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Excerpt from Impact of Certain Tax-Related Aspects of the Administration's Health Care Reform Proposal on Residents of Inner-City and Other Distressed Neighborhoods: Hearing of the Subcommittee on Select Revenue Measures of the Committee on Ways and Means House of Representatives; One Hundred Third Congress, First Session; November 9, 1993 The Honorable Charles B. Rangel (D., N.Y.), Chairman, Subcommittee on Select Revenue Measures, Committee on Ways and Means, U.S. House of Representatives, today announced a public hearing on the impact of certain tax-related aspects of the Administration's health care reform proposals on the health and well-being of residents of inner-city and other distressed neighborhoods. The hearing will be held on Tuesday, November 9, 1993, beginning at 10:00 a.m., in the Committee's main hearing room, 1100 Longworth House Office Building. In announcing this hearing, Chairman Rangel stated: "Now that the Administration has released the outlines of its health care reform proposal, it is appropriate for the Subcommittee to return to its examination of the impact of health care reform, and specifically, certain tax-related aspects of the Administration's proposal, on the health and well-being of residents of inner-city and other distressed neighborhoods. " The Subcommittee will take testimony from invited and public witnesses. Background The Subcommittee held its first day of hearings on tax issues affecting the health and well-being of residents of inner-city and other distressed neighborhoods on June 29, 1993. At that time, the Subcommittee heard testimony from invited and public witnesses, many of whom had extensive experience in delivering health care to the residents of these communities. They testified to the intricate interrelationship of the problems of economic development, education, health, substance abuse, and violence in the inner city and other distressed neighborhoods. This testimony provided the Subcommittee with a framework by which to evaluate the effectiveness of any proposal for health care reform in improving the health and well-being of the residents of inner-city and other distressed neighborhoods. On September 22, 1993, President Clinton addressed a Joint Session of Congress to provide the outlines of the Administration's proposal for health care reform. The proposal includes some specific provisions intended to address the unique problems faced by residents of inner-city and other distressed neighborhoods, for instance, tax incentives for providers who agree to work in underserved areas. In addition, the reform proposal raises questions about the future role of tax-exempt hospitals in distressed neighborhoods because the proposal envisions the elimination of most uncompensated care. Under current law, a hospital's tax-exempt status depends in part on its willingness to provide care to those with limited ability to pay, including Medicaid and Medicare patients, as well as to provide other community benefits. Therefore, it may be appropriate to develop new standards for tax exemption in the case of hospitals and other health care providers who deliver care in the new system. The Subcommittee invites public testimony on these specific issues. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com
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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.