[Congressional Record Volume 146, Number 44 (Monday, April 10, 2000)]
[Senate]
[Pages S2462-S2463]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              EXPANDING ACCESS TO COMMUNITY HEALTH CENTERS

 Mr. HOLLINGS. Madam President, it has been over 30 years since 
I set off on my hunger tour of South Carolina, where I observed first-
hand the shocking condition of health care and nutritional habits in 
rural parts of my state. The good news is, we have come a long way 
since then. The bad news is, there is still much work to be done. Like 
the ``hunger myopia'' I described in my book ``The Case Against 
Hunger,'' we suffer today from a sort of ``health care myopia,'' a 
condition in which a booming economy and low unemployment rates mask a 
reality--that many Americans eke out a living in society's margins, and 
most of them lack health insurance. Ironically, as the stock market 
soars, so do the numbers of uninsured in our country, at a rate of more 
than 100,000 each month; 53 million Americans are expected to be 
uninsured by 2007.
  The health care debate swirls around us, reaching fever pitch in 
Congress, where I have faith that we will soon reach an agreement on 
expanding coverage and other important issues. However, I see a need to 
immediately address the health care concerns of these left-behind and 
sometimes forgotten citizens. They cannot and should not have to wait 
for Congress to hammer out health care reform in order to receive the 
medical care so many of us take for granted. That's why I sponsored, 
along with Senator Bond, a sense-of-the-Senate amendment to double the 
funding for health centers over the next five years. The Bond-Hollings 
Resolution to Expand Access to Community Health Centers (REACH) 
recommends that we start the process with a $150 million increase in FY 
2001. Let me emphasize that this measure is a cost-saving investment, 
not an increase in spending.
  While ideas about health care have changed dramatically, community 
health centers have remained steadfast in their mission, quietly 
serving their communities and doing a tremendous job. Last year, 
community health centers served 11 million Americans in decrepit inner-
city neighborhoods as well as remote rural areas, 4.5 million of which 
were uninsured. It's no wonder these centers have won across-the-board, 
bipartisan support. They have a proven track record of providing no-
nonsense, preventive and primary medical services at rock-bottom costs. 
They're the value retailers of the health care industry, if you will, 
treating a patient at a cost of less than $1.00 per day, or about $350 
annually.
  Not only are these centers providing care at low costs, but they are 
saving precious health care dollars. An increased investment in health 
centers will mean fewer uninsured patients are forced to make costly 
emergency room visits to receive basic care and fewer will utilize 
hospitals' specialty and inpatient care resources. As a consequence, a 
major financial burden is lifted from traditional hospitals and 
government and private health plans. Every federal grant dollar 
invested in health centers saves $7 for Medicare, Medicaid and private 
insurance: $6 from lower use of specialty and inpatient care and $1 
from reduced emergency room visits.
  The value of community health centers can be measured in two other 
significant ways. First of all, the centers' focus on wellness and 
prevention, services largely unavailable to uninsured people, will lead 
to savings in treatment down the road. And secondly, health centers 
foster growth and development in their communities, shoring up the very 
people they serve. They generate over $14 billion in annual economic 
activity in some of the nation's most economically depressed areas, 
employing 50,000 people and training thousands of health professionals 
and volunteers.
  It should also be noted that community health centers are just that--
community-based. They are not cookie cutter programs spun from the 
federal government wheel, but area-specific, locally-managed centers 
tailored to the unique needs of a community. They are governed by 
consumer boards composed of patients who utilize the center's services, 
as well as local business, civic and community leaders. In fact, it is 
stipulated that center clients make up at least 51 percent of board 
membership. This set-up not only ensures accountability to the local 
community and taxpayers, but keeps a constant check on each center's 
effectiveness in addressing community needs.
  In South Carolina, community health centers have a long history of 
meeting the care requirements of the areas they serve. The Beaufort-
Jasper Comprehensive Health Center in Ridgeland, the Franklin C. Fetter 
Family Health Center in Charleston, and Family Health

[[Page S2463]]

Centers, Inc. in Orangeburg were among the first community health 
centers established in the nation. The Beaufort-Jasper Center was very 
innovative for its day, in the late 1960s, tackling not only health 
care needs, but related needs for clean water, indoor toilets and other 
sanitary services. Today, the number of South Carolina health centers 
has grown to 15. They currently provide more than 167,000 people, 10 
percent of which are uninsured, with a wide range of primary car 
services. Yet despite the success story, a need to throw a wider net is 
obvious. Of the 3.8 million South Carolinians, nearly 600,000 have no 
form of health insurance. That means roughly 15% of the state 
population is uninsured. Another 600,000 residents are 
``underinsured,'' meaning that they do not receive comprehensive health 
care coverage from their insurance plans and must pay out-of-pocket for 
a number of specialty services, procedures, tests and medications.
  South Carolina's statistics are mirrored nationwide. The swelling 
ranks of the uninsured are outgrowing our present network of community 
health centers. Adopting this sense of the Senate amendment will ensure 
the reach of community health centers expands to meet increasing 
demand. It is our responsibility to continue providing our neediest 
citizens with a basic health care safety net. What better way to do 
that than by building on a program with a record of positive, fiscally 
responsible results? Everyone can benefit and take pride in such a 
worthwhile investment.

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