[Congressional Record Volume 150, Number 66 (Wednesday, May 12, 2004)]
[Senate]
[Pages S5244-S5245]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           COVER THE UNINSURED

   Mr. DASCHLE. Mr. President, this week is ``Cover the Uninsured 
Week.'' Today, and for the rest of this week, in all 50 States and the 
District of Columbia, Americans will take part in nearly 1,500 public 
events to call attention to the growing number of Americans without 
health insurance and the growing price they, and all of us, pay for the 
gaping holes in America's health care safety net.
   The nonpartisan campaign is co-chaired by former Presidents Gerald 
Ford and Jimmy Carter and supported by a diverse coalition of 
organizations representing business owners, union members, educators, 
health consumers, hospitals, health insurers, physicians, nurses, 
religious leaders and others. It is also endorsed by several former 
Surgeons General and Health and Human Services Secretaries from both 
Republican and Democratic administrations.
   This is the second ``Cover the Uninsured Week.'' Unfortunately, the 
problem has only gotten worse in the last year. Last year, nearly 44 
million Americans, including 8.5 million children, had no health 
insurance. That is more than 15 percent of all Americans. Tens of 
millions more Americans were uninsured for at least part of the year. 
In my State, South Dakota, 12 percent of the people have no health 
insurance.
   Most uninsured Americans go to work every day. In fact, many work 
two or three jobs. But their employers do not offer health coverage, or 
they cannot afford the premiums and other costs. And they cannot afford 
to buy private coverage on their own. So they, and their families, live 
with the daily dread that one serious illness or accident would wipe 
them out financially.
   Last summer, I received an e-mail from a father who lives every day 
with that fear. He lives in South Dakota. He and his wife asked me not 
to use their names or the name of her employer because they do not want 
to risk losing her job and the very meager health benefits it provides.

  This couple has two children, both in high school. When the father e-
mailed me last summer, he had just spent hours in a hospital emergency 
room. He went to the hospital because he thought he might be having a 
heart attack. He ended up leaving without seeing a doctor because he 
was afraid he might end up with a medical bill he could not pay.
  He said that his chest pains started around midnight on a Saturday 
night. He asked his son, the only other person at home at the time, to 
take him to the hospital. Before he left home, the father grabbed a 
file folder containing his last 5 years' worth of tax returns. Why did 
he do this?
  Two years earlier, his son had been hit by a car, and the family 
ended up with $34,000 in medical bills. The father did not want anyone 
at the hospital to think he was trying to take advantage of them when 
he warned them that he would not be able to pay another huge medical 
bill. After they arrived at the hospital, the father sat in the waiting 
room for 3 hours waiting to talk to someone in the hospital's business 
department. Before he accepted any treatment, he wanted to be sure it 
was not going to bankrupt his family.
  But there was no one in the business office in the middle of the 
night on a weekend. So he sat there for 3 hours, clutching his tax 
returns, and praying that he was not having a heart attack. Finally, a 
nurse came out, spoke to him for a few minutes, and told him he was 
probably just having a panic attack. So he went home. To this day, he 
does not know if what he suffered was a panic attack or a mild heart 
attack. He still has not seen a doctor.
  This man and his family are not even counted among the nearly 44 
million Americans without health insurance. They used to have family 
health coverage through his employer, but 3 years ago, that company 
moved out of State. He has been self-employed ever since. Now, they get 
their health insurance through his wife's job.
  I hear, as I heard on the floor yesterday, from some of our 
colleagues that in this country, thank goodness, we never have to 
ration health insurance. If this is not rationing health care, health 
insurance, I do not know what is. What does one call it when a person 
sits at midnight on a Saturday night with 5 years of tax records to 
prove they do not have the ability to pay and then walk out not knowing 
if they had a heart attack. Tell someone today that is not rationing 
health care. A family income for this particular family is about 
$13,000.
  Two years ago, this family paid $2,800 in premiums for family 
coverage and another $5,800 out of pocket for medical costs that 
weren't covered--$8,600 in all. Their family income that year was about 
$13,000.
  This is what that father wrote to me in his e-mail last summer:

       Our family hasn't seen a dentist for over 3 years. I 
     haven't seen a dentist in nearly 10 years. Simply cannot pay 
     the cost. My son needs glasses. My wife has a broken tooth. I 
     haven't seen a doctor in 15 years.
       We all work hard and play by the rules and cannot make ends 
     meet. The last three years have been devastating to us. We 
     will probably lose our house because we cannot afford to keep 
     it up. We are a sad case and getting more depressed every 
     day. I am embarrassed and ashamed to even talk about it. I 
     just wanted you to know about the suffering many of us are 
     enduring.

  Recently, a woman wrote a long letter to a paper in my State, the 
Eagle Butte News, about her sister. As a Native American, her sister 
was theoretically guaranteed free health care from the United States 
Government, through the Indian Health Service.
  Last June, the sister went to see an IHS doctor because of severe 
stomach pains. The doctor told her she had a bacterial infection and 
sent her home with an antibiotic. A month later, the pain was so 
intense she could no longer eat. When she went to IHS clinics, she was 
given a shot for pain and some antacids and told there was no money to 
send her to a specialist. By October, she had lost 70 pounds. Last 
November, she finally saw a different doctor and got an accurate 
diagnosis. By then, her stomach cancer was inoperable. She died on 
April 7.
  In her letter to the editor, her sister wrote:

       She was prepared to accept her fate, which she did bravely 
     and with courage. But I am

[[Page S5245]]

     not going to accept her death quietly because her life was 
     cut short and I don't want to see others suffer the same fate 
     that she did.

  As terrible as these stories are, these people are technically among 
the lucky ones. The father who sent me that e-mail has what amounts to 
catastrophic health coverage through his wife's job. American Indians 
are promised health care by the Federal Government, even though that 
promise is routinely broken.
  The nearly 44 million uninsured Americans have even less than that. 
None of us should accept this quietly.
  The lack of health insurance has devastating consequences for 
uninsured individuals, for families, and for our Nation as a whole. 
According to the National Institute of Medicine:
  Children and adults without health insurance are less likely to 
receive preventive care and early diagnosis of illness. They live 
sicker and die younger than those with insurance.
  Eighteen thousand Americans a year die prematurely because of lack of 
health insurance.
   Families suffer emotionally and financially when even one member is 
uninsured.
  Communities suffer as the cost of uncompensated care is shifted onto 
doctors, hospitals and taxpayers.
  The Nation suffers economically. The Institute of Medicine estimates 
that lack of health insurance costs America between $65 billion and 
$130 billion a year in lost productivity and other costs.
  The National Institute of Medicine has called for universal health 
coverage for all Americans by 2010. Democrats have been leading the 
fight for universal health coverage in America for decades. We created 
Medicare.
   We welcome Republicans' concern about the rising number of Americans 
without health insurance, and we want to work with them to find 
solutions. But the proposals offered by the President and congressional 
Republicans will not work.
  A recent study concluded that the President's proposals would only 
reduce the number of uninsured Americans by between 2.1 and 2.4 million 
people out of the 44 million who have no health insurance. That is not 
even as many people as have lost their health coverage during his 
administration. We have to think bigger, for if we ``cover the 
uninsured'' at that rate, we will continue to lose ground.
  Moreover, some of the President's ideas would actually make matters 
worse. According to CBO, the President's plan to create ``association 
health plans'' would decrease the number of uninsured Americans by only 
about 600,000 people--600,000 out of nearly 44 million. But it would 
increase premiums for 80 percent of employees of small businesses. It 
would also exempt ``association health plans'' from important State 
regulations, including solvency requirements and other protections.
  The administration's proposed health care tax credit is far too low 
to help most people who need help. It also ignores two fundamental 
problems: Premiums for individual health care coverage are far too high 
for most Americans, and, if you are not young and in good health, you 
may not be able to purchase an individual health insurance policy at 
any price.
  Health savings accounts are no solution, either. They are a tax 
shelter that primarily benefit the healthy and the wealthy--those who 
are least likely to be uninsured. A new study by an M.I.T. expert 
released just this week concludes that the President's health savings 
account proposal would actually increase the number of uninsured 
Americans by 350,000--and cost taxpayers $25 billion. There are better 
ideas.
  After that father sent me that e-mail, we told him about the CHIP 
program. Today, his two children have health insurance through that 
program.
  In the words of that South Dakota father;

       The CHIP program is a tremendous safety net for families. 
     At least now, when my children are sick, I can take them to 
     the doctor. It takes some of the fear away. And, when you 
     walk in to the doctor's office or the hospital and show them 
     that card, they treat you like a human being.

  The CHIP program is working. We should continue it--and our other 
successful Federal health care programs--and ensure they are adequately 
funded.
  We recently introduced a bill that could significantly reduce the 
number of uninsured Americans and help small business owners create new 
jobs at the same time. The Small Business Health Tax Credit--S. 2245--
would provide small businesses with tax credits to cover up to 50 
percent of the cost of their employees' health insurance. Businesses 
with 36 to 50 workers would get a tax credit worth 30 percent of their 
employee health care costs. Companies with 26 to 35 workers would get a 
40-percent tax credit. And companies with 25 or fewer employees would 
get the full 50-percent tax credit. This is a far more generous tax 
credit than what small businesses can claim now.
  Business owners and entrepreneurs are working hard to make a profit--
but their profits are being eaten up by out-of-control health care 
costs.
  Finally, later this morning, my colleagues and I are going to 
announce a bold new commitment that will enable the Federal Government 
to offer every American access to quality health care at an affordable 
price within 2 years. We look forward to working with our Republican 
colleagues to make that commitment a reality.
  I recently received another letter from a woman in South Dakota. She 
wrote:

       I have noticed that gas stations continue to place spare-
     change jars on counters for fundraisers, and small towns 
     often hold pancake breakfasts for the same reason. However, 
     rather than raising money for band trips and sports, they are 
     increasingly for a local uninsured person's health care.

  There are better ways. Working together, we can tap the spirit of 
community and compassion those spare-change jars represent, and we can 
find ways to ensure that every American is able to see a doctor when he 
or she is sick.
  We do not have to be the only major industrialized nation in the 
world that fails to guarantee health care for all its citizens. We can 
do better, and none of us should rest until we do.
  I yield the floor.

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