Diana DeGette

Speech at the City Club in Denver - April 7, 2009

Diana DeGette
April 07, 2009— Denver, Colorado
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I would like to you to consider the following passage:

(We), the conscience of a people, in a time of grave national problems here dedicate ourselves to the supreme duty of the Nation — social justice, (including) minimum safety and health standards (and) public health without discrimination against or for any school of medicine. It is time to set the public welfare in the first place.

These words come from 1912 when Teddy Roosevelt first campaigned for universal national health coverage—nearly 100 years ago.

Since then, our nation has taken steps toward fulfilling its "supreme duty" to the health of its people: Medicare, Medicaid, health insurance for poor children, and, I am proud to say, with President Obama's executive order, an end to the ban — the "discrimination against" — federal funding of embryonic stem cell research, bringing new hope to millions of patients and families.

But nearly a century after Teddy Roosevelt uttered those words, the sad truth persists: the United States remains the only industrialized nation in the Western world that still doesn't guarantee health care for all its citizens.

As the vice chair of the Committee on Energy and Commerce, which will play a critical role in health care reform, I have a simple message: this is morally unacceptable.

It is unacceptable when a record 47 million Americans — including 800,000 Coloradoans — have no health insurance and when thousands more Americans are losing their coverage every day. That means they're less likely to get the medical care they need, more likely to develop chronic and life-threatening diseases and more likely to die prematurely, causing more than 20,000 preventable deaths in America every year.

It is unacceptable when the uninsured population includes 9 million children — 180,000 here in Colorado — children who are less likely to have their immunizations or see a doctor or dentist and more likely to be hospitalized because the only option for their sore throat or ear infection is the emergency room.

It is unacceptable when even families with health insurance struggle to keep up with skyrocketing premiums and co-pays only to have to fight their insurance companies for the coverage they thought they had.

They're families like my sister's—insured, middle-class family with two kids, paying monthly premiums of $1,100. And when my nephew had a skateboarding accident—a compound fracture of his wrist—what did her insurance company say? "Sorry. You didn't get pre-approved for the emergency room service."

And, it is unacceptable when—despite the more than $2 trillion Americans pay for health care every year twice as much, per person, than other industrialized countries—the outcomes are abysmal.

Americans often think we have the best health care in the world. But consider this. In terms of women's health — compared to other countries — the United States ranks 24th. In infant mortality, we rank 29th. In life expectancy, we rank 31st. And for health outcomes overall we rank 37th — below the Dominican Republic and Costa Rica. Put simply, when it comes to health care, Americans pay so much more but get so much less.

This is not only morally unacceptable, it is financially unsustainable.

It's unsustainable for families who often spend more on medical bills than on food and housing, who fear that just one illness or accident could plunge them into bankruptcy or cost them their home. In fact, medical bills are now the leading cause of personal bankrupts — call it "medical bankruptcy."

It's unsustainable for businesses especially small businesses, like the Denver Bookbinding Company, which had to slash its employer contributions and drop its 401(k) plan.

"It's unsustainable for hospitals, especially safety-net hospitals like Denver Health, where a surge of unemployed and uninsured patients have pushed uncompensated care costs above $300 million a year.

It's unsustainable for states overwhelmed by exploding Medicaid costs, including Colorado where the rolls are rising at an unprecedented 3,000 new Medicaid recipients every month.

And the status quo is unsustainable for our nation. The more than $2 trillion we spend every year on health care constitutes 16 percent of our gross domestic product. Over the next decade — without reform — it could swell to 20 percent, to more than $4 trillion. That's why even the chairman of the Federal Reserve—not someone typically associated with health care or hyperbole — has called this broken system "one of the most important challenges our nation faces."

Now, some say that this recession is the wrong time to confront this challenge. On the contrary, it is precisely the right time. Because, in the short-term, millions of jobs at risk means health care for millions at risk. And, over the long-term, we will never achieve our full economic potential as a nation if we don't free ourselves from the ball and chain of a dysfunctional health system.

That's why the new Congress and President Obama have moved swiftly to confront the most pressing short-term challenges.

We passed an historic expansion of the Children's Health Insurance Program, CHIP, preserving health care for millions of low-income children and expanding coverage to millions more, including 63,000 more children in Colorado.

And as part of the economic recovery package, we extended health coverage for those who've lost jobs in this recession; increased federal support for Medicaid; and — something I personally fought hard to include in the recovery package — we increased reimbursements for uncompensated care at disproportionate share hospitals (DSH) like Denver Health.

"And we're confronting the long-term challenge by embarking on comprehensive reform with a clear goal — quality, affordable health care for every American.

In his first budget, President Obama proposed a reserve fund of $634 billion as a "down payment" on health care reform.

My committee is holding hearings on the best way forward.

Different plans and various proposals are now being debated and I have not yet taken a position on any of them. My committee chairman, Congressman Henry Waxman, has asked me as vice chair to bring people to the table, listen to ideas from all sides, find common ground and help forge a plan that can pass.

So many questions — on coverage and cost — need to be answered. So many details need to be decided. There will be hard bargaining and hard choices. That said, I believe the broad principles of reform are already quite clear.

Reform must reflect this fundamental truth: affordable, quality health care is not the privilege of the fortunate few, it is the right of every American.

Reform must achieve key goals: reduce costs, expand coverage to those who lack it and improve the quality of care.

Reform must preserve the values we cherish as Americans: choice — of doctors, providers and plans; strong doctor-patient relationships — free from government interference, and; accountability—to avoid profiteering and discrimination based on pre-existing conditions. So disregard the fear-mongers and let there be no doubt: "socialized medicine" is not coming to America.

And reform must reflect what is politically possible. There are those who favor a single-payer, government-run health care system. But let's be clear: such an approach has neither public nor political support at this time despite that, we must not lose sight of our goal of providing health care for every American.

Guided by these principles, I believe a reformed system should have three essential pillars. It must cover every American; it must be affordable; and it must be portable.

It must cover everyone. Every American must have access to coverage — whether through the private plans they have now or a new public plan, perhaps modeled after the one offered to federal employees.

Why "every" American? Because if everyone is not enrolled, the old, familiar cycle will repeat itself: younger, healthier people will opt-out, leaving insurers and government programs with huge pools of older, sicker people resulting in higher costs and premiums. In contrast, covering everyone — including the formerly uninsured — would spread the risk among more people, resulting in more efficiencies and lower costs and premiums.

A reformed system must be affordable. Beyond covering everyone, there are so many ways to reign in soaring costs:

  • We need to put a new emphasis on preventative care — anti-smoking efforts, cancer screening and pre-natal care, where every dollar spent saves four dollars in long-term care. That's why I'm exploring a new way to calculate not simply the costs of preventative care, but the long-term benefits — what I call the "prevention dividend."

  • We need to invest in health care information technology — as the recovery plan does—to computerize health records and save billions of dollars now being lost every year to administrative costs.

  • And we need to give the federal government, under Medicare, the power to negotiate lower prices for prescription drugs.

Finally, in a reformed health care system, coverage must be portable. You shouldn't lose your health care just because you lose or change your job. Or just because you move to another state. If we mean what we say —t hat quality, affordable health care is indeed the right of every American — then it must be a right that can never be taken away.

Health care for every American that is both affordable and portable that is what we are called upon to deliver.

Few understand the urgency better than Susan Molina, a single mom from my district who testified before my committee on behalf of MOP Metro Organizations for People. When her abusive husband left her, she took a job as a janitor. Health care for her two children was covered by Colorado, CHP+.

In time, Susan worked her way up — from janitor to manager, this promotion came with a huge price — she made too much money to qualify for Colorado's Medicaid plan but too little to afford private insurance. And when her son got the flu, the best she could do was go to the pharmacy for chest rub and cough medicine. At which point, she broke down in tears. At the hearing she said:

"I felt ashamed that I couldn't just take my son to the doctor right there and then. It's sad that as parents we have to make hard choices — whether to pay a bill or buy groceries or take our children to the doctor. I felt like a failure."

Ladies and gentlemen, no mother or father should ever have to feel like a failure because they can't care for their children. No child should ever go without medical attention because their parents have to choose between food and health care. And no nation should — and certainly not the wealthiest in the world — should tolerate it.

As I mentioned, my committee is currently holding hearings on reforming our nation's health care system. As the House and Senate moves forward on developing a comprehensive plan, I am partnering with the members of the Colorado delegation to hold health care roundtables across our state.

We must enact comprehensive health care reform. And when we do — a century after Teddy Roosevelt first called for it, after so many attempts to achieve it — we will, at long last, fulfill our "supreme duty" — to Colorado, to our country and to future generations.

Thank you so much.

Speech from http://www.denverpost.com/ci_12091616?source=bb.