[Congressional Record Volume 156, Number 42 (Saturday, March 20, 2010)]
[House]
[Pages H1795-H1796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from Texas (Ms. Jackson Lee) is recognized for 5 minutes.
  Ms. JACKSON LEE of Texas. Mr. Speaker, I was on this floor just a 
moment ago, and I guess I am struck by this quote by Thomas Edison, 
because as I have listened to more of my colleagues, it seems as if 
they are driving themselves into failure and they just want to see this 
determined and committed number of Members who represent constituencies 
across America driven into failure as well. But it says: Many of life's 
failures are people who did not realize how close they were to success 
when they gave up.
  And so the stories that we have heard about a young 11-year-old who 
has the common sense to know that maybe his mother would have lived had 
she had the right kind of coverage, to my good friend who was just on 
the floor of the House and mentioned his constituents from his great 
State of Alabama, I don't know if that constituent that drove 900-plus 
miles realized that Alabama has one insurance company, only one, no 
competition.
  And so when we think about where we are today on the eve of that 
magnificent vote, this is not arrogance, it is not an attempt to have 
the majority abuse the minority. It is to reflect on those Americans 
who did not come, who in silence suffer and die because they have no 
insurance.
  I support this legislation, but there are fixes that I would like to 
have, and I am committed to working beyond the vote tomorrow. I don't 
like to see the comments that I have seen on signs. I respect it, 
because I am someone who appreciates the Constitution.
  There is no instruction or demand on people to get insurance that is 
unconstitutional. In States, we require people to buy auto insurance, 
get seat buckles, to wear helmets when they are riding on motorcycles. 
This is to save lives. And we provide incentives to small businesses 
and subsidies.
  And so today in the Rules Committee I submitted amendments, because I 
want to help a body of hospitals that are in rural and minority areas. 
My amendments had to do with what we call physician-owned hospitals. My 
first amendment was to preserve physician-owned facilities. They have a 
greater percentage of Medicaid inpatient admissions than the State 
average in operation and allows them to expand, a fix that is not 
illegal but one that we want to work on as we move forward.
  My second amendment is extremely critical for minority communities in 
high-poverty areas. This amendment would prevent physician safety-net 
hospitals from closing and preserves critical care access for 
impoverished communities and the disabled.
  My third amendment, that is supported by the Physician Hospital 
Association of America, would effectively prevent the closure of 230 
existing hospitals, save $2.9 billion in total payroll, $608 million in 
Federal taxes, $3.5 billion in trade payables, and preserves 62,000 
full- and part-time jobs, the Senate amendment, by striking all 
language that prohibits the grandfathered facilities from expanding.
  I am grateful for what we have done so far. We have extended the time 
in which these hospitals can receive their Medicare certificate, which 
means that more hospitals can come online. That is a good thing.
  That is why I understand that I am so close, that we are so close, to 
success, that I am not going to allow failure to destroy that success 
for millions of Americans.
  But I do want to tell you about St. Joseph's Hospital in Houston that 
was going to close until many of us intervened. In fact, I said 
something like, Over my dead body would this hospital close and not 
serve our constituents. Well, a group of doctors were able to invest, 
and lo and behold this hospital now serves one of the most income-
challenged and a hospital that serves in the African American 
community. Physician ownership provides an avenue for it to stay open.
  Or in south Texas an out-of-state corporation forced over 700,000 
Texans to travel more than 250 miles to receive life-saving medical 
procedures. Decisions not to offer needed services by out-of-state 
health care conglomerates and the lack of public or county hospitals 
left patients with two options: go without or transfer to another 
facility 350 miles away.
  So there is value to physician-owned hospitals, and one opened in 
south Texas and therefore stopped this drain of sick people having to 
drive 350 miles just to get medical care or hospitalization.

[[Page H1796]]

  Or in the Chinatown section of Los Angeles, the Pacific Alliance 
Medical Center is a 142-bed full-service hospital and has been the 
community's main hospital for 140 years. This facility was purchased by 
a group of physicians 20 years ago after the existing hospital board 
planned to close and demolish this facility. Throwing a lifeline, this 
is what these hospitals do.
  Or in Wisconsin, the Aurora Bay Care Medical Center, a 167-bed full-
service hospital, holds seven centers of excellence, and it was the 
first hospital in the country to become a designated emergency center.
  Or the Wenatchee Valley Medical Center established in 1940 in the 
State of Washington is a large rural health care center that helps 
serve patients in a largely rural area.
  There is a lot of good work that has already been done. This bill has 
been reviewed over and over again. So what my opponents say on the 
other side or the opponents of this bill, this bill has been on the 
table for a long time. We know that we can work going forward to make 
things better.
  So no amount of attack, being spat on by those who have come here to 
this place to show their opposition, or being called names is going to 
stop us from seeing success just down the road. But we want to work for 
these hospitals who are in rural and minority areas and poor areas to 
be able to stay open as well.
  I know that in working with my colleagues and moving to the other 
body we will have that opportunity. Why don't my friends on the other 
side sit down and work as well so that we can have what all America is 
crying out for, those who are listening and understanding the issue, 
that is, health care for all Americans. Not socialized medicine, not a 
government takeover, but the opportunity to see the good and the value 
of good health care for this great country of ours. I want to see 
success. I am not going to allow failure to get in the way of success.

  Mr. Speaker, I have three amendments at the desk and I rise to speak 
in support of my amendments No. 1, No. 2 and No. 3 to H.R. 4872, the 
Reconciliation Act of 2010. My first amendment would preserve 
physician-owned facilities that have a greater percentage of Medicaid 
Inpatient Admissions than the state average in operation and allows 
them to expand.
  My second amendment is extremely critical for minority communities 
and high poverty areas.
  This amendment would prevent physician safety-net hospitals from 
closing and preserves critical care access for impoverished communities 
and the disabled.
  My third amendment, supported by Physician Hospital Association of 
America, would effectively prevent the closure of 230 existing 
hospitals, save $2.9 billion in total payroll, $608 million in federal 
taxes, $3.5 billion in trade payables, and preserves 62,000 full- and 
part-time jobs by striking all language that prohibits grandfathered 
facilities from expanding.
  As you know during the ongoing healthcare debate, discussions about 
physician ownership of hospitals have ignored the positive impact these 
facilities have had on minority communities and minority physicians. 
Physician-owned general acute care hospitals, who have unprecedented 
amounts of minority owners, have allowed Hispanic, Black, and Asian 
Americans to enter into the field of hospital ownership. The largest 
physician-owned hospital, Doctors Hospital at Renaissance, is over 50 
percent minority owned.
  Physician-owned hospitals have created a positive change in the 
quality and delivery of care to minority populations.
  The insight gained by the diversification of hospital ownership has 
led to many new advances in care delivery and opened up untapped 
avenues and knowledge in the race to cure and/or prevent diabetes, 
AIDS, cancer, and other illnesses we all face.
  While we are pleased that language to grandfather existing physician 
hospitals has been included in the Senate Amendment package, this bill 
still contains language that prohibits these needed institutions from 
expanding. This prohibition will lead to their eventual closure and 
endanger hospital access for minority and low-income communities.
  Physician ownership has enabled high poverty and minority areas to 
open hospitals where corporate-owned facilities wanted to abandon a 
current site or refused to bring in needed services. By way of 
competition, physician hospitals have raised the bar of service in 
communities often ignored by large healthcare corporations, offer 
exceptional overall care, and forced all hospitals in an area to do 
better for their community.
  To help you understand what is stake, I would like to highlight some 
of these success stories:
  In Houston, St. Joseph's Hospital, a full service general acute care 
center, is the only hospital that serves one of the most income-
challenged and minority sections of the city. Within the last few 
years, a for-profit corporation abandoned this hospital and the 
surrounding community. Physician ownership provided an avenue for it 
stay open and prevent a critical loss for the neighborhood.
  In South Texas, out-of-state corporations forced over 700,000 Texans 
to travel more than 250 miles to receive life-saving medical 
procedures. Decisions not to offer needed services by out-of-state 
healthcare conglomerates and the lack of public or county hospitals, 
left patients with two options: go without or to transfer to another 
facility up to 350 miles away. Income challenged families who could not 
afford the travel were placed in great peril. Physician ownership 
enabled a group of local doctors to open a new hospital with advanced 
medical capabilities that reduced the need for travel to seek care. 
Doctors Hospital at Renaissance, a 506-bed premiere general acute care 
center, now provides some of the best care in the nation and 
consistently has been recognized by Thompson Reuters as a Top 100 
Hospital in the nation.
  In the Chinatown section of Los Angeles, California, the Pacific 
Alliance Medical Center (PAMC), a 142-bed full service hospital, has 
been the community's main hospital for 140 years. This facility was 
purchased by a group of physicians 20 years ago after the existing 
hospital board planned to close and demolish the facility. Physician 
ownership once again provided an avenue for the hospital to stay open 
and serve an at risk community.
  In Wisconsin, Aurora Baycare Medical Center, a 167-bed, full-service 
hospital hosts seven Centers of Excellence and was the first hospital 
in the country to become a designated Emergency Center of Excellence. 
The Women's Center at Aurora Baycare was also the first in Wisconsin to 
be accredited for breast care by the American College of Surgeons.
  Established in 1940, Wenatchee Valley Medical Center in the state of 
Washington, is a large rural healthcare delivery system that helps 
serve patient needs in a largely rural area. It has brought countless 
life-saving procedures to a community in need.
  Without physician ownership, the number of minority hospital owners 
will decrease substantially, low-income and minority communities will 
see a reduction in the amount of available services in their community, 
and some will be left with no access to hospitals. While this may sound 
extreme, unfortunately, it has happened and will happen if this measure 
is left unchanged. This is also extremely distressing since the effect 
of this section will be to reduce access while simultaneously adding 30 
million new Americans to the healthcare system, mostly in these very 
communities that will see their safety net hospitals close.
  While I support all physician-owned facilities and comprehensive 
efforts to incorporate everyone into our national hospital network, 
today I start that process by helping preserve physician-owned 
facilities that serve poor, disabled, indigent, or uninsured patients. 
These amendments were crafted with strict adherence to the 
reconciliation process and fully comply with the Byrd Rule.
  As a Member of Congress whose constituents are greatly assisted by 
physician-owned facilities, I urge my colleagues to--help my community, 
help my constituents, and help America build a better and inclusive 
health care system.

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