[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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