[Congressional Record (Bound Edition), Volume 154 (2008), Part 10]
[Senate]
[Pages 14015-14016]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  LIHEAP AND COMMUNITY HEALTH CENTERS

  Mr. SANDERS. Mr. President, on Tuesday, I introduced S. 3186, the 
Warm in Winter and Cool in Summer Act. This bill would provide $2.53 
billion in emergency funding for the Low-

[[Page 14016]]

Income Home Energy Assistance Program, commonly known as LIHEAP.
  I take this opportunity to thank the majority leader for completing 
the rule XIV process of placing this bill directly on the Senate 
calendar yesterday. I also want to express my deep appreciation to him 
for his goal of moving this legislation forward within the next month. 
I think there is widespread support, in a nonpartisan way, for this 
legislation, which impacts people when the weather gets hot and it 
impacts people when the weather gets cold.
  This bipartisan bill is being cosponsored by Senators Leahy, Snowe, 
Brown, Sununu, Cardin, Coleman, Kerry, Collins, Kennedy, and Smith and 
I expect that the numbers of Senators from both sides of the aisle who 
will be supporting it will only grow. The bottom line here is pretty 
simple, and that is: With the cost of energy soaring, we have many 
millions of Americans wondering next winter how they are going to be 
able to stay warm, and we have got to expand LIHEAP funding to match 
the inflationary costs of home heating fuel.
  For those people living in warm weather States, what we understand 
right now is that electricity rates are also soaring. There are many 
Americans--elderly people, lower income people--who are unable to 
afford the increasingly high cost of electricity. They run the danger 
of seeing their electricity cut off. When the weather gets 110 degrees 
and the electricity gets cut off, and you are a senior citizen or you 
are a person who is frail or who is ill, you have a problem dealing 
with heat problems.
  So I hope and expect there will be widespread support for this 
legislation. Once again, I thank the leader for putting this on the 
rule XIV process.
  I also want to say a few words about the Medicare package that was 
approved overwhelmingly in the House on Tuesday, and which we expect, 
hopefully, to take up here shortly. This bill is nearly identical to 
the bill put forth on the floor last week by Finance Committee Chairman 
Baucus, and I thank the chairman for his commitment and his effort in 
putting together this excellent piece of legislation.
  There is a lot in this bill, but there is one particular section I 
want to focus on, and that is the section pertaining to Medicare 
payments to community health centers.
  Specifically, this bill provides for a much needed increase in the 
cap on Medicare payments to community health centers, and also requires 
a GAO study to determine whether the current structure for Medicare 
payments to community health centers provides adequate compensation for 
the care provided. I believe it does not.
  According to the National Association of Community Health Centers, 
the artificially low cap on Medicare payments costs community health 
centers $50 million annually--money that could be used to provide 
primary care access to thousands more of our Nation's seniors. An 
overwhelming majority of community health centers--a full 75 percent--
now lose money--they lose money--treating Medicare beneficiaries. An 
inadequate and arbitrary payment system jeopardizes the ability of 
community health centers to continue to provide necessary primary care 
to the 1.5 million Medicare beneficiaries who are seen at community 
health centers each year, many of who live in the most isolated and 
medically underserved regions of this country.
  Let me say a word on community health centers, because I am a very 
strong advocate of that program. The truth is that in the midst of the 
disintegrating health care system, one of the major crises we are 
facing is in primary health care access. All over America, especially 
in rural areas, millions and millions of people simply cannot get 
access to a doctor, to a nurse, to a dentist, to people who will help 
them deal with their day-to-day health problems. The insanity of 
continuing that situation, that lack of health care access, means 
people will simply get sicker. They are going to go to the emergency 
room and they will end up in the hospital at far greater expense and a 
lot more human suffering.
  I happen to believe this country has to join the rest of the 
industrialized world and establish a national health care program which 
guarantees health care to every man, woman, and child. I think at a 
time when we spend twice as much per person on health care as any other 
nation and have 47 million people uninsured and see our social indices, 
in terms of infant mortality or longevity, much worse than many other 
countries, I think we should finally conclude there is something 
fundamentally wrong with our health care system.
  Health care should be a right of all people. We should do it in a 
cost-effective way. The function of health care should not be to make 
insurance companies rich or make drug companies rich but should be to 
provide quality health care to every man, woman, and child.
  In the midst of all that, while we try to take on the insurance 
companies and all their lobbyists and while we try to take on the drug 
companies and all their lobbyists and advertising and campaign 
contributions, there is one simple thing we can do, where I suspect 
there is going to be tripartisan support, and that is substantially 
increase the funding for community health centers. In that regard, I 
thank Senator Kennedy and Senator Enzi for a very strong authorization 
package that came out of the Health, Education, Labor Committee. I 
thank Senator Harkin and Senator Specter for their support in giving us 
a reasonable increase in appropriations funding. But we have a long way 
to go.
  The simple truth is--and this is a point that should be understood by 
all Members--if we spend as a nation $2 or $3 billion more on community 
health centers, do you know what? We could provide primary health care 
access to every man, woman, and child. That is about 1 week of the war 
in Iraq. So you have war in Iraq, 1 week; or $2 billion or $3 billion 
building hundreds of community health centers, providing primary health 
care, dental care, mental health counseling, low-cost prescription 
drugs, to every man, woman, and child.
  In the course of the coming months and years, I will be fighting for 
that $2 or $3 billion. It certainly is not going to solve all our 
health care problems, but by providing a place where any American--
whether you are insured, uninsured, Medicare, Medicaid--regardless of 
your income you can walk in and get high-quality primary health care--
wow, that is a huge step forward in this country.
  In order to make sure these community health centers function, we 
have to do something else. Do you know what we have to do? We have to 
graduate doctors and nurses. We are living at a time when we are not 
graduating from medical school enough doctors or enough nurses or 
enough dentists. We have to work on that. One of the ways we work on 
that is to significantly increase funding for the Health Services 
Corps, a program which provides debt forgiveness and scholarships for 
those willing to serve in underserved medical areas.
  There is a lot of work to be done. I think we are making some 
progress on the Medicare bill coming before us. The day has to come 
when all our people, by right, have primary health care access and 
access to health care.
  The PRESIDING OFFICER. The Senator from Missouri is recognized.
  Mr. BOND. Mr. President, I was asked by the Senator from Montana, Mr. 
Tester, if there would be any objection if I asked that, after I finish 
my remarks, he be recognized for 5 minutes; that the Democratic time be 
extended 5 minutes and the Republican time be extended 5 minutes.
  Is there any objection to that?
  The PRESIDING OFFICER. Without objection, it is so ordered.

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