[Congressional Record Volume 144, Number 143 (Sunday, October 11, 1998)]
[House]
[Pages H10546-H10553]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
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MANAGED CARE REFORM AND OTHER TOPICS
The SPEAKER pro tempore (Mr. Mica). Under the Speaker's announced
policy of January 7, 1997, the gentleman from New Jersey (Mr. Pallone)
is recognized for 60 minutes.
[[Page H10547]]
Mr. PALLONE. Mr. Speaker, I wanted to start out this evening by
pointing out that the problem that I as a Democrat and I think most of
the Democrats have with what has been happening here the last 2 years
is not necessarily that we are not willing to debate with the
Republicans on these issues because in many ways I think that what
happened today in the discussion that we have had today on both sides
of the aisle has been rather interesting. The problem is that on most
of the Democratic initiatives which I think are the initiatives that
the average citizen is concerned about, we have not had the opportunity
to bring them up. We have talked as Democrats about how we want to
bring up before the Congress adjourns education concerns, money to
modernize our schools, to hire additional teachers, 100,000 new
teachers. We are going to talk this evening in the next hour quite a
bit about HMO reform. We have talked about the need to address Social
Security because we know that eventually down the road there is not
going to be enough money in the Social Security trust fund. But what we
have found is that the Republican leadership does not allow these
things to come up. They do not even allow, and the very debate that we
have had tonight in the context of these special orders is not a debate
that we are allowed to have on legislative issues because the
legislation that deals with these education or HMO, health care
concerns or Social Security concerns, we do not get an opportunity to
deal with it. The Republicans control the House. The Republicans decide
what comes to the floor. And they have basically stalled and not
allowed most of these concerns that the American public has to even be
considered. That is why we are here tonight on Sunday to debate this,
why we are demanding that these issues be addressed before we go home,
and all we keep hearing from the other side of the aisle is that they
want to get out of here quickly, they think they have completed their
business. Well, they have not completed their business. We would like
to point that out.
I yield to the gentlewoman from Connecticut who started the special
orders earlier this afternoon and who has been our leader on so many of
these issues.
Ms. DeLAURO. I thank the gentleman from New Jersey. I just wanted to
make a couple of points before we start our hour's time here. The
gentleman who led the previous discussion here this evening is the
third-ranking leader in the House of Representatives, the majority
whip. I think it was interesting to note that he commented about the
government shutdown 2 years ago. What is quite extraordinary to note is
that the government was shut down twice, unheard of in the history of
the United States, by the Republican majority because, as my colleague
from New Jersey has rightly said, and sometimes people do not
understand this, when the party is in power and they have the majority,
they control what happens here. You can say anything that you want
about the Democrats were in the majority and you could agree or
disagree on what they have, but the fact of the matter is that the
Republicans control both the House and the Senate. But an interesting
point, because he talked about how terrible a government shutdown would
be and that is not what they were looking for and that it was the
President looking for a government shutdown. Well, I was so stunned by
a comment that the majority whip made when the government was shut down
2 years ago that quite honestly I had it blown up and I have it in my
office because I could not believe anyone who held such an honor and
held a position in this body would say such a thing. It was in a Texas
newspaper and I am happy to provide it to anyone who would like to see
it. I am not making this up. He said that when he heard that the
government was reopened, that it was the worst moment, and I am
paraphrasing, the worst moment of his life. He was grilling steaks on
his balcony with some other Republican members, and he said, ``We
should have kept the government closed for as long as it was
necessary.''
Now, he has the luxury of saying that because he was earning a salary
while the government was closed and people who were furloughed or laid
off had no idea whether or not they were going to get their salaries,
and the hundreds and hundreds of services that are supplied by this
United States Government were shut down. So that he truly is someone
who, in fact, was pleased that the government was shut down in the
past, and I hasten to view that he would not mind if that happened
again. That is where they are going.
I might also make just one more point. We are talking about how this
Republican majority, how they legislate and the reasons for what they
do and how that is tied in to special interest money. There is a big
argument, if you will, a feud, GOP Feuding About Lobbyists. The point
here, and it is in the papers here, again the majority whip is locked
in a feud with the chairman of the Republican Conference because what
they want to do is to dump the choice of president of something called
the Electronic Industries Alliance. The long and the short of it, the
person that is scheduled to become the president of this organization
is a former Member of the House, Representative Dave McCurdy, who is a
Democrat from Oklahoma. Essentially what they want to do, and this is
by their own admission here, this is a quote, they want to send a
message to this EIA that Republicans will not deal with trade
associations and lobbying groups run by Democrats. Now, this is a quote
by John Linder who is the head of their Republican Congressional
Campaign Committee who says, quote, we think they, ``they'' being the
trade associations, et cetera, ought to look back and see who won the
last couple of elections. And Mr. Linder confirmed that Republican
leaders held intellectual property legislation, that means that our
patents, all of our inventions, that laws restricting foreign
governments, speaking of foreign governments, Chinese, everywhere where
they are stealing our intellectual property around the world. What he
is saying is that they held the legislation hostage that would have
restricted foreign governments from stealing our intellectual property.
He confirmed, ``Republican leaders held intellectual property
legislation favored by these EIA members hostage, quote, to send a
message, that if you don't play by the Republican rules and don't do
business with the Democrats, we are not going to pass legislation and
you are not going to be able to get anything done up here.'' That is
the way this Republican majority is dealing, fast and loose, fast and
loose with the lives of the people in this country. It is on
intellectual properties, it is on tobacco, 3,000 of our kids start to
smoke every single day, a thousand of whom die. And they refused to
pass tobacco legislation in this body. They are the single biggest
recipients of tobacco dollars in the country. So who are they kidding
when they talk about what they want to do for the American public? It
was Mr. DeLay, it was Mr. Gingrich who said, ``There isn't enough
money in our system. That's why we cannot pass campaign finance
reform.'' And it was the Republican leadership of this House who said
take Social Security dollars and squander them away.
Mr. PALLONE. ``And let Medicare wither on the vine.''
Ms. DeLAURO. That is right.
Mr. PALLONE. That was Speaker Newt Gingrich's quote.
Ms. DeLAURO. I believe it was Mr. Armey, the second-ranking member,
who said Social Security is not a system that ought to be in existence
or that we ought to have a part of. We need to remember some of those
things.
In terms of public education, what we were talking about before, they
would just as soon see public education come crumbling down and take
public education and take those dollars and put them in the hands of
the very few and the very rich and take away our birthright to
education in this country.
Mr. PALLONE. I want to introduce the gentlewoman from California, but
I just wanted to follow up on one of the things that the gentlewoman
from Connecticut said. I am glad that she brought up this issue of Mr.
DeLay, his remarks that he made when the government had been shut down
by the Republicans and he regretted the fact that it was not shut down
longer. There is a basic difference of philosophy here, or ideology,
and, that is, that this Republican leadership does not believe in the
government essentially, and they believe that it is better if the
government does nothing. I have had
[[Page H10548]]
many Republicans on the other side of the aisle the last couple of days
say, ``Well, it doesn't matter if we're labeled as the do-nothing
Congress because a do-nothing Congress is better.'' Many of them
actually believe that. They do not look at the concerns that we have
for the health and the safety and the protection of the average
American as something that is actually positive. Remember that the
issues that we feel that they should be raising, managed care reform,
as far as many of them are concerned, there is no need for managed care
reform because they do not have a problem with the insurance industry
basically running roughshod over the American people and not providing
medically necessary procedures and operations and length of stay in the
hospital that a person needs to provide for adequate health care.
As far as education issues, I think the gentlewoman is right when she
says that for many of them they would just as soon not have public
education. So when we talk about modernizing school or class size, that
is not their concern. They want more students to go to private schools.
They are not concerned about public education. When we talk about
Social Security, we have heard some of these same leaders say that
Social Security was a bad thing from the beginning, so they are not
concerned about whether or not we bring up efforts to try to shore up
Social Security. She mentioned teen smoking. The same thing. Let the
tobacco interests sell whatever they want to whomever. That is laissez
faire. They believe that. They are not going to have us play some role
in trying to protect young people or teenagers from smoking. And on
down the line. Minimum wage. They do not want to raise the minimum
wage. We have had to fight that so many times. Every time it has been
raised here, it has been a battle by the Democrats to try to raise
minimum wage. As far as they are concerned, there is no need to deal
with that. For them to talk about how they really care about these
issues, they do not care about these issues, they want to go home and
they are proud of the fact, many of them, not all, but many of them
that this is a do-nothing Congress. I yield to the gentlewoman from
California.
Ms. WOOLSEY. I thank the gentleman from New Jersey and I thank the
gentlewoman from Connecticut for this day of standing up for the rights
of the minority party. I was listening to the majority whip yammer
along about the fact that blaming everybody else for this being a do-
nothing Congress. Of course if he had anything to say about what they
had achieved, they would have stood there and told us what they had
done. Instead, they talked and talked and talked about why nothing had
happened and pointed fingers and blamed others. If they had managed
this Congress any better than the Soviets managed Chernobyl, they would
have something to say. If they had been working on the American
public's needs instead of trying to raid Social Security, trying to cut
taxes so the wealthy could benefit, trying to give education tax breaks
for private schools, cheating the public education funding and
threatening our national resources with anti-environmental riders,
maybe they would have achieved enough that they could have stood up
there earlier and said, ``But this is what we did.'' But instead they
had to say, ``Oh, it's everybody else's fault, not ours.'' I will quote
the Vice President in his saying, ``The right hand does not know what
the far right hand is doing,'' if they had their ranks together. They
are the majority. And at what cost have they left this country without
really anything except renaming National Airport to the Ronald Reagan
Airport. They have not produced a managed care bill. There has been no
bill to train and hire more teachers so we can reduce class size. They
have no bill to modernize our schools, no safeguards for our Social
Security, nothing to reduce teen smoking, no increase in minimum wage
for working families, and the campaign finance bill that passed the
House over their dead bodies, if Members can remember what Majority
Whip DeLay said and what the Speaker said about campaign finance
reform. And then when we did pass it, it could not get through the
Republicans in the other body. They forget. They forget that children,
25 percent of our population are 100 percent of our future. Because of
that, they are setting a record, a record that has not been broken for
generations, for the least amount of days worked, the least number of
bills enacted and the first time since the budget process was created,
they have failed to pass a budget. This is not management. This is
disaster. That is why they are complaining over there and trying to
blame somebody else. But our families deserve better. It is time for a
change.
Let me tell you how this has affected our children. 71,682,000 of our
population in the United States are children. 10,000,743 more American
children have no health insurance, that is up over 10 million from the
start of this Congress. This number has continued to rise during the
105th Congress. It continues. Five thousand schools in the United
States are in desperate need of repair and many are unfit learning
environments.
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Zero, none, of the 100,000 teachers needed to reduce class size and
improve education quality have been approved; 14,113,000 children are
living in poverty. This is in the richest Nation in the world. Despite
a very strong economy, children continue to represent 40 percent of the
impoverished while compromising only 20 percent of the Nation's
population, and yet we have to remember 100 percent of the Nation's
future. Seventy-three percent more children have taken up a daily
smoking habit. Each day 3,000 kids become habitual smokers. Of these
1,000 will die of smoking-related illnesses.
It is time that we turn the debate to the needs of our children, our
seniors, our environment. Enough about politically inspired
investigations, and excessive partisanship and wasteful spending on
duplicative and wasteful Republican committee investigations that have
ended in dead ends, costing millions of American dollars. Instead, we
have to do something about managed care reform. We have to have
campaign finance reform. We have to have bills that will reduce teen
smoking. We have to have bills that will enhance environmental
protections. And we must raise the minimum wage. Then our children will
be considered our number one priority. But most of all, making them our
number one priority, we must invest in their education. We cannot leave
here without an agreement for 100,000 more teachers and new and
improved classrooms.
Twenty-five percent of our population are our children. One hundred
percent of our future are those same children.
Mr. PALLONE. Mr. Speaker, I want to thank the gentlewoman, and I
wanted to point out tonight, if we could just spend a little time on
the issue of HMO reform, because all three of us went over to the
Senate; I believe it was a couple days ago now when the democratic
majority leader Mr. Daschle tried for the last time, and he has tried
many times, to bring up the issue of HMO reform or the Democratic,
really bipartisan, proposal that we call the Patients Bill of Rights.
And many of us in the House, the three of us included, went over to the
Senate and basically stood in the back of the room to show our support
for the effort to bring up HMO reform, and, as you know, it was a
defeated. We had a couple of Republicans that joined all the Democrats,
but not enough because we do not have the majority to bring it up and
to discuss it.
Again, we were only asking that the Senate take up the issue on the
floor. The issue of whether they passed something, the Patients' Bill
of Rights or any kind of managed care reform, never came up. Again, we
are just asking that they consider these things as part of the debate,
and that was denied, and that unfortunately probably means the death
knell of that issue in the Congress for this year.
What I wanted to point out very emphatically, if I could, is that
what the Democrats and some Republicans, this is not just a Democratic
issue, but it is something opposed by the Republican leadership; what
the Democrats are asking for are very simple common sense protections.
Most people, when I discuss this with them, unless they have had a
problem with their HMO, you know, because maybe they have been healthy
and
[[Page H10549]]
have not had to deal with this, they think that these things are
already there. They are surprised to learn that these protections do
not already exist, and just to give you an idea, I just listed some of
the main ones here that we would like to have provided for all
patients, all Americans, is guaranteed access to needed health care
specialists; if you need a specialist, that you should be able to get
one; access to emergency room services. Many people go to the emergency
room and are either turned away or find out later that their health
insurance will not cover the emergency room care. Continuity of care
protections, access to timely internal and external appeal; if the HMO
or insurance company denies you a particular procedure, then you should
be able to appeal that and have it overturned. Limits on financial
incentives to doctors. Unfortunately, and many people are surprised to
learn, that doctors in many managed care organizations are actually
encouraged and given extra money if they limit the number of people
that are provided care, assuring doctors and patients can openly
discuss treatment options. Can you imagine? I do not think there is
anybody probably who thinks that there is anything out there that would
deny doctors and patients the right to openly discuss treatment
options. We live in a free society, we value the first amendment, and
yet many of the HMOs tell their physicians that they cannot talk about
treatment options that are not covered by the health insurance. It is
called the gag rule, which is un-American. Assuring that women have
direct access to OB/GYN; I know that Congresswoman DeLauro has been
very much involved with that and some of the other issues that women
have been denied by their insurance companies, various types of care,
and lastly an enforcement mechanism that insures recourse for patients
who are maimed or die because of health plan actions. Many people do
not know that if their HMO denies them a particular type of care and
they are seriously insured or die from it, that they cannot sue the
HMO. Well, they should be able to.
We are just pointing these things out because we think that every
American should be guaranteed these basic protections. But if we do not
enact them into law, if we just proceed with this do-nothing Congress
that says that the government does not have to do anything, you know
laissez-faire, or whatever the term is, then we have a situation where
these insurance companies simply deny care, decide what is medically
necessary, and you have no recourse, and that is what we are trying to
prevent.
Mr. Speaker, I yield to the gentlewoman again.
Ms. WOOLSEY. Well, you said that maybe some of our colleagues have
never experienced the shortcomings of managed care because they are
healthy. Well, oops, maybe it is because they can afford other
coverage. It might have something to do with people being wealthy, and
I think we have to remember that, and we have to continually remember
that if an appeal process does not have real teeth, it is not an appeal
process.
There is some very good managed care providers in my district, the
Sixth Congressional District in California. I mean they are models for
the Nation. But I tell you we can be assured that even these good
managed care providers are going to have to give up some of their
quality, some of their standards if we do not have real reform because
they will have to compete, and they will be competing against providers
that do not do as well, do not do as much, do not have protections, and
everybody is going to lose because we will be slipping sliding to the
lowest rung of the ladder; there is no question about it.
We have to have real managed care reform, and the doctors in my
district want it. They want to be part of making the decision about
health care with their patient. They do not want to have to be
listening to what a clerk in an insurance company is telling them that
they can to or not do for their patient. The patient and the doctor
want to make those decisions, and the insurance company is responsible
for paying for it.
Mr. PALLONE. I want to thank the gentlewoman and yield to the
gentlewoman from Connecticut.
Ms. DeLAURO. I think that this is such an appropriate discussion, and
it is such an issue that is on the minds of the American people, and
that is what is being flaunted here. It is not us. It is about what the
American people have talked about in terms of the whole managed care
system which they find is out of control.
There was a recent Times CNN poll that found that 76 percent of
Americans support managed care reform. Only 41 percent said that they
were very confident that their health care plan would pay for their
treatment if they really got sick. And now you have another, and most
people, and I think everybody saw it, As Good As It Gets, the movie
where there is the great applause line when Helen Hunt expresses her
frustration with the HMOs and managed care because people feel that
that is out of control, that they, in fact, have no way of being able
to handle this system.
More recently we have found that the HMOs are pulling out of Medicare
and leaving seniors on their own. It has happened in my State of
Connecticut where we have 12,000 people now who are, you know, trying
to scramble around for what they are going to do for their health care.
Now, it is not only happening in Connecticut, it is happening all over
the country. So, the fact is that the public truly knows that the
managed care system is out of control.
Now we tried to address that, as both my colleagues have pointed out,
with a very simple set of guidelines, if you will, in which my
colleague from New Jersey mentioned about emergency room care, and
speciality care and continuity of care if your employer changes plans,
and employers change plans every year now.
Just interesting to note that that was a bipartisan piece of
legislation. There are lots of folks said if we can put the bickering
aside and do something on behalf of the American public, let us set the
record straight. It is a bipartisan piece of legislation. Dingell,
Ganske, a number of other folks including the gentleman from New Jersey
who worked very hard on this issue that could have passed this House in
a heartbeat. But go back to the notion that who was in charge? Who has
the jurisdiction to bring up the legislation? Who has the jurisdiction
to hold hearings?
Three days of hearings on the issue of managed care reform; contrast,
63 days of hearings on politically-motivated investigations. More to
the point: 2 days of hearings on renaming National Airport the Ronald
Reagan Airport.
Now for 3 days, only 3 days for our health care system, they finally
passed; they brought up after months and months, they passed this sham
bill, sham bill, and I just want to mention it because they will come
up and claim that they passed a HMO bill, but let me just say that it
makes things worse, the bill that they passed. It does not guarantee
coverage of emergency care, it does not guarantee privacy of medical
records. That is your medical records which today is such a problem
with regard to employment or with regard to insurance coverage can be
given away to anyone without your knowledge. It would not guarantee
access to specialists, it does not guarantee the continuity of care if
your doctor is arbitrarily dropped from the plan, does not hold health
plans accountable for their decisions when things go wrong. And above
all, above all, it will not give the power to decide what is medically
necessary to your doctor.
That is the fundamental reason people want to see health, managed
care reform because of they want doctors to make the decisions along
with them, with themselves.
Again, this is thwarting the will of the public, it is thwarting the
will of the majority in both the House and in the Senate, and they
recently, just 2 days ago, defeated managed care. That is not the way
that this place should be operating. We are here to represent people's
interests. We are not for political reasons to thwart the will of the
people particularly on their health care and their health and their
safety.
Mr. PALLONE. The gentlewoman points out, makes a very good point I
should say, with regard to the HMO reform, and that is that, as we
know, back in August, there was so much heat, if you will, on the
Republicans to deal with the issue of managed care reform, so many
constituents who were
[[Page H10550]]
clamoring that they take up the issue that they finally did just on one
day with a very brief debate on the House floor allow the issue to come
up. But what they did as a result of that was to pass a bill that was
actually worse than the status quo.
I have not been dwelling that much on that, although I think we
should talk about it a little bit because when it went over to the
Senate, they would not even take that sham bill up. So we are faced in
a situation now where they will not even bring it up again because they
think that, you know, circumstances have changed and the public is not
paying as much attention to that, which I think is garbage. There is no
question that the public is still very much concerned about it.
But if we can just take a minute to elaborate a little more on this
sham bill that they brought up, and I think you pointed out this issue
of medical necessity which is really the heart of this debate because
when we say that a person is not getting care, it is usually because
they are not allowed to have a certain operation or they are told they
cannot stay in the hospital more than 2 days for a certain procedure,
and so the decision about what is medically necessary in that case,
just to have the operation or to stay the extra few days, is
essentially made by the insurance company.
{time} 1900
What the Democratic or bipartisan, if you will, Patients' Bill of
Rights says is that medical necessity will be based on generally
accepted principles of professional medical practice.
So it goes back to what the physicians and the physician groups say
is necessary, as opposed to what the insurance companies say. They do
not change that in their bill. They simply say it is up to the
insurance company to decide what is medically necessary.
This kind of trickery goes on for just about everything in their
bill. Emergency room care is another example. You can theoretically go
to any emergency room under the Republican bill, but there is no
guarantee that the insurance company is going to pay for it.
We use this example of severe pain, because under the Democratic
bill, we use a lay person's standard, a prudent layperson. Obviously
the prudent or typical citizen, if you will, if they get severe pain in
their chest, figures they had better go to the emergency room because
they may be having a heart attack.
Under the Republican bill there is no guarantee that severe pain is a
basis for your getting emergency room care. You could go to the
emergency room with what you think is a heart attack because you have
severe pain, and, if it turns out you do not have a heart attack, they
do not pay the emergency room.
Ms. DeLAURO. If you survive, they do not pay. Only if you die.
Mr. PALLONE. I just want to mention one more example. We laugh, but
it is not funny; but it is ridiculous when you think about it. I talked
about the gag rule before where they do not allow or many of the HMOs
do not allow the physicians to talk about procedures that are not
covered by the insurance plan. In the GOP bill, a health plan would
still be allowed to restrict communications between doctors and
patients, because their bill only prohibits gagging doctors who
contract directly with the HMO plan. What they do not tell you is that
most doctors subcontract with health plans and their bill does not
prohibit plans from gagging doctors who subcontract with plans.
So here again we have got all these little quirks in their
legislation, little exceptions and things that turn out to be big
exceptions that still impact the majority of the people.
There are similar things with the financial incentives, where most
insurance companies can still create financial incentives for doctors
who do not provide care.
So, again, I have not stressed this too much, because I would have at
least appreciated if the Senate would bring up any managed care reform
bill and let us debate the issue the way we have tonight in this
special order. But we did not even get that. So there is almost no
point in talking about what should or should not be in the bill,
because they will not let us bring the bill up.
I yield to the gentlewoman from California.
Ms. WOOLSEY. We should not be surprised, because a year ago, November
1997, let me read to you from the New York Times.
Business and insurance lobbyists who helped kill President
Clinton's health plan in 1994 are mobilizing a new campaign
to block more modest proposals that would set Federal
standards for quality of care. Republican leaders of Congress
are urging the lobbyists to step up their activities against
an array of managed care reform bills, backed by consumer
advocates as a way to protect patients in a turbulent medical
market.
That was the first. Then the times reported on October 22, 1997 that
Melody Harnad, a Federal Affairs Counsel at the Health Insurance
Association of America, summarized the situation in a confidential memo
to her supervisor, the vice president of the association, and she said,
The message we are getting from the House and Senate GOP
leadership is that we are in a war and need to start fighting
like we are in a war. Republican leadership is now engaged on
this issue and is issuing strong directives to all players in
the insurance and employer community to get activated.
Well, I would like to say that there was a lot of fear in 1993 when I
was first sworn into the House of Representatives, a fear of a single
payer national health care system.
Well, I think we are going to get there sooner than we ever thought,
because, with attitudes like this, the public has to be fearful that
they will have health care in their future, a national health care
system could protect them and will.
Ms. DeLAURO. If the gentlewoman will yield for one second, because I
think it is interesting, and this is a quote, because we started
talking earlier about how special interest money plays into this
effort. It happened, as we pointed out, with tobacco, and there was a
$40 million ad campaign by the tobacco companies to defeat tobacco
legislation, and they succeeded. They succeeded.
Now, this is what Senator Lott said, that the Senate Republicans need
a lot of help from their friends on the outside. ``Get off your butts;
get off your wallets.''
Then we see another $40 million ad campaign by the group of votes
here.
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore. Members must not make personal references to
members of the Senate.
Ms. DeLAURO. Mr. Speaker, then the leader of the other body, that was
his quote, so that in fact what you understand here is that they wanted
their folks to get up, get their money out there, and defeat managed
care reform. Another $40 million ad campaign to defeat managed care
reform, one of the single biggest issues that the American public is
trying to grapple with today. It just reinforces the point of how this
Republican-controlled Congress is dealing with legislation that faces
people.
Ms. WOOLSEY. Taking my time back, it worked. Did it not work? We do
not have managed care health reform in this Congress.
Now we have to change it. The people of this country have to know
what is happening, and I thank both of you for making this possible so
we can speak to the issues and the people who are listening can hear
the issues, and we can be moving forward. We need a Congress that cares
about health care, our seniors, our children and our environment, and
this Congress and its majority does not.
Mr. PALLONE. I want to thank the gentlewoman. Let me talk a little
bit more about health care, if I can, and then maybe we could also
bring up this whole debate over Social Security, if you would like,
because I think that is another one of the major points that I feel
needs to be addressed and that the Republicans have gone on off on a
totally different course.
I was so glad when you mentioned about the President's health care
plan a few years ago, because, if we remember, at the time the
President brought up his proposal for universal health care, it was a
different proposal. It was not a single payer system, it was a
different approach. But, nonetheless, he was responding to the fact
that so many Americans, and more Americans every day, did not have
health insurance.
Many of the issues that we have brought up are sort of aspects of
that. We talk about managed care reform, we talk about portability, we
talk
[[Page H10551]]
about preexisting conditions, about people being denied care. But, most
important, the President was addressing the fact that more and more
Americans do not have health insurance.
What we have found since the President's plan was defeated by the
special interest lobbyists and their multimillion dollar campaign was
the number of people that have no health insurance has gone up. There
was a report that came out just a few weeks ago that had an all-time
high, it was over 40 million Americans, 42 or 43 million Americans have
no health insurance. So we know the concern he had then was a
legitimate concern, and, in fact, the situation is getting much worse.
Now, we have tried sort of dragging and kicking to get this
Republican Congress over the last few years to address some of these
concerns. We did manage to get a kids health initiative passed last
year. But what we found, in fact, we had a hearing just a couple of
weeks ago in the Committee on Commerce on the kids health initiative,
because that initiative came out of the Committee on Commerce and was
also another focus of our Democratic Health Care Task Force, is that
although we were now on the way to ensuring about 5 million more young
children, that the number of uninsured children is rising at a much
more dramatic rate than it was when we were trying to address this kids
health initiative. So as fast as we are with this new program trying to
ensure more kids, the number of children uninsured is growing even
larger.
The main reason for that is because so many people who are working,
and we are not talking about people who are on welfare or eligible for
Medicaid, we are talking about families that are working, who cannot
get health insurance for their kids because more and more employers are
not providing for health insurance, are not given the opportunity for
health insurance on the job.
I have always felt what we needed to do was somehow encourage more
employers to provide health insurance. I do not know how you do that,
whether it is a mandate or through some tax incentives or whatever, but
the HMO reform, as important as it is, only helps those who already
have insurance. The numbers who do not have insurance continues to
grow.
This Republican Congress, it just ignores this whole health insurance
debate, and essentially, as Ms. DeLauro said, is basically just in the
pockets of the insurance industry, and they do not want any of these
reforms to take place. They just do not want to hear it, every aspect
of this health insurance debate.
We are at the end of this session. We are not going to be able to
address most of these things. But we cannot let them go home, we cannot
let them go home without addressing some of these concerns, whether it
is HMO reform or the education initiatives or some of the other
concerns that we have brought up here.
As I said before, with all the things I think should have been done
in this Congress, if I was able to say that I only stayed here a few
more days and was at least able to get the school modernization program
passed, I would be happy and say okay, ``let's go home.'' But, right
now, they are not willing to address any of these things, and we just
have to keep pointing it out over and over again.
Ms. DeLAURO. I think the gentleman is right. Also, just because of
what they will say on the other side of the aisle, I would just say
this: There are reasonable people, as I said, because the managed care
reform bill was a bipartisan piece of legislation. It was the
leadership who will not bring it to the floor. I think that is
critical, because this is not bickering back and forth. We could have
done this. We had enough votes.
Mr. PALLONE. If I could just take my time back a second, you remember
that we have our Democratic Health Care Task Force, but the Republicans
had set one up also, and they had come forward at some point in the
summer, early in the summer, with a patient protection bill that was
very similar to the Patients' Bill of Rights. Some of the people on
there had actually endorsed the concept of our Patients' Bill of
rights. But when Speaker Gingrich got a copy of that thing, he
immediately said, ``No way. We are not going ahead with this.'' He
obviously showed it to the insurance industry and they said, ``No way,
this is much too protective of the interests of the patients,'' and he
told them literally, ``Go back to the drawing board.''
They went back, two or three more weeks, and they came out with this
awful bill that they eventually brought up in one day.
Ms. DeLAURO. That is precisely the point. Let us listen to the
public. We reflect their interests here. We put a piece of legislation
together. Let us get it passed.
The other thing they would say is that this was going to drive the
cost of health insurance sky high and make it unable for people to pay
for.
Wrong. The CBO analysis, Congressional Budget Office analysis of the
Patients' Bill of Rights of 1998, was it would have only a minimal
effect on premiums, with most individuals paying only about $2 more per
month for all of the protections that have been cited in the past. So
they should not have said that.
Mr. PALLONE. If you remember, we had many of the Members of the Texas
delegation, and these are not ideological liberals by any means,
Democrats, many of them of conservative ideology, who had the
experience in Texas where Texas passed a Patient Protection Act, and it
was very similar to what we want at the Federal level. The results are
already in and show that the cost is practically nothing. I think it
was like 34 cents a month or something like that.
One of the reasons that the cost was so minimal, and this was brought
out by one of our task force hearings where we had someone testify from
some of the Texas organizations that were involved, was because it led
to prevention. In other words, it was sort of like what Congresswoman
Woolsey was saying: Once the HMOs have this sort of floor that they
have to provide these basic protections, they are very careful to make
sure that the level of health care that is provided is of good quality,
and you have preventative measures taking place so that you do not get
lawsuits, you do not get all these problems that result from the
current system, because they know they are being watched, and it
actually cuts the costs down considerably.
Ms. WOOLSEY. One thing I would like to call to everybody's attention
is that these 10 million children that are not covered, more than 80
percent of them live in families with at least one working parent.
{time} 1915
That is a huge number. We are not talking about welfare recipients,
we are talking about the working poor who work every day as hard as
everybody else, or harder, at maybe more than one job, and they cannot
afford health care for their children. One of the reasons that
businesses do not provide it is that health care costs are going up
again.
One of the reasons we supported HMOs in the first place, and HMOs
were going to be the savior for health care, is because the cost of
health care leveled as the number of HMOs grew in this Nation. Now we
have passed that nexus. Health care costs are going up in rapid, rapid
numbers, and the quality of the HMO is going down, so we have to put
that floor. That is what HMO reform would do, managed care reform. I
thank the gentleman.
Mr. PALLONE. Mr. Speaker, I know we only have about 10 or 15 minutes
left, but if we could just spend a little time talking about the Social
Security issue and what the Republicans tried to do a few weeks ago
with regard to these tax breaks for the wealthy versus Social Security,
because this was very disturbing to me.
We passed the Balanced Budget Act last year. For the first time in a
long time, this year there was a bit of a surplus in the budget.
However, when we look at the budget, we realize very clearly that that
surplus is totally the result of money that has been set aside in the
Social Security trust fund, because at some time down the road that
trust fund money is going to be needed to pay out benefits to senior
citizens. We know that at some point, even more money is going to have
to be available than what is set aside in the trust fund years down the
road.
But they had the audacity a few weeks ago to suggest and to actually
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pass on the House floor a bill that would take money from the surplus
for tax breaks, a lot of which, from what I can see, would just help
wealthy corporations. But regardless of who it helps, they would be
taking this money out of the Social Security Trust Fund. They actually
had to change the House rules or get around the House rules because the
money was coming directly from the Social Security Trust Fund.
When I talk to the senior citizens in my district, I do not even have
to explain this to them. They know it right off the bat. They
understand. They become very upset, because if we start skimming this
trust fund, we are going to aggravate the problem that we already have
in not having enough money to pay out benefits in the future.
Then what is going to happen is the pressure is going to be on to
reduce benefits, either by raising the age or eliminating the COLA or
somehow changing the Social Security program. That gets back to what
the gentlewoman from Connecticut (Ms. DeLauro) was saying again; this
Republican leadership does not care about Social Security anyway, so
that probably fits into their scheme.
I am thankful at least, in this case, that the Senate did not take up
this terrible bill. It just goes again to show the kinds of things we
have had to deal with and the kinds of things we have wasted our time
with in this Republican Congress.
Ms. DeLAURO. When we voted, I know the gentleman from New Jersey (Mr.
Pallone) did and the gentlewoman from California (Ms. Woolsey) and I
did, we voted for tax cuts. We all support tax cuts. We voted for the
tax cuts, and we said that they would go into effect when there was a
law in place that would make sure that the Social Security system was
solvent. Because in fact with this opportunity for a surplus, the
Social Security Trust Fund surplus allows us to have the surplus, so in
fact you are using the surplus and then shortchanging Social Security.
We vetoed four tax cuts. I support tax cuts. Men and women are
working hard today. Families are literally throwing every hour that
they have into the workplace, and they are barely staying even. We need
to do that.
However, the point was, let the tax cuts go into effect when we are
sure that Social Security is solvent, so the beneficiaries today will
keep getting their benefits, and, if you will, my generation, the
gentleman's kids' generation, will have the opportunity.
I want to just tell the gentleman why, because this is critical.
Social Security is 60 years old. It has been one of the major success
stories of this country. We have men and women who are working hard all
their lives, and now for their financial security and their retirement
years they rely on Social Security. Today two-thirds of America's
seniors rely on Social Security for over one-half of their income.
That is staggering, and is why we cannot be political with Social
Security. Social Security, we cannot play fast and loose with it. It
has to be a thoughtful and reflective process. We have the opportunity
immediately to take a look at this potential surplus in order to be
able to make it solvent over the next 75 years. This is going to be the
critical issue in the next session of the Congress.
There are going to be a number of issues that are going to come up,
such as privatizing Social Security, which is something that I lean
against, because the other piece, which is important to note, Social
Security provides for a guaranteed annual income for these two-thirds
of seniors who rely on Social Security for over half of their income.
There is a guaranteed annual income.
The privatizing solutions remove that guaranteed annual income, so we
need to be very, very careful with it. That is what we were saying by
that vote a couple of weeks ago in this body: Let us not raid Social
Security, let us make sure it is safe for the next 75 years. Then, yes,
let us move to tax cuts, targeted tax cuts for working families today
in this country.
Mr. PALLONE. Again, the biggest concern I have is that so much time
was wasted on this debate. The Republicans basically knew this was
going nowhere, so what happens? We are back here again today. They have
not accomplished anything in terms of trying to achieve any of these
goals relative to education, HMOs, or Social Security.
The issue is how to deal with Social Security in the long run and try
to shore up Social Security for the future. Instead, they waste all
this time again, forcing us into a situation where we are going to be
back in session here tomorrow. There is no budget, there is so little
time, and basically they are saying, look, do not worry about it. Go
home. A do-nothing Congress is fine with us. We take pride in it.
It is just very upsetting. I think the only thing we can do is keep
doing what we are doing now, keep demanding something be done. Mainly,
I think the education initiative is something we can try to achieve
over the next few years.
I yield to the gentlewoman from California (Ms. Woolsey).
Ms. WOOLSEY. Mr. Speaker, I, for one, am embarrassed at how little
this Congress has produced. I would think the leadership of this
Congress, of this House, would be red in the face when they look at
themselves in the mirror.
I, too, voted for Social Security first and tax cuts afterward. But I
want to tell the Members, I represent if not the, one of the best-
educated districts in the Nation. They know about this stuff. They have
been saying to me since the day I was elected in 1992, when is the
Congress going to pay back what this country owes our Social Security
Trust Fund? I have said, it is going to be paid back. We are on our way
to a surplus. It will happen then.
I am telling the Members, it had better happen, because if we do not,
not only are we putting the Generation Xers and the baby boomers at
risk, we are putting our national debt at risk, because a great
percentage of that national debt is what we owe back to the Social
Security trust.
It is a win-win. It is a two-fer, if we take care of Social Security.
We need to get Social Security off-budget. Social Security deserves to
stand on its own. It must be secure. I will not fool around with
privatizing Social Security, but I certainly would encourage people to
have a base, and we have to find a way to encourage people to invest
more. We cannot just depend on Social Security for our retirement,
because that is not enough. It is not intended for that. It is intended
for a safety net. So, Social Security first; tax cuts, yes,
particularly for middle-income working families, next.
Mr. PALLONE. My fear is that in the same way, and I do not know when
it was, I think it was in the seventies or maybe eighties before any of
us were here in Congress, that the Congress actually passed a law
raising the payroll tax on Social Security to make sure that there were
enough benefits. That is my fear.
In other words, what is going to happen here is if this money from
this trust fund keeps getting siphoned off for these tax breaks or
whatever it happens to be, then 10 or 20 years from now, the next
Congress or future Congresses will be faced with actually having to
raise taxes in order to pay for the benefits.
What we are doing now, or what the Republicans are doing now, is
taking that money away, or they are not succeeding, but they are trying
to take it away for tax breaks, and they are going to make future
generations possibly pay more taxes to make sure that money is there.
That is the possibility we could have down the road.
Mr. Speaker, I yield to the gentlewoman from Connecticut.
Ms. DeLAURO. Mr. Speaker, I just want to say, and it kind of sums it
up for me about this Congress, it is really the political equivalent of
the Maytag repairman. The Maytag repairman's phone never rang because
nobody ever needed his help.
Our phones are ringing off the hook here, but we have a Republican
Congress that refuses to pick up the line. All the Democrats are saying
on these issues is, let us answer the call from the American public.
First and foremost, we have talked about HMO reform, we have talked
about saving Social Security, but what we are asking for in these next
several days while we are here is education reform. Let us reduce the
size of classrooms, 100,000 teachers in grades 1 through 3, and let us
in fact modernize our classrooms, provide those tax credits to local
government, so that they
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can float the bonds to build the schools, and it will bring down their
own property taxes, if you will. Let us do that for the good of our
children. That is what we are claiming to want to do in the next
several days.
We can talk all we want about what has not been done. We have a few
more days. This we can get done. I think we have an obligation to go
for it.
Mr. PALLONE. Mr. Speaker, I agree with the gentlewoman. I regret to
say that HMO reform is dead, and that there is no opportunity here to
really deal with the Social Security issue anymore, because they have
run the clock.
But at least over the next few days if we can get the budget to
include these two education initiatives, the modernization of the
schools and the 100,000 additional teachers, then at least we can say
that we have accomplished something before this do-nothing Congress
goes home. We are just going to be out there every day saying that. We
are not leaving. We are not leaving this place until we get some
response from the other side of the aisle on these two issues.
Again, I started off today by saying that when I was back in New
Jersey in my district and I was at an event, this is what the people
were talking about. I had a lot of educators there, I had a lot of
elected officials on the local level, and as the gentlewoman from
Connecticut (Ms. DeLauro) was saying, they were saying they need to
modernize their schools, and they cannot do it. They cannot get the
bonding. The cost of the interest rate on the bonding is so excessive
that they either cannot do it, or the taxpayers are upset because of
the amount of money that is involved.
We need to address these issues. I know the gentlewoman has the dozen
education initiatives that they failed to do. I wish the gentlewoman
would go over that.
Mr. Speaker, I yield to the gentlewoman from Connecticut (Ms.
DeLauro).
Ms. DeLAURO. Mr. Speaker, I would be happy to. This is the dirty
dozen that the Congressional Republicans wanted to do to our public
schools: eliminate the Department of Education; divert billions of
dollars in public school funds for private school vouchers; cut school
lunches for poor children; block-granting critical education programs,
and when we block-grant those programs, we eliminate programs, and
there is no accountability by the Governors as to where that money is
being spent; ending equal opportunity in higher education; tax cuts for
wealthy taxpayers who send their children to private schools;
eliminating summer jobs; eliminating school-to-work; ending school
interest subsidies for student loans; eliminating safe and drug free
schools. That is the litany, that is the legacy of this Republican
Congress.
Mr. PALLONE. Hopefully, we can get something done before we adjourn.
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