Floor Statements

I thank my colleague from New York.

You know, we prepare our remarks to come down here and speak, but as I listen to my colleagues across the aisle, I just have to comment on a couple of things here today. First and foremost, this is not a Democratic or a Republican issue. The debt that this Nation faces is not partisan. It's an American issue. We need to join together and figure out a path forward. And to hear my colleagues across the aisle demagogue our Republican budget--well, I challenge the Senate to put forth a budget, and let's put a spending plan in place.

This debate about the debt ceiling is critical to this country because we can't get the Senate to the table to debate a budget, so we've got to somehow get their comments out and get to the American people how very important it is to stop the spending.

The United States of America doesn't have a taxing problem; we have a spending problem. And until and unless we get our spending under control, we cannot move forward as a Nation. It isn't about taxing the American people anymore. They are taxed enough. We need a fairer and a flatter income tax. We need to revise our Tax Code. But, most importantly, we need to stop the spending.

This past week, our President came out, Madam Speaker, and he talked to us about consolidating Departments within the Federal Government, about decreasing government, making it more efficient, and yet he comes to us and he asks us to increase the debt ceiling. That's talking out of both sides of your mouth, Madam Speaker. This President, I believe, thinks that government has the answers, and he wants to give the bureaucrats a blank check to move forward and to spend this country into oblivion.

I came here as the mother of six children and a grandmother of 12 because I believe the best thing we can do for this country is to get our spending under control, stop spending money that we don't have so that the country that we give to our kids and our grandchildren is a better place with more opportunity to achieve the American Dream.

Mr. Speaker, the National Institute of Health estimates that over 15,000 American Women will die from ovarian cancer and an additional 22,000 new women will be diagnosed with the disease this year alone. Each year, ovarian cancer is a heartbreaking tragedy and a threat to the lives of thousands of women.

To that end, Mr. Speaker, I would like to take this opportunity to recognize the remarkable inspiration of one mother who is taking up her daughter's passionate fight against ovarian cancer. In my district of New York, Frieda Weeks has dedicated her efforts to promoting research, awareness, and community support through ``Hope for Heather.''

``Hope for Heather'' is a not-for-profit organization in memory of Heather Weeks, who lost her life to cancer at age 24. Heather was an advocate for women's cancer awareness, who was committed to educating all women on the symptoms of ovarian cancer and raising funds to find a cure.

Mr. Speaker, I encourage all of my colleagues to join me in raising awareness of ovarian cancer, and today I honor Heather, whose dream remains alive and strong today within the central New York community.

Mr. Speaker, I rise to honor the victims of the bombing of Pan Am flight 103 and recognize the twenty-third anniversary of the tragedy.

Pan American Airways Flight 103 departed London Heathrow Airport for John F. Kennedy Airport in New York City on December 21, 1988. The flight would never reach its destination as a bomb exploded on the aircraft killing its 259 passengers and crew, along with 11 people on the ground in Lockerbie Scotland.

Among the passengers killed were 189 Americans, including 37 people from my own district; a couple from the Town of Clay and 35 Syracuse University students returning home from Christmas after a semester abroad in London.

As we prepare to celebrate the holiday season with our loved ones let us remember those who can no longer do so because of this senseless act of terrorism. Twenty-three years have passed, but nothing can replace the loved ones lost in the attack. We must never forget the innocent victims who were killed on Flight 103, nor the families that they left behind. May we use their memory to remind us to stay vigilant in the fight against terrorism and in committing ourselves to creating a safer world.

Mr. Speaker, I rise today to remember and pay tribute to our men and women in uniform during this holiday season.

While we must always remember those who make the ultimate sacrifice for our country, it is especially important to remember them as we celebrate this holiday season. What should be a time of joy, will be a difficult time for many families who are dealing with the loss of a loved one who has died in service to our Nation.

Two families in my own district are coping with the tragic loss of their loved ones this year. Marine Corporal Kyle Schneider of Phoenix, New York was killed by an improvised explosive device while serving in Helmand province, Afghanistan. He is survived by his parents, Richard and Lorie Schneider, his brother Kevin, and his fiancee Theresa Lynn Dodge.

Chief Warrant Officer Brad Gaudet, a native of my colleague Mr. Gohmert's district, was killed in Afghanistan after his helicopter crashed near Kabul. He is survived by his wife Ginny, of Liverpool, New York, and two young daughters.

In this season of giving we must remember not only those who have fallen, but also the families they have left behind.

In addition to remembering those we have lost, we must continue to honor those who currently serve. We must remember that there are soldiers who will spend their Christmas in a war zone fighting for our freedom; soldiers who have not seen their families for months.

We must also remember veterans at this holiday time. While their service is over, the debt of gratitude we owe to them for their sacrifice should never be forgotten.

Christmas is an important time to stop and pay tribute to our men and women in our armed services. We are privileged to live in the greatest nation in the history of the world because of their service and sacrifice.

Mr. Speaker, I rise to call attention to a looming crisis for our seniors. We are facing the very real prospect of millions of Americans losing their access to health care providers because of reductions in Medicare payments to physicians due to the flawed Sustainable Growth Rate, SGR, formula.

Mr. Speaker, on January 1, 2011, the SGR formula will trigger a 27.4 percent pay cut across the board for Medicare physician services. According to the AMA, in my home State of New York, Mr. Speaker, the cut will amount to $28,000 per physician. That loss makes it harder for physicians to pay for office staff, space, and equipment, which translates, Mr. Speaker, to decreased access to care for many patients.

Many physicians have indicated that they will no longer accept Medicare patients. Our seniors, Mr. Speaker, rely on Medicare, which they have paid into and has been there for them.

Mr. Speaker, doctors want to provide care to our seniors, and we cannot allow Medicare payment cuts to prevent doctors from serving all of their patients. Our doctors deserve better. Our seniors deserve better.

I thank my colleague from Louisiana.

Mr. Speaker, I just want to say what an honor it is to be here tonight on the floor with my colleagues and the members of the Doctors Caucus.

I do stand here as a nurse and also as the daughter of a 90-year-old mother. So Medicare for her, I know how she depends on the system.

One of the things we didn't talk about and one of my roles in life was as an attorney, as an attorney who represented a large teaching hospital. About 2 weeks ago, I joined with some of my colleagues on the House floor, and we talked about what this health care law is going to do to our hospitals. When our hospitals and our doctors are affected by reimbursements, by Medicare cuts, that really affects our seniors. That reduces their access to care.

So the first thing I want to do tonight as a health care professional and as someone who cares deeply--and I think that's the beauty of this tonight, of our getting together as people who have invested their lives in health care, who love people, who care about people. This isn't a Republican or a Democratic issue. This is an American issue because health care affects all of us. This is a group of people who really believes that there is a better way, that there is a much better way to provide access to health care in our country without jeopardizing that access and without jeopardizing the quality of care that our country has to offer.

So the first thing I want to do tonight is reassure our seniors that we are talking about protecting and allowing the Medicare system to continue on. What they need to understand is that the health care law has changed Medicare forever. Medicare is different now than it was before the health care law passed. The health care law cuts, Mr. Speaker, $500 billion from Medicare.

I just want to make clear on this graph what happens to Medicare reimbursements from 2012. You can see where we are. It's a minus, a cut of 9.7 percent; but here in 2018, the cuts to Medicare and the reimbursements to our hospitals are down 28.6 percent. I've had all the hospitals in my district come to me, and they were proponents of the health care law. They wanted reform. They've come to me and they've said, This health care law is going to bankrupt us because not only is the health care law affecting their Medicare reimbursements; it's affecting their disproportionate share reimbursements, which keeps many hospitals afloat that treat indigent patients and that treat Medicaid patients. It also affects their GME and their IME, which we talked about in the last Special Order we had in regards to how we're going to keep our teaching hospitals and keep all of our hospitals viable.

So I just want to leave the message tonight with the American people that we care about preserving Medicare for our seniors. We are not proposing anything in our budget proposal that would affect our seniors and those back to age 55. We want to assure the American people that we care so deeply about health care and about the quality of health care; but we are very concerned about this health care law, and it's why we voted to repeal it several months ago. One of the first things we did when we came to Washington was to repeal the health care law because we know what it will do to our seniors and to our health care providers.

I thank my colleague for organizing our time here tonight on the floor. Again, we just want to reassure the American people that we care about our seniors. We want to make sure they have access to quality care, to good health care.

Thank you, Mr. Speaker.

Here in Washington, we are divided on many issues, but whether we are a Republican or a Democrat, Members of Congress recognize the essential role that our hospitals play in our communities.

Hospitals provide care for the sick, and the clinics provide essential care to many. They are engaged in important medical research, and teaching hospitals are educating doctors and nurses to provide care for future generations. In many districts across the country, including mine, New York's 25th Congressional District, our hospitals are our major employers.

They're perhaps the largest single employer a congressional district may have.

The health care sector constitutes nearly 18 percent of the United States' economy, and it is one of the more stable portions of our economy. American hospitals employ more than 5.4 million people; and as hospitals and hospital employees buy goods and services from other businesses, they create additional jobs. The economic impact is felt throughout the community. Hospitals are a vital part of our local and our national economy. In New York State, particularly in my home district, hospitals are the largest single employer.

I want to call your attention to this chart, Mr. Speaker, with data provided by the Hospital Association of New York, which shows the importance hospitals have on my district's local economy. Five hospitals in my district employ over 18,000 people. Together, payroll and purchases in my district alone amount to over $2.4 billion. They generate over $100 million in State and local income sales taxes. This is in my district alone with regard to the economic impact of our hospitals.

Looking at New York State as a whole--and I hope some of my New York colleagues will join me here tonight--the hospitals contribute nearly $108 billion to our State and our local economies. Mr. Speaker, it is no exaggeration to say hospitals are a mainstay of our New York State economy; so when our hospitals are hurting, the effects extend to the entire community. Our hospitals are under assault. Not only will it affect our local and State economies, but it will also affect access to health care, to some of the most basic services that our hospitals provide to our communities.

I now yield to the gentleman from Georgia, Dr. Gingrey.

I thank the gentleman from Georgia for being here this evening.

Mr. Speaker, as my colleague mentioned, the President's Patient Protection and Affordable Care Act, which became law in March of 2010, included some welcome provisions, such as allowing people to stay on their parents' insurance until the age of 26 and prohibiting insurers from denying coverage based on preexisting conditions. These positive provisions, which proponents quickly point to when facing criticism, are far outweighed by the negative consequences that the Affordable Care Act has on our providers and the health care system.

These measures could have been accomplished in a much simpler manner. I say to you, Mr. Speaker, so many roads are paved with good intentions, but the unintended consequences are devastating to our hospitals.

As a health care professional, my opposition to the Affordable Care Act has never been solely based on philosophical grounds, but on strategic and tactical ones. Most Americans--myself included and my colleagues here in Congress--recognize that health care needs to be reformed and that health care costs continue to rise. We need to figure this out. We disagree as to what the health care reform should look like. If I thought that the Federal Government could be the necessary agent of change, that would be one thing; but I don't believe the government can change health care.

The Affordable Care Act affects our hospitals and our providers. This is not a Republican or a Democratic issue, but an American one--as access to health care affects every American.

Mr. Speaker, I yield now to the gentleman from Michigan, Dr. Benishek.

I thank the gentleman from Michigan.

Mr. Speaker, we've touched upon it, and I want to continue having this conversation about the effect that the Affordable Care Act is going to have on our hospitals in our Medicare population. Now, Mr. Speaker, you may have heard over and over again from our colleagues from the other side of the aisle, demagoguing our budget proposal that came out in April. They say we want to kill Medicare; we want to kill Social Security; we don't care about our seniors.

Tonight I stand here, Mr. Speaker, and I tell you, and I want to tell the American people, that the Affordable Care Act, in fact, cuts Medicare spending by $500 billion. Those are actual cuts that are now in the Affordable Care Act, or what is known as the health care law. One of the most negative effects is the result of reductions in hospital Medicare payments and the CMS code, offsetting reductions to hospital payment plans.

I have a chart here, Mr. Speaker. And as I go through my notes, I want it to be clear that you can see 2010 and what happens to Medicare reimbursements, down until 2018. Our hospitals can't sustain these cuts. The five hospitals in my district have come to me, and they said, This Affordable Care Act--and many of these hospitals were big proponents of the Affordable Care Act because they know in our country we need to reform our health care system, we need to make some changes, so they were in support of the law.

But what they didn't realize was this law is going to cut their Medicare reimbursements, which so many of them depend on. It's the mainstay--by 28.6 percent. I've had hospitals in my district say to me, We cannot sustain these cuts. We will go bankrupt. Because you see, Mr. Speaker, it's not only this Medicare, the reduction in these rates, but it also is a series of other cuts which we will get into as the evening proceeds.

I yield to the gentleman from Georgia.

I thank the gentleman from Georgia.

I have spent most of my professional career in the health care industry. I have represented a hospital for a number of years, so I know up close and personal how these issues have affected and will affect our hospitals and our providers. And despite the best intentions of this health care law--whether we disagree with it or we agree with it--despite the best intentions of this health care law, what we are seeing are the unintended consequences.

The fact that our hospitals, our health care providers, will not be able to proceed, will not be able to perform the services that our communities need and expect and have come to expect. That certainly wasn't the intent of the health care law, but ladies and gentlemen and Mr. Speaker, that's exactly what is happening.

I would like to yield and recognize the gentlewoman from North Carolina.

And I thank the gentlelady from North Carolina for being here this evening.

I would just like to continue on because of my concern, and I know my colleagues have such concerns, about the health and the well-being of their hospitals. As I mentioned earlier, they are the largest employer in my district. We refer to it as ``eds and meds.'' We have a large university there and some colleges, but we also have five hospitals in my district. So our reliance for our local economy and for our State economy is just so very important.

I want to talk a little more about what this health care law is going to do to Medicare and do to our hospitals. There is $112 billion in reduced market basket updates to hospitals. There is a $36 billion reduction to Medicare and Medicaid disproportionate share hospital payments.

Now, Mr. Speaker, disproportionate share may sound a little confusing. I'm going to explain what that is. In a district such as mine, we have hospitals that have missions. And I'm sure across the country, many hospitals have missions. They want to make sure that the indigent population, folks who can't afford insurance, who are self- pays or maybe are on Medicaid, that they have access to quality services. So the government says to these hospitals, we understand that Medicaid reimbursements or self-pay patients will not cover your services. So what we're going to do is, we're going to try to make you whole with this disproportionate share. Mr. Speaker, the health care law eliminates the disproportionate share for hospitals, and so hospitals that have a high indigent population or a high number of self-pay patients or those who are on Medicaid, they are not going to get that disproportionate share.

The hospital in my district came down here. It is a large teaching institution. They made a special trip down here to tell me that provision of the health care law will bankrupt them. They probably receive somewhere around $80 million a year to make them whole because of their mission. And isn't that what we want? We want to make sure-- and wasn't that the original intent of the health care law?--to make sure that there was accessible care for all Americans. But here again we reached the unintended consequences, and the effect that this law is going to have on our hospitals.

There is a $7.1 billion reduction for readmissions. We will talk about that in a little bit.

Hospitals, and many of the ones in my district, and I know throughout this country, they are heavily dependent on Medicare and Medicaid dollars. And with that narrow margin, Medicare and Medicaid don't even cover their costs. And so there's such a small margin for them to operate that there's really little capacity for improvements. Realistically, hospitals--especially teaching hospitals and hospitals that are treating the underserved--cannot bridge that gap, and they won't be able to bridge that gap because of this new health care law.

Hospitals must be able to invest in their infrastructure. Having such a narrow margin and/or no margin operating in the red, they're not going to be able to do that. They're not going to be able to invest in infrastructure, systems improvements, new techniques to reduce hospital-acquired infections, new models of delivering health care and electronic health records.

And I want to talk about electronic health records because they were mandated in the health care law. The Affordable Care Act mandates that hospitals must move to electronic health records. Now, from a patient safety standpoint, that's a good thing, but getting hospitals up to speed and getting them ready for business has very high IT costs for our hospitals. So, again, you've got this health care law mandating electronic records, and you've got these drastic cuts to our hospitals in their Medicaid and Medicare reimbursements.

I yield to the gentleman from Georgia.

I thank the gentleman from Georgia.

Mr. Speaker, I want to just emphasize again with regards to this health care law and the fact that this law--and, Mr. Speaker, this is a law, this isn't a budget proposal, this is a law--guts Medicare by $500 billion. It should be of concern, Mr. Speaker, to our seniors because this law, in fact in 2014, will begin to gut Medicare. I again would look at this chart and the Medicare reimbursements. There will be no hospitals that will be able to provide health care. If you look at what the trend is for Medicare reimbursements to our hospitals, they cannot continue to exist based on what is set forth in the Affordable Care Act.

I spoke with the CEO of one of our local hospitals, Crouse Hospital in Syracuse, and he spoke with one of my health care staff; and he indicated to us today that Crouse Hospital, one hospital in the district, is facing a projected loss of $18 million in reimbursement reductions. That number goes to access to care. We can have the most comprehensive health care law on the books, but if we don't have hospitals who are able to provide that care, and we don't have physicians who are able to provide that care, we will have access-to- health-care problems.

Mr. Speaker, earlier I talked about hospital readmission penalties. This is another concern hospitals have to deal with. And tonight we've talked a lot about what the Affordable Care Act will do to hospitals, the effect that it will have on our hospitals, the drastic cuts in Medicare and Medicaid reimbursements and the disproportionate share being eliminated.

But our hospitals are under assault from all sides, and that's part of the difficulty. Maybe they could somehow figure out how to deal with these cuts in the Affordable Care Act; but taken in its totality, our hospitals are having a very difficult time. In fact, as I mentioned earlier, many are concerned that they will be unable to sustain and unable to continue on with their services, given the whole assaults that are coming from all directions.

And this actually is part of the Affordable Care Act. It establishes a punitive policy for our hospitals when they readmit a patient. And I will explain that, Mr. Speaker. Under the health care law, the Affordable Care Act--we call it the Affordable Care Act, we call it ObamaCare, we call it many things--but under this new law that is taking effect gradually, under this to their expected readmission rates, if even more than one readmission occurs--and that readmission means that you discharge a patient, the hospital sends a patient home and then for some reason they have to come back. If that happens with one of three diagnoses within the Medicare scheme, the hospital will be penalized for all of the Medicare reimbursements, not just that one case where there was a readmission, but all of the Medicare reimbursement cases. You can imagine the magnitude and how that will affect Medicare reimbursements.

The other part of this provision in the health care law is that it really doesn't discern between what's avoidable and what's not avoidable readmission. So sometimes a hospital may discharge a patient and it was premature, or something wasn't done and the patient needs to come back. And certainly that should be considered, and we should figure out what went wrong because readmissions are expensive, and so Medicare doesn't want to pay for them. And I understand that. However, some readmissions are unavoidable, and a hospital shouldn't be penalized for an unavoidable readmission; and yet the Affordable Care Act does exactly that.

The Secretary of the Department of HHS, Health and Human Services, which has the authority now to expand what were three diagnoses, now has the authority to expand that list of conditions with regards to readmissions. Hospitals nationwide, Mr. Speaker, are projected to face more than $7 billion in Medicare reductions over 10 years because of this policy, $7 billion to our hospitals.

We began this discussion tonight, Mr. Speaker, talking about the importance to our local economies, the employment numbers, what hospitals pay into our community with their purchases and with their employees, the taxes that they give back to the community; and now we're talking about cutting them again because of this policy.

You know, the issue of hospital readmission is complex, and I hope I did a good enough job tonight of explaining it. And while health care providers agree there's always room for improvement across the continuum of care, readmissions occur for many reasons. And punitive action via reduced reimbursements is not only counterproductive, but it's also potentially harmful to our hospitals, to our patients, and to our communities.

Mr. Speaker, as we work hard to make sure our seniors get the Medicare benefits from the system that they have paid into--and, Mr. Speaker, I want to emphasize that over and over again during the course of this hour, our seniors have paid into Medicare, into the health care system all of their life. And now, as they reach the Medicare eligibility age, they deserve to get Medicare coverage that they expect, that they deserve, and that they've paid into.

But this health care law, this $500 billion cut to Medicare, is going to change that for our seniors. It's not the budget proposal in April that's going to--that was a budget proposal. And you've heard my friends and colleagues across the aisle demagogue our budget proposal in April, saying we want to cut benefits to seniors, Medicare, and Social Security.

The fact is, Mr. Speaker, this health care law, passed into law in 2009, will devastate Medicare. And our seniors, Mr. Speaker, should be very, very concerned about this Affordable Care Act. Not only will it affect our hospitals--as we've spent so much time talking about tonight--but it will also affect

the care and the access to care for our seniors.

Hospitals, Mr. Speaker, already operate on such thin margins, and we talked about this earlier, that for many providers, especially specialized programs, treating patients struggling, say, with substance abuse or helping the developmentally disabled, they will be reduced or they will end those programs. Hospitals cannot operate on such a thin margin and then run the risk of all of these devastating Medicare and Medicaid reimbursements.

Mr. Speaker, I also want to speak tonight a little bit about graduate medical education. As I mentioned earlier, I was an attorney in Syracuse, New York, and I represented a hospital that was a large teaching hospital. And so I know how much they rely on what's called graduate medical education. We often refer to it as GME, sort of the acronym for it, the initials. I'm going to explain what GME is because it's so important to our hospitals. And even hospitals that don't have a medical school attached to them, we'll talk about some of the reimbursements they get because medical students and residents train within these facilities.

Graduate medical education is the training medical school graduates receive either as a fellow or an intern or a resident. Medicare is the largest contributor to the GME. Now, why do I even bring this up? I bring this up because we talked earlier about the many assaults on health care providers, the many assaults that hospitals are concerned about. This is not per se in the health care law, so I want to make that clear. But when it comes to cutting, when it comes to finding and helping this terrible national debt that we have that is now $15 trillion, often we look to Medicare. And one of the areas in Medicare, the low-hanging fruit--whether it's a hospital or a physician--that seems to be the easiest place to go to rather than really looking at our health care system, making it a free market, allowing the market to compete, getting the government out of health care and letting folks buy insurance across State lines. Rather than letting the free market in it, we have the government involved. So Medicare is the largest contributor to this GME.

GME payments, as I mentioned, have been targeted. They've become a target for recommended budget savings. In 2010, the President's Simpson-Bowles Deficit Commission recommended limiting hospitals' GME payments to 120 percent of the national average salary paid to residents in 2010, and reducing another reimbursement the hospitals get, the IME, the indirect medical education, by 60 percent, from 5.5 to 2.2 percent.

Mr. Speaker, these two changes--Medicare reimbursement to the GME, Medicare reimbursement to the IME--would reduce Medicare medical education payments by an estimated $60 billion through 2020, $60 billion.

Mr. Speaker, these aren't just numbers. These proposed cuts would endanger the ability of teaching hospitals to train physicians. We must face the fact that cuts to graduate education would result in fewer practicing physicians and ultimately reduced access to care, which is getting back to why there was an Affordable Care Act.

I talked about this road paved with good intentions. And now what we are seeing is that our hospitals, our health care providers, and the training of physicians are both going to be significantly and severely impacted to the point where access to health care becomes a problem. And so seniors--not just seniors, but all Americans--will have to begin to deal with the fact that primary care physicians, there won't be as many of them. There will be fewer doctors being trained, and for a number of reasons.

The GMEs and the IMEs going to hospitals, if there is any reimbursement reductions to those, but also the fact that as a physician goes through all those years of training and he goes through 4 years of college, 4 years of medical school, an internship, 3 years of a residency, and then if he's a fellow because he wants to specialize, all of those years, and then they go into practice. And you see what the Affordable Care Act, you see what all these assaults are doing on our Medicare and Medicaid reimbursements to physicians as well as our hospitals.

Hospitals that are primarily teaching hospitals face an additional challenge that could threaten the stability of their institutions. Hospitals that have residents in an approved graduate medical education--again, that GME program--receive an additional payment for a Medicare discharge to reflect the higher cost of care. Because they are a teaching hospital, their cost of care is higher.

The regulations regarding the calculation of this additional payment--and I talked about this earlier--is the indirect medical education. This is all very complicated, but what I want to say and what I want to make clear, Mr. Speaker, is that if these cuts go through, it has been estimated that it will cost GME and IME reimbursements from Medicare $60 billion.

This could mean a loss of 2,600 jobs and $653 million in State and local revenue. And, Mr. Speaker, a $10.9 billion loss to the U.S. economy.

At current graduation and training rates, the Association of American Medical Colleges projects that the Nation could face a shortage of as many as 150,000 doctors in the next 15 years--150,000 doctors.

We talked about this, and I think whether you're on one side of the aisle or the other, whether you agree with the health care law, we all agree that we want to have, in a country as rich and as generous as ours, we want to have access to health care for all Americans. But if we don't have physicians to provide that care--and this estimate is 150,000 doctors in the next 15 years--a shortage of that many, it will discourage this access to health care and will result in the longer waiting times for patients.

Mr. Speaker, in closing, I want to just emphasize a few points this evening. And it's always an honor to be here on the House floor. It's always an honor to talk to the Speaker. And tonight it's been an honor to be able to address health care.

As a health care professional, I spent years as a nurse and then, as I mentioned, as an attorney representing a hospital. I know that people within the health care profession are dedicated. They have a passion to provide the American people, to provide any people with quality health care, to make sure and ensure that they have quality health care.

Mr. Speaker, the United States of America has the best health care in the world, and so it is so imperative that we preserve this health care system.

My colleague from North Carolina mentioned earlier that we voted to repeal the health care law, the Affordable Care Act, because it's not in the best interest of good health care. And tonight you heard, Mr. Speaker, from several of my colleagues who are health care professionals who dedicated their whole lives to providing medical services to the people in their communities. They care about quality health care. They care about people, and they care that the United States of America has a good health care system.

But we don't believe that good health care, access to health care, reasonable costs within health care, are going to result from the Affordable Care Act. The Affordable Care Act, I want to emphasize this one more time, Mr. Speaker, cuts Medicare to our seniors by $500 billion. To our seniors, that will be a devastating blow to the services and the access to services that you will have.

But beyond that, it affects how our hospitals can provide care, how our hospitals will be paid, how our doctors and our young doctors will be trained for future generations. This Affordable Care Act may have been the most well-intentioned law, but it is devastating for health care and health care delivery services in the United States of America.

Mr. Speaker, hospitals serve us and our communities. The crafting of the Affordable Care Act was carried out with the good intentions of many, as I said. I don't want to indicate or imply that people didn't have good intentions with this Affordable Care Act, but they approached it from the wrong direction. They put the government in the middle of a physician and the patient, and that can never work.

But good intentions are not enough to excuse legislation which has a terrible and far-reaching, albeit unintended, consequence for all sectors of our society, especially our patients, our doctors, and our hospitals.

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

Mr. Speaker, I rise today to honor the life of Brigadier General Curtis J.

Irwin, who, at the age of 88, passed away peacefully at his home in North Syracuse, New York on Wednesday, October 5th, 2011.

Brigadier General Irwin was born in Syracuse on November 4th, 1922, to the late Joseph A. and Violet M. Irwin. He was preceded in death by his wife, Natalie J. Irwin ``Noble Nanny'' and his sister, Marilyn J. Irwin Boison.

A combat veteran of WWII, he served as commander of the 174th Fighter Wing, (formally the 174th Fighter Group) New York Air National Guard at Hancock Field from January 1st, 1958 until March 13th, 1977. He retired from the New York Air National Guard on August 31st, 1978.

General Irwin's flying career spanned more than 35 years, beginning when he was still attending North Syracuse High School. Working weekends at the old Amboy Airport, he received compensation for his labor in flight instruction.

He began his military service in August of 1942 and entered pilot training the following March. After winning his wings and commissioning as a Second Lieutenant in the Army Air Corps in May of 1944, he served in the Pacific Theatre of Operations as a fighter pilot flying the P-47 Thunderbolt.

Campaigns in which he participated include the China Offensive, Western Pacific, and the Air Offensive of Japan and the Ryukyus Islands. He was decorated with the Air Medal, the Oak Leaf Cluster, and four battle stars for his wartime service.

Following World War II, General Irwin was an original member and assisted in the organization of the Air National Guard in Syracuse. While commander of the 174th Fighter Wing, General Irwin saw the unit undergo many aircraft conversions and unit changes. It was the first unit to operate jet aircraft in New York State and in 1951, was selected as one of the two units in the country to test a secret program of runway alert to augment the Air Force. The results were so successful that this program is to this day a vital part of the United States' air defense.

In 1960, the 174th was recognized by the National Guard Bureau as the most combat-ready F-86 unit in the country. During the Berlin Crisis in 1961, the 174th was activated and within 30 days, all personnel, planes, and equipment were deployed to Phalsbourg Air Base in France. This was the largest movement of jet fighter aircraft in Europe since World War II. General Irwin led his unit's planes and crews across the northern Atlantic route via Labrador, Greenland, Iceland, Scotland, and on to the mainland of Europe. Despite many dramatic moments, all arrived safely on the continent. The unit was again called up during the Pueblo Crisis and was deployed to Cannon Air Force Base in New Mexico.

In addition to his military service, General Irwin was instrumental in linking the 174th Fighter Wing with the local community. He organized a program of community education for planning and zoning actions compatible with aviation growth.

Honors bestowed upon General Irwin are many. General Irwin was awarded the Governor's Trophy in 1960, 1973, and 1976. In addition, he received the first Department of Defense Award for Domestic Action in 1971. Thompson Road through Hancock Air Base now bears his name and is called the ``General Curtis Irwin Parkway''. In our local community, General Irwin was named to the North Syracuse School District Wall of Distinction in 1990.

Surviving General Irwin are his children, Laurinda ``Laurie'' A. Irwin of Cottage Grove, Minnesota; Sheila M. (Lester) Austin of Lafayette, New York; Lisette ``Lisa'' Damon of North Syracuse; several nieces and nephews; his longtime companion Betty Tryon of Liverpool; and his 174th Fighter Wing Family.

On behalf of the people of the 25th District of New York and a grateful Nation, I thank General Irwin for his service.

Thank you very much.

Mr. Speaker, I am so proud to stand here this evening with my fellow Republican female Members of Congress, and we stand here tonight united on behalf of our seniors.

I come before the House tonight, Mr. Speaker, not only as a nurse and someone who's been involved in health care most of my professional life; but I come here as the daughter of a 90-year-old senior citizen.

I rise here tonight to express my appreciation to my mother and to all the other seniors who've made such valuable contributions, both in my district and throughout the United States of America. The seniors of today have fought wars, they've educated us, they've helped to build infrastructure and technology that has led the way to our modern life.

Today's seniors are still busy enriching our society. Some of our seniors are busy in the community with care giving, with volunteering, with sharing important life lessons with their children, with their grandchildren and with their neighbors.

Yet some seniors, Mr. Speaker, in today's economy find themselves working later in life; and when they finally have the ability to retire, they will be dependent on Social Security and Medicare, programs that they have paid into their entire lives.

Mr. Speaker, America must honor its obligations to our seniors. We must achieve bipartisan solutions that don't cut our seniors' benefits but, rather, ensure continued existence of these programs.

I'm so saddened by the calls I get from seniors day in and day out, Mr. Speaker. They call my office, they write letters, and they're so fearful because of the misinformation that they have been given.

I want to stand here tonight with my Republican colleagues and ensure our senior citizens we are protecting your back. We are protecting Medicare and Social Security, the programs that you rely on. We want to assure them they don't have to worry, that we will take care of them. We will honor our commitment to them, just as they honored their commitment to the United States of America.

I thank the gentlewoman from Missouri.

Mr. Speaker, I rise on this occasion to speak about one of the most significant issues facing us today: domestic violence. Mr. Speaker, domestic violence is both unacceptable and intolerable.

As a legal domestic violence counselor, I have had the opportunity to offer pro bono

legal services through Vera House in Syracuse, New York to help victims of domestic abuse and sexual assault. Vera House provides services for women, children and men, as well as domestic violence prevention programs for the Central New York region. Through my work at Vera House, I have seen how domestic abuse affects people of all ages, races, religions, socio-economic conditions.

Domestic violence is known by many titles: domestic abuse, spousal abuse, family violence, and intimate partner violence. It also takes many forms from physical violence involving such things as hitting, kicking, biting, shoving, or restraining. It can be emotional or verbal abuse which manifests in many types of behavior--controlling, domineering, threatening, or humiliating.

Mr. Speaker, domestic violence is a problem facing every community in America. According to the Centers for Disease Control, domestic violence is a public health problem affecting over 32 million Americans, or 10 percent of the population. The effects of domestic abuse are staggering. Physical abuse can be bruises, broken bones, head injuries, lacerations. But those are just the external physical wounds. Internal bleeding and chronic health conditions such as arthritis, irritable bowel syndrome, ulcers, migraines, and miscarriages can also be linked to physical abuse in abuse victims.

Not only is domestic abuse physically dangerous, it also takes a psychological toll. The damage from this kind of abuse is not limited solely to survivors. It extends to their children, family, and community.

All Americans have a moral obligation to stand up against those who commit violence against women, men, and children. We must be able to both recognize and prevent domestic abuse. We must come together to support survivors of abuse, while providing alternatives to this destructive cycle. As a country, we are equal to the task of fighting domestic abuse and sexual assault if we put our minds and spirits to it.

Madam Speaker, on rollcall No. 803, had I been present, I would have voted ``yea.''

I thank the chairman.

Madam Speaker, I rise in strong support of H.R. 2074, as amended, the Veterans Sexual Assault Prevention and Health Care Enhancement Act.

Mr. Speaker, it is with great sadness that I wish to inform the House of Representatives that on June 30, 2011, Marine Corporal Kyle Schneider of Phoenix, New York, in Onondaga County was killed by an improvised explosive device while serving in Helmand province, Afghanistan.

Corporal Schneider was born in Syracuse and lived in Baldwinsville, New York, for most of his life. He was a graduate of Baker High School and attended Onondaga Community College for a year before enlisting in the Marine Corps in 2008. Corporal Schneider is survived by his parents, Richard and Lorie Schneider; a brother, Kevin; and his fiancee, Theresa Lynn Dodge of West Columbia, Texas.

Corporal Schneider was a proud and valiant marine. But he was also a son, a brother, a grandson, a fiancee, friend, and comrade. He will be greatly missed, and no words will diminish the grief of those who knew and loved him. In his death, he has earned the thanks of a grateful Nation.

I thank the gentleman from Wisconsin for yielding me this time.

Mr. Speaker, I rise in support of H.R. 2560, the Cut, Cap, and Balance Act. This legislation is strong medicine, Mr. Speaker, but it is what will cure what ails the American economy.

For far too long, Washington has overspent, borrowed, and heaped debt upon our children and our future children. If we don't make a change with cut, cap, and balance now, the American Dream will go away; and our children and our grandchildren won't have the opportunities that this country has always offered.

It's time for the Federal Government to get our spending under control; and this legislation, Mr. Speaker, is a good first step. It's a reasonable plan, far more than we've seen from the Senate or from the President. It is the only plan that will cut, cap, and balance, and do what we need to do for this economy.

Mr. Speaker, Washington has a spending problem. It does not have a taxing problem.

I would just remind the Speaker, in December, a Democratic-controlled House, a Democratic-controlled Senate, and a Democratic President passed a bill to extend the current tax rates because they knew what would happen if we raised taxes in an economy as sluggish and as poor as this one is right now. Raising taxes is the wrong thing to do for this economy and for this country.

Mr. Speaker, most States have balanced budget amendments. It's time for the Federal Government to do the same. This massive spending- induced debt is crushing the American Dream. We must stand up for the American Dream and do what's right for America.

I urge my colleagues to pass H.R. 2560, Cut, Cap, and Balance.

Mr. Chair, I rise in support of the Cole Amendment to H.R. 2219. Mr. Cole's amendment would restrict the use of funds for furnishing military equipment, military training or advice, and other military activities in Libya.

The President has failed to properly consult Congress on the engagement of hostilities in Libya. The President is also in violation of the War Powers Resolution because of the continued military action past the 90 days allowed under the War Powers Resolution. The Administration's attempt to excuse the continued U.S. military actions in Libya by saying that the hostilities do not reach the threshold set by the War Powers Resolution is disingenuous.

The power of the purse plays an important part in the U.S. government's system of checks and balances. This amendment today will prohibit the President from continuing to conduct military operations in Libya until he can justify the actions to the Congress. I strongly support the limitation of funding of current military activities with respect to Libya. The President should not have a blank check to conduct wars without the consultation and authorization of Congress.