[Congressional Record Volume 140, Number 4 (Friday, January 28, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: January 28, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                         ADDITIONAL STATEMENTS

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                    FACES OF THE HEALTH CARE CRISIS

 Mr. RIEGLE. Mr. President, this is a historic year for 
Congress. Our country has been facing a health care crisis for decades. 
Based upon my personal experience from holding over 40 hearings on 
health care and receiving testimony from hundreds of individuals, I can 
tell you that this crisis does exist and that we must pass 
comprehensive health care reform.
  I rise this morning in my continuing effort to put a real face on 
this health care crisis. Over the past year and a half I have told the 
stories of over 40 people from Michigan who have had problems with our 
current health care system. Today I want to tell the story of Stephen 
Datema, from Grand Rapids, MI. Stephen is facing almost $30,000 in 
unpaid doctor and hospital bills because of a preexisting condition 
clause in his insurance policy.
  Stephen and his wife, Deb, are a typical middle-class working family 
with four children. Stephen is 38 years old and works for an insurance 
company as a claims adjuster. Deb is 37 years old and works in their 
home.
  Stephen has hereditary coronary artery disease which was discovered 
in 1988 when he had a heart attack at 33 years old. Between 1988 and 
1989, Stephen underwent several angioplasty procedures to open a 
collapsed artery. At the time he had employer-provided health insurance 
that covered all of his expenses.
  In January of last year, Stephen accepted a new job with a higher 
salary. But he did so only after confirming that he and his family 
would have good health care benefits. Stephen openly discussed his 
health condition in an effort to make sure that the company's insurance 
would cover him if he needed angioplasty treatment again. Stephen's 
employer informed him that he and his family would be eligible for 
insurance coverage 30 days after his hiring date. But he and his family 
did not actually receive health insurance coverage until March 1, 
almost 2 months later. Fortunately, Stephen and his family stayed 
healthy during this time.
  Just recently, after 4 years of relatively good health, Stephen once 
again required treatment for his condition. In August of last year, 
Stephen underwent two angioplasty procedures in an attempt to open a 
collapsed artery. He was hospitalized again in November under similar 
circumstances. Stephen and Deb were under the impression that their 
insurance would cover all of his medical bills, but there were problems 
once the bills were submitted for payment.
  At first the insurance company denied payment for the bills claiming 
that they needed more information. It was not until December that the 
insurance company finally said they would not pay for any of the 
services rendered in August because of a 6-month preexisting condition 
clause.
  Stephen and Deb were stunned. They had no idea a preexisting 
condition clause even existed in their policy. When Stephen discussed 
his health condition and his benefits with his future employer, there 
had been no mention of a preexisting condition clause.
  As a result of the insurance company denying payment, Stephen and Deb 
are faced with a $24,000 hospital bill and over $5,000 in cardiologist 
and emergency room bills. This is a great financial burden for a 
middle-class family with four children.
  Deb has asked the hospital if she could work out a payment plan that 
would allow them to pay off the balance over several years. But the 
hospital will only accept good faith payments on bills that are less 
than $5,000. The hospital is going to send Stephen's bills to a 
collection agency, even though they have made every effort to work out 
a payment plan with the hospital. Stephen and Deb know that this will 
ruin their credit record for the rest of their lives.
  Mr. President, all American families deserve to have affordable 
health care coverage and know that their coverage will be there when 
they need it. But under our present system, which allows gaps in 
coverage and preexisting condition clauses, even middle-class families 
who have insurance can face devastating health care costs.
  Mr. President, we have to comprehensively reform our health care 
system for all Americans--including middle-class families like the 
Datemas and the millions of Americans who can't afford coverage at all. 
And we must do it this year. I am going to invest every once of energy 
that I have to work with my Democratic and Republican colleagues to 
iron out a plan that provides comprehensive, continuous, health care 
coverage for every American.

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