Speech #930006051

Mr. President. I am please to join today with the distinguished Senator from New Jersey in proposing legislation to extend the Migrant Health Act for 4 years and to expand the effort to provide adequate health care to the Nations migrant workers. Last year. I was pleased to introduce a similar measure which was approved unanimously by the Senate. Unfortunately. the House did not act on this bill. Senator WILLIAMS was the original author of this program as chairman of the Senate Migratory Labor Subcommittee and I am pleased to join with him again this year in seeking to see that the Federal Government meets its responsibilities to the Nations migrant workers. This measure steps up quite significantly the amount of resources available by providing authorizations of $60 million for fiscal year 1974. $105 million for 1975. $120 million for 1976 and $135 million for 1977. That will actually double the authorization for next year over this year. but it is a needed program. and the testimony we had before our committee was that if we were to try to provide minimum standards for health care for the migrants. it would cost some $600 million. so $60 million is a bare minimum. This measure also includes a separate authorization to help defer the cost of hospital services to migrant workers. That is an extremely important provision. because we have seen time and time again. during the course of our health hearings. where hospitals today are operating on such a thin line between bankruptcy and survival that they have refused to provide migrants with health care. because they cannot afford it. This measure would provide resources for migrant hospitalization. It would authorize $10 million in fiscal year 1973. $25 million for fiscal year 1974. $35 million for 1975. $40 million for 1976 and $45 million for 1977. Mr. President. for too long. the health needs of the approximately 1 million migrant agricultural workers in the Nation have remained unmet. Low economic and educational levels. forced mobility. and the lack of State resident status. as well as cultural and language barriers all serve to deny access to any health care service. Government reports and private studies have convincingly documented the poor health of migrant farmworkers. For example. the infant mortality for migrants is 25 percent higher than the national average. Mortality rates for tuberculosis and other infectious diseases are 2 times higher than the national rate. Hospitalization for accldents is 50 percent higher than the national rate. The average life expectancy for the migrant is under 60. for the average U.S. citizen. it is over 70. Witnesses before the joint hearings held by the Senate Subcommittees on Health and Migratory Labor last year all concurred without exception. that there continues to be a need for a distinct. identifiable program to meet the special health needs of the migrant farmworker and his family. Although there are almost 900 counties in 46 States which have substantial numbers of migrant and seasonal farmworkers. at the current time. the Department of Health. Education. and Welfare finances projects in only 130 counties. Perhaps no single group in oun Nation continues to be as exploited and unserved as the agricultural migrant worker who harvests the food we consume daily. The three major amendments proposed within the bill are a small effort to improve the health care of these citizens. They were included for the following reasons: First. the bill for the first time specifically authorizes sums for hospitalization. Although the act has authorized the cost of hospitalization since 1965. the program has been unable to stretch the appropriations to cover this vital service. The witnesses have all testified that despite medicare and medicaid. less than 7 percent of the migrant and seasonal farmworkers and their families receive hospital benefits. Second. we have included a provision to permit projects which so request. to use funds for the payment of premiums for health services. where adequate outreach and followup services are provided. This provision looks ahead to the day when it might be possible to enroll more and more migrant and seasonal farmworkers in an improved health care delivery system which serves the entire rural population. Third. the act also provides for the Secretary to give priority to funding over those projects whose policymaking body is composed of 51 percent or more from the population being served. There are two basic elements which justify this bill: First. the overwhelming demonstration by consumerbased projects that they in fact are more effective in providing a higher quality and more responsive health care service system. and second. the commitment Congress and all Americans have for local community control over those services which are designed to serve the people.