Speeches & Floor Statements

Floor Remarks of U.S. Senator Lamar Alexander (R-Tenn.) -- Step by Step, Not Comprehensive, Health Care Reform

Posted on September 15, 2009

Mr. President, I believe it is time for us in Congress to admit that we do not do "comprehensive" well, and that the era of the 1,000-page bill is over. Look at immigration in 2007. Some of the best Senators here worked day and night trying to deal with that issue -- Senator Kennedy, Senator Kyl, Senator McCain, Senator Martinez, and many others. They worked and they got 34 votes at first, not the 60 they hoped. Then finally they got 46 votes, 14 votes shy of the votes needed to pass a comprehensive immigration bill. Or look at the economy-wide cap and trade as a way of dealing with climate change and clean energy. Senator McCain and Senator Lieberman worked on a bill 2 or 3 years ago. Last year the Warner-Lieberman version of the bill got 48 votes and it needed 60 votes. Earlier this year we had 66 or 67 Senators, including two dozen Democrats, who voted to say don't put the economy-wide cap and trade through the so-called reconciliation process, the budget process which would take only 50 votes to pass. Then, add to that, health care is in the ditch. The President has said there can't be any deficit added by the health care bill, so that kills deader than a doornail the House health care bill which has been worked on by several committees over there. It kills deader than a doornail the Senate health care bill because both add to the debt in the next 10 years and, according to the Congressional Budget Office and others who have reviewed it, add to the debt in the 10 years after that. So the President said he won't sign a bill with any deficit, the House bill is deader than a doornail, the Senate bill is deader than a doornail, and we still have unresolved problems even if you fix the debt problem. We have the President saying he is going to take the savings out of Medicare to pay for the bill. Many of us believe that any Medicare savings ought to be spent on Medicare. We ought not take money from Grandma's Medicare and spend it on anybody other than Grandma, because the program is about to go broke in 2017. The Democratic as well as the Republican Governors are worried about what the Governor of Tennessee called "the mother of unfunded mandates," when these bills say we are going to expand Medicaid and we might pay for it a few years in Washington but after that we are going to shift it to the States with hundreds of millions of dollars of new State taxes. Employers are worrying about raising taxes in a recession. Older Americans, seniors, are worried about whether some government official is going to say you can't have your hip replaced because you are 70 years old. If debt hasn't killed the Senate and the House bills, all these other issues are still out there. I propose we take a page from a famous little book which was widely passed out in Iowa and New Hampshire in 1995 and 1996. It is called Lamar Alexander's "Little Plaid Book." I used it when I ran for President of the United States. Obviously not enough people read it for me to be successful. It has lots of good instructions about rules, lessons, and reminders about running for office and making a difference, whether you are President of the United States or president of your senior class. Here is rule 259: Keep in mind that enough small steps in the right direction will still get you where you want to go. Mr. President: Keep in mind that enough small steps in the right direction will still get you where you want to go. I think we should take that advice. I think it is plainly obvious that we in Congress have been biting off more than we can chew -- on immigration, on health care, and on other issues. We have been producing 1,000-page bills which, in truth, most Members of Congress have not even read and in which voters have no confidence, and out of which will come unintended consequences and results that are bad for our country. The worst consequence is that the ambition of ours is so large, to solve these problems, that it inevitably adds to the debt -- the national debt, the Government's debt, our taxpayer debt -- at a time when we are adding $9 trillion to the debt in just 10 years and everyone is worried about how we are going to pay that back; and at a time, fairly or unfairly, when the American people are saying the new administration, it seems, has a new Washington takeover every other day: taking over banks, taking over insurance companies, taking over student loans -- nobody asked them to take over student loans, they are just going to take them all over, all 15 million student loans are going to be run out of the U.S. Department of Education -- taking over your farm ponds, maybe taking over health care, taking over car companies, maybe taking over climate change by having a czar in the Environmental Protection Administration wave a magic wand and impose it on the country. The American people see 32 so-called czars who are unaccountable and it looks like a runaway Federal Government with no checks and balances. Senator Byrd, the senior Democrat, has warned about the consequences of these unaccountable czars. Senator Hutchison, Senator Collins -- senior Republicans -- have warned about that as well. Instead of thousand-page bills that do not succeed and in which the people of this country have no confidence, I suggest we change course, we follow rule 259 in the "Little Plaid Book," and we begin to work on major issues facing our country, step by step, to re-earn the trust of the American people, to begin to solve the big challenges of this country. We bite off what we can swallow. We make sure we get it right and after we have taken the first steps then we can take another series of steps until we eventually resolve the problem. A few steps in the right direction is a good way to get where you want to go. How would this work in practice? Let's take health care. Instead of a trillion-dollar thousand-page comprehensive health care government-run plan, as a first step we might allow small business pooling to reduce health care costs, increase accessibility for small business owners, unions, associations and their workers, members and families. This bill has been here for 4 years. It is ready to pass. There are actually competing bills. But the estimates are it would add a million workers that small businesses could afford to cover by insurance. That is a good step in the right direction. We might reform medical malpractice laws so runaway junk lawsuits don't continue to drive up the cost of health care. In Tennessee, there are 60 counties where there are not any OB/GYN doctors. That means mothers in those 60 counties of Tennessee have to drive a long way, they have to drive to Memphis, maybe 60 miles, to get the prenatal health care to have their babies. The President mentioned the other night some steps about junk runaway lawsuits, so there is a second small step we could take that could make a big difference about cost. Third, we could allow individual Americans the ability to purchase health care across State lines as they can with car insurance today. We can probably agree on that here and it would probably make a difference. I used to be a Governor so I have an aversion to not respecting State lines, but in this case we may need to do this because the cost of health insurance could come down if we did it and cost is what we are focused on. No. 4, we could ensure that Americans who currently qualify for existing programs such as Medicaid and the Children's Health Insurance Program but are not enrolled get signed up. There are 11 million Americans, 20 percent of all the uninsured people in this country, who are eligible for current government programs called Medicaid or the Children's Health Insurance Program but have not signed up. Rather than wringing our hands about whether to pass some new thousand-page bill to try to run up the debt and deal with uninsured people, why don't we sign up the uninsured people who are already eligible for programs, and, No. 5, create health insurance exchanges so Americans can find affordable coverage. The President mentioned that the other night. It is in almost all the Republican bills. In other words, that is just a marketplace, a shopping center where you can go look for a variety of programs. No. 6, we could enact meaningful insurance market reforms, meaning you are guaranteed you can get a policy and that if you have a preexisting condition, you can get affordable coverage. If we did this, this would probably raise the cost of insurance for some Americans. It would mean that every American would either have to be automatically enrolled or have to be enrolled. But a lot of Americans are getting tired of paying an extra $1,000 on their health insurance just so you do not have to buy any until you are on the way to the emergency room. So maybe we can do that as well. Those are just six steps. But six steps of that size in the right direction are a good way to get where we want to go. Then, if we can pass those, maybe we can pass six more. Or take clean energy. What do we have facing us out of the House of Representatives? A massive contraption, spending hundreds of billions of dollars a year, causing us to lose millions of jobs under an economy-wide cap-and-trade climate bill. That climate bill that is proposed by the House would raise the electric bill for every American and raise the price of your fuel at the gasoline tank. It is a high-cost energy and climate change bill. Well, instead of a high-cost energy and climate change bill, how about taking a few steps in the right direction toward a low-cost one? One. What about building 100 new nuclear plants in 20 years? That would double the amount of nuclear power we produce. Nuclear power is 70 percent of our carbon-free electricity. Is not carbon-free electricity supposed to be our goal? Did we not invent nuclear power in the Atoms for Peace Program? Is not the rest of the world now way ahead of us? And have not our Navy submarines operated safely since the 1950s and effectively with nuclear power and does not Dr. Chu, the Energy Secretary for this administration, a Nobel Prize winner, say they operate safely in America and that we can safely store the waste for the next 40 or 60 years while we decided how to reprocess it so it does not produce plutonium? The answer to all that is yes. So why not build 100 nuclear plants in 20 years? We have done it before, we can do it again. Two. We can make half the cars and trucks plug-in electric cars and trucks in 20 years. I think we can agree on that on both sides of the aisle. We can do that without building any new power plants because we have so much unused electricity at night; if we plug in at night at a cheap rate, we can fuel our cars and reduce our imported foreign oil, keep our fuel prices low, use less gas, clean the air, and deal with climate change all at once. Three. Offshore exploration for natural gas and oil. We need plenty of natural gas if we want our manufacturing companies to stay here with their jobs. We need plenty of natural gas. Every new big power plant built in the last 20 years has been a natural gas plant because it has less carbon than coal. We do not want to be importing natural gas in the same way we import oil. So let's do that. Four. Then double clean energy research and development. Instead of subsidizing entrepreneurs, let's have a mini Manhattan Project for the most promising efforts to make solar costs competitive, to make possible the recapture of carbon from existing coal plants, to have better electric batteries, to have advanced biofuels from crops we do not eat. So there are four steps in the right direction on clean energy which would actually lower our prices, instead of a 1,000-page bill, which would begin to collect hundreds of billions of dollars a year and put much of it in a slush fund that Congress would spend and raise your taxes, have all sorts of unforeseen consequences, send manufacturing jobs fleeing overseas; that would be what we should not do. Immigration. I mentioned immigration before and how the best Members of this body were trying hard on immigration, and it fell of its own weight. I do not think we can pass a comprehensive immigration bill. But I think we can take several steps in the right direction, such as a secure work card, a tamper-proof worker ID card, to make sure workers are legal. Senator Schumer has talked about that. I join him in talking about it. Most of the people who are illegally here are here to work. If they have to prove they are legally here, that will dry up the number of people illegally here and then we can deal with that. Second, we could achieve full operational control of our borders. President Bush and the Congress made a lot of progress on that, not always recognized, but we need to finish it. And third, help legal American immigrants and new Americans learn English and learn civics and learn American history and assimilate into our society and learn what it means to be an American. We can take the first steps on debt and fiscal responsibility, instead of more bailouts and doubling our debt, which is the route we are on. We can end government ownership of car companies, we can have a bipartisan commission to control spending. We call that the Gregg-Conrad bill because it means the commission would decide how to control spending, recommend it to us, and we would vote up or down, or a similar BRAC-like Commission to do the same thing. There are other steps we can take to reduce the debt. We might not be able to reduce it all in 1 day or all in one bill. But a few steps in the right direction to reduce the debt are a good way to get where we want to go. The same on taxes. Instead of a complicated Tax Code that penalizes working families, we probably would fail if we came in with a comprehensive proposal to change the Tax Code. In fact, President Bush asked two respected former Members of the Senate, John Breaux and Connie Mack, and others to recommend a plan to us. They recommended a pretty good plan, and it got lost in the dark. Nobody ever heard another word of it, probably because it was a comprehensive plan. Why do we not take a few steps in the right direction, such as an optional one-page flat tax, such as doubling the child tax credit to make it easier for parents to be better parents, such as ending the death tax on families with assets of less than $5 million? And then coming up soon: financial regulatory reform. We had a bipartisan breakfast this morning on this subject. Fifteen Senators attended, listened to Senator Dodd, a Democrat, and to Senator Shelby, a Republican, talk about financial regulatory reform. After the near collapse of the economy a year ago, we all know we need that. We would be best off doing it in a bipartisan way. But, again, rather than come up with a 1,000- or a 2,000-page bill on financial regulatory reform, maybe we can take a few steps in the right direction. Bipartisanship helps, but it is not, as some might say, an opportunity to sing "Kumbaya." The Senate is a place for differences of opinion vigorously expressed. If we do not have those, we would not be here. The real value of bipartisanship is a better bill and a bill in which the people who elected us will have confidence. Such bipartisanship is absolutely essential to any comprehensive bill and even to a few steps. We had it on the Energy bill of 2005, which got 74 votes. We had it on the America Competes Act, an early version of which got 70 cosponsors. The Gang of 14 had it when we were dealing with Supreme Court nominees. On the controversial TARP vote, we had bipartisan support with 74 votes. How did we get it? We worked in the open with no secrets, everyone gets credit. I am afraid that even when we have that spirit, the problems we have to tackle are so large we need to begin to solve them in pieces. These are problems we must solve. But we are not a debating society. In the end, we need to get a result. I have concluded that the best way to get a result on health care, on immigration, on other major issues facing our country is to put aside the 1,000-page bills, and re-earn the trust of the American people by working step by step to begin to solve the challenges facing our country.