Personal Responsibility in Food Consumption Act of 2005

Mr. Speaker, I am joined by my colleagues this evening to talk about Children's Health Month. It is very important for all families in our Nation, and certainly an issue that concerns all of us on both sides of the aisle.

While the rhetoric of the House often echoes through these walls about cuts and people being harmed, it seems to me that is the only part of the discussion that we are taking away. Little offers are made in terms of what is needed.

What we do often hear is discussions of who is paying. Should individuals pay, insurance companies be taxed more, businesses be given tax cuts, perhaps health savings accounts, association health plans, or just have the Federal Government take over? But this should not just be an issue of who is paying, for although that is important, and how much we are paying is important, really much of this comes down to what we need to have is an open discussion of what we are paying for.

According to the National Center of Health Statistics, 83 percent of children in this country under 18 years of age have excellent to very good health. That is good news.

Now 17 percent of America's children are in less than favorable health, either to mild or severe levels. We have to make sure we do all we can to help these children have a better health future and help the rest remain healthy. According to the American Academy of Pediatrics, 6.3 million uninsured children, over two-thirds of all uninsured children in America, are currently eligible either for Medicaid or for the State health insurance programs, but they are not enrolled. There are many opportunities. I know the State of Pennsylvania, where I represent the 18th Congressional District, really has very good services and insurance for children of a low income level but we need to make sure that we expand enrollment and get those kids beyond. For those who are uninsured or underinsured but beyond the level of Medicaid, there are several things that we should be looking at to make sure that they get the health care they need to maintain their health to prevent higher expenses for emergency care.

But what this means is not just more discussions on we are cutting money out of Medicaid or other aspects. Look at what has happened to the growth of Medicaid. In 1995, and this is for all ages, Medicaid spent $150 billion. We are now up to $300 billion. About half of Americans are covered by some level of Federal insurance or health care. But the system is growing, and the concern is it is growing out of control.

While we are looking at such things as how do we pay for Hurricane Katrina's outcome in this devastated gulf region, how do we take care of so many needs, is it fair to just continue to say to the American people we are going to continue to spend more without finding ways of eliminating waste and fraud and abuse?

Let me give an example. The New York Times wrote recently about an amount of some $4.4 billion in Medicaid fraud in that State. One dentist billed for over 980 procedures in one day. Clearly these were patients that were actually being seen. Another company used van rides for supposedly disabled people, billing those rides to the government. But these people when followed by a reporter clearly were not disabled. They walked around just fine. There is example after example after example.

I believe the American taxpayer wants to make sure that this waste, this fraud, this abuse is removed from the health care system. But it is not just a matter of that. When it comes to our children, we also have to make sure the system works with these programs in ways that optimize the health and outcome.

One of the things that I want to talk about today, along with the gentleman from Georgia (Mr. Gingrey), is transforming our health care system. We oftentimes use a tongue-in-cheek quote around here that says one of the definitions of insanity is doing the same thing over and over again and expecting different results. Indeed, in the health care system where so much money is used inappropriately and wastefully, we ought to have some changes.

From the Center of Health Transformation, they say we have this current health care system and we are trying to come up with some reforms within the network. We try things like so much money is going to pay for diagnoses. We ask for some procedures to be done inpatient and outpatient, all within that system. What happens is if this system does not change, it will lead to some decay. The system cannot continue to go the way it is. Anyone who owns a small business or a household cannot continue to operate the way our health care system operates. When we go into hospitals, inpatient/outpatient, you will see the latest equipment, the greatest skilled personnel, MRIs, PT scans, CT scans, but very often we also see that data is kept on patients on pieces of paper. We have 21st century health technology kept on 16th century monitors. What happens, people slip through the cracks. The wrong prescriptions are ordered. Tests that are done have to be repeated because someone cannot get them.

I was talking to one of our colleagues today and he was telling me how a sonogram was done of his wife who is pregnant, but he cannot get it from here back home to his wife because he has to carry it manually. It cannot be e-mailed. We take e-mails for granted, but doctors have to wait for papers to transfer locations.

What happens? Can we come up with some real changes to really help our children? Yes, if we switch to an intelligent health system that uses electronic prescribing, electronic medical records, real patient care management for our children rather than having a system that gets bogged down and collapses of its own expense and weight, we can come up with success for our children and no longer be mired in failure.

Let me describe a little bit about what we mean by managing the whole patient. A lot of what people think happens when they have an individual or chronic disease is something common, like diabetes or asthma in a child, the doctor will examine and make sure that the child has the right medications, watches their diet and the environment around them, and hope all goes well. As long as the parents are monitoring that carefully and there is communication between doctor, nurse, patient and child, you can have a pretty good system. What happens if the information does not get to the parents, the patient education is not quite there? Maybe they skip a prescription, maybe they did not pick it up on time, maybe they do not fully understand all the elements of diet and medications for complicated diseases. What does that mean? You can end up with chronic diseases, repeat tests, many hospitalizations, emergency care may be required, increasing medications, going from doctor to doctor who may not know the other medications the child is on, leading to further risks, and all of this costs unnecessary money, unnecessary time in hospitals, increases the risk for harm, and what happens, we end up paying for it.

About 10 percent of the cases that show up in an emergency room are someone who has no ability to pay, but it is estimated that 60 percent or more, 60 percent or more of patients who show up in emergency departments are nonemergencies. If in such cases the care was given ahead of time, whether it is through a community health center, a clinic, direct patient care with a physician, if we monitored and kept a careful eye on those children with chronic conditions, we could save massive amounts of money.

This is not cutting care, it is improving care. Emergency care can cost five to eight times more than outpatient care, and we can actually save billions of dollars in the system. This is where we can find savings, and in so doing we save lives as well as money. But this means we use a chronic care model and not the inefficient going to a doctor, another disease, go to another doctor.

What this involves is not just the health system, it really involves the community, the resources. What takes place, the support systems, the families, the individuals helping to make sure they are watching their children, they are educated and they know what to do. It is making sure we have a delivery system involved with making sure doctors are notified if someone does not pick up their prescriptions. A lot of this can be done with electronic prescribing notification. It is making sure that clinical information systems are there so that if X-rays are done, procedures and tests are done, that information is communicated back to the doctor.

One study I looked at said something like 14 percent of the charts reviewed the physician found that they were missing some important data. Perhaps the physician referred the patient on to have some testing done, and it was never done. In the majority of these cases, the doctor said it would affect what diagnosis they had and future tests called for.

This is not a matter of just saying we are going to cut care, this is improving care. But this also means that clinical information systems must be there. They are a critical component of health care, of having the physician and nurse and family work together. What does that do? It is a matter of having productive interaction between everybody involved. You have an informed, active patient and you have a prepared, proactive practice team.

No longer the passive system, the doctor says here is your diagnosis, here is your prescription, good luck, call me if there is a problem. If that prescription is not filled, there is a call from the doctor. It is a system of interaction between the patient and doctor to make sure they are going back and forth.

Mr. Speaker, I am not talking about things that take place only in families that have access to computers and finances to do this. A lot of this is done in areas of low income levels, of high risk populations where we really find it is much more affordable. What we need to be looking at here as Congress is when we are reviewing such things as the Medicaid system, it is not just saying we are going to lop off $8 billion or $10 billion and see what happens. It is a matter of doing more effective work.

Much like a household that says our spending is going out of control, they do not just say let us not spend any more. Every small business and family does this. They look at what they are spending, but you have to change some of your habits and make habits more effective.

The system that seems to be adapting the slowest is our health care system, perhaps because we just keep doing the same thing over and over again and expecting different results.

What the Federal Government is going to do and what we are doing here in the Republican Conference is asking those questions and demanding some answers of changing some of that system.

What I would like to do is call upon the gentleman from Georgia (Mr. Gingrey), who as an obstetrician has worked with many families, particularly in the area of prenatal care. One of the critical areas in cutting costs and being more effective in health care is dealing with prenatal care in an effective and positive way.

Mr. Speaker, I yield to the gentleman from Georgia (Mr. Gingrey) to talk about these aspects of prenatal care, and he can tell us about some of the elements of saving money by doing more effective patient care management.

Mr. Speaker, reclaiming my time, I thank the gentleman for his learned information for our colleagues to be aware of not only Head Start but about prenatal care.

One program I want to mention, the National Nurse-Family Partnership, is a great example of success. It is a public-private nonprofit center. I believe it is centered in Colorado, with over 700 nurses delivering in-home prenatal care and early infant care to more than 13,000 low- income families throughout the Nation. Interestingly enough, they were able to demonstrate they could

return $4 savings for every $1 invested in these services by the time the children reach age 15 by reducing expenditures for such things as special education, emergency room visits. Again, when we use a more comprehensive patient care model, we look at the whole family and not just the individual disease, we can save money and provide care.

Secondly, I also applaud my colleague for bringing up those aspects about Head Start and Early Head Start, so critically important for families who are struggling to make ends meet to have this system that really puts the parent at the center of the child's care, making sure they are involved in all the decisions, making sure they have the information they need to have, making sure that they are, in essence, put into the role of parent and not government in the role of parent; and that makes all the difference in the world.

Let me shift into another area here, however, that is also critically important and something we dealt with today. At any point if my colleague has comments he wants to make, I certainly would encourage him to do so. But this is the area of childhood obesity. Today, we passed a bill out of the House that said that we cannot just be blaming restaurants and fast-food companies and food manufacturers when someone has obesity problems. Indeed, it is something we all have to work on and have responsibility for because whether they are healthy snacks that a person eats too much of or unhealthy snacks, whatever that is, we have to make sure that we watch our diet and have proper exercise.

Unfortunately, what has happened in this Nation, I believe it may only be the State of Illinois that still requires gym class in school, and as such, children spend much more sedentary time at home, playing video games or in front of the television, less active, and eating more during that time. This is a major contributor to childhood obesity. And what has happened in the last 10 years, and look here, the proportion of obese children has tripled since 1970. It has doubled in the last 10 years, tripled among teenagers actually during this time period, and increased incidences of disease associated with that, including such things as now we see adult onset diabetes showing up in our children. We also see heart problems showing up. We see the risks that take place with blood pressures that are showing up in children who really did not have these problems before.

This is an estimated annual cost of obesity-related diseases in the United States: $100 billion. $100 billion annual cost of obesity- related diseases. This is not something that is cured by simply having government come in and tell people what they can and cannot eat. Something has broken down in our families and our communities where we are no longer telling kids they have had enough to eat or they are not going to eat any more of that or they need to get out and play.

The annual hospital costs for obesity-related disorders in children ages 6 to 17 years of age increased from $35 million to $127 million between 1979 and 2000. It is a lack of physical exercise; 38.6 percent of United States adults report they have no leisure-time physical activity at all. The annual estimated cost for diseases associated with this physical activity in 2000 was $76 million, but we know that daily participation in physical ed classes by high school students has dropped from 42 percent in 1991 to 29 percent in 1999 and continues to decline.

Even though we have data that continues to tell us physical exercise is critical and important, not just for a child's physical health, but really, as we are looking at ways of managing this, we cannot continue to just pump money into the Medicaid system and into our insurance systems to cover the costs of the outcome at the end of the line.

We need to go upstream and work on some basic prevention, and that means, quite frankly, mothers and fathers across America have to work on these issues of teaching their children to be responsible for their own bodies, making sure that we, as Members of Congress, are talking about these issues, but making sure as we monitor how money is spent we are much better off looking at ways that funding could be given to communities, programs, to schools, to hospitals to help make sure we are working on prevention of obesity rather than paying the high costs at the end of the line for so much of the increases in health care because obesity has continued to climb.

Now, with obesity often comes behavioral disorders as a matter of fact. Many a child I saw in my clinical practice as a psychologist oftentimes came in a child who was well overweight, teased by their peers, struggled with this on top of their other physical problems. They oftentimes got in this downward spiral, less activity, more socially isolated. Perhaps they were teased by other kids, the butt of jokes, a sad condition, and many of these children also suffered problems with mental health.

What happens in the area of mental health is sometimes in this Chamber and our Nation, we look down upon it from a couple of different angles. We see perhaps mental health problems are some sign of softness, that perhaps people should be a little tougher, take it on the chin, not be so sensitive. Sometimes I am not sure we have advanced from the days of the Salem witch trials, and blame those who suffer from mental illness and say somehow you should have done more.

Sometimes we ridicule those who are on medication. Jokes still abound on television calling people crazy, loony, out of control, retarded, in derogatory terms, for something that we continue to see in this Nation as a sign of weakness instead of a real disease.

Again, if we are going to deal with things in the health care area, to truly reduce costs and deal with patients, we have to understand in the area of children's mental health psychological disorders are real. They are not made up. They are not indications where someone is weaker and ineffective.

There is a very strong and consistent scientific basis to say that the myth of psychological disorders and psychiatric disorders has to be debunked. Kids do have real problems. Adolescents have more problems. Adults have even more problems, and all these grow when we do not deal with these problems at an early level.

There are biological and environmental causes. It is interesting, you can have some children face tremendous difficulties in their life and they do not seem to show problems in mental outcomes, but that does not mean that those who do have problems are simply weak. Just like some of us may be exposed to the flu, some of us may eat different, and be around those who smoke and never develop any symptoms at all, where others are susceptible to them as part of their own biological genetic makeup.

Again, it does not mean they are weak or ineffective. It means a combination of the biological and environmental factors that caused this. You cannot simply say if we take care of these environmental causes it will never occur. Sometimes people say, well, maybe it is poverty that causes some of these difficulties with mental illness, and that is not the case at all. Depression, bipolar disorders, attention disorders, anxiety disorders occur at all lines of children. Boys sometimes have more than others, but there is this link between biological and environmental causes. Boys have more problems, for example, with attention disorders. Girls may have different symptoms with depression, but in all cases we also see there is a commonality between parents and grandparents having some of these diagnoses that I mentioned for anxiety, bipolar disorder, attention disorder, depression and their children. Not always children, but certainly some where you have significant environmental stresses and reactions which interact.

We may see, for example, as the outcome of the hurricanes in the gulf coast that there will be some children who live through tremendous trauma, and they may have some post-traumatic stress reactions, but it may never reach the level of post-traumatic stress disorder. It becomes a longer term debilitating factor, exhibited, for example, as such things as depression, trouble concentrating, nightmares, et cetera. It may never reach that level because they may in their own biological factors have resilience, but their family may be there to support.

The other things here is to understand that psychological disorders do

respond to treatment. This may be pharmaceutical; that is, medication, and it certainly is also matters of counseling and therapy. This is not just a matter of talking to someone, giving common-sense ideas. This is a matter of very strategic, scientifically based things such as cognitive behavioral therapy to work with patients.

We know, for example, that children with depression respond fairly well, pretty well, to some of the talk therapy or counseling to help them understand strategies to deal with problems in their life, recognize the symptoms and do their own intervention themselves to change those symptoms.

But we also know when people move from moderate to more severe levels of depression, medication, it is pretty darn helpful and sometimes almost necessary for them to have that. It does not help when we have movie stars out there saying there is no such thing as mental illness, an irresponsible statement. It does not make things go away just because you wish it to be so. I do not want situations put upon our country where we see that, again, people from Hollywood are saying, well, there is no such thing as mental illness, and therefore, we do not treat it. That is wrong. We do know that they can respond to treatment, and it is important we continue to fund in areas of Medicaid and everywhere else, Medicare, psychological, psychiatric treatment because it is helpful.

We also need to, however, carefully evaluate the treatment, the planning and follow-up assessment of these. I will give you a couple of examples.

Last year, there was a lot of discussion about some anti-depressant medication, and when some children took it, there was a higher risk for suicidal thinking, suicidal ideations we call it. What did not come up in those discussions are a couple of important factors. One, 75 percent of psychiatric medications are prescribed by nonpsychiatrists. They may be highly qualified physicians. In many cases, they may be general practitioners, pediatricians, family doctors, obstetricians. Seventy- five percent, however, and they may or may not be doing the other follow-up that is necessary.

What anti-depressant medications do is they can change a person's mood. They can help change the chemical, biological reaction that a person's central nervous system and brain of how they process stresses that can lead to the debilitation of depression, but it does not change the way a person thinks. That is why it is so important that we make sure we are funding programs that also provide the psychological therapy for children to help them understand what these thoughts are, to help them change the way they are thinking about the world so as they start to feel better they do not have more suicidal risks.

Interestingly enough, one of the things we oftentimes taught medical students in medical schools is once patients start getting better with symptoms of depression, the risk for suicide may increase because the support systems back off and they say Johnny's feeling better, we do not need to have him in the hospital or do not need to be around him as much. Perhaps people are no longer monitoring the person 24 hours a day. They start to go back to school, face more stresses.

As they are getting their energy up, as they are back in the world and thinking if we do not change the way they think with depressive thought patterns, if we do not interrupt that and change it, you can actually increase the risk for suicide. That being the case, we have to make sure that as we are looking for more effective ways of spending money, the taxpayer dollars in Medicaid and Medicare and Head Start that we are working comprehensive care with the patient, with mental illness as well, such problems as I said before about bipolar; that is, manic depressive illness, attention deficit disorder, anxiety disorders, all of these with a strong genetic component and elements where we can make huge changes in people's lives.

It is something that we need to make sure we are no longer just criticizing about overprescribing or perhaps saying that too many kids are getting stimulant medication with attention disorder; we should or should not do this.

Here is the crux of this. It really is a matter of having accurate diagnosis and treatment and making sure that we are not overmedicating or undermedicating our children. Somehow in this Chamber we politicize this to somehow think we are doing something wrong in both areas of the conservative far right, the liberal far left, somehow accuse maybe there is some conspiracies involved in this, and there is not. It is a matter of making sure the physicians have the training to deal with this. They are interacting a comprehensive care model, a patient care model, disease management model, together with people of various professions and working closely with the families.

We see this in the area of children's health when you start to look at so many aspects here that you really can make some huge differences.

I would like to point to a couple of things here and then call upon the gentleman from Georgia (Mr. Gingrey), my colleague, on a couple of questions. But one of the things to keep in mind about depression, which is one of the most common mental illnesses affecting more than 19 million Americans each year, that it can cause longer lasting forms. You can lose pleasure in life, complicate other medical conditions, can lead to suicide, but it is also associated with many other medical issues.

For example, cancer has a higher incidence of depression, stroke. Diabetes, people with diabetes have a 25 percent chance of having depression. That is higher than the rest of the population. Depression also affects as many as 70 percent of patients with chronic diabetic complications. People with heart disease, 40 to 65 percent of them will have depression, and what is interesting is untreated depression in these patients can lead to complications, such as the health care costs can double.

Now, I ask the gentleman from Georgia (Mr. Gingrey) on this, he certainly treated many a patient who had medical complications as well as some of the psychological ones, and I would like to ask him, in looking at some of these more comprehensive chronic care models, of how we need to be moving forward in a modern system of health care and not be just looking at individual disease, but how looking at more advanced forms of bringing technology and changing the system, how he sees that affecting the patient in a cost-effective way.

I thank the gentleman. I asked about another issue, too, which is one that is so critically important for children. My colleague from Georgia had mentioned before, during pregnancy, smoking being one of the risk factors. I believe that the sad statistic is that the Pittsburgh region has some of the highest maternal smoking rates during pregnancy in the Nation. My understanding is a lot of complications can come when you have a mother who smokes during pregnancy. Certainly an important part of prenatal care for our children is understanding the importance of helping a mother to stop smoking during that time.

I wonder if the gentleman can comment on some of the complications that might come for that mother and that baby not only during labor and delivery but the long-term effects for that child when the mother smokes during pregnancy.

Also, it is related to, my understanding is yet so many other aspects come from this that you may find in such children also eating disorders and diabetes and cancer risks even if that child never themselves smoked cigarettes. But the risks are huge. I believe a direct and indirect medical cost of smoking in this Nation is about $138 billion per year.

Of course, another reason why I believe it is so important not only for the government but really for individuals and businesses to focus so much on helping to change that is the State of California, for example, estimates that their statewide tobacco prevention program during the 1990s resulted in overall cost savings of $8.4 billion in health care. That is pretty remarkable.

Again, unfortunately, the way the Congress scores things with the Congressional Budget Office, when we talk about starting programs that would actually save money, my colleagues are aware of this, we never can get an accurate measure of what it actually saved because of the way the CBO, the Congressional Budget Office, scores things. It is not how much you save, but how much you spend. So if we would do similar things that would lead to a smoking cessation during pregnancy, and it might cost X number of dollars, the CBO would score that but never tell us how much money it would save over time. That is something that frustrates all of us because the things we are talking here tonight really require some expenditures to get these savings.

Businesses are picking up on this. A recent review of health promotion and disease and management programs in businesses that provided health education to their employees, including exercise, health-risk screening, weight control, nutrition information, stress management, disease screening, and smoking cessation, found a significant return in investment, saved about $1.50 to about $5 for every dollar spent in the program.

For example, Motorola, their wellness program saved the company about $4 for every dollar invested. Northeast Utilities' program in its first 24 months reduced some of the claims by about $1.4 billion. Caterpillar Company, they had a program that saved about $700 million. Johnson and Johnson's health and wellness program saved about a couple hundred dollars per employee per year.

What is interesting here is how much we can save and what we have to look at here. And I call upon my colleagues, we need to make some fundamental changes in how CBO scores these things. We have got to stop just looking at how much it costs up front and look at how much it saves in the long run. Again, I look at such things as if we are able to have more people go to federally approved health centers, community health centers in their community instead of showing up in the emergency departments, yes, it may cost money; the President called for a couple billion dollars to put into those community health centers. But if it is one-fifth of the cost of going there rather than the cost of going to the emergency departments, that is a massive cost savings.

Certainly I call upon my colleague, too, it is one of those things you have seen as well, how do we get these prevention issues begin to be scored. It is of fundamental importance to health care.

I am reminded of the story of the fellow who was on his hands and knees late at night under a streetlight in the city, probably had too much to drink, and a police officer sees him and says: Excuse me, sir, what are you doing? The gentleman says: I am looking for my car keys. And the police officer says to him: Well, where did you lose them? He said: I lost them down at the end of that dark ally down there. And the policeman says: Well, why are you not looking for your keys at the end of that dark ally over there? And the gentleman says: Because there is more light over here.

Sometimes I think the way we look at these medical issues, instead of looking at the cost savings involved with prevention, we simply are able to look at how much it costs us up front because it is easier to find that data. It is tougher to pay attention to prevention.

My colleague brought up some great points. Prenatal care, Early Head Start, Head Start, what that contributes to in helping save problems. We talked about community health centers and spending money. I like the President's plan of a community health center in every county in America where there is poverty and an uninsured, can help reduce emergency visits by four-fifths, the cost of the emergency visits. It is an incredible amount of savings, but not one that we can get those scores for. And it is one of those things where, unfortunately, the political rhetoric comes through in this Chamber, and I do not know of anybody who has ever been cured by a floor speech, but it certainly is one where there is just so much talk that continues on, spending too much here, spending too much there. We need to pay attention to spending too much.

The problem is not what we are spending, but what we are spending it on. And if we are continuing to spend on wasteful or fraudulent or abusive or simply health care issues that are not taking care of the disparity of outcomes between, for example, low socioeconomic families, families that are struggling to make ends meet and feel they do not have the money to pay for their doctor visits, and those that may be in poverty, we need to work on those disparities of outcomes and make sure that we take care of those children early on; and that is why the issue of community health centers for our kids is so critically important. But, again, some will say we are spending too much, causing the budget to go up, and we cannot get the proper numbers.

Now, some of the public that may be listening is wondering why we are even talking about the CBO. But that is, unfortunately, the way this Chamber operates now and that people oftentimes look at those numbers. We have seen tremendous inaccuracies in those numbers. My colleague from Georgia spoke about those inaccuracies when it came to looking at things such as the death tax and them being off over $1 trillion in their estimates. But also it is one of those things in health care, too.

Think about this: if you take a medication that costs you $50, but it may prevent you from having a heart attack and further hospitalizations, surgery, disability, workers comp, losing your job, having the family require other care, that is a massive amount of cost savings. But, instead, we may focus on only that aspect of the cost of that medication, instead of all the other costs that are saved there. When we look at what we are doing with children's health, it is so critically important that we look at the big picture here as well.

Now, I am going to see if my colleague has any final comments to make in this area of health care. Barring that, I just want to mention a couple of final comments here.

We are certainly the stewards of the people's money, and although we are not here to take the place of the family, we are here to do sometimes what Abe Lincoln said. President Lincoln said, ``Governments should do that which the people cannot do for themselves.''

Now, in the areas of such things as food and consumption, people and parents ought to be watching what they eat. Well, what we also ought to be doing ourselves is working along with physicians and schoolteachers and people in the community to make sure our kids are healthy and safe and exercise and eat right.

But we also have to make sure we are working at comprehensive care, real patient care models, that involves nutrition and exercise and prevention and mental health, and integrated care of all of those things together. If we are

truly going to do what is right and decent and honorable for the next generation, it is a matter of doing what is right in health care.

It is a matter of pooling our resources together and looking at the answers, to be science-based and not emotion-based on this. The science tells us we have things we can do, but we are not yet doing. The science tells us when it comes to managing the disease it is not appropriate to just look at that individual disease, but to see how it operates in the context of the child and their family.

This is true compassion. This is where we will save lives. This is where we will save money. This is where if we do things like looking at electronic medical records, and make sure that every hospital around the Nation has this, and providers and pharmacists have these, you can find out these things and work on them together.

That is what takes place in States like Nebraska and other hospitals around the Nation. We have here an opportunity to make a huge difference, to save lives by the hundreds of thousands, and to save money by the hundreds of billions of dollars. We have that opportunity before us.

The question is, will we have the courage to work together in a bipartisan manner to do it? My hope is that our colleagues drop the gloves on this, put down the swords, stop looking for opportunities to send out sound bytes and to have people make phone calls and use it as political fodder, but instead to be able to look our constituents in the eye and say when we were all here, when we were all granted the authority to do something about America, we took an opportunity to save lives and save money, and we ought to start with our children.

I thank my colleagues.

Madam Speaker, by direction of the Committee on Rules, I call up H. Res. 508 and ask for its immediate consideration.

Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Massachusetts (Mr. McGovern), 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.

Madam Speaker, House Resolution 508 is a structured rule. It provides for 1 hour of general debate, equally divided and controlled by the chairman and the ranking minority member of the Committee on the Judiciary. It waives all points of order against consideration of the bill, and it provides that the amendment in the nature of a substitute recommended by the Committee on the Judiciary now printed in the bill shall be considered as an original bill for the purpose of amendment and shall be considered as read.

It makes in order only those amendments printed in the Rules Committee report accompanying the resolution. It provides that the amendments printed in the report may be offered only in the order printed, may be offered only by the Member designated in the report, shall be considered as read, shall be debatable for the time specified in the report, equally divided and controlled by the proponent and an opponent, shall not be subject to amendment, and shall not be subject to a demand for division of the question in the House or in the Committee of the Whole.

This resolution waives all points of order against the amendments printed in the report, and it provides one motion to recommit, with or without instructions.

Madam Speaker, I rise today in support of House Resolution 508 and the underlying legislation, H.R. 420, the Lawsuit Abuse Reduction Act of 2005.

First, I want to commend the gentleman from Wisconsin (Mr. Sensenbrenner), the distinguished chairman of the Committee on the Judiciary, not just for the underlying bill but for a number of recent bills aimed at strengthening our legal system by protecting people's rights under the law and shielding them from frivolous proceedings. Additionally, I want to thank the gentleman from Texas (Mr. Smith), the chairman of the Subcommittee on the Courts, the Internet, and Intellectual Property, for sponsoring H.R. 420.

Madam Speaker, over the past couple of weeks, this House has taken several important steps to reform our legal system, to relieve our overburdened court dockets and drastically reduce the number of costly frivolous claims against innocent and legitimate businesses.

On October 24, we passed and sent to the President's desk S. 397, the Lawful Commerce in Arms Act of 2005, by a vote of 283 to 144 in the House. I might add that in the spirit of bipartisanship, 59 Democrats and one Independent joined 223 Republicans in passing this landmark legislation that refocuses liability for gun violence on the actual criminal, the person who pulled the trigger.

Additionally in this House, 226 Republicans, along with 80 Democrats, passed H.R. 554, the Personal Responsibility in Food Consumption Act of 2005. This bill also reaffirms the need for individuals to take responsibility for their own actions and not expect someone else to foot the bill for the adverse health consequences of their own gluttony.

Today, Madam Speaker, we have another prime opportunity to pass meaningful legislation to strengthen our court system even further and to protect the falsely accused.

The Lawsuit Abuse Reduction Act of 2005 will go a long way to curb the actions of individuals who would seek to abuse our courts by gaming the judicial system. Last week, there were probably millions of people across this country who tuned in, ticket in hand, to see if they had won a $340 million Powerball jackpot. Unfortunately, there are also people who look to the courts, legal briefs in hand, as if it were the Powerball lottery.

However, Madam Speaker, it is the American people and small businesses that pay the ultimate price for frivolous lawsuits and this type of jackpot justice. They pay for it through higher prices for goods and services, they pay for it through diminished quality of products, they pay for it through loss of economic freedom, and they pay for it through a clogged court system that has been turned into an ATM for junk lawsuits. In fact, the current tort system is estimated to cost American people well over $200 billion per year.

Clearly, the Lawsuit Abuse Reduction Act of 2005 is a bill that is sorely overdue, sorely needed and, I might add, was approved by this House in the last Congress by a vote of 229 to 174.

With respect to the underlying bill, it would amend Rule 11 of the Federal Rules of Civil Procedure by restoring the mandatory sanctions for the filing of frivolous lawsuits. This bill would require that courts impose an appropriate penalty on attorneys, law firms, or parties who continue to file frivolous lawsuits. Also this bill would eliminate the ``free pass'' provision that allows attorneys to avoid sanctions if they withdraw their frivolous claim after a motion for sanctions has been filed.

Madam Speaker, H.R. 420 also would prevent forum shopping by requiring that personal injury cases only be brought in those jurisdictions either where the plaintiff, the defendant or a related business resides, or where the alleged injury or surrounding circumstances occurred.

This act would also institute a three-strikes-and-you're-out sanction that would suspend an attorney from practicing in Federal court if a Federal judge determines the lawyer has violated Rule 11 on three or more occasions.

H.R. 420 clearly emphasizes that personal responsibility is not just some catch phrase that applies only to some people, such as a fast-food connoisseur, a firearms owner, a consumer or, indeed, a doctor. Personal responsibility and professional accountability should be the rule for those in the legal field, too, and that is why this House should pass this bill.

In closing, Madam Speaker, I would just emphasize that House Resolution 508 is a straightforward rule and H.R. 420 is a straightforward bill. Simply put, it just makes sense to stop and punish the willful abuse of our legal system by the slash-and-burn tactics of frivolous lawsuits.

As always, I look forward to the consideration of this rule, and I ask my colleagues to support it and the underlying bill.

Madam Speaker, I reserve the balance of my time.

Madam Speaker, in response to some of the comments that were made, I just want to hold up this document that lists over 300 groups in support of LARA, the Lawsuit Abuse Reduction Act of 2005, and I will include them in the Record.

I would like to also point out that the Federal Judicial Center was in opposition to class action reform, which we passed in the previous Congress and in the 108th by a vote in this body of 279 to 149.

Groups Supporting H.R. 420--The Lawsuit Abuse Reduction Act of 2005

Advanced Medical Technology Association.

Air Conditioning Contractors of America.

Alabama Civil Justice Reform Committee.

Alabama Restaurant Association.

Alabama Trucking Association, Inc.

Alaska Cabaret, Hotel, Restaurant and Retailers

Association.

Alliance of Automotive Service Providers of Minnesota.

Alliance of Automotive Service Providers of Pennsylvania.

America Chamber of Commerce (NV).

American Apparel and Footwear Association.

American Automotive Leasing Association.

American Bakers Association.

American Boiler Manufacturers Association.

American Business Conference.

American Chemistry Council.

American Council of Engineering Companies.

American Health Care Association.

American Home Furnishing Alliance.

American Insurance Association.

American International Automobile Dealers Association.

American Legislative Exchange Council.

American Machine Tool Distributors Association.

American Petroleum Institute.

American Rental Association.

American Road & Transportation Builders Association.

American Supply Association.

American Trucking Associations.

American Tort Reform Association.

American Veterinary Distributors Association.

American Wholesale Marketers Association.

Antelope Valley Chamber of Commerce (CA).

Ardmore Chamber of Commerce (OK).

Arkansas Chapter, National Electrical Contractors

Association.

Arkansas Hospitality Association.

Arizona Chapter, National Electrical Contractors

Association.

Arizona Restaurant & Hospitality Association.

Associated Builders & Contractors.

Associated General Contractors of America.

Associated Equipment Distributors.

ASFE--Associated Soil & Foundation Engineers.

Associated Wire Rope Fabricators.

Association for High Technology Distribution.

Association of Equipment Manufacturers.

Association of Pool & Spa Professionals.

AMT--The Association for Manufacturing Technology.

Automotive Aftermarket Industry Association.

Automotive Parts Remanufacturers Association.

Automotive Parts & Service Association of Illinois.

Aviation Distributors & Manufacturers Association.

Bay Area Citizens Against Lawsuit Abuse.

Bearing Specialists Association.

Brunswick-Golden Isles Chamber of Commerce (GA).

Business Council of New York State, Inc.

Business Roundtable.

California Central Coast Chapter, National Electrical

Contractors Association.

California Restaurant Association.

California/Nevada Automotive Wholesalers Association.

Central California Citizens Against Lawsuit Abuse.

Central Illinois, National Electrical Contractors

Association.

Chamber of Business and Industry of Centre County (PA).

Chamber of Commerce for Anderson & Madison County (IN).

Chamber of Commerce of the Mid-Ohio Valley (WV).

Citizens Against Lawsuit Abuse of Central Texas.

Citizens for Civil Justice Reform.

City of Chicago, National Electrical Contractors

Association.

Civil Justice Association of California.

Cleaning Equipment Trade Association.

Cleveland Chapter, National Electrical Contractors

Association.

Coalition for Uniform Product Liability Law.

Colorado Civil Justice League.

Colorado Motor Carriers Association.

Colorado Restaurant Association.

Connecticut Restaurant Association.

Construction Industry Round Table.

Copper & Brass Service Center Association.

Council of Insurance Agents and Brokers.

Crawfordsville/Montgomery Chamber of Commerce (IN).

Dayton Area Chamber of Commerce (OH).

Delaware Motor Transport Association.

Delaware Restaurant Association.

East Texans Against Lawsuit Abuse.

The Employers Association.

Electrical Manpower Development Trust.

Equipment Leasing Association.

Florida Chamber of Commerce.

Florida Restaurant Association.

Food Industry Suppliers Association.

Gas Appliance Manufacturers Association.

Gases and Welding Distributors Association.

General Aviation Manufacturers Association.

Georgia Association of Petroleum Retailers, Inc.

Georgia Industry Association.

Georgia Restaurant Association.

Great Lakes Petroleum Retailers & Allied Trades

Association.

Georgia Motor Trucking Association.

Hawaii Restaurant Association.

Hawaii Transportation Association.

Health Industry Distributors Association.

Healthcare Distribution Management Association.

Heating, Air Conditioning & Refrigeration Distributors

International Association.

Hobbs Chamber of Commerce (NM).

Hospitality Association of South Carolina.

Hospitality Minnesota--Minnesota's Restaurant, Hotel &

Lodging and Resort & Campground Associations.

Hudson Valley Chapter, National Electrical Contractors

Association (NY).

Humble Area Chamber of Commerce (TX).

Idaho Lodging and Restaurant Association.

Illinois Chapter, National Electrical Contractors

Association.

Illinois Civil Justice League.

Illinois Lawsuit Abuse Watch.

Illinois Quad City Chamber.

Illinois Restaurant Association.

Independent Electrical Contractors.

Independent Insurance Agents & Brokers of America, Inc.

Independent Sealing Distributors.

Industrial Compressor Distributor Association.

Industrial Supply Association.

International Association of Plastics Distributors.

International Foodservice Distributors Association.

International Franchise Association.

International Furniture Suppliers Association.

International Housewares Association.

International Safety Equipment Association.

International Sanitary Supply Association.

International Sign Association.

International Sleep Products Association.

International Truck Parts Association.

Iowa Hospitality Association.

Iowa Motor Truck Association.

Jackson Area Manufacturers Association.

Kansas Chamber of Commerce.

Kansas City Chapter, National Electrical Contractors

Association.

Kansas Restaurant and Hospitality Association.

Kentucky Motor Transport Association.

Kentucky Restaurant Association.

Kern County Chapter, National Electrical Contractors

Association (CA).

Kingman Area Chamber of Commerce (AZ).

Lakewood Chamber of Commerce (WA).

Latrobe Area Chamber of Commerce (PA).

Lawn and Garden Marketing and Distribution Association.

Lebanon Valley Chamber of Commerce (PA).

Los Angeles Citizens Against Lawsuit Abuse.

Los Angeles Fastener Association.

Louisiana Motor Transport Association.

Louisiana Restaurant Association.

Maine Liability Crisis Alliance.

Maine Restaurant Association.

Manufactured Housing Institute.

Manufacturers' Association of Northwest Pennsylvania.

Marion Area Chamber of Commerce (IL).

Maryland Business for Responsive Government.

Maryland Chapter, National Electrical Contractors

Association.

Massachusetts Restaurant Association.

Material Handling Equipment Distributors Association.

Mechanical Contractors Association of America.

Memphis Chapter, National Electrical Contractors

Association.

Metals Service Center Institute.

Mason Contractors Association of America.

Michigan Chamber of Commerce.

Michigan Lawsuit Abuse Watch.

Michigan Restaurant Association.

Minnesota Trucking Association.

Mississippi Hospitality and Restaurant Association.

Mississippi Manufacturers Association.

Mississippi Trucking Association.

Mississippians for Economic Progress.

Missouri Motor Carriers Association.

Missouri Restaurant Association.

Montana Chamber of Commerce/Montana Liability Coalition.

Montana Motor Carriers Association.

Montana Restaurant Association.

Motor & Equipment Manufacturers Association.

Motorcycle Industry Council.

National Association of Chemical Distributors.

National Association of Convenience Stores.

National Association of Electrical Distributors.

National Association of Home Builders.

National Association of Manufacturers.

National Association of Mutual Insurance Companies.

National Association of Sign Supply Distributors.

National Association of Wholesaler-Distributors.

National Concrete Masonry Association.

National Council of Chain Restaurants of the National

Retail Federation.

National Electrical Contractors Association.

National Federation of Independent Business.

National Lumber & Building Materials Dealers Association.

National Marine Distributors Association.

National Paint & Coatings Association.

National Pest Management Association.

National Propane Gas Association.

National Restaurant Association.

NRF--The National Retail Federation.

National Roofing Contractors Association.

National School Supply & Equipment Association.

National Shooting Sports Foundation.

NAHAD--The Association for Hose & Accessories Distributors

NPES--The Association for Suppliers of Printing, Publishing

and Converting Technologies.

National Small Business Association.

Nebraska Restaurant Association.

Nebraska Trucking Association.

Nevada State Medical Association.

New Hampshire Lodging and Restaurant Association.

New Jersey Automobile Wholesalers Association.

New Jersey Business & Industry.

New Jersey Motor Truck Association.

New Jersey Restaurant Association.

New Mexico Alliance for Legal Reform.

New Mexico Chapter, National Electrical Contractors

Association.

New Mexico Restaurant Association.

Nevada Restaurant Association.

New York State Automotive Aftermarket Association.

New York State Motor Truck Association.

New York State Restaurant Association.

North American Horticultural Supply Association.

North Carolina Citizens for Business and Industry.

North Carolina Restaurant Association.

North Carolina Trucking Association.

North Dakota State Hospitality Association.

North Florida Chapter, National Electrical Contractors

Association.

North Louisiana Chapter, National Electrical Contractors

Association.

North Texas Chapter, National Electrical Contractors

Association.

Northeastern Illinois Chapter, National Electrical

Contractors Association.

Northern California Citizens Against Lawsuit Abuse.

Northern Illinois Chapter, National Electrical Contractors

Association.

Northern New York Chapter, National Electrical Contractors

Association.

Northern Rhode Island Chamber of Commerce.

Office Products Wholesalers Association.

Ohio Association of Wholesaler-Distributors.

Ohio Manufacturers Association.

Ohio Restaurant Association.

Ohio Trucking Association.

Oklahoma Restaurant Association.

Orange Chamber of Commerce (CA).

Orange County Citizens Against Lawsuit Abuse.

Oregon Restaurant Association.

Outdoor Power Equipment & Engine Service Association.

Outdoor Power Equipment Institute.

Outdoor Power Equipment Aftermarket Association.

Pacific Printing & Imaging Association (AK, HI, ID, MT, OR,

To the gentleman from Massachusetts, we do not actually have any additional speakers at this time, so right now I am reserving the balance of my time for the purpose of closing, unless another speaker comes.

Madam Speaker, I might point out that the people that oppose this legislation, as the gentleman from Massachusetts mentioned earlier, are the very ones that support his party. So I think that there is a little balance there, if that be true in either instance.

Madam Speaker, I would first like to close this debate by thanking my colleagues for a very productive discussion of both the rule and H.R. 420. The opportunity before this House today is another example of how this Congress has improved our legal system and preventing frivolous lawsuits from closing the doors of justice for those who have truly been harmed.

Contrary to what the opponents of legal reform might say, the underlying bill, as well as other recent bills, do not demonstrate contempt for our legal system or the esteemed profession of attorneys, but rather demonstrate respect for the important and historic role of our judicial system in defending the rights and ensuring the constitutional application of the laws. Frivolous lawsuits have not only driven up costs and destroyed economic opportunity for the American people, but they have also damaged the image of the courts. When the American people stop respecting the decisions of the judiciary, the courts begin to lose their effectiveness, and they cease to perform their constitutionally mandated role.

For the sake of the courts and for the sake of the American people, we in this House need to push forward with this additional meaningful and genuine reform. Therefore, I would like to urge all of my colleagues on both sides of the center aisle to support this rule and the underlying bill.

Madam Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

The previous question was ordered.

Mr. Speaker, I thank the gentleman from Pennsylvania (Mr. Murphy) for leading this hour during this week of Children's Health Care Initiative and calling attention to the health of our children. The gentleman from Pennsylvania (Mr. Murphy) has worked extensively in the field of psychology, particularly child psychology. He has actually written a book and has another coming out soon on the subject. I think as we get further into the hour, we probably will discuss a little about bit about how important a child's not only physical health but their mental health is.

But I do appreciate the opportunity that the gentleman has given me, Mr.

Speaker, to share some of this time with him.

My background in a prior life, my professional experience was for 30 years in the practice of medicine, and the specialty that I enjoyed practicing was obstetrics and gynecology; and we have that opportunity in that field of medicine to see a child at the very beginnings of life and know how critically important a good start is. We talk about some of the things that this Republican majority has done, some of the very good programs since President Bush has been in office, certainly not the least of which is No Child Left Behind regarding our K-12 education program. But it is so important from the health care perspective that no child is left behind from the moment of conception.

So I do want to talk a little bit about the importance of prenatal care and actually call my colleagues' attention to this one poster that I have here regarding prenatal care, entitled ``Proper Prenatal Care Leads to Healthy Children.'' No question about it. Some of the bullet points, these may be a little bit difficult to see, Mr. Speaker, but hopefully we can focus the camera in on the bullet points.

First of all, 1 million, 1 million, American women deliver babies annually without receiving prenatal care. Secondly, in the United States, more than 250,000 low birth weight infants are born each year. More than 250,000. Now, for my colleagues' understanding, a low birth weight infant is one that weighs less than 2,500 grams. That is about 5\1/2\ pounds. Those children are not all premature. In some instances they are unhealthy children who are near term, but low birth weight. But most of them, most of these 250,000 low birth weight infants are actually born premature as well.

And the third bullet point, low birth weight infants are more likely to suffer from disabilities, things like heart defects and respiratory illnesses. They are four times more likely to prematurely die than infants with a normal birth weight.

I have had many situations, Mr. Speaker, as an obstetrician having delivered over 5,000 children, where women come into the emergency room having had no prenatal care. And they are clearly the ones who are more likely to deliver these low birth weight babies and deliver them prematurely. That is why I think it is so important, and I know the gentleman from Pennsylvania (Mr. Murphy) would agree with me, that when we emphasize the issue, the immigration issue, of securing our borders and want to make sure that every immigrant that comes into this country comes here legally and has an opportunity to get prenatal care, as, of course, many of those who come in an illegal manner are afraid or do not now how or where to get prenatal care and will just show up in the emergency room having delivered an unhealthy premature low birth weight infant, the cost of taking care of a child in that situation in the very expensive setting of an intensive care nursery, a 2-month stay, and that would not be uncommon for a very small infant, could approach easily $750,000 to $1 million worth of health care. And that, Mr. Speaker, is really just the beginning.

That is just the beginning of the cost, because if there is a disability that is long lasting or maybe even lasting a lifetime, and that is often the case, whether it is a heart defect or a musculoskeletal deformity or a mental defect as a result of lack of oxygen, sometimes even blindness, the cost is just astronomical. So it is so important, it is so important, that we do things in this Congress at the Federal level to encourage that women get prenatal care and that children are born healthy and that, indeed, no infant, not just no child left behind, but no infant is left behind.

So I just wanted to go over with my colleagues some of the things in regard to prenatal care that are so important that I always stress to my patients: of course, encouraging immunizations and vitamin supplements, monitoring of diet, increased physical activity, clearly to avoid smoking and alcohol use during pregnancy and drug use. Certainly any drug use that is nonprescription or not under the jurisdiction and guidance of a physician is to be discouraged. Environmental factors are hugely important. As I say, a healthy diet, a regular weight check, physical activity, all of these things are so important. And then to come see the physician on a regular basis during the pregnancy. This is how we avoid, Mr. Speaker, these 1 million American women delivering babies annually either without receiving prenatal care or ending up with premature deliveries.

I want to, if the gentleman would allow me, to expand on this a bit. It is not just being born healthy and well; but the first 5 years of life, what happens to the child after that is tremendously important as well. I have a grandson, little Grey Collins. He will be a year old soon. And it is so much fun to see him, and I often have that opportunity to see him, watching the little Baby Einstein tapes, that he is hugged many times a day and loved by his parents and grandparents and his aunts and uncles and how important it is to provide that love and affection to a child and let them know that they are loved, and we will get into that. I am sure the gentleman from Pennsylvania (Mr. Murphy) will talk about that later in the hour as he discusses things like childhood obesity and childhood mental health.

But I wanted to speak a little bit about a program that we just reauthorized in the last couple of weeks here in this 109th Congress, and what I am talking about is the Head Start program. Sometimes we get criticized, we, the Republican majority, that we do not care enough about social programs and we do not care enough about the poor and underprivileged and people that do not maybe have the same opportunity that the upper middle class society has.

But let me tell the Members we do care. We do care. And this reauthorization is proof of the pudding.

Just a little historical perspective on that. Head Start and its cousin, Early Head Start or comprehensive child development programs, serving children from birth to age 5, as I stated, as well as pregnant women and their families, the critical component of the Head Start program is that it is child focused with the overall goal to increase school readiness of young children in low-income families, Mr. Speaker. The Head Start program has a long tradition of delivering comprehensive and high-quality services designed to foster healthy development in children that need our help the most.

The program provides a range of individualized services in areas of education, early childhood development, but not stopping there. It also offers medical, dental, and mental health services to these children and to their families. It even goes a step further by providing nutritional counseling and encouraging parental involvement in their child's development. It is a rich program. I have got a lot of statistics, and as we continue the hour, I will relate some of those specifics, particularly in regard to the reauthorization and how much we are doing in that program.

But I just wanted to point out, as I know the gentleman from Pennsylvania (Mr. Murphy) agrees, how important it is that we do everything we can to make sure that our children get a good start in life. And as I have stated at the outset, the prenatal care aspect is hugely important. Programs like the Early Head Start and Head Start program so that the children, all children, when they get to that 5- year-old kindergarten class or get to the first grade, that they have an equal opportunity with their peers and they are not starting school with one hand tied behind their back. So it is hugely important that they are healthy, that they are happy, that they are loved and they have an opportunity, as we all want, in life.

At this point I will continue to be here with the gentleman from Pennsylvania (Mr. Murphy) during this hour.

Mr. Speaker, as the gentleman pointed out, and he is so right, we need to move into the 21st century in regard to our health care system and modeling. Just trying to come up with better drugs and the latest surgery techniques to treat complicated illness is not enough. We really need to focus on preventive care.

You are talking about in the last few minutes, of course, your specialty, in talking about mental illness, and as it relates also to childhood obesity, and I could not help but think as I was listening to your discussion, and as you know, this week we just passed H.R. 554. H.R. 554 is the Personal Responsibility in Food Consumption Act of 2005. This is a bill my colleagues are aware of the fact it would not allow someone to sue a fast food manufacturer because they have gorged themselves with a multiple number of Big Macs or any other kind of fast food, or sometimes what we refer to as junk food. It is not the fault of the food industry.

I used a little analogy when I was talking about this on the floor yesterday in discussing the rule of my belt, which is a size 36. That is, I hate to admit, the size of my waist, but if I wanted really out of blind pride to suggest that I had a 24-inch waist and I cinched that belt down a couple of notches, in doing so, I put pressure, compression on something referred to as the lateral femoral cutaneous nerve, it would result in a condition of numbness and lack of feeling on the anterior thigh. Then should I go out and sue the belt company because they are at fault because I misused a product?

This is what this bill, of course, is all about, a common-sense type bill.

Parenthetically, Mr. Speaker, I also want to mention the gentleman from Florida (Mr. Keller), the author of the bill, our good friend and colleague, is actually in the hospital now and recovering hopefully from a fairly minor condition, but we want to pay tribute to him. I know he is proud that we passed this bill this week.

The comment that I wanted to make is this issue of personal responsibility, and parents should have that personal responsibility obviously in the way they conduct themselves in regard to how they eat and a healthy diet and exercise, but even more importantly is the responsibility that they have to give a good example and instruction to their children.

I think it is probably the worst form of child abuse to let these youngsters that at a very early age overeat and become obese. You have talked about the issue of poor mental image, self-image, and of course, I also see you talked about Hollywood and, of course, this issue of there is no such thing as mental illness. I think probably they might predominate in some of those diseases, which we categorize as mental illness.

But quite honestly, when a child goes to school and there is this emphasis on thinness and you see these youngsters wearing these Britney Spears' jeans and that sort of thing, a child even a little bit overweight and certainly one that is significantly obese, of course they are going to have a poor image of themselves. They are going to withdraw, and they are going to become shy. It is very likely they are going to be picked on. How in the world can they grow and develop with a healthy self-image? No wonder they end up needing to be counseled and treated by the gentleman from Pennsylvania (Mr. Murphy) and other mental health care specialists.

Yes, unfortunately, some even go on to harm themselves and possibly even commit suicide. So I guess the most important thing that I would want to say as a physician Member is that we need to prevent this.

We need to make sure that parents get the message that they have an obligation, not just to take care of themselves, but first and foremost to take care of these precious children that they bring into the world. It is their responsibility to make sure that they are from the very beginning, when they start eating at the table, to make sure that they are healthy and stay healthy so you do not have to have them ending up in your office treating them for not only mental illness but also the many complications of obesity.

You mentioned them. You mentioned diabetes, high blood pressure, so many things. And talk about the cost to this health care system of ours. We always talk about waste, fraud, and abuse in the Medicare and the Medicaid programs and wanting to eliminate that, and we are very diligent and will continue to be so. But this is almost a no-brainer. It is like we heard former Speaker Newt Gingrich say to a group of us earlier today, and the gentleman from Pennsylvania was a part of that as we had him come to speak to Members of the House. We are not talking about low-hanging fruit here in regard to saving money and saving lives. We are talking about fruit that is lying on the ground sitting there rotting waiting for us to pick it up. So clearly that is what my message would be in regard to that.

Without question probably the most common condition that we see in smoking moms is something called toxemia of pregnancy. Toxemia, by the very word, it is a poison. We do not know exactly what that poison is, but something occurs in those moms that develop toxemia. It is not always because of smoking, but frequently it is. And also so often that condition will lead also to pre-term labor and delivery and one of these low birth weight infants.

In the extreme, toxemia of pregnancy before birth results in a very, very high blood pressure. It can cause a stroke, a deep coma, one from which sometimes the mother never recovers and the child is lost. So we are talking about one of the worst complications of pregnancy other than just out and out exsanguination from bleeding, which is also a possibility in any pregnancy.

But smoking, we see that condition more often. And then, of course, childhood asthma, which I am sure the gentleman has seen plenty of cases of that, youngsters that come in because there is that secondary smoke situation. Not only do they have to suffer with it during the 9 months of pregnancy of their mom; but once they are born, that smoking continues in the household. So it is a huge complication, no question about that.

The gentleman is so right, and I appreciate the opportunity to weigh in on this issue.

This issue of scoring, as the gentleman is talking about, it reminds me of course of the debate during the Medicare Modernization and Prescription Drug Act that we passed in December of 2003. Of course, that part D will go into effect and the modernization piece is already in effect for Medicare, but part D, the prescription drug part, will start January 1. But all we heard and continue to hear, particularly from the other side and for those nay-sayers who keep wanting to talk negative about really a very good program that is going to be a Godsend for our neediest seniors, I talked about this on the floor, my colleagues I know heard me last night. But the talk, the emphasis is on the cost of part D, and the cost estimate is based on the number of seniors that participate ultimately.

I do not think anybody really knows, Mr. Speaker, what that number will be; but at one point it looked like the CBO said, well, it is going to be $400 billion additional Medicare cost over a 5-year period of time. Then those numbers were revised, and then we were hearing as much maybe as $750 billion. That is the scoring that the gentleman from Pennsylvania is talking about, and my colleagues understand what he means. You get no credit for the fact that many people who sign up and, yes, there will be an additional Medicare cost for them on this part D program, but the fact that they are able to take those medications, they can finally afford to take that statin to lower their cholesterol and that medication, that insulin to lower their blood sugar or whatever antihypertensive to lower their blood pressure, guess what, we get less spending on part A, the hospital part, when you end up in the emergency room with a stroke because you could not take your medicine, or you end up on the operating table for your coronary bypass or maybe even worse an amputation or a kidney transplant, and then you have this huge cost to the physician under part B.

The truth of the matter is, and what the gentleman was emphasizing, is that you get no credit for saving those costs, not to mention the fact that it is so much more compassionate to spend money on prevention rather than treatment, particularly when the treatment sometimes is not very successful and a person could ultimately be in a nursing home for years and disabled for the rest of their lives.

I will take it a step further before turning it back over to my colleague. It is the same thing, this scoring issue, in regard to the tax cuts that this Republican leadership has effected over these past 3 years. The scorers, the CBO, the number crunchers say, well, these tax cuts, the elimination of the marriage tax penalty, increasing the child tax credit from $600 an infant to $1,000 a child, giving small business men and women an opportunity to more rapidly depreciate investment in bricks and mortar and creating new jobs, all of these things, elimination of the death tax, no taxation without respiration I firmly believe in, the scorers said that was going to cost us $1.3 trillion.

My colleague remembers that. And a lot of people said, oh, we cannot afford that. What are we doing cutting taxes? Well, after about a year and a half, when we looked at our revenue stream, what was the result? We had about 225 billion more dollars, which on the scoring side we get no credit for.

So the gentleman is so right. So many of these things that we are talking about tonight in this hour, these innovations, these community health centers that the President has funded, recommended, and feels so strongly about, on the scoring side you get no credit for; but we do save money, as the gentleman points out. And just think, also, it is the compassionate, conservative thing to do for the American people.

Mr. Chairman, I yield myself such time as I may consume.

The gentleman makes a valid point that we have a lot of obese children. I think it is actually more like 40 percent in some recent studies I have seen. This is a terrible problem, but I urge the Members to defeat this amendment. It was defeated by voice vote last year, and it should be defeated again this year.

The gentleman from California (Mr. Filner) also talks about the accountability of the food industry; but this amendment tells parents that if they are not responsible for their children's eating, they can become millionaires. This amendment manages to exploit children and discourages parents from exercising parental responsibility all at the same time. It literally would hold food companies liable when parents buy their kids a six-pack of kid meals every day for 8 years. Adopting this amendment would turn the Personal Responsibility in Food Consumption Act into the Parent Irresponsibility Act.

Even the ultra-liberal Los Angeles Times has stated this is wrong, saying in an editorial: ``If kids are chowing down to excess on junk food, aren't their parents responsible for cracking down? And if parents and other grown-ups overindulge, isn't it their problem, not that of the purveyors of fast food? Why boost their food bills because of illegal jousting? People shouldn't get stuffed, but this line of litigation should.''

Even our best obesity doctors realize that this amendment is another sad assault on the concept of parental responsibility. As Dr. Jana Klauer, a fellow at the New York City Obesity Research Center of St. Luke's Roosevelt Hospital has said, ``I just wonder where were the parents when kids were having these McDonald's breakfasts every morning. Were they incapable of pouring a bowl of cereal and some milk?''

Let us do what we did last year and defeat this parental irresponsibility amendment by voice vote.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I yield myself the balance of my time.

Mr. Chairman, I urge my colleagues to defeat this amendment. There is a problem in America. There is no question but that there is a problem. We do not solve that problem by shifting responsibility to corporations. It would be good if corporations did perfect things, but we live in an imperfect world where parents have the ability to turn off the television, parents have the ability to teach their children what to eat and how to eat well. And, interestingly, food that is better for you actually costs less.

Parents have the ability to deal with these issues in ways that this Congress and industry cannot do. I urge my colleagues to reject this amendment.

Mr. Chairman, I yield back the balance of my time.

Mr. Chairman, I yield myself such time as I may consume.

This gutting amendment was defeated on the House floor last year by a vote of 241 to 177, and it should be defeated again this year.

Lawsuits relating to obesity and weight gain are wrong no matter who brings them. If private claims are frivolous and should be blocked, then we should not encourage States to bring them either. This bill only applies to lawsuits arising out of or related to obesity and weight gain.

State consumer protection statutes are not intended to cover these kinds of claims. In fact, not a single State consumer protection law allows a State agency to sue for damages because someone got fat from eating too much. However, because the amendment implies State consumer protection laws do allow lawsuits in which the claim is obesity or weight gain, courts may well read it to grant all State agencies new powers to use their State consumer protection laws to seek damages against the food industry for obesity-related claims. That is directly contrary to the purpose of this bill. It would not be right to allow States to use their consumer protection laws in ways they cannot use them now, namely, to sue the food industry for obesity-related claims. Consequently, this amendment should be defeated.

In any case, section 4(5)(b) of H.R. 544 makes it clear that obesity- related lawsuits can be brought by anyone who can prove he suffered harm as a result of a violation of State or Federal law, including laws that prohibit deceptive or misleading advertising, by showing he individually and justifiably relied on such deceptive or misleading advertising and that such reliance was the proximate cause of the injury.

So the bill itself already allows lawsuits against bad actors while preserving the concept of personal responsibility. The amendment does not do that, it should be defeated, and I urge my colleagues to vote against this amendment.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, in closing, let me just say that we have consumer protection laws. This bill is not intended to expand those laws. It is not intended to put restaurants out of business. It is not intended to shift responsibility from individuals and from parents. It is about personal responsibility, and I urge opposition to this amendment.

Mr. Chairman, I yield back the balance of my time.

Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, the amendment is substantially the same as the amendment offered by the gentlewoman from Texas (Ms. Jackson-Lee), which was defeated on the House floor last year by a vote of 166 to 250, and it should be defeated again this year.

This amendment must be defeated because it would gut the bill. This amendment, if adopted, would allow anyone to eat as many health bars and drink as many diet shakes as they wanted and then sue the makers of the health bars and the diet shakes for millions of dollars for making them fat when the health bar and diet shake manufacturers had done absolutely nothing wrong.

The term ``dietary supplement,'' as defined in 21 U.S.C. can include just about any food imaginable. It is defined in 21 U.S.C. 321(ff) as ``a product intended to supplement the diet that bears or contains one or more of the following ingredients,'' including ``a vitamin or mineral.'' Do we really want to encourage lawsuits by people who get fat because they choose to eat too much food that happens to meet this definition? Of course not. And that is why this amendment must be defeated.

The same concept of personal responsibility should apply to anyone who chooses to eat too many health bars or diet shakes, or other similar products, just as it should be applied to anyone else.

If you want to destroy every company that sells products that help keep our waistlines trim by allowing them to be sued out of existence, then vote for this amendment. But if you want to help combat the obesity problem in America, vote down this gutting amendment and preserve the concept of personal responsibility.

Allowing the types of lawsuits this amendment would allow flatly contradicts the advice of our Nation's leading nutritionists. Listen to the insightful words of Dr. Gerard Musante, a clinical psychologist with training at Duke University Medical Center, who has worked for more than 30 years with thousands of obese people. He is the founder of Structure House, a residential weight-loss facility in Durham, North Carolina. He said the following at a Senate hearing on this legislation:

``Lawsuits are pointing fingers at the food industry in an attempt to curb the Nation's obesity epidemic. These lawsuits do nothing but enable consumers to feel powerless in a battle for maintaining one's own personal health. The truth is, we as consumers have control over the food choices we make, and we must issue our better judgment when making these decisions. Negative life-style choices cause obesity, not a trip to the fast food restaurant or a cookie high in trans fat.

``Through working with obese patients, I have learned that the worst thing one can do is blame an outside force to get themselves `off the hook,' to say it is not their fault and that they are a victim. Congress has rightly recognized the danger of allowing Americans to continue blaming others for the obesity epidemic. It is imperative that we prevent lawsuits from being filed against any industry for answering consumer demands. The fact that we are addressing the issue here today is a step in the right direction.''

Even the chairman of the American Council For Fitness and Nutrition, Susan Finn, has written that ``Although obesity is a serious health threat to millions of Americans, lawsuits and fingerpointing are not realistic solutions. If you are obese, you don't need a lawyer, you need to see your doctor, a nutritionist and a physical trainer. Playing the courtroom blame game won't make anyone thinner or healthier.''

Section 4(5)(b) of H.R. 554 makes it clear that obesity-related lawsuits can be brought by anyone who can prove he has suffered harm as a result of a violation of State or Federal law, including laws that prohibit deceptive or misleading advertising, by showing they individually and justifiably relied on such deceptive or misleading advertising and such reliance was the proximate cause of their injury. So if a manufacturer of a health bar or a diet shake lies concerning the calorie content of the food, and someone relies on that false statement and suffers injury, the person can sue the manufacturer under this legislation.

But let us not encourage people to sue makers of health bars and diet shakes because they choose to eat too many of them and get fat. I urge my colleagues to defeat this amendment.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I yield myself such time as I may consume.

The gentleman is talking about various kinds of supplements. He mentioned ephedra and other supplements to help people lose weight. That is a substantial distinction here. If a person buys a supplement and there has been misleading advertising or the manufacturer knows of adverse effects and does not communicate those, and if that constitutes a violation of law, a lawsuit is not prohibited by this legislation. This legislation is going the other way and saying you cannot sue people if you get fat because you make wrong choices, as opposed to you have had some kind of injury or illness because of a misadvertised or otherwise inappropriate utilization of a supplement.

I yield to the gentleman from California.

Reclaiming my time, we are not trying to change the whole world of consumer law here, we are only trying to change one aspect of it. If the gentleman is concerned about, and I know the gentleman has great concern about the effect of supplements like Ephedra which have largely been abandoned by the industry, that is something we ought to be considering, but not in the context of this legislation. I urge my colleagues to reject this amendment.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 494 and ask for its immediate consideration.

Mr. Speaker, for purposes of debate only, I yield 30 minutes to the gentlewoman from California (Ms. Matsui), 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.R. 494 is a structured rule. It provides 1 hour of general debate, equally divided and controlled by the chairman and ranking minority member of the Committee on the Judiciary. It waives all points of order against consideration of the bill. It provides that the amendment in the nature of a substitute recommended by the Committee on the Judiciary and now printed in the bill shall be considered as an original bill for the purpose of amendment. This resolution makes in order only those amendments printed in the Committee on Rules report accompanying the resolution, and it provides that the amendments printed in the report may be considered only in the order printed in the report, may be offered only by a Member designated in the report, shall be considered as read, shall be debatable for the time specified in the report equally divided and controlled by the proponent and an opponent, shall not be subject to amendment, and shall not be subject to a demand for division of the question in the House or the Committee of the Whole. It waives all points of order against the amendments printed in the report, and it provides one motion to recommit with or without instructions.

Mr. Speaker, I rise today to speak on behalf of House Resolution 494 and the underlying bill, H.R. 554, the Personal Responsibility in Food Consumption Act. First, I want to take this opportunity to thank the distinguished chairman of the Committee on the Judiciary, the gentleman from Wisconsin (Mr. Sensenbrenner), and the ranking member, the gentleman from Michigan (Mr. Conyers), and additionally I want to commend the gentleman from Florida (Mr. Keller), a member of the Committee on the Judiciary, for authoring the underlying bill.

Mr. Speaker, today the House will consider H.R. 554, the Personal Responsibility in Food Consumption Act, a common sense piece of legislation that passed this House in the last Congress by a substantial bipartisan vote of 276 to 139. I might further add that 55 Democrats joined with 221 Republicans supporting this bill in an effort to help rein in this mentality of jackpot justice that has plagued our judicial system and cluttered the dockets to a virtual standstill. This legislation would require courts to dismiss any lawsuits that seek damages for injury resulting from weight gain, obesity, or any health condition associated with obesity filed against manufacturers, distributors, sellers, marketers, or advertisers of any food product, in addition to trade associations that represent them.

Of course, support of this bill is not limited to Capitol Hill, Mr. Speaker. A recent Gallup poll found that approximately 9 in 10 Americans, a number of whom are themselves in the ranks of overweight or even obese, opposed holding the fast food industry legally responsible for diet-related health problems of people who eat that kind of food on a regular basis.

Without question, Mr. Speaker, obesity is a problem in our society. Having practiced medicine for nearly 30 years, I am well aware of the habit and complications that obesity can wreak on a person's health, especially over a long term. Like most other Americans, I am also well aware that obesity is on the rise in our country, and particularly among our children. However, the root of the problem is not the existence of fast food or the presence of a local fast food restaurant, but rather the root of the problem lies in the choices of consumers. I have never heard of anyone pulling up to the drive-through window with a hamburglar sitting in the passenger seat forcing someone to buy just one more Big Mac.

Mr. Speaker, allowing an individual to sue a restaurant because the consumer chose to eat there often or chose to eat too much is simply ridiculous and, frankly, it is a dangerous waste of the court's time. For every frivolous case that takes up a spot on the docket, a legitimate case where an individual is truly harmed and truly needs expeditious judicial review gets pushed farther and farther down the line. And as we all know, justice delayed is justice denied.

The title of this bill emphasizes the type of solution needed to address the underlying problem. It is called personal responsibility. It is not just a catch phrase. Individuals have to take control of their own lives. They have to make wise decisions, especially when it comes to their health. And when an individual does make a poor decision, he or she should not be able to abuse the courts so as to shift responsibility to someone else in order to cash in.

Mr. Speaker, while H.R. 544 prohibits certain types of lawsuits, it does make various reasonable exceptions to ensure the protection of a consumer's legitimate claim for legitimate harm. An individual, for example, can still sue in those instances where a contract or a warranty is breached, as long as the basis for the lawsuit is not related to weight gain, obesity or a health condition associated with either. Additionally, a manufacturer or seller is still liable if they knowingly violate a Federal or State statute concerning the marketing, the advertising, or the labeling of a product.

Mr. Speaker, this bill would still allow individuals to bring obesity or weight gain related matters before the FTC, the Federal Trade Commission, or the FDA, the Food and Drug Administration, for consideration and appropriate action. Obviously, individuals can still sue in accordance with applicable State laws protecting against deceptive trade practices and if a person becomes sick from a tainted food product.

In closing, I just want to emphasize that this legislation is common sense and it includes exemptions to ensure legitimate claims still make it to court while abusive lawsuits are stopped at the courthouse door.

Again, Mr. Speaker, I look forward to the consideration of this rule, and I ask my colleagues to support the rule and the underlying bill.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume, following which I will yield 2 minutes to the gentlewoman from Michigan.

Mr. Speaker, this bill, the Personal Responsibility in Food Consumption Act, H.R. 554, is all about, again, personal responsibility and to point out how ludicrous it would be if we allowed personal injury lawsuits against the food industry or any other company that makes a legitimate product.

We just talked earlier in the afternoon, Mr. Speaker, in regard to gun manufacturers.

Mr. Speaker, let me just give an example, if I might. This is a belt, an alligator belt. In fact, it is my belt. Size 36. I have a size 36 waist. This belt, I am proud to say, is hand-finished, American alligator, produced right here in the good old U.S.A. This alligator skin was obtained from a Louisiana hunt, it says on this belt, 1993, manufactured by the Trafalgar Limited Belt Company, a good company. And the belt has served me very well. Size 36 fits me well.

Mr. Speaker, let us suppose now that I decided, it is unlikely that I would do this, but let us suppose I decided I wanted to wear a size 42 and I punched a few extra holes in this belt, which is a size 36, so I could wear it and buckle it with a size 42 pair of trousers. These trousers fell right to my knees in a public place. I do not think I should have the right to sue the belt company because I used its product in a manner that it was not designed to use. I could go out and buy myself a size 42 belt.

Let me give another example, and this is more likely. Let us suppose I really felt like my waist was a size 34, and so I cinched this belt up really good so I could proudly say I am not a 36, I have a 34 inch waist at my age. I would feel pretty good about myself.

But, unfortunately, Mr. Speaker, there is a nerve at my waist called the lateral femoral cutaneous nerve. If someone puts too much pressure around their waist by wearing a belt inappropriately, by cinching it up too tightly, they put compression on that nerve, that lateral femoral cutaneous nerve, and I speak from knowledge on this from 30 years as a practicing physician. That condition, my colleagues can look it up, but I will share it with them, it is called meralgia paresthetica. If Members do not believe me, look it up. It creates tremendous numbness and loss of feeling in the anterior part of the thigh.

Let us suppose someone misused this belt and wore it as a size 34 and decided for that reason to sue this Trafalgar Company, this good, solid American company that makes this belt, for damages. That is totally ridiculous and ludicrous, and that is why this bill is so important. That is why it is called personal responsibility.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Michigan (Mrs. Miller).

Mr. Speaker, I yield myself the balance of my time.

Mr. Speaker, I would like to close by thanking my colleagues for a productive discussion on the rule and the underlying bill. Today, this House has an

opportunity to again pass meaningful reform to not only promote personal accountability but also to strengthen the opportunities for legitimate claims to be heard and adjudicated. Let us take one more step to turn back the tide of so-called ``jackpot justice.''

While runaway juries and frivolous lawsuits might make a few individuals and certain ambulance-chasing lawyers rich, the American people ultimately pay the price both economically and socially.

Mr. Speaker, discouraging individuals from taking personal responsibility does not help anyone. In fact, it will only make matters worse. Encouraging healthy lifestyles and wise dietary choices should always trump rewarding poor decisions by shifting the blame to innocent bystanders.

The Personal Responsibility in Food Consumption Act of 2005 is a good bill, and I look forward to further discussing its merits on the House floor today.

Mr. Speaker, as I mentioned earlier, a strong bipartisan majority passed this bill in the last Congress; and I have no reason to doubt that we should be able to pass it again by a similar, maybe even a stronger, margin; and I urge my colleagues to support this rule and the underlying bill.

Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution.

The previous question was ordered.

Mr. Speaker, on that I demand the yeas and nays.