[Congressional Record Volume 141, Number 180 (Tuesday, November 14, 1995)]
[House]
[Pages H12206-H12212]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     REPEALING AN UNNECESSARY MEDICAL DEVICE REPORTING REQUIREMENT

  The Clerk called the bill (H.R. 2366), to repeal an unnecessary 
medical device reporting requirement.
  The Clerk read the bill, as follows:

                               H.R. 2366

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REPEAL.

       Section 1862 of the Social Security Act (42 U.S.C. 1395y) 
     is amended by striking subsection (h).

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida [Mr. Bilirakis] will be recognized for 30 minutes, and the 
gentleman from Ohio [Mr. Brown] will be recognized for 30 minutes.
  The Chair recognizes the gentleman from Florida [Mr. Bilirakis].
  Mr. BILIRAKIS. Madam Speaker, I yield myself such time as I may 
consume.
  (Mr. BILIRAKIS asked and was given permission to revise and extend 
his remarks.)
  Mr. BILIRAKIS. Madam Speaker, I rise in strong support of H.R. 2366, 
legislation to repeal the unnecessary regulatory burden of the cardiac 
pacemaker registry imposed by the Social Security Act.
  Section 1862(h) of the Social Security Act requires doctors and 
hospitals receiving Medicare funds to provide information to the 
Federal Government upon the implementation, removal, or replacement of 
pacemaker devices and pacemaker leads. However, in 1990 the Congress 
amended the Federal Food, Drug and Cosmetics Act to establish 
comprehensive reporting requirements that make the registry requirement 
in the Social Security Act duplicative and unnecessary. Removal of this 
unnecessary reporting requirement will be welcomed by the health care 
community and by manufacturers as well 

[[Page H 12207]]
as by the Federal agencies charged with complying with this 
requirement.

                              {time}  1045

  I want to emphasize that repeal of the requirement will have no 
impact on the public health, because it is redundant of a newer and 
more comprehensive requirement.
  Madam Speaker, I want to commend my colleagues, the gentlewoman from 
Nevada [Mrs. Vucanovich], a Republican, and the gentleman from 
California [Mr. Waxman], a Democrat, for recognizing the need for this 
legislation and working for its quick consideration. During these times 
it is nice to have a little bit of bipartisanship.
  I also want to commend the Speaker for instituting the Corrections 
Calendar. I believe this bill is a perfect example of the type of 
legislation for which the new Corrections Calendar is intended.
  Madam Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, this is the sort of bill that is appropriate for a 
corrections day calendar.
  It truly corrects a legislative oversight, and does nothing more or 
less.
  This bill was introduced by my colleague, Mr. Waxman, with 
Representative Vucanovich, in response to concerns of both the 
administration and the pacemaker industry about duplicative reporting 
requirements.
  When section 1862(h) was added to the Social Security Act about 10 
years ago, there was a need to identify and keep track of defective 
pacemakers. In particular, there was a need to identify circumstances 
in which a defective pacemaker was surgically implanted in a patient, 
and then surgically removed, with both procedures being paid for by 
Medicare.
  One of the main reasons for this early pacemaker registry was that 
there was no good way, in 1984, to track defective implantable medical 
devices, and no viable way for HCFA to recover costs in those 
circumstances where a defective product was used. At that time, it made 
both fiscal and public health sense to require health care providers to 
report information about pacemakers and pacemaker leads, including 
information about device defects and costs recovered from 
manufacturers.
  Since enactment of this provision, HCFA has collected the required 
data and provided the information to FDA, which maintained the 
pacemaker registry.
  However, in 1990, Congress passed the safe medical device amendments, 
which included broad requirements for medical device tracking and 
reporting. These more comprehensive provisions superseded the 
requirements of section 1862(h), but did not repeal those requirements. 
However, without repeal of section 1862(h), FDA still must maintain a 
separate pacemaker registry. Further, providers and manufacturers must 
report essentially the same information to both HCFA and FDA, for two 
separate registries.
  This duplication of effort is not necessary either for budget reasons 
or for public safety. HCFA does not need the separate registry to 
assist in recovering costs, and FDA maintains a master registry of all 
implantable medical devices, which can be used in cases where there are 
health concerns about particular products.
  Both HCFA and FDA have suggested this repeal. I am pleased to support 
it, and urge my colleagues to do likewise.
  Madam Speaker, I yield such time as he may consume to the gentleman 
from California [Mr. Stark].
  Mr. STARK. Madam Speaker, I thank the gentleman for yielding. I would 
say at the very outset that the gentlewoman from Nevada [Mrs. 
Vucanovich], the gentleman from California [Mr. Waxman], and the 
gentleman from Florida [Mr. Bilirakis], are to be congratulated, as 
well as the gentleman from Ohio [Mr. Brown], for a bill that fixes a 
problem that we should have attended to some time ago.
  Madam Speaker, today is corrections day, part of a new dawning, part 
of a revolution here in this Chamber. And I do not disagree with any 
item that my Republican colleagues have brought to the floor today. 
But, boy, do we need corrections.
  If one wants to talk about errors that need fixing, the Republicans 
have created or are about to create errors that boggle the mind; 
errors, I might suggest, that are going to destroy the Medicare system 
and leave senior citizens without any health care.
  So I would just like to talk about errors that the Republicans are 
ignoring and errors that they are creating. This is a whole game of 
errors. There are not any hits or any runs. As a matter of fact, there 
are not any players on the field. I do not notice a Republican member 
of the Committee on Ways and Means on the floor, and they have 
jurisdiction over some of this. They did not even bother to come here 
today.
  Now, on corrections day, let us talk about a major error in the 
making in the Republican plan for Medicare and Medicaid. Last month the 
Republican majority rammed through their Medicare and Medicaid bills, 
and, despite repeated calls from Democrats, only one hearing was held. 
Today we understand why they had to ram those plans through in the dead 
of night, with secret meetings in the Speaker's office with major 
lobbyists from the American Medical Association. The number of 
uninsured Americans will increase 50 percent, from 40 million to 66 
million, by the year 2002.
  There is an error that the Republicans ought to think about 
correcting before they even get out of the gate.
  Let me say that once again. As a result of the Republican plans to 
slash Medicare and Medicaid spending by $450 billion over the next 7 
years, the number of uninsured Americans will rise by 50 percent; 26 
million more Americans will be uninsured.
  Now, this is the finding of the Council on Economic Impact of Health 
Care Reform, a nonpartisan group with membership of leading Republican 
and Democrat health care experts. There, Madam Speaker, is an error 
that must be corrected before it is enacted into law. Where are the 
Republicans? Where are you on corrections day to correct your own 
heinous mistakes?
  Now, a second item, according to press reports, is that in your 
budget, your Republican budget, you Republicans are planning to extend 
the health insurance deduction for self-employed to 50 percent. Now, is 
that not nice? But did you not also mean to include individual 
employees who buy their own health insurance as well?
  It seems to be a significant oversight that we would extend this tax 
subsidy for health insurance to self-employed lawyers, doctors, CPA's, 
but not their secretaries and nurses. Could it be that the doctors and 
the lawyers are all rich Republicans, and the hard working secretaries 
and nurses who allow them to function are Democrats, and you do not 
care about low-income people?
  So if you are giving away all this money to rich self-employed, why 
not a little worry about the average working person in the small 
business who is denied health insurance by their less than munificent 
boss, who is probably a Republican, and why not extend this to the 
lower paid workers?

  Now, that is not enough. We have got corrections? Boy, have we got 
corrections. I understand that the Republicans agreed last night to 
leave the disabled out of the Medicaid plan. Now, is that not fine? 
What are you going to do for all the people who are disabled? You are 
going to kick them out of the Medicaid plan. There is no guarantee that 
all the disabled people who get Medicaid coverage today will be covered 
under the Republican plan.
  Now, that needs correction. That is heartless. That is cruel. What 
are you going to do, break up their crutches and give them to the rich 
for their fireplaces?
  Come on. Can you not find, when you are cutting $450 billion out of a 
budget to pay for tax cuts to the rich, can you not find enough to 
maintain or require that Governors under these block grants keep 
disabled people in the Medicaid plan?
  That is not enough. You want corrections? You want egregious errors? 
You want problems that the Republicans are creating that have to be 
corrected?
  Another item in the Medicare is the copayment. Beneficiaries today 
pay up to 53 percent in copayments when they have an outpatient 
procedure. These are Medicare beneficiaries who are not supposed to pay 
those kinds of copayments. Why, a beneficiary could pay, say, $3,000 
out-of-pocket for an outpatient procedure. How do you fix 

[[Page H 12208]]
it? You give the hospital back the money, but you make the beneficiary 
keep paying the $3,000.
  So much for your fixing Medicare. You are sticking it to the seniors 
and making them pay these outrageous charges. Should that not be 
corrected? Where are you? Where are these great correctors of the 
errors they are creating? They are probably in the back room right now 
trying to give away more money to the rich, to the doctors, to the 
hospitals.
  Currently, a provision in the law referred to as COBRA was written in 
1986. Forty-one million Americans are extending their health care 
insurance when they become disabled or laid off or have been divorced 
at no cost to the Federal Government, not a penny to the Federal 
Government. And today there are 3.5 million people abroad in the land 
who are about to have their COBRA benefits expire.
  And, yo, Republicans voted not to extend that. In the Committee on 
Ways and Means, every Republican voted not to extend COBRA benefits, at 
no cost to the Federal Government. Here is a correction that does not 
cost a penny to anyone. All it takes is a little concern. All you got 
to do is care about people who have lost their jobs and are losing 
their health care insurance, and you would not even let them pay for it 
out of their own pocket.
  Talk about heartless, cruel, awful people. The people who would turn 
their backs on the disabled, on the unemployed, certainly do not 
deserve to be in here saying they are going to correct errors. They are 
creating errors faster than we could correct them if we met all week.
  In other Medicare and Medicaid plans, Republicans plan to turn 
nursing home regulations over to States. Now, there is an error in the 
making that you want to look for. Why, you may not be aware that States 
do an awful job monitoring the quality of nursing home care. As studies 
come to light that find when States monitor nursing homes, they find 
about 5 percent of the nursing homes are in violation. When Federal 
regulators inspect these nursing homes, they find almost 14 percent in 
violation.
  Should not we have decent nursing home standards, so that we do not 
handcuff poor, old people to their beds, let them die of bed sores, so 
we do not give them tranquilizers to make vegetables out of them? Where 
is your compassion? Why are you destroying Medicare and Medicaid 
nursing home regulations to the detriment of the seniors? You want an 
error you are creating? You can fix it right now.

  Finally, in your Medicare reform plan you only catch 1 percent of the 
fraud estimated to take place currently. Now, surely you all want to be 
tough on crime. I have heard that from your side. You want to build 
jails. You do not want to have any welfare to prevent people from going 
to jail, but you are sure going to build jails.
  Well, let me tell you, what you are doing allows 1 percent of finding 
Medicare fraud and reforming it. One percent? Come on, a blind pig 
could find a pearl rooting in the barnyard faster than you all can find 
fraud the way you are going about this.
  So, Madam Speaker, as we talk about corrections, a corrections day, 
how about a corrections week, or a corrections month? And for the 
Republicans, I might suggest a corrections institution, because you are 
destroying the institutions of this country that the seniors have 
counted on, that the poor and children have counted on, for over 30 
years.
  With one ill-thought-out bill, with one ill-thought-out budget 
reconciliation, you are destroying the health care of the seniors. You 
are taking away the support system for the disabled. You are cutting 
back on children's education and school lunches. Surely, that needs 
correction.
  So if you are closing hospitals and pumping up the fees that we pay 
to doctors, how about dealing with some of the errors that you are 
creating and that you are doing nothing to correct.
  Yes, sir, this is a bill worth voting for, but it is such a piddling 
splatter on the platter that needs correcting. Would you please think 
about the people you are harming, the disabled, the senior citizens, 
the 26 million you are going to add to the uninsured, the children who 
will be denied medical care, the crippled, halt and lame you are 
kicking off the rolls? What are you going to do to collect your 
Speaker's bill that none of you have had any impact in?
  There are the corrections that really need correcting. There are the 
errors the Republicans are creating. There is humanity that is lacking. 
There is an indifference to the problems of the people in this world. 
That is what this institution should be doing.
  Mr. BILIRAKIS. Madam Speaker, I yield such time as she may consume to 
the gentlewoman from Nevada [Mrs. Vucanovich] to get back to the point 
here, and that is to the legislation to repeal the unnecessary 
regulatory burden of the cardiac pacemaker registry imposed by the 
Social Security Act.
  Mrs. VUCANOVICH. Madam Speaker, I thank the gentleman for yielding me 
time.
  Madam Speaker, it is a shame that some Members of this body cannot 
put aside their disagreements, even when we are trying to do something 
positive. I do not think this is very constructive and serves only 
further to enforce the cynicism of the voters. But I would first like 
to thank the gentleman from Florida [Mr. Bilirakis] and the gentleman 
from Virginia [Mr. Bliley] and the Committee on Commerce for their hard 
work to report this bill out of committee so quickly.

                              {time}  1100

  For corrections day to fulfill its mandate, we have to be able to act 
quickly, and the Committee on Commerce has gone the extra mile to see 
that the process is successful.
  The problem of the duplicate heart pacemaker registry was brought to 
my attention by the gentleman from California [Mr. Waxman]. The 
gentleman and I decided to cosponsor this legislation to eliminate the 
redundant reporting requirement. I think this might just be the first 
bill ever cosponsored by both the gentleman from California [Mr. 
Waxman] and myself.
  Madam Speaker, the fact that the two of us can agree on the 
foolishness of this requirement shows how ridiculous it really is, but 
more importantly, it demonstrates the corrections day has become a 
truly bipartisan process. Our corrections day advisory group has been 
working together now for nearly 5 months with little acrimony and a 
real spirit of cooperation.
  I especially want to thank the gentleman from California [Mr. Waxman] 
for his cooperation on this bill and the others we have passed and are 
working to pass in the coming weeks. I think it is important to point 
out that we as a group have been able to resolve some regulatory 
problems by simply proposing to put matters on the corrections 
calendar. This approach has been bipartisan and has resulted in 
regulatory relief for thousands of small businesses.
  Madam Speaker, I hope before the end of the year to give the House a 
comprehensive review of the corrections day process and the good we 
have been able to accomplish. While we are tied up in the midst of 
major policy disagreements over the direction of the Federal budget, it 
is important for our constituents to know that real work is getting 
done. So much focus it put on what is not working, it is nice to see 
that our system can work and does work every day.
  Mr. BROWN of Ohio. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I am glad we are having this debate today. I think it 
is important certainly to pass this bill, as we talked about, because I 
think it is an unnecessary regulation, and that makes sense for every 
standpoint, from a government standpoint, from industry standpoint for 
Medicare, for consumers, for Medicare beneficiaries. I am glad we are 
having this discussion about Medicare and Medicaid because we have had 
so few chances, Madam Speaker, to talk about this legislation on the 
floor. We had 1 hour of general debate on the reconciliation bill in 
the Committee on Ways and Means of the gentleman from California [Mr. 
Stark], and there was only 1 hour, there was only one hearing on 
Medicare in that committee, is my understanding, and the committee I am 
on, the other committee of jurisdiction on Medicare and Medicaid, we 
had no hearings whatsoever on either of those issues. We simply marked 
the bill up, generally on party line votes where 

[[Page H 12209]]
every Republican in the committee almost on every vote voted with 
whatever Speaker Gingrich wanted.
  That was disturbing, but it gives us an opportunity today during this 
corrections day to talk about a couple of issues that are particularly 
important. One of them is the part B increase in Medicare. People right 
now, Medicare beneficiaries in this country, are paying $46 a month for 
part B Medicare. Under the Gingrich plan, this will be increased; we 
will see a 25-percent increase. That is why the President vetoed these 
two bills this week, the continuing resolution and the debt ceiling 
increase, because of increases in Medicare premiums.


                            points of order

  Mr. BILIRAKIS. Madam Speaker, I rise to a point of order.
  The SPEAKER pro tempore (Mrs. Myrick). The gentleman will state his 
point of order.
  Mr. BILIRAKIS. Madam Speaker, I have sat here and listened to all of 
this and I have no problem with giving these gentlemen their time to 
speak on this particular subject, but I would like to get this bill out 
of here so that we can go on to our business, and if they want to talk 
in some way, they can go ahead and do so. But it is a point of order.
  This harangue that we have had from the other side is certainly not 
germane to what we are talking about here, and I think it violates the 
rules of the House.
  The SPEAKER pro tempore. The point is sustained. Debate will be 
confined to the bill under consideration, H.R. 2366.
  Mr. BROWN of Ohio. Madam Speaker, we are talking about Medicare, we 
are talking about that section. I ran for Congress understanding that 
on the floor of the House you could talk about issues that affected 
people's lives and issues that affected the particular legislation you 
are working on.
  On this side of the aisle I control my 30 minutes. My friend from 
Florida can talk about what he wants in his 30 minutes.
  The SPEAKER pro tempore. Under the rules, the debate must pertain to 
the question under debate specifically. The gentleman may proceed on 
that basis.
  Mr. BROWN of Ohio. I will do that, Madam Speaker, and I will continue 
to talk about how we correct Medicare, because part of this corrections 
day calendar is to correct one section of Medicare, and I think that 
the way to correct Medicare certainly is to pass this bill, and we will 
have a total of 1 hour of debate to do that. But as we move on, the 
real way to correct Medicare is not to destroy it by increasing 
people's premiums 25 percent and by making $270 billion in cuts in 
order to give major tax breaks to the wealthiest people in this 
country.
  Mr. BILIRAKIS. Madam Speaker, with all due respect to my colleague 
from Ohio, we are talking about the cardiac pacemaker registry here. I 
do not quite understand this.
  I have sat here very patiently. I think I have had the opportunity, I 
know I have had the opportunity to interrupt previously. I have not 
done so, but I think the other side is taking advantage of the 
situation.
  The SPEAKER pro tempore. The gentleman from Florida made the point of 
order that the debate is not relevant.
  Does any other Member want to be heard on the point of order?
  Mr. STARK. Madam Speaker, I wish to be heard on the point of order.
  Madam Speaker, under the point of order could the Speaker define for 
us what is the topic before us and wherein we may speak within the 
parameters set by the distinguished Speaker?
  The SPEAKER pro tempore. The question under debate is the bill, H.R. 
2366.
  Mr. STARK. And to what does that pertain, Madam Speaker?
  The SPEAKER pro tempore. The title of the bill is to repeal an 
unnecessary medical device reporting requirement.
  Mr. STARK. I see, and the area of jurisdiction is what?
  The SPEAKER pro tempore. The bill was referred to the Committees on 
Commerce and Ways and Means.
  Mr. STARK. And the bill pertains to Medicare and Medicaid and health 
care in general; doe it not?
  The SPEAKER pro tempore. The subject under debate is the bill.
  Mr. STARK. Madam Speaker, I would just ask for clarification.
  The SPEAKER pro tempore. The clarification is, this is a bill to 
repeal an unnecessary medical device reporting requirement.
  The point of order is well taken. The gentleman from Ohio [Mr. Brown] 
should confine his debate to H.R. 2366.
  Mr. BROWN of Ohio. Madam Speaker, when you talk about these pacemaker 
devices, you are talking about Medicare. You are talking about how you 
pay for these pacemaker devices, how Medicare pays. If Medicare 
premiums are increased, does that mean that if the Gingrich plan wants 
to go over 25 percent double over the next 7 years, does that mean that 
people will not be able to afford these pacemakers?
  I think it is a discussion, frankly, in spite of your misreading of 
the rules, I think it is a discussion that people in this country want 
to have, what they are going to pay for Medicare, what is going to be 
covered by Medicare, what regulations surround Medicare and Medicaid or 
whether it is the cost of premiums.
  That is a discussion that people in this country want to have, Madam 
Speaker, and it is a discussion that we have been denied in committee 
and it is a discussion that we ought to have.
  Mr. STARK. Madam Speaker, may I be heard on the point of order?
  The SPEAKER pro tempore. Members will suspend.
  There is no point of order pending at this time.
  Mr. STARK. Madam Speaker, I rise to a point of order.
  The SPEAKER pro tempore. The gentleman will state it.
  Mr. STARK. Madam Speaker, in H.R. 2366 line 3, section 1, it says, 
repeal section 1862 of the Social Security Act, and it is amended by 
striking subsection (h). It is my understanding that in amending a 
section of the Social Security Act, the Member can strike the last word 
and discuss anything under that Social Security Act, which would be 42 
U.S.C. 1395, and if section 1862 of the Social Security Act covers all 
of these topics, I would like the Speaker to suggest whether or not we 
may therefore discuss anything in section 1862, which this bill seeks 
to repeal, or a subsection thereof.
  The SPEAKER pro tempore. Is the gentleman asking a parliamentary 
inquiry?
  Mr. STARK. Yes.
  The SPEAKER pro tempore. Does the gentleman from Ohio [Mr. Brown] 
yield to him for that purpose?
  Mr. BROWN of Ohio. Madam Speaker, I yield to the gentleman from 
California [Mr. Stark] for a parliamentary inquiry.
  The SPEAKER pro tempore. As previously stated, the proper debate is 
on the subject matter of the bill, H.R. 2366, and the Chair will 
repeat, to repeal an unnecessary medical device reporting requirement.

  Mr. BILIRAKIS. Madam Speaker, may I inquire at this time as to how 
much time remains on each side?
  The SPEAKER pro tempore. The gentleman from Florida [Mr. Bilirakis] 
has 26 minutes remaining, and the gentleman from Ohio [Mr. Brown] has 
11 minutes remaining.
  Mr. BROWN of Ohio. Madam Speaker, was all of this debate when the 
gentleman from Florida [Mr. Bilirakis] raised his point of order, was 
that all subtracted from our time?
  The SPEAKER pro tempore. No, it was not.
  Mr. BROWN of Ohio. Madam Speaker, I yield 2 minutes to the gentleman 
from Kentucky [Mr. Ward].
  Mr. WARD. Madam Speaker, I would ask the gentleman from Florida [Mr. 
Bilirakis], because of the crisis that we are facing right this minute 
in the Government. Those who are watching these debates understand that 
we are at this point acting without, we are moving forward in the U.S. 
Government without, a budget. I would ask the gentleman, would it not 
be reasonable to ask the gentleman from Florida not to raise a point of 
order, and if the gentleman from Florida did not raise a point of 
order, could we not then discuss these serious issues relating to 
Medicare?
  Mr. BILIRAKIS. Madam Speaker, will the gentleman yield?
  Mr. WARD. I yield to the gentleman from Florida.
  Mr. BILIRAKIS. Madam Speaker, the gentleman from Florida sat here 
very patiently and respectfully while the 

[[Page H 12210]]
gentleman from California went on for something like 15 minutes in 
spite of the fact that I felt he was out of order at that point in 
time. We have special orders here, we have many ways in order to get 
this done.
  We have a very simple corrections bill here that everyone has agreed 
to go forward, and I think we should just go forward with this and have 
regular order.
  Mr. WARD. Madam Speaker, reclaiming my time, I appreciate that the 
gentleman from Florida [Mr. Bilirakis] did allow this debate without a 
point of order, and I guess what I am asking is, would it not be fair 
to continue to allow that since we in the minority are not being 
allowed to continue?
  Mr. BILIRAKIS. Madam Speaker, if the gentleman would yield further, I 
did not make the rules of the House. I would suggest to you that your 
party, when you controlled this House for 40 years, made these rules of 
the House in terms of germaneness and sticking to the point.
  Mr. BROWN of Ohio. Madam Speaker, reclaiming my time, the fact is 
that this order was made by the Chair because a Member asked for this, 
because it is pretty clear that some people in this House do not want 
to debate Medicare on this House floor, did not want to debate Medicare 
and have hearings in the Committee on Commerce, did not want to debate 
Medicaid and Medicare in the Committee on Ways and Means.
  We have wasted 15 minutes talking about nothing when we have a 
Speaker of the House who said, ``We don't want to get rid of Medicare 
in round one because we don't think that is politically smart. We don't 
think that is the right way to go through a transition.''
  Mr. BILIRAKIS. Regular order, Madam Speaker. Enough is enough.
  The SPEAKER pro tempore. The gentleman will suspend. All Members will 
suspend.
  Does the gentleman from Florida state a point of order?
  Mr. BILIRAKIS. Madam Speaker, I ask for regular order at this point 
in time. The point of order I believe has already been made, Madam 
Speaker.
  The SPEAKER pro tempore. The Chair will take this opportunity to read 
from clause 1 of rule XIV of the Rules of the House of Representatives.

       When any member desires to speak or deliver any matter to 
     the House, he shall rise and respectfully address himself to 
     ``Mr. Speaker,'' and, on being recognized, may address the 
     House from any place on the floor or from the Clerk's desk, 
     and shall confine himself to the question under debate.

  With that guidance, the gentleman from Ohio [Mr. Brown] may proceed.
  Mr. BROWN of Ohio. Madam Speaker, H.R. 2366, which we on this side of 
the aisle support, is about Medicare, and it is about repealing a part 
of Medicare. That is within the entire structure of the Medicare bill.
  When I hear the Speaker of the House on October 24 make a statement 
about Medicare withering on the vine, it also includes H.R. 2366, a 
part of the Medicare bill. H.R. 2366 includes section 1862, because the 
Speaker said, ``We don't want to get rid of Medicare,'' and also 
section 1862, ``We don't want to get rid of it in round one because we 
don't think that is politically smart, and we don't think that is the 
right way to go through a transition.''

                              {time}  1115

  Again the Speaker is talking about this section, 1862, talking about 
the Social Security Act, talking about Medicare.
  The Speaker says, ``We don't want to get rid of Medicare in round one 
because that's not politically smart. We don't think that's the right 
way to go through a transition. But we believe that Medicare is going 
to wither on the vine,'' again talking about section 1862 and talking 
about the Social Security Act, talking about Medicare. That is very 
debatable on this floor because that is a serious attempt to dismantle 
Medicare, Madam Speaker.


                             point of order

  Mr. EHRLICH. Regular order, Madam Speaker.
  The SPEAKER pro tempore (Mrs. Myrick). The gentleman will suspend.
  Does the gentleman from Florida have a point of order?
  Mr. BILIRAKIS. Madam Speaker, I have the continuing point of order. 
But the point of order has already been ruled upon and is being 
violated by the Members on the other side of the aisle. This is 
ridiculous. Let us stay on point for crying out loud.
  The SPEAKER pro tempore. Will the gentleman please restate his point 
of order.
  Mr. BILIRAKIS. My point of order is to the effect that the debate 
over there has nothing at all to do with the legislation before us, 
which is to repeal the unnecessary regulatory burden of the cardiac 
pacemaker registry imposed by the Social Security Act, period. It is 
limited to that particular point, that subsection.
  The SPEAKER pro tempore. The Chair finds that the most recent debate 
maintains the proper nexus to the bill. The gentleman may proceed.
  Mr. BROWN of Ohio. Madam Speaker, it concerns me when we talk about 
section 1862 and we talk about this bill. Again I applaud the 
gentlewoman from Nevada [Mrs. Vucanovich], the gentleman from Florida 
[Mr. Bilirakis], and the Committee on Commerce chaired by the gentleman 
from Virginia [Mr. Bliley] in their support of this legislation.
  I would hope that when we talk about Medicare and talk about section 
1862 that we do look at the entire Medicare package. That is, are we 
going to save Medicare? Are we going to follow the words of the Speaker 
of the House who says that it is politically not smart now to get rid 
of Medicare, that is why we need the Gingrich plan now, so that we can 
begin the process of Medicare withering on the vine. That is what 
concerns me, Madam Speaker, that this entire bill, whether it is 
section 1862----


                             point of order

  Mr. EHRLICH. Point of order, Madam Speaker.
  The SPEAKER pro tempore. The gentleman will state his point of order.
  Mr. EHRLICH. Call for regular order. Nongermane debate again, Madam 
Speaker.
  Mr. BROWN of Ohio. Madam Speaker, I have mentioned section 1862 in 
almost every sentence of my discussion here.
  Mr. EHRLICH. Madam Speaker, the gentleman just quoted the Speaker 
with respect to the issue of Medicare generally. I believe that 
directly violates the Chair's ruling.
  Mr. BROWN of Ohio. Madam Speaker, it is not my fault that the Speaker 
was speaking to a bunch of insurance agents who are going to benefit by 
the passage of this bill and that he said that he wants Medicare to 
wither on the vine. I did not write his speech, Madam Speaker.
  The SPEAKER pro tempore. The Chair is entertaining the argument on 
the point of order, sir. Has the gentleman completed?
  Mr. BROWN of Ohio. The ruling has been made in support of our 
position again, Madam Speaker?
  Mr. EHRLICH. The point of order has not been ruled upon, is my 
understanding.
  The SPEAKER pro tempore. The Chair is prepared to rule.
  Quotations of the Speaker are not out of order, per se, but a nexus 
needs to be maintained to the subject of the bill.
  Mr. BROWN of Ohio. I thank the Speaker.
  I will make the nexus again that the Speaker, speaking to an 
insurance executive group in, I do not know, perhaps in Washington, in 
October, talking about section 1862 and Medicare as a whole, said, ``We 
don't want to get rid of Medicare''----


                             point of order

  Mr. EHRLICH. Point of order, Madam Speaker.
  The SPEAKER pro tempore. The gentleman will state his point of order.
  Mr. EHRLICH. Medicare as a whole is not the proper subject of this 
debate in the rulings that the Chair has made in the last 10 minutes.
  Mr. BROWN of Ohio. Madam Speaker, what is the other party afraid of 
when I quote the Speaker? I do not understand. Maybe I am missing 
something, Madam Speaker, if you could clarify your ruling.
  The SPEAKER pro tempore. The gentleman will suspend. Will Members 
please allow complete sentences to be made in the point of debate 
before interrupting?
  The Chair cannot judge an incomplete sentence. The gentleman from 
Ohio may proceed.
  Mr. BROWN of Ohio. I thank the Speaker.

[[Page H 12211]]

  Madam Speaker, a month ago, Speaker Gingrich speaking about Medicare 
to a group of insurance executives, most of whom will benefit mightily 
from the Gingrich Medicare $270 billion in cuts to give tax breaks for 
the wealthy, said to this group, ``Now, we didn't get rid of Medicare 
in round 1 because we don't think that's politically smart, and we 
don't think that's the right way to go through a transition. But we 
believe that Medicare,'' parenthetically I would add, Madam Speaker, 
section 1862 which we are debating today and is part of Medicare, ``but 
we believe,'' Speaker Gingrich went on to say, ``that Medicare is going 
to wither on the vine.''
  That is my concern, Madam Speaker, that we need to discuss this bill 
on the floor because 1862 is part of this bill, and I do not quite 
understand why people in this body are so afraid of quoting the Speaker 
of the House.
  Mr. EHRLICH. Regular order, Madam Speaker. I believe that was 15 
complete sentences. If the purpose of the gentleman is to appeal the 
ruling of the Chair, I would ask the gentleman to do so. If the purpose 
of the gentleman is simply to disregard the orders of the Chair, the 
gentleman should so state.
  Mr. BROWN of Ohio. I say to my friend from Maryland, the Speaker 
asked me----
  Mr. EHRLICH. I will suspend, Madam Speaker. It is my understanding 
now you are deciding on the motion.
  The SPEAKER pro tempore. The Chair rules that a subject matter nexus 
must be maintained in the debate, between the debate and the bill under 
discussion, and the Chair has ruled such.
  Mr. BROWN of Ohio. And I had the nexus, Madam Speaker?
  The SPEAKER pro tempore. The most recent debate has maintained that 
nexus.
  Mr. BROWN of Ohio. I thank the Speaker. So I can talk about section 
1862 and Medicare?
  The SPEAKER pro tempore. As long as the gentleman maintains that 
subject matter nexus.
  Mr. BROWN of Ohio. Madam Speaker, I yield such time as he may consume 
to the gentleman from Texas [Mr. Gene Green] to continue to make the 
nexus on 1862 and the Speaker wanting Medicare to wither on the vine.
  Mr. GENE GREEN of Texas. Madam Speaker, I thank my colleague from 
Ohio for allowing a gentleman from Texas to make the nexus with this 
bill.
  Let me talk a little bit about H.R. 2366. I know he has been 
comparing and contrasting this bill with the Speaker's comments in an 
earlier speech but let me talk about the continuing budget resolution 
that concerns all of us and to contrast the CR with this bill we are 
debating today, H.R. 2366.
  I am glad we have this opportunity to discuss the Speaker's comments 
and H.R. 2366, because there is a comparison between the two. First, we 
had the same committee, the Committee on Ways and Means, consider H.R. 
2366 and the continuing resolution.
  Madam Speaker, we also have a continuing resolution passed by the 
Ways and Means Committee that would increase Medicare premiums from 
$46.10 to $53.50 a month, which is the same committee from which this 
bill came.
  That is why I think there is some concern. That is why I am glad that 
the gentleman from Ohio has brought up the comparison between what we 
are doing here today on the shutdown of the Federal Government and the 
concern about the increase in Medicare premiums with H.R. 2366 that 
came out of the same committee.
  I think there is a comparison between the two, because H.R. 2366 
deals with a problem that was solved on a bipartisan basis and actually 
when it is passed, it will be. But the continuing resolution that was 
passed here was not passed on a bipartisan basis, even though it came 
out of the same committee.
  I think H.R. 2366 is a great example of recognizing a problem with 
the Social Security Act and Medicare and the medical device reporting 
requirement, and slowing it. Yet again today, because of the veto 
yesterday of the continuing resolution and recently of the debt 
ceiling, we have not seen any of the bipartisanship that we should have 
on H.R. 2366.
  It was not stated by just myself on the floor but by the President 
himself, that if we go back to the actual $46.10 a month on a 
bipartisan basis like we have done on H.R. 2366, we might not see 
having the Federal Government shut down today and not having lots of 
Federal employees furloughed.
  I would hope that the Committee on Ways and Means that sent us H.R. 
2366 would also consider working on other even more important 
legislation, although I think the medical device reporting is 
important, particularly if you are dealing with pacemakers and folks 
that need it. But senior citizens also need to be able to afford that 
Medicare monthly premium. Going from $46.10 to $53.50 is just something 
that they cannot afford and frankly I applaud the President for vetoing 
that effort. Again hopefully it will come back to us and the Committee 
on Ways and Means and the Committee on Commerce can work together so we 
can have bipartisan resolution to this.
  Mr. BROWN of Ohio. Madam Speaker, again I am pleased to support 
repeal of 1862(h) but oppose the Medicare withering on the vine as the 
Speaker has reminded us that his plan does.
  Madam Speaker, I reserve the balance of my time.
  Mr. BILIRAKIS. Madam Speaker, I yield such time as he may consume to 
the gentleman from Texas [Mr. Barton].
  Mr. BARTON of Texas. I thank the gentleman from Florida, the chairman 
of the Subcommittee on Health and Environment, for yielding me the 
time.
  Madam Speaker, unlike some of my Democratic colleagues, I am going to 
rise in support of this legislation and strictly speak on this 
legislation.
  I would like to point out that the bill was reported out of the 
Committee on Commerce on a bipartisan basis. My good friend, the 
gentleman from California [Mr. Waxman], and the gentlewoman from Nevada 
[Mrs. Vucanovich] are the chief sponsors of the bill. The purpose of 
the bill is to repeal the cardiax pacemaker registry established in 
1984 by the Social Security Act. I would like to read the background on 
this legislation. It is only two paragraphs, and I think it may be of 
some value to our colleagues.
  It says that section 1862(h) of the Social Security Act requires 
doctors and hospitals receiving Medicare funds to provide information 
upon implementation, removal, or replacement of pacemaker devices and 
pacemaker leaders. These requirements became redundant in 1990 with the 
enactment of amendments to the Federal Food, Drug, and Cosmetic Act 
that established a more comprehensive system for reporting on medical 
devices. This legislation is needed to eliminate the unnecessary burden 
on the health care system, the Health Care Financing Administration, 
and the Food and Drug Administration. On October 12, 1995, the 
Speaker's advisory group on corerctions, a bipartisan task force, 
recommended to the Speaker that H.R. 2366 be placed on the House 
Corrections Calendar, which it is being done today, and which I would 
assume in the next 5 minutes or so that we are going to pass this, 
probably by a voice vote, perhaps by a rollcall vote.
  This is an example of where we can work together in a bipartisan 
fashion to eliminate some of the unnecessary Federal rules and 
regulations that have grown like barnacles in the Federal Code over the 
last 20 to 30 years.
  I support the leadership of the gentleman from Florida [Mr. 
Bilirakis], the chairman, and his effort on this and hope that we would 
focus on the issue at hand, this piece of legislation, and pass it 
forthwith.
  Mr. BILIRAKIS. Madam Speaker, I guess unfortunately I misspoke in my 
opening remarks when I talked about the bipartisan nature of what we 
were doing here this morning, regarding this piece of legislation. That 
is very unfortunate.
  Madam Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Madam Speaker, I yield myself the balance of my 
time.
  Madam Speaker, this is a bipartisan bill. We want to see it passed.
  The gentleman from California, Mr. Stark, the gentleman from Texas, 
Mr. Gene Green, and the gentleman from Kentucky, Mr. Ward, that have 
spoken on this side of the aisle, all of us that are on the Commerce or 
Ways and Means committees that supported this bill want to see it 
passed.
  We simply wanted, and I guess it was just too touchy an issue in this 
body, 

[[Page H 12212]]
we wanted to debate perhaps the greatest Government program ever, 
Medicare, that has been with us for 30 years, that where 50 percent of 
the people in this country were not covered, did not have any health 
insurance, 50 percent of the elderly in 1965, today only 1 or 2 percent 
of the elderly do not have coverage because of Medicare.
  Yet this Gingrich plan will increase people that are uninsured by as 
much as 50 percent according to nonpartisan experts.
  More to the point on section 1862, by striking subsection (h) which 
is what we should do, repealing that but not repealing and allowing 
Medicare to wither on the vine, the poorest elderly are going to have a 
$700 out-of-pocket expense to pay for these pacemakers because of the 
Medicaid reforms on something called QMB that the Gingrich plan has 
allowed.
  Madam Speaker, I support this bill, I do not want to see Medicare 
wither on the vine. I hope that down the road we can have a real 
Medicare debate where people are not interrupting one another to say 
that it is not germane because the American people deserve that.
  Madam Speaker, I support H.R. 2366.
  Madam Speaker, I yield back the balance of my time.
  Mr. BILIRAKIS. Madam Speaker, I yield myself such time as I may 
consume.
  Possibly, present company excepted, I do not know, I would suggest 
that most of the Members on the other side of the aisle have been 
involved in Medicare debates over the years, particularly during 
election time. They are very adept at it, and this morning proves that, 
I think, more than anything else.
  Madam Speaker, I yield back the balance of my time.

                              {time}  1130

  The SPEAKER pro tempore (Mrs. Myrick). Pursuant to the rule, the 
previous question is ordered.
  The question is on the engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read a third time.
  The SPEAKER pro tempore. The question is on the passage of the bill.
  The question was taken; and (three-fifths having voted in favor 
thereof) the bill was passed.
  The motion to reconsider was laid on the table.

                          ____________________