[Congressional Record Volume 148, Number 93 (Thursday, July 11, 2002)]
[House]
[Pages H4540-H4545]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          UNINSURED AMERICANS

  The SPEAKER pro tempore (Mr. Rehberg). Under the Speaker's announced 
policy of January 3, 2001, the gentlewoman from Wisconsin (Ms. Baldwin) 
is recognized for 60 minutes as the designee of the minority leader.
  Ms. BALDWIN. Mr. Speaker, I am pleased to have the next hour on the 
floor to discuss with my colleagues a grave situation in our country, 
the issue of the uninsured. I would like to set the stage on this topic 
before calling on a number of my colleagues who are equally committed 
and tenacious about fighting to bring this issue back to the forefront.
  We are facing an extremely serious health crisis. I listen carefully 
to those that I represent in Congress. I hear from constituents every 
day who have lost their health insurance and have nowhere to turn. I 
hear from mothers and fathers who are afraid that their healthcare 
premiums will become so expensive that they simply cannot afford them 
any more. I hear from small business owners who are facing skyrocketing 
premium increases and may

[[Page H4541]]

not be able to offer health care coverage to their employees any more.
  I believe that it is time once again to bring the issue of the 
uninsured and health care for all back to this House floor. I believe 
we need to act soon if we are going to save those families teetering on 
the edge of losing their health insurance, and I believe that it is 
unconscionable that in our country, the richest country on earth, that 
almost 40 million Americans have no health care coverage at all.
  During 1999, about 15 percent of our population was uninsured. The 
Government defines being uninsured as being uninsured for a full year, 
but almost three out of every 10 Americans, more than 70 million 
people, were uninsured for at least a month over a 3-year period 
between 1993 and 1996. Although the uninsured population decreased 
slightly in 1999, the long-term trend has been growing of uninsured 
people. Without substantial restructuring of the opportunities for 
coverage, this trend is likely to continue. It is clear that the time 
to take action to solve this crisis is now.
  I am sure many are aware of the recent reports issued by the 
Institute of Medicine of the National Academy of Sciences regarding the 
uninsured in America. The Institute of Medicine is in the process of 
conducting a 3-year study on the uninsured. It has two major 
objectives. The first is that the study will assess and consolidate 
evidence about the health and economic consequences of being uninsured 
for persons without health insurance and their families, for health 
care systems and institutions, and for communities as a whole.
  Secondly, the study will raise awareness and improve understanding 
for the public and the policymakers about the magnitude and nature of 
the consequences of lacking health insurance.
  The 16-member committee on the consequences of the uninsured has 
already issued two reports and plans to issue four more by September of 
next year. The first report, Coverage Matters: Insurance and Health 
Care, concluded, and I should mention not surprisingly, that the high 
cost of health insurance along with public policies prevent tens of 
millions of Americans from obtaining health care coverage. The 
Institute on Medicine report also found that there are persistent 
misperceptions about the uninsured that present obstacles to addressing 
the issue constructively.
  I would like to talk briefly about some of these misconceptions. 
First, many people may think that the number of uninsured in the United 
States is not large and that it might not have increased in the recent 
years. But despite a very modest dip at the end of the 1990s and in 
2000 following an obviously extended period of economic prosperity and 
growth and low unemployment in our country, the number of uninsured 
people has grown over the long term.
  According to the Institute of Medicine report, the number of 
uninsured people is greater than the combined population of Texas, 
Florida and Connecticut.
  In 1992 Congress debated health care reform and a plan that would 
guarantee every American the health care they needed. That vision was 
never realized. And now we have more Americans who are uninsured than 
we did back in 1992.
  The second misperception is that it is assumed that the people who 
are uninsured do not live in families that work. This is incorrect. 
According to the Institute on Medicine study, 80 percent of the 
uninsured children and adults live in working families. Included among 
the uninsured are parents who are working two, sometimes three, jobs 
just to make ends meet. But increasingly they work in sectors of our 
economy like small business, family farms, the service sector or maybe 
part-time employment that do not offer health insurance coverage to 
their employees or that require them to pay so much of it that they 
simply cannot afford it and do not take the coverage. Even families 
with two full-time wage earners have a one-in-ten chance of being 
uninsured.

  The third myth is that it is improper to assume that the uninsured 
get adequate medical attention. A report by the Kaiser Commission on 
Medicaid and the Uninsured found that the uninsured receive less 
preventative care and are diagnosed at more advanced stages of 
diseases. The uninsured are less likely to see a doctor within any 
given year and have fewer visits annually, and they are less likely to 
have a regular source of medical care. Uninsured persons receive fewer 
preventative services and less care for chronic conditions than those 
who have health insurance. This ultimately adds to the costs because in 
many cases their medical conditions become much more serious, producing 
adverse outcomes that will need extensive follow-up care.
  It is clear that the costs associated with the delay of care for the 
uninsured could be prevented if they had access to affordable coverage.
  Another problem we are facing in our system is that the cost of 
health care services and insurance premiums have been steadily 
increasing and more employers and consumers are viewing coverage as 
prohibitively expensive. A gap in the ability to purchase health care 
coverage has been growing ever since the growth in the cost of health 
insurance has outpaced real income. This gap has added almost 1 million 
people to the ranks of the uninsured every year.
  Now many employers absorbed premium increases during the economic 
boom of the 1990s, but they cannot be expected to continue this 
practice in our current economy. Many lower wage workers pass up on 
coverage because they cannot afford their share of the premium. On 
average, workers pay 14 percent of the costs of individual coverage and 
27 percent of family coverage. Over the past 20 years, private sector 
employers have become less likely to cover part-time workers or new 
employees. And small businesses are faced with hurdles such as higher 
group premium rates and frequently do not offer coverage these days to 
their employees.
  A business owner in my district could no longer provide health 
insurance to her employees because of the high costs of the premiums. 
Nancy Potter owned a bakery in New Glaris, Wisconsin for 25 years. Her 
health insurer left the region, and when she sought coverage from other 
companies, the quotes she received represented a 180 percent increase 
in premiums. She would have had to pay an additional $50,000 each year 
to continue offering coverage. Unfortunately, she had to tell her 20 
employees that she could no longer provide health insurance to them and 
their families. Even more devastating to her was the knowledge that one 
of her employees had recently been diagnosed with cancer and was 
undergoing treatment. This tragic state of affairs is not isolated and 
it is simply wrong.
  On that note I would like to recognize one of my colleagues who has 
been a champion of the uninsured and of health care for all. We have 
worked very closely together and it is my privilege to yield to the 
gentlewoman from California (Ms. Lee).
  Ms. LEE. Mr. Speaker, I would like to thank the gentlewoman from 
Wisconsin (Ms. Baldwin) for her leadership on health issues as well as 
on each and every issue that affects Americans on a daily basis, and 
also I want to just thank the gentlewoman for organizing this special 
order, because oftentimes health care remains under the radar, and I 
thank the gentlewoman for raising the level of awareness of this issue 
for all Americans, because for the wealthiest country in the world 
which claims liberty and justice for all, the fact that there are 44 
million people without health insurance is really a shame and disgrace.
  The fact that the bulk of the uninsured are low income and people of 
color is really no surprise. Although our Nation has a record low 
unemployment level, we still have one in six Americans who do not have 
health insurance. How fair and how just is that? Most Americans receive 
health insurance through their employers, but millions lack coverage 
because their employers do not offer insurance or simply cannot afford 
to pay it. Medicaid covers 40 million low income individuals, but 
millions more do not meet its limiting income and eligibility 
requirements because of really, quite frankly, savage welfare reform 
restrictions, leaving the most vulnerable uninsured.

  Although State Children's Health Insurance Program is supposed to 
cover all low income children, 16 million low

[[Page H4542]]

income children still remain uninsured. Who are the uninsured? The 
uninsured are predominantly workers and their families, low income 
people, and oftentimes people of color. Fifty-six percent of the 
uninsured population is low income and nearly one in five of the 
uninsured are low income children.
  Although people of color comprise only 34 percent of the population, 
over half of the Nation's uninsured are minorities. Twenty percent of 
those uninsured are African-Americans and 34 percent are Hispanic. In 
my own district we have one of the only organizations studying the 
disparities in the minority community. The Ethnic Health Institute is a 
community service of Summit Medical Center engaged in coordinating 
health education, research, health provider training and community 
outreach and awareness for the entire community with a very special 
focus on the underserved and community of color.
  We must correct this imbalance in access which results in racial and 
ethnic disparities in care, and I am very proud that the Ethnic Health 
Institute is a wonderful example of an organization committed to this 
goal. People of color and the underserved bear a real disproportionate 
burden of mortality and morbidity rates across a wide range of health 
conditions. Mortality is a cruel indicator of health status and 
demonstrates how critical these disparities are for minorities. For 
African-Americans and Latinos, these disparities begin early in life 
and they persist. African-American infant mortality rates are more than 
double those of whites, 14 percent versus 6 percent; and the rate for 
Latinos is 9 percent compared to 6 percent for whites. The death rate 
for African-Americans is 55 percent higher for whites, with AIDS being 
the sixth leading cause of death for African American males.
  I could go on and on with the multitude of statistics that clearly 
illustrates the stark disparities that exist for people of color. Yet 
the point remains that these disparities are the result of a lack of 
insurance, lack of access to health care, and, of course, still we are 
dealing with the economic divide.
  Health insurance is important because it impacts health outcomes. 
Nearly 40 percent of the uninsured have no regular source of health 
care and use emergency care more due to avoiding higher costs of 
regular business. This situation creates an ongoing cycle of adults and 
children skipping routine checkups for common conditions, recommended 
tests, and treatments because of the financial burden resulting in 
serious illnesses that are, of course, more costly. The uninsured are 
more likely than those with insurance to be hospitalized for conditions 
that could have been avoided such as the flu.
  I would ask my colleagues, are the people dying who have no access to 
health care, are they really important to you? Is it because mainly 
that they are maybe children or poorer people of color or the working 
class that really blinds us all to their importance?

                              {time}  1845

  I do not believe that this is the message that any of us want to 
send, but that is the message that is being communicated.
  The message that we must have then, however, is that universal health 
care, which provides high quality health care, should be provided 
without discrimination.
  This challenges us as Americans to take another look at the 
fundamental role of government. We must do this if we are ever to 
achieve an equitable health care system, and I am totally convinced 
that sooner or later we must really come to grips with the fact that as 
long as the profit motive is central to our own health care system, and 
as long as health care remains big business, an industry, we will never 
have equal access to health care.
  Universal health care is the only way we can provide equal access and 
fairness to our health care system. The uninsured are suffering, and if 
we do not acknowledge health care, sooner or later, as a basic human 
right, our society's most vulnerable will continue to grow.
  Our Nation is the only industrialized nation that does not have a 
health insurance program for everyone and our health care system is 
truly failing. So we should make health care accessible. We should make 
health care affordable. We should really make health care a guarantee, 
and I want to once again thank my colleague from Wisconsin for 
continuing to beat the drum on health care and for calling us all down 
here tonight so we can ensure that our country knows that there are 
many Members of Congress who are going to insist that this be part of 
our legislative agenda.
  Ms. BALDWIN. Mr. Speaker, I would next like to recognize a physician 
Member of this House of Representatives, and a distinguished member of 
the Committee on Ways and Means, and a champion for universal health 
care, the gentleman from Washington (Mr. McDermott).
  Mr. McDERMOTT. Mr. Speaker, I thank the gentlewoman very much for 
yielding to me. I am pleased that she has called this special order 
today. Of the lady from Wisconsin, from the day she ran, do not, they 
told her, do not run on universal health care. She ran on it, anyway, 
and she is here. That tells us something about what is out there in 
this country. The American people know that there is really no excuse 
for what is going on in this country, and my colleague from California 
(Ms. Lee) just gave us the statistics about the unfairness and the 
inadequacy of our health care system in this country.
  I think the fact that we are the richest country in the world and 
that 72 percent of the uninsured are from a family where somebody works 
full time, and, in fact, 13 million or 16 percent are in a family where 
two people work full-time and still do not have health insurance is 
simply a disgrace to this country.
  I know there are people out there who say, well, it is going to cost 
so much money and we cannot handle it. Let me tell my colleagues what 
the real facts are, because a lot of what we will hear and see in 
advertisements is simply misleading.
  Today, the United States spends $1.2 trillion on health care. That 
averages out to $4,350 a person. The average in the next 29 
industrialized countries in the world, Sweden, Norway, France, Japan, 
Australia and so forth and so on, the average is $1,760. We spend 
$4,350. They spend an average of $1,760.
  Switzerland, which is the next one below us in amount of expenditure, 
only spends $2,853, about 60 percent of what we spend, and none of 
those people have the problem we have in the United States that a 
person can be bankrupted by an illness or an injury at any time because 
we do not have health assurance of insurance.
  We take care of people, oh, yes, we do. We take care of them in the 
emergency room, in the absolutely most inefficient way, when they have 
had a major catastrophe, no prevention, in an attempt to deal with it 
when it is a small problem. But when it is a catastrophe, they come 
into the emergency room. We see the strokes, the heart attacks. We see 
all of the things that could have been dealt with by medication for 
blood pressure or heart medication, a variety of other things.
  Low birthweight children in this country. We spend a quarter of a 
million dollars on a child that is born at two or three pounds. If we 
had taken care of that young woman during the time the child was being 
developed, we would have had a normal child without the expenditure of 
a quarter of a million dollars. We could have done it for nickels and 
dimes.
  So it is simply not that we do not have enough money in our health 
care system, it is that we spend it inefficiently and very wastefully.
  A recent article in Health Affairs highlighted that most of the money 
for health care comes from, where do my colleagues suppose? Government 
spending. Either through direct expenditures of Medicare and Medicaid, 
but also through public employees' health benefits and tax breaks 
offered to businesses that give insurance.

  That means that $720 billion out of the $1.2 trillion that we spend 
every year, remember that, $1.2 trillion, and $720 billion of it is 
tax-financed. That is about 60 percent. More than half is presently 
paid for by the government. $213 billion comes from Medicare. That is 
about 18 percent of the spending. $186 billion is for Medicaid, which 
is 15 percent of the spending. $65 billion is spent on public employee 
benefits between Federal and State and local people, and then there is 
$110 billion worth

[[Page H4543]]

of tax subsidies to businesses to provide health insurance for those 
companies that do it for their employees. If they do not, of course 
they do not get the benefit.
  When we take that, that is over $2,600 that we spend on average in 
this country from the government. The average, remember, in 
industrialized countries is only $1,760. So we already spend more money 
in our country from the government than they spend in any country in 
the world.
  So then the question we ask ourselves is, why, if we spend that much 
money and we still have forty some million people without insurance, 
how can this be? What is going on? We have the best technology in the 
world, the best physician training. Doctors come from all over the 
world to train here. We have the most advanced services in the world. 
Those are good things. So we have good things for our money, and then 
what do we pay for it? Well, we pay for the profit of a myriad of 
health care companies and two groups, I think, deserve special 
attention.
  One is insurance companies. Every time there is an attempt to deal 
with a health insurance program for the country, we suddenly see the 
insurance companies throwing millions of dollars out there as they did 
when Mrs. Clinton in 1993 and 1994 tried, they spent $110 million 
advertising at the American people that you do not want the government 
to get into your health care. We are in health care. We are paying 60 
percent of the bill right now.
  The insurance companies get 15 percent or more for their overhead 
costs. Medicare, for example, the government program, gets 1 percent, 1 
percent; insurance companies, 15 percent. So right there we have got 
heaps of dough. We have got way more than $100 billion right there that 
we waste on insurance company overheads, and then they have to take 
away a profit, of course. So we have got all kinds of ways.
  The argument that they help control costs may have worked in the mid-
1990s, but they do not hold up today. Premiums have increased 50 
percent in the last 5 years and are projected to go up as much as 15 to 
20 percent per year in the foreseeable future. So the insurance 
companies, everybody says, well, oh, they are so efficient and they are 
so creative and the private sector can do all this. They are not doing 
a thing. It is totally out of control.
  The second place that we spend more money than we need to is with 
drug companies. They are the single most profitable industry in this 
country. We have seen recently two companies that have had to go back 
and kind of recalculate because they were playing with the numbers a 
little bit, but the profit margin as an industry has been 16 percent. 
If we put money into the drug industry, we can get 16 percent a year. 
That has been the average over the last few years. On revenues of about 
$200 billion a year, they make money. Do not ever listen to their 
crying.
  They are right out there. They had a fundraiser for the Republicans 
the other day. The president of a British company, his pharmaceutical 
company came in, laid down a quarter of a million dollars, and they 
said, well, if you are going to lay down that much, why do you not be 
chairman. They raised $30 million. If my colleagues do not think that 
affects what goes on the floor of this House, they do not understand 
how this place works.
  The argument that they need these profits to continue research into 
new drugs is very questionable, not when so much money for the 
development of the drugs has been done by the Federal Government itself 
through the National Institutes of Health and the government pays for 
the trials and everything else.
  They spend three times as much on marketing as they do on research 
and development. Every time a person opens the newspaper and there is a 
full-page ad that says if you feel this in your stomach, you should go 
to your doctor and get X, Y, Z drug, that is where that advertising is 
going. They are direct-advertising to the American people. The people 
then go to the doctor and say, well, I should have that drug I saw in 
the newspaper, it is right there, here is the ad, doctor.
  That costs us money. Whether that is necessary or not, they are doing 
advertising just like selling cars and Coca-Cola and new clothes and 
whatever. They are just like every other company and they are using 
three times as much. Do not forget that, three times as much for 
advertising as they spend on research. They always say, well, if we 
clamp down on our profits, we will not have any money to develop any 
more new magic drugs. Nonsense. They are taking us for a ride.

  I think it is time, and I think the gentlewoman from Wisconsin (Ms. 
Baldwin) is absolutely correct in bringing up the issue again of a 
universal health care plan for this country. We should have health 
insurance that can never be taken away. We can do it a lot of different 
ways.
  I have one plan that I have been pushing for 10 years, but there are 
other ways to do it. Why do we not say in Medicare, if you are 50 years 
old, between 50 and 65, you can buy into Medicare. If you get laid off 
by your company or you get an early out for retirement or whatever, you 
can buy into Medicare. It is a good deal and you have guaranteed 
coverage. My brother is, I forget, 56 or 57. He is at Boeing. Boeing's 
laid off 30,000 people. My brother's 57 years old and he is going to go 
out and he is going to find insurance as an individual? How? Do my 
colleagues know how much it costs? Most people cannot afford it even 
when they are working to buy an individual policy. That is why we buy 
group policies, but to do it on an individual policy, on our own, when 
a person is unemployed, is simply not possible.
  So why not let my brother buy into Social Security early or buy into 
Medicare early? Or we could say, let us start with all the children and 
we could work our way up. There are many ways to do it. It is simply 
what is lacking in this House is the will to do it.
  We know it can be done. It is done all over the world, and yet when 
it comes to this issue, we will not look over and see how the Germans 
do it or how the Canadians do it or how the British do it or how the 
Australians do it or the Japanese. We say no, our way is the best way, 
and we have got 44 million people without health insurance and we have 
got people bankrupted all the time. It is a disgrace, and we must begin 
to work on this, and I commend the gentlewoman for bringing this issue 
to the floor.
  Ms. BALDWIN. Mr. Speaker, next I would like to recognize the 
gentlewoman from Indiana (Ms. Carson), a colleague who has been a 
tremendous champion on advocating for the uninsured and advocating for 
universal health care.

                              {time}  1900

  Ms. CARSON. Mr. Speaker, let me first and foremost enthusiastically 
and with a great deal of appreciation commend the gentlewoman from 
Wisconsin (Ms. Baldwin) for her leadership in bringing this issue to 
the fore, to the United States House of Representatives, and certainly 
to the United States of America.
  It is unconscionable, I believe, that there are over 40 million 
people in the country who are living without insurance. That is over 14 
percent of the population of the most advanced nation of the world.
  I am a Member of the Democratic Party. This House represents, for the 
most part, a two-party system, and of course, we have a list of sundry 
Independents and Libertarians, et cetera, but it is like the 
mathematical axiom that the whole equals the sum of its parts, and 
there is not a Member in this House who does not have universal health 
care.
  We pay a pittance of a fee on an annual basis and we have top-drawer 
medical care, emergency care, we get all kinds of physical 
examinations, and it is just wonderful. So if anyone wonders why we 
stay here sometimes until 2 a.m. in the morning debating issues that 
have nothing to do with anything, it is probably because we have good 
insurance and we do not want to walk off and leave it. I am just going 
to be perfectly honest about it.
  I am very concerned about all the women in this country. We had 
welfare reform, which was needed in a lot of ways, but we threw a lot 
of women out into the job market with no insurance. They have children 
who are uninsured.
  I come from the State of Indiana, where there are countless people 
who are in dire need. Something happens unexpectedly and they need 
emergency medical attention. Our urban hospitals are on the brink of 
bankruptcy right now. We have one large caregiver of the

[[Page H4544]]

indigent, a hospital, who can dispatch an ambulance out to an emergency 
situation. When the ambulance returns, if that person is uninsured, 
oftentimes that person gets turned away at the emergency room even 
though they are in dire need of emergency medical care.
  In Indiana, there are over 625,000 nonelderly people without access 
to insurance. I say nonelderly because those over the age of 65 have 
access to medical care through Medicare, no matter what their income 
level might be. One constituent wrote to me saying that in the span of 
18 months her husband died, she broke her ankle and foot in two 
different accidents, and she could no longer walk. She is losing her 
job. She has not been able to find a new job. Her preteen child was 
diagnosed as having a moderate mental handicap. She cannot get 
insurance. Her bills are piling up. If it were not for her church, she 
would not be able to even feed her daughter and herself.
  These are the kind of people that represent a major segment of the 
population, not just in my district of Indianapolis or in my State of 
Indiana, but in the United States as a whole.
  We have corporate greed that has knocked so many people out of work. 
WorldCom, 17,000 people, boom, unemployed. People who wanted to work, 
who enjoyed going to work and being responsible, American citizens who 
paid their taxes, abruptly, suddenly, without notice, unemployed and 
uninsured.
  The number of young people under the age of 18 who are uninsured in 
Indiana is like 167,600 people. Now, how can we expect these young 
people to be productive members of society if, in fact, they have a 
medical condition that could be reversed with proper medical care and 
yet they are uninsured?
  Now, there is a tendency of some to accuse doctors of being 
insensitive, and it is true that a lot of doctors are no longer 
interested in the medical field because they cannot even get reimbursed 
for the expenses that they apply to a patient. We have to be realistic 
about what is right in terms of how we reimburse medical providers.
  This country has a major, acute shortage of nurses, and we do not 
have the wherewithal to insist and provide opportunities for people to 
go to nursing school if they do not have the resources.
  We in this House last week raised the debt ceiling for some reason. I 
am still trying to figure out why Congress voted to raise the national 
debt ceiling. For what? It certainly was not for we the people of the 
United States.
  According to the nonpartisan Congressional Research Service, people 
who lack health insurance differ totally from the population as a 
whole. They are more likely to be young adults, poor, Hispanic, other 
minority cultures, or employees in small firms. More than 17 percent of 
the uninsured were 19 to 24 years of age, even though this age group 
represents less than 9 percent of the under-65 population.
  For the first time since 1994, when the Congressional Research 
Service first began this annual analysis, the percentage of the 
uninsured who were white fell below 50 percent. Also for the first time 
since 1994, more than three-quarters of the uninsured were above the 
poverty level. The poor accounted for 12 percent of the under-65 
population, but represented 24 percent of the uninsured.
  About 76 percent of the uninsured were native citizens, and 27 
percent worked or were dependents of workers in small firms. More than 
half were full-time, full-year workers or their dependents; 27 percent 
had less than full-time attachment to the labor force; and 17 percent 
had no labor force ties at all.
  We need to ensure that even women who have cardiovascular disease, 
even though they may not be insured, can have access to quality medical 
care. I stand here today as an example of the benefits of quality 
medical care when a woman like me finds herself confronted with a very 
critical and serious medical situation diagnosed as a cardiovascular 
problem. More women than we can count are dying every year with 
cardiovascular disease and heart attacks. Many of them are uninsured, 
and they avoid going to see about how they are feeling and why they are 
having the symptoms because they cannot afford it.
  A lot of people who work lost their insurance and are now losing 
their assets because of the spiraling costs of medical insurance, which 
wiped them out. They do not have any way to compensate for their 
medical needs. We need to make sure that the uninsured have access to 
health care, that it is affordable, and that it covers all the people 
all of the time within this great country of ours.
  When I first came to Congress, I introduced legislation calling for 
universal health care. I believe that this country of ours, this 
superpower nation, can actually access the resources when it needs the 
resources. It makes it happen. And certainly one of the priorities that 
this Congress should have is to ensure that we the people, all of the 
people, regardless of who they are, where they are, how they look and 
how they do not look have access to insurance and that they become 
insured for the benefit of getting quality medical care whenever and 
however it may be needed.
  I applaud the gentlewoman once again for her keen interest, her 
compassion, her concern, and her incredible leadership in this regard.
  Mr. BALDACCI. Mr. Speaker, I appreciate my colleagues who have joined 
me this evening to share their concerns about this issue and offer 
practical solutions to the problem.
  Before I close, I would like to discuss a couple of measures that are 
or have the capacity to reignite the debate on the uninsured and health 
care for all. One was just referenced by the gentlewoman from Indiana, 
and that is House Concurrent Resolution 99. It is a resolution that was 
crafted by the Universal Health Care Task Force, of which I am a 
member.
  This resolution directs Congress to enact legislation by October of 
2004 that provides access to comprehensive health care for all 
Americans. The resolution designates 14 separate principles that would 
guide us in that process. They include issues such as affordability and 
removal of financial barriers to access to care, cost efficiency, 
comprehensive care, including making mental health parity a priority, 
and promotion of prevention and early intervention. Our health care 
system should eliminate disparities in access to quality health care.
  One of the other guiding principles is that it should address the 
needs of people with special health care needs and underserved 
populations in rural and urban areas. These are basic guiding values 
that we should look to as we reform our health care system.
  Now, my colleagues and I mentioned various approaches to assuring 
health care for all and addressing the needs of the uninsured. I have 
offered universal health care legislation, as have a number of our 
speakers here this evening, and I have certainly cosponsored many of 
their bills. All of these bills abide by the principles that I just 
outlined and are an effort to reach the goal of health care coverage 
for all.
  The legislation that I have offered achieves this goal by allowing 
the States to decide for themselves how to provide quality, affordable 
health care to all of their residents, and it provides broad Federal 
guidelines and financial assistance. My Health Security for All Act 
will secure health insurance for all Americans, guarantee affordable 
health care by limiting out-of-pocket expenses, and provide 
comprehensive health care by guaranteeing a minimum benefit package 
equal to the benefits offered to Members of Congress. It would also 
ensure the quality of health care benefits by providing very strong 
patient protections.
  This is a proposed answer to our uninsured crisis, and I know my 
colleagues with me tonight share my commitment to addressing the needs 
of the uninsured and those underinsured in this country.
  I would like to reiterate the point that being uninsured is not a 
choice. Over 40 million people do not have access to quality, 
affordable health care in America not because they choose that, but 
because circumstances beyond their control result in their inability to 
access affordable health insurance. Our country has the most expensive 
health care system in the world, and the gentleman from Washington (Mr. 
McDermott) brilliantly outlined that in his remarks. This is in terms 
of absolute costs, per capita costs, and percentage of gross domestic 
product.
  Despite being the first in spending in the United States, the World 
Health

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Organization has ranked the United States number 37 among nations in 
this world in terms of meeting the health care needs of its people. 
More and more people are slipping through the cracks in the system of 
health care coverage in our Nation.
  So what are the consequences for all of us in having tens of millions 
of Americans uninsured? We have a sicker population, we as a society 
have to assume the loss of productivity and the costs for serious 
medical conditions that go undiagnosed and untreated. We suffer the 
shame of being the richest nation on Earth that cannot provide basic 
health care to all of its citizens.
  In just a few decades, we have put astronauts on the moon, we have 
created a global village united by computer technology, we have 
perfected travel from one end of the world to the other in mere hours, 
and yet 40 million of us cannot afford or cannot get health care. And 
there are tens of millions of Americans who have lost faith in this 
system, lost faith that comprehensive, quality health care will be 
available to them without a struggle when they need it, where they need 
it, and from whom they want it.
  My colleagues, it is time to put health care for all at the top of 
our national agenda. Many people have called for it and many more 
believe it should happen. But universal health care will never happen 
until we create the national will to make it so. We know that if 40 
million uninsured people found their political voice tomorrow, and 
spoke as one and demanded universal health care, that we would have it.

                              {time}  1915

  Mr. Speaker, I ask my colleagues to join me in helping them find 
their voices. The voters in my district are tired of hearing ``we 
cannot.'' They reject the cynicism of the naysayers and the keepers of 
the status quo. I ask these naysayers if you are not for health care 
for all, who would you leave behind? If you agree that everyone should 
have health care and affordable access to quality comprehensive health 
care, then let us talk about the best way to achieve that. That is why 
we are here tonight. Together we must reignite the debate about 
extending quality, affordable, comprehensive health care to everyone in 
our country.

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