[Congressional Record Volume 140, Number 145 (Friday, October 7, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: October 7, 1994]



                        CHILDREN AND HEALTH CARE

  (Mr. MORAN asked and was given permission to address the House for 1 
minute and to revise and extend his remarks.)
  Mr. MORAN. Mr. Speaker, while my colleagues and I will go home to our 
respective districts next week to campaign and to talk about what 
happened to health care reform, 9.6 million uninsured children, and 1 
million uninsured pregnant women, primarily poor, will continue to go 
without access to badly needed preventive, primary, and acute health 
care. In addition, millions of children live in medically unserved 
areas of the country, whereby access to health insurance would not 
ensure access to timely health care.
  These children do not have a primary care doctor whom they see on a 
regular basis. Instead, they get their medical care in local emergency 
departments and free clinics when their situation has become acute. 
There is no case management, no followup, no parental counseling, and 
no preventive measures instituted to avoid recurring episodes of 
unnecessary illness or injury.
  For those of us covered under the Federal Employee Health Benefit 
Program, when our children are ill, we do not think twice about seeking 
medical advice from our regular pediatrician or pediatric specialist. 
When an uninsured child becomes ill, the parent has no alternative. 
Even under Medicaid, a program originally intended to overcome 
financial barriers to preventive and primary health care for the poor 
children and pregnant women, the low level of physician reimbursement 
precludes significant participation by pediatricians.
  In those States with particularly low Medicaid reimbursement rates, 
children are seen in emergency departments, not in doctors' offices. 
These children, who are at high risk for a number of acute and chronic 
conditions, never get the opportunity to receive the legislated benefit 
package of preventive screening and diagnostic services, and thus do 
not reap the intended long-term benefits of improved health status.
  Children that live in medically underserved areas or are uninsured, 
including many who are Medicaid eligible, are more likely to have 
chronic health problems from birth complications; they have higher 
blood lead levels; they are three times more likely to have severely 
impaired vision, two times more likely to have severe iron deficiency; 
they suffer from more severe cases of asthma; and they have poorer 
survival rates from life-threatening conditions such as leukemia. 
Uninsured children are 75 percent more likely to be admitted to a 
hospital in a given year and for four times as long as other children. 
They miss 40 percent more school days than the nonpoor due to acute 
illness, and 30 percent more due to chronic health problems which go 
uncontrolled.

  Pregnant women who are uninsured or live in medically underserved 
areas do not receive timely or adequate prenatal care and counseling, 
and are at high risk for delivering low-birth-weight babies. In fact, 
86 percent of all infant deaths and 86 percent of all low-birth-weight 
babies are born to these women. Low-birth-weight babies are at risk for 
a multitude of acute and chronic health problems that follow them 
throughout their lives. For every $1 spent on prenatal care, an average 
of $15 is saved on the care of each low-birth-weight baby and 
complications of delivery.
  Providing preventive and primary health care to pregnant women and 
children is one of the most effective and least costly investments our 
Nation can make to lower its total health bill and improve health 
status. Without exception, European countries take the health and 
welfare of their children much more seriously than we do, through 
federally funded, comprehensive preventive health programs aimed at the 
young and, as a direct result, face lower total medical bills. For 
example, the average age of detecting impaired hearing in the United 
States is 2\1/2\ years of age, compared to 7 months in countries like 
the United Kingdom and Israel. The mortality rate of American children 
1-4 years of age is 35 to 250 percent greater than in Europe, primarily 
due to preventable injuries. While European countries are experiencing 
a decline in death rates among teenagers, U.S. teens are dying in 
greater proportions: They are 31-66 percent more likely to die than 
their European counterparts.
  Our children are the future of this country. Yet, over one-fourth of 
all U.S. children live in poverty, and less than half of these families 
participate in any assistance program. Fewer than one-third of all 
eligible children participate in Medicaid, in large part due to the 
gross underfunding of the program.
  Children have replaced the elderly as the predominant group living in 
poverty in this country. We explicitly require all employers and 
employees to pay for the health needs of their parents and grandparents 
through the Medicare hospital insurance tax, yet we leave the fate of 
our children to legislators faced with increasingly tight State 
budgets. Real per capita spending of Medicaid, AFDC, and Social 
Security for surviving children continues to decrease by several 
percentage points a year, in contrast to real per capita spending on 
Medicare and Social Security, which continue to increase.
  The problem of inadequate health coverage is not limited just to poor 
children. Fewer than half of all private insurance policies cover the 
range of preventive and primary care services recommended for children, 
resulting in financial deterrents to seeking prenatal care, 
immunizations, screening, and early detection of illness. I have been 
working on a plan to extend health insurance and appropriate medical 
services to uninsured children and pregnant women of working families. 
I have called this bill KidsCare, as it is intended to improve the 
health and medical care that is available to all children.

  The bill would establish a federally funded program for States to 
expand coverage to pregnant women and children up to 200 percent of the 
Federal poverty level; expand the capacity of the Public Health System 
to better meet the needs of underserved populations across the country; 
increase funding to the National Institutes of Health for biomedical 
and behavioral research on diseases that disproportionately affect 
children and pregnant women; institute insurance reforms to ensure that 
no one could be denied health insurance as a result of a preexisting 
condition; and establish a 100 percent tax deduction for the self-
employed.
  The bill is financed by revenues derive from a $2 excise tax on 
tobacco products. Tobacco products are the leading cause of morbidity 
and mortality in the United States and cost taxpayers in excess of $65 
billion each year, in medical costs and lost productivity.
  As the 103d Congress comes to a close, we must rededicate ourselves 
to protecting the health and welfare of our children. KidsCare is meant 
to serve as a staring point for comment and discussion. I hope that 
Members of Congress can work together over the next few months to craft 
legislation that achieves the goals articulated in this bill. We have a 
responsibility, as trustees of the national interest, to protect and 
nurture our most important national resource, our children.

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