[Congressional Record Volume 147, Number 111 (Thursday, August 2, 2001)]
[House]
[Pages H5185-H5194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




PROVIDING FOR CONSIDERATION OF H.R. 2563, BIPARTISAN PATIENT PROTECTION 
                                  ACT

  Mr. GOSS. Mr. Speaker, by direction of the Committee on Rules, I call 
up House Resolution 219 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 219

       Resolved, That at any time after the adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 2563) to amend the Public Health Service Act, 
     the Employee Retirement Income Security Act of 1974, and the 
     Internal Revenue Code of 1986 to protect consumers in managed 
     care plans and other health coverage. The first reading of 
     the bill shall be dispensed with. All points of order against 
     consideration of the bill are waived. General debate shall be 
     confined to the bill and shall not exceed two hours equally 
     divided among and controlled by the chairmen and ranking 
     minority members of the Committees on Energy and Commerce, 
     Education and the Workforce, and Ways and Means. After 
     general debate the bill shall be considered for amendment 
     under the five-minute rule. The bill shall be considered as 
     read. No amendment to the bill shall be in order except those 
     printed in the report of the Committee on Rules accompanying 
     this resolution. Each such amendment may be offered only in 
     the order printed in the report, may be offered only by a 
     Member designated in the report, shall be considered as read, 
     shall be debatable for the time specified in the report 
     equally divided and controlled by the proponent and an 
     opponent, shall not be subject to amendment, and shall not be 
     subject to a demand for division of the question in the House 
     or in the Committee of the Whole. All points of order against 
     such amendments are waived. At the conclusion of 
     consideration of the bill for amendment the Committee shall 
     rise and report the bill to the House with such amendments as 
     may have been adopted. The previous question shall be 
     considered as ordered on the bill and amendments thereto to 
     final passage without intervening motion except one motion to 
     recommit with or without instructions.

  The SPEAKER pro tempore (Mr. Fossella). The gentleman from Florida 
(Mr. Goss) is recognized for 1 hour.
  Mr. GOSS. Mr. Speaker, for the purpose of debate only, I yield the 
customary 30 minutes to the gentlewoman from New York (Ms. Slaughter), 
pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purpose 
of debate on this issue only.
  Mr. Speaker, the legislation before us is a structured rule providing 
for the consideration of H.R. 2563, at last. It provides 2 hours of 
general debate equally divided and controlled by the chairmen and the 
ranking minority members of the Committee on Energy and Commerce, the 
Committee on Education and the Workforce, and the Committee on Ways and 
Means, the three committees of jurisdiction.
  The rule waives all points of order against consideration of the bill 
and makes in order only the amendments printed in the Committee on 
Rules report accompanying the resolution. It further provides that the 
amendments printed in the report may be offered only by a Member 
designated in the report, shall be considered as read, shall be 
debateable for the time specified in the report equally divided and 
controlled by the proponent and opponent, shall not be subject to an 
amendment and shall not be subject to a demand for division of the 
question in the House or the Committee of the Whole.
  The rule waives all points of order against the amendments printed in 
the report and provides one motion to recommit with or without 
instructions.
  In fact, it is pretty standard and fair in terms of rules on this 
type of matter. What is unique is the long, long preparation, the 
participation of so many Members to bring this legislation to the 
floor. We believe on the Committee on Rules that we have crafted a good 
rule to have full debate for the balance of the day and probably into 
the early evening.
  We have three major amendments with time specified of 40 minutes for 
one, 40 minutes for another and 60 minutes for another. Members having 
done

[[Page H5186]]

their homework will know what those are and we will get into them as we 
go along. I think this should be comprehensive and give every Member 
the opportunity to have their say.

                              {time}  1230

  Mr. Speaker, this truly is a red letter day, not just for the 
Congress but for the American people, because today, after 10 years of 
debate and compromise, we are finally having the opportunity to put 
forth patient protection legislation that will really change the way 
our health care system operates for the better.
  A true patients' bill of rights must make our health care system more 
accessible. Health care insurance is no good if someone cannot get it. 
So accessibility of health care and health care insurance is critical. 
Obviously, it has to be affordable, more affordable. Affordable is an 
area we have focused on. And most importantly, more accountable, 
accountable to the Americans that health care serves.
  This fair rule and the underlying legislation represents a reasoned, 
commonsense approach that allows people that disagree with health care 
providers an opportunity for just and impartial appeal. This is what 
Americans have been asking for.
  I have worked on health care legislation with so many colleagues ever 
since coming to Congress, and I can tell my colleagues that this is 
something that matters a lot back in my district and every other place 
I go in the country when I talk about it. When I am back in my 
district, not one town hall meeting goes by without constituents 
registering concerns about their health care and questioning how things 
will be fixed, how much it will cost, can I afford it, will I be able 
to get it, and so forth.
  It has always been a very delicate balance to come up with something 
that will be supported by the House, of course our colleagues in the 
other body, and the administration; and I commend the hard work of so 
many, but especially the diligent efforts now on a timely basis of 
people like the gentleman from Georgia (Mr. Norwood) and President 
Bush, who understood compromise is still better for the American people 
than nothing at all. Laws are better than unresolved issues.
  Frankly, one of the reasons we can be here today is because of the 
respect our colleague, the gentleman from Georgia, has in this body. In 
the words of Senate Majority Leader Tom Daschle, and I quote him, ``If 
Dr. Norwood, who I think knows the issue better than anyone else does, 
feels that some of these proposals are acceptable, I would certainly 
entertain them.'' Well, we are entertaining them today in an amendment 
that every Member has had a chance to read, and we will have 60 minutes 
set aside for debate on that.
  What is important is that when our constituents ask, will I have 
access to affordable health care, we can say forthrightly, look them 
right in the eye, and say yes. When they ask, can I sue my HMO if there 
is cause, the answer will again be yes.
  With these positive reforms comes great responsibility, of course; 
and I commend my colleagues for entertaining the compromise that will 
not overburden the courts with frivolous lawsuits but will still allow 
justice under the law. We must be sure that the courts are the last 
resort and not the first. This bill provides for an independent review 
process that is immediately responsive to patients' needs.
  My constituents in southwest Florida are tired of standing in lines, 
as I suspect Americans are elsewhere. The lines at the doctor's office 
is bad enough, to say nothing of waiting times. They certainly should 
not be waiting in additional queues at the courthouse. Instead of 
driving people to court, a true patients' protection plan will enable 
Americans to get the care they need and ensure the accountability of 
medical providers. And I think that is what this legislation does.
  Certainly the rule is designed to bring out the debate on these 
points. Mr. Speaker, I urge my colleagues to continue the careful 
manner in which this legislation was drafted, and I urge them to 
support this rule.
  Mr. Speaker, I reserve the balance of my time.
  Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from Florida for 
yielding me the customary 30 minutes, and I yield myself such time as I 
may consume.
  (Ms. SLAUGHTER asked and was given permission to revise and extend 
her remarks.)
  Ms. SLAUGHTER. Mr. Speaker, I rise in strong opposition to this rule. 
I am opposed to the process the rule represents and the political 
cynicism it embodies.
  Make no mistake, this rule is designed to kill the bipartisan 
patients' bill of rights. This is death by a thousand cuts. By slicing 
away at the bipartisan-based bill, the leadership today once again will 
bury one of the most important pieces of legislation to face this body 
in a generation, all in an effort to appease the insurance companies 
and the HMOs.
  Mr. Speaker, there is no new agreement regarding the bipartisan 
patients' bill of rights. Yesterday's hastily arranged news conference 
by the administration was pure theater. Only one sponsor of the 
bipartisan patients' bill of rights, the gentleman from Georgia (Mr. 
Norwood), was included in the discussion with the administration. And 
even the gentleman from Georgia admitted to the Committee on Rules last 
night that he did not have a deal. And, indeed, until he saw what was 
written in the Committee on Rules, he would not have one. And at that 
moment last night he had no idea what would be written.
  And now with ink barely dry, the Republican leadership is demanding a 
vote. We wonder how many Members will see this so-called agreement 
before they have to vote.
  A dangerous pattern is developing in the Committee on Rules. Knowing 
that they do not have the support to kill important measures, like 
campaign finance reform or a balanced energy program that maintains the 
environment, the leadership cloaks itself in the darkness of night. 
When daylight breaks, they emerge with procedural hurdles designed to 
obfuscate, confuse, and ultimately bury these measures that may mean 
life and death for many of our constituents.
  The leadership knows the Senate will not agree to this version of the 
patients' bill of rights, and they know by passing the administration's 
version they can force a conference with the Senate, thereby relegating 
the patients' bill of rights to the legislative graveyard.
  The rule today makes in order only those amendments designed to kill 
the measure. There are poison pills. Each one weakens and dilutes 
patients' protections. The amendments block legal remedies in State 
courts under State laws, they hand over to HMOs the right to choose 
which court to adjudicate in, and they stack the deck against anyone 
who tries to enforce the patient protections we have worked for so long 
to secure.
  Moreover, the new Norwood bill fails to pay for any of the revenue 
losses it causes. In case Members are unaware, the surplus we worked so 
hard to secure the past 8 years is gone. In fact, the Treasury has had 
to borrow $51 billion just to pay for the tax rebate mailed just last 
week. Now, for the second time in 24 hours, we have blocked amendments 
by Democrats who want to be responsible and pay for the cost of the 
legislation we are considering.
  The House is now preparing to blow an additional $25 billion hole in 
the deficit. Democrats did offer responsible offsets but were voted 
down unanimously in the Committee on Rules.
  Where will this money come from? The only place left after the 
massive tax cuts enacted by Congress are the Medicare and Social 
Security Trust Funds.
  I want to remind my colleagues this is about real people, about real 
lives, and as I stated earlier, a matter of life and death for many. 
H.R. 2563 would make a difference for the man who goes to the emergency 
room suffering a heart attack and the woman who has to wait to get 
permission to see her OB-GYN for a gynecological problem and the parent 
whose child is being shunted from doctor to doctor by an insurer. It 
would help patients obtain speedy reviews when potentially lifesaving 
treatment is denied or when a financially crippling bill will not be 
covered by the insurer.
  The bipartisan bill would make a difference in the day-to-day lives 
of the people we represent. And for this body to treat this measure so 
cavalierly defies conscience and defies belief.

[[Page H5187]]

  Make no mistake, this agreement is a win for the special interests 
and especially the HMOs and insurance companies who support with their 
contributions this new bill.
  It is a loss for the American people on one of their biggest issues, 
and a sad day for America, patients, doctors, and virtually every 
family around the country.
  One of the most egregious things is they have held HMOs to different 
standards than they are holding doctors and hospitals. The HMOs alone 
among the health care providers will be shielded from the consequences 
of their own bad decisions, but the doctors and the hospitals are left 
hanging out to dry. And I understood the AMA has just opposed this 
bill.
  HMOs will also have an extraordinary care standard, not a medical 
standard, but what any ordinary insurance company would do. And in fact 
what is being given to them goes to no other industry in the United 
States. And by waiving away the State laws, many people in the United 
States where they have good strong State laws will be worse off than 
had this bill not passed.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GOSS. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Ohio (Ms. Pryce), a distinguished member of the 
committee and a member of our leadership.
  Ms. PRYCE of Ohio. I thank my good friend from Florida and colleague 
on the Committee on Rules for yielding me this time, and I rise in very 
strong support of this rule.
  Mr. Speaker, I came to the House of Representatives nearly 9 years 
ago, and for the majority of my tenure here, Congress has been 
struggling with the concept of a bill of rights for patients. There are 
no policy arguments that have not been made, no statements left 
unspoken, and no new points to interject.
  Mr. Speaker, 95 percent of the patients' bill of rights is agreed to 
by every one here. We all agree that patients should have access to 
emergency room and specialty care and direct access to obstetricians, 
gynecologists, and pediatricians. We agree that doctors should have 
input in the development of formularies for prescription drugs and that 
patients should have access to health plan information.
  All the players agree that gag clauses that prevent doctors from 
discussing certain health care options with their patients should be 
prohibited and that patients should have a right to continuity of care. 
In fact, I would like to remind my colleagues that the House has 
previously passed a patients' bill of rights. We have, we have done it 
here, and yet we still have no Federal protection to offer the 170 
million Americans with private health insurance.
  Well, help is on the way. We finally have a President committed to 
making this happen and a Congress which has worked long and hard to 
help him. Mr. Speaker, I understand this task has been a daunting and 
difficult one, and that is why the agreement President Bush forged 
yesterday is a giant step forward. An agreement that involved so many 
hardworking, committed Members on both sides of the aisle needs a 
chance to go forward today.
  Mr. Speaker, we need a bill that will not penalize employers for 
offering health care benefits; we need a bill that will not drive up 
the cost of premiums; and we need a bill that will offer remedy to 
patients who have been wronged; and, most of all, we need a bill that 
can be signed into law.
  There are many who would rather not see this happen today. They would 
rather the American people not have this benefit. They would rather 
have a political issue. And it is so easy to stand in the way. It is 
much harder to forge consensus. This time the Committee on Rules, which 
has met into the wee hours nearly every night this week, has forged a 
fair and good rule that will do all of this.
  We have already spent too much time on solutions that go nowhere. 
This legislation, with the agreement offered by the gentleman from 
Georgia (Mr. Norwood), has been agreed to by the President. It will 
offer our best chance to provide real patient protection to those 
Americans who desperately need it and have needed it for far too long.
  I urge my colleagues to support this rule. It is fair, it is very 
delicate, it is balanced, and it will bring a patients' bill of rights 
to our President for his signature.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
New Jersey (Mr. Menendez).
  Mr. MENENDEZ. My colleagues, make no mistake, this bill is a special 
deal for special interests. The patients' bill of rights went into the 
White House emergency room with the gentleman from Georgia (Mr. 
Norwood) and it came out as an ``HMO Bill of Rights,'' an ``Insurance 
Bill of Rights,'' a special set of rights no other industry in America 
has.
  And speaking of rights, this bill kills State rights in protecting 
patients. Just this week in New Jersey, a Republican governor signed a 
bill passed by a Republican legislature which would provide for 
enforcing our patients' bill of rights. This bill we are debating today 
destroys New Jersey's patients' protections, and California and Texas 
and every other State's right to protect patients, by superceding it.
  This bill is a huge step backwards in patient protections. This bill 
will not guarantee the care patients deserve and need but it will 
guarantee HMOs' abuses.
  Let us vote for patients, for people, for our constituents, and 
against the special interests. Vote against the rule and the bill.
  Mr. GOSS. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Missouri (Mr. Blunt), the distinguished member of our 
leadership, the deputy whip.
  Mr. BLUNT. Mr. Speaker, I thank my good friend for yielding me this 
time, I want to use the last of the voice I have left this week to talk 
for a few minutes about this bill and the rule that allows it to come 
to the floor.
  What we have a chance to do here today is to end 6 years of gridlock, 
6 years of striving for a solution that has been outside of our reach. 
Today we can achieve that solution.
  Lots of Members have worked very hard to try to find that solution on 
both sides of the aisle. My good friend, the gentleman from Iowa (Mr. 
Ganske); the gentleman from Georgia (Mr. Norwood); the gentleman from 
Michigan (Mr. Dingell); the gentlewoman from Connecticut (Mrs. 
Johnson); and the gentleman from Kentucky (Mr. Fletcher) have all 
worked hard to try to find that ground that gets us to a solution that 
really does create parents' rights.

                              {time}  1245

  I think what this bill does, and the amendments that go along with it 
is, it puts patients first. It puts health care first. It puts the 
health care decision first, and that is a critical difference in this 
and some of the other concepts that we have talked about, such as the 
health care professional review panel that has an immediate answer. In 
fact, how they respond to that answer depends on the way that patients 
are dealt with in the future of this process.
  If in fact an individual is provided insurance, and responds to what 
that doctor-driven health care professional panel says needs to be 
done, they have done the right thing and the law recognizes that.
  This law talks about greater access to the system. It talks about 
liability, but it also talks about some ways to avoid that liability, 
which continues to encourage employers to provide health care to their 
workers.
  For a generation now, one of the questions that workers first asked 
when they filled out a job application was, Is health insurance 
provided? What we do not want to see at the end of our debate here is 
the answer to be, We used to have health care. We used to offer health 
care, but now we just give employees money because we do not know what 
our liability is. It was undefined.
  Our bankers, if it is a small business, would not let us continue 
down that path. Our shareholders, if it is a large business, because of 
the responsibility we have to them, we decided not to have health care 
insurance any longer because we did not understand our liability.
  That is one reason many of us thought it was so important to 
understand the limits of that liability. This bill sets a higher limit 
than many of us would have ever thought we could accept; but employers 
can work with it, the system can work it.

[[Page H5188]]

  Most importantly, the results of the hard effort in the last 24 
hours, the President's efforts, the efforts of the gentleman from 
Georgia (Mr. Norwood), the gentleman from Arizona (Mr. Shadegg) stayed 
up all night to make sure of the language, to come up with a bill that 
this House can vote on this week that can be signed into law.
  Mr. Speaker, 6 years of talking about this is too long. Now is the 
moment when we can reach a final decision. We can send a bill to the 
Senate that is a better bill than the Senate's bill. We can put a bill 
on the President's desk. He wants to sign a bill; we ought to give him 
the chance to do that.
  This bill truly does protect patients' rights.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from 
Michigan (Mr. Dingell).
  (Mr. DINGELL asked and was given permission to revise and extend his 
remarks.)
  Mr. DINGELL. Mr. Speaker, the Senate last week spent a whole week in 
arriving at a decision on this legislation. It was a thoughtful debate, 
compromises were worked out on a bipartisan basis, and a good bill was 
sent here.
  Let us look at where we are and why. A Member in this Chamber went to 
the White House in a closed meeting and worked out a deal. That deal 
was not reduced to writing until this morning. He did not know what was 
in the deal at the time he appeared before the Committee on Rules. 
Nobody else knew. I do not know now. None of you know. I seriously 
doubt that the Member who cut the deal knows what he has done.
  I do not think that any Member can understand the ramifications of 
these curious transactions. In the Senate, the leaders were willing to 
forgo the Independence Day recess in order to work this legislation up. 
Here, without the vaguest understanding of what we are doing, we are 
now rushing to send a bill to the President.
  The doctors have a way of describing this thing. They say, First, do 
no harm. There is a plethora of amendments which have been added to 
this legislation under the rule. If Members vote for the rule, they are 
going to vote for a bill that has not been tested and that the author 
of the amendment cannot satisfactorily explain to himself or to us.
  Mr. Speaker, this is a bad process. I would point out that it sets up 
a whole new Federal standard for torts and for jurisprudence, something 
which has not been done for 300 years in this country. I ask my 
colleagues to note whether they can explain this or understand it, or 
whether they or anyone, or the author of the amendment, can assure us 
that this amendment does not foster mischief and misunderstanding and 
the potential for real trouble for the American public.
  I would note some other things for the benefit of this Chamber. This 
is an HMO bill. It is a step backwards in that it preempts State laws. 
It puts its finger on the scale of justice. Nay, it puts its whole fist 
or forearm on the scales of justice because it lays in place 
presumptions in favor of the HMOs.
  The HMOs are smiling today. No one else is. Members who vote for this 
amendment will not be smiling in a little while because the end result 
of that is going to be that they are going to have hurt their 
constituents, and have done the wrong thing.
  I will tell Members some additional things. The States are making 
fine progress in enacting patient protection laws. Those patient 
protection laws are making real progress. This bill would essentially 
preempt them and set aside all of that progress. States like Georgia, 
States like New Jersey, States like Texas, are going to see their laws 
superseded.
  Mr. Speaker, the amendment to this bill is titled the Bipartisan 
Patient Protection Act. It should be entitled, the Partisan HMO 
Protection Act.
  Mr. Speaker, I urge my colleagues to vote against the amendment.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Maryland (Mr. Wynn).
  Mr. WYNN. Mr. Speaker, I rise in strong opposition to the rule and to 
the underlying bill. The fact of the matter is that without a right to 
redress, the so-called patients' rights are worthless. Today we will 
hear the Republicans talk about the rights that they give patients, but 
if patients cannot get into court in an easy, convenient manner, they 
cannot redress their rights.
  Remember, it is the patient's back, the patient's knee, the patient's 
neck, the patient's facial scars that have to be corrected. If the HMOs 
deny a patient relief, they should have the right to go to court, and 
this bill does not do it. It guarantees every roadblock possible to 
benefit the HMOs; every presumption possible to benefit the HMOs. It 
wipes away State laws to benefit the HMOs. The protections are not in 
this bill, the protections are for the HMOs. That is what is wrong with 
this bill.
  They will say if we let patients go to court, they will not be able 
to get insurance. Studies have shown that the increase in costs are 
minimal; people are willing to pay it. In Texas, which has the right to 
go to court, they have not had a lot of lawsuits.
  Reject this bill.
  Mr. GOSS. Mr. Speaker, I yield 4 minutes to the gentleman from Iowa 
(Mr. Ganske), a major player in this legislation.
  Mr. GANSKE. Mr. Speaker, I thank the gentleman for yielding me this 
time.
  Yesterday was an amazing day in the Committee on Rules. I have been 
to the Committee on Rules three times on the Patients' Bill of Rights; 
and I must admit when we were talking about the Norwood amendment last 
night and we did not have any language to talk about, and the gentleman 
from Georgia (Mr. Norwood), was saying I reserve the right to not agree 
with my own amendment, it was sort of bizarre. But I must say that I 
have been treated with respect and kindness by the Committee on Rules.
  Mr. Speaker, I wish very much that we had more time to see the 
language of the Norwood amendment so people could fully understand it. 
We are going to have a chance to talk about the Norwood amendment, and 
I will go into it in more detail later. I intend to support the rule. I 
understand fully how my colleagues on the other side of the aisle very 
well are upset about this, but I feel it is time to move on with this 
debate.
  Mr. Speaker, I thank my colleagues from both sides of the aisle who 
throughout the last 5 or 6 years have stood up as protectors of 
patients and have been very interested in this. I cannot remember the 
number of times I have given Special Orders late at night.
  I have shown patients like this: HMOs Cruel Rules Leave Her Dying for 
the Doc She Needs; What His Parents Did Not Know About; HMOs May Have 
Killed This Baby. I have spoken about how, as a plastic surgeon, HMOs 
using medical necessity, unfair definitions, which have denied children 
care. I have spoken about this woman who lost her life because an HMO 
did not provide her with the treatment she needed.
  I have spoken about how an HMO would not pay this young woman's 
emergency care and hospital bill because when she fell off a cliff, she 
did not phone ahead for prior authorization.
  A couple of years ago when we had this debate, this little boy came 
to the floor. An HMO made a medically negligent decision which cost him 
both hands and both feet. Under Federal law, if that is an employer 
plan, the HMO is responsible only for the cost of his amputations.
  I think we now have bipartisan support that is not fair or just, and 
that we need to do something to prevent that from happening, and that 
is why the underlying Ganske-Dingell bill sets up a strong external 
appeals program, similar to what they have in Texas, to prevent this 
from happening, to prevent cases from going to court.
  Mr. Speaker, there will not be that much debate on the patient 
protection part of the Ganske-Dingell bill because there are not any 
amendments coming up, but they are solid. We are going to have three 
amendments coming to the floor. One will be on access provisions, one 
will be on medical malpractice liability, and the third is a very, very 
important one, and that is, in fact, whether to provide additional 
protections to HMOs.
  We will go into some details, how the Norwood amendment would provide 
affirmative defenses for HMOs that they do not have now, and how it 
would actually preclude State law. I will at that time recite the lines 
in the Norwood

[[Page H5189]]

amendment that do that, and provide Members with information on that.
  Mr. Speaker, I just urge my colleagues to have a civil debate. Let us 
get past the point of name-calling. Let us have a debate that is as 
enlightened as they had in the Senate a couple of weeks ago, move 
forward and defeat the Norwood amendment, and pass the Ganske-Dingell 
bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Frost).
  Mr. FROST. Mr. Speaker, let me start with the rule today. In a 
continuing effort to block Democrats from imposing fiscal 
responsibility on the House, Republican leaders have prevented us from 
paying for this bill. That fiscal irresponsibility is why Republicans 
are about to raid the Medicare and Social Security trust funds, as an 
internal Republican memo made clear recently, and it is why just 6 
months after Republicans inherited the biggest budget surplus in 
history, the Federal Government is borrowing money again.
  Now for the bill itself: For the past 5 years, Mr. Speaker, Democrats 
and some courageous Republicans have worked hard to pass a real 
bipartisan Patients' Bill of Rights, one that takes health care 
decisions out of the hands of insurance companies and puts them back 
into the hands of doctors and patients.
  Mr. Speaker, the Ganske-Dingell bill does that. It protects patients' 
rights without reducing health care coverage. During those same past 5 
years, Mr. Speaker, Republican leaders have fought the bipartisan 
Patients' Bill of Rights every step of the way. For the past 6 months, 
the Bush administration has joined them in fighting tooth and nail to 
protect insurance companies and HMOs.
  It should be so no surprise that the Republican plan, proposed by 
President Bush and the gentleman from Illinois (Mr. Hastert), that is, 
the Norwood amendment we will debate later today, protects HMOs and 
insurance companies at the expense of patients. Make no mistake, 
Republican leaders are trying to turn the Patients' Bill of Rights into 
an HMO Bill of Rights.

                              {time}  1300

  The Republican plan creates special protection for HMOs and insurance 
companies, one that no other industry enjoys, and would override State 
HMO laws, including the patient protections that my constituents in 
Texas enjoy today and that President Bush bragged about in last year's 
campaign.
  Mr. Speaker, the Republican plan would ensure that HMOs and insurance 
companies, not doctors and patients, keep making vital medical 
decisions.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Arkansas (Mr. Berry).
  Mr. BERRY. I want to thank the gentlewoman from New York for yielding 
time. I also want to thank the gentleman from Iowa (Mr. Ganske) for his 
great leadership in this matter and, of course, the gentleman from 
Michigan (Mr. Dingell) and all the others that have worked so hard for 
this.
  Mr. Speaker, the only way I can describe this rule and the bill that 
is going to be offered as amended to this House today is ridiculous. 
Just to begin with, the Committee on Rules was asked to take up a rule 
for a bill they had not seen, that nobody had written yet. They had to 
declare Wednesday was Thursday. If you have got something planned on 
Thursday you very well may lose it, because we are going to skip 
Thursday this week. Today is Wednesday. Tomorrow is going to be Friday. 
That just shows you how ridiculous this whole thing has gotten. We have 
got an old Southern saying about politics that those that get on early 
get taken care of, everybody else gets good government. I think we have 
clearly seen the evidence that the insurance companies got on early in 
the last campaign. They have clearly been taken care of.
  We have been presented with this so-called agreement between the 
White House and someone on Capitol Hill where we have said that we are 
just going to trample State law, do whatever you have to do to take the 
State courts out of it; we are going to take away any rights from the 
American people to deal with their insurance companies.
  This whole bill should be called the HMO Protection Act, because they 
have got more protection now than they had before this bill was 
written. I do not think it will ever become law. I think it will die in 
conference. But it is such a ridiculous idea that we would present this 
to the American people and try to hoodwink them into thinking that they 
are going to have a better deal.
  Besides that, Mr. Speaker, it is not paid for. We are just going to 
issue a magic lucky card to pay for it. I am surprised that the lucky 
card is not described in the language.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from 
Texas (Mr. Stenholm).
  (Mr. STENHOLM asked and was given permission to revise and extend his 
remarks.)
  Mr. STENHOLM. Mr. Speaker, I rise in opposition to the rule. It is 
not a fair and it is not a good rule. I know that my friends on this 
side of the aisle are getting a little tired of Members on this side 
standing up and talking about that we are not paying for the 
legislation that we proposed. I certainly recognize and support the 
right of the majority to do as you wish regarding legislation, as you 
are proving day after day. But for the last several years, I have 
listened to my colleagues on both sides of the aisle speak with passion 
and conviction about their commitment to putting an end to the practice 
of raiding the Social Security and Medicare Trust Fund surpluses to 
cover deficits in the rest of the budget. I believe that all Members of 
this body who have voted time and time again to protect those trust 
funds are sincere in their desire to honor that commitment. 
Unfortunately, the manner in which we continue to consider legislation 
is making it impossible to keep that commitment.
  The $1.35 trillion tax cut recently signed into law, whether 
acknowledged or not, has taken up the available surplus. It is becoming 
increasingly clear that CBO and OMB when they offer their revised 
budget forecasts next month will show the facts. No point in debating 
whether it is or it is not; either it is or it is not. Those of us that 
believe that it is, those that say it is not, we are going to know.
  But let me point out a few facts. Last week, this House voted to 
break the spending limits on the VA-HUD bill. There is a reasonably 
good chance that this body is going to break those limits on defense 
and on education. Last week, it was 8 billion additional dollars for 
the faith-based initiative. This week it was $18 billion for the 
railroad retirement fund. Yesterday it was $32 billion for the energy 
bill. Today it is at least 20, probably as much as $30 billion for this 
bill.
  I heard my colleague from Arkansas say a moment ago, ``It's not paid 
for.'' I respect the right of the majority to bring legislation to this 
floor and not pay for it if that is what you wish. But why and how can 
you continue to come to the floor and say it is a fair rule when you do 
not allow the minority side the opportunity to pay for the bill in the 
legislation that we are for? What is it that would let anyone stand on 
the floor and say it is a fair rule when you deny the opportunity of 
the other side of the aisle to work their will regarding the 
legislation as they see it and let you work the will of the body as you 
see it?
  I really think we ought to defeat this rule, and we ought to send it 
back to committee with at least allowing our side of the aisle the 
opportunity to pay for that legislation that we propose. And if you 
wish to raid the Social Security and Medicare Trust Funds, I respect 
your right to do it.
  Mr. GOSS. Mr. Speaker, I yield 4 minutes to the distinguished 
gentleman from Florida (Mr. Foley), a Member of the Committee on Ways 
and Means and a great contributor to this legislation.
  Mr. FOLEY. Mr. Speaker, I appreciate the gentleman from Florida 
yielding me this time. Listening to the debate this morning is causing 
me some concern because I have heard phrases like ``we are rushing this 
legislation to the floor.'' Yet it seemed to me weeks ago the other 
side of the aisle demanded action on this bill before the summer 
recess.
  Let me just give you some quotes from National Journal's Congress 
Daily today that appeared in print. The senior Senator from 
Massachusetts

[[Page H5190]]

says about the gentleman from Georgia (Mr. Norwood): ``He has our 
complete confidence and he's demonstrated time in and time out his 
commitment to patients in our country.''
  The gentleman from Arkansas who just spoke a moment ago: ``I don't 
think anyone at any time has ever questioned Charlie Norwood's 
sincerity or dedication to this mission. So the fact that he's out 
there working doesn't give me any heartburn at all.''
  That was yesterday, the wonderful gentleman from Georgia, and today 
they will have you think he has become Dr. Kevorkian. The gentleman 
from Georgia and I have worked on this bill since 1995. There is one 
person in this Capitol more concerned with patients than any of us here 
and that is the honorable gentleman from Georgia. But he recognizes one 
very important and cogent point of this debate, that if somebody is 
sick and somebody is ailing and somebody is hurt, they do not need to 
wait in queue for 5 years to get a court of law to render a verdict on 
their case, because regrettably if we wait for the court of law, likely 
the patient will have died.
  A good friend of mine, a trial lawyer who is a personal friend and a 
supporter, called me yesterday. ``Please support the Dingell bill. 
Support the right for patients to sue their HMOs.''
  So I posed the question: ``You're a partner in a law firm. If you 
provide health insurance, do you feel you should be sued for the 
negligence of the managed care?''
  He paused and said, ``Well, no, we merely provide the health care 
policy.''
  And I said, ``But you may in fact be drawn into liability because you 
didn't give them an option of several policies, you gave them the 
firm's policy. And should the firm be engaged in litigation with their 
provider.''
  Mr. Speaker, we can rant and rave about bipartisanship and I have 
tried on several issues with the other side of the aisle, on several 
key issues that my leadership gets madder at me by the day, whether it 
is campaign finance reform or legislation that I think is important for 
Florida and I get taken to the woodshed for being too bipartisan. But 
on that side of the aisle, bipartisanship really truly means to me, 
``It is our way or the highway. And God forbid you interfere with our 
campaign plans for 2002 so we can deride the Republicans as a do-
nothing Congress.''
  If we look in our hearts and search for the right answer and not try 
and pillorize anybody who has been participating since 1995, we have 
several good doctors working on this issue and I think they care 
desperately about patients. And if we rise from the din of this kind of 
conversation about simply the right to sue, which is really a nice club 
over the heads of the insurers and I agree with most of that; but we 
also recognize, too, that if anybody is being sincere, try filing an 
action and see how long before your case is heard in court. Try going 
down to a State or a local courthouse and find out not only what the 
fees are involved but how soon they may get to your case. And ask the 
person with breast cancer or lupus or some other disease that is 
struggling trying to get recovery and coverage whether the wait was 
worth it, whether hanging out at a courthouse with a bunch of lawyers 
waiting 3 years for somebody to maybe render an opinion is better than 
what is in the Norwood bill which is an expedited appeals process that 
gets you into the facility that you most need to be in which is a 
hospital rather than a jury box.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
New Jersey (Mr. Andrews).
  (Mr. ANDREWS asked and was given permission to revise and extend his 
remarks.)
  Mr. ANDREWS. Mr. Speaker, I thank my friend from New York for 
yielding time.
  Mr. Speaker, the House is about to embark on a travesty of procedure 
if it adopts this rule. The last speaker said that we wanted to hurry 
up and get the Ganske-Dingell bill to the floor, and he is correct. The 
Ganske-Dingell bill was filed in February. February. For the last 4 or 
5 months we have all had a chance to read it, question it, understand 
it. The principal alternative to the patients' bill of rights that is 
going to be offered by the gentleman from Georgia (Mr. Norwood) this 
afternoon, the copy I read indicates it was printed at 7:18 a.m. today 
for the first time. We were in the Committee on Rules last night, or 
this morning, excuse me, after midnight, nearly at 12:30 in the 
morning, I know it went on long after that, I commend the Rules members 
for their diligence, and they had not started writing the bill yet. So 
an immaculate conception occurred sometime during the night last night. 
Sometime between 1 a.m. and 8 a.m., we gave birth to a product here 
that purports to do in 6 hours what lawyers and scholars and judges 
have taken 300 years to accomplish, and, that is, to write a complete 
set of rules about proximate cause, affirmative defenses, contributory 
negligence, rules of evidence, rules of discovery, all the things that 
come into the process of adjudicating a legal dispute.
  This is a travesty. Most of the Members who will consider this bill 
today will not know what is in it. We have a few hours to try to find 
out. Once this process goes forward, the American people will have a 
few weeks and a few months to find out. And when they do, they will 
recognize the deception that is about to be perpetrated upon the House 
this afternoon.
  Oppose this rule. Support the Ganske-Dingell bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentlewoman from 
North Carolina (Mrs. Clayton).
  Mrs. CLAYTON. I thank the gentlewoman for yielding me this time. I 
oppose this rule. I oppose this rule both on process and content. The 
process indeed should have allowed us to at least know what the 
amendments were. But even on content, all of us say that we want to 
have a Patients' Bill of Rights. When there is an amendment to undercut 
the very rights that you purport to have, I am not sure how you can say 
that we all are supporting a Patients' Bill of Rights. The right of 
enforcement of legislation is the integrity of your words when you say 
you have a Patients' Bill of Rights.
  Do we need a Patients' Bill of Rights? Yes. Why do we need it? We 
need it because there are children who are sick who need to have the 
opportunity to see a specialist. There are women who need to go to the 
emergency room or to see their OB-GYN. There are sick older people who 
need to be rushed for cardiac treatment. All of these are things we 
know, that we experience from family members. This rule will not allow 
that to happen. Indeed, this is a fraud. We should make sure that we 
vote down this rule and allow us to have a more deliberative debate.
  Mr. Speaker, this rule limits debate on one of the most important 
pieces of legislation Congress will consider this year.
  The authors of the Ganske- Dingell- Berry-Norwood bill worked hard to 
craft a bi-Partisan Patient's Bill of Rights bill that would provide 
meaningful patient protection to consumers. The authors also re-drafted 
portions of their bill to include enhanced measures provided for in the 
Senate Bi-Partisan Managed Care legislation by adding additional 
protections for employers. Rather than moving towards a bi-partisan 
bill that had a strong possibility of moving out of conference 
committee quickly, we are on the verge of passing a bill that may be 
stuck in a conference committee. The more we delay passing a bill that 
makes HMO's more accountable and that extends access to care, the 
longer the American people will have to wait before getting a full 
range of the kind of patient care they deserve.
  Although we are now debating this rule, we have not been provided an 
adequate opportunity to fully examine the compromise legislation that 
came about as a result of the agreement between the President and 
Congressman Norwood. Legislation that affects so many Americans should 
not be thrown on the Floor of the House in an effort to win a battle of 
the words.
  A Patient's Bill of Rights now means ready access to emergency 
services. Health Plans would be required to cover emergency care in any 
hospital emergency facility, without prior authorization, whether or 
not the hospital is a participating health care provider in the plan.
  A Patient's Bill of Rights now means ready access to services 
provided by an OB-GYN. Women will have direct access to a physician 
specializing in obstetrics or gynecology, without having

[[Page H5191]]

to obtain prior authorization or referral from their primary 
physicians.
  A Patient's Bill of Rights now means ready access to Pediatric Care. 
Parents will be able to readily designate a pediatrician as their 
child's primary care provider.
  A Patient's Bill of Rights now means ready access to Specialty care. 
Specialty care will be included as a benefit to ensure that patients 
receive timely access to specialists. If no participating specialist is 
available, the bill requires the plan to provide for coverage by a non-
participating specialist at no extra cost to the patient.
  These and countless other measures in the Bi-Partisan Patient's bill 
of Rights will be compromised because of the latest agreement with the 
White House to limit the accountability of HMOs. The Ganske-Dingell-
Norwood-Berry Bi-Partisan Bill of Rights legislation is a meaningful 
patient's bill of rights that has been open to scrutiny and debate. 
This legislation should not be compromised because of late agreement 
that did not include all of the authors of this bill.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
New Jersey (Mr. Pallone).

                              {time}  1315

  Mr. PALLONE. Mr. Speaker, I deeply resent the suggestions on the 
other side that somehow what they are doing today is going to help a 
person who is denied care get the care, get to the hospital, get the 
operation. Just the opposite is going to happen here.
  This rule allows for amendments to be brought up on things totally 
unrelated to care, malpractice reform, medical savings accounts. These 
are the kinds of provisions that, if they are included in this bill, 
when we go to conference with the Senate, will kill the bill, just like 
it did last time.
  And then you have the other amendment that changes the liability and 
makes it almost impossible for someone who has been denied care to even 
have an independent review by an outside board. All sorts of roadblocks 
are put in the way so that a person can never have an actual review. 
Forget the court. They will never get to the court. They will never 
have that kind of independent review by an external review board that 
will let them have their care, let them go to the hospital.
  Finally, most insidious of all, you change the State law so 
progressive States like my own of New Jersey or Texas or others that 
have put in place a real Patients' Bill of Rights, are now going to be 
preempted. That person will never get to the hospital. You are making 
the situation even worse for them than it is now.
  Mr. GOSS. Mr. Speaker, I am very pleased to yield 2 minutes to the 
distinguished gentleman from Kentucky (Mr. Fletcher), from the 
Committee on Education and the Workforce, who has also been a major 
player in this legislation.
  Mr. FLETCHER. Mr. Speaker, I thank the gentleman for yielding me 
time. We appreciate the work the gentleman has done, as well as the 
Committee on Rules, on putting together a fair rule, and a rule that is 
very timely.
  As a family physician, one of the things that you learn to recognize 
very early is that some things need to be done in a timely basis and 
other things can wait. This needs to be done, I think, in a basis that 
we can get this accomplished, because this has been debated for at 
least 6 years, even longer. I think the first Patients' Bill of Rights 
in this body was offered in 1991. Anyone, I say anyone and everyone who 
has been engaged in this debate, is familiar with all the language in 
all of these amendments.
  I woke up this morning and got over here to read the bill very early, 
it is 30 pages long, very easy to read, very understandable for those 
folks who have dealt with this issue for a long time. It is something 
not uncommon here. Five hours is plenty of time for folks to understand 
what this bill does.
  I commend the gentleman from Georgia (Mr. Norwood). He has been 
willing, and maybe let me say very willing, to finally say let us put 
patients above politics, let us break away, let us stop the logjam, let 
us get a bill that the President will sign.
  This rule allows the House to really express its will. We have an 
excellent opportunity to start with the base bill, that the other side 
prefers, and we allow for some amendments to that bill.
  The bill certainly ensures us of quality. We are going to have some 
access provisions, because I think there has been a flagrant disregard 
for the uninsured from the other side. We address that.
  But I think it is also important to realize that we do modify and 
reach a compromise on liability, so that HMOs are held accountable, but 
so that we do not allow frivolous lawsuits that drive up the cost and 
take money out of patient care and put it into personal injury lawyers' 
pockets.
  I encourage Members to support this rule, and I thank the Committee 
on Rules for an excellent job.
  Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to gentleman from New 
York (Mr. Rangel).
  (Mr. RANGEL asked and was given permission to revise and extend her 
remarks.)
  Mr. RANGEL. Mr. Speaker, it is amazing how the leadership here can 
get hold of one or two Democrats and believe that everything they do is 
bipartisan. It reminds me of the story that Jim Wright told about this 
wonderful Texas stew that everyone loved, and they asked what kind of 
stew it was?
  He said it was horse and rabbit stew.
  They said, it tastes delicious. What is the recipe?
  He said, oh, it is one horse and one rabbit.
  They said, it tastes delicious, but how do you do it?
  He said one-half horse, one-half rabbit is how we make it.
  Except it is one whole horse and one small rabbit. And that is how 
the Republicans have moved forward in trying to get bipartisanship 
here.
  But I tell you, the tax bill, the $1.3 trillion tax bill, certainly 
was not bipartisan. This bill is not bipartisan. And the rule which I 
stand to oppose will not even allow us the opportunity to provide the 
revenues to pay for this bill, if and when it becomes law.
  There is a train wreck that is going to occur, and the train wreck is 
that we have signed more checks, or promised to sign more checks, than 
we have made deposits in the bank.
  We have this $500 billion contingency fund over 10 years, but we said 
we are going to have $300 billion of it for defense, $73 billion for 
agriculture, $6 billion for veterans, $50 billion for health insurance, 
$82 billion for education, $122 billion for expiring tax provisions, 
$200 billion to $400 billion to change the alternative minimum tax. And 
there is just not enough money in our account to pay for these things, 
without invading the Medicare trust fund or the Social Security trust 
fund.
  Now, we know that there are some people on the other side of the 
aisle that wish that we did not have these programs, and we also know 
that they know that these programs are so popular that they cannot be 
legislated out. But what you can do is to do what the President said in 
his campaign, and that is get the money out of Washington, because they 
will spend it.
  I think the answer is, if we are spending it for Social Security 
benefits, if we are spending it for health care and education, if we 
are spending it for a stronger America, to invest in our young people, 
then that is what we were sent here to do.
  But if we are just getting the money out of Washington so that we can 
create a deficit, so that we leave to our kids indebtedness, that we do 
not repair the Social Security system, we do not repair the health 
system, then I do not think that is what we were sent to Congress to 
do.
  In the middle of the night a deal was cut, after so many good Members 
on both sides of the aisle tried to present a bill to the President 
that was good for the men and women of the United States of America. It 
is not a day to be proud of, but it is a day that we are going to vote 
down the rule, I hope, and vote down this legislation.
  Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Texas (Mr. Paul).
  (Mr. PAUL asked and was given permission to revise and extend his 
remarks.)
  Mr. PAUL. Mr. Speaker, I thank the gentleman for yielding me time.
  Mr. Speaker, as you know, I am a physician. I practiced medicine for 
more than 30 years, and I can certainly

[[Page H5192]]

vouch for the fact that medicine is a mess, managed care is not working 
very well; and, hopefully, we do something good to improve it. 
Unfortunately, I am not all that optimistic.
  I support this rule because it is dealing with a very difficult 
subject and it brings the Democratic base bill to the floor. I do not 
see why we should not be able to amend that bill, so I do support the 
rule.
  But the IRS code has 17,000 pages of regulation. The regulations that 
we as physicians have to put up with are 132,000 pages. Most everything 
I see that is happening today is we are going to increase those pages 
by many more thousands. So I am not optimistic that is going to do a 
whole lot of good.
  I think we went astray about 30-some years ago in the direction of 
medical care when the government, the Federal Government, got involved. 
The first thing is we changed our attitude and our definition of what 
``rights'' are. We call this a Patients' Bill of Rights. It has very 
little to do with rights, because most of what we do in medicine, we 
undermine individual rights.
  We have a right in society, in a free society, to our life and our 
liberty, and we have a right to use that liberty to pursue our 
happiness and provide for our own well-being. We do not have a right to 
medical care. One has no more right to a service than one has a right 
to go into someone else's garage and steal an automobile. So the 
definition of ``rights'' has been abused for 30 years, but the current 
understanding is that people have a right to services. So I think that 
is a serious flaw and it has contributed to our problem today.
  The other serious flaw that we have engaged in now for 30 years is 
the dictation of contract. For 30 years now under ERISA and tax laws, 
we have forced upon the American people a medical system where we 
dictate all the rules and regulations on the contracts; and it causes 
nothing but harm and confusion. Today's effort is trying to clear this 
up; and, unfortunately, it is not going to do much good.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Michigan (Mr. Bonior).
  Mr. BONIOR. Mr. Speaker, the gentleman from Texas (Mr. Paul) really 
said it well, probably one of the understatements of the day, when he 
said that the managed care system is not working very well.
  In the last 2 weeks, 20,000 Michigan seniors have been told that they 
will lose their health insurance. They are being dropped by their HMO 
health insurers who are abandoning their commitments. Our seniors are 
getting broken promises instead of the care that they expected and the 
care that they deserve.
  Now, on top of that, we get this double whammy that has come before 
us, yesterday and today. For 6 years the American people have been 
waiting for a Patients' Bill of Rights. For 6 years insurance companies 
have done everything they can to block it. Access to the nearest 
emergency room, insurance companies say no; give doctors the authority 
to make the medical decisions that are right; insurance companies say 
no; hold HMOs accountable for denying patients the care they need, the 
HMOs and insurance companies say no.
  The deal cut yesterday, the deal that is being rushed through this 
House so we do not have to read the fine print, and, boy, if there was 
ever one area you wanted to read fine print, it is this area, is not a 
Patients' Bill of Rights, it is an insurance company bill of rights.
  It is a radical betrayal of the public trust. Instead of protecting 
patients, it protects HMOs. Instead of helping patients get the care 
they need, it puts more roadblocks in that patient's way. Instead of 
giving injured patients the right to seek justice, it gives HMOs 
special immunity from the lawsuits and the standards and the laws that 
every other American business must uphold.
  Mr. Speaker, it is time we hold the insurance companies accountable. 
Pass a true Patients' Bill of Rights. Defeat all these poison pill 
amendments that this rule would make in order. Pass a good bill. Vote 
no on the previous question, vote no on this rule.
  Mr. GOSS. Mr. Speaker, I am privileged to yield 1 minute to the 
distinguished gentleman from Indiana (Mr. Pence).
  Mr. PENCE. Mr. Speaker, I thank the gentleman for yielding me time.
  Mr. Speaker, even though I am a new conservative Member of this 
institution, I came to Congress anxious to support a Patients' Bill of 
Rights. I became involved in the front end of this debate to preserve 
our free market health care system and to strengthen patient choice.
  For too long, Mr. Speaker, I believe Congress has walked by on the 
other side of the road, leaving patients, doctors and well-meaning 
employers to fend for themselves in an increasingly complex health care 
economy.
  What we have before us today is truly a bipartisan Patient Protection 
Act that will provide protections for all Americans, and trust doctors 
with the power to make medical decisions, and so it will also encourage 
employers to provide quality health insurance for their employees.
  I urge all of my colleagues, regardless of your stripe or party, let 
doctors provide timely care, give patients choice, and let this 
Congress end the decade of walking by on the other side of the road, 
and speed this timely aid to patients, doctors and well-meaning 
employers.
  Support the bipartisan Patient Protection Act.
  Ms. SLAUGHTER. Mr. Speaker, I yield 1 minute to the gentleman from 
Texas (Mr. Green).
  (Mr. GREEN of Texas asked and was given permission to revise and 
extend his remarks.)
  Mr. GREEN of Texas. Mr. Speaker, I looked forward to this day when we 
could have a Patients' Bill of Rights on the floor, but after seeing 
what happened, I am so disappointed and so frustrated, and I think that 
is what is going to happen with the American people.
  Instead of a Patients' Bill of Rights, we have a patients' bill of 
wrongs. We have a Patients' Bill of Rights that is masquerading, but it 
is really the patients' bill of wrongs.
  What it does is it transfers the decision-making from the State 
courts, where in Texas we have it now, to under Federal rules in State 
courts; and that is wrong, and nowhere in our jurisprudence history do 
we have that. So it is going to make it harder.
  It gives a presumption for the HMO so they are right and you have to 
prove them wrong. We are actually going to increase litigation. My 
colleagues do not want more litigation. When you give that right to the 
insurance companies, you are going to make people hire an attorney just 
to go through the appeals process, and that is wrong.

                              {time}  1330

  In Texas, we had a Patients' Bill of Rights for 4 years, very few 
lawsuits, 1,400 appeals, 52 percent in favor of the patient. So more 
than half the time, the HMO was wrong; and they are wrong today.
  Mr. GOSS. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from Ohio (Mr. Boehner), the chairman of the Committee on 
Education and the Workforce.
  Mr. BOEHNER. Mr. Speaker, I thank the gentleman from Florida for 
yielding me this time, and I congratulate the Committee on Rules for 
bringing to the floor the Patients' Bill of Rights.
  Let us not make any mistake about what this bill is. It is the same 
patient protections that we have talked about for years. It is the base 
bill. There is only one real change in the bill that we are going to 
bring to the floor today, and that is in the area of how much liability 
we are going to impose on employers and insurers.
  Many of us believe, under the base bill, that we will have unlimited 
lawsuits that will tremendously increase costs for both employers and 
their employees, and as a matter of fact, I believe will cause tens of 
millions of Americans to lose their health insurance because of these 
increased costs. That is unacceptable when we have 43 million Americans 
with no health insurance at all.
  Under the rule, the gentleman from Georgia (Mr. Norwood) will offer a 
compromise that he struck with the President that does provide for 
greater remedies and greater access to courts for those who have been 
injured. But it will not unduly raise the cost of health insurance and 
it will not force employers out of employer-provided coverage.
  I think it strikes the right balance for the American people and we 
ought

[[Page H5193]]

to stand up today and think of the patients, not the trial lawyers and 
the politicians.
  Ms. SLAUGHTER. Mr. Speaker, I would like to inform the gentleman from 
Florida (Mr. Goss) that we have one speaker remaining, and I would ask 
if he has more and does he plan to close.
  Mr. GOSS. Mr. Speaker, I thank the gentlewoman for her inquiry. The 
fact is, we have many speakers remaining, but we are only going to have 
time for 1 more to be on the floor to close, and that will be the 
gentleman from California (Mr. Dreier), the distinguished chairman of 
the Committee on Rules.
  Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Missouri (Mr. Gephardt).
  (Mr. GEPHARDT asked and was given permission to revise and extend his 
remarks.)
  Mr. GEPHARDT. Mr. Speaker, I urge Members to vote against this rule. 
I urge Members to vote against the Norwood amendment if the rule is 
approved.
  This is a bad rule, but more importantly, this is a bad bill. This is 
not a Patients' Bill of Rights, this is an HMO and health insurance 
company bill of rights. If the Norwood amendment passes, we are giving 
HMOs and health insurance companies, who make many of the important 
health care decisions in our lives today, a different standard of 
accountability than doctors who make other decisions in our lives. We 
are treating HMOs and health insurance companies in a preferential way, 
as compared to doctors and nurses and hospitals that are held 
responsible for their medical decisions.
  If the Norwood amendment passes, what started out to be a Patients' 
Bill of Rights becomes a dream bill for HMOs and health insurance 
companies. They will have achieved what they often try to achieve in 
making medical decisions, which is how to save money, how to make more 
profit, not how to give people quality health care.
  Let us look at just three things that Norwood changes in this bill 
that are dramatic changes in our legal system as it applies to only 
HMOs and health insurance companies. First, there is a presumption, a 
presumption that if you lose at the arbitration level, at the board 
level of appeals, against the patient, there is no presumption against 
the HMO and the health insurance company; in no other area of our tort 
law do we have that kind of presumption. Why would we want to give a 
presumption against the patient, but not the HMO or the health 
insurance company? It is a stunning abdication to the HMOs and health 
insurance companies.
  Secondly, and perhaps worse, this bill, if Norwood passes, will 
preempt State tort laws. Our friends on the other side of the aisle are 
fond of saying we need a Federal system; we need States to have 
discretion. We have to look to States to put these laws in place, but 
by the same token, when it suits them, because it suits the HMOs and 
health insurance companies, then it is fine to preempt the State laws; 
and for the first time in the history of this country, we will have a 
Federal tort law that applies to malpractice and injury caused by HMOs 
and health insurance companies. So States like Missouri or Texas or 
California who have passed a good patients' bill of rights will have 
all of that wiped out, and if a patient gets to court, can get through 
the maze to get to court, they will be faced with a Federal tort law, 
not the law of their State.
  Thirdly, damages. We have $1.5 million cap on noneconomic, on 
punitive, and that sounds like a lot of money. The problem with that is 
that in many cases, that will be less than what one would get if one 
was under State law. And even though it sounds like a lot of money, let 
us stop for a minute and think about some of these cases.
  Let me give my colleagues an analogy. There are a lot of cases now 
about rollovers, Firestone cases. People have been gravely injured. I 
heard of a woman who has two children; she rolled over and was badly 
injured. She is now paralyzed; she is what you call a ``shut-in.'' She 
can only move her eyes. She is on a ventilator.
  What if she were a victim of malpractice by an HMO or a health 
insurance decision? What if she were limited to $1.5 million with the 
responsibility at her age to raise two kids? What if she were limited 
to a new Federal tort law for the first time in our history, rather 
than being able to use the law of her State to be justly compensated 
for being injured in this way?
  This is a stunning reversal for the patients and the people of this 
country. This is special-interest legislation. This is doing the 
bidding of health insurance companies and HMOs over the interests of 
the people that we represent in our districts. This is a stunning 
abdication of what we should be fighting to protect for the people that 
we represent.
  I defy any of us to go into a hospital room of someone who has been 
done in by bad decisions made by HMOs and health insurance companies 
and look them in the eye and say, I voted today to take away your 
rights, to preempt your rights, to set up a new Federal tort law that 
has never existed in this country.
  In the name of God and common sense, I hope Members will vote against 
this rule and vote against the Norwood amendment if it passes. Stand 
for the people that you represent in this country. You have a solemn 
obligation to fight for their interests and rights and not the profit 
and the money for the health insurance companies and HMOs.
  I beg you to vote against this rule, vote against the Norwood 
amendment if it passes; and if the Norwood amendment goes in, vote 
against this legislation.
  Ms. SLAUGHTER. Mr. Speaker, I yield myself the remaining time.
  I urge my colleagues to defeat the previous question, and if the 
previous question is defeated, I will offer an amendment that makes in 
order the Ganske-Dingell-Berry bipartisan Patient Protection Act 
substitute amendment. This amendment pays for patient protections and 
expanded MSA provisions provided in the bill by extending the regular 
customs taxes and closing tax loopholes for businesses set up solely 
for the purposes of tax relief.
  Mr. Speaker, I yield back the balance of my time.
  Mr. GOSS. Mr. Speaker, it is my privilege and honor to yield such 
time as he may consume to the distinguished gentleman from California 
(Mr. Dreier).
  (Mr. DREIER asked and was given permission to revise and extend his 
remarks.)
  Mr. DREIER. Mr. Speaker, I thank the gentleman for yielding time, and 
I want to congratulate him. He has worked for 12 years.
  I would like to thank several other people, including the gentleman 
from Iowa (Mr. Ganske) who is here; the gentleman from Georgia (Mr. 
Norwood), the gentleman from Kentucky (Mr. Fletcher), and the gentleman 
from Illinois (Mr. Hastert), the Speaker of the House of 
Representatives, who has spent a decade working on this issue.
  We are here with legislation which is designed to ensure that we have 
a Patients' Bill of Rights. We want everyone to have recourse. But as I 
listened to the arguments from the other side of the aisle, we are 
hearing the same old, tired and failed class warfare, us versus them, 
the haves and the have-nots. I have not heard much talk about the real 
reason that we are here beyond ensuring that there is a recourse for 
those who have been wronged.
  There are a couple of important reasons. Frankly, they are going to 
be addressed in the amendment process that we have here. We want to 
make sure that we provide both availability, increase the availability 
of health care and increase the affordability.
  Now, we have heard from witnesses before the Committee on Rules, and 
I would like to thank my colleagues of the Committee on Rules on both 
sides of the aisle for working until the middle of the night and then 
just a few hours later being here to report this rule out today. But we 
heard in testimony before the Committee on Rules that we have a very 
serious problem with the uninsured in this country. There are some who 
have predicted that we can see an increase by 9 million in the number 
of uninsured if we do not take action.
  That is one of the reasons that the proposal of the gentleman from 
Kentucky (Mr. Fletcher), which I believe is a very important one, along 
with a number of our other colleagues, including the gentleman from 
California (Mr.

[[Page H5194]]

 Thomas) and others, dealing with medical savings accounts, is a very 
important provision. Last night the gentleman from California (Mr. 
Thomas) told us how the 18- to 29-year-olds are increasingly drawn to 
the prospect of putting dollars aside to plan for their health care. 
This is a very important step that we can take to deal with the issue 
of the uninsured; and, of course, affordability. Affordability is 
something that we are all very, very troubled about. And how is it that 
we most effectively deal with it? Well, obviously, we have to have some 
degree of competition, and I think that we have a chance to do that as 
we move ahead with this legislation.
  We have all worked hard. People keep talking about looking at the 
fine print. As the gentleman from Illinois (Mr. Hastert) said on Meet 
the Press last Sunday, 98 percent of this bill was agreed to in a 
bipartisan way. We focused on a very small part of it that was an area 
of disagreement, and we have seen the President of the United States 
step forward with a wonderful array of proposals.
  This morning he talked to us in the Republican Conference about the 
wonderful successes that we have enjoyed over the last 6 months in the 
area of education, tax relief, his faith-based initiatives, the energy 
measure which we successfully passed here late last night, and now this 
issue on a Patients' Bill of Rights. It was a key plan of his platform 
when he ran for President. He said all along that he did not want to 
veto legislation.
  Mr. Speaker, we have here the chance to, from the House of 
Representatives, pass legislation which the President of the United 
States can sign so that we can enhance those issues of affordability 
and availability that are so important and so badly needed, and so that 
we can ensure that we have a meaningful and balanced Patients' Bill of 
Rights.
  Mr. Speaker, I urge my colleagues to support the rule, to support the 
Norwood amendment, and to support the other two very important 
amendments we have on medical malpractice and on the issue of 
accessibility with medical savings accounts. Support the rule and 
support those measures.
  Mr. GOSS. Mr. Speaker, I yield back the balance of my time.

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