June 17, 1992 EXTENSIONS OF REMARKS 15251 EXTENSIONS OF REMARKS HEALTH CARE IS AN IMPORTANT a physician-enduring the ordeal of the com­ And the cost of it all is threatening to ISSUE mencement speech. That may not be easy for bankrupt the nation. you or for me, for that matter. The last time Th1nk about it: Until 1965 there was no sig­ I spoke before so many doctors was in Al­ nificant national governmental involvement HON. 1HOMAS J. DOWNEY bany in 1988 at a conference of 500 psychia­ in making health care available to all Amer­ OF NEW YORK trists. Th1s is the truth. As my turn to speak icans. Medicare and Medicaid were the first IN THE HOUSE OF REPRESENTATIVES approached, one of the doctors-! think a Re­ great national steps, but they are not enough to meet today's problems. Wednesday, June 17, 1992 publican-leaned over and said, "Governor, would you prefer a podium or a couch?" Today, the United States spends $800 bil­ Mr. DOWNEY. Mr. Speaker, health care is I'll try not to intrude too long on the fes­ lion a year on health care and it will be in­ one of the most important issues facing us tivities that are surP- to follow and that you creased by 50 percent before the end of the today. On Long Island, my constituents are so richly deserve. But I will use this oppor­ decade. $800 billion. That's more than two concerned about the lack of affordable and tunity to focus on an important subject be­ and a half times the entire defense budget. adequate health insurance coverage. In addi­ cause it will be a significant part of your Yet, some 35 million Americans, more than 2 continuing medical education and, of course, million of them in New York State, have no tion, there is a genuine need for us to recog­ you-every one of you-will be vital to its coverage. nize the importance and cost effectiveness on proper resolution. Private insurance for the middle class is preventative care and support. The development of medicine in America, being sliced like Swiss cheese-thin and full The distinguished Governor of my State, the like the nation itself, has made a miraculous of holes. Red tape is strangling the system, Honorable Mario M. Cuomo, recently ad­ journey in just over 200 years. From the Co­ 'making it much more expensive than it need dressed the graduates of the New York Uni­ lonial period, when most sickness was treat­ be. Our population is growing old and more versity Medical School. In his usual eloquent ed in the home by women who relied on pop­ frail, more people in need of long-term care. style, Governor Cuomo presented an insightful ular medical allllanacs; to the eighteenth Exquisite technology grows more exquisite and thought-provoking overview of the health century, when bloodletting and the liberal and more expensive. Costs are exploding. use of emetics abounded; to the turn of the People are frightened everywhere. Suddenly care issue. With your permission Mr. Speaker, century, when American medicine revolved it's a huge national issue. Everyone des­ I would like to include the text of the Gov­ around the doctor, his black bag and h1s of­ perate for answers. ernor's speech in my remarks: fice; to today, when we are blessed with star­ All of this happened just as you arrive on REMARKS BY GoVERNOR MARIO M. CUOMO tling technical capacity with internation­ the scene. Thank you Dr. Farber for that truly gener­ ally-renowned medical schools, with well­ Now to find the solution, we will need ev­ ous introduction. It's a great honor to be in­ paid and respected hospital administrators eryone on this stage and everyone in this au­ vited. It's a great honor to be here today and and physicians, and more Nobel Prize win­ dience contributing to the analysis, the dia­ I thank you. ners in medicine than any other country in logue and formulation of a plan to reform Larry Tisch, Marty Begun, John Rosen­ the world. the entire system. But most certainly, we wald, Dr. Dinowitz, Dr. Eng, all the members In only 200 years, the immense wealth of will need you and the entire great institu­ of the board, trustees, faculty, staff, all dis­ this vast nation and its gift for enterprise, tion of NYU and this state's government and tinguished honorees, ladies and gentlemen. innovation and compassion, have produced the government of all the states. And to you, the honored principals of th1s some of the best intelligence, technology and The challenge we all face as doctors, as occasion, the graduating class of 1992. All of health care anywhere in the world. politicians, as Americans, is immense. But us applaud you. Your intelllgence, your But after 200 years, health care in America so is the opportunity. strength, your persistence, your faith. This faces a confounding and even an agonizing For the first time in nearly 50 years, there day belongs to you and to your mothers. paradox. The vagaries of th.e free enterprise is a strong consensus that we need universal Also all of your friends, all of your relatives, economy and the unevenness and insuffi­ health care reform. There is also a universal all of your significant others. ciency of our political and governmental sys­ understanding that such reform would be And to all who have stood by you through tem have left us, despite all of these accom­ more than lip service, Band-aids, or half­ the trials and tribulations of medical plishments, with daunting health care prob­ baked theories dreamt up by rigid ideologues school-that hard journey described already lems. who have never even seen the inside of a ma­ by Dr. Dinowitz. Through the written and In many ways, we have too few doctors and ternity ward. It must be real reform that practical exams. Through the 36-hour rounds nurses. In many instances, we overuse or preserves the best of the current system, be­ in the emergency rooms and wards at Belle­ abuse our technology. Sometimes we don't cause much of it is very good, and builds on vue. Through the verbal pummeling suffered have enough technology. Sometimes we it to make it better. at the hands of residents-sometimes over­ don't have enough care. It's now clear to most Americans that uni­ bearing residents. Through the cadavers, the A few blocks from NYU lie people suffering versal health care can only be achieved with scatological med school humor and the late­ the ravages of epidemics we thought we had the help of the national government. Believe night moral qualms. conquered: drug resistant tuberculosis, mea­ it or not, that is a giant step forward. For You have exposed yourselves to disease. sles, congenital syphilis ... while inside the the past 25 years, the responsibility for ex­ You have witnessed and assisted in the mir­ neonatal units in the hospices lie the victims panding access and controlling costs has fall­ acle of birth, and you have studied the per­ of our terrible new plagues: babies the size of en primarily, nearly exclusively, to the plexing realities of death. You have sub­ my hand, literally, strapped to respirators, states. Many states, including New York, jected yourselves to the full range of human clinging to life, born addicted to crack; AIDS have excelled in that role. In fact, in many emotions; fear, joy, anger and suffering. And babies .. born to die. ways, we're far ahead of much of the rest of many of you will continue to for years to People are dying because they come to the the country. We expanded coverage for chil­ come. hospital too late in their diseases for acute dren through our Child Health Plus Pro­ You have proven yourselves worthy of par­ care to save them, or they suffer more than gram: invested massively in pre-natal care, ticipating in one of the world's most re­ they would have had to if we had only done and, even in tough fiscal times, we've in­ spected and most important professions. the simple thing-provided the ounce of pre­ creased funding for primary care. We created Through it all, your family and friends have vention called primary care, provided pre­ the first AIDS Institute. We compensate hos­ supported you, encouraged you and, when natal care, regular check-ups, easy-to-under­ pitals for the otherwise uncompensated care necessary, tolerated you. stand instructions from a physician they that they provide, and we help businesses As a father of a physician, I know the sense could trust. buy coverage for their employees. of joy and relief that many of these people It is shocking and humiliating that the We were able to do all of this, in part, be­ feel today. The joy that you got through it United States, by far the greatest, most pow­ cause we control costs better than most all, and relief that medical school is over for erful nation in world history, ranks 17th in states thanks to two people whose names you-and for them. Now only one hurdle life expectancy and 21st in infant mortality you probably don't hear often. I didn't have stands between you and your full-time life as among industrialized countries. anything to do with it except I was part of • This " bullet" symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor. Matter set in this typeface indicates words inserted or appended, rather than spoken, by a Member of the House on the floor.