[Congressional Record Volume 146, Number 135 (Wednesday, October 25, 2000)]
[Extensions of Remarks]
[Page E1910]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        LACK OF HEALTH INSURANCE BANKRUPTS MILLIONS OF AMERICANS

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                      Wednesday, October 25, 2000

  Mr. STARK. Mr. Speaker, the record of the 106th Congress on major 
health care policy issues--Medicare prescription drug coverage, managed 
care reform, and extension of coverage to the 44 million Americans who 
lack it--is appalling. Our failure to enact legislation that provides 
baseline coverage for all of our citizens is not simply that emergency 
rooms are overcrowded and public health clinics are overflowing. Our 
lack of a guaranteed health care safety net indirectly plunges millions 
into bankruptcy and financial ruin who, once sick, cannot afford to pay 
for their high medical treatment costs out-of-pocket.
  This piercing fact is highlighted in a column that was published in 
the Philadelphia Inquirer on Oct. 8. Health care economist Uwe 
Reinhardt points out the fallacy of self-reliance when it comes to 
health insurance. I submit the following article in the Congressional 
Record.

             [From the Philadelphia Inquirer, Oct. 8, 2000]

                 Issue No. 1: Health-Care System Wanted

                           (By Uwe Reinhardt)

       Several years ago, in a fit of compassion, New York Mayor 
     Rudy Giuliani appointed former Republican Mayor John Lindsay 
     to two no-show municipal jobs, solely to provide the latter 
     with city-financed insurance coverage for health care not 
     covered by Medicare. Lindsay, after several strokes and with 
     Parkinson's disease, was facing out-of-pocket outlays for 
     health care that had begun to strain his finances.
       Millions of fellow Americans share Lindsay's predicament. 
     The most recent estimate by the U.S. Bureau of the Census 
     revealed that about 42 million Americans find themselves 
     without any health insurance coverage for at least part of 
     the year. Almost half the uninsured at any time have been 
     uninsured for more than two years. Many millions more, 
     including Medicare beneficiaries like John Lindsay, have 
     shallow insurance coverage.
       To be sure, most of the uninsured probably are relatively 
     healthy. When they do fall seriously ill, they usually 
     receive critically needed care at nearby hospitals. 
     Ultimately, the hospital tries to recover the cost of its 
     ``charity care'' from insured patients, but only after first 
     hounding the uninsured themselves for payment, often with the 
     help of tough collection agencies. According to survey 
     research by Harvard law professor Elizabeth Warren, medical 
     bills now are the second most frequently cited reason for the 
     bankruptcy of American families, right behind ``job loss'' 
     and ahead of ``divorce.''
       Political leaders in any other industrialized nation would 
     think it unacceptable nation would think it unacceptable to 
     force families, stricken by serious illness, to face the 
     added prospect of bankruptcy. Not so with this nation's 
     policy-making elite. To illustrate, in their first debate, 
     neither presidential candidate addressed the problem on his 
     own. And moderator Jim Lehreer saw no reason to accord the 
     issue an explicit question. Perhaps all of them surmised 
     that, in these times of economic bounty, their audience would 
     have little interest in the acute distress of a misfortunate 
     few.
       Alas, the economy may not always remain bountiful. If it 
     doesn't, American consumers, feeling poorer, might tighten 
     their belts, thereby triggering a consumption-led recession. 
     With a recession would come layoffs, and with them a loss of 
     employment-based health insurance. The middle class might 
     then be reminded once more that it lacks what families in all 
     other industrialized nations enjoy; universal, permanent 
     protection against the financial consequences of illness.
       Universal coverage could easily be provided in this 
     country, if only the nation's political elite were willing to 
     do three things. First, there must be a mandate on every 
     individual to have at least catastrophic health insurance. 
     Second, between $60 billion and $100 billion a year would 
     have to be appropriated to subsidize the health insurance of 
     low-income families. Third, government regulation would have 
     to ensure an efficient market for individually purchased 
     health insurance. That insurance could be private or, should 
     private insurance fail to meet social needs, public (e.g., 
     Medicaid and Medicare). The shelves of the nation's think 
     tanks bend under the weight of ready-to-go proposals that 
     could achieve both objectives.
       Opponents of such measures are fond of reminding us of this 
     nation's ``rugged individualism'' and its tradition of 
     ``self-reliance.'' For the most part, it is empty talk. Most 
     corporate executives, for example, enjoy comprehensive, tax-
     sheltered ``social insurance'' paid for by their 
     corporations, literally until these executives' last day on 
     earth. Furthermore, the plight of former Mayor Lindsay stands 
     as a stark warning to all would-be rugged individualists who 
     believe that self-reliance is the proper solution to this 
     nation's health-care woes. In the end, even he could not be 
     protected by our nation's brittle private health-insurance 
     system. He was saved by what is otherwise decried as ``a 
     complete government takeover'' of his health-care needs.
       A common lament is that the typical college student today 
     insists on doing well by doing good. Too few of them are said 
     to heed President John Kennedy's eloquent exhortation to 
     self-sacrifice: ``Ask not what your country can do for you--
     ask what you can do for your country.'' But why would any 
     American youngster seek to lay out for a country that thinks 
     nothing of letting its citizens slide into the undignified 
     status of health-care beggars, and into financial 
     destitution, simply because serious illness struck? America's 
     allegedly selfish young have read their country's soul and 
     are acting accordingly.

     

                          ____________________