WASHINGTON - As the health care debate cranked up on Capitol Hill last week, Sen. Patty Murray talked about 10-year-old Marcelas Owens, whose mother lost her job, her health insurance, became sick and died.
Murray told the Senate Health, Education, Labor and Pension Committee that the story of the Seattle boy's mom was a tragic example of why health care reform is urgently needed.
The Washington Democrat has been here before, in 1994, with the failed Clinton health care plan.
But back then, as a very junior senator she didn't have a seat at the table. This time, Murray and Washington's other senator, Democrat Maria Cantwell, have seats near the head of the table.
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The No. 4 Democrat in the Senate Democratic leadership, Murray is helping develop strategy for passing what she hopes will be a landmark health care bill. She is one of five members of the Senate Health, Education, Labor and Pension Committee who were tabbed by its chairman, Sen. Ted Kennedy, D-Mass., to help draft one of the bills that eventually could emerge for floor consideration.
The other bill will come from the Senate Finance Committee, whose membership includes Cantwell. She has been lobbying committee chairman Max Baucus, D-Mont., to include in his bill several provisions that are of special interest to Washington, including revamping the Medicare reimbursement formula. This bill received a boost Saturday when pharmaceutical companies agreed to improve benefits for seniors on Medicare.
Murray and Cantwell have been to the White House repeatedly to meet with President Obama and his aides. Over the past few weeks they have been in countless hearings and meetings.
"The climate in this country has changed dramatically since 1994," said Murray. "Things have gotten worse in the past 15 years."
Over the past decade, health insurance premiums have nearly doubled while wages have been stagnant. By some estimates, unless changes are made health care coverage for a typical family will cost $24,000 a year by 2016 - an 84 percent increase from current levels.
Meanwhile, the number of uninsured continues to grow. Today an estimated 47 million people don't have health insurance, including almost 830,000 in Washington state.
"Doing nothing isn't the prescription to our health care crisis," said Murray, who met Marcelas Owens at a rally in Seattle several weeks ago.
Owens' mother, Tiffany, died two years ago of pulmonary hypertension, according to Murray's office. She was fired from her job after she got sick and missed a lot of work. When she lost her job, she lost her medical benefits.
"I miss my mom," Marcelas said at the rally. "But the thing I miss most is her big hugs."
Murray places blame for Tiffany Owens' death squarely on the health care system. "Marcelas lost his mom because our system is terribly broken," she said.
While Murray and Cantwell believe providing health insurance to those who don't have it is a top priority, it is not their only priority. "We are not going to build a new health care system on an old rickety one," said Cantwell.
Cantwell said the key to reforming health care is trimming costs while providing quality care.
She cites a story in the June 1 edition of The New Yorker on health care costs in McAllen, Texas, which are among the highest in the nation because doctors there are quick to order additional tests and procedures to increase their billing. The article has become required reading at the White House.
"I went to this meeting in the White House where the president held up a copy of the magazine," Cantwell said. She said she told Obama that while everyone wants to insure more people, "unless the system is changed there won't be true reform. He told me he was glad I had brought that up."
Using an integrated, high-efficiency health care delivery system like that in Washington state could save Medicare more than $55 billion a year and could be a model if a government-sponsored plan is included in a health care bill, Cantwell said.
Cantwell and Murray said any bill has to overhaul the Medicare reimbursement formula for doctors, which they say punishes states like Washington that have efficient health care systems. Average annual Medicare spending on beneficiaries in Washington is about $5,280, compared with New Jersey, where beneficiary spending is $7,834.
Neither Murray nor Cantwell support the so-called single-payer approach, in which private health insurance companies would be replaced by a health care system run by the government.
But both say a reform bill should include a "government option" that could compete with private health insurance.
"All Americans should have access to health care. That could include a public option," Murray said.
Cantwell said one government option could be a cooperative nonprofit like Group Health Cooperative in the Northwest. "The system in the Northwest isn't perfect," she said. "It has its problems. But it has worked."
Republicans staunchly oppose any government option, saying it would put private insurers out of business and result in a government-run health care system.
So far, most of the attention on health care reform has focused on the Senate, where a bill is expected to be harder to pass. The Senate health committee started marking up its bill last week, but there are more than 300 amendments. In addition, the nonpartisan Congressional Budget Office said the health committee's bill could cost more than $1 trillion and reduce ranks of the uninsured by only 16 million people.
Murray isn't deterred. "We are so at the beginning of this," she said.
The Senate Finance Committee is expected to release its version of the bill this week. Chairman Baucus has been working with Republicans on the committee to write a bipartisan bill, but some Democrats fear he will water down a bill too far to secure GOP support.
The Finance Committee also will decide how to pay for health care reform. Some Democrats have suggested taxing the health insurance premiums millions of families receive from their employers. The White House has suggested raising taxes on the wealthy by limiting their itemized deductions.
Murray said taxing employer-provided health insurance premiums is a nonstarter for her.Though he is only 10 years old, Marcelas Owens said he will continue to speak out for health care reform. "I'm marching today to continue her fight," he said of his mother at the Seattle rally.
Murray said there are too many stories like Marcelas'.