Floor Statements

Mr. Speaker, I rise today to honor Roy Parke, Jr., a friend, constituent,

and pioneer in our country's strawberry industry.

Roy Parke virtually founded our country's strawberry industry. He moved to my district in the 1950s and, with his father, founded Parkesdale Farms, which today is a multimillion-dollar operation which produces most of our country's winter strawberries.

Roy was a farming pioneer. He oversaw the first successful shipment of berries to Europe in 1963. He was the first farmer to spray strawberries with water during the winter to protect them from freezing temperatures. He is considered one of our country's leading authorities on cutting-edge production techniques.

I am pleased to say that Roy has dedicated his life to more than personal success. He has for years actively supported and promoted local volunteer and civic organizations, as well as helping area schools and students. He also helped make the Florida Strawberry Festival the country's premiere event for strawberry lovers. He helped make it such a success that presidents, movie stars, entertainers, and everyone in between have stopped to visit Roy and eat shortcake with him.

Roy recently turned over the day-to-day operation of his company to his children and his wife of 60 years, Helen. Although he attributes all of his success to her, I know that his hard work, dedication, and perseverance also have helped him succeed in what anyone who knows farming will tell you is a very difficult way of life.

Mr. Speaker, Roy Parke is an outstanding husband, father, farmer, and American. I am proud to call him, and his wonderful wife, friends and constituents. They are, without question, national treasures who should serve as examples to us all.

Mr. Speaker, I would say I wish I had $100 for every hour that I spent in the wee hours of the morning during the time that the gentleman's party was in charge of this House.

Mr. Speaker, we have before us today an opportunity to finally provide our constituents with a meaningful prescription drug benefit that our Nation can afford. To finally do it; to finally do it, not to merely talk about it and to demagogue it. For four decades the other party controlled, and they did nothing. It seems every time we, since gaining the majority, attempt to meet a need, the Democrats finally awaken with nay comments. They do nothing. We attempt to do something, and they call our efforts a charade. We have not taken a pass, as one gentleman from the other side of the aisle said earlier. I would suggest the gentleman's party, which controlled for 40 years, took the pass.

While the bill before us certainly is not perfect, and we have admitted that, it targets the $400 billion available under our budget resolution towards areas where it can do the most good. Our bill provides a great deal of assistance to our low-income seniors. In fact, seniors who earn under $13,470 as a single or $18,180 as a couple will only be responsible for nominal copayments and will not experience a coverage gap. This is very generous coverage for the population of seniors who need it the most.

The conference report will also ensure that seniors will have the peace of mind of knowing that they will only be responsible for a very small amount of cost sharing once their out-of-pocket drug costs exceed $3,600 annually. It is a critical provision, and one I strongly support. This bill helps the poorest and sickest, and who can argue against that.

The conference report makes many other improvements to the Medicare program; in fact, too many to list tonight. However, I want to point out that the bill contains two provisions that I have long advocated for: Improved reimbursements for our Nation's physicians, and Medicare coverage for a physical exam upon entering the program. I call that the Dr. William Hale, ``Welcome to Medicare Program.'' Dr. Hale of Dunedin, Florida, gave me the idea some time ago. I am confident that this new benefit will ultimately save the program billions of dollars in the long term.

I would like to close by quickly dispelling a number of myths that we have heard on the House floor tonight, and over the past few months. The conference report does not privatize Medicare. It improves it, namely by adding a voluntary prescription drug benefit available to everyone, including those who do not wish to leave traditional fee-for- service Medicare. We are not pushing seniors into HMOs; I will not be a part of that. Or creating a voucher system. We are offering seniors voluntary choices other than traditional Medicare. And, finally, the conference report does not signal the end of Medicare. Instead, it marks the beginning of a new, better Medicare that will be available for generations to come.

Mr. Speaker, I would like to close by thanking all of the staff members who have worked to help make this bill possible.

Mr. Speaker, I rise in strong support of H.R. 2297, the Veterans' Benefits Act of 2003. This bill addresses an issue that I have been working on for a number of years. Dependency and Indemnity Compensation (DIC) is the benefit accorded to the surviving dependents of those members of the Armed Forces who died while on active duty or of a service-connected cause.

DIC is the only federal annuity program that does not allow a widow who is receiving compensation to remarry at an older age and retain her annuity. Earlier this year, I reintroduced legislation which provides that the remarriage of the surviving spouse of a veteran after age 55 shall not result in termination of Dependency and Indemnity Compensation.

I was pleased that my legislation was incorporated into H.R. 2297 when it passed the House in October. The bill that we are considering today, which was worked out with the Senate, slightly modifies my original provision to provide that a surviving spouse upon remarriage after age 57 would retain DIC, home loan and educational benefits eligibility. Surviving spouses who remarried after attaining age 57 prior to enactment of the Compromise Agreement would have one year to apply for reinstatement of these benefits.

I think it is a wonderful thing if an older person finds companionship, falls in love and decides to marry. I don't think we should be discouraging such marriages by making them financially burdensome. In these circumstances, it is often the case that both partners are living on fixed incomes. the prospect of one partner losing financial benefits as a result of the marriage is a real disincentive.

Once again, I would like to thank Chairman Smith, Ranking Member Evans, Benefits Subcommittee Chairman Brown and Subcommittee Ranking Member Michaud for working with me to include a DIC remarriage provision in H.R. 2297.

I urge my colleagues to support the bill before us today.

Mr. Speaker, I yield myself such time as I may consume, and I rise in opposition to the motion to instruct offered by the gentleman from Washington (Mr. Inslee).

Mr. Speaker, I would say at the outset, through the Chair, that the only air of omission is that the gentleman's party was in charge so very many years did not see fit to decide that prescription drugs were necessary for our poor seniors. Now, all of a sudden, when the Republicans are doing it, they are taking issue with it.

This motion to instruct, Mr. Speaker, no longer serves any purpose, no longer serves any purpose, since a bipartisan group of Medicare conferees has already reached, as the gentleman knows, reached an agreement that will greatly improve the Medicare program, and most notably through the addition of a long-awaited prescription drug benefit.

In fact, I can assure the gentleman from Washington (Mr. Inslee) that the provisions he seeks to strike in his motion to instruct were not included in the bipartisan Medicare conference agreement.

Additionally, the three positions that the gentleman is advocating, insuring that all hospitals receive the large urban standardized rate, that there be a floor on the work component on the physician fee schedule, and that the conference report include increases in reimbursements to physicians, are all already in the conference report.

I have led the opposition to a number of motions to instruct Medicare conferees over the past couple of months; and in doing so, I continually urge my colleagues to allow the bipartisan negotiations that I was a part of to play out. As Members know, these negotiations have run their course, and the result is a bipartisan agreement that is endorsed by a number of organizations, including the AARP.

That is why this motion no longer has any meaning, Mr. Speaker. It seeks to strike provisions not included in the final agreement and direct these nonexistent funds towards provider-payment increases that are already included in a bipartisan Medicare conference agreement.

In fact, the American Medical Association has strongly opposed previous motions to instruct that attempt to move money from patients to providers. In fact, the AMA forwarded me a statement earlier this week in response to a motion which took place, I believe, a couple of nights ago to instruct that said it strongly opposes the Berkley motion to instruct and urges Congress to pass the pending Medicare conference report before we adjourn.

I support reimbursing physicians and hospitals fairly for the valuable services they provide. I have been particularly passionate about fixing the formula that the Centers for Medicare and Medicaid use to annually update Medicare physician payments. In fact, I introduced a bill in late 2001, I believe it was jointly with the ranking member of my Subcommittee on Health, the gentleman from Ohio (Mr. Brown), that would have prevented the 5.4 percent cut in physician reimbursements under Medicare that went into effect in 2002.

Physicians were slated to receive another cut, this time a 4.4 percent, if not for congressional action that corrected flawed data in the update formula and provided physicians with a 1.6 percent update for 2003.

However, persistent flaws in the update formula mean that physicians are looking at a 4.5 percent cut next year and further negative updates through 2007. It makes no sense, does it, that we would be cutting payments to our Nation's doctors at the same time their costs are rising. That is why the bipartisan Medicare conference agreement contains provisions that will ensure that physicians see their reimbursements under Medicare increased by 1.5 percent in fiscal years 2004 and 2005. Rather than the 4.5 percent cut, we are talking about a 1.5 percent increase, a 5.9 percent swing.

This will provide Congress with the time that it needs to make long- term reforms to the Medicare physician payment update formula so that physicians can count on predictable, rational payments from Medicare; and it will also avoid a major physician access problem for Medicare beneficiaries.

I would note that a number of organizations representing America's health care providers, including the American Medical Association, the American Osteopathic Organization, the American Hospital Association, and the Federation of American Hospitals, all strongly support the bipartisan Medicare conference agreement.

Mr. Speaker, over the past few months, I have had to listen to an awful lot of rhetoric about how Congress was privatizing Medicare or implementing a voucher system or handing Medicare over to the HMOs. That was not true then, and it certainly is not true now. What the bipartisan Medicare conference agreement does do is improve the Medicare+Choice program and set up a new system that will encourage regional plans to offer seniors another choice besides traditional Medicare.

It is a voluntary thing. Seniors can choose to retain traditional Medicare, something that they are accustomed to, something I would recommend to my parents if they were still alive, retain it and then go ahead and purchase a private drug prescription plan to add to it. It is my hope that this will extend new choices to folks in rural areas who have not had a choice in Medicare before.

The bipartisan Medicare conference agreement also includes a limited pilot project that will test a new system that could help put Medicare on sound financial footing for future generations. It is a pilot program. I think conferees came to a solid compromise. It is bipartisan, and it will help us fulfill our promise to America's seniors, and that is why I am so pleased that AARP strongly endorsed this agreement.

I can attest to the gentleman that a bipartisan group of conferees worked around the clock to reach this compromise. Soon Congress, I suppose tomorrow, will vote on a conference report that will add a new prescription drug benefit that will be available to all Medicare beneficiaries and that will provide seniors with new choices under Medicare and will reimburse our health care providers, including physicians, fairly so that beneficiaries will continue to have access to high-quality care; and I would also throw in at this point that under this bipartisan Medicare conference agreement, as under the original House-passed bill, seniors retain complete freedom to choose a private plan or to remain, as I have already said, in the traditional fee-for-service program. Medicare will continue to offer every beneficiary access to Medicare's defined benefit.

I hope Members will join me in supporting the conference report tomorrow and rejecting this motion to instruct which is meaningless because the conference agreement has already taken place.

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

Mr. Speaker, will the gentleman yield?

Mr. Speaker, every House Democratic Member who showed an interest in having a piece of legislation rather than an issue in November was invited into this coalition. It was bipartisan because there were two Democratic Senators who did have enough dedication who wanted to have a bill who were invited to participate, and I am here to tell Members that their comments and their recommendations probably took up 50 percent of the time over a period of months.

Mr. Speaker, I yield myself 1 minutes.

Mr. Speaker, to respond to the gentleman's statements, the regulatory reform portion of this bill, the electronic prescribing portion of this bill, the medication therapy management portion of this bill, and many of the provider issues were worked out on a bipartisan basis by all of the staffs, even prior to the conference. They were not discussed as part of the conference because they were already worked out. I just wanted to point that out.

Mr. Speaker, I yield such time as he may consume to the gentleman from Georgia (Mr. Gingrey).

Mr. Speaker, I yield such time as he may consume to the gentleman from Texas (Mr. Burgess).

Mr. Speaker, I yield myself 1 minute to respond to a point just made by the gentleman from Washington regarding premium support because that was the point. I am reading from the AARP endorsement, this insurance company as it was referred to a few minutes ago:

AARP is pleased by the improvements made to the conference report in recent days. A new structure called premium support--their words--which required competition between traditional Medicare and private plans was downsized to a limited test starting in 2010 which has significant protections--their words--significant protections for those in traditional Medicare.

I should think they would know at least as much about this as many of you gentlemen over there do. The government will provide coverage in areas where private plans fail to offer coverage. The integrity of Medicare will be protected.

Mr. Speaker, I yield such time as he may consume to the gentleman from Kentucky (Mr. Whitfield).

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

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

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

Mr. Speaker, I would remind the gentleman through the Chair that I am not sure what his definition of bipartisanship is, but a few years ago, we had a tort reform bill on the floor, and the most elderly Member in terms of service of this House had the bill on that side. He had one Republican cosponsor of that bill and continually, continually harped on it being bipartisan, bipartisan, bipartisan. I should think that two United States Senators, two United States Senators, I think one, maybe both ranking members of the appropriate committees, two out of 12 would be considered every bit as bipartisan as one out of 435.

I would also, additionally, remind the gentleman through the Chair that in addition to the other areas that I said that have been worked out on a bipartisan basis by all of the staffs, there were the Hatch- Waxman reforms and the reimportation and whatnot, and the gentleman from Michigan's (Mr. Dingell) staffers were at every one of certainly the Hatch-Waxman reforms and the reimportations, as I understand it.

The point was made regarding the catastrophic. If memory serves me correctly, I believe I voted for that bill. How many of us, 400-some of us did. It turned out to have been the wrong thing to do, but 400 some. Bipartisan? My colleagues better believe it. I would suggest that if the gentleman were here at that time, he probably would have been part of the 400 and some that voted for that particular bill. That was a mandatory thing. This is voluntary. That was mandating on these people. This is voluntary.

I would just finish up my comments, Mr. Speaker, by reminding the people over there through the Chair of the AARP endorsement. AARP believes that millions of older Americans and their families will be helped by this legislation. Though far from perfect, the bill represents an historic breakthrough and an important milestone in the Nation's commitment to strengthen and expand health security for its citizens at a time when it is sorely needed. The bill will provide prescription drug coverage at little cost to those who need it most: people with low incomes, including those who depend on Social Security for all or most of their income. It will provide substantial relief for those with very high drug costs. It will provide modest relief for millions more.

It also provides a substantial increase in protections, protections for retiree benefits and maintains fairness by upholding the health benefit protections of the Age Discrimination and Employment Act.

The gentleman from Ohio who most recently spoke talked about some sort of a meeting which was held with PhRMA. I really do not know about that. I do not deny it took place. But I will tell my colleagues that there was a meeting held in the last couple of days where AARP appeared with the two Democratic Senators, and they wrote many of the provisions of this bill. I would not call this an AARP bill, I would not call this a Republican bill nor a Democratic bill. It is a bipartisan bill.

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

Mr. Speaker, will the gentleman yield?

Mr. Speaker, I agree with the gentleman, they deserve better. I agree with the gentleman, it is not perfect. But I would simply say to the gentleman that it will help an awful lot of seniors in the meantime. In the meantime, it will help a lot of seniors. The alternative is zero.

Mr. Speaker, the gentleman has the right to close, as I understand it. I have no further speakers, so I yield back the balance of my time.

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

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 2218) to amend the Federal Food, Drug, and Cosmetic Act to provide for the regulation of noncorrective contact lens as medical devices, and for other purposes.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and to include extraneous material on H.R. 2218, the bill now under consideration.

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

Mr. Speaker, I rise today in support of H.R. 2218, which amends the Federal Food, Drug and Cosmetic Act to provide for the regulation of noncorrective contact lens as medical devices, and I commend the gentleman from Arkansas (Mr. Boozman) for his work on this legislation.

As the corrective contact lens industry has grown, so has the practice of using noncorrective contact lenses for cosmetic purposes. Currently, there is very little regulation of these lenses. However, all contact lenses have significant effects on the eye and pose health risks if improperly manufactured or used without the supervision of a qualified eye care practitioner. Both corrective and noncorrective contact lenses have been approved as medical devices by the FDA. It just makes sense that the FDA should have the authority to regulate these lenses.

Mr. Speaker, having said that, I would urge all of my colleagues to support this important resolution.

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

Mr. Speaker, I yield such time as he may consume to the gentleman from Arkansas (Mr. Boozman), who is himself an optometrist and certainly has lived with this problem for many, many years and knows the real world, and I thank the gentleman for bringing this to our attention.

Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 650) to amend the Federal Food, Drug, and Cosmetic Act to authorize the Food and Drug Administration to require certain research into drugs used in pediatric patients.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and to insert extraneous material on the bill.

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

Mr. Speaker, I rise today in support of S. 650, the Pediatric Research Equity Act. This bill gives the Food and Drug Administration new statutory authority to require certain pediatric tests, to require certain research into drugs used for pediatric patients, and it provides for appropriate enforcement of the requirement to submit timely pediatric assessments.

As chairman of the Energy and Commerce Subcommittee on Health, I have been a long-time supporter of pediatric research efforts. To that end, it is important that the FDA has the authority that it needs to require pediatric studies and also information for drugs and biological products in cases where the needed information is not generated by using existing incentive and funding mechanisms. S. 650 will provide that authority.

I think it is appropriate to express appreciation to Senator DeWine for this piece of legislation and to the gentleman from Ohio (Mr. Brown), the gentleman from California (Mr. Waxman), the gentlewoman from California (Ms. Eshoo) and so many others who have shown concern in this regard and, of course, join us here today.

I urge my colleagues to support the bill that the Senate has passed.

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

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

Mr. Speaker, I yield such time as he may consume to the gentleman from Pennsylvania (Mr. Greenwood).

Mr. Speaker, I yield such time as she may consume to the gentlewoman from Ohio (Ms. Pryce).

Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 686) to provide assistance for poison prevention and to stabilize the funding of regional poison control centers, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on S. 686.

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

Mr. Speaker, I rise today in support of S. 686, the Poison Control Center Enhancement and Awareness Act amendments.

This bill, Mr. Speaker, amends the Poison Control Enhancement and Awareness Act to provide additional assistance for poison prevention and to stabilize the funding of regional poison control centers.

I would like to extend my thanks first to my colleague, the gentleman from Michigan (Mr. Upton), for all of his work on this important legislation and also add to that list the gentleman from New York (Mr. Towns), who has been very interested in this subject for a long time, the gentleman from Texas (Mr. Barton), Senator DeWine, and, of course, the gentleman from Ohio (Mr. Brown) and the others who have been so very cooperative.

Poisoning is the third most common form of unintentional death in the United States. Many of these exposures involve children. Poison control centers are a primary defense against injury and death from poisoning.

In the events since September 11, poison centers have taken on the additional role, Mr. Speaker, of providing medical information about biological, chemical, and nuclear domestic terrorism. S. 686 would authorize funds to maintain national toll-free poison control hotlines and the Poison Control Center Grant Program. Additionally, the legislation would create a nationwide media campaign to promote poison control center utilization and to allow the Secretary to assist in the implementation and maintenance of continuous national surveillance of poison control center data to detect new hazards from toxic substances, household products and pharmaceuticals.

I urge my colleagues, Mr. Speaker, to support this important legislation that the Senate has passed.

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

Mr. Speaker, I yield such time as he might require to the gentleman from Michigan (Mr. Upton), the father of this act.

Mr. Speaker, I yield such time as he might consume to the gentleman from Texas (Mr. Barton).

Mr. Speaker, I would say that the gentleman from Texas (Mr. Barton) was here earlier, before even the votes. He wanted to really speak on this subject because he has a great interest in it, and I appreciate that interest.

Mr. Speaker, I yield such time as he might consume to the gentleman from North Carolina (Mr. Hayes).

Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

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

Mr. Speaker, I move to suspend the rules and pass the Senate bill (S. 286) to revise and extend the Birth Defects Prevention Act of 1998.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on S. 286, the bill now under consideration.

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

I rise today in support of S. 286, which is the Birth Defects and Developmental Disabilities Prevention Act. This legislation will allow public health surveillance for developmental disabilities using records maintained by local educational institutions.

A baby born in America today has a life expectancy 30 years longer than a child born at the turn of the century. Public health initiatives are largely responsible for this vast improvement, but we cannot rest on our laurels, Mr. Speaker, because much more remains to be done.

Many of us have worked diligently to examine many of the difficult barriers we face in working to improve children's health and well- being, and this legislation, initiated by our colleague, the gentleman from New Jersey, (Mr. Ferguson), and helped to a large degree by another colleague from New Jersey (Mr. Smith) and so many others, the gentleman from Ohio (Mr. Brown) and so many others, will assist the Centers for Disease Control and Prevention in accurately determining the size and scope of many developmental disabilities, including autism, mental retardation, and cerebral palsy.

My hope, Mr. Speaker, is that this information will ultimately help us identify causes and possible cures for these disabling, very disabling conditions. I might add these diseases are not only disabling insofar as the child is concerned, but what it does to the parents is just unbelievable. I know we have all seen that, and, hopefully, we can find some way to find at least the causes.

In any case, Mr. Speaker, I urge all of my colleagues to support this legislation that the Senate has already passed.

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

Mr. Speaker, I yield myself such time as I may consume, and I want to thank the gentleman for all those comments. He puts it so very well.

My oldest son, Emmanuel, is a physician, an internist. He works awfully hard, puts in a lot of hours and does not make much money. Sort of like the late father of the gentleman from Ohio (Mr. Brown). But when he was going through his rotation, he told me the toughest one was the one dealing with pediatrics, with children, and to see some of these parents, particularly with the autistic children.

I would say that the children's health bill that the gentleman from Ohio (Mr. Brown) referred to, a great impetus on that, to a large degree, was due to the actress Rene Russo. She really pushed us on that. She came here and testified, and I am just glad we were able to do it. But at the same time, we see all these terrible things happening.

Mr. Speaker, I yield such time as he may consume to the gentleman from New Jersey (Mr. Ferguson), the father of this bill, this very needed bill, this very great bill.

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

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

Mr. Speaker, I move to suspend the rules and concur in the Senate concurrent resolution (S. Con. Res. 48) supporting the goals and ideals of ``National Epilepsy Awareness Month'' and urging support for epilepsy research and service programs.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and to include extraneous material on H. Con. Res.48, the concurrent resolution now under consideration.

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

Mr. Speaker, I rise today in support of Senate Concurrent Resolution 48, a concurrent resolution supporting the goals and ideals of National Epilepsy Awareness Month. This resolution urges funding for epilepsy research and service programs.

More than 2 million people in the United States have epilepsy. Approximately 300,000 of those 2 million are children or adolescents. November has been designated as National Epilepsy Awareness Month to increase public awareness of this very debilitating disease.

Epilepsy is a chronic condition that produces random, temporary changes in the brain's electrical activities. These changes cause seizures that affect awareness, movement, or sensation. Although there is currently no cure, there is medication available that can help to control seizures and to enable people with epilepsy to lead normal lives.

I would like to acknowledge, I guess I will call them the mothers of this legislation, Senator Lincoln from the other body, and the gentlewoman from Florida (Ms. Brown), my colleague from my home State, for their making us aware of this.

As chairman of the Subcommittee on Health of the Committee on Energy and Commerce, Mr. Speaker, I believe it is important that Congress work to increase public awareness of epilepsy and to dispel any myths and stigma, and, gosh knows, even today, there is still some stigma associated with this disease, and to promote research into the causes, treatment, and possible cures.

Mr. Speaker, I urge my colleagues to support the resolution.

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

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

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

Mr. Speaker, in closing, I would like to say how pleased I am to have worked with the gentleman from Ohio (Mr. Brown) on these suspensions here today. We have had a number of them. We have been here quite awhile, about 4 hours; and it is an illustration of what we can do if we work together. I would also like to express my appreciation to the staff on both sides of the aisle.

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

Mr. Speaker, as to the issue of concurrent receipt, which the other side keeps referring to as a tax on disabled veterans, as the Members know, and I appreciate all the kind remarks that I have received from both sides of the aisle, but I have worked on this for 18 years, and during the first half of those 18 years, the other party was in charge, and we have to ask ourselves what was done during all that period of time. I say to the Members nothing, nothing. I am searching my mind to try to find out how many hearings we were able to have on this issue during that period of time. We may have had one. I am not even sure we had even that. Never in any of their budgets had they even put a single penny into their budgets for full concurrent receipt, even the most recent ones. The discharge petition would bring H.R. 303 on the floor. There is going to be a motion to recommit, which basically says we have got to have the entire amount.

Why did you all not crank those dollars into your budget? You have not chosen to do so.

The gentleman has talked about his discharge petition. My discharge petition back in the early 1990s, 1993 I believe it was, failed. Where were all the signers from that side of the aisle back in 1993, or whatever that year was, when we had that discharge petition? Politics, I might say, politics, politics.

Starting January 1 of next year, the proposal will phase in full concurrent receipt for all retirees who have disability ratings 50 percent or more. It expands the combat-related special compensation program to cover all 100 percent combat-related disability categories, as opposed to those that are 60 percent now. It also extends these benefits to the Reserve and National Guard, who have not been getting it up to now.

Despite this breakthrough, Mr. Speaker, full concurrent receipt remains a priority goal for all of us. Only let us show it. Rather than just discharge petitions, let us put the dollars into the budget, if we will, on both sides of the aisle if we are really serious.

I ask everybody to vote for this bill and to oppose the motion to recommit, Mr. Speaker, for the reasons stated.

Mr. Speaker, I rise today to call attention to a little-known but debilitating disease that profoundly impacts its victims.

Vitiligo is an auto-immune disorder which causes the skin to lose its pigmentation, resulting in the development of white patches around the bodies of those afflicted with it. Although its physical effects are neither as severe nor life-threatening as some diseases, vitiligo profoundly impacts the social and psychological well-being of its victims, particularly children and African-Americans.

Vitiligo may physically be painless, but the discrimination it precipitates hurts nonetheless. The more than 5 million American men,

women, and children who have vitiligo know the sting and emotional distress it causes. I have seen it in the eyes and heard it in the voices of those with whom I've met who have it.

I learned about vitiligo from one of my constituents, Stella Pavlides, who is the Founder and President of the American Vitiligo Research Foundation, which is headquartered in my congressional district in Clearwater, Florida. Stella is a tireless advocate who has dedicated her life to finding a cure for vitiligo and ending the hurt it causes. I have pledged to her that I will work with my House colleagues to raise public awareness about vitiligo so that we can make it a disease of the past and not the mystery illness shrouded in ignorance that it is today.

Mr. Speaker, I want to commend our colleague, Congressman Todd Tiahrt, for taking a leading role in helping me bring this disease to the attention of our colleagues. I hope that all of our colleagues will join us in raising public awareness about vitiligo and dedicating ourselves to helping the medical and scientific communities find a cure for it.

Mr. Speaker, I appear to be the only speaker on this side. I do not know how many speakers the gentlewoman has.

Mr. Speaker, what I would like to do is reserve the balance of our time and be the last speaker, just before the gentlewoman's closing.

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

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

Mr. Speaker, I thank the gentleman from Ohio, particularly for his kind remarks. I rise in opposition to the motion to instruct offered by the gentlewoman from California (Mrs. Capps). This is just the latest, I think, in a long line of motions to instruct that hurt our ability to finish our Medicare bill and provide prescription drugs to seniors. I am going to focus my remarks principally on the comments made of saving money from taking money away from the H.R. 1 program, if you will, and putting it into providers.

I have been a tireless advocate of fixing the formula that the Centers for Medicare and Medicaid Services uses to annually update Medicare payments to physicians. In fact, I introduced a bill in late 2001 that would have prevented that 5.4 percent cut in physician reimbursements under Medicare that went into effect in 2002. I believe the gentlewoman was supportive as were others. Physicians were slated to receive another cut, this time of 4.4 percent, were it not for congressional action that corrected flawed data in the update formula and provided physicians with a 1.6 percent update for 2003.

However, persistent flaws in the update formula mean that physicians are looking at negative updates next year and through 2007, and this motion to instruct does not fix that. It makes no sense, and the others have said it, it makes no sense that we would be cutting payments to our Nation's doctors at the same time that their costs are rising.

That is why the House bill contains provisions, and if this bill goes down, those provisions will not be applicable and the increases that we are all talking about would not take place.

That is why the House bill contains provisions that will ensure that physicians will see their reimbursements under Medicare, rather than cut by 4.4 percent, would be increased by 1.5 percent in fiscal years 2004 and 2005. This will provide Congress with the time that it needs to make long-term reforms to the Medicare physician payment update formula so that physicians can count on predictable, rational payments from Medicare. It will also avoid a major physician access problem for Medicare beneficiaries.

I would note, Mr. Speaker, that a number of organizations representing America's physicians, including the American Medical Association, the American Osteopathic Association and the Alliance of Specialty Medicine all strongly support the House bill. I would quote from an October 30, 2003, letter from the American Medical Association. I believe the minority is aware of this. The last few lines basically say:

Pending Medicare payment cuts must be addressed now, not in 2010, which is basically what the instructions go to, and the flawed payment formula must be addressed through replacement of the formula. Simply attempting to transfer dollars from patients to physicians through some ambiguous, unspecified mechanism, as is intended under the Capps motion to instruct, would not change the flawed Medicare payment formula, and thus would not ensure long-term access for Medicare patients.

I received another letter dated the same date, October 30, from the American Osteopathic Association. It starts out:

On behalf of the 52,000 osteopathic physicians represented by the American Osteopathic Association, I write to thank you for your efforts to reform and improve the Medicare program. The AOA applauds the consistent effort by the committee and their staffs to finalize a legislative compromise that will improve the health care of millions of Medicare beneficiaries. We encourage the committee to complete work on the pending conference report, enabling both Chambers to approve the legislation before the end of the year.

In the next paragraph it finishes up by saying:

Additionally, section 601 of the bill includes reforms that reduce the future economic volatility of the physician payment formula. These provisions have strong bipartisan, bicameral support. We urge their inclusion in the final conference report.

It goes on the next page:

Given budget constraints, the AOA understands that a long-term solution

for the physician payment issue could not be included in this legislation, and I add to that my own comment, unfortunately. However, we believe strongly that section 601 provides short-term relief that will allow physicians to continue participating in the Medicare program, preventing an increase in access problems for Medicare beneficiaries. Furthermore it provides Congress ample time to develop and implement long-term reforms of the Medicare physician payment. I would add parenthetically, in my own words, that I would hope we could work together with the minority to fix that terrible, terrible, unfair formula.

We received another letter from the Alliance of Specialty Medicine basically saying the same sort of thing in a different way. It is signed by the American Academy of Dermatology Association, American Association of Neurological Surgeons/Congress of Neurological Surgeons, American Association of Orthopedic Surgeons, American College of Cardiology, American College of Emergency Physicians, American College of Radiology Association, American Gastroenterological Association, American Society for Clinical Pathology, American Society for Therapeutic Radiology and Oncology. American Society for Cataract and Refractive Surgery, American Urological Association, National Association of Spine Specialists, Society of Thoracic Surgeons.

Mr. Speaker, I would also note, and I hate to put it this way, but if my friends really would like to help America's physicians and, yes, I appreciate the fact that they are on our side in terms of trying to have an increase rather than that great, terrible decrease, then I would recommend that they support, or at least favorably, objectively, open-mindedly look at the balanced liability reform like H.R. 5, which is the HEALTH Act. The gentlewoman from California voted against this legislation. I do not question that she wants to help the providers. I certainly do not. But those people who voted against this legislation, I would like to think they basically did so with a closed mind which America's doctors so desperately, desperately need.

I have heard a number of charges that Congress is considering handing Medicare over to the HMOs. That is not what the House did at all in the Medicare reform bill that we passed.

What the House did do was to improve the Medicare+Choice program and set up a new system. It has been said that people have been dealt unfairly by virtue of losing their HMO because they moved out. That has happened in my district in Florida, too. I have reprimanded and I have admonished as far as that is concerned but, my gosh, if that is the case, then those programs apparently were liked. They were liked by the particular patients. They are distressed because they have been taken away. Their Representatives are standing on the floor of the House here and complaining that they have been taken away. So there must be some good to them. I am not sure that I would have recommended any of them to my parents, but that is my personal choice.

What the House did do was to improve the Medicare+Choice program and set up a new system that will encourage regional plans to offer seniors another choice besides traditional Medicare. It is my hope that this will extend new choices to folks in rural areas who have not had a choice in Medicare before.

I talked to the gentlewoman from Florida (Ms. Corrine Brown) on the floor of the House during our last series of votes. We talked about this. I said, what we're basically saying is let's be open-minded. Let's be objective. Let's take a look at new ideas. They may not be any good. There may be some good to them, there may be some bad to them, but let's be open-minded. That is basically what I was pleading. That is what we are trying to do in the conference. We are going back and forth. It is a bipartisan thing.

I remember one of the most important gentlemen, the longest in seniority in the House basically calling a particular piece of legislation he introduced bipartisan when there was one Republican who cosponsored that legislation. So he called it bipartisan. We have two Senators in these gatherings. That is pretty darn bipartisan, I would say even more so bipartisan. But what the House did not do, and I would never support, and I very much appreciate the gentleman from Ohio making those comments, is force seniors to leave traditional Medicare. I feel very strongly about that. There are a lot of lengthy, sometimes heated discussions taking place regarding that. Any statements that characterize the House bill in any other way are, I say without any hesitation, 100 percent false.

I would have voted, Mr. Speaker, in the mid-sixties, I like to think I would have if I had been in the House at that time, to establish the concept of Medicare. My parents, along with so many others, took advantage of it. They are both gone now. I certainly look forward to retiring one of these days and taking advantage of it. I am concerned that it be a viable system, it is a system that is hurting right now, but be a viable system.

The reality that we are all facing and that many folks here in Congress seem to not want to address is that reforms must be made to ensure that Medicare continues to exist. It is a great program. There is no question about it. In my opinion it is. I say that. I do not hesitate. There are faults in it. It has got to be reformed. Anything that has been in effect for something like 40 years has got to be looked at again and possibly some changes made. We have got to ensure that Medicare continues to exist for future generations. As we add a $400 billion benefit, a $400 billion drug benefit to a program that already has, we forget this, do we not, $13 trillion in unfunded liabilities, we have got to take a serious look at how we can place the program on a sound financial footing for the future.

The House and the Senate did take different approaches in trying to meet this goal. We are currently working through those differences, but I want to emphasize and what I do want to emphasize, and really emphasize, is that none of those options involve forcing any senior to ever leave traditional Medicare.

Conferees are working around the clock, almost literally around the clock. We meet again tomorrow. We will meet Monday and Tuesday, on Veterans Day. My veterans back home will not be happy to hear that, but we will be up here meeting Monday, and we will be meeting on Tuesday and there is a possibility, a very strong probability, we may not have any votes in the House next week, but the conferees will be here as we were during the last few days when we did not have any votes for 3 days during the particular week.

We are trying to reach a compromise on this issue. I am hopeful that we will emerge with a conference report that will add a new prescription drug benefit that will be available to all Medicare beneficiaries but be voluntary, provide seniors with new choices under Medicare and reimburse our health care providers, including physicians, fairly, so that beneficiaries will continue to have access to high quality care.

Mr. Speaker, the gentlewoman means well, and we have worked well together in the past, but I submit that this motion to instruct will not help us to meet that goal. I urge my colleagues to oppose it.

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

Mr. Speaker, will the gentlewoman yield?

That $6 billion, as I understand it, is in the Senate version. There is no money contemplated in terms of a cost in the House version. But in any case I do not disagree with her on this $6 billion.

Mr. Speaker, I rise today with a heavy heart to honor Congressman Bill Cramer, one of our former colleagues who recently passed away.

William Cramer, or Bill as he was known, lived a life of public service. He served 18 months as a Naval gunnery officer during World War II and was among the brave young men who invaded France and liberated Europe. He returned to the United States following the war, and after graduating from Harvard Law School, served as a city and county attorney in Pinellas County, Florida. He also actively involved himself with local volunteer and charitable organizations.

Bill Cramer was a revolutionary in Florida politics. He was, when he won his seat in 1954, the first Republican from Florida elected to Congress since the Civil War. Congressman Cramer opened the door, so to speak, for Republicans seeking office in the Sunshine State. Before his election, many used to joke that Republicans could not get elected to anything in Florida, let alone a congressional seat. Congressman Cramer changed that and quickly became our party's standard bearer in the state.

Congressman Cramer, in just his fifth term, became the ranking member on the House Public Works Committee. In 1964, he became Vice Chairman of the House Republican Conference, the second ranking House Republican behind Michigan Congressman and future President Gerald Ford. He vacated his

House seat in 1970 for what ultimately was an unsuccessful bid for the U.S. Senate. One of Congressman Cramer's congressional aides, Appropriations Committee Chairman Bill Young, replaced him as the representative of Florida's Tenth Congressional District.

Bill Cramer's public service did not end with his departure from Congress. He practiced law, held various positions with the Republican National Committee, and accepted several jobs in the Nixon and Ford Administrations. He then, as he later said, ``decided he wanted to spend more time back home'' where he grew up, so he returned to Florida where he continued to use his talent and influence to help Tampa Bay area residents.

Mr. Speaker, next year marks the fiftieth anniversary of Bill Cramer's election to Congress. I hope that, as we approach that milestone, our colleagues on both sides of the aisle will join the Florida delegation in remembering him and his dedicated work in this institution on behalf of his constituents and his country.

Mr. Speaker, I rise proudly to celebrate ``oxi'' day. The historical significance of this day and what it meant to the outcome of World War II cannot be overstated. By October of 1940, World War II had begun and the Nazi war machine was already in high gear. Along with Hitler's ally, Italian dictator Benito Mussolini, the German and Italian forces were threatening the whole of Europe. European nations were bowing to tyranny and destruction as the Germans and the Italians marched through Europe. Great Britain endured German's aerial bombardment, forcing Hitler to seek another avenue to subdue the British. Hitler intended to eliminate British operations in the Mediterranean in order to weaken their ability to deter German advances.

To achieve this, Hitler needed the Axis powers to strike at British forces in Greece. By conquering Greece, Hitler would gain access to an important connecting link with Italian bases in the Dodecanese Islands. This would give the Italians a stranglehold on British positions in Egypt where British forces were already facing attack from the Italian Army in North Africa. The British considered the defense of Egypt vital to Allied positions in the oil-rich Middle East.

On October 28, 1940, the Italian ambassador in Athens presented an insulting ultimatum to Greek Prime Minister Metaxas, demanding the unconditional surrender of Greece or Italy would declare war and invade Greece. Mussolini had given the Greek Prime Minister Metaxas 3 hours to reply.

Prime Minister Metaxas responded with the now historic word ``oxi,'' which means ``no'' in Greek. Italy then invaded.

It is important to note that in addition to Greece having a population seven times smaller than Italy, the disparity in their armed forces was even greater. Italy had close to 10 times the firepower of Greece in its army and navy and seven times the troops. Italy's large air force had total air superiority, since Greece had a very small defensive air force. However, despite their lack of equipment, the Greek army proved to be well-trained and resourceful. Within a week of the invasion, it was clear that Italian forces were suffering serious setbacks, despite having control of the air and fielding superior armored vehicles.

On November 14, the Greek army launched a counter-offensive and quickly drove the Italian forces back into Albania. The fighting continued for a few more months. In a last ditch effort to bring the war to a close before the Italians would be forced to ask Hitler to intervene, they launched another assault on March 12, 1941. After 6 days of fighting, the Italians made only insignificant gains, and it became clear that German intervention was necessary.

On April 6, 1941, Hitler ordered the German invasion of Greece. It took the Germans 5 weeks to finally end the conflict. This delay proved to be critical to the outcome of the war.

Due to Mussolini's humiliating defeat by the Greeks in Albania and Greece, Hitler was compelled to capture the Balkans, mainly Yugoslovia and Greece, thus delaying his Barbarossa plan to invade and capture the Soviet Union before the winter of 1941. The Greek resistance, both in Albania and in the other famous battle in Crete, altered, favorably for the allies, his Barbarossa timetable by at least 6 months.

Perhaps most importantly, the Germans never gained the advantage against the British. Although Germany had conquered much of Europe, its inability to decimate British and Russian forces early in the war would eventually prove to be fatal. Thanks to the heroic Greek resistance and their countless sacrifices, the war tide had been permanently changed for Hitler due to the delay of this critical timetable.

Nearly one million Hellenes died during that time. That was 14 percent of the population in 1940. That is equivalent, Mr. Speaker, to losing 39 million people in this country today in the case of a war to defend our country.

The entire Western world, discouraged and fearful of the Axis powers and the growing ugly war, took hope from these incredible victories. British Prime Minister Winston Churchill said of the Greeks, ``Today we say the Greeks fight like heroes; from now on we will say that heroes fight like Greeks.''

A very small number of those Greeks who fought like heroes are still alive today. Some now are American citizens. One of these heroes lives in my Congressional district, Mr. Demetrios Palaskas, who, along with others, has shared those traumatic stories of the mountain fighting by the rag-tag Greeks against such a powerful equipped invader. We all salute you, Mr. Palaskas, you and your many fellow heroes, for helping to keep the world free.

Mr. Speaker, ``oxi'' day is an inspiration to all those who cherish democracy and freedom. It marks defiance against terrible odds. As an American of Greek descent, I am proud to honor the memory of those brave patriots who fought for freedom for themselves and ultimately for all the free world on this important day.

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

Madam Speaker, a group of Members, both Republicans and Democrats, have been meeting for months in an attempt to reach a compromise on a very important and complicated subject, namely, Medicare reform or Medicare modernization.

There are Members who care deeply about Medicare who have very different views about how to best strengthen and improve Medicare for future generations, which is why there are some substantial differences between the House and the Senate-passed Medicare prescription drug bills. That is why it has taken so long for this bipartisan group of negotiators to reconcile the differences between the two bills.

However, Madam Speaker, I am pleased to report that this group is making substantial progress and that it is my sincere hope that we will get a conference report done this year and provide our seniors with a prescription drug benefit they need and deserve.

Motions to instruct like this are not helpful; and, in fact, they hinder our ability to reach a compromise on Medicare prescription drugs. I honestly, and I mean this sincerely, do not believe that that is the goal of the author of this motion. And it certainly is not mine. I want a bill.

The particular section the gentleman refers to is not without controversy. And that is why we are working through it in a bipartisan manner. However, the section that we are talking about, which would inject competition into the Medicare program and provide seniors with choices similar to those choices Members of Congress enjoy, is probably the most misunderstood provision in the House-passed bill, and the most mischaracterized, I might add.

Let me attempt to clarify some of the issues that are often misunderstood surrounding so-called FEHBP-style competition. First, H.R. 1 contains no changes, no changes to the basic entitlement to Medicare. The traditional Medicare program will continue to be

available to all seniors throughout the country and will continue to pay providers in the same way as today. However, it is an undisputed fact that we need to reform Medicare to ensure that it is around for future generations.

Social Security, Medicare, and Medicaid currently comprise more than 40 percent of the Federal budget. By 2030 the General Accounting Office estimates that these three programs could consume 75 percent of the Federal budget if no changes are made. In addition, the Medicare part A trust fund is scheduled to go insolvent in 2026 while the Medicare part B trust fund will require increases in Medicare part B premiums to remain solvent, increases that are much higher than the 13.5 percent increase Medicare beneficiaries will see in 2004.

So reforms must be made to ensure that Medicare continues to exist for future generations. As we add a $400 billion drug benefit to a program that already has $13 trillion in unfunded liabilities, we must also enact real reforms that will place the program in a sound financial footing for the future. The provision in the House-passed bill attempts to do that. Is it the best way to go? I do not know. I do not know. But that is why members of the conference committee are working on the provisions and the issue right now.

I would urge Members to allow the process to work its will and to not support the motion to instruct which, while nonbinding, would do more harm than good.

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

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

Mr. Speaker, there is no intent, never has been any intent to take that life boat away in the year 2010. The programs that we are talking about are strictly voluntary. And that choice will be available in 2010 as it is today. And anybody who would say otherwise either does not know what is included in the legislation or else they are ignoring it.

Mr. Speaker, I yield such time as he might consume to the gentleman from New Jersey (Mr. Ferguson).

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

Mr. Speaker, I would say to the gentleman that we learned of the doughnut hole from the Democratic plan in the last Congress. And I also would join the previous speaker in voicing strong opposition to any legislation which would adversely effect my senior constituents. I, obviously, do not feel that this legislation would do that. And I would again ask the Members to vote against the motion to instruct.

Mr. Speaker, I yield such time as he may consume to the gentleman from Texas (Mr. Burgess).

Mr. Speaker, I do not have any further requests for time, and I yield back the balance of my time.