[Congressional Record Volume 140, Number 68 (Thursday, May 26, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: May 26, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
             THE ESSENTIAL COMPONENT OF HEALTH CARE REFORM

                                 ______


                          HON. JOHN D. DINGELL

                              of michigan

                    in the house of representatives

                         Thursday, May 26, 1994

  Mr. DINGELL. Mr. Speaker, I commend to my colleagues the following 
editorial dated April 25, 1994 which I read in the Detroit Free Press. 
It speaks to the single most essential component of true health care 
reform--universal coverage. While my colleagues sort through and debate 
various financing mechanisms and timetables for reform, I urge them to 
remember that without universal coverage, any reform measure that 
Congress passes will only institutionalize the worst parts of the 
status quo.

   Health Care--Boldness and a Single-Payer System are Best Medicine

       Congress has plunged into health care reform with a 
     vengeance, vastly increasing the chances that a viable bill 
     will emerge this session. Such key Democratic players as 
     Senate Majority Leader George Mitchell and Rep. John Dingell 
     of Michigan are working hard to deliver on Bill Clinton's 
     promise of universal coverage--although not necessarily in 
     the form the president first proposed.
       If we could add two words of advice to the millions they're 
     already getting, they would be these: Be bold. Cut through 
     the complexities, flummox the lobbyists and go for a single-
     payer system. That's still the simplest way to deliver 
     universal coverage, even at this late date in the debate.
       Mr. Clinton might usefully cast his eye north from 
     Washington to Canada, where such a system seems to work just 
     fine. Opponents of dramatic reform like to cite anecdotes 
     from Canada about long waits for doctors and about treatments 
     delayed or denied. But every horror story out of Canada 
     probably can be matched by ten from the United States.
       At least under the Canadian system, poor people don't clog 
     emergency rooms for lack of care elsewhere, running up gilt-
     edged hospitals bills for common ailments. Hospitals aren't 
     forced to swallow or sneak onto the bills of the well-heeled 
     or well-insured the cost of providing indigent care.
       Canada doesn't have millions of people who live in sheer, 
     unabashed terror of getting sick or being fired and losing 
     their health insurance. And it doesn't bear the stigma, as we 
     do, of having the worst infant mortality rate in the 
     developed world.
       The chief arguments against the single-payer system come 
     from the billing bureaucracy, that legion of insurance 
     companies and others who earn their living by selling, 
     administering, marketing or servicing the health care 
     industry. They eat up 15 to 20 percent of the U.S. health 
     care dollar before the first aspirin is prescribed. And they 
     are heavy contributors to the congressional campaign coffers.
       If Congress can't resist their blandishments, it should at 
     least incorporate into any reform plan the best features of 
     single-payer: simplicity, universality, portability and 
     choice. Reform also needs to protect incentives for medical 
     research, to be wary of octoploidal cost control measures, 
     and not to lay too great a burden on employers.
       The president and Congress do need to be more frank about 
     costs and how to spread them fairly. Otherwise, they risk the 
     kind of backlash that panicked Congress a few years ago into 
     rescinding an otherwise estimable catastrophic health care 
     plan.
       But President Clinton deserves credit for getting reform on 
     the table and creating a groundswell for universal coverage. 
     We doubt that Congress will dare back off from that principle 
     now, no matter how many lobbyists or what blizzard of dollars 
     descends on Capitol Hill.
       Universal care is the last great gap in the safety net. 
     With the help and advice of the wiser heads in Congress, the 
     president may close it at last.

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