[Congressional Record Volume 149, Number 39 (Tuesday, March 11, 2003)]
[House]
[Pages H1693-H1694]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        COVER THE UNINSURED WEEK

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 7, 2003, the gentleman from Florida (Mr. Stearns) is recognized 
during morning hour debates for 5 minutes.
  Mr. STEARNS. Mr. Speaker, this week is Cover the Uninsured Week where 
lawmakers, the media, and our constituents will consider how we can 
help provide health care coverage for some 35 million Americans. No 
doubt some will pronounce that the answer lies in a single payer, 
universal health care coverage program. I say there are better ways. 
Why? Let us look at countries that do have national health care in 
place and see its problems.
  Let me share with Members a story I read in a February 13 article in 
the New York Times about the growing lag on the Canadian health care 
system. According to this article, a Canadian government study shows 
that 4.3 million Canadians, 18 percent of those who saw a doctor in 
2001, had a problem getting tests or surgery done in a timely fashion. 
Three million could not find a family physician. Canada spends $86 
billion on the health care. Only the United States, Germany and 
Switzerland spend more as a proportion of economic output, but budget 
cuts since the early 1990s have impeded efforts to keep health care up 
to date.
  Waiting lines have also increased because an aging population is 
placing more demands on the system. A study by the Fraser Institute 
recently concluded that patients across Canada experience waiting times 
of 16.5 weeks between receiving a referral from a general practitioner 
and undergoing treatment in 2001-2002, a rate 77 percent longer than in 
1993.
  Mr. Speaker, can Members imagine an insured American putting up with 
a wait for 4 months? As Members can imagine, those with the means to 
seek other options do not, due to what the Canadians call ``line 
jumping'' by the affluent and well-connected.
  While the goal of many who recommended socialized health care is 
egalitarian, equal health services for all, that is exactly what they 
get, an equally long wait for all. But if a Canadian has money, they 
just fly south to a private physician in the United States. My State of 
Florida is notoriously a haven for Canadian snowbirds to winter in and 
seek medical care.
  Last month I had members of various Canadian provincial governments 
visit me asking how they could work out an arrangement and fee schedule 
with physicians in Florida to provide services to them.
  And to point out another example of the erosion of egalitarian goal 
that national health care is supposed to provide, there is an ad for an 
up-scale maternity service in London's Portland Hospital. It points out 
women do not have to be famous to give birth there, they just need to 
have money. Deluxe private suites, champagne, and a beauty salon are 
just among some of the amenities. I thought all English women could 
receive quality, timely obstetrical care in their assigned hospital. 
But why then would the Duchess of York and supermodel Jerry Hall choose 
to have their babies outside the socialized system, because those who 
can afford to pay want choice, and we should provide nothing less for 
all Americans.
  To seek a legacy in his final years of office, Canada's Prime 
Minister Jean Chretien has agreed to spend $9 billion more over the 
next 3 years. Fortunately for Canadians, the system's shortfalls have 
opened the way for tentative but growing movements toward privately 
managed medical services.
  Let us resolve today to promote choice and opportunity for the 
uninsured to obtain the health care plan that works best for them. One 
of the major ways is to institute a tax parity into health insurance. 
The 90 percent of us who receive our health insurance through our 
employers are receiving a substantial tax benefit. We should extend 
this to those in the individual market also.
  When this Congress convened on January 7, I introduced my bill, H.R. 
198, that would allow any tax filer to deduct 100 percent of the cost 
of their health insurance as well as nonreimbursed prescription drugs. 
Currently, only the self-employed can deduct 100 percent, but what 
about the unemployed or the retired? H.R. 198 would help them also. 
Likewise, many of my colleagues have introduced legislation to provide 
tax credits for Americans to use for purchasing health care. These are 
all ways we can help cover the uninsured and enable them to purchase 
the health insurance of their choice.

              Long Lines Mar Canada's Low-Cost Health Care

                          (By Clifford Krauss)

       TORONTO. Feb. 11--During a routine self-examination last 
     May, Shirley Magee found

[[Page H1694]]

     a lump on her breast. Within weeks she had it and some lymph 
     modes removed. So far so good, until it came to the follow-up 
     therapy.
       Mrs. Magee, a 55-year-old public school secretary, 
     researched her condition on the Internet, and read that 
     optimally, radiation treatment should begin two weeks after 
     surgery. But the local provincial government clearinghouse 
     that manages the waiting time for radiation therapy told her 
     she had to wait until the end of September--nearly three 
     months after her surgery--to begin treatment.
       ``I was supposed to feel lucky I got in so quickly,'' said 
     Mrs. Magee, still viscerally annoyed though she has since 
     successfully completed her radiation regime. ``It's a 
     horrible feeling that something in your body is ticking that 
     you have no control over. If I were a politician's wife I 
     wouldn't have had to wait.''
       Long heralded for giving all Canadians free health 
     insurance and paying for almost all medical expenses, the 
     health care system founded in the 1960's has long been the 
     third rail all of Canadian politics; not to be touched by 
     private hands, nor altered by Parliament.
       But growing complaints about long lines for diagnosis and 
     surgery, as well as widespread line-jumping by the affluent, 
     and connected, are eroding public confidence in Canada's 
     national health care system and producing a leading issue for 
     next year's national elections.
       A recent government study indicated that 4.3 million 
     Canadian adults--or 18 percent of those who saw a doctor in 
     2001--reported they had difficulty seeing a doctor or getting 
     a test or surgery done in a timely fashion. Three million 
     Canadians are unable to find a family physician, according to 
     several private studies, producing a situation all the more 
     serious since it is the family doctor who refers patients to 
     specialists and medical testing.
       ``The sky isn't falling, but things are not rosy,'' said 
     Dr. Dana W. Hanson, president of the Canadian Medical 
     Association. ``Nevertheless if things are not fixed, the sky 
     may fall.''
       Canada spends $86 billion a year on health care--only the 
     United States, Germany and Switzerland spend more as a 
     proportion of total economic output--but budget cutbacks 
     since the early 1990's have impeded efforts to keep health 
     care up to date. A recent report by the Senate's Standing 
     Committee on Social Affairs. Science and Technology indicates 
     that well over 30 percent of the country's medical imaging 
     devices are obsolete.
       Overworked technology is one reason for the long lines; 
     others include a shortage of nurses and inefficient 
     management of hospital and other health care facilities, 
     according to several studies.
       Waiting times have also increased because an aging 
     population has put more demands on the system, while the 
     current generation of doctors is working fewer hours than the 
     last.
       Waiting can occur at every step of treatment. A study by 
     the conservative Fraser Institute concluded that patients 
     across Canada experienced average waiting times of 16.5 weeks 
     between receiving a referral from a general practitioner and 
     undergoing treatment in 2001-2002, a rate 77 percent longer 
     than in 1993. The recent Senate report noted that waiting 
     times for M.R.I., CT. and ultrasound scans grew by 40 percent 
     since 1994.
       ``Waiting lists are the hornets' nests that are 
     jeopardizing the system,'' said Dr. Tirone E. David, 
     professor of surgery at the University of Toronto. He noted 
     that Ontario residents needed to wait an average of two 
     months to see a cardiologist unless it was an emergency, 
     queries for angiograms took four to six weeks, and waiting 
     times between initial examination and micro-valve repairs 
     could take as long as six months.
       ``It wasn't that way 15 years ago,'' Dr. David added. ``It 
     does not alter the ultimate outcome, but there's an anguish 
     and uncertainty when a person feels their life is in a 
     holding pattern for up to a year.''
       Defenders of the Canadian system note that only patients 
     waiting months for nonemergency care, like treatments for 
     cataracts and hernias skew the waiting time statistics.
       And they argue that within life expectancy of 78 years, 
     Canadians still enjoy one of the longest life expectancies in 
     the world, slightly higher than the United States where 41 
     million people have no health insurance.
       Still recent polls show that while Canadians want to keep 
     their national system they are worried about its future 
     effectiveness.
       ``I don't think there's a lot of patience among the public 
     for a lot more study,'' said Deputy Prime Minister John 
     Manley in a recent interview noting that his own driver 
     needed to wait a year for hip replacement surgery. ``There's 
     not a lot of time to deal with it.''
       In response to the growing concerns, Prime Minister Jean 
     Chretien and the Senate conducted studies of the system, that 
     concluded in recent months that shortages of doctors nurses 
     and diagnostic equipment had caused at least some 
     deterioration of care over the last 10 years.
       Seeking a legacy in his final year in office. Mr. Chretien 
     agreed last week to spend over $9 billion more over the next 
     three years on programs to improve diagnostic equipment, 
     primary care, drug coverage and home care. But the provincial 
     and territorial premiers say that isn't nearly enough to 
     alleviate shortages of services, particularly in rural areas.
       The system's shortfalls have opened the way for tentative 
     but growing moves toward privately managed medical services 
     and user fee in return for quicker service. A hospital in 
     Montreal has begun charging fees for some surgical procedures 
     and renting operating rooms to patients for several hundred 
     dollars an hour. A Vancouver hospital has begun selling full-
     body C.T. scans for $860.
       In an effort to reduce waiting lists, the provinces of 
     Alberta, Nova Scotia and Ontario have established about 30 
     private M.R.I. and C.T. clinics, some of which offer 
     nonemergency services to be paid for by private insurance.
       ``With the system cracking at the edges and waiting lists 
     growing, people will eventually stay ``all right, let me pay, 
     said Dr. Tom McGowan, president of Canadian Radiation 
     Oncology Services, Canada's first for profit cancer radiation 
     treatment center which has treated nearly 2,000 patients 
     since it opened in Toronto two years ago. (Patients still pay 
     nothing at the radiation clinic; Dr. McGowan is paid by the 
     province and receives bonuses if he surpasses productivity 
     targets.)
       The Ontario provincial government allowed Dr. McGowan to 
     open his night clinic after it was forced to send 1,650 
     cancer patients to the United States for radiation treatments 
     during a 25-month period in 2000 and 2001 because of waiting 
     lists that were up to 16 weeks long.
       Dr. McGowan said the emergency, which cost the province $20 
     million in travel costs, was not rooted in a shortage of 
     equipment nor staff but inefficient public management. 
     Whatever the reasons his patients are quick to tell horror 
     stories about their waits for diagnostic tests and 
     treatments.
       ``Your worst fear is it is going to grow while you are 
     waiting.'' said Pat McMeekin, a 53-year-old hospital clerical 
     worker, recalling the two months she had to wait between a 
     mammogram and the first of two biopsies confirming she had 
     breast cancer last summer. ``When you have something you want 
     to take care of it and be done with it.''

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