[Congressional Record Volume 150, Number 66 (Wednesday, May 12, 2004)]
[House]
[Pages H2821-H2829]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROVIDING FOR CONSIDERATION OF H.R. 4279, PROVIDING FOR DISPOSITION OF
UNUSED HEALTH BENEFITS IN CAFETERIA PLANS AND FLEXIBLE SPENDING
ARRANGEMENTS; H.R. 4280, HELP EFFICIENT, ACCESSIBLE, LOW-COST, TIMELY
HEALTHCARE (HEALTH) ACT OF 2004; AND H.R. 4281, SMALL BUSINESS HEALTH
FAIRNESS ACT OF 2004
Ms. PRYCE of Ohio. Mr. Speaker, by direction of the Committee on
Rules, I call up House Resolution 638 and ask for its immediate
consideration.
The Clerk read the resolution, as follows:
H. Res. 638
Resolved, That upon the adoption of this resolution it
shall be in order to consider in the House the bill (H.R.
4279) to amend the Internal Revenue Code of 1986 to provide
for the disposition of unused health benefits in cafeteria
plans and flexible spending arrangements. The bill shall be
considered as read for amendment. The previous question shall
be considered as ordered on the bill and on any amendment
thereto to final passage without intervening motion except:
(1) one hour of debate on the bill equally divided and
controlled by the chairman and ranking minority member of the
Committee on Ways and Means; (2) the amendment in the nature
of a substitute printed in part A of the report of the
Committee on Rules accompanying this resolution, if offered
by Representative Rangel of New York or his designee, which
shall be in order without intervention of any point of order,
shall be considered as read, and shall be separately
debatable for one hour equally divided and controlled by the
proponent and an opponent; and (3) one motion to recommit
with or without instructions.
Sec. 2. Upon the adoption of this resolution it shall be in
order to consider in the House the bill (H.R. 4280) to
improve patient access to health care services and provide
improved medical care by reducing the excessive burden the
liability system places on the health care delivery system.
The bill shall be considered as read for amendment. The
previous question shall be considered as ordered on the bill
to final passage without intervening
[[Page H2822]]
motion except: (1) one hour of debate on the bill, with 40
minutes equally divided and controlled by the chairman and
ranking minority member of the Committee on the Judiciary and
20 minutes equally divided and controlled by the chairman and
ranking minority member of the Committee on Energy and
Commerce; and (2) one motion to recommit.
Sec. 3. Upon the adoption of this resolution it shall be in
order to consider in the House the bill (H.R. 4281) to amend
title I of the Employee Retirement Income Security Act of
1974 to improve access and choice for entrepreneurs with
small businesses with respect to medical care for their
employees. The bill shall be considered as read for
amendment. The previous question shall be considered as
ordered on the bill and on any amendment thereto to final
passage without intervening motion except: (1) one hour of
debate on the bill equally divided and controlled by the
chairman and ranking minority member of the Committee on
Education and the Workforce; (2) the amendment in the nature
of a substitute printed in part B of the report of the
Committee on Rules, if offered by Representative Kind of
Wisconsin or his designee, which shall be in order without
intervention of any point of order, shall be considered as
read, and shall be separately debatable for one hour equally
divided and controlled by the proponent and an opponent; and
(3) one motion to recommit with or without instructions.
Sec. 4. (a) In the engrossment of H.R. 4279, the Clerk
shall--
(1) await the disposition of H.R. 4280 and H.R. 4281;
(2) add the respective texts of H.R. 4280 and H.R. 4281, as
passed by the House, as new matter at the end of H.R. 4279;
(3) conform the title of H.R. 4279 to reflect the addition
of the text of H.R. 4280 or H.R. 4281 to the engrossment;
(4) assign appropriate designations to provisions within
the engrossment; and
(5) conform provisions for short titles within the
engrossment.
(b) Upon the addition of the text of H.R. 4280 or H.R. 4281
to the engrossment of H.R. 4279, H.R. 4280 or H.R. 4281 (as
the case may be) shall be laid on the table.
(c) If H.R. 4279 is disposed of without reaching the stage
of engrossment as contemplated in subsection (a), H.R. 4280
shall be treated in the manner specified for H.R. 4279 in
subsections (a) and (b), and only H.R. 4281 shall be laid on
the table.
The SPEAKER pro tempore. The gentlewoman from Ohio (Ms. Pryce) is
recognized for 1 hour.
Ms. PRYCE of Ohio. Mr. Speaker, for the purpose of debate only, I
yield the customary 30 minutes to my colleague and friend, 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 only.
Mr. Speaker, H. Res. 638 provides for separate consideration of three
different measures. The rule provides that when these measures are
agreed to, each will be engrossed as one bill and sent to the other
body.
Mr. Speaker, this week communities across this country are
participating in activities associated with Cover the Uninsured Week.
Why? Well, because almost 44 million Americans have zero health
insurance.
These 44 million Americans live in sleepy towns and bustling towns
all across America in each and every one of our districts. They are
children and adults. They are families. The majority are hardworking
men and women just trying to make a living, provide for their families
and offer their children opportunities they may never have had.
Yet nearly 44 million of our constituents are living every day
without health insurance coverage. They are living without the security
of knowing that they have a family doctor to call upon when they are
sick and when it comes to time for their annual checkup. They are
living without the security of knowing that when their child is ill,
whether it is just a bad bug or a life-threatening ailment, they can
access emergency care or see a specialist.
Without a doubt, the major reason people do not have health insurance
is because they simply cannot afford it. In fact, 71 percent of the
uninsured forego health insurance because of the cost.
As I have come to find, for every 1 percent increase in health
insurance premiums, 300,000 more individuals go without health
insurance. Whether in the halls of Congress, at the Washington think
tanks, among not-for-profit organizations, in the boardrooms of
businesses or at the corner coffee shops, everyone is talking about
what they believe is the remedy to one of the toughest questions ever
asked: How do we stop sky-rocketing health insurance costs and get more
people insured?
Quite frankly, I think we have talked long enough. Mr. Speaker, it is
time we place on the table the best market-based solutions to provide
more Americans with access to quality and affordable health care. So
here we are.
Today and tomorrow, this House will debate and consider three
legislative solutions. These steps in the right direction will address
this larger challenge by focusing on the three major pieces to the
puzzle: access, quality and affordability.
The rule we are debating today will allow us to consider legislation
to improve upon and strengthen flexible spending accounts, address the
sky-rocketing costs of medical liability insurance, and allow small
businesses to join together through association health plans.
As I begin to talk in greater detail about each of these initiatives,
they may sound rather familiar to my colleagues and to those watching
C-SPAN this morning. That is because the House has already considered
each of these initiatives in one way, shape or form already, but so far
they are going nowhere in the other body. So let us give them one more
opportunity.
The first part of our health security plan will improve upon and
strengthen flexible spending accounts or FSAs. FSAs allow workers to
put money from their paychecks into an account, tax free, to pay for
health care expenses. Employees spend this money on health services,
giving them responsibility over their own health care decisions and
spending.
While FSAs are a great concept and have worked well under current
law, the money contributed by employees have actually forfeited to the
employer at the end of the year if it is not used. That means use it or
lose it.
Our plan would allow up to $500 of that money to be carried over into
the following year. If an employee gets to keep $500 in unused money,
they will have a greater incentive to make wise decisions about their
spending.
Mr. Speaker, we see a barrier standing in the way of access to
quality and affordable health care so we are trying to knock it down.
It is a solution.
In the second part of our plan, we will revisit a critical initiative
to address a growing and dangerous problem in our legal system that
impacts each and every one of us, if not today, then tomorrow or in the
future. I am talking about our medical liability system, a system that
must be reformed if health care in America is to remain affordable.
The medical liability crisis in America is virtually everywhere, but
one of the places that we are seeing the most frightening and tangible
effects of this crisis is in the area of prenatal care and delivery.
This crisis is turning the very necessary treatment of prenatal care
into a luxury, sometimes totally unavailable to far too many women.
{time} 1045
It is estimated that about one in 10 obstetricians nationwide have
actually stopped delivering babies. The crisis is most acute in rural
areas where obstetricians are already in short supply. In my State of
Ohio, professional liability insurance premiums have increased by 60
percent in the past 2 years. Sixty percent. According to a recent
survey, more than 58 percent of responding Ohio OB-GYNs have been
forced to make changes to their practice, such as quitting obstetrics
all together, retiring, or relocating because of the unaffordability
and unavailability of medical liability insurance. Fifty-eight percent
of Ohio's obstetricians.
These statistics reflect the reality of real people in our cities and
towns who are cutting back their practices or closing up all together.
Just last month, an article ran in my local paper about a baby doctor
in Columbus, Ohio, facing the prospect of a third year in which he and
his OB-GYN partners have seen their malpractice insurance rise by 40
percent or more. He is leaving his practice to teach residents at the
local hospital. His two other partners are leaving too, one to an early
retirement and the other to Utah, where she will not have to pay
malpractice premiums as large as the ones in Ohio. They say they do not
have a choice, they have to leave. Together, just this one practice
will leave 4,500 patients looking for new doctors. That is 4,500 women
who have relied on these talented doctors for years, in just this
single practice, with no one to turn to.
[[Page H2823]]
One of these women is 7 months pregnant with her fourth child. At 7
months along, she is looking for another doctor to deliver her baby.
This example is not uncommon to my State. It is not only affecting
the doctors who currently practice, but it is affecting future doctors
and patients. Recently, the chairman of an OB-GYN residency department
in Ohio said he is even unable to train future OB-GYNs. He said that
due to high liability premiums, it is difficult to find faculty to
teach obstetrics residents. When counseling his students, he encourages
them to still choose obstetrics as a profession, but now he offers a
warning: just pick the right State, a State with good medical liability
reforms. He also said in the past 2 years not a single one of his OB-
GYN residents set up practice in Ohio.
The strides our country has made in reducing maternal and infant
mortality rates through quality prenatal care are now being
jeopardized. Across America, too many expectant moms are foregoing
essential prenatal care, and they are asking, who will deliver my baby?
I am concerned that without a change, the future of pregnant women's
health is in serious jeopardy.
The American people are fed up with abusive personal injury
practices, aggravating frivolous lawsuits, and a health care system
that is getting more expensive and less accessible as a result. That is
why we are here today. That is why we must pass this important
initiative. The Congressional Budget Office estimates that when our
plan is enacted, premiums for medical malpractice insurance ultimately
would be an average of 25 to 30 percent less than they are now.
Mr. Speaker, we see a barrier standing in the way of access to
quality and affordability in health care, so we are trying to knock it
down. It is a solution.
And the third piece of our puzzle will help address skyrocketing
health care costs where they hurt the most, small businesses. When you
consider that small businesses employ 50 percent of employees across
our country, it is troubling to learn that 60 percent of the uninsured
work for small businesses. They are uninsured because small business
owners cannot afford to pay the cost of health insurance for their
workers. The Small Business Health Fairness Act brings the benefits
enjoyed by corporate America to these small businesses.
This important initiative will allow small businesses to create
association health plans, or AHPs. AHPs will enable small businesses to
join together through existing trade associations to purchase health
insurance for their workers at a lower cost than what is available to
them now. It is the wholesale strength-in-numbers approach that will
allow these groups of small businesses to band together to negotiate
for lower prices on health insurance than individual employees could
secure on their own.
AHPs will save small businesses an average of 13 percent on their
employee health care costs, which means more small business employees
will have access to affordable health care coverage. And there is no
question that 13 percent will be better spent by employers expanding
their businesses by hiring unemployed Americans.
Mr. Speaker, once again we see a barrier stand in the way of access
to quality and affordable health care, so we are trying to knock it
down. Once again, it is a solution.
We have laid our common-sense solutions on the table, and now it is
time to put them to work. I urge my colleagues to join me in
implementing these critical initiatives that will help control the cost
of health care in this country.
Mr. Speaker, I reserve the balance of my time.
Ms. SLAUGHTER. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, two wrongs do not make a right, and three wrongs do not
make a right, and passing bad legislation a second and third time will
not make it a good bill. And I do not believe the Senate is going to
like it a bit better. As a matter of fact, if the problem is the United
States Senate, the other body, it would seem to me that we could take
the bill over to the other body and find out exactly what the problem
is and not take the time of the House over and over passing a bill that
will go nowhere.
Last year, the House considered and passed the legislation that is
identical to two of the bills considered under the rule, and I do not
believe the people of this great Nation sent us here to change the
number on a bill and pass it again during the same Congress.
Instead of playing these legislative games, we should be working on
the grave issues that face this country. Americans are out of work, the
Federal deficit is reaching all-time highs, American troops are in even
greater danger in Iraq, the serious abuses of Iraqi prisoners and the
failure to find weapons of mass destruction in Iraq should be
aggressively investigated, and our hard-earned reputation and
relationships throughout the world are in a shambles. So why, Mr.
Speaker, are we on the floor of the people's House doing the same thing
we did last year?
Why are we wasting valuable time reconsidering the bills that were
passed and sent to the other body? The bills do nothing to help the
more than 40 million uninsured Americans. It is shameful, with so many
issues facing this Nation, that so many pieces of good legislation
languish while we waste valuable floor time on bills that have already
been passed and are not expired.
Why are we not considering bipartisan legislation to expand access to
preventive health care services and to education programs that help to
reduce unintended pregnancies, reduce infections of sexually
transmitted diseases? And why are we not considering legislation that
would allow children of deployed servicemembers to remain at their
public schools in the event of a temporary residences change? Why do we
not consider legislation to keep law enforcement uniforms out of the
hands of criminals and terrorists? Why are we not on the floor debating
and passing important bipartisan genetic nondiscrimination legislation?
This replay game is not even an effort to improve the earlier work.
The bills are not new and improved. Last year's medical malpractice
legislation was considered under a closed rule, and this year the same
malpractice legislation is subject to a closed rule. In the Committee
on Rules hearing on each of the medical malpractice bills, Democrats
offered a total of 39 amendments. Zero were made in order. Last year,
the rule on the association health plans, the AHP bill, was
restrictive, allowing only one amendment. This year, the same AHP bill
with a new number is subject to a restrictive rule and again only one
amendment is made in order.
I make the point again, Mr. Speaker, there is no change in the bill
that has already passed the House.
Mr. Speaker, it does not help the millions of uninsured Americans at
all. The wealthy are able to take advantage of the health savings
accounts, but the poor are not. The uninsured will continue to be the
uninsured.
H.R. 4281 suffers from the same fatal maladies as last year's bill
creating the AHPs. The Congressional Budget Office found that under
this proposal, now this is very important, the Congressional Budget
Office found that under the proposal passed that the premiums would
increase for 80 percent of workers in small firms, and that 100,000 of
the sickest workers would lose coverage all together.
The bill would eliminate the protection of over 1,000 State consumer
protection laws and vital State oversight. AHPs are likely to
destabilize the health insurance market. Over 850 organizations oppose
this legislation, including the National Governors' Association, the
National Conference of State Legislators, and the National Association
of Insurance Commissioners.
The cure offered by the same medical malpractice bill is worse than
the disease. Just like last year's bill, the bill ignores the major
player in rising malpractice insurance premiums: the insurance
corporations. Why we do that, I do not know; but they are continually
left out of this equation. Proponents want to blame the jury awards for
rising insurance premiums, but a study by Americans for Insurance
Reform reported that rising insurance premiums are in no way tied to
jury awards.
Nothing in the bill requires the insurance corporations to lower
premiums for medical malpractice insurance. Nothing in this bill
requires the insurance companies to pass along to the physicians any
savings the corporations might gain from this legislation.
[[Page H2824]]
And, disappointingly, nothing in this bill gets rid of incompetent
doctors.
Statistics say that 5 percent of doctors are responsible for 54
percent of all medical malpractice claims paid. Logic cries out that
those 5 percent of doctors be dealt with. Now, this legislation
punishes injured patients with valuable claims against negligent or
reckless physicians and allows repeatedly reckless doctors to continue
to practice medicine. We should weed out the 5 percent of physicians
causing most of the harm and who force the insurance to pay again and
again for their mistakes.
We should stop playing games and consider legislation that will
really help patients and that will really aid the doctors in providing
quality health care. What we need is a reasonable regulation of the
insurance industry, aggressive removal of bad doctors, and affordable
prescription drugs.
Mr. Speaker, my concern goes beyond this obvious waste of time and
resources and the poor substance of these three bills. Once again, the
House is denied the opportunity to engage in full and open debate.
Members are being muzzled. This abuse of process is becoming the norm
rather than the exception.
Excluding H. Res. 638, the Committee on Rules has produced 22 rules
this year: one open rule, 14 restrictive, five closed, and two
procedurals. Debate is narrowed and stifled. Amendments and policy
alternatives routinely are made out of order and not allowed on the
floor. The body is elected to deliberate and debate, but the process is
becoming much less democratic and much less deliberative.
This abuse of power and process harms this institution and does
nothing to help the over 40 million Americans without health care
insurance. Reconsideration and repassage of these bills is a
meaningless exhibition of political theater, and I urge my colleagues
to vote ``no'' on this rule so the House can get down to some serious
work on behalf of the American people.
I must also say, Mr. Speaker, that I am particularly aggrieved at the
portion of this bill that allows the pharmaceutical companies and the
producers of medical devices to get off without being sued.
Mr. Speaker, I reserve the balance of my time.
Ms. PRYCE of Ohio. Mr. Speaker, I am very pleased to yield 2 minutes
to the gentlewoman from West Virginia (Mrs. Capito), who has such a
passion for health care concerns for her constituents.
Mrs. CAPITO. Mr. Speaker, I wish to speak about the medical liability
reform bill.
Being from a State like West Virginia, we have been in crisis for
many years, and I am exceedingly frustrated that we are not able to
pass this bill and get it to the President for signature. We have
passed this bill seven times, while our colleagues in the other Chamber
have not acted on this. As a result, we are a Nation faced with torts
gone wild.
Mr. Speaker, the medical liability crisis our Nation is faced with is
not a recent development. It has been an ever-present problem of
varying degrees over the last 3 decades. Some States, like California,
have been proactive and enacted tort reforms 3 decades ago. The
California reforms, commonly referred to as MICRA, resulted in
significantly limiting the increase in medical liability premiums as
compared to the rest of the Nation.
The other States' premiums have risen over three times as much as
those in California. Doctors are retiring, moving, and throwing up
their hands in frustration across this land. Access, affordability, and
quality of our health care is at stake.
Mr. Speaker, some State legislatures have acted recently to change
their respective tort law system for medical liability claims. I am
proud to say my own State of West Virginia has been a leader in this.
However, this much-needed reform is now vulnerable to judicial review
and can be ruled unconstitutional.
Other States, like Pennsylvania, are specifically prohibited by their
State constitution from considering such reforms. Mr. Speaker, this is
why a Federal reform is so desperately needed. This reform will defer
to State tort law where it is present, but will serve as a backstop for
States where the respective State supreme court rules against the new
laws.
{time} 1100
Mr. Speaker, it is time to take control of the health care costs that
are spiraling out of control due to a legal system gone wild. Our
Nation's health care is at risk.
Ms. SLAUGHTER. Mr. Speaker, I yield 6\1/2\ minutes to the gentleman
from Ohio (Mr. Brown).
Mr. BROWN of Ohio. Mr. Speaker, I thank the gentlewoman for yielding
me this time. I am almost a little embarrassed to be here today. This
country is dealing with serious problems in Iraq, this country is
dealing with serious unemployment problems. In Ohio, we have lost 1 out
of 6 manufacturing jobs. This country is facing incredible confusion
with the new Medicare bill and seniors are sorting through 50 Medicare
cards to get a 10 or 15 percent discount while drug prices go up 15 or
20 percent a year, yet we are here today to debate issues which have
already passed in the House and bills that clearly will not make a dent
in the problem of the uninsured, the 40 some million uninsured.
Instead of debating proven solutions, solutions that we know will
work, but solutions that just might, they just might hurt the drug
industry and the insurance industry, they might be bills the insurance
companies do not like, instead of working on bills that expand access
to health insurance, the Republican leadership has chosen to pat itself
on the back. They are frittering away the Cover the Uninsured Week by
reconsidering bills which have already passed this House, bills that
cater to the insurance industry, some of the biggest contributors to
President Bush and the Republican Party, bills that give away the
Federal Treasury to the drug industry, industries that give tens of
millions of dollars to Republican leadership and to President Bush, and
bills that help the HMO industry by sheltering them from liability.
These bills will not necessarily reduce the number of uninsured, but
we know they will undermine hard-fought State insurance laws, they will
cover some small number of employers at the expense of others, they
will provide tax shelters to people who already have coverage, and they
will perpetuate the type of high-deductible coverage that actually
discourages people from seeking preventive care.
Republican leadership will spend this week, Cover the Uninsured Week,
trying to cull out the uninsured issue so they can hand out more tax
breaks to their HMO and insurance companies and prescription drug
company contributors and butter up more of their campaign contributors.
The President's budget does not spend a dime on the uninsured, but it
will cut $24 million from the Medicaid program, clearly a program that
works and which has helped millions of America's elderly and poor
families.
The President's plan will increase the number of uninsured. My
Republican colleagues would also cut the Medicaid program by billions,
stripping health insurance coverage from the most vulnerable among us.
So let me see, the Republican bills protect the drug companies and
the HMOs from harm they cause their patients, they destabilize the
entire small group insurance market to buck State insurance laws, and
they give tax breaks to the already insured. I am sure none of this has
anything to do with the fact this is an election year, President Bush
is out raising $200 million, Republican leadership is trying to equal
that amount of money, and so much of it comes from the drug industry,
the insurance industry and the HMOs.
Now, this is my Republican friend's response to the fact that 43
million people in this country are uninsured. It is outrageous that we
are voting for a second time on these issues. It is not just futile;
frankly, it is shameful.
The other side of the aisle were talking about the malpractice crisis
for physicians which is very real in many places. The gentlewoman from
New York said this bill has liability protections, not just helping the
doctors but for the drug industry?
Ms. SLAUGHTER. Mr. Speaker, will the gentleman yield?
Mr. BROWN of Ohio. I yield to the gentlewoman from New York.
Ms. SLAUGHTER. Not only for the drug industry, Mr. Speaker, but for
the
[[Page H2825]]
people who manufacture medical devices. I know that is hard to believe,
given that the drug companies just cleaned up from the Medicare bill
passed here, but they are indemnified in this bill if the FDA has
approved what they are doing.
Mr. Speaker, this is the same FDA that just last week threw science
overboard and declined to approve a drug that has been found safe in 36
countries and by 24 of 29 scientists that studied it for the FDA. I do
not trust the FDA anymore. But the FDA gives it approval, and then says
citizens will have no recourse.
Mr. BROWN of Ohio. So to make sure I understand this, the FDA, the
same FDA that has begun to throw overboard science, the same FDA that
is clamping down on Americans going to Canada for less expensive drugs,
the same FDA that approves prescription drugs, if they approve them,
this FDA which is way too controlled by the drug industry, which is
controlled and influenced by the drug industry, if they approve a new
drug, even if that drug is found to be unsafe and injures hundreds of
thousands of people, there is no liability? There is no way to bring
suit?
Ms. SLAUGHTER. Mr. Speaker, if the gentleman would continue to yield,
there is no punitive damage; none. In addition to that, just last week
it was reported that science in the United States is falling
considerably behind. We are no longer the leaders. This is the same
leading by this FDA. I am very sorry to see that in this bill, and I
believe most Americans will not approve it being in this bill. Frankly,
I hope the Senate will again refuse to take it up.
Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, buttressed by our colleagues in the other body who are
holding all these bills hostages, certainly they would like to have us
give up, but when 58 percent of the OB-GYNs in Ohio are changing or
leaving their practices, it is exactly the right time to turn up heat
on these bills, and that is exactly what we are doing.
Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from Texas (Mr.
Sam Johnson).
Mr. SAM JOHNSON of Texas. Mr. Speaker, I am appalled at some of the
rhetoric going on around here. The FDA is doing a good job. The FDA is
controlling drugs. I have seen drugs out of Canada that are not good,
so I think they are doing a good job.
Mr. Speaker, I want to say I am here today to support the rule for
H.R. 4280, the Small Business Health Fairness Act. The state of health
care in America is reaching a crisis level. Costs continue to escalate
annually at unprecedented rates. Our employers are being forced to drop
health care coverage. This disproportionately affects small businesses
burdened with shopping for health insurance in the costly small group
markets. Large employers bring bargaining clout to the table when they
work with insurance companies. Small businesses have fewer employees,
and thus have little or no bargaining power. Not only that, but large
employers and unions are exempt from burdensome State mandates already.
These mandates dictate what health plans must cover and vary from State
to State. Small employers do not have that luxury.
We know that more than 60 percent of the uninsured Americans either
work for a small business or are dependent upon someone who does. The
clear course of action here is to help our small businesses afford
health coverage by giving them those same opportunities that unions and
large businesses have. Association health plans or AHPs do just that.
Small businesses would be able to group together in bona fide trade
associations. AHPs would then be able to use economies of scale to
their advantage and provide more affordable health care for working
families while avoiding administrative costs of State mandates.
According to the CBO, AHPs would save small business owners and their
employees as much as 25 percent on their health insurance.
I was pleased to see that the Senate task force on the uninsured
included association health plans in their report just this week. They
are not the only solution to the uninsured in America, but they are
certainly an important part of any solution. This is a bipartisan bill.
The time to act is now. I urge a yes vote on the rule and on the bill.
Ms. SLAUGHTER. Mr. Speaker, I yield 3 minutes to the gentleman from
Oregon (Mr. DeFazio).
Mr. DeFAZIO. Mr. Speaker, the previous gentleman would not yield to
my colleague, but it is the FDA's own assistant commissioner, Mr.
Hubbard, who said they have seen no unsafe drugs from Canada but have
found adulterated drugs in our relatively unregulated secondary
wholesale market. So the gentleman is wrong on that. He said he has
seen them. He ought to contact the FDA.
Mr. Speaker, there is some room for agreement here. There is a
problem in the affordability of insurance, health insurance for many
Americans and businesses, medical malpractice insurance for many
doctors. But guess what? It has spilled over into car insurance,
homeowners insurance, personal liability insurance. It seems to be a
big crisis in the health insurance industry. And is it that there is
this whole new tide of claims in these areas? No, it is because the
industry mismanaged its funds.
It is an industry that is exempt from antitrust laws of the United
States of America. They can and do collude to fix prices, redline
people, and choose who they want to cover and who they do not. So they
are sticking it to the docs and the American people and American
businesses who buy health insurance in all lines of insurance.
So one logical thing to do would be to subject the health insurance
industry to the same rules that every other industry in the United
States of America has to follow, make them follow antitrust laws, do
not allow them to collude to set prices. But since they are such
generous contributors to the other side of the aisle and to the
President, oh, no, we are not going to make them like other industries,
we are not going to make them competitive, let us give them a little
gift here. We are going to go after other ways of dealing with this
problem.
Of course, the other way of dealing with this problem is exactly the
same bill passed by the House of Representatives last year which is not
going to pass the Senate. So why are we here today? We are here today
because they want to remind their political contributors they did this
last year and they can do it again this year. The Senate is not going
to do it. They do not want to really legislate. They do not want to
come up with compromises that might pass.
There is a problem in affordability and access. There is a problem
for both citizens and for docs to get the health insurance that they
need. We are losing specialties. All those things are true, but their
conclusion is to bail out their friends, the HMOs, the pharmaceutical
companies, the insurance industry, not to help the docs, because there
is not going to be a bill, and not to help the American people get
affordable health insurance.
Mr. Speaker, there are better ways to deal with this problem. A
number of States have adopted things that are called soft caps. The
bill the other side of the aisle is trying to pass here today was
brought up by initiative petition in my State. We hear people in
America want this legislation. Guess what? In my State, which I think
is a pretty good cross-section, the initiative for hard caps at
$250,000 when people saw the egregious things that happen to some
people through negligence, was rejected 4 to 1. The other side of the
aisle is telling us the American people want this solution. No, the
American people want access to their doctors, and they want access to
affordable health insurance. But the other side is not going to do
either of those things today because it would go against the economic
interests of some of their most generous political contributors.
This is identical to legislation passed in the House of
Representatives last year, but here we are doing it again for political
purposes, not legislative purposes.
Ms. PRYCE of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman
from Washington (Mr. Nethercutt).
Mr. NETHERCUTT. Mr. Speaker, Washington State is facing a health care
crisis because medical liability lawsuits have run amok. We are one of
19 States in the country that is in a
[[Page H2826]]
health care crisis. We have lost 500 doctors because they could not
afford medical liability insurance in my State. What this means is
women who are seeking an OB-GYN in some of our communities cannot find
one to deliver their babies. That is a crisis. Emergency rooms are not
able to stay open 24 hours a day; that is a crisis. We are losing
doctors to Idaho, right across the line from my State.
As a member of the Medical Malpractice Crisis Task Force, I am
pleased to support H.R. 4280, the Health Act, and pleased to support
the rule. It is the right thing to do. There is every reason in the
world that critics of any reform can try to give to mask the concept
that we have to address the issue of medical liability reform first. We
will not do that until we pass a bill in this House and we pass a bill
in the other body so there can be communication and discussion and
resolution of this problem.
{time} 1115
To do nothing does not solve the problem, Mr. Speaker. So I am
pleased that this HEALTH Act is being brought up again. We have to make
sure we establish again and again and again the commitment of the House
to medical liability reform, because doctors, hospitals, nurses, and
patients are at risk if we do not change this system, modify this
system, reform this system with a commonsense proposal that will lower
costs and premiums so that doctors can stay in business. The damage
that is being done here is that we are losing very good physicians and
hospitals are at risk, risking closing, and also nurses are leaving the
practice. They are going elsewhere because they are concerned about the
liability insurance that they cannot get in States like mine. I urge my
colleagues, vote for this measure, vote again in this House to pass it.
Then let us urge the other body to adopt the same sort of commonsense
reform. We can do that. I urge my colleagues to support the rule and
the bill.
Ms. SLAUGHTER. Mr. Speaker, I yield 2 minutes to the gentleman from
Maryland (Mr. Cardin).
Mr. CARDIN. Mr. Speaker, first let me thank the gentlewoman from New
York for yielding me this time. I was listening to her comments. I just
want to concur in that this is a very unusual process. Once again we
are not going to have full debate and the opportunity to offer
amendments. Although we might be getting used to it because it seems to
be the norm around here, we should never be silent as to how this is
wrong. We should have an opportunity to offer amendments. We should
have an opportunity for an open process. We should have an opportunity
to debate a bill on its merits. And we are not going to get that
chance.
Mr. Speaker, let me mention just two matters that affect the people
that I represent in Maryland and the reason I took this time. First, I
agree with the previous speaker on this side of the aisle that we
should be doing something to bring down the cost of prescription
medicines in this country. That is why I will vote against ordering the
previous question, because I think we should have a debate on the floor
dealing with the cost of medicines which is still the number one
problem that I hear when I go to my town hall meetings. The second
issue deals with these association health plans. I went to the
Committee on Rules and asked for an amendment that would exempt States
from these association health plans if the State requested it and they
had a small-market reform which already provided help for their small
businesses. In my State of Maryland, the adoption of the association
health plans will actually be counterproductive. There will be fewer
companies that will be offering health care benefits than there are
today. That is why Governor Ehrlich has opposed that plan and many
other Governors around the Nation have done the same. But I am not even
going to have an opportunity to offer that amendment that would give
the States the opportunity to continue their initiative. After all, I
thought we believed in States rights here and the ability of States to
be able to move forward with initiatives to cover their uninsured. But
no, this bill works just the opposite. That is why many of our States
we have heard from would oppose the association health plans in the way
that it is currently drafted.
Mr. Speaker, I regret that the Committee on Rules did not allow that
amendment to be made in order nor did they allow any amendment to be
made in order. That is not the way that we should be operating in this
body. It does not speak to the democratic process. Therefore, I would
oppose the rule.
Ms. PRYCE of Ohio. Mr. Speaker, I am very pleased to yield 3 minutes
to the gentleman from Florida (Mr. Weldon), who, as a doctor, has
personal knowledge of how this stuff works.
Mr. WELDON of Florida. Mr. Speaker, I thank the gentlewoman for
yielding me this time. Yes, I do confess to being a doctor. I practiced
medicine for 15 years before I was elected to the House of
Representatives. I still see patients. I see them once a month. I want
to address the issue in this rule of medical malpractice reform. A lot
of people when they debate the issues surrounding the need for medical
malpractice reform and reining in all of these plaintiffs' attorneys
who are advertising on television, a lot of focus is on the size of the
judgments and the costs, the legal fees associated with this system.
But the real burden on our health care system is the high cost of
defensive medicine.
What is defensive medicine? I can tell you exactly what defensive
medicine is because I practiced it for 15 years. I spent daily between
$300 and $3,000 a day unnecessarily. Primary care providers, they do
not like to talk about this because it gets them in trouble with their
insurance companies, not with their medical malpractice insurance
companies but with the Blue Cross/Blue Shields and the Aetnas. The
executives of those companies, if they hear doctors saying that they
are spending money unnecessarily, they get very upset and they try to
clamp down on it.
But how does it work? You come in and you have a headache, you have
just lost your job or you have got problems at home. You order a CAT
scan, anyway, just because you are worried that you might miss
something. And you see the next patient and you are worried about this.
Some of you may listen to me and say, oh, this is just rhetoric, this
is just hot air. This has been studied scientifically. They studied it
in California. They studied it before and after the medical malpractice
reforms went through. They discovered that just in the Medicare plan
alone that for one diagnosis of heart disease, we are probably spending
in excess of $600 million a year unnecessarily just within Medicare,
just within one disease, because of defensive medicine.
They passed medical malpractice reform in California. They looked at
a reduction in costs with no increased incidence of complications, what
we call morbidity and mortality. In other words, quality stayed the
same and costs went down. The only way to explain that, the researchers
said, is a reduction in defensive medicine. What does this mean? This
means if you want to save Medicare money so we can afford prescription
drugs, pass medical malpractice reform. If you want to reduce the
number of uninsured, pass medical malpractice reform. If you want to
reduce the cost of health insurance for American businesses so they can
be more competitive in the international marketplace, pass medical
malpractice reform.
Ms. SLAUGHTER. Mr. Speaker, I yield myself 1 minute. CBO reports that
proponents of limiting malpractice liability argue greater savings in
health care, possible through reductions in practice of defensive
medicine. However, the defensive medicine is motivated less by
liability than by the physicians, by the money it generates for them.
And on the basis of existing studies and its own research, the
Congressional Budget Office says savings from reducing defensive
medicine would be very small.
Also, there is no evidence that restriction on tort liability reduced
medical spending.
Mr. Speaker, I am pleased to yield 3 minutes to the gentleman from
Illinois (Mr. Emanuel).
Mr. EMANUEL. Mr. Speaker, I thank the gentlewoman from New York for
yielding me this time. I rise in strong support of the motion of the
gentleman from Texas (Mr. Frost) to move the previous question and
allow a vote on the two bills that are essential to lowering health
care costs and helping
[[Page H2827]]
Americans afford their prescription drugs.
I would like to note the irony that today in the House of
Representatives we are dealing with health care, the Senate is dealing
with health care, and Senator Kerry is dealing with the issue of the
uninsured and health care. The only person missing from this debate is
the President of the United States, who still lacks an agenda as it
relates to health care.
As we are focusing on health care costs, for the last 6 years the
cost of prescription drugs in this country have gone up on average 18
percent. This year alone they are going to go up 18 percent. They are
projected to go up next year 20 percent. That is five times the rate of
inflation. The two bills that this motion would bring up on the floor
would make an immediate and lasting impact on the cost of prescription
drugs that our seniors are being asked to pay and our taxpayers are
being asked to also pay. People from around the world come to America
for their medical care. Yet Americans are forced to go around the world
for their medications. That is wrong, and we can do better.
Just recently, the CEOs of Walgreens and CVS now came out in favor of
allowing people to buy their drugs in Canada and in Europe. Secretary
of Health and Human Services Tommy Thompson, who has opposed it, now
supports allowing Americans to buy their prescription drugs in Canada
and in Europe. The Secretary of Health and Human Services uses Lipitor.
Where is that made? Ireland. The difference between that Lipitor that
he buys and the people in Canada and Europe is that in the United
States that costs 67 percent more here in the United States than it
does in Europe and Canada, yet it is made from the same factory in
Ireland and we import it into this country. It is distributed worldwide
from one country.
Last year alone we imported $14.5 billion worth of prescription
drugs. They are safe. The only thing different with those drugs from
anywhere else in the world is those drugs here in the United States at
our pharmacy cost 50 to 60 percent more here in the United States than
they do in Canada and in Europe. It is high time we bring competition
and choice to market and bring prices down. This legislation would
allow us to do that.
In addition to that, half the States in the country now have
legislation or some ability allowing people to buy prescription drugs
in Canada and Europe. Congress has passed this on a bipartisan basis.
It is not a Democrat-Republican issue. It is between right versus
wrong. It is high time we bring this legislation back up and give
people real financial relief from a cost where inflation is running 2
percent, prescription drug costs are running close to 20 percent each
year for the last 6 years. It is time we bring competition to bear on
the market and allow prices to drop through choice and through
competition.
I would hope that my colleagues on the other side, given that 83
Members voted for this, allow this legislation to bear so we can
finally force the other Chamber to allow prescription drugs prices to
be driven down. This is about cost, cost, cost. When somebody tells you
it is not about money, it is about money. The prescription drug
companies have a hold on this Congress. It is time we break the hold
and allow the voices of our constituents to be heard and the pressure
on their wallets to be relieved.
Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may
consume.
I may have misheard my colleague earlier when I thought she said that
CBO estimates on the premiums for medical malpractice insurance would
be very small. If that is the case, I am sorry, but let me just let the
record stand that CBO estimates predict that under this very act,
premiums for medical malpractice insurance ultimately would be an
average of 25 to 30 percent below what they are under current law.
Twenty-five to 30 percent below the premiums that we have currently is
not a small amount. It is very, very significant.
Mr. Speaker, I reserve the balance of my time.
Ms. SLAUGHTER. Mr. Speaker, let me yield myself 1 minute to respond
to my colleague who did misunderstand what I was saying. The speaker
had said that practicing defensive medicine was one of the reasons that
the costs were so high. What the CBO has said was that defensive
medicine is motivated less by liability concerns than the income it
generates for the physician. On the basis of CBO's own studies and
research, they believe that savings from reducing defensive medicine
would be very small.
Mr. Speaker, I am pleased to yield 2 minutes to the gentleman from
New Jersey (Mr. Pallone).
Mr. PALLONE. Mr. Speaker, I have been on the floor yesterday as well
as earlier today essentially pointing out that the Republicans who have
now said that this is the week of the uninsured, that somehow this is
the week they are going to pass legislation to help the uninsured are,
in fact, doing nothing of the kind. We face a health care crisis in
this country. It is a crisis that is based primarily on cost because
the cost of health care keeps going up and also because more and more
people have no health insurance. Nothing that is being presented in
these bills today and tomorrow is going to do anything major to bring
costs down for the patients or for those people who are now uninsured.
I oppose the rule because I think there should be an opportunity to
bring up some Democratic measures that would do exactly that, reduce
the costs of health care and also cover more people. Specifically, I
know it has already been mentioned with regard to cost, is the idea of
reimportation from Canada and other countries. We all know that that
saves the consumer money. Why not let us have an opportunity to bring
that up? The Republicans are wrong in not allowing it to be brought up.
Secondly, let us amend the Medicare prescription drug bill so that we
can have negotiated price reductions. Let the Medicare agency, let the
Federal Government negotiate prices to bring prices down. This is what
other countries do. This is what we do with our VA and with our
military. It is a way of lowering costs. But beyond that for the
uninsured, allow us as Democrats to bring up other measures. We have a
measure that would allow the nearly elderly, those who are over 55, not
yet eligible for Medicare, to buy into the Medicare program so that
they can be insured. That is the second largest group around this
country that have no health insurance right now.
In addition to that, we have a very successful bipartisan program
called S-CHIP that insures a lot of the kids around this country who
were uninsured. Let us amend that bill. Let us bring up an amendment
that would allow us to expand the S-CHIP program to cover the parents
of the kids. These are people that are working, they are lower-income
but they are working, and they cannot get health insurance on the job.
Let us also address the problem that small businesses have. The
Democrats have another proposal, a piece of legislation that would
increase what small businesses can do in terms of tax deductions if
they provide health care for their employees. The Republicans do not
allow us to do this. They are doing nothing to deal with the crisis of
health care in terms of cost and the uninsured.
Ms. SLAUGHTER. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I will be asking for a ``no'' vote on the previous
question. If the previous question is defeated, I will offer an
amendment to the rule that will allow the House to add two more
important health-related bills to this multibill rule.
{time} 1130
Since we are revoting on health initiatives that have already passed
the House in some form in this Congress, I think we should take this
opportunity to consider two other very important pieces of healthcare-
related legislation. My amendment would allow for the consideration of
a bipartisan drug reimportation legislation. If the purpose of this
rule and these bills is to restate our commitment to House-passed
health-related matters, this bill certainly deserves to be included. It
has been passed several times. Drug reimportation legislation would
provide relief for millions of Americans including the over 40 million
uninsured. The House overwhelmingly passed similar legislation last
year but it is worth
[[Page H2828]]
considering again, now that the Secretary of Health and Human Services
has said that he supports reimporting drugs from Canada.
The second bill would amend the Medicare Prescription Drug Act to
provide for negotiation of fair prices for Medicare prescription drugs.
I cannot think of a more important correction to the Medicare
prescription drug bill than fixing the irresponsible language in that
bill that prohibits the Federal Government from negotiating lower
prices for prescription drugs for our Nation's senior citizens.
Let me emphasize that a ``no'' vote on the previous question will not
stop consideration of the three bills already covered by the rule. It
will allow the House to add these two important health bills to this
multibill rule. However, a ``yes'' vote will block Members from
considering two more critical health initiatives. Again, I urge a
``no'' vote on the previous question.
Mr. Speaker, I ask unanimous consent that the text of the amendment
be printed in the Record immediately prior to the vote on the previous
question.
The SPEAKER pro tempore (Mr. LaHood). Is there objection to the
request of the gentlewoman from New York?
There was no objection.
Ms. SLAUGHTER. Mr. Speaker, I yield back the balance of my time.
Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I cannot stress enough the importance of moving forward
with these solution-based initiatives. We have a chance here now to
make a difference in the lives of hardworking Americans across this
great Nation. So let us put a stop to the politicizing of the plight of
the uninsured. Let us help the small business owners insure their
employees. Let us help Americans have more say about how their health
care dollars are spent. Let us help these pregnant women and their
babies who have no doctors to deliver them and care for them. Let us
help the 58 percent of OB-GYNs in Ohio that have to leave or change
their practices than stay in the profession they have chosen.
Mr. Speaker, I urge my colleagues in the strongest way to support
this rule and the underlying legislation.
Mr. COSTELLO. Mr. Speaker, I rise today to oppose the rule that
refuses to allow for an open debate or the ability to offer amendments
to the medical malpractice legislation brought to the floor today by
the Republican leadership.
We have a medical malpractice crisis in downstate Illinois. Doctors
are leaving the area at an alarming rate.
There is not a simple solution to this complex problem. Some believe
that restricting or capping damages that victims of malpractice receive
alone will solve the problem. Others believe that placing restrictions
on the insurance industry is the answer. There have been many studies
on the issue reaching conflicting conclusions on the cause of the
problem or the solution.
However, one thing is clear. If we do not have the ability to put all
of the issues on the table for consideration, and if we do not have the
ability to debate each issue and offer amendments on medical
malpractice legislation, we will not be able to solve the problem.
The bill before us today is identical to the bill passed by the House
that has been tied up in the Senate for months. The bill restricts or
caps damages that a victim of malpractice can receive. However, the
bill does nothing to restrict premiums that insurance companies can
charge doctors or health care providers. It does nothing to stop or
restrict the frivolous lawsuits that clog our court system and the bill
does nothing to establish an alternative arbitration system to settle
claims outside of the court system.
If we are serious about finding real solutions to the crisis rather
than scoring political points, the Republican leadership should allow
for open debate on all points of view and allow members to offer
amendments to the bill to be considered and vote them up or down.
Unfortunately, they have restricted debate on the bill and have
refused to allow any amendments to be offered, debated or considered.
It is--take it or leave it as is with little debate and no amendments--
no room to compromise.
I will vote no on the closed rule prohibiting amendments and
restricting debate, and I will vote to recommit the bill so that we can
come back to the floor with a bill that fully addresses all issues
putting everything on the table for consideration and adoption.
I urge my colleagues to join me.
Mrs. CHRISTENSEN. Mr. Speaker, the House today considered a rule
providing for the consideration of three bills that are intended to
solve our nation's insurance crisis which has reached epidemic
proportions. Today, an estimated 43 million in the United States have
no health insurance. About 60 percent of those, approximately 24
million, are employed by a small business or are a member of a family
whose income derives in some way from a small business. The
skyrocketing prices of malpractice liability is driving insurance
premiums up and making it impossible for employers of 500 or less
individuals to afford the high cost of health care.
The bills being debated today while seeking to address these issues
does so unfortunately, by providing the wrong solutions. Today, the
House will once again bring up a bill to create Associated Health Plans
(AHP). Providing a permanent solution to the uninsured is critical to
our nation's economy because Small Businesses, the engine of our
nation's economic growth because they create about 75 percent of new
jobs in America, deserve a sound and permanent solution to the
affordable health care.
Mr. Speaker I oppose the rule that will control the disposition of
these bills primarily because it does not provide for Democrats to
include their measures in solving the issue of the uninsured. The
proposed rule only makes in order a substitute amendment and not an
amendment to the underlying bill. Stacking the deck against the
Democratic efforts to ensure that the legislation has a sense of
balance and accurate in addressing the need of the American people.
Additionally, Mr. Speaker, I must also express my displeasure with
the majority's efforts to address the current malpractice crisis. As a
former family doctor I am fully aware of the feeling many doctors have
about being forced out of practice by very high insurance premiums. The
Republican bill, H.R. 4280 does not address the problem, however.
According to the Institute of Medicine, ``At least 44,000 and perhaps
as many as 98,000 Americans die in hospitals each year as a result of
medical errors. Deaths due to preventable adverse events exceed the
deaths attributable to motor vehicle accidents (43,458), breast cancer
(42,297) or AIDS (16,516).'' The IOM estimates annual costs to the
economy of medical errors between $17 billion and $29 billion. Congress
would better serve the public with legislation that promotes patient
safety, rather than overriding state-law deterrents that help prevent
patient deaths and injuries.
Instead of reducing the costs of medical malpractice and defective
products, the majority's approach would shift costs onto injured
individuals, their families, voluntary organizations and taxpayers. Not
only are the provisions unfair to victims, they also sacrifice the
principles of market economics and private property long professed by
the bill's conservative advocates.
Furthermore, punitive damages are rarely awarded in medical
malpractices cases, but the threat of punitive damages is important to
deterring reckless disregard for patient safety by HMOs, nursing homes,
and drug and medical device manufacturers. The $250,000 cap on non-
economic damages awards are for non-economic loss (pain and suffering
resulting from injuries such as lost child-bearing ability,
disfigurement, and paralysis) compensate for the human suffering caused
by medical negligence and defective medical products.
These damages generally account for 35 to 40 percent of a jury's
award. Typically, such damages exceed $250,000 only in cases of NAIC
Level 6 injury severity or higher--that is cases involving permanent
significant injuries. Thus, the cap will not affect patients with minor
injuries; instead, it targets only victims of injuries such as
deafness, blindness, loss of limb or organ, paraplegia, or severe brain
damage. Since the cap makes no allowance for inflation, its arbitrary
limits become more unjust as each day passes.
I implore my colleagues to reject this rule and H.R. 4280 and support
the Conyers-Dingle substitute. The Democratic substitute does not
restrict the rights of injured patients who file meritorious claims. It
requires certification, with civil penalties, that a pleading is not
frivolous, factually inaccurate or designed to harass. It includes a 3-
year statute of limitation; establishes an alternative dispute
resolution process; limits suits for punitive damages; and applies 50%
of awards from any punitive damages to a patient safety fund at HHS.
Finally, it requires insurance companies to develop a plan to give 50%
of their savings to reductions in medical malpractice rates for
doctors.
The Democratic substitute also addresses the causes of rising medical
malpractice insurance rates by creating a new commission to evaluate
the causes of the malpractice premium crisis and recommend solutions,
including a medical reinsurance program, risk distribution among health
providers and other changes that might avoid such increases in the
future.
[[Page H2829]]
Because experience has shown that capping damages will not lower
malpractice insurance rates for doctors, the Democratic substitute
promotes competition in the marketplace so doctors can get lower
insurance rates. The five states with the highest malpractice insurance
premiums in the country in 2002 already had damage caps. Only insurance
reform will help bring down rates. The Democratic substitute
specifically requires the newly created commission to study various
insurance reform proposals, particularly repealing the medical
malpractice insurance exemption under the McCarran-Ferguson Act (which
would foster competition).
Mr. Speaker, we need a real malpractice relief, I urge my colleagues
to put partisan gamesmanship aside and pass health legislation that our
nation is so badly in need of.
The material previously referred to by Ms. Slaughter is as follows:
Previous Question for H. Res. 638 Rule for H.R. 4279, H.R. 4280, & H.R.
4281
Strike section 4 and insert the following:
``Sec. 4. That upon the adoption of this resolution it
shall be in order without intervention of any point of order
to consider a bill consisting of the text of H.R. 2427, to
authorize the Secretary of Health and Human Services to
promulgate regulations for the reimportation of prescription
drugs, and for other purposes, as passed by the House. The
bill shall be considered as read for amendment. The previous
question shall be considered as ordered on the bill and on
any amendment thereto to final passage without intervening
motion except: (1) one hour of debate on the bill equally
divided and controlled by the chairman and ranking minority
member of the Committee on Energy and Commerce; (2) an
amendment in the nature of a substitute if offered by
Representative Dingell of Michigan or his designee, which
shall be in order without intervention of any point of order,
shall be considered as read, and shall be separately
debatable for one hour equally divided and controlled by the
proponent and an opponent; and (3) one motion to recommit
with or without instructions.
``Sec. 5. That upon the adoption of this resolution it
shall be in order to consider in the House the bill (H.R.
3672) to amend part D of title XVIII of the Social Security
Act, as added by the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003, to provide for negotiation of
fair prices for Medicare prescription drugs. The bill shall
be considered as read for amendment. The previous question
shall be considered as ordered on the bill and on any
amendment thereto to final passage without intervening motion
except: (1) one hour of debate on the bill equally divided
and controlled by the chairman and ranking minority member of
the Committee on Energy and Commerce; (2) an amendment in the
nature of a substitute if offered by Representative Dingell
of Michigan or his designee, which shall be in order without
intervention of any point of order, shall be considered as
read, and shall be separately debatable for one hour equally
divided and controlled by the proponent and an opponent; and
(3) one motion to recommit with or without instructions.
Sec. 6.(a) In the engrossment of H.R. 4279, the Clerk
shall--
1. await the disposition of all the bills contemplated in
sections 2-5;
2. add the respective texts of all the bills contemplated
in sections 2-5, as passed by the House, as new matter at the
end of H.R. 4279;
(3) conform the title of H.R. 4279 to reflect the addition
to the engrossment of the text of all the bill contemplated
in sections 2-5 that have passed the House;
(4) assign appropriate designations to provisions within
the engrossment; and
(5) conform provisions for short title within the
engrossment.
(b) Upon the addition of the text of the bills contemplated
in sections 2-5 that have passed the House to the engrossment
of H.R. 4279, such bills shall be laid on the table.
(c) If H.R. 4279 is disposed of without reaching the stage
of engrossment as contemplated in subsection (a), the bill
contemplated in section 2-5 that first passes the House shall
be treated in the manner specified for H.R. 4279 in
subsections (a) and (b), and all other bills contemplated in
sections 2-5 that have passed the House shall be laid on the
table.
Ms. PRYCE of Ohio. Mr. Speaker, I yield back the balance of my time,
and I move the previous question on the resolution.
The SPEAKER pro tempore. The question is on ordering the previous
question.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Ms. SLAUGHTER. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further
proceedings on this question will be postponed.
The point of no quorum is considered withdrawn.
____________________