Sen. Tom Harkin makes remarks on health savings accounts at White House health summit

CQ Transcriptions
Thursday, February 25, 2010; 4:10 PM

HARKIN: Mr. President, thank you again for bringing us together today. I think, if anything, what I have learned here so far is that, quite frankly, we may be closer together than people really think in actually getting agreement that we can move forward on. I hope that's the case.

There's been a lot of figures thrown out here and a lot of process things, but I keep thinking we've got to bring it back home to what this is all about. We all have our stories.

I got a letter yesterday from a farmer in Iowa. It really encapsulate (inaudible).

"I'm a 57-year-old Iowa farmer. I'm writing to voice my concern regarding my family's rapidly escalating health care costs. On Saturday, February 20th, I received a notice from Wellmark Blue Cross/Blue Shield of Iowa informing me that our health insurance premium will be increasing $193.90 per month, to a monthly total of $1,516.20.

"This is a 14.6 percent increase and will result in a yearly cost of $18,194.40 for a family of four. Ten years ago our monthly health insurance premium was $373.50 per month for a similar policy which had a lower deductible and covered three additional children.

"Health care costs are out of control and as a self-employed individual I feel powerless. At the current rate of increase, by the time I reach Medicare age, my premiums will cost $42,000 per year.

HARKIN: "As a farmer, I manage risk on a daily basis, weather, weeds, insects and fluctuating commodity prices. I have not yet found a way to control my exposure to health care expenses.

"Because of pre-existing conditions, I've been denied access to coverage under more economical insurance plans. Therefore I'm stuck in an expensive pool and have few options.

"The best option would be for the U.S. Congress to pass comprehensive health care reform, resulting in affordable health care for all. The health of my family and the future of my small business depends on it.

"Sincerely, Raymond Smith, Buffalo Center, Iowa."

Mr. President, we spent -- I hear talk about, well, we've got to start over and do all this thing again. You know, we spent one year considering a range of ideas from experts from all over the political spectrum. Two committees, the HELP Committee, under the able leadership of Senator Dodd; the Finance Committee, under the leadership and Senator Baucus, held over 100 bipartisan meetings and walk-throughs to discuss this bill. Our bill contains over 147 distinct Republican amendments.

Now, on the issue of health insurance reform. Of the 10 key elements in the House bill, we have nine of them in our bill -- nine out of 10. That's not bad. The only one that's missing is the -- is the health savings accounts. But nine out of ten are in our bill that are in the House Republicans' bill.

Now, again, what are they? You know, again, preexisting conditions -- we've covered that; no rescission when you get sick; no lifetime annual caps, no gender-based ratings; keeping your kids on until they're age 26.

That's in the House Republican bill. That's it's in our bill. So I think we're very -- we're very close on this.

The last two things I just want to address myself to is this idea that somehow we can do a little bit; we can take an incremental type of an approach; somehow we can do insurance reforms but we don't have to do anything else.

Well, quite frankly, if we want insurance reforms, you can only do that if everybody's in the pool. You can only get everybody in the pool if you make it affordable for middle-class families and others. You can only make it affordable for middle-class families and others if you have cost controls.

What I'm saying, Mr. President and others, is this all hangs together. You can't pick one out and do it without doing it all together. It all hangs together.

Cases in point: Some states, in the '90s, tried to do health insurance reform without doing anything else. And they found it to be a debacle because the insurance premiums skyrocketed.

New Hampshire, Kentucky and Washington were forced to repeal their reforms because of that. Case in point, Massachusetts, in the '90s, put in health insurance reforms without anything else. Individual market premiums doubled.

Four years ago, when they did their comprehensive reform and they put the package together, premiums dropped by 40 percent in Massachusetts.

That's why you can't do this incremental approach. Every time I hear about -- you know, we're sinking. We're drowning, in this country, on health care. An incremental approach is like a swimmer who's 50 feet offshore drowning, and you throw him a 10-foot rope. And you say, well, it didn't reach him, but we'll get it back and we'll throw him a 20-foot rope next time. Then we'll throw him a 30- foot and a 40 -- by that time, the swimmer's drowned.

And that's what's going to happen to Ray Smith and so many other families in this country. They're going to drown by the time, if we do this kind of incremental type of an approach that I hear others talking about.

Lastly, I would like to put this in a different kind of a contextual framework. We don't allow segregation in our country on the basis of race, creed, color, national origin, et cetera. Twenty years ago this year, we also said we're not going to allow segregation on the basis of disability, and we passed the Americans with Disabilities Act.

And yet we still allow segregation in America today on the basis of your health. Why should we? Why should we allow that to happen?

It's time to stop segregating people on the basis of their health. That's why insurance reform is so vital, because the health insurance industry in this country is based on a flaw. And the flaw is the ratings are based on segregating people because of their health.

Think about that. Whenever I hear the word "pool," this pool, that pool, this pool, I think segregation. You're segregating people out because of their health status. I think it's time to end that.

I sold insurance. I was an insurance agent when I was a young man. And there's one principle of insurance I learned then that I've never forgot. The more people in the pool, the cheaper it is for everybody. You start setting up these pools, you're going to make it more expensive and you're going to be segregating people on the basis of health. Let's think about that. It's time to stop that kind of segregation in our country.

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