[Congressional Record Volume 155, Number 113 (Friday, July 24, 2009)]
[Extensions of Remarks]
[Pages E1971-E1972]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  PHYSICIAN-OWNED HOSPITALS AND OTHER JACKSON-LEE PROPOSALS ON HEALTH 
                                  CARE

                                 ______
                                 

                        HON. SHEILA JACKSON-LEE

                                of texas

                    in the house of representatives

                        Thursday, July 23, 2009

  Ms. JACKSON-LEE of Texas. Madam Speaker, tonight, I come before you 
representing Texas' 18th Congressional District in Houston. As some of 
you know, my hometown of Houston is the 4th largest in the country. 
Houston is home to some of the nation's largest oil companies: Citgo 
North America, Conoco Phillips-North America, El Paso Corp., 
Halliburton, Kinder Morgan Energy, Marathon Oil Company, and Shell U.S. 
Oil Division. Yet as the economy has declined and the nation has begun 
to shift towards greener fuels, the petroleum business in my District 
and throughout Texas has also seen a decline.
  Today, my state of Texas is facing an unemployment rate of around 
7.5%, the highest it has been since in the past 16 years. Additionally, 
Texas lost 40,600 jobs last month alone. Thus, the six figure jobs 
common to Houston that have attracted people to my District from all 
over the country are being slashed. And as my constituents, many of 
them well-to-do middle income and upper income Americans, have lost 
their jobs and their businesses, they have also lost their health care.
  Truly, Madam Speaker, this issue of health care is not a poor 
people's problem it is an American problem. And thus, I rise today with 
my fellow members of the Congressional Progressive Caucus to urge all 
of my colleagues to get behind this health care bill and pass it before 
we leave for the August recess next week. Today, while I stand as a 
representative of Houston, I believe I represent hard working men and 
women, young and old who can't wait till after recess for health care. 
They risk bankruptcy and even the poor house because of the rising 
costs of health insurance. Some of them have cancer, some of them have 
diabetes, and some of them have simple tooth decay that requires a root 
canal. However, root canals are not covered by most basic health 
insurance plans. As such, some of them are now finding that their teeth 
have become infected and the infection has entered their blood stream 
and some of them now face terminal illness--all because they lack the 
health care that many of us in this body take for granted.
  Madam Speaker, my colleagues on the Republicans side have partnered 
with some insurance companies to misrepresent the facts about health 
care and are now using scare tactics to prevent the health care bill 
from being voted out of the Energy and Commerce Committee. These forces 
have pressured conservatives in the Democratic ranks to stall the 
process. The other side holds up the process of change while over 47 
million Americans remain uninsured, while Americans with health care 
pay as much as $207 billion excess in

[[Page E1972]]

health related taxes, and while hospitals and clinics around the 
country continue to shutter their doors.
  A brighter future is on the horizon with the health care bill now 
stalled in committee. Central to this bill is its public insurance 
option, which as the President said, is designed to keep the large 
insurance companies honest. And as my friend Michael Moore documented 
in his acclaimed film ``Sicko'' we cannot always trust our insurance 
companies. The Public Option, similar to Medicare, will provide a 
publicly driven health care system, unique to the U.S. and separate 
from what is in place in any other country. The program will ensure: 
(1) Early and periodic screening, diagnosis and treatment; (2) Case 
management for chronic diseases; (3) Dental and mental health services; 
(4) and even language access services.
  Though this health care plan solves many of our nation's health care 
woes, there are still more improvements that are needed. And I believe 
that the Democratic leadership is open to good ideas to improve this 
legislation, improvements from the Progressive Caucus, from the Blue 
Dogs, from the New Dems, and even from the Republicans.
  One of the ideas that I hope to work with Chairman Rangel, Health 
Subcommittee Chair Stark, Chairman Waxman and our leaders to address 
are ways to allow for the spread of good serving physician owned 
hospitals, many of which are caring for those with little to no 
insurance who would otherwise go underserved populations. And just what 
is a physician owned hospital . . . as its name implies, it's a 
hospital that has been started by, purchased by, or in some cases 
invested in by physicians. While some fear that such hospitals will 
allow physicians to skim off high end treatment and ignore routine 
procedures, I believe these concerns focus on only the few bad apples 
and not the lot of physicians who believe in their oath not to harm and 
to place people over profit.
  So where do we stand today with physician owned hospitals. Under the 
current version of the health reform bill, 104 physician owned 
hospitals under development, 42 of which are scheduled to come on line 
by the end of 2010, will have to shut down. These 104 hospitals at risk 
represent more than 20,000 new jobs which will be lost in 21 states, 
over 40 in my home state of Texas. At least $5 billion in current 
investments will be lost. It will also affect hospitals that were built 
to serve working men and women with little or no insurance. I and other 
Democrats and Republicans urge the leadership to change the bill by 
eliminating the retroactive date in the bill and ``grandfather'' all 
the existing hospitals with physician ownership, including the 104 
hospitals under development.
  In addition to threatening physician owned hospitals under 
development, the current bill also limits growth of existing physician 
owned hospitals. Of the 223 physician hospitals now in operation in 32 
states, only three would qualify to apply to the Secretary of HHS for 
permission to expand. The remainder of the hospitals would have future 
growth frozen and would likely close because they could no longer be 
responsive to the medical needs of patients, the community and 
physicians.
  My solution is to eliminate the conditions for growth in section 1156 
and the HHS application process, and allow ``grandfathered'' physician 
owned hospitals, including projects under development that qualify for 
the grandfather provision, to expand and respond to the expanded needs 
of the communities they serve.
  Finally, the current bill repeals the whole hospital exception in the 
Stark law, thus prohibiting physicians from investing in new hospitals 
that were not grandfathered. This provision aims to discourage 
entrepreneurship and risk taking in health care. However, I believe 
that there are doctors who can do good and do well at the same time. As 
such, I urge the leadership to amend the exception to allow physicians 
to invest in acute general care hospitals, hospitals that serve a 
significant population of the uninsured, or hospitals on the verge of 
bankruptcy where physicians are the only interested investors.
  Such was the case for St. Josephs Medical Center in my district. St. 
Joseph Medical Center is the first and only hospital in Downtown 
Houston--a metropolitan area that has grown to over 4 million. In 
August 2006, over 80 medical staff members out of the 500 on staff, 
elected to purchase a stake in the hospital to keep it from closing. 
Because of this partnership, St. Joseph Medical Center remains today as 
a viable institution, caring for hundreds of thousands of patients each 
year through the various services of this general, acute care, inner-
city hospital. Nearly 5,000 new Houstonians are born annually at this 
hospital--the first maternity hospital in Houston.
  St. Josephs remains the only hospital in Downtown Houston, and 
without it hundreds of thousands of individuals each year would not 
have a convenient place to go for their inpatient and outpatient care. 
With two medical towers adjacent to the campus, physicians' offices are 
close by, making this a one-stop shop for many who come downtown for 
their healthcare. Bus lines, rail lines, and two major freeways run 
right past the hospital, making it even more convenient for the 
populations that surround it--many of whom have limited or no 
transportation options.
  This model of physician partnership works and in addition, adds 1,800 
full time jobs to the Houston economy, pays millions in taxes and 
provides 40 million dollars of uncompensated care each year, and 
continues the traditions of the Sisters of Charity--to provide quality 
healthcare for all. This model saves hospitals in underserved areas and 
is part of the solution to the health care system problems, not the 
cause of them. Only to serve as ``buyers of last resort'' in 
communities that have a critical access problem and are otherwise 
providing good care to patients across the country. Thus, I look 
forward to working with the leadership to reward, not punish, such 
physician owned hospitals.
  Other good proposals that I'm recommending are:
  Grants to high schools and middle schools to increase health care 
professionals, particularly those in underserved communities;
  Providing incentives for the development of Community Health Care 
Centers that are housed in healthy green buildings;
  Tax credits for employers who not only offer good health care 
benefits but encourage their employees to utilize these benefits;
  A pilot program to study and demonstrate the benefits of proven 
alternative medical techniques and medicines; and
  A program to study this ongoing problem of people who seek to address 
depression or enhance athletic performance by abusing prescription 
drugs.
  Madam Speaker, I believe that these are good proposals and if adopted 
will improve the outstanding work done by our leaders. Furthermore, 
while I seek changes in the health reform bill, I'm not at all about to 
stand in the way of change, my goal is to inspire change. Moreover, I'm 
not going to succumb to scare tactics aimed to put politics over 
people, people who deserve health reform now, not next week, next 
month, or next year.

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