[Congressional Record Volume 143, Number 1 (Tuesday, January 7, 1997)]
[Extensions of Remarks]
[Page E20]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       COMPREHENSIVE PREVENTIVE HEALTH AND PROMOTION ACT OF 1997

                                 ______
                                 

                        HON. BENJAMIN A. GILMAN

                              of new york

                    in the house of representatives

                        Tuesday, January 7, 1997

  Mr. GILMAN. Mr. Speaker, we are all aware of rising health care costs 
and reports of abuses by private health insurance companies. The United 
States spends far more per capita on health care than any other major 
nation; according to 1993 estimates, national health expenditures 
totaled $884 billion, or 13.4 percent of the gross domestic product 
[GDP]. Projections on health care expenditures indicate that consumer 
spending for health services will exceed 18 percent of GDP in the year 
2000.
  As health care costs continue to climb, insurance carriers have 
increasingly used experience ratings and underwriting practices to 
reduce their expenses. This has caused insurance companies to compete 
for business based on risk selection rather than on efficiency or 
service to the customer. Essentially, insurers find themselves 
competing for the healthiest, lowest-cost groups--a situation that 
leaves individuals, small businesses, families, and high-risk groups 
searching for affordable, accessible health insurance.
  Making matters worse are reports which continue to surface describing 
practices by HMO's which restrict patients access to quality health 
care. Examples include health plan restrictions governing their 
relationships with providers, limiting consumer access, and failing to 
cover or offer adequate preventive health care.
  Accordingly, I rise today to introduce legislation which will help 
produce a healthier Nation. This measure will cover individuals for 
periodic health exams, as well as counseling and immunizations.
  The Comprehensive Preventive Health and Promotion Act of 1997 will 
direct the Secretary of Health and Human Services [HHS] to establish a 
schedule of preventive health care services and to provide for coverage 
of these services under private health insurance plans and health 
benefit programs of the Federal Government.
  More specifically, the Secretary of HHS, in consultation with 
representatives of the major health care groups, will establish a 
schedule of recommended preventive health care services. The list of 
preventive services will follow the guidelines published in ``The Guide 
to Clinical Preventive Services'' and ``The Year 2000 Health 
Objectives.'' The preventive services will cover periodic health exams, 
health screening, counseling, immunizations, and health promotion. 
These services will be specified for both males and females, and for 
specific age groups.
  Additionally, HHS will publish and disseminate information on the 
benefits of practicing preventive health care, the importance of 
undergoing periodic health examinations, and the need to establish and 
maintain a family medical history for businesses, providers of health 
care services, and other appropriate groups and individuals.
  Moreover, prevention and health promotion workshops will be 
established for corporations and businesses, as well as for the Federal 
Government. A wellness program will be established to make grants over 
a 5-year period to 300 eligible employers to establish and conduct on-
site workshops on health care promotion for employees. The wellness 
workshops can include: counseling on nutrition and weight management, 
clinical sessions on avoiding back injury, programs on smoking 
cessation, and information on stress management.
  Finally, my legislation directs HHS to set up a demonstration project 
which will go to 50 counties over a 5-year period to provide preventive 
health care services at health clinics. This program will cover 
preventive health care services for all children, adults under a 
certain income level. If above the determined income level, fees will 
be based on a sliding scale. Additionally, the project will entail both 
urban and rural areas in different regions of our Nation to educate the 
public on the benefits of practicing preventive health care, the need 
for periodic health exams, and the need for establishing a medical 
history, as well as providing services.
  Mr. Speaker, we can all agree that our current health care system 
needs to be improved, and our Nation needs to become healthier. Experts 
have concluded that practicing preventive health care does work, and 
will produce a healthier Nation. Although there is a consensus on the 
benefits of practicing preventive health care, only approximately 20 
percent of health insurance companies offer coverage for periodic 
health exams.
  Accordingly, to all my colleagues who share my concern regarding the 
importance of producing a healthier Nation, I invite and urge you to 
cosponsor this measure, sending a clear message to our Nation's 
citizens that Congress is taking significant steps to improve our 
Nation's health care system.

                          ____________________