Senate Proceeding on Apr 1st, 2009 :: 2:41:15 to 2:48:50
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2:41:11 to 2:41:32( Edit History Discussion )

Max Baucus: yield the floor. the presiding officer: the senator from montana. mr. baucus: madam president, thank you very much. i thank my colleagues. we are in this congress this year embarked in major efforts to enact health

2:41:15 to 2:48:50( Edit History Discussion )
Speech By: Max Baucus

2:41:33 to 2:41:54( Edit History Discussion )

Max Baucus: it is very much in the president's budget. president obama very much wants that health care reform this year. there are provisions in the budget resolution, madam president, to encourage us as a body of the congress to enact health care reform. the basic reason is because it's so needed. it's incredibly important that our nation enact health care reform this year. i'm not going to get into all

2:41:55 to 2:42:15( Edit History Discussion )

Max Baucus: the details and all the provisions that we must enact to get meaningful health care reform. by meaningful health care reform, i mean controlling costs. i want to remind my colleagues, we in america s trillion, $2.6 trillion a year in health care. that's this year. and if costs are -- if we don't

2:42:16 to 2:42:36( Edit History Discussion )

Max Baucus: do anything, that's going to almost double in six or eight years. we can't contie to spend as much as we do on health care. we spend twice as much per capita as expensive country. our american companies are becoming less competive. why? because our health

2:42:37 to 2:42:57( Edit History Discussion )

Max Baucus: are high. business costs business health care costs are too high. look at our medicare budget. it's gone out of sight. if we do nothing, if we don't curb underlying medicare costs, our budget along with medicaid will probably double in nine or ten years. that's unsustainable.

2:42:58 to 2:43:18( Edit History Discussion )

Max Baucus: to say nothing of individual americans, the premium costs. this country, madam president. we have a hodgepodge, lots of different functions. you've got doctors, you've got hospitals, nurses, insurance companies, sphraoeurz, p.m.d.'s -- suppliers, p.m.d.'s.

2:43:19 to 2:43:42( Edit History Discussion )

Max Baucus: everybody's part of the system. they all try to provide health care. because it is so disjointed, we have a nonsystem where costs are rising also a nonsystem where 46 million don't have health insurance. about 25 million additional americans are underinsured. it is ridiculous.

2:43:43 to 2:44:03( Edit History Discussion )

Max Baucus: is a solution here which is uniquely american solution. we're not canada. we're not great britain. we're not france, we're not sweden. we're the united states of america. by uniquely american, i mean it should be a combination of public and private. that $2.6 trillion that we spend today is d half-and-half, public and private.

2:44:04 to 2:44:24( Edit History Discussion )

Max Baucus: we must find a way to curb costs to get coverage to americans and retain that approach of private and coverage. we're going to work hard to try to find that solution. part of the solutio madam president, is reducing unnecessary costs and waste in

2:44:25 to 2:44:45( Edit History Discussion )

Max Baucus: our system. ere is immense waste in the american health care system. immense waste. and basically it's because of practice it's because the way we reimburse, we reduce -- we reimburse on volume and

2:44:46 to 2:45:06( Edit History Discussion )

Max Baucus: quantity, not quality. and concepts like bundling and medical home and health i.t. which is in the budget so we have information -- technology-assisted help. se need to know that comparative

2:45:07 to 2:45:28( Edit History Discussion )

Max Baucus: effectiveness of drugs, procedures, and medical equipment, et cetera, so we get the best, highest quality, and we therefore will know which ones will tend to cost more than others and doctors can make choices, patients can make choices, insurance companies can make choices as to which procedure, which drug, makes the most sense.

2:45:29 to 2:45:49( Edit History Discussion )

Max Baucus: basically, it is up to the doctor to decide which mak most sense. the effect of the kyl amendment is, frankly, to say that you have to pay for a very costly procedure that somebody deems to be not only ineffective

2:45:50 to 2:46:11( Edit History Discussion )

Max Baucus: may be harmful, you have to pay for it. that doesn't make sense, madam president. rather, and i think the senator from arizona agrees with me we're trying to figure out a way we utilize comparative effectiven have more information and hospitals more information as

2:46:12 to 2:46:32( Edit History Discussion )

Max Baucus: which works better, as higher quality, works better, compared to something else. we have to get into issues like evidence-based medicine to determine quality and lots of concepts here make a lot of sense but i want to say, mr. president, that whereas the intention, i somewhat understand the intention of the

2:46:33 to 2:46:55( Edit History Discussion )

Max Baucus: amendment -- entirely understand it but the effect of the amendment is to say that the procedure, let me get this straight, it says "does not curb growth in health care spending by data obtained by comparative

2:46:56 to 2:47:16( Edit History Discussion )

Max Baucus: it says that can be a procedure determined to be totally ineffective or even harmful but because, but it has to be used or a doctor has to use it. i think it's a doctor's choice as to whether or not by looking at the various procedures, what makes more sense compared with

2:47:17 to 2:47:37( Edit History Discussion )

Max Baucus: something else, using the data provided by this process. that's still a that doctor, he or she, that doctor should decide these makes the most sense. therefore, i think it makes more sense, frankly, this not be aprooned. it's just not necessary, madam president. it gets in the

2:47:38 to 2:47:59( Edit History Discussion )

Max Baucus: senator hatch and i and senator grassley and enzi introducing comparative effectiveness amendment. it gets to what i think the senator from arizona wants, to move toward, where we look at the comparative quality of procedures which is what we are really trying to do her not costs.

2:48:00 to 2:48:21( Edit History Discussion )

Max Baucus: but quality. there is a big dust up in the stimulus bedate by comparative effectiveness because someone in the were putting cost-benefit analysis in it. we're not. we took that out. cost was taken out. and we took it out so it is just comparing quality.

2:48:22 to 2:48:44( Edit History Discussion )

Max Baucus: and the bill that senator grassley and hatch and indifficult are going to intro -- and enzi and i are going to introduce take costs out just looking at quality. that is what we want to do, based on quality. i would be very happy with that bill because it gets at what the

2:48:45 to 2:48:52( Edit History Discussion )

Max Baucus: senator wants, comparing quality but let's not put the cost component interest it because that would not be app