Donna Christensen

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman from Ohio (Mr. Strickland) for yielding me this time. I also want to thank the gentleman from Georgia (Mr. Norwood) and the gentleman from Michigan (Mr. Dingell), the ranking member, for their leadership and work in getting S. 1880 to the floor today. Mr. Speaker, I also want to applaud the gentleman from Georgia (Mr. Lewis), the gentleman from Mississippi (Mr. Thompson), the gentleman from Illinois (Mr. Jackson), the gentleman from Oklahoma (Mr. Watts), and Senator Edward Kennedy who sponsored the bill in the other body for shepherding this bill through the entire process, as well as all of our staff. I thank the leadership in the committee and the House on both sides of the aisle. Mr. Speaker, health care disparities in people of color, those of low socio-economic status, and in our rural areas should cause us all concern in this country which boasts of the best in medical expertise and the most advanced medical technology. But they exist, and even as we turn the page into a new century, the gaps are not closing but getting wider. Heart disease, cancer, infant mortality, stroke, diabetes, HIV/AIDS and mental illnesses are among the diseases which represent the most glaring disparities. Surely, lack of insurance, deficiencies in the health delivery system and the lack of culturally and linguistically competent providers are some of the factors responsible. It has been proven that bias and prejudice has a significant role as well. But there remains much that we do not know, and without more in-depth knowledge we will never be able to develop the appropriate remedies. Therefore, S. 1880, though long overdue, comes at a critical time, but also at a time when this country has the resources and I think the will to right the wrongs, to close the gaps, and to bring fairness and equity to the system and access to quality health care for all of our citizens and residents. I am proud, Mr. Speaker, of the role that the Health Brain Trust of the Congressional Black Caucus played in this bill's development. I want to be proud of this body tomorrow, and so I ask all of my colleagues to vote ``yes'' for S. 1880, to vote ``yes'' to the research and related activities that will usher in a millennium of health and wellness for many who, until now, have been left behind, and to vote ``yes'' to a healthy and a better America.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. I thank the gentleman for yielding on something that I feel is very important. I look forward to working with the gentleman on these health care issues and other health care issues.

Mrs. CHRISTENSEN. Mr. Speaker, I think the point of the gentleman is that our seniors should not have to be made to shop around for prescription drug coverage. I would like to talk about an issue that came up today. I have joined the gentleman on the floor, as he said, several times this week on health care issues and also on education issues by the way. But today I am asking for this time, and I appreciate the gentleman yielding to me, to express my great disappointment that S. 1880, which is the Minority Health and Health Disparities Research and Education Act of 2000, was not passed with the other suspension bills today. But more than my disappointment, I am really disturbed by some of the race baiting, ultra conservative propaganda that is being used to distract Members from the important issue that this bill would begin to address and the important role that establishing such a center at the National Institutes of Health has, the role that it would have in eliminating disparities that all people of color and people in the low socioeconomic status suffer in this country. I think that the gaps in health care that we experience in this country is an ugly blemish on the record of our Nation and that each and every Member of this Congress should want to remove it by remedying the years of neglect and in some cases the outright denial of health care to the citizens of color in this country. The bill, S. 1880, is a key part to beginning this process. It was championed here by the gentleman from Illinois (Mr. Jackson) the gentleman from Mississippi (Mr. Thompson) and the gentleman from Georgia (Mr. Lewis) and in the Senate by Senator Edward Kennedy. It has enjoyed wide support at the Department of Health and Human Services, particularly that of our Surgeon General, Dr. David Satcher and many in the wider health community, such as the National Medical Association and the Association of Minority Health Professions Schools under the leadership of Dr. Lewis Sullivan, who is the President of Morehouse School of Medicine and former Secretary of Health and Human Services himself. We have also been really grateful, as we tried to work this through over the last 2 years, for the support of the now acting Director of NIH, Dr. Ruth Kirschstein. If I might just point out one of the key provisions of S. 1880. It establishes a National Center on Minority Health and Health Disparities at the National Institutes of Health, which would conduct and support basic and clinical research, training, and the dissemination of health information with respect to the health of racial and ethnic minority groups, as well as other populations, who are suffering health disparities. It authorizes the Director of the National Center, in collaboration with all of the other NIH institutes and centers, to establish a comprehensive plan and budget for the conduct and support of all of the minority health as well as other health disparities research activities at NIH. It establishes an extramural loan repayment program for minority health and health disparities researchers. It authorizes the Agency for Health Care Research and Quality to conduct and support research to improve the quality of outcomes of health care services for health disparity populations. This research would focus on identifying the causes of health disparities, including barriers to health care access and environmental factors. It also authorizes the Department of Health and Human Services Secretary, through the Health Resources and Services Administration and several other agencies, to support research and demonstration projects conducted by both public and nonprofit entities aimed at developing curricula to reduce disparities in health care outcomes, including curricula for cultural competency in graduate health professions education. And lastly, it authorizes the Secretary to establish an advisory committee on cultural competency and health professions curricula development. The bill is a good bill and it is an important bill. It is needed. Research plays an essential role in understanding the disparities and in uncovering the factors underlying them and developing the points of intervention and improved methods of treatment. Such research also provides the only means by which we can derive the knowledge necessary to prevent disease. A few points of information that will help paint a clearer picture: The gaps between life expectancies for blacks and whites have widened in recent years. Although infant mortality in African-Americans has decreased somewhat, the disparity has increased. And the same pattern is seen in Native Americans and Alaskan Natives. Under heart disease, the data indicates that the prevalence of cardiovascular disease is higher among African-Americans than among their white counterparts. Cardiovascular disease is nearly two times higher among African-American women than among their counterparts. And recent research has shown that African-American women of the same socioeconomic status and education level, with everything being equal, they are the least likely to receive the diagnostic tests and the treatment compared to other women. In cancer, despite significant advances in the detection and treatment of several forms of cancer, the data continues to indicate that communities of color continue to suffer disproportionately in terms of occurrence, the lateness at which the cancer is discovered and death from cancer. And AIDS we have talked about a lot. African-Americans comprise approximately 12 percent of the population, yet we are 37 percent of those diagnosed with AIDS since the beginning of the epidemic. In 1998, the rate of reported number of new AIDS cases was eight times higher among African-Americans than among whites. And we could go on and on. So I just wanted to say in closing that this bill was been worked on on a bipartisan basis in the committee. It went through the normal committee process before it was brought to the floor. It passed the Senate unanimously, which indicates that Members in the other body with widely disparate views supported this legislation. It was on the suspension calendar today. It was pulled. I just want to ask my colleagues who are opposing the bill to take another look at it, work with us, withdraw their objection to the bill, and I ask the leadership of the House to work together to bring the bill back to the floor and have it pass before we leave to go home, if we ever leave to go home.

Mrs. CHRISTENSEN. Mr. Speaker, and the leadership on both sides have been willing to work on bringing it back. There are some objections on the other side of the aisle and from some conservative groups in the country which have sent e-mail wrongly identifying the bill as a quota bill. It does not provide a quota for research. It does particularly state that minority research would be done because we are the ones who experience these disparities that must be eliminated. But it also does not exclude anyone. It is for any population group that experiences disparities and gaps in their health status and their access to health services. Among those would be our rural citizens. People in the rural areas of this country are also suffering from disparities in health care regardless of their race or ethnicity. And so, we feel that the bill is important. I think to the extent that there are citizens in this country who still do not have access to health care who do not enjoy the same quality of life as others because of health disparities, the country's health in general suffers and I think it is something we need to address. This bill, which has been worked on for many years, as I said, has been worked on on a bipartisan basis with the Department, the Congress, the White House, nonprofit national health organizations for years. Is a good bill and we would like to have it passed. It is past due.

Mrs. CHRISTENSEN. Mr. Speaker, I just wanted to join the gentleman in the discussion for a moment about the HMO give-backs. Because I was in Milwaukee yesterday visiting a church and one of the parishioners, a Ms. Riley, and this was at Greater Galilee Church in Milwaukee, came up to make an announcement to the congregation and in that announcement she told them that, as Medicare beneficiaries, the HMOs in their area were doubling their premiums. I thought that was outrageous. Because I thought here they are asking for 40 percent of the Medicare give-back and they are still gouging the seniors, at least in Milwaukee, and I am sure it is happening in other parts of the country, as well.

Mrs. CHRISTENSEN. Mr. Speaker, if the gentleman would continue to yield, is it not true that where prescription drug coverage has been tried in some States that trying to do it through providing it through HMOs is not working and that is why the Democratic proposal and the Vice President's proposal to provide it through Medicare is a much better way, it assures the seniors that it will be there when they need it?

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I come to the floor this morning as the final funding for health care is being negotiated, to make a final plea for full funding for the Congressional Black Caucus HIV/AIDS Minority Aids Initiative, and the increase we are seeking for Medicaid for the territories. Mr. Speaker, as HIV infections and cases of AIDS come under control in other communities, in African Americans and Hispanics or Latinos it remains a major killer. Eighty-one percent of all new HIV infections are among African American and Latino women. Even in minority communities that have not seen the same numbers, their fragile health care infrastructure places them at an extreme risk. We must fund the CBC request at the full $539 million, provide Medicaid for early treatment, and make a significant investment for Medicaid for citizens in my district and the other territories by funding the request of the gentleman from Guam (Mr. Underwood) and me. Mr. Speaker, health care, quality health care, is a right that we in this body and the White House must extend to all.NOTICE--OCTOBER 23, 2000 A final issue of the Congressional Record for the 106th Congress, 2d Session, will be published on November 29, 2000, in order to permit Members to revise and extend their remarks. All material for insertion must be signed by the Member and delivered to the respective offices of the Official Reporters of Debates (Room HT-60 or S-123 of the Capitol), Monday through Friday, between the hours of 10:00 a.m. and 3:00 p.m. through November 28. The final issue will be dated November 29, 2000, and will be delivered on Friday, December 1, 2000. None of the material printed in the final issue of the Congressional Record may contain subject matter, or relate to any event that occurred after the sine die date. Senators' statements should also be submitted electronically, either on a disk to accompany the signed statement, or by e-mail to the Official Reporters of Debates at ``Records@Reporters''. Members of the House of Representatives' statements may also be submitted electronically by e-mail, to accompany the signed statement, and formatted according to the instructions for the Extensions of Remarks template at http://clerkhouse.house.gov. The Official Reporters will transmit to GPO the template formatted electronic file only after receipt of, and authentication with, the hard copy, signed manuscript. Deliver statements to the Official Reporters in Room HT-60. Members of Congress desiring to purchase reprints of material submitted for inclusion in the Congressional Record may do so by contacting the Congressional Printing Management Division, at the Government Printing Office, on 512-0224, between the hours of 8:00 a.m. and 4:00 p.m. daily. By order of the Joint Committee on Printing. WILLIAM M. THOMAS, Chairman.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman for yielding me this time. I rise in support of H.R. 2462, the Guam Omnibus Opportunities Act. I congratulate my colleague and fellow Democrat, the gentleman from Guam (Mr. Underwood), for his successful work in shepherding this legislation through the Congress. Few will ever fully appreciate the difficulties faced by the delegates from the U.S. territories in moving legislation through the Congress. The process entails many emotional highs and lows, and often requires our full attention to educate others with the issues that confront our fellow Americans in the territories. The Guam Omnibus Opportunities Act is important legislation for Guam and good policy for the United States. Of all the territories, Guam has historically played a strategic role in the planning of our national defense. However, the ending of the Cold War and our shifting defense strategy has caused much of the military land owned in Guam to become excess, as it has also downsized military activities across our Nation. Mr. Speaker, H.R. 2462 sets out a process so that Guam can have the right of first refusal for the return of future excess Federal land in Guam. Taking into consideration the island's limited and precious resources, this new policy will provide opportunities for Guam to maximize the use of these lands that have been in Federal control for the past 5\1/2\ decades. Mr. Speaker, this is good legislation for the people of Guam, and I again congratulate the gentleman from Guam (Mr. Underwood) for his tireless work in getting this measure to the floor. I urge full support from my colleagues.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentlewoman from North Carolina (Mrs. Clayton). Mr. Speaker, I yield to the gentlewoman from California (Ms. Waters).

Mrs. CHRISTENSEN. Mr. Speaker, I next yield to the gentlewoman from California (Ms. Millender-McDonald).

Mrs. CHRISTENSEN. Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Eddie Bernice Johnson).

Mrs. CHRISTENSEN. Mr. Speaker, I yield to the gentleman from Texas (Mr. Hinojosa).

Mrs. CHRISTENSEN. Mr. Speaker, I yield to the gentlewoman from the District of Columbia (Ms. Norton).

Mrs. CHRISTENSEN. Mr. Speaker, I yield to the gentleman from Illinois (Mr. Davis).

Mrs. CHRISTENSEN. Mr. Speaker, it has been my privilege to manage this hour of tribute to the gentleman from the First District of Missouri (Mr. Clay), a steadfast champion of education, labor, and the founding member the Congressional Black Caucus. We have heard but a few of the accomplishments and contributions of the gentleman in this short hour, and I associate myself with all of the prior remarks. Truly he has left a rich legacy in labor. And in education he has been to minority education what his long-term friend and colleague Congressman Stokes has been to the cause of minority health. The gentleman from Missouri (Mr. Clay) will leave a great void, but we will fill it with his rich legacy. I am pleased to join my colleagues in saying thank you on behalf of this body and our Nation. I would say thank you also to his dear wife, Carol, and his family for sharing him with us. Godspeed and God bless as he leaves this body. But I am sure he is not leaving a life of service and many, many more contributions to his country. We thank him very much for his service.

Mrs. CHRISTENSEN. Mr. Speaker, I yield to the gentleman from Illinois (Mr. Rush).

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman from South Carolina (Mr. Clyburn) for yielding. Mr. Speaker, there are many Members who are gathering here this afternoon to pay tribute to Congressman Clay. Mr. Speaker, first, I yield to the gentlewoman from North Carolina (Mrs. Clayton).

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentlewoman from California (Ms. Waters) for those comments. Next, I would like to yield to our distinguished leader from Congressman Clay's home State, the gentleman from Missouri (Mr. Gephardt).

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I am here this morning to call on my colleagues to include the provisions of the Immigration Fairness Act in the final Commerce-Justice bill. In my district as in all of yours, we have families that have been awaiting reconciliation with their loved ones for years. Families need to be together. It is also unreasonable for someone to be made to leave the country to apply for a change of status here. It creates undue hardship, and it just makes no sense. We witness even in our small community the different ways that immigrants in the Caribbean are treated by Federal agencies. Illegal entries from the other side of the globe get preferential treatment compared to, for example, Haitian immigrants from our own region. Lastly, we have asked for years for a shopping visa so our Caribbean neighbors could visit the U.S. Virgin Islands for short periods. The visa waiver program has been made permanent, and the Caribbean is still waiting. The provisions of the bill would finally bring fairness to the process, support families and finally see our neighbors from the Caribbean, Liberia and Central America treated fairly. It must be a part of the conference report.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr.Speaker, I rise to join my Democratic colleagues to express my outrage at the ommission of immigration fairness from the Commerce--Justice Appropriation Bill. I am a Caribbean American and I am calling on my colleagues to vote against this bill because it fails to right the wrongs that are being perpetrated against Haitians and other people from our region, Central Americans, Liberians and others. I also think that it is shameful that once again the people of the District of Columbia, the nation's capital and our home away from home, have their budget bogged down with this bill that includes a poison pill that ought to kill it here, but which certainly will be vetoed at the White House. Why can't we do the right thing on this? People of color across the country and around the world cannot seem to get fairness under this Republican Congress. District residents, Caribbean people, Central Americans, Liberians and others deserve fairness just like you and I. Do the right thing. Vote no on this until we get justice in the Commerce, Justice and Appropriations bill.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. I was fortunate that I was in a fee for service. But if you listen to the doctors who came to the Senate a few weeks ago, they talked about the fact that they just in good conscience sometimes had to just take the risk of going against the HMO's decision because they just could not deny an examination that they felt was needed for a patient. The testimony of the mother whose daughter's name is the same as mine, Donna Marie, who died because she did not have the appropriate test was a testimony to that. We took an oath. To make some of the decisions that the HMOs place on us goes against the oath that we took as physicians.

Mrs. CHRISTENSEN. Mr. Speaker, I thank the gentleman for yielding. Mr. Speaker, as my colleague the gentleman from New Jersey (Mr. Pallone) said, the big issues that remain before us as we come close to the end of the 106th Congress are the same ones that we have not been able to get the Republican leadership of this body to adequately address through several Congresses, not just this one, education and health care. Last week I was able to join some of my colleagues to call for passage of our education agenda. But tonight I want to join my colleague in talking about health care. A few weeks ago, I joined Senator Byron Dorgan of North Dakota, along with the gentleman from Arkansas (Mr. Berry) and others at a hearing in the other body to call on their leadership to bring the patients' bill of rights to the floor for a vote and to pass it. To date nothing has happened. That is despite the testimony of patients, of a mother who lost her daughter because she was denied the test and care that she needed, the testimony of health care professionals who said how their professional judgment and their values were daily compromised by having to work under the current managed care system. The system has to be reformed to allow doctors and other providers to make decisions in consultation with their patients on what medical tests and care is indicated in each instance, to have the system better respond to the needs of patients for access to emergency services and specialists, and to make those who are making decisions on health care to be accountable for those decisions. People all over this country are dissatisfied with managed care. They want the system revamped. They want a patients' bill of rights. The Vice President is poised to make that happen and we, their Representatives, need to respond. I want to spend the rest of my time on the Medicare give-backs that are being proposed as a remedy for the cuts that took place in the Balanced Budget Amendment of 1997. It is important that, in this measure, the one that is proposed, those who are on the front lines providing health care to those in need be treated fairly and be given precedence since they are the ones who have suffered the most along with the patients who rely on them for service. In my district, our only private home care agency was forced to close and our public health agency forced to cut back because of the cuts that were imposed in BBA 1997. This is a situation that has been repeated in towns, cities and rural areas around the country. Our hospitals and nursing homes in the Virgin Islands are lucky to still be open, although it has been a struggle to continue to provide care. Others have had to close their doors. I want to say to the Nation's hospitals, do not accept the Trojan Horse that is being offered to you. The recommendation as it now stands is wrong. Do not let us be picked off one by one and pitted against each other. We can all win if we stand together on this issue. As a doctor, I know how difficult it is to meet overhead costs and to keep providing services when the fees keep getting smaller. Our expenses and our operating overhead are not going down. They are going up. Our patients need, at the very least, the same level of care, and they deserve to have their needs met. I resent the fact that the Republican leadership wants to give HMOs any part of that give-back. For what? They promise nothing in return. They have left Medicare patients, our elderly, stranded because they could not make the desired profit. They are holding out their hands for more money now, and they are not even being made to increase the service to the special population. For too long, HMOs have been allowed to take the care out of ``health care,'' and we say enough is enough. We need to give the dollars back to the providers of health care, to the doctors and nursing homes, hospitals and home health care agencies. The people of this country deserve the full range of health services, and giving our providers fair reimbursements and helping them to stay in business makes that possible. We in the Democratic Caucus say give the money to those who care, give it to the providers, not to the HMOs. I must also mention an issue that is important to my district. That is the increases in Medicaid that the administration is seeking and the redistribution of the Children's Health Insurance Program funds that are not used by the States. In my district and the other territories, we have a cap on our Medicaid dollars; and we receive CHIP funds under a formula which does not allow us to provide the level or the scope of health care that our residents need. With our cap, we are unable to provide Medicaid to people even at the poverty level. So we have a large gap between those who are covered by Medicaid and the uninsured. The Journal of the American Medical Association today reported a study on uninsured adults showing that when they are uninsured they are just not able to access any care, they go without even preventive services. And Sanda Adamson Fryhofer, the President of the American College of Physicians American Society of Internal Medicine, which funded this study, is quoted as saying, ``Studies such as this one,'' the one on the uninsured adults, ``prove that living without insurance,'' which many of the people in my district do and have done for years, ``is a serious health risk that needs to be treated with the same sense of urgency as not wearing seatbelts or drunken driving.'' In my district, close to one-third of the children are estimated to be uninsured. Kids count. The Community Foundation of the Virgin Islands recently released a report that showed that 41 percent of our children live in poverty, twice the national rate, and that deaths among Virgin Islands children under 14 are also nearly twice the national rate. Health care is a right for all, not a privilege for the few. We have to get that straight before we adjourn and leave for this election. This means passing a meaningful patients' bill of rights. It means adding prescription drug coverage to Medicare. It means making up for the damage we have done to hospitals, home health agencies, nursing homes, doctors and other providers with the cuts in 1997. And it means making CHIP and Medicaid fair and equitable to all Americans. In closing, I want to take this opportunity because some of my colleagues will be on the floor later to pay tribute to another of our colleagues. I want to wish the gentleman from Rhode Island (Mr. Weygand) well and thank him for his service to our class in the Congress. I want to especially thank him for the interest and help in the national park and other issues in my district. And although we hate to see him leave this body, it is good to know that they will be able to count on his able leadership in the other body. He will make a great Senator from Rhode Island. We thank him for his service.

Mrs. CHRISTENSEN. I cannot give you a specific number as you asked, but I know that it is multiplied severalfold because of the inability to take the drugs. For example, we know that if someone is able to take their hypertensive medication or their diabetic medication and maintain their hypertension or diabetes within the normal range, they can expect to live a normal life span and avoid the complications which put them into the hospital and greatly increase the cost of medical services. If we focus on prevention in health care instead of worrying about the cutting costs, if we focus on prevention, we will cut the costs of health care in this country.

Mrs. CHRISTENSEN. Absolutely.

Mrs. CHRISTENSEN

Mrs. CHRISTENSEN. Mr. Speaker, I support H.R. 782, the Older Americans Act Amendments and I commend its sponsors for getting it to the floor of the House today. This program has not been reauthorized since it expired in 1995, but continued only through annual appropriations. Today when we pass this reauthorization measure, we can finally say to our Senior citizens that we care about their concerns, enough to provide the support and assistance they need. Mr. Speaker I especially applaud the bills provisions with regard to older people of color, who are often poorer, lack health care services and experience greater difficulties having their needs met. The seniors in my district have benefited greatly from this act in the past and from the annual appropriations to continue the services-- from the elderly nutrition programs to the home care for the frail elderly and the senior community service employment program. They are very proud of the variety of needed services they give to the community through this latter program. We are also pleased that this reauthorization includes a national family caregiver support program. Many families across the country will be helped through this important measure. Mr. Speaker, this reauthorization is long overdue and I am pleased to join my many colleagues in supporting it.