[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. ____________________