Tom Udall

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. Would the Senator withdraw his request?

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. Absolutely. Those two things occurring drive up the costs, so the comparison--let me make this one more point. The comparison on administrative costs--let's look at a government- run program such as Medicare that has 3 percent administrative costs. Then we go over to the insurance industry, and we are talking 30 percent. It is those people in the process who are denying the claims and all of that activity.

Mr. UDALL of New Mexico. Correct. Would Senator Whitehouse like to speak?

Mr. UDALL of New Mexico. Please, go ahead.

Mr. UDALL of New Mexico. I thank the Senator from Ohio. I know tonight he is leading this effort, this hour we now have on the floor, and I thank him for being down here and leading the effort and showing incredible leadership on the public option. What I think it means is, when we talk about the lack of competition, this is a concentrated market, that they can basically do whatever they want and drive up the premiums and drive up these incredible profits. I don't know if the Senator was on the floor when we showed this chart, but publicly traded insurance companies saw a 428-percent increase in profits over 7 years. So the lack of competition drives those profits. We are not against people making profits; it is just this is profit in terms of health care. So let's compare it. To answer the Senator's question, one of the things that I think is important to compare is the high-tech industry. They have six, seven, eight companies all competing against each other, driving the prices down, lowering costs. What the public option does is exactly that: It drives the premiums--it puts competition into the market; it drives the costs down.

Mr. UDALL of New Mexico. Let's ask unanimous consent to carry this on as a colloquy.

Mr. UDALL of New Mexico. Mr. President, first, I wish to say to the Presiding Officer, I know Senator Sherrod Brown from Ohio and a number of us are going to be down here from the 6 to 7 o'clock period, and I am starting out here for the first 10 minutes before 6 to talk a little bit about health care reform and this whole issue that many of us have been addressing on the floor. We did this several weeks ago and we did it last week. What we are doing is talking about the whole issue of the public option and how important it is to have a public option. The Presiding Officer from Rhode Island, Senator Whitehouse, has been down here with us. He has pointed out, on a number of occasions, how important it is to have a public option. But I think one of the things I would like to do today is talk a little bit about what these insurance companies are doing and where they are coming from. Insurance companies made a point of playing nice over the first couple months of this reform process, but they revealed their true colors earlier this month when they released a series of biased, misleading reports to scare people about the impact of reform. The truth is insurance companies aren't worried about how reform will impact consumers--far from it. What they are worried about is the impact of reform on their profits. The insurance industry has shown where it stands when it comes to health care reform. In the process, they have given us yet another reminder of why we must have a robust public option included in the final legislation. A public option is one of the only ways still on the table to keep the insurance companies honest. It will allow us to restore competition back into the market and hold companies accountable for their abusive practices. If you need further proof that insurance companies are putting profits above people, let's look at this chart and look at some of the statistics and numbers here. Over 7 years, publicly traded health insurance companies saw a 428- percent increase in profits--again, a 428-percent increase in profits. The 10 CEOs of those companies made $118 million in 2007. That is why 47 million Americans went without coverage. The premiums more than doubled over 9 years, three times faster than wage increases. Going to chart No. 2, insurance companies are afraid of competition and want to protect their strangleholds in most State markets. Ninety- four percent of the commercial health insurance market is highly concentrated. In 21 States, 1 carrier dominates more than half the market. In 39 States, 2 carriers control more than half the market. This is the case in New Mexico, where 2 companies control 65 percent of the market. What does this mean for individuals and families in New Mexico and across America? Nearly one in four Americans under the age of 65--some 64 million people--will spend more than 10 percent of their family income on health care in 2009. This means families often have to choose between paying health insurance premiums and putting food on the table. Outrageous health insurance premiums are a heavy burden for working families who already are dealing with tight budgets. This can often lead to significant medical debt, bankruptcy, and home foreclosure. I wish to talk a little bit about some of the New Mexico families who have called me and written me and told incredible stories. I know the Presiding Officer, the good Senator from Rhode Island, Mr. Whitehouse, has been down here talking about his stories in Rhode Island, and we have the Senator from Ohio here right now whom I spoke about earlier.

Mr. UDALL of New Mexico. As the Senator pointed out, it happens at two points in the process, right?

Mr. UDALL of New Mexico. Well, Senator Brown makes a very good point. I think, first of all, when you have a public option, it is a nonprofit that is dedicated entirely to health care, and you are not going to see these outrageous kinds of CEO salaries. The purpose of a public option nonprofit is to put moneys that come in above the goal of providing health care back into the overall system. So what we are talking about is dedicating ourselves on that basis to providing the very best quality care. So if you take out the profits and you take out these salaries, you are going to have a very competitive--

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. Mr. President, I thank very much the Senator from New Hampshire. I thank her for her leadership on the floor and for the hard work she has done on this issue. I know everybody back in New Hampshire very much appreciates that. This is the fourth time the Senate's freshman class has gathered on the Senate floor to talk about health reform. Already we have talked about why maintaining the status quo is not an option. We have talked about how reform will contain costs and dispel the myths about reform. We have talked about how reform will mean many things to many different people. What I wish to talk about today is what reform will mean for rural New Mexicans. Our rural areas are the backbone of America. It is where we grow our food. It is where the values and traditions that make our country unique continue to thrive. It is where the potential for a clean energy future grows brighter and brighter every day. Unfortunately, our rural areas are also places where the disparities in America's health care system are the most startling. It shouldn't matter whether one lives in a vast metropolis such as New York City or a frontier town in New Mexico. All Americans, regardless of where we choose to call home, deserve access to quality, affordable health care. However, the reality is that right now, where one lives does have a big impact on whether they have access to quality, affordable coverage. Americans living in rural areas are more likely to be uninsured, and if they do have insurance, it can be very difficult to find a doctor. As a result, rural Americans end up getting sicker, they have higher rates of chronic disease, and they are often forced to travel hundreds of miles for preventive or emergency care, if they are able to find any at all. I have seen these disparities firsthand, as a Member of the other Chamber and now a Senator for one of the most rural States in the Nation. Geographically, New Mexico is the fifth largest State in the country with more than 120,000 square miles of some of the most beautiful land that God created. Of the 2 million people who call New Mexico home, about 700,000 live in rural areas. Several places in New Mexico are so sparsely populated they are classified as frontier areas with less than six people per square mile. Many of New Mexico's rural residents are farmers and ranchers, and they run their own businesses. Their only access to health insurance is often through the individual market where coverage can be extremely expensive, difficult to obtain, and nowhere near as comprehensive. As a result, rural Americans pay nearly half of their health insurance costs out of pocket, and one in five farmers lives in medical debt. With health care reform, we must ensure that America's farmers and ranchers, as their small business counterparts in more urban areas, have more affordable choices for coverage. I believe the best way for making this happen is through a health insurance exchange that includes a strong public option. Inserting more choice into the market would keep insurers honest and allow consumers to compare plans and prices and decide what works best for them. With health care reform, we must also address the growing doctor shortage in rural America. In my State, for example, 30 of 33 counties are categorized as ``medically underserved.'' Americans should not have to travel hundreds of miles for health care. Whether it is lifesaving treatment for a heart attack or a basic preventive service such as a mammogram, people are more likely to get the help they need when they need it if the services are close to home. Through incentives such as low-interest student loans, loan repayment programs, and scholarships for students and midcareer professionals, we can encourage more doctors and nurses and specialists to establish and grow their medical careers in rural America. Finally, with health care reform, we must better support rural hospitals that serve large numbers of low-income and uninsured patients. This could be through initiatives such as expanded drug discount programs, increased Medicare payment caps for rural health plans, increased National Health Service Corps doctors, and expanded demonstration programs to test reasonable cost reimbursement for small and rural hospitals. We will never achieve true reform in our country if we don't address the very real health care challenges facing rural Americans from the deserts of New Mexico to the mountains of Maine and everywhere in between. The improvements I have outlined are a good start, but there is more left to do, and I plan on talking about how we can accomplish this in the coming weeks. We have traveled a long way over the past few months. I applaud my fellow freshman Senators for standing up each week and making sure their voices were heard in this process. I believe, working together, we can create a system where all people can find and afford quality health insurance that provides the care they need. We can guarantee quality, affordable health insurance to every American, and we must do that. Thank you, Mr. President. I yield to the distinguished Senator from New Hampshire.

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. Mr. President, it is good to see our Presiding Officer, the new Senator from Massachusetts, here, who has joined us within the last couple of weeks, Mr. Paul Kirk. Today we are talking about myths, inaccuracies, deliberate exaggerations, and outright lies that have abounded over the months we have been debating health care reform. Some have been dreamed up by those who stubbornly cling to the status quo. Others reflect fears lying just beneath the surface. If we step back, it is easy to see these scare tactics for the lies they are, but for Americans who will be most impacted by this reform, it may be difficult to separate fact from fiction. The myth I would like to talk about today is a bit different from the others being discussed by my colleagues. It is a myth that existed long before the current debate but is being used in a new way by people fighting this reform. They are using it as a weapon against change. It is a myth we have all heard about. It is the myth that reform is not necessary because we have the greatest health care system in the world. What makes this myth different from the others is that parts of it are absolutely true. Americans are blessed with some of the best doctors and nurses and health care professionals in the world, hard- working men and women who have dedicated their lives to the health and healing of others but often work in difficult situations. Our technology is unmatched. Our emergency care system is repeatedly cited as the best of the best, and we rank highly regarding the levels of dignity and respect with which patients are treated. But all these achievements, as great as they are, do not add up to the best health care system in the world for all Americans--not as long as we are spending $2.4 trillion a year on medical care but continue to rank near the bottom when it comes to premature deaths from diseases such as diabetes, stroke, and pneumonia; not when we spend twice as much of our GDP on health care as Japan and the UK but have lower life expectancy at birth; not when we rank last in infant mortality among industrialized countries; and not when half of the personal bankruptcies in the United States are related to medical bills. Right now in America, if people have the money, they have access to the best health care money can buy. For the vast majority of Americans, that access is not there. If a person is a small business employee or laid off from a job or someone with a preexisting condition, the ``best health care system in the world'' is much harder to come by. When 80 million people are either uninsured or underinsured, there is no way a country can lay claim to that title. But there is something we can do about it. With this reform, we have the opportunity to build on the strengths of the U.S. health care system while also addressing its weaknesses. Comprehensive health reform will go a long way toward remedying these and other inequalities and reducing the health care disparities between rich and poor, the majority and minority. The solution is not always spending more money. Sometimes it is about making better use of the money we are already spending. It is about finding ways to achieve better returns on our investment. The reforms we are proposing would allow us to do that by ridding the system of waste, by increasing our investment in prevention, by helping small businesses afford insurance for their employees, and by covering more individuals whose only medical option right now is expensive emergency room visits. The status quo is unsustainable, but that is what reform opponents are hoping to continue with, myths like those we are discussing today. America has the potential, the talent, the technology to achieve the best health care outcomes in the world. Whether we reach that goal depends on the actions we take now. I yield the floor.

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. Mr. President, I rise today to mourn the untimely deaths and celebrate the lives of two New Mexico heroes. One died just last week from injuries he sustained while serving his country in Afghanistan. The other was killed this past June in a helicopter crash after rescuing a stranded hiker lost on the Santa Fe Baldy Mountain. Both men served their countries with distinction and honor. Both were raised in families with a strong tradition of public service. Both said ``Choose me'' when they were needed the most. Both paid the ultimate sacrifice. They are Army SFC Kenneth Westbrook and New Mexico State police sergeant Andrew Tingwall. I would like to tell you about them today. Sergeant Westbrook's career in the military began more than 20 years ago after he graduated from Shiprock High School in northwest New Mexico. He married his childhood sweetheart, Charlene. Along the way, they had three children--Zachary, Joshua, and Joseph. He served in the Persian Gulf war and did numerous other stints overseas in places such as Korea and Germany. He was a proud member of the Navajo Nation. He loved to hunt and fish, build model military vehicles, and was an expert chef and grill master. His brother says Kenneth was looking forward to retiring from the military and spending more time with his family when he got the call for one more tour of duty--this time to Afghanistan. As much as he cherished the idea of spending more time with his family, Kenneth knew what he had to do: Of course, I will go, he said. Kenneth believed in the work being done in Afghanistan, his brother said. And if the Army needed him to complete that work, there was no question he would be there. Kenneth was gravely wounded on September 8 when his unit was attacked by insurgents in Afghanistan. He was quickly flown to Walter Reed Army Medical Center for treatment. That is where I met his wife Charlene and other members of his family. That is where Sergeant Westbrook died from his injuries last week. Military families are a special group of people. Every day they face sacrifices and challenges the average person can't imagine. They do it with grace and strength and an unwavering belief in the country they call home. That is what I saw the day I visited Charlene and Sergeant Westbrook's three boys. I saw a strength made even more striking when you realize this tragedy wasn't their first. Four years earlier, almost to the day, another Sergeant Westbrook died. His older brother--SGT Marshall Alan Westbrook--was killed in Iraq when an improvised explosive device detonated near his humvee in Baghdad. The Westbrooks have given more than most families. Their tight-knit family has paid the ultimate sacrifice, and for the Westbrooks, it happened not once but twice. As Americans, we often take for granted our freedoms, but we should never forget those whose sacrifice makes those freedoms possible. Sergeant Westbrook will be laid to rest on Friday in Farmington, but he will forever live in the memory of New Mexicans. This story of New Mexican heroism doesn't end there. I would also like to talk about New Mexico State Police SGT Andrew Tingwall, who was killed last June in a helicopter accident after rescuing a stranded, lost hiker. Sergeant Tingwall is being honored on Friday with a posthumous induction into the New Mexican Military Institute Alumni Association Hall of Fame, which I helped nominate him for. His honor is for Eminence in a Chosen Field. Similar to Sergeant Westbrook, Andy Tingwall's chosen field was service--service to his community, service to his State, and service to his country. Known as ``Ting'' to his friends, Sergeant Tingwall graduated from the New Mexico Military Institute in Roswell in 1991 and joined the U.S. Marine Corps shortly after. During his military career, he became a jump-qualified reconnaissance marine and served with Delta Company's Fourth Reconnaissance Battalion. He continued his distinguished career as a New Mexico reservist from 1993 to 1995, when he joined the New Mexico State Police. Eventually, he became lead instructor for the Training and Recruiting Division of the New Mexico Law Enforcement Academy before joining the New Mexico State Police aircraft section, where he became a pilot. Sergeant Tingwall proved his merit there, serving as chief pilot of the unit--the youngest man to ever have that title. Sergeant Tingwall was known by his colleagues, friends, and family for his heroism and love of the sky, saving many lives in his time with the State police. In 2008, he was celebrated as Officer of the Year by the New Mexico Sheriffs and Police Association and would have received a Medal of Valor in June, but for Sergeant Tingwall, that day would never come. Sergeant Tingwall was in the middle of saving the life of a stranded hiker on June 9 when tragedy struck. He and his spotter, Officer Wesley Cox, had located the stranded hiker and Sergeant Tingwall was transporting her to safety when the helicopter struck a mountainside and crashed. After the crash, as he had throughout his career, Sergeant Tingwall put the safety of others before his own. Despite being severely injured, he managed to pull the hiker from the wreckage before they both died from their injuries. Sergeant Tingwall was just 36 years old. Duty, honor, country--three words you hear often when talking about those who commit themselves to a life of public service. Sergeants Westbrook and Tingwall personified those words, both in the way they lived their lives and in the way those lives ultimately ended. New Mexico is proud to honor these true American heroes. To their families, we say thank you and ask them to accept the thanks of a grateful State and a grateful nation. I suggest the absence of a quorum.

Mr. UDALL of New Mexico

Mr. UDALL of New Mexico. I ask unanimous consent to have 3 additional minutes.

Mr. UDALL of New Mexico. I thank the Senator. I point out tonight that we have had a number of Senators come down here, and we have also been presided over by the gracious Senator from the State of Washington, Senator Cantwell. I know she is a strong proponent of a public option. We have had Senator Cardin from Maryland, Senator Brown from Ohio, Senator Whitehouse from Rhode Island; we had our distinguished majority whip, Senator Durbin, here talking about public option. We have also had Senator Roland Burris from Illinois. So we have had a key group here. We are going to continue to do this because, as Senators Brown and Whitehouse and Burris know, we have to get this done. Our constituents want it. The American people want it. There was a poll done, and 72 percent of the American people want to see a public option here. I don't know if any other Senators want to sum up.

Mr. UDALL of New Mexico. I thank Senator Coburn for not objecting. I thank all Senators who appeared here today. I yield the floor.

Mr. UDALL of New Mexico. Madam President, I say to Senator Whitehouse, thank you very much. One of the things I have just realized now, one of the things the three of us have in common is we were all attorneys general. I am proud of that fact. I am very proud of my service as attorney general. I know you both are. We were out there as attorneys general fighting for these working Americans we are talking about, whether it was consumer protection or doing law enforcement. Madam President, I say to Senator Burris, I know those working families the Senator worked for back in the 1990s are the same working families he is fighting for on the public option. Could you jump in here? I know you have a situation in Illinois where you have traveled throughout the State. You have taken a measure of what is happening in Illinois with regard to health insurance. What would you say?

Mr. UDALL of New Mexico. Senator Whitehouse and Senator Burris, if you would just give me a second, I want to make sure he talks about the situation of workmen's compensation in the State of Rhode Island. I believe several States--and you have had experience with this--have experimented with a public option in the workmen's compensation context. It tells us a lot about what public option would mean if we put this in our health care bill. Could the Senator speak to that a little bit?

Mr. UDALL of New Mexico. Senator Whitehouse, if I can interject at this point, I think you have given great examples of why we need a public option. As part of health care reform we are going to be doing in the next couple of weeks in the Senate--we have a Senate Finance Committee bill out of the Finance Committee now and we have the HELP Committee bill and our leadership is putting those two bills together-- we have to have a public option be a part of the bill. Senator Burris was visiting a little bill earlier about Illinois and the Illinois citizens and their comments on the public option. The Senator from Illinois may want to join in with what Senator Whitehouse said about that competitive factor with workmen's compensation.

Mr. UDALL of New Mexico. I thank the Senator from Maryland. I think the Senator from Maryland has made such a strong case of why we need a public option. You know many of the folks who are out there wondering: Well, what is a public option? I think we need to go through a little bit of what we are talking about, because this is something that the American public understands. They know it in their heart. But let's go through a few of the details. First, this is not going to be subsidized by the government. It is going to be fully funded by premiums. So we are going to be out there in the private sector. Premiums will be flowing in to this nonprofit entity, and it will be able to function and compete with other businesses. It is not going to make a profit for its shareholders because it is a nonprofit. It would have low administrative costs since it operates as a nonprofit. That would allow it in the marketplace to serve as a competitor with these big insurance companies that are out there. It would offer savings to its subscribers through lower premiums, greater benefits, or lower out-of-pocket expenses. It will have the same insurance requirements as private plans. So we are talking about something that will offer low cost and high value. Let's take a look here at why it costs so much. You can see by this chart right here that in New Mexico, we have a situation where we have two companies controlling 65 percent of the market. All of us know the way the market system works. It works best when you have a lot of competitors. When you take a market and drive it down and only have two competitors, what you end up getting is those two competitors that are able to push up the cost. So that is something a public option would inject into the market, a competitiveness that we have not seen in a long time. One of the things it would do is it would start lowering those premium costs we are seeing in New Mexico. I know Senator Whitehouse is here from Rhode Island. One of the things I want to say about the Senator from Rhode Island is he has participated in this process already. Everybody knows he was on the HELP Committee. He had the opportunity to help write this bill. He has got a great deal of knowledge about what the public option is. I believe it is only about 19 pages of the bill that passed out of the HELP Committee. People can read it. It is out there on the Internet. That 19 pages sets up the public option. So all we need to do is make sure that is in the bill that comes to the Senate floor, or that we amend it on the Senate floor if it is not in the base bill, or that we have the President of the United States say he wants a public option. He can weigh in to the conference and say those 19 pages, the public option, we want them in there. I want to ask the Senator from Rhode Island to talk a little bit about the way he sees things from his perspective. What is happening up in Rhode Island on the public option?

Mr. UDALL of New Mexico. We have now been joined by Senator Brown from Ohio. As the Senators who are on the floor know, he led an effort like this last week to put the public option forward. He has been amazing in terms of being dogged and being here on the floor fighting for the public option. I know he talks frequently about how people in Ohio have a real passion for this.

Mr. UDALL of New Mexico. Madam President, I say to Senator Whitehouse, I want to ask you a question and see what evidence there was in the HELP Committee because what I understand in New Mexico is, if you look at the uninsured--I showed a chart in the Chamber a little bit earlier--one in four New Mexicans is uninsured. The big question is, Who are the uninsured? Who are the folks out there who are uninsured? As shown on this chart, adults under the age of 65, 31 percent; working New Mexicans, 31.4 percent; Hispanic Americans, 49 percent. So the uninsured are people we fight for every day, people we know, people we run into. I know in the HELP Committee one of the things really focused on was the fact that we are talking about working people, working families who do not have insurance. They are out there in these smaller businesses. I know when you worked on the bill in the committee, you heard that kind of evidence. And you know your Rhode Island situation. Could you talk a little bit about that because I think people somehow think, like you said--I think you said earlier that being uninsured is from a foreign planet or something. These are people who are in our midst all the time. They are working hard, but they cannot afford insurance, and these small businesses cannot afford insurance to cover them. I was wondering if you could talk about that a little bit. I see Senator Burris from Illinois has also joined us.

Mr. UDALL of New Mexico. Mr. President, I rise to speak about Indian health care legislation. This is legislation introduced by the chairman of the Indian Affairs Committee, Senator Dorgan. I wish to talk a little bit about Native Americans and their health care situation. We have spent the last 6 months talking about health care. We have debated the quality of care, the cost of care, access to care. I am glad to say we are making progress in fixing what is broken in our health care system. But there is one group of Americans that has not engaged in this national conversation, Americans who suffer from an inadequate health care system and alarming health disparities. I am talking about the first Americans, the American Indians and Alaska Natives who are suffering because the Federal Government is not living up to its promise to them. Right now Native Americans are being diagnosed with diabetes at almost three times the rate of any other ethnic group. Right now too many Native American families don't have access to preventive health care. Right now Native American teens are attempting and committing suicide at alarming rates. The bottom line is, too many Native Americans are struggling to receive quality health care. For too many years, America has stood aside and let it happen. Today is a new day. It is time for America to make good on its promises to Native Americans. I believe Senator Dorgan's bill would help us do just that. This legislation will bring much needed reforms to the Indian health care system and will allow us to connect Indian health improvements to national reform efforts. By tying these initiatives together, we will increase the likelihood of success not only today but for years to come. This legislation would make reauthorization of the Indian Health Care Improvement Act permanent so Indian country can better predict and plan for its health care needs. It will also build on what works by expanding services for mental health and prevention. We encourage stronger collaboration with the Veterans' Administration. We provide resources so that more Native Americans can train to become health care providers. We promote new ideas and future progress through funding of demonstration projects. Finally, we begin addressing a tragedy that is tearing apart too many Native American families, especially in my home State of New Mexico. That tragedy is the epidemic of teen suicide which I spoke of a moment ago. New Mexico's suicide rate is almost two times that of the national average, and far too many of these suicides are happening in Indian country. This summer, over the course of a little more than a month, four people from the Mescalero Apache Reservation committed suicide, all of them teenagers or young adults. The latest was a 14-year-old girl just last week. In this bill we will take the first steps in addressing this crisis. We will fund new grant programs and telehealth initiatives, and we will expand a program that has proven successful for the Zuni tribe in New Mexico. It is a program that connects schools and parents with the community, where students learn to be peer educators, and middle and high school students learn life skills to prevent suicide. America has an obligation to provide quality, accessible health care for our country's first Americans. That begins with engaging American Indians and Alaska Natives in the national conversation about health reform. I am honored to cosponsor this bill and look forward to its passage by the Senate. I thank the Chair. I suggest the absence of a quorum.

Mr. UDALL of New Mexico. I ask unanimous consent that the order for the quorum call be rescinded.

Mr. UDALL of New Mexico. I ask unanimous consent to speak as in morning business.