Senator Sheldon Whitehouse provides an update on health care following the August recess

Mr. President, why are we working so hard on health care reform right now? Well, one reason is because the present system is out of control and unsustainable. This is the cost curve of our national health expenditures. In 2009, it hit $2.5 trillion, and it is going to continue to go up to the point where right now it is estimated that in the year 2016--which is not too far from where we are right now--in the year 2016, a standard family policy on average in Rhode Island will cost that family $26,000 a year. A middle-class family in Rhode Island cannot afford $26,000 a year just for health insurance. Something urgent has to be done.

During the 8 years of the Bush administration, it probably increased by nearly $1 trillion, and nothing got done. Our friends on the other side of the aisle were happy as clams with that state of affairs. Now, in the first year of the Obama administration, with more progress made on health care than at any time since back when the Clintons tried it, we hear once again the catcalls and the criticisms from our colleagues--anything to stand in the way of progress. But that is why it is so important. We simply can't afford not to do so when we look at the risks our country faces economically.

There has been some criticism of the stimulus bill, the Economic Recovery and Reinvestment Act. This is it right here: $0.8 trillion. From all the noise on the other side of this Chamber, one would think this dwarfed, shadowed the fiscal health of the Republic, but, in fact, it is a tiny little sliver compared to the debt that was run up during the Bush administration. We see that $8.9 trillion is the difference between what the nonpartisan CBO projected when President Bush took office from President Clinton and when President Bush left us when he was done--$8.9 trillion. This doesn't even count the Bush hangover of all the spending President Obama has had to do to help save the banks, to help save the financial system, and to help save the American auto industry.

He campaigned on none of that. None of us wanted to do that. When catastrophe asserted itself, we had to respond. The catastrophe took place not on President Obama's watch but beforehand. He has led this effort to put out the fires. The big risk is the $38 trillion in unfunded liability for Medicare alone. That is part of that climbing cost picture that is driving us out of control.

Of that, the Lewin Group--a pretty respected group around these parts for their opinions on health care--says the excess costs in the health care system add about $1 trillion a year: $151 billion for excess costs for incentives to overuse services; $519 billion for excess costs from poor care management and lifestyle factors; $135 billion a year for excess costs due to competition and regulatory factors; $203 billion a year from excess costs due to transactional inefficiencies.

We can reform this health care system in a way that improves the quality of care, while addressing this $1 trillion in excess costs, which, according to George Bush's former Treasury Secretary, Paul O'Neil, who ran the Pittsburgh Regional Health Initiative and knows something about health care, is associated with ``process failures.''

Process failures can be corrected. One of the ways you can correct them is with a competitive public option. We have had a lock in the main middle market of health care by the private insurance market for all these years. This is what we are left with--$1 trillion in waste from process failures. Obviously, they failed at the job. They have catastrophically, indisputably failed.

All we ask is to put a public option in side by side to compete with them--in the same way a public option in workers' compensation insurance competes in Senator McCain's home State of Arizona with the private insurance providers in workers' compensation. I don't hear complaints from him about the business community and the workers' compensation.

In the home State of Senator Ensign, Nevada, there is actually a single-payer public option for workers' compensation health insurance, and his employers seem absolutely fine with it. So it is not as if it is some strange, bizarre idea out on the fringes; it is a way of doing business in some of the home States of the opponents of this.

Our colleagues and their predecessors in this Chamber opposed Medicare when it was first proposed. Now it is probably the most popular program in the country. We have seen them in this Chamber fighting against children's health insurance. It was only thanks to our beloved colleague, Senator Kennedy, coming back from his sick bed to cast the tie-breaking vote, that we actually were able to win that against Republican opposition.

The ideas they have seem, to me, to be abject failures. One is to continue the lock for private health insurance companies so they are the only place you can get coverage, unless you are old enough for Medicare or you qualify for Medicaid or you are in the military. That is clearly not a sign of success.

As Senator McCain indicated, it would be good to be able to cross State lines and buy insurance from out-of-State insurance companies. Yes, look how well that turned out for us with the credit card industry. We just had to pass legislation, thanks to Chairman Dodd, to rein in the abuse and practices of the credit card industry because you can go to practically unregulated States and get credit cards that don't have basic consumer protections.

We don't want to see that in health insurance. We want careful, thoughtful local regulation of health insurance. We have 100,000 people who are killed every year by medical errors--and who knows how many injured--and the solution our friends across the aisle see is to take away the damages that the worst injured Americans are entitled to. That is how the reform they proposed in the HELP Committee works. It cuts damages, caps them, meaning it only would affect the people for whom the damages are the highest, who are harmed the worst, who would disproportionately be women because of the way it was organized, focusing on economic damages. So if you take a system where you kill 100,000 Americans every year because of medical errors--and injure who knows how many more--and your solution to the problem is to put the cost of it entirely on the backs of the worst victims of that error and injury, I think that is a mistake.

We would prefer, as Democrats--and I think as rational people--to reduce the incidence of malpractice and error, reduce the errors of malpractice claims by reducing the incidence of malpractice and error. We put enormous effort in this bill into putting structures into place to allow that to happen.

In terms of the real fear people heard when they went back home, it was a little disingenuous when that fear was whipped up by our colleagues with false statements about death panels in the legislation, how this was socialized medicine, and how a bureaucrat would jump in between you and your doctor if the bill passed. That is patently false. It spread like wildfire. Who wouldn't be afraid of those things? Now they observe there is real fear out there. I also had the opportunity to travel around my State during this break, similar to many colleagues, and I sat down with my constituents and heard what they had to say about health care reform. I sat down with hospital executives; pediatricians; OB/GYNs; family physicians; critical care doctors; the State medical society; health insurers; CVS, the pharmaceutical chain that makes its home in Rhode Island; the Rhode Island MS chapter; business community leaders; members of our Rhode Island quality institute, which is reforming health care at the State level and it gives great leadership to our country right now; and with members of all walks of life who have come together and are working tirelessly to help build our State's information technology infrastructure.

I learned a great deal from those individuals and institutions. I learned a great deal also at two community dinners I held in West Warwick and in Johnston, RI, where hundreds of Rhode Islanders came out to join me and our senior Senator Jack Reed, not only for spaghetti and meatballs--and they were good. I think I might be the only Senator to introduce meatballs into the town hall formula, and it worked fine. They were for a serious, civil, and constructive debate on the state of our current health care system. It brought out some stories I wish to share quickly this afternoon.

The first story is about Christine, who is a wife and mother, from Coventry, RI. Her family's struggle to maintain health insurance has left her and her husband with very difficult choices and few options. In 2007, Christine was diagnosed with multiple sclerosis. Shortly thereafter, she lost her job. She was shifting the family's coverage to her husband's employer, when her husband was laid off as well. That left Christine and her husband and their 6-year-old son with no health insurance. Still reeling from those bits of bad news, Christine and her husband were faced with decisions no one should be forced to make. Without medical insurance, with no affordable options for health coverage because of Christine's preexisting condition, they faced a choice now of leaving their home--think about that. You have a 6-year-old son who might lose his home--or paying for health insurance. At the moment, they cannot see a way to manage both.

As Christine told me: "I don't want any handouts. Unfortunately, life has handed me and my family a difficult path, and right now my family needs a little help. We should not have to make a decision between our health and our financial stability."

Until her husband finds a job, Christine says that every day they hold their breath and pray nothing will happen because that is all our broken health care system now has to offer them.

I also met Anna from Johnston, RI, who shared the story of her sister Tina. As is the story of so many today, Tina's husband lost his job. Their only option for health insurance was through COBRA. At $1,500 a month, on top of mortgage and car payments and groceries, Tina knew, financially, this coverage was unsustainable. Finally, she had to give it up.

Shortly after dropping coverage, Tina began to lose weight. Anna explained that, at first, she thought her sister's weight loss was a reaction to the stress of the family's financial situation. But then the weight loss continued, and they realized something was seriously wrong. Despite urging from her family, Tina resisted going to the doctor because she was afraid the medical bills would make a very difficult financial situation unbearable.

Eventually, Tina felt so sick they called the ambulance, and she was taken to the hospital. Tina died 3 days later of a heart attack, complicated by bone cancer and diabetes. When Anna talked to the doctor who treated Tina, they asked the family why Tina had avoided coming to the hospital for so long because, with proper early intervention, her sister's conditions would have been treatable.

Anna told me she understands people get sick and die, but the manner in which her sister passed away was tragic because it didn't have to happen.

Over the August recess, I also heard from Rhode Islanders through the health care storyboard I ran on my Web site. Two of the stories are remarkable.

The first is from Ken, a recent Rhode Island College graduate from Greenville. He worked hard, dreaming he would be the first in his family to achieve a college degree. A year after graduation, Ken has that college degree, but he cannot find a full-time job with health insurance benefits. In this difficult economy, he works two part-time jobs at minimum wage, and he has no health benefits.

Ken wasn't looking to make a six-figure salary after graduation, but he was looking to be able to get by. On his current income, he has difficulty making ends meet with his day-to-day expenses, and he says it will take years to pay off his student loans at this rate. On such a limited income and in this situation, health insurance is simply not an option for Ken.

Ken is discouraged and frustrated. Despite his hard work and achievement, he knows that at any moment he is one sickness or injury away from thousands of dollars in debt or ruined credit that would affect his chances for a prosperous future. He has worked for everything he has earned, but health care costs are so high he is scared about his future, if nothing is done to fix our health care system.

Last is Beth, a small business owner in Providence. She and her husband have two full-time and two part-time employees. They find themselves at the whim of insurance companies. Because they don't have the bargaining power to negotiate the terms of their health insurance package, they have seen 41 percent increases in their insurance rates for 2 years in a row.

Beth told me the cost of health insurance is breaking the backs of small entrepreneurs, those critical drivers of innovation and building blocks of our Nation's economy. She doesn't understand how or why anyone would start their own business under the deep financial burdens imposed on small business by our current health insurance system.

Beth also cannot afford health insurance coverage for her twin 3-year-old girls. Beth admits she is terrified about what might happen to them without the safety net that health coverage offers. She urges us to work quickly toward reform so others do not have to struggle with the same fear and frustration as her family.

The Senate has been working hard on health reform legislation since the very beginning of this year. The process is trying and tiring and extremely complex. As we turn up the heat even more the next few weeks and become mired in the intense process of drafting a final bill and getting it to the floor, I urge my colleagues to remember health care reform is not about the interest groups, it is not about parliamentary procedures, it is not about secret meetings, and it is not about CBO scores. Reforming our health care system in America is about Christine and Tina and Beth and Ken and thousands like them in every one of our States across the country. And it means injecting some fairness and some reason into a system that has punished the sick, rewarded the greedy, and discouraged those who try to do the right thing.

For me, these stories reinforce the urgency of what we need to get done in the Senate. I am fully committed to completing this task, as I know the Presiding Officer is, and I look forward to getting it done over the next few weeks.

In closing, let me just say this is the first time I have spoken on the Senate floor since our colleague, Senator Kennedy, has left us. His desk is three down from me. I don't know if the camera shows it now, but there is a black drape over it and some flowers and a copy of Robert Frost's ``The Road Less Traveled.'' I know this poem meant a lot to him, and he certainly meant a lot to me as a very gracious mentor with vast experience who could easily have ignored a new colleague. But he took an interest, and I will never forget his kindness to me.

We all will miss his booming voice. He could fill this Chamber with his voice. We will miss his rollicking good humor. No one enjoyed life and enjoyed his colleagues more than the senior Senator from Massachusetts. We will miss his masterful legislative skills as we try to work our way through the obstructions the other side will be throwing up against progress on health care reform. His wise voice and counsel will be missed.

Finally, we will miss his lion's heart. He knew when the fight was right, he knew when it was worth fighting for, and he was in it to win it.

Ted, God bless you. We miss you.

I yield the floor.