[Congressional Record Volume 142, Number 55 (Thursday, April 25, 1996)]
[Extensions of Remarks]
[Pages E625-E626]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 NATIONAL PUERTO RICAN AFFIRMATION DAY

                                 ______


                          HON. JOSE E. SERRANO

                              of new york

                    in the house of representatives

                       Wednesday, April 24, 1996

  Mr. SERRANO. Mr. Speaker, National Puerto Rican Affirmation Day was 
held on March 29, 1996, and I would like to share with my colleagues 
the remarks I made as the host of a public policy forum on health 
issues affecting the Puerto Rican community.
  Welcome to this public policy forum. Today we are going to discuss 
the health issues that are affecting the Puerto Rican community. We 
will try to find solutions to the problems and to develop public policy 
guidelines that would help improve the health and access to medical 
services for our community.
  Participants in this forum are: Dr. Nilsa Gutierrez, former director 
of the AIDS Institute of the New York Department of Health; Dr. Eric 
Munoz, medical director at the University Hospital in New Jersey; Mr. 
Aldoph Falcon, vice president for policy and research of the National 
Coalition of Hispanic Health and Human Services Organizations; Ms. 
Suleika Cabrera-Drianane, founder and executive director of the 
Institute for Puerto Rican and Hispanic Elderly; Mr. Enrique Baquero, 
president of Cyber Tech and a member of the board of directors of the 
Puerto Rico Hospital Association; and Ms. Miguelina Maldonado, director 
of Government relations and policy at the National Minority AIDS 
Council in Washington, DC.
  After we finish the presentations on the various health issues we 
will open the debate to answer questions from the audience.
  Puerto Ricans in the United States and those living on the island 
often suffer from diseases which are related to their environmental and 
socioeconomic conditions. Puerto Ricans have a high incidence of 
chronic illnesses, infant mortality, alcohol and drug abuse, and more 
recently, HIV/AIDS infection.
  Poor living conditions, hazardous working environments, lack of 
access to medical services, and the rising costs of health care are 
some of the health challenges that the Puerto Rican community faces.
  Many in our community work in industries which have a high number of 
uninsured employees. A large portion of the population resides in 
inner-city areas which lack adequate medical services for our 
community. In addition, low median family income, the lowest of any 
other group in the nation, and a high cost of living in inner-city 
areas have prevented Puerto Ricans from purchasing private health 
insurance. In 1992, 50 percent of the population had no private health 
insurance and 21 percent had no health coverage whatever. These are 
alarming rates for any community.
  Puerto Ricans are growing every day more dependent on Government 
programs for health care insurance. In 1992, 32.2 percent of the Puerto 
Rican population received Medicaid benefits, a higher percentage than 
that of African-Americans, and five times higher than

[[Page E626]]

that of non-Hispanic Whites. In addition, 60 percent of the population 
in Puerto Rico depend on Government health care programs.
  The proposed cuts in funding for Medicaid and Medicare therefore pose 
a disproportionate threat to the health of the Puerto Rican population. 
Although President Clinton, in budget negotiations, has forced them to 
moderate their demands, the Republican leadership in Congress still 
proposes to slash the funding for Medicaid by $132 billion and Medicare 
by $270 billion. These cuts will force the elimination of health care 
services, such as dental care, physical therapy, and nursing facilities 
for children.
  In addition, because Puerto Rico is a commonwealth of the United 
States, it does not receive funding at full parity in Government 
programs. Funding for Medicaid is at one-tenth the amount that Puerto 
Rico would receive if it was treated equally. This is not a statement 
in opposition to the commonwealth status, nor an expression in support 
of statehood or the independence of Puerto Rico. But it is a fact of 
disparity. Although Puerto Ricans are U.S. citizens, they receive a 
much lower share of Federal funding for Government programs than that 
which is allocated to programs for U.S. citizens who live in the United 
States. Reductions in funding would further jeopardize access to health 
care for Puerto Ricans.
  The high incidence of HIV/AIDS infection among heterosexual drug 
users is a growing epidemic that requires special assistance in our 
community. In addition to the growing need to increase the access to 
medical services is the urgent need to provide culturally sensitive 
services to our community. Many providers do not have bilingual 
personnel or programs that identify with the culture of our community.
  In short, low utilization rates of medical services, lack of prenatal 
and post partum care, low birth weights for infants, high infant 
mortality, and inadequate child immunization, are all indicators of a 
community that it is highly underserved.
  We need to pursue a pro-active health care agenda which would provide 
coverage for the vulnerable population, the elderly, the poor, pregnant 
women, children, the medically disabled, and the working uninsured. We 
also need more effective outreach efforts to inform our community of 
the availability of health care services.
  Community-based organizations which already provide culturally 
sensitive medical services could be one of the catalysts for increasing 
the access to adequate health care in our community. In addition, we 
need to increase the participation of the Puerto Rican community in the 
medical field by providing Federal scholarships and other programs that 
would enable our students to pursue careers in health professions. We 
should also provide incentives to educational institutions to develop 
scholarships for our medical students.
  Slashing the funding for Government programs that are often the only 
source of health coverage for the poor will pose higher health risks to 
a population, such as ours, which is already disproportionally lacking 
access to medical services.
  I would like now to ask the members of the panel to talk more in 
detail about the health issues which are afflicting our community.

                          ____________________