shows that if you really do an empirical, data-based survey, wait times are, frankly, worse off in the United States than in many, if not most of those other countries. And with respect to the one country that does tend to have wait times greater than the United States, Canada, most of those, in fact, all of those, are really for nonessential procedures. And I think it's worthwhile to then sort of mirror back to the United States. In Canada, one of the things that comes up all the time is that if you want a hip replacement surgery you've got to wait about 6 or 8 weeks. And that's true. And that's a long time to wait, and too long. In the United States, you've got to wait about 2 weeks to get that surgery. But you know who pays for that surgery in the United States? Medicare. The government. So our government-run health care system does a pretty good job at eliminating wait times. And for those of us who believe that ultimately you're going to have to have some increased footprint of a government-sponsored health care option for individuals and businesses, I think we can find solace in the fact that, although Medicare may not be perfect, it actually does pretty well with regard to at least that one indicator, wait times, compared to some of our other neighboring countries. Mr. Klein.

Mr. MURPHY of Connecticut. Let's think about that soldier that comes back from serving his country overseas and goes and gets a job that pays a decent wage but works for a struggling company that just can't afford to continue to employ people and give them health care benefits. And so he, returning from serving his country abroad, putting his life on the line, comes back and gets a decent, hardworking, fair- paying job and has no health care benefits. And then he looks to this House. He looks to the people that he sent to Congress who sit here in this nice air-conditioned Chamber with pretty decent health care. And he wonders to himself, I fought for this country, I came back and got a job, did everything that I was supposed to. And the people that I send to Washington, D.C. get a pretty good health care plan, and what am I left with. I think that whatever we do, whatever Federal regulatory scheme that we come up with for health care insurance, it should at least guarantee that everybody out there gets to have health care like we do. That if you are going to elect men and women to go to Congress who are going to enjoy the benefits of the Federal employee health care plan, that every American out there should have access to that, certainly those that come back from duty overseas and are playing by all the rules we ask them to when they return.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Speaker, another health care myth. It is amazing that opponents of comprehensive health care reform still make the argument that Americans don't want it, but they do, and it is time to debunk it. According to an April 2009 Kaiser Family Foundation Health Tracking Poll, just from this month, 59 percent of Americans say that it is more important now than ever to pass health care reform, 59 percent. And it is easy to understand why. Because of costs, 42 percent of Americans reported that they didn't see a doctor in the past year; 36 percent skipped dental care; 27 percent skipped a recommended medical test or treatment; and 18 percent of Americans reported that they cut their pills in half because they couldn't afford it. This isn't time for small ideas. This isn't time to just protect the status quo. Americans demand comprehensive health care reform, and it is time that this Congress gives it to them this year.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, I rise today to recognize the 50th Anniversary of the Young Marines. I am honored to represent the proud and patriotic City of Waterbury, Connecticut where the first Young Marines Unit was founded in 1959 by members of the Brass City Memorial Detachment of the Marine Corps League. Just three years later, the ranks of Waterbury's Young Marines had swelled to 1,500 and spread to 9 other cities all because of the fine young men from Waterbury. In 1974, Waterbury's own Young Marine program was chartered as a subsidiary organization of the Marine Corps League, whose mission is to preserve the traditions and promote the interests of one of our very finest institutions, the United States Marine Corps. The Young Marines embody our core values as Americans--honesty, fairness, courage, respect, loyalty, and love of country. These principles are instilled on the Young Marines by the steady hand of hundreds of volunteers from communities all over the country, many of whom are former, retired, Active Duty, or Reservist Marines who believe passionately in the values they learned during their service. I can think of no better mentors for these youngsters. Many of my district's finest and most involved citizens are products of the Young Marines; some went on to join our nation's Armed Forces, others found another way to serve their community. In 1960, a young man named Sam Beamon joined the Young Marines with his brothers. After graduating from high school, he went on to serve honorably in the United States Marine Corps in Vietnam. Sam is now active in many veterans' organizations and is the State Commandant of the Marine Corps League, Department of Connecticut. Since its inception, the Young Marines have sponsored many initiatives to improve their communities. I stand here honored to represent those seminal Young Marines from Waterbury, Connecticut whose organization went on to take a leadership role in the U.S. Marine Youth Drug Demand Reduction Program in 1993. This community-based program sought to reduce the impact of harmful drugs on our communities and encouraged other youths to live a drug-free lifestyle. The values of this program are perfectly aligned with those of the Young Marines, and communities around the country are lucky to have such respected advocates for clean and healthy living. In 2006, the Young Marines, now a nationally respected organization, conducted the Veterans Appreciation Week campaign, which sought to challenge Young Marines throughout the country to dedicate some of their time to honor our nation's veterans and to demonstrate, through their actions, their sincere appreciation for our veterans' service to our country. In a time when fewer Americans seem to be aware of the sacrifices that our veterans made, I am glad that we can look to the Young Marines to provide leadership on how we should honor those who have served. Here, on this the 50th Anniversary of this vital and impressive organization, we are reminded of its mission statement: the Young Marines' mission is to positively impact America's future by providing quality youth development programs for boys and girls that nurture and develop its members into responsible citizens who enjoy, and promote, a healthy, drug-free lifestyle. On Saturday April 25th, Young Marines and former Young Marines from across the nation came to the organization's birthplace to join several of the members of the Marine Corps League Brass City Memorial Detachment who established the Young Marines. I would like to congratulate Ray Bozzuto, Art Corcoran, Roland Hamel, Tony Szantyr, Ed Zuraitis, and the other founding members on the legacy of patriotism and civic involvement that their idea produced. With a half century of overwhelming success, I think it's safe to say, ``job well done.''

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Another health care myth--and we've heard it all before: opponents of health care reform claim that, of the 45 million uninsured, many don't have health care insurance because they just don't want it. So no need to reform the health insurance system-- everybody who wants it already has it. So who are these people who just don't want health care insurance? Well, according to a 2008 Kaiser study, 68 percent of the Nation's uninsured were under 200 percent of the Federal poverty guidelines--or making under $44,000 a year for a family of four. Of those, 37 percent were actually living in poverty--making under $22,000 a year. These are families that cannot afford health insurance. For a family living at the poverty line, health insurance could cost them up to half of their income. Sure, there are some amongst the uninsured who simply choose to pay their own way. But there are many more who are employed, who are playing by the rules, who want health care insurance but just can't cut out those frivolous things like food and clothes to pay the premium.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Another health care myth--if we reform our health care system, patients will lose choice. Again, this is simply not true. First, it begs the question: What choice do patients have today? In America, we have choice, but too often it lies not with the doctor or patient, but with the insurance company. Patients are denied physician-prescribed treatment, doctors are denied reimbursement for necessary care, and increasingly restrictive networks of coverage mean restrictive choice for patients. A survey of the leading proposals for reform shows that no one is talking about limiting patient choice. In fact, a publicly sponsored plan, with a potential network of millions of Americans, would likely have one of the most robust networks of providers in the system, since doctors and hospitals would want and need to have access to this large pool of patients. A public plan itself increases patient choice by allowing families to decide whether they want to continue with their private insurance plan or move to a publicly sponsored plan that might provide better coverage due to lower administrative and profit costs. Health care reform limiting patient choice? It's just another myth about our health care system.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Mr. Speaker, as we begin a potentially transformational debate about health care this year, I think it is critical that we start making policy based on facts and empirical data, rather than anecdotes. Currently, our Nation's conversation about the future of health care is a little sloppy when it comes to backing up interesting stories with actual data. The result is that dozens of myths both about our own health care system and about that of other countries with systems of universal care have become so dangerously prevalent as to risk becoming accepted truth. So, I thought it might be useful for the next few months to try to come down to this floor and dispel some of those myths and to put hard cold facts back on the table as we begin to move forward with a better way of providing health care for this country. So let's start with this. Over and over I have heard the health care reform skeptics tell stories about people that they know or that they have heard of living in Canada or living in England waiting for care, who had to wait weeks or months or maybe even years to get to see a doctor or to get to have a procedure done. Every time I hear these stories I think to myself, ``Well, they are right; that one person probably did encounter that type of resistance from the system.'' But then I also think to myself that it doesn't matter, because in this place we need to make policy not on anecdote, we need to make policy based on true, real, aggregated data. So I think it is time that we started talking about this idea, often promulgated by menacing stories of people waiting in other countries for a necessary surgery, that a health care system run or overseen by a public entity comes automatically with unreasonably long wait times for care. The fact is not only is that idea a myth, but the very idea that our own health care system delivers the speediest care in the world might be an even bigger myth. So here are the facts. Mr. Speaker, a Commonwealth Fund study of six industrialized nations showed that the U.S. actually ranked fifth out of six in patients reporting that they could receive a same day or next-day appointment for an immediate medical problem. We were behind New Zealand, Great Britain, Germany, and Australia, just in front of Canada. In fact, the difference between us and England was astonishing, especially because many of the stories that you hear about wait times come from the British system. In England, 71 percent of patients receive a next-day appointment for a nonroutine or emergency care visit. In the United States, that number is 47 percent. That means, in other words, that more than half of Americans when they believe that they have an immediate need to see a doctor have to wait at least 48 hours to get in to see that physician. Here's another fact. A study by the Institute for Health Care Improvement cited in a recent speech by a medical director of a large U.S. insurer showed that, on average, Americans are waiting nearly 70 days to see a health care provider. That same medical director noted that many people who are diagnosed with cancer are waiting over a month to get in for their first appointment for care. Compare that to Canada, a country with a system of universal health care most often cited as having unreasonable wait times. Canada's national statistics agency reports that its citizens are now waiting about 3 weeks for elective surgery, a week less than many people in the United States are waiting for cancer treatment. And today in Canada, there are no wait times for emergency surgery. Now as Paul Krugman points out, it is true that across the board, Canadians do wait longer for nonelective surgeries. For instance, in one case, the facts back up the claim that hip replacement and knee replacement surgeries happen more quickly in the United States. And, in fact, there probably are people from Canada traveling to the United States to get those procedures done. But you know who pays and schedules those procedures here in the United States? You guessed it, the government. As it turns out, in America's government run health care system, Medicare, which pays for those hip replacement and knee replacement surgeries, wait times aren't really that much of a problem. The fact is, there is ample evidence to dispel the myth that Americans don't wait for health care, and those in government-run systems do. And when we looked at the Canadian, which in some cases does have longer wait times, we need to remember this: In Canada, they are spending about half as much money on a per capita basis as the United States. If they spent 1 percent more of their GDP, they could eliminate their wait times. The bottom line? Stories about people waiting in lines for health care in other countries are just that; they are stories. The facts, on the other hand, dispel that myth. We wait for health care, too. Mr. Speaker, health care reform is our chance to fix that.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. I thank the chairman for his work on this bill, and let me give yet another example of the good work that has been put into this bill. For years there have been hundreds of volunteers and land conservationists from throughout Connecticut, New Hampshire and Massachusetts who put their time into preserving and upkeeping the Triple M Trail, the Metacomet Monadnock Mattabesett Trail. For years they have asked for a Federal partnership to work along with them to preserve this incredibly important resource for the more than 2 million people throughout the northeast who live within 10 miles of what we refer to as the Triple M Trail. This 220-mile trail goes from southern New Hampshire's southern border all the way down to Long Island Sound and provides limitless opportunities for hikers and bikers and nature enthusiasts throughout the Northeast. This legislation, giving Federal designation to this trail, is going to provide, I think, a very important lasting partnership between the Federal Government, private landowners and local conservation groups to preserve this for generations to come, and I urge passage of this legislation.

Mr. MURPHY of Connecticut

Mr. MURPHY of Connecticut. Madam Speaker, we are here to convene what has unfortunately become a little bit more infrequent in this legislative session, our 30-Something Working Group. We're so glad that the Speaker of the House has once again convened the 30-Something members of the Democratic Caucus to work on issues affecting not only our generation of Americans who are struggling like everyone else with this very difficult economy, but also on behalf of all Americans who are crying out right now to the Obama administration, to this Congress, to both Democrats and Republicans, to step up to the plate and help them start making ends meet. And we're going to be here today with my colleague, Mr. Altmire-- hopefully we will be joined a little bit later by one of our new members of the 30-Something Caucus, Mr. Boccieri--to discuss really what I think is becoming a historic moment in this Nation's history as President Obama challenges this Congress and this Nation to do two things; to step up to the plate and enact short-term stimulus to create jobs in this country, to put people back to work, to make banks start lending again, and to get our economy recovering, but also to do something else; to recognize that this economy has been imperiled for a very long time by a weak energy policy, by a crippling health care system with rising costs, and a relative lack of investment in education compared to those countries that we compete with. And his challenge to us last night was to do what we need to do now and to come together to rebuild this economy in the short term, but also in the long term. Now, Madam Speaker and my colleagues, I got to hear just the end of the presentation of our colleagues who spoke before us on the floor. And it is, I think, amazing to many of us to see this newfound interest on behalf of the Republicans on this floor of the issue of fiscal responsibility and deficit reduction. As President Obama pointed out last night, this administration has inherited the largest debt in the history of this Nation. Coming after the Bush administration, which took a national debt from $4 trillion to nearly $10 trillion, who racked up more debt for this Nation in one administration of 8 years than every single other President combined, that's what this Congress inherits. The Republicans who controlled this House for 12 years sat by idly as our children and our grandchildren were put in hock. They ignored the growing weakness of our health care system and the burden that it placed on small businesses. They ignored the fact that our energy system was being held hostage by those who produce oil and gas overseas. And they let our education system and our investments therein wither away, as Head Start got cut, as special education funding got cut, as higher education and financial aid funding got cut. And all of a sudden we woke up overnight to the fact that our economy was in great peril and that we owed $10 trillion to the rest of the world. For 8 years, the Republicans and the President stood here on the floor of this House and down Pennsylvania Avenue in the White House and allowed all of this to happen, meanwhile, pursuing a system of vast deregulation and laissez-faire policies on Wall Street, which then ultimately created the crisis that occurred last summer. A lack of investment in health care reform, an inattention to energy policy, and a withdrawal from education investment combined with a strategy of whatever Wall Street wants Wall Street gets, and we find ourselves where we are today. So I appreciate hearing from our Republican friends that now we should start paying attention to the debt. We absolutely should. And President Obama set a mission before us last night to halve the American deficit in the next 4 years. We're going to accept that challenge. But the fact is that the Republicans are Johnny-come- latelies to this debate. We wouldn't be in the situation that we are today if we had had more friends on the Republican side of the aisle who practiced what they preached when it came to fiscal responsibility. It's the very reason why Mr. Altmire and Mr. Boccieri and myself are here. We were sent to Congress to fix this mess. We were sent here to represent districts that were represented by Republicans for a very long time because people in our districts are waking up to the notion that if they really cared about the debt that was being levied on their kids, that maybe it wasn't the Republican Party that was best to carry that banner. We're going to talk about positive steps that this country and this Congress can take from here on out to start lessening that burden. We're going to tighten our belts, we're going to get our revenue and expenditure policy straight, we're going to start stimulating this economy again. We're going to talk about positive things. And I bet you there is going to be plenty of opportunity for Republicans and Democrats to agree on that. But I think we should also agree on what the history of this institution is and the fact that this President and this Democratic Congress inherited an absolute fiscal mess from the Republicans. So I appreciate the charts and the graphs and the Newsweek covers and the political cartoons that get brought up here in the Republican Special Orders, but there is a certain amount of revisionist history that's happening here. And the 30-Somethings have always been about trying to talk about how we can move forward, but also about making the record very clear for the American people. And I think it is appropriate that we do a little bit of both today, that we talk about our path forward--the very difficult one that we are going to have to chart--but we also make it very clear what the division is on these issues and what our history has been, Mr. Altmire.

Mr. MURPHY of Connecticut. Would the gentleman yield? And you have to look at all of the different ways that we got here and all of the different ways we can start to repair this. And I just think of one right now. You talk about what would have happened if we just continued the policies of the Clinton administration. Obviously one of the things that changed the financial dynamic in this country is the fact that we decided to go wage a $700 billion war. And if that wasn't bad enough, we did it all off budget. And that's one of the great untold stories of the Bush administration. No matter what you think about the war in Iraq--whether you think that we should have never gone, that we should have left earlier, that we should leave now, that we should stay for another 5 years--the fact was that maybe the first year of funding could have been deemed emergency off-budget funding, and maybe even the second year, but in the third and the fourth and the fifth and the sixth year, this wasn't a surprise to anybody. But one of the ways that we masked the amount of money that we were using for that war was we put it all off budget, and so it didn't make the annual deficit look as bad as it really was. With one stroke of a pen, President Obama changed that. He said, you know what, no matter how bad it's going to make the numbers look on a yearly basis, we've got to start having some honest books here. We have got to start having some real accounting. So President Obama said, listen, from here on out, and he said this last night in his speech and he said it when he made this change in budgeting rules on Friday, we're going to put the cost of the war in both Iraq and Afghanistan online. It's going to be part of the budget; so we're going to have to pay for it. We're going to have to pay for it. Now, frankly, Mr. Altmire and Mr. Boccieri, when it comes to protecting the American people, I think people are willing to step up to the plate and make some sacrifices to do that. Now, we may disagree about what that entails, but in the days after September 11, this country was ready to step up and sacrifice. This country was ready to step up and pay for whatever it took to protect this country. And I really congratulate President Obama for stepping forward and saying, listen, yes, I want to get out of Iraq; yes, I think I need to step up our commitment in Afghanistan; but for however long that takes and however much it costs, we're going to do it in the confines of a budget. We're going to have an honest budget, an honest document. The American people are going to see the numbers however raw or bad or ugly they may be, but we're going to be honest about it. And I think that's what people out there are asking for, Mr. Altmire. I mean we're back in our districts every weekend, and as bad off as people are right now, as difficult as the times are, I think they're willing to sort of see a path forward. They know it's going to be hard, but they want to know how hard it is, how big the challenge is, and then they are, I think, ready to step up. But we've been masking the problem up until now. And I think President Obama has got some room right now in order to basically put it all on the table, be honest with the people about what the problem is, and then ask us to step up to the plate and solve it. And he's facing right now Republican opposition, if I may make one more point, whose answer to every solution is let's do nothing. Everybody on the Democratic side has agreed or disagreed with different parts of the economic recovery strategy, but at least we're over here trying to think of a way out of this. The response from the other side has been essentially to just sit back and let the economy tumble into chaos. The American people want action. They want to know how big the problem is, and they want to step up to the plate and help solve it, Mr. Altmire.

Mr. MURPHY of Connecticut. At last count, Mr. Altmire, it was up to seven.