[Congressional Record Volume 148, Number 93 (Thursday, July 11, 2002)]
[Extensions of Remarks]
[Page E1240]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E1240]]
                      THE CRISIS OF THE UNINSURED

                                 ______
                                 

                         HON. CHARLES B. RANGEL

                              of new york

                    in the house of representatives

                        Thursday, July 11, 2002

  Mr. RANGEL Mr. Speaker, today America faces a crisis that affects 
more than 40 million people. This is the number of Americans who are 
currently without health insurance. Additionally, if we account for the 
number of people who have insurance but are underinsured, then we 
arrive at a far more disturbing number. Let's face it. The health care 
system as we know it is falling far short of its goals.
  During a time in which the economy is lagging and health care prices 
are rising, companies are having to make cutbacks and consumers are 
having to choose between health coverage and meeting their daily needs. 
For example, when faced with the choice of paying for a vehicle needed 
to get to work each day or for expensive health care coverage, millions 
opt to forgo their health in favor of a much needed paycheck.
  On the other hand as business profits have been decreasing 
substantially, employers can no longer afford to offer employees lower 
prices for health insurance. This means that businesses feel the 
pressure to pass the health care bill on to employees. Since 74% of the 
U.S. population is covered by private health care insurers, mostly 
provided by the workplace, this means that most consumers will feel the 
squeeze of skyrocketing health care premiums.
  Why is it so important that we insure all Americans? Lack of health 
care drastically affects access to proper medical treatment. Since the 
uninsured are less likely to have regular health care treatment, their 
level of health is lower on average compared to the insured. People 
without health insurance tend to allow medical problems to go untreated 
because they cannot afford doctor visits or recommended medications. 
More that a third of uninsured adults say they have not filled a drug 
prescription in the past year due to cost. More than a third did not 
get a medical test or treatment that had been recommended.
  The uninsured do not normally have access to preventative care, which 
may mean the difference between catching cancer in its early, treatable 
stages as opposed to a stage in which the cancer is incurable. For 
example, uninsured women diagnosed with breast cancer are more likely 
to die from it because they have a much greater chance of being 
diagnosed with late-stage cancer.
  We must address the problem of the uninsured because this health care 
crisis also affects the decisions of health care providers. Under the 
current system of competitive managed care, physicians are often forced 
to choose between giving proper treatment to the uninsured (risking 
uncompensated care) and not providing adequate treatment (risking the 
life of the patient). To alleviate this problem, the uninsured are 
often required to pay for services ``up front.'' This requirement 
causes uninsured individuals to either wait until they can afford 
treatment or charge their medical bills to credit cards, potentially 
building debt that may take years to pay.
  Another problem evident in the current health care system is that 
minorities disproportionately represent the uninsured. Roughly a third 
of Hispanic and Native Americans are uninsured. About 20% of African 
Americans and Asians are uninsured compared to 11% of whites.
  The poor and near-poor are also much more likely to be without health 
insurance. If it were not for Medicaid, many more of the poor would be 
uninsured and would have reduced access to medical care. Yet Medicaid 
does not cover a significant number of the near-poor. Since nearly 60% 
of the uninsured at or below the poverty level have at least one worker 
in the family, many near-poor individuals earn too much to qualify for 
Medicaid. It is evident that we must work to narrow the gaps of health 
care coverage disparities along racial and socioeconomic lines.
  We can no longer sit back and hope that the problems within the 
current health care system correct themselves. It is imperative that we 
rise together in a bipartisan effort to address the health care crisis 
of the uninsured. We must find a solution before this crisis grows to 
affect additional millions of Americans.

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