[Congressional Record Volume 140, Number 94 (Tuesday, July 19, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 19, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]


                              {time}  1950
 
    TIME FOR CONGRESS TO ACT ON HEALTH CARE FOR THE AMERICAN PEOPLE

  The SPEAKER pro tempore (Mr. Deutsch). Under a previous order of the 
House, the gentleman from Kentucky [Mr. Barlow] is recognized for 5 
minutes.
  Mr. BARLOW. Mr. Speaker, as we enter this most important debate--the 
providing of affordable medical care for our people--let us reflect 
upon the necessity for action by the Congress. I pray that we do not 
hang ourselves up in divisive rhetoric. I pray that we do not hang 
ourselves up in rigid frameworks of political alignment for voting. I 
pray that as we cast our votes on the floor of this House that we come 
together in unity for the welfare of our people. Let us keep our eye on 
the main.
  It is the steadily rising costs of medical care that are compelling 
us in Congress, the representative body of our people, to act. And it 
is these costs as they are sorted out through today's medical payment 
framework that, increasingly, delivers and distributed costs in 
painfully unfair contortions that are compelling us to act.
  Let us consider rising costs first. For a young working family today 
with a medical insurance premium of $300 a month, at a 10-percent 
increase in the costs per year, that $300 premium becomes a $500 per 
month premium in the year 2001. For a senior citizen on a fixed limited 
income, a $100 cost for prescription medicines goes up to almost $200 
per month by the year 2001 at a yearly 10-percent increase.
  For the demonstration of a medical payment framework that shifts 
costs unfairly consider this example--a healthy young person without 
insurance is in a car accident. With serious injuries and unconscious, 
the victim is taken to the nearest hospital as quickly as the ambulance 
can travel. Surgery and rehabilitation to restore this young person to 
good health will cost many, many tens of thousands of dollars. 
Remember, this person is without insurance. But the medical charges 
must be paid in some manner. The hospital must continue to function. 
The staff must get their pay. The lights must go on at night. 
Therefore, inevitably, these costs will be shifted and payment of this 
person's bills will be made by insurance plans, private patients, and 
government medical accounts that do business with the hospital.
  Today, we are accomplishing miracles in modern medicine. Who would 
have thought just a few decades back that we would develop such 
miracles as open heart surgery, hip replacements, cancer treatments, 
and rehabilitative methodologies that put people back in their 
communities, in their working lives, happily enjoying their families 
and loved ones, looking forward to productive worlds for years to come.
  But as we know, many of these miraculous cures come at high prices. 
Consider then the quiet desperation of many of our seniors on limited, 
fixed incomes--social security and perhaps slim pensions--as they look 
ahead at these expensive treatments. Reflect upon this statistic--one 
in five working Americans, working full time earns under $13,091 each 
year, the poverty line--a 50 percent increase in the numbers of working 
Americans in this below poverty category since 1979. How are they to 
pay for their families' medical needs if they become serious?
  I pay my deep respects and gratitude to our business people who down 
through the years have labored hard in sacrifice to provide medical 
insurance and care for their employees. I urge them on in their efforts 
at self insurance, alliances, and group coverage to negotiate lower 
costs for their employees.
  And yet, here is why I believe we must have ``Universal Coverage.'' 
Because anyone not covered by affordable medical care is inevitably 
going to be made to pay higher charges by their medical service units 
to enable those units to recover fees they had to give up in 
negotiations with group alliances. Similarly, the small business with 
its insurance plan is not able to negotiate as favorably with insurers 
and providers as can the large employers with thousands of employees. 
Thus, individuals not covered by affordable medical care will pay the 
most: Small business with coverage will pay somewhat lower tiers of 
costs--while large businesses with their negotiating power will pay the 
least. And inevitably the government will come in for a billing of all 
the unpaid costs in some manner. So the tax burden on taxpayers 
increases.
  What I believe we are talking about with the term ``Universal 
Coverage'' is not just the receiving of medical treatment when needed--
that is generally available now, especially for catastrophes, for 
crisis medicine. If you break a leg, the emergency room is going to fix 
your leg regardless of your ability to pay. What I believe we are 
visualizing with ``Universal Coverage'' is providing everyone with, 
generally, the same cost schedule and then providing the means for each 
of us to pay ahead to meet those costs when they eventually, inevitably 
raise.
  This financial crisis in our medical care accounts has been building 
steadily for some years. Since we did not get here quickly, we will not 
resolve ourselves along more responsible financial courses quickly. But 
the financial crisis must be dealt with. I do believe that if we do not 
act we will be hung up for heavy criticism by our people. For now, we 
have studied enough. For our people, we must move ahead.

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