[Congressional Record Volume 146, Number 19 (Monday, February 28, 2000)]
[Senate]
[Pages S840-S841]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          THE REACH INITIATIVE

  Mr. BOND. Mr. President, I rise today to talk about one of the hot 
topics in the world of health care--health care access. Many people see 
this as the biggest problem in health care today.
  Part of the problem, and the part that has received the most 
attention, is that too many Americans lack health insurance--about 44 
million Americans are not covered by any type of health plan. But an 
equally serious part of the problem is many people's simple inability 
to get access to a health care provider. Even if they have insurance, a 
young couple with a sick child is out of luck if they cannot get in to 
see a pediatrician or another health care provider. And in too many 
urban and rural communities across the country, there just are not 
enough doctors to go around.
  Several plans have been proposed recently on how to deal with the 
health care access problem. Senator Bradley has a plan. The Vice 
President has one. There's also a bipartisan proposal for tax credits 
to help people buy health insurance. All of these plans have at least 
three things in common:
  First, they all address a worthwhile goal. I think we all want to see 
that people have access to good health care, even if we might disagree 
on how to get there.
  Second, they are all very ambitious. Senator Bradley in fact is 
basically proposing to use close to the entire $1 trillion surplus to 
provide people with health insurance.
  The third thing these plans have in common--and perhaps the most 
important thing--is that it will be difficult or impossible for them to 
become law this year. Whether because of policy differences or 
political differences, it is just not likely that they will pass.
  So last week, we launched a bipartisan effort--along with Senators 
Hollings, Cochran, Lincoln, Hatch, Hutchinson of Arkansas, I and other 
Senators--called the REACH Initiative, that does have a chance this 
year. There is no need to wait for an election, we can do it now.
  Our proposal builds on the crucial work that organizations known as 
community health centers have been doing to ensure better access to 
health care. Health centers are private nonprofit clinics that provide 
primary care and preventive health care services in medically-
underserved urban and rural communities across the country. Partially 
with the help of Federal grants, health centers provide basic care for 
about 11 million people every year, 4 million of whom are uninsured.
  The goal of the REACH Initiative is simple--to make sure more people 
have access to health care. We plan to achieve this by doubling Federal 
funding for community health centers over a period of 5 years. We 
believe this will allow up to 10 million more women, children, and 
others in need to receive care at health centers. If we are successful 
with the REACH Initiative, we can practically double the number of 
uninsured and underinsured people cared for at health centers.
  I am pleased that 12 colleagues--led by my good friend from South 
Carolina, Senator Hollings--have joined me to introduce this resolution 
calling for doubled health center funding over 5 years.

[[Page S841]]

  The REACH Initiative basically recognizes the key contributions that 
community health centers have already made in addressing the health 
care access problems. But there is so much more that can still be one.
  Now, out of all the ways we can address health care access problems, 
why are health centers a good solution and a worthwhile target for 
additional funding?
  No. 1, they are building on an existing program that produces 
results. Too many health care proposals want to start practically from 
scratch, and make breathtakingly revolutionary changes. When I look at 
the health system and its admittedly huge problems, I sometimes think 
that might not be a bad idea. But it is also extremely risky. We need 
to remember that despite the many flaws in our health system, many 
people are pleased with it. We should be wary about making too radical 
changes that could interfere with what is right in our system. Instead, 
we can expand an existing part of the system that has been proven to 
provide cost-effective, high-quality care.
  No. 2, health centers play a crucial role in health care, and are 
vastly underappreciated. It is amazing to me how few people know what 
community health centers are. After all, health centers care for close 
to one out of every 20 Americans, one out of every 12 rural residents, 
one out of every 6 low-income children, and one of every 5 babies born 
to low-income families.
  No. 3, health centers truly target the health care access problem. By 
definition, health centers must be located in ``medically underserved'' 
communities--which simply means places where people have serious 
problems getting access to health care. So health centers attack the 
problem right at its source. Unlike other health care proposals, the 
REACH Initiative does not create problems of ``crowding out'' private 
insurance by replacing private dollars spent on health insurance with 
Federal dollars. The health centers are partially funded by those 
patients who do have health insurance.
  No. 4, they are relatively cheap. Health centers can provide primary 
and preventive care for one person for less than $1 per day--about $350 
per year. That's just about the best value you will ever see in health 
care. Even better, health centers are able to leverage each grant 
dollar from the Federal Government into additional funding from other 
sources--meaning they can effectively turn one grant dollar into 
several dollars that can be used to address health care problems. With 
an extra billion dollars a year--the goal of the REACH Initiative in 
its fifth year--health centers could be caring for an additional 10 
million people.
  No. 5, this initiative is not a government takeover of health care. 
Admittedly, our plan calls for more government spending. This is of 
course true for most plans that try to deal with health access 
problems. But this new funding would not go to create a huge new 
bureaucracy. Instead, the REACH Initiative would invest additional 
funds into private organizations that have consistently proven 
themselves to be efficient, high-quality, and cost-effective health 
care providers.
  To me, all of these reasons point to one logical conclusion--a need 
for drastically increased funding for health centers. Health centers 
are already helping millions of Americans get health care. But they can 
still help millions more--pregnant women, children, and anyone else who 
desperately needs care.
  Simply put, we must reach the goal of the REACH initiative--doubled 
funding for health care centers within 5 years--and we can and should 
make it happen.
  Let me close with what this means in human terms.
  The REACH initiative will help make sure that a young woman who has 
just found out she is pregnant but does not have health insurance has a 
place to get prenatal care so she does not risk her health and the 
baby's health by waiting until late in the pregnancy.
  The REACH initiative will help make sure that a 6-year-old boy who is 
living in a deep rural Missouri community, a community that otherwise 
would not have any health care providers at all, has a place to get 
regular checkups so he can stay healthy at home and in school.
  The REACH initiative will help make sure a young couple without 
anyplace to go will be able to get their infant daughter immunized to 
protect her from a variety of dreaded diseases.
  The REACH initiative will make sure Americans like Denise Hall, a 
Washington, DC, resident, and her children have a place to get needed 
care. Denise joined us for our announcement last week and talked about 
her reliance on health care centers. The REACH initiative will make 
sure she and her children have a place to get needed care. Denise, at 
our press conference kicking off the REACH initiative, said she is an 
out-of-work mother of two who is working to improve her job skills so 
she can rejoin the workforce. But for the moment, she and her children 
simply have nowhere to go for health care needs other than a local 
community health center.
  These Americans, and millions like them, are the reasons why we must 
make the REACH initiative--doubled funding for community health 
centers--become a reality. I invite my colleagues to join me and 12 
others who cosponsored this resolution, and 29 distinguished health 
care organizations, in support of the REACH initiative. If we work 
together, we can make a difference and serve those who are in the 
greatest need of access to health care and who, without community 
health centers, will not have that access.
  I thank the Chair and yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. THOMAS. Mr. President, what is the current status of business?
  The PRESIDING OFFICER. The Senator from Wyoming is notified that 
under the previous order, time until 2 p.m. is under the control of the 
Senator from Wyoming or his designee.

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