[Congressional Record Volume 144, Number 145 (Tuesday, October 13, 1998)]
[House]
[Pages H10789-H10796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       WOMEN'S HEALTH RESEARCH AND PREVENTION AMENDMENTS OF 1998

  Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the 
Senate bill (S. 1722) to amend the Public Health Service Act to revise 
and extend certain program with respect to women's health research and 
prevention activities at the National Institutes of Health and the 
Centers for Disease Control and Prevention.
  The Clerk read as follows:

                                S. 1722

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Women's Health Research and 
     Prevention Amendments of 1998''.
  TITLE I--PROVISIONS RELATING TO WOMEN'S HEALTH RESEARCH AT NATIONAL 
                          INSTITUTES OF HEALTH

     SEC. 101. RESEARCH ON DRUG DES; NATIONAL PROGRAM OF 
                   EDUCATION.

       (a) Research.--Section 403A(e) of the Public Health Service 
     Act (42 U.S.C. 283a(e)) is amended by striking ``1996'' and 
     inserting ``2003''.
       (b) National Program for Education of Health Professionals 
     and Public.--Title XVII of the Public Health Service Act (42 
     U.S.C. 300u et seq.) is amended by adding at the end the 
     following:


                       ``education regarding des

       ``Sec. 1710. (a) In General.--The Secretary, acting through 
     the heads of the appropriate agencies of the Public Health 
     Service, shall carry out a national program for the education 
     of health professionals and the public with respect to the 
     drug diethylstilbestrol (commonly known as DES). To the 
     extent appropriate, such national program shall use 
     methodologies developed through the education demonstration 
     program carried out under section 403A. In developing and 
     carrying out the national program, the Secretary shall 
     consult closely with representatives of nonprofit private 
     entities that represent individuals who have been exposed to 
     DES and that have expertise in community-based information 
     campaigns for the public and for health care providers. The 
     implementation of the national program shall begin during 
     fiscal year 1999.
       ``(b) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 1999 through 2003. The authorization of 
     appropriations established in the preceding sentence is in 
     addition to any other authorization of appropriation that is 
     available for such purpose.''.

     SEC. 102. RESEARCH ON OSTEOPOROSIS, PAGET'S DISEASE, AND 
                   RELATED BONE DISORDERS.

       Section 409A(d) of the Public Health Service Act (42 U.S.C. 
     284e(d)) is amended by striking ``and 1996'' and inserting 
     ``through 2003''.

     SEC. 103. RESEARCH ON CANCER.

       (a) Research on Breast Cancer.--Section 417B(b)(1) of the 
     Public Health Service Act (42 U.S.C. 286a-8(b)(1)) is 
     amended--
       (1) in subparagraph (A), by striking ``and 1996'' and 
     inserting ``through 2003''; and
       (2) in subparagraph (B), by striking ``and 1996'' and 
     inserting ``through 2003''.
       (b) Research on Ovarian and Related Cancer Research.--
     Section 417B(b)(2) of the Public Health Service Act (42 
     U.S.C. 286a-8(b)(2)) is amended by striking ``and 1996'' and 
     inserting ``through 2003''.

     SEC. 104. RESEARCH ON HEART ATTACK, STROKE, AND OTHER 
                   CARDIOVASCULAR DISEASES IN WOMEN.

       Subpart 2 of part C of title IV of the Public Health 
     Service Act (42 U.S.C. 285b et seq.) is amended by inserting 
     after section 424 the following:


   ``heart attack, stroke, and other cardiovascular diseases in women

       ``Sec. 424A. (a) In General.--The Director of the Institute 
     shall expand, intensify, and coordinate research and related 
     activities of

[[Page H10790]]

     the Institute with respect to heart attack, stroke, and other 
     cardiovascular diseases in women.
       ``(b) Coordination With Other Institutes.--The Director of 
     the Institute shall coordinate activities under subsection 
     (a) with similar activities conducted by the other national 
     research institutes and agencies of the National Institutes 
     of Health to the extent that such Institutes and agencies 
     have responsibilities that are related to heart attack, 
     stroke, and other cardiovascular diseases in women.
       ``(c) Certain Programs.--In carrying out subsection (a), 
     the Director of the Institute shall conduct or support 
     research to expand the understanding of the causes of, and to 
     develop methods for preventing, cardiovascular diseases in 
     women. Activities under such subsection shall include 
     conducting and supporting the following:
       ``(1) Research to determine the reasons underlying the 
     prevalence of heart attack, stroke, and other cardiovascular 
     diseases in women, including African-American women and other 
     women who are members of racial or ethnic minority groups.
       ``(2) Basic research concerning the etiology and causes of 
     cardiovascular diseases in women.
       ``(3) Epidemiological studies to address the frequency and 
     natural history of such diseases and the differences among 
     men and women, and among racial and ethnic groups, with 
     respect to such diseases.
       ``(4) The development of safe, efficient, and cost-
     effective diagnostic approaches to evaluating women with 
     suspected ischemic heart disease.
       ``(5) Clinical research for the development and evaluation 
     of new treatments for women, including rehabilitation.
       ``(6) Studies to gain a better understanding of methods of 
     preventing cardiovascular diseases in women, including 
     applications of effective methods for the control of blood 
     pressure, lipids, and obesity.
       ``(7) Information and education programs for patients and 
     health care providers on risk factors associated with heart 
     attack, stroke, and other cardiovascular diseases in women, 
     and on the importance of the prevention or control of such 
     risk factors and timely referral with appropriate diagnosis 
     and treatment. Such programs shall include information and 
     education on health-related behaviors that can improve such 
     important risk factors as smoking, obesity, high blood 
     cholesterol, and lack of exercise.
       ``(d) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 1999 through 2003. The authorization of 
     appropriations established in the preceding sentence is in 
     addition to any other authorization of appropriation that is 
     available for such purpose.''.

     SEC. 105. AGING PROCESSES REGARDING WOMEN.

       Section 445H of the Public Health Service Act (42 U.S.C. 
     285e-10) is amended--
       (1) by striking ``The Director'' and inserting ``(a) The 
     Director''; and
       (2) by adding at the end the following subsection:
       ``(b) For the purpose of carrying out this section, there 
     are authorized to be appropriated such sums as may be 
     necessary for each of the fiscal years 1999 through 2003. The 
     authorization of appropriations established in the preceding 
     sentence is in addition to any other authorization of 
     appropriation that is available for such purpose.''.

     SEC. 106. OFFICE OF RESEARCH ON WOMEN'S HEALTH.

       Section 486(d)(2) of the Public Health Service Act (42 
     U.S.C. 287d(d)(2)) is amended by striking ``Director of the 
     Office'' and inserting ``Director of NIH''.
TITLE II--PROVISIONS RELATING TO WOMEN'S HEALTH AT CENTERS FOR DISEASE 
                         CONTROL AND PREVENTION

     SEC. 201. NATIONAL CENTER FOR HEALTH STATISTICS.

       Section 306(n) of the Public Health Service Act (42 U.S.C. 
     242k(n)) is amended--
       (1) in paragraph (1), by striking ``through 1998'' and 
     inserting ``through 2003''; and
       (2) in paragraph (2), by striking ``through 1998'' and 
     inserting ``through 2003''.

     SEC. 202. NATIONAL PROGRAM OF CANCER REGISTRIES.

       Section 399L(a) of the Public Health Service Act (42 U.S.C. 
     280e-4(a)) is amended by striking ``through 1998'' and 
     inserting ``through 2003''.

     SEC. 203. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION 
                   PROGRAM.

       (a) Services.--Section 1501(a)(2) of the Public Health 
     Service Act (42 U.S.C. 300k(a)(2)) is amended by inserting 
     before the semicolon the following: ``and support services 
     such as case management''.
       (b) Providers of Services.--Section 1501(b) of the Public 
     Health Service Act (42 U.S.C. 300k(b)) is amended--
       (1) in paragraph (1), by striking ``through grants'' and 
     all that follows and inserting the following: ``through 
     grants to public and nonprofit private entities and through 
     contracts with public and private entities.''; and
       (2) by striking paragraph (2) and inserting the following:
       ``(2) Certain applications.--If a nonprofit private entity 
     and a private entity that is not a nonprofit entity both 
     submit applications to a State to receive an award of a grant 
     or contract pursuant to paragraph (1), the State may give 
     priority to the application submitted by the nonprofit 
     private entity in any case in which the State determines that 
     the quality of such application is equivalent to the quality 
     of the application submitted by the other private entity.''.
       (c) Authorizations of Appropriations.--
       (1) Supplemental grants for additional preventive health 
     services.--Section 1509(d)(1) of the Public Health Service 
     Act (42 U.S.C. 300n-4a(d)(1)) is amended by striking 
     ``through 1998'' and inserting ``through 2003''.
       (2) General program.--Section 1510(a) of the Public Health 
     Service Act (42 U.S.C. 300n-5(a)) is amended by striking 
     ``through 1998'' and inserting ``through 2003''.

     SEC. 204. CENTERS FOR RESEARCH AND DEMONSTRATION OF HEALTH 
                   PROMOTION.

       Section 1706(e) of the Public Health Service Act (42 U.S.C. 
     300u-5(e)) is amended by striking ``through 1998'' and 
     inserting ``through 2003''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Bilirakis) and the gentleman from Ohio (Mr. Brown) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida (Mr. Bilirakis).


                             General Leave

  Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and include extraneous material on S. 1722.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise in strong support of S. 1722, the Women's Health 
Research and Prevention Amendments of 1998. This legislation will 
revise and extend a number of important women's health research and 
prevention programs at the National Institutes of Health and the 
Centers for Disease Control and Prevention.
  Earlier this month, Mr. Speaker, I introduced the House companion 
measure, H.R. 4683, with the gentleman from Virginia (Chairman Bliley), 
the chairman of the Committee on Commerce. Both S. 1722 and the House 
bill enjoy strong bipartisan support, including members of the 
leadership and the chairman and ranking members of the committees of 
jurisdiction. The American Cancer Society and the American Heart 
Association have also endorsed this legislation.
  In a recent letter, the Secretary of Health and Human Resources 
expressed the administration's support for passage of the bill. 
Secretary Shalala stated, ``The research, prevention and health 
promotion activities that would be reauthorized are critical to the 
health and well-being of the Nation's women.''
  While noting that the bill does not include some of the 
administration's legislative proposals on women's health, the Secretary 
concluded that ``extension of the vital efforts that are addressed in 
the bill should not be delayed.''
  Mr. Speaker, both the NIH and the CDC play critical roles in efforts 
to improve women's health through research, screening, prevention, 
treatment, education and data collection. S. 1722 reauthorizes programs 
at the NIH for vital research into the causes, prevention and treatment 
of some of the major diseases affecting women, including osteoporosis, 
breast and ovarian cancer and for research into the aging processes of 
women.
  In addition, the bill authorizes a new research program at the 
National Heart, Lung and Blood Institute to target heart attacks, 
strokes and other cardiovascular diseases in women, and this program 
will advance research into cardiovascular disease, which is the leading 
cause of death in women. In fact, one in ten American women between the 
ages of 45 and 64 has some form of heart disease, and this increases to 
one in five women over 65. According to the American Heart Association, 
more than 500,000 American women die of cardiovascular diseases each 
year.
  NIH data indicates that 1.6 million women have had a stroke and 
90,000 women die of strokes each year. In the past, the medical 
community has focused on men in research, treatment and counseling for 
heart disease and stroke. Clearly we need to do more to prevent and 
treat these diseases in women.
  S. 1722 also reauthorizes several major programs at the CDC for 
prevention and education activities in women's health issues. These 
include the

[[Page H10791]]

National Center for Health Statistics, the National Program of Cancer 
Registries, the National Breast and Cervical Cancer Early Detection 
Program, and the Centers for Research and Demonstration of Health 
Promotion and Disease Prevention.
  It is particularly important that we reauthorize these programs this 
year, Mr. Speaker. While funding is currently available, the CDC relies 
on its statutory authorization for certain critical activities. For 
example, the National Center on Health Statistics relies on its legal 
authority to ensure complete privacy of the data collected. Without 
this authority, the center's ability to collect the data is threatened.
  The Congressional Budget Office has issued a preliminary estimate of 
the bill's cost, which totals $5.1 billion over five years. However, 
and it is important to realize this, all of the spending authorized in 
this bill is discretionary, subject to appropriation. The bill 
reauthorizes programs that are already funded, already funded, with the 
exception of the new cardiovascular disease program. However, NIH is 
currently conducting research in this area and the new cardiovascular 
research program will expand and coordinate those efforts.
  Mr. Speaker, we have worked very, very hard to develop legislation 
that enjoys strong bipartisan support. The bill does not purport to 
address every woman's health concern, and there is clearly more work 
ahead for our committee.

                              {time}  1645

  To avoid unnecessary controversy and to speed reauthorization of 
these important programs, however, it was necessary to maintain a 
consensus-based approach in developing the bill.
  The legislation also represents the work product of several Members. 
Mr. Speaker, I want to take a moment to acknowledge their 
contributions. Section 101, which establishes a national education and 
research program regarding the drug DES, is modeled on legislation 
introduced by the gentlewoman from New York (Ms. Slaughter).
  Section 104, which promotes research related to cardiovascular 
diseases in women, is similar to provisions of H.R. 2130 introduced by 
the gentlewoman from California (Ms. Waters).
  I also want to recognize the efforts of the gentleman from New York 
(Mr. Lazio) to promote access to treatment for patients screened under 
the CDC's National Breast and Cervical Cancer Early Detection Program.
  At the urging of the gentleman from New York (Mr. Lazio) and the 
American Cancer Society, provisions were added to section 203 of the 
bill to emphasize the importance of case management services. This 
language recognizes the critical role of case managers in assisting 
breast cancer patients in obtaining access to treatment.
  Mr. Speaker, I believe the Congress must play an active role in 
promoting women's health research and prevention efforts. I am 
particularly proud of the Committee on Commerce's role this year in 
reauthorizing the Mammography Quality Standards Act, which ensures safe 
and accurate mammography services for women.
  The measure before us today reauthorizes a number of other critical 
women's health programs, and I urge all Members to join me in 
supporting passage of this important legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I am pleased to support S. 1722, the Women's Health 
Research and Prevention Amendments of 1998. For far too long, women's 
health issues have been neglected. The bill is a necessary step to 
begin addressing critical health issues that are affecting women 
exclusively or at highly disproportionate rates. Eighty percent of 
Americans who suffer from osteoporosis are women. One in eight women 
develop breast cancer, one in 25 will die of breast cancer, the second 
leading cause of cancer deaths. Despite the misconception that women 
rarely suffer from heart attacks, cardiovascular disease is the leading 
cause of death among American women. These are only a few of the 
devastating statistics concerning women's health issues that signal the 
need for more research, treatment, and education to prevent women's 
needless suffering.
  H.R. 4683 and S. 1722 would extend research and prevention efforts of 
the National Institutes of Health to explore some of the most dangerous 
and critical diseases and conditions affecting women, including 
osteoporosis, cancer, and cardiovascular disease, the leading causes of 
death in American women.
  The bill also extends women's health programs at the Centers for 
Disease Control, such as the National Center for Health Statistics, the 
National Program of Cancer Registries, and the National Breast and 
Cervical Cancer Early Detection Program.
  Expanding these programs will allow the CDC to conduct more research 
to prevent and treat women's health issues, insure screening for early 
detection of breast and cervical cancer, and curb premature morbidity 
and mortality that lead to excessive health care costs.
  The job will not be finished with the enactment of this bill alone. 
Issues of quality and access need to be addressed. The Patients' Bill 
of Rights should be enacted without further delay.
  The National Partnership for Women and Families and more than 30 
other women's organizations have listed numerous elements of the 
Patients' Bill of Rights that are particularly important to the health 
of women.
  This bill would allow women to choose an OB-GYN as a primary health 
provider, and have direct access to their services or to those of 
allied health professionals, such as nurse midwives. The Patients' Bill 
of Rights would require managed care companies to provide access to 
clinical trials, a direct link between the research authorized by the 
bill before us today and the actual receipt of health care by women.
  Listen to what a couple of witnesses at our July hearing on the 
Subcommittee on Health and Environment said about the importance of 
clinical trials. Dr. Edison Liu of the National Cancer Institute said, 
``Clinical trials are instrumental in these improvements. As examples, 
within the last two years we have established new standards of optimal 
therapy for women with node-negative and locally advanced breast 
cancer, for women with advanced ovarian cancer, for melanoma, and for 
childhood renal cancer. These new approaches to cancer therapy are the 
direct result of the Nation's clinical trials system.''
  Dr. Leonard Zwelling with the Anderson Cancer Center said at the same 
hearing, ``Remember, all of the great approved cancer therapies in use 
today were once being tested in the clinical trial setting. Without 
clinical trials, we would have made no progress at all.''
  The Patients' Bill of Rights would allow women to continue to see the 
same provider throughout a pregnancy, even if the provider left the 
plan or their employer changed plans. Prescription drugs that are 
medically indicated but are not on an HMO's formulary would also be 
covered. Drive-by mastectomies would be eliminated, performance and 
quality measures would take the special needs of women into account, as 
would data collections and plan summaries. Plans would be prohibited 
from discriminating on the basis of sex. All of that is in the 
Patients' Bill of Rights.
  I would hope, Mr. Speaker, that we will authorize all NIH programs so 
the research priorities of our Nation will be openly and equitably 
addressed. Although S. 1722 deals with some of the health research 
issues that impact women, it by no means addresses all of them. A 
comprehensive reauthorization of NIH programs, coupled with passage of 
the Patients' Bill of Rights, would achieve this objective.
  Women are disproportionately affected by disease and conditions that 
our medical community has the ability to halt. It is essential that we 
do a better job in addressing women's health care issues. I commend the 
gentleman from Florida (Chairman Bilirakis) for leading us to act on 
solid bipartisan legislation. I commend the gentleman from Michigan 
(Mr. John Dingell), ranking member of the full committee, for his work 
on this issue, on women's health generally, and specifically, for his 
leadership on the Patients' Bill of

[[Page H10792]]

Rights, legislation that this Congress should be addressing before it 
adjourns.
  I look forward to working with the gentleman from Florida (Mr. 
Bilirakis), the gentleman from Michigan (Mr. Dingell), and others on 
other pressing health care issues that are beyond the scope of this 
bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Pennsylvania (Mr. Fox).
  Mr. FOX of Pennsylvania. Mr. Speaker, I thank the gentleman for 
yielding time to me.
  Mr. Speaker, I appreciate the time to speak on behalf of the Women's 
Health Research and Prevention Amendments of 1998. This is legislation 
long overdue, and certainly the number one priority in the public 
health interest. This legislation will help overall the women's health 
research and prevention activities at the National Institutes of Health 
and, of course, the Centers for Disease Control and Prevention of the 
CDC.
  Specifically, it will extend the research program on DES, the drug 
widely prescribed years ago from 1938 to 1971, which has been shown to 
be harmful to pregnant women and their children.
  Moreover, the bill deals with research on osteoporosis, extends the 
research program in that regard, and on Paget's Disease and related 
bone disorders.
  It also further will conduct research on cancer, breast cancer and 
ovarian cancer especially. This is an area of great interest of mine. 
Many people in Pennsylvania and across the country are trying to 
support the additional efforts for breast cancer outreach, detection, 
prevention, treatment. I just have to look to Suzanne Kay from my 
district, who fought a long battle with breast cancer and it was her 
life's hope, and I hope that we continue her dream, to have that cure 
in our lifetime.
  On ovarian cancer, we only have to look to Laurie Beecham from my 
district, who has had a 9-year battle with ovarian cancer. This is 
especially troublesome since ovarian cancer is so hard to detect and 
has alluded us up until now. So with these additional women's health 
research and prevention amendments, we will be able to win the war 
against breast cancer, win the war against ovarian cancer.
  This legislation goes further, Mr. Speaker, into research on heart 
attacks, stroke and other cardiovascular diseases. The new 
authorization is included to support research into something which has 
been the leading cause of death in women, cardiovascular disease; long 
overlooked. As prior speakers may have related, we have been looking, 
from a male point of view, at heart disease but now this is an area of 
interest we must pursue in order to be receiving the kind of 
information that we can attack this cardiovascular disease and be 
successful for women as well.
  The aging processes in women, this legislation will also study the 
effects and come up with cures regarding the diagnosis, disorders and 
complications relating to menopause.
  The legislation also goes into the National Center for Health 
Statistics by producing data regarding systems to identify and address 
a wide spectrum, Mr. Speaker, of health concerns from birth to death, 
including overall health status, life-style, exposure to unhealthful 
influences, the onset and diagnosis of illness and disability, and the 
use of health care and rehabilitation services.
  The National Program of Cancer Registries will be aided by this bill 
because it will generate reliable cancer surveillance and data 
collection to monitor trends, guide cancer control programs, to assist 
in allocations of health resources, to advance population based health 
services research.
  Mr. Speaker, I just want to conclude by saying that we have just seen 
a March Against Cancer here in Washington. We have our anti-cancer 
caucus led by the gentleman from New York (Mr. Lazio), we have our 
women's caucus, all working together.
  With the passage of this legislation, S. 1722, we will be able to 
move forward for women, for health care, for America. So I am pleased 
to lend my support to this important legislation.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the 
distinguished gentleman from Michigan (Mr. Dingell). He has done great 
work on all of these health care issues.
  Mr. DINGELL. Mr. Speaker, I thank the gentleman from Ohio (Mr. Brown) 
for yielding time to me.
  Mr. Speaker, I rise in support of S. 1722, and H.R. 4683, its 
identical version in the House, which is not at this moment before us.
  I am pleased to be the cosponsor of this legislation recently 
introduced by my good friend and colleague, the gentleman from Florida 
(Mr. Bilirakis).
  I do note, however, Mr. Speaker, that this is a very good bill, 
worthy of support, but unfortunately in the haste of the conclusion of 
this session it has not had the benefits of hearings or markup sessions 
in the Subcommittee on Health and Environment or in the Committee on 
Commerce. That normal and usual practice undoubtedly would have 
improved the bill.
  My colleagues on the committee from both sides of the aisle possess 
great expertise in matters of this kind and they would have given 
generously of their time and knowledge and thereby added greatly to the 
quality of the legislation.
  The legislation before us enjoys the support of many organizations 
with strong credentials in the area of women's health issues. The 
administration also supports the bills, but each of these supporters 
would have welcome opportunities to come before the committee to convey 
comments and concerns.
  The hearings would have revealed that this bill is a bit limited in 
scope, with many serious and controversial issues left unaddressed. In 
the area of research, the bill does not address controversial issues 
that affect women's health, such as sexually transmitted diseases. 
Other than a few programs named, the bill does not address the broad 
band of diseases that affect both genders and therefore, significantly, 
women's health issues, as well as men's health issues. This is why 
reauthorization of all NIH programs is urgently needed.
  I hope that this bill begins that process and that we deal with NIH 
in a more comprehensive and thorough going fashion in the next session.
  Moreover, the bill does nothing to improve women's access to quality 
health care. Women are the majority of enrollees in managed care plans. 
Women have unique health care needs that go well beyond reproductive 
health, and indeed their needs are quite different than those of men.
  The National Partnership for Women and Families, along with more than 
30 other organizations, has outlined a long list of women's health 
issues that are addressed by the Patients' Bill of Rights, which 
regrettably will not be passed by this Congress and which urgently 
needs to be done.
  Those include selection of an OB-GYN or allied health professional as 
a primary care provider; access to clinical trials; gender specific 
data; plan evaluation criteria, and a ban on gender discrimination by 
HMOs. The legislation before us is regrettably silent on these issues.
  Mr. Speaker, I support this bill. It is a good bill. It has, 
regrettably, limitations, and we are now finding ourselves in a curious 
procedural setting into which we need not have been cast had this 
matter been brought up earlier and on which we had done perhaps a 
better job of evoking hearings and all of the normal processes that are 
undertaken in the Committee on Commerce.
  It is important to know here today that as we pass a good bill, many 
important women health care issues remain to be addressed. None of this 
should be satisfied until this work is done.
  Mr. BILIRAKIS. Mr. Speaker, I yield 4 minutes to the gentleman from 
Oklahoma (Mr. Coburn).
  Mr. COBURN. Mr. Speaker, every day when I am not here I practice 
medicine, and 70 percent of my patients are women.
  There are wonderful things in this bill. However, this bill comes up 
short, especially in addressing cervical cancer in our country.

                              {time}  1700

  Mr. Speaker, 43 percent of the young women in this country today are 
carrying human papilloma virus. That is important. The reason that it 
is important is because that causes 94 percent of the cancer of the 
cervix to women in this country.

[[Page H10793]]

  We also have in the bill a complete section on diethylstilbestrol, 
which has not been used in almost 30 years in this country. The last 
time it was used in any frequency was in the mid-1960s. The consequence 
of cancer associated with that drug shows itself before the woman is 30 
years of age. So, in fact what we are doing is authorizing a program 
that is no longer needed with this bill.
  My concerns, regardless of all the positive things in this bill, are 
that we should make sure we reach beyond where we have been in the 
past. And there is no question, breast cancer affects a vast majority. 
My sister, my sister-in-law both had breast cancer as well as many 
patients that I diagnose that disease in, and this bill is great in 
that regard. This bill is great in cardiovascular health risks for 
women. But it comes up very short in addressing a problem that is going 
to burgeon and balloon on us.
  Cervical cancer is going to grow at the rate of 10 or 15 percent per 
year each year in the future. We have not instructed the CDC to do the 
proper job with this bill. The CDC should have a program that mandates 
human papilloma virus, the agent that causes cervical cancer, as a 
reportable disease. They have refused to do that.
  Mr. Speaker, 40 percent of the women in this country now have herpes. 
It is also associated with anomalies and carcinomas of the reproductive 
tract of women. We have done nothing to address that in this bill.
  Mr. Speaker, I am going to support this bill, and I want us to move 
forward with this. But I would like to have a colloquy with the 
gentleman from Florida (Mr. Bilirakis), chairman of the committee, to 
in fact see if we cannot address these issues and send out a 
supplemental authorization in the next Congress so that we can impact 
cervical cancer the way we are attempting to impact breast cancer in 
this bill.
  It is my hope that we will have a hearing so that what I have just 
stated can be put in the Record by not me as a practicing physician, 
but the scientists who know these issues well, and that that will 
become a part of what we do in the future.
  Mr. BILIRAKIS. Mr. Speaker, will the gentleman yield?
  Mr. COBURN. I yield to the gentleman from Florida.
  Mr. BILIRAKIS. Mr. Speaker, I would say that not only talking about 
the scientific community, but certainly the gentleman's knowledge on 
these areas certainly greatly exceeds that of ours, and I have no 
reason to dispute what the gentleman says.
  I have already indicated that what we try to do with this legislation 
was try to work it out with the other body, with the other side, so 
that we could have a piece of legislation which would be a good piece 
of legislation, but certainly far from perfect.
  So having said all of that, I assure the gentleman that we will 
address those issues in the next Congress.
  Mr. COBURN. Mr. Speaker, reclaiming my time, I thank the gentleman 
for that assurance.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2\1/2\ minutes to the 
gentleman from Vermont (Mr. Sanders).
  Mr. SANDERS. Mr. Speaker, I thank the gentleman from Ohio (Mr. Brown) 
for yielding me this time.
  Mr. Speaker, I am pleased today to support S. 1722, the Women's 
Health Research and Prevention Amendments. I am an original cosponsor 
of the House version, H.R. 4683, and I congratulate the gentleman from 
Florida (Chairman Bilirakis) and the gentleman from Ohio (Mr. Brown), 
the ranking member, for their efforts.
  This is a good piece of legislation which authorizes or reauthorizes 
a number of important acts. I am especially pleased that the National 
Cancer Registries Act, which I introduced in 1992, is included for 
reauthorization in this legislation.
  Mr. Speaker, we all understand that cancer is a terrible disease 
striking millions of Americans of all ages and from all walks of life. 
The National Cancer Registries Act, which is being reauthorized now, 
provides detailed information about who is coming down with cancer, 
where they live, where they work, and how effective the treatment is 
that they are receiving.
  For years, cancer researchers wanted information, for example, about 
the incidence of breast cancer in Vermont as opposed to the incidence 
of breast cancer in another region. What might be the factors which 
cause the difference in incidence rates? In other words, why is a 
particular type of cancer more prevalent in one area of the country 
than in another area?
  Why within a given community is cancer more prevalent in one part of 
that community than in another part of that community? In other words, 
why are there certain hot spots that have developed?
  All of that information is important because the more information 
that researchers have, the better able they will be to understand what 
might be causing different types of cancer, and also in developing 
prevention efforts to stop the spread of cancer as well as better 
treatments to treat cancer.
  Clearly, the more detailed information that we have about cancer, the 
better able we will be to understand the cause of this terrible disease 
which is killing more than a half million Americans every year and will 
account for one out of every four deaths in the United States this 
year.
  Mr. Speaker, I want to mention that several years ago when Senator 
Leahy and I successfully introduced this legislation, we were given the 
means to do so by a number of breast cancer survivors in the State of 
Vermont, women who stood up and said, ``We are going to fight back.'' 
Among those were Joann Rathgeb, who passed away several years ago, and 
Pat Barr and Virginia Soffa, who are continuing their battle against 
cancer today.
  Mr. BILIRAKIS. Mr. Speaker, how much time do we have remaining?
  The SPEAKER pro tempore (Mr. Boehlert). The gentleman from Florida 
(Mr. Bilirakis) has 7 minutes remaining, and the gentleman from Ohio 
(Mr. Brown) has 9\1/2\ minutes remaining.
  Mr. BILIRAKIS. Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1\1/2\ minutes to the 
gentlewoman from New York (Ms. Slaughter).
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from Ohio (Mr. 
Brown) for yielding me this time, and I rise in strong support of this 
legislation.
  I am particularly proud to vote for it today. I an thankful for the 
good work of the gentleman from Florida (Mr. Bilirakis) and the 
gentleman from Ohio (Mr. Brown) for bringing this to us this afternoon.
  This bill contains a vital section extending Federal research and 
education on the drug diethylstilbestrol, or DES. It was prescribed to 
pregnant American women from 1938 to 1971 in the mistaken belief that 
it would prevent miscarriage. Not only did DES fail to impact 
miscarriage rates, but it caused deformities and other health problems 
in the reproductive systems of many of the children exposed in utero.
  Touted as a ``wonder drug,'' DES was taken by women who believed they 
were getting the best medical care in the world. But DES is now known 
to cause a fivefold increased risk for ectopic pregnancy as well as a 
threefold increase for a risk of miscarriage and preterm labor. One in 
every 1,000 girls and women exposed to DES in utero will develop clear 
cell of the vagina or cervix and will have to undergo treatment that 
ends their fertility. Men exposed in utero have a higher incidence of 
undescended testicles and fertility problems. Recent studies have 
hinted, and this is one of the reasons that research is so important, 
that DES may cause similar reproductive tract problems in a third 
generation of grandsons and granddaughters.
  In 1992, I was proud to sponsor the legislation that established the 
first Federal research and education programs on DES. And last year, we 
introduced H.R. 1788, the DES Education Research Amendments, to 
authorize and expand the education efforts nationally.
  Congress has a rare opportunity to act today to ensure that all men 
and women exposed to DES are made aware of their special health risks 
and needs. Further, we must continue research into the effects of DES, 
research which is yielding such important insights into the effects of 
environmental estrogens on the human body.
  Mr. Speaker, I am proud to support S. 1722, and urge my colleagues to 
do so as well.
  Mr. BILIRAKIS. Mr. Speaker, I yield 4 minutes to the gentlewoman from 
Maryland (Mrs. Morella).

[[Page H10794]]

  Mrs. MORELLA. Mr. Speaker, I thank the gentleman from Florida (Mr. 
Bilirakis) for yielding me this time.
  Mr. Speaker, I rise in very strong support of what I call the B&B 
bill, ``Bilirakis and Brown.'' I want to congratulate the gentleman 
from Florida (Chairman Bilirakis) and the gentleman from Ohio (Mr. 
Brown), the ranking member, for bringing this bill before us.
  Why am I interested? Not only because as a woman, but I represent the 
National Institutes of Health and work very closely with the Centers 
for Disease Control, and I remember when we worked very hard and 
inspired the National Institutes of Health to establish their Office of 
Research on Women's Health, which has worked very effectively. Now 
codified is the fact that women will be included in all clinical trials 
and protocols, unless there is adequate reason why they would not be.
  So, this bill really follows along beautifully, reauthorizing many of 
the programs at NIH that really pretty much come under the jurisdiction 
of the Office of Research on Women's Health and the Centers for Disease 
Control in terms of research and prevention.
  Just looking at it, for instance the DES bill, I am on a bill with 
the gentlewoman from New York (Ms. Slaughter) dealing with DES. Much 
more needs to be done. We need to do more research on it.
  Osteoporosis. I am very pleased with the fact that in Medicare, bone 
mass measurement standardization for osteoporosis is part of that. I 
pushed it and am continuing to work on research for it. We know that 
one out of every eight men will have an osteoporotic fracture over the 
age of 50, and one out of every two women after the age of 50.
  The research on cancer. Look at breast cancer. Mr. Speaker, 182,000 
women will be touched by breast cancer, diagnosed having breast cancer 
every year, and 46,000 of them are going to die because of that. Much 
more is being done with that research.
  We could cite all kinds of examples. For instance, at the Race for 
the Cure to see those women wearing those pink hats, which means they 
are survivors, and each year the numbers increase because each year we 
do a lot more with research, making sure that quality mammograms are 
available, notification.
  Ovarian cancer is increasing, and yet we know now that it is 
treatable. If we can learn how to detect it earlier, it can make a 
difference between life and death.
  Heart attack, stroke, cardiovascular diseases. Remember the famous 
aspirin test where they used 43,000 male medical students to determine 
the effect of aspirin on cardiovascular diseases, and used no women, 
and yet they extrapolated from that that this is the way that women 
would be responding to it. They did the same thing with coffee. They 
did a test with how would coffee and caffeine affect cardiovascular 
diseases, and it was done with all men.
  Well, we know that it is the number one killer of men and women, but 
it kills even more women than it does men. And with women, they get it 
later and they die faster.
  Mr. Speaker, these are the kinds of things that mean that this bill, 
with its reauthorization, is critically important. Of course, aging 
processes. Obviously, I stand here and I can say that I am a testament 
to the fact that we need to do more work with regard to the aging 
processes. And, of course, people are living longer lives, too.
  The Office of Research on Women's Health. That is kind of a technical 
amendment that is put in there to allow Dr. Varmus, for instance, to do 
the appointing of the Advisory Committee on Research on Women's Health.
  Also with regard to CDC, we had the gentleman from Vermont (Mr. 
Sanders) speak. I am cosponsor of his legislation. I think it is 
important that we look at the Cancer Registry and find out whether we 
have some other facets or conditions that yield an extraordinary number 
of cancer deaths in particular regions. So, in the CDC National Breast 
and Cervical Cancer Early Detection Program, again looking at the 
underserved women.
  So, all in all, maybe as someone said, this bill could even go 
further. But I think it is terrific. I think it is a great piece of 
legislation. Again, I want to commend the authors of it, who have 
worked very hard to make sure that here in this penultimate day of 
session, that we have an opportunity to vote on it. So I congratulate 
them and say let us move on.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentlewoman 
from California (Ms. Waters).
  Ms. WATERS. Mr. Speaker, I rise today in strong support of H.R. 4683, 
the Women's Health Research and Prevention Amendments of 1998.
  I would like to thank the gentleman from Florida (Mr. Bilirakis), 
chairman of the Subcommittee on Health and Environment of the Committee 
on Commerce, and the gentleman from Ohio (Mr. Brown), ranking Democrat, 
for sponsoring this most important bill here in the House.
  This bill would bring much-needed attention to research and 
prevention programs at the National Institutes of Health and the 
Centers for Disease Control and Prevention that target the particular 
health concerns of women, including osteoporosis, breast and ovarian 
cancer and the aging process.
  I am particularly pleased that in addition to the reauthorization of 
these important programs, the bill includes a new research program at 
the National Heart, Lung, and Blood Institute to target heart attack, 
stroke, and other cardiovascular diseases in women.

                              {time}  1715

  The language of this provision was drawn from the Women's 
Cardiovascular Diseases Research and Prevention Act that I and Senator 
Boxer introduced earlier in the Congress. I introduced this bill 
because I strongly believe that aggressive steps needed to be taken to 
combat this silent killer of American women.
  There has been far too little focus on the number one killer of women 
in the United States, cardiovascular disease. This is despite the fact 
that more than 500,000 women die of heart attack, stroke and other 
cardiovascular diseases. One in five females has some form of 
cardiovascular disease. While all women are at risk, statistics show 
that African American women are especially at risk. For African 
American women between the ages of 35 and 74, the death rate from heart 
attacks is twice that of Caucasian women. Yet studies show that four 
out of five women are unaware of the threat of cardiovascular diseases.
  It is tragic that the symptoms of women's heart disease often go 
unrecognized or are often misdiagnosed. H.R. 4683 would target this 
killer of American women. It would educate women and doctors about the 
dire threat heart disease poses to them, educate doctors on the risks 
and symptoms unique to women and improve research and services for 
women in cardiovascular disease.
  I want to thank the American Heart Association, the American Medical 
Women's Association, the Washington Hospital Center and many other 
organizations and individuals for all of their work on this issue, and 
especially Dr. Davidson.
  In particular, I want to recognize the work of the American Heart 
Association. They have worked tirelessly to educate the public about 
women's heart disease. They have launched a special initiative focusing 
on women and heart disease and made the Women's Cardiovascular Diseases 
Research and Prevention Act a centerpiece of their legislative 
strategy.
  Once again, I would like to thank the gentleman from Florida (Mr. 
Bilirakis) for all that he has done and Senator Frist, who carried the 
bill on the Senate side, for including heart disease in this important 
women's health research and prevention bill.
  Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Fox).
  Mr. FOX of Pennsylvania. Mr. Speaker, great credit is owed to the 
gentleman from Florida (Mr. Bilirakis), chairman of the Subcommittee on 
Health and Environment, for his leadership in moving this legislation 
forward and really making a difference for all Americans. This 
legislation obviously affects the women in our families, and we 
certainly know that is the number one health care issue, funding for 
the NIH, National Institutes of Health, and the Centers for Disease 
Control. That kind of funding then goes to teaching hospitals, to 
research centers all across the country, coming

[[Page H10795]]

forth with new discoveries on strategies to help women's health care.
  My thanks again to the American Heart Association for what they are 
doing to move forward, as the gentlewoman from California just 
outlined. I also have to look to the Philadelphia Stroke Council, to 
Toby Mazer, who has been a trailblazer in this area. Every one knows 
that stroke is a brain attack. And what people may not know is there 
are warning signs for stroke just like there are warning signs for 
heart attack. What she is trying to do in her Philadelphia Stroke 
Council is to make sure that we know about those warning signs, that 
there is public education in that regard, that there are prevention 
strategies. Just like every other major illness, we want to get people 
to the hospitals as quickly as possible in that golden hour.
  This legislation goes to the research to determine the reasons 
underlying the prevalence of heart attack, stroke and other 
cardiovascular diseases in women. This legislation will give us the 
funding for basic research concerning the etiology and causes of 
cardiovascular diseases in women. It also will give us the 
epidemiological studies to address the frequency and natural history of 
such diseases and the development of safe, efficient and cost-effective 
diagnostic approaches.
  Our thanks to the Linda Creed Foundation, the Susan Komen Foundation, 
the National Ovarian Cancer Council and the American Cancer Society. 
All of them have worked, together with the gentleman from Florida (Mr. 
Bilirakis) and with the gentleman from Virginia (Mr. Bliley), to make 
sure that working with the Senate legislation like this, which is going 
to help us prevent cardiovascular disease, will in fact be an 
accomplished fact. It will include applications of affected methods for 
the control of blood pressure and obesity, information and education 
programs for patients and health care providers regarding risk factors 
associated with heart attack, stroke and other cardiovascular diseases.
  I stand to support again this important legislation. And one last 
item, Mr. Speaker, the cancer registry will help us with the regional 
aspects of diseases and what we can do as States and regions to make 
sure we are changing the environmental factors that may be affecting a 
very large health care concern.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself 2 minutes.
  I want to point out as several of us have mentioned but discuss for 
another moment part of this bill. The only part of this bill that is a 
new authorization deals with research in heart attack, stroke and other 
cardiovascular diseases in women. During a women's health seminar, a 
program that my office put on in Medina, Ohio some time ago, a 
cardiovascular surgeon, a female cardiovascular surgeon from Cleveland 
pointed out to us something that I think women across the country are 
too often unaware of. That is that while men more often have heart 
attacks than women do, women are more often, more likely to die of 
heart attacks than men because women do not really think of themselves 
as likely victims of heart disease because our society, for whatever 
reason, has led most of us to believe that men get heart attacks and 
women get other diseases. And so I think it is particularly important 
that more research is done on this.
  It is particularly important that we do better education, among women 
especially. Whether it is my mother in Mansfield, Ohio or whether it is 
women across this country, they need to obviously be aware to look for 
those symptoms, as men I think in society are conditioned to look at 
those symptoms that might be leading up to a heart attack.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  I would like to close strongly recommending an aye vote on this 
legislation. It is really the result of a work in progress over a 
period of time. We have recognized other Members who have introduced 
pieces of legislation which we have incorporated in so many words into 
this piece of legislation. And certainly my gratitude to Senator Frist 
was mentioned. He has been very, very cooperative. We have worked with 
him for quite some time on this. His staff, the gentleman from Virginia 
(Mr. Bliley), the majority committee staff, the gentleman from Michigan 
(Mr. Dingell) and the gentleman from Ohio (Mr. Brown) and their fine 
staff over there. We were able to show what can be done, another 
illustration of what can be done when Members are willing to sit around 
the table and work in a bipartisan fashion.
  Ms. DeLAURO. Mr. Speaker, I rise today in support of the Women's 
Health Research and Prevention Amendments of 1998. This bill will make 
significant contributions to research in many diseases which affect 
women. I thank Chairman Bilirakis for his work in drafting this 
legislation and moving it to the floor so quickly at the end of this 
session.
  Women's health research and has been ignored for far too long, and 
this bill will add to the important progress we have made over the last 
several years. As an ovarian cancer survivor, I am particularly pleased 
that this bill will reauthorize programs into research for ovarian 
cancer.
  Currently there is no diagnostic test to detect ovarian cancer in the 
early stages when it is highly curable. Instead, most cases of ovarian 
cancer are found in the advanced stages, and nearly two-thirds of women 
with the disease die within 5 years of diagnosis because their illness 
was detected too late. This research will help the National Institutes 
of Health to continue its work to improve early detection, find new 
treatments, and one day find a cure.
  But there are a number of other bills before this Congress which 
would do just as much to promote women's health, and I am deeply 
disappointed that we have not yet had the opportunity to act on them. 
We have not yet taken any action to outlaw drive through mastectomies 
by passing the Breast Cancer Patient Protection Act. I introduced this 
bipartisan bill in the first days of the 105th Congress, and it has 219 
cosponsors--Republicans and Democrats alike, enough to pass it today if 
it was brought to the floor for a vote. This bill is vitally important 
in ensuring that breast cancer patients get the care they need to 
recover from this devastating surgery.
  Congress has not yet acted to pass legislation that would ensure that 
women with no health insurance, who are diagnosed with breast cancer 
after getting a mammogram through the Breast and Cervical Cancer Early 
Detection Program, have access to treatment. As it stands now, many 
women who discover through this screening program that they have breast 
cancer are left in the unfathomable position of being unable to afford 
the treatment they need to survive.
  Other important women's health bills we have yet to address include: 
legislation which would provide coverage of reconstructive surgery 
after mastectomies for breast cancer patients; legislation which would 
outlaw genetic discrimination by insurance companies; and legislation 
which would allow women to choose OB/GYNs as their primary care 
physicians.
  I am also disappointed that this bill does not expand the Centers for 
Disease Control's WiseWoman project. During the 103rd Congress, we 
started this demonstration project at three clinics which participated 
in the Breast and Cervical Cancer Early Detection Program. WiseWoman 
gives uninsured women access to better all-around health care, and 
allows them to develop relationships with staff that keeps them going 
back for fellow-up care.
  The clinics participating in this project do more than just test for 
breast and cervical cancer--they test for high blood pressure, 
diabetes, and other illnesses. The WiseWoman program has been highly 
successful in improving women's health and I would hope that as 
Congress expands funding for the successful Breast and Cervical Cancer 
Early Detection Program, we would expand the WiseWoman program as well.
  This bill is a good first step in furthering a research agenda that 
will improve women's lives. I hope that we can continue to work 
together to pass all of these bills which are vital to the health of 
American women.
  Mr. BLILEY. Mr. Speaker, I am pleased the House will pass S. 1722, 
``The Women's Health Research and Prevention Amendments of 1998.''
  This bill revises and extends a number of important women's health 
research and prevention programs at the National Institutes of Health 
(NIH) and the Centers for Disease Control and Prevention (CDC). Mr. 
Bilirakis and I introduced the companion measure to S. 1722, the 
``Women's Health Research and Prevention Amendments of 1998.'' S. 1722 
was introduced by Senator Bill Frist and enjoys strong 
bipartisan support, including Senators Lott, Daschle, Jeffords and 
Kennedy.

[[Page H10796]]

  One of the most important programs reauthorized by this bill is the 
National Breast and Cervical Cancer Early Detection Program. S. 1722 
extends this important program, which provides for regular screening 
for breast and cervical cancers to underserved women, prompt follow-up 
if necessary, and assurance that the tests are performed in accordance 
with current quality recommendations. The CDC supports activities at 
the State and national level in the areas of screening referral and 
follow-up services, quality assurance, public and provider education, 
surveillance, collaboration and partnership development. S. 1722 would 
assist CDC to be more aggressive in helping women fight the twin 
scourges of breast and cervical cancer.
  I am very proud that our Committee has done more than reauthorize the 
National Breast and Cervical Cancer Early Detection Program. Just a few 
weeks ago this committee led the effort on the floor to pass H.R. 4382, 
the Bliley-Bilarikis Mammography Quality Standards Reauthorization Act 
of 1998. This bill assured the safety, accuracy, and overall quality in 
mammography services for the early detection of breast cancer. Women 
who seek mammograms, however, must be assured that their results will 
be accurate and not misleading. I am pleased that the President has 
signed the Mammography Quality Standards Reauthorization Act of 1998 
into law.
  I urge my colleagues to join me in voting for S. 1722 ``The Women's 
Health Research and Prevention Amendments of 1998'' and I urge the 
President to sign this bill into law as well.
  Mr. GILMAN. Mr. Speaker, I rise today in support of S. 1722, the 
Women's Health Research and Prevention Amendments of 1998. Since 
October is National Breast Cancer month, it is appropriate that this 
legislation, that not only deals with breast cancer, but also cervical 
and ovarian cancer and cardiovascular diseases, be brought to the floor 
today.
  This legislation will reauthorize many important programs at the 
National Institutes of Health and the Centers for Disease Control which 
have been instrumental in combating various diseases such as breast, 
cervical and ovarian cancers and heart attacks and strokes. Studies 
performed by NIH and the CDC have helped educate many women about the 
advantages of early detection and prevention and have saved millions of 
lives. Further funding for these programs will help to ensure that 
research and studies of diseases affecting women continue.
  Without past studies and demonstration projects, many women would not 
have been informed about early detection and as a result would have 
succumbed to the horrible effects of cancer and cardiovascular 
diseases. This bill will not only educate the public, but will also 
help educate the doctors and nurses who treat women about how these 
diseases specifically attack women.
  I applaud the efforts of my colleague, the gentleman from Florida, 
Mr. Bilirakis, for bringing this important legislation forward today. 
Accordingly, I urge my colleagues to support this significant 
legislation.
  Mr. BILIRAKIS. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Boehlert). The question is on the motion 
offered by the gentleman from Florida (Mr. Bilirakis) that the House 
suspend the rules and pass the Senate bill, S. 1722.
  The question was taken.
  Mr. BILIRAKIS. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 5 of rule I and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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