[Congressional Record Volume 149, Number 50 (Thursday, March 27, 2003)]
[Senate]
[Pages S4521-S4522]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

    By Mr. BAUCUS (for himself, Mr. Hatch, Mr. Rockefeller, and Mr. 
                               Jeffords):

  S. 732. A bill to amend title XI of the Social Security Act to create 
an independent and nonpartisan commission

[[Page S4522]]

to assess the health care needs of the uninsured and to monitor the 
financial stability of the Nation's health care safety net; to the 
Committee on Finance.
  Mr. BAUCUS. Mr. President, it has been said that, ``Good health and 
good sense are two of life's greatest blessings.'' Senators Hatch, 
Rockefeller, Jeffords and I hope to further the cause of good health 
and good sense today, through introduction of the Health Care Safety 
Net Oversight Act of 2003.
  Currently no entity oversees America's health care safety net. This 
means that safety net providers--including public and teaching 
hospitals, emergency departments, community health centers and rural 
health clinics--are laboring on their own. They are like master 
musicians performing without a conductor. Each is trying their hardest 
and performing their part--but no one is coordinating their efforts.
  This Act changes that, by creating the Safety Net Organizations and 
Patient Advisory Commission--SNOPAC--an independent and nonpartisan 
commission to monitor the health care safety net.
  Safety net providers are often the last resort for patients unable to 
afford the health care they need. For example, in my State of Montana, 
we have eight community health centers, serving about 44,000 Montanans 
per year. Without these health centers, many of these uninsured and 
underinsured Montanans would have no place to turn.
  According to a recent report, nearly 75 million Americans lacked 
health insurance at some time in the past two years--amounting to 
almost one-third of all Americans younger than 65. Of these 74.7 
million individuals, about 30 percent had no coverage at some time in 
2001 and 2002 while 65 percent had no coverage for at least six months.
  And who are these people? In Montana, about 80 percent of uninsured 
individuals are in working families. And self-employed workers--
including owners of small businesses--and their dependents account for 
about one-fifth of the uninsured in our State. Montana has one of the 
lowest rates of employer-sponsored insurance in the Nation, with about 
46 percent of Montanans receiving health insurance through their 
employers.
  So what do we do about this problem? How do we ensure that all 
Americans, irrespective of color, creed, gender, or geography, have 
access to qualify health care?
  About 10 years ago Congress and the Administration worked on the 
problem of the uninsured. A tremendous amount of time and effort went 
into the Health Security Act, on both sides of the issue. As we know, 
passage of that bill failed. Since then, Congress has taken a more 
incremental approach to the uninsured. Congress passed legislation in 
1996 to ensure portability of health insurance. A year later, the CHIP 
program was signed into law, bipartisan legislation to cover children 
of working families. And last year, we worked together to provide 
health coverage for workers who lost their jobs because of increased 
international trade.
  While these incremental steps have helped, we need to do more. Last 
year I introduced bipartisan legislation to provide employers with tax 
credits so they can offer their employees health insurance. And I am 
hopeful that the Baucus-Smith, OR bill can be enacted into law.
  But the fact remains, for most uninsured and underinsured Americans, 
the safety net is still the only place to turn.
  Yet, the safety net has been seriously damaged in recent years. 
According to report a few years ago by the Institute of Medicine, the 
health care safety net is ``intact but endangered.''
  And according to a report I requested of the General Accounting 
Office, issued today, emergency departments across the nation are 
facing severe overcrowding problems, forced to send patients to other 
hospitals. The GAO found that about two-thirds of hospitals reported 
asking ambulances to be diverted to other hospitals at some point in 
fiscal year 2001. And about 10 percent of hospitals reported being on 
diversion status for more than 20 percent of the year.
  September 11 taught us that we need to be ready. Our emergency 
response systems must be prepared to manage an unexpected terrorist 
attack. But based on the GAO's findings, it seems that we are far from 
prepared. If emergency departments cannot care for all the patients 
they are sent under current conditions, how can we expect them to 
manage a terrorist attack of potentially catastrophic proportions?
  We need an entity responsible for recommending changes to our safety 
net, including our emergency departments. And though SNOPAC will not 
solve the problems of America's uninsured, it will work to ensure that 
safety net is not further frayed. An independent, non-partisan 
commission, modeled on the Medicare Payment Advisory Commission 
(MedPAC), SNOPAC will include professionals from across the policy and 
practical spectrum of health care. And like MedPAC, SNOPAC will report 
to the relevant committees of Congress on the status of its mission: 
tracking the well-being of the health care safety net.
  SNOPAC is not a panacea. But it is a positive step toward a 
coordinated approach in caring for the uninsured. Absent large-scale 
improvements in the number of insured Americans, we should at least 
work to monitor and care for what we already have--an intact, but 
endangered, health care safety net.
  I urge all my colleagues to join me in this effort towards good 
health and good sense.
                                 ______