[Congressional Record Volume 146, Number 53 (Wednesday, May 3, 2000)]
[House]
[Pages H2501-H2505]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            CONGRESS MUST CAREFULLY WEIGH TAX CUT PROPOSALS

  The SPEAKER pro tempore (Mr. Reynolds). Under the Speaker's announced 
policy of January 6, 1999, the gentleman from Iowa (Mr. Ganske) is 
recognized for 60 minutes.
  Mr. GANSKE. Mr. Speaker, times could hardly be better. We are in the 
longest business expansion in our Nation's history. The economy is 
booming. Companies are reporting solid profits. Orders for durable 
goods were up 2.6 percent in March, and the Commerce Department has 
reported first quarter GDP grew by 5.9 percent. Mr. Speaker, that is 
after growth in GDP at 7 percent the previous quarter.
  Unemployment is at record lows. Welfare rolls are down 50 percent or 
more around the country, thanks to work requirements and job training 
and the welfare reform bill that Congress passed a few years ago, and, 
yes, also thanks to a very strong economy.
  Last year, Congress paid down more than $130 billion in national 
privately held debt. And we did not use the Social Security Trust Fund 
to fund our appropriations.
  Part of the economic boom is due to the consumer perception that 
Congress, despite all our battles with the President, has kept spending 
down. At the same time, the increased government revenues have allowed 
for significant increases in funding for education, health care 
research, and law enforcement. And despite a rash of rampage shootings 
at workplaces and schools, about which I will talk more in a little 
bit, better law enforcement has led to lower crime, including violent 
crimes like armed burglary.
  But the good economy helps keep crime down too, if only because 
having

[[Page H2502]]

a job helps reduce domestic tension. Indeed, we have almost an economic 
miracle going on. The wealth of the 50 percent or more of Americans who 
invest in the market has grown considerably. In testimony before my 
committee, Alan Greenspan, Chairman of the Fed, attributes this 
remarkable economic story to the fruits of increased efficiencies due 
to computer technology investment and also to Federal budgetary 
restraint.
  It is true that the gap between the average wage earner and his boss 
has increased dramatically, primarily because of new wealth creation at 
the top. Bill Gates is just the prime example.
  But new data also shows increases in average wages starting to rise. 
However, the average level of savings for wage earners in this country 
is very low. We need to do more to help all Americans become wealthier. 
It would be enlightened public policy, especially with baby boomer 
retirement starting in 2011, at which time a baby boomer will retire 
every 8 seconds, if the Government would facilitate personal investment 
accounts. But I digress.
  The economy is great, and we can all be very thankful. The strength 
of the economy is going to determine how much Congress will be able to 
do in many areas, including a potential prescription drug benefit. I 
would argue not just for senior citizens, but something we ought to 
consider for all Americans.
  However, Mr. Speaker, it is imperative that Congress not muck up this 
great economy. The Dow was down 250 points today. The Dow is off 1,500 
points from its high this year. That is almost 13 percent, amid rumors 
that Mr. Greenspan is going to larger interest rate increases.
  Mr. Speaker, since we just paid our income taxes, I want to talk for 
a minute about tax cuts. Last year, I was one of only four Republicans 
who voted against the congressional leadership's $785 billion tax cut. 
That was a very tough vote for me, because I fundamentally consider 
taxes to be my constituents' money and not Washington's money.
  It was no secret the Chairman of the Committee on Ways and Means, the 
gentleman from Texas (Mr. Archer), who I respect very much, originally 
wanted to introduce a much smaller and more focused tax cut. But, Mr. 
Speaker, the Senate got involved. Well, I will have more to say about 
that body a little later in this speech.
  Now, on that vote I could have taken the easy way out, and I could 
have voted for a tax cut, knowing that President Clinton would veto it. 
But I will tell my colleagues something, the day I start voting on this 
floor politically rather than on the merits is the day I had better 
stay home.
  I did not vote on President Clinton's impeachment because of partisan 
politics, and I will not vote on important economic matters that make a 
lot of difference to my constituents because of party positioning 
either.
  So why did I vote for the $250 billion tax cut instead of the larger 
tax cut? By the way, Mr. Speaker, the tax cut I voted for made 
permanent the Research and Development Tax Credit which the larger tax 
cut neglected. So why did I make that vote?
  Exactly, Mr. Speaker, because the economy is so superheated right 
now. Throwing a $785 billion tax cut, a tax cut of that size, on this 
economy would be like tossing gasoline on a bonfire. Chairman of the 
Fed, Alan Greenspan, in testimony before my committee made it clear 
that in the interest of sustained economic growth, he is going to raise 
interest rates. Can my colleagues imagine what the interest rates would 
be today had that larger tax cut become law last year? I think we would 
have seen interest rate increases twice as large.

  Mr. Speaker, I do not need to tell my colleagues, I do not need to 
tell the people back in Iowa what a prime rate 1\1/2\ points or 2 
points higher than it already is after Mr. Greenspan's quarter point 
increases, what that would be doing to the economy.
  We are already starting to see the effect of those smaller interest 
rate hikes. Look at the volatility of the markets. Just the other day I 
asked a businessman in Des Moines, How are things going, Jim? Great, he 
replied, but the increased interest rates and reduced consumer 
confidence in the market are really starting to affect our home sales.
  Mr. Speaker, I think we need to be very careful with congressional 
action that can affect the economy. We should be very careful not to 
rock this boat too much.
  Yes, we can safely do a modest tax cut, as long as we keep some 
control of spending. And when we factor in cost of living increases and 
average emergency funding for things like droughts and hurricanes, that 
$2 trillion surplus that everyone talks about shrinks to about $600 
billion over 10 years, and that is over if the economy continues to do 
well.
  I believe the time for a really big tax cut is when the economy needs 
a stimulus, not when it may actually need a little Ritalin.
  What should we do yet this year? Well, Congress passed and the 
President signed a $250 billion tax cut in 1997. I hope that by the end 
of this year, we could actually get signed into law about $250 billion 
in tax cuts that would increase health insurance deductibility and 
address the marriage tax penalty. Beyond that, Mr. Speaker, I think we 
should wait and see how the economy does in 2001.
  There is nothing wrong with doing a responsible tax cut every few 
years. But we must be prudent and careful, and we should keep our 
fingers crossed that Congress and other fiscal policymakers can bring 
this big roaring jumbo jet of an economy to a safe and sustained 
landing.
  Mr. Speaker, I also want to talk briefly about three health matters: 
violence in schools, children smoking tobacco, and HMO reform. Let us 
talk first about school violence.


                            School Violence

  Mr. Speaker, we are just past the 1-year anniversary of the Columbine 
High School shooting in which two high school students killed 12 fellow 
students, a teacher and themselves. Columbine, unfortunately, is not an 
anomaly. There have been school shootings in Moses Lake, Washington; 
Springfield, Oregon; Olivehurst, California; Bethel and Jonesboro, 
Arkansas; Edinboro, Pennsylvania; Grayson and West Paducah, Kentucky; 
Fayetteville, Tennessee; Conyers, Georgia; Pearl, Mississippi.

                              {time}  1900

  Well, Mr. Speaker, public action can make a difference. Increased 
cops on the beat, keeping guns out of the hands of felons, and longer 
jail terms for violent criminals have helped lower crime. Yet even 
though some types of criminal behavior such as burglary have decreased, 
the Littleton massacre was one of only 13 rampage attacks last year; 
and we have already seen several this year.
  It is a sad fact that multiple murders at work and at school are 
becoming commonplace news stories that barely shock us. What can we do 
to prevent these rampage killings? Well, there is a tangle of cultural, 
psychological, and medical factors that I think leads to these events: 
higher divorce rates, parental abuse in some cases, poor impulse 
control stemming from violence on TV and the movies, lack of access to 
mental health services, and a general sense of isolation and alienation 
from other people.
  The decline of the traditional family may be the most important 
factor. However, there is a common thread to the children and adults 
who commit multiple murders. They are almost invariably mentally ill. 
They may be schizophrenic, maybe they are just sociopathic; but they 
almost always are depressed and suicidal.
  The two Columbine students carefully planned their own deaths for 
nearly a year. John Stone, the Jefferson County Colorado sheriff had it 
right. He said, ``They wanted to do as much damage as they possibly 
could and then go out in flames.''
  Case studies of rampage killers have shown that they typically leave 
warnings of suicide and violence long before they shoot to kill. But 
they do not get the help they need. If we are going to address the 
growing incidents of rampage shootings, we must devote time and 
resources, both public and private, including personnel, including 
taking some responsibility ourselves back in our communities with 
individuals to identify and treat the mental health conditions that 
lead to that destructive murderous behavior.
  It is also true that these isolated despondent people have more 
lethal

[[Page H2503]]

means at their finger tips than ever before. In the largest survey on 
gun storage ever taken, the American Journal of Public Health recently 
reported that more than 22 million children in the United States live 
in homes with firearms. In 43 percent of those homes, the guns are not 
locked up with trigger locks. And this statistic is mind boggling 
because some 1.7 million children live in homes today where guns are 
kept unlocked and loaded.
  In 1997, 4,207 children and teenagers were killed by guns. Guns are 
the medicine of choice for suicidal use. More than two-thirds of boys 
and more than one-half, more than 50 percent of girls who kill 
themselves use a gun. The rate of suicide deaths from guns for those 14 
and under in the United States is nearly 11 times that of the next 
largest 25 industrialized countries combined.
  Many, including Members of Congress, are trying to find solutions to 
this problem. Just this past month, I and 357 other Members of this 
House voted to spend $100 million in block grants to States that choose 
mandatory jail sentences for gun crimes.
  Mr. Speaker, I expect Congress to increase appropriations to the 
Federal agencies that prosecute felons who buy guns. But this is what I 
really hope for: I hope that we increase funding to treat the mentally 
ill.
  Mr. Speaker, it is noteworthy that the woman who helped the Columbine 
high school shooters obtain some of their guns had said it was too 
easy. She has urged closure of the loophole that allowed her to buy the 
guns at a gun show without a background check.
  Congress should listen to the public this year. A recent poll shows 
that 88 percent of the public supports a change in the law to require a 
person attempting to purchase a handgun at a gun show to wait 3 
business days. And this is the important proviso: if the instant 
background check on that person shows an arrest record. Let me repeat 
that. If an instant background check on a person who wants to buy a 
handgun shows an arrest record, 88 percent of the public supports a 
change in the law to require that person to wait 3 business days until 
they are fully checked out, to make sure that one is not selling a gun 
to a criminal who should not get it.
  Mr. Speaker, more than two-thirds of the public think that a trigger 
lock should be attached to all stored guns.
  Tragically, we are going to see more rampage shootings unless we 
reach out and help those mentally disturbed youths and adults, and 
unless we also address the easy availability of the guns they use to 
kill themselves and kill others.
  Mr. Speaker, let us talk for a minute about the number one public 
health issue facing Americans today, the use of tobacco.
  Mr. Speaker, each day 3,000 kids start smoking in this country. One 
thousand of those kids, those under the age of 18, 1,000 of that 3,000 
that started smoking today will die of a disease related to smoking 
tobacco. Each year in this country, over 400,000 people die of smoking-
related disease.
  Prior to coming to Congress as a surgeon, I took care of many of 
these people. I have held in my hands lungs filled with lung cancer 
from somebody who smoked. As a reconstructive surgeon, I have had to 
remove portions of people's tongue and lips and jaws and neck because 
they either smoked or chewed tobacco. Then I have had to try to put 
them back together.
  Heart attacks. Smoking is the leading preventable cause of heart 
attacks or strokes in this country. The list goes on and on. There are 
like 20 different types of cancers that are caused by smoking.
  Peripheral vascular disease. I am also board certified in general 
surgery. In my training I have taken care of many people who no longer 
have any circulation left in their legs because of atherosclerosis 
caused by smoking.
  In Des Moines, we are starting to see now billboards that are like 
these. Here is one, the Marlboro Man. At the top, this one is on Fleur 
Drive on the way in from the Des Moines Airport. It says, ``Bob, I have 
got emphysema.''
  This billboard is on I-235 coming into Des Moines from the east side. 
Two cowboys riding along there, and one says, ``I miss my lung, Bob.''
  Here we have got the Marlboro Man, who by the way, did my colleagues 
know that the Marlboro Man died of lung cancer. Before he died of lung 
cancer, he came out and made commercials against smoking tobacco. This 
one says, the cowboy is talking to his horse, ``Chemotherapy scares me, 
Scout.''
  Well, I introduced a bill about 2 weeks ago that would give the FDA 
authority to regulate tobacco and nicotine. The gentleman from Michigan 
(Mr. Dingell) is my Democratic cosponsor on that bill. It is not a tax 
bill. It would not increase the price of a pack of cigarettes. It is 
not a liability bill. It does not deal with the right to sue. It does 
not have anything to do with the State settlements. It is a real simple 
bill.
  It would give the FDA the authority to regulate nicotine, which, 
according to the tobacco companies' own documents, show that it is an 
addicting substance with nicotine being as addictive, if not more 
addictive, than morphine and cocaine.
  I mean, why is it so hard for people, especially when they start 
smoking young, to quit smoking? It is because nicotine is really 
addicting. Just this week, I rented a movie. It is a movie with Al 
Pacino in it; it is called The Insider. I would highly recommend that 
everyone watch this movie. It is about how Jeffrey Wigand, who was the 
chief tobacco scientific investigator for Brown & Williamson, decided 
to give his story to 60 Minutes. It is a riveting story. It will tell 
my colleagues just how the tobacco companies play to keep. I would 
highly recommend it to all my colleagues.
  Well, what did those internal tobacco documents show? It showed that 
they knew that the earlier one can get somebody hooked on tobacco, the 
harder it is for them to quit. That is why they targeted kids. They 
wanted to get those 11-, 12-, 13-, 14-years-olds hooked on tobacco, so 
they came up with Joe Camel. They came up with things like, remember 
all those inducements to products that one could get with Marlboro on 
it, or Joe Camel on it.
  Well, here is a chart that maybe has a little different spin on the 
type of product that maybe a tobacco company should really be offering. 
It says the more one smokes, the more cool gear one will earn. Then it 
has an all-expense paid trip to the cancer clinic of one's choice. It 
has got here a deluxe carrying case, which is a coffin. I really like 
this one. A sport defibrillator for one's smoking. Or how about when 
one goes on one's hikes, with all those points from purchasing those 
cigarettes, one can get a portable respirator.
  We need to talk about the truth. There are over 1 million high school 
boys who are chewing tobacco today. What did those tobacco companies 
do? Well, first of all, they reduce the nicotine because they do not 
want to make those boys sick and green from too much nicotine. So they 
reduce it. They flavor it in just the flavors the research that they do 
that makes it taste great to get those kids hooked. Once they get them 
hooked, they increase the nicotine to really get them hooked.
  Well, here is a chart. As I said, what happens when one chews 
tobacco? We have not had spittoons around here for a long time. Well, 
one keeps that wad right there next to one's gum, and pretty soon one 
is going to have mucosal lesions, and those mucosal ulcers and sores 
turn into cancer, and then one loses one's lip and one loses one's jaw.
  So this is how to ask for some chew after the doctors remove one's 
tongue. If one chews tobacco, one can get oral cancer, one can lose 
one's lip, one's tongue, one's cheek, one's throat. So for somebody who 
wants to keep smoking and chewing, they better learn sign language. 
This shows us how to ask for chewing tobacco. It says, ``chewing 
tobacco, please.''

                              {time}  1915

  And if that is not enough to bother my colleagues on both sides of 
the aisle, remember I mentioned how tobacco causes atherosclerosis? 
This is a photo of a billboard that is in California. Why am I not 
surprised it is California? It probably is especially effective in 
California because what it says is, and here we have a gentleman with a 
droopy cigarette, it says ``recent medical studies indicate cigarettes 
are one of the leading causes of impotence.'' I can hardly wait. Maybe 
the

[[Page H2504]]

tobacco companies are going to combine Viagra now with nicotine.
  Mr. Speaker, I now have about 65 bipartisan cosponsors to the FDA 
Tobacco Authorities Act. I encourage all my colleagues to join on to 
that. This is a bill that, as I said before, is not a tax increase, it 
is not a litigation bill, it is a real simple bill. It would allow the 
Food and Drug Administration to implement those 1996 regulations which 
were directed specifically to preventing tobacco companies from 
marketing and targeting children to get them smoking. That is what it 
is about. Let us pass this. Let us do not get bogged down like they did 
a couple of years ago.
  The Supreme Court just ruled 5 to 4 that Congress needs to give the 
FDA explicitly that authority. But if we read Sandra Day O'Connor's 
final paragraphs in her opinion, she practically begs Congress to give 
the FDA that authority. We should do that.
  Mr. Speaker, I want to finally speak for just a few minutes about HMO 
reform. Mr. Speaker, it has been 6 months since this House passed, 275 
to 151, in a bipartisan vote, a bipartisan managed care consensus, the 
Managed Care Reform Act, the Norwood-Dingell-Ganske bill. Six months. 
The Senate had already passed their bill and they have been in 
conference. And where are they going? Nowhere. That is why today 
President Clinton invited the conferees down to the White House to see 
if they could get something moving on this very important issue.
  Why is this issue important? This issue is important because, for 
instance, the HMOs are able to, under Federal law, deny repair of this 
baby with a cleft lip and palate as medically unnecessary. More than 50 
percent of the reconstructive surgeons in this country within the last 
2 years have had cases like this or related to this birth defect denied 
by HMOs. These are real people that are affected.
  We are all familiar with the young lady who about 70 miles west of 
here fell off a 40-foot cliff, broke her skull, broke her arm, 
fractured her pelvis, had to be air flighted in to the emergency room 
and then her company refused to pay because she had not phoned ahead 
for prior authorization. I mean, like she was supposed to know ahead of 
time she was going to fall? Or maybe when she was on a morphine drip in 
the ICU she was supposed to make the phone call? Come on.
  At least that young lady got better. This woman did not. This woman 
had care inappropriately denied by her HMO and she died. Her children 
and her husband are now without their mother and wife. This story was 
profiled on the front page of Time magazine, if my colleagues want 
details. Talk about HMO abuse.
  Now let us talk about this little boy. This little boy, 6 months old, 
tugging at his sister's arm, was sick one night, a temperature of about 
104, 105 at about three in the morning. His mother phoned the HMO's 1-
800 number saying I have to take Jimmy to the emergency room. Fine, 
they said, but we will only authorize one hospital, and that was 70 
miles away. And little Jimmy had an arrest in the car before he got 
there. Somehow they managed to save his life, but they did not save all 
of him. And because that HMO made a medical decision, because they did 
not say just take him to the nearest emergency room but said they would 
only authorize her to go to their emergency room, which was a long, 
long ways away, they contributed to his cardiac arrest by that 
decision. That was a medical decision. And it resulted in this little 
boy losing both hands and both feet.
  We have been working on patient protection legislation now, my 
colleagues, for 5 years. It is time that we come together and get 
something to the President's desk that he will sign. Now, in light of 
the fact that very little progress is being made in the conference, and 
I should point out that of the Republican conferees that were appointed 
to this conference from the House, 13 or 14, only 1 actually voted for 
the bill that passed the House. And the two Republican authors, the 
gentleman from Georgia (Mr. Norwood) and myself, the authors of the 
bill, were not even named as conferees. We are not on the conference. 
We wrote the bill which passed the House 275 to 151, but we were not 
named to the conference.
  Well, I would refer my colleagues to a timely new investigative 
report that documents how campaign cash, particularly unlimited soft 
money contributions, has cemented an alliance between pro managed care 
interests and Senate leaders that has thwarted strong new 
patient rights protection that is supported by the majority of 
Americans. This is in a report on the Internet, so I will give the 
address: http://www.citizen.org/congress/reform/hmo-senate.htm.

  My colleagues need to read this report. Drawing on interviews, 
according to this report, with key lobbyists, Capitol Hill staff and 
written sources, the report details the intimate working relationships 
between two top managed care trade associations that are major 
contributors to the majority party in the Senate.
  We are talking about the Blue Cross/Blue Shield association and the 
National Federation of Independent Businesses. Now, I want to hasten to 
say that my voting record with the NFIB has always been good and we 
share many goals. But on this issue the NFIB lobbyists here in 
Washington are wrong and, in my opinion, are not representing the 
desires of their own NFIB members back home.
  I have met with NFIB members back in my State, and overwhelmingly 
they tell me they support our patient protection legislation. And that 
is borne out by this: According to a Kaiser Family Foundation and 
Health Research and Educational Trust study done last year, there is 
overwhelming employer support for patient protections. We are talking 
about payment for emergency department visits. Eighty-five percent of 
small firms think that Congress ought to pass a law that does that. 
Large firms, 69 percent; the general public, 76 percent. So employers 
support that even higher than the general public.
  How about on the issue of a denial of care, where an individual goes 
to an independent appeals process? Small firms, according to this 
Kaiser Family Foundation study, supported that provision for Federal 
law to the tune of 94 percent; large firms, 79 percent; the general 
public, 83 percent.
  Now, on the issue of enforcement, on the right to sue, small firms, 
the employers who own these small firms, 61 percent support that 
provision. Why? Because they have got the same policy as their 
employees and they have seen their employees abused by HMOs and then 
have no recourse. They do not think that is right. That is almost two-
thirds. That is almost two out of three employers of small businesses. 
And the general public feels even stronger about that; 70 percent on 
that.
  That is why I think that some of the Washington lobbyists are not 
even representing the wishes of their own constituents back home.
  This report reveals the extraordinary range of pressures that Senate 
leadership has deployed to keep reluctant Republican Senators in line. 
And based on this new analysis of political contributions that is in 
this report, the report lays bare the financial ties that bind the iron 
triangle of pro managed care contributors, their lobbyists, and Senate 
leadership that has worked in concert against strong patient rights 
legislation. Senate leadership represents the last bastion of HMO 
resistance to public regulation of HMOs, which most Americans blame for 
decreasing the quality of health care.
  In 1998, Senate leadership prevented the Senate from even considering 
the Patient's Bill of Rights. In 1999, they steered a weak patient 
rights bill through the Senate by a narrow margin. Only 2 months later, 
the House of Representatives, as I have said, passed a strong bill. 
But, today, one of those Senate leaders chairs the House-Senate 
conference, and he often makes pessimistic statements on the outlook. 
He recently told Congressional Quarterly magazine, ``It's not a high 
probability to even have a successful conference.'' While his pro 
managed care allies fight to kill any legislation.
  Here are some of the report's highlights. Let me repeat this again. 
This report is in http://www.citizen.org/congress/reform/hmo-
senate.htm. Here are some of the highlights of this report:
  Members of the pro managed care, this is the HMO organization, the 
health benefits coalition, have given more than $14 million in campaign 
contributions to the majority party and

[[Page H2505]]

its candidates since 1995. That is about 80 percent of their total, 
according to new data analyzed by this report. Nearly 40 percent 
consisted of soft money donations to the majority party. Senate leaders 
have established an intimate iron triangle working relationship with 
two leading health benefits coalition donor lobbyists, Blue Cross/Blue 
Shield and, as I said, NFIB.
  The Blues, which comprise the Nation's largest provider of managed 
care services have dispatched lobbyist Brenda Becker, their national 
PAC coordinator and key lobbyist, to serve as one of a small number of 
cochairs for the majority party fund-raising. She has responsibility 
for soliciting millions of dollars from the health care industry and 
other businesses. She has cochaired the annual GOP House-Senate fund-
raising dinner for the last several years. She cochaired the majority 
fund in 1997 and again this year. She has personally orchestrated 
leadership PAC fund-raisers for Senate leaders, as well as golf tourney 
fund-raisers, including the upcoming Senate leader sponsored event in 
July.
  There is an appendix to this report that my colleagues can look up on 
the Internet that details this. NFIB, sadly, chairs the health benefits 
coalition. As I said, I think they have worked on a daily basis with 
the Senate leadership and the Senate leadership staff to develop 
legislative strategy to kill strong patient protections.
  According to interviews with congressional staff and lobbyists, 
Senate leaders have employed a variety of strong pressures, including 
social ostracism on majority Senators to create near unanimous 
Republican support on the Senate for a weak patient rights bill. Those 
Senate leaders pressured four independent-minded Senators.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. Ryan of Wisconsin). The Chair must 
remind all Members that under the rules and precedents of the House it 
is not in order to cast reflections on the Senate or its members 
individually or collectively.

                              {time}  1930

  Mr. GANSKE. Mr. Speaker, I appreciate the advice.
  Let me talk about a parable. There is a book down in the lobby. It is 
called House Mouse, Senate Mouse. It is a little book that I take to 
grade schools, usually about third-graders, and I read this story about 
the House mouse and the Senate mouse in the Congress. They have, for 
instance, the oldest mouse in the Senate is Senator Thurmouse.
  Well, let us just talk about this mouse Senate. It seems to me that 
this report is very similar to what may be going on in the mouse 
Senate, where senior mouse senators from Rhode Island who tried to work 
in an independent manner, bipartisan fashion, were ostracized by those 
other mouse majority senators.
  Or how about the senior mouse senator from Arizona who tried to work 
with the junior mouse senator from Illinois.


                announcement by the speaker pro tempore

  The SPEAKER pro tempore (Mr. Ryan of Wisconsin). The gentleman will 
suspend. The Chair kindly reminds the gentleman from Iowa (Mr. Ganske) 
that, under the rules and the precedents of the House, it is not in 
order to cast reflections on the Senate or its members, even by 
innuendo.
  Mr. GANSKE. Mr. Speaker, I would ask a question.
  Do you think that when I am referring to a mouse Senate that I am 
actually referring to the actual Senate?
  The SPEAKER pro tempore. Would the gentleman just kindly refrain from 
casting reflections upon the Senate or Members of the Senate 
individually or collectively. The gentleman may proceed in order.
  Mr. GANSKE. Well, I appreciate the discretion of the Speaker.
  Mr. Speaker, and even though we are talking about some diminutive 
legislative activities, just what I think I will do is I will simply 
recommend again to my colleagues that they look up this report. It 
details connections between lobbyists and legislation related to 
patient protection legislation that is going on here in Washington, and 
I think it does establish an unsavory connection between campaign 
contributions and public policy. I highly recommend it.
  Let me once again point out that on the Internet this is under http:/
/www.citizen.org/Congress/reform/HMO-Senate.htm.
  That report concludes that there is a strong body of evidence linking 
pro-managed care industry campaign contributions with, in my opinion, 
what is going on in the conference.
  We need to break that iron triangle. That is one of the reasons why 
the House passed the Shays-Meehan campaign finance bill. It needs to be 
dealt with, both campaign finance reform, and also getting real pro-
consumer Patients' Bill of Rights in order to address the tragedies 
that occur due to HMOs making medical decisions that harm patients and 
a Federal law that prevents those HMOs from being responsible for those 
decisions and a lack of a Federal law that would set up a mechanism to 
prevent those tragedies from happening before they occur.
  That is what we passed on the floor of the House, a strong bipartisan 
patient protection bill, the bipartisan consensus Managed Care Reform 
Act, the Norwood-Dingell-Ganske bill.
  I would beg the conferees not to give up, to bring forward from the 
conference committee a real patients' protection bill so that we do not 
have to continue to deal with these tragedies.
  Mr. Speaker, I appreciate your indulgence.

                          ____________________