WASHINGTON, DC- U.S. Senator Bob Casey (D-PA) today spoke on the Senate floor about health care reform and the need to ensure that no child is worse off as a result of this legislation. Senator Casey’s full remarks are below.
Statement of U.S. Senator Bob Casey
June 19, 2009
Now we're at the point where the Health, Education, Labor and Pensions Committee is voting on amendments. We know that this is a challenge that has faced America for decades - the challenge of covering people in our country who don't have coverage, and making sure that those who do have coverage have quality health care coverage that's affordable.
So, all of these challenges are presented to us now. And we have a situation in the country today, Chairman Dodd just mentioned this morning in a hearing - about 14,000 people a day losing their health care coverage. It's hard to comprehend that every single day that many Americans are losing their health care coverage. That’s unacceptable.
But that is in a very real way the status quo, where we are now: people losing coverage every day. Thousands and thousands. 14,000 by one count. People who might have coverage but it's hard for them to afford it, or to continue to afford it. And sometimes people have coverage and it's not of the kind of quality that would ensure the best health care for them and for their families.
So, really, we're at a point now where we're beginning to see a basic choice that the Congress has to make, and the American people have to make. It's the status quo or change. It's the status quo, where we are now, which, in my judgment, is unacceptable. That status quo, or reform. It really is coming down to basic fundamental choice.
The status quo right now is the enemy of change. The status quo is the impediment in front of us. The tree across the road. Or whatever image you want to illustrate it. So we have to get to work making sure that the status quo doesn't stay in place. And there are so many ways to tell this story.
Every member of the United States Senate and every member of the House and, frankly, virtually every American could tell a story about someone they know or someone they've read about and the challenges they face. And in Pennsylvania we've got a lot of examples of people that are living the reality of a lack of health care coverage, or bad quality coverage, or coverage they cannot afford.
One letter I got stood out for me among many. It was written back in February of this year by Trisha Urban from Berks County - the east side of Pennsylvania. I will read portions of her letter that will tell the story as well as anyone's could, and unfortunately in this one the case of a tragic circumstance.
She wrote, talking about her husband Andrew. He had to leave his job for one year to complete an internship to get his doctorate in psychology. And the internship was unpaid and they could not afford COBRA coverage, extending health care coverage. I'm quoting from the middle of the letter. She says, Trisha Urban says, and I quote: “Because of pre-existing conditions, neither my husband’s health issues nor my pregnancy would be covered under private insurance.” He had some heart problems. She mentioned that she was pregnant, and that neither his health issues nor her pregnancy would be covered under insurance. “I worked 4 part-time jobs and was not eligible for any health benefits. We ended up with a second rate health insurance plan through my husband’s university. When medical bills started to add up, the insurance company decided to drop our coverage stating the internship did not qualify us for the benefits. We were left with close to $100,000 worth of medical bills. Concerned with the upcoming financial responsibility of the birth of our daughter and the burden of current medical expenses, my husband missed his last doctor’s appointment less than one month ago.
In the letter from there, she talks about what happened at one particular moment, after summarizing their health care situation and when I was describing the pregnancy, " My water had broke the night before, we were anxiously awaiting the birth of our first child. A half-hour later, 2 ambulances were in my driveway. As the paramedics were assessing the health of my baby and me, the parametric from the other ambulance told me that my husband could not be revived.”
She concluded the letter this way, and I quote, “I am a working class American and do not have the money or the insight to legally fight the health insurance company. We had no life insurance. I will probably lose my home, my car and everything we worked so hard to accumulate in our life will be gone in an instant. If my story is heard, if legislation can be changed to help other uninsured Americans in a similar situation, I am willing to pay the price of losing everything.”
Trisha is telling us in that poignant but tragic story of her own circumstances and the circumstances surrounding the birth of her daughter and the death of her husband, telling us all we need to know about this debate and posing that question, or that challenge, I should say, to all of us, especially those of us who have a vote in the United States Senate, "I’m willing to pay the price of losing everything if my story can be told and legislation can be enacted to deal with health care."
That's a basic challenge that Trisha Urban has put before the United States Senate, and the Congress, and the Administration. It's a challenge that we must respond to. We cannot pretend that it's not there, we cannot pretend the status quo of 14,000 people losing their health insurance every day, so many others worried about the coverage they have. We cannot pretend that's not there.
We cannot just say to Trisha Urban, we're sorry but Congress cannot get it done this year. We have to get it done. We have to pass a bill in our committee. We have to get a bill through the Finance Committee. We have to make sure the Senate votes on this legislation, this year. Frankly, this summer. Not late in the fall, not in the winter, not in 2010.
Right now is the time for action.
And the president, President Obama, has led us on this. He has attached the same sense of urgency to this issue that I know the American people feel.
Now what is it about? Well, it's about an act that a lot of Americans are just hearing about. Which goes by a very simple name, the Affordable Health Choices Act, that's the act that is presently before our committee.
It does a couple of things. It focuses on fundamentals to get at that change that should come to the status quo. First of all, it reduces costs by way of prevention. Very important. We know that we can reduce costs substantially. And it reduces costs by better quality information technology. That is still hard to believe when other industries like banking and insurance and other parts of our economy have moved into the new era of technology. That our health care system isn't where it has to be, to reduce medical errors and provide better quality.
By focusing on information technology we can reduce costs. That's in the bill.
Also, the bill contemplates rooting out waste, fraud and abuse, another means of cost reduction. We know that the big questions on costs will be dealt with in the other committee, the Finance Committee, but there are elements in this bill that, in fact, reduce cost.
Secondly, the bill preserves choice. If you like what you have and your insurance plan and the coverage you have, you can keep it. There's no reason why that should change and it won't change under this bill. But if you don't like the coverage you have we want to give you options and we also want to give you an option in coverage if you obviously don't have any health insurance at all. So it does reduce costs, it does preserve choice.
Thirdly, it will ensure quality, affordable health care for the American people. We believe, I believe, and I think most people in the United States Senate believe, you ought to have the option of not just any health care but quality care that is affordable, that you can actually make work in your own budget.
So we're going to build on the system that we have and we're not going to throw the old system out we're going to build on the system we have and make it better.
We're also going to make sure in this legislation that we protect the patient-doctor relationship. There's no reason why anyone should get between those two. This bill will not do that.
Finally, and this is just a quick summary, I know, but finally we will make sure at long last a preexisting condition does not prevent you from getting the kind of quality health care you have a right to expect in America today. And as we move forward on this legislation I wanted to make sure we highlight the fundamental obligation we have, not just in the bill but especially in the bill, but even beyond this legislation and that is the obligation we have to get this right for the American people but to get it right especially for our children.
The presiding officer knows that the great progress we made this year on children's health insurance. Thank goodness we got that done. Instead of having six million kids in America covered by the children's health insurance program we're, by way of the legislation we passed this year, we extend that to almost 11 million kids. That was wonderful, and a big success. But it is not enough. We have to make sure the other five million children out there who don't have coverage today will get it. But especially for a child who happens to be in a poor family, a low-income family or a child with special needs.
Here's what the rule ought to be. This is what should happen throughout this process of enacting health care reform but certainly at the end of the road, so to speak.
Ideally, this fall, when we pass a bill that the president can sign. The rule ought to be no child worse off and especially "no child who is poor or has special needs is worse off."
A great line from the scriptures that talks about a faithful friend. We have heard this over many years in the context of friendship and the context of sometimes a reading at weddings. But I like it for today to think of it in the context of our children.
This is what the scriptures say: a faithful friend is a sturdy shelter, a great image about what friendship means. There are a lot of us, day in and day out, year in and year out who talk about how important children are to us; that we are advocates for children. And we should be; that we have solidarity with our children. We're going to do everything we can to protect them. We are saying we're their friend -- that those of us who are elected to public office have an obligation to be a friend, an advocate for our children.
I go back to the line from scripture, if we are going to be a faithful friend to children we better make sure we provide a sturdy shelter, not just in the context of the obvious meaning of shelter but in this case the meaning of shelter in the context of health care. What is more fundamental than that? Other than making sure a child has enough to eat, making sure a child has the opportunity to learn, other than those two, health care is essential in the life of a child especially a vulnerable child whether they're poor or have special needs or both. So if we are faithful friends in the United States Senate to our children we better provide that sturdy shelter, and we better make sure that at the end of the day these children are not worse off because of our legislation.
I want to conclude with a thought from an expert, not someone who's just interested in children but someone who has an area of expertise which is probably unmatched. I'm speaking of someone who testified last week, a week ago today, it was, in front of our committee. Her name is Dr. Judith Palfrey, a pediatrician, a child advocate, and just happens to be president-elect of the American Academy of Pediatrics. She provided compelling testimony and I won't go through all of her testimony, but here is something she said which I think has relevance for the debate we're having on health care.
She says, and I quote, “Sometimes, we as child advocates find it hard to understand why children’s needs are such an afterthought and why, because children are little, policymakers and insurers think that it should take less effort and resources to provide them health care.”
Because children are little we think less effort is required or fewer resources are required. Well, none of us really believe that, do we? We don't really believe that?
Children, the health care we provide them, the protection, the shelter we provide them, should be every bit as significant, every bit as fully resourced as the protection and help we give to adults. I think we all believe in this chamber children may be little but in God's eyes they're seven feet tall and we must treat them accordingly especially on legislation so significant as legislation on health care reform.
So the rule ought to be: no child worse off. That simple. And I believe we can get it right.
This is a great challenge. We understand that. We understand the difficulty. This is a great challenge but it's a challenge worthy of a great nation. And it's a challenge that will help us in our continuing struggle, our continuing journey to make it a more perfect union.
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