Outlines Republican Steps to Fix Health Care, Challenges Democrats to Take Reconciliation Off the Table
Posted on February 25, 2010
WASHINGTON – U.S. Senator Lamar Alexander (R-Tenn.), chairman of the Senate Republican Conference, today delivered the following opening remarks on behalf of Republican members of Congress attending the White House health care summit:
“Mr. President, thank you very much for the invitation. Several of us were a part of the summits that you had a year ago, and so I've been asked to try to express what Republicans believe about where we've gotten since then. As a former governor, I also want to try to represent governors’ views, because they have a big stake in this; I know you met with some governors just in the last few days. We also believe that our views represent the views of a great number of the American people who have tried to say in every way they know how – through town meetings, through surveys, through elections in Virginia and New Jersey and Massachusetts, that they oppose the health care bill that passed the Senate on Christmas Eve.
“And more importantly, we believe we have a better idea. And that's to take many of the examples that you just mentioned about health care costs and make that our goal: reducing health care costs. We need to start over and go step by step toward that goal. And we would like to briefly mention –others will talk more about it as we go along—what those ideas are.
“I would like to begin with a story. When I was elected governor, some of the media went up to the Democratic leaders in the legislature and said, ‘What are you going to do with this new young Republican governor?’ And they said, ‘We’re going help him, because if he succeeds, our state succeeds.’ And they did that—that’s the way we worked for eight years. But often, they had to persuade me to change my direction to get our state where it needed to go. I would like to say the same thing to you. I mean, we want you to succeed. Because if you succeed, our country succeeds. But we would like respectfully to change the direction you're going on health care costs, and that's what I want to mention here the in next few minutes.
“I was trying to think if there were any kind of event that this could be compared with. And I was thinking of the Detroit Auto Show, that if you had invited us out to watch you unveil the latest model that you and your engineers had created, and asked us to help sell it to the American people. When we look at it, it’s the same model we saw last year. We didn't like it, and neither did they, because we don't think it gets us where we need to go, and we can't afford it. As they also say in Detroit, ‘We think we have a better idea.’
“Your stories are a lot like the stories I heard when I went home for Christmas after we had 25 days of consecutive debate and voted on Christmas Eve on health care. A friend of mine from Tullahoma, Tennessee, said, ‘I hope you'll kill that health care bill.’ Then before the words rattled out of his mouth, he said, ‘But, we've got to do something about health care costs. My wife has breast cancer. She got it 11 years ago and our insurance is $2,000 a month. We couldn't afford it if our employer weren't helping us do that. So we've got to do something.’ That's where we are, but to do that, we have to start by taking the current bill and putting it on the shelf and starting from a clean sheet of paper.
“Now, you have presented ideas. There's an 11-page memo—I think it’s important for the people to understand that there's not a presidential bill; there are good suggestions and ideas on the web. It’s a lot like the Senate bill. It has more taxes, more subsidies, more spending. So what that means is, when it's written, it will be 2,700 pages, more or less. It will probably have a lot of surprises in it. It means it will cut Medicare by about half a trillion dollars and spend most of that on new programs, not on Medicare and making it stronger, even though it's going broke in 2015. It means there will be about a half trillion dollars of new taxes in it. It means that for millions of Americans, premiums will go up, because when people pay those new taxes, premiums will go up, and they will also go up because of the government mandates. It means that from a governor's point of view, it’s going to be what our Democratic governor calls the ‘mother of all unfunded mandates.’
“Nothing used to make me madder as a governor than when Washington politicians would get together, pass a bill, take credit for it, and send me the bill to pay. That’s exactly what this does, with the expansion of Medicaid. In addition, it dumps 15 to 18 million low-income Americans into a Medicaid program that none of us want to be a part of, because 50 percent of doctors won't see new patients. So it’s like giving someone a ticket to a bus line where the buses only run half the time.
“When fully implemented, the bill would spend about $2.5 trillion a year, and it still has sweetheart deals in it—one is out, some are still in. What's fair about taxpayers in Louisiana paying less than taxpayers in Tennessee? What's fair about protecting seniors in Florida and not protecting seniors in California and Illinois and Wyoming?
“Our view, with all respect, is that this is a car that can't be recalled and fixed, and that we ought to start over. But we’d like to start over. When I go down to the Senate floor, I’ve been there a lot on this issue, some of my Democratic friends will say, ‘Well, Lamar, where's the Republican comprehensive bill?’ And I say back, ‘Well, if it you're waiting for Mitch McConnell to roll in a wheelbarrow with a 2,700-page Republican comprehensive bill, it's not going to happen because we have come to the conclusion Congress doesn’t do comprehensive well.’ We have watched the comprehensive economy-wide, cap and trade; we have watched the comprehensive immigration bill, we have the best Senators we have got working on that in a bipartisan way; we have watched the comprehensive health care bill. And they fall of their own weight.
“Our country is too big, too complicated, too decentralized for Washington to write a few rules about remaking 17 percent of the economy all at once. That sort of thinking works in a classroom, but it doesn't work very well in our big, complicated country. It doesn't work for most of us and if you look around the table -- and I'm sure it's true on the Democratic side -- we have got shoe store owners and small business people and former county judges and we've got three doctors. We've got people who are used to solving problems, step by step.
“That’s why we said 'step by step' 173 times on the Senate floor in the last six months of last year in support of our step-by-step plan for reducing health care costs. I would like to just mention those in a sentence or two:
- First, you mentioned Mike Enzi’s work on the small business health care plan. That’s a good start. It came up in the Senate. He will explain why it covers more people, costs less, and helps small businesses offer insurance.
- Two, helping Americans buy insurance across state lines. You’ve mentioned that yourself. Most of the governors I've talked to think that would be a good way to increase competition.
- Number three, put an end to junk lawsuits against doctors. In our state, half the counties’ pregnant women have to drive to the big city to have prenatal health care or to have their baby, because the medical malpractice suits have driven up the insurance policies so high that doctors leave the rural counties.
- Number four, give states incentives to lower costs.
- Number five, expanding health savings accounts.
- Number six, House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer; because she has a preexisting condition, it makes it more difficult to buy insurance.
“So there're six ideas—they’re just six steps. Maybe the first six, but combined with six others and six more and six others, they get us in the right direction.
“Now, some say we need to rein in the insurance companies; maybe we do. But I think it's important to note if we took all of the profits of the health insurance companies entirely away, every single penny of it, we could pay for two days of health insurance for Americans. And that would leave 363 days with costs that are too high. So that’s why we continue to insist that as much as we want to expand access and to do other things in health care, that we shouldn't expand a system that's this expensive, that the best way to increase access is to reduce costs.
“Now, in conclusion, I have a suggestion and a request for how to make this a bipartisan and truly productive session. And I hope that those who are here will agree, I’ve got a pretty good record of working across party lines, and of supporting the president when I believe he's right, even though other members of my party might not on that occasion. And my request is this: before we go further today, that the Democratic Congressional leaders and you, Mr. President, renounce this idea of going back to the Congress and jamming your bill through on a partisan vote through a little-used process we call reconciliation.
“You can say that this process has been used before, and that would be right, but it’s never been used for anything like this. It’s not appropriate to use to rewrite the rules for 17 percent of the economy. Senator Byrd, who is the constitutional historian of the Senate, has said that it would be an outrage to run the health care bill through the Senate like a freight train with this process. The Senate is the only place where the rights to the minority are protected, and sometimes, as Senator Byrd has said, the minority can be right.
“I remember reading Alexis de Tocqueville’s book Democracy in America, in which he said that the greatest threat to the American democracy would be the ‘tyranny of the majority.’
“When Republicans were trying to change the rules a few years ago, you and I were both there. Senator McCain was very involved in that – getting a majority vote for judges. Then-Senator Obama said the following, ‘What we worry about is essentially having two chambers, the House and the Senate, who are simply majoritarian, absolute power on either side. That's just not what the founders intended.’ Which is another way to saying that the founders intended the Senate to be a place where the majority didn't rule on big issues.
“Senator Reid in his book, writing about the ‘Gang of 14,’ said that the end of the filibuster requiring 60 votes to pass a bill ‘would be the end of the United States Senate.’ And I think that's why Lyndon Johnson, in the ‘60s, wrote the civil rights bill in Everett Dirksen’s office, the Republican Leader, because he understood that by having a bipartisan bill, not only would pass it, but it would help the country accept it. Senator Pat Moynihan has said before he died that he couldn't remember a big piece of social legislation that passed that wasn't bipartisan.
“And after World War II, in this very house and in the room back over here, Democratic President Truman's Secretary of State, General Marshall, would meet once a week with Senator Vandenberg, the Republican Chairman of the Senate Foreign Relations Committee, and write the Marshall Plan. And General Marshall said that sometimes Van was my right hand, and sometimes he was his right hand.
“And we know how [Congressmen] John Boehner and George Miller did that on No Child Left Behind. [Senators] Mike Enzi and Ted Kennedy wrote 35 bills together; you mentioned that in your opening remarks. You and I and many other others worked together on the America COMPETES Act. We know how to do that – and we can do that on health care as well.
“But to do that, we'll have to renounce jamming it through in a partisan way. And if we don't, then the rest of what we do today will not be relevant. The only thing bipartisan will be the opposition to the bill, and we'll be saying to the American people—who I've tried to say this in every way they know how -- town halls and elections and surveys—that they don't want this bill, that they would like for us to start over. So if we can do that – start over – we can write a health care bill. It means putting aside jamming it through. It means working together the way General Marshall and Senator Vandenberg did. It means reducing health care costs and making that our goal for now, not focusing on the other goals. And it means going step by step together to re-earn the trust of the American people. We would like to do that, and we appreciate the opportunity that you have given us today to say what our ideas are, and to move forward. Thank you very much.”