Thank you, Congressman Conyers. Mr. Speaker, I rise with Chairman Conyers and my esteemed colleagues to stress the need for comprehensive health care reform that not only tackles the core issues but substantively transforms the foundation…
Thank you, Congressman Conyers.
Mr. Speaker, I rise with Chairman Conyers and my esteemed colleagues to stress the need for comprehensive health care reform that not only tackles the core issues but substantively transforms the foundation upon which this Nation's health care crisis is existing. And the story that Congressman Conyers told about Taylor could be repeated over and over again across this country.
The pursuit of and desire to have good health and access to reliable, high quality health care cuts across geography and gender; across race and ethnicity and political affiliation. These wants and needs are basic to all human beings. And because they are basic human needs, the time has come for health care to be affirmed as a basic human right.
As an American and as a physician, I am embarrassed that, today, the United States is the only industrialized Nation that does not guarantee access to health care as a right of citizenship. So I think that we have much to learn from the industrialized nations who, through either single payer universal health care systems or a multipayer universal health care system, have put the health and wellness of their residents at the top of their agendas and, as a result, are healthier than we are today.
For example, compared to the rest of the world, the United States ranks 41st in maternal mortality rates, which means that 40 other nations, most of which have fewer resources than we do, have lower mortality rates than us.
Additionally, we are ranked 42nd in infant mortality, which means that 41 nations, including Cuba, the United Kingdom, Anguilla, Japan and Singapore, have a lower infant mortality rate than we do.
The underlying reason for these shameful numbers is this country's failure to address health disparities and to put into place effective, comprehensive and culturally appropriate programs to eliminate them. Not only do people of color make up most of the 45 million uninsured and the additional 50 million underinsured, but because of this as well as because of discrimination and the lack of culturally and linguistically appropriate care, they also are the majority of those who die prematurely from preventable causes in this wealthy and technologically advanced country.
It's very important to note that the millions of Americans who comprise our Nation's un- and underinsured population are not people who are lazy. They're not people who are looking for a handout. They are hardworking, honest Americans. The overwhelming majority of the uninsured are members of working families who do not have access to employer-sponsored health coverage. In fact, more than 8 out of 10 uninsured Americans make too much money to qualify for Medicaid but not nearly enough to purchase health care insurance on their own.
The provision of health care to Americans living in the territories paints an even worse picture. And that's my individual story this evening, the story of 4.5 million people living in offshore areas.
Those of us who live in the offshore areas of the United States have an additional burden when it comes to accessing health care services. For Guam, American Samoa, the Commonwealth of the Northern Marianas, Puerto Rico, and the U.S. Virgin Islands, Medicaid and the Children's Health Insurance Program is capped, and it is capped far below what is needed to provide the most basic of services to those who are at or below the poverty level.
So, even in those families at 100 percent of poverty, they can't qualify. There's not enough money in our programs. Many who need long- term care cannot get it because our Medicaid program cannot afford it. Other programs that are taken for granted in the States are not available to us because the funds are just not there to cover them. And in fact, the level of funding per Medicaid patient, even at the low numbers that are enrolled, is one-tenth of that spent on Medicaid beneficiaries in the States. Many of those States are richer than we are and have lower health care costs, and yet they get 10 times more funding per Medicaid beneficiary.
Both on the mainland as well as in the offshore areas, our Nation's un- and underinsured Americans are paying the ultimate price for the absence of universal health care. They pay more out-of-pocket health costs, as we heard, and worse, they pay for it with poorer health and even with premature disability and death.
And everyone, including those who have insurance, pay for it in rising premiums, higher deductibles and co-pays, and reduced quality of health care services for everyone.
The grim statistics and analyses prove one thing: We need to expand access to health care and completely eliminate un- and underinsurance in this country. The only way to accomplish this is through universal health care.
Access, however, is but one issue that we need to address within a comprehensive health care reform package. There is another issue that must be addressed because it, too, has to be an integral component of our health care reform discussions and efforts. And that issue is health disparities.
The direct and indirect impacts of health disparities are well-known, and we know that they cut across every aspect of life. Additionally, we know that these disparities leave millions of African Americans, Native Americans and other people of color, women and rural Americans also, in a particularly precarious position as it relates to their health and health care. Not only are those most affected by health disparities disproportionately more likely to
be un- and underinsured, as I mentioned, but they also are disproportionately less likely, far less likely to receive the high quality of health care services and treatments available for everyone else.
For example, the rates of hospital admissions for uncontrolled diabetes, which is an indicator of the quality of care received, for Hispanics and African Americans were more than three and five times, respectively, higher than the rate for Whites.
The same scenario holds true for hospital admissions for asthma. African American children and adults have hospitalization rates for asthma that are five and four times, respectively again, higher than Whites.
African American diabetics and Native American diabetics are three times more likely than White diabetics to have lower limb amputations.
The differences in health care quality are not just evident in the hospitalization rates, but also in the disparate rates of utilization of services and treatments. African Americans are disproportionately less likely than whites to be referred to undergo cardiac catheterization or to receive more aggressive treatments for lung cancer or colorectal cancers, although they are known major causes of death in the African American community.
In fact, studies confirm that across several dozen health care quality measures, African Americans receive a poorer quality of care than whites almost half, 43 percent, of the time for African Americans; for Hispanics, they receive a lower quality of care more than half of the time, 53 percent of the time; and for American Indians and Alaska Natives, they receive a lower quality of care more than one-third of the time, 38 percent.
These differences in quality, like the differences in access, have a profound and detrimental impact on their health, wellness and ability to achieve their full lives' potentials. Additionally, these racial and ethnic differences in quality persist, even when insurance status, educational level, socioeconomic status, and disease severity are taken into consideration.
Mr. Speaker, the time for comprehensive health care is upon us, and the time to ensure that our efforts not only surmount access barriers but also achieve health equity is now.
As we as a Nation engage in increased discussions about health care reform, propose solutions to our under-and uninsurance plight and mounting health care costs, and finally move the idea of universal health care from concept to reality, we must address the health disparities and the root causes of health inequities, the social determinants of health, in order to be successful.
The Nation's public health and health policy experts agree that a health care reform effort that fails to incorporate and integrate health disparity elimination as a core benchmark and objective is an effort that is flawed.
So I urge my colleagues on both sides of the aisle and all of our friends off the Hill to work together to ensure that as we work towards a health care system where everyone is in and no one is out and to reform the system, that we do so in a manner that positively transforms the lives of the millions of Americans for whom quality health care has been denied and deferred for far too long.
I thank Chairman Conyers for holding this Special Order this evening on this very important issue.
I picked that up from the American Student Medical Association. I believe that was their slogan.