[Congressional Record Volume 154, Number 71 (Thursday, May 1, 2008)]
[House]
[Pages H3002-H3006]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
OUR WORSENING HEALTH CARE CRISIS
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 18, 2007, the gentleman from Michigan (Mr. Conyers) is
recognized for 60 minutes as the designee of the majority leader.
Mr. CONYERS. Mr. Speaker, we are in the midst of the ``Cover the
Uninsured Week,'' and I rise to remind the Chamber of the worsening
health care crisis that we face as a Nation, and propose a solution to
one of the biggest challenges of the 21st Century facing us.
Lack of health insurance often denies necessary medical care. Forty
seven million Americans are uninsured. This problem is not limited to
the poor or the unemployed. Researchers have estimated that about four-
fifths of the uninsured are either employed or members of a family with
an employed adult.
As well, there are an additional 50 million Americans who are
underinsured; that is, they have coverage that would not protect them
from catastrophic medical expenses. Simply put, an increasing number of
Americans lack adequate health insurance because they and their
employers simply cannot afford it.
Despite the challenges of the war in Iraq and the slumping economy,
we all agree that the uninsured need to be covered. Even the health
insurance companies have their own plan for covering the uninsured. I'm
glad that we're on the same page, after all these years.
The real question we face is, how do we go about covering the
uninsured? And how do we ensure that every American has access to
quality medical care when they need it?
I strongly believe in a single-payer national health insurance, an
approach that has been too often marginalized in debates on this issue,
even though it has been successfully employed in almost every
industrial nation except our own.
Mr. Speaker, it's time for Congress to consider single-payer, not
only as a viable option to cover the uninsured, but as the preferred
solution to fix our broken health care system. And make no mistake
about it, it is in very bad shape.
According to a January 2007 article in the Journal of Health Affairs,
France, Japan and Australia rated best, and the United States worst in
new rankings focusing on preventable deaths due to treatable
conditions, in 19 leading industrialized nations.
The article revealed that if the United States health care system
performed as well as those top three countries, there'd be 101,000
fewer deaths in the United States each year.
Equally disturbing, the Institute of Medicine reports that 20,000
Americans die each year as a direct result of having no health
insurance. How can we, in the Congress, who receive fairly decent
health care, tell 47 million uninsured Americans that they cannot have
access to health care?
With the knowledge that 20,000 Americans die each year without health
insurance, how can we, in Congress, who do have health insurance, not
place universal health care as a front burner issue in this chamber?
This is a moral challenge that we all must pick up. And
incrementalism will not work. Expanding a broken system or fixing parts
of it will not work. We must approach the health care solution the same
way a physician approaches the treatment of disease. Doctors do not
employ treatments only because they are easy or feasible. They choose
evidence-based solutions based upon peer-reviewed research in order to
employ the most state-of-the-art care available. And so I propose we
take the same approach to crafting a universal health care plan.
So today, I ask the following question: What further disaster must
befall us before we face the crisis of the uninsured and the
underinsured?
How many more people must die due to the inability to receive care in
the world's healthiest Nation before we, in Congress, take action and
create a truly universal health care system?
For those who believe that we are not ready to have a universal
health care system, and must delay the formation of a comprehensive,
national health insurance program, I ask you to consider the following
evidence that demonstrates why we can ill afford delaying action on a
universal health care system.
Health care horror stories are cases in which the result is so tragic
that it shocks the conscience. We hear about them almost every day, in
the newspapers, magazines, the Internet, television, radio, personal
encounters with our friends and neighbors.
In the movie ``Sicko'' we, as a Nation, saw firsthand how even those
with health insurance suffer under the current, for profit, employer-
based private health insurance system.
In my office, I receive scores of health care horror stories each
month, and have binders in my office of health care tragedies that we
have collected over the last 8 years. In fact, when Michael Moore was
doing research for ``Sicko'' he received 25,000 health care horror
stories himself, after he made an appeal for those horror stories on
his website.
I'd like to read a health care horror story sent to us by Adrienne
Campbell from Michigan, a story, that, unfortunately, millions of
Americans who are underinsured or uninsured can relate to. Here's her
story.
My sister, who is 22 years old right now, was diagnosed with cervical
cancer, the same cancer I had at the same age. She graduated from
college back in December, so she is off my dad's insurance.
Jobs are hard to find here in Michigan, so she's working two part-
time jobs, and neither of them provide insurance for part-time workers.
She has to go through what I did, but instead of actually being able
to get medical treatment right away, then having to pay for it, she has
to put off until she and the hospital can work out a payment plan. They
told her the soonest they might be able to perform the surgery will be
in April.
We've been calling around seeking other options. She's at Stage 4. I
was at Stage 2, when I went through my ordeal, so she's in much worse
condition than I was; which worries me.
This is unacceptable. It's like I am living my horror all over again,
only this is my sister. This is why we have
[[Page H3003]]
to fight. We have to shake things up this election year.
There's nothing you can do for my sister at this point, except keep
her in your prayers, and I hope that she can get surgery soon. But, for
those women who may get cervical cancer down the road, let's fight for
universal health care so they don't have to go through the money
worries.
I love my sister, Victoria, or as my daughter calls her, Aunt Gickie,
because she can't say Vickie.
Please, just keep her in your prayers and thoughts. Thanks for
letting me vent. I love her too much to see this happen to her.
Mr. Speaker, we do not have a health care system in this country.
What exists is a fragmented, nonsystem of health care. It's a wasteful
and inefficient patchwork of different plans and schemes that allow too
many people to fall between the cracks.
The complexity of this nonsystem is what makes it unsustainable.
Private health insurers are in the business to make a profit. Make no
mistake about it. In fact, the real problem is that insurance companies
are not as much in the business to provide care as they are in the
business to deny care. They keep profits up by avoiding high risk
patients, limiting the coverage of those they do insure, and passing
costs back to patients through copayments and deductibles.
They deny coverage based on pre-existing conditions, including such
costly diseases as athletes foot and yeast infections.
They employ an army of adjusters who go through mountains of
paperwork, all mostly working to figure out a way to deny a claim. We
have the story of insurance company whistleblower, Dr. Linda Pino, who
tells us she was paid a bonus on how many claims that she could deny,
and threatened with demotion if she authorized payment on more claims
than her peers.
These practices are harmful. They're expensive. All those adjusters
and paperwork cost a lot of money. Add to that insurance costs the
insurance company's spending on advertising, huge executive salaries,
and profits for shareholders, and the result is an average overhead of
15 cents on the dollar. Compare that with Medicare's overhead which is
between 2 and 3 cents.
The complexity of this nonsystem not only leads to gaps in coverage
and navigating nightmares, but it's underscored by the duplicity and
waste created by the multitude of health insurance companies.
Mr. Speaker, I'm pleased now to recognize the gentleman from Ohio,
who's been on this plan for--several Congresses ago he was and is the
original co-founder and original signer with me to this bill. He's
worked relentlessly in the Congress and across the country in making it
clear that we're working on a system that some day is going to bring so
much joy and benefit to the millions of Americans in this country. He's
a fearless, dedicated, articulate leader, and I would now yield to my
colleague, Dennis Kucinich.
{time} 1615
Mr. KUCINICH. Mr. Speaker, I'm so grateful to have the opportunity to
work with Mr. Conyers on this important bill. Years ago, when we were
having those meetings where the legislation was being crafted, we both
knew what an important moment it would be for the people of the United
States to be able to have a health care system they could call their
own. So I want to take this opportunity, as I begin my remarks, to
salute the work of you, Chairman Conyers, and all that you have done
and your dedication in working to make sure that the American people
have a national health care system, a not-for-profit system. That's
been your dedication. It has been an honor to work alongside of you in
this endeavor.
As we speak today about covering the uninsured, we speak to the
American people who are worried about whether loved ones are going to
be able to get the care that they need. There is nothing that is more
troubling to a family than to have a family member who is ill and yet
cannot get the medical care that would be necessary to bring them back
to health. There are 50 million Americans who are uninsured. This means
that when they see others able to get the care they need, they
recognize in their own families that they cannot sustain the health of
loved ones or themselves.
Why is it that people are uninsured? Well, there are many reasons,
but the principal reason is they simply cannot afford health insurance.
You know and I know, Mr. Chairman, that there are so many families
that are called upon to spend $1,000 or more a month for health
insurance. The price of gasoline going up to more than $4 a gallon, the
cost of bread going up, milk, eggs, meat, all basic staples of an
American diet, costs going up, up, up. People are finding that the
costs of health insurance is becoming prohibitive. And so they simply
can't afford it. So they remain uninsured, thereby leaving their entire
family health open to a challenge.
How many of us would be able to survive financially being uninsured?
Very few, because what happens is that if you're uninsured and you have
health care bills, you're going to have to pay those bills. And you
know that the greatest cause of bankruptcy in the United States relates
to people not being able to pay their hospital or their doctor bills.
That's a fact of life. There is no other issue which touches the
American family and touches all of us so uniquely as this issue of
health insurance. People can't afford it.
This is a tragic problem, and it's getting worse. About 22,000 people
die every year because they're not insured; this, according to the
updated Institute of Medicine Statistic. But we cannot talk about the
uninsured without talking about the underinsured as well.
There are another 50 million Americans who are underinsured. Now
think about it. 50 million uninsured, 50 million underinsured. 100
million Americans. One out of every three Americans is touched by this
dilemma, and that means virtually every American family is either
uninsured or underinsured. If you're underinsured, premiums are
expensive, you may not be able to pay the premium to get the coverage
you need, Co-pays and deductibles go higher and higher and higher. The
American family is owned by the health insurance companies.
What kind of a country are we becoming where the people of this
country can't get the care they need because almost $1 out of every $3
is taken off the top by the for-profit insurance companies for
advertising, marketing, the cost of paperwork, corporate profits, stock
options, executive salaries, all of those necessary things that Mr.
Conyers has talked about in the past. $700 billion a year goes for
expenses that are totally unrelated to the cost of health care. $700
billion a year. Meanwhile, you have 50 million uninsured and another 50
million underinsured. The insurance companies own us. We don't own our
own health care system.
And the insurance industry is the reason for the underinsurance
problem and all that goes with it. Half of all bankruptcies are tied to
medical bills. And of those medical bankruptcies, listen to this,
three-quarters of those had insurance before they got sick. So even
with insurance, people are going bankrupt because they can't handle the
co-pays and the deductibles.
Of all of the medical bankruptcies in the United States, three of
every four people had some kind of insurance before they got sick. They
fell victim to insurance companies whose only way to make money is to
deny care. How do these insurance companies make so much money? They
make money by not providing health care. They make money telling
people, We're not going to pay that claim. You're not going to be
covered. The more people they can exclude, the more money they will
make. It is a racket. Health care is a racket. Health insurance,
rather, is a racket.
It is time we took America in a new direction, which is what the
Conyers' bill, that I am proud to be a co-author of, is all about. H.R.
676 is to provide for a universal, single payer, not-for-profit health
care system. It finally puts health care back in the hands of the
doctors and the patients. It eliminates the insurance companies as
middle persons, middlemen, who are able to skim almost $1 out of $3 off
the top while 50 million Americans are uninsured and another 50 are
underinsured.
We need to make a clear distinction between ``health care'' and
``health insurance.'' The two are very different.
[[Page H3004]]
Doctors and nurses are not the same as health insurance CEOs. Doctors
and nurses provide care. Insurance companies' CEOs, they deny it.
There's a difference between health care and health insurance. If you
have insurance, it doesn't mean you have health care. There are
increasingly creative and complex ways to deny health care: co-pays,
deductibles, premiums, limits on daily coverage, caps on annual amount
spent, failing to cover certain medical conditions, failing to cover
certain accidents, failing to cover certain drugs, failing to cover
certain total spending amounts, like the privatized Medicare Part D
donut hole, failing to cover hospital stays, or minimizing the
coverage.
What has this hunt for profitability in health insurance cost us?
Well, it's cost us a lot of money. It's driving up health care costs
beyond the reach of most Americans. Listen to this statistic: between
1970 and 1998, the number of doctors and other clinical personnel
increased by 2.5-fold. During the same time, the number of health
administrators increased more than 24-fold. There's an explosion of the
number of people in the health care system who do not provide care.
They instead are told to deny care.
It boils down to this: The insurance industry is the problem. It is
not the solution. The only way to truly cover everyone is to guarantee
access, not to force working men and women to subsidize the insurance
industry whose very presence forces people to pay out of pocket to keep
the industry alive. We need health care run by doctors and their
patients, not insurance companies. Health care is a basic human right.
So Mr. Conyers, I just want to express to you my appreciation for the
work that you have done to bring this issue before the American people.
To have had the opportunity over many of the last few Congresses to
work with you on this has really been an honor.
And when we remember when we go back home, you to Detroit and me to
Cleveland, and we see people who need care, our hearts break when we
realize that they can't get it because insurance has just ended up
being a big business and they don't care about people anymore. It's all
about making money. All about profit.
So Mr. Conyers and I know that H.R. 676 stands alone in an
increasingly crowded field of ideas that are going to provide health
care for people. And this proposal addresses the accessibility problem.
Employer-based insurance requires people to continue to work in order
to keep their insurance even if it worsens their health. Now, I know
Mr. Conyers worked with the UAW for years and years before coming into
Congress. What happens if you lose your job? People end up, after their
COBRA benefits are gone, they lose their health insurance. Our proposal
says if you lose your job, you're still insured. If you don't have
money, you're still insured. If you have a pre-existing condition,
you're still insured. This covers dental care, vision care, mental
health, long-term care, prescription drugs. It's all covered.
Mr. Conyers, thank you. Thank you for your dedication to the American
people. Thank you for your willingness to lead the way, and I'm just so
grateful that I have the opportunity to work with you.
Mr. CONYERS. Mr. Speaker, may I say to my colleague that I am so
flattered that he remembers the days when we started out with just a
few Members. We're up somewhere about 90 now and growing every week,
every month. More and more people are joining us. And in addition,
there are growing numbers of medical professionals, doctors,
researchers, health care experts, who are all recognizing how important
what you have said is in terms of how we move out of the situation that
we're in.
Your description of the pain and suffering of so many of our citizens
because of the lack of health care leads to situations so horrible that
they truly shock the conscious.
Mr. KUCINICH. Mr. Speaker, if the gentleman will yield, you
mentioned, Mr. Conyers, that many doctors support this. When I first
ran for Congress in 1972, doctors generally opposed this idea. But
there is a new survey that just came out published in the Annals of
Internal Medicine that states that of the physicians that were
contacted in this survey, thousands of them, 59 percent of the
physicians now support a national health care plan, which is why I
believe when you have the physicians supporting it, the patients
support it, all we need is to keep adding to the numbers in the House
of Representatives; and with Mr. Conyers' leadership, we're on our way
to creating a national health care system.
Once again, I want to thank the gentleman for the opportunity to
share some time with you here. And again, the people of the United
States owe you a debt of gratitude for your relentlessness and your
dedication on this, and I intend to keep working at your side as we
move forward to create a universal, single-payer, not-for-profit health
care system. H.R. 676, the Conyers bill, is the way to go.
Thank you.
Mr. CONYERS. Thank you, Congressman Kucinich.
And as our numbers grow in the Congress, you know that the American
people have already indicated in policy after policy that they want a
universal health care plan. Many are willing to even pay more to get
it, but they don't have to. And this is a labor of love which I am so
proud that nearly 100 of our colleagues are now working with us.
And I yield again to the gentleman.
Mr. KUCINICH. As the Chairman is always able to do, you bring up
another point that I think would be helpful to amplify, and that is
that people will say, Well, how are you going to pay for this? Well,
guess what? We're already paying for a universal standard of care;
we're just not getting it. $2.3 trillion a year goes for health care in
the United States. $2.3 trillion.
And when you consider the fact that the for-profit insurance
companies take almost $1 out of every $3 or almost $700 billion a year,
you take that $700 billion--am I right, Mr. Chairman--you put that
money into care and you suddenly have enough money to cover all
Americans, the underinsured and the uninsured are covered. So how we
pay for it is using the money that's already in the system, and that's
how much profit is in health care insurance or health insurance these
days.
{time} 1630
Mr. Speaker, once again, thank you for bringing out that point about
the fact that it is able to be covered without any current change in
our system, although we have a funding formula that you've helped to
develop that will guarantee that all Americans will be covered far into
the future.
So again, Mr. Chairman, I'm grateful the people of Detroit are
fortunate to have you representing them in the United States Congress.
Mr. CONYERS. In addition, we are creating a system of preventive
health care. We are creating a system in which people, when they
initially get sick, can go to a doctor instead of being forced to go to
emergency rooms where they get temporary treatment, and then they're
back at home or on the streets again. We will make the country
healthier. And national health care is an ambition that is very much
related to national security. So I'm pleased that all of these things
can occur with the consideration of House Resolution 676.
In the last 10 years, the cost of health care to businesses has
increased 140 percent. We need an efficient universal health care
system that protects American businesses from skyrocketing health care
costs so that, as a Nation, we can remain competitive in the global
marketplace.
The rising cost of health care in this country has played a
significant role in the current economic climate, specifically with
regard to the outsourcing of labor to foreign countries. Between 2000
and 2007, United States health premiums have risen 98 percent, while
wages have only increased by 23 percent. The average family health
insurance plan now costs more than the earnings of a full-time minimum
wage worker.
Our fractured non-system of health care is crippling our economy. But
don't take my word for it, just ask the United Automobile Workers and
the AFL-CIO, or even the automobile makers themselves. Health care has
become such a central issue for General Motors that Economists magazine
only partly
[[Page H3005]]
in jest called the company a pension hedge fund wand health insurance
business that happens to make cars.
Ford and General Motors pay nearly $1,500 in health care costs for
each vehicle they produce, while BMW pays $450 in Germany, and Honda
only $150 per vehicle in Japan.
A General Motors executive told former Senator Tom Daschle, a
proponent of universal health care, that the high cost of health care
is the single largest impediment to creating more jobs in the United
States. An IBM executive, Senior Vice President for Human Resources Mr.
J. Randall McDonald, recently predicted that 5 years from now this
problem will have to be cured or the competitiveness of the United
States will be drastically impacted.
Small business employees are one of the fastest growing segments of
the uninsured and now comprise about one-fifth of the total uninsured
population. Kansas Governor Kathleen Sebelius told the New York Times,
``Affordable coverage for small business owners and self-employed
individuals is probably the biggest challenge that we have in Kansas
and most states.''
Incredibly, one-fifth of working age Americans, both insured and
uninsured, have medical debt that they are paying off over time. More
than two-fifths of these people owe $2,000 or more. Medical bills are
the leading cause of bankruptcy in the United States, accounting for
half of the personal bankruptcies. If unpaid medical bills are the
leading cause of bankruptcy in this country, then how can we in good
conscience delay any longer in Congress to create a truly universal
health care system?
High deductibles in private health insurance plans are another
barrier to consistent care. Eleven million people with health insurance
have per-person deductibles of $1,000 or more. One recent study found
that 44 percent of adults with deductibles of $1,000 or more did not
fill a prescription, declined to see a specialist, skipped a
recommended test or treatment, or didn't see a doctor when they had a
serious medical problem.
There are additional sums spent by hospitals and doctor's offices to
deal with each insurance company's rules, regulations, and forms to
fill out. After a number of our satellite industries take a cut, we're
looking at up to 50 cents on the dollar being spent on administration,
marketing and profits. All this is money we could be spending on health
care.
Drug prices in this country are about 60 percent higher than prices
in Canada or Britain, and this is not because Big Pharma is doing so
much research and development. In fact, data from the pharmaceutical
companies' own annual reports show that they spend almost three times
as much working on marketing and administrative costs as they do on
research and development.
It is not because American companies are carrying the burden of doing
research and development for the rest of the world. Drug companies in
the European Union put out about the same number of new products each
year that American companies do. And our drug industry's research and
development gets huge taxpayer subsidies from government-supported
research done by the National Institutes of Health and American
universities. In fact, only a very small percentage of the new drugs
produced in America are in fact innovative developments. Most are
varieties of old drugs developed simply to extend patent protections so
that they can keep on charging those high, excessive prices.
The reason drugs cost more in America than anywhere else boils down
to a single factor: Profit. The drug companies have the highest profit
margins of all American corporations. Their profits as a percent of
sales run about 19 percent, compared to a median of about 5 percent for
Fortune 500 companies.
Mr. Speaker, the American people are concerned about the direction in
which our economy is heading. As we spiral headlong toward a recession,
if we're not already in one, both large corporations and small
businesses have to make difficult decisions to keep their business
afloat. For most Americans, the loss of employment means the loss of
health insurance.
The bottom line: If we can streamline the operations of the health
care system by decreasing wasteful overhead and appropriately
allocating funds, we can not only ensure the coverage of everybody in
the United States, but we can provide for true health care. And that is
an important point; coverage does not equal care.
My plan, H.R. 676, is simple. And its simplicity is the very thing
that will allow it to succeed where others will fail. Many of the plans
generally add an individual mandate and even more insurance options.
Others suggest financial mechanisms like tax credits or savings
accounts. These other plans will not guarantee coverage that is
universal, affordable or comprehensive. They fail to do anything to
decrease administrative costs or complexity, in fact, they add to it.
They can't control costs, and so ultimately they will be unsustainable.
Now, I began from the premise that health care is a basic human
right, not a privilege, a basic human right. This is the consensus
opinion of the international community, as enshrined in the Universal
Declaration of Human Rights and other documents.
I also believe that government has a fundamental role to play in
guaranteeing this right to each and all of its citizens. This is the
view of the other industrialized nations, all of which have single
payer health care systems that cover all their people, cost far less
than ours and, sadly, get more and better results in terms of health
outcomes.
I believe that health care must not be a market commodity. The market
dictates that one's ability to consume a particular product is
constrained by one's ability to pay for it. This approach may be
feasible when one is talking about buying hamburgers or tennis shoes,
but it is unacceptable when it comes to health care. Our access to
health services should be determined by only one thing, what our doctor
thinks we need. Profit should not be a factor.
Let me clarify: I do not advocate socialized or government-run health
care, such as the National Health Service in Great Britain. I propose a
plan that is publicly financed, but privately delivered, like those in
Germany or France or Taiwan.
The role of the government in the H.R. 676 proposal is limited to
collecting revenues and disbursing payments to providers. Doctors,
hospitals and clinics will continue to be run privately. I believe they
will be required to operate as not-for-profit organizations.
In a single payer system, we could do just that. We will do just
that. Revenues would flow into the system through an automatic payroll
tax, very little paperwork required. Doctors would bill the government
electronically and they would be reimbursed electronically, cutting out
the middle man, and the savings would be tremendous.
Studies by the Congressional Budget Office, the Government
Accountability Office and consultancies such as the Lewin Group
consistently find that the savings under a single payer plan would be
more than enough to cover all of the uninsured. So, in fact, it's
possible to cover all Americans under a comprehensive health plan
without spending any more money than we do now. We would just be more
efficient with it.
The two other major drivers of health inflation are the increasing
use of expensive prescription drugs and the proliferation of new and
expensive medical technologies. A single payer system would address
both these costs.
By leveraging the buying power of the Federal Government, we can
negotiate huge discounts both for drugs and for other major drivers of
health inflation such as medical technology. We can bring down the cost
of medical technology by allocating it more efficiently. As it is, we
have no organizing structure to manage the distribution of health care
resources. The result is that we have a glut of medical imaging
machines, specialists, and other medical services which are seen as
generating the most potential profit for their owners; hospital A has
one MRI machine, hospital B then feels it must have two MRI machines,
and so on. To end up with MRI machines all over town standing vacant
while we continue to spend enormous sums on acquiring more is unwise
and impractical and should be ended.
Under a single payer system, we can distribute resources more
efficiently so
[[Page H3006]]
that we are buying MRI machines based on the need for them, not based
on how much profit they can generate for a particular hospital.
{time} 1645
A regional board could determine, with the input of doctors and other
providers, what number of machines would be appropriate for the
population based on demographics and other factors.
Allow an explanation of how a single-payer system under H.R. 676
would work. Existing public health care spending, including government
spending for Medicare and Medicaid, would continue, but it would flow
into a single trust fund. We would add a payroll tax of about 3.3
percent each to workers and employers. In addition to the 1.45 percent
Medicare tax, the total health care tax would be 4.75 percent. This is
cheaper than what the private health insurance companies charge; so
families and businesses will be spending less than what they are
spending now if they have insurance.
We also get revenue from other sources like one quarter of 1 percent
tax on certain stock and bond transactions. All these revenue sources
add up to more than enough to cover current spending. But just in case
there are additional expenses in a particular year, we also authorize
an annual appropriation.
Revenue flows from the Federal trust fund into the accounts of the
currently existing Medicare regions. Reimbursement is then negotiated
with doctors and other providers at the regional level, with current
levels being the starting point. Doctors are paid on a fee-for-service
basis, while hospitals and other large institutions are paid with
monthly lump sums known as global budgets based on current
expenditures. Global budgets are cost-control mechanisms that are very
effective in other single-payer systems.
Every American would receive a national health insurance card at
birth or would be able to apply for one at the post office or other
government facility. The application form is limited to 2 pages.
Everyone living in the United States would be eligible. All medical
necessary services would be covered, including inpatient and outpatient
care, mental health care, dental care, and prescription drugs. Patients
can go to the doctor or health care provider of their choice.
Private insurance companies are prohibited from duplicating the
coverage provided under the plan. They may still offer coverage for
nonmedically necessary services, such as cosmetic surgery. They are not
prohibited from being hired by the government to do billing services,
but overhead costs would be strictly regulated.
This plan relies on the existing Medicare infrastructure for
administration. There is no ``new government bureaucracy.'' In fact,
there will be far less bureaucracy in health care after the role of the
insurance companies has been limited.
Just to let you know, there are nationally recognized health
economists and physicians who believe that if we spent more efficiently
the money we are already currently spending on health care, then we
would cover every American with quality and affordable health insurance
right now through a privately delivered, public financed, single-payer
system.
Mr. Speaker, I thank you for your cooperation.
Ms. LEE. Mr. Speaker, I rise today in support of Cover the Uninsured
Week, to highlight the deplorable fact that over 47 million Americans--
including 9 million children, lack health insurance in our country.
Mr. Speaker, I strongly believe that health care is a basic human
right. Yet far too many people have no access to even the most basic
health services. Contrary to popular belief, 8 out of 10 Americans who
lack health insurance come from working families who just can't afford
the high cost. Minority communities also disproportionately suffer from
a lack of health coverage. More than one-third of the Hispanic
population in our country and more than one-quarter of Native Americans
live without health insurance. Nearly 22 percent of African Americans
and 20 percent of Asian Americans also lack health insurance. These
statistics are just plain shameful.
What's worse is that because these individuals lack health coverage
they are more likely to wait to seek treatment until they are really
sick, which in turn further drives up health care costs and creates a
vicious cycle of un-insurance.
Mr. Speaker, the sad truth is that over the last 8 years of this
administration, the number of uninsured Americans has been steadily
rising. Instead of supporting proposals to expand access to health
care, however, this administration has continually supported policies
that have driven more people into poverty, placing affordable health
care even further out of reach.
Perhaps the clearest example is this President's veto of the SCHIP
bill and his refusal to provide health coverage to 10 million children.
That is just unconscionable.
As the only industrialized nation in the world that does not
guarantee health care for all our people, I believe we must move toward
a system of universal health coverage. That is why I have introduced
H.R. 3000, the Josephine Butler United States Health Service Act, to
make the United States Health Service its own independent executive
branch and establish an Office of the Inspector General for Health
Services.
My bill would require the Health Service to ensure that everyone has
the right and the ability to access the highest quality health care
available regardless of cost. Mr. Speaker, providing universal health
care is the right thing to do and it is consistent with our values as a
nation and the goals of Cover the Uninsured Week.
Mr. WEXLER. Mr. Speaker, I rise to acknowledge ``Cover the Uninsured
Week.'' We must recognize the tragic reality that 47 million Americans,
including 9 million children, are uninsured in America. In my home
State of Florida, the figures are even more striking, with 20 percent
of Floridians lacking health insurance. Millions of hard-working
Americans with full-time jobs lack affordable health care options.
For example, a woman in my district, Florianne, has worked as a
housekeeper for a local hospital for 3 years and is uninsured. She
cannot afford to pay for health insurance for her children despite
having a full-time job. In 2004, when Florianne worked directly for the
hospital, she received health benefits. Today, the hospital
subcontracts its housekeeping operations, causing her to lose her
health insurance. With rent, food, gas, and utilities eating up her
$692 biweekly paycheck, there is not a dollar to spare for her son's
glasses or basic checkups, let alone a $768 monthly premium.
I wish Florianne's predicament was unique. All across Palm Beach
County, the State of Florida and throughout the United States, children
like Florianne's miss doctor's appointments, forego needed
prescriptions, and are denied adequate health care. Their parents work
hard but still cannot afford health care for their families. This is
totally unacceptable in the wealthiest nation on Earth.
In Congress, I have sponsored legislation to fund insurance for
millions of children across the country, introduced legislation to make
Medicare more affordable for seniors, and voted to increase funding for
community health centers willing to treat uninsured individuals. I am
also a sponsor of the U.S. National Health Insurance Act (H.R. 676),
which would reform our health care system and provide health insurance
for every man, woman, and child. Unfortunately, many of these proposals
have been shot down by the Bush administration.
``Cover the Uninsured Week'' reminds us all that America desperately
needs leadership in the White House and in Congress to work together to
achieve the affordable health care that all Americans deserve.
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