Mr. Chairman, I join my colleagues today in opposition to H.R. 5006, the LHHS appropriation bill. We know that Congress has many priorities to consider during this fiscal year. And we implore Congress to make eliminating health and…
Mr. Chairman, I join my colleagues today in opposition to H.R. 5006, the LHHS appropriation bill. We know that Congress has many priorities to consider during this fiscal year. And we implore Congress to make eliminating health and healthcare disparities top priorities. This HHS bill, unfortunately, does not contain such investment in the health and welfare of Americans nor does it demonstrate unwavering commitment to well-being of our citizens, including those most in need. With this bill, it is clear that the Republicans do not see America's greatest asset is its people, and refuse to invest in making its people as strong and healthy as possible.
Let me say at the outset, Mr. Chairman, that this great country of ours ranks at the bottom of all of the industrialized countries of the world with regard to the quality of our health care system, we are not where we should be given our resources in infant mortality, HIV/AIDS, immunization, substance abuse and many of the major diseases. In most cases the reason is because more than one third of our population remains outside of the healthcare mainstream.
Today almost 45 million Americans are uninsured, of which 50 percent are minorities: 18 percent of the total elderly population has no coverage at all; 1 out of 6 Americans does not have health insurance; more than 100,000 people lose their health insurance every day; and an astounding 23 percent of African Americans have no insurance at all.
Our health care system in this country is currently in peril. It is falling short on promise and contributing to the disabling illness and premature death of the people it is supposed to serve. The picture is the worst for African Americans who for almost every illness are impacted most severely and disproportionately--in some cases more than all other minorities combined. Every day in this country
there are at least 200 African American deaths, which could have been prevented. Today we know that must of it happens because even when we have access to care, the medical evaluations and treatments that are made available to everyone else are denied to us--not only in the private sector but in the public system as well.
What I am here to try to do today is to leave you with one indelible message: that there are gross inequities in healthcare which cause hundreds of preventable deaths in the African American community every day and which tear at families, drain the lifeblood of our communities, and breed an escalating and reverberating cycle of despair which this subcommittee has the power to end this today if it has the will to do so.
The choice if it can be considered that, is either to write off human beings--our brothers and sisters--who make up this segment of our population, or to make the requisite investment in fixing an inadequate, discriminating, dysfunctional health care system.
The current strongly held-to ``cost-containment'' paradigm, while it sounds good on the surface, has obviously not worked. We now have double digit increases in premiums in an industry that was to rein in its costs. What it did instead was create a multi-tiered system of care, both within managed care and without. Those at the lowest rungs of the system got sicker, the sicker, i.e. more costly, were and still are being dropped, and those who were the sickest were and remain locked out entirely. So not only are health care costs continuing to escalate, the overall health picture in this country is worse than ever.
What we now have is a system, which continues the failed paradigm in which African Americans and other people of color who because they have long been denied access to quality health care, now experience the very worst health status. Not doing what is needed to change this is to threaten the health of not just African Americans and other people of color but every other person in this country, especially at a time when we live under the cloud of possible bioterrorism.
Controlling the cost of health care, which can only be done in the long term, will never be achieved without a major investment in prevention, and leveling the health care playing field for all Americans through fully funding a health care system that provides equal access to quality, comprehensive health care to everyone legally in this country, regardless of color, ethnicity or language.
The funding requests I am outlining today are the bare minimum to ensure that our children have the opportunity for good health, that there are health care professionals who can bridge the race, ethnicity and language gaps to bring wellness within reach of our now sick and dying communities, that states and communities will receive the help to fill the gaps and repair the deficiencies of access and services, and which will enable the affected communities themselves to take ownership of the problems as well as the solutions to their increasing healthcare crisis--a crisis that threatens the health and security of all Americans. Yet this bill fails to even meet this baseline obligation.
If we have learned nothing in the last 10 years, we should have learned that cost containment strategies in our unequal system of care can never bring down healthcare costs. We can only ensure that quality health care will be within the reach of future generations if we make a major investment in prevention and increasing access to care now.
On March 20, 2002, the Institute of Medicine (IOM) released a landmark report entitled: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care which was requested by Congressman Jackson. Among other key findings, the report documented that minorities in the United States receive fewer life-prolonging cardiac medications and surgeries, are less likely to receive dialysis and kidney transplants, and are less likely to receive adequate treatment for pain. Its first and most telling finding states that ``racial and ethnic disparities in healthcare exist and, because they are associated with worse outcomes in many cases, are unacceptable.''
And so I urge the committee to give serious and favorable consideration to our funding requests. Because of time limitations, let me focus on just a few areas contained in the request:
Sixty-six million dollars for the Office of Minority Health, OS,
Mr. Chairman, I rise to urge my colleague to oppose the previous question on H.R. 5006, the FY 2005 Labor-HHS-Education Appropriations bill in order that we could get an opportunity to debate an amendment by Ranking Member Obey which the majority on the Rules Committee refused to make in order. The Obey amendment would add $7.4 billion to the GOP bill, paid for by reducing the average tax cut for millionaires in FY 2005 from $127,000 to $89,000.
As a physician and the chair of the Congressional Black Caucus' Health Braintrust, I am particularly supportive of the amendment's proposed to add additional funds for health care. The amendment would increase health care and funding by $1.1 billion, including providing $500 million for critical investments in medical research at NIH; providing $333 million for maintaining access to health care, including restoring the Community Acess Program for the Uninsured, eliminated by the Republican bill, increasing funding for rural health, and increasing funding for the Maternal and Child Health Block Grant and Healthy Start; and providing $100 million for childhood immunization and infectious disease programs.
Conversely, the majority bill shortchanges health care programs in some critical ways. It cuts rural health care activities by 21 percent from FY 2004. It cuts helath care professions trading by 8 percent. It cuts public and preventative health activities by 18 percent. And it only provides a piddling 4.6 percent increase in HIV/AIDS programs for the second year in a row.
My colleagues the majority bill clearly demonstrates that their rhetoric about supporting the middle class and families are not reflected in the legislation they propose. Democrats on the other hand have consistently fought on behalf of programs that would strengthen the middle class and families.
I urge my colleagues to defeat the previous question and support the Obey substitute.
Mr. Chairman, I rise to join my colleagues Madeleine Bordallo and Eni Faleomavaega in strong support of our amendment to provide some additional relief to our constituents in the form of additional health care dollars. It remains a national shame in my view, that because of where they live, my low-income and indigent constituents, as well as those of my colleagues, are not able to receive the same level of Medicaid assistance because of a punitive cap.
My colleagues, while the national per capita expenditure for Medicaid is $3862, the expenditure for the Virgin Islands is only $436. The total cost of Medicaid in the Virgin Islands is about $15 million per year but the Federal government only covers about $6 million of that amount. According to the Virgin Islands Medicaid Director, the 18,000 Medicaid recipients she serves receive an absolute ``bare bones'' service.
Mr. Chairman, a report 3 years ago entitled the Access Improvement Project of the Virgin Islands, revealed that great disparities exist for eligible children in the Virgin Islands compared to the continental United States. The report shows that while the Nation as a whole spends an average of $76 for EPSDT screening per Medicaid eligible child, the U.S. Virgin Islands only spent $1.20. Additionally, the total Medicaid expenditures per child also shows an astonishing disparity.
In the age group 15 to 20, national Medicaid expenditures were approximately 599 percent more than what is being spent in the Virgin Islands. We also received a 50 percent match, despite a State like Mississippi where the average income is $1,500 higher than ours. They receive 80 percent match. And the Virgin Islands Medicaid program cannot provide wheelchairs, hearing aids or prosthetic devices, and only provides physical and occupational therapy to a limited degree because of the limited funding.
Mr. Chairman, this modest amendment which we are offering today, would provide a one time 25 percent increase in Medicaid payments to the Virgin Islands, Guam, and American Samoa so that our most vulnerable constituents could receive better health care services which they otherwise would have to do without because of our already overburdened local governments.
I urge my colleagues to support this amendment.
Point of Order