Congressional Record, Volume 150 Issue 31 (Thursday, March 11, 2004)

[Congressional Record Volume 150, Number 31 (Thursday, March 11, 2004)]
[House]
[Pages H1063-H1069]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

{time} 1715
ISSUES FACING CONGRESS

The SPEAKER pro tempore (Mr. Bishop of Utah). Under the Speaker's
announced policy of January 7, 2003, the gentleman from Texas (Mr.
Burgess) is recognized for 60 minutes.
Mr. BURGESS. Mr. Speaker, I thought we would finish up this week
touching on several issues. We just heard about a lot of issues from
the other side of the aisle; and I have several things that I want to
address, and the gentleman from New Mexico (Mr. Pearce) is here to
speak as well. I want to speak on the reauthorization of the
transportation bill that we will be taking up in the latter weeks of
this month. I want to talk a little bit about where we stand on
fighting and winning the war on terror, and I would like to finish up
with a discussion about retooling Medicare and debunking some of the
myths that we have heard expressed on the floor of this House this
week.
Mr. Speaker, I yield to the gentleman from New Mexico (Mr. Pearce) to
speak on his part of the discussion.
Mr. PEARCE. Mr. Speaker, first of all, I would like to talk about
education and an exciting thing that is occurring in my district.
I would also address some of the economic factors that this Nation
has faced and will continue to face. We have important things about
Medicare that we need to communicate to the American people, and I will
do that this afternoon also. If we get a chance, we will talk about the
concurrent receipts issue, an issue of fairness for our veterans that
this Congress, under Republican control, took care of. It had been a
problem since 1892 when the bill was passed that disallowed concurrent
receipts. The Democrats continue to say that we have not taken care of
our veterans, and yet we took care of that concurrent receipts issue,
which was a problem during the entire time of the 40 years of
uninterrupted power that the Democrats held in this Congress and they
refused to take care of it. They refused to hear the bill, refused to
get it out of committee, and now they are claiming that we did not do
that. The facts speak differently.
Mr. Speaker, returning to my education issue first, Roswell High
School, New Mexico, is in my district. They recently have been named as
one of 12 breakthrough high schools in the Nation by the National
Association of Secondary School Principals, the NASSP. The breakthrough
high schools project identifies and showcases exemplary high schools
which have met the challenges of low-income, high-minority student
populations, which describes my district. It describes some of the most
desperately needy high schools in the Nation. That is the reason No
Child Left Behind was put into place. It causes our school systems to
acknowledge the difficulties of teaching the low-income, high-minority
student populations because they are the ones that are being left
behind.
Roswell High School's success is one of the best examples of school
turnaround that I personally have seen. No Child Left Behind gives
schools the resources, the flexibility and local control to make great
changes. I am both excited and proud to talk about Roswell High School
and its principal, Mike Kakuska from the floor of this House. Mike
Kakuska is my hero. He is the one who deals with young people on a day-
to-day basis, encourages them to do better, convincing them that they
can do better, all of the while making progress in his school. His
comment is that we have a credo here: dinosaurs disappeared because
they did not change. If something does not work, we change it. The
education system in America has not been working. We were leaving too
many children behind, and simply the title of the bill says it best.
Let us stop leaving kids behind because it is the poorer and
disenfranchised who never will have an opportunity to go to a different
school.
No Child Left Behind has channeled tremendously increased resources
at education. When President Bush came to office, the expenditure from
a Federal level was about $27 billion on education. That number is over
$50 billion now and increasing. Yet we are told by the Democrats that
we are underfunding education when they know, when they are talking
about the fact that we have increased over double what they funded
education at during their tenure.
The most egregious example of Democrats misusing facts is when they
send our constituents in to say we are not funding IDEA, the
Individuals with Disabilities Education Act; and yet the facts tell us
that traditionally from the very onset of IDEA, the funding was around
$1 billion. Finally after about 30 years, under President Clinton the
funding increased from $1 billion to $2 billion; yet in the time that
President Bush has been in office, funding has increased from $2
billion to over $11 billion.
Mr. Speaker, I think that we need to tell the American people the
truth. The greatest thing that I see No Child Left Behind doing is that
it allows local flexibility and local control. Local school districts
are given four different income streams where they can move money back
and forth between programs. They are given the flexibility to direct
money where it belongs.
If a school is failing, increased resources are sent to that school
for mentorship, 101 training, or whatever it takes to get each
individual student up to par. One of the most important aspects of No
Child Left Behind is right now there are over 150 school districts
nationwide who have 100 percent control over the education dollars that
go to their school from the Federal Government.
We think that if the local school board will make decisions, if the
local school board is responsible for the education of their children,
if we take education out of the hands of Washington bureaucrats, if we
take Washington out of the hands of the State bureaucrats that local
school boards and local administrators and teachers will solve the
problem.
The No Child Left Behind Act begins that process of giving local
autonomy and local control. I think that Michael Kakuska and Roswell
High School are the best examples in my district of what No Child Left
Behind can do, and I commend them for that.
Mr. Speaker, I will speak later on about taxes, Medicare, and a few
other issues.
Mr. BURGESS. Mr. Speaker, we will transition from the part of the
infrastructure in our communities that is responsible for education to
the part of the infrastructure in our communities that allows us to get
to schools. I am talking about our transportation infrastructure.
Mr. Speaker, in regards to transportation, we are at a crossroads in
this country. We are at the intersection of the demands for creating
the type of infrastructure that will facilitate commerce and move our
citizenry and trying to achieve some type of rational spending limit
within our Federal budget.
Back home in my area of north Texas, we face a silent crisis. This
crisis is largely unrecognized by residents

[[Page H1064]]

until they find themselves in an unbearable commute to work, or unable
to make the necessary connections between home, work and other
activities in their daily lives. My area of north Texas has experienced
an increase in traffic over the past 3 decades which is the result of
unprecedented population and employment growth. Added to this is the
underinvestment of Federal transportation dollars to my area.
Mr. Speaker, the time is now to make the necessary investments in our
transportation infrastructure. In Texas, our transportation needs
outstrip available funding three to one, and these are not trivial
funding needs, these relate to supporting international trade,
streamlining the environmental process, and expanding innovative
financing techniques.
Handling taxpayers' dollars with care is one of our highest callings
here in the House of Representatives. That obligation is enshrined in
the Constitution. Our charge as congressional representatives is to
protect dollars taken from the taxpayer by streamlining and improving
activities of the Federal Government, not just to simply spend and
dispose of those dollars.
Sadly, when Federal dollars are not handled with care, important
Federal programs such as our transportation programs find themselves
being hurt and neglected. Last year shortly after my election to my
first term in Congress, I was very fortunate to be chosen a member of
the House Committee on Transportation and Infrastructure.
I wanted to be sure that the United States Department of
Transportation was ensuring the most efficient business practices
within the agency. I requested and had a meeting with the Department of
Transportation Inspector General, Mr. Kenneth Mead. We discussed the
business practices of the agency and how Congress could better
facilitate removing inappropriate expenditures in relationship to
transportation spending.
Mr. Speaker, the Department of Transportation has not changed the way
the agency disburses transportation funding to State and local entities
since President Eisenhower was in office. The Inspector General
recommended that if one cent had been saved out of every dollar spent
over the last 10 years in transportation programs, the Department of
Transportation would have had an initial $5 billion to spend. That is
$5 billion. That would equate to the amount of funding needed for four
of the 11 major transportation projects currently under way in this
country. Clearly, greater efficiency within the Department of
Transportation could have an enormous impact on more efficiently
spending taxpayer dollars.
The Inspector General shared with me examples of how transportation
projects could be used as examples or models of government efficiency.
In the State of Utah in the preparation for the Winter Olympics,
Interstate 15 needed substantial improvement. By streamlining the
design-build process on that project, Interstate 15 was completed ahead
of schedule and underbudget and available for individuals traveling to
the Winter Olympics that year.
Similarly in north Texas, the Dallas Area Rapid Transit System worked
within their budget last year and actually returned over $20 million in
transit funding to the Federal Government. Unfortunately, there are
examples of transportation projects which are not carefully managed;
and as a result, taxpayer dollars are not wisely spent.
The Ted Williams Tunnel, the central artery project in Boston,
Massachusetts, the project known as the Big Dig, is the poster child
for inefficient Federal spending on a transportation project.
The GAO has estimated that for fiscal years 1998 through 2001, the
highway trust fund account lost over $6 billion because of the ethanol
tax exemption and the general fund transfer. Using the Department of
Treasury's projections of gasohol tax receipts, the General Accounting
Office has estimated that the highway trust fund account will not
collect $13 billion because of the tax exemption from fiscal years 2002
through 2012. There is an almost $7 million shortfall from the general
fund transfer between the same years.
Prior to the last reauthorization bill in 1998, the highway trust
fund earned interest on its balance which was paid by the general fund.
If the highway trust fund had continued to earn interest on its
balance, the United States Department of Treasury estimates that the
highway trust fund would have realized about $4 billion from September
1999 through February 2002.
Mr. Speaker, between modifying the Department of Transportation's
practices with State and local governments and reevaluating the true
purposes of the highway trust fund, I believe we can work together to
ensure that the Federal Government is more effective and efficient for
the American taxpayer, and we have more dollars to spend on needed
transportation projects.
If we are unwilling to make the monetary investment and the necessary
policy changes, then I am afraid our vision for our Nation's highways
will be of a congestion-bound commuter sitting in a traffic jam
literally watching the bridges and roadways crumble before their very
eyes.
There are policies that we could put into this year's reauthorization
bill which would have a dramatic impact on the efficiency with which
our highway dollars are spent. I believe we need to have policies
included which will allow States the flexibility to complete large
projects in less time and consequently save money. Streamlining the
design-build process, as was done with Interstate 15 in Utah, will
achieve this goal; and I seek inclusion of this concept in the final
reauthorization legislation. More funding and flexibility, which allow
for an increase in efficiency, will equate to better roads, better
bridges, and better transit facilities.
Logically following from that, we can expect less congestion,
improved safety, as well as the economic value of increased commercial
transportation.

{time} 1730

I remain committed to working with Federal, State and local officials
during this reauthorization year to address the long-term needs, not
just of my district, not just of my State, but of the country at large.
We need to ensure that our Federal Government wisely spends the
taxpayer dollars on transportation infrastructure. We need to do our
work. We need to produce a bill which adequately provides for our
economic security, creates and sustains jobs, enhances safety and
continues to improve mobility for our Nation's citizens.
I think a worthwhile goal, Mr. Speaker, would be to allow Americans
to spend as much time in family discussions at the dinner table as they
currently spend simply trying to get home.
I yield back to my friend from New Mexico.
Mr. PEARCE. I thank the gentleman from Texas.
Mr. Speaker, right now we have National Guard members in Iraq who are
defending not only the freedom of this Nation in fighting back in the
war on terror that began on 9/11 in this country, Mr. Speaker, but
those National Guard troops are serving and putting their lives on the
line. And that is not new. Our National Guard has been doing that
throughout our history.
In World War II at Omaha Beach, some of the greatest casualties
occurred in the Virginia National Guard. Members of my own New Mexico
National Guard in World War II were in the Pacific. They made a thing
called the Bataan Death March. I have known about that event throughout
my entire life because I had next-door neighbors who were on the Bataan
Death March. It was not until I went to the New Mexico House of
Representatives that I began to understand why we had so many of those,
and that is because the New Mexico National Guard was activated, sent
there, they did their duty and many of them died.
It is with this backdrop that I was profoundly disappointed several
weeks ago when Terry McAuliffe, the chairman of the Democratic National
Committee, said President Bush served in the National Guard, but never
served in our military and our country.
I will tell you, those comments are so demeaning to the people who
served in our National Guard that I was offended and asked for an
apology. I am now asking that the chairman of that committee would
resign over his comments that detract from the service of all of our
National Guard Members.

[[Page H1065]]

I came to the floor of this House several weeks ago to talk about the
rhetoric that was starting in the campaign, and just earlier today we
saw a report from the leading Democrat contender for President where he
referred to the ``crooks and liars on the other side.'' I will tell you
as a Republican, I will say that his comments were unfounded, they were
extremist and they have no basis in fact.
He has already turned down a demand for an apology. I do not think he
will do that, because I do not think he is a large enough person to do
it. But I am profoundly disappointed by the comments from the Democrat
candidate for the office of President.
I yield to the gentleman from Texas for the next segment.

Announcement by the Speaker Pro Tempore

The SPEAKER pro tempore (Mr. Bishop of Utah). The Chair would remind
Members not to make personal references to Members of the Senate, even
if not by name, including candidates for the presidency.
Mr. BURGESS. Mr. Speaker, I thank my friend for yielding.
Mr. Speaker, I heard those same comments last night when I was
working late in my office, and I, too, took offense at those. I was
reminded that the founder of our party, Abraham Lincoln, said that if a
man asserts something to be true, even if he does not know whether it
is true or false, that man is in fact himself guilty of a falsehood.
When an individual refers to all members of this Republican side of the
aisle and this body as crooks and liars, I assert that that that man is
in fact himself guilty of a falsehood, and then thereby becomes that
which he condemns.
I join with my friend from New Mexico in asking for an apology from
this individual. I think it is only proper that he do so.
Since the gentleman was talking about the service of our troops and
our National Guard overseas, let us also think about our success in the
war on terror. We must remember that our President, our leader, George
Bush, led us into this battle, and in fact if a Member of the other
body had been in control, Saddam Hussein would still be the dictator in
Iraq, brutalizing and terrorizing his people. The President and the
Republican-led Congress are winning the war on terror and bringing the
light of democracy to all corners of the world.
Just this morning on a conference call with Ambassador Bremer in
Baghdad, he talked about the signing of the Iraqi Constitution that
took place earlier this week. In fact, it was not quite a week ago that
all parties were gathered to sign the Constitution, but it did not
happen last Friday.
Of course, we saw that reported rather generously in the newspapers,
that the signing of the Constitution did not occur at the time that it
was supposed to. We did not read that much about its signing on Monday,
other than the fact that it was indeed signed. All 25 members of the
Iraqi Governing Council signed the Constitution. There was no change in
verbiage that occurred between Friday and Monday. Whatever differences
there were worked out with a concept of compromise that is apparently a
new concept in the country, the free country of Iraq.
The signing of that Constitution was such a big event that sometimes
something happens that is so big it almost gets lost and you almost do
not realize how big it was and how much that means, not just for that
area of the world, but for our country. Maybe not for people in our
lifetimes, but certainly in our children's lifetimes, they are going to
see a world markedly different because of the work that has gone on in
that country, really for not quite a year's time. I believe next week
will be the one year anniversary of the beginning of Operation Iraqi
Freedom.
Certainly the press in Iraq was amazed by the fact that they had come
this far to craft an interim Constitution, the fact that it had
happened this quickly. Certainly they have got an aggressive task ahead
of them in Iraq in getting approval for this interim Constitution, but
Ambassador Bremer emphasized this was indeed a revolutionary concept in
the country of Iraq. They are going to be governed under the rule of
law, which is a new concept for them.
They have a robust component of individual rights built within that
Constitution. I believe, if I am not mistaken, there is a provision
that 25 percent of the elected representatives in that country will now
be women, a marked change from what they were looking at before. They
will have an independent judiciary. They will have majority rule, but
the rights of the minority will be protected. There is a commitment to
democratic principles. There is freedom of religion, but there is also
freedom to practice religion as a person sees fit.
All of these are enormous concepts that have been crafted, again, in
a relatively short period of time in an area of the world that has not
known much freedom for the last 20 or 30 years.
I was in Iraq just a little over 2 weeks ago. In fact, we heard on
the floor of this House earlier this week some criticism of the
administration because there is no capture of Osama bin Laden yet, and
that the effort was diverted by what was going on in Iraq.
Well, I also visited the country of Afghanistan and the country of
Pakistan. I met with both President Musharraf and President Karzai
respectively in those countries.
I want to share with this House a picture which was given to me by
General Austin of the 10th Mountain Division out of Fort Drum, New
York. This is a picture where I think one picture worth 1,000 words,
probably so. This picture demonstrates the degree to which our soldiers
are going to capture, contain and kill those who would harm innocent
Afghani citizens, certainly bring harm to our troops.
This was an individual who was sought by the coalition forces in
Afghanistan. He thought he was relatively immune from prosecution,
living high on a steep mountainside. He was visited by some of our
forces. Then, to bring him to justice, they landed half a helicopter on
his house. You can see his campfire still burning down there. He was
brought up to the roof and loaded into the back of the helicopter.

Think of the effort involved in the capture and containment of that
individual. I do not recall whether that was a Taliban or al Qaeda or
simply a warlord that they were attempting to bring to justice, but it
was quite a startling turn of events for that man that morning when
half of that helicopter landed on his roof to bring him back to meet
whatever fate awaited him.
I cannot tell the gentleman from New Mexico how glad I am that he
brought up the service of the National Guard in this country. When I
was in Iraq and we spoke to the General of the Fourth Infantry
Division, General Odierno, the division that captured Saddam Hussein,
he said under his control, I cannot say numbers, but there were a
substantial number of Guard and Reserve under his command, and he said,
``I cannot tell you at this point who is Guard and who is regular Army.
They are all the same in my eyes.''
As the father of a young man in the Air National Guard back in Texas,
I thank the gentleman from New Mexico for bringing up the valor of
their service, not just in this conflict, but throughout the history of
this country.
Mr. PEARCE. I thank the gentleman for yielding. As I look at that
picture, I wonder about the person that is taking the picture. That is
a stunning shot from high up in the mountains there, taken at the
moment of impact, and it just expresses in detail the fine job that our
troops are doing.
At the end of October of last year, October 31, November 1 and 2, I
was in Iraq. I visited with our troops to find out what their attitudes
were. I can tell you that every single troop I visited with, both from
New Mexico and from outside New Mexico, they all believed in what they
were doing, they were highly motivated, well trained and doing great
work.
Their one comment was, ``Why do the people in America not find out
the good things we are doing?'' I cannot tell them why the news will
not cover the good things that are going on in Iraq, the very positive
rebuilding efforts, the winning over of the hearts and minds of the
Iraqi people, but I can tell you that those soldiers know about it.
They see firsthand that people in the neighborhoods who have been told
their entire lives, for 35 years under Saddam Hussein, that Americans
are evil and will be coming there to hurt them, and as the Iraqis find
that not to be true, they bring their kids out in

[[Page H1066]]

the streets and hold them up to see the Americans eyeball-to-eyeball,
and that is touching the lives of the young men and women from New
Mexico serving there. I compliment our troops for the fine job that
they are doing.
But our reconstruction efforts are going well. We have about 75
percent of Iraq is fairly stable. About 25 percent is unstable. But I
visited also with General Odierno. That was before we captured Saddam
Hussein. He told me, ``My troops have stepped on his tail a couple of
times and we missed him.'' He said, ``It is going to be my people to
capture him,'' and the gentleman from Texas (Mr. Burgess) pointed out
it was the troops under General Odierno that captured Saddam Hussein.
I will tell you that when I look back on the short time that we have
been engaged in the war on terror, we have the Taliban completely
uprooted and out of Afghanistan. Al Qaeda is on the run. The funds
raising mechanism in Saudi Arabia that was funding the war on terror
has been eliminated. Under A.Q. Khan, nuclear armament components were
being sold on the world market, and that completely marketing network
of nuclear armament has been taken down and disassembled. We have gone
back and repossessed some of the nuclear things that were sold to
countries. Pakistan now is energized and willing to help us in the war
on terror. Iran is admitting publicly that they had nuclear weapons and
nuclear capability. Syria is beginning to change their attitude. Libya
has changed theirs.
We have come so far in this war on terror. It disturbs me when I hear
the national campaign from the Democrats saying we should back up, we
should bring our troops home, we should rethink it. I will tell you
that the worst thing we could do is to stop the war on terror, because
that is one of the events that destabilized our country.
People wonder why we are doing the tax cuts. I will tell you, our
economy has suffered three deep shocks. The first, of course, was the
dot.com collapse. That occurred in the last years of the President
Clinton term. We had stocks that were valued at way over their actual
dollar value. That occurred because people were euphoric. Some of these
companies had no products, they had no net income, they had no sales.
They just had a name and a concept, and people were bidding the stock
up from nothing to $200 and $300 per share. That euphoria in a market
cannot be sustained. What we found is that the dot.com collapse came,
as well it should have.

{time} 1745

It brought a correction into the market to bring reality into the
market, but it also set our economy back on its heels. We were just
about out from underneath that recession when the 9-11 attack occurred.
That was approximately a $2 trillion shock to our economy and over
2,000 lives in one day. When people worry about the cost of the war, I
would just remind them, yes, it is extremely expensive. War is never
inexpensive. It is at almost $200 billion right now. But I will tell my
colleagues that $2 trillion in one day is over 10 times the total cost
up to now of the war.
Mr. Speaker, 9-11 set our economy back yet a second time into a
little bit different and deeper recession. Finally, we are just about
to come out of that when the Enron, Global Crossing, the WorldCom
collapses began to occur and people started taking their money out of
the stock market. That was a deeper shock still to the economy, causing
an interruption in the confidence of the American people in our system.
During those three events, we found that our economy was so resilient
that it never got plunged as deeply as it could have into recession,
but it was always lingering in the last phases of it.
We gave the tax cut in this institution, we voted for the tax cut
because tax cuts create jobs. We had hoped when we offered the tax cut
that we could get a 3.5 percent rate of growth in our economy. We were
stunned in the third quarter to find out that the rate of growth was
actually 8.2 percent instead of the 3.5 percent that we had hoped for.
The rate of growth has settled down to a more modest 4 percent, but
Alan Greenspan says that he expects that number to remain constant; and
I will tell my colleagues, if we can remain at the 4 percent growth
level, that this economy is going to be in good, good shape.
There are many reasons that the tax cuts were given, but one of the
most important things that occurred is that 75 percent of the people in
the higher income brackets that got tax cuts are small business owners.
When we give small business owners a tax break, we are affecting over
half of the employees of the United States. Small business is one of
the most vibrant forms of employment in this country; and the tax
breaks, the expensing for small businesses, the accelerated
depreciation were two of the most dynamic parts of the equation. They
are the things that caused our orders of manufactured goods to
increase, the orders of vehicles, of large equipment, of new
capability; and it is that expansion that brings on new jobs into this
economy.
When our opponents talk about the number of jobs lost, they simply
refuse to talk about the number of jobs that are sent overseas by hard
policies and too invasive regulation. I was in committee the other day,
Mr. Speaker, and the Committee on Resources was talking to the people
who cut timber and who process timber into lumber. Those fine union
members of that group declared to us that 3 million jobs in that one
industry had been sent overseas by policies that refuse to let people
cut timber anymore. The Democrats on that committee said, you will be
okay, you will be fine. You will have jobs in tourism. The members of
those unions in that meeting told the Democrats, we do not want jobs in
hotels; we want our good, high-paying jobs in the timber industry back.
Many times we fail to account for the jobs that are sent overseas by
the regulations that we impose as a government. I think that it is an
important consideration in the job loss for this country, because I
know that our companies would rather stay here and compete as long as
they can.
Mr. Speaker, I yield back to the gentleman from Texas (Mr. Burgess)
before I go into my next discussion. I would ask him to let me know
when we would like to yield back the floor.
Mr. BURGESS. Mr. Speaker, I thank the gentleman for yielding. I would
like now to move on to the topic of Medicare and perhaps health care in
general; but let us start with, let us start with a discussion of
Medicare. When I do my town halls and discussions back home, I am
asked, Why in the world did you even take on the task of trying to
reform Medicare? Why even do it? It is such a heavy lift. It is such a
big job.
The fact remains, Mr. Speaker, that in 1965 when the Medicare bill
was signed into law, they covered the two things that arguably would
pose the greatest financial threat for a senior citizen, and that would
be a major surgical procedure or a prolonged hospitalization, say for
example, for treatment of pneumonia or a bad kidney infection. The
prescription drug benefit was not written into law at that time because
prescription drugs available, I think, looking back at that time, I was
not in practice, but I think we had penicillin and cortisone and those
two were interchangeable; but prescription drugs and the availability
of treatments for medical illnesses has drastically changed over the
last 39 years since the enactment of Medicare. And to have modern-day
practice of medicine without the ability to provide prescription drugs
essentially made no sense. We were looking at a situation where, and we
have heard this quoted many times on the floor of this House during the
debate, we would be more willing to pay for the end-stage renal disease
or the amputation than we would be willing to pay for the medication to
treat the diabetes to prevent the end-stage condition from happening in
the first place.
So it was important, from the standpoint of the perspective, if you
are going to have a Medicare system, and I realize that there are
people who would argue that perhaps the Federal Government should not
be doing that, but the fact is, we are doing it, we have been doing it
for almost 40 years now. And if you are going to have a Medicare system
in the year 2004, we cannot have a publicly funded health care system
that does not provide a way to provide prescription drugs to the
beneficiaries.
We also hear a lot of criticism from the other side of the aisle that
we did

[[Page H1067]]

not go far enough, we are not spending enough in this process. We are
either spending too much or not enough. But we have to look at who is
targeted for coverage under the Medicare Modernization Act that we
passed last November.

The individual who is targeted for coverage is the individual who is
of extremely low income, the person who is at 150 percent of poverty or
below, and those individuals who have high out-of-pocket expenses, the
so-called catastrophic drug coverage that was provided in the
prescription drug bill as part of the Medicare Modernization Act. Yes,
that does leave a group, a segment in the middle that is not going to
be covered for every drug purchase; and if someone finds themselves in
that area, certainly they can be grateful that they are not at 150
percent of poverty or below as far as an income and that they do not
have the needs of catastrophic coverage, and we should always be
thankful for good health.
Paying for health care in this country, and I read a rather
disappointing op-ed article last December from Ronald Brownstein of the
Los Angeles Times when he talked about how you pay for health care in
this country, there are only two ways. It is either an employer-derived
insurance policy, or it is a government-funded proposition. Mr.
Speaker, I would suggest that there are at least two other ways. I know
from my years of practice of medicine there is a good number of bills
that just simply are not paid, so there is uncompensated care or a
gift, if you will, by the hospital or provider that they are not going
to be paid for the services rendered. And then, of course, there are
individuals who will pay for their care themselves.
Mr. Speaker, tapping into that group of people who are willing to pay
for their care for themselves is an enormous reserve that we as yet
have not properly addressed in this country. We had the old Archer
Medical Savings Account from 1996, and I myself had a medical savings
account and found it a very, a very worthwhile type of medical
insurance to have. But in the Medicare Modernization Act that we passed
in November, we allowed for the formation of what are called health
savings accounts, not just for seniors. This is for anyone, any age
group in the country who wants to put dollars away for their health
care needs in the future. They are now going to have a mechanism for
doing that within the health savings account program. This is an
enormously powerful way to put money back in the hands of the consumers
and put consumers in charge of making their own health care decisions.
Because after all, the consumer is going to be more wise with spending
their money than they are with someone else's money, and I think
someone made the point on the floor of this House back when we were
having this debate about, you never spend money washing a rented car.
Well, of course not, it is not yours; you do not care what it looks
like when you turn it in.
Well, the same can be true, if you are not actually paying yourself
for your health care, you do not care how much money you spend. But if
it is your money and you are allowed to control it, you tend to be a
much wiser steward with health care dollars. I know that from my own
experience from having a medical savings account for the last 5 or 6
years.
Other aspects of health care that we need to address, and I believe
we are addressing, the Republican leadership is addressing in this
House and, in fact, the President of the United States when he stood up
and gave his State of the Union address in this House at the end of
January, the daily newspaper Roll Call, Mort Kondracke who writes a
column for that, not necessarily a great friend of the President or the
administration, but talked about the President's speech afterwards and,
in a way, he was actually being critical of the President. He said the
President's health care initiatives that were outlined in the State of
the Union message would only cover about 25 percent of the uninsured in
this country. Only about 10 million people would be covered by the
programs that the President outlined.
Well, Mr. Speaker, I would submit to my colleagues that if we have
within our grasp right now the means of bringing coverage to 10 million
uninsured in this country that, for heaven's sakes, we ought to be
about the business of doing that.
The President outlined in his State of the Union address the
deductibility, full deductibility for old income tax deductibility for
a high deductible insurance policy, the one that would fit well with
the concept of an HSA. This is a tremendously valuable concept. For the
first time, if we will do that in this House, if we will provide that
full deductibility of a high deductible insurance policy or a
catastrophic insurance policy, anyone who pays income taxes in this
country has no excuse for not having health insurance. We will have
provided them the health savings account to grow that money tax
deferred and the tax deductibility for buying their catastrophic
coverage. Mr. Kondracke and I might argue about the number of people
who would actually be covered by that, but that is a substantial number
of individuals who would have coverage available to them in this
country who today, voluntarily, do not have insurance coverage.

Association health plans, a bill that was passed by this House in
June of last year, association health plans allow small businesses, and
we heard about the value of small businesses and growing our economy,
allow small businesses to band together across State lines, if need be,
to get the purchasing power of a larger corporation and by having that
larger purchasing power, or having that same purchasing power of a
large corporation, go out into the insurance market and purchase
insurance policies for their employees at a lower price. It is a win-
win proposition for both the small business owner and for the
employees. This House has passed that bill last June. It languishes and
I, for one, do not understand why we do not pick up and get that done,
get it to conference and get that bill out there, going to work for the
American people.
Finally, there is the concept of tax credits for the uninsured. When
talking about the deductibility for a catastrophic policy, well, if
somebody does not make enough money to pay income tax, they are going
to say well, that is a great program for someone who makes more money
than I do, but I do not pay income tax anyway, so that is not going to
help me. The gentlewoman from Texas (Ms. Granger), my neighbor down in
Tarrant County, has a bill on the floor that we have yet to vote on
that would allow for tax credits for the uninsured. This is, again, an
enormously powerful concept that would bring insurance a pre-fundable
tax credit, if you will, that would be available to someone at the
beginning of the year before they file their income taxes to purchase
health insurance for that year. These three things done together,
expansion of the HSAs, tax credits for the uninsured, association
health plans, and we are covering 25 percent of the uninsured in this
country, right now, this year, without any heavy lifting, again, I do
not understand why we do not go forward with those three plans and
simply get that done.
The Congress has done the work on health savings accounts and those
are now part of the law of the land; full deductibility for the
catastrophic policy needs to happen right away. Association health
plans have been passed by this House, they await activity on the other
side of the Capitol, and I would welcome some activity in the near
future. And then finally, tax credits for the uninsured we could take
up this spring and pass, get it over to the Senate and get their sign-
off on it and provide that coverage to 10 to 15 million of the
uninsured in this country and get that done right now.
I will be happy to yield to my friend from New Mexico for his
comments.

{time} 1800

Mr. PEARCE. Mr. Speaker, I thank the gentleman from Texas (Mr.
Burgess) for yielding.
As he talked about the Medicare bill I began to remember my own
discussions in our offices and also with my family about this. The
discussions right now that are critical of this Medicare bill that has
been passed and signed into law was that there is this donut hole. I
called my mom before we voted on it the first time, I asked her, I
said, ``Mom, you are going to fall in the category that they are
describing as the gap in coverage or the donut hole.'' She said, ``Why
would that be?'' I said, ``Because your assets are high

[[Page H1068]]

enough and your yearly income is up. We are targeting the poor and we
are targeting the people with catastrophic health care, prescription
drugs cost.'' She said, ``Son, we have been very blessed. I do not mind
paying more if I can pay more.''
And I feel like that that is the way most Americans are going to
approach this, that they do not mind paying more if they can pay more.
Again, I told my mom that. She said, ``Exactly why are you doing
that?'' And I said, ``It is so we do not break the country, so we do
not tag the next generation with more cost than they could ever pay. So
the gap in coverage is there because you are able to do it and we do
not want to pass those costs on to the next generation.''
My colleague has adequately pointed out the great work that was done,
and I want to commend the gentleman as one of the physicians in this
freshman class, I think he was very instrumental in driving many of the
components of this bill, and I congratulate him for that.
The health savings account is a thing that I talked from the floor of
this House last night. Basically it is a medical IRA. You can put the
money in tax free, you can take the money out tax free. The difference
between this medical IRA the health savings account and other IRAs is
that you can take the money out at any age if you pay for medical
expenses. You can pay for your premiums, you can pay for deductibles,
you can pay for prescription drugs, or you can pay for your doctor
visit, dental, whatever.
Now, the nice thing about this account is that not only is it yours,
and it is yours to dispose of the way that you would, but it is the
part of your estate and it goes to the next generation, to your sons
and your daughters to help them pay for their medical costs if you do
not use it.
I think that it is one of the most important pieces of legislation
that we passed this year. It is in law. It is a part of the
prescription drug Medicare bill and has been signed by the President of
the United States and is actually in law at this time.
We recently sent a mailer out to my district talking about Medicare
in general, but the health savings account particularly got calls back
to the office wondering where can we buy them right now.
One of the most significant things that I found there New Mexico that
we did in this Medicare bill is that we began to offer certain reforms.
To me it is never made sense why Medicare could not do some of the
screening so it would catch the diseases up front, so that we catch
them before they get to catastrophic stages.
That is one thing that happened in this Medicare bill is we allow
preventative care and screening. We allow physical exams for the first
time so that we understand if people have a cholesterol problem or have
an impending heart problem because the blood pressure is too high, that
we take care of it before it becomes catastrophic. And we all know if
you take care of medical problems before they are catastrophic, they
are much cheaper to take care of. I think that those components make
this bill a very good bill. But in New Mexico in my rural district, it
is a 9-hour drive across my district at 75 miles an hour, we have got
almost 60,000 square miles, it is a very large district, and we have
not too much access to health care, but the access that we do have was
reimbursed at a different rate.
As a physician, you understand that the urban areas were given far
greater reimbursement for the same treatment that would be received by
a rural hospital. I campaigned saying that this inequity needed to be
fixed. Much to my surprise, we fixed it in this bill. Rural hospitals
receive 100 percent of the reimbursement that the urban hospitals
receive because of the actions that we took in this bill.
Another thing that I campaigned about, Mr. Speaker, was that our
border hospitals are tagged with an expense to take care of the medical
cost of immigrants who come to the border. Our immigration law says if
they present themselves at the border with a medical problem, that the
local hospital or the local county will take care of the problem.
I am on the Mexico border. My district borders the Mexico border. And
yet my rural hospitals tell me they have carried people in an ambulance
to Denver, Colorado, had heart surgery for them, and when they were
recovered, they had to go up in an ambulance, pick them up and take
them back to the border. I will tell you that our country was not
reimbursing at all the expenses that our border hospitals were having
to be faced with. And this bill adds $1 billion into a pool of money to
be shared by those hospitals which are currently being faced with those
expenses.
So for those two reasons, for rural areas and especially for my
district, it was a good bill. But there are good things beyond that.
One of the greatest complaints that I hear among my constituents is
they do not like the prescription drug manufacturers. I think that they
are just mostly upset with them. I think that they would do more than
what we should. But we did ring the bell here in this bill for a
prescription drug manufacturers. We did not want to choke all of the
profits out from the drug manufacturers because the research and
development is creating miracle drugs that are causing the fastest
growing population group to be the over-100 population.
The second fastest group that we have, the second fastest growing
group is 85 to 100. These changes are brought about by prescription
drug makers who make great products, but they were doing some things
that we felt like we ought to ring the bell on, maybe bring them back.
So we are in the Medicare bill bringing generics to the market much
sooner. We also stopped the process of extending patents almost
indefinitely to where now we give them patent protection for one period
and we extend it for one period, but not the continual extensions that
were being gotten before.
Both of these actions serve to lower in the long run the cost of
medications that we find in the country. And, of course, we know that
that starting right now, everyone that is 150 percent the rate of
poverty and below has access to the two drug cards this year and next
year, which provides immediate cash relief.
Mr. Speaker, this Medicare bill combined a lot of elements of reform,
it combined elements of change for rural areas, it brought in the
health savings account, it brought prescription drug coverage to those
who most desperately need it who are having to choose between food and
medicine. And I am telling this Chamber that this bill is good for
people in this New Mexico.
Mr. Speaker, I yield back to the gentleman from Texas (Mr. Burgess.)
Mr. BURGESS. Mr. Speaker, I thank my friend for yielding.
And the gentleman makes an excellent point that by speeding the
availability of generic drugs, we are bringing down the cost of
prescription drugs in this country. In other words, an important point
that I failed to make in my initial comments is this program is
entirely voluntary. No one is forced into this program. You do not have
to buy prescription drug coverage. You do not have to change any aspect
of Medicare. If you enjoy what you are doing today, it does not have to
change for you.
The gentleman from New Mexico (Mr. Pearce) spoke about the cost of
prescription drugs. And, Mr. Speaker, I want to again quote from the
Washington periodical Roll Call, Mort Kondracke's column, again, not
necessarily any friend of the Republican majority or the
administration, but writing in Roll Call a couple of weeks ago, Mr.
Kondracke said, ``Mr. Kerry and Mr. Edwards regularly attack drug
companies for price gouging, neglecting to observe that it costs an
average of $700 million to bring a new drug to market. They want, in
effect, to impose price controls on drugs by allowing the government to
negotiate with drug companies on behalf of the Medicare and Medicaid
program and legalizing mass importation of drugs from Canada.''
He goes on to say, Mr. Speaker, that Medicare does not negotiate with
providers such as doctors and hospitals on reimbursement levels. I know
this full well. I lived under Federal price controlled my entire
professional life.
Going back and quoting from the article, ``It imposes them and
Congress often gets into the act of changing formulas.'' The reasons
that drugs are cheaper in Canada and Europe is that governments there
fix the prices based

[[Page H1069]]

on the production costs of new drugs, escaping participation in the
astronomical cost of drug development.
In other words, Mr. Speaker, our trade laws which should protect us
from this type of activity, are, in fact, asking our poorest
individuals, our seniors without prescription drug coverage, to foot
the cost of research and development of life savings pharmaceuticals
for the rest of the world. And that is wrong. And that is what needs to
change, not how we handle reimportation of drugs at the border.
Finally, I do want to, in the few minutes that are left, I want to
address something else. We actually heard this this afternoon on the
floor of the House from the individual on the other side of the aisle
who was talking about health care, and was critical of the prescription
drug plan passed by this Congress because of the cost of the
prescription drug plan. $395 billion was the Congressional Budget
Office estimate for 10 years. The White House Office of the Budget came
back with a different figure that was some $500 billion over 10 years
time. And that discrepancy has attracted a great deal of attention.
Mr. Speaker, the fact remains that it is almost impossible to
precisely fix what the cost of this drug program is going to be over 10
years time. Chairman Thomas, when he brought the conference report to
us last fall, admitted that there was no attempt on the Congressional
Budget Office to factor in any cost savings in the Medicare program by
virtue of the fact that we were treating illnesses in a more timely
fashion and that we were bringing disease management, we were going to
be more aggressive about preventative care in the new Medicare with the
new Medicare Modernization Act.
Mr. Speaker, in the few minutes, that are left I have to make this
point. This House a year ago passed H.R. 5, which was the medical
liability bill that would cap the medical liability awards for non-
economic damages, pain and suffering at $250,000. We actually did this
back in my home State of Texas. And medical liability rates have fallen
dramatically. But, more importantly, more importantly, when you look at
the cost of defensive medicine in this country, and, in fact, that was
looked at in a study at Stanford University in 1996. And these are 1996
dollars, several years ago, the cost of defensive medicine for the
Medicare program was estimated to be $50 billion a year.
Mr. Speaker, if we are concerned about the cost of the prescription
drug program, we could pay for it by our savings in defensive medicine
if we could simply pass that medical liability bill that is stuck on
the other side of the capital that we got through this House a year
ago. We need to get that bill passed and get it to conference and get
on about the business of reducing this high tariff, this high cost of
defensive medicine in this country.
Mr. Speaker, we have almost consumed a full hour of talk. And I just
wanted to yield to my friend from New Mexico if he had any closing
comments. I really appreciate his being here with me and staying in
town late today so we could bring our good Republican message to the
floor of this House, to the country at large. And I really appreciate
him being here and helping me with this discussion this afternoon.
Mr. PEARCE. Mr. Speaker, I thank the gentleman for yielding one last
time. Again, I want to talk in one sense if possible to say thanks to
those people who work in our education establishment, those who are out
there on the front lines of the education war, especially those success
stories like Roswell High School in New Mexico. That is one of the 12
break-through high schools in the Nation. I think that this kind of
outcome is exactly what we had hoped for when No Child Left Behind was
passed.
If the administration in any school is dedicated to the changes that
are allowed under No Child Left Behind, I believe that the program will
be the success that each of our parents wants throughout the Nation.
So thanks again to the gentleman from Texas (Mr. Burgess) for
yielding time to me today.

____________________