Congressional Black Caucus: Health Care
Thank you, Congresswoman Fudge. Thank you for yielding. Thank you for being so steadfast in anchoring this special order every Monday night. I know many times I have wanted to join you and have not been able to be here and to support you…
Thank you, Congresswoman Fudge. Thank you for yielding. Thank you for being so steadfast in anchoring this special order every Monday night. I know many times I have wanted to join you and have not been able to be here and to support you in it, but you have managed to keep it going and to provide good information on many, many topics to the people who are listening across America.
I also want to thank you for your very clear explanation of what the public plan really is. We've heard a lot of misinformation about that public plan, as Congresswoman Fudge says, one of many plans that will be in the exchange that will offer choice. And it is not a single- payer, it's nothing like the Canadian plan--not to disparage the Canadian plan; I think they have a good system--but ours will not be that. It will be an exchange where you, the American public, will have choices and can choose a public plan or a private plan. So thank you for making that clear.
And as we meet, Mr. Speaker, the Democratic Caucus is probably finishing up downstairs discussing the health care reform, America's Affordable Health Choices Act, going through it section by section; and there is nothing about abortion in it. There have been many complaints about the bill, and some of them are rather weak and just plain wrong. Some people complain that they don't know what's in the 1,000-page bill. Well, the basic outline of that bill has been available for almost 4 weeks now, and the bill itself for over a week. I think that has given enough time for everyone and their staff to have the opportunity to read the bill if they wanted to. And as important as that bill is, I hope everyone has taken the time to read it.
Other complaints are of regional disparities in Medicare and Medicaid reimbursement. They've been a big issue for us. It's one that may now be solved satisfactorily--at least on the regional level--and poor and minority communities, which have also had historically disparate and low reimbursement rates, will also see that fixed in H.R. 3200.
But no one has more of a disparity than the people that I represent and those in the other territories who are not getting equal treatment in Medicare or Medicaid and who, as of now, are not even in the insurance exchange. And yet, despite all of that, because of the overall good this bill will do for us in the territories and our fellow Americans, I fully support this bill.
I want to also address some of the myths that are out there. No bill is perfect. Especially not one that has to do as much as this will have to do to fix the longstanding systemic malfunctioning of our health care system.
But what we have produced after many meetings, many preliminary hearings, followed up by a week of daylong hearings where over 50 people and organizations testified, it's a good bill. And we can get it out of the Energy and Commerce Committee this week. If we can do that, we're not going to bring it to the floor and keep everyone in here, but we would like to get it through this week so that when we go home, we'll have time to read the final product, discuss it with our constituents at home, and come back prepared to pass it when we return in September.
But I firmly believe that we have to keep moving forward. If we don't, it won't be a President Obama loss or Speaker Pelosi loss or even a Democratic Party or Caucus loss. It will be a serious loss of the American people, especially to the more than 46 million who are uninsured and the millions more who are underinsured or intermittently insured. As well, it will be a loss to the poor, rural, and minority communities in our country.
Too many of the under- and uninsured are people of color, so this is an important issue for the Congressional Black Caucus. That's why we've devoted four or more of our special order times here on the floor of the House to this issue and to urging support and passage of the health care reform bill in the House. It's why we met with Speaker Pelosi last week, why we're going to sit down with the President, and why we've written or discussed our concerns with chairmen and ranking members of the relevant committees in the House and the Senate. In many of our efforts, we are joined with the Congressional Hispanic Caucus and the Congressional Asian and Pacific Islander Caucus as a Tri-caucus in support of this bill.
To go back to some of the gross misrepresentations and to explain the real provisions of the bill, let me say that one erroneous criticism that's often heard is that this bill will put Washington bureaucrats in between the patient and the doctor or other health care provider. Nowhere is there anything in this bill that would do that.
Yes, your Members of Congress, the Democratic Members of Congress, want to include a public plan. Yes, we want to ensure that every insurance provides a comprehensive, basic package of services, that they must accept you for coverage, that they do not exclude you if you have a preexisting disease, that they cannot drop you if you get sick, and cannot put a limit on how much they will pay over a year or over your lifetime.
What we in Washington want to do in this bill, and will do when we pass it, is to make sure that there is no obstacle between you and your doctor. And yes, we want everyone to be able to get the important preventive care without having to pay for it. We want you to be the healthiest you can be. And again, we are taking down important barriers that stand in the way of your getting the health care you need.
Preventive care, such as mammography, colonoscopy, immunizations, and others, will cost you nothing. And we insist that if you have insurance or a provider you like, as Congresswoman Fudge said, you can stay with those, you can keep that provider and that insurance carrier. We do not put government between you and your doctor.
Many of you either have or work for a small business. You are the target of much of the fear-mongering that is out there. Rather than raise taxes on small businesses, as the opponents of your getting your health care would have you believe, this bill makes it easier for small businesses to provide or continue to provide insurance because of the exchange, because of the public plan and the tax credit that they will get if they provide insurance for their workers. And smaller businesses which aren't able to pay high salaries or have less employees will be exempted from having to provide that insurance, but their employees will have access to the exchange and be able to have their insurance premiums subsidized so that it won't take a big chunk out of your already stretched salary.
Some of you, like many in my district who are Medicare or Medicaid beneficiaries, have difficulty finding a doctor or provider who will give you the services that you need. Some of you live in communities which don't have a hospital and have to travel many miles to one because the one that was there was not able to keep its doors open because of low reimbursement rates in your community. The
House health care reform bill, H.R. 3200, will increase reimbursements. Many of our congressional districts lose over $100 million every year in uncompensated care, and that compromises the ability to get the quality of care you need and deserve.
First of all, with this bill, your local hospital will be able to survive, maybe even return, because when it is passed, they will be paid for every patient that they take care of.
Secondly, Medicare will pay more, especially to primary care providers and those providers who come together to make sure that your care is better managed and more complete in groups called accountability care organizations or medical homes. And if the community you live in can demonstrate that they not only provide good care but improve your health, the reimbursement will also be increased.
So this legislation that we want to see passed will not only increase payment to help make sure the providers you need are there in your communities, but those providers will be supported and encouraged to take the time needed to listen to you and to coordinate your care to ensure that you will be healthier. This is a real win-win.
Those of us who become health care providers choose this life of service to help individuals and communities have a better quality of life and help individuals live long enough and well enough to see and enjoy their grandchildren. The new payment structure and the eliminated copayments for preventive care will help us to do what we went into our professions to do in the first place.
And then, as we have always said, for those who have not had the ability to be fully a part or fully utilize the health care system for many reasons, just providing insurance, as important as that is, is not enough. And for African Americans and other people of color who are the most disenfranchised in the current system of health care delivery, the additional services and support are critical if we are ever to close the health gaps that cause us to die prematurely from preventable causes, that causes our life expectancy to be 7 to 8 years shorter than other Americans, and that causes over 86,000 excess deaths that should never have happened every year in this rich country.
And so the bill includes a major expansion of community health centers, more National Health Service Corps scholarships to help more of our young people enter the health profession, more loan forgiveness, especially for those who are going to be a primary care provider, the main doctor or nurse practitioner you see to get and manage your health care.
There will be funding to help more students better prepare for medicine, for nursing, for pharmacy, allied health and other health professions, and support for institutions that train underrepresented minorities. This is important because, although there is a need for many more primary care providers, it is just as critical that they come from all communities, including communities of color, which make up more than 30 percent of our population.
The Congressional Black Caucus has always taken the position also that communities know best what they need, and the way to ensure that when health information and care is provided, it is done in a way that will be understood, accepted, and effective. We have, therefore, been able to have community-based and -driven programs included in the bill.
These provisions are patterned after our health empowerment zones, which provide the technical assistance and funding to enable communities to not only meet their specific health care needs with respect to specific diseases, but to also be able to address the social and economic determinants of our health: housing, economic opportunities, safety, the environment, nutrition, and others.
Also included are provisions to ensure that data is collected which includes race, ethnicity language, and other socioeconomic factors, and also provisions that provide that language differences would not be a barrier to getting health care.
This bill, H.R. 3200, America's Affordable Health Choices Act, must pass and must not be allowed to be derailed by any group or industry that does not have our best interests at heart. The basis of the opposition has nothing to do with better health for all of us who live in this country. We recognize, as the gentleman said, this effort is about change, and change is what the people in this country voted for. It is about major change, which is always difficult. But this is change that must happen, and it must happen now.
Sure, there will be losses to some in the interest of providing more to everyone to ensure that the benefits of this country will be more fairly shared; that is a basic tenet on which this country was founded, and in no place is this more important than in our health.
This country has the best and most advanced health care services, expertise, and technology, but because so many are not able to access it, we lag behind the rest of the industrialized world in life expectancy, maternal and infant mortality, and health in general. Closing the insurance gap, as well as the racial and ethnic minority gaps, will make this country the true leader in health that we ought to be.
So my plea to those who are listening outside of the beltway is do not let the misinformation and the self-serving propaganda steer you wrong and away from supporting this important legislation that many of the best minds in this country have guided to ensure that your right to health care will be protected and delivered.
This bill is important to the African American community. It is important to the Native American community and all communities of color. It is important to rural areas, And it is important to every American. With your help and support, it can also provide more equity to your fellow Americans in the U.S. territories.
Passing H.R. 3200 is important to all of us, our families, and our communities. We cannot lose this great opportunity that President Barack Obama has worked so hard to bring this far. As he has said to us, it is not if we can afford this bill or if we can afford health care reform, the real issue is we cannot afford not to do it.
Covering everyone, providing increased access to preventive care and disease management, will surely reduce health care spending because prevention saves. But most importantly, it will improve and save lives. So I join my Congressional Black Caucus colleagues in saying, let's pass this bill. Let's get it out of the Energy and Commerce Committee. Let's give the American public a bill before we leave for our recess, and then let's come back in September and pass it and provide quality health care to every American.
I yield back the balance of my time.