[Congressional Record Volume 140, Number 138 (Wednesday, September 28, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


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

 
                E X T E N S I O N   O F   R E M A R K S


       INTRODUCING THE HEALTH INNOVATION PARTNERSHIP ACT OF 1994

                                 ______


                         HON. PETER A. DeFAZIO

                               of oregon

                    in the house of representatives

                     Wednesday, September 28, 1994

  Mr. DeFAZIO. Mr. Speaker, 1 year ago, President Clinton stood in this 
Chamber to announce his health care reform legislation. He told us that 
our health care system was in crisis and that we are the only 
industrialized Nation that does not provide health care to all of its 
citizens. One year later, nothing has changed.
  The Congress did not accept the President's proposal, in fact, it did 
not agree on any proposal. Congress failed to reach a consensus to 
deliver a national health care plan. If it was impossible to overhaul 
the health care industry when the national momentum was at its peak, 
then it would take nothing short of a miracle for reform to take place 
next year in a more partisan and unfriendly climate.
  What is obvious after 2 years of intense health care debate is that 
many individuals, health care professionals, and policymakers agree 
some type of reform is needed. What's unresolved is what kind of reform 
is necessary and how to get there.
  In the effort to overhaul the Nation's health care system, the shared 
goals of cost containment, increased access, and improved quality were 
lost. In fact, the latest health care reform effort seems to have 
abandoned the goals of health reform in a last-minute attempt to find 
the unattainable middle-ground reform solution. According to a 
statement by Senator Daniel Patrick Moynihan in the September 14 
Congressional Record.

       The Mainstream Coalition proposal would be a step backward 
     for New York and other progressive states that have already 
     taken actions to expand coverage and contain costs.

  State efforts and innovation should not be thwarted in any national 
effort. It's ridiculous to ask progressive States to take a step 
backward and wait while other States try to catch up.
  The reforms proposed are all based on programs abroad or theoretical 
models. As Yale professors Ted Marmor and Jerry Mashaw said in a New 
York Times editorial of June 12, 1994,

       If Congress adopts an unproven and untested * * * plan and 
     it turns out to be the health care equivalent of a train 
     wreck, it would be sensible to not have the country on the 
     same train at the same time.

  As we've learned from past Federal legislation, it's difficult to 
repair a system once it's enacted into law. A one-size fits all bill 
ignores that what may work it Oregon may not work in Pennsylvania, 
Connecticut, or Texas.
  Without concrete examples of what works, I'm afraid we'll spend 
future congressional sessions rehashing this year's debate. While 
Congress abandons this issue, many Americans are left without coverage 
and some States are moving ahead with reforms of their own.
  Six States have already enacted comprehensive health care reform 
proposals--Oregon, Hawaii, Massachusetts, Minnesota, Florida, and 
Washington. In addition, 44 States have begun small group insurance 
reform, 44 have enacted data collection systems and 41 have Medicaid 
managed care experiments underway.
  Mr. Speaker, there is a viable alternative to this congressional 
impasse. Today, I introduce the Health Innovation Partnership Act. 
Senators Mark Hatfield of Oregon and Bob Graham of Florida are the 
principal sponsors in the Senate. This important legislation allows 
States the flexibility, with Federal assistance of $50 billion in State 
grants, to devise their own health reform plans that increase access, 
control costs, and improve the quality of care.
  The Health Innovation Partnership Act uses States as laboratories to 
test successful reform efforts, allowing States to adopt single-payer, 
alliances, managed care, or any other plan that works for their 
citizens. This bill ensures that all individuals in a State will have 
equal or superior benefits to those they currently receive. 
Furthermore, this bill gives priority for grants to States expanding 
health coverage to children and youth.
  At the end of the 5-year State innovation project period, a report 
will be made to Congress on the progress States made toward reaching 
the goals of expanding coverage and containing costs. This report will 
include recommendations for future action at both the national and 
State level, in addition to highlighting the successes and failures of 
individual States.
  This bill also establishes a process for the creation of minimum 
national insurance standards, expands the infrastructure for public 
health and prevention activities in rural and underserved areas, and 
increases the funding for medical research.
  The public health section seeks to promote prevention, public health, 
cost effective treatment, and health education through: First, 
strengthening the partnership with capacity of local and State public 
health departments to carry out core public health functions; second; 
expanding access to preventative and primary care services for 
vulnerable and medically underserved populations; third; supporting 
applied research on prevention and effective public health 
interventions; and fourth addressing public health work force needs and 
access problems.
  Dr. C. Everett Koop, a leading advocate for preventative medicine, 
noted that 70 percent of all illness is preventable and that there are 
approximately 1 million deaths annually that are preventable. The 
failure to prevent these illnesses carries a hefty price tag in the 
billions. Ironically, our Nation invests less than 1 percent of our 
total health care dollars on public health. Common sense tells us it's 
time to redirect our priorities and increase funding for vital public 
health programs.
  Our health care system could be more adequately described as a sick-
care system. Instead of preventing illness and promoting healthy 
living, our system focuses on sickness and acute medical care. Keeping 
communities safe and healthy has long been the priority of public 
health organizations and departments.
  We need to do more than control the costs of health care and rework 
the payment structure. We need to evaluate our delivery system and find 
ways to keep our citizens healthy.
  The medical research component of the bill dedicates a minimum of 6 
billion over the next 5 years to increase the annual appropriations to 
the National Institutes of Health Research. While I believe prevention 
should be the cornerstone of any health plan, we must also invest the 
money and energy needed to find cures for those illnesses that cannot 
be prevented. Medical research also augments our efforts to discover 
preventative treatments and genetic patterns that help improve the 
health of our people.
  A mere 2 to 3 percent of our Nation's total health care spending goes 
to support medical research. At a time when our Nation is on the 
forefront of major medical research breakthroughs, we're unfortunately 
funding the fewest number of research grants in 10 years. Cures and 
preventive treatments will truly help us contain the costs of health 
care.
  This federalist bill forms the Federal-State partnership our 
forefathers sought. The States can serve as microcosms, giving us 
accurate data on reform efforts and informing our national debate.
  This bill is not the last word in the health care debate--but 
instead, a sturdy beginning. It's the first step toward improving 
health care coverage for all Americans.
  In closing, I'd like to thank Senator Bob Graham and Mark Hatfield 
for their leadership on this legislation and their dedication to health 
care reform. I look forward to working with them to pass this important 
bill. I am also glad to work with any of my colleagues and others who 
have recommendations to improve this bill.

                          ____________________