Date: 1989-05-31
Speaker: CLAUDE PEPPER (democrat)
Chamber: H

walked into that room. and you could see the light go on In literally a thousand faces. No one knew who the other Members were who were visiting. but everyone knew CLAUDE PEPPER. They flocked around him. They were excited just to touch him. to feel him. that person that they had seen and heard about. and perhaps in some cases met before. He generated such excitement. He went on from there to another function and then another function after that. CLAUDE PEPPER carried that message to the hills and hollows and towns of West Virginia and to Michigan and to all over this world. He would go wherever you asked him to go. That is something that we cannot replace. that kind of energy. He was also someone with an incredible faith in the system because he suffered setbacks. I have heard him speak and many others have recounted the election difficulties that he had. the setback that he had many years ago. But he did not give tip on the system. he did not despair. He ran again later. and he won. Here in the House is where he found his niche. where he carved out that reputation so welldeserved of being the tireless fighter and advocate for senior citizens. CLAUDE PEPPER is Representative. CLAUDE PEPPER is Senator. CLAUDE PEPPER is chairman. CLAUDE PEPPER is spokesman for the American people. That is what we need to remember. I would hope that we can all reflect on exactly what it is that CLAUDE PEPPER would have had on his agenda this year. I would hope that we would remember that there are still many great unmet needs in addition to longterm health care. Social Security is a system that still needs to be protected. Medicare. a system that requires significant revision and revisiting. and of course longterm health care. [] 1500 Following that. guaranteed or adequate medical access for all. These are the things that would be on CLAUDE PEPPERS agenda and need to be on the Congress agenda. It will be a far different place without CLAUDE PEPPER. It will be a far different Committee on Rules without CLAUDE PEPPER. It will be a far different institution. but I think that he would have said. "I have left you the basis. J. have left you the foundation. and that you can go on from here." So I think at this time it is worthwhile and important to remember that. Because I would like to return for just a second to that issue of health care. and indeed. if any of my colleagues wish to join me in remembering CLAUDE PEPPER or in talking about health care. I urge them to come to the well and participate. but I would like to talk for a minute about health care because for the life of me I still do not understand why it is that we have people that have to enter the hospital with half a hand. we have people who have to live in fear that they will not be able to get the adequate medical treatment. we have people that avoid the preventive medicine they need today because they cannot afford the visit to the doctor and yet what that results in both to them and to our society is untold costs later in the illness that results. It results in untold costs physically because the illness that they could have prevented now is severe and requires much greater treatment. so the physical toll that it takes upon them. the physical burden. the physical price they have to pay. but society pays a price also. Society pays that price when indeed instead of $1 worth of prevention. it has to pay for thousands of dollars a day hospitalization. It pays that price when instead of paying $30 to $60 a month for hypertension medications. it has to then pay $2.500 a month for nursing home care for someone with high blood pressure which could have been controlled at an earlier stage. Society pays that price instead of paying $1 for adequate prenatal. It must pay $4 and $5 for the low birth weight babies. Society pays that pric? when that child that could have been a healthy baby born and delivered in a proper manner. instead the mother does not get to a doctor. and if she does get to the doctor at all. not until the delivery is there. and then society must raise a child who is underweight or malnourished. and all the costs that come attendant to that. So there Is no escaping the costs. What we do by not enacting adequate longterm health care by guaranteeing health care to all citizens. what we do is guarantee that society and individuals are going to pay a stiff and deep price. It is a price that simply is not acceptable. Why is It that in this great society of ours we cannot have that kind of coverage? The kind of coverage that says to somebody. "You do not need to fear. you do not need to fear hospitalization. you do not need to fear the ravages of grave illness. you do not need to fear that. you can go to the doctor." I am been doing a survey In my own State. and I think that the efforts or the results will be much the same in many other States. and I find that in some areas. for instance. there will be no physican taking the Medicaid card to do OB/GYN work. There will be no physician or perhaps one or two taking the Medicaid card. and I find that then. even though to take the Medicaid card. the Medicaid coverage is not adequate for many of the problems we face and many of the health problems. Where are we in society when we cannot say to those people. "You will have health care." Where are we when we cannot say to the poor. when we can actually. to the lower income. the person who is out of work. when we cannot say to them. there are a lot of things you may have to worry about. but health care is not one of them. I have been In an eyeopening experience In the last year and a half. because I have been blessed with a son who is now 20 months old. A young child causes a person to focus things in a little different way. What that child has caused me to do Is to realize that of all the things that I might be concerned about. the things that I might fear the most. the one that I am most concerned about Is not having adequate health care for my child. That should something happen to me or should I become unemployed. as many become unemployed. how would I be able to take care of that son? Think of the parent who has to take. who wonders whether they can take their child to a clinic. who faces the possibility of being turned away at a doctors office. Why? Because they do not have adequate financial resources. It is one thing to be turned away yourself. but to have your own child turned away. what kind of society are we that says that can happen? So. some way. Members cannot have that kind of health insurance. whether it be provided by the Government or whether it be provided by voucher or by the private sector. Members cannot have that sort of total health care coverage. It is too expensive. It costs billions of dollars. that Is what they told CLAUDE PEPPER just a year ago in the well. It could cost $30 or $40 billion. Well. ladles and gentlemen. what does it cost not to have it? What does it cost in the lost productivity when someone is not able to recover from an illness or an injury? What does it cost in the number of children. low birth weight babies In ICUs at thousands of dollars a day? What does it cost to the person who is not able to be a productive citizen. a productive worker in society. because they are not able to because of health concerns? What does it cost Members not to provide that coverage? What Is it costing Members in health coverage today? Health coverage that in many cases is not adequate. What is it costing? So to those who would say we cannot afford it. I say to those Members we cannot afford not to do It because we are already paying that price. Mr. Speaker. at some point. I have to come to grips with the problem of health care. I happen to think that that is coming sooner than later. It is no longer just an isolated group. no longer senior citizens who perhaps do not have adequate Medicare. no longer just a few young people. It is today larger and larger groups are concerned about the rising costs of health care and how do they deal with them. If a person is working. they have seen a higher deductible payment in insurance. They have seen higher copayments. They have seen their insurance costs rise. and they know they cannot afford this. But yet at the same time. people know that the Congress and the President cannot afford not to do something about it. If you are a senior citizen. you are concerned about the increased costs for the catastrophic illness bill. and seniors also know the high cost of nursing home care. seniors know the high cost of hospital care. If you are a hospital administrator. you have to be concerned about the lack of insurance In our overall medical policies in this country. our overall health care policies. rural hospitals and the problems they face. Urban hospitals have somewhat different problems. nonetheless. whether Medicare reimbursement. Medicaid reimbursement. whatever it Is. as a health professional. a person has to be concerned that we do not in this country have any guaranteed or have any direction in health policy. So how much does it cost? It is costing Members a lot Just not to have some sort of guaranteed excess for health care in our society. Mr. Speaker. We cannot continue to go longer. To the new pressure building. we have heard so much of the statistics about the 37 million uninsured. about how many millions more go without any adequate coverage. Oh. yes. they have a policy that may kick In once they have incurred $1.000 worth of medical costs. but what does that do for basic preventive medicine? What about the senior citizens who. while catastrophic illness can cover some costs now. look to the bankrupting effects of having to be hospitalized in a nursing home for a period of time? What about them? So. what about the young person who works at minimum wage. who does not have a medical card. who does not have a medical policy. receives no benefits? Minimum wage. Membeis want to raise minimum wage. go to $5 an hour. $6 an hour. The fact is. that still many of the Jobs now do not have adequate health care coverage. I ran Into a couple. one working in a restaurant. the other day. and he had worked at a job with one of the major automobile manufacturers. The plant shut down. moved to Mexico. and where is he now? Working at $3.50 an hour. No medical coverage. His wife is also working at $3.50 an hour. So this couple. which before enjoyed. with his Job at roughly $10 an hour plus health benefits. today earned between them $7 an hour and no health care benefits. Of course. as he told me. he Is sick. He said to me. and said this without any sort of irony or sarcasm or anger. he said. "Well. Congressman. how do you expect us to make it. how do we make It?" Ladies and gentlemen. there is no way to answer that question. How do you make it without health benefits on that kind of an income? That is the group that I think is going to be pressing this Congress more and more. and when that group gathers. it is going to be a volatile force. It has been unorganized to this point. It has not really come forward. but I think we are going to see a massive movement in the next few years. saying that there is one thing the greatest democracy in the world. the most powerful nation In the world. the richest nation in the world ought to provide. and that is guaranteed health coverage. As I say. It can be one where we pick the system. Do we want it to be distinctly private sectordriven? Do we want it administered by the Government. or do we want a voucher system? Do we want some kind of privatepublic mix? Whatever it is. we can pick a model from all over the world. because much of the industrialized world has already led us and beaten us In this regard. They have a system. and we caii pick the model. The point is that this is something that has to come. There are 37 million uninsured. millions are underinsured. and there is a crying. critical need out there. Of course. that also means that we have to deal with health care costs. We have to deal with the fact that our hospital costs rise above inflation. not simply because hospitals are greedy but because their costs are rising. because of the sophisticated equipment that is so important. equipment that we all request when we enter the hospital. That sophisticated equipment is expensive. and it must be paid for. We want good medical education. and the costs of medical education are soaring. So there must be an attempt to have the ability to guarantee that we have the best medical education possible. So also do we need to guarantee that our rural hospitals particularly remain open. because those are the ones that are shutting down at the most rapid rate. Five hospitals In my State alone last year closed their doors. They were major employers. but even more significantly. they were major health care providers. So we must guarantee that the rural hospitals are able to keep their doors open. Indeed in many areas of the country 70 percent of the medical care that is provided in a hosptial is either charity care. Medicaid. or Medicare. Only 30 percent is being paid for by the private sector and by private insurance. So at this point if we have 70 percent of our health care being paid for either by Medicaid or Medicare or uncompensated care. we have the Government involved in health care whether we like it or not. So what I would urge is that we have a policy. that we have a direction. that we have a sense of where we are going. as opposed to the yearly paying out without any sense of where the money is going. Just as in the treatment of regular illness or injury. we cannot simply continue to put BandAids on. so we can not continue that with health care. Indeed we have BandAids now on top of BandAids. and now is the time for true treatment. That is necessary both at the governmental level and the private level. as 1 say. and also at the policy level. This is the question we started asking before. How long do we go without health care? How long can this country take to generate a policy? How long can this country go without a policy? Madam Speaker. I would encourage any Member who has any thoughts on this to feel free to participate in this discussion. We started this discussion remembering CLAUDE PEPPER and also remembering that which CLAUDE PEPPER stood for. and that was making sure the Americans in this country had the health care to which they were entitled. We do not have that now. and I think CLAUDE PEPPER was determined that at some point we would. At this point. Madam Speaker. if there is no one else who wishes to participate in this discussion. I yield back the balance of my time.