Floor Statements

I thank the gentleman for yielding me this time.

Mr. Speaker, this is Insure the Uninsured Week, and for me as a physician and Chair of the Health Brain Trust of the Congressional Black Caucus, ensuring health coverage to everyone is a priority every day.

And so I want to be very clear that I rise in strong support of providing small businesses and their employees access to high-quality health insurance that is truly affordable. That is why I oppose H.R. 4281, the Association Health Plan bill, and support the Kind-Andrews substitute.

We in the minority caucuses have spent a great deal of time looking at the issue of insurance, of how we can allow small business associations to come together to pool their purchasing power to buy quality health coverage at the lowest possible cost. We examined the AHPs. I did not originally sign on to the bill, but after a closer look at what it would do and as a physician who understands how important it is to do no harm, I removed my name from what I consider a harmful bill.

In H.R. 4281, the base bill, AHPs would be exempt from State insurance regulations and consumer protections. They would increase health care costs for most small business employees, cause premiums to rise for those outside of the AHP market, and eventually not lower, but increase, the number of uninsured in small business firms.

While AHP supporters will insist that this will not happen, by removing these important protections, the major harm this bill can do is too great a risk to take. We are talking about workers' health; we are talking about their lives. There is a better way to provide this insurance which will not harm, and that is the Kind-Andrews substitute. It would establish an employer health benefit plan similar to the Federal employees' health benefits, which would contract with state- licensed health insurers to offer an insurance package for employees of businesses of fewer than 100 employees.

Unlike the underlying bill, this better Democratic substitute will keep these small employer plans subject to State health insurance and consumer regulations and protections. It would provide small businesses and their employees access to high-quality health coverage; and by ensuring that the risk is spread, that everyone is included, not keeping sicker employees out, it keeps it truly affordable.

As a member of the Committee on Small Business since coming to this Congress, I am for helping small businesses. This substitute does that. H.R. 4281 will not.

I urge my colleagues to join the more than 150 organizations, including all of the prominent civil rights organizations, in opposing H.R. 4281. Instead, I urge them to vote for the Kind-Andrews substitute. Let us make sure we cover this important group who are over 60 percent of all the uninsured; and above all, let us do no harm.

Mr. Speaker, the House today considered a rule providing for the consideration of three bills that are intended to solve our nation's insurance crisis which has reached epidemic proportions. Today, an estimated 43 million in the United States have no health insurance. About 60 percent of those, approximately 24 million, are employed by a small business or are a member of a family whose income derives in some way from a small business. The skyrocketing prices of malpractice liability is driving insurance premiums up and making it impossible for employers of 500 or less individuals to afford the high cost of health care.

The bills being debated today while seeking to address these issues does so unfortunately, by providing the wrong solutions. Today, the House will once again bring up a bill to create Associated Health Plans (AHP). Providing a permanent solution to the uninsured is critical to our nation's economy because Small Businesses, the engine of our nation's economic growth because they create about 75 percent of new jobs in America, deserve a sound and permanent solution to the affordable health care.

Mr. Speaker I oppose the rule that will control the disposition of these bills primarily because it does not provide for Democrats to include their measures in solving the issue of the uninsured. The proposed rule only makes in order a substitute amendment and not an amendment to the underlying bill. Stacking the deck against the Democratic efforts to ensure that the legislation has a sense of balance and accurate in addressing the need of the American people.

Additionally, Mr. Speaker, I must also express my displeasure with the majority's efforts to address the current malpractice crisis. As a former family doctor I am fully aware of the feeling many doctors have about being forced out of practice by very high insurance premiums. The Republican bill, H.R. 4280 does not address the problem, however.

According to the Institute of Medicine, ``At least 44,000 and perhaps as many as 98,000 Americans die in hospitals each year as a result of medical errors. Deaths due to preventable adverse events exceed the deaths attributable to motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).'' The IOM estimates annual costs to the economy of medical errors between $17 billion and $29 billion. Congress would better serve the public with legislation that promotes patient safety, rather than overriding state-law deterrents that help prevent patient deaths and injuries.

Instead of reducing the costs of medical malpractice and defective products, the majority's approach would shift costs onto injured individuals, their families, voluntary organizations and taxpayers. Not only are the provisions unfair to victims, they also sacrifice the principles of market economics and private property long professed by the bill's conservative advocates.

Furthermore, punitive damages are rarely awarded in medical malpractices cases, but the threat of punitive damages is important to deterring reckless disregard for patient safety by HMOs, nursing homes, and drug and medical device manufacturers. The $250,000 cap on non- economic damages awards are for non-economic loss (pain and suffering resulting from injuries such as lost child-bearing ability, disfigurement, and paralysis) compensate for the human suffering caused by medical negligence and defective medical products.

These damages generally account for 35 to 40 percent of a jury's award. Typically, such damages exceed $250,000 only in cases of NAIC Level 6 injury severity or higher--that is cases involving permanent significant injuries. Thus, the cap will not affect patients with minor injuries; instead, it targets only victims of injuries such as deafness, blindness, loss of limb or organ, paraplegia, or severe brain damage. Since the cap makes no allowance for inflation, its arbitrary limits become more unjust as each day passes.

I implore my colleagues to reject this rule and H.R. 4280 and support the Conyers-Dingle substitute. The Democratic substitute does not restrict the rights of injured patients who file meritorious claims. It requires certification, with civil penalties, that a pleading is not frivolous, factually inaccurate or designed to harass. It includes a 3- year statute of limitation; establishes an alternative dispute resolution process; limits suits for punitive damages; and applies 50% of awards from any punitive damages to a patient safety fund at HHS. Finally, it requires insurance companies to develop a plan to give 50% of their savings to reductions in medical malpractice rates for doctors.

The Democratic substitute also addresses the causes of rising medical malpractice insurance rates by creating a new commission to evaluate the causes of the malpractice premium crisis and recommend solutions, including a medical reinsurance program, risk distribution among health providers and other changes that might avoid such increases in the future.

Because experience has shown that capping damages will not lower malpractice insurance rates for doctors, the Democratic substitute promotes competition in the marketplace so doctors can get lower insurance rates. The five states with the highest malpractice insurance premiums in the country in 2002 already had damage caps. Only insurance reform will help bring down rates. The Democratic substitute specifically requires the newly created commission to study various insurance reform proposals, particularly repealing the medical malpractice insurance exemption under the McCarran-Ferguson Act (which would foster competition).

Mr. Speaker, we need a real malpractice relief, I urge my colleagues to put partisan gamesmanship aside and pass health legislation that our nation is so badly in need of.

Mr. Speaker, in this Cover the Uninsured week, I rise to say that our health care system in this country is falling short on promise and contributing to disabling illness and premature death of the people it is supposed to serve. The picture is worse for African Americans who, for almost every illness, are impacted more severely and disproportionately, in some cases more than all other minorities combined. Every day in this country there are at least 200 African American deaths which could and should have been prevented.

The current strongly held-to ``cost containment'' paradigm, while it sounds good on the surface, has obviously not worked. We now have double digit increases in premiums in an industry that was to rein in costs. What it did instead was create a multi-tiered system of care, both within managed care and without. Those at the lowest rungs of the system got and continue to get sicker. The sicker, and the more costly, were and are still being dropped, and those who are sickest were and remain locked out entirely.

In 2003, health care spending rose to $1.7 trillion, or an average of almost $5,000 per person. As a percentage of the gross domestic product, it grew from 13.1 percent in 1999 to 15.2 percent in 2002. National health care expenditures are expected to reach $2.8 trillion in 2011.

These health care costs are driven by, among other things, lack of preventive care, poor disease management, the consequent use of high- cost care, and the cost burden of uncompensated care.

A recent study by the Kaiser Family Foundation found that the uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, the average cost of which in 2002 was estimated to be about $3,300. Close to 93 percent of the uninsured report having a more difficult time getting access to primary care and, therefore, are coming first to emergency rooms. About 97 percent of them report having medical conditions that have persisted or worsened because of a lack of early intervention or preventive care.

To add insult to injury, these uninsured individuals are also often penalized by being charged higher fees for health care services and not given the discounts afforded insured patients. A Health Affairs article published in 2000 entitled ``Gouging the Medically Uninsured'' found that an uninsured patient paid up to twice as much as the insured patient. A New York Times article titled ``Medical Fees Are Often Higher For Patients Without Insurance'' cited examples of uninsured patients being charged up to 7 times more for a gynecological exam.

Mr. Speaker, lack of health insurance is a major factor in the escalating costs of health care and it affects minority populations more than others. Over a third of Latinos are uninsured, the highest rate among all groups studied, and 2\1/2\ times higher than the rate for whites. Nearly a quarter of African Americans and about one fifth of Asian Americans and Pacific Islanders have no health coverage.

Uninsured rates are lower among Native Americans only due to their ability to receive services through the Indian Health Service, which represents a set of federally provided health services as opposed to coverage, yet the

level of care for them leaves much to be desired as well.

It is because of these and many other grave health statistics that we are asking Congress to pass comprehensive health care reform, understanding that none of the diseases causing disparities can be successfully managed without sustained universal access to health care.

This week, the Democrats will introduce three bills to do just that: the Family Care Act, the Medicare Early Access Act, and the Small Business Health Insurance Promotion Act. There are also other bills that have already been introduced, of which I am proud to be a cosponsor, by the gentleman from Michigan (Mr. Conyers), the gentlewoman from California (Ms. Lee), the gentleman from Maryland (Mr. Cummings), and the gentleman from Washington (Mr. McDermott).

This week we will take up H.R. 660, the Association Health Plan proposal, which poses, in my opinion, a serious threat to our existing employer-based health insurance system. It would exempt small employer plans from important State regulatory protections, and there is no reason to believe that eliminating these protections will help small employers expand coverage.

Instead, AHPs will be able to design services to cover industries and sectors with the healthiest employees and leave out small businesses with older or sicker workers, those who most need coverage. This ability to cherry-pick would drive up the cost of coverage for small businesses with less healthy profiles of workers who will then be left in the insurance pool by themselves. AHPs would be able to offer less generous benefit packages in order to bring down the costs of coverage. The CBO has already estimated that 80 percent of workers would be worse off under AHPs.

In closing, I urge my colleagues to put politics aside in addressing the issue of coverage as well as in malpractice reform, and the other health care bills we will be considering this week. Let us not opt for the short-term fix that is really no fix at all. Let us not support proposals that do not provide substantive remedies for these problems which affect the life and death of those we represent. And, above all, let us commit ourselves, this week and always, to do no harm.

Mr. Speaker, I rise today to pay tribute to an individual who, surrounded by culture in his formative years, had a vision to preserve an important aspect of the Virgin Islands quality of life. Mr. Bradley Christian, along with Norma Christian and Claudia Walker were the first officers of the St. Croix Heritage Dancer, founded by Enrique Santos.

Mr. Christian has committed himself to preserving our cultural dances for future generations so that they may have an awareness of the rich culture to be found in the Virgin Islands, specifically on St. Croix. These dances are a combination of the influence of the seven flags that flew over our island and the ethnicities of the different people who have lived here. They have evolved into a performance that is second to none, incorporating the influences of the German and French quadrille.

Mr. Christian and the St. Croix Heritage Dancers have performed all over the Caribbean and the United States, including being featured during the Smithsonian Folklife Festival in 1990. The St. Croix Heritage Dancers is celebrating their 23rd year anniversary with a Hibiscus Ball on Saturday, May 22nd. King Michael Dow and Queen Slyvia Stewart will rule over this year's celebration. The 2004 honorees are Eldred ``Edgie'' Christian, Jr. and Ernest ``Prince Galloway'' Galloway, Jr.

Mr. Speaker, on behalf of my family, staff and the people of the United States Virgin Islands, it is an honor for me to enter this tribute to Mr. Bradley Christian into the Congressional Record.

Mr. Speaker, I rise today as my beloved U.S. Virgin Islands celebrates the 87th anniversary of the transfer of sovereignty from Denmark to the United States of America.

On March 31, 1917, our American journey began in earnest as we became an official part of the American family. While that journey was predated by a friendship with the United States that began during the Revolutionary War, we are told by our grandmothers that on that spring day long ago there were tears of joy and sadness as they said good-bye to the old and welcomed the new.

Today, we are proud Americans serving in all of its wars, rejoicing at its accomplishments, and working with our brothers and sisters to meet its challenges in health care, education, and social justice.

We have not forgotten, however, our shared history of over 250 years with Denmark as we welcome tourists seeking Caribbean roots, apprentice our children to learn of shared craftsmanship, and share the archival materials we have in common.

Mr. Speaker, the uniqueness of the U.S. Virgin Islands can be found in its relationship to many nations, as it has been a cultural crossroads for people the world over.

Today, on March 31, 2004, we celebrate the roots of our diversity as we celebrate yet another Transfer Day.

Mr. Chairman, I thank the gentleman for yielding me this time, and I want to applaud our chairman, the gentleman from Maryland (Chairman Cummings), and also the gentleman from Virginia (Mr. Scott) for this budget. I join them and my colleagues in strong opposition to the Republican budget.

On November 6 of last year, we introduced the Health Care Equality and Accountability Act of 2003 with the Democratic leadership in this House and the Senate. Today I am here to assure my colleagues that that was not just a message bill. The CBC budget seeks to meet the needs of people of color in this country, the health care needs, as well as other needs, who have been left behind for so long.

Mr. Chairman, giving taxes breaks to the wealthy cannot be a priority of this country when our people are sick, disabled, and dying and do not have access to healing and lifesaving care. So our budget reauthorizes funds to the Office of Minority Health, the Indian Health Service, Health Professions and other programs that reach out to and bring wellness to our communities. It supports our teaching and safety net hospitals and other facilities, and fully funds Medicaid.

This is not increasing taxes; this is stopping corporate giveaways, giveaways to the wealthy, and investing in the strength of this country: our people.

Dr. Martin Luther King said, ``Of all forms of inequality, injustice in health care is the most shocking and inhumane.'' We agree. And with the CBC budget, we continue our work to correct that injustice, to restore health as a right, and to heal America.

We urge our colleagues to vote ``yes'' on the Congressional Black Caucus budget.

Mr. Speaker, I thank the gentleman for yielding me the time.

I rise in strong support of H.R. 2993, the District of Columbia and U.S. Territories Circulating Quarter Dollar Program Act.

It is a pleasure for me to be here as we again move closer toward rectifying the omission of the District of Columbia and the insular areas from the original 50 State Commemorative Coin Program Act. It has been more than 3 years; but with the vote today on H.R. 2993, my constituents as well as those of my colleagues from the Nation's capital and the other territories will finally get the opportunity to have our Nation commemorate and celebrate a significant event or fact about our respective homes.

My district, the U.S. Virgin Islands, also known as America's Paradise, has many ecological, historical and cultural treasures which are worthy of commemoration. We also boast of having been the place where the first Secretary of the Treasury, Alexander Hamilton, grew up and honed the skills which served our fledgling nation so well.

For the benefit of those who might not know this, the Virgin Islands have been a member of the American family since 1917 when Denmark sold the islands of the former Danish West Indies, St. Thomas, St. Croix and St. John, to the United States for just $25 million.

We are located 1,000 miles southeast of Miami in the Caribbean Sea and are four main islands with numerous keys, with beaches that have consistently ranked among the best in the world. We also boast the only site where the members of Christopher Columbus' party are known to have set foot on what is today the U.S. The Salt River National Historical and Ecological Park was established in 1992 to, among other things, commemorate this important historical event.

Mr. Speaker, the people of the Virgin Islands see it as only fitting that we, along with the residents and citizens of Guam, American Samoa, the Northern Mariana Islands, Puerto Rico and the District of Columbia should also have the opportunity to educate our fellow Americans on whose side we have fought to defend and protect our Nation in every conflict from the Revolutionary War to the present day about our unique qualities, as well as promote our pride at being Americans.

Mr. Speaker, I also want to thank the gentleman from Delaware (Mr. Castle), the champion of the original bill, and our ranking member, the gentleman from Massachusetts (Mr. Frank), for including the District of Columbia and our territories, and I particularly want to also extend our gratitude to the gentlewoman from the District of Columbia because it was her leadership and dogged determination that made this day possible, and I ask my colleagues to support her in our effort and vote ``yes'' on H.R. 2993.

Mr. Speaker, I rise today to pay tribute to an individual that was not only a leader to the people of the Virgin Islands but a political role model for me and many of us who have chosen a life of public service to the people of the United States Virgin Islands. Former Lt. Governor Henry Allan Millin, one of our most revered public servants, passed on into eternity on February 4, 2004, on St. Thomas.

Henry A. Millin was destined for a life of public service. The son of the pioneering woman senator, Lucinda A. Millin, Henry Millin's contributions to the 20th century modernization of the U.S. Virgin Islands have been significant. He lead the way in public housing development, having been appointed Assistant Executive Director of the newly established Virgin Islands Housing Authority in 1950. Mr. Millin later assumed the position of Executive Director.

During his tenure at the Housing Authority, he oversaw the construction of the first public housing units in the Territory. He was commended by President John F. Kennedy for administering one of the outstanding housing operations under the Department of Housing and Urban Development. Henry Millin later assumed the distinguished position as a Senior Vice President for First Pennsylvania Bank N.A. This period of distinguished service in the private sector of our community was followed by an even more momentous four-year term (1978- 82) as the third elected Lt. Governor of the Virgin Islands during a tumultuous period for Virgin Islanders, following the death of Governor Cyril Emmanuel King.

Mr. Speaker, I fondly remember Mr. Millin as being one of my first bosses, when I interned with the Virgin Islands Housing Authority as a high school student. He was also a close friend of my father, the former District Court Judge Almeric Christian. I consider myself fortunate to have had such a personal relationship with Mr. Millin. He was certainly an inspiration and a role model for me.

Mr. Millin was also a dedicated husband and father. He was married to Graciela G. Millin and was the father of five children, six grandchildren, and two great-grandchildren.

Mr. Speaker, on behalf of my family, staff and the people of the U.S. Virgin Islands, it is an honor for me to immortalize the memory of Lt. Governor Henry A. Millin by entering this tribute into the Congressional Record. I want to close with a quote from this great leader and public that exemplifies the spirit with which he served:

The people have the right to look forward to changes, not

made hastily, nor on the basis of political spleen nor

political favoritism. Rather, changes must be on the basis of

careful planning, objective thinking, and the interests of

the people being the main and determining factor.

May his memory evoke the legacy of progress that he worked so tirelessly to establish for Virgin Islanders.

Mr. Chairman, I rise in support of the Miller- Woolsey amendment to H.R. 3030 which ensures that Federal funds will not be used to support discrimination in hiring and I commend the authors for sponsoring it.

Mr. Chairman, I support and have always supported faith based organizations. They have played a major role in the delivery of social services in our country, in particular those who have been a part of the Congressional Black Caucus's Minority AIDS Initiative.

But what the White House and the Republicans are trying to do is relinquish government responsibility for the safety nets that millions of people rely on. More importantly, under cover of supporting the work of our faith-based institutions, they are attempting to unravel our civil rights by writing into the bill the right to discriminate.

Mr. Chairman, we need to call this egregious hand that they are trying to deal to the American public and say no to weakening our safety nets and a big no to discrimination.

Is there no shame?

Mr. Speaker, I rise today to introduce legislation to create the position of Chief Financial Officer for the Government of the Virgin Islands. It is my hope and intention that by temporarily placing the reins of fiscal management of the Virgin Islands government outside of the political arena we will be able to end years of crisis management and place the islands on sound financial footing for the long term.

Mr. Speaker, my beloved community, has been plagued over the years and several administrations, by one economic or fiscal crisis after another. If allowed to continue or recur, they have the potential of forcing us into total fiscal collapse.

The factors which have caused these crises are numerous and include among other things: the decline in our tourism sector due to the demographic shift from cities of the Eastern Seaboard to areas in the West and Midwest; being hit by as many as 6 catastrophic hurricanes since 1989; and the fact that the territory's geography mandates a large government workforce and necessitates the replication of many basic services.

When the current administration of Governor Charles W. Turnbull took office in January of 1999, the territory was in a fiscal state of enormous and alarming proportions.

While Governor Turnbull is to be commended for his response to that crisis and the succeeding ones he has faced, because of the special and unique burdens we face, history informs that the necessary political resolve to put measures in place to address these problems, some of which will call for public sacrifice, is best found and sustained outside of the political process.

It is for this reason that I am introducing the Virgin Islands CFO Act today. The CFO will be empowered to oversee and approve all spending of the government of the Virgin Islands and be authorized by law to disapprove items of spending which would send the government into financial deficit. The CFO position would sunset after five years and while he or she would be appointed by the Governor of the Virgin Islands from a list of names selected by a search commission, and confirmed by the Legislature, he or she will not be an ``at-will'' employee of the government and could only be removed for cause.

Mr. Speaker, this is not an easy bill for me to introduce, but it is a necessary one at this time. It is an action that I feel is in the best interest of all of my constituents and the responsible course of action for me to take. I ask for my colleagues support.

Mr. Speaker, on March 20, 2002, the Institute of Medicine (IOM) released a landmark report entitled: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Among other key findings, the report documented that minorities in the United States receive fewer life-prolonging cardiac medications and surgeries, are less likely to receive dialysis and kidney transplants, and are less likely to receive adequate treatment for pain. Its first and most telling finding States that ``racial and ethnic disparities in healthcare exist and, because they are associated with worse outcomes in many cases, are unacceptable.'' The reasons for these disparities in treatment are wide and varied, and include, but are not limited to: healthcare provider prejudice or bias, the implicit nature of stereotypes, and broader historic and contemporary social and economic inequality. The report included a series of recommendations and interventions for policy changes to eliminate these unacceptable disparities.

Whether it is the recently released IOM report on Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, the Commonwealth Fund's report Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans or a recent report by Physicians for Human Rights (2003) found that many minority groups receive lower quality evaluation and treatment than white Americans for a wide range of medical conditions, even when each has health insurance.

We are continually reminded that throughout the history of our great Nation, our people have been denied access to the best that medical science has had to offer--often relegated to hospitals with outdated equipment and served by African-American health care providers who, although as capable, intelligent, and gifted as their white counterparts, often could not obtain equivalent training because of racist practices such as segregation.

This segregated health system was largely responsible for the health inequities that existed during the early and middle part of this century. Indeed, in 1951 Dr. W. Montague Cobb, editor of the Journal of the National Medical Association, stated ``For nearly fifty years the retarded health status of our Negro population has been common knowledge and the object of sporadic corrective effort''. With the Civil Rights came an acknowledgment came greater equality in many aspects of life for African-Americans, including greater access to quality health care.

As an effort to extend such acknowledgment I am proud to introduce the Health Empowerment Zone Act of 2003. This act directs the Secretary of Health and Human Services with the Administrator of the Health Resources and Services administration and the Directors of the Office of Minority Health, of the Office of Community Services and National Center for Minority Health and Health Disparities to establish health empowerment zone programs in communities that disproportionately experience disparities in health status and health care, and for other purposes.

To be eligible the communities must demonstrate that they experience disproportionate disparities in health status and health care, set forth a strategic plan and create a partnership, with individuals, businesses, schools, minority health associations, nonprofit organizations, community-based organizations, hospitals, health care clinics, and foundations.

The health empowerment zone designation would provide communities the ability to effectively access Federal programs (namely in the Department of Health and Human Services, the Department of Agriculture, the Department of Education, the Department of Labor, the Department of Housing and Urban Development and the Small Business Administration) to improve the health or environment of minority individuals in the community and to coordinate the efforts regarding the elimination of racial and ethnic disparities in health status and health care. Special consideration is given to community that have demonstrated expertise in providing culturally appropriate and linguistically responsive services.

The bill directs communities to establish a health empowerment zone coordinating committee that will provide technical assistance and evidence-based strategies to the zone, including providing guidance on research, strategies, health outcomes, program goals, management, implementation, monitoring, assessment, and evaluation processes.

This bill recognizes that disparities in health and health care found among minority Americans have multiple causes. Lower socioeconomic status and a higher rate of uninsurance are major contributors to the health disparities experienced by minority Americans but non-health factors also play an important role.

The bill codifies legislatively the framework needed to implement sound public health practices such as:

Primary health promotion and disease prevention: Identifying and strengthening protective ecological conditions conducive to health; and identifying and reducing various health risks.

Secondary health promotion and disease prevention: Identifying, adopting, and reinforcing specific protective behaviors; and early detection and reduction of existing health problems.

Tertiary health promotion and disease prevention: Improving the quality of life of community members affected by health problems; and avoiding deterioration, reducing complications from specific disorders, and preventing relapse of risky behaviors.

This bill is a start to a new paradigm for health and I urge my colleagues to support this bill, so that we do what is so clearly needed to improve the health and health care for millions of minority Americans.

Mr. Speaker, I want to respond to one of my physician colleagues who was on the floor last evening and speak to others who think that they and we ought to support the conference report on Medicare reform. One of the most important tenets of the oath we take as physicians is that we must do no harm. This is to guide us in our practice and our interactions with both our patients and society.

The Medicare bill that will be before us today will do much harm by threatening to take away retiree prescription drug coverage. By refusing to provide wraparound coverage for poor seniors and disabled on Medicare, it will exclude many poor, disabled, and elderly by means testing, and most of all it will begin to destroy this important program which so many depend on and need.

Mr. Speaker, if this bill were to pass tomorrow, it would not help one senior next year. We have time to do it right and fulfill the promise we made to provide a comprehensive plan. Physicians, do not allow our profession to be used to pass a bad bill or hurt our patients.

I urge physicians to call their representatives and tell them to vote ``no.'' I urge my colleagues to vote ``no.''

Whether physician or Member of Congress, above all we must do no harm.

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

Mr. Speaker, we fully support the goals of H.R. 1964. The purpose of this legislation is to facilitate conservation and preservation, ideals we fight for in this Congress on a regular basis.

However, we must point out that the scope of H.R. 1964 is truly stunning. This legislation will create a new Federal conservation program covering 2 million acres and 1.4 million people in 4 States. The precise boundaries of this new Federally created area are only generally defined in the bill, and there are no references to a map to allow property owners to know if their property is included or not.

Furthermore, the goals of this new conservation program are sweeping. The bill states that the Federal Government should work with States, units of local government and private property owners to ``protect, restore and preserve the water, forest, agricultural, wildlife, recreational and cultural resources'' contained in this new Federal area. It is difficult to imagine a broader conservation mandate.

Given the ongoing and severe underfunding of the land and water conservation funds, we continue to have concerns regarding the impact of this new $100 million effort may have on other worthy conservation programs funded with LWCF dollars. However, we will support H.R. 1964 at this time.

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

Mr. Speaker, I yield 5 minutes to the gentleman from New York (Mr. Engel).

Mr. Speaker, I yield 5 minutes to the gentleman from New Jersey (Mr. Pascrell), my good friend and classmate.

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

As stated, we did have some concerns about the expense of the bill and the funding for it, given the limitations of the land and water conservation fund, but we are supportive of the bill.

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

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

(Mrs. CHRISTENSEN asked and was given permission to revise and extend her remarks.)

Mr. Speaker, I rise in support of H.R. 135. This legislation would establish the 21st Century Water Policy Commission to study Federal, State, local, and private water management programs in an effort to develop recommendations for a comprehensive national water strategy.

Mr. Speaker, the objectives of H.R. 135 are worthwhile, and I appreciate the cooperation we have received from the sponsor of this bill. I urge my colleagues to support this legislation.

Mr. Speaker, I yield 10 minutes to the gentleman from Illinois (Mr. Costello) and ask unanimous consent that he be allowed to control said time.

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

Madam Speaker, I yield myself such time as I may consume.

(Mrs. CHRISTENSEN asked and was given permission to revise and extend her remarks.)

Madam Speaker, as stated by the previous speaker, H.R. 2584 is noncontroversial legislation that would convey a decommissioned research vessel formerly operated by the National Oceanic and Atmospheric Administration to the local government of Utrok Atoll located in the Republic of the Marshall Islands.

Congress should do whatever we can to help the residents of Utrok Atoll. It is imperative that they receive the critical medical testing and treatment necessary to address the increased rates of thyroid cancer and birth defects that have arisen as a result of the U.S. nuclear testing program we conducted in the Northern Marshall Islands between 1946 and 1958.

The conveyance of this former NOAA vessel will allow more convenient and less expensive transportation for these residents who have to make a 265-mile trip to the neighboring islands of Majuro where the medical facilities are located.

I commend the gentleman from American Samoa (Mr. Faleomavaega) for introducing this legislation to help the residents of this very remote atoll in the Pacific Ocean.

This legislation also contains a very important amendment to address a problem regarding serious lapses in procedure affecting past appointments and promotions for NOAA's Uniformed Corps of Officers.

It is important that the chain of command of the NOAA Corps not be disrupted. And while any future repeat of these procedural lapses may not be tolerated, this matter must be addressed expeditiously to prevent any operational or command dysfunction from arising.

I urge all Members to support this legislation.

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