The Importance of Strengthening Preventive Care

I rise today to
share a few thoughts about our health care proposal and also to address the
amendment of my good friend from Maryland, Senator Mikulski.  We’ve heard the word “arrogant” echo in this
Chamber. “The bill before us is arrogant.”

   And, I come to
it with a somewhat different perspective.  For 10 years, as a Representative of a working class neighborhood
back in Oregon, as a State legislator, I have heard a lot of stories from
America’s working families–from the working families in my House district back
home, a lot of stories regarding health care.  A lot of concern that they can’t afford health
care.  A lot of concern
that their children do not have appropriate coverage.  A lot of concern
that their health care is tied to their job, and if they lose their job, they are going to lose their health care.

is a huge amount of stress for America’s families who understand that if you have health care you have to worry
about losing it, and if you don’t have it, you have to
worry about getting sick. That is why we are here today in this Chamber
debating health care, because so many of us have heard from our constituents,
so many of us know from our
personal experience what a dysfunctional,
broken health care system we have in America.

   Now sometimes, listening to this conversation on
the Senate floor, you would think this is a rather complicated debate.  But the heart
of this bill is not that complicated.  The heart of this bill is that every single
American should have access to affordable, quality health care, and that we can
take a model that has worked very well for the Federal employees of our Nation,
a model that encourages competition, a model that says let’s create a
marketplace where every individual, every small business that currently
struggles to get health care
–  has to
pay a huge premium for health care–enable them to join a health care pool that
will negotiate a good deal on their behalf.

think every American who has tried to get health care on their own, every small business that is paying a
15 to 20-percent premium because they don’t
have the clout of a large business, understands if they could join with other
businesses, if they could join with other individuals, they would get a lot
better deal.

understand if there is a large pool of citizens who are seeking health
insurance that insurers are going to be attracted to market their goods. We
have seen that in the Federal employees system, where insurers come and
compete.  It turns the
tables.  It takes the
power away from the insurance companies and it gives the power to the American
citizen because now the citizen is in charge.  Now the citizen gets to choose between health
care providers instead of having to search for anyone who they can possibly get a policy from.

do not find that it is arrogant to try to create a system in which individuals
and small businesses get health care that is more affordable health care.  I don’t find that a bill that says we are
going to invest in prevention
– that’s not arrogant, that’s smart.  I don’t find a bill that says we are going to
create incentives to do disease management so someone suffering from diabetes
has the disease managed rather than ending up with an expensive amputation of
their foot.  That is
intelligent, that is not arrogant.

don’t find that having a bill that says that every single
American is going to find affordable health care, and if they are too poor to
afford it we will provide
a subsidy to assist them – get everyone in
the door, that is not arrogant. That is saying we are all in this together as
citizens and that health care is a fundamental factor in quality of life.  It is
a fundamental factor in the pursuit of happiness.  It is not arrogant to find for fundamental
access to health care.

rise specifically to address the amendment offered by my good friend from
Maryland, Senator Mikulski.  The legislation
we are considering has many parts that make health care more affordable and
available, expand access; many parts to hold insurance companies
accountable.  But a big part
of health care reform also deals with helping people avoid illness or injury in
the first place.  That is what
Senator Mikulski’s amendment
does and why it is so important that it be included in this package.

   Preventative screening saves lives.  That is a fact.
 Early detection
saves lives.  That is a fact.
 Too many women
forgo both because of the cost.

want to share a story from a physician in Oregon.  The physician
is Dr. Linda Harris.
 I am
going to quote her story in full.  It is not that long.  She says:

work one day a week at our county’s public health department.  There I met
Sue, a 31-year-old woman who came in with pelvic pain and bleeding.  She proved to
have extremely aggressive cervical cancer that was stage IV when I diagnosed


Sue was 18 she had a tubal ligation after she gave birth to her only child.  As a
single mom she did not have the financial resources to have more children.  She
concentrated on raising her daughter. Sue always worked, sometimes two jobs at once, but never the kind of job that
offered health insurance.  But because she
had a tubal ligation she
did not qualify for our state’s family
planning expansion project that
provides free annual exams, pap smears and
contraceptive services to many of our clients.

doctor continues:

cancer is an entirely preventable disease.  Pap smears almost always find it in its pre-invasive form, but Sue never came in for a pap smear or an annual exam.  Her lack of
affordable access to basic
health care proved fatal. When Sue died of
cervical cancer her daughter was 13.

is the completion of the story that the doctor shared.  Sue
should not be viewed as a statistic in a broken health care system.  But, instead,
we should take her story to heart, about the importance of preventive services.  Sue is one of
44,000 Americans who die each year because they lack insurance, according to a
recent Harvard Medical School study.

me repeat that statistic because I think it is hard to get your hands
around–44,000 Americans die each year because they lack insurance. I don’t
think it is arrogant to say we should build a health care system that gives
every single American access to affordable, quality care so that 44,000 of our
mothers and fathers, our sons and brothers, our daughters, our wives, our
sisters–so that 44,000 of them do not die each year because they lack

Mikulski’s amendment will help
keep this tragedy from happening to our families.  To put it plainly, it will save lives.  It
does this by allowing the Health Resources and Services Administration to
develop evidence-based guidelines to help bridge critical gaps in coverage and
access to affordable preventive health services–the same approach the bill
takes to address gaps in preventive services for children.  This will
guarantee women access to the kinds of screenings and tests that can prevent
illnesses or stop them early.

the American Cancer Society Cancer Action Network notes:

our broken “sick care” system depends on an increased emphasis on prevention and early detection, enabling
us to find diseases when they are easier to survive and less expensive to

last point is also important.  Treating illnesses
also saves money.  With so much
emphasis on the cost of health care, we should all agree that it is common
sense to include reforms that lower health care costs for all Americans.

was noticing that her amendment has a long list of organizations stating how
important this is–the National Organization for Women, the National
Partnership for Women and Families, the Religious Coalition for Reproductive
Choice, the American Cancer Society-Cancer Action Network, the National Family
Planning and Reproductive Health Association.

applaud Senator Mikulski for
offering this amendment.  I urge my
colleagues to remember the 44,000 Americans who die every year because they do
not have access to insurance, they do not have access to preventive services,
and vote to include this important reform.