[Congressional Record Volume 154, Number 149 (Thursday, September 18, 2008)]
[House]
[Pages H8463-H8467]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    IMPROVING OUR HEALTH CARE SYSTEM

  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, and Members of the Congress, I am delighted 
to come here this evening to have listened to two doctors and a judge 
talking about a subject that is of great interest to me as well. And 
the reason that I mentioned their names is that the subject matter that 
brings me to the well tonight with other colleagues is how we improve 
the health care system.

                              {time}  1915

  And when I hear Judge Louie Gohmert, who serves with distinction on 
the Judiciary Committee, I always love to try to involve him in what 
we're doing. And of course we have great respect for Representative 
Gingrey, the gentleman from Georgia, who is a physician, a medical 
doctor; Dr. Boustany of Louisiana. All of these are gentlemen whose 
attention I would like to draw and invite to join us in this and future 
discussions about the state of health care in the country. I will be 
making every attempt to communicate with them on it.
  We happen to have a doctor here on our side, Dr. Donna Christensen 
from the Virgin Islands, a medical doctor as well. And so just think of 
the exciting exchange of views that might have otherwise occurred.
  But this is nevertheless an opportunity to take special orders to 
review, Mr. Speaker, that over 45 million Americans are currently 
without any form of health insurance whatsoever. More than eight out of 
ten of these Americans are members of working families, of all things. 
And then another 50 million Americans are underinsured and face 
possible financial ruin due to an unexpected medical bill for 
hospitalization or other emergencies that might occur.
  And so for many Americans, the cost of health care, the cost of 
insurance, the insecurity of employer-based coverage--because many 
companies are downsizing or moving out of the country entirely--and 
these factors limit their most important choices in life: staying well 
and staying healthy, their decisions to work, to raise a family, to 
return to school, to have children, to retire early or not, to change 
careers. And the fact of the matter is that health care is the number 
one subject for nearly everyone in this country.
  And so it is truly odd that some of my colleagues seem to believe 
that health care for all is somehow divorced from what they perceive to 
be the ``American Dream.'' Indeed, the American Dream is posited on the 
notion that you would be healthy. Before you would become educated, 
prosperous, rich, accomplished, you have to have good health. Physical 
and mental as well.
  And so I begin our discussion underscoring the fact that the American 
Dream assumes that we're in good health and that good health, continued 
good health is available to all.
  One of the Presidents of the United States once stated that Americans 
already have universal health care because the emergency rooms cannot 
legally refuse to treat patients. That is the sitting President of the 
United

[[Page H8464]]

States that made that statement, the 43rd President of the United 
States. And there's only one way that he could have made that 
statement, and that is that he's never had to use the emergency room 
for health care or it would be very clear to him that this is the most 
expensive and immediate and emergency-type circumstance that a person 
could receive medical care.
  I wish he would come with me--if I had one wish, I would probably 
wish something else other than coming with me to the hospital to an 
emergency room to find out what it's like and how limited the treatment 
of necessity is because the hospital is defective or the doctors are 
not fully prepared--but they're under the stress of all emergencies 
coming from anywhere in the area to come in.
  So that sort of reminds me of the phrase ``Let them eat cake.''
  ``Go to the emergency room. What is the problem?''
  Well, the problem is that many emergency rooms cannot handle all of 
the cases for people who don't have insurance. And I am sorry to report 
that on some occasions, they are not able to entertain the health needs 
of the people that seek emergency room medical treatment.
  And so we, in our office, have been bombarded with the tales, the 
tragic stories from people who are facing permanent injury, 
unemployment, death, bankruptcy, foreclosure, even the breakup of 
families due to the unaffordable health care costs.
  So during this discussion this evening, we want to share--I invite 
that we share with each other the experiences that have been related to 
us, Mr. Speaker, that have come from the American people because 
nothing has become clearer in the course of my experience here that 
before we can discuss policy options to reform our health care system, 
Congress needs to hear from patients and citizens and constituents who 
suffer under our current non-system, broken way that we deliver health 
care in the United States.
  And so it is in that spirit that we begin this discussion.
  I want to just relate one, and this is entitled ``Robin's Story.''
  ``My son was 16 when he was diagnosed with a rare form of liver 
cancer (undifferentiated sarcoma of the liver). I was married. My 
husband and I were both working and we had health insurance through my 
husband's employer,'' Robin says. ``I had recently lost my job as a 
professor at a business college and was trying to start up my law 
practice from my home office. When Taylor got sick, we were barely 
making ends meet.
  ``The doctors had told us Taylor,'' 16 years old, ``Taylor didn't 
have cancer but they weren't sure what the mass in his liver was. When 
they opened him up, they knew it was cancer but it took 5 days to 
determine the exact type of cancer. They had to close Taylor up without 
removing the tumor because it was so intertwined with his major blood 
system. They would have killed him,'' they thought, ``if they tried to 
remove it.
  ``As I sat next to Taylor's bed at about 3 in the morning, we both 
were awake because we couldn't sleep. My husband and I had words. We 
were so stressed over the uncertainty of our future. We were facing the 
possibility of losing our son to cancer and we couldn't even pay our 
bills, let alone pay for the medical bills we were already facing from 
the surgery and hospital stay. Then to have to pay the cost of cancer 
treatment was overwhelming.
  ``Apparently Taylor had heard parts of our conversation. He lay on 
the bed, barely able to get up to go to the bathroom, facing an 
uncertain future. He said, `Mom, I'm so sorry about the money.'
  ``I can't begin to explain how inadequate I felt. I couldn't take 
care of my own son. He should be focusing on recovering from this major 
surgery and on gathering his strength to fight the biggest battle of 
his life. Instead he was worrying about how we were going to pay for 
all of this.
  ``We had insurance but we had a large deductible and co-pay. The cost 
of his treatments over the next year was a quarter of a million 
dollars. Even though we only had to pay a percentage, 20 percent of an 
astronomical figure is astronomical. Our phone rang constantly with 
creditors and collection agents wanting to know when we were going to 
pay our bills. I was unable to work much because Taylor's treatments 
and the everyday issues of cancer were as much as I could handle. So in 
addition to extra bills, we had a fraction of our previous income.
  ``After Taylor's first surgery and chemo treatment, we were preparing 
to leave the hospital. We were told we would have to administer a shot 
to Taylor every day to try to keep his blood counts high enough to 
continue his cancer treatment. It was stressful to consider giving your 
son a shot every day. That doesn't compare to the moment the first 14 
shots were delivered to our hospital room along with a statement for 
$6,122! My heart sank to my stomach. I asked the delivery person if I 
had to pay them right then. He said they would bill us. Thank God. I 
can only imagine having to decide whether we would pay our mortgage 
payment and electricity, or give our son a shot that might save his 
life.
  ``We eventually got to the point we couldn't pay our mortgage. Our 
electricity was turned off many times. Each time, I had to pay the 
amount due plus an extra $100 cut-off fee. If I couldn't afford the 
original bill, how would I afford the additional $100? Friends and 
family raised money to help us. It didn't even begin to touch the 
amounts we owed. And as he turned the corner towards survival, everyone 
believed that the crisis was passed and stopped helping us.
  ``We are so blessed because our son survived cancer. It is truly a 
miracle. But our family didn't survive. After 23 years, my marriage 
dissolved. The financial pressures were more than the marriage could 
stand. I still have all of the medical debts and other debts on top of 
that. I try to just get through each day. I know that I am one of the 
lucky ones. Although I didn't survive cancer, my son did. I know many 
families who lost their child and then are also financially devastated. 
. . . probably even more so than I because they had years of medical 
treatment that failed to save their child.
  ``We tried to keep our insurance coverage. But we had to go on COBRA 
coverage, which was over $1,000 per month in addition to the medical 
bills. So both Taylor and I and Taylor's father have no insurance. 
After treatment, Taylor went in for a checkup every 3 months. Each 
checkup costs $6,000. We are now on six month checkups and hope to go 
to one a year next year.
  ``However, all of the other medical issues will just have to be 
placed on hold. Because I don't have health insurance, I don't take 
care of medical issues I used to address as they arose. Last summer I 
fell. I may have broken my wrist or at least tore ligaments. I didn't 
go to the doctor but just let it heal on its own. My wrist will always 
be a problem because it didn't heal right. Taylor's beautiful teeth 
that we worked so hard to straighten with braces will just have to be 
dealt with later.

                              {time}  1930

  ``I just pray Taylor or I don't have a major medical problem. I live 
in fear for both of us because I know what treatment can cost.
  ``What I learned through our ordeal is that the individual is 
expected to pay for an inflated `retail' price for health care but the 
insurance companies, the ones who have the financial ability to pay, 
have made deals with the providers to pay a fraction of the `retail' 
price. As an `insured,' we received an explanation of benefits showing 
that the insurance company was given a `discount' and they usually only 
paid one-third of the amount paid by an individual with no insurance. 
That is so wrong. That means that the individual is paying the price 
for the insurance companies' `discounts.'
  ``This insanity must stop. We need to tell our story. The insurance 
companies and providers are making money on the backs of individuals 
already in crisis, facing life threatening illness and financial 
struggles because their income is reduced. I knew that survival is 
related to attitude. I assure you we are losing lives because it is 
hard to have a positive attitude through financial crisis on top of 
medical crisis. I want to help tell the story.''
  A similar wind is now blowing in the 21st century. I believe the 
people, not special interests, should decide what type of health care 
system exists in this country. I believe this

[[Page H8465]]

wind of change will usher in a new day; a day when hope for the just 
treatment of all of our brothers and sisters will be reborn.
   A truly open and democratic process is needed as we pursue this 
endeavor to ensure equal, just, and comprehensive care for all. To this 
end, I implore the inclusion of the American people in this discussion, 
so that the singular, resounding voice of those who believe in change, 
who believe in moral responsibility, can reverberate across the nation 
loudly enough so as to drown out those who would profit from continued 
injustice.
  The struggle for health care for all is the civil rights struggle of 
the 21st century. Let there be no doubt: the powers aligned against us 
are powerful and vast; the coming struggle will be long and hard. But, 
we have been down this road before, and we have succeeded. We shall 
succeed once again, because as Fannie Lou Hammer once said, we are sick 
and tired of being sick and tired.


                            Kathryn's Story

   My sister was 46 when she saved enough money and was able to go to 
her doctor for a physical. Her doctor discovered an orange sized mass 
in her uterus. He recommended that she have an ultrasound. She said she 
would when she had saved more money. This was August 2005. She 
continued to work two part time jobs, one at a hospital as a 
housekeeper in the operating room on the OB/GYN floor. The other job 
was working for the State of Michigan as a maintenance worker cleaning 
restrooms. She worked hard and was a loyal employee. Unfortunately, 
both jobs were part time, so no benefits were offered. She also didn't 
qualify for aid from the county or State because she worked too much! 
By September 2006, she was dead. The mass was cancerous, spread to her 
ovaries, and finally to her lungs. She died three months after 
diagnosis. Medicaid was approved after her death.


                               conclusion

  My friends, the vital issue of the health care crisis in this country 
is rising to the surface; the plight of the uninsured and the 
underinsured can no longer be ignored. As the election season continues 
to progress, and as we draw nearer to a new administration, the time is 
now for Members of the House to call for serious, comprehensive health 
care reform.
  Martin Luther King, Jr. once said, ``Of all the forms of inequality, 
injustice in health care is the most shocking and inhumane.'' I am 
privileged to have known Martin Luther King, Jr. and to have worked 
closely with him on civil rights issues. Madam Speaker, health care is 
a civil right.
  It is the spirit of the civil rights crusaders of the past from which 
we should draw inspiration and strength. Abolitionists did not settle 
for piece-meal appeasements or token change. Rather, a dynamic and 
sweeping wind reshaped the Nation for the better, capitalizing on a 
nagging conscience that Americans, both black and white, knew was the 
moral and just thing to do.
  I'd like now to turn to the gentlelady from the Virgin Islands, Dr. 
Donna Christensen, who not only serves on two very important committees 
in the House of Representatives, but in addition, she chairs the 
Congressional Black Caucus Health Caucus, and I've had the honor of 
working with her across the years, and I would yield to her.
  Mrs. CHRISTENSEN. Thank you, Congressman Conyers.
  Mr. Speaker, I rise with Chairman Conyers and my esteemed colleagues 
to stress the need for comprehensive health care reform that not only 
tackles the core issues but substantively transforms the foundation 
upon which this Nation's health care crisis is existing. And the story 
that Congressman Conyers told about Taylor could be repeated over and 
over again across this country.
  The pursuit of and desire to have good health and access to reliable, 
high quality health care cuts across geography and gender; across race 
and ethnicity and political affiliation. These wants and needs are 
basic to all human beings. And because they are basic human needs, the 
time has come for health care to be affirmed as a basic human right.
  As an American and as a physician, I am embarrassed that, today, the 
United States is the only industrialized Nation that does not guarantee 
access to health care as a right of citizenship. So I think that we 
have much to learn from the industrialized nations who, through either 
single payer universal health care systems or a multipayer universal 
health care system, have put the health and wellness of their residents 
at the top of their agendas and, as a result, are healthier than we are 
today.
  For example, compared to the rest of the world, the United States 
ranks 41st in maternal mortality rates, which means that 40 other 
nations, most of which have fewer resources than we do, have lower 
mortality rates than us.
  Additionally, we are ranked 42nd in infant mortality, which means 
that 41 nations, including Cuba, the United Kingdom, Anguilla, Japan 
and Singapore, have a lower infant mortality rate than we do.
  The underlying reason for these shameful numbers is this country's 
failure to address health disparities and to put into place effective, 
comprehensive and culturally appropriate programs to eliminate them. 
Not only do people of color make up most of the 45 million uninsured 
and the additional 50 million underinsured, but because of this as well 
as because of discrimination and the lack of culturally and 
linguistically appropriate care, they also are the majority of those 
who die prematurely from preventable causes in this wealthy and 
technologically advanced country.
  It's very important to note that the millions of Americans who 
comprise our Nation's un- and underinsured population are not people 
who are lazy. They're not people who are looking for a handout. They 
are hardworking, honest Americans. The overwhelming majority of the 
uninsured are members of working families who do not have access to 
employer-sponsored health coverage. In fact, more than 8 out of 10 
uninsured Americans make too much money to qualify for Medicaid but not 
nearly enough to purchase health care insurance on their own.
  The provision of health care to Americans living in the territories 
paints an even worse picture. And that's my individual story this 
evening, the story of 4.5 million people living in offshore areas.
  Those of us who live in the offshore areas of the United States have 
an additional burden when it comes to accessing health care services. 
For Guam, American Samoa, the Commonwealth of the Northern Marianas, 
Puerto Rico, and the U.S. Virgin Islands, Medicaid and the Children's 
Health Insurance Program is capped, and it is capped far below what is 
needed to provide the most basic of services to those who are at or 
below the poverty level.
  So, even in those families at 100 percent of poverty, they can't 
qualify. There's not enough money in our programs. Many who need long-
term care cannot get it because our Medicaid program cannot afford it. 
Other programs that are taken for granted in the States are not 
available to us because the funds are just not there to cover them. And 
in fact, the level of funding per Medicaid patient, even at the low 
numbers that are enrolled, is one-tenth of that spent on Medicaid 
beneficiaries in the States. Many of those States are richer than we 
are and have lower health care costs, and yet they get 10 times more 
funding per Medicaid beneficiary.
  Both on the mainland as well as in the offshore areas, our Nation's 
un- and underinsured Americans are paying the ultimate price for the 
absence of universal health care. They pay more out-of-pocket health 
costs, as we heard, and worse, they pay for it with poorer health and 
even with premature disability and death.
  And everyone, including those who have insurance, pay for it in 
rising premiums, higher deductibles and co-pays, and reduced quality of 
health care services for everyone.
  The grim statistics and analyses prove one thing: We need to expand 
access to health care and completely eliminate un- and underinsurance 
in this country. The only way to accomplish this is through universal 
health care.
  Access, however, is but one issue that we need to address within a 
comprehensive health care reform package. There is another issue that 
must be addressed because it, too, has to be an integral component of 
our health care reform discussions and efforts. And that issue is 
health disparities.
  The direct and indirect impacts of health disparities are well-known, 
and we know that they cut across every aspect of life. Additionally, we 
know that these disparities leave millions of African Americans, Native 
Americans and other people of color, women and rural Americans also, in 
a particularly precarious position as it relates to their health and 
health care. Not only are those most affected by health disparities 
disproportionately more likely to

[[Page H8466]]

be un- and underinsured, as I mentioned, but they also are 
disproportionately less likely, far less likely to receive the high 
quality of health care services and treatments available for everyone 
else.
  For example, the rates of hospital admissions for uncontrolled 
diabetes, which is an indicator of the quality of care received, for 
Hispanics and African Americans were more than three and five times, 
respectively, higher than the rate for Whites.
  The same scenario holds true for hospital admissions for asthma. 
African American children and adults have hospitalization rates for 
asthma that are five and four times, respectively again, higher than 
Whites.
  African American diabetics and Native American diabetics are three 
times more likely than White diabetics to have lower limb amputations.
  The differences in health care quality are not just evident in the 
hospitalization rates, but also in the disparate rates of utilization 
of services and treatments. African Americans are disproportionately 
less likely than whites to be referred to undergo cardiac 
catheterization or to receive more aggressive treatments for lung 
cancer or colorectal cancers, although they are known major causes of 
death in the African American community.
  In fact, studies confirm that across several dozen health care 
quality measures, African Americans receive a poorer quality of care 
than whites almost half, 43 percent, of the time for African Americans; 
for Hispanics, they receive a lower quality of care more than half of 
the time, 53 percent of the time; and for American Indians and Alaska 
Natives, they receive a lower quality of care more than one-third of 
the time, 38 percent.

  These differences in quality, like the differences in access, have a 
profound and detrimental impact on their health, wellness and ability 
to achieve their full lives' potentials. Additionally, these racial and 
ethnic differences in quality persist, even when insurance status, 
educational level, socioeconomic status, and disease severity are taken 
into consideration.
  Mr. Speaker, the time for comprehensive health care is upon us, and 
the time to ensure that our efforts not only surmount access barriers 
but also achieve health equity is now.
  As we as a Nation engage in increased discussions about health care 
reform, propose solutions to our under-and uninsurance plight and 
mounting health care costs, and finally move the idea of universal 
health care from concept to reality, we must address the health 
disparities and the root causes of health inequities, the social 
determinants of health, in order to be successful.
  The Nation's public health and health policy experts agree that a 
health care reform effort that fails to incorporate and integrate 
health disparity elimination as a core benchmark and objective is an 
effort that is flawed.
  So I urge my colleagues on both sides of the aisle and all of our 
friends off the Hill to work together to ensure that as we work towards 
a health care system where everyone is in and no one is out and to 
reform the system, that we do so in a manner that positively transforms 
the lives of the millions of Americans for whom quality health care has 
been denied and deferred for far too long.
  I thank Chairman Conyers for holding this Special Order this evening 
on this very important issue.
  Mr. CONYERS. Thank you, Dr. Christensen. ``Everybody in, nobody 
out.'' I know a doctor in Chicago that uses that term very frequently.
  Mrs. CHRISTENSEN. I picked that up from the American Student Medical 
Association. I believe that was their slogan.
  Mr. CONYERS. I'm pleased now to yield to the distinguished gentleman 
from Illinois (Mr. Davis), who I had the great privilege to be in the 
White House when his Second Chance bill was signed into law after many 
years of working in this body and the other body to see that it came to 
fruition. It derived from his long experience as a civil rights 
activist, as a commissioner, a county commissioner in Chicago, and as a 
community health worker in community clinics for a considerable period 
of time. I'm so proud that he's an original cosponsor of H.R. 676, and 
I yield to him.
  Mr. DAVIS of Illinois. Thank you very much, Chairman Conyers, and you 
know, as you and Representative Christensen were talking about, 
everybody in and nobody out, of course you were talking about Dr. 
Quinton Young, who kind of coined the slogan, who started the Student 
Medical Association. So I can understand how Donna would have picked it 
up.
  Mr. CONYERS. And Physicians for a National Health Plan, PNHP.
  Mr. DAVIS of Illinois. Unequivocally and without a doubt. So it has 
been an absolute pleasure to know and work with Dr. Young for a number 
of years. Those of us who considered ourselves to be health activists 
always wondered how Quinton practiced medicine, I mean, because he was 
so engaged and so involved, and yet he was engaged in the private 
practice of medicine part of the time. And of course, he was the 
medical director also at Cook County Hospital and a leader in the 
American Medical Association; although, he was considered a renegade.

                              {time}  1945

  Mr. CONYERS. We're expecting his presence at the 38th Congressional 
Black Caucus event next week in which we will be having a forum on 
universal single-payer health care.
  Mr. DAVIS of Illinois. Well, I should look forward to seeing him.
  But I also want to commend you for your tremendous leadership. As a 
matter of fact, you have been a hero of mine on these issues long 
before I came to Congress, and even before I had the opportunity to 
really know who you were.
  As a matter of fact, when I think of you, I often think of one of my 
favorite Biblical Scriptures that says, ``They that wait on the Lord 
shall renew their strength; they will mount up like the wings on an 
eagle; they will run and not get tired; and they will walk and not 
faint.'' And you have been running on these tracks for a long time. And 
still, while most Members have gone home, have gotten their flights and 
have made their way back--or trying to make their way back--here you 
are on the floor, late in the evening, leading a discussion on the need 
for national health insurance, or universal health care, and I can't 
help but commend that.
  Mr. CONYERS. Thank you.
  Mr. DAVIS of Illinois. You know, as I think about the issue of health 
and all the problems that we face individually and collectively, I 
think of how unfortunate it is when individuals are illiterate because 
it cuts them off from the ability to communicate with the rest of the 
world; and how unfortunate it is when people live in substandard 
housing because they don't have the sanctuary or they don't have the 
feeling of knowing that at the end of the day they can come in out of 
the rain or out of the cold or come in from a society that may not be 
as comforting as they would like for it to be.
  It's so terrible when children don't have access to good schools and 
decent education and can't be in a position to compete effectively with 
other members of society. And then to be unemployed, not have a job to 
go to, not be able to sustain oneself, not be able to know that you 
have the resources that you need. But then to be sick on top of all 
that means that your life is relegated, for all practical purposes, to 
a level of despair and uncertainty for which you can find or see no way 
out. The child who is sick at school and can't see a physician or go to 
a clinic.
  There is no point to the teacher talking about, ``Johnny, study 
hard,'' because Johnny doesn't feel like studying. I mean, Johnny's 
stomach is hurting, or Johnny can't see the board. And so telling 
Johnny to study hard doesn't mean a great deal to Johnny. Or the guy 
who wakes up in the morning and turns on the radio and the blues singer 
is saying, ``get a job.'' ``Every morning about this time you bring my 
breakfast to the bed crying. Get a job.'' Well, that person doesn't 
feel like going out looking for a job because they're sick. They don't 
feel like it; they're despondent, they're in despair. And so they're 
not going to get a job. They're not even going to go out and look for a 
job because they don't feel like going to work.
  And so health care, as far as I'm concerned, and for my money, is the 
most important aspect of life, because without a sense of well-being, 
one cannot

[[Page H8467]]

challenge or confront the rest of societal needs.
  Our health is the foundation of everything that you can think of. I 
often believe that my mother died prematurely because she had to travel 
100 miles to go to the hospital for her dialysis treatment because that 
was the closest hospital to where she lived where she could get the 
treatment. And so not having access to health care has limited, in so 
many different ways, the ability for people to just have hopes of the 
American Dream, to just believe that they can experience it.
  Yeah, there are those who take the position that we could never have 
universal health care; I mean, they say, ``never, ever.'' But, you 
know, I remember when people said that you could never put poor people 
into managed care. I remember when people said that HMOs would not 
survive, that they would never, ever make it. I remember when people 
said that you really couldn't have the proliferation of clinics. I 
worked in a community health center, and I remember when those were 
getting started. They were part of the ``Great Society'' programs, part 
of the legislation that came out of the marches and demonstrations led 
by Dr. Martin Luther King that came after John Kennedy had been elected 
President, assassinated, and then Lyndon Baines Johnson became 
President. And Democrats--I mean, they were Democrats--embarked upon a 
new program, something called the ``Great Society'' programs, just as 
years before a fellow named Franklin Delano Roosevelt kind of led the 
Nation towards social reform that brought us Social Security and some 
other protections that we didn't have.
  Well, I think that right now is the best possible time for us to take 
another giant step, a quantum leap, if you will, and make sure that no 
single individual in our country, no matter who they are, where they 
come from, how wealthy they are, how poor they are, how without 
resources they are, no single individual should have to live in the 
United States of America without adequate protection for health care.
  I mean, we are the wealthiest Nation on the face of the Earth. We are 
the most technologically advanced Nation. Yes, we are hurting in some 
ways. And of course we are hurting because we have not seen the 
distribution of the resources be as adequate as we need to see them. We 
have not seen as many people with access to the goodness and the 
greatness of this country. But when 41 percent of working age adults 
have a problem paying their medical bills or have a medical debt that 
they will never be able to pay, then something is wrong.
  And we have not seen what we are capable of seeing. I was just 
thinking of some of the things that people have been telling us about 
their experiences. And I guess if you live in an environment that I 
live in and where I live, you individually know these people. It's not 
a matter of reading it in the newspaper or reading it in the magazine, 
you know the individuals personally who are having these kind of 
problems. For example, Jerome. Jerome said to us, ``My wife was 
diagnosed with melanoma in September and died in November. I believe 
preventive health care and better diagnosis might have prolonged her 
life or provided a cure. She saw two dermatologists last year, and both 
failed to diagnose her condition. She went on to have moles and a cyst 
evaluated and removed. In addition to the failure to diagnose, the cost 
of insurance and deductibles exceeded $40,000. Prior hospital visits in 
the past 5 years for a stroke resulted in medical bills of 
approximately $100,000, which brought us to the verge of bankruptcy.

  ``Fortuitously, I received an inheritance last year which enabled me 
to pay the current bills. However, since being downsized 5 years ago at 
age 56, I have been unable to obtain employment. And my wife was unable 
to work due to the stroke and subsequent illnesses. I am a relatively 
well-educated man and I'm willing to work; however, I do not feel our 
current economic system values my experience and education. I am a 
certified financial planner. I have worked over 30 years with 
approximately $150,000 accumulated in retirement savings, all of which 
has been used for medical expenses. Without my inheritance, I would 
have my home, worth about $250,000, as my only asset.''
  Julia writes, ``I've been fighting ovarian cancer for 19 years. I 
developed a secondary blood cancer last year and had to have a bone 
marrow transplant in January of 2007. Medicine is outrageously 
expensive. Luckily, I have mail order service that only costs $5 a 
prescription; otherwise, my medication would cost over $1,000 a month.
  ``Our insurance premiums cost $965 a month. My COBRA, just for me, is 
$565 a month. My husband and two children, which my husband pays for, 
$400 a month. My deductible is low, $250, but my family's is over 
$1,000. I am dreading if I am unable to work before COBRA runs out. I 
don't know what I will do for insurance as I am a teacher and don't 
know if I can get Medicare. I can't go on my husband's insurance as he 
works for a small company. They will get dropped by the insurance 
company if I am added. This has happened twice before.
  ``The medical system is broken. People shouldn't have to choose 
between health care and bankruptcy, which is the case for many who go 
through bone marrow transplants.''
  Well, Congressman Conyers, as long as there are people like these in 
America, as long as there are individuals for whom the American Dream 
continues to be a tremendous nightmare, as long as there are people who 
have, in many instances, lost hope and given up, as long as there are 
individuals who can't see their way out no matter how much they 
struggle, how long, how hard and how difficult the challenges, and as 
long as there are people like you, who are willing to fight for every 
American, as long as there are people like you, I am going to be 
willing to join you.
  And so I'm pleased that I was able to be here this evening to share 
with you and with Americans all over the country that health care 
should, in fact, be a right and not a privilege, that we must have a 
system where everybody is in and nobody is out.
  I thank you. And I yield back the balance of my time.

                              {time}  2000

  Mr. CONYERS. I thank the gentleman for his kind references.
  I ask unanimous consent to include any other materials in the body of 
our discourse today.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. CONYERS. I return the balance of our time.

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