Congressman Elijah Cummings: It's Our Moral Responsibility

Congressman Elijah Cummings (D-MD) is a senior member of the House Committee on Oversight and Government Reform. He also serves on the Joint Economic Committee as well as the House Task Force on Health Care Reform.

He is a member of the Congressional Black Caucus and former chairman. Also, the congressman is a member of the Progressive Caucus.

We talked extensively and what is apparent is the Congressman’s passion for the necessity to reform our nation’s health care system.

Kathleen Wells: Now that we’ve heard the president’s speech, are you holding to your pledge for a strong public option as part of health care reform? If not, why not?

Congressman Cummings: First of all, deep in my heart, I feel that the public option is the only way, let’s say, the most effective way to keep the insurance companies honest, particularly with regard to price. But after listening to the President, I am thoroughly convinced that we have to do something. We cannot afford to let the American people down by not passing some type of very meaningful health care reform and insurance reform. So, I’m going to work very hard to try and make sure that we can get a public option and I’m going to be reminding my colleagues of what the president said. The main purpose for the public option was to help people who could not otherwise get insurance or afford it. And so, if they are going to find a way where we can make sure that insurance is accessible, available and affordable to all Americans — if they have a way of doing that and having some reasonable cost controls, then, I want to hear that option and maybe there is a better way.

Kathleen Wells: Should I interpret that to mean that you are open to an alternative way of getting there?

Congressman Cummings: That’s correct. The bottom line is we have to get there. My Republican colleagues and some of the more conservative Democrats have been saying they don’t want the public option. More than 20 of our colleagues in the Democratic party, [known as] the Blue Dogs, have said they will not vote for something with a public option and so what I would say to them is the president has now invited all of us to give him our ideas as to how we will accomplish insuring all of our people, making sure it is affordable and making sure that the cost doesn’t escalate at an unreasonable pace and that we be able to provide quality care for our people. If they can figure out how to do that without a public option, I’m all ears.

Kathleen Wells: One of the alternatives that has been bandied about and is, in fact, included in Senator Max Baucus’ draft version of the bill is the trigger. What are your thoughts about that?

Congressman Cummings: The thing that concerns me about the trigger is that I’ve been in the Congress now for almost 14 years and the players in the Congress come and go. And a lot of them come and go. The thing that worries me about the trigger is that you have a new cast of players and when the circumstances arise whereby the trigger should be pulled, I fear that the same forces that are presently now against health insurance and health care reform will be even more adamant to make sure that that trigger doesn’t happen. That’s what worries me about a trigger. I just think that the stakes are too high, the moment is too perfect and the urgency is too great for us not to act at this moment. I think that if there is any time for the urgency of now, as our president talks about, it is this moment.

Kathleen Wells: Am I characterizing your position correctly by saying you are open to an alternative to the public option, but against the trigger?

Congressman Cummings: That is correct.

Kathleen Wells: What do you think was the most salient point of the president’s speech?

Congressman Cummings: There is something that I have been saying that has gotten lost in this entire discussion and that is our moral responsibility to our fellow citizens. I believe that the president laid out a very strong case with regard to why it is important that we reform the health care system for those who have insurance, but he also showed us exactly why it’s important that we make sure that those who don’t have insurance have it.

He talked about the economics of it, which was fine. The economics is one thing, but the thing that really struck me was [the idea of] our moral responsibility. One of the things that he emphasized was that at any moment, any of us, could find ourselves with no insurance and the probability of a pre-existing condition arising in our bodies each day. Quiet as it is kept, the longer you live, chances are better for you getting a pre-existing condition.

One of the things that the president emphasized was that over a course of a two-year period, one out of every three Americans has a lapse in their insurance; they have a break in their insurance. That’s very significant.

When you lose insurance, it’s quite probable, and particularly as you get over 30, that you are going to have a pre-existing condition. Therefore, you will be locked out of insurance even if you had $150,000 to pay per year, you couldn’t get insurance — not today.

So, that whole idea of the moral authority, the whole idea of this is who we are. We are not a nation that leaves our fellow citizens by the wayside to die.

Kathleen Wells: You’re referring to the character of the country?

Congressman Cummings: That’s exactly right. And that touched me as a matter of fact because it goes to what I see on a daily basis in the neighborhood in which I live. I live in the inner city of Baltimore. I know of people who are walking around with cancer and have to choose between whether they — and these are people, some of whom have insurance — and they have to choose whether they are going to pay the [medical insurance] co-pay or the deductible with regard to their chemotherapy and between literally feeding themselves. So, this is real. The Institute of Medicine has said that some 18,000 people die each year because they don’t have insurance.

So, when I think about things like that and when I hear our military say that they would leave no soldier behind; when I think about our mourning for all of our people that were lost on 9-11; when I think about one of our brave men or women dying in Iraq or Afghanistan, all of that is painful, but is also just as painful if we think about 18,000 of our fellow citizens per year who’ve died because they don’t have insurance. I’m sure that there are others who have died because they are underinsured.

Kathleen Wells: Some have indicated to me a concern about the four years it would take for the exchange option to kick-in. There’s concern that health insurance premium rates will increase during the interim period between the time the president signs the health care reform bill and the point at which the exchange would be available. Do you have any thoughts on that?

Congressman Cummings: I think that should concern all of us because I believe that the insurance industry will find every way it can to make sure that it still makes a substantial profit. I don’t say that to beat up on the insurance industry, but when I see what happened with the prescription drug program… there is that “donut hole.” This is something that no one talks about, how that donut hole got bigger and bigger because the industry went up on the prices of the drugs that it was selling to Medicare recipients.

Let’s say, for example (hypothetically), Zocor for 30 tablets may have been 60 dollars. Well, they [the drug company] would jack the price up to, maybe, 75 dollars. So you see, the donut hole, gets bigger and bigger. The Congress has to be very careful that those kinds of things do not happen and you know what the president said the other night — there are still a lot of details to be worked out. I think that’s one of them. The whole thing of cost control and the period that you are talking about — that [interim] period — we must find a way to make sure we guard our citizens concerning their premiums going up because that would go against everything that we are trying to do.

Kathleen Wells: I’ve looked at the president’s plan online and it includes a “high risk pool” for that interim period — that 4 year period between the president signing the bill and the time that the exchange kicks in so that high risk persons interested in getting insurance can go into a pool that will keep the premium rates down for others who are not high risk. Do you think the high-risk pools would work?

Congressman Cummings: I think it would work, but we have to make sure that we put all of the proper teeth in it. Keep in mind, there is still a lot to fill in on these bills. I had not heard about the issue you’ve brought up, but I can guarantee you that I’ll have people researching it this weekend.

Kathleen Wells: Is there anything else you’d like to address?

Congressman Cummings: Yes. I have a strong passion about his issue because I see so many people who suffer needlessly and die before their time.

I recently had a town hall meeting that was aired on CSPAN. I asked the people at the town hall meeting, “How many of you know people who have died and when they died, you said to yourself that they shouldn’t have died at this time and the reason why they died was because they didn’t have access to proper medical care or [they were] in the process in trying to get medical treatment but somebody did something that was not proper?” 90 percent of the people raised their hand. This was a predominately African-American audience and no matter when I have asked that question of a predominately African-American audience, I get at least 80-percent of the people raising their hand. I’m sure that even if I went to other audiences, I would get a significant amount of people raising their hands, too.

What is happening is that I think a lot of people are suffering silently. They think they are by themselves. There is a problem with our medical system, our health care system-a lot of problems. I think that what the insurance industry did in 1992 (and I’m not here to beat up on the insurance industry, but I’m just talking facts), the same things that they are agreeing to do today, they agreed to do in 1992 when President Clinton was putting his [health reform] program together — getting rid of pre-existing conditions, getting rid of annual and lifetime caps, getting rid of recission — the same things. Then we had the Harry and Louis commercials and they called it socialized medicine and they were able to drown out the Clintons, who were trying to get something done with regards to health care. When that happened [the defeat of health care reform], the insurance companies went right back and threw their promises, proposals aside and said now we go back to business as usual.

Basically, [the president is] saying: Show me how we are going to do this and control costs because, keep in mind that controlling costs is very, very significant. The reason why it is so significant is because while Elijah Cummings is moved by this whole issue of the morality of taking care of all our people, not everybody is moved by that, based upon the polling data.

Then you can go next and say, will you be able to afford this in, say, 10 years if you are paying almost half of your salary for health insurance? I mean, c’mon. There is a problem there.

The other thing that is so wonderful about all this is (and I think we need to be even stronger with regards to wellness and with regard to prevention), we have to get a mindset that we are going to be healthier. When I go through my neighborhood and I see some of the things that I see, I just say to myself we have got to find ways to live better. We, as Americans, have to change our way of living. We really do if we want to live longer and live healthier and avoid having to go to the hospital. I don’t know if you’ve ever spent any time in the hospital. It isn’t fun.