Floor Statements

Mr. Speaker, I rise to ask why we are not doing more to ensure fewer mistakes are made in the first place.

Mr. Speaker, nobody disputes that malpractice premiums are heavily impacting many physicians. I think very few of us would dispute that there are frivolous claims filed. All of the justifications for this bill about losing physicians in high-risk practices are real concerns.

So why is it that we are spending this time debating a bill that won't address this problem? Repeatedly dramatizing the problem doesn't make this bill a solution. This bill does nothing to prevent frivolous lawsuits. It doesn't rein in the bad actors, in penalizes those who are the most grievously injured.

Experience shows that the link between awards or settlements and premiums is tenuous at best. An exhaustive study published this month showed that premiums have gone up 120 percent over the last 5 years while claims were flat. The GAO has found no evidence that caps on damages hold premiums down.

But even if this bill could work--it would not, Mr. Speaker, but even if it could--we are completely missing the real issue.

We are fighting about how or how not to compensate the victims of mistakes and hold negligent providers accountable. Shouldn't we be talking instead about how to ensure fewer mistakes in the first place?

We are talking about closing the barn door but the horse is already galloping across the field.

Mr. Speaker, Sorrel King can teach us all a lesson. Several years ago, her 18-month-old daughter Josie suffered severe burns and was rushed to the ICU at Johns Hopkins Hospital.

She got the world-class care you would expect and they saved her life. She was going home in just a few days. And then communications were botched, orders were lost, and Josie was administered a drug she was not supposed to get, over Sorrel's objection. And even then, further warning signs were missed.

Josie King wound up dying of dehydration in one of our Nation's finest hospitals. Johns Hopkins settled with Sorrel and her family. And--here is where we can learn something--Sorrel turned around and gave the money back to Hopkins to create a new patient safety program.

Mr. Speaker, like Sorrel, we need to spend less effort apportioning blame and more effort making our system safer and better. Hundreds of thousands of our constituents die in hospitals every year not in spite of the care they get, but because of it. These are mostly systems problems, not the result of individual negligence.

Last year I introduced the Josie King Act to begin transforming health care delivery so that the system itself is driving better quality at lower costs. It laid out a roadmap to bringing health care into the information age and promoted the development of uniform quality metrics so that providers, the public, and purchasers have a clearer picture of which providers get the best outcomes for patients.

Now we are finally beginning to see attention to these priorities, which, unlike the current debate, have bipartisan support. We won't reach agreement about capping damages to patients who are hurt, but we can agree that the system should hurt fewer people.

We can pass strong health IT legislation this year, like the bill Mr. Murphy from Pennsylvania and I introduced or the one that was reported out of committee in the other body.

We can pass legislation this year to begin linking reimbursements to outcomes and quality. I know we have strong leadership on both sides of the aisle, in several committees and in the House leadership, for both of those things.

Until we begin aligning incentives in health care so that providers who go the extra mile to make their patients better or, even better, keep them healthy--people are going to keep getting hurt.

Until we begin aligning incentives in health care so that the tools of the information age can help make care more accurate and more efficient.

Mr. Speaker, I agree with my friends on other side that physicians need lower malpractice rates. I also believe that the best way to get fewer lawsuits is to get fewer mistakes. Let's keep our eyes on the ball and make our health care system better, safer, and more efficient and make everyone better off.

Mr. Speaker, I would like to thank the gentleman from Ohio (Mr. Brown) for his leadership in this area, as well as the gentleman from Florida (Mr. Bilirakis) for his, in addition to the committee chairman, the gentleman from Texas (Mr. Barton), and the ranking member, the gentleman from Michigan (Mr. Dingell).

Of the many bills we are talking about on the floor this week, this is the only one that is really addressing the root problem in our health care system. We stand here in the well of the House, all of us from both sides of the aisle, pontificating about the high cost of care, malpractice rates, access to prescription drugs, or the uninsured. All of these are serious problems with big negative impacts on people, but these issues are all symptomatic of a real problem in health care. Our system is not set up to get the right care at the right time to the right people.

Hundreds of our constituents will die today, tomorrow, and every day until we get this right. Millions will be priced out of care until we get this right. My friends just mentioned the statistics; the equivalent of a jumbo jet crashing every 3 days is how many people we lose in our health care system due to inadequate information because there is inadequate information technology to make the information intraoperable and transparent for all to see so there are not those medications that one is being prescribed by one doctor contravening the medications that are prescribed by another doctor because no one has an electronic medical record.

This bill is a step in the right direction. It aligns the incentives in health care to promote outcomes we want: higher quality, higher safety and higher efficiency. We have seen studies where Medicare has had a single procedure. That procedure has been done all around the country, and even in the markets where it costs us the most, we often see where we have the worst outcomes. We have to ask ourselves why is it that we are paying for more care and getting less results? This bill does a lot to address that problem. We need to learn from our mistakes and use them to make better decisions in the future.

This is a bill that is carefully designed to compromise so we do not have a situation where we close down people's right to seek redress for those that are seriously and grievously injured in the course of their health care.

I hope this patient safety bill is the tip of the iceberg in what we will do to transform health care. We need to pass a strong health care information technology bill. This bill was reported out of the committee and I think it will go a long way to getting us on that road, but I hope that we continue in this legislative session to move us even further, where we begin as a country to make our health care system come up to the same level of technology as every other area in our country is right now.

It is inconceivable that people can have an ATM card and get information

or dollars anywhere in the country, and yet they cannot get their medical record to the doctor that they need to have that medical record so that physician can make the right decision based upon all of the information that is there about their background, and that we are not having situations where there are drug overdoses because of lack of being able to read the orders. As is too often the case, we not only have people die, but also seriously injured.

One instance, a little girl named Josie King in Baltimore was seriously scalded when she went into the bathtub and the tub was too hot. Her mother took her to the hospital, and she got the best care because this country has the best health care in the world. She had the best professionals because this country has the best professionals in the world. But when it came to the system, the system is what is broken, and this system let Josie King down to the point where she was given the wrong medication because her physician did not have the right information before him. As a result, Josie King was in a coma and eventually had to be removed from life support.

Mr. Speaker, we need to learn from these tragedies if we are to prevent them in the future. This legislation moves us down that path. I ask my colleagues to support this legislation.

Mr. Speaker, just to answer the lady about walking the walk and talking the talk, this administration and this Congress just cut child labor enforcement around the world by 87 percent in our dollars that we contribute to the international labor organization.

So on the one hand for people to say that we are really strengthening labor law, but on the other hand not putting the dollars behind it to make sure children are protected to me does not sound like we are walking the walk that we are so talking the talk.

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

As we all know, we are in a health care crisis and many propose many solutions. But let us just find out the simple facts. Facts are, insurance ratings are really dependent on the notion that some people are higher risk than others. Those are the people that insurance companies love to insure. They love to insure them because if they have low risk, every dollar that they pay in terms of premium is another dollar down on their bottom line of profit. However, if you are unfortunate enough to be born with a congenital defect in your organs, if you are unfortunate to be run over by a car, if you are struck by some ailment that is out of any control that you have whatsoever, under the insurance system you are known as a risk. Simply growing old titles you as a risk.

Do you think an insurance company wants to cover you? Of course they do not.

This is a zero sum game. If some get insurance, others get zero. But the fact of the matter is we all pay. The notion that some people are going to get away from paying, meaning some small businesses are going to get away from paying, is just hogwash.

The fact of the matter is, we all know that when we pay our premiums, we are paying for someone who is uninsured. We are paying for someone who is underinsured. The way out of this problem is not to escape giving people health insurance, which this legislation does. Of course it is going to be cheaper if you do not pay for care. That should not be a surprise to any of us. That is pretty obvious. If you want to get lower insurance costs, let us just cut out treatment for cancer. That will reduce insurance costs. Let us just cut out treatment for mental health.

That is just what this act does. It says ``no State mandates'' which means all the provisions, for example, for pregnant women to be able to have at least 72 hours after giving birth, all those provisions that States have put in for consumer protection, are no longer there under this legislation because this obviates all those State requirements that the people want in their insurance coverage. By joining the insurance pool of Federal employees, we bring everyone under a community rating, which means that we all pay our share, irrespective of whether someone is healthy and young versus old and sick.

All of us should be paying our fair share unless you want to escape paying for the notion that there but for the grace of God go you. The fact of the matter is there but for the grace of God go you, someone else, and I. All of us

have an obligation to those who have needs that need that health insurance.

Why? Because it could be any one of us that is the person that is in great need. And I do not think any one of us would be denied health care coverage simply because as a human being we have greater health care needs. And that is why I believe people ought to support the Kind substitute. We ought to support people's access to the same coverage all of us as Federal Members of Congress receive.

Thank you to my good friends, Mr. Kind and Mr. Andrews, for yielding me this time to speak in support of this substitute, the Small Employer Health Benefits Program, which will provide a real solution for many of the forty-five million Americans without health insurance.

Mr. Speaker, our health care system is broken.

To live in a country as great and as wealthy as ours, and to have millions of hard working, employed Americans who cannot afford quality health insurance is inexcusable.

My friends from across the aisle would like the American people to believe that Association Health Plans are the only available option to relieve the burden of increased health care costs on small business owners.

However, the fact remains that Association Health Plans not only ignore the unique needs of small businesses, but will actually undermine our insurance system by allowing healthy individuals to opt out.

We shouldn't be making policy only for the fortunate. We should be making policy for everybody.

The proposed substitute, the Small Employers Health Benefits Program, would provide the same access to health benefits as the Federal Employees Health Benefits Program, FEHBP.

If we are not ready to provide an overall solution to the Nation's health care crisis, then why don't we at least extend small businesses the courtesy of providing a plan that meets the same requirements that Members of Congress and their families currently enjoy.

My colleagues on the other side of the aisle are right about one thing, small business owners are facing a crisis. Now let's provide them with a solution.

Mr. Speaker, I just want to respond to the previous speech, and that is to say I wish that we would call people ``undocumented workers.'' I do not think it is too much to call people ``undocumented workers'' because that is who they are. Many times people are working hard in our communities, with families, who are trying to get their families food at night, a place for them to sleep.

To call them aliens, I think, is demeaning to them, and I think it is derogatory, and I think it is unfitting for this country to refer to people in that

manner. And I would hope that, in the rest of the debate, instead of calling them ``illegal aliens,'' Members would call them what they are, and that is ``undocumented workers.''

Mr. Chairman, as we consider reauthorizing The USA PATRIOT Act today, it is important to recognize that the 16 expiring provisions addressed by this legislation are controversial with good reason. That is why Congress wisely established sunset timelines for these particular sections when the original legislation was passed amidst extraordinary circumstances in 2001; this is one of the main reasons that I voted for its original passage. The sheer fact that Congress included a sunset provision in the bill shows that Members did have concerns with the bill, and recognized its troublesome aspects, even as they acted on the need for swift passage in the immediate wake of September 11th. While I believe it is critical that we update our law enforcement tools to respond to the deadly and unconventional threats we face from global terrorist organizations, it is vital that we do not at the same time endanger the basic civil liberties and freedoms that we hold so dear. I will vote against this legislation because I believe it fails to strike the critical balance between civil liberties and national security.

Reestablishing sunsets for all 16 controversial provisions, thereby recognizing the crucial role that Congress needs to continue to play in providing ongoing oversight in this most sensitive of legislative areas impacting our basic civil freedoms, would greatly improve this bill, but the rule does not allow us to vote on this. The rule also does not allow an amendment which would have defended important civil liberties, including the right to freedom of speech, by excluding booksellers and libraries from the scope of Section 215 FISA search orders. Before the PATRIOT Act, these requests at least had to be directed at ``agents of a foreign power.'' Now they can be used against American citizens, even if they are not suspected of doing anything wrong, as long as there is a showing of ``relevance'' to a terror investigation. I strongly oppose such a provision which would allow government officials to collect personal data on ordinary Americans, including medical and library records, without any evidence linking them to terrorism or other crimes.

I also remain very concerned with Section 213 of the PATRIOT Act and the fact that it is not subject to a sunset. This permanent section of the law allows the delay of notification in executing warrants. I have serious misgivings about this provision, as it could indefinitely delay notice of a search or seizure. This notice provides a crucial check on the government's power by requiring authorities to operate in the open and by allowing the subjects of such searches to protect their Fourth Amendment rights. I also have concerns about the use of National Security Letters under Section 505 of the Act, which require no judicial review, and the use of roving ``John Doe'' wiretaps, which deserve increased oversight, such as requiring the FBI to identify with particularity the person targeted. Further, I am baffled that the majority voted twice to prevent the consideration of amendments which would have kept dangerous firearms out of the hands of terrorists. These amendments, which would have criminalized the selling of firearms to anyone on an FBI terrorist watchlist and prevented terrorists from obtaining .50-caliber

sniper rifles, would have gone a long way towards achieving the goal of securing our nation against the threat of terrorism.

I believe that successfully addressing our national security needs while protecting our basic freedoms and civil liberties requires continual Congressional oversight, and I will continue to work to assert the role of this body in carrying out this grave responsibility. I will also continue to fight for increased funding for state and local law enforcement, as well as for increased security measures to protect our nation's public transportation and critical infrastructure systems. I would like to have an opportunity to vote for a reauthorization of the USA PATRIOT Act that more perfectly strikes a balance between civil liberties and national security, and am hopeful that the Senate will address the aforementioned issues of concern. It is my understanding that the corresponding bill approved by the Senate Judiciary Committee today would incorporate greater checks on several of these controversial powers, and I remain open to reevaluating my vote should a bill incorporating such modifications come before the House of Representatives in the near future. The bill in front of us today, however, does not adequately reform parts of this law which I believe violate important civil liberties. Likewise, it fails to provide for continued congressional oversight of many questionable provisions. I cannot vote for this measure, as it fails to adequately safeguard our country's fundamental freedoms.

Mr. Chairman, I want to thank the gentleman from Tennessee (Mr. Gordon), ranking member, and also the gentleman from New York (Chairman Boehlert) for their leadership in this matter.

I am excited once again to see our Nation inspired by space travel with the imminent launch of Discovery and the recent success of the Deep Impact mission. That was an extraordinary success.

Creating new and far-reaching goals, such as the Moon landing and the International Space Station, and subsequent conquering of these goals, is one of the great legacies of NASA.

However, I remain concerned that the narrow focus on the Mars mission that has been proposed by the President may limit other critical science initiatives that have played an integral role in the evolution of NASA. I think that a lot has been done in this bill to give the NASA administrator the flexibility to be able to accommodate the various changes that will be necessary as time moves on. But we all know the lesson that has been taught us in NASA's history so far, and that is that we have to have continuity if we are going to have success.

Every administration cannot come up and say, I want my new initiative, and then the next President comes in and says, I want my new initiative. And, in fact, there is no way that it is going to be successful unless we have a kind of well-thought-through decision where the country comes to a decision that this is going to be the goal.

And one of the things that I was concerned with is that the President seemed to put this new direction out like it was a press release and did not, in my view, seem to bring in all of the different points of view as to what were going to be the various options, the various courses of action for the future of NASA. Were we going to put the money into the life sciences, or were we simply going to put vehicles into space? What was going to be the measure of success in the future? These are the kinds of questions that I think need to continue to be asked. And my only concern is that we would embark upon a path that is so stringent it would leave us no flexibility to move in other directions.

I thank the ranking member for yielding me this time.

Mr. Speaker, I would like to take this opportunity to congratulate the Special Olympics on the celebration of their 37th anniversary. When the Special Olympics was founded in 1968, individuals with developmental disabilities were all too often separated from their families, as well as segregated from their communities. My aunt, Eunice Shriver, was able to see the potential of individuals with intellectual disabilities through her sister, and my Aunt, Rosemary. She was confident in her, and other disabled individuals', ability to participate in a meaningful way in their communities. By using sport as a vehicle and stage for demonstrating the dignity and capability of people with intellectual disabilities, Mrs. Shriver recognized the impact not only on the athletes themselves, but on the nation, as well. When the first International Special Olympic Games were held in 1968, 1,000 athletes participated from 26 states and Canada. Today, the Special Olympics serves more than 1.73 million athletes in 150 countries around the world.

The Special Olympics goes far beyond serving the athletic needs of their participants, and has recently developed an initiative to provide much needed medical health services titled ``Healthy Athletes.'' Special Olympics ``Healthy Athletes'' improves access and health care for athletes at event-based health screenings, as well as makes referrals to local health practitioners when necessary. The data collected during these screenings also provides valuable information on the specific health needs of individuals with intellectual disabilities. In fact, data from the 2003 Summer games showed that 30 percent of all athletes reported never having an eye exam and also referred 23 percent of athletes for follow-up by a physical therapist.

The benefit of the Special Olympics to athletes, families, volunteers, and coaches cannot be adequately measured by statistics and numbers, but can be best represented by the recognition of the potential of individuals with intellectual disabilities by our society. Congratulations to the Special Olympics on 37 years of extraordinary service.

Mr. Speaker, on the evening of July 12, I missed one rollcall vote. It was my intention to vote ``no'' on rollcall 366 for H. Res. 351, Rule providing for consideration of H.R. 739, H.R. 740, H.R. 741, and H.R. 742.

Mr. Chairman, I come to the floor today to highlight my disappointment with the lack of an adequate response from the the National Institutes of Health concerning the conduct of basic behavioral research and training by the National Institute of General Medical Sciences. NIGMS is the institute dedicated to basic science that serves as the building blocks for applied research at multiple disease-specific institutes. For many years, Congress has directed NIGMS to fulfill its statutory mandate to include basic behavioral research and training as a component of its mission.

Two years ago, in August 2003, I met with the Deputy Director of NIH, and urged that he help ensure that this basic function at NIGMS receive funding. This meeting led to the formation of an advisory committee to the NIH Director. That Special Task Force reported to the NIH Director in December and recommended that basic behavior research and training authority be funded at NIGMS. The National Academy of Sciences, in May of this year, also urged implementation and funding of this authority, particularly in research training, as such researchers will support the important advances in understanding the wide ranging of fundamental behavioral topics relevant to a variety of diseases and health conditions.

Basic behavioral science is critical to a comprehensive research agenda at NIH, and as several expert panels have concluded, NIGMS is the logical place to house such research and training. I intend to work with my fellow appropriators in the other body and with the Chairman and Ranking Member to see that our final bill makes sure this priority is realized.

Mr. Chairman, will the gentleman yield?

Mr. Chairman, I am pleased that the chairman accepted an amendment that would strengthen the privacy safeguards within the Office of Information Technology to which our committee appropriated over $75 million for safeguarding information.

Medical information is so critically important as we start to put together a national infrastructure of information technology that is interoperable and that is transparent and that will allow providers to adequately provide the care that they need to, with all of the knowledge of the patient's background that they need to have, in order to make the right decisions at the point of care.

I thank the chairman for yielding to me and for supporting this amendment.

Mr. Chairman, in politics there are show horses and there are work horses. This process, instead of seeking a solution, only sought headlines. We had an opportunity to make real progress and address the concerns of these tribes.

Instead of addressing this issue in a substantive manner in committee, we are once again addressing it in a political way on the floor of the House simply for political gain.

Mr. Chairman, will the gentleman yield?

Mr. Chairman, the danger in our society now is basing policy on old stereotypes

that somehow mental health and mental science is not real science.

I have here a board that shows that there is a different metabolizing in people's brains for those who have mental illness versus those who do not. We have the tools today with PET scans and MRIs to be able to diagnose brain disorders and mental illnesses, and these things are backed up by science.

The notion in this amendment that somehow mental illness is not a real illness, that mental health is not real health, and that is why in this country we continue to discriminate against these illnesses by having them pay higher copays, higher premiums, and higher deductibles than other health care costs.

What is the difference between treating an organ in the brain and diabetes and kidneys? What is the difference between treating an organ in the brain or the lungs or the heart? Nothing is different.

The fact of the matter is in our schools we ought to be looking at this. We have more people committing suicide, 10 young people a day. More youth die from suicide each year than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. All of them combined do not rank as high as the cost of suicide to our young people.

Mr. Chairman, in the next year we are going to lose 1,400 young people in our colleges and universities because of suicide. We have twice the rate of homicide as our suicide rate. For every homicide in this country, there are two suicides.

The problem here is not overtreatment, it is undertreatment. That is why I think the Paul amendment, unfortunately, continues to ascribe to the stereotypes of the past that mental illnesses are not real illnesses and therefore they should not be treated and taken care of. That is why I would ask my colleagues to please vote against the discrimination, the intolerance, the stigma of the Paul amendment.

Mr. Chairman, I want to thank the chairman and ranking member for giving me the opportunity to serve on this committee and to work with them on so many of these important issues. I know this would be a different bill if the budget had provided the gentleman from Ohio more dollars to work with. I just want to explain some of the things that this bill does that will impact my State of Rhode Island.

In the area of education, the Leave No Child Behind Act is crushing each and every one of our communities because it is driving our property taxes up. All of our local school committees are in an outrage because of the Leave No Child Behind and we do not properly fund it.

In IDEA, Rhode Island is the number one State in the country with the most kids in IDEA, so the cuts to IDEA will obviously affect us disproportionately.

And, Mr. Chairman, we also have the case of military families. Rhode Island is home to the Navy. We have many families from the Navy, children, and they do not get the Impact Aid dollars that they need to properly get a decent education.

As has been said before, child labor has not been properly funded. Actually it has been cut by 87 percent, inspections. Medical research has gone up less than it has in 32 years.

But let me also, to the credit of Chairman Regula, point out some of the good things that the bill does. The bill does restore money for elementary school counseling and the foundations for learning, both of which are programs that help deal with the emotional needs of our young people. In the area of mental health, the seniors mental health program has been restored, the child mental health block grant has been restored, and the youth suicide are restored. Suicide is twice the rate of homicide in this country. In the next year, we will lose 1,400 young people in our colleges and universities to suicide, and I am glad that those dollars have finally been restored in the budget. They should have never been cut by the President in the first place.

Finally, I am glad that this budget includes dollars to fund health information technology. We lose 98,000 people every year of preventable medical errors because providers do not have the information that they need at the point of service to give the best quality care that they can provide, and I am glad that we provided money in this bill to enable those providers to make those proper decisions and to save lives in our country.

Mr. Chairman, I rise today in support of the amendment by Representatives Steven LaTourette, George Miller, Major Owens, and Bennie Thompson, to the Labor/HHS appropriations bill to strike a provision that bans the annual fit-testing of respirators for first responders and first receivers.

As many working Americans know, this ban on annual fit-testing undermines our national preparedness and that of our first responders in the event of a bio-terrorism attack. In the wake of the tragedies of September 11, 2001, it seems irresponsible for us to ban the annual fit-testing of respirators.

We all have heard about the dangers of air-borne pathogens becoming ``weapons of mass destruction.'' The only federal rule mandating annual fit-testing of respirators for workers is the Occupational Health and Safety Administration's, OSHA, TB prevention standard. The bill before us would prohibit OSHA from enforcing this requirement.

This amendment is supported by the AFL-CIO, AFSCME, American Nurses Association, ANA, International Association of Fire Fighters, IAFF, and the International Safety Equipment Association, ISEA.

I strongly urge my colleagues to support this amendment.

Mr. Speaker, on the evening of June 13, I missed three Rollcall votes.

I respectfully request the opportunity to record my position on Rollcall votes 241 and 242.

It was my intention to vote:

``Yes'' on Rollcall 241 for S. 643--A bill to amend the Agricultural Credit Act of 1987 to reauthorize State Mediation programs.

``Yes'' on Rollca1l 242 for H.R. 2326 to designate the facility of the United States Postal Service located at 614 West Old County Road in Belhaven, North Carolina, as the ``Floyd Lupton Post Office''.

At this time I would ask for unanimous consent that my positions be entered into the Record following those votes or in the appropriate portion of the Record.

Mr. Speaker, on the evening of June 7, I missed 3 rollcall votes.

It was my intention to vote: ``yes'' on rollcall No. 228, H. Con. Res. 44--Recognizing the historical significance of the Mexican holiday of Cinco de Mayo; ``yes'' on rollcall No. 229, H. Res. 282--Expressing the sense of the House of Representatives regarding manifestations of anti-Semitism by United Nations member states and urging action against anti-Semitism by United Nations officials, United Nations member states, and the Government of the United States.

Mr. Speaker, on the evening of May 23, I missed three rollcall votes. I respectfully request the opportunity to record my position on rollcall votes. It was my intention to vote: yes on H.R. 744--Internet Spyware (I-SPY) Prevention Act of 2005; yes on H.R. 29--Securely Protect Yourself Against Cyber Trespass Act; yes on H. Con. Res. 149--Recognizing the 57th anniversary of the independence of the State of Israel.

At this time I would ask for unanimous consent that my positions be entered into the Record following those votes or in the appropriate portion of the Record.