[Congressional Record Volume 143, Number 53 (Tuesday, April 29, 1997)]
[House]
[Pages H1961-H1965]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         MORE ON WOMEN'S HEALTH

  The SPEAKER pro tempore [Mr. Rogers]. Under the Speaker's announced 
policy of January 7, 1997, the gentlewoman from Connecticut [Mrs. 
Johnson] is recognized for the balance of the time as the designee of 
the majority leader.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I yield to the gentlewoman 
from New York [Ms. Slaughter], my colleague in this special order.
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentlewoman for yielding to 
me.
  Mr. Speaker, there are a wide range of both triumphs and shortcomings 
in women's health that could be discussed this evening. On the one 
hand, a woman's life expectancy has increased from 48 years in 1900 to 
79 years today. But on the other hand, many devastating women's health 
disorders still remain a mystery and research is desperately needed to 
find effective diagnostics, treatments, cures and preventive medicine.
  Women are now regularly included in clinical studies after having 
been excluded for decades. There is now an Office of Women's Health at 
the Public Health Service with corresponding offices at other agencies 
like NIH, the CDC, FDA, and the Health Resources and Services 
Administration and the Agency for Health Care Policy and Research.
  Breast cancer survival rates are up for women for the first time 
ever. And genes have been identified that are linked to early onset 
breast and cervical cancers as well as a number of other disorders that 
affect women like Alzheimer's disease. Estrogen replacement therapy has 
provided relief for millions of women from the harsher symptoms of 
menopause as well as osteoporosis and other age-related disorders.
  The NIH is conducting major women's health initiative designed to 
study and to track women health in a large population over decades. 
This research will yield invaluable information about the normal aging 
process and its pitfalls for women. All of those things have happened 
since 1990, as my colleague, the gentlewoman from Maryland [Mrs. 
Morella] pointed out, when we first set up the Office of Women's 
Health.
  But there are some shortcomings still in the health of women in the 
country. They suffer from a variety of gender-specific disorders that 
we do not really understand yet and which, in many cases, are receiving 
insufficient attention from the medical and research establishments.
  Each year breast cancer strikes 182,000 American women and kills 
44,000. We still do not know why breast cancer occurs, how to cure it 
or how to prevent it. We do not even know whether is for different ages 
and groups of cancer types and the mammography machine which we have 
had for the past number of years is all we still have. We need to do 
more.
  About 12,000 babies are born each year with fetal alcohol syndrome, a 
disorder that is completely preventable if women just abstain from 
alcohol during pregnancy, and yet we have just learned that the rate of 
pregnant women drinking alcohol is on the increase, showing a great 
need for education. About 4,000 pregnancies are affected by disorders 
like spina bifida or hydrocephalus, which are almost totally 
preventable if the woman consumes adequate levels of folic acid. Again, 
another need for education.
  One-quarter million women die each ear of heart attacks and strokes. 
Many of them could have reduced their risk by making dietary changes, 
quitting smoking, getting more exercise and, I might add, getting the 
kind of medical care that they need. Some of the bills that the 
gentlewoman from Maryland [Mrs. Morella] mentioned are very important, 
and I am sure all of us will sponsor and work for them very hard, 
because there are a number of things that we need to do to move along 
the issue of women's health.
  One bill that I have introduced is the genetic information 
nondiscrimination bill, because I want to make sure that as the human 
genome mapping continues that no one man, woman or child in America is 
discriminated against when it comes to health insurance. Our bill just 
says that the insurance company cannot cancel, deny, refuse to renew or 
change the terms or the premiums or the condition of health insurance 
coverage based on genetic information.
  And most importantly, it says that your genetic information belongs 
to you. And without your specific written concept, no one may use it.
  H.R. 306, the bill number, has 96 cosponsors and has been endorsed by 
over 60 respected health organizations, included the American Cancer 
Society, the American Heart Association, the National Breast Cancer 
Coalition, and the Jewish Women's Community.
  Congress should not be forcing women into making the Hobson's choice 
between learning valuable genetic information that they must have and 
their risk of losing their insurance or remaining ignorant and keeping 
the coverage.
  We will also be introducing information on education efforts for DES 
or diethylstilbestrol, which was given to pregnant women during the 
1970's so that they could have a healthy, bouncing baby. DES was given 
to pregnant women in the United States long after the Department of 
Agriculture had denied its use for cattle because they knew that it 
caused reproductive damage. Yet women in the country continued to be 
damaged.
  We are seeing that their children and again into a second generation 
now have often been damaged by DES, and we need to have more of an 
understanding about DES and similar synthetic estrogens because amazing 
impacts and discoveries are being made on the effects of estrogen on 
women's health. It also authorizes a national education effort to 
identify DES-exposed women and their children and their grandchildren 
and educate them about the continuing health needs and the risks.
  I have also introduced an Eating Disorders Prevention and Education 
Act, which I think is terribly important. We are very concerned about 
young women who are very unlikely to have a good diet because of their 
concern about their weight. Girls as young as 8 are dieting. This is a 
national disgrace that interferes with their normal development and 
their continued health. We have to make sure that young women 
understand that milk and dairy products will not make them fat but will 
indeed help to give them the calcium to lay down a good bone mass.
  In conclusion, women's health should not be taking a back seat 
anymore. We compose over half the Nation's population and a large 
number of us are workers and taxpayers. And we want some of our 
taxpayer dollars to be used in the health of women in the country.

[[Page H1962]]

 We want to make sure that we continue to be part of the clinical 
trials. We do not want to be left out anymore.
  As the great statesman Benjamin Disraeli said, The health of the 
people is really the foundation upon which all their happiness and all 
their powers as a state depend.
  We should remember those words.
  I would also like to quote Hippocrates, who once wrote, ``Healing is 
a matter of time, but it is sometimes also a matter of opportunity.''
  Today we have more opportunities than ever to heal the diseases and 
the disorders that affect human beings. We must grasp these 
opportunities and act.

  Mrs. JOHNSON of Connecticut. Mr. Speaker, I yield to the gentlewoman 
from Florida [Ms. Ros-Lehtinen].
  Ms. ROS-LEHTINEN. Mr. Speaker, I would first like to recognize and 
acknowledge the wonderful support that all of the women Members of 
Congress have received from the gentlewoman from Connecticut [Mrs. 
Johnson] and the Delegate from the District of Columbia [Ms. Norton]. 
They have done a spectacular job of leading the charge on behalf of 
women in the United States, and we congratulate them for their 
leadership not only on women's health care that we are discussing 
tonight but on a myriad of issues as well.
  I would like to briefly address the problem of women's health care as 
it relates in my community to Hispanic women. Hispanic women are of 
particular importance to the health care system not only as recipients 
of care themselves but as the member of the family most likely to deal 
with health care providers on behalf of children and the elderly. The 
health care system must learn how to deliver medical care to women that 
are in tune with their cultural realities.
  It must be pointed out that Hispanic women are part of one of the 
fastest growing populations in the United States and, as such, deserve 
special attention by those who deliver health care. There are already 
27 million people of Hispanic origin in our country, and in my area of 
south Florida there are nearly 1 million Hispanics. A doctor who is 
unaware of the cultural framework of her patient will find her job that 
much harder. A doctor is unaware of how cancer is viewed by some 
Hispanic women, for example, and may have trouble arriving at the 
correct diagnosis and then have to deal with the complications that 
follow delayed detection.
  The Hispanic female population is not monolithic. The differences run 
the gamut from different countries of origin to different regions of 
those countries, from different educational levels to various lengths 
of time in this country. It is important that we address the health 
care needs and the concerns of Hispanic women and to develop plans that 
will work in harmony with our cultural traditions.
  Hispanic women, for example, are less likely to enjoy the full 
benefits of our Nation's health care system. Part of this stems from 
the fact that 22 percent of Hispanic women are uninsured as compared to 
13 percent of non-Hispanic women. As a result of underinsurance and for 
various cultural reasons, many Hispanic women are unlikely to receive 
preventative health care. For example, 39 percent of Hispanic women did 
not have a pap smear last year as opposed to 27 percent of the general 
female population who also did not have a pap smear. And 46 percent of 
Hispanic women did not undergo a pelvic exam last year as compared to 
30 percent of the general female population who did not have such an 
exam.
  Mr. Speaker, to eliminate this disparity in preventative care, we 
need to develop a comprehensive strategy to educate both the medical 
profession as well as the underserved Hispanic women to deal with 
medical and cultural realities. I urge the medical profession, our 
government and the entire spectrum of health care providers to focus on 
this rapidly growing population and find new ways to reach out and 
provide preventative care. I congratulate once again the gentlewoman 
from Connecticut [Mrs. Johnson] and the gentlewoman from the District 
of Columbia [Ms. Norton] for leading the charge on behalf of all women 
everywhere.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I yield to the gentlewoman 
from California [Ms. Woolsey].
  Ms. WOOLSEY. Mr. Speaker, I am proud to be here today as a member of 
the Congressional Women's Caucus to talk about women's health. As we in 
Congress look for ways to improve the health of our children and the 
long-term well-being of our Nation, women's health is the place to 
start.
  Last week President Clinton held a conference on early childhood 
development. We saw new scientific research from that conference that 
showed us that a child's future brain development depends greatly on 
his or her first years of life. We know that nurtured and healthy 
babies become children who are educated and adults who are productive.
  But, Mr. Speaker, we must take it one step further. If we are going 
to have healthy children, we must have healthy mothers. A healthy mom 
is one who has access to proper nutrition and prenatal care. The WIC 
program, the special supplemental nutrition program for women, infants, 
and children, has provided critical nutritional assistance to needy 
pregnant women and, later, their children for the last 23 years. And 
now it is time for us to renew our commitment to this important 
program.
  Mr. Speaker, WIC works. Pregnant women on Medicaid who participate in 
WIC have improved dietary intake and weight gain. They are more likely 
to receive prenatal care. Mothers on WIC have children with better 
learning abilities and higher rates of immunization. And WIC reduces 
both the number of low birth weight babies and the infant mortality 
rate.
  Mr. Speaker, WIC works. It works because it is cost-effective. By 
providing nutritional assistance to pregnant women and their babies, we 
can prevent more serious and costly health problems associated with 
premature and low birth weight babies.
  Studies have found that for each dollar spent on pregnant women in 
the WIC program, we save up to $3.50 in Medicaid, SSI, and other 
program expenditures.
  But like so many other programs that help women and children, WIC is 
in danger. Congress underfunded WIC last year, so this year hundreds of 
thousands of poor women and children risk being thrown out of the 
program.
  Just last week, Mr. Speaker, the Committee on Appropriations denied 
the administration's request for $78 million in supplemental 
appropriations. Instead, the committee appropriated only half of this 
amount, leaving 180,000 poor women and children at risk of losing 
nutritional assistance.
  Mr. Speaker, it is simply outrageous that the budget axe is poised 
above pregnant women, mothers and infants.

                              {time}  1900

  Next week the House will vote on the supplemental appropriations 
bill. We must restore this cruel cut. And as we shape next year's 
budget, let us not forget the success of the WIC Program. It is time to 
expand WIC to include all eligible women and children; all of those who 
are not now covered in the program.
  Above all, Mr. Speaker, we must renew our commitment to the WIC 
Program and to the women, infants, and children that it serves. If we 
want a healthy America, we must have healthy mothers and then we will 
have healthy, productive children. Now is the time to act. Later may be 
too late.
  Mr. Speaker, I thank my colleague from Connecticut for having this 
event tonight.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentlewoman.
  It is a great pleasure to have so many women here on the floor of the 
House to participate in this special order on women's health, and I 
want to recognize now my colleague from New York, Sue Kelly.
  Mrs. KELLY. First, Mr. Speaker, I want to recognize the gentlewoman 
from Connecticut, Nancy Johnson, and the gentlewoman from the District 
of Columbia, Eleanor Norton, for creating a true bipartisan group 
concerned and focused on women's health.
  Mr. Speaker, I want to take a few moments to discuss the Women's 
Health and Cancer Rights Act, H.R. 616. This legislation, which I 
introduced in February, along with my colleagues, the gentlewoman from 
New York, Ms. Molinari, and the gentleman from New Jersey, Frank 
LoBiondo, is a comprehensive measure that focuses on women and breast 
cancer; those who

[[Page H1963]]

fear it, those who live with it, and in memory of those who have died 
as a result of it.
  As we all have heard, through new reports or personal experience, 
some women who must undergo mastectomies, lumpectomies or lymph node 
dissections for the treatment of breast cancer are rushed through their 
recovery from these procedures on an outpatient basis at the insistence 
of their health plan or insurance company in order to cut costs. Other 
insurance companies cut costs by denying coverage for reconstructive 
surgery because they have deemed such procedures as cosmetic. 
Ironically, they do not deny reconstructive surgery for an ear lost to 
cancer.
  The Women's Health and Cancer Rights Act guarantees coverage for 
inpatient hospital care following a mastectomy, lumpectomy or lymph 
node dissection based on a doctor's judgment, and requires coverage for 
breast reconstructive procedures, including symmetrical reconstruction.
  In addition, this bill requires coverage of second opinions when any 
cancer tests come back either negative or positive, giving patients the 
benefit of a second opinion. This important provision will not only 
help ensure that false negatives are detected but also give men and 
women greater peace of mind.
  Several key organizations have endorsed this legislation, 
organizations that agree we have a responsibility to protect the 
doctor-patient relationship, ensuring that the medical needs of 
patients are fully addressed. In fact, I would like to thank the 
American Cancer Society, the American Medical Association, the National 
Breast Cancer Coalition, the Center for Patient Advocacy, the Susan G. 
Komen Foundation, and many, many others for their support of this bill.
  Some critics claim this measure is nothing more than a mandate 
leading to government-controlled health care. Usually those critics 
believe that all health care should be individually based and should 
utilize medical savings accounts and other initiatives that maximize 
individual control over cost. I agree with these ideas, but they are 
not in place.
  There is also a misconception that this legislation requires 48 hours 
of inpatient care. It does not. The length of stay under this bill is 
simply determined by the physician and the patient, as it should be.
  Developing a system of health care which maximizes an individual's 
control over the health care available is the goal that I in particular 
strongly support, and so do these organizations. Such a system uses 
free market principles to ensure that the health care we receive is of 
the highest quality.
  However, I realize that while this is a goal we strive for, we are 
not there yet. Most Americans do not have access to multiple health 
care plans from which to choose. Until they have this choice, it is 
going to be necessary for Congress to enact targeted reforms, such as 
the Women's Health and Cancer Rights Act, reforms that safeguard 
quality care while at the same time avoiding overly broad regulations 
and mandates.
  I am for market-based health care, but I am not willing to stand by 
idly while approximately 44,000 women die of breast cancer every year. 
They will this year, they did last year. This is a figure which is 
comparable to the number of men and women who died in all of the 
Vietnam war.
  Mr. Speaker, the Women's Health and Cancer Rights Act aims to give 
women with breast cancer a fighting chance and the dignity to endure 
the fight.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I yield to the gentlewoman 
from Florida, my colleague, Congresswoman Meek.
  Mrs. MEEK of Florida. Mr. Speaker, I thank my cochair, the 
gentlewoman from Connecticut, Nancy Johnson. It is also my privilege, 
Mr. Speaker, to thank the Women's Caucus for having us here today to 
discuss important facets of women's health.
  In our focus today on issues of concern in women's health, I want to 
shine the spotlight on a very silent national killer of women, lupus, 
L-U-P-U-S. A lot of people have never heard of that term, but it is a 
silent killer of women.
  Lupus is a serious, complex inflammatory autoimmune disease. It 
affects women nine times more often than men. Between 1.4 to 2 million 
Americans have been diagnosed with this terrible disease called lupus. 
Many more cases go undiagnosed, since the symptoms of this disease come 
and go. Lupus also mimics many other illnesses.
  Although lupus may occur at any age and in either sex, 90 percent of 
those affected are women. During the childbearing years, lupus strikes 
women 10 to 15 times more often than men. In addition, lupus is more 
prevalent in African-Americans, Latinos, Native Americans and Asians. 
There is a disproportionate effect upon African-American women.
  Among African-American women, the disease occurs with three times the 
frequency of occurrence in white women. An estimated 1 in 250 African-
American women between the ages of 15 and 65 develops the disease. So 
it attacks women in their prime of life, this terrible disease that 
people have trouble remembering the name of, lupus, L-U-P-U-S.
  What exactly is lupus and how does it affect those who suffer from 
it? Lupus causes inflammation of various parts of the body, especially 
the skin, joints, blood and kidneys. Many women many times think they 
have arthritis or some kind of rheumatism.
  Our body's immune system normally protects the body against viruses, 
bacteria and other foreign materials. However, in one who is suffering 
from lupus, the immune system loses its ability to tell the difference 
between foreign substances and its own cells and tissues. The immune 
system then makes antibodies that turns them against itself. So the 
immune system, which is supposed to be a protector, becomes the 
attacker in the instance of lupus.
  Many victims of this disease in the early years suffer debilitating 
pain, particularly in the joints. They suffer fatigue. Many of them do 
not know what is wrong with them. Doctors have a lot of trouble 
diagnosing this disease. It is very hard for a woman in her prime years 
to maintain employment and to lead a normal life if she has lupus.
  Although lupus can range in severity from mild to life-threatening, 
it can be fatal if not detected and treated early. Thousands of women 
die each year, Mr. Speaker, and many of them who are stricken do not 
have the financial means for treatment which can help control this 
terrible disease called lupus.
  Lupus is not infectious. It is not rare. It is not cancerous. It is 
also not well known. Lupus is not well known. In fact, it is more 
prevalent than AIDS, sickle cell anemia, cerebral palsy, multiple 
sclerosis and cystic fibrosis combined.
  Perhaps the most discouraging aspect of lupus for sufferers, family 
members and friends is the fact that there is yet no cure for lupus. 
That is why research is needed so badly for this disease which catches 
women in the prime years of their life.
  Lupus is devastating not only to the victims but to family members as 
well. They must watch helplessly while the victim slowly and painfully 
succumbs to this terrible disease. I know this from firsthand 
experience, Mr. Speaker, having lost a sister and a very close friend 
to this disease, lupus.
  Because of my involvement in various lupus organizations, I have also 
heard firsthand the heartbreaking stories of other women and their 
families across this Nation. I recently received a letter from a mother 
of a 42-year-old woman who had heard of the lupus bill that I 
introduced in the 104th Congress. This woman, who I will call Jane, was 
finally diagnosed with lupus in 1993 after repeatedly being tested for 
AIDS, repeatedly being treated for arthritis, bursitis, allergies, and 
other ailments.
  Although Jane was fortunate to encounter a doctor who specialized in 
disease control during a near death hospital stay, the aftermath of 
this discovery has been devastating. Since beginning treatment for 
lupus, both of Jane's hips have deteriorated to the extent that she is 
on crutches and is waiting for total hip replacement. This young woman.
  Her medication and doctor visits cost over $900 per month. Jane is a 
chemist. She was laid off last year when the company she worked for 
downsized and was bought out by another company which denied her 
medical insurance

[[Page H1964]]

coverage because she has lupus. Many times, Mr. Speaker, the medication 
for lupus works against the system as badly as lupus itself.
  Jane now receives Social Security benefits of only a fraction of her 
former $30,000 per year salary and is unable to meet her debts, buy 
food and pay for medication. Jane wants to work and she wants to get 
well, but she is no longer able to care for herself. Her mother and 
other family members must bear the hardship which this terrible 
disease, lupus, which is not well-known, has brought on Jane's life.
  This is not an isolated situation. Many cases are worse, because the 
women who are victims of lupus have no family many times or friends to 
turn to for support.
  Something must be done, and I appeal to our appropriations panels and 
also to authorizing committees and to the Women's Caucus. If they have 
a very strong interest in women's health, something must be done on a 
national level to help lupus patients.
  To that end, Mr. Speaker, I have introduced H.R. 1111. It is a 
bipartisan bill, the Lupus Research and Care Amendments of 1997 to the 
Public Health Service Act. My bill has two main focuses.
  First, the bill authorizes expanded and intensified research 
activities at the National Institutes of Health and other national 
research institutes and agencies. We must find a cure for lupus. This 
will provide for increased resources to determine reasons why so many 
women get lupus, especially African-American women, Latinos and Asians.
  The bill also covers research on the causes of the disease, its 
frequency, and the differences among sexes, racial, and ethnic groups.
  My bill also provides funding for the development of improved 
screening techniques, clinical research and development on new 
treatments, and information and education for health care professionals 
and the public.
  The amount allocated to lupus research by NIH in fiscal year 1997 
amounted to $34 million. We are very happy about that, but that $34 
million is less than one-half of 1 percent of the National Institutes 
of Health budget. My bill proposes raising this allocation to $50 
million more for fiscal year 1998. And the Women's Caucus is supporting 
this because, after all, one of their most major emphasis is on women's 
health.
  The second part of my bill calls for the establishment of a grant 
program to provide for projects to set up, operate and coordinate 
effective and cost-effective systems for getting essential services to 
lupus sufferers and their families.
  Mr. Speaker, American women are at high risk for this deadly and 
debilitating disease. Increased professional awareness and improved 
diagnostic techniques and evaluation methods can contribute to early 
diagnosis and treatment of lupus. We must step up this research to find 
a cure and treatment for this silent killer and for this silent 
disease.
  Mr. Speaker, I urge my colleagues to join the Women's Caucus in 
saving the lives and advancing the health of American women by not only 
cosponsoring my bill, the Lupus Research and Care Amendments of 1997, 
but to support and step up the emphasis on research and development of 
all of these killers of women.

                              {time}  1915

  Mrs. JOHNSON of Connecticut. Mr. Speaker, in view of the fact that we 
have quite a few speakers, I am going to limit my remarks rather more 
than I had intended. I do want to thank my colleagues from both sides 
of the aisle for their participation tonight. It is impressive, the 
work that Congress has done in the area of women's health in recent 
years, and much of it has been the direct result of the focus on that 
issue that the bipartisan caucus of women Members of Congress has 
generated.
  I want to talk briefly tonight about two things. I want to talk about 
Medicare and women's health, and I want to talk about smoking and 
women's health.
  It is true, and terrible, that Medicare is an illness program. It 
provides health care after you get ill. Medicare by law is not a 
preventive health program, and that is something that I believe this 
Congress is going to address. We have been holding hearings on 
preventive health, we have been generating information about which 
preventive tests are important to both women and men on Medicare, and I 
believe this year we are going to finally pass a package of preventive 
health services that will improve Medicare dramatically and meet the 
needs of both men and women far more effectively than the current 
program.
  For women, it will mean annual mammograms. It will also mean passage 
of a bill I introduced recently reauthorizing the Mammogram Quality 
Standards Act, which will assure that those mammograms will continue to 
be done by well-trained people with high quality equipment, read and 
interpreted by able physicians. It will also, I hope, mean that we will 
have national standards for testing bone density to help women prevent 
osteoporosis and all of the crippling fragility that results from loss 
of bone density.
  It will also mean, I hope, that we will pass a bill that the 
gentlewoman from New York [Ms. Slaughter] has introduced this year, and 
she spoke about it earlier, that will guarantee that women who have had 
genetic indicators that they are inclined to get breast cancer or some 
other disease will not be discriminated against by insurers.
  We made a giant step forward on this subject last year when an 
amendment I introduced passed and was part of the Medicare legislation 
of the last Congress that said that women could not be discriminated 
against because they had genetic tests indicating a tendency toward 
cancer. That was an important step, but the more extensive bill that my 
colleague the gentlewoman from New York [Ms. Slaughter] has introduced 
goes on to the issues of privacy, ownership of your medical data that 
are terribly, terribly important as we move into the new era of genetic 
science and health.
  Lastly, I believe that we will this year pass inclusion of women in 
clinical trials. It is indeed the Congresswomen's caucus that first 
passed legislation assuring that the National Institutes of Health 
would include women in all of their health research trials.
  It is truly remarkable that we ran the first long-term trial looking 
at heart disease on a population entirely of males, and so we came out 
of that multi-year project knowing a lot about heart disease in men and 
knowing literally nothing about the course of that disease in women, 
only to find out later that the course of that disease in women is 
really quite different, as we have found out in HIV and a number of 
other areas. It is not only unfair to our seniors that they do not have 
access to some of the remarkable treatments available through our 
cancer clinical trials program, but it is also a disadvantage to the 
Nation not to know how those medications that are being tested, those 
procedures that are being tested affect both men and women in their 
senior years. This Nation needs far better health research data than 
our current clinical trials program provides, and it is my hope that in 
this session we will see Medicare expanded to provide coverage for 
cancer treatments in clinical trials.
  Let me talk briefly also about smoking, because smoking is really the 
most preventable cause of death and disability and tobacco use studies 
have indicated is far more detrimental to women than to men. Women are 
far more susceptible than men to tobacco-related disease. Lung cancer 
has surpassed breast cancer as the leading cause of cancer death among 
women. Recent research suggests that women may be more susceptible than 
men to the development of lung cancer. Several recent reports also 
provide strong evidence of an association between smoking and 
osteoporosis. In addition, research shows a dangerous link between 
smoking and the use of oral contraceptives.
  So while tobacco use directly increases a person's risk of lung 
cancer, heart disease, stroke and diseases of the blood vessels, it 
holds many additional perils for women. Furthermore, each day 3,000 
kids become regular smokers. That is more than 1 million a year. One 
third of them will die from tobacco-related disease. While smoking is 
declining in adults, teenage girls are the fastest growing group of 
smokers.

[[Page H1965]]

  Smoking by mothers during pregnancy can adversely affect the supply 
of oxygen and nutrients to the fetus and has been shown to increase the 
risk of low birth weight, miscarriage, still birth, premature birth and 
death in the first few weeks of life. Maternal smoking during and after 
pregnancy has been estimated to be responsible for one-quarter of the 
risk of sudden infant death syndrome, or crib death, and parents who 
smoke around their children put them at increased risk for developing 
bronchitis, pneumonia, ear infections and asthma. Children exposed to 
smoke may also be at increased risk for cancer in their adult years. 
Smoking does cause illness. It causes illness in adults, illness in 
children, and it is particularly lethal to women.
  Let me conclude by saying that this is a Congress that not only will 
address some important women's health issues, it is also, I believe, 
the Congress that will move forward on providing coverage for children 
whose parents work for employers who do not provide insurance or for 
some other reason are without insurance. It is a crime for this Nation 
to leave children uncovered for simple diseases like ear infections, 
much less their parents exposed to the paralyzing catastrophic costs of 
the hospitalization of a child without coverage.
  Mr. Speaker, I yield to my friend and a new Member of Congress the 
gentlewoman from the Virgin Islands [Ms. Christian-Green].
  Ms. CHRISTIAN-GREEN. I thank the gentlewoman from Connecticut for 
yielding.
  Mr. Speaker, as the first female physician to serve in this body, I 
find a special cause in women's health and I would like to thank my 
colleagues in the Congressional Caucus on Women's Issues and our 
chairs, the gentlewoman from the District of Columbia [Ms. Norton] and 
the gentlewoman from Connecticut [Mrs. Johnson], and my colleague the 
gentlewoman from Maryland [Mrs. Morella] for organizing this special 
order.
  Mr. Speaker, women make up more than 50 percent of our Nation's 
population. Further, we are the primary caregivers for our husbands, 
children and aging parents. Consequently, we as a country have a great 
stake in the health of our women. To paraphrase a well-known saying, as 
the health of women goes, so goes the health of our country.
  Traditionally, the issue of women's health had not been a political 
or a legislative priority. However, because of the insistence of women 
from different walks of life that our stories be heard, that our 
statistics be included in research, that the problems which 
specifically affect us be studied and addressed, and because of the 
leadership of the Caucus on Women's Issues, thank God this is changing.
  There are many important issues, such as AIDS, heart disease, cancer, 
diabetes and violence, each in themselves deserving of our focus. 
However, today I choose to address one of the root causes underlying 
some of the dire statistics that diseases such as these represent, 
problems such as poverty, poor or inadequate education, lack of 
opportunity and limited access to health care. Central to all of these 
is the issue of women's access to health insurance.
  According to the Institute for Women's Policy Research, 12 million 
women of working age between the ages of 18 and 64 have no insurance of 
any kind. As a result, many of these women have little or no access to 
our health care delivery system which is predicated on having insurance 
or Medicaid. The Institute for Women's Policy Research further says 
that women traditionally obtain health insurance indirectly through 
their husband's jobs. But more of these women are falling through the 
cracks as more men have jobs that do not provide health insurance and, 
in addition, many women do not marry, are divorced, widowed or have a 
spouse that has retired or lost his job. Studies also show that only 37 
percent of women have access to insurance through their own jobs. Five 
million young women under age 30 have no insurance whatsoever, even 
though 70 percent of all births are to women in this age group. Single 
mothers are also more likely to be uninsured despite the presence of 
Medicaid.
  It is a sad reality that even today for women, health insurance and 
as a consequence health care is available only to those who can afford 
to pay. With this in mind, it is imperative that we take a hard look at 
the needs of women with regard to health insurance. In this Congress, 
the cause of children's health care will be addressed, but we cannot 
stop there. Rich or poor, we as women must know that our needs and the 
needs of our families will be met when illness, accident or old age 
befalls us.
  Mr. Speaker, quality health care should not be an option. It must be 
an available choice, not only for women but for all the people of this 
Nation. Universal health coverage and universal access to health care 
for all must remain our goal.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I yield back the balance of 
my time.

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