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Health Summit 2010

Rep. Steny Hoyer makes remarks at White House health summit

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Thursday, February 25, 2010; 12:10 PM

HOYER: Mr. President, thank you very much. A quote I will use is "we should have available and affordable health care to every American citizen, to every family."

I suppose there are a whole lot of every Americans and American families listening to us today and watching us. And they're hoping that we're all sitting around here talking about them, not about us. That's the message they're sending to all of us. And they're absolutely correct.

And we believe that we have been addressing them and trying to get some of these stories that all of us hear to a place where they won't be so tragic for individuals and for families.

Every one of us has a story. I had a message on my telephone answering machine just a little while ago, a couple weeks ago. A woman that I know well called me up. She said, "Steny, I was just diagnosed with a tumor. And I've got to be operated on. I don't have any insurance. My husband makes $28,000. I work part-time and make about $5,000."

She says, "We're making too much money for Medicaid, and we're going to go to the University of Maryland hospital. They want 50 percent down of a $25,000 bill."

She doesn't have that. And we're working on that, trying to get her some additional help. Hopefully we can.

I had a small business in my district, like all of you, who last year paid $1,100. A couple, healthy. Paid $1,100. Their bill is going to go up to $1,830 -- one thousand eight hundred and thirty dollars -- next year. That's a 67 percent increase.

They called me up and said, "We don't know that we can afford to keep our small business going."

So all of us -- John McCain, my good friend, that was your quote, as you probably recall, in the debate that you had with President Obama. And the good thing was that both of you in effect said the same thing: That we need to get to the objective of covering all Americans and having them have access to affordable health care.

We agree with that. I think probably everyone around this table agrees to it. So what we're going to talk about is the how. Cost containment is clearly one of those issues that we need to deal with. Cost containment for that small business that is having a 67 percent increase. Cost containment for that woman who can't afford insurance but has a health care issue that she can't avoid. It's not optional for her. So we have to deal with that.

Many in my caucus believe that one way of doing that is to increase competition and have an open, free market that is transparent. I think all of us around this table agree that a free market does that -- an open market, a transparent market, where people could compare prices and compare what they're going to get.

And that's what we've tried to do in both these bills. We did it a little differently, but that's what we tried to do. We hope we can get agreement on doing that. An open, transparent market will bring down costs, we believe.

And, in addition to that, Senator Coburn, we certainly agree with you that $1 in $3 is not being spent as effectively as it should be. And we have a lot of provisions in both bills, as you well know, that try to get us to a place where administrative costs, health information technology, so many other things are done to wring the costs out.

And, in addition, you speak eloquently and correctly about wringing fraud, waste and abuse out of this system. I know you're happy to have seen in our bill -- in the House bill -- and in the Senate bill, very substantial investment in doing just what you suggest.

So I think we have agreement on conflict of interest in delivery of medicine as well. We've dealt that -- with that in our bill. We've dealt with it previously, as you well know.

We've put in incentives for prevention in here, which you mentioned. We absolutely agree on that. We think this bill does that.

Now, you may have a better way of doing it, when you talk about how that better way is. But we certainly have addressed the issue of making sure that we have wellness as a focus, not sickness.

We have to deal with sickness, but what we really want is wellness. So we've worked very hard on that in this bill.

You mentioned the school lunch and food stamp programs. I'm sure we can get there, too, an agreement. We certainly agree with the premise you stated. We'll figure out the way and means to get there.

What have we done? We've stopped premium discrimination. That clearly ups cost. If you're in a small market, as the president pointed out, you're going to pay a higher price.

We don't do that. Why? Because we're in a big market. We have the competitive edge, and the insurance company doesn't have preexisting conditions for us. They just take us as a group.

That's what we're trying to get for every American. That they have access to a large group, whether they're an individual, this woman who has the tumor, or whether they're a small business, they can get into a large group. We're trying to do that.

We want to go after fraud, waste and abuse. I reiterate that. Transparent market. Stop premium discrimination. And make sure that people with a preexisting condition, as none of us have a problem with, but a lot of people do have, because we're in a big group, that are in a large group. And we prohibit that. You agree with that rhetorically. Now, it's not in your legislation, but you certainly agree with capping out-of-pocket expenses on an annual basis or a lifetime basis that you don't think that's right, that people ought to be continued to be covered.

We believe there needs to be better coordination of care. You're a doctor. You have a number of doctors in the room. We believe that there ought to be a way that we can incentivize the coordination of care.

We also believe that there should be incentives to provide care based upon best practices, not based upon simply procedures being reimbursed. I think we all agree on that. You're shaking your head in agreement. And I know we all agree on that. And, you're right, we have to get there.

But I would suggest to you that one of the things that many in my caucus felt very strongly about in terms of competition was having a public option. Now, there was real disagreement on that issue. But many in my caucus thought that would open up competition, would provide for access for every citizen, if they didn't have access in some other way. Now, Senator Baucus is going to speak more specifically in terms of our cost containment, but doughnut hole certainly is one of the issues that we need to deal with. Doughnut hole, we deal with in our legislation in the House, and we would hope that it is in the legislation that we agree upon.

HOYER: Because seniors are confronted with extraordinary out-of- pocket costs for a very significant portion of the cost of their prescription drugs. And seniors are concerned about that we take care of that in our bill.

But I think what the American public that's listening and watching expects us to do, Mr. President, is what you're doing, bringing us together, coming to agreement to make sure that we get to a place where we reach the objective that President Obama and Candidate McCain expressed as the objective on behalf of the American people.

Thank you, Mr. President.

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