[Congressional Record Volume 140, Number 90 (Wednesday, July 13, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 13, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
February 11, 1994, and June 10, 1994, the gentleman from Pennsylvania 
[Mr. Goodling] is recognized for 60 minutes as the designee of the 
minority leader.
  Mr. GOODLING. Mr. Speaker, on June 23 the Committee on Education and 
Labor reported the amended version of the Health Security Act, the 
legislation originally sent to the Congress by President Clinton last 
November.
  This was one of the most disappointing days of my career in the 
Congress of the United States, because I had hoped when we began the 
process 7 weeks earlier that we would take some of the issues that 
everyone agrees need to be dealt with and build from that point.
  The majority was very cordial. They allowed us in subcommittee and 
full committee to speak as long as we wanted to speak, to offer any 
amendment we wanted to offer, but they had also decided before we began 
the markups both in subcommittee and full committee that they were 
going to start with the highest-priced Cadillac what was available, and 
then they were going to embellish that with some parts from Rolls 
Royce, Mercedes Benz, Ferrari, and Porsche. Unfortunately, that is what 
happened in the committee, and those of us on the Republican side of 
the committee made clear our intentions to respond to the problems with 
the current system of health insurance and health care delivery which 
were evidenced by the many who testified during the nearly 30 days of 
hearings held by the committee and the subcommittee.
  Our preference was to take a problem-solving approach and build a 
bipartisan consensus on what needs to be accomplished without 
disrupting the positive qualities of the current system or inducing a 
decline in the quality of medical care Americans expect to receive.
  As I indicated, unfortunately the committee rejected this bipartisan 
approach.
  What we plan to do this evening, as members, minority members, of the 
Committee on Education and Labor is point out to the American public 
that we had alternatives to offer, and we offered them, and also to 
point out to the American public what we believe is totally wrong with 
the piece of legislation that came from our committee.

  Mr. Speaker, at this point I would yield to the gentlewoman from New 
Jersey [Mrs. Roukema], who is the ranking member on the subcommittee 
where this all began.
  Mrs. ROUKEMA. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, I certainly want to extend my appreciation to the 
gentleman from Pennsylvania, our ranking Republican Member, for giving 
us this opportunity to discuss the actions in our Committee on 
Education and Labor.
  I think this is particularly a propitious time for us to do this, 
because obviously health care reform remains, and has obviously become 
to be understood as the most complex and interrelated subject to come 
before the Congress in modern history. In fact, the American people are 
learning what we learned when we worked on the committee, namely, that 
the more you work on health care reform, the more you realize you do 
not know.
  I think we would all do well to heed these facts as we consider 
health care reform both in the context of what we did in the committee 
and as we look ahead now that the future of health care reform seems so 
clouded and so perplexing.

                              {time}  2020

  I think specifically we must agree and understand that no one is not 
for health care reform. We all want that. The question is how do we 
extend coverage for the uninsured Americans while still protecting the 
highest quality of health care coverage enjoyed by more than 80 percent 
of the American people and at a cost that can be borne by society?
  I think it is important now to understand, and many of us having been 
home with our constituents over the recess, have learned that the 
American public is now pulling back. Yes, there are certain things that 
they want and that they understand, that they need, but the national 
polls show as much as anything that there is confusion among the public 
and a certain cynicism among the public and lots of unanswered 
questions. Certainly, that is what we have learned in our long trek in 
fashioning an alternative to the Clinton ``Chubby,'' as it was dubbed 
in the Committee on Education and Labor committee proposal. But I want 
to say here that we know, as the American people now know, that there 
is no magic pill to cure everything that ails our system and that 
health care reform is not simply a matter of going after the so-called 
rich doctors and greedy hospitals and the waste, fraud, and abuse. If 
it were that, if it would get at the people who were gaming the system 
and all, we would be able to fix it almost overnight. But we have a new 
understanding of all the things that we need, but above all we know 
through the work that we have done and through the work with our 
constituents that paying more for less health care is not what the 
American people had in mind when they called for health care reform.
  Unfortunately, I believe that is the program, that will be the 
consequence of what the Democrats on the Committee on Education and 
Labor have put forth.
  I think we kept as our standard the first principle of health care, 
which is to do no harm. That should certainly be our principle. And it 
was our guiding principle both on the subcommittee and on the full 
committee as we presented our alternative.
  I would like to give a little attention to how we developed this 
alternative. Many of us had worked with our Republican leader, Bob 
Michel, and the health care task force. So we took the very fine work 
of that committee and we dubbed it, we added to and we dubbed it 
``Michel-plus'' in subcommittee. Then it became ``Michel-plus-plus'' in 
full committee.

  I think the important thing is not what we call it but we have to 
explain exactly how it works, following our principle of do no harm 
while still not harming in any way the very fine coverage that 80 
percent, as I have said, of the American people already enjoy.
  I think we have to go back to the way this whole health care debate 
first started. I have got to give credit to the President because he 
put it very succinctly in one of his speeches. But I am afraid he lost 
sight of what he originally talked about, namely, that the fear that 
the American people have is that their health care insurance might be 
canceled. So he had put out as a goal health care insurance that can 
never be taken away. And indeed I do not know about you, but I have 
found in discussing with all of my constituents that it is the sick 
joke of the health insurance industry that you can only get health 
insurance as long as everyone in your family is completely healthy. If 
someone gets ill, you are in danger of having that health insurance 
taken away.
  So taking that first principle that the President correctly laid out 
at the beginning, we built on that principle in this Republican 
alternative. And we said, ``All right, now, what are the problems that 
most shift from anxiety to near panic in the minds of the American 
people?'' Very simply put, that became known as comprehensive health 
insurance reform, and it formed the basis of the Michel-plus-plus 
alternative that we put forward.
  Just to summarize, and I know the rest of our colleagues on the 
committee are going to focus on some of the more specific areas, but 
just to summarize, I want to say that this proposal of the Republicans 
on the committee was fashioned on comprehensive insurance reform 
principles. It would continue access to coverage, eliminate the job 
lock. It certainly goes a long way to eliminate the job lock; namely, 
giving you portability if you happen to lose a job or must or want for 
some reason to change your job. So that you have that portability that 
goes with you.
  It restricts the loss of coverage due to preexisting conditions. And 
here I want to make it very clear for all our colleagues that Michel 
bill had gone a far distance but we improved upon it and closed any 
continuing loopholes on the preexisting question. So that is made whole 
there. It ends the cancellation of coverage due to illness.

  So it would give the American people that surety of knowing that when 
a person gets sick or when a job opportunity comes along, they would 
have continuous coverage.
  I think an important thing that we also did was that we used a 
modified community rating system. We understood that you have got to 
get a lot of people into the pool in order to make insurance reform 
work. But we did not go to the extremes of total community rating. We 
used the very well accepted actuarial standards of a modified rating.
  It also permits us to develop affordable coverage for small 
businesses in group reform. It gives us the assurance of continued 
ERISA requirements for self-insured plans, and I think that is 
essential for continuing to be an incentive for the good health care 
coverage that Americans currently enjoy.
  I am going to conclude now. I could go on to some of the more 
detailed issues here, but I think I summarize the feeling on our 
committee by saying that I think we should form this as the basis for a 
bipartisan effort to pass legislation this year. It will be admittedly 
incremental reform, but I think that is what the American people want. 
It would satisfy their genuine needs, and it will be a giant step in 
terms of bringing into the insurance pools both small businesses, the 
self-insured plans, the self-employed, who would get 100 percent 
deduction for their costs, and we could all go home, face the voters in 
the fall by showing that we have made progressive reforms, that we have 
dealt with the genuine needs, the obvious needs of the American people 
for continuous insurance, have done no harm to their existing insurance 
program, and we have broken the gridlock and set a foundation for all 
future actions as we reach towards universal coverage.
  Mr. GOODLING. I thank the gentlewoman for walking us through our 
actions in subcommittee, where we tried our best to bring about a 
bipartisan effort that all Americans could support.
  I would like to speak just very briefly about rhetoric versus what 
the committee bill actually does.
  As you have heard a lot of rhetoric about what was done in our full 
committee markup, rhetoric that says Americans should have private 
health insurance. The fact is that the bill tips the balance to 
a government-run system by means of the so-called single-payer option.

  The rhetoric says the bill builds on the current employer-based 
system; the fact is that for the vast majority of working Americans, 
the bill would eliminate their current individually purchased or 
employer-based health insurance plans and instead would require most to 
obtain coverage through government-based entities.
  The rhetoric says security and savings, but what reliance can the 
American people place on legislation that is at least $120 billion 
unfunded at the very start of the program?
  The rhetoric says choice; but what choice will consumers have when 
the Government stipulates one set of benefits each family must purchase 
regardless of whether it contains less than is wanted or costs more 
than at present?
  The rhetoric says let the public choose the same health insurance 
that Members of Congress have. But the bill denies this option. The 
gentlewoman from New Jersey gave them that choice: Just take the 
Federal program. There you have 400-plus choices and you have many, 
many different options in relationship to cost. The rhetoric says 
quality, but the global budgets negotiated fee schedules and other 
Government controls in the bill would place the world's best medical 
technology and health care at risk of stagnation, of decline or of 
being rationed. The rhetoric says simplicity, but in nearly 2,000 pages 
of fine print, the bill is as top-heavy with complexity as the 
President's plan and mandates regulation under nearly 5 dozen new 
Federal, State, and other Government offices.

                              {time}  2030

  We offered, as the gentlewoman said--I offered in full committee what 
I called the Michael enhanced, and it was our attempt to move the 
process toward the goal of a bipartisan effort. Unfortunately, as I 
indicated earlier, the decision had already been made by the majority 
that we would have, as our beginning, the very best we could find and 
then add to that, not worrying about the fact that we may have moved 
from a $74 billion deficit to a $102 billion deficit to a $120 billion 
deficit, and all of these will be much, much higher than the projected 
deficit.
  At this time I would like to yield to the gentleman from Illinois 
[Mr. Fawell] who worked long and hard in trying to deal with some 
remedies to the proposal by the majority to offer some suggestions that 
the minority wanted to put forth.
  Mr. FAWELL. Mr. Speaker, Winston Churchill said: ``You can always 
trust the Americans to do the right thing * * * after they've exhausted 
every bloody alternative.''
  Probably, only one committee in all of Congress could take a very 
expensive, underfinanced, big government health plan, and make it more 
expensive, more underfinanced, and bigger government. What we have in 
the Ford bill is the grotesque monument to the law of unintended 
consequences. While some alternatives to the Clinton plan are called 
``Clinton Lite'' because they are leaner, we call the Ford bill 
``Clinton Slovenly Fat'' because it is so much bigger, more intrusive, 
and more expensive.
  The problem areas I will focus on tonight are: First, the Ford bill 
includes remedies which award malpractice-like damages in cases of 
denials of health benefits which will add immeasurably to the cost of 
health care. Second, the Ford bill mandates that all individuals give 
up their present health care coverage and be directed to buy only the 
Federal Government's one-size-fits-all health plan, composed of an HMO, 
PPO, and FFS plan.
  As to the remedies issue: The Ford bill, amazingly includes 
provisions which award malpractice-like damages, that is, compensatory 
and/or punitive damages upon proof that a regional alliance or 
corporate alliance health plan was guilty of a wrongful denial of 
health benefits. By malpractice-like damages, I refer to compensatory 
damages, that is, those customarily awarded in negligence cases, 
including mental distress, pain and suffering, and so forth. By 
punitive damages, I mean damages also awarded in negligence cases over 
and above compensatory damages. These types of damages are what makes 
medical malpractice insurance so expensive to health care providers--
primarily doctors!
  Compensatory and punitive damages are customarily confined to tort--
negligence--cases, such as medical malpractice--negligence--cases. 
Conversely, such damages are usually not awarded in contract cases, 
that is, cases construing the provisions of a contract, such as, for 
instance, a health insurance policy. For example, no such damages have 
ever been awarded under employer-sponsored health plans operating under 
Federal law. Nor have such damages ever been a part of remedies 
available to the 9 million Federal employees under the Federal 
Employees Health Benefit Act.
  Therefore, it is surprising to see compensatory and punitive damages 
included as remedies in any breach of contract case involving the 
administration's health care package, including every alleged wrongful 
denial of a health plan benefit. We all know the results of medical 
malpractice damage awards against health care providers. To now provide 
another dose of malpractice-like damages whenever there is an 
allegation that benefits under a regional alliance or corporate 
alliance health plan were wrongfully denied, is no way to control 
health care costs!
  Such provisions will undoubtedly encourage litigation. Every health 
claim disagreement would have the potential of a huge jury award of the 
type which have plagued medical malpractice and product liability. The 
expense will be passed on up the chain, driving up health costs! In 
addition, fears of huge damage awards will result in the awarding of 
benefits not actually covered under the health care plan.
  Under the Ford bill, remedies for malpractice-like compensatory 
damages are allowed in administrative actions and compensatory and/or 
punitive damages are allowed in court cases against both corporate 
alliances and health plans operating under regional alliances. There is 
one notable exception: Preferential treatment is afforded to 
multiemployer-union plans which are exempted from any court imposed 
malpractice-like compensatory and/or punitive damages!
  Why the lack of uniformity of remedies? I think the answer is because 
of the strong inference of a bias toward union health plans in the 
construction trade. In committee, I offered an amendment to eliminate 
malpractice-like damages against all health plans.
  So far, it has been refused by the majority along party lines. I hope 
that changes. We don't need Malpractice II in health care. One is 
enough.
  Finally, the Ford bill mandates that people give up their existing 
health care insurance coverage in return for a one-way-for-all 
federally mandated comprehensive health care plan which includes about 
everything except Chinese acupuncture.
  If however, the mandated plan is as good as its sponsors calm, then 
it should be able to compete successfully in the marketplace. If it is 
that good, we should not have to mandate that anyone enroll in it. If 
it is that good, it need not be a competition killer in the market of 
health insurance coverage
  And it is a killer of all existing health care plans with the 
exception of medicare, postal union employee health plans, and 
veterans' health care. It kills off all employer-sponsored health care 
plans, in spite of the fact that 50 percent of employers now, under the 
Federal law known as ERISA, voluntarily provide health coverage for 70 
percent of all employees. And these employer health plans of course 
compete against each other and supply new and innovative health care 
plans.
  Most Americans don't know that the Clinton and Ford plans will force 
them to turn in their present health coverage and stand in line with 
millions of others to accept whatever the Federal Government dictates, 
along with global budgets, premium price controls, mandated fee-for-
service schedules, ad infinitum.
  There is a basic right of people--especially the middle class--to be 
able to choose the type of health care coverage they and their families 
need. Some may not want to be covered, for instance, for substance 
abuse, or stress management, or detoxification or abortion--the list 
goes on and on. No matter what big government knows best--the citizen 
must accept and pay for the coverage congress deems best.
  This is not to say that health care in America does not need repair--
that is targeted reform.
  Indeed, there is a consensus in Congress for one or more of the 
following targeted reforms, to-wit:
  First, funding medicaid up to or beyond the Federal poverty level.
  Second, proscribing insurance companies from refusing health 
insurance coverage, or renewal, because of preexisting health 
conditions.
  Third, voluntary regional or national health plans, protected by 
Federal law, competing nationally or, some day, internationally.
  Fourth, high health risk pools, between insurers, so that affordable 
access can be assured for high health risks.
  Fifth, market incentives, that is, employer tax deductions tied to a 
minimum standard health care plan; the use of reasonable coinsurance 
and deductibles; employee 401K-type medical savings plans with employer 
catastrophic coverage; individual out-of-pocket health care deductions; 
100-percent tax deductions for the self-employed; standard judicial 
contract remedies rather than malpractice-like negligence remedies for 
breaches of insurance contracts; systemic changes such as malpractice 
and antitrust reform, extension of rural health care, computerized 
administration of health services, and so forth.
  Concensus in these areas can be reached to help achieve affordable 
and portable access to health care without dismembering our entire 
health care structure in America. Remember, just because the present 
system is flawed does not mean Congress can't make it worse:

                              {time}  2040

  Again, I thank the gentleman for having this special order and 
allowing me to take a part in it.
  Mr. GOODLING. Mr. Speaker, I thank the gentleman for bringing to the 
attention of the American public what they might get if a plan such as 
that, that has come from our committee, would ever become the law of 
the land.
  I would like to yield at this time to the gentlewoman from New York 
[Ms. Molinari].
  Ms. MOLINARI. Mr. Speaker, First, I want to take this opportunity to 
thank our ranking member, Congressman Goodling, for his leadership 
during the Committee on Education and Labor's consideration of the 
Health Care Security Act.
  President Clinton has clearly stated the important goals of health 
care reform in his plan which in concept we all share: Universal 
coverage for all, simplicity, and above all, security. However what the 
President's health care reform plan would do, is allow for the 
Government takeover of our Nation's health care system.
  Despite the rhetoric we have heard on competition and consumer 
choice, the Clinton plan provides for massive Government intervention 
in the entire $900 billion a year health care industry, which 
constitutes one-seventh of the country's entire economy.
  In my home State of New York, implementation of the Clinton health 
care plan would be devastating to a state and a city that is slowly 
trying to fight its way back to economic recovery.
  Nearly 280,000 people in New York City work in health care, according 
to the Bureau of Labor Statistics--in hospitals, doctors' and dentists' 
offices, clinics, nursing homes, home-health-care services, 
laboratories and dialysis centers. Health care employment now accounts 
for about 9 percent of the city work force.
  However, if the Clinton plan is implemented, it has been estimated 
that 71,099 New York workers would lose their jobs, and another 1.8 
million would face reduced wages, hours or benefits. And, New York 
workers would suffer a loss of wages and benefits of $8.15 billion. 
These are numbers that cannot be ignored.
  Another fact that cannot be ignored is that New York has made a 
remarkable commitment to medical education. New York State's 13 medical 
schools graduate 1,900 new doctors each year, and its graduate medical 
education programs have more than 15,000 residents in training--60 
percent more than the next largest State, almost 20 percent of all 
physicians trained in the Nation.
  Currently, the Medicare Program reimburses hospitals for direct 
medical education costs on the basis of 1984 hospital-specific costs 
inflated by the Consumer Price Index. Direct medical education reform 
proposals in the Clinton plan would abandon the hospital-specific 
historical approach and instead use a price based upon a national 
average of costs across all teaching hospitals.
  Teaching hospitals in the New York metropolitan area have above-
average direct medical education costs, in part due to the abundance of 
services provided to indigent communities. If a national average direct 
medical education pricing policy were enacted for all payers, New York 
City teaching hospitals could lose between $200 million and $550 
million annually.
  New York's medical education programs are a national resource and 
must be viewed in that regard. Most of the current health care reform 
plans will force New York's medical centers--some of them established 
before the birth of the Nation--onto the endangered list. Some might 
ask if these hospitals deserve special consideration in the pending 
health care bill--consider this brief, and only partial--record of 
accomplishment:
  In 1943, Dr. George Papanicolaou developed the Pap test for early 
cancer detection at New York Hospital.
  In 1961 New York University's Dr. Albert Sabin began the work that 
lead to the live-virus oral polio vaccine.
  In 1971, Dr. Saul Krugman of Bellevue Hospital developed the first 
vaccine for hepatitis B.
  In 1993, Columbia-Presbyterian's Nancy S. Wexler, Ph.D., won a Lasker 
Award for her role in identifying the Huntington's disease gene.
  As one doctor put it, ``if you think excellent biomedical education 
and research are expensive--try ignorance and disease.''
  Clearly that is the road the Clinton health care plan takes us down.
  Under the Education and Labor Committee bill, New York hospitals 
would lose 25 percent of their residents--about 3,800 of the current 
16,000. As a result, hospital costs would soar, for hospitals will lose 
25 percent of the payments they now get to train residents.
  No one in the Clinton administration has thought through how to deal 
with that reduction.
  Residents treat patients and they teach medical students and junior 
residents--they are the backbone of the health care system--they are 
the ones that are there 24 hours a day, 7 days a week. When residents 
are eliminated, somebody will have to care for patients--but the 
hospitals will have to hire two, possibly three replacements, for every 
resident lost. No one else has thought about how to pay for those 
additional doctors.
  Foremost, reform of the Medicaid program should be central to true 
health care reform and it must include a change in the Medicaid 
matching formula to correct the inequities and insure that States like 
New York will get their fair share. Right now, New York receives only a 
50 percent Federal match of funds, while States like Arkansas receive 
above 70 percent--even though they provide less comprehensive Medicaid 
coverage.
  For more than a quarter of a century, New York has contributed more 
than its fair share to the Federal Government. But while Washington has 
taxed New York's wealth, it has not adequately assisted New York's sick 
and indigent.
  While President Clinton's intentions are admirable, his health care 
plans does not answer our health care problems. He exacerbates it. 
Implementing an untested and unproven Government-run health care plan 
would be a mistake.
  The United States has the finest quality health care in the world. We 
have 86 percent of Americans covered by health insurance, and three-
quarters of Americans are satisfied with that coverage.
  Every day due to the medical education that we can still afford in 
many cities and rural areas in our country, we come closer and closer 
to finding cures to incurable diseases that remain today.
  Yes, we have to make changes, Mr. Speaker, but clearly the 
President's plan is not the answer.
  I thank the gentleman for giving me some time to talk albeit it a 
little parochially about the effects of the President's plan and the 
plan passed out of the Committee on Education and Labor and its effects 
on one of the largest States in the Union.
  Mr. GOODLING. I thank the gentlewoman for the statistical information 
she gave us and the devastation that could come to medical education if 
we were to actually pass the plan that came from our committee.
  At this time I yield to the gentleman from California [Mr. 
Cunningham].
  Mr. CUNNINGHAM. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, on the minority side, we did not support the plan out of 
the Committee on Education and Labor. There were such things as quack 
medications that were included, Hawaii had waivers to take itself out 
of the health care plan and was granted that waiver.
  One committee member, the gentlewoman from California [Ms. Woolsey], 
offered a $3.5 billion increase, and when the gentleman from Wisconsin 
[Mr. Gunderson] asked her a question about it, the chairman said, ``You 
know how you're going to vote. There's no need for debate.''
  No need for debate on a $3.5 billion add in a health care plan?

                              {time}  2050

  There was no dealing with the illegal immigration costs on health 
care across the Nation. Clinton's plan contributed $120 billion toward 
the deficit. And we also tried to have Congress Members have the same 
plan that we were going to insist that our constituents had. All of 
these were on partisan line votes, and beaten.
  It has been repeatedly stated that choice and flexibility are the key 
to the success of any health care plans of over the 18 that are out 
there today. I offered a medical saving type option that again was 
defeated on a party-line vote.
  Let me give you an idea of what we were talking about in Medisave, 
because, Mr. Speaker, it is very, very important to understand it.
  The Wall Street Journal said the idea of the medical savings account 
is the most bipartisan proposal in Congress. It is also included in 
Senator Dole's health care reform. It is included in the Republican and 
Democrat version of the House Ways and Means legislation. But in our 
committee, it could not be passed.
  But under the Medisave plan, a worker and his employer might now be 
paying $4,500 for a year for a family policy. They could buy a high 
$3,000 deductible policy for about $2,000. That leaves you $2,500 that 
you still have. That $2,500 in a medical savings account, called an 
MSA, is the property of the worker. He gets to retain it. He gets to 
apply it to either the premiums or additional health care costs that 
that individual would incur. If the family has medical expenses during 
the year, that $2,500 is used by the person, the employee. If there is 
catastrophic care, it is handled by the insurance. But it is a dual 
plan with the insurance company, to where the employee has control of 
his life and dollars going toward medical care.

  The key advantage of a medical savings account is that it puts the 
consumer in control. That is a rare moment in this body, that usually 
tries to put the Government in control of every issue of anyone's life.
  Since the account belongs to the consumer, it gives them an 
incentive. And if you were going to ask in one word, in one word, the 
difference between Bill Clinton and Duke Cunningham, it would be the 
word incentive. Give someone an incentive to save, give someone an 
incentive, such as an IRA to save, that is tax deductible, and they are 
going to do it. You take that away, and it takes away that incentive.
  The consumer, not the Government, decides where to spend the money. 
There is incentive to manage this money carefully, the flexibility to 
save and seek preventive care and make your own decisions. It may not 
be the answer for everyone, but it sure would be the answer for the 
majority of people.
  The MSA, the medical savings account, is also portable. If you go 
from one job to the other, your insurance policy and the medical 
savings account is transportable. It is portable, which most people 
wanted. Also it covers with preexisting conditions.
  Currently providers who receive revenue based-only services provided 
get financially rewarded by ordering the most expensive tests. If you 
are dealing with your own accounts and your own dollars, then you will 
be more careful in how and how wisely you spend that money, thus saving 
the health care expenses and costs.
  Medical MSA's empower the consumer by restoring the patient-physician 
relationship. Health care must have the MSA.
  California has led the Nation in the introduction of managed health 
care delivery, because the California population is growing twice as 
fast as the Nation's. Twenty-one percent of California's population is 
currently uninsured. But we also offered an amendment that would take 
care of the illegal immigrant problem that is costing the State of 
California much money. We would have hospitals not reimbursed by 
constituents, but the hospitals would be reimbursed by the Government. 
They turned that down. A mandate by OPA '86, and they turned it down. 
The Government mandates it, they should have to pay for it. Even that 
was defeated in this committee.
  Mr. Speaker, I thank the gentleman from Pennsylvania [Mr. Goodling], 
for taking this special order and letting the Members know how it 
affects every American.
  Mr. GOODLING. I thank the gentleman for his contribution.
  Mr. Speaker, I yield to the gentleman from Michigan [Mr. Hoekstra].
  Mr. HOEKSTRA. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, what I would like to share with my colleagues are some 
of the observations that I have made sitting through 7 weeks of 
hearings, 7 weeks of markup. Some of the interesting things, when we 
take a complex problem like health care, and where I thought we would 
be focusing on how best to deliver health care to the American people, 
and we did spend a lot of time in talking about that, but then what 
happens, as we move it in the political process and start to politicize 
health care, we move away from talking about a solution to what works 
politically or what may work for a Member in a specific district, or, 
heaven forbid, what do we need to do to get somebody to vote for a 
plan.
  I have a couple of examples that I think the Members would again be 
very interested in. Before I talk about what we did in the Committee on 
Education and Labor, I would like to talk about what happened at the 
tail-end of the other committee that passed out the Clinton bill, which 
is the Committee on Ways and Means.
  It talks about a little story. This is out of the Chicago Tribune. 
They described this as what happens to get people to support a bill or 
how we take care of the powerful people in health care.
  Now, remember what this means. It means as we talk about health care 
in the future, whether you get good health care or get a new hospital, 
or whether you get doctors or you get so many medical students in your 
hospitals, teaching universities in the future, may depend not on the 
need or the requirement, but may depend on which party your 
Representative is in.
  This is an example on the Committee on Ways and Means. They tacked in 
an amendment which benefits teaching hospitals. It does not benefit all 
teaching hospitals in the country. It happens to benefit three teaching 
hospitals.
  On June 29, an amendment was prepared with the help of Members of 
Congress from Chicago and New York, approved with little public 
discussion. It is going to benefit three teaching hospitals, one in 
Chicago, of the former chairman of that committee, Congressman 
Rostenkowski. It is going to benefit another senior Member's district 
in New York, Charlie Rangel, and it is going to benefit a teaching 
hospital in Los Angeles.
  Three teaching hospitals, not specifically mentioned in the bill, but 
the requirements are written so stringently that only three teaching 
hospitals of all the teaching hospitals in the country will reap 
millions of dollars of reward because their Congress people were on the 
right committee at the right place at the right time.
  Now, let us go and talk about what we did in the Education and Labor 
Committee, which just astounded me. We have what we call a National 
Health Care Security Act.
  Well, what we did in our committee is made sure it is no longer a 
national program, it is now a continental U.S. Health Security Act, 
because we included language that allows the National Health Care 
Board, now the semi-National Health Care Board, to exempt Hawaii from a 
national or semi-national system.
  So Hawaii can now be exempted. So we went through the process and 
said well, there is a set of criteria that says if Hawaii meets these 
criteria, Hawaii can be exempted. So the rationale would be well, if 
Michigan meets those criteria, we should maybe change the language that 
says if any state meets these specific criteria, they also can be 
exempted.
  That was a stroke of logic which I find does not work here in 
Washington. We proposed an amendment like that, and it was defeated.
  Then we said, what about the process? States have been experimenting 
on health care in all 50 States about delivering good health care. 
There are other States that have developed systems that work as 
effectively as what Hawaii does. But they have done it in their own 
way. The States have taken action. State legislatures, local countries, 
local units of government, have taken actions to solve the health care 
problems in their area.

                              {time}  2100

  So we came up with another proposal that said, perhaps if Hawaii can 
exempt itself what we ought to do, and this is the amendment that we 
proposed, and it says very simply, no State shall be considered to be a 
participating State for the purposes of this act unless a majority of 
voters in the State by a statewide referendum approve the State 
becoming a participating State. That is the legalese language. That is 
how they make us write stuff here in Washington. What it basically says 
is, if the people of Michigan want to give up the system that they have 
developed, they can do so, not by what we do here in Washington by 
mandating on the State ``you will be a part of this program.'' But it 
says the voters in the State will be the ones that determine, through a 
referendum, we are going to vote, we are going to give up our system. 
We are going to participate in the national system through a statewide 
referendum. We are moving decisionmaking exactly where it should be.
  We are moving it out of Washington. We are giving the people in the 
country the opportunity in each State to pick which program they want 
to participate in.
  The disappointing thing is, those same people that voted to exempt 
Hawaii defeated this amendment and said, sorry for the rest of you, 
what we have decided here in Washington is what you are going to get.
  Mr. GOODLING. Mr. Speaker, I thank the gentleman from Michigan.
  I yield to the gentleman from California [Mr. McKeon].
  Mr. McKEON. Mr. Speaker, I want to thank the gentleman for the 
leadership that he has provided in setting up this special order 
tonight and for the leadership he has provided in taking us to this 
point.
  I think that there are two things that I would like to talk about 
that scare me about the Government-run bureaucracy running something as 
important as our health care system. As you know, the earthquake that 
devastated our area last year, the epicenter was in my district. And I 
have an actual example that I have seen in my district of national 
health care.
  The veterans hospital was damaged and a decision was made here in 
Washington to take the hospital down, to move the patients from that 
facility down to another facility in West Los Angeles. The reason given 
was that that hospital in West Los Angeles was underutilized and it was 
best for the Government to move those nations to that facility where we 
could get better utilization and the patients that were using the 
hospital, the veterans and their families would just have to put up 
with the inconvenience. It was just another 15 miles, which equates to 
about an hour driving down there and causes great difficulty.
  I have a letter from one of my constituents. I would like to read 
just a couple of excerpts from this letter, indicating the problem that 
one of these families has under Federal bureaucratic health care:

       Dear Mr. McKeon: In May of 1994, we wrote to you about 
     John's father who is a World War II veteran who is an amputee 
     and a former POW. At that time we requested answers as to why 
     the Sepulveda VA was not going to be rebuilt. We thought that 
     you should hear the rest of the ordeal this man and his 
     family was put through thanks to the Wadsworth VA.
       When dad checked into Wadsworth on Friday, June 10, 1994, 
     no one knew he was coming. It was 3:30 p.m. before he was 
     given a room and he missed lunch, which isn't a good idea for 
     a diabetic, but he was busy waiting, taking tests and 
     following orders. He rode home that afternoon on a bus 
     with three other people and the driver.

  Skipping, I will just highlight this:

       Dad had a total knee replacement on June 13, 1994. He was 
     taken from his room at 6:30 a.m. No one knew where his family 
     was supposed to wait and no one advised us of his status 
     until after we started knocking on doors to see if he was 
     back from surgery. This was after 1 p.m. His wife of 52-plus 
     years and family were worried for several hours due to not 
     being advised of the delay in surgery.
       He awoke after surgery to find that his left arm cannot be 
     raised and two fingers are numb. No one seems to have an 
     answer for how that condition occurred or what to do 
     regarding it.
       The doctor was supposed to order his Indocin on the 
     Thursday after surgery because he developed gout and he never 
     received it until Friday evening.
       One-and-a-half days before he was supposed to go home he 
     was moved from floor 5 to floor 2.

  They go on and tell other problems that he had. He was put in a room 
with a bathroom and told that they do not use bedpans on that floor. 
You take a man with one leg and get him to try to reach a bathroom.

       Needless to say this was not a pleasant stay. It was a 
     lonely stay also, since his wife could not make the long 
     drive by herself and the rest of the family has to work. 
     Therefore it was weekends and 1 day in the middle of the week 
     because of the horrendous traffic on the freeway. Had he been 
     at Sepulveda his wife and family could have visited him every 
     day and his spirits would have been much better. After 20 
     days he was really depressed. They wanted him to stay another 
     week but he pled a good case to go home.

  This is one example of a health care run by a Federal bureaucratic 
system where a decision is made in Washington without regard to the 
patients somewhere across the country.
  One other thing that scares me to death is the effect that this will 
have on business. Small businesses account for a major part of the 
American economy. We know that several reports show that there will be 
a drastic job loss. In California alone, the employer mandate, which is 
a payroll tax, which is a tax by any name, they might call it a 
premium, but we know, and the American people are smart enough to know 
that it is a tax. This mandate shows that there will be huge job 
losses. In California alone, a report was released just last month by 
the State of California Governor's Office of Planning and Research 
which showed the effect of the Clinton plan on California and the 
Nation.
  In California alone, the study concludes that job loss would range 
between 476,000 and 650,000 jobs. These losses would exceed all of the 
California jobs lost from the defense cuts and would postpone the 
California economic recovery by up to 2 years.
  We have been in a depression out there now for going on 3 years. To 
add another 2 years onto this, based on this kind of a health care 
system, I think is a travesty and should not be imposed upon the 
American people. They have shown that they are strongly opposed to 
this. I think it is time that we just back up a little bit, bring some 
common sense to the debate and the discussion, bring the American 
people in on the discussion.
  We have a vote coming up in November. Let them participate.
  Mr. Speaker, I thank the gentleman for this opportunity.
  Mr. Speaker, I include for the Record the letter to which I referred.

                                        John & Jean Halvorson,

                                    North Hills, CA, July 2, 1994.
     Re rebuilding of Sepulveda VA Hospital.

     Mr. Howard ``Buck'' McKeon,
     Cannon House Office Building,
     Washington, DC.

       Dear Mr. McKeon: In May of 1994, we wrote to you about 
     John's father who is a WWII Vet who is an amputee and a 
     former POW. At that time we requested answers as to why the 
     Sepulveda V.A. was not going to be rebuilt. We thought that 
     you should hear the rest of the ordeal this man and his 
     family was put through thanks to the Wadsworth V.A.
       When Dad checked into Wadsworth on Friday, June 10, 1994 no 
     one knew he was coming. It was 3:30 pm before he was given a 
     room and he missed lunch, which isn't a good idea for a 
     diabetic, but he was busy waiting, taking tests and following 
     orders. He rode home that afternoon on a bus with 3 other 
     people and the driver.
       When we brought him back to his room on Sunday, June 12, 
     1994 we noticed his name was on the board in front of the 
     nurses station and the word ``SEPULVEDA'' in parentheses 
     after it. In fact the word ``SEPULVEDA'' was after every 
     patient's name from the Sepulveda V.A. None of the other 
     patients had ``Las Vegas'', ``Arizona'' or ``Bakersfield'' 
     after their names.
       Dad had a total knee replacement on June 13, 1994. He was 
     taken from his room at 6:30 am. No one knew where his family 
     was supposed to wait and no one advised us of his status 
     until we started knocking on doors to see if he was back from 
     surgery. This was after 1:00 pm. His wife of 52+ years and 
     family were worried for several hours due to not being 
     advised of the delay in surgery.
       He awoke after surgery to find that his left arm cannot be 
     raised and 2 fingers are numb. No one seems to have an answer 
     for how that condition occurred or what to do regarding it.
       The doctor was supposed to order his Indocin on the 
     Thursday after surgery because he developed gout and he never 
     received it until Friday evening.
       He was in Wadsworth 20 days and most of his meals were 
     cold, eggs runny, and food tasted like sawdust. We realize he 
     was on a diabetic diet, but we know from experience that food 
     doesn't have to taste like sawdust nor does it have to be 
     half cooked. He says that his weight hasn't been this low 
     since he was a POW.
       1\1/2\ days before he was supposed to go home he was moved 
     from Floor 5 to Floor 2. There, he was informed that they 
     didn't use bedpans on that floor. Try going to the bathroom 
     on one leg with a new knee replacement. When they moved him 
     to floor 2 they forgot to transfer his Indocin so he wasn't 
     given that medication for the duration of his stay. They did 
     however start to check his blood sugar 18\1/2\ days after he 
     entered the V.A.
       Needless to say this was not a pleasant stay. It was a 
     lonely stay also, since his wife could not make the long 
     drive by herself and the rest of the family has to work. 
     Therefore, it was weekends and 1 day in the middle of the 
     week because of the horrendous traffic on the freeway. Had he 
     been at Sepulveda his wife and family could have visited him 
     every day and his spirits would have been much better. After 
     20 days he was really depressed. They wanted him to stay 
     another week but he pled a good case to go home.
       1. Why are Sepulveda V.A. Vets labeled?
       2. Why can we afford to run several empty buses between the 
     Sepulveda V.A. and the Wadsworth V.A.?
       3. Why can we afford to fly patients in from other states 
     but not be able to give Sepulveda patients good care?
       4. Why is the Wadsworth V.A. so incompetently run? Or is it 
     that they really are treating the Sepulveda patient 
     differently?
       It really seems as though priorities have been misplaced 
     badly. We all owe the Vets much, much more than we can ever 
     repay. Seems that rebuilding the Sepulveda V.A. is a small 
     token of that repayment, but it would mean a lot to those 
     Veterans.
       Sorry, not for you. You did answer.
           Sincerely,
                                            John & Jean Halvorson.

  Mr. GOODLING. Mr. Chairman, I yield to the gentleman from Florida 
[Mr. Miller].
  Mr. MILLER of Florida. Mr. Speaker, when I first came to Congress 
over 18 months ago I came with high hopes about the prospects of 
achieving real, bipartisan health care reform. The new President and 
his wife expressed their intention to reach out and work with both 
sides of the aisle and I saw a real commitment on the part of my 
Republican colleagues to craft sensible solutions. Those hopes quickly 
evaporated when I saw Bill Clinton's big-Government plan coupled with 
stridently partisan rhetoric. According to Bill Clinton, anyone who 
didn't support his plan was against health care reform, against the 
middle class, against the poor, and against the elderly. In the 
meantime, House Republicans continued to develop workable solutions 
that resulted in the Goodling substitute.
  Unfortunately, the White House has decided to ignore Republicans, 
ignore moderate Democrats, and to ignore the American people and 
attempt to ram a massive tax-and-spend plan through. Senator Jay 
Rockefeller has vowed that ``we're going to push through health care 
reform regardless of the views of the American people.'' It won't work. 
The more the American people learn about the Clinton plan, the less 
they like it. The American people have made it clear that health care 
reform doesn't mean supporting a Government takeover of one-seventh of 
the economy. Today, I received a letter from Barbara Brand of Sarasota, 
FL, a constituent. She summarized exactly what I've been hearing for 
the past 10 months. It says, ``no to Government controlled health care; 
not to the give-a-way of our freedoms. Is this clear?'' Yes, Mrs. 
Brand, it is clear. The American people have made it clear and the only 
people who haven't gotten the message are the folks at 1600 
Pennsylvania Ave.
  I would now like to focus on a particularly troubling aspect of the 
bill produced by the majority on the Education and Labor Committee. The 
district I represent contains the largest number of senior citizens in 
the Nation and I think senior citizens are the big losers under this 
plan.
  The Health Security Act will reduce both the access and the quality 
of health care for our seniors. First, the legislation allows States to 
place Medicare patients into mandatory purchasing cooperatives. 
Medicare patients would then be forced to choose between the three 
plans offered by the Government. Millions of lower income seniors would 
be forced to choose the low-cost-sharing option. I offered an amendment 
to give Medicare patients the option of staying in Medicare, but the 
Democratic majority voted it down.

                              {time}  2110

  Why? According to a Democratic staff member, ``we are under pressure 
to get this health reform bill out of the way and we're just not 
willing to get into the whole Medicare thing right now.'' That's a 
direct quote. They didn't have time to protect the elderly.
  Next, I do not support financing universal coverage on the backs of 
the elderly. Based on what the Ways and Means Committee produced we all 
know that the financing for this legislation relies on $480 billion in 
Medicare cuts. As former HCFA Administrator Gail Wilensky has said, 
removing this much money would ``be a serious mistake unless the 
elderly understand that it will affect the level and availability of 
their health care.'' I haven't heard many statements from the White 
House asking seniors to accept a lower standard of care.
  But by far the most damaging aspect of the Clinton plan for seniors 
are the price controls and global budgets of title VI. Rapidly and 
inflexibility ratcheting back on health care spending will result in 
the rationing of health care in America--and the group most vulnerable 
to rationing schemes are the elderly. This legislation mandates zero-
real growth in health care spending by the year 1999. No country in the 
world, even those that explicitly ration care, have controlled health 
care spending to that extent.
  In short, the Ford mark asks the elderly to finance universal 
coverage. The Ford mark goes beyond the Clinton plan by offering even 
more benefits--without saying how to pay for them. That makes it even 
more likely that the draconian Medicare cuts of the original Clinton 
bill will be needed to finance the plan. The Ways and Means bill offers 
fewer benefits and contains $480 billion in Medicare cuts!
  Reduced choice, forced enrollment in new untested systems, lower 
quality of care, and reduced access to medical services are not what 
the seniors in my district have in mind when they talk about health 
care reform.
  In the next few weeks the White House and the Democratic leadership 
and their allies will attempt to brand anyone who opposes their bill as 
opposed to health care reform. Nothing could be further from the truth. 
There is not a Member of Congress who does not recognize the need for 
change in the system. But we are talking about people's health care. We 
are talking about one-seventh of the economy. We are talking about 
people's jobs. I will not support a bad bill, even if it means we have 
to wait until next year to forge a workable solution.
  Mr. GOODLING. Mr. Speaker, I thank the gentleman for his 
participation, and now yield to the gentleman from Delaware [Mr. 
Castle].
  Mr. CASTLE. Mr. Speaker, I thank the gentleman from Pennsylvania [Mr. 
Goodling], the ranking member of the Committee on Education and Labor, 
and not just for yielding to me, but for all the work he has done for 
the children of this country. Working with him for the past year, I 
have been tremendously impressed by not only health care, education, 
labor standards, whatever.
  Mr. Speaker, the Members have had a long night, and I will try to be 
brief. The time for this special order is almost over, as it is.
  Mr. Speaker, I just want to share a few thoughts at the end of all 
this about where we are going with health care. We hear the debate 
about health care, and it is without a doubt in my mind the most 
complicated domestic issue we have ever undertaken to deal with in the 
Congress of the United States of America.
  Yet, I think in a sense it can be boiled down to relatively simple 
elements, because 85 percent of the people of America are covered by 
Medicaid, Medicare, health insurance through an employer or their own 
health insurance, in some way or another, and about 15 percent, 
roughly, are not covered.
  The people who are covered basically feel, even though they may be 
underinsured in certain areas, that they are receiving good health care 
coverage in this country, perhaps better than anyplace in the world. 
Everyone is concerned about costs. I have not spoken to anyone or 
talked to anyone or have had anyone address me at a parade or whatever 
it may be, who has not said, ``Why is health care so expensive today?'' 
So we have to worry about that 15 percent who do not have the coverage 
and we have to worry about the costs of health care.
  Mr. Speaker, we tend to think that all the conventional wisdom on how 
to solve the problems of health care is right here in Washington, DC. I 
do not think that is accurate. I think it is out in the States, it is 
out in the capitals of the States. It is certainly out in Hawaii, which 
has been exempted under the Education and Labor markup, because they 
feel their system is doing so well that they do not want to be included 
in it if they can meet certain standards.
  The gentleman from Michigan [Mr. Hoekstra] mentioned that he had 
introduced an amendment which was turned down, saying that other States 
could get out by referendum. I introduced an amendment which was also 
turned down, saying if the other States met those same conditions, 
could they get out, and the answer was no, they could not. But why 
should they not be able to get out?
  What we are missing in the United States of America today is the fact 
that it costs this country, in all of those State capitals, all manner 
of problems dealing with health care being solved on a day in and day 
out basis. We basically have to expand universal access to health care. 
We have to contain costs, and we can do this by not passing a major 
piece of legislation, turning it over to the Federal Government in 
Washington, but giving more flexibility to the States, particularly in 
the Medicaid programs, which the States helped pay for anyhow, about 50 
percent of them, and giving them the flexibility to carry out what they 
need to get done.
  When I was Governor of the State of Delaware, we passed a piece of 
legislation that allowed us to work within the Nemours Foundation 
through the Medicaid program in order to provide universal health care 
for all the children in the State of Delaware. I cannot imagine a more 
beneficial program to offer in a State than that was, and yet we spent 
18 months moving a mountain of paper work through Medicaid, and we are 
spending $7 million in addition to that, but it took us 18 months in 
order to get this done.

  State after State has had this problem and yet 10 States are talking 
about universal health care, some States are talking about universal 
health care, without any other greater expenditures except to give them 
more flexibility under Medicaid.
  I know in my State, after having examined very carefully a whole 
series of services which we provide there, try to provide there, that 
of that 15 percent or 95,000 people in my State, when we look at the 
Nemours Foundation for Children, when we look at the clinics we have in 
the city of Wilmington and in our rural areas, when we look at the 
services provided by our medical society, when we look at what our 
hospitals do, when we look at a variety of other services for the poor, 
when we look at insurance reform, all of a sudden we find that perhaps 
it is not 15 percent; that yes, there is 15 percent without insurance, 
but it is a much lesser number that we are dealing with who may not 
have access to health care in the United States of America.
  The States have universally, each and every one of the 50 States, 
have come forward and they have taken steps which have greatly 
addressed and alleviated this problem, and yet we are trying to 
reinvent the wheel because somehow or another we have to do it in 
Washington.
  Frankly, Mr. Speaker, it does not work particularly well from 
Washington, DC., and we have seen that with numerous programs. Medicaid 
and Medicare are an example of that, as are some other programs which 
we have seen come out of Washington, DC.
  I would suggest, Mr. Speaker, that whatever we do in health care, 
regardless of which plan actually comes up in the House or in the other 
body, that we take the opportunity to make sure that the States are 
given that flexibility, the States are given the opportunity to solve 
the problems.
  In fact, Mr. Speaker, I would suggest that we give that to them first 
and then see what they can do, give them extra flexibility, come back 
in a couple of years and see what we can do to resolve whatever 
problems are left. What we will have, we will get the universal health 
care a lot faster than we are going to if the Federal Government does 
it, we are going to do it at less expense, we are going to do it in the 
way services are being delivered in those States now, and you will have 
a dramatically improved system without going through the large 
bureaucracy and expense of the Federal system.
  I will leave it at that, Mr. Speaker. I feel strongly we need to 
pursue it in that way, and hopefully we can address that here in the 
weeks to come.
  Mr. GOODLING. Mr. Speaker, I thank the gentleman for his 
participation. Particularly having been a Governor, he truly 
understands what problems the different States face.
  Again, I hope the American public understands that we on the minority 
were there with substitutes, we were there in a spirit of compromise, 
we were there trying to build a bipartisan coalition. We wanted to 
attack the portability issue, the preexisting condition issue, the 
malpractice issue, paper work simplification, cost containment.
  All of these things we could have done, Mr. Speaker, but we did not 
have that opportunity. I hope we will in the near future.
  Mr. BOEHNER. Mr. Speaker, we in this body must ask ourselves a 
question on health care reform--who will really pay for an employer 
mandate? The proponents of the mandate claim that it will be the 
employer who pays. Studies and statistics show that the employees will 
bear the brunt of a mandate.
  As a small businessman, I know how difficult it is to run a small 
business and meet a payroll. I know that if businesses can afford to 
provide health insurance to their employees, they will do so. What 
Congress must understand is that health insurance is a valuable 
benefit. Employers want to offer it in order to retain high-quality 
employees. However, the fact is--most simply cannot afford to provide 
the insurance to each and every employee.
  If Congress forces employers to pay for the insurance, they will have 
to find the money from within their own operations in order to comply 
with the mandate. If they cannot find the money, they will have to 
either lay-off employees, raise prices, or close their doors 
altogether. Various studies have put the estimated job loss from an 
employer mandate at between 800,000 and 3.8 million individuals.
  If an employee can hold onto his job, he will most likely receive 
health care at the expense of wages and benefits. CONSAD predicts that 
23 million workers will have their wages and benefits reduced as a 
result of the mandate. The National Bureau of Economic Research 
estimates that 85 percent of mandated benefits would be paid by workers 
through reduced wages. The Congressional Budget Office [CBO] has 
concluded that ``employers facing an increase in their premiums would 
probably shift most of the added costs to their workers through reduced 
cash wages.''
  The employer mandate will impact the poor and unskilled workers the 
hardest. As the Employment Policies Institute recently reported, 
``since a percentage increase in the cost of unskilled labor reduces 
demand for that labor more than a comparable increase reduces the 
demand for skilled labor, job losses will be concentrated in these 
unskilled positions.''
  Of course, businesses could raise their prices, however, raising 
prices in response to a government mandate is the same as imposing a 
hidden tax on consumers. We must also remember that retailers must 
account for the price increases passed on by suppliers, manufacturers, 
and wholesalers--all of which will be affected by the mandate. There 
are those businesses that simply cannot raise their prices without 
pricing themselves out of a market, or having people decide to forgo 
their product or service.
  I am fully aware of the increasing pressures facing small businesses. 
Government already makes it difficult enough to succeed considering the 
multitude of taxes, regulations, and mandates. In the past few years 
alone, there have been mandates from the Clean Air Act, Americans with 
Disabilities Act, Civil Rights Act, and Family and Medical Leave Act. 
Congress shouldn't make it worse with a health care mandate and tax.
  On a final note, the proponents of the employer mandate are trying to 
sell their plan as a free lunch. They are in effect saying to the 
American people, ``don't worry, your employer will pay 80 percent of 
your health care.'' However, it will not be the employer who pays, but 
rather the employee--through lower wages, reduced benefits, and the 
possibility of permanent job loss. Congress should be honest with the 
American people and reject the employer mandate.
  Mr. GUNDERSON. Mr. Speaker, after 7 weeks of deliberations, the House 
Education and Labor Committee completed consideration of their version 
of President Clinton's health reform initiative. Our committee had a 
great opportunity to design a bipartisan package that could improve the 
affordability and accessibility to our health care delivery system. 
Unfortunately, we were not able to vote out a bipartisan package, 
although several bipartisan amendments were included.
  Any legislation of this magnitude contains both positive and negative 
elements. The sections of the bill pertaining to rural health care 
illustrate the positive result that comes from bipartisanship. Mr. 
Williams, the chairman of the Subcommittee on Labor-Management 
Relations, and I worked together to guarantee that the rural health 
care delivery system will be greatly improved. This will be 
accomplished through the creation of Rural Emergency Access Care 
Hospitals [REACHs] which will enable rural communities access to 24-
hour emergency medical care, additional assistance to Medicare-
Dependent Hospitals (hospitals that have over a 50-percent Medicare 
patient load), and the development of rural hospital and outpatient 
facility assistance grants to expand health care services to 
underserved communities.
  Despite some of the Education and Labor Committee's provisions that 
improve health care, there are many which will have a negative impact 
on the health care system. These include elements regarding self-
insured businesses and the training of health professionals.
  The bill that passed the Education and Labor Committee contains an 
improved provision over President Clinton's original proposal for self-
insured businesses. The Clinton plan states that if a business has 
5,000 or more employees, they may self-insure. The Education and Labor 
Committee lowered the number to 1,000. Although the change to 1,000 is 
a step in the right direction, this number must be lowered even further 
for two reasons: First, over 67 percent of the U.S. workforce receives 
benefits under self-insured plans and second, between 50 to 60 percent 
of the businesses that self-insure are under 500. I believe that a 
business should be allowed to self-insure if it meets the following 
test: First, offers at a minimum, the same benefits package included in 
the health reform proposal that passes the Congress and second, 
includes a risk assessment component. The self-insured issue is one of 
the most important to small-and medium-sized businesses. In western 
Wisconsin, alone, there are at least 200 businesses that self-insure 
and have an average number of 50 employees. Most of these businesses 
have successfully been self-insured for years. Let us all work toward 
enabling those businesses to continue their self-insured status.
  The Education and Labor Committee bill establishes a National 
Institute for Health Care Workforce Development. The purpose of this 
institute is to develop and implement high performance, high quality 
health care delivery systems by working with the entire community. My 
concern with the creation of this Institute is that it duplicates the 
responsibilities of existing entities overseeing health care workforce 
issues. One example of duplication is the Office of the American 
Workplace located in the Department of Labor and an annual budget of 
$30 million. The specific goal of this office is to ``build 
partnerships with business, labor, and Government to promote high-
performance work practices and effective labor-management relations'' 
which appears to be similar to the goal of the new National Institute 
for Health Care Workforce Development. Although I am sensitive to the 
needs of health care personnel who may have to make career transitions 
due to health care reform, I do not see the need for the Federal 
Government to say that health care workers should be given special 
treatment over any other group of workers. I urge my colleagues to 
delete this section when the health reform bill comes before this body 
in the near future.
  Mr. BALLENGER. Mr. Speaker, the House Education and Labor Committee 
approved a health care plan that mirrors the proposal put forth by 
President Clinton. It includes burdensome Government mandates, a costly 
standard benefit package, global budgets, price controls, and 
inefficient Government bureaucracies. During 19 days of deliberation, 
the committee managed to add at least $120.3 billion to the Federal 
deficit--roughly $6 billion a day. The original Clinton proposal was 
1,342 pages long, and with the input from the Education and Labor 
Committee, another 658 pages was added to an already complex bill. The 
House Education and Labor expansion of the Clinton plan takes bad 
policy and makes it worse. Needless to say, I am opposed to the 
proposal.
  Today, I would like to focus on several of the amendments that I 
offered during the committee debate that were rejected by the majority.
  One amendment I offered addressed a serious labor law concern raised 
by the Ford-Clinton health care proposal, that is, the relationship of 
guaranteed comprehensive health care benefits for every worker and the 
continuing obligation of employers and employees to bargain 
collectively over such benefits. As we know, negotiating over health 
care can be one of the most contentious subjects in the collective 
bargaining process, and it frequently leads to labor and management 
strife.
  As you know, under the National Labor Relations Act [NLRA], issues 
that may be negotiated by labor and management are generally separated 
into two classes--mandatory subjects of bargaining and permissive 
subject of bargaining. The respective rights and obligations of unions 
and employers in bargaining with each other often depend on whether an 
issue is considered to be permissive or mandatory. Of course, some 
subjects are simply illegal to bargain over, such as proposals to 
implement a policy contrary to existing law.

  Mandatory subjects of bargaining include wages, benefits, working 
hours, or working conditions. Health care is a mandatory subject of 
bargaining. If management and labor bargain over a mandatory subject, 
like health care benefits, either party may insist on its position 
until an impasse is reached and then labor may strike or management may 
order a lockout. Thus, failure to reach consensus on a mandatory 
subject of bargaining can prevent a collective bargaining agreement 
from being reached. In addition, during the life of an agreement 
already in place, an employer may not order any changes in mandatory 
subjects previously agreed to without first bargaining with the union.
  Permissive subjects of bargaining include any other item that the 
union and the employer may bargain over such as internal union affairs. 
In this case, either party may try to initiate bargaining, and, if the 
other party is willing, they may address the subject in the agreement. 
However, if the other party does not wish to bargain, the issue is 
taken off the table. A strike may not be ordered by a union and a 
lockout may not be ordered by the company. The parties simply go on to 
other matters.
  My amendment, if it had been adopted, would have virtually eliminated 
labor-management tensions over health care issues by taking increases 
in health care benefit levels off of the collective bargaining table 
unless both of the parties--the employer and the union--want to 
negotiate over them. My amendment would be limited to situations where 
labor wanted to press for increases over what is in the law or a 
collective bargaining agreement. If the employer wanted to seek 
cutbacks below the agreement, that would still be a mandatory subject 
and the union could strike.

  Now, under the Education and Labor version of health care reform the 
Federal Government is saying to employers and their employees: This is 
your health care benefit package. We have already decided what is the 
best package for you and do not worry, because it is a comprehensive 
package. Indeed, it has even been expanded.
  By requiring every employer to provide a comprehensive package of 
health care benefits, the Clinton-Ford bill imposes substantial costs 
on companies--both large and small. Let us be honest--comprehensive 
health care is expensive. Under the Clinton-Ford plan, benefits 
mandated by the Government would include hospital care, emergency 
services, preventive care, mental health and substance abuse services, 
family planning, hospice care, home health and extended care services, 
ambulance services, outpatient laboratory and diagnostic services, 
prescription drugs, vision and hearing care, periodic medical checkups, 
and preventive dental services for children. The Ford plan and the many 
amendments adopted during the markup in the Education and Labor 
Committee expand upon the Clinton plan, adding several billion in new 
mandated benefits.
  This is a comprehensive package of federally mandated benefits, some 
would even call it a Cadillac plan. Employers will be obligated by law 
to provide every one of these benefits. In addtion, employers with 
union employees must continue to provide any health benefit 
collectively bargained prior to passage of the Health Security Act. It 
is ridiculous that employers would be obligated by law to negotiate 
over additional health care benefits, or suffer the consequences of 
strikes.
  We have heard a great deal from organized labor in recent years about 
tensions generated at the bargaining table about health care issues. In 
fact, a representative of the Services Employees International Union 
[SEIU] testified before the House Education and Labor Committee 
recently that ``Health care is the No. 1 issue at the bargaining table 
and the No. 1 cause of strikes.'' I would tend to agree that health 
care costs generally have been a subject of workplace tensions, as 
employers and their employees have struggled to cope with rising costs.
  If one of the intended effects of this bill is to reduce those 
tensions by ensuring a package of comprehensive benefits to every 
worker, then my amendment would have helped ensure reduced tensions in 
the future by resolving that, once and for all, there will be no more 
labor-management battles over health care.
  I believe it is time for organized labor in America to make a choice. 
Unions can either try to achieve comprehensive benefits for employees 
through collective bargaining or they can try to get these benefits 
from the Congress. The system, and our ability as a nation to compete 
effectively, cannot afford both. The Ballenger amendment should be 
included in health care reform legislation to ensure that businesses do 
not have to risk a strike over having to provide even more.
  I would also like to comment on two other amendments that were 
offered and were rejected by the full committee on rollcall votes. The 
committee bill includes a provision that requires a health care 
employer who replaces another health care employer through merger, 
consolidation, acquisition, or contract, to provide employees who would 
otherwise be displaced, a right to continued employment unless their 
positions no longer exist--the provision sunsets after 5 years. My 
amendment would have eliminated this requirement because under current 
labor law, an employer who acquires a business is under no general 
obligation to retain current employees. The provision in the Ford bill 
creates a statutory entitlement to continued employment of no defined 
duration, makes no allowance for displacement of employees for cause, 
and gives all displaced employees preferential rehire rights for 6 
months. The continued employment provision creates yet another cause of 
action that may be advanced by employees in Federal or State court 
subjecting employers to liability for backpay, double backpay, and 
attorneys' fees. Finally, although technically limited to health care 
employers, the reach of the provision in the bill is very broad because 
the definition includes any employer that provides ``necessary related 
services, including administrative, food service, janitorial, or 
maintenance services, to an entity that provides health care items or 
services.'' My amendment to strike this provision should have been 
adopted because it prevents the creation of yet another employment 
right to be litigated in court.

  I also offered an amendment to strike a section of the Ford bill that 
would require a health care employer to recognize the exclusive 
bargaining agent and to assume the collective bargaining agreement of 
the predecessor employer if a majority of its employees were previously 
covered by the agreement and if there has been no substantial change in 
operations. This provision would sunset after 5 years of enactment. The 
amendment would have also stricken a provision--again sunsetting after 
5 years--which assumes joint employer status whenever employees of a 
contractor to a health care employer work on the premises and are 
functionally integrated with the operations of that employer.
  The provision in the Ford bill concerning the collective bargaining 
obligation of health care employers would make significant changes in 
labor law, without hearings or discussion of the magnitude of those 
changes. These provisions signal the kinds of amendments to current law 
that might be sought by organized labor in a push for comprehensive 
labor law reform and should be considered at that time--not during a 
debate on reform of our health care system. Under current law, while a 
successor employer may be obligated to recognize the exclusive 
bargaining agent of the previous employer, it is not required to assume 
the previous collective bargaining agreement. Requiring successor 
health care employers to be bound by a collective bargaining agreement 
to which it is not a party creates a disincentive for any restructuring 
of the health care industry that may lead to better and more efficient 
care.

  Also, the Ford bill would create a new test for determining joint 
employer status under the National Labor Relations Act. Under current 
law, the test is whether an employer has sufficient control over the 
essential terms and conditions of the employment of any group of 
workers. The Ford bill assesses whether the tasks performed by a group 
of employees are functionally integrated with the operations of the 
employer. Again, the Ford bill establishes a new legal standard without 
discussion of its significance. I am concerned that these changes would 
unnecessarily complicate the health care marketplace and would be 
particularly detrimental to the restructuring of the health care 
industry.
  Mr. PETRI. Mr. Speaker, the markup process in the Education and Labor 
Committee unfortunately was not an effort to reach real consensus on a 
health care reform bill.
  Rather, it was an exercise in ramming through a partisan bill. And 
that's a shame, because I don't believe that kind of a process will 
lead to a good health care reform bill in the long run.
  It's a double shame, in fact, because all of the elements are already 
there for the making of a bipartisan compromise, a compromise that can 
achieve our foremost objectives. So instead of continuing this partisan 
exercise, let's begin the final round of the health care debate by 
looking at those issues on which we all agree.
  First, I think it's safe to say that we all want insurance market 
reform that provides guaranteed issue, portability, at least modified 
community rating, and the elimination of preexisting condition 
exclusions. We all want some kind of medical malpractice liability 
reform, although we may disagree on its details.
  Clearly, we need administrative simplification provisions to reduce 
overhead, and we need to provide consumers with the comparative value 
information they need to make smart medical decisions.
  I'd suggest we require mandatory price disclosure by providers, 
publication of the average prices for health care services in the 
regional market, information on common patterns of practice, and 
indicators of the quality of health care offered by plans and 
providers.
  With insurance market reform a given, many of us agree we should 
provide a graduated subsidy for Medicaid enrollees and the low-income 
uninsured so that they, too, can enroll in competitive health plans. 
Finally, we know there will have to be some risk adjustment between 
plans, and we ought to at least allow voluntary purchasing alliances.
  We should start there, as several bipartisan bills already have--with 
the elements of reform on which we have the most hope of consensus. 
Then we can turn next to the issues which divide us: the mandated 
benefits package, for example. I'm sure we can agree that a benefits 
package should provide at least catastrophic coverage, but we disagree 
about whether any other benefits should be mandatory.
  I'd argue that universal catastrophic coverage can accomplish most of 
the objectives we've set out to achieve: We can protect American 
families from financial disaster and we can eliminate our cost-shifting 
problems.
  Cost shifting should not be much of a problem if poor people have 
more comprehensive coverage and middle-income people, in relatively few 
instances, only have to come up with a few thousand dollars out of 
pocket to cover medical emergencies.
  Without a comprehensive, mandated benefits package, of course, we'd 
have to rely more heavily on risk adjustment between plans in order to 
prevent comprehensive plans from being driven out of the market because 
they attracted mainly higher risk people. That's another contentious 
aspect of the benefits issue.
  But, perhaps the most fundamental issue of disagreement is how best 
to accomplish universal coverage for all Americans. The first question 
here is what we mean by universal coverage. I think we can agree that 
we mean by that at least universal catastrophic coverage. And although 
most people think we cannot get universal coverage without a broad-
based tax increase or mandates, that's not the case.
  There is a way to get universal catastrophic coverage without either 
a net tax increase or a mandate--and that's through tax reform. By that 
I mean rationalizing the $100 billion of subsidies for health care that 
we already have in the Tax Code.
  As it stands, the main health subsidy in the Tax Code is the 
exclusion from individual income of employer-paid health premiums or 
benefits.
  This subsidy is extraordinarily regressive, because its value to any 
individual depends on both his marginal tax rate and the cost of his 
benefits, both of which are higher for wealthy people. In fact, it's 
estimated that the value of this subsidy is six times as great for 
people in the top 20 percent of our Nation's income distribution as it 
is for those in the bottom 20 percent.
  Moreover, the more your employer spends on premiums and benefits, the 
more subsidy you get, which contributes to third-party payment and 
inflation.
  This is a rotten way to design a Federal health care subsidy. Why 
provide a subsidy only to those who already have employer-paid 
benefits? Why provide a far bigger subsidy to wealthy people? And why 
make it open ended?
  It would be much fairer to turn this $100 billion pot of money into a 
fixed voucher for the purchase of competitive health plans. Those with 
employer-paid coverage, which the employer could still deduct as a 
business expense, would use their vouchers to cover their share of 
premiums and their cost sharing and would receive a cash rebate for any 
excess.
  By my calculation, the average 1995 Federal voucher amount would be 
$1,764 for a couple with children, $1,219 for a childless couple, 
$1,133 for a single parent, and $612 for a single person. Reforming 
State tax subsidies the same way would typically add 15 to 30 percent 
to these amounts. Vouchers this big should allow people otherwise 
uninsured to purchase at least catastrophic coverage.
  And they'll be highly motivated to do at least that if failure to do 
it will cost them the value of their vouchers. Finally, with vouchers 
this big, virtually all 15 percent bracket taxpayers--that is, all four 
person families below $55,000 in income--would be much better off than 
with the present exclusion, and many 28 percent bracket families would 
be as well off.
  Thus, although highly paid union leaders would be hurt initially, the 
vast majority of their members would be better off with an egalitarian 
voucher than with the present regressive exclusion. They may be right 
to oppose taxing generous benefits when they get nothing in return, but 
they should support taxing all benefits in return for a voucher of 
greater value.
  Therefore, I believe this kind of tax reform can be the basis of a 
sound compromise on the most difficult issue before us. It can provide 
the key that unlocks a solid health care reform bill this year, and for 
that reason, I've already made it the centerpiece of my own multicare 
proposal, H.R. 4469.
  I urge my colleagues to join in a dialog aimed at real consensus, 
rather than retreating behind partisan battle lines, as we did so often 
during the Education and Labor Committee markup.
  Mr. ARMEY. Mr. Speaker, I want to thank my distinguished colleague 
from Pennsylvania for his leadership on the committee. For the past 
several months, we in the party of freedom, the Republican party, have 
been fighting to prevent the Government, and therefore the party of 
government, from nationalizing the world's best health system. The 
American people rejected the idea of a government-run health system. 
But alas, on our committee, what the American people want is an 
inconvenience. The Democrats seem determined, in the words of Senator 
Rockefeller, to pass this unpopular bill ``regardless of the wishes of 
the American people.''
  America's health system does have problems that must be fixed. But it 
doesn't need a government takeover. It doesn't need a national health 
board. It doesn't need price controls. It doesn't need the Government 
defining everyone's insurance package. And it doesn't need criminal 
penalties for so-called ``health care crimes.'' America does not need 
this bill.
  Nearly a year ago, I compiled this flowchart to depict the workings 
of the President's plan. People ask me if I meant it as a joke, but, on 
the contrary, I meant it to be completely accurate, based strictly on 
the language of the Clinton plan itself. Not even Ira Magaziner has 
been able to find an error or omission, or at least that's what I 
deduce from the silence with which he has greeted my repeated requests 
for comment. Now what differentiates the original version of the bill, 
depicted here, from the one reported by the Education & Labor Committee 
is the number of lines and boxes. Our committee felt the Clinton plan 
was too simple.
  Here we have a portrait of what happens when power meets an Ivy 
League degree. Apparently some people in this day and age actually 
believe that 250 million people have less wisdom and less common sense 
than Ira Magaziner's seven-member National Health Board.
  Perhaps the most misbegotten of all the misguided features of this 
mind-boggling plan is its price controls. As an economist, I take a 
professional interest in this, but you don't have to have a Ph.D. to 
understand why price controls are a bad idea. As you can see from this 
second chart, forty centuries of human history show that price controls 
do not work. Price controls cause suffering.
  Hammurabi tried price controls and got a permanent depression. The 
Roman Emperor Diocletian tried price controls and got riots, hoarding, 
and mass executions, and, after 4 years, had to abdicate. The ancient 
Greeks tried price controls on grain and got grain shortages. The 
Romans tried it on wheat, and got wheat shortages. President Nixon 
tried petroleum price controls in the 1970's and gave us the energy 
crisis. Now President Clinton wants to give us price control on health 
insurance premiums. Why do I have a bad feeling about this?
  With this long, melancholy history in mind, I offered an amendment in 
our committee to remove price controls from the Clinton plan. The 
amendment was defeated on a straight party line vote. Now you may ask, 
given the history sketched out on this chart, why would the Democrats 
vote for price controls? I certainly tried to persuade them of the 
likely result. I pointed out that no nation in modern times has ever 
achieved the President's goal of bringing medical inflation to zero. 
Let me say that again. No nation has ever achieved zero medical 
inflation. Yet this bill would try to mandate it, by force of law.
  I also told my committee colleagues about the study by the 
independent economics firm DRI-McGraw Hill, which predicts that if the 
President's price controls are implemented, health-care services would 
be reduced by about 5 percent over the first 3 years. Sound harmless? 
What this means is that if price controls begin in 1998, by the year 
2000 every American household will suffer a reduction of available 
health services of about $500. Or put another way, health insurance 
price controls will mean a $500 tax hike for every family in this 
country. And it may turn out to be a lot more than $500, because the 
American Academy of Actuaries estimates the premiums for the 
Government-defined insurance package will cost at least 20 percent more 
than the White House claims.

  But more important than the dollar figures is the very real pain that 
will be felt by sick people who will be denied medical care. Price 
controls invariably produce scarcity, and scarcity produces rationing. 
When you make it illegal to sell a product at its natural market price, 
producers respond by reducing the quantity and quality of the product 
until supply and demand meet at the new, lower, Government-imposed 
price. This is a law of economics, which no parchment law can repeal.
  What will happen if we impose President Clinton's price controls? At 
first, the pain may not be terribly noticeable. But after a few years, 
as the controls begin to bite, we will start to see the telltale signs. 
Lines will form. Surgeries will be delayed. People will go without 
necessary care. The Government will stop covering certain procedures.
  All of this happens right now in Canada. Despite all the praises 
lavished upon it by left-wing liberals, the Canadian system is in 
crisis. The Canadian Government is canceling health coverage for 
foreign nationals, even if those foreigners pay Canadian taxes. It is 
imposing 3-month waiting periods before new residents can apply for 
health care coverage. It is limiting coverage for Canadians abroad. It 
is rationing care and imposing premiums and copayments for Canadians at 
home. The province of Quebec now refuses to pay for hip replacements. 
At this very moment, 250,000 Canadians--the equivalent of 2.5 million 
Americans--are on a government waiting list for needed medical care. 
Canadian patients have to wait, on average, 5 weeks just to see a 
specialist. A sample group of 177,000 Canadian patients had to wait up 
to 14 weeks for surgery. Coronary bypass patients wait 5 and a half 
months on average for surgery. Some die while waiting. Others pay to 
travel to the United States for immediate service. Indeed, one-third of 
Canadian doctors have sent patients outside the country for treatment 
during the past 5 years. And a Canadian firm is reportedly offering a 
private insurance policy that will fly you to the United States if 
you've been on the Government waiting list more than a certain number 
of weeks, depending on the illness. Mr. Chairman, it seems the best 
thing about the Canadian health system is the American health system.
  All of these statistics simply confirm what economists have always 
known: Fiat rationing is unavoidable under a price-controlled, 
government-financed system.
  Some of my more left-leaning colleagues claim that a government 
system of universal coverage is more moral than the free market in 
health care. Let me tell you about the moral superiority of government 
medicine. This past Christmas, the Canadian province of Ontario sent 
doctors and nurses home for several weeks, for no other purpose than to 
save money. The financial crunch had gotten so bad, the authorities at 
the Toronto Hospital for Sick Children told parents not to bring their 
children to the emergency room unless the child had a fever and was 
experiencing, and I quote, ``lethargy, convulsion, or 
nonresponsiveness.'' My friends, is this what health security has to 
mean--turning sick children away because they're not sick enough to be 
having convulsions?

  On January 13, President Clinton received a letter, which I would 
like to quote. I have edited if for brevity, but here is the meat of 
what the authors said:
  ``Price controls produce shortages, black markets, and reduced 
quality. In countries that have imposed these types of regulation, 
patients face delays of months and years for surgery, government 
bureaucrats decided treatment options instead of doctors or patients, 
and innovations in medical techniques are dramatically reduced.
  ``In the 1970's, government tried to regulate the price of a simple 
homogeneous product, gasoline. The result was that people were forced 
to waste hours waiting in lines to purchase gasoline. Long waits for 
surgery will have more serious consequences. Price controls may appear 
to reduce medical spending, but such gains are illusory. We will still 
end up with lower-quality medical care, reduced medical innovation, and 
expensive new bureaucracies to monitor compliance. These controls will 
hurt people, and they will damage the economy. We urge you to remove 
price controls, in any form, from your health care plan.''
  Mr. Speaker, the letter is signed by 562 Ph.D. economists, including 
several Nobel Prize winners.
  Reading this letter, I was reminded of the letter President Hoover 
received in 1930, signed by 1,028 economists, begging him not to raise 
taxes on imports. As every school child knows President Hoover ignored 
their advice, and the result was a catastrophic deepening of the Great 
Depression just as the country was beginning to recover from the crash 
of 1929.
  I am suggesting that we should always heed the advice of economists, 
but I do think we should think twice before disregarding the plain 
lessons of history. Those who cannot remember the past are condemned to 
repeat it. But we need not repeat it. We can learn from history.
  I have tried to lay out what I hope is a persuasive case against 
price controls, but no argument of mine could compare with the 
eloquence of our predecessors of the Continental Congress. Listen to 
what our Founding Fathers wrote on June 4th, 1778:
  ``Whereas * * * it hath been found by experience that limitations 
upon the prices of commodities are not only ineffectual for the 
purposes proposed, but likewise productive of very evil consequences to 
the great detriment of the public service and grievous oppression of 
individuals * * * [Therefore, be it] resolved, that it be recommended 
to the several states to repeal or suspend all laws or resolutions 
within the said states * * * limiting, regulating, or restraining the 
price of any article, manufacture, or commodity.''
  Thankfully, the 13 States heeded Congress' call and lifted their 
wartime price controls. Scarce provisions became abundant. And by the 
fall of 1778, our armies were able to procure needed winter supplies 
that only a year before had been unavailable to General Washington at 
Valley Forge. I sometimes wonder how Washington's armies, and our 
fledgling Nation, would have fared had the reinous price controls never 
been lifted.
  I urge my colleagues on the other side of the aisle to choose the 
wiser course and take the higher road and strike from the President's 
bill these disastrous price controls.

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