Congressional Budget For The United States Government For Fiscal Year
Mr. President, this week the Senate focuses on the Federal budget and folks at home are going to hear a lot about reserve funds and reconciliation and a lot of other technical budget lingo. A reserve fund, for example, is not some kind of…
Mr. President, this week the Senate focuses on the Federal budget and folks at home are going to hear a lot about reserve funds and reconciliation and a lot of other technical budget lingo. A reserve fund, for example, is not some kind of checking account where you can go get a bunch of money to spend on Government programs. It is more like a work plan that is used to structure how difficult policy judgments are made on important issues.
Budget reconciliation is perhaps even more incomprehensible to folks. That is why I want to spend a few minutes this afternoon talking about what it means, particularly in terms of health care reform, which we all understand is a particularly pressing domestic concern. Budget reconciliation, strictly speaking, means reconciling Government policy with budget targets. If you were to pursue health care reform using budget reconciliation, you would, under the Senate rules, need only a majority vote here in the Senate as opposed to 60 votes, which is often needed in the Senate to cut off debate. So Senators now find themselves being buttonholed by reporters for something of a health care interrogation. The question invariably is, is a Senator in favor of using reconciliation for health care reform?
The theory, I gather, is if a Senator is in favor of using budget reconciliation, the Senator is just in favor of bullying health care reform through the Senate with a narrow majority. And somehow, if a Senator is not for using reconciliation on health care reform, that Senator is not sympathetic to the cause of fixing the American health care system.
It is my view that, like most of these kinds of issues, this is vastly oversimplifying the case. In my view, I have spent more than 5 years trying to make the issue of reconciliation on health care irrelevant. Senator Bennett and I, for example, have teamed up, now joined by 14 colleagues of both political parties, evenly divided, because we believe it is critically important to address this issue of health care reform in a bipartisan way.
Every time we talk about this issue, we talk about our desire to work with the chairman of the Finance Committee. I see the ranking minority member on the floor, Senator Grassley. It is our desire to work with Chairman Baucus and Senator Grassley and Chairman Kennedy and our colleague from Wyoming, Senator Enzi. Everything we have worked toward in this area of health care reform has been pointed toward the goal of making reconciliation irrelevant because we wish to be part of an effort, working with Chairman Baucus and Senator Grassley and Chairman Kennedy and Senator Enzi, on a path to getting 68 to 70 votes here in the Senate so we can have an enduring and bipartisan coalition in place to fix American health care.
I will tell you, on the basis of visiting most of our colleagues in their office to listen to them on the issue of health care reform, I think it is possible to find a path to 60 to 70 votes on this critical domestic question. I think there is a growing consensus here in the Senate that both political parties have been right on major concerns they have about American health care. I think there is a growing awareness that our party, the Democratic Party, has been right on the issue of ensuring that all Americans have good quality, affordable coverage. If you don't do that, what happens is the people who are uninsured shift their bills to the insured and they shift the most expensive bills. So you cannot fix this system unless you get all Americans good quality, affordable coverage.
I think Republicans have had a very valid point with respect to giving flexibility to the private sector on the issue of health care. It is important, so as to not freeze innovation, to make sure there are not price controls, there are not global budgets so there are plenty of private sector choices, the way Members have with respect to this issue. It is something of a philosophical truce. Democrats have been right on the issue of making sure that you expand coverage to stop the cost shifting and deal with the question of holding down costs which is so important to American business and tough global financial markets. And Republicans have had a valid point with respect to the role of the private sector.
I think there is a growing consensus about how, if you are going to contain costs in American health care, you have to go to areas that change the incentives, that drive the behavior in American health care. Right now, most individuals don't even have a choice with respect to their health care. If they are lucky enough to have employer-based coverage, they don't get a choice. So they are already in a position, in my view, that is not fair and certainly is not in sync in a way that works for the Members of the Senate. The distinguished President of the Senate and every other Member come here and get plenty of private sector choices for their health care, and I think there is a growing sense here in the Senate that those kinds of choices ought to be available to all Americans. Fourteen Senators are behind legislation that would do that. I point out the very fine white paper offered on American health care by the distinguished chairman of the Finance Committee envisions Americans having more choices for their coverage, the way Members of Congress have.
We are going to talk about a lot of issues this week with respect to the budget. You are going to hear a lot about reserve funds and reconciliation. I hope that as colleagues go through this topic and issues related to it, the rules with respect to how you are going to pay for American health care, I hope there will be a recognition that a lot of Senators wish to make the issue of reconciliation on health care irrelevant.
Senator Bennett and I, for example, have received a report from the Congressional Budget Office--it is on my Web site--making it clear that our proposal is revenue neutral 2 years in and in the third year starts bending the cost curve downward. The way we get those savings, in most particulars, is through approaches that Chairman Baucus has advocated in the white paper I have mentioned here on the floor.
There are plenty of opportunities for finding common ground on this budget, on bringing Democrats and Republicans together on key issues such as
health care, on making the whole question of reconciliation go by the boards because Democrats and Republicans have come together.
I want to close by commending Chairman Conrad for the approach he has taken with respect to the budget and for his desire, particularly, to work in the health care area of the budget in a bipartisan way. He worked with me, for example, on the issue of suggesting in the budget that periodic reports would have to be made with respect to health cost containment. That sends a strong message that the Senate is not going to wait around for 10 years or so to see if there are any savings. Chairman Conrad has added language to make it clear that on an ongoing basis there should be an effort to wring out savings from the existing $2.5 trillion being spent on American health care this year. Chairman Conrad does not want to sit around and wait for 10 or 12 or 15 years to see if anybody can save some money on American health care. He has picked up, as the Congressional Budget Office said in their report to Senator Bennett and me and our colleagues, there are savings that can be made over the next few years.
There is enough money being spent on American health care today. It is not being spent in the right places. This year we will spend $2.5 trillion on health care. There are 305 million of us. If you divide 305 million into $2.5 trillion, you can go out and hire a doctor for every seven families in the United States. You could hire a doctor for every family in the State of Virginia or Oregon or elsewhere, pay the doctor $225,000 a year, and invariably when I bring this up to physicians, they say: Where can I go to get my 7 families?
We spend enough on health care. We don't spend it in the right places. Chairman Conrad, by approaching the health care issue as he has in this budget, allows us to first focus on the savings that can be produced out of the existing $2.5 trillion. I commend Chairman Conrad for working with us in that fashion.
I also commend the ranking minority member for his work on health care as well. He is a cosponsor of the Healthy Americans Act and has made it very clear that he wants to work with Chairman Baucus and Senator Grassley and Chairman Kennedy and Senator Enzi so that we bring the Senate together in a bipartisan fashion.
There is much to work with here. As Senators do get buttonholed by reporters with respect to the issue of whether they are in favor of using reconciliation for health reform, I hope Senators will see that this is not a yes or no answer but that there is a large and bipartisan group of us who want to pass health care reform this year on President Obama's timetable--this year--but we want to do it by bringing Democrats and Republicans together and making the issue of reconciliation on the issue of health care reform irrelevant.
I yield the floor.
I suggest the absence of a quorum.