[Congressional Record (Bound Edition), Volume 149 (2003), Part 21]
[House]
[Pages 29435-29436]
[From the U.S. Government Publishing Office, www.gpo.gov]




 ELIMINATION OF DISPARITIES IN HEALTH CARE FOR MINORITIES LONG OVERDUE

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 7, 2003, the gentlewoman from California (Ms. Watson) is 
recognized during morning hour debates for 2\1/2\ minutes.
  Ms. WATSON. Mr. Speaker, as former chair of the California Senate 
Health Committee for 17 years, let me say how pleased I am with the 
comprehensive legislation that the Health Care Equality and 
Accountability Act of 2003 contains. The elimination of racial and 
ethnic disparities is an issue whose time is long overdue, and I 
commend the CBC Brain Trust, the Tri-Caucus, the Democratic leadership, 
the Senate Health Committee, the gentlewoman from the Virgin Islands 
(Mrs. Christensen), Senator Ted Kennedy, and everyone else who remained 
vigilant in completing this project.
  As Americans, we take pride in our diversity, and it is our greatest 
achievement that based upon that diversity, whether it is economic, 
political, or cultural diversity, we have built a Nation that is 
dedicated to providing equal opportunity for all. But, Mr. Speaker, 
much needs to be done before we can say that we have accomplished that 
goal, most notably in the field of health care.
  Racial and ethnic minorities too often are denied the high quality 
health care that most Americans receive. The Federal Government has 
recognized this serious problem and has set the goal of eliminating 
health disparities by the end of the decade. House and Senate Democrats 
have introduced legislation, the Health Care Equality and 
Accountability Act of 2003, that takes an important step towards making 
this national goal a reality.
  We may have the finest health care system in the world, but too many 
of our people receive too little health care and are denied the right 
to lead full lives.
  The reality is that the health care needs of minority Americans are 
often greater than those of white Americans. Minority populations 
disproportionately suffer from many diseases. Minority groups have 
higher rates of acute conditions such as tuberculosis, HIV/AIDS, 
chronic diseases, diabetes, heart disease and stroke, and many forms of 
cancer. In addition, minority women are at greater risk than white 
women for pregnancy-related complications, and their babies are at 
higher risk of dying during their first year of life.
  Despite a substantial need for health care, minority groups often 
encounter obstacles in obtaining health care. Minority groups are less 
likely to have health insurance and are less likely to receive 
appropriate health care services.
  Mr. Speaker, I ask all of my colleagues to support our Health Care 
Equality and Accountability Act of 2003 so we can improve the health of 
all Americans.
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise today to 
address the need for racial equity in health care in our great Nation.
  As a former nurse, I have spent much of my public career working to 
ensure that the nation's health care system is affordable and provides 
the best services possible to all Americans.
  Disparities in the burden of death and illness experienced by 
African-Americans, as compared with the U.S. population as a whole, 
have existed since the government began tracking such statistics. These 
disparities persist, and in some areas continue to grow.
  Cardiovascular disease is the leading cause of death for all racial 
and ethnic groups, with a disproportionate burden of death and 
disability from cardiovascular disease in minority and low-income 
populations.
  The prevalence of diabetes in African Americans is approximately 70 
percent higher than whites. Racial and ethnic minorities have higher 
rates of hypertension, tend to develop hypertension at an earlier age, 
and are less likely to undergo treatment to control their blood 
pressure.
  Many minority groups suffer disproportionately from cancer and 
disparities exist in both mortality and incidence rates.
  For men and women combined, African-Americans have a cancer death 
rate about 35 percent higher than that for whites. African-American 
women develop breast cancer less often than do white women, but have a 
higher mortality rate (27 per 100,000), due most likely to later 
diagnosis and late entry into treatment. African-American and Hispanic 
women have higher cervical cancer death rates.
  The incidence rate for lung cancer in African-American men is about 
50 percent higher than in white men and the death rate is about 27 
percent higher.
  The prostate cancer mortality rate for African-American men is more 
than twice that of white men.
  African-American women are less likely to receive care, and when they 
do receive it, are more likely to have received it late. For example, 
one out of four African-American mothers did not receive prenatal care 
during the first trimester during 1999. Other risk factors, such as 
obesity, contributes to heart disease, diabetes, and stroke. 
Approximately 69 percent of African-American women between the ages of 
20 and 74 were overweight during the period 1988 through 1994.
  The prevalence of obesity in minority populations can be as much as 
three times higher than that of whites, and is higher among women than 
men. African Americans and Hispanics have a particularly high 
prevalence rate of obesity as do Pacific Islanders, Native Americans, 
Alaska Natives, and Native Hawaiians.
  More than 75 percent of AIDS cases reported among women and children 
occur in minority women and children. While racial and ethnic groups 
account only for about 25 percent of the total United States 
population, they account for more than 50 percent of all AIDS cases.
  Children from minority communities are disproportionately represented 
among those with incomplete immunizations. In addition, infant death 
rates among minority populations are above the national average, with 
the greatest disparity existing among African Americans. Minority 
populations are at the greatest risk for SIDS.
  The rates for the uninsured minority are quite frightening. Blacks 
and Latinos are far more likely to be uninsured when compared to their 
Anglo or white counterparts.
  Nationally, 11.6 percent of the Anglo population, 20.1 percent of the 
African American population and 34.8 percent of the Hispanic population 
are without health insurance. In Texas, while 12 percent of whites are 
uninsured, 21.2 percent of African Americans and 36.7 percent of 
Hispanics do not have medical coverage.
  That is why I am an original cosponsor of The Healthcare Equality and 
Accountability Act of 2003. The Healthcare Equality and Accountability 
Act of 2003 would reduce health disparities and improve the quality of 
care for racial and ethnic minorities by:
  First, expanding health coverage. To reduce the number of minorities 
without health insurance, the bill would give states the option to 
expand eligibility and streamline enrollment in Medicaid and the State 
Children's Health Insurance Program.
  This bill also removes language and cultural barriers to good health 
care that plague many of our minority communities.

[[Page 29436]]

  Because language and cultural differences create barriers to health 
care, the bill would help patients from diverse backgrounds, including 
those with limited English proficiency, with provisions such as 
codifying existing standards for culturally and linguistically 
appropriate health care, assisting health care professionals provide 
cultural and language services, and increasing federal reimbursement 
for these services.
  Instruments in this bill have been put in place to encourage 
workforce diversity. Increasing the number of minority health care 
providers will improve access to care because these providers are more 
likely to serve low-income, uninsured, and minority patients.
  Date collection would be improved to better identify sources of 
health disparities, implement effective solutions, and monitor 
improvement.
  Under this bill, the Office of Civil Rights and the Office of 
Minority Health at the Department of Health and Human Services (DHHS) 
would be expanded to promoting accountability and reduce health 
disparities.
  And finally, this bill strengthens health institutions that serve 
minority populations. By establishing loan and grant programs, health 
institutions that provide substantial care to minority populations will 
receive necessary funding to carry our their mandates.
  Protecting the health care of citizens, no matter their ethnicity or 
race, should be the number one priority of any great nation. An 
investment in our health care system is one of the wisest investments 
we can make for the future of this country.
  Now is the time for all Americans to have equal access to quality 
health care and meaningful patient protections. That is why I urge my 
colleagues to support this legislation. Our citizens deserve and expect 
nothing less.
  Ms. LEE. Mr. Speaker, I am proud to stand here with the membership of 
the Congressional Black Caucus, the Hispanic Caucus, the Asian-Pacific 
American Caucus, and the caucus for all Americans, the Democratic 
Caucus, in support of inclusive, quality, affordable health care for 
all Americans. I want to thank the gentlelady from California for her 
consistent leadership on these many issues important to those with no 
voice.
  Democrats are committed to the elimination of racial and ethnic 
disparities in health care access, health care quality, health outcomes 
and the diversity of the health care workforce because all Americans 
deserve equal treatment and care.
  A proper investment in health care will improve both the health and 
economic well-being of all our country and that's why we came together 
and drafted the Healthcare Equality and Accountability Act of 2003, 
which our caucuses introduced on November 6, 2003.
  Our goal is the complete elimination of racial and ethnic health 
disparities and I believe this bill provides a major first step toward 
that goal.
  The goal of equity in health care must be met, particularly in a 
country that boasts about upholding and spreading democracy and human 
rights.
  It is criminal that in the United States the color of your skin and 
the languages that you speak can make you more likely to die of HIV/
AIDS, heart disease or diabetes, as a result of our negligent and 
culturally insensitive health care system.
  We came together because we saw a need to offer solutions for the 
inclusion and the prioritizing of minorities in the health care system 
which today remains sorely inadequate.
  In this bill, we have diagnosed the major health care shortfalls and 
provided sound and culturally-conscious solutions.
  1. We ask for an expansion of the health care safety net, which will 
increase the availability, quality, and affordability of health 
coverage options that provide meaningful access to health services.
  2. We ask for much needed diversification of the health care 
workforce, which will reflect the communities that have been neglected 
while incorporating a personal understanding of the backgrounds, 
experiences, languages, and perspectives of the minority people.
  3. We ask that health care be declared not only a human right, but a 
basic civil right, and that every part of the 1964 Civil Rights Act is 
honored.
  4. We ask for aggressive collection and dissemination of data on 
minorities to become a priority for the health care community.
  The collection of this data keeps us on the pulse of our communities. 
We cannot help the minority community if we are blinded by Prop. 54's 
and other antiquated rules and regulations that negate the advances 
health care professionals have attempted.
  5. We ask for a complete assault on HIV/AIDS and other diseases that 
are disproportionately killing the minority community.
  Undiagnosed and uncared for, over 43 million Americans are 
uninsured--half of whom are minorities.
  Further, those who have access to care are still dying of diseases 
that go undetected and undiagnosed because the quality of their care is 
sub par.
  We cannot stand by while the pharmaceutical and private insurance 
industries profit off of our communities.
  We cannot stand by while rates of prostate and breast cancer, 
diabetes, and high blood pressure disproportionately take the lives of 
people of color around this country.
  We cannot stand by while this Republican led Congress privatizes 
Medicare and cushions the pockets of their industry donors with the 
prescription drug bill, H.R. 1.
  And finally, we cannot allow the Congress to pass any more health 
related legislation that doesn't have at heart the interests of the 
African American, Latino, Native American, or our Asian and Pacific 
Islander communities.
  We will win the battle against ethnic and racial health disparities, 
because we are united.
  I thank the leadership of all the caucuses who worked so diligently 
on this bill and I thank the Congressional Hispanic Caucus for 
designating this hour to talk about this progressive and comprehensive 
bill.

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