Floor Statements

Madam Speaker, I submit for the Record a copy of my opening statement delivered before the Committee on Oversight and Government Reform on October 23, 2007 on Uranium Contamination.

I want to thank and commend the Chairman for holding this

hearing. Native Americans have borne a disproportionate

burden of the toxic legacy from this country's pursuit of

nuclear weapons and nuclear power. This is a topic that has

been important to me for a long time. In this classic

environmental justice story, we can see how long

disadvantaged peoples have been burdened with inhumane levels

of contamination. And we see how long it can take just to

begin to undo the damage that such contamination brings.

The stories we will hear today will also make clear that

quests for power--be they political or electrical--have no

respect for life and exact an unacceptable cost to human

health and the environment. The EPA guesses there are about

520 abandoned uranium mines in the Navajo nation and 1,200

abandoned mines in the area. The Navajo nation is home to 5

old uranium mills. Each of the mill sites and the mine sites

represent a potential groundwater contamination site in

addition to being sources of air and soil contamination.

There are many potential exposure routes. Children play in

the water that accumulates in the radioactive tailing piles.

Homes and hogans are built out of materials that are

radioactive. Wind-blown dust from the tailings is inhaled.

Groundwater is contaminated with uranium and its daughter

products. Wildlife and plantlife concentrate the

contamination and become food for other wildlife or for

Navajo living off the land.

Uranium can be toxic in two ways. First, its properties as

a chemical confer an ability to irreversibly destroy parts of

the kidney when acting in isolation. But, like lead and

mercury, it is a metal which interacts with uranium in the

human body. Native Americans are known to experience

disproportionately high levels of lead poisoning. And when

uranium and lead both make their way into a person, the toxic

effect on the kidney could be additive or even synergistic.

Uranium is also toxic because it naturally decays into

other elements like radium, thorium and radon, each of which

is also radioactive. Radon alone is the number two cause of

lung cancer in the U.S. behind smoking.

The industrial process of extracting and concentrating

uranium uses a host of other highly toxic compounds like

various acids and cyanide, which are common mine tailing

contaminants. And of course there are the other elements that

co-occur with uranium like arsenic and fluoride which are

left behind when the uranium is refined. Each of these

compounds bears its own list of health effects. And each

combination of two or three or more of these compounds brings

their own set of health effects. It could take generations

just to completely understand the health effects of the

contamination at all of these sites in question.

Making things worse, it is a formidable challenge just to

understand the magnitude of the contamination--so much so, it

hasn't even been done yet. No comprehensive review of

groundwater contamination at all of the mine sites has been

done. No comprehensive review for the presence of elevated

levels of radiation in Navajo houses has been done even

though dozens are known to have been built with radioactive

materials. No comprehensive review of the health effects of

the contamination from the mines and mills has been done.

There is no way we can begin to address the problem if we

can't define it.

One estimate I've heard is that the entire cleanup could

cost around $500 million. That seems unrealistically low.

Efforts just to clean up the groundwater at three of the old

mill sites on the Navajo nation are predicted to take 20

years. Already, the contamination has spanned generations and

will span many more if we continue the current pace of

cleanup.

Some effects can't be cleaned. Before the mines were

opened, the Navajo way of life was heavily dependent on

natural resources, which fostered a healthy respect for their

environment. Not only did they rely on it for clean water and

abundant food, but they incorporated it into their customs,

their religion, and their way of life. Carol Markstrom and

Perry Charley pointed out in their chapter of The Navajo

People and Uranium Mining, that the contamination of

livestock, of the medicinal herbs they used, and the water

bodies their children played in, changed the view of the

land. It was embraced and used as the conceptual center for

their way of life. After the contamination, they feared it.

It is hard to imagine how destabilizing it would be if we

thought radioactive contamination permeated all that we rely

on to be clean and safe.

Now, almost 60 years after the first uranium contamination

began, there are corporations who want to reopen some of

these very same mines and extract more uranium for nuclear

power plants.

Never mind the contamination already created that we're

still trying to define, let alone clean up. Never mind the

permanent social damage inflicted by this contamination.

Never mind that nuclear power is nowhere near economical.

Never mind the lack of a viable and safe storage facility for

the waste that will continue to be toxic for thousands of

years.

I look forward to hearing from our witnesses about plans

for cleaning up the contamination in shortest possible

timeframe. And I stand ready to do whatever I can to not only

help this process along, but to make sure we don't do anymore

damage by failing to learn our lessons from the past.

Madam Speaker, I submit for the Record a copy of my speech delivered at the summit on the future of Medicare on October 19, 2007.

Good afternoon. I want to thank each of you for coming to

discuss one of the issues that reflects the values of this

country--health insurance for retirees and the disabled. I

want to especially thank the Senior

Voice Coalition, a group of organizations and passionate

individuals who are truly the grassroots leaders in

organizing around issues affecting seniors in our community.

Before I begin, please know that while there are many issues

of importance, we will only be talking about Medicare at this

summit today. If there are other issues on your mind, I would

be happy to discuss them with you if there is time after.

Many of you recall that I held 13 town hall meetings in

2005 during the Social Security privatization debate. At

these town halls, I presented detailed information on the

reasons why I rejected the notion advocated by the President

and some in Congress that there was a ``crisis'' in the

solvency of the combined Old Age, Survivors, and Disability

Insurance Trust Fund. We were told that to correct this

manufactured crisis, the best solution was to privatize

Social Security. Even if there was a ``crisis,'' which did

not actually exist, according to both the Social Security

Administration and the Congressional Budget Office, the worst

solution would be to drain the trust fund more quickly and

therefore undermine the entire program.

Folks, we are on the verge of a very similar debate today

with Medicare, our nation's other social insurance program.

There is a symbiotic relationship between Social Security and

Medicare. But unlike with Social Security, much of Medicare

has already been privatized. Today I want to explore that

with you by looking at two different Medicare programs that

have been the cornerstones of efforts to privatize Medicare

to see how they have performed. First, we'll look at the

Medicare prescription drug plan, also known as ``Part D,''

which leaves enrollees no choice but to go through the

extraneous insurance companies. Second, Medicare Advantage

shoehorns in the option to have private insurance industry

middlemen to dole out health care according to what is

profitable.

Part D

In 2003 came the single biggest Medicare privatization

effort to date, the Medicare Modernization Act. It passed the

House of Representatives only because the then-Majority party

held open a 15 minute vote for over three hours in the middle

of the night so they could strong-arm their way to a passing

vote. Not only did it create an entirely private, chaotic

prescription drug program, but it also dramatically increased

subsidies to Medicare Advantage plans.

Several of us in Congress warned of what we were buying

into with Part D. We warned against the forced inclusion of

the unnecessary middleman--the insurance industry--and its

likely effects on cost and access to meds. We warned about

CMS' inability to negotiate drug prices like the VA does. We

warned of a benefit that was far too complex. We warned of

the now famous doughnut hole that left people without

coverage for a period of time even though they were still

paying premiums. We supported a bill that created a new

prescription drug benefit that did away with all those

problems by keeping the insurance industry out of the benefit

and letting Medicare administer it.

As you know, we were not alone in our fight. At the time,

the Center for Economic and Policy Research released a study

showing that even if we took the modest step of allowing

Medicare to negotiate drug prices, we would save so much

money that we would be able to cover every single beneficiary

with no co-payments, no deductibles, and no premiums . . .

and still have $40 billion dollars left.

Oversight and Government Reform Committee report on Part

D.--I am sad to say that we were right. Just this Monday, the

Committee on Oversight and Government Reform released a

study, which was requested by a handful of my colleagues and

me, on the performance of Part D so far. It found three

things. First, it confirmed the most obvious concern; that

administrative costs are far higher than they should be. This

was expected because of the forced inclusion of the insurance

industry in the benefit. The insurers reported administrative

expenses, sales costs, and profits of almost $5 billion in

2007--including $1 billion in profits alone. The

administrative costs of the privatized Part D program are

almost six times higher than the administrative costs of

the traditional Medicare program.

The second finding was that the insurance industries were

not doing a good job of negotiating with the pharmaceutical

companies to lower prices. One of the main rallying cries of

the Part D privatization effort was that the private insurers

could be more effective negotiators than Medicare. Turns out

to not be true. Now, instead of negotiating for lower prices,

the insurers negotiate for rebates from the drug companies,

which is what the Part D law calls for. The committee

investigation found that drug price rebates negotiated by the

insurers reduce Medicare drug spending by just 8.1 percent.

In contrast, rebates in the Medicaid program reduce drug

spending by 26 percent, over three times as much. Because of

the difference in the size of the rebates, the transfer of

low-income seniors from Medicaid drug coverage to Medicare

drug coverage will result in a $2.8 billion windfall for drug

manufacturers in 2007. Furthermore, the insurers receive no

rebates or other manufacturer discounts for three-quarters of

the drugs used by seniors.

And the third finding was that when insurers do actually

get a rebate from the drug companies, rather than passing the

savings on to seniors in the form of lower prices, they keep

the money for themselves! This year alone, the private

insurers will receive $1 billion in rebates on purchases that

seniors pay for out of their own pockets, thanks to the

doughnut hole. But beneficiaries continue to pay premiums.

Unpredictability in Part D.--Another problem with Part D as

it has been implemented is that stability is lost. Much like

with corporate pension scandals, instead of receiving a

guaranteed benefit, those enrolled in Medicare Part D only

receive a guaranteed bill to pay. Instead of being able to

have peace of mind when it comes to whether or not drugs

prescribed by a doctor will actually be covered, a state of

financial nervousness and uncertainty is par for the course

with Medicare Part D. A consumer's Union study found that

most insurers raise the cost of their drugs during the year--

in one case by 28 percent. The same uncertainty is present in

predicting which month beneficiaries will hit the doughnut

hole and be forced to pay all your drug costs as if you had

no benefit at all.

Clearly, Part D is more of a benefit for the pharmaceutical

and insurance industries than retirees and the disabled. The

Part D provisions of the Medicare bill alone guaranteed $139

billion in guaranteed profits for the pharmaceutical

industry, which amounts to 61 percent of the total spending

in the bill for prescription drugs, according to Boston

University School of Public Health. Even so, Part D is not

where the real money is. The real money is in the Medicare

Advantage, the HMOs, PPOs, PFFSs and other alphabet soup of

private plans offered through Medicare as an alternative to

traditional Medicare. I'd like to talk a bit about these

plans now.

Medicare Advantage

Medicare Advantage plans have been in existence for several

years now, but the 2003 Medicare Modernization Act has

drastically accelerated privatization. Lets take a look at

how the plans have done, starting with how they deal with

customers. I'll start with their efforts to sign you up and

then we'll see how they treat you after you're already on the

plan and are requesting coverage.

Marketing.--An October 7 article in the New York Times

conducted their own review of 91 federal audits of privately

run Medicare plans--both Medicare Advantage Plans as well as

Part D plans. They found that ``tens of thousands of Medicare

recipients have been victims of deceptive sales tactics.''

They also found that ``since March, Medicare has imposed

fines of more than $770,000 on 11 companies for marketing

violations and failure to provide timely notice to

beneficiaries about changes in costs and benefits.'' I want

to read you two other quotes from that article to round out

the picture. ``In July, Medicare terminated its contract with

a private plan in Florida after finding that it posed an

`imminent and serious threat' to its 11,000 members.''

``Medicare officials said that compliance problems occurred

most often in two areas: marketing, and the handling of

appeals and grievances related to the quality of care.''

That stands to reason since that is where the profit is

made.

Humana is a good case study. Humana, which is the second-

largest provider of Medicare Advantage plans, was required to

fulfill corrective action plans for 300 different violations.

The Center for Medicare and Medicaid Services or CMS

administers Medicare. Their audit results for Humana included

findings that marketing agents were not trained or

supervised, enrollees were not informed of changes to plan

formularies (list of covered drugs), and enrollees were not

provided with explanations for claims denials or appeal

rights when their claims had been denied. This is the same

company that gained 4 million new policy holders and reported

to stockholders in April that it had amassed ``record-

breaking revenues,'' according to an article in ``The

Nation.'' Keep in mind that this company pays its agents a

commission five times greater for enrolling individuals into

their Medicare Advantage plan than the commission they

receive for enrolling them into a stand-alone prescription

drug plan. Similar arrangements are true for other leading

insurers like United Health Care, Aetna, and Blue Cross and

Blue Shield. But why would they do that?

Big insurance companies are quite eager to sign up people

for Part D plans. But Part D plans are nothing compared to

the profit to be made in Medicare Advantage. So insurers

offer low price Part D plans in order to get their foot in

the door with those who were on traditional Medicare. Then

they aggressively marketed their Medicare Advantage plans,

too often using the unscrupulous tactics I just described.

Such marketing tactics are especially effective when the

plans are so complex, the customer is easily fooled. In

Humana's case, the tactics worked. They were a relatively

small company before the prescription drug plan and the

Medicare Advantage push. But they were able to get 100,000

people to move to Medicare Advantage plans. An insurance

consultant said ``an additional 100,000 people contributing

to top line revenue is not insignificant--it's an extra

billion dollars.''

Customer Service.--Now that's just the marketing. What do

they do when they have you? The New York Times article found

that both Medicare Advantage and Part D enrollees ``had

claims improperly denied by private insurers.'' Some examples

of other problems found include ``the improper termination of

coverage for people with H.I.V. and AIDS, huge backlogs of

claims and complaints, and a failure to answer telephone

calls from consumers, doctors and drugstores.''

WellPoint, an Indianapolis-based company that covers

360,000 members under Medicare, had a backlog of 354,000

claims under its Medicare plans. Auditors logged an average

wait time of 27 minutes to answer enrollee phone calls and a

16-minute wait time to respond to provider calls. Of the more

egregious offenses, Sierra Health, based in Las Vegas,

wrongfully terminated drug coverage for 2,300 HIV-positive

Medicare Advantage enrollees, improperly claiming they had

defaulted on plan premiums.

Fewer options, not more.--Medicare Advantage advocates

often speak of the greater choice in their plans as opposed

to traditional Medicare. I don't think you can have more

choice than to be able to choose from any doctor, which is

the case with traditional Medicare, but we'll take a look

anyway.

As with Part D plans, there are countless stories of

beneficiaries seeing changes to their plan midyear, including

cost increases, dropping certain drugs from formularies, or

doctors dropping out from frustration with the plans. In

fact, Medicare Advantage plans talk a lot about their

extensive network of doctors but customers frequently find

that when try to go to one, the docs won't take Medicare

Advantage customers. Many doctors don't like it because of

the low pay and because of the insurance industry second-

guessing their diagnoses and choices for providing care. Even

though all these changes can be made at any time in the

enrollment cycle, beneficiaries can only switch plans once

per year.

Some argue that Medicare Advantage offers a better quality

of care than traditional Medicare. The Congressional Budget

Office disagrees, stating ``though Medicare Advantage plans

cost more than care under the fee-for-service program does,

on average, they would be more cost-effective if they

delivered a sufficiently higher quality of care . . . The

limited [quality] measures available suggest that Medicare

Advantage plans are not more cost-effective than the fee-for-

service program.''

Those enrolled in Medicare agree, as traditional Medicare

beneficiaries are less likely to have problems accessing

specialists, according to MedPAC.

Out of pocket costs.--Medicare Advantage insurance

companies make money when they shift the costs onto you and

me. One of the ways they do that is by providing incomplete

insurance or underinsurance. They can offer meager coverage

in specific unnoticeable areas that only matter if you get

the illness that isn't covered well. Because Medicare

Advantage plans are not required to be standardized--meaning

different companies are not required to offer the same plan

structure and compete only for price--these companies can

skew their plans to maximize their profits and decrease

benefits. One tragic result is that people in more need of

services, especially those in need of physician-administered

chemotherapy drugs and dialysis services, pay more under

Medicare Advantage than they would under traditional Medicare

for less service, Their out-of-pocket costs are unexpectedly

and dangerously high. This is one of the biggest health care

problems that we don't hear enough about. About half of all

bankruptcies in this country are related to medical bills. Of

those medical bankruptcies, 75 percent of the people had

insurance before they got sick. But because their insurance

still allowed them to go bankrupt, it was clearly lacking.

Profitable, but lacking.

For those of you that have seen Sicko, the Michael Moore

movie about health care, you know that another way insurance

companies make money is to deny benefits, which is done in

spades under Medicare Advantage. The Medicare Rights Center

who collects many Medicare Advantage complaints told the

story of an 80 year old man enrolled in a private Medicare

plan called HealthSpring. He had a heart attack and went to

the hospital. All of his claims were denied because he didn't

get prior authorization from the plan to enter the hospital.

His hospital bills now top $87,000 dollars.

Propping Medicare Advantage up.--You would think that since

Medicare Advantage beneficiaries are getting such an inferior

product, that it would cost less. It is not so. As with Part

D, Medicare Advantage is far more costly than traditional

Medicare. Both the Medicare Payment Advisory Commission

(MedPAC) and the Congressional Budget Office (CBO) report

that for 2007, it costs taxpayers 12 percent more (on

average) to cover beneficiaries enrolled in private Medicare

Advantage Plans than under traditional Medicare. That is an

extra $149 billion over 10 years. The Chief Medicare Actuary

has said that the beneficiary enrolled in traditional

Medicare pays an extra $24 per person this year because of

overpayments to Medicare Advantage. This overspending also

cuts years off the life of the Medicare trust fund and

diverts money away from hospital and acute care services,

While the Social Security trust fund can pay 100 percent of

benefits until at least the year 2041 without any changes

whatsoever, the Medicare Hospital Insurance (or HI) Trust

Fund can pay 100 percent of claims only until the year 2019,

based on current actuarial assumptions, in large part because

of privatization.

Not only is the program inefficient, but it is growing

steadily. According to the Congressional Budget Office, 18

percent of current Medicare beneficiaries are enrolled in a

Medicare Advantage plan. This number is expected to increase

to 26 percent by 2017. The biggest growth--about 650 percent

since 2005--has been in enrollees in the private fee for

service plans which have enjoyed exclusive access to major

subsidies from Congress as well as exceptions to standards of

quality care. Unfortunately, the fastest growing type of plan

is also the least efficient of all Medicare Advantage plans.

They cost, on average, 19 percent more than traditional fee

for service Medicare. Where does all that money that should

go to health care, actually go? MedPAC found that half of the

overpayments go directly to profits, marketing, and

administrative costs. That's worth repeating. Half of the

overpayments go directly to profits, marketing, and

administrative costs.

These private fee for service plans aren't the only ones to

get corporate welfare. The PPO ``stabilization'' fund is a

slush fund designed to encourage growth of new regional PPOs

of 10 billion dollars over 10 years. That's in addition to

general subsidies for Medicare Advantage plans. But in 2006,

88 percent of beneficiaries had access to a regional PPO. So

subsidies for growth are unnecessary. Even MedPac recommended

eliminating the slush fund.

I mentioned earlier that Medicare Advantage Plans are

lucrative for insurance companies. UnitedHealthcare will make

about 11 percent of its net income for 2007 from Medicare

Advantage. That number is 66 percent for Humana. Between 2005

and 2006, when a lot of these subsidies took effect, United

and Humana saw increases in revenue of over 50 percent.

WellPoint saw an increase of 27 percent. When there is so

much money at stake, it is very cost effective to have not

only a big marketing push, but also a strong lobbying army

to make sure your Congressional subsidies don't go away.

That is what they do.

general discussion

There is a race in the health insurance world to determine

who can provide the lowest quality benefits for the highest

possible cost that consumers, companies, and the government

will accept.

Seniors and disabled individuals who have contributed to

Medicare from a lifetime of work deserve to have simple,

clearly defined benefits which do not change from month to

month, year to year. We should not be paying companies

exorbitant administrative costs and overpayments that

maximize profit margins in order to put beneficiaries,

benefits at risk. All of this is the case with the private

Medicare Advantage and Medicare Part D, and it should be

stopped.

The best, most efficient way to ensure all Medicare

beneficiaries will always have real, reliable, and complete

benefits is to end private involvement in Medicare. That's

why I, along with John Conyers of Michigan, coauthored the

Expanded and Improved Medicare for All Act, H.R. 676, back in

2003. HR 676 captures the enormous savings to be had if

Americans had health care provided through Medicare and uses

them to cover everyone for all medically necessary services

with no copayments, no deductibles and no premiums. This bill

would strengthen Medicare by removing the for-profit

interests, decrease the financial burden to beneficiaries,

and increase the quality of care--all without the confusing

maze that privatized Medicare has become today. There is

enough money that America spends in health insurance and

health care today to cover everybody. Every year, $2.2

trillion is spent, and only about 69 cents out of every

dollar actually goes to providing health care services. We

are all paying for universal health coverage, we just aren't

getting it.

Congress will be required to hold hearings on and propose

changes to Medicare due to the financial situation of the

program which privatization has created. I intend to use this

opportunity to emphasize the best, most comprehensive, and

most cost efficient way to strengthen benefits for those

enrolled in Medicare--H.R. 676.

What's happening in Washington.--Many of you know an early

version of a bill to provide health insurance to millions of

children through a program called SCHIP, also called for cuts

to one of Medicare Advantage slush funds I mentioned earlier.

I supported that bill but the insurance industry mounted an

expensive and aggressive lobbying campaign that ensured their

slush fund stayed in place. Now there is talk of using that

slush fund money to pay for maintaining Medicare payments to

doctors as opposed to allowing scheduled cuts of about 10

percent to take place.

H.R. 676 now has 85 cosponsors and is the only national

health care reform bill that has an entire national movement

behind it. There are two national non-profit organizations

and several regional organizations devoted to its passage.

And it has the official backing of 93 Central Labor Councils,

including several Cleveland and Ohio unions as well as cities

and states across the nation.

There is the possibility of implementing an interim measure

of providing a prescription drug benefit that gets rid of the

insurance companies and lets the benefit be administrated by

Medicare. Doing so would clearly lower costs, increase access

and increase quality. But I would like to hear what you think

of that idea. Would people be willing to give up their

privatized plans for more plans that give greater security

and coverage?

And while I'm asking for your input, I'd like to ask you

about another related issue that has recently come up. As I

understand

it, Ohio Public Employees Retirement System (OPERS) has

announced that it will shift from offering two traditional

Medicare plans to offering one traditional Medicare plan and

one Medicare Advantage plan. I am concerned about this choice

and would like to hear from you about it.

I know you all have been waiting for the opportunity to ask

questions and share your comments, so let's transition to

that right now.

Madam Speaker, I rise today in recognition of Dr. Elizabeth Balraj as she retires after 35 years of dedicated public service to the people of Northeast Ohio, including 20 years as Cuyahoga County coroner.

Dr. Balraj began her career in the 1960s, immigrating to the United States to become a physician and surgeon after completing her studies in her native India. She practiced medicine at Akron General Hospital and St. Luke's Hospital in Cleveland before coming to the Cuyahoga County Coroner's Office as deputy coroner and pathologist. In 1987, she was appointed Coroner of Cuyahoga County, following the retirement of Coroner Dr. Samuel Gerber, a position she held until her retirement in July of this year.

During her time as Coroner of Cuyahoga County, Dr. Balraj established herself as a very capable and energetic leader. She worked very hard with local law enforcement officials to help solve murder cases and was there to console the many people who lost loved ones. Additionally, she advanced the cause of women in the medical field by blazing the trail for women to become more involved in science and medicine, as well as the law enforcement field.

Madam Speaker and colleagues, please join me in honoring Dr. Elizabeth Balraj or her service to Cuyahoga County, her passion for her work, and her kindness to the many families and individuals of Cuyahoga County over the last 35 years.

Madam Speaker, I rise today to honor the 100th anniversary of Lakewood Hospital, which has proven to be a leader in northeastern Ohio's health care community.

Founded in 1907, Lakewood Hospital provides high quality and innovative treatment to more than 130,000 patients annually from throughout Cuyahoga County. The hospital's affiliation with the Cleveland Clinic and other regional hospitals offers individuals access to state-of-the-art technology and individualized care.

Lakewood Hospital is not only a vital community resource for treating illnesses and injuries, but it also works to keep individuals healthy through educational wellness programs, public health screenings and other community outreach programs.

Lakewood hospital has introduced ``A Century of Touching Lives'' as the theme of its year-long centennial anniversary celebration. This theme reflects the tradition of caring and personal patient experiences that have become Lakewood Hospital's legacy.

To recognize the important relationship between the hospital and local schools, Lakewood Hospital plans to sponsor a year-long series of health education programs. It will also celebrate ``Nurse's Week'' and ``Hospital Week'' to recognize the contributions of nurses and other employees throughout the hospital's history.

Madam Speaker and colleagues, please join me in honoring Lakewood Hospital for its 100-year commitment to high quality, community-based health care.

Madam Speaker, I opposed H.R. 3580, a bill to reauthorize the Prescription Drug User Fee Act (PDUFA), because it failed to address the fundamental drivers of the high cost of pharmaceuticals, the pharmaceutical industry's deplorable safety record, and their lack of accountability.

The bill ignores the single biggest conflict of interest at the FDA. The pharmaceutical industry pays hundreds of millions of dollars every year to the Food and Drug Administration, which is tasked with regulating them. The result is that the FDA has a relationship with industry that treats them more like a customer than an entity in need of oversight and evaluation. A 2002 Government Accountability Office report found that ``Our analysis of FDA data found that a higher percentage of drugs has been withdrawn from the market for safety- related reasons since PDUFA's enactment than prior to the law's enactment . . .'' Furthermore, FDA staff morale has declined. The GAO found that ``FDA's attrition rates for most of the scientific occupations involved in its drug review process are higher than those for comparable occupations in other federal public health agencies and the remainder of the federal government.'' A Consumer Reports poll in

April 2007 found that 67% of customers ``are concerned that much of the FDA's funding comes from the drug industry.'' This bill actually increases the amount the drug companies pay to the FDA. To ensure independence, the drug approval process should be funded by Congress.

Second, the bill passed on a rare opportunity to address ways in which the pharmaceutical industry makes profits at the expense of health. An early version of the bill gave the FDA authority to ban Direct to Consumer advertising for three years, a practice which has repeatedly proven to influence drug use based on reason other than the merits of the drug. This bill contained only authority to assess penalties which pale in comparison to the profit to be made from running the ads.

Another opportunity lost was to address the failure of the industry to put out new drugs that are substantially different from drugs that are already on the market, but which are less profitable because their patent monopolies are running out. Requiring clinical trials to compare new drugs not only to placebos but to existing drugs would, for the first time, give a clear indication of how useful the proposed drug is. It would also therefore provide a powerful incentive for the industry to focus its resources on truly innovative drugs instead of spending copiously on marketing to sell more profitable but less beneficial drugs. This bill gives lip service to these head-to-head trials when it should require them.

Madam Speaker, I rise in support of the vote to override the President's veto of SCHIP. I do so because the President's objections to government health insurance for low income children are outrageous.

That said, I still believe, the bill's failure to provide coverage for legal immigrants is reprehensible. All children deserve health care coverage. Health care is a right, not a privilege. The denial of a lifesaving service based on an arbitrary length of citizenship is simply wrong.

It is the responsibility of Congress to address the main difficulties that prevent legal immigrant children from gaining access to health care. This bill does exactly the opposite. Thus I felt compelled to vote against the bill after the Senate negotiators refused to provide health benefits to legal immigrant children. Negotiating away health care for 400,000-600,000 children as a political compromise is not acceptable.

The President has vetoed the bill because he calls it a step toward socialized medicine. This perennial straw-man is trotted out when meritorious arguments are lacking. In fact, SCHIP uses private doctors and private health care plans. More importantly, however, the President is fond of ignoring the volumes of literature showing that government- run health insurance programs that use private hospitals and doctors like Medicare and Medicaid, deliver higher quality care at lower costs with higher rates of satisfaction than private insurance plans. According to a 2007 article in the journal, Health Affairs, administrative costs of private plans were about twice as much as those for Medicaid. Medicare's overhead costs are approximately 3 percent while those of the private sector are closer to 31 percent.

That is one of the main reasons that H.R. 676, the Expanded and Improved Medicare for All Act, is the best cure for our health care ills. It captures the enormous savings to be had if Americans had health care provided through Medicare and uses them to cover everyone for all medically necessary services with no copayments, no deductibles and now premiums. That is how wasteful private insurance is. Providing cheaper coverage through the private sector simply leaves Americans with dangerously weak coverage. About 50 percent of all bankruptcies in the U.S. are related to medical bills. Of those with medically related bankruptcies, about 75 percent had insurance before they got sick. Their so-called ``coverage'' did not cover them. They were, in fact, underinsured. The President chose to ignore this crisis by vetoing a bill that would have not only covered uninsured children but provided better coverage for many who are one illness away from losing their money and their home.

The provisions in the bill would make substantial and crucial progress in providing health care for all American children. It would provide coverage for 3.8 million more children than are covered now and preserve coverage for 6.6 million more. It would help ensure Ohio can expand its program to include an additional 20,000 children. It targets the lowest-income uninsured children for outreach and enrollment, ensures dental coverage and mental health parity.

The President was fundamentally wrong to veto the SCHIP bill. He needs to understand the economic and moral realities behind SCHIP. I cast my vote to express that.

Madam Speaker, I rise today to recognize the Retired Senior Volunteer Program of Greater Cleveland (RSVP) on the occasion of their 35th anniversary of service to community non-profits and countless people in the Cleveland area.

RSVP is part of the Corporation for National and Community Service, one of the largest volunteer efforts in the country. The Greater Cleveland chapter of RSVP opened its doors in 1972, back when I was a Cleveland city councilman, and it is one of the biggest--and perhaps the best--in the country today.

Based on principles of giving back to a society which has given, the over 3,200 volunteers contribute over 400,000 hours of service to the community each year to more than 200 nonprofit agencies. Many of these organizations simply could not exist without the help of the RSVP volunteers, and none could provide the level of quality service the volunteers offer without them. The list of organizations utilizing generous commitment of RSVP volunteers is broad and ranges from hospitals, to museums, to hunger centers, and to schools.

Meals are prepared and delivered to homebound residents that might otherwise not have access to this service. School children are helped with their literacy skills and provided with quality adult role models. New citizens are welcomed to the country. The bereaved and ill are counseled. Educational tours are provided to students and the general public at NASA, the Cleveland Museum of Natural History and the Great Lakes Science Center, among many educational and entertaining outlets. And the list goes on.

One of the great successes of Cleveland's RSVP program is the management of a tutoring program for children in the Cleveland municipal schools called Experience Corps. During this school year alone, 220 tutors mentored 1,400 students in 14 elementary schools, and the hope is to someday be able to provide quality tutors to all children that need help. Cleveland's Experience Corps program, part of a national effort, has been so successful that it was selected as one of four throughout the country to serve as a model for expansion of the program nationally.

Community projects, such as festivals, fairs, walkathons and other civic functions, depend largely on volunteers for short-term or one- time assignments, and RSVP comes through with a group called Team RSVP. This year, Team RSVP volunteers have already participated in more than 100 community events, with many more scheduled through the end of 2007.

A group of volunteers called the RSVP Players creates and presents educational and entertaining performances for audiences of older adults throughout Northeast Ohio. The troupe has also assisted with informational programs about Medicare information, prescription misuse, predatory lending, re-entering the job market and other issues relevant to seniors.

Madam Speaker and colleagues, please join me in honoring RSVP of Greater Cleveland, an organization with an extraordinary commitment to service in the Cleveland area, and its humble volunteers that fill numerous needs in Ohio's 10th Congressional District and beyond. Their footprint is large and deep, and their accomplishments will be felt for generations to come.

Madam Speaker, I rise today in remembrance of Bernadette Pavlish, a devoted wife and loving mother, and I celebrate her dedication to her family and the community.

By all accounts, Bernadette simply lit up an entire room with her presence. Her smile became an instant source of comfort and joy for anyone who was lucky enough to cross paths with her. Bernadette was extremely generous with her time and talents; she never passed up an opportunity to help someone.

Madam Speaker and colleagues, please join me in remembering Bernadette Pavlish, who is survived by her husband James, and her children Ursula, Vincent and Lavinia. Although she has passed, her spirit will continue to shine brightly and her memory will live on in all those blessed to have known her.

Mr. Speaker, I rise in support of the resolution. One must put this debate in perspective. The administration certainly helped to create the war. Iraq didn't have weapons of mass destruction, but Iraq did have one thing that is very valuable, and that is oil. The administration helped create the war. They created the Coalition Provisional Authority, and they helped to create the Maliki government. Now they are withholding information and classifying previously unclassified information. Again, no WMDs in Iraq, but oil.

I maintain that has all been about oil. The administration looks the other way on corruption, putting great pressure on the Maliki government at this very moment to privatize 20 to $30 trillion worth of Iraqi oil assets. Now, they can classify all they want over at the White House. But this is still about oil. It can't classify nearly 3,800 deaths of our soldiers. They can't classify 1 million deaths of innocent Iraqis. They can't classify that the war will cost up to $2 trillion. They can't classify that they are borrowing money from China to fight a war against Iraq. This war has been based on lies. We agree we should all abide by the rules of the House. We should also abide by the United States Constitution. That is why I support this bill. It is also why I support accountability, and I support impeachment.

Madam Speaker, I rise today to recognize David Shipler, a former national and international reporter, former diplomatic correspondent, and author, as he speaks at Case Western Reserve University, my alma mater, on his latest book, ``The Working Poor: Invisible in America.''

In his writing, Mr. Shipler brings the issue of poverty in America front-and-center. He spent years interviewing and building lasting relationships with people falling between the cracks, despite their steady work, many of whom live in the Cleveland area. The people he describes make incredible sacrifices and still are unable, in many cases, to provide for their basic needs and those of their family, such as food, health care, child care, transportation, sick days, and adequate time with their families.

He identifies acts of kindness of friends and employers who assist those not able to meet these needs through work as their saving grace, but he also discusses these interactions as the exception. There are many, many more working people in constant struggle without the help they need from their employers or their Government.

In all of his works, Mr. Shipler describes and explains real social and personal conflicts while emphasizing the need for principles of peace and understanding as the way forward.

Madam Speaker and colleagues, please join me in honoring David Shipler for his distinguished and passionate career of spreading public awareness of crucial issues of inhumanity and injustice. His work has undoubtedly led many towards a greater awareness and push for social change.

Madam Speaker, I rise today in recognition of the Bring Back the 70's Street Club (BB70), a community improvement organization, located in Cleveland, Ohio.

The story of BB70's inception is an inspiring one. Concerned Cleveland residents, on March 10, 2004, decided to gather and discuss their vision for a safer, more secure, and more beautiful Cleveland. Since its first event, the ``Spring Clean Up,'' the social entrepreneurs who founded BB70 have demonstrated an admirable commitment to northeast Ohio. BB70 accomplishments include instituting a community gardening project, creating a drug-free zone, posting security cameras and surveillance equipment, demolishing

burned buildings, hosting an out of school bash, and starting a mural youth project.

A multitude of organizations and residents, through BB70, continue to work towards developing the Cleveland community and improving civic engagement. Local merchants, banks, companies, schools, law enforcement officers, and other organizations have welcomed and aided the BB70 cause as their success is dependent on BB70's mission.

Madam Speaker and colleagues, please join me in recognizing the great accomplishments of the Bring Back the 70's Street Club in its mission to improve their communities for current and future Cleveland residents.

Madam Speaker, I rise today in honor of the 55th year of Holy Trinity Ukrainian Autocephalous Orthodox Church in North Royalton, Ohio. In the time Holy Trinity has been in existence, it has served the Ukrainian community of greater Cleveland well. It has brought a community together in a spirit of caring and love for others.

Holy Trinity has served as the site for hundreds of christenings, marriages, funerals and holidays in its 55 years. In addition, it has hosted many concerts, festivals, picnics, fundraisers, and other Ukrainian-oriented functions. As people have immigrated to the United States from Ukraine, Holy Trinity has served as a vital link between the Ukraine and the United States for the Ukrainian community in Cleveland.

Madam Speaker and colleagues, please join me in recognizing Holy Trinity Ukrainian Autocephalous Orthodox Church for its 55 years as a cornerstone of Cleveland's Ukrainian community and a shining example of spiritual guidance.

Madam Speaker, I rise today in honor of Hispanic Heritage Month--a celebration of Americans of Hispanic heritage and their collective and individual contributions to our community and to our Nation.

Hispanic Heritage Month is a celebration of the five hundred year history of Hispanic culture in and its contribution to America. Hispanic Americans have contributed immeasurably to all areas of our culture--from medicine, law, and business to education, music, and the fine arts. Hispanic Americans in our community and in communities across the country are life-saving doctors and nurses, veterans, inspiring professors, dedicated teachers, committed elected officials, fair-minded judges, and hardworking factory employees. Americans of Hispanic heritage continue to bring energy, innovation and a real sense of social justice to America, while retaining the cultural traditions of their homeland for all citizens to enjoy.

I honor in a special way Hispanic American servicemen and women. Hispanic Americans have a long and honorable history of service to our country in the Armed Forces. They have served valiantly at all levels and in every capacity, and I salute them for their service to our country.

Madam Speaker and colleagues, please join me in honor and celebration of Hispanic Heritage Month, and join me in expressing my gratitude for the outstanding contributions made by Hispanic Americans. Their journey to America, fraught with significant obstacles and strife, paved the way for a better life for their children and future generations, and signifies what it means to be an American. Within our diversity we find strength, and within our traditions we find unity. Because of their journey, and the journey of people from all points of the world, we are stronger as a community, more unified as a nation, and better as people.

Madam Speaker, I rise today in honor of the 50th year of the Original Harvest Missionary Baptist Church of Cleveland, Ohio. For the past five decades, the leadership and membership of the Church has served to lift our Cleveland community through worship, faith and song.

The Church came to life in 1957, when the Reverend Marcellus Chatman, guided by his faith and a mission to serve, founded the Original Harvest Missionary Baptist Church. His wife, Mrs. Anna Lee Young Chatman, not only named the Church but also organized, directed and performed in the Church choir. Their daughters, Marcella and Ruby, have also been faithful members and leaders of the Church since its inception: Marcella as pianist and Ruby as administrator of Harvest Day Care, which was founded by their mother in 1969.

The loyalty, support and commitment that the Chatman family continues to infuse throughout our neighborhoods are also reflected within the Church congregation. Reverend Fred Caffie, Jr. began his service in 1979, and served for 25 years. The Church Patriarch and Musical Director, David Smith, has faithfully served the Church for over 30 years. The Reverend Michael W. Turner, who was installed as Pastor in early 2005, continues the Church legacy of hope, joy and inspiration.

Madam Speaker and colleagues, please join me in recognizing the Chatman family, and all the leaders and members of the Original Harvest Missionary Baptist Church, past and present, as they celebrate 50 years of faith, love and spirituality that continue to strengthen our community.

Madam Speaker, I rise today in recognition of Burt Saltzman, CEO of Dave's Supermarkets, whose entire career has focused on serving the community. His kind and charitable demeanor has made him a well-known and widely embraced individual amongst the citizens of Cleveland, the supermarket employees, vendors, and community organizations alike.

Dave's Supermarket is named after Mr. Saltzman's father and employs over 1,500 associates. This year, the store celebrates 75 years of providing the people of the neighborhood with quality groceries at affordable prices, as well as an unmatched kind of customer service. Mr. Saltzman is one of few CEOs who will work alongside employees and help customers one-on-one.

Not only does he take time to show he cares for Dave's associates, Mr. Saltzman is also very active in the community. He supplies food to soup kitchens, hunger centers, shelters, a day care, and supports the Cleveland Food Bank as well as Mental Health Services, Inc. Mr. Saltzman's charitable efforts have not gone unrecognized; he is in the Grocer's Hall of Fame and has received an ``Others'' award from the Salvation Army. The ``Others'' award is given in recognition of those who benefit the Salvation Army and/or the community as a whole.

Madam Speaker and colleagues, please join me in thanking and honoring Mr. Burt Saltzman for his enduring commitment to Northeast Ohio. His devotion and care are the epitome of civic engagement and community pride.