Date: 1981-04-01
Speaker: ROBERT C. BYRD (democrat)
Chamber: S

Mr. President. I rise in support of this amendment. The reconciliation instruction to the Labor and Human Resources Committee. as it currently stands in Senate Concurrent Resolution No. 9. could cause a grave inJustice to a number of people most in need of basic medical care. I am speaking of people in rural areas. people who work as migrant laborers. and miners who have contracted black lung disease. These people do not have money to go to the best hospitals. Far from it. Sometimes. any kind of hospital might be available to them only in case of an emergency. What many of us may consider to be routine health care may be difficult or impossible for many of these people to obtain. The rural areas of America. including the Appalachian region. receive less than their fair share of medical services. Community health centerssmall clinicsIn rural areas attempt to provide fundamental health care for people in those areas. Thousands of victims of black lung disease have had their suffering reduced in some part through the efforts of specially trained people in other small clinics in nine States. Medical personnel in Alabama. Colo. rado. Illinois. Indiana. Kentucky. Ohio Pennsylvania. Tennessee. and my owr State of West Virginia help black luni victims to live. however uncomfortably with that dreaded lung disease.. Thesi medical personnel are trained to instruc black lung victims in the use of simpli oxygen equipment in their homes. Man. black lung sufferers require such equip ment.- including oxygen tents and face masks. The health care information pro vided to these miners is invaluable. The administrations proposal to con f solidate these kindsof small health pro gramsfor rural areas and black lun victimsis intended to save money. Ove s the long run. that may be the case. But I the short term. administrative costs fo these programs may increase. as State s struggle to fill the void left by the Fed 7 eral Government. And in the long tern it should be noted that the proposed re duction in these health programs is fou t or five times greater than the adminti trative costs of the programs. An inhu - mane cut in the black lung and commu - nity health clinics program would resul For these reasons. I support tl 1. amendment. and I urge its adoption. d 0 Mr. LEAHY. Mr. President. I enthus astically support Senator KENNEDY amendment to restore funds for thr programs which provide essential health services to poor Americans residing in the rural and urban medically underserved areas of the ..ation. The community health center program. the migrant health center program. and the black lung clinics together provide health care to 6 million Americans. The vast majority of these people l1v below the level of poverty and have little or no health insurance. The President has requested a 25percent reduction in funds for these programs. If that proposal is approved. more than 2 million Americans will no longer have access to primary health care. Senator KENNEDYS amendment would merely allow these programs to receive in fiscal year 1982. the same amount they received in fiscal 1981. No increase in funds for these programs has been requested. I support this amendment and urge my colleagues to support it for a number of reasons. First. the continuation of these programs is essential to the national goal of containing soaring health care costs. Numerous studies. Federal and private. have demonstrated that people who use community health centers have far lower rates of hospitalization than those who do not use health centers. Health centers reduce hospitalization between 25 and 60 percent. The savings to the health care system. through reduced rates of hospitalization and emergency room use. amount to over $400 million. Thus. these programs have saved more than they cost. Second. the continuation of these programs at the current years level is essential to the national goal of encouraging the most costeffective and efficient use of Federal tax dollars. Over the last 6 years. the inflation rate equaled 55 percent. Appropriations for these programs grew by only 47 percent. Yet during this time. community health centers were able to reduce their costs for administration by 20 percent. In addition. the number of people served by the community health centers grew by 200 percent. Third. the continuation of these prot grams is crucial to the national goal of e protecting the most truly needy in our y society. Only 6 million of the 26 million . Americans who are medically under. served are currently assisted by these . three programs. These programs serve the most needy Americans. Seventyone - percent of those aided have incomes be. low $7.000 and 60 percent have incomes g below the poverty level. Almost 50 perr cent have no health insurance and are n not entitled to medicaid because they are Ir migrants or members of intact families. . These programs have been extremely L effective. In some communities. they have . reduced infant mortality rates by 50 per. cent and reduced the incidence of prer ventable diseases. such as rheumatic s. fever. by 60 percent. Their emphasis on . preventive health care. screenings and . immunizations have prevented or cont. tained outbreaks of typhoid fever. tuberie culosis. and parasitic infections. Mr. President. this is a reasonable i- amendment which will serve to further s our national goals of reducing heoth ee care costs. promoting the effective use of Federal tax dollars. and alleviating health personnel shortages in rural and urban areas. I strongly urge its adoption.* (By request of Mr. ROBERT C. BYRD. the following statement was ordered to be printed in the RECORD:)