[Congressional Record (Bound Edition), Volume 151 (2005), Part 6]
[House]
[Pages 8457-8461]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        HEALTH INSURANCE CRISIS

  The SPEAKER pro tempore (Mr. Dent). Under the Speaker's announced 
policy of January 4, 2005, the gentlewoman from Wisconsin (Ms. Baldwin) 
is recognized for half the time until midnight.


                             General Leave

  Ms. BALDWIN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and include extraneous material on the subject of my special 
order this evening.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Wisconsin?
  There was no objection.
  Ms. BALDWIN. Mr. Speaker, for the third consecutive year, this week 
our country has designated Cover the Uninsured Week. Led by former 
Presidents Ford and Carter, hundreds of national and local 
organizations, as well as thousands of Americans in all 50 States, are 
participating in week-long activities to highlight the national health 
care crisis. This is one of those annual events that I wish we did not 
need to observe.
  Cover The Uninsured Week should be unnecessary. Moreover, millions of 
Americans who are underinsured should not be paying such a high price 
both emotionally and financially. There is simply no justifiable reason 
why the United States is the only industrialized country in the world 
that does not guarantee health care for all. So, Mr. Speaker, I rise 
tonight to draw attention to the 45 million Americans who do not have 
health insurance and the millions more who are underinsured.
  Our Nation is in the midst of an escalating health care crisis. As 
health care costs soar, it becomes increasingly difficult for Americans 
to obtain comprehensive and affordable health care. Our current health 
care system is failing not only the 45 million Americans who are 
uninsured, but also millions more who do not receive comprehensive 
health care. We can no longer turn our backs while millions more lose 
access to health care.
  Additionally, health care is becoming increasingly expensive even for 
those who are fully insured. Rising premiums, increasing deductibles, 
and the increasingly high cost of prescription drugs are making health 
care more and more unaffordable for those who have insurance. The lack 
of comprehensive and affordable health care affects every single 
Congressional district in this Nation. To highlight this issue and the 
real impact that being uninsured has on the lives of Americans, I have 
decided to read to my colleagues from some of the people that I 
represent in their own words. Often the people most affected tell the 
story of our uninsurance crisis more eloquently than many policymakers.
  I would like to begin with a few letters from my district in 
Wisconsin that express real people's struggles as part of our Nation's 
45 million uninsured. Starting with Kimberly from Madison, Wisconsin, 
Kimberly writes ``I am writing you today because of my family's 
frustration and anxiety over health care. My husband recently quit his 
job to launch his new company. Obviously, it will take some time for 
his new company to see any profit, much less income. In the meantime, 
we are without health insurance.'' She writes, ``I am 5 months 
pregnant, and we have a 2-year-old son. Because of my preexisting 
condition, we cannot buy affordable health insurance. COBRA would cost 
us $1,200 a month. I am currently applying for Medicaid and other forms 
of public assistance as a last resort. This is ridiculous.''

                              {time}  2300

  ``As someone with no insurance, I wonder what could possibly be the 
problem with implementing a public health care system. Oh, I have heard 
the horror stories about having fewer choices and doctors, longer 
waiting lists for procedures, and less incentive among doctors and 
researchers to develop new techniques. What is most frightening for me 
is the chance that my son might get sick or my baby might be born with 
expensive complications and we are uninsured.''
  Janet from Portage, Wisconsin writes to me: ``I have a 53-year-old 
brother who has psoriasis all over his body and arthritis caused by 
this. Three weeks ago he fell and needs surgery on his shoulder to 
repair it. He has no job, no money and no insurance. We started looking 
for a program to help him. There are none that we can find. There is 
nothing to help him get his shoulder fixed, but after it heals wrong 
and he is disabled because of it, then there are programs to help him. 
They will not help him get it fixed so he can find a job. Instead, they 
would rather support him for the rest of his life instead of trying to 
help him now.''
  Gail from Janesville, Wisconsin writes: ``My husband lost his job in 
October 2003. He has applied for over 100 positions only to be told 
that he lacks a college degree or he is overqualified or they can only 
pay $8 an hour.'' Gail writes: ``I was diagnosed with breast cancer in 
June 1989 and again in 2003. I have gone through breast cancer twice, 
and have undergone a mastectomy and reconstructive surgery. COBRA has 
run out and without a stable income, we cannot afford to pay the 
premiums of our own health care policy. My husband is 59 years old and 
I am 58 years old. We have no medical coverage. I have looked in every 
insurance company and get turned down because of my medical history. 
All our lives we paid into these insurance companies only to be turned 
away when we need that coverage the most.''
  Lisa from Madison writes: ``I write to tell you and let you know that 
I understand why most people would not think there is a health care 
crisis. Most middle-class employed people never have to do an insurance 
questionnaire. We just sign on the dotted line and get into a group 
policy with our employer.'' Lisa writes: ``I am a very healthy person 
and my husband and children are very healthy. We cannot get insurance. 
I think everyone should attempt to get an individual health insurance 
policy to see just how impossible it is. I am not a risk, really I am 
not. I am terrified right now because we are uninsured. The insurance 
companies are not concerned with our health. They are concerned with 
profits. That is sad and that is wrong.''

[[Page 8458]]

  Countless studies, including that of the Institute on Medicine has 
confirmed over and over again that uninsured has real consequences. One 
of those most serious and troubling consequences of being uninsured or 
underinsured is having to postpone or skip needed health care. Families 
USA reports that one out of five Americans has postponed needed medical 
care due to lack of coverage. And of those, more than one in three said 
the delay brought about significant pain or suffering. This is 
happening every single day all over America.
  Another letter I received from Carol from Madison says: ``As someone 
who has had no health insurance at all for 3 years, I can tell you that 
it was pretty miserable being one of the 45 million people in this 
country without health insurance. Not long ago, my best friend died at 
age 42 because of ovarian cancer because she did not have health 
insurance and waited too long to see what was causing all of her 
symptoms. Yes, people in America actually die from not having health 
insurance.''
  Darla from Fitchburg, Wisconsin writes: ``I lost my job because of 
unpredictable attendance due to my health issues. Upon losing my job, I 
signed up for COBRA. Last week I received a letter indicating my COBRA 
eligibility ends soon. In order for me to get health coverage, I would 
have to work at least 20 hours per week. My physicians believe that 
would do me more harm than good relating to my health issues. If I do 
not get some kind of health insurance, I will need to stop all 
treatments as I have no money to pay for doctors' services. My 
prescription drugs will have to stop as I will not be able to pay for 
them either. What can I do?''
  Heather from Waterloo, Wisconsin writes: ``I am married. Together 
with my husband, I own a home. We live a modest, middle-class life, 
managing always to have what we need except for health care coverage. 
My husband has excellent health care at his job, but for me to also be 
covered by the plan, we would need to pay nearly $400 per month. That 
is two-thirds as much as our mortgage. Through school, I have worked 
less and less. In order to maintain health care coverage, I have only 
been able to afford short-term, major medical coverage. I am grateful 
that we can afford this, but it does make a difference. However, even 
now if I have a sore throat, I will wait for several days and see how I 
feel. I will wait because if I do not need to go, I will save money.'' 
She writes: ``This is disturbing to me as a nursing student because I 
know about the importance of early treatment and prevention. It is 
upsetting to me as a person because I value my health, and it is 
unacceptable to me as a citizen because I know there are people just 
like me who wait and get sicker, or cannot even get the medications 
that they need.''
  These are heart-breaking stories, but perhaps what is more heart 
breaking is they are just not unique. Millions of American families are 
confronted with these impossible decisions regarding their health care 
every single day. According to a recent Kaiser Family Foundation poll, 
more Americans are personally worried about their health care costs 
than they are about losing their jobs, paying their rent or mortgage, 
losing money in the stock market, or being the victim of a terrorist 
attack.
  I will give an example. Roberta from Janesville, Wisconsin writes: 
``I think the insurance bills for both medical and dental are 
horrendous. Both my husband and I work full time with two small 
children, living paycheck to paycheck. My insurance costs have caused 
us many heartaches with us owing more money that needs to be paid. As a 
result, I will not get a needed medical procedure done. Something 
drastically needs to change in the United States of America where hard-
working families and individuals can get the treatment they need 
without going broke.''
  David from Cross Plains, Wisconsin, writes: ``My wife and I have been 
self-employed for over 18 years and have paid thousands of dollars for 
health insurance premiums. As of a few months ago, we had to drop out 
and are now without health insurance. The cost is completely out of 
reach. In fact, it is nuts. Now that I am 50 years old, it is not a 
matter of if I will ever have health problems, it is when. Tammy, we 
will lose everything we have ever worked for. So much for the American 
Dream. Now we look forward to dying, broke and possibly homeless.''

                              {time}  2310

  Mr. Speaker, part of the reason why I find these letters so 
compelling and why I make a point to share them with my colleagues and 
the American public is that finding and affording health care is a 
challenge faced by all types of Americans, young and old, those living 
in Wisconsin and those living in Texas, those who have jobs and those 
who do not. Put simply, this is a national crisis.
  I have been especially troubled lately that instead of working hard 
to find a solution to the health care crisis, the majority party here 
in the House seems to be making the crisis worse for Americans in need. 
The House recently passed a bankruptcy bill which makes it more 
difficult for people to cope with the massive costs brought on by 
health care crises. This is ridiculous, especially since we know that 
nearly half of all personal bankruptcies filed in the United States are 
due to medical reasons, be it medical debt or an illness or injury that 
keeps somebody from the workforce and earning a living.
  We are now poised to enact cuts to Medicaid, the Nation's health care 
safety net. On that note, I would like to share a few additional 
stories before I get a chance to call on my colleague from Missouri to 
make a few statements.
  First I share the letter of Chris from Monona, Wisconsin. She writes, 
``I'm writing because I'm concerned that the fiscal 2006 budget 
resolution may include drastic funding cuts to Medicaid. I have lived 
with multiple sclerosis for 12 years, and I know that significant 
decreases in funding would be devastating to people like me who have 
chronic conditions. I'm still able to work, but other folks with MS 
depend on Medicaid to access critical health programs. I need you to 
stick up for me and the thousands of Americans with MS.''
  And then there is Mary from Madison, Wisconsin, who came to meet with 
me in my office to talk about Medicaid. Mary is a nurse and while she 
was certainly familiar with the Medicaid program, she never thought she 
would have to rely on Medicaid. But then her daughter had a child who 
was born with a heart defect. The child had to have heart surgery 
almost immediately after he was born and was in the hospital for a very 
long time. During this time, Mary's insurance for her daughter and her 
grandson expired, but they were very fortunate to have Medicaid to fall 
back on. Mary is incredibly thankful that she had Medicaid. Otherwise, 
her grandson's health would have suffered and she would literally be 
hundreds of thousands of dollars in debt.
  And lastly, there is the story of Silvia from Fitchburg, Wisconsin. 
Silvia was uninsured when she was hospitalized with a need for an 
appendectomy. Even after the hospital charity program reduced her bill, 
she still owed over $11,000 to the hospital. Sometimes bill collectors 
call her home five times a day. Silvia chips away at this bill, sending 
$20 to $50 a month.
  Mr. Speaker, before I continue, I yield to the gentleman from 
Missouri (Mr. Carnahan) who has some words to share about Cover the 
Uninsured Week.
  Mr. CARNAHAN. I thank the gentlewoman from Wisconsin for yielding.
  Mr. Speaker, this week is Cover the Uninsured Week in our country. I 
rise tonight to voice my concern for the 45 million Americans, 
including 8 million children and over 600,000 citizens in my home State 
of Missouri who are currently living without health insurance. I want 
to encourage all Americans to get involved in this week-long observance 
in their communities or on the Web at www.covertheuninsuredweek.org and 
to dedicate ourselves to getting America covered. This is a broad and 
diverse coalition of individuals and organizations throughout our 
country, including the U.S. Chamber of Commerce, the AFL-CIO, Health 
Care Leadership

[[Page 8459]]

Council, AARP and many other organizations in our country that have the 
common goal of getting America insured. Uninsured Americans come from 
many age groups and backgrounds. In fact, eight out of 10 people who do 
not have insurance live in families with at least one person working 
full-time. Yet either their employer does not provide health insurance 
or they cannot afford the premiums that continue to escalate out of 
control. These Americans live day to day, dreading the slightest cold, 
praying for their children, that they stay healthy. This can no longer 
continue in our country.
  I understand these concerns all too well. When my wife and I owned 
our small business many years ago, we did not have insurance for the 
birth of our youngest son. We were fortunate that there were no serious 
complications and that we were able to obtain insurance eventually. But 
many American people are not so fortunate. This is a grave and serious 
problem that affects all Americans, not just those without insurance. 
Even those who currently have health insurance are impacted by this. 
When people do not have the protection of quality health insurance 
coverage, they often put off seeing a doctor until their condition 
worsens to the point that they must go to the emergency room. If they 
cannot pay for the large hospital bill, the costs are passed on to 
other patients who are insured through higher premiums and oftentimes 
overcrowded emergency rooms.
  There is a better way. I am proud to stand here with the gentlewoman 
from Wisconsin and many other Members of this Congress to recognize 
Cover the Uninsured Week and to advocate for real solutions to this 
nationwide crisis. The problem of the uninsured is not something that 
we can put off solving anymore. I urge Congress to act and improve the 
lives of millions of hardworking and uninsured Americans by ensuring 
accessible and affordable health care.
  Ms. BALDWIN. I thank the gentleman for his words. As I was earlier 
sharing some of the letters written to me by my constituents, I 
recognized how powerful those stories are. I thank the gentleman also 
for sharing his own and his own experience with this issue. I am sure 
it strengthens his advocacy on behalf of all of his constituents and 
all Americans.
  Mr. Speaker, when I first announced that I was going to seek a seat 
in Congress several years ago, I chose the location of the football 
stadium in my hometown, the stadium where the UW Badgers play their 
football games. It is a stadium with a capacity of just under 60,000 
people. The reason I chose that location was to bring to light the fact 
that if you filled that stadium, every seat, with people who are 
uninsured from that congressional district, there would still be a line 
to get in. That is how many people there are. In other congressional 
districts around the country, you could fill multiple football stadiums 
of that same size.
  It is staggering. It is hard for us to get a grip on what it really 
means that there are 45 million Americans with no health insurance at 
all. And these are people who have had longtime uninsurance. In fact, 
the Census Bureau, who puts out that number, bases it on being 
uninsured for a full year. If you count the people who are only 
uninsured for a month or two, some estimates go as high as 70 million 
Americans who experience some time without insurance. Forty-five 
million is a staggering number. And add to that some of the people I 
referenced earlier who have some type of insurance but are still facing 
exorbitant expenses, whether it is rising premiums, enormous 
deductibles, copays. It is a system in crisis.
  I hope as we observe Cover the Uninsured Week and as we think about 
our responsibilities as Members of Congress representing many people 
who are uninsured and underinsured that we take serious aim at this 
crisis in our country. I hope that in a few years, maybe even next 
year, that there will be no need to commemorate and observe Cover the 
Uninsured Week. This is a problem that screams out for our response. I 
invite my colleagues to join me in working to provide health care for 
every American.
  Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, we all know someone 
who is living without health insurance. The perception is that the 
uninsured don't work. Over 80 percent of the uninsured have jobs. Most 
work in retail and service industries, but many are small business 
owners and employees. They are the individuals who care for our 
children, check our groceries, or run the local pharmacy. Americans who 
work hard for a living, should have health insurance.
  Often times, the uninsured ignore their medical problems and delaying 
doctors visits. Children go without vaccines because visiting the 
doctor is just too expensive. They are gambling that they won't get 
seriously ill. But those who lose face staggering medical bills. 
Millions of dollars and many lives can be saved with timely medical 
attention.
  Almost one quarter of Texans are uninsured. This is the highest rate 
of uninsured in the United States. In Dallas, 25 percent of the 
population is uninsured.
  Despite the number of Texans who are uninsured, medical assistance 
programs continue to be cut. In 2003, the Texas Health and Human 
Services Commission implemented budget cuts to the Children's Health 
Insurance Program. CHIP was designed to help families who earn too much 
to qualify for Medicaid, but not enough to afford private medical 
insurance. These budget cuts made it more difficult for families to 
qualify for CHIP. It also imposed higher premiums and co-payments. In 
addition, there is now a 90 day waiting period before coverage begins. 
There is no longer any coverage for dental care, vision, or mental 
health. And families are now required to reapply for CHIP every 6 
months.
  Since the budget cuts, over 175 thousand children have been dropped 
from CHIP. Less than half of those children were able to find another 
form of medical insurance.
  For weeks now this Congress has dealt with legislation that harms 
some of our most vulnerable citizens. Many of whom are dealing with 
serious medical difficulties.
  Staggering medical bills and considerable debt is a problem for many 
uninsured Americans. Many of these individuals are forced to file 
bankruptcy. Last month the House passed the Bankruptcy Reform Bill. 
With these changes, those with moderate or higher incomes are now 
required to pay back most, if not all, of their debt.
  For example, under these reforms an uninsured family who has a child 
to cancer will now be saddled with those medical bills indefinitely.
  Mr. Speaker, last month the House also passed the Energy Bill. This 
was NOT a positive bill for Americans whose health depends on clean air 
and clean water.
  Under the Clean Air Act, areas that have unhealthy air were required 
to reduce ozone-forming pollution by strict deadlines. The Energy Bill 
extends these deadlines allowing polluters more time to continue 
polluting. This means more asthma attacks, hospital visits, and 
premature deaths for residents in highly polluted areas.
  Today, 45 million American are uninsured. Even those families that do 
have health insurance today, fear they may not have coverage tomorrow. 
The truth is that no American family is more than one job change, one 
corporate cost cut, or one serious illness or accident away from being 
uninsured.
  This country faces an uphill battle in solving this health crisis. 
Now is the time for this Congress to address this problem with 
innovative ideas and actions.
  Mr. LANGEVIN. Mr. Speaker, I rise to acknowledge ``Cover the 
Uninsured Week.'' Many of us have heard from our constituents this 
week, asking that we make health insurance coverage a top priority in 
the 109th Congress. America's families are living in fear that someone 
they love might develop a health problem they can't afford. We must 
begin a meaningful dialogue about this problem that will continue until 
every American has access to quality, affordable health insurance.
  This national disgrace has reached crisis proportions. Forty-five 
million Americans--more than 8 million of whom are children, and more 
than 80 percent of whom live in working families--are one ambulance 
trip away from financial devastation.
  I was pleased to join Leader Pelosi and other Democrats in 
cosponsoring three bills introduced this week as part of the Democrats' 
plan to build on programs that already work. Together, the Family Care 
Act, the Medicare Early Access Act and the Small Business Health 
Insurance Promotion Act would cover over half of all uninsured 
Americans. I have also been proud to be a part of other initiatives, 
both nationally and in my home state of Rhode Island to preserve and 
expand existing health insurance programs for retirees, children with 
disabilities, and adults attempting to

[[Page 8460]]

return to the workforce. These are all important aspects to addressing 
the health care crisis, and I am honored to be part of building 
momentum around a solution.
  Our small business owners know we are in a crisis. Rising health care 
costs are undermining their ability to purchase coverage for their 
employees. They are frustrated with the increasing burden of 
negotiating and administering health care plans, and they are taking on 
extra costs or passing them on to employees just to maintain level 
coverage. Without systemic change, these problems will continue to 
threaten the health security of all Americans.
  What frustrates me most about the health insurance crisis is what 
little attention it receives. But I believe that with the proper amount 
of consideration and planning, the health care system in America can be 
saved. An enormous amount of money circulates through our health care 
system--we spend $35 billion on uncompensated care for individuals who 
don't have health insurance, with federal, state and local governments 
covering as much as 85 percent. Wouldn't it be better for American 
families, and also more cost effective, to transfer a large share of 
these funds to a new program to subsidize the cost of covering the 
uninsured? We spend millions treating illnesses diagnosed at later 
stages, thus requiring more costly treatments, because we didn't offer 
people the screenings to catch these problems earlier. This is the 
least efficient way possible to treat people. While we may not be in 
the best of economic times, if we made this issue a priority and 
committed ourselves to spending our health care dollars more wisely, we 
could offer all Americans access to quality, affordable care.
  With these principles of efficiency and inclusion in mind, I have 
developed a model for universal health insurance. Introduced last year 
as the American Health Benefits Plan. This bill is modeled after the 
Federal Employees Health Benefits Program--which everyone in this 
chamber is familiar with, as it offers coverage to Members of Congress, 
their families and staffs.
  Under my proposal, private companies will compete to offer health 
insurance, attracting enrollees on the basis of benefits as well as 
efficiency, service, and lower premiums. The government should make a 
substantial contribution to every American's premium, and for those for 
whom paying a portion of the premium would be a hardship, the 
government should offer subsidies--as we currently do under Medicaid. 
Employers should continue to contribute to the health care system, and 
they can do so through a payroll tax, which would fund the government 
contribution--but the burden of negotiating and administering health 
care plans should be taken on by the government.
  A national template for this model already exists. FEHBP manages 
health insurance for more than 8 million federal employees, annuitants 
and dependents. This program is administered by the Office of Personnel 
Management, which assumes responsibility for approving or disapproving 
carriers, negotiating benefit and rate changes, and auditing carriers' 
operations under the law. With administrative costs of less than 1 
percent, OPM has managed to offer a wide variety of health care choices 
and protections to federal employees.
  Mr. Speaker, I believe that the federal government should offer this 
kind of coverage and oversight to all Americans. I sincerely hope to 
continue this dialogue with my colleagues, beyond ``Cover the Uninsured 
Week,'' but this is an important place to start.
  Mr. McGOVERN. Mr. Speaker, I would like to take time today to 
recognize ``Cover the Uninsured Week,'' a project of the Robert Wood 
Johnson Foundation designed to raise awareness of the issue of access 
to health care.
  It may be hard to believe, but more than a decade has passed since 
the Clinton Administration's health care plan died in Congress. In 
survey after survey, Americans consistently rate access to health 
insurance as one of their top concerns. But unfortunately, our nation's 
political leaders have failed to lead on this critical issue.
  The facts reveal a startling truth--as a Nation, we are facing a 
crisis of the uninsured. In just the last four years, the number of 
uninsured Americans has ballooned to 45 million, an increase of more 
than 5 million people. If the millions that go without health insurance 
for some period during the year are included, the number of uninsured 
dramatically increases to more than 85 million people.
  To dispel one myth: This rise in the number of uninsured is not the 
result of people deciding not to work. Rather, an overwhelming majority 
of the uninsured--80 percent--are working families, many employed by 
businesses that have become less able to provide health coverage for 
their employees.
  And if things weren't bad enough, the Administration has proposed 
broad cuts to Medicaid, essentially gutting the healthcare system of 
last resort for poor Americans, by at least $10 billion. In these 
worsening times, how can we justify pulling the rug out from underneath 
our community's most vulnerable?
  In my home state of Massachusetts, we have been fortunate; we are 
among those states with the lowest percentage of uninsured. But, even 
there we have a lot more work to do. According to a recent Urban 
Institute report, there are currently 532,000 uninsured people in 
Massachusetts, and most of the health care available to these people is 
provided by local hospitals.
  And like many other states, since 2000, Massachusetts workers have 
seen their health premiums rise three times faster than their wages. If 
these trends continue, fewer individuals and families will be able to 
afford to pay for coverage, and fewer small businesses will be able to 
provide this vital benefit to employees.
  As we all know, we often tend to ignore that, which does not directly 
affect us, but we can no longer afford to do so; there are clear 
consequences to all of us for ignoring the plight of the uninsured. 
According to a recent Institute of Medicine report, the United States 
loses $65-$130 billion each year as a result of the poor health and 
early deaths of uninsured adults. Should things continue to worsen, we 
will all be forced to bare the financial burden of the uninsured.
  But this problem extends beyond the dollars and cents. As citizens, 
we have a moral responsibility to our communities, and we cannot stand 
by in good conscience as millions are denied access to basic health 
care.
  So, as we take this time to recognize ``Cover the Uninsured Week,'' I 
hope that my colleagues will join me in raising awareness about the 
reality facing the millions of uninsured. We must not allow this issue 
to remain on the back burner of the national political debate. Health 
care is a right, not a privilege, and all of us must work to extend 
that right to every single American.
  Mr. KENNEDY of Rhode Island. Mr. Speaker, I rise today in the hopes 
that this day might mark a turning point for our nation's health care. 
I'm proud to join my friend from Pennsylvania and my co-chairman of the 
House 21st Century Health Care Caucus, Mr. Murphy, in introducing the 
21st Century Health Information Act.
  Mr. Speaker, we politicians love to say that we have the best health 
care system in the world. It's true that we have the best medicine in 
the world, practiced by the best people in the best facilities. But the 
system we have makes it harder rather than easier to deliver the best 
care at the lowest cost.
  The status quo is not sustainable. Hundreds, of Americans die every 
day as a result of preventable errors or health care-acquired 
infections. Nearly half the time, patients aren't given recommended 
care. Doctors and other providers face extraordinary bureaucratic 
demand that, coupled with tightening reimbursement rates, leave them 
with less time to--treat patients. Administrative costs consume 30 
cents on the health care dollar. Duplication, inefficiencies, and 
unnecessary care result in some regions of the country spending 60% 
more than others on Medicare, on a risk-adjusted basis, with worse 
health outcomes and patient satisfaction.
  Whether you're worried about Medicaid, access to prescription drugs, 
malpractice premiums, the uninsured--you name it--the trend lines are 
going in the wrong direction because we aren't set up to get the best 
possible health outcomes at the lowest possible cost.
  We are living in the information age, and information technology is 
the underpinning of any effort to improve the long-term quality, 
safety, and efficiency of health care. And that's why I'm hopeful that 
the legislation we introduce today will begin the much needed 
transformation of health care.
  Today can be the beginning of the end of us having to fill out that 
confounded clipboard every time we go to the doctor.
  Today can be the beginning of the end of the 150 million calls 
pharmacists make to doctors every year to clarify handwriting on 
prescriptions.
  Today can be the beginning of the end of the bureaucratization of the 
practice of medicine, letting physicians get back to what they love, 
and what we need them to do: take care of patients.
  And today can be the beginning of the end of seeing hundreds of 
thousands of Americans die unnecessarily because our system isn't set 
up to deliver the safest, most effective care despite the best efforts 
of doctors and nurses.
  This bill is the first bipartisan legislation that addresses some of 
the systemic obstacles that have hindered the movement of health care 
into the information age. It is based on a

[[Page 8461]]

regional approach, catalyzing a process that will bring together 
providers, patients, health plans, employers--all stakeholders--locally 
to do three crucial things: first, figure out how to collaborate on 
getting IT into physicians' hands; second, build a secure, confidential 
health information network to allow information to be shared as 
appropriate and authorized; and third, begin coming up with strategies 
to use the new information capabilities to make sure we get the right 
care to the right people at the right time as efficiently as possible.
  This bill will make sure that the federal government, in addition to 
getting the process rolling with grants, carries its own weight as a 
stakeholder in every community. And it takes down existing barriers by 
accelerating the process of standards adoption to ensure that 
information can be exchanged across platforms and creating narrow safe 
harbors in the Stark Act and anti-kickback law.
  A key to making this work, Mr. Speaker, is ensuring that privacy is a 
key priority as we move into an electronic medium. Electronic health 
records can be significantly more secure than paper records. Unlike 
with paper, we can create audit trails so we know whenever someone 
accessed a record. We can set up authentication systems to ensure that 
people are only able to access the parts of records that they need to 
see. While people understandably worry about security breaches and 
hackers, it's a lot easier to limit unauthorized access to electronic 
records than paper records that are passing through countless hands as 
they are filed, copied, faxed, transcribed, or simply left lying 
around. We can and must ensure that privacy and security are paramount 
as these systems are designed.
  It is also important to note that under this bill, no physician will 
be required to implement anything unless he or she wants to. Physicians 
will have a key decisionmaking role in deciding how networks will be 
structured and what information will be shared. The bill does not 
require the use of a common platform or product but accelerates the 
development of interoperable electronic medical records and other 
products so physicians can choose products that are right for them. 
Well-designed systems should simplify physicians' compliance with 
HIPAA, not expand their potential liability, and should given doctors 
new tools to streamline billing, eligibility checks, patient tracking 
and notification, and public health and quality reporting.
  We received a vast amount of help an input on this legislation from 
too many quarters to mention individually. I would like to single out, 
however, a distinguished former colleague of ours, Speaker Newt 
Gingrich. He has been a terrific supporter of this legislation, and I 
know both the gentleman from Pennsylvania and I are grateful for his 
help and that of his staff.
  Mr. Speaker, with the President's support for health IT, with David 
Brailer and Secretary Leavitt laying out a vision that's very similar 
to this bill, with our colleagues in both the House and Senate 
increasingly interested in health IT, we are poised to finally begin 
the belated transformation of our health care system.
  Each of us, whether as patient, provider, taxpayer, or health care 
bill-payer, desperately needs to see our health care system to produce 
better value for the dollar. The stakes are enormous and I look forward 
to working with my colleagues to see that we meet this challenge, 
starting today. Thank you.

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