[Congressional Record Volume 150, Number 97 (Wednesday, July 14, 2004)]
[Senate]
[Pages S8057-S8059]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           INCREASING NUMBER OF UNINSURED FAMILIES IN AMERICA

  Mr. DASCHLE. Mr. President, this morning we were again reminded of 
how much remains to be done in addressing the health care crisis in 
America. Today's paper has this headline: ``Medicare Law Is Seen 
Leading to Cuts in Drug Benefits for Retirees.'' According to the 
article, the government is now estimating that 3.8 million retirees who 
currently receive prescription drug benefits through their employers 
will see their coverage reduced or eliminated as a result of the 
Republican drug law passed last fall.
  That is simply unacceptable, and it is only one of the many problems 
we are facing when it comes to health care. Over the past several 
years, the cost of health insurance has skyrocketed, and millions more 
Americans have found themselves uninsured.
  A while back, I held a ``living room meeting'' on health care costs 
in Sioux Falls. An older, married couple came to that meeting. He's a 
veteran, 68 years old, with diabetes and congenital heart failure. 
She's 62, with cerebral palsy. Last year, shortly after the husband 
retired, this couple learned that the wife's bladder cancer had come 
back. This couple pays $418 a month in health insurance premiums 
through COBRA, plus another $400 a month for prescriptions, and more on 
top of that in co-pays for doctor visits. Soon, their COBRA eligibility 
will expire.
  The husband is on a waiting list--a waiting list--to see a VA doctor. 
But they don't know how they will pay for the wife's health care after 
they lose their current insurance coverage. Individual coverage for a 
62-year-old woman with cerebral palsy and cancer would be prohibitively 
expensive--if they could get it at all. So, after nearly 20 years of 
marriage, this couple is contemplating divorce as the only option for 
getting essential health care for the wife.
  If this Senate wants to protect American families, let's discuss what 
we can do to make health care more affordable and accessible so that 
spouses don't have to consider divorcing each other in order to get 
essential health care.
  Forty-four million Americans were uninsured in 2002--the most recent 
year for which figures are available. That's 2.4 million more Americans 
without health insurance than the year before--the largest 1-year 
increase in a decade. Eight-and-a-half-million of those 44 million 
Americans are children. Sixteen million are women, many in their child-
bearing years.
  As shocking as those figures are, they tell only half the story--
literally. A new study conducted for Families USA, using census data, 
shows that almost 82 million Americans--one in three Americans younger 
than 65--were uninsured at some point in the last two years. Two thirds 
were uninsured for at least six months. Half were uninsured for 9 
months or longer.
  Who are these people? They're working people, mostly. Eighty percent 
of uninsured Americans live in families in which at least one adult 
works. But their employers don't offer health insurance, or their pay 
is so low they can't afford to buy it. A growing number are middle 
class. One in four had family incomes between $55,000 and $75,000.
  In South Dakota, more than 27 percent of people younger than 65 were 
uninsured for at least some part of the last 2 years. That's 180,000 
people living with the fear that they are just one serious illness or 
accident away from financial disaster.
  In 14 States, according to the Families USA study, more than one-
third of all people younger than 65 were uninsured for at least part of 
the last two years. One in three people. The State with the highest 
percentage of uninsured was Texas: 43.4 percent.

[[Page S8058]]

  We have the highest per capita health care spending of any nation on 
Earth. Yet, in comparison with other developed, high-income nations, 
the United States consistently scores at or near the bottom on infant 
mortality, life expectancy, and the proportion of the population with 
health insurance.
  We hear a lot today about who is more optimistic about America's 
economy and our future. I believe it is pessimistic to look at the 
state of health care in America today and conclude that we really can't 
do much better. I believe it is pessimistic to watch the cost of health 
care increase sharply every year; to watch the number of uninsured 
Americans grow every year; and to watch more businesses be forced to 
reduce or eliminate employee and retiree health benefits every year--
year after year--and conclude there isn't really much of anything we 
can do about it. And I believe it is deeply irresponsible for this 
Senate to spend almost no time on serious discussions of responsible 
proposals to address this crisis. People all across America are looking 
to us for help on health care.
  Lowell and Pauline Larson are two of those people. I've known the 
Larsons for years. Lowell is 68, almost 69. Pauline turned 64 on the 
Fourth of July. They live in Chester, SD. Lowell Larson has worked hard 
all his life. He started work in a furniture mill in Sioux Falls just 
out of high school and stayed there for 20 years before he finally got 
the chance--about 30 years ago--to do what he'd wanted all his life: 
own his own farm.
  It's a small farm--160 acres. The Larsons raised corn and beans and 
kept a few cows. It's hard work. I don't think Mr. Larson would mind me 
telling you, he and Pauline don't have much money. Small family farmers 
don't make much money. Some years, if the weather's bad, or the market 
is weak, they don't make any money.
  What Lowell Larson does have, in abundance, is a strong sense of 
personal and family responsibility. It's part of the South Dakota 
ethic. It's what we're taught, and what we teach our children: If 
someone you love needs help, you help them. And if you owe someone 
money, you do everything you can to pay them.
  When Lowell Larson was a young man, his mother had a stroke. He 
postponed marriage and spent 20 years caring for her. After his mother 
died, Lowell met Pauline. At 45, he finally married. A few years later, 
Pauline began having trouble walking, and she was diagnosed with MS. 
Over the next few years, she progressed from a cane to a wheelchair.
  In early November 2002, Pauline had a serious stroke. She spent a few 
weeks in the hospital, followed by a few months in a nursing home. Then 
she had to have her gall bladder removed--more time in the hospital. In 
less than 2 years, the Larsons ended up with $40,000 in medical bills 
from Pauline's stroke and surgery. On top of that, they spend more than 
$200 a month on muscle relaxants and other medications Pauline needs 
for her MS.
  The Larsons used to have private health insurance. But it got so 
expensive, they gave it up about 5 years ago. ``We didn't know she was 
going to have a stroke,'' Lowell says.
  Today, Lowell Larson gets Medicare. Pauline has a very bare-bones 
health policy that pays $75 a day for hospital care and $50 a day for 
nursing home care--nothing else. Last year, the Larsons held a sale. 
They sold many of their personal possessions and much of their farm 
equipment to raise money to pay their medical bills. The sale brought 
in about $30,000. Lowell Larson talked with doctors and hospitals and 
got them to forgive another few thousand dollars of their debt.
  Lowell Larson brought Pauline home from the nursing home about 18 
months ago because they couldn't afford the $4,000 a month it cost and 
because they were both too lonely living apart. These days, Pauline 
spends most of her time in a hospital bed set up in their home. She has 
difficulty speaking. She also has trouble using her right arm, which 
makes it hard for her to feed herself.
  It can wear you down, living with the fear that your family is just 
one more medical emergency away from financial disaster. Lowell Larson 
says, ``A lot of mornings, I wake up around 4:30 or 5 o'clock and I 
just start worrying about things.'' The Larsons are counting the days 
until Pauline turns 65 and can get Medicare.
  Since President Bush took office, family health care premiums have 
increased by more than $2,700 a year. The average cost for a family 
health plan is now $9,000 a year. Workers pay about $2,400 of that 
amount out of their own pockets. That's just for premiums. It doesn't 
include copayments and deductibles. And these are the people in the 
best situations; they have access to group plans through their 
employers. This is just one more example of how the middle class is 
being squeezed in America. Families are paying more for skimpier 
coverage every year. Unless we act, the number of families without 
health insurance will continue to grow.
  And the consequences of un-insurance are staggering. People without 
insurance use one-third less health care. They skip preventive care and 
regular check-ups. They don't fill prescriptions. They postpone 
surgeries if they can. They live with pain. When they get sick, they 
crowd emergency rooms where the care they get is often too little, and 
too late.
  In a new survey by the American College of Emergency Physicians and 
the Robert Wood Johnson Foundation, two-thirds of ER doctors said the 
uninsured patients they see are sicker than those with insurance, and 
nearly all--94 percent--said it was harder to schedule needed followup 
care with uninsured patients.
  People without insurance pay more for health care. Hospitals 
routinely charge uninsured patients up to four times as much as 
patients with insurance for the same services. Too often, people who 
are already battling illness find themselves having to fight off 
aggressive debt collectors, too.
  And 18,000 Americans die prematurely every year because they do not 
have health insurance. Forty-nine people every day.
  Our economy also suffers. 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.
  Democrats have been leading the fight for universal health coverage 
in America for decades. We want to work with our Republican colleagues 
to reduce the number of uninsured Americans and make health care more 
affordable and accessible.
  But the few proposals offered so far by the President and 
congressional Republicans will not work. Independent studies of these 
proposals show that they would do little to address soaring health care 
costs and the growing insurance gap, and, in some cases, they would 
actually make matters worse.
  There are better ideas. Democrats have proposed that, within 2 years, 
all Americans have access to affordable health care that is as good as 
the health care members of Congress have--at the same rates, or lower. 
We ask our Republican colleagues to work with us to make that a 
reality.
  In addition, we should adequately fund the Children's Health 
Insurance Program. We should also adequately fund the VA and the Indian 
Health Service--we must keep our promises to America's veterans and 
honor our treaty obligations to American Indians.
  We can reduce the cost of prescription drugs--one of the driving 
forces behind medical inflation--by letting Medicare negotiate the best 
prices for American seniors, and by allowing Americans to re-import 
safe prescription drugs from Canada and other industrialized nations.
  I introduced a bill recently 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. These health 
care tax credits would help businesses save money, which means they 
will have more money to invest in new equipment, hire new workers, and 
give their employees raises.
  If our Republican colleagues have additional ideas that will actually 
reduce the cost of health care and increase the number of Americans 
with insurance, we welcome the chance to work with them on those ideas 
as well.
  What we cannot do is to continue to ignore this urgent problem. 
Lowell and

[[Page S8059]]

Pauline Larson sold much of what they owned to pay their medical bills 
because they take their responsibilities seriously. It's time for this 
Senate to take seriously its responsibility--to find solutions to 
reduce the cost of health care and the number of Americans without 
health insurance.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Nevada.

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