[Congressional Record (Bound Edition), Volume 149 (2003), Part 13]
[House]
[Pages 17589-17590]
[From the U.S. Government Publishing Office, www.gpo.gov]




  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
 RELATED AGENCIES APPROPRIATIONS BILL HAS TERRIBLE EFFECTS FOR AMERICA

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from the Virgin Islands (Mrs. Christensen) is recognized 
for 5 minutes.
  Mrs. CHRISTENSEN. Mr. Speaker, I rise to call attention to the big 
let-down that is the fiscal year 2004 Labor, Health and Human Services, 
and Education, and Related Agencies bill just passed by this House. I 
want to commend my colleague, the ranking member of the Committee on 
Appropriations, the gentleman from Wisconsin (Mr. Obey), for his 
tireless efforts to reverse the terrible effects of this bill on the 
less fortunate in our country. I cannot believe that in the face of the 
many needs that remain, this body was unwilling, either in committee or 
as a body, to just cut a small amount from the highest tax cuts to fund 
them.
  Mr. Speaker, as a physician I am very concerned, as we all should be, 
that our health care system in this country remains in serious peril, 
and the bill before us today does very little to reverse the downward 
spiral. Our flawed system is falling short on its promise and 
contributing to the disabling illness and premature death of the people 
it is supposed to serve.
  The picture is worse for African Americans who, for almost every 
illness, are impacted most severely and disproportionately and, in some 
cases, more than all other minorities combined. Every day in this 
country, there are at least 200 African American deaths which could 
have been prevented. This bill does nothing to reduce or address this 
whatsoever.
  Today, we know that they happen because even when we have access to 
care, the medical evaluations and treatments that are made available to 
everyone else are denied to us, not only in the private sector, but in 
the public system as well.
  The current, strongly held-to ``cost containment'' paradigm, while it 
sounds good on the surface, has obviously not worked. What it has done 
instead is to create a multi-tiered system of care, both within the 
managed care system and without. Those at the lowest rungs of the 
system get sicker; the sicker, therefore, are more costly, were and 
still are being dropped, and those who are the sickest are blocked out 
entirely. So not only are health care costs continuing to escalate; the 
overall health picture in this country is worse than ever.
  Passing this bill means we will just continue on the path of 
fostering a separate and unequal health care system.
  It provides the smallest percentage increase since 1998 for the 
administration's centerpiece, the community health centers, which serve 
13 million people who lack access to health services in rural and urban 
areas.
  The bill provides no increase at all for the Maternal and Child 
Health block grant or the National Health Service Corps, leaving many 
pregnant mothers and infants without services at a time when this 
administration and Congress have singled out the safety net of Medicaid 
for attack. It further harms our children by providing no increase for 
the childhood immunization program, which is already having trouble 
keeping up with the rising costs of vaccinating children.
  This so-called appropriation bill completely ignores recommendations 
from the Institute of Medical Reports which we commissioned and paid 
for. Despite an important recommendation for more minority health care 
providers to overcome discrimination in the health system, which is 
critical to eliminating health care disparities, this bill cuts 
programs that help students from minority and disadvantaged backgrounds 
prepare for and do well in medical school and other health professional 
schools.
  It further freezes funding for the Health Professions Training 
Program at the 2003 level. This program provides scholarship and 
student loan repayment assistance for doctors, or it would, and 
dentists, who agree to work in medically underserved areas. It is a key 
source of health professionals to staff community health centers and 
rural health clinics, making the small increase to community health 
centers another empty promise.
  As a supposed sign of generosity, the bill provides a negligible 0.3 
percent increase over the current year for the Ryan White program, 
which will mean that that program will fall further behind the rising 
costs and needs of the AIDS community. But in a cruel twist, the bill 
increases funding for AIDS drugs assistance programs, which provide 
access to drug therapies and needed treatments to sustain and improve 
the lives of those living with HIV and AIDS by $39 million, but it pays 
for that increase largely by cutting $33 million from other Ryan White 
programs; and it still keeps the program underfunded by about $100 
million. States are reporting every day growing lines of waiting lists 
for people waiting for treatment.
  We have problems with the administration's new initiative to focus on 
HIV-positive persons at the expense of primary prevention. But even 
then, few, if any, resources are being provided for the health services 
needed to help people with HIV remain as healthy as possible and slow 
the transmission of the virus because of the cutbacks in the Ryan White 
program.
  The Members of the Congressional Black Caucus have made a sustained 
effort to ensure that our poor and minority communities across the 
country have access to AIDS services. What will happen with this bill 
is, tragically, that the funds will not be available to build a 
capacity of our community-based organizations to help patients reach 
lifesaving medicines once those patients have been identified.
  Mr. Speaker, the fiscal year 2004 Labor-HHS bill would be considered 
a joke if the programs were not so critical to the lives of the 
American people. I wish that I could hope for it to be fixed during 
conference, but the President and the Republican leadership here have, 
through their tax cut and ill-advised war, and their commitment to 
provide for Iraq what they will not provide for people in this country, 
have

[[Page 17590]]

made it next to impossible for us to provide the needed funds to make 
our own people whole.
  I think that the leadership here is probably happy that they passed 
this bill, but it is a bad day for the people of the United States.

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