John Yarmuth

Mr. YARMUTH

Mr. YARMUTH. I'll yield.

Mr. YARMUTH. Mr. Speaker, it's a great honor to be here tonight to join with at least one of my colleagues from the class of 2006, the Majority Makers, to discuss the theme: What we did on our summer vacations. As everyone knows, it has been a very fascinating few months, as we in Congress and people throughout the country have talked about how we can solve one of the great problems that this country has been trying to deal with for generations, and that is a health care system that serves every one of its citizens. I, like all of my colleagues in the House, have spent the greater part of August talking with my constituents. We have had town hall meetings, we have had telephone town hall meetings, we've met with groups, we've met with providers, we've met with individual citizens to talk about the problems facing Americans--the challenge of finding quality, affordable health care for every citizen. I think what was most revealing to me as I spent all of this time talking about health care with my constituents is how receptive they were and are to comprehensive health care reform once they understand, first of all, the need for reform; secondly, the direct benefit to them and their families of the reform that we're proposing in the House; and, third, the relevance of health care to our economic future. President Obama, in this Chamber last Wednesday night, discussed those very themes, and he did it in a very compelling way. I think anyone who watched that speech would have to have left it feeling, one, we can wait no longer to make major reforms in our health care system, that the trajectory that we're on now is an unsustainable one, that we are facing extraordinarily high costs for insurance, we are facing extraordinarily high deficits in Medicare, and that we have to act now in order to mitigate the disaster that we face if we don't act. Secondly, the absolute challenge--and I think the national shame-- that we have that 18,000 Americans die every year because they don't have health insurance or access to care, the absolute shame in this country that almost 1 million people are forced to file bankruptcy every year because they either have no health insurance and are facing enormous medical bills or they have inadequate health insurance, that even though they had it, it was not sufficient to pay for the cost of their care. I mean, this is not what should happen in the wealthiest country in the world, a country that has met every challenge it has faced in its 220-year history. I think the President clearly defined that challenge for us last Wednesday night. And then there is the question of how this all relates to our economic challenges, the fact that employers who are now insuring, at least partially, 160 million of our citizens are going to be facing such high costs--they face them now, and even higher costs in the future--that their ability to compete in the global economy is severely impeded because of these high insurance costs. We have enormous challenges in this area. And again, once I met with citizens and was able to discuss with them their situations and their challenges and how what we're proposing to do in the House would address them, they change their opinions almost instantaneously. And I just have to relate one story which was extremely meaningful to me. I was at what's called a ``district dialogue'' one of our metro council members in Louisville put on. And there were 35 or 40 citizens there to address issues with him. I was invited as a guest. And when I walked in the room, I would say that the body language that I saw was, to put it lightly, very cold. And they were very skeptical because they knew I was going to talk about health care. Well, I spent 1 hour and 15 minutes there explaining the need for reform, the cost of doing nothing, the benefits to citizens with and without insurance, and answering all their questions about our legislation in the House and many of the myths that had developed around it. And I will never forget one couple sitting down to my left. At the beginning of the meeting, the husband asked me a very challenging question--wasn't quite hostile, but it was very challenging, and you could tell that he was extremely skeptical about what we were trying to do here. And I answered the question very respectfully and factually. About 10 minutes later his wife said, Congressman, let me tell you about our situation. We're 55. Eight months ago, my husband lost his job and we lost our insurance. We finally got insurance; it cost us $750 a month. So they're paying $8,000 a year, after-tax income, unemployed, $8,000 a year. She said our deductibles, our copays are very high. And 2 weeks ago, my husband had to go to the emergency room, I had to take him. Our bill was several hundred dollars and our insurance policy wouldn't pay for it. And I said, Ma'am, you are exactly why we're doing this reform measure. You are one of the case studies about what's important about what we're doing, because there are so many people in your category, middle-aged individuals who lost their jobs who really can't afford the insurance that's available to them, if it's available at all, in the individual private market. And while you're paying $8,000 now, under our proposal you would probably pay something like $2,000 a year. You could never be denied coverage because of a preexisting condition. If, heaven forbid, you got a serious illness, the insurance company couldn't take your benefits away. And I went through the list of all these ways in which our plan would help this couple. And she looked at me and said, Wow, that sounds pretty good. And that's what I found throughout our community when I talked about health care. And it was very gratifying as we went through all of these meetings and we encountered hostility, we encountered passion, we encountered a lot of people who are frustrated at a lot of the things that are going on in the world. But when it boiled right down to it, when you talked about what this plan that we're considering in the House would mean to them, their objections seemed to melt away. And I think they began to believe, for the first time probably, that we were truly working to help them and not to in any way harm them or take away what they have. So I thought my summer vacation was terrific in that regard because I know I was reassured that we are on the right path, that the American people are receptive to the type of reform we're trying to provide. And I'm energized and look forward to the next few months when we actually refine our legislation and bring a package to the floor and hopefully deliver one to the President that will accomplish what we've been trying to accomplish--again, for generations--and that is to provide security and stability in the health insurance lives of every American. With that, I take great pleasure in introducing my colleague from the class of 2006 from Colorado, the great State of Colorado (Mr. Perlmutter).

Mr. YARMUTH. I thank the gentleman. And I want to pick up on his conversation about small businesses because this is one of the very interesting reactions I got when I was home during the month of August. And of course I have some experience in that regard as well. I ran a small business for a number of years. We struggled very, very hard to provide health coverage for all of our employees. We had somewhere between 20 and 23 employees the entire life of my involvement in that business, and they were generally young, very healthy men and women. Unfortunately, we had a middle-aged woman who had cancer, and because we had that one unfortunate situation among our employees, everyone suffered financially because of her misfortune. Every year, we faced premium increases of 20, 25, 30 percent. We'd have to shop around as best we could. We'd have to increase co-pays and deductibles, things we had to do to be able to afford to provide coverage for everyone. Yet it wasn't just the business that was struggling; it was all of the individuals, again, all of whom had to pay dearly because of the misfortune of one person. Under our health care reform, that would never happen. Everybody-- every small business, every individual, regardless of their health histories or their health situations--would be guaranteed the lowest rates that anybody else could find. This is the way that America should function. The misfortune of one person should not adversely affect other people. In this particular case, the misfortune, through no fault of this woman's, should not put her in the situation of being discriminated against. So the gentleman is absolutely right. We had a session back in Louisville during the break, and we invited about 20 to 25 small business people because we wanted to take the opportunity to talk with them and to get their questions because, again, a lot of the discussion surrounding this bill has been, oh, there's going to be a huge employer mandate and we're going to impose this huge tax on small businesses. A lot of people, when they hear those types of headlines, understandably get very concerned. So we met. We spent 2 hours with this group of small business people, and what we found was exactly the situation that I described with my prior experience with small businesses. Every one of them was facing annual increases of double digits, sometimes approaching 30 percent. Just today, for instance, I had a small business in the office. They're paying now $7,200 per person for every one of their employees. They have about 35 employees. The quote for their policy that's up for renewal is a 30 percent increase. So they're spending now about $2.5 million a year. The increase alone would add $750,000 to their expense to keep the same level of coverage for their employees. I don't know many businesses that can experience a 30 percent increase in any aspect of their cost structure and survive for very long, and that's what all of these small business people were facing. One of the things that we talked about was--they said, Well, you have an incentive in this bill that we're covered, which most small businesses aren't because we exempt 95 percent of the small businesses from the employer mandates. But if I'm over there, why wouldn't I just drop my coverage and put my employees into the public market, the exchange, where they would again have these choices, but they would give up their coverage with me? I said, Well, you know what? You might very well have that financial incentive to do that. On strictly a dollars-and-cents basis, it might make sense for you to do it, but you know what? Your employees may be better off because, under our plan, they'll have far more choices than they will under your plan. They don't have a choice under your plan. It's whatever you can negotiate for your group, and they're stuck with that. It may not be the provider network they want. It may not have the terms that they want. They're stuck with it. Under our plan, if you decided to drop your coverage, they could shop in the exchange. They could pick the provider network, the plan that fits them best; and because of the subsidies that we provide, they're probably going to be out of pocket less money overall than they are with you. So it's not necessarily a bad thing that you would drop your coverage. They said, Oh, well, that's interesting. I said, Furthermore, under our plan, if you get someone who has a high cost of insurance--somebody who has a cancer or a condition that puts someone at a disadvantage--he's not necessarily locked in. I mean, he's not job-locked at all. If you were to drop your coverage under today's terms, he'd probably have to go to work for a big company to make up for it.

Mr. YARMUTH. I had another case just like that. I was at an actual event that was saluting many of the benefits of the summer jobs program that we provided as part of the Recovery Act. It was called YouthBuild where they build homes. They get teenagers who are at risk; they're from the at-risk population. They give them jobs; they give them training, and they have them spend a summer productively. I walked out to this construction site, and here was a young man, probably about the same age as yours, probably mid-30s. He said, May I talk to you a minute about my situation? I said, Absolutely. He said, My wife and I pay for the two of us, plus our one child, a $900-a-month premium. So that's almost $11,000 a year. I asked, And your employer pays part as well? He said, Oh, yeah. The $900 a month is my part. My employer pays more. So I don't know what the whole policy cost, but it was a lot of money. He said, I've got a preexisting condition. I've got a very bad allergy situation. I've had it all my life, and I can't get insurance in the private sector. I would love to go out and start my own construction company, but I'm locked into this job because of health care, because I would be stuck without it if I had to leave it. Interestingly enough, he was not supportive of what we're doing. At the outset, he said, I really wish you wouldn't do this. You know, I don't like the Federal Government's getting involved in coverage--all of the standard arguments that we hear sometimes. Again, he was someone whose problems with health care would have been solved, whose ambition to form his own company would have been restored, and yet he was still kind of blinded by a lot of rhetoric that's out there. I think I comforted him some in the conversation, but these stories are found throughout the country. We know that there are so many thousands and thousands of people who are in this situation, and this is the type of situation which has, I think, motivated all of us to work so hard to create reform that will be meaningful for the American people. Just quickly back to the small business issue: so we spent 2 hours in this meeting with the 20 or 25-or-so small business people answering all their questions. At the end of the meeting, about half of them said, Go get it. Go get it. Go for it. We're with you. There were still two or three holdouts who just didn't think that the Federal Government should get involved in any way. When they're eligible for Medicare, we'll have to ask them if they still feel that way. These small business owners, for the most part, understood finally that this was something that would free them from a problem that they have been trying to work out. So when you work it through, whether it's with senior citizens, with small businesses or with young families who have a situation where one of them might have a preexisting condition, this is exactly what we are trying to do--to create the opportunity for every American, regardless of their conditions or their situations, to have access to affordable health care. You did make reference to kind of the global situation. My colleague, Mr. Perlmutter, talked about the fact that we are the only industrialized Nation in the world that does not provide a certain level of benefits, that is, guaranteed health care benefits for its population, and that we spend twice as much per person as any other country and a much larger percentage of our gross domestic product than any other country does. Right now, we spend about 17 or 18 percent of our GDP on health care. I think the next highest level in the world is about 11 percent. While we do have some of the best health care anywhere available, it's just not available to enough people; and because of that and because of the fact that many people have virtually no health care and have no insurance and get very little care, we have poorer outcomes in this country even though we spend so much more. The World Health Organization ranks us 37th in the world. In their entire picture of health care outcomes, which includes infant mortality, life expectancy and survivability with certain diseases, we're 37th in the world overall. That's something that should be a challenge and a motivation for all of us to do better because, again, America has always been the problem- solving Nation. Whenever we put our minds to it and our collective will, we have been able to solve any problem that has confronted us. People say, Well, we don't want to be Canada. We don't want to be Great Britain. We don't want to be Japan, or whatever it is. I say that we don't have to be any of those countries. We're not those countries. We can do better than those countries; and we can create a health care system that is uniquely American, one that, again, provides security and stability to every American citizen, because that's what we're all about. Before I yield back to my friend, it's interesting--as we talk about the world situation--and we have to confront issues like the myth that illegal immigrants are going to be covered under our bill. Now, we know there are people who are out there who will say anything to undermine this effort; but to me, the discussion about the illegal immigrants is intriguing because on the one hand it's very clear in section 246 that no undocumented aliens will receive Federal payments under this plan; but the opponents say, Well, but they'll still have access to care in the emergency rooms. Yes, because President Reagan pushed for a law that requires hospitals and emergency rooms to treat anybody who goes there without regard to insurance or citizenship. What's intriguing to me is that people don't necessarily take the next step, which is to ask, for instance: Do you really want people, doctors and nurses in the emergency rooms, to be worried first about checking somebody's citizenship when somebody is lying on a gurney or when your child or a child, any child or any adult, is mortally injured or has a very serious disease or is having a coronary? Do you want the doctor or nurse to say, Oh, wait a minute. I've got to go check your citizenship before I can treat you? People don't think about the fact that it's not just that they would check Hispanic citizens or Hispanic people who would go to the emergency rooms or Asian people or whoever it is. They would have to check everybody. They would have to check everybody who would come in, and they would have to check senior citizens who would come in with grave illnesses. So we don't necessarily think through that. The opponents would also say, Well, they can still buy insurance if they pay for it. The answer of course is yes. Why is that a problem? Wouldn't you want people to have insurance rather than to go to the emergency rooms where all of us would subsidize their care? If they're illegal immigrants and can afford insurance, wouldn't you rather they have it so their kids, if they're in school next year, are not spreading a contagious disease? Wouldn't you rather they get the health care they need? I mean, some of the arguments really just don't hold water once you think through them and understand that health care is a very specific category in society and humanity. And I am always amused when we say, well, illegal immigrants can still get care. Yes, I think we want them to still get care, but there is nothing in the legislation that we are proposing or that's being proposed on the Senate side, nothing in that law which would add a benefit, a Federal benefit, to illegal immigrants, and that is clearly spelled out. So it takes a lot to work through these arguments, as my good friend knows, but it's worth working through them, because once you do, again, people feel much more comfortable and supportive with what we are doing.

Mr. YARMUTH. It's important to reemphasize the point that Mr. Perlmutter just made was that this is an incredibly complicated endeavor. And that's one of the problems we have in terms of a communications effort, that there are so many things that need to be explained. And as I have described it before, this is the biggest Rubik's Cube that anyone has ever tried to solve because there are so many moving parts. And one of the things that I have heard from a number of people in my district is they say, well, why don't you do it piece by piece? Why don't you do it incrementally? And the answer is, of course, that because of the system we have in this country, you can't really approach this problem piecemeal, because you could say, for instance, we are going to address the problems in Medicare. You could do that, or you could say we are going to address the private insurance system. The problem is that they use the same provider networks. The same doctors service the private system and the public system, Medicare, Medicaid. The same hospitals service them, the same home health care companies, the same skilled nursing facilities service both. So there is so much cost shifting going on, so that because Medicare pays less to providers, they charge private insurance companies more, which drives rates up. And they are always trying to balance their overall business to provider networks with the compensation they get, a reimbursement from both sides. So unless you deal with it holistically, you are going to basically push the finger in one side of the balloon and push it out the other end. We know that game. And so incrementalism, while it might be desirable, it might be easier to achieve a comfort level in the country because people might be able to digest what we are proposing to do a little bit better, the fact is that reform that doesn't touch all of these areas is not going to be effective, and we will just distort the system even more and probably have more and more people fall through the cracks. So nobody said this was going to be easy. I think it was Teddy Roosevelt 100 years ago who talked about providing universal health care, and we are still struggling with a way to bring health care to all our citizens. But we can do it. It's important work. I don't think there is anything we will ever do in this body at least domestically that will be as important as this effort. And as I look around the world and see what other countries have done, see both the positive aspects of many other systems, some of the negatives, again, I don't think there is anywhere else in the world where I would say we can take that system and plop it down in the United States and it would be the perfect system for us. There are elements of everybody's system around the world that could be useful in, again, creating that uniquely American solution. There is a new book out called ``The Healing of America'' by a Washington Post journalist named T.R. Reid, and he traveled around the world examining the health care systems, and he said there are three universal laws about health care reform or health care around the world. One is that no matter how good the system is for so many people, for as many people as possible, some people always complain about it. Secondly, doctors and hospitals will always complain that they are not being paid enough. And the final point was, the last reform always failed. So we are in an imperfect arena, and we know that whatever we do here in this Congress, hopefully this year, will be far from perfect. We know that we will be working on this for as long as we are all alive, because there will be thousands of unintended consequences and unpredictable consequences of what we do. But as my friend said, we have to start somewhere, and this is the time because we are looking at a very, very bleak picture moving forward, with tens of trillions of dollars of added debt in Medicare, with insurance premiums that are projected to increase by $1,800 a year for the next 10 years for a family policy, which would take it in the range of $30,000 by the end of the next decade. And we know that the American economy, certainly not American businesses, and definitely not American families can afford that type of cost. So this is the biggest challenge, but also the biggest opportunity we have ever faced in this country. And I am so glad, not just to be in Congress being able to work on this incredible endeavor, but also that the American people are so engaged in the process, because when the American people pay attention, the American people will respond, and they are responding with their input, with their reactions, and I think, ultimately, they will respond with their wholehearted support with the reform effort that we are engaged in. So I would just offer the floor to my colleague, if he has any closing remarks, and then we will surrender our time.

Mr. YARMUTH. I thank the gentleman and thank him for his participation tonight. As I said a moment ago, we are involved in an incredible historic endeavor here, and I am very appreciative of the fact that we in the class of 2006, the Majority Makers, most of whom campaigned on a platform that included affordable quality health care for all, are able to participate here with the cooperation of the American people.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, across the country, tens of thousands of passionate, boisterous Americans have come to townhall meetings to make their voices heard to Members of Congress. I welcome that expression of concern. Those concerns have touched a wide range of issues, but there is a common theme running through all of them, and that is that people feel they are not being listened to. While I understand the frustration, I think, maybe, the source of their frustration is not understood. It is that, no matter how loud we scream, there is still a torrent of money that is pouring into the political system on the other side that drowns out those voices. So, as we debate health care and energy and the reform of our financial system, I hope those same passionate Americans will talk to Congress about the need to reform our campaign finance system, about the need to create public financing so that their voices, as passionate and as intelligent as they may be, are not drowned out by the huge amounts of money that we now see in the political system. I think this is the cause for the future as the Supreme Court debates a decision which could make this even more compelling need more salient. We need to deal with this important topic.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, Maureen Dowd had it right in her column today when she said there's a lot of confusion and skepticism out in the American public about the health care plan. There isn't, however, a lot of opposition. What I've found is that once you spend time with the American people explaining things like the public option, they become very supportive, as national polls now show. And why shouldn't they? There are lots of examples of public and private competition in this country. We spend billions of dollars as a society on bottled water every day when there is a public option, a much less expensive public option, turning on the faucet. Millions of Americans every day face the choice, they can drive their car to work or they can take the public option, a bus or a metro line. We understand in this country that sometimes competition and choice make a difference for the American people. When we adopt the public option as part of our health care reform package, we will make a difference in the health care delivery system in this country, and the American people will benefit from it.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, we are on the verge of something very significant in this body and in this Congress. I am proud to join my colleagues from the Ways and Means Committee here tonight to talk about the prospects of health care reform in this country. I heard the other day that it was in 1912 that President Teddy Roosevelt first talked about proposing a national health care system for the United States. Today, we're still the only industrialized nation that doesn't have health care for all of its citizens. We believe it's time, almost 100 years later, to try and get this accomplished for the American people. Now, a little earlier, my colleague from Texas--my colleague, friend and classmate from college--talked about polls that are out this week that indicate that the American people have somehow turned against the President in his quest to provide health care reform in this country. But what he didn't mention was the other part of that poll, which said, once people understand what H.R. 3200 does, they overwhelmingly support it. There have been a lot of efforts to mischaracterize what this bill does, what our proposal does. Quite frankly, we're in that sausage- making process now. We have three committees in the House that are working on health care reform. We have two committees in the Senate that are trying to accomplish the same thing, and we have a 1,000-page bill. There are thousands and thousands of pages of legislation that are designed to finally build a kind of health care system that is responsive to the needs of the American citizens and, more importantly, that is responsive to the Nation, its future and its economy. So I'm not surprised that Americans are a little bit uncertain about what we're doing here, because, again, we're still in that process; but I can assure the people watching tonight, the American public, that the battle lines are about to be drawn. This bill is going to come into focus as the final committee of three in our House reports the legislation out. Over the next month, we will take the argument to the American people. We're very confident that, once the American people understand what we're doing and how we're going to improve their situations, they will overwhelmingly support our proposal. What the American people want--and what my constituents in Louisville, Kentucky want, what the constituents in New Jersey, in Washington, in New York, and in California all want--is basically the same thing: they want security for life in health care for themselves and for their families. If they're going to lose their jobs, if they're going to lose their coverage, if they want to change jobs, if they want to go back to school or if they want to make those important life decisions, they want the stability of insurance so they don't have to worry about whether a preexisting condition or something in their health histories will prevent them from being covered. They won't have to worry about getting sick and about having their policies rescinded, as we've heard much evidence about. Most importantly, they will be able to go to sleep every night knowing that a disease or an illness will not bankrupt them and will not change their standard of living. These are the things we're about to do for the American people, for ourselves as well, because we know, as the Republicans know, if we accomplish this major, major goal, we will have the everlasting appreciation of the American public. We know that because the Republicans have said it. We heard a Senator the other day say, Well, if we can defeat health care reform, it will be President Obama's Waterloo. He will be finished. We know from a Republican consultant, Frank Luntz, of his memo 3 months ago, which states, We cannot afford to let the Democrats succeed on getting health care reform. We have no answer to that, but we've got to stop it at all costs. That's what they've been trying to do. They've been talking about things that are nowhere in the bill. They've been talking about comparisons with Canada, which, by the way, is the only country in the world that does health care the way they do it. As I asked a witness at one of our hearings in Ways and Means: Other than hockey, what have we ever copied from Canada? We can do something very special in this country. We can create a unique American solution that will bring choice and competition--the two things that have characterized American society throughout its history--to our health care environment by using choice and competition, by creating a public option for American citizens to participate in that will compete with private insurance companies. We can make private insurance companies better, and we can make health insurance more affordable for every American. This is our goal. This is what we know that H.R. 3200 will do, and we look forward, over the next month, in taking this argument to the American people, because the case we have is a winning case. The hand we have is a winning hand, and we know that the American people will embrace what we are attempting to do.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, our Republican friends, perhaps in a bit of wishful thinking, are trying to convince the American public that the American Recovery Act has been a failure. Well, they're going to have a hard time convincing my constituents in Louisville, Kentucky, where it was just reported that home sales have increased by 27 percent this month over last year, almost all due to the $8,000 first-time home buyer's credit that we put in that act. They're going to have a hard time convincing the people at GE's Appliance Park, where they're about to bring 400 jobs back from China to Kentucky to build a revolutionary, energy-saving water heater. They're going to have a hard time convincing the 95 percent of my constituents who have had their paychecks increased because of the almost $300 billion in tax cuts that were part of that act. No, Mr. Speaker, the American Recovery Act is far from a failure. It is succeeding to rebuild the economy of this country.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, one of the myths that's being perpetrated by those who are trying to stop health care reform is that this is going to be somehow dangerous to small businesses. Well, small businesses know what it is to feel the pain of the dysfunctional health care system. They know that 60 percent of their owners and workers and their families are uninsured. They know that their premiums have gone up 129 percent in just the last 9 years. They know that they pay 18 percent more in premiums and their deductibles are twice as much as somebody working for a large firm. Our reform measure creates competition so that small businesses have the same bargaining power, the same opportunities as the largest companies in this country to provide health care for their families and their owners. We also know that we're providing a tax credit to help those small businesses do what they want to do, which is to provide their employees with health care. So forget the myths. Rely on the facts. This is one of the greatest benefits for small business that we could possibly provide, helping them help their families and their employees provide stability in their health care situation.

Mr. YARMUTH

Mr. YARMUTH. Madam Speaker, it is an honor for me to take the floor after Patrick Kennedy from Rhode Island, who, along with his father, Senator Edward Kennedy, have devoted so much of their careers, their emotions, their passion to resolving the health care problems in this country. And as we talk about health care and reforming our system, we talk a lot about billions and billions of dollars, we talk about government agencies, we talk about the politics of it, but at its core this issue isn't about any of those things. This is about human beings. This is about men, women and their families and trying to help them deal with health care crises, wellness issues, things that every American has to deal with. Yesterday, in southern Indiana, right across from my district, a subcommittee of the Energy and Commerce Committee held a field hearing in which we were able to see the face of this issue, three people who came before us to tell their stories about how the health care system in America has failed them. One of them was a constituent from my district, Patricia Reilling. Patricia is a small businessperson. For 20 years she was insured under a small business policy by the same company. She paid her bills every month religiously. The only claim she ever made was for some pain killers for a back injury. And then, last year she was found to have breast cancer. She had a double mastectomy. She contracted a staph infection while she was in the hospital. And while all that is going on, she received notice from her insurance company that they were not going to renew her policy as of June 30 of this year. She is still fighting that staph infection. She is unable to work. And she is still fighting without insurance because the only insurance available to her now is far beyond her means to pay. She is the real person, and someone whose situation could be replicated in any household across this country if we don't do something about reforming our insurance system. Another woman who was at the hearing yesterday was Ms. Beaton from Dallas, Texas. Ms. Beaton is 59. She had an individual policy. She also contracted breast cancer, had a double mastectomy, except before she could have that operation the insurance company rescinded her policy, basically said we know we insured you, but because there was a notation in something in a medical chart years ago that referred to a skin issue--namely, pimples--and somebody misinterpreted it as saying it was precancerous, which the doctor denied, we are not covering your cancer treatment. Fortunately, Congressman Barton from Texas intervened on her behalf and was able to eventually get her policy reinstated. But by the time it was, her tumors had grown by more than 300 percent in size, and the treatment that she got was vastly more complicated and more expensive than it ever needed to be. These are the faces of the insurance crisis, the health crisis that we face, and we have to change our system. Fourteen thousand Americans lose their health insurance every day. It could be any one of us. And you know what? In that situation that we heard about yesterday, that has recurred. Three insurance companies testified before Congress a month ago; three insurance companies rescinded 20,000 policies over the last 5 years, did what they did to Ms. Beaton. They saved $300 million by doing that, but that was only the cost of the care they denied, the claims they refused to pay, not the prospective cost of covering and treating all of those illnesses, which would have been in the billions of dollars. So as we debate health care over the next week, over the next few months, let's remember that it is more than about money, it is more than about government agencies, it is more than about process, this is about American human beings and their only simple desire to have quality, affordable care. That is what we are about, and that is what we intend to do.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, we already know that the Republicans have committed themselves to doing everything possible to prevent this body from passing the health care reform that the American people desperately need and want. Yesterday and today, we've heard a Greek chorus of Republican talking points designed to misrepresent what we are trying to do to help the American people maintain and gain access to affordable quality care. Among the most glaring misrepresentations is that we're somehow going to force the American people to be insured in a public plan. Nothing could be further from the truth. The essence of our proposal is to provide choice and competition so that insurance companies will have to compete for the American people's business rather than the American people having to beg for coverage, only to find that their coverage isn't adequate when they really need it. This is the type of reform that we need for this country, for the American people; and no Republican misrepresentations will prevent this body from acting.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, when I was a young boy, a radio station went on the air in Louisville, Kentucky, and for the first week of its existence played one song over and over. It was called ``Purple People Eater.'' I am reminded of that event today as we've heard speaker after speaker from the other side repeat the same tired Republican talking points. What we haven't heard is one idea about how to fix our dysfunctional health care system which is threatening every business in this country, threatening our competitiveness and our long-term economic prospects. It is time that this Congress and our colleagues from the other side focus on saving this country's health care system. We heard one gentleman from the other side saying we're facing $38 trillion in additional debt in Medicare. We're trying to make sure that that doesn't happen. I wish our colleagues on the other side would help us in that task.

Mr. YARMUTH

Mr. YARMUTH. Mr. Speaker, opponents of health care reform have tried for months to attack our efforts to bring high-quality, affordable care to all Americans. Their favorite scare tactic has been to allege that a public option will somehow lead to a ``government takeover'' of health care. This could not be further from the truth. Under the plan we introduced yesterday, the CBO projects that just 3 percent of Americans will be enrolled in the public plan once it is fully implemented, hardly a government takeover. In fact, the CBO estimates that employer-provided plans will have millions of new enrollees under the legislation and that most of those Americans using the health care exchange will choose private insurance for their coverage. This is a uniquely American solution that combines the best of the public and private sectors to bring some much-needed competition to the health care marketplace, giving American families the peace of mind of knowing they will always have high-quality, affordable health care choices.

Mr. YARMUTH

Mr. YARMUTH. I thank the gentleman because he talked so much about the higher level of care at the emergency room, most of which is uncompensated for those providers and are shifted to the private-pay customers. I know there are estimates out there that indicate that there is somewhere around a hundred billion dollars a year that's actually care administered in the emergency rooms to people by hospitals who do it as part of charity work, but it's all being shifted to the people who are covered. So when we talk about a health reform plan that's going to cost roughly $100 billion a year for 10 years, we're already spending that $100 billion. So it's not money new to the system, which is, I think in the example of we have plenty of money spent in this country on health care right now.

Mr. YARMUTH. Oh, absolutely. I think that's the uniquely American element of this plan that is most important to stress. No one is forced to do anything in this plan. If you like your coverage, if you have employer-sponsored insurance that you're happy with, you get to keep it. No change is necessary, no change is mandated. You get to keep your choice of doctors. You get to choose your hospital. These are the fundamental elements that we considered extremely critical to this legislation because we know many Americans are satisfied with their health coverage, and we don't want to change their situation. We want to make sure that everyone is satisfied with their coverage, that everyone has coverage; and through the competitive American spirit, that we think we are building, creating this legislation, that we will be able to provide the type of environment where people who like what they have can keep it, people who don't like what they have can shop for something that better suits their family's needs; and that's what the entire purpose of this great legislation is.

Mr. YARMUTH. Well, I think that's the most essential part of this legislation. If we can't control costs in the health care system, if we can't see to it that people get what they need at a lower price, then we know, for instance, that if we don't have reform, it's projected that the average family's cost will increase $1,800 per year for the foreseeable future. That's unsustainable. We know that. So cost control through competition is the critical--and through changes we hope that we can incentivize in the way medicine is delivered, health care is delivered and practiced in this country, that we can make affordable, quality health care available to every American.

Mr. YARMUTH. I thank the gentleman for his very important contribution. And someone else who's been very much engaged in the development of the legislation that was introduced today, the gentleman from Connecticut, who's a member of the Energy and Commerce Committee. I yield to Mr. Murphy from Connecticut.

Mr. YARMUTH. And, you know, this is supposed to be a conversation of the Class of 2006, but occasionally we adopt Members from other classes because we know that they share the values that brought us to Congress. And it's now my great pleasure to introduce one of those colleagues, Mr. Ryan from Ohio.

Mr. YARMUTH. I thank Dr. Kagen for his expert contribution. As we move forward, we will rely more and more on those people who have been in the trenches. And for someone who has been in the trenches and knows the problems that face his patients and his colleagues in the medical profession, we will be able to craft a much better piece of legislation. So I thank him for his contribution tonight. Now it gives me great pleasure to introduce another individual who has been focused on health care throughout his political career, a good friend from Memphis, Tennessee (Mr. Cohen).

Mr. YARMUTH. I yield to the gentleman.

Mr. YARMUTH. I thank the gentleman. He raises a point that, I think, is appropriate to make at this time. We will hear a lot over these few weeks as we're going to be actively engaged in this issue of trying to bring a bill to the floor and of passing it before August 1. You will hear a lot about the Canadian system, and you will hear a lot of fear tactics being thrown at the debate because, right now, those people who are opposing what we are trying to do really have nothing but fear tactics to throw at it. It's interesting, because we had a hearing in Ways and Means several weeks ago. A gentleman was there who was arguing against our public option, the public option part of the proposal, which basically is a government-run plan that would compete with private insurers and that would compete for your business, for the business of the American people. He kept saying, We don't want Canada. We don't want Canada. We don't want Canada with the long lines and all of these things--all of these myths that have arisen around the Canadian system. I asked him if he knew how many countries in the world, how many industrialized nations, had a nationalized health insurance system. He said all of them except the United States. How many have universal coverage? All of them except the United States. How many have a blend of public and private where you have a basic level of coverage provided by the government but where people can buy private insurance to enhance their positions? He said, Well, all of them except Canada. I said, So you have chosen the one country in the world that is an outlier. He used that to undermine the arguments for an American plan when we haven't copied anything from Canada in this country, that I know of, except hockey. He really didn't have a response to that. The point is you will hear a lot of these myths thrown out, and they really don't relate to what we're doing or are trying to do, which is to create a uniquely American solution to a uniquely American problem. With that, I would like to yield time to my colleague from Massachusetts, Congresswoman Niki Tsongas.

Mr. YARMUTH. I appreciate all the comments from my colleagues, and I'd like to close by reading a letter that I received from a constituent of mine who's 10 years old. It says: ``Dear Congressman Yarmuth,'' My name is Matthew Gregory, and I am a 10-year-old that lives in Louisville, Kentucky. ``I am writing this letter because I have a younger brother with autism, and I want you to cosponsor the Autism Treatment Acceleration Act.'' Not the piece of legislation we're talking about now, but relevant. ``I would really appreciate the efforts you would provide to cosponsor the bill that would help end autism insurance discrimination. My parents spend $50,000 per year for my brother's autism, and I think it's a national crisis. ``It seems like families that have not had their State's autism insurance bills passed have to pay unnecessary expenses just because a child is different.'' And here's the kicker. ``It's just not fair, and this is a fair country and everybody, no matter who they are, including my brother Eric, should be treated equally.'' So there you have it. A 10-year-old understands the essential unfairness of the system we have now, the fact that so many people are uninsured, the fact that so many people pay too much for the insurance they have, have to make life decisions based on whether they can get insurance or not, and that's what this Congress is determined to correct. We have an historic opportunity here to create a just, fair health care system, one that is affordable and sustainable for this country and which will make sure that every American citizen has the health care he and she needs for their families well into the future.

Mr. YARMUTH. I'd like to yield again to the gentleman from Wisconsin.