Congressional Record, Volume 146 Issue 138 (Saturday, October 28, 2000)

[Congressional Record Volume 146, Number 138 (Saturday, October 28, 2000)]
[House]
[Pages H11476-H11483]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

IMPROVING HEALTH CARE FOR AMERICANS

The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 1999, the gentleman from Texas (Mr. Turner) is recognized
for 60 minutes as the designee of the minority leader.
Mr. TURNER. Mr. Speaker, I thank my Democratic colleagues who have
joined me on the floor today for this Special Order hour. We are here
this afternoon on a beautiful fall day, here in this House Chamber,
trying to urge this Congress not to adjourn for the year until we
finish the job of meeting the health care needs of America's families.
Democrats in the House have worked for the entire 2-year session of
this Congress to give America's families a strong Patients' Bill of
Rights to ensure that you and your family make your health care along
with your doctor, rather than having some insurance clerk who has never
had a day of medical training, decide the treatment that you need. We
have worked to make sure that when you are ill and when you are
fighting for your life, that you do not have to also fight your
insurance company to get the help that you need.
Democrats in this Congress have been united also in the fight to give
a prescription drug benefit to our senior citizens. We have worked for
an optional part D under Medicare to guarantee that our seniors will
never again have to make the choice between buying groceries and paying
the rent or filling their prescriptions. And the Democrats in this
Congress are united in our efforts to protect Americans' access to
quality health care. We are fighting as we speak during the ongoing
negotiations in the closing days of this Congress to answer the pleas
from our hospitals, from our home health care providers, from our
nursing homes and our other health care providers that we must
strengthen Medicare, because many of us know that we have Medicare-
dependent hospitals that will close their doors if Congress fails to
get this job done.

{time} 1415

Home health agencies have already closed by the thousands and our
teaching hospitals are no longer able to pursue teachers, research, and
indigent care due to lack of funding.
The American people have a right to know where this Republican-
controlled Congress has failed to lead and failed to solve these
pressing problems that confront every American family.
They have a right to know who is on their side, and they have a right
to know who is fighting for them. The answer is all too clear. The
Republican-controlled Congress has become the special-interest-
controlled Congress. The powerful special interests are in the driver's
seat, and the public interests are in the backseat.
On these three critical issues, patient protection, prescription
drugs and protecting Medicare, the Republicans have danced to the tune
of the big insurance companies and the big prescription drug
manufacturers.
On patient protection, the powerful insurance industry has fought in
every State legislature and in this Congress to defeat meaningful
patient rights. I carried the first patient protection legislation in
the country when I was a State senator in Texas. The State Senate there
and the State House voted almost unanimously in favor of a bipartisan
patient protection bill. That bill was vetoed by Governor Bush, and he
vetoed it after the legislature had adjourned when we had no
opportunity to override.
Fortunately, the legislature came back in the next session 2 years
later and passed almost the identical package in four parts, and
Governor Bush signed three, but let the fourth, regarding
accountability of HMOs, become law without his signature.
Fortunately, we have patient protection in many of our States, but we
know that we must also pass a Federal bill to be sure that all patients
under all plans are covered with these protections.
Early in this session of Congress, this House passed a strong
patients' bill of rights with near unanimous support from Democrats and
the courageous support of Republican Members, like the gentleman from
Iowa (Mr. Ganske) and the gentleman from Georgia (Mr.

[[Page H11477]]

Norwood), only to see the bill watered down in the Senate and now
languish in a conference committee with no action.
I ask the American people, who is on your side? Who is fighting for
you? On prescription drugs, Democrats have united in support of a
voluntary universal prescription drug benefit under Medicare, but our
Republican friends have joined with the pharmaceutical industry to
defeat our plan.
The pharmaceutical industry created a front group called Citizens for
Better Medicare, if you can imagine, and spent millions of dollars in
advertising across this country to say to the American people that
private insurance can take care of the problem of prescription drugs
for our seniors.
We know that Medicare is the system that our seniors trust, and we
know that the big pharmaceutical manufacturers do not want a
prescription drug benefit under Medicare because they know if Medicare
is in the business of helping our seniors get prescription drugs,
Medicare is not going to pay the same high prices that our seniors are
having to pay every day when they walk in their local retail
pharmacies.
Our Republican friends even introduced and passed a bill on the floor
of this House authorizing insurance companies to offer prescription
drug-only plans to seniors when even the president of Blue Cross and
Blue Shield testified to this Congress that the plan was neither
workable nor affordable for our senior citizens.
Well, that plan backed by the Republican leadership and by the big
pharmaceutical companies never has become the law fortunately; but
still we have been unable to pass a prescription drug benefit under
Medicare.
Democrats want to update Medicare to make it consistent with the
times, because we know that prescription drugs are now a big part of
all of our health care costs.
It is time to end the pharmaceutical manufacturers' practice of
charging America's seniors the highest prices paid anywhere in the
world for prescription drugs. I ask the American people, who is on your
side? Who is fighting for you?
Finally, when we look at what is happening today, this week, in this
Congress, when we are fighting to increase funding for Medicare to save
our hospitals and our health care providers, the Republicans put forth
a bill and passed it on the floor of this House, which the President
has pledged, fortunately, to veto, that dedicates 40 percent of the
increase in funding directly to the insurance company HMOs with no
guarantee that any of that money will ever get to our hospitals, our
health care providers, or our senior citizens on Medicare.
Why with only 15 percent of America's seniors living in an area where
they even have access to a Medicare HMO plan would the Republican
leadership give 40 percent of the increase in funding to the insurance
industry? I ask the American people, who is on your side? Who is
fighting for you?
We, Democrats, have gathered on the floor today to talk about these
issues, and it is a pleasure for me to yield to the gentlewoman from
Florida (Mrs. Thurman), one of the best and hardest working Members of
this Congress. The gentlewoman has worked on prescription drugs for
seniors as long as any of us, and I am proud to yield time to her to
discuss these important issues.
Mrs. THURMAN. Mr. Speaker, I appreciate those words from the
gentleman from Texas (Mr. Turner), but I would dare say that the
gentleman and other Members of this Congress feel passionately about
this health care issue as the gentleman so eloquently described in your
opening remarks.
I think the gentleman is right, we are on their side.
I just want to go over some things, because the gentleman mentioned
about a piece of legislation that potentially is going to be vetoed, if
it ever gets to the President, I understand we may not get it there,
but the fact of the matter is, two things I would say to the gentleman.
I just received a letter October 20 from a gentleman, and he has also
sent me some additional information on what is happening with his
Medicare choice program, but it is very interesting. In the middle of
his letter he says the medication providers made it tough to live up to
these standards and something must be done to save the senior citizen,
as well as the poor and middle-class citizens who cannot afford these
high prices of medication.
Mr. Speaker, he went on to say, when I was in the Marine Corps in
World War II, we were taught how to survive. But what is happening to
us now with this health care system and prescriptions does not afford
or teach us the liberty of surviving.
What I think caused him to send this letter to me was the letter that
he just received from his Medicare choice program. Now, remembering the
gentleman just said what was just passed was about $8 billion or more
that will go to these Medicare choice programs, even one of them
getting about a 3 percent increase, before this bill was even voted on,
before they even knew what potentially would be the outcome, this is
what they wrote to him, the name of the plan is changing in 2001 as
shown in the table below. So-and-so's premium will no longer be offered
in 2001. You will be automatically enrolled in this particular plan
instead. I am not going to mention names. If after reviewing the
benefit changes, you decide that this plan is not acceptable, you may
wish to receive information about a valued plan available in your area.
This is how it goes. They have a chart. I would have blown up this
chart, because I think it is very interesting. It is these kinds of
phone calls and letters I am getting.
Benefit, monthly plan premium, 2000, $19; 2001, $179, from $19 to
$179. Outpatient, physician specialist services, $10 office visit
copayment; $15 office visit copayment, 2001. Outpatient hospital, $20
in 2000; $35 in 2001. Inpatient, no copayment; $1,000, 2001, $200 per
day, limit 3 copayments per year. Inpatient hospital care, nonnetwork
facility, no copayment; 2001, $500 copayment per admission. Mental
health, no copayment; 2001, $200 per day, limit 3 copayment per year.
Prescription drug, $1,000 on outpatient prescription drug benefit,
maximum benefit $1,000, annual maximum for brand name drugs, the amount
applied towards the benefit maximum was calculated as follows, the
usual and customary price of the medication or the average wholesale
price, whatever is less, plus the dispensing fee, minus your copayment.
That is what happens in 2000. 2001, $50 monthly maximum for brand name
drugs, the amount applied to the benefit maximum is the amount that
this company pays for the drugs.
Now, they are going to get a 3 percent, only covering about 15
percent by the way of the entire population, which is 40 percent of
this entire package, and they are already sending out these notices
saying that they are going to go from $19 to $179 and every other
expense they have is also out of pocket expense going up. That is what
I received.
Now, have we addressed this? We tried to address this. It was not
going to make any difference. This is what they already said. By the
way, on the back page, it says if you want to know you can opt out of
this. I mean, these people are not going to have any place to go.
At a rare moment of this year in a political debate that I have
actually made on a Sunday afternoon, I was handed, not by the same
person, but by another person a monthly statement of what their
medicines would cost. This is what really struck me. At the end of it,
it said previous balance, $649.59, charges this month $2,322.56.
We have stood on this floor, the gentleman from Arkansas (Mr. Berry),
the gentleman from Connecticut (Mr. Larson), the gentleman from Texas
(Mr. Lampson), the gentleman from Washington (Mr. Baird) have stood
here and talked about at least one thing that we could have done that
would have cost the Federal Government nothing. We are missing the
gentleman from Maine (Mr. Allen), our friend.
I say to the gentleman from Texas (Mr. Turner), we have offered it in
the committee. We said put it under the Federal supply system. Use the
Federal Government's buying power by buying the medicines at a reduced
price. Use us just like we do in the VA system, just imagine this one
alone would have been cut by almost $1,200, just that one. Not even a
benefit that we are fighting about right now. Just cut this in half.
Let us be the buyer of this.
We buy bulk paper. We buy the hammers. We buy the highways. We buy

[[Page H11478]]

the bridges. We do all of those things. We use our buying power for
those purposes. Why can we not use that for these folks? Why are we
saddling not only with the prescription drug costs that are outrageous
and expensive and certainly not going for research, and I am sure
somebody could jump up and talk about that, as we all could, but the
fact of the matter is it is lining somebody's pocket. And on top of
that, we have the increased costs.
My colleagues know what my solution is. I think we ought to get rid
of Medicare choice. I think we ought to get rid of MSAs. I think we
ought to get rid of all of that. I think we ought to look at a Medicare
program that gives the safety net for every senior and not discriminate
because they live in an area where they can get a Medicare choice or
not.
We ought to be making sure that these things are covered under
Medicare, become a Medicare benefit, and that would solve an awful lot
of problems for a lot of people and would give us a health care system
that is stabilized and not so off and on again and pulling people in
and out of these programs, but something they can count on, which is
what they always thought they were going to have when they had
Medicare.
Mr. TURNER. I thank the gentlewoman from Florida (Mrs. Thurman), and
I appreciate her hard work on these issues. Her work in committee as
well as on the floor has meant much to all of us.
Mr. Speaker, I yield now to the gentleman from Connecticut (Mr.
Larson), one of the most effective younger Members of this Congress,
another Member who has worked with us very closely on these very
critical issues.
Mr. LARSON. Mr. Speaker, I thank the gentleman from Texas (Mr.
Turner), and I appreciate his great leadership on this very important
issue before Congress.
I think it is instructive to those that are listening today on a
Saturday afternoon that we are here continuing to press this vitally
important issue. We are here for the people that Tom Brokaw
appropriately recognized as the greatest generation ever, those people
who persevered through the great Depression, who won the Second World
War, who came home and rebuilt this great country of ours, provided for
interstate commerce and made sure that we had school systems that were
second to none so that we have risen today to be the preeminent
military, economic, cultural and social force in the world.

{time} 1430

All they are asking for is to live out their final days in dignity. I
can say it no better than the woman who was on 60 Minutes who said, ``I
feel like I am a refugee from my own health care system, a refugee from
my own health care system because I have to travel to Canada to get the
prescription drugs that my doctor has recommended I take because I
cannot afford them here in my own country.''
That is why we need the legislation that the gentleman from Texas
(Mr. Turner) has sponsored, that the gentlewoman from Florida (Mrs.
Thurman) spoke about. That is why it is so important, as it should have
been in 1965, that we follow the President's lead and the Vice
President's lead in making sure that we make prescription drugs part of
Medicare.
As the gentlewoman from Florida (Mrs. Thurman) has pointed out as
well, also following along the lines of the Allen bill which so many of
us have supported here as well, that makes nothing short of common
sense, that will not cost one new dollar in terms of adding onto
bureaucracy, no new tax dollars, but just using the Federal Government
as a resource, and pulling those Medicare recipients along with those
Federal employees that already receive a discount, thus driving down
the cost of prescription drugs for our elderly.
Everywhere I go across my district I can think of no more poignant
issue where people have been calling upon Congress to put down their
partisan differences. Instead, we get a charade. We get a charade of
proposals claiming to have been for or have passed something akin to
prescription drug relief.
The Republican proposal I have aptly named the Marie Antoinette plan.
My colleagues all recall when those in Paris were starving and the then
Queen said, ``They are without bread. Let them eat cake.''
The seniors of this country have come to the capital, have plead with
us to give them prescription drug relief, and our Republican
counterparts are saying, ``They are in need of prescription drugs. Let
them buy insurance.''
That is not the way to make sure that we protect and provide for the
greatest generation ever, those individuals that have sacrificed so
much for this Nation of ours. Let us get behind the American plan, not
Democrat, not Republican, but the plan that allows people to live out
their final days in dignity and provides them the access to
prescription drugs, as the gentleman from Texas (Mr. Turner) pointed
out, that will not have them faced with the decision of choosing
between the food they put on their table, the monies they need to heat
their home, or the drugs that their doctors have recommended that they
take to survive. I commend the gentleman from Texas (Mr. Turner) for
putting forward this very important issue at this critical time.
We have got a governor out there who is cawing how he can bring
people together. I have a suggestion, call the gentleman from Texas
(Mr. DeLay), call the gentleman from Texas (Mr. Armey), two of his
fellow Texans, tell them to pull this Congress together in the waning
days and pass on to those seniors. This is not a bipartisan issue, this
is an issue of survival, this is a moral obligation on the part of this
Congress to make sure that those seniors, those citizens that have
given so much need these drugs to survivor. Let us get together and
make it happen. I commend the gentleman from Texas (Mr. Turner) for his
leadership.
Mr. TURNER. Mr. Speaker, I know we all agree with the gentleman from
Connecticut (Mr. Larson) completely. I appreciate his conviction on the
issue.
Another Member who has worked tirelessly on this effort to bring
fairness in prescription drug prices and a prescription drug benefit
under Medicare to our seniors is the gentleman from Washington (Mr.
Baird).
Mr. Speaker, it is my pleasure to yield to the gentleman from
Washington (Mr. Baird) on this subject.
Mr. BAIRD. Mr. Speaker, I thank the gentleman from Texas (Mr. Turner)
for his leadership on this, and my colleagues who are here to speak to
this.
Mr. Speaker, I did not come to the health care issue as a new Member
of Congress because it polled well. I came to Congress as a member of
the health care profession because we have a health care crisis.
For 23 years before serving in this body, I worked with patients. I
was a clinical psychologist. I worked with cancer patients, with head
injury patients, with folks with severe mental illness. I can tell my
colleagues that, when we talk about 44 million uninsured Americans, 11
million uninsured children, those are not just numbers, those translate
into real human lives.
I have worked with patients who put off needed health care. By the
time they came to us, their disease had progressed so far, there was
nothing more we could do. I have been by their bedside as they died.
This is not a political issue. It is not something for rhetorical
flourish. It is a day-to-day matter of life and death for American
people.

This Congress has named post offices. This Congress has passed
resolutions on this and that. But this Congress has yet to pass a real
Patients' Bill of Rights, a Patients' Bill of Rights that lets one
choose one's health care provider, puts medical decisions in the hands
of medical professionals, and holds insurance companies accountable
when they deny one care.
This Congress has not passed that bill. Part of the reason we have
not passed that bill is we have also not passed campaign finance
reform. We have had a chance, but it has been held up again, two
critical bills that could have passed.
The reason we cannot pass the Patients' Bill of Rights is the special
interests who do not want to see that pass, who make money off other
people suffering, have so heavily invested in certain campaigns that we
will not even bring it to a serious discussion in the conference
committee.
This Congress has not addressed pharmaceutical costs. The gentleman

[[Page H11479]]

from Connecticut (Mr. Larson) talked about the Republican plan as the
Marie Antoinette plan, very apt prescription. I call it the placebo
plan. Placebos, as my colleagues know, are medications or pseudo-
medications designed to make one feel better if one believes they work,
but they have no real effect. They are sugar pills.
Congress should not be passing sugar pills. The American people
deserve better than placebos. The only bill we have managed to bring up
is a placebo bill that resulted from polling that said the following:
you have got to do something because the American people think there is
a need for pharmaceutical benefits. But it does not matter what you do,
so long as you say you care.
Saying you care and showing you care are different things. This body
is in session still. We have set a record, I understand, one of the
longest sessions of Congress in an election year. But in that time we
have taken, that extended time, we have passed no Patients' Bill of
Rights, no real pharmaceutical benefits. We have not done anything
substantive to reduce the numbers of uninsured children and uninsured
seniors in this country.
Our rural hospitals, Mr. Speaker, are suffering. There is a little
bitty hospital named Morton General in a little mountain town, a timber
town that has been pretty hard hit over the years. The winter weather
is hitting Washington State right now up in the Cascades.
That town is an hour away from any trauma center. If a woman has a
complicated pregnancy, or a logger sustains a serious ailment, that is
the only hospital within an hour they can get to. With that winter
weather, one is not going to be able to get a life flight up there.
This week we passed a bill before this Congress that will not do what
we need to do to protect our rural hospitals. It will not do what we
need to do to protect our urban and suburban hospitals. It will not do
what we need to do to protect our home health agencies. We passed it
for the same reason we passed the placebo prescription medication bill,
for political purposes, not for health care purposes. That, Mr.
Speaker, is wrong.
We are in the richest country in the history of the world, the
richest country in the history of the world; and 44 million Americans,
11 million children have no health insurance. Senior citizens choose
every week whether or not to take their medication or pay their rent.
Doctors are leaving our suburban and rural hospitals because they
cannot afford to pay back their student loans. It is a disgrace.
Mr. Speaker, almost every weekend for the past 2 years, I have flown
home to be with my constituents. I have had 103 town meetings. At every
one of those, someone has brought me their prescription medication bill
and said, please help us with this.
I would like to be home in my district right now, not so much because
there is an election, but because I would like to be home and listen to
my constituents.
But if we are here, for goodness sakes let us do something that
matters. Let us do something that matters. We are not going to do that.
We are going to pass CR after CR after CR. We are not going to do it.
It is a shame. The 106th Congress is going to go down as the longest
Congress to have done the least in American history.
I applaud the leadership of the gentleman from Texas (Mr. Turner). I
applaud my Democratic colleagues who have tried to do something really
substantive for the American people.
I would appeal to this body, in the few days left, let us take a
chance and work together and solve at least some of these problems, a
Patients' Bill of Rights, a pharmaceutical benefit, real help for our
rural hospitals, not a give-back to HMOs, but real help for our
hospitals.
Mr. TURNER. Mr. Speaker, the gentleman from Washington (Mr. Baird)
certainly brought the issues right down to home by the examples that he
gave. I think many times people feel like we are down here debating
some high-minded set of issues. But the truth is these issues make a
difference to America's families. They make a difference to our
hospitals and our districts. They make a difference to those health
care providers that are out there trying to take care of the needs of
the people we represent.

Mr. Speaker, it is my honor to yield to the gentleman from Texas (Mr.
Lampson), one of my Texas colleagues who has also worked very hard on
these issues, who comes from a background where he has firsthand
familiarity with the home health care industry, an individual who has
fought hard on behalf of the people of his district and of Texas.
Mr. LAMPSON. Mr. Speaker, certainly not near as hard as what the
gentleman from Texas (Mr. Turner) has. The leadership that he has taken
and put forth, both in the Texas legislature as a member of the Texas
Senate, and then up here following through has been most appreciated.
Without the effort that the gentleman has made, many of our colleagues
would not have had the benefit of the knowledge, nor the encouragement
to have played much of the role that we have. So we commend the
gentleman from Texas (Mr. Turner), and we thank him very much for that.
Mr. Speaker, I was involved in the home health care business. I went
to graduate school in hospital administration following college. Then
after, I taught school for a number of years. I have basically done
three things. I was a schoolteacher. I was involved in local politics.
Then I, when I was very much involved with the area agency on aging for
southeast Texas, became involved with home health care.
I was a delegate to the White House Conference on Aging in 1995. One
of our colleagues spoke a few minutes ago of our elderly seeking the
opportunity to live out their years in dignity. Well, at that White
House Conference on Aging in 1995, there were basically three goals
that were set. They were to save social security, save Medicare, and
save the Older Americans Act.
It was felt that, through the 5,000 people or so that participated in
that conference, through the many, many, many meetings that took place
over 6 or 8 days that we were there, that the primary goal was to give
people the opportunity to live in dignity and to be independent in
their last years of their lives.
That is what I want to talk about today. I guess it is the state of
this Nation's health care that concerns me so greatly, all of us so
greatly.
We saw recently, after we passed H.R. 2614, that the Republican
leadership combined five bills into a conference report, even though
much of what was in those conference reports had not been even
considered by the Senate.
Some of the key components, like the Medicare provisions and even
the, going back to education for a second, the school construction tax
subsidized bonds, none of those were considered by either the House or
the Senate.
It is the Democrats who have taken the lead in proposing a balanced
package of Medicare and Medicaid restorations. This package ignores the
efforts of the President and congressional Democrats to get Republicans
to the table to craft such bills.
Instead, Republicans unilaterally put forward this partisan package.
It truly bothers me. I am bothered by the Medicare, the Medicaid and
the State CHIP provisions in this bill. This portion of the bill has
never been acted on by either the House or the Senate.
There are increases of some $31 billion over 5 years for Medicare,
Medicaid and State CHIP providers. Of this, 41 percent goes to HMOs
with no real guarantee that they will pass the funds on to
beneficiaries in the form of enhanced benefits. In fact, there is not
even a guarantee that they will have to stay in the communities that
they now serve.
So much of the money in this bill is spent on HMOs that there is not
enough for hospitals or nursing homes or home health care agencies or
hospices or even community mental health centers. Only about 7 percent
of the net increase in Medicare spending in the bill will directly
benefit Medicare beneficiaries.

{time} 1445

While I have my colleague's ear, and while I have the opportunity to
visit for a few minutes up here, I would like to make a comment about
prescription drugs. It was about a month ago, I think, that the
gentleman from Illinois (Mr. Hastert), the Speaker of the House, sent a
letter to the President outlining a number of health care issues that
could be resolved before

[[Page H11480]]

Congress adjourns. And the President wrote back, and his response said,
``I am extremely disappointed by your determination that it is
impossible to pass a voluntary Medicare prescription drug benefit this
year. I simply disagree. There is indeed time to act, and I urge you to
use the final weeks of this Congress to get this important work done.
It is the only way we can ensure rapid, substantial, and much-needed
relief from the prescription drug costs for all seniors and people with
disabilities, including low-income beneficiaries.'' That is what the
President said.
Similarly, I signed on to a letter to Speaker Hastert expressing my
concern to learn that he had sent a letter to the President declaring
his unwillingness to adopt a real Medicare prescription drug benefit
before Congress adjourns this year. I disagreed that it is too late to
pass real prescription drug legislation. I urged the Republican
leadership to schedule for consideration legislation to improve
meaningful drug coverage for all seniors. And has that been done yet?
Is it on the schedule? No.
The Republicans' low-income-only prescription drug plan is an empty
promise to seniors because it is not a Medicare plan. It would exclude
25 million Medicare beneficiaries from coverage. It includes no real
protections or guaranteed benefits. It would provide no help to a
majority of even those who would be eligible. It would take years
before its coverage provisions would be implemented. And even State
officials, who would be responsible for implementing the program, said
that they cannot do it. Well, this proposal is really no help at all to
seniors who desperately need prescription drug coverage.
We have a responsibility to the American people to act on important
issues facing this Nation. It is time to listen to the thousands upon
thousands of seniors who have deluged our offices, certainly mine, with
heart-wrenching letters of outrageously expensive prescription bills;
to hear the stories like that from my own constituent, a widower, of a
lady who taught school and died because her insurance company would not
pay for the treatment that she needed to save her life from breast
cancer.
It is this call for leadership that this Congress has so far refused
to answer, and it is time to put the people's interests ahead of the
special interests and pass a universal voluntary Medicare prescription
drug benefit.
One of the things that stuck out in my mind, and it has been a few
years now, obviously; but back in that last Presidential campaign, Bob
Dole made a comment at some point that in 1965 he voted against
Medicare. I think that that was indicative to me of the difference in
commitment to honoring the goals that were set by those seniors in the
1995 White House Conference on Aging. The gentleman asked the question
properly a few minutes ago: Who is it that is going to be on the side
of America and make these things reality for our Nation as we have
enjoyed them over the last several decades; those things that have
expanded our life-span; that has given us a quality of life to be able
to enjoy the last years? It is going to be the Democrats and the
Democratic proposals.
I guess the final thing that I can say is that the work that we have
done has been done in a manner and a way that families in southeast
Texas make decisions, with common sense and fairness. That is what I
think we represent, and what our efforts are trying to be. And I thank
again and commend the gentleman for his efforts that he has made and
the work of all my colleagues in trying to make this become a reality
for the United States of America.
Mr. TURNER. I thank the gentleman from Texas (Mr. Lampson).
Well, Mr. Speaker, we have heard from a clinical psychologist; we
have heard from the gentleman from Texas (Mr. Lampson), who has
experience in home health care; in a minute I am allowing that we will
hear from the gentleman from Arkansas (Mr. Berry), who has a background
in pharmacy. But now I want to yield to the gentlewoman from California
(Mrs. Capps), an outstanding Member who brings to this body her
experience as a registered nurse.
Mrs. CAPPS. Mr. Speaker, I thank my colleague from Texas and
appreciate my fellow Members of Congress for the time that we can have
to discuss this important topic. We are in the final hours of this
106th Congress. We have passed some spending bills, but there remains
still a few more.
When I think of my communities in the district that I represent and
the concerns of the people that I represent, and I am so honored to
represent them, I know that they look to me and to all of us in the
area of health care as the most significant contribution that we can
make to their lives here within the Federal Government, whether it is
addressing the crisis of the number of uninsured Americans, people who
face every day in terror that they will have health care needs that
they have no resources to meet, or whether it is the people that I can
call up in my mind, those seniors who live in my district who have to
choose each day whether to fill their prescriptions, lifesaving
prescriptions, or to put food on their table. These are people living
on fixed incomes. They are not poverty stricken, but middle-class
seniors.
These are issues that we really need to be addressing here. We need
to put an affordable voluntary prescription drug opportunity for all
seniors within Medicare. We need to address the issues of the
uninsured.
I also want to use the minutes that the gentleman has given me to
talk about another issue that people in my district have said we should
do something about. They want us to do something about those HMOs that
are making health care decisions in the place of their doctors.
We have had, we have still, a great opportunity to enact a bipartisan
bill that passed here in the House, the Norwood-Dingell patient's bill
of rights, 68 Republicans and an overwhelming number of Democrats. A
good bill, yet it languishes. This is something we can still do in
these last few hours of this session of Congress. It contains critical
provisions which, I believe, are key to quality patient care and which
come directly from the experiences of people in my district and around
this country with their managed care providers and with their insurance
companies.
They tell me in my district that they want to be able, as a patient,
to choose their own doctors, their own hospital, to see specialists
when it is appropriate. They do not appreciate having these decisions
being made by insurance clerks and having the doctors told what they
cannot and can do. The bill we enacted right in this House would
protect medical privacy, guarantee emergency room care, and ensure that
health plans cannot interfere when patients enrolled in clinical
trials. Most importantly, this bill we passed holds HMOs accountable
when they make medical decisions that harm patients.
And this is a sticking point, and this is why there is such
tremendous opposition to it right now. But we hold physicians
accountable for malpractice. And when insurance companies practice
medicine in a way that is not in the interests of the patients, they
should be held accountable as well.
I am from California, where HMOs got started; and I have seen for
myself in my own experience and those of the people with whom I worked
so many years as a school nurse that HMOs have done some wonderful
things, such as spreading the availability of preventive care. But over
the past decade or so in my district, the power has swung too far into
the corner of HMOs and insurance companies making health care decisions
and into the area of pursuing profits over patient care. Patients are
being cut out of the decision-making process of their own health care.
Doctors, nurses, other health care professionals are overruled by bean
counters and profit takers. The bottom line is what is being intruded
into health care, and our health care system is eroded today by
mistrust and by anger.
This legislation that we passed here, the model that we could still
enact into law, is supported by virtually every major health care
organization in this country. As I mentioned, this House passed it by
nearly a two-to-one margin last year. The American people support it
overwhelmingly. We have no excuse that we cannot afford to do something
about this. We have examples of the gentleman's own State where a
patient's bill of rights has been in place and where it has worked
effectively. It has not cost people more than a dollar or two more in
their premiums.

[[Page H11481]]

The fear about everything going to the courts has not, in fact,
turned that way. A very small number of lawsuits have actually
resulted. When we have the example of Texas' patient's bill of rights
being put into place, there is absolutely no reason why we should not
be addressing this in this session of Congress before we adjourn. Our
constituents at home are asking us to do this, and I am urging the
leadership in this House and in the Senate and in that conference
committee to deal with this before we adjourn.
Mr. TURNER. Mr. Speaker, we appreciate so much the experience the
gentlewoman brings to this body with her background in nursing. It
gives us a unique perspective.
I want to yield now to the gentleman from Arkansas (Mr. Berry). He
was one of the original cosponsors of the Prescription Drug Fairness
Act. He comes to this body with a background of training in pharmacy,
and I think he brings not only the expertise of pharmacy to bear on
these issues but I have found him to bring the common sense of rural
Arkansas to bear on these issues, and for that I have been very
appreciative. So I am honored to yield to the gentleman.

Mr. BERRY. I thank the distinguished gentleman from Texas (Mr.
Turner), my great friend; and I want to commend him for his leadership
on health care matters in this Congress and in the time that he has
been here. It is nice to be here with my Democratic colleagues today
that have all worked so hard to try to improve the health care system
in this country.
One of the previous speakers on the Republican side earlier today
said it is time for a reality check. I could not agree more. Let us
check the reality of the situation we are dealing with today. We are at
the end of the session. We are here on a Saturday afternoon and would
be proud to be here if we were just taking up the legitimate business
of the American people. We have no patient's bill of rights. We have no
prescription drug coverage for our senior citizens. That is the
reality. We have not made provisions for more reimbursements for our
hospitals to keep them in business. They are going broke every day.
That is the reality. We have made no provisions to keep our home health
care providers in business. That is the reality. Nor to keep our
ambulance services in business. That is the reality. We have not made
provisions for school bonds, smaller classrooms, after-school classes,
teacher training, or any of the education programs that our children so
desperately need. That is reality.
Let us talk about what we have done. We passed a patient's bill of
rights in a bipartisan way in this House, and the leadership in the
House and the Senate killed it in the Senate and in conference in a
disgusting way. They should be ashamed of themselves.
They raised, and the Democrats voted against it, I voted against it,
but the Republicans raised their own budget. They raised their own
spending caps just a few days ago so that they could give an $11.5
billion Christmas present to the HMOs, not to correct these problems I
just talked about, not to help our seniors with a prescription drug
benefit, not to provide a patient's bill of rights, not to help our
hospitals or our health care providers, but to give a Christmas
present, granted it would be early, but it would be a nice Christmas
present to the insurance companies that have poured money, in an
unprecedented way, into their campaigns. That is reality.

{time} 1500

Governor Bush stands before the American people and proclaims his
great concern for our senior citizens not having prescription
medicines. He claims that he almost single-handedly passed a Patients'
Bill of Rights in Texas, which we all know is not right. And he also
proclaims that he has this great ability to work in a bipartisan way.
I would suggest to you today, the Democrats are here. We are on the
floor of the United States House of Representatives, and we are ready
to go. We are ready to pass a Patients' Bill of Rights. We are ready to
pass a prescription drug benefit for our seniors. We are ready to pass
increased Medicare reimbursements to keep our hospitals and nursing
homes and all of our other health care providers in business, not to
enrich them, just keep them in business so that our seniors and our
citizens in this country have decent health care in the greatest Nation
that has ever been.
And he claims to have this great bipartisan ability. He will not even
need bipartisan ability. We are ready to go. The Democrats are here. We
are ready to do business. He has got to work on the Republicans. I
would suggest, maybe he should call the Speaker Hastert. Maybe he
should call the majority leader in the Senate and tell them, ``I am for
this.'' That is what he says. He says, I want to help America's
seniors. I want to be sure every American that buys health insurance
has the opportunity to make their own health care decisions along with
their health care professionals. That is what he says. Maybe he should
give the majority leader in the House a call. Maybe he should call the
whip on the Republican side and say, ``I'm ready to go. Let's just go
ahead and do this this fall. It will be great for the campaign. We can
say we don't even have to get elected. We have already gotten it
done.'' But the reality is they only talk about it.
This is the greatest attempt to deceive a Nation that has ever been.
The pharmaceutical manufacturers in this country have poured tens of
millions of dollars into this campaign in an attempt to deceive the
American people. Any time the American people see this tag line,
Citizens for Better Medicare, look out. What they mean is citizens for
more profit for the pharmaceutical industry, and we are supporting this
candidate because we think they will support us when the time comes,
and we think they will protect our outrageous profits at the expense of
the wonderful senior citizens in this country. And it has already been
mentioned, they are the greatest generation.
It is unbelievable that we are here today and have been fighting this
battle for over 2 years. Yet even though we are here on Saturday
afternoon, the Democrats virtually alone in their effort to move these
issues forward, and it still has not happened. The President is ready
to do these; he knows it is the right thing to do. The Republicans
claim they are. It is absolutely amazing that we have not been able to
get this done. That is the reality check. I thank the gentleman from
Texas once again for his leadership in this matter.
Mr. TURNER. I thank the gentleman from Arkansas (Mr. Berry). He has a
unique way of bringing it right down to home in good common sense
terms. As I asked in my opening remarks for this Special Order hour of
the American people, who is on your side, who is fighting for you, I
think it is clear that you and the other Democrats in this Congress are
working hard to provide the prescription drug benefit, the Patients'
Bill of Rights, and funding for the Medicare program that the American
people want.
It is almost amazing as I heard you express it when you talked about
the issue, when you try to identify who is against these things, who
would want this Congress to fail to pass a Patients' Bill of Rights,
who would want this Congress to fail to pass a prescription drug
benefit for seniors. There are only two groups, the insurance industry
and the big pharmaceutical manufacturers. Everybody else would say,
``Let's move on and get the job done.'' As you said, we are here and we
are ready to go to work and get it done before this Congress ends.
The gentleman from Arkansas (Mr. Berry) brought experience as a
pharmacist. The gentleman from Washington (Mr. Baird) brought his
experience as a clinical psychologist. The gentlewoman from California
(Mrs. Capps) brought her experience as a nurse. The gentleman from
Texas (Mr. Lampson) brought his experience to the table from home
health care. It is now an honor and a privilege to yield time to the
gentleman from Arkansas (Mr. Snyder), a medical doctor.
Mr. SNYDER. Mr. Speaker, I thank you for spending part of your
Saturday afternoon with us today.
I had lunch today at a Chinese restaurant. I got the little fortune
cookie. I was walking, eating my cookie on the way over here. It said,
``Laughter is the best medicine.'' My experience as a family doctor is
the best medicine often causes hysterical laughter because when people
get the bills and see

[[Page H11482]]

what they are paying for these drugs, it is a shocker for them.

My experience as a family physician, and it is a sad experience, is
that the patient comes into the doctor, you write out the prescription
that you think is the right thing to do and you think this can help
that person and they come back a week or two later. I bet the
gentlewoman from California has had this experience, the gentleman from
Washington has had this experience.
``How are you doing?''
``About the same.''
Well, I wonder what happened. You talk and talk and talk. You finally
find out, I went to the pharmacist to get that medicine and they filled
it for me, they gave me the bill and I could not afford it, and I
decided not to take the medicine. That is the experience in Arkansas,
as over a third of our seniors have no drug benefit at all. Also, those
are the same group of people, I think it is over 60 percent of our
seniors, their only source of income is Social Security. So this
problem of not having a prescription drug benefit is a real one.
I was very optimistic when we began this Congress almost 2 years ago
that we would do something in Medicare to modernize it. That is all we
are asking for. We have a Medicare program. People talk about those
bureaucrats in Washington. This is Medicare. They talk about the one-
size-fits-all. This is Medicare. It is the Medicare program that my
mother relies on, our parents all rely on; but it needs to be updated,
and it needs to be updated with a drug program. Here we are on a
Saturday afternoon, hoping that somehow in the next week before we
finally adjourn that something will occur in this area; but I suspect
most of us are not very optimistic that will happen.
The Patients' Bill of Rights. Let me relate another anecdote from my
experience as a physician. I think that to me the worst thing I had to
do that illustrates why I am a supporter of the Patients' Bill of
Rights was I have had several occasions as a family doctor in recent
years where if a patient came to see me and they were depressed, they
had some mental health problem and I may or may not give them a
prescription or do whatever I can do as a family doctor, but I thought
they needed counseling and they had an insurance program. I would have
to take them in, this is the way their plan worked, I would take them
into a room and say, ``Here's the telephone. Here is an 800 phone
number; dial this number. You're going to get a complete stranger at
the end of that line who will tell you, number one, do you get any
counseling, number two, what kind of person will give you that
counseling and, number three, how often and for how long a period you
will get that counseling.''
Well, that is that person. That is the patient's insurance company.
They have made that decision, with their employer perhaps, to choose
that insurance company. But my opinion as a health care provider, as a
family doctor, if that clerk at the end of that phone is going to make
health care decisions, then they should be just as liable as I am if
something goes wrong. I see my fellow health care professionals over
here also nodding their heads. That is what the most controversial part
of the Patients' Bill of Rights is about, that if a health insurance
program is going to practice medicine, they should be responsible
legally like the rest of us that practice medicine for real. I do not
know why that seems to be so controversial, but it is.
A third issue I want to touch on is this issue we have had come up
just recently in the last few days with the vote on what was called
this tax bill and the Medicare give-back provisions. That deals with
the problem that our hospitals are struggling with around the country.
A lot of us, I had promised my folks back home, yes, before we are out
of here we are going to have some additional money for rural hospitals
and health care providers. Lo and behold, I said, it is not going to be
a problem because it is bipartisan; there is great support for it.
What happened? Instead of getting the kind of bill we all thought we
were going to get, we are getting a bill that gives far too much money
to managed care organizations, to HMOs, and not enough to hospitals. It
is really difficult to understand at this late hour why on something
like that we are here today, why that cannot be worked out so that we
can give our health care providers back home some relief.
The last point I would like to make is on campaign finance reform. I
think that sadly a lot of us have concluded, we would like these issues
to be decided on what is the best policy. Unfortunately, a lot of these
issues are being decided by who gives the most money to which party to
help their particular position. The gentleman from Arkansas (Mr. Berry)
is trained as a pharmacist. He actually made most of his money now as a
farmer, but he understands these drug issues so well, made mention of
Citizens for Better Medicare and the reason that he and I talk about it
is that they are now spending a ton of money in the Little Rock media
market trying to influence this congressional race we have in South
Arkansas.

It is not the race that he and I are involved in in our two
districts, but it is in the same media market. The Arkansas Democrat-
Gazette had a report come out about a week ago. Citizens for Better
Medicare, which is financed by drug company money, these are
pharmaceutical companies, has now spent close to $800,000, if not more
by this week, to impact that one race. They are opposing the proposals
that we all support to include a drug benefit in Medicare.
I do not deny anyone their right to run an ad. I do not deny anyone
the right to support whatever candidate they want, but when they call
themselves Citizens for Better Medicare, people need to understand and
the folks in south Arkansas and in my district also need to understand
that Citizens for Better Medicare is drug company money trying to block
a drug benefit for Medicare, and that is wrong.
I thank the gentleman from Texas for his work today and I thank the
Speaker again for being here.
Mr. TURNER. I appreciate the comments of the gentleman from Arkansas
(Mr. Snyder). I know all of us have been confronted with that front
group called Citizens for Better Medicare, which there is no citizens
there. It is just the big drug companies pouring money into these
issues, trying to influence the outcome of elections, and it is wrong
and I hope the American people understand who is on their side and who
is fighting for them.
We have only a minute or two left. I want to yield to the gentleman
from Washington because he wanted to share some of his thoughts about
the unfairness of pouring the lion's share of the money into the HMOs
for the Medicare+Choice side instead of giving it to our rural
hospitals and other health care providers.
Mr. BAIRD. I will be fairly briefly. Most Americans do not realize
it, but there is a tremendous inequity in Medicare compensation in our
country today and it works like this: all Americans pay the exact same
amount of money into Medicare as a percentage of their salary. But not
all Americans receive the same benefit. Depending on where you live in
this country, you may receive pharmaceutical benefits, eyeglasses,
hearing aids in one part of the country under Medicare, but in another
part of the country you may receive none of those benefits and pay a
supplemental premium and have to pay copays. This inequity, more than
anything else I believe is what we should be correcting in these so-
called BBA fixes that we have been trying to pass in the last week, but
this bill that came before us this week did not adequately address it.
It was painful for many of us who know the desperate straits of our
hospitals, who know the desperate straits of our rural health care
communities and who also would like to see a minimum wage increase
passed to have to vote against that bill because it did not do enough
to restore fundamental fairness and equity to the Medicare compensation
system. Neither did it do enough to protect our home health agencies,
nor did it protect and promise that the money that went to the HMOs
would actually get to our hospitals.
I applaud the leadership of the gentleman from Texas (Mr. Turner) in
raising these issues and thank him for his efforts and leadership on
this.
Mr. TURNER. I thank the gentleman from Washington (Mr. Baird). I
appreciate his participation along with the gentlewoman from Florida
(Mrs. Thurman), the gentleman from Arkansas

[[Page H11483]]

(Mr. Berry), the gentleman from Texas (Mr. Lampson), the gentlewoman
from California (Mrs. Capps), and the gentleman from Arkansas (Mr.
Snyder) as we have tried to lay out before the American people the
issues to let them have the choice and the decision as to deciding who
is on your side on these critical issues. We are going to continue to
work to get the job done for the American people.

____________________