November 21, 2009

In Senate Speech, Whitehouse Speaks in Favor of Making Affordable Health Care a Reality for All Americans

Washington, D.C. – As the Senate continues the debate on legislation to reform the nation’s broken health care system, U.S. Senator Sheldon Whitehouse (D-RI) spoke today on the Senate floor in favor of making quality, affordable health care a reality for all Americans and noted the extreme similarities between Senate Republicans’ and the health insurance industry’s opposition to reform.

Full text of Whitehouse’s remarks, as prepared for delivery, is below.

Madame President, I rise today to speak about the impact of our appallingly designed health care system on individuals – people with families and hopes for the future who have been ambushed by illness.

When we think about our huge health care system, comprising a sixth of our economy and involving thousands of players, it’s easy to lose sight of its entire reason for being: to make people healthier. Doctors, hospitals, insurance companies, drug companies, medical devices manufacturers….all exist to serve a specific individual, who arrives at a doctor’s office or hospital on a specific day, needing specific advice or treatment.

At these moments, we are often at our most vulnerable. Perhaps we don’t know what’s wrong with us, and imagine the worst. Perhaps we face a grim prognosis and are desperate for hopeful news about treatment. Or perhaps we worry about what will happen to our loved ones, our children, our parents, and others who depend on us.

An intelligent health care system would treat these moments with care and delicacy. A humane health care system would treat these people with reverence and respect. But too often, our health care system treats the moments as a profit opportunity, and the patient as a commodity.

I say this with a deep appreciation for the world-class, warm-hearted, and attentive care that our doctors, nurses and health care professionals provide. In almost every case, it is not health care providers themselves, but the outmoded system in which they work, that is to blame.

A few weeks ago, I talked about how one of my dearest family members fell victim to this system when his insurance company tried to deny him state of the art treatment, prescribed by a world class physician from the National Institutes of Health, on the grounds that it was “not the indicated treatment.”

Today I want to share another story about a person close to me – a member of my staff, Richard Pezzillo. Rich has hemophilia. While Rich has gotten the treatment he has needed so far, he’s been lucky. But luck shouldn’t enter the equation. His story vividly illustrates the need for comprehensive reform.

In 2003, after experiencing a turbulent flight, Rich unfastened his seatbelt from the airplane, collected his things, and walked out of the airport, and suddenly started to feel tremendous pain. He started vomiting blood. Simply wearing his seatbelt had caused Rich to bleed internally, inside of his stomach, eventually requiring that his gall bladder be removed.

This kind and thoughtful young man from North Providence, RI was hospitalized in very serious condition and spent roughly 3 weeks in the hospital. Thankfully, he received excellent treatment and, today, he works in my office in Washington. The doctors, nurses and hospital staff in Rhode Island gave Rich the best treatment. He now leads an energetic, vigorous life – and works a challenging job.

But the most stunning part of Rich’s story isn’t his treatment. It’s his treatment’s cost –

$1.5 million.

We’ve heard a lot of talk around here lately about how burdensome it is for members of Congress to make it through a 2,000 page long health care bill. How about dealing with Rich Pezzillo’s one and a half million dollar health care bill? That’s the excessive bill that lies at the heart of health care reform, and the one we should be concerned about here in the Senate.

The hard truth is that Rich was able to get life-saving treatment because he was lucky – since he hadn’t graduated from college, he was still covered by his parents’ insurance policy. Because he was covered, the hospital only charged his insurer less than half of its total cost. Such is the bargaining power that those in a large insurance pool have over large health care providers.

What if things had been just a little different?

• What if he had needed treatment a couple of years later, when he wasn’t on his parents policy and couldn’t afford his own?

• What if he applied for his own coverage but was denied by an insurance company because his illness was deemed a preexisting condition?

• What if Rich’s father had lost his job and his health insurance along with it?

• Or what if Rich’s parents’ policy had a limit on benefits, and they had to pay the rest of that $1.5 million out of pocket?

In these situations, Rich would have been a victim, not only of his illness, but of the health care status quo. If he or his family had been uninsured, they almost certainly would not have been able to afford the full care that Rich needed. And their financial future would have been irrevocably altered — probably ruined.

Luck – is that any way to run a health care system?

Unfortunately, Americans need all the luck they can get when dealing with health insurance companies, who use every bit of their bureaucratic guile and financial might to delay and deny health insurance benefits that they’re obligated to provide.

For example, in March 2006, the Arizona Department of Insurance ordered health insurance giant United Healthcare to pay fines of more than $364,000 – the largest in the department’s history. Regulators found that the company illegally denied more than 63,000 claims by doctors without examining all of the information needed to accept or deny a claim.

And in January of 2008, California insurance regulators found that a subsidiary of United Healthcare had committed more than 130,000 violations of law in handling claims. For example, the company inappropriately denied more than $750,000 in claims on the grounds that insureds had a preexisting condition. The regulators found that the company “made large scale and willful decisions to use broken systems to process claims and respond to providers, while continually and effectively collecting premiums.” The total potential liability of the company for all violations — $1.3 billion.

United Healthcare CEO Stephen Helmsley made $3.2 million last year and holds almost $120 million in stock options.

The health care reform bill that we debate today would right this massive power imbalance. It would empower average Americans to take control of their health and their financial future. Rather than taking their health insurance premium dollars to the casino, Americans could take them to the bank.

Unfortunately, many on the other side of the aisle wildly misrepresent both the status quo and how reform would empower consumers. To them, the system as it currently exists is a fair, open, transparent marketplace, where informed, empowered consumers shop at a leisurely pace for their health insurance plan. Do you recognize that reality? I do not, and my constituents of Rhode Island – thousands of whom have written, called or spoken to me about their frustrations with the current system, do not.

They opponents of reform, however, depict our bill as an Orwellian takeover of the system. Madame President, let me close with a story that illustrates how bitterly ironic – and completely wrong — these hysterical cries of “death panels” or “government interference” really are.

In 2000, Christiane Hymel – insured by a subsidiary of Blue Cross and Blue Shield of Louisiana – scheduled an appointment for a routine physical. During the examination, she reported to her doctor her history of back pain and weakness in her legs over the past year and a half. Her doctor ordered x-rays of her spine and referred her to a neurologist.

The neurologist, after detecting troubling symptoms, ordered an MRI. In accordance with Mrs. Hymel’s insurance policy, the doctor sent Blue Cross a request to pre-authorize the MRI. The day before the MRI was scheduled, Blue Cross denied the request on the basis that the service was for a pre-existing condition — Mrs. Hymel’s back pain.

Mrs. Hymel appealed the insurance company’s decision in accordance with the terms of her policy, but Blue Cross never processed that appeal.

After Blue Cross denied coverage for the MRI, Mr. and Mrs. Hymel were told that the MRI would cost them approximately $4,000.00. It took them three months to save up the money necessary to pay cash for the procedure, but they were eventually able to pay for it out of pocket. After three months.

The MRI showed that Mrs. Hymel had massive tumors involving “nearly the entire cervical and thoracic [spinal] cord,” and she was immediately scheduled for surgery. But again, Blue Cross denied coverage, stating that it was for a pre-existing condition.

Mrs. Hymel’s neurosurgeon later testified at trial that “tumors inside the spinal cord are growing tumors, and as they grow, they cause damage to vital structures in the spinal cord, which are important to walking, sensation, and breathing.” The longer the wait in removing a tumor, the more damage the tumor will cause to the spinal cord. The doctor testified “that two-thirds of Mrs. Hymel’s current condition and disabilities were the direct result of the growth of the tumor during the three to four month delay between the time Blue Cross denied the MRI until the time Mrs. Hymel was able to pay for it herself. Additionally…this delay also caused the tumor’s quick recurrence, necessitating the second surgery.”

In ruling for Mrs. Hymel in her lawsuit against Blue Cross, the court described the consequences of the three month delay in treatment:

Mrs. Hymel testified that when she first woke up from surgery, she could not move her arms or head and she thought she was paralyzed. She felt painful burning sensations in her body … While she was in the surgical ward of the hospital, she contemplated committing suicide. During her hospital stay, she suffered from bowel obstruction, fecal impaction, and had to wear diapers. Mrs. Hymel did not see her children in the hospital until two weeks after the surgery, and when her children finally saw her, they were scared of her and would not touch her. Mrs. Hymel spent approximately eight months in a wheelchair after her surgery.

Mrs. Hymel is house-bound, she cannot take a shower, work in her garden, ride a bike, swim, or drive, as she had frequently enjoyed prior to the surgery. … Mrs. Hymel must also take large doses of medication to relieve the burning and shocking sensations from which she suffers. She cannot be touched on her back or leg, because ‘[t]he second something touches [her] lower back, it’s like fireworks that go off.’

Every day that insurance companies delay or deny payment is another day that they earn interest on your premiums, adding to profits and their massive executive pay packages. When Blue Cross failed to pay for Mrs. Hymel’s MRI, it didn’t just make an error – it made a crass, heartless profit-maximizing decision. Christiane’s story isn’t just a sad tale – it is a symptom of a disease that has spread through the private health insurance system.

For many Americans like Christiane and Rich, our heath care system is a casino where a roll of the dice, or a spin of the roulette wheel, determines one’s fate. Such an irrational and random system does not comport with the society that Franklin Roosevelt described in his 1944 State of the Union:

“We have come to a clear realization of the fact that true individual freedom cannot exist without economic security and independence. Necessitous men are not free men.”

By passing health care reform, we will take health insurance off of the casino floor and make it a reliable part of every family’s economic foundation. No longer will happenstance or chance determine whether a treatment will be paid for. Parents of kids like Rich Pezzillo won’t worry whether their son’s illness could lead him to be turned down for a preexisting condition. Or whether a layoff and lack of insurance could deny their son the treatment he needs.

“Necessitous men are not free men.” Let us redeem FDR’s promise by passing health care reform.


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