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STATE OF ILLINOIS
93rd GENERAL ASSEMBLY
REGULAR SESSION
SENATE TRANSCRIPT
112th Legislative Day 5/19/2004
Text of Bill Resulting Report
SENATOR OBAMA:
Thank you very much, Mr. President, Ladies and Gentlemen of
the Senate. This bill seeks to address what is a growing crisis
all throughout the State. I don’t need to, I think, reiterate
the fact that we have a full-blown health care crisis. When I
first came to the Legislature seven years ago, we already had a
problem with the forty million plus nationally who were
uninsured, the millions in Illinois who were uninsured. But now
what we’re seeing is not only problems among the uninsured,
problems among seniors and their prescription drugs, but we are
also seeing now people who have employer-based health care plans
seeing their copayments go up, deductibles go up and premiums go
up so that all people are feeling the pinch. Geographically, it
doesn’t matter whether they’re in downstate Illinois, City of
Chicago or the suburbs. Black, white, Hispanic and Latino, all
of us are concerned about rising health care costs, and small
employers and self-employed persons are among the hardest hit.
What this bill does is to create a task force that over the next
year will examine mechanisms by which we can expand
affordability and accessibility of health care to all persons in
Illinois. The task force, thanks to suggestions from some of my
Republican colleagues, will be made up of five appointees from
the Governor as well as six from each Legislative Leader. They
will meet and discuss how we can provide more effectively a full
range of preventative, acute and long-term health care services,
provide portability of coverage, provide core benefits to all
Illinois residents, encourage cost savings, cost containment,
and would promote affordable coverage options for the small
business market. Within the bill, it enumerates a number of
issues that the task force should be looking at. There have
been some back-and-forths between myself and the insurance
industry, which was originally concerned that somehow this was a
Trojan horse, to introduce single payer. I want to say on
record that I am not in favor of a single-payer plan. I don’t
think that we can set up that kind of plan, and if we were going
to even attempt to some sort of national health care, that would
have to, obviously, be done at the federal level. What this does
do is to try to figure out how can we at the State level more
effectively address this crisis. With that, I would entertain
any questions or comments people may have.
PRESIDING OFFICER: (SENATOR WELCH)
Is there any discussion? Senator Righter.
SENATOR RIGHTER:
Thank you, Mr. President. Briefly, to the bill. Ladies
and Gentlemen, first I want to thank the sponsor for the changes
-- the two changes that he did make that were in response to
concerns from our side of the aisle in Health and Human Services
Committee. And there isn’t any question that there is a kind of
cloud that surrounds this bill, if you will, because of what it
started out to be. What it started out to be was a mandate on
the State of Illinois that we would adopt some kind of universal
health care plan no later than the beginning of 2007. And what
we’ve seen in this legislation is somewhat of a retreat from
that, but to characterize it as just an open-ended study bill is
not accurate. This tells the task force what it must study and
tells the task force exactly what has to be in the plan. Now, it
may have a little tinkering here or there as far as how it
achieves those points, but it does tell us what’s got to be in
those plans. For those of you, like all of us, who are
concerned about costs of health care, not just quality and
access, but costs as well -- because cost is what drives the
problem, Ladies and Gentlemen. The reason that we can’t keep up
is because health care inflation is double digit. We have an
amendment, Senate Amendment 3, that’s sitting in the Rules
Committee. For those of you who want to say I’m for studying
this problem, there is a study out there. It’s an open-ended
study. It doesn’t tell the task force exactly what it has to
study. It doesn’t tell the task force what it has to arrive at.
And it places an emphasis on controlling costs. Because we can
do everything else we want, Ladies and Gentlemen. It doesn’t
matter who pays the bill. Whether you’re saying that the
physicians are paying it or the -- or the other medical
providers are paying it because of lower reimbursements or the
taxpayers are paying it through the Medicaid program or public
aid or whatever it might be, we’re all paying the bill, and
we’re all paying the bill because we can’t get these costs under
control. This task force should focus on cost containment.
That’s what Senate Amendment 3 does. If you are uncomfortable
with a task force being told exactly what it has to have in its
report, you can vote No and point to something that is on file
that is truly a study bill. I would urge a No vote.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
Just a brief response to Senator Righter, and I know he
didn’t ask a question. But I -- couple of things. One, I will
acknowledge that when this bill came over from the House and I
picked it up, it did have the sort of mandate that the
Legislature would have to come up with something, and that was
something that I worked diligently with the insurance industry,
as well as Members of that side of the aisle, in addressing. It
is now addressed here. With respect to the issue of cost
containment, I just want to point out that what this task force
is assigned to do is to look at a range of issues, one of which
is cost containment. So, the notion, I think -- the
implication, at least, that was set forth by Senator Righter
that somehow we have this open-ended study that doesn’t address
cost containment is simply not accurate. As I read provision (6)
the health care task force is urged to, among other things, look
at how we institute cost-containment measures, because I think
all of us are aware that we can’t expand accessibility and
affordability unless the baseline costs of health care are
curbed. So, I -- I just want to make sure that everybody is
clear here. We have given some direction to the task force in
terms of broad outlines, basic things that people have to look
at. That’s appropriate. If we just had an open-ended study, it
would mean nothing. We want to give some direction to the task
force so that they have some sense of what their assignment is,
but there’s nothing in there that predetermines the kind of
recommendations that they may come up with. They could decide to
come up with a tax credit plan that many on that side of the
aisle would support. They may decide to come up with some other
mechanisms to contain costs. That’s exactly what we -- need
debating, but what we don’t have right now is any kind of sense
of urgency about the extraordinary difficulties that our --
constituencies are experiencing with respect to health care
costs. And I would -- before I urge a No vote -- or, an Aye
vote, let me -- let me go ahead and answer any other questions
people may have.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Harmon.
SENATOR HARMON:
Thank you, Mr. President. I would like to both move the
previous question and speak to the bill. Is that in order?
PRESIDING OFFICER: (SENATOR WELCH)
Yes. Senator Harmon moves the previous question. Without
objection, leave is granted. There are one, two, three, four,
five, six speakers in addition to Senator Harmon. Please
proceed, Senator.
SENATOR HARMON:
Thank you, Mr. President, Ladies and Gentlemen of the
Senate. As a cosponsor of this bill, I rise in strong support.
I -- I’m sure that many of you have the same experience that I
have in my district office hearing from constituents. Health
care is truly a crisis, both directly and as a subtext for so
many other issues that we deal with. I know this has been no
easy task for Senator Obama, but I applaud him for navigating
this bill and building a truly impressive list of organizations
and entities that are supporting the bill. It is -- it is pro-
consumer, pro-business, pro-labor, pro-hospital. It -- it is
quite a list, and I -- I applaud the Senator for being able to
pull together such an impressive list of -- of supporters. And
I’d ask all of my colleagues to vote Aye.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Wendell Jones.
SENATOR W. JONES:
Will the sponsor yield for a question, Mr. President?
PRESIDING OFFICER: (SENATOR WELCH)
Indicates he’ll yield, Senator.
SENATOR W. JONES:
Senator Obama, my question involves if you know how many
people in Illinois are covered - are covered - by private health
insurance.
Senator Obama.
SENATOR OBAMA:
I don’t have those statistics on me immediately, Senator
Jones. What we know is that -- that the rate of increase among
the uninsured who are working - and so, we’re not talking about
those who are covered under Medicaid - but working people who
lack health insurance has grown exponentially over the last
several years and is approaching, I think, one out of every five
working people. Now, I can’t guarantee that statistic is
correct, but there have been recent articles and studies showing
that we’re seeing a growing number of persons who are working
every day on the job, lacking health insurance.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Wendell Jones.
SENATOR W. JONES:
I’d like to get an answer to that question, if we could,
because if it’s -- let’s say it’s eighty-five percent are
covered, that means we’re trying to plan a program for -- for
the remaining fifteen percent. Instead of planning a program
for a hundred percent and put everybody on a government program,
which -- which we know can be expensive and cumbersome and
bureaucratic, try to implement something through private
industry, through tax incentives and tax deductions and those
kinds of things rather than a government-driven program. Thank
you.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
I know we have a lot of questions, but just a quick
response. That’s exactly the kind of information that I think
would be generated from the task force.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Brady.
SENATOR BRADY:
Sponsor yield?
PRESIDING OFFICER: (SENATOR WELCH)
Indicates he’ll yield, Senator.
SENATOR BRADY:
Senator Obama, and I -- I don’t know if you remember this
or not, but this bill first came through the Insurance
Committee. In that committee, you made two commitments. One is
that you would not move the bill on 3rd Reading unless there was
an agreement and no one was opposed to the bill. Second
commitment was that an amendment would come back to that
committee. I think it’s important for the Body to understand
that you made that commitment, both those commitments, and then,
in fact, the amendment that came on this bill went through a
different committee than the Insurance Committee. Now, we noted
that last year. I’d like to hear you respond to it.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
That was essentially a different bill. The -- the -- the
original -- the original presentation of the bill was the House
version that we radically changed - we radically changed - and
we changed in response to concerns that were raised by the
insurance industry. The assurance that I received from the
insurance industry was that if we took out the mandate that the
Legislature would have to implement the bill, then, in fact,
their objections would be lifted. And I got repeated
commitments from the insurance industry to that effect. What
then happened is, after we removed the provisions that initially
had been the source of criticism and made a bill that studies
the problem and does not mandate that the Legislature act on it,
I got a reversal from industry which said, “No, we’re still not
interested in it.” And it was in the face of that obstinance
that we ended up moving it into another committee. So, I’m
happy to stick with my agreements. What I expect is that the
other side do the same. That did not take place in negotiations
with respect to this bill.
PRESIDING OFFICER: (SENATOR WELCH)
Senator -- Senator Brady.
SENATOR BRADY:
Senator, with all due respect to you - and you know I
respect you - a bill is a bill. The agreement was made with the
House committee Members. Two agreements were made: That this
bill would not be advanced to 3rd Reading unless an amendment
came back to our committee and unless there was an agreement -
no opposition. I can’t speak to what you just spoke to. I was
not a party to that. And with all due respect, Senator, I think
you ought to take this bill out of the record based on the
commitment made to the Republican Members of the committee - not
anybody else, but the Republican Members of the committee,
Senator.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
Senator Brady, I, too, respect you. What I don’t respect is
a situation in which there is a unwillingness on the part of
industry to negotiate a bill and go back their word. And I’m not
going to have a situation in which people who are struggling
without health care are held hostage, and are not even willing
to have a discussion about how we solve the problem. If this is
a problem with respect to you thinking that -- that I have
violated my commitment to you, so be it. And I regret that and
will -- be happy to have a conversation about that afterwards.
But what I do know is this: That I made every effort. And
anybody who was involved -- and I would ask that the Chairman of
your committee acknowledge the fact that I made every effort to
negotiate this thing and nothing would move the other side.
PRESIDING OFFICER: (SENATOR WELCH)
Senator -- Senator Brady.
SENATOR BRADY:
Not to paraphrase another piece of legislation, but I don’t
want to beat a dead horse. Senator -- and know I bring humor to
something that probably doesn’t deserve it. Senator, you
control this Chamber. The Democrats control that Chamber. We
think they control the Mansion. You have the right to introduce
any piece of legislation and move it forward. The simple fact
is, this piece of legislation and another one, you made a
commitment to the committee. No one else. I don’t disagree with
the fact that you did everything you could to try to get an
agreement. But the fact of the matter remains, you made an
agreement with us. Alls I ask is you find another piece of
legislation where you didn’t make that agreement, Senator, a
piece of legislation where you didn’t commit not to move it
through another committee, where you didn’t commit only to move
it if we have an agreement. That’s the right thing to do,
Senator. I ask that you do that, and that’s -- that’s my final
comments on this issue.
PRESIDING OFFICER: (SENATOR WELCH)
With -- with leave of the Body, the Chicago Tribune seeks
leave to take pictures. Senator Trotter.
SENATOR TROTTER:
Thank you very much, Mr. President, Members of the Senate.
First, I want to thank Senator Obama, one, for bringing this to
the Floor and -- and for articulating the issue so well and --
and also to understand that this is just a beginning. And all
our other Members should understand this is just a beginning in
trying to address our health care crisis in this State. We do
know -- we don’t know how many people are insured, but we do
know that there’s 1.8 million people uninsured in our State or
underinsured. And that’s -- that’s a big number. Those costs,
the cost of those people being uninsured and underinsured, also
drives up our health care costs in our hospitals and along with
our other providers. There’s a domino effect that’s in place
here because we have so many people in need of health care. So,
if we’re going to look at and really try and tighten up our
budget deficits and -- and looking at what is driving our
budget, well, this is the first -- one of the first places to
look, is the rising cost of health care. We can do that in the
next couple of years with this study, and that’s what this does.
What this will do, it provides access to a full range of
preventive, acute and long-term health care services. What this
bill will do, it will maintain and enhance the quality of health
care services offered to all of our residents in the State. It
provides for core benefits for all of our residents. These are
not special services. This is no Botox and all those other big
cosmetic things that -- that people do now when they have money.
These are core, basic services. It encourages regional and
local consumer participation, and it contains -- yes, it
contains cost-containment measures as well and provides for
mechanisms to evaluate and implement those multiple approaches
to delivery of health care in this State. This is how we start
-- reeling in the cost of health care. This is a wonderful first
start, and I encourage everyone to vote Aye.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
Sponsor yield?
PRESIDING OFFICER: (SENATOR WELCH)
Indicates he’ll yield, Senator Forby.
SENATOR FORBY:
Is there any -- is there any cost to this bill?
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
There are no costs attached to the bill. Other than
subject to appropriations, it says that the Department is
authorized to contract with an independent researcher to help
the task force in terms of gathering the data.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
And there is no mandate in 207 {sic} or 208 {sic}?
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
The only thing that this bill says is that once the plan or
recommendations are released, that no later than 2006, the
General Assembly is strongly encouraged to vote on legislation
that enacts the recommendations or provides for another health
care access plan that meets the criteria set forth in Section
15. It provides encouragement. Does not mandate it.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
Do you see anything in this bill that will hurt the
insurance company?
PRESIDING OFFICER: (SENATOR WELCH)
The only thing that has happened here -- and this is --
this is essentially what happened in this bill. The original
bill on the House side I think would have legitimately raised
some concerns with respect to some industry who might have been
fearful that it was a mandate to introduce a single-payer plan.
I modified this. And I have to say, by the way, just to pick up
on something that was raised earlier, that this is a different
bill number than the original bill. It has gone through a
complete restructuring from the original bill. But that initial
concern, as Senator Righter said, that original cloud continued
over it because industry and industry lobbyists -- insurance
lobbyists here in Springfield had been engaging in such fear-
mongering among its agents, suggesting that this was a single-
payer bill, that, in fact, a lot of concerns were raised that
had nothing to do with the bill that was before the Body today.
And, you know, what I -- what I would strongly suggest is people
take the time to look at the three-page bill that is before
them, as opposed to some of the mischaracterizations of this
legislation that have been raised by others.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
To the bill. As everybody knows in this room, you know,
we’ve had a problem with our health care and Medicaid -- and
Medicaid and our malpractice problems. You know, this came up.
Seemed to me like the -- it came up all a sudden. You know, we
need to stop this and this here will help down the road to take
care of our doctors and our health care. In my district alone,
you know, health care has been a big issue, and we’ve got a
couple doctors down home that’s left already. And without our
doctors down home, you know, I can’t create any jobs. We’ve got
to have hospitals. We’ve got to have doctors. You know, I’m
worried about my people in my district. So, if this will help
create {sic} a problem down the road in two or three years, I
think it’s a pretty good idea, because right now, we should have
been looking at Medicaid -- or, Medicaid and our malpractice
three or four years ago, getting prepared for what we’re having
today. So, I had a little problem with the bill he had first
time, but with this amendment on this bill, I urge everybody to
vote Yes.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Roskam
SENATOR ROSKAM:
Thank you, Mr. President, Ladies and Gentlemen of the
Senate. You know, this concept is really controversial, and I
know the sponsor has worked hard to try to come up with a good
idea and he’s a little bit chagrined that some people don’t like
his idea. That’s because they think it’s a bad idea. And the
premise of the negotiation is basically, “Well, you negotiate
with us, otherwise we’re going to roll you. We’ve got the
power.” And that’s what we’re seeing here, and he’s got the
power. He’s in the Majority, and that’s what’s happening. But
really, make no mistake about it. One of the previous speakers
characterized this as a pro-business bill, and it was sort of in
a long litany of descriptions of pro-labor, pro this, pro that -
pro-business. Well, the folks that are the businesspeople of
Illinois don’t look at it that way, which is why the Illinois
Life Insurance Council is opposed, the Illinois State
Association of Health Underwriters is opposed, the National
Federation of Independent Business is opposed, and the Illinois
Chamber Employment Law Council is opposed. You know, this
concept was one that Hillary Clinton took on in 1994 and it
created such a stirring that there was a sea change, ultimately,
in the politics of the United States. And it’s a bill that
while it is not as draconian as what the Clinton administration
tried to do, which was basically a nationalization of health
care, it is a bill that you’re being asked to consider today
that has a lot of similar characteristics. One of the things
that was interesting when people started to look at the Clinton
bill was the number of times things were criminalized in the
bill. Now, there’s no criminal penalties in this bill, but what
I asked our staff to do was to do a search. It -- it is being
presented today as a bill that is just a study, really a -- a
study with no other agenda, we’re told, other than good things.
But there’s a lot of us who are very, very concerned about the
growing role of government in our lives and the growing cost of
government in our lives. Our staff ran the -- just ran a quick
spell check, and this isn’t -- this isn’t a bill with a lot of
“mays”; it’s a bill that is littered with “shalls,” and we all
know the difference between may and shall. In fact, in this
bill, there’s thirty-two shalls. Now, one of those shalls is
really I -- I think a linchpin. It says that the final report,
which is what -- everybody is driving towards here, the final
report shall make recommendations for a health care access plan
or plans that would provide access to a full range of
preventive, acute and long-term health care services. You know,
it’s as if a -- a high school teacher gives you a book and says,
“Here, I want you to read the book, but the quiz is going to be
on chapter three.” Well, what do you do? You read chapter
three. You spend all your time looking at chapter three. You
memorize chapter three. You -- you make chapter three a dog-
eared thing. And if -- what this legislation says to this
committee is what you’ve got to do is come up with this plan,
that -- you’re not -- you’re not asked to -- to really look at
the whole totality of everything. What -- what this bill will
do is set the table for what some people don’t like to hear it
characterized this way, as socialized medicine. That’s very
uncomfortable. Oh! And God bless you. That was on cue.
You’re acting shocked and appalled that the Health Care Justice
Act is being linked, of all shocking concepts, to socialized
medicine. Well, let me tell you, that is exactly what this is
all about. It is an agenda, which is why so many people are
fearful, why the business community has said, “You know what,
this is untenable. We can’t accept it.” It -- it -- the
underlying premise is flawed. Now, the Blagojevich
administration has come out -- apparently the Department of
Public Aid has come out and they’ve -- they’ve given us some
numbers, and I -- I assume they’ve shared them with all of you.
They say that this -- if this is implemented, their conservative
estimate is this would cost between three and six billion
dollars annually. Now, we can’t afford it. We’ve got -- we’ve
got bills moments ago that are talking about recruiting people
for welfare, which fortunately we rejected. You know, one of
the previous speakers said that -- that the trouble is that
doctors are leaving. Well, you know what? There’s a solution
to the “doctors leaving” part of this whole equation and that is
to move several bills that are posted in the Senate Executive
Committee that are probably not going to see the light of day,
I’m told. But make no mistake...
PRESIDING OFFICER: (SENATOR WELCH)
Senator, hold on. Ladies and Gentlemen, you’re not at the
theater. Please refrain from applauding or expressing
congratulations, remonstrances of any type of approval or
disapproval. Senator, please proceed.
SENATOR ROSKAM:
Thank you, Mr. President. Make no mistake, this is a bill
with -- with an agenda, and it’s not an agenda for an open-
market discussion about how best to meet health care needs.
It’s not an agenda that I think there’s a Republican vote for,
frankly. What we’re driving towards, what we’re saying is,
“Look, let the free market intervene here.” But don’t -- don’t
tie the hands of a commission and tell them what the conclusion
is that they need to come to and then act all surprised when
it’s characterized in a different way. I urge a No vote.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
You know, I know we’re pressed for time. Normally, I don’t
get too exercised when we engage in these pyrotechnics, and
Senator Roskam has his job to do as the spokesperson over on
that side on these issues. But it’s pretty rare on the Floor
where a bill gets this mischaracterized repeatedly. It’s pretty
rare where that happens. Now, a couple of statements that were
just made, pretty quickly, that we need to go over. Number one,
Senator Roskam, you are well aware of the fact that that
estimate of three to six billion dollars had to do with if there
was a State health care plan that was fully funded by government
and that that had nothing to do with this bill, as amended. You
are aware of that. You got up there and you said that that’s
what the Department said about this bill, and you know it’s not
true. You also characterized this as socialized medicine, or
Hillary Clinton’s bill, which is great politics, but there’s
nothing in there -- in this bill, as amended, that would
indicate that. So, if you want to debate Hillary Clinton’s bill
from 1992, that’s fine, but the notion that you would blatantly
characterize this bill as being that is dishonest. And I object
to it, because every time I’ve debated one of the bills over on
that side of the aisle, I’ve gone to the bill. And if I had
serious questions about it, I would at least read the bill and
talk about what’s in the bill, not what’s not in the bill. You
want to have a discussion about medical malpractice? I’m happy
to have that discussion. And we’ve got a whole bunch of people
on this side of the aisle who are trying to deal with the crisis
that’s facing doctors all across the State. That’s not in this
bill. What is in this bill is very simple. It says on or
before July 1st, the State of Illinois is strongly encouraged to
implement a health care access plan that does the following:
Provides access to a full range of preventive, acute and long-
term health services; two, maintains and improves the quality of
health care services offered to Illinois residents; three,
provides portability of coverage, regardless of employment
status; four, provides core benefits for all Illinois residents;
five, encourages regional and local consumer participation; six,
contains cost-containment measures; seven, provides a mechanism
for reviewing and implementing multiple approaches to preventive
medicine based on new technologies; and eight, affords
affordable coverage options for the small business market. It
does not mandate that it has to be government-run. It does not
preclude tax credits or a market-incentive approach to providing
these services. I would challenge you to find something in
there that suggests anything remotely close to socialized
medicine. And we can play politics with this thing, but let me
tell you something. Last weekend I was up talking to a bunch of
Galesburg workers who’ve been laid off from the Maytag plant and
the Butler plant. And I stood there and sat with a Butler
worker who had spent thirty years putting his heart and soul
into that company, and his wife had worked in the company as
well. They’re going to be laid off in September. Their son just
had a liver transplant, and the first month’s bills just on
their prescription drugs is forty-five hundred dollars a month.
And he’s trying to figure out, once he loses his job and his
health insurance, how in the heck he’s going to be able to
provide drugs to keep his son alive. Now, if that side of the
aisle thinks that that is not an issue worth studying or looking
at or trying to figure out, then feel free to -- to vote No on
this bill. But the notion that somehow that all is hunky-dory
and we can characterize this with a bunch of ad hominem attacks
and play politics with this situation is not going to satisfy
that man and -- and -- and his wife. And everybody here knows
of same stories of Members of your constituencies in your
district. If you want to vote No on this bill, vote No on it,
but don’t lie about it.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Roskam, you’ve spoken once. For what purpose do
you seek recognition?
SENATOR ROSKAM:
Thank you, Mr. President. My name was used in debate. And
just to the sponsor of the bill, my attack was not ad hominem.
I was speaking to the bill. Your -- or, your problem is with
Senator Brady, and that’s between you and Senator Brady. Let me
address the question, since I think my characterization was
unfairly characterized. The question is, who can do the things
that the sponsor wants to accomplish in his own bill? Who other
than the State can put together an integrated system or systems
of health care delivery? Who other than the State can put
together core benefits that would be provided under each type of
plan? There is only one answer, and the answer is that this is
a setup, setting the table, as I characterize it, for the type
of government intervention in medicine that is a failure. The
way that I’ve characterized it is dead-bang-on accurate, which
is why it has so animated the sponsor. If I was wrong, if I was
off the mark, my response would be -- would -- would roll off
his back like water off a duck as partisan flack. But the
characterization that I’ve made is accurate and it’s dead-on,
and it has been rejected wholeheartedly in different
jurisdictions around this country. You know what to do when the
bell rings, and you know when to do it. Vote No.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Schoenberg. Last speaker.
SENATOR SCHOENBERG:
Thank you, Mr. President and Ladies and Gentlemen of the
Senate. I’d like to rise in support of the bill. Several years
ago, in fact, throughout most of my twelve years in the House, I
could not have supported earlier versions of this because I,
indeed, felt - and I made these comments in committee - that it
was -- then the very notion of what was being proposed may have
been skewed to achieve certain outcomes. This bill, through
Senator Obama’s hard work, his perseverance and, perhaps most
importantly, his integrity and sense of fairness, provides a
framework for developing a blueprint of options that is
available, that incorporates both public and private roles, and
which is not -- despite the best attempts to impugn the
negotiations, to impugn the bill and, perhaps most sadly, to
impugn Senator Obama’s personal integrity, this is not a single-
payer or a skewed process. This is so inherently fair and
balanced that perhaps the only thing it doesn’t do is skew the
process to outcomes which, frankly, are -- are health care
Darwinism, like health savings accounts. I believe that the
market should play a very prominent role, and -- and health care
is a major portion of the health care economy -- I’m sorry.
Health care is a major portion of both the State economy and the
national economy, and it’s very difficult for government to
reposition such a significant portion of the economy. But by
doing nothing, the choices are getting made for so many people
that there is now fear in the hearts not just of the lower
classes, not just the -- in the hearts of the middle classes,
but in the hearts of everybody in this State and in this
country, because everybody knows that they are one personal
tragedy in their family away from financial ruin. Now,
government plays a major role in our health care system.
Indeed, I wish -- I mean, as you know, we all spoke about the
hospital assessment plan and what we needed to do to help
hospitals in communities around our State. Why was that so
important? That’s because we wanted to alleviate the pressure on
cost-shifting to private insurance -- to patient’s with private
insurance. I wish that the private insurance market was as
successful as Medicaid in containing costs. If you look at the
-- you’re laughing, but I’ll tell you, if you look at the Keiser
Foundation’s definitive study on the increases of -- on the
percentage of cost increase for health insurance on an annual
basis, private insurance, on an annual basis, actually exceeds
what’s transpiring in Medicaid on the actual cost of service.
That’s -- that’s more than an irony. That’s a lesson to be
learned for all of us. But in closing, Ladies and Gentlemen of
the Senate, I have to say that I have found it very distressing
that when all else fails, we have to try to discredit the
personal integrity of a Member of this Chamber because we may
have a political or ideological difference. I don’t think it
should ever reach that point. Isn’t that why they call it the
upper Chamber? Thank you.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama, to close.
SENATOR OBAMA:
Well, I -- I welcome the fact that we had a significant
debate on this, although I’m sure the President does not ‘cause
we’ve got a busy Calendar. Let me just close by saying this:
In the time that it took for us to debate this thing, everybody
here should have read the actual bill before us. Perhaps
because of the fact that I am a nominee for another office, I’ve
already read repeated characterizations of this bill as some
radical, you know, socialized strategy akin to Hillary Clinton’s
bill. The exact arguments that were made today on the Floor
have been made already by my opponent in another race. And so,
I -- you know, I understand that, and I’m -- you know, as Harold
Washington said, “Politics ain’t bean bag.” And -- and -- and
part of our task, as partisans across the aisle, is to try to
get an edge. But this is a crisis that’s hitting people all
across the State. There are a number of elements to the crisis.
Doctors leaving is an element of the crisis, and high liability
insurance rates. That’s part of the crisis. Part of the crisis
has to do with small businesses unable to provide health care
for their employees. Part of the crisis is reflected in terms
of negotiations between unions and employers about the levels of
their health benefits. Part of the crisis is millions of people
who have no insurance whatsoever and that the market has utterly
failed - millions, many of whom work every single day. The
majority of people who do not have health insurance are not
welfare recipients who are covered by Medicaid. They’re folks
who work every single day, doing their best to make ends meet
and try to raise a family, and the single biggest cause of
bankruptcy is when they get sick. Now, we can choose to do
nothing. That is an option. We can say that, you know, we’re
just going to muddle through, primarily because everybody in
this Chamber has health insurance. I don’t think that’s an
option. I don’t think muddling through and pretending as if the
problem doesn’t exist or characterizing attempts to deal with
the problem, in broad strokes, as socialized medicine is going
to address the real needs of these families. So, what I’ve done
is I’ve put together a bill that suggests, let’s all sit down
and actually try to figure out how to solve a problem. And it
doesn’t predetermine how we solve it, but it does say that we,
in this Chamber, are expressing a sense of urgency about the
problem. If all of you have read the bill, there’s no reason
why anybody in this Chamber, on either side of the aisle, should
be willing to vote against this bill. I would ask for an
affirmative roll call.
93rd GENERAL ASSEMBLY
REGULAR SESSION
SENATE TRANSCRIPT
112th Legislative Day 5/19/2004
Text of Bill Resulting Report
SENATOR OBAMA:
Thank you very much, Mr. President, Ladies and Gentlemen of
the Senate. This bill seeks to address what is a growing crisis
all throughout the State. I don’t need to, I think, reiterate
the fact that we have a full-blown health care crisis. When I
first came to the Legislature seven years ago, we already had a
problem with the forty million plus nationally who were
uninsured, the millions in Illinois who were uninsured. But now
what we’re seeing is not only problems among the uninsured,
problems among seniors and their prescription drugs, but we are
also seeing now people who have employer-based health care plans
seeing their copayments go up, deductibles go up and premiums go
up so that all people are feeling the pinch. Geographically, it
doesn’t matter whether they’re in downstate Illinois, City of
Chicago or the suburbs. Black, white, Hispanic and Latino, all
of us are concerned about rising health care costs, and small
employers and self-employed persons are among the hardest hit.
What this bill does is to create a task force that over the next
year will examine mechanisms by which we can expand
affordability and accessibility of health care to all persons in
Illinois. The task force, thanks to suggestions from some of my
Republican colleagues, will be made up of five appointees from
the Governor as well as six from each Legislative Leader. They
will meet and discuss how we can provide more effectively a full
range of preventative, acute and long-term health care services,
provide portability of coverage, provide core benefits to all
Illinois residents, encourage cost savings, cost containment,
and would promote affordable coverage options for the small
business market. Within the bill, it enumerates a number of
issues that the task force should be looking at. There have
been some back-and-forths between myself and the insurance
industry, which was originally concerned that somehow this was a
Trojan horse, to introduce single payer. I want to say on
record that I am not in favor of a single-payer plan. I don’t
think that we can set up that kind of plan, and if we were going
to even attempt to some sort of national health care, that would
have to, obviously, be done at the federal level. What this does
do is to try to figure out how can we at the State level more
effectively address this crisis. With that, I would entertain
any questions or comments people may have.
PRESIDING OFFICER: (SENATOR WELCH)
Is there any discussion? Senator Righter.
SENATOR RIGHTER:
Thank you, Mr. President. Briefly, to the bill. Ladies
and Gentlemen, first I want to thank the sponsor for the changes
-- the two changes that he did make that were in response to
concerns from our side of the aisle in Health and Human Services
Committee. And there isn’t any question that there is a kind of
cloud that surrounds this bill, if you will, because of what it
started out to be. What it started out to be was a mandate on
the State of Illinois that we would adopt some kind of universal
health care plan no later than the beginning of 2007. And what
we’ve seen in this legislation is somewhat of a retreat from
that, but to characterize it as just an open-ended study bill is
not accurate. This tells the task force what it must study and
tells the task force exactly what has to be in the plan. Now, it
may have a little tinkering here or there as far as how it
achieves those points, but it does tell us what’s got to be in
those plans. For those of you, like all of us, who are
concerned about costs of health care, not just quality and
access, but costs as well -- because cost is what drives the
problem, Ladies and Gentlemen. The reason that we can’t keep up
is because health care inflation is double digit. We have an
amendment, Senate Amendment 3, that’s sitting in the Rules
Committee. For those of you who want to say I’m for studying
this problem, there is a study out there. It’s an open-ended
study. It doesn’t tell the task force exactly what it has to
study. It doesn’t tell the task force what it has to arrive at.
And it places an emphasis on controlling costs. Because we can
do everything else we want, Ladies and Gentlemen. It doesn’t
matter who pays the bill. Whether you’re saying that the
physicians are paying it or the -- or the other medical
providers are paying it because of lower reimbursements or the
taxpayers are paying it through the Medicaid program or public
aid or whatever it might be, we’re all paying the bill, and
we’re all paying the bill because we can’t get these costs under
control. This task force should focus on cost containment.
That’s what Senate Amendment 3 does. If you are uncomfortable
with a task force being told exactly what it has to have in its
report, you can vote No and point to something that is on file
that is truly a study bill. I would urge a No vote.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
Just a brief response to Senator Righter, and I know he
didn’t ask a question. But I -- couple of things. One, I will
acknowledge that when this bill came over from the House and I
picked it up, it did have the sort of mandate that the
Legislature would have to come up with something, and that was
something that I worked diligently with the insurance industry,
as well as Members of that side of the aisle, in addressing. It
is now addressed here. With respect to the issue of cost
containment, I just want to point out that what this task force
is assigned to do is to look at a range of issues, one of which
is cost containment. So, the notion, I think -- the
implication, at least, that was set forth by Senator Righter
that somehow we have this open-ended study that doesn’t address
cost containment is simply not accurate. As I read provision (6)
the health care task force is urged to, among other things, look
at how we institute cost-containment measures, because I think
all of us are aware that we can’t expand accessibility and
affordability unless the baseline costs of health care are
curbed. So, I -- I just want to make sure that everybody is
clear here. We have given some direction to the task force in
terms of broad outlines, basic things that people have to look
at. That’s appropriate. If we just had an open-ended study, it
would mean nothing. We want to give some direction to the task
force so that they have some sense of what their assignment is,
but there’s nothing in there that predetermines the kind of
recommendations that they may come up with. They could decide to
come up with a tax credit plan that many on that side of the
aisle would support. They may decide to come up with some other
mechanisms to contain costs. That’s exactly what we -- need
debating, but what we don’t have right now is any kind of sense
of urgency about the extraordinary difficulties that our --
constituencies are experiencing with respect to health care
costs. And I would -- before I urge a No vote -- or, an Aye
vote, let me -- let me go ahead and answer any other questions
people may have.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Harmon.
SENATOR HARMON:
Thank you, Mr. President. I would like to both move the
previous question and speak to the bill. Is that in order?
PRESIDING OFFICER: (SENATOR WELCH)
Yes. Senator Harmon moves the previous question. Without
objection, leave is granted. There are one, two, three, four,
five, six speakers in addition to Senator Harmon. Please
proceed, Senator.
SENATOR HARMON:
Thank you, Mr. President, Ladies and Gentlemen of the
Senate. As a cosponsor of this bill, I rise in strong support.
I -- I’m sure that many of you have the same experience that I
have in my district office hearing from constituents. Health
care is truly a crisis, both directly and as a subtext for so
many other issues that we deal with. I know this has been no
easy task for Senator Obama, but I applaud him for navigating
this bill and building a truly impressive list of organizations
and entities that are supporting the bill. It is -- it is pro-
consumer, pro-business, pro-labor, pro-hospital. It -- it is
quite a list, and I -- I applaud the Senator for being able to
pull together such an impressive list of -- of supporters. And
I’d ask all of my colleagues to vote Aye.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Wendell Jones.
SENATOR W. JONES:
Will the sponsor yield for a question, Mr. President?
PRESIDING OFFICER: (SENATOR WELCH)
Indicates he’ll yield, Senator.
SENATOR W. JONES:
Senator Obama, my question involves if you know how many
people in Illinois are covered - are covered - by private health
insurance.
Senator Obama.
SENATOR OBAMA:
I don’t have those statistics on me immediately, Senator
Jones. What we know is that -- that the rate of increase among
the uninsured who are working - and so, we’re not talking about
those who are covered under Medicaid - but working people who
lack health insurance has grown exponentially over the last
several years and is approaching, I think, one out of every five
working people. Now, I can’t guarantee that statistic is
correct, but there have been recent articles and studies showing
that we’re seeing a growing number of persons who are working
every day on the job, lacking health insurance.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Wendell Jones.
SENATOR W. JONES:
I’d like to get an answer to that question, if we could,
because if it’s -- let’s say it’s eighty-five percent are
covered, that means we’re trying to plan a program for -- for
the remaining fifteen percent. Instead of planning a program
for a hundred percent and put everybody on a government program,
which -- which we know can be expensive and cumbersome and
bureaucratic, try to implement something through private
industry, through tax incentives and tax deductions and those
kinds of things rather than a government-driven program. Thank
you.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
I know we have a lot of questions, but just a quick
response. That’s exactly the kind of information that I think
would be generated from the task force.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Brady.
SENATOR BRADY:
Sponsor yield?
PRESIDING OFFICER: (SENATOR WELCH)
Indicates he’ll yield, Senator.
SENATOR BRADY:
Senator Obama, and I -- I don’t know if you remember this
or not, but this bill first came through the Insurance
Committee. In that committee, you made two commitments. One is
that you would not move the bill on 3rd Reading unless there was
an agreement and no one was opposed to the bill. Second
commitment was that an amendment would come back to that
committee. I think it’s important for the Body to understand
that you made that commitment, both those commitments, and then,
in fact, the amendment that came on this bill went through a
different committee than the Insurance Committee. Now, we noted
that last year. I’d like to hear you respond to it.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
That was essentially a different bill. The -- the -- the
original -- the original presentation of the bill was the House
version that we radically changed - we radically changed - and
we changed in response to concerns that were raised by the
insurance industry. The assurance that I received from the
insurance industry was that if we took out the mandate that the
Legislature would have to implement the bill, then, in fact,
their objections would be lifted. And I got repeated
commitments from the insurance industry to that effect. What
then happened is, after we removed the provisions that initially
had been the source of criticism and made a bill that studies
the problem and does not mandate that the Legislature act on it,
I got a reversal from industry which said, “No, we’re still not
interested in it.” And it was in the face of that obstinance
that we ended up moving it into another committee. So, I’m
happy to stick with my agreements. What I expect is that the
other side do the same. That did not take place in negotiations
with respect to this bill.
PRESIDING OFFICER: (SENATOR WELCH)
Senator -- Senator Brady.
SENATOR BRADY:
Senator, with all due respect to you - and you know I
respect you - a bill is a bill. The agreement was made with the
House committee Members. Two agreements were made: That this
bill would not be advanced to 3rd Reading unless an amendment
came back to our committee and unless there was an agreement -
no opposition. I can’t speak to what you just spoke to. I was
not a party to that. And with all due respect, Senator, I think
you ought to take this bill out of the record based on the
commitment made to the Republican Members of the committee - not
anybody else, but the Republican Members of the committee,
Senator.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
Senator Brady, I, too, respect you. What I don’t respect is
a situation in which there is a unwillingness on the part of
industry to negotiate a bill and go back their word. And I’m not
going to have a situation in which people who are struggling
without health care are held hostage, and are not even willing
to have a discussion about how we solve the problem. If this is
a problem with respect to you thinking that -- that I have
violated my commitment to you, so be it. And I regret that and
will -- be happy to have a conversation about that afterwards.
But what I do know is this: That I made every effort. And
anybody who was involved -- and I would ask that the Chairman of
your committee acknowledge the fact that I made every effort to
negotiate this thing and nothing would move the other side.
PRESIDING OFFICER: (SENATOR WELCH)
Senator -- Senator Brady.
SENATOR BRADY:
Not to paraphrase another piece of legislation, but I don’t
want to beat a dead horse. Senator -- and know I bring humor to
something that probably doesn’t deserve it. Senator, you
control this Chamber. The Democrats control that Chamber. We
think they control the Mansion. You have the right to introduce
any piece of legislation and move it forward. The simple fact
is, this piece of legislation and another one, you made a
commitment to the committee. No one else. I don’t disagree with
the fact that you did everything you could to try to get an
agreement. But the fact of the matter remains, you made an
agreement with us. Alls I ask is you find another piece of
legislation where you didn’t make that agreement, Senator, a
piece of legislation where you didn’t commit not to move it
through another committee, where you didn’t commit only to move
it if we have an agreement. That’s the right thing to do,
Senator. I ask that you do that, and that’s -- that’s my final
comments on this issue.
PRESIDING OFFICER: (SENATOR WELCH)
With -- with leave of the Body, the Chicago Tribune seeks
leave to take pictures. Senator Trotter.
SENATOR TROTTER:
Thank you very much, Mr. President, Members of the Senate.
First, I want to thank Senator Obama, one, for bringing this to
the Floor and -- and for articulating the issue so well and --
and also to understand that this is just a beginning. And all
our other Members should understand this is just a beginning in
trying to address our health care crisis in this State. We do
know -- we don’t know how many people are insured, but we do
know that there’s 1.8 million people uninsured in our State or
underinsured. And that’s -- that’s a big number. Those costs,
the cost of those people being uninsured and underinsured, also
drives up our health care costs in our hospitals and along with
our other providers. There’s a domino effect that’s in place
here because we have so many people in need of health care. So,
if we’re going to look at and really try and tighten up our
budget deficits and -- and looking at what is driving our
budget, well, this is the first -- one of the first places to
look, is the rising cost of health care. We can do that in the
next couple of years with this study, and that’s what this does.
What this will do, it provides access to a full range of
preventive, acute and long-term health care services. What this
bill will do, it will maintain and enhance the quality of health
care services offered to all of our residents in the State. It
provides for core benefits for all of our residents. These are
not special services. This is no Botox and all those other big
cosmetic things that -- that people do now when they have money.
These are core, basic services. It encourages regional and
local consumer participation, and it contains -- yes, it
contains cost-containment measures as well and provides for
mechanisms to evaluate and implement those multiple approaches
to delivery of health care in this State. This is how we start
-- reeling in the cost of health care. This is a wonderful first
start, and I encourage everyone to vote Aye.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
Sponsor yield?
PRESIDING OFFICER: (SENATOR WELCH)
Indicates he’ll yield, Senator Forby.
SENATOR FORBY:
Is there any -- is there any cost to this bill?
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
There are no costs attached to the bill. Other than
subject to appropriations, it says that the Department is
authorized to contract with an independent researcher to help
the task force in terms of gathering the data.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
And there is no mandate in 207 {sic} or 208 {sic}?
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
The only thing that this bill says is that once the plan or
recommendations are released, that no later than 2006, the
General Assembly is strongly encouraged to vote on legislation
that enacts the recommendations or provides for another health
care access plan that meets the criteria set forth in Section
15. It provides encouragement. Does not mandate it.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
Do you see anything in this bill that will hurt the
insurance company?
PRESIDING OFFICER: (SENATOR WELCH)
The only thing that has happened here -- and this is --
this is essentially what happened in this bill. The original
bill on the House side I think would have legitimately raised
some concerns with respect to some industry who might have been
fearful that it was a mandate to introduce a single-payer plan.
I modified this. And I have to say, by the way, just to pick up
on something that was raised earlier, that this is a different
bill number than the original bill. It has gone through a
complete restructuring from the original bill. But that initial
concern, as Senator Righter said, that original cloud continued
over it because industry and industry lobbyists -- insurance
lobbyists here in Springfield had been engaging in such fear-
mongering among its agents, suggesting that this was a single-
payer bill, that, in fact, a lot of concerns were raised that
had nothing to do with the bill that was before the Body today.
And, you know, what I -- what I would strongly suggest is people
take the time to look at the three-page bill that is before
them, as opposed to some of the mischaracterizations of this
legislation that have been raised by others.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Forby.
SENATOR FORBY:
To the bill. As everybody knows in this room, you know,
we’ve had a problem with our health care and Medicaid -- and
Medicaid and our malpractice problems. You know, this came up.
Seemed to me like the -- it came up all a sudden. You know, we
need to stop this and this here will help down the road to take
care of our doctors and our health care. In my district alone,
you know, health care has been a big issue, and we’ve got a
couple doctors down home that’s left already. And without our
doctors down home, you know, I can’t create any jobs. We’ve got
to have hospitals. We’ve got to have doctors. You know, I’m
worried about my people in my district. So, if this will help
create {sic} a problem down the road in two or three years, I
think it’s a pretty good idea, because right now, we should have
been looking at Medicaid -- or, Medicaid and our malpractice
three or four years ago, getting prepared for what we’re having
today. So, I had a little problem with the bill he had first
time, but with this amendment on this bill, I urge everybody to
vote Yes.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Roskam
SENATOR ROSKAM:
Thank you, Mr. President, Ladies and Gentlemen of the
Senate. You know, this concept is really controversial, and I
know the sponsor has worked hard to try to come up with a good
idea and he’s a little bit chagrined that some people don’t like
his idea. That’s because they think it’s a bad idea. And the
premise of the negotiation is basically, “Well, you negotiate
with us, otherwise we’re going to roll you. We’ve got the
power.” And that’s what we’re seeing here, and he’s got the
power. He’s in the Majority, and that’s what’s happening. But
really, make no mistake about it. One of the previous speakers
characterized this as a pro-business bill, and it was sort of in
a long litany of descriptions of pro-labor, pro this, pro that -
pro-business. Well, the folks that are the businesspeople of
Illinois don’t look at it that way, which is why the Illinois
Life Insurance Council is opposed, the Illinois State
Association of Health Underwriters is opposed, the National
Federation of Independent Business is opposed, and the Illinois
Chamber Employment Law Council is opposed. You know, this
concept was one that Hillary Clinton took on in 1994 and it
created such a stirring that there was a sea change, ultimately,
in the politics of the United States. And it’s a bill that
while it is not as draconian as what the Clinton administration
tried to do, which was basically a nationalization of health
care, it is a bill that you’re being asked to consider today
that has a lot of similar characteristics. One of the things
that was interesting when people started to look at the Clinton
bill was the number of times things were criminalized in the
bill. Now, there’s no criminal penalties in this bill, but what
I asked our staff to do was to do a search. It -- it is being
presented today as a bill that is just a study, really a -- a
study with no other agenda, we’re told, other than good things.
But there’s a lot of us who are very, very concerned about the
growing role of government in our lives and the growing cost of
government in our lives. Our staff ran the -- just ran a quick
spell check, and this isn’t -- this isn’t a bill with a lot of
“mays”; it’s a bill that is littered with “shalls,” and we all
know the difference between may and shall. In fact, in this
bill, there’s thirty-two shalls. Now, one of those shalls is
really I -- I think a linchpin. It says that the final report,
which is what -- everybody is driving towards here, the final
report shall make recommendations for a health care access plan
or plans that would provide access to a full range of
preventive, acute and long-term health care services. You know,
it’s as if a -- a high school teacher gives you a book and says,
“Here, I want you to read the book, but the quiz is going to be
on chapter three.” Well, what do you do? You read chapter
three. You spend all your time looking at chapter three. You
memorize chapter three. You -- you make chapter three a dog-
eared thing. And if -- what this legislation says to this
committee is what you’ve got to do is come up with this plan,
that -- you’re not -- you’re not asked to -- to really look at
the whole totality of everything. What -- what this bill will
do is set the table for what some people don’t like to hear it
characterized this way, as socialized medicine. That’s very
uncomfortable. Oh! And God bless you. That was on cue.
You’re acting shocked and appalled that the Health Care Justice
Act is being linked, of all shocking concepts, to socialized
medicine. Well, let me tell you, that is exactly what this is
all about. It is an agenda, which is why so many people are
fearful, why the business community has said, “You know what,
this is untenable. We can’t accept it.” It -- it -- the
underlying premise is flawed. Now, the Blagojevich
administration has come out -- apparently the Department of
Public Aid has come out and they’ve -- they’ve given us some
numbers, and I -- I assume they’ve shared them with all of you.
They say that this -- if this is implemented, their conservative
estimate is this would cost between three and six billion
dollars annually. Now, we can’t afford it. We’ve got -- we’ve
got bills moments ago that are talking about recruiting people
for welfare, which fortunately we rejected. You know, one of
the previous speakers said that -- that the trouble is that
doctors are leaving. Well, you know what? There’s a solution
to the “doctors leaving” part of this whole equation and that is
to move several bills that are posted in the Senate Executive
Committee that are probably not going to see the light of day,
I’m told. But make no mistake...
PRESIDING OFFICER: (SENATOR WELCH)
Senator, hold on. Ladies and Gentlemen, you’re not at the
theater. Please refrain from applauding or expressing
congratulations, remonstrances of any type of approval or
disapproval. Senator, please proceed.
SENATOR ROSKAM:
Thank you, Mr. President. Make no mistake, this is a bill
with -- with an agenda, and it’s not an agenda for an open-
market discussion about how best to meet health care needs.
It’s not an agenda that I think there’s a Republican vote for,
frankly. What we’re driving towards, what we’re saying is,
“Look, let the free market intervene here.” But don’t -- don’t
tie the hands of a commission and tell them what the conclusion
is that they need to come to and then act all surprised when
it’s characterized in a different way. I urge a No vote.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama.
SENATOR OBAMA:
You know, I know we’re pressed for time. Normally, I don’t
get too exercised when we engage in these pyrotechnics, and
Senator Roskam has his job to do as the spokesperson over on
that side on these issues. But it’s pretty rare on the Floor
where a bill gets this mischaracterized repeatedly. It’s pretty
rare where that happens. Now, a couple of statements that were
just made, pretty quickly, that we need to go over. Number one,
Senator Roskam, you are well aware of the fact that that
estimate of three to six billion dollars had to do with if there
was a State health care plan that was fully funded by government
and that that had nothing to do with this bill, as amended. You
are aware of that. You got up there and you said that that’s
what the Department said about this bill, and you know it’s not
true. You also characterized this as socialized medicine, or
Hillary Clinton’s bill, which is great politics, but there’s
nothing in there -- in this bill, as amended, that would
indicate that. So, if you want to debate Hillary Clinton’s bill
from 1992, that’s fine, but the notion that you would blatantly
characterize this bill as being that is dishonest. And I object
to it, because every time I’ve debated one of the bills over on
that side of the aisle, I’ve gone to the bill. And if I had
serious questions about it, I would at least read the bill and
talk about what’s in the bill, not what’s not in the bill. You
want to have a discussion about medical malpractice? I’m happy
to have that discussion. And we’ve got a whole bunch of people
on this side of the aisle who are trying to deal with the crisis
that’s facing doctors all across the State. That’s not in this
bill. What is in this bill is very simple. It says on or
before July 1st, the State of Illinois is strongly encouraged to
implement a health care access plan that does the following:
Provides access to a full range of preventive, acute and long-
term health services; two, maintains and improves the quality of
health care services offered to Illinois residents; three,
provides portability of coverage, regardless of employment
status; four, provides core benefits for all Illinois residents;
five, encourages regional and local consumer participation; six,
contains cost-containment measures; seven, provides a mechanism
for reviewing and implementing multiple approaches to preventive
medicine based on new technologies; and eight, affords
affordable coverage options for the small business market. It
does not mandate that it has to be government-run. It does not
preclude tax credits or a market-incentive approach to providing
these services. I would challenge you to find something in
there that suggests anything remotely close to socialized
medicine. And we can play politics with this thing, but let me
tell you something. Last weekend I was up talking to a bunch of
Galesburg workers who’ve been laid off from the Maytag plant and
the Butler plant. And I stood there and sat with a Butler
worker who had spent thirty years putting his heart and soul
into that company, and his wife had worked in the company as
well. They’re going to be laid off in September. Their son just
had a liver transplant, and the first month’s bills just on
their prescription drugs is forty-five hundred dollars a month.
And he’s trying to figure out, once he loses his job and his
health insurance, how in the heck he’s going to be able to
provide drugs to keep his son alive. Now, if that side of the
aisle thinks that that is not an issue worth studying or looking
at or trying to figure out, then feel free to -- to vote No on
this bill. But the notion that somehow that all is hunky-dory
and we can characterize this with a bunch of ad hominem attacks
and play politics with this situation is not going to satisfy
that man and -- and -- and his wife. And everybody here knows
of same stories of Members of your constituencies in your
district. If you want to vote No on this bill, vote No on it,
but don’t lie about it.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Roskam, you’ve spoken once. For what purpose do
you seek recognition?
SENATOR ROSKAM:
Thank you, Mr. President. My name was used in debate. And
just to the sponsor of the bill, my attack was not ad hominem.
I was speaking to the bill. Your -- or, your problem is with
Senator Brady, and that’s between you and Senator Brady. Let me
address the question, since I think my characterization was
unfairly characterized. The question is, who can do the things
that the sponsor wants to accomplish in his own bill? Who other
than the State can put together an integrated system or systems
of health care delivery? Who other than the State can put
together core benefits that would be provided under each type of
plan? There is only one answer, and the answer is that this is
a setup, setting the table, as I characterize it, for the type
of government intervention in medicine that is a failure. The
way that I’ve characterized it is dead-bang-on accurate, which
is why it has so animated the sponsor. If I was wrong, if I was
off the mark, my response would be -- would -- would roll off
his back like water off a duck as partisan flack. But the
characterization that I’ve made is accurate and it’s dead-on,
and it has been rejected wholeheartedly in different
jurisdictions around this country. You know what to do when the
bell rings, and you know when to do it. Vote No.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Schoenberg. Last speaker.
SENATOR SCHOENBERG:
Thank you, Mr. President and Ladies and Gentlemen of the
Senate. I’d like to rise in support of the bill. Several years
ago, in fact, throughout most of my twelve years in the House, I
could not have supported earlier versions of this because I,
indeed, felt - and I made these comments in committee - that it
was -- then the very notion of what was being proposed may have
been skewed to achieve certain outcomes. This bill, through
Senator Obama’s hard work, his perseverance and, perhaps most
importantly, his integrity and sense of fairness, provides a
framework for developing a blueprint of options that is
available, that incorporates both public and private roles, and
which is not -- despite the best attempts to impugn the
negotiations, to impugn the bill and, perhaps most sadly, to
impugn Senator Obama’s personal integrity, this is not a single-
payer or a skewed process. This is so inherently fair and
balanced that perhaps the only thing it doesn’t do is skew the
process to outcomes which, frankly, are -- are health care
Darwinism, like health savings accounts. I believe that the
market should play a very prominent role, and -- and health care
is a major portion of the health care economy -- I’m sorry.
Health care is a major portion of both the State economy and the
national economy, and it’s very difficult for government to
reposition such a significant portion of the economy. But by
doing nothing, the choices are getting made for so many people
that there is now fear in the hearts not just of the lower
classes, not just the -- in the hearts of the middle classes,
but in the hearts of everybody in this State and in this
country, because everybody knows that they are one personal
tragedy in their family away from financial ruin. Now,
government plays a major role in our health care system.
Indeed, I wish -- I mean, as you know, we all spoke about the
hospital assessment plan and what we needed to do to help
hospitals in communities around our State. Why was that so
important? That’s because we wanted to alleviate the pressure on
cost-shifting to private insurance -- to patient’s with private
insurance. I wish that the private insurance market was as
successful as Medicaid in containing costs. If you look at the
-- you’re laughing, but I’ll tell you, if you look at the Keiser
Foundation’s definitive study on the increases of -- on the
percentage of cost increase for health insurance on an annual
basis, private insurance, on an annual basis, actually exceeds
what’s transpiring in Medicaid on the actual cost of service.
That’s -- that’s more than an irony. That’s a lesson to be
learned for all of us. But in closing, Ladies and Gentlemen of
the Senate, I have to say that I have found it very distressing
that when all else fails, we have to try to discredit the
personal integrity of a Member of this Chamber because we may
have a political or ideological difference. I don’t think it
should ever reach that point. Isn’t that why they call it the
upper Chamber? Thank you.
PRESIDING OFFICER: (SENATOR WELCH)
Senator Obama, to close.
SENATOR OBAMA:
Well, I -- I welcome the fact that we had a significant
debate on this, although I’m sure the President does not ‘cause
we’ve got a busy Calendar. Let me just close by saying this:
In the time that it took for us to debate this thing, everybody
here should have read the actual bill before us. Perhaps
because of the fact that I am a nominee for another office, I’ve
already read repeated characterizations of this bill as some
radical, you know, socialized strategy akin to Hillary Clinton’s
bill. The exact arguments that were made today on the Floor
have been made already by my opponent in another race. And so,
I -- you know, I understand that, and I’m -- you know, as Harold
Washington said, “Politics ain’t bean bag.” And -- and -- and
part of our task, as partisans across the aisle, is to try to
get an edge. But this is a crisis that’s hitting people all
across the State. There are a number of elements to the crisis.
Doctors leaving is an element of the crisis, and high liability
insurance rates. That’s part of the crisis. Part of the crisis
has to do with small businesses unable to provide health care
for their employees. Part of the crisis is reflected in terms
of negotiations between unions and employers about the levels of
their health benefits. Part of the crisis is millions of people
who have no insurance whatsoever and that the market has utterly
failed - millions, many of whom work every single day. The
majority of people who do not have health insurance are not
welfare recipients who are covered by Medicaid. They’re folks
who work every single day, doing their best to make ends meet
and try to raise a family, and the single biggest cause of
bankruptcy is when they get sick. Now, we can choose to do
nothing. That is an option. We can say that, you know, we’re
just going to muddle through, primarily because everybody in
this Chamber has health insurance. I don’t think that’s an
option. I don’t think muddling through and pretending as if the
problem doesn’t exist or characterizing attempts to deal with
the problem, in broad strokes, as socialized medicine is going
to address the real needs of these families. So, what I’ve done
is I’ve put together a bill that suggests, let’s all sit down
and actually try to figure out how to solve a problem. And it
doesn’t predetermine how we solve it, but it does say that we,
in this Chamber, are expressing a sense of urgency about the
problem. If all of you have read the bill, there’s no reason
why anybody in this Chamber, on either side of the aisle, should
be willing to vote against this bill. I would ask for an
affirmative roll call.
