Floor Statements

Mr. Speaker, I rise today with a heavy heart to honor the memory of Lonnie Lee Nutt, a City of Marietta, Georgia firefighter, and fallen hero. On the evening of March 7th--at the young age of 49--Nutt was in the line of duty, assisting the victim of a car accident when he tragically suffered a fatal heart attack.

For nearly 20 years, Nutt selflessly served and protected his community as a firefighter, inspector, investigator, and most recently as a firefighter engineer.

He was a tested veteran and deeply respected by his colleagues. But more importantly, he was a devoted husband to his wife Rosa, and loving father to his daughter Cassandra.

Mr. Speaker, I extend my deepest felt condolences to his family and friends, his fellow firefighters, and the Marietta community for their loss during this most difficult time.

Madam Chair, I rise today in support of H.R. 803, the SKILLS Act, and urge my colleagues to support its passage.

Our current workforce development system is broken. Each year, the federal government spends billions on job training programs, but only a fraction of workers receive and complete the training necessary to get a job. Roughly 12 million Americans are unemployed

and looking for work, yet the Bureau of Labor Statistics reports millions of job openings are unfilled, with a large number of people giving up the search for employment completely.

Madam Chair, the SKILLS Act works to correct these problems. This bill eliminates and streamlines 35 ineffective and duplicative programs and gives state and local governments more flexibility to consolidate employment and training programs at the state level. Additionally, H.R. 803 increases employer involvement in local training boards, which ensures that training can be adapted to local demands.

Madam Chair, the SKILLS Act protects taxpayer dollars and provides workers with more effective job training services, while further empowering state and local governments. I urge my colleagues to join me in supporting H.R. 803.

Mr. Speaker, I rise today to recognize American Legion Post 316, located in Woodstock, Georgia, which will celebrate 94 years of patriotic service on March 21, 2013.

Since the American Legion received its Congressional Charter in 1919, it has grown to more than 2.4 million members at over 14,000 posts across the world. Mr. Speaker, as the country's largest wartime veteran's organization, the National American Legion has become a leading advocate for devoted veterans, active service members, and strong communities.

In that spirit, American Legion Post 316 will honor local men and women for their exemplary service. Detective Ron Hughes, Lieutenant Matt O'Keefe, Officer Cullen Fitchett, Jenny Banas, Matt Marano, Bobby Brian Dean, James Brennan, and Eagle Scout William Harrison Stepat will receive awards for their accomplishments in Cherokee County law enforcement, firefighting, and Boy Scouts.

To American Legion Post 316, Cherokee County law enforcement, firefighters, and community leaders: On behalf of Georgia's 11th District, my deepest thanks for your service and your commitment.

Madam Speaker, I thank the majority leader for yielding this time to discuss an extremely important issue facing the patients in this great country of ours that are going to have a very difficult time in finding a physician.

Madam Speaker, in March of 2010, when the so-called Affordable Care Act, or PPACA, was passed into law, the purpose, of course, was to increase access to physicians for all patients across this country and also to bring down the cost of health care. Well, we're 2 years into this bill--which will become fully effective in January 2014--and what are we seeing?

Madam Speaker, the CBO reported just recently that some 7 million people have actually lost their health insurance, the health insurance provided by their employer. For those who do still have health insurance--particularly those who get it maybe not from their employer but from the individual market, a small group policy--the cost has actually increased some $2,500 a year instead of coming down, as anticipated and predicted and promised, in fact, by President Obama, but that just absolutely is not happening.

So what we're going to be talking about, Madam Speaker, is, again, what needs to be done to correct this situation. Because the thing that was never really discussed to my satisfaction when this bill was crafted was, how are you going to get the best and the brightest young men and women in this country to continue to go into the field of medicine, to become the doctors--particularly in primary care, internal medicine, and the pediatricians--to provide that care when the reimbursement system under Medicare, called the sustainable growth rate, year after year after year for the last 6 or 8 years we have actually cut the income to the providers, to the point, Madam Speaker, where they can't provide this care, they can't even break even? So this is what we're going to be talking about, this flawed sustainable growth system. It has certainly contributed to the physician shortage crisis that we see today.

Now, I have a number of slides that I want to present to my colleagues, and we'll go with some specifics on that. But I'm very pleased to be joined today in this House with the cochair of the House GOP Doctors Caucus, my good friend and fellow physician Member from Tennessee, Dr. Phil Roe, and I yield to Dr. Roe at this point.

Dr. Roe, if you would yield just for a second, I wanted to point out to my colleagues and to Dr. Roe the poster that we have before us. Because this is exactly what the good doctor is talking about right

now in regard to what's been going on since the year 2000. Dr. Roe, you may want to refer to this slide.

I yield to the gentleman.

Dr. Roe, that would be right here.

Dr. Roe, if you will yield for just a second and then I will return to you, again, I wanted to point out to our colleagues that this poster, this slide that's on the easel before us is exactly what the gentleman from Tennessee is talking about in regard to shortage of primary care physicians. And as he pointed out, primary care is a family practitioner, is a general internist--of course pediatricians provide primary care to our children. But so many of these doctors are the very ones that take the Medicare, take the Medicaid, take the SCHIP, the State Health Insurance Program for children. They see them.

And what Dr. Roe is referring to, before I yield back to him, on this poster it shows in the dark blue the areas of these States, several States, including my own of Georgia--Tennessee is not quite as bad--but in my State of Georgia, there are anywhere from 145 to 508 areas of the State of Georgia where there are an insufficient number of doctors to take care of these folks. Tennessee is a little bit better. There are only 67 to 99 areas. But all of this blue are critical areas, are they not, Dr. Roe? And I yield back to you.

I thank the gentleman, because what the gentleman from Tennessee is talking about is having an insurance card, a health insurance card--and indeed even having a Medicare card--does you very little good if you have to spend 2 hours going through the Yellow Pages trying to find some physician, primary care doctor in your area that you wouldn't have to get in your car and drive 50 miles--if you could even drive. If you don't have that access, then you don't have anything.

So here again, this bill, this massive bill was passed 2 years ago at the cost of almost $1 trillion. Unfortunately, a lot of that money was taken out of Medicare to create this new entitlement program, if you will, for younger people so that they can have health insurance. But what we've done is we've just made the crisis in the Medicare system that much more difficult.

What Dr. Roe was talking about, colleagues, is in regard to not just a shortage of the physicians, but what happens in the waiting rooms all across our country. This slide shows the number of primary care physicians per 1,000 population, the number of primary care physicians per 1,000 population.

Now, we've already gone over, we're talking about, again, general internists and family practitioners, primarily, and pediatricians for SCHIP and Medicaid. If you look at that map across the country, again, look at my State of Georgia in the deep red, and there are several States, Texas, Oklahoma, Mississippi, Alabama, Utah, Nevada and Idaho in the West where the number of primary care physicians per 1,000 of the population is fewer than one. So less than one doctor per 1,000 people that need that care. Many other States, including Tennessee, it is somewhere between one and 1.2. Now, I don't know how you get 1.2 physicians. I don't know exactly what that provider looks like. But you know how that math is calculated. Clearly, the shortage is acute, and it's only going to get worse and worse.

With that, I want to yield to one of my good colleagues, good friends on the Energy and Commerce Committee whose father actually was the chairman of the Health Subcommittee of the Energy and Commerce Committee for many, many years before he retired and his son took his place, and now the gentleman from Florida, Gus Bilirakis, is serving on that Health Subcommittee with me on Energy and Commerce.

I yield to Representative Bilirakis.

If the gentleman would yield, I want to thank the gentleman from Florida because what he is addressing right now goes back to the creation of this law, the Affordable Care Act, PPACA-- sometimes referred to as ObamaCare--where money was taken out of the Medicare program, the existing Medicare program, which is already strained almost to the bursting point, and the Medicare Advantage program. Probably 20 percent of Medicare recipients select that model because it gives them more bang for the buck. It gives them more coverage, and it includes things--and the gentleman from Florida knows this, and this is what he is referencing--it includes more than just an annual physical when you turn 65. It includes more than being able to go to see a doctor and have it reimbursed under Medicare when you have an episode of illness.

There is a strong emphasis on Medicare Advantage to wellness. Let's say you do go and see the doctor because of an episode of illness, and maybe several prescriptions were written. It's very important that the patient take the medication on a regular basis and not run out of medication. So under Medicare Advantage, there would be a nurse maybe in the doctor's office who within just a few days of that encounter would call the patient to make sure that he or she could afford to get those prescriptions filled and they were taking them in the right way. That's what the word ``Advantage'' was all about, Medicare Advantage, rather than just a traditional fee-for-service Medicare.

But this new law created 2 years ago, and will go into full effect in January, 2014, literately gutted that Medicare Advantage part, did it not, Representative Bilirakis? It cut that program 12 to 14 percent. I mean, it's just literally gutted. I'm talking about $130 billion was taken out of that one program.

So now seniors that were on Medicare Advantage are having to look for new doctors, look for new programs, try to again go through those Yellow Pages and find somebody that will see their momma who's been going to this other group for years and is totally satisfied.

When the President said to the American public, If you like the health insurance plan you have, don't worry, you can keep it; you will not lose it, that just wasn't true. I don't think he deliberately told an untruth, but it clearly is not true. And as I said at the outset of this hour, some 7 million people have already lost insurance provided by their employer, and many more of these people that were getting their Medicare through the Advantage program, they have lost that through no choice, Madam Speaker, of their own. They have been forced out of those programs.

I yield back to my colleague, and we will continue this colloquy.

I thank the gentleman from Florida and I thank his dad, Representative Mike Bilirakis, Madam Speaker, who served in this body for so many years with distinction. I hope that he is enjoying a happy and healthy retirement in the Sunshine State. And I hope he's able to find care, but I bet you it's not under Medicare Advantage, as his son just told us.

At this point, I would like to yield back to the gentleman from Tennessee (Mr. Roe).

If the gentleman will yield for just a second, I want to weigh in on that issue of electronic medical records.

I'm normally, as the good doctor from Tennessee knows, walking around here in a sling, as I have been for the last couple of weeks. Madam Speaker, I probably should have it on right now, but I'm resting my arm on the podium.

But I just recently had rotator cuff surgery back home in Marietta, Georgia. Madam Speaker, I was blessed with a great physician who did a wonderful job and has a fabulous staff, but going through the process of doing the paperwork, I bet I filled out the exact same form four different times. That was wasting my time and that was wasting their time. Of course, what they want to make sure is that no mistakes are made. Obviously, they want to make sure they operate on the correct arm. So I understand why, and I'm sure many of you, your parents, your grandparents, and you yourselves, my colleagues, as patients have gone through all of that.

But what Dr. Roe is talking about--and I will yield back to him-- electronic records are indeed, in my opinion, the wave of the future. Honestly, I believe if we had concentrated on that 2 years ago to make sure that it was fully implemented so that duplication of testing, unnecessary procedures, maybe medications prescribed to which the patient had a dangerous allergy, you really do ultimately save lives and save money by having an electronic medical record system.

The other thing is if we had had medical liability reform. The President promised that before this ObamaCare bill of 2,700 pages was put into law, but there was nothing in there about medical liability reform.

Here again, those were two things, and I think the gentleman from Tennessee would agree with me on that.

I just wanted to interject my thoughts about electronic medical records, and I yield back to the gentleman.

The top of the green line is where we in the Congress mitigated these cuts because we can do that. That's what it says in the Constitution, that we're in charge of the purse strings. So, when there is a recommendation, as Dr. Roe is referring to, Madam Speaker, of the cuts in the pink--below the line, from 2001 to 2012, there is almost every year a 5 percent, 3 percent, 4 percent, 10 percent--then in the aggregate, that number just keeps getting bigger and bigger.

What Dr. Roe is about to explain to us is how we were heretofore able to mitigate, which is by making these changes above the line and by saying, no, we're not going to cut the doctors because we know, if we do that, they won't be there, that they won't be there for our parents and our grandparents and ourselves and our children.

Dr. Roe, what will happen in reference to this slide right here--if you look at these blue areas, these States that have the acute shortage areas, like Georgia and Florida--is that this whole map of the United States will be blue.

I thank the gentleman, and I want to continue a colloquy with him and maybe even ask a question of him. Dr. Roe, Madam Speaker, explained very clearly how that is a section of ObamaCare, a very important section of a group of 15 bureaucrats appointed by the President.

In regard to the IPAB, they basically can now say from year to year, Well, the doctors and the hospitals are going to be cut so much reimbursement. These cuts are going to occur.

We showed in the first slide how over the years Congress has been able to mitigate. Read the Constitution. We, the Members of the Congress, control the purse strings. So, fortunately, we were able to make these changes into what was suggested; but this IPAB board of 15 bureaucrats, they're not making a suggestion. They're telling us what has to be done.

The question I wanted to ask of Dr. Roe, Madam Speaker, was: when this case went before the Supreme Court, questioning the constitutionality of the law and saying that if a Governor of a State, like the Governor of Georgia, Governor Nathan Deal--an 18-year Member of this body, by the way--makes a decision not to expand Medicaid because the State can't afford it as the State's already going broke on the current Medicaid program, is it constitutional for the Federal Government to say, If you won't expand the Medicaid program, we're going to make sure that you can't participate at all and that all of your current recipients of Medicaid in the State of Georgia are out on the street?

That was a question that was asked of the Supreme Court as well as: was it constitutional to force people to engage in health care if they didn't want to, if they did not want to purchase health insurance? Now, I'm not recommending that they don't; but the question before the Supremes was: is it constitutional under the Commerce Clause to make people engage in commerce if they don't want to do it? The Supremes said, in a very pained, strained, pretzel-like decision, that that was constitutional.

Dr. Roe, do you know whether or not this question about IPAB was addressed by the Supremes: is it constitutional or not? I'm not sure. I'm thinking it wasn't addressed. Would you speak to that.

So you're saying that it's in the law, but because it hasn't been applied yet. And, in fact, indeed, as Dr. Roe pointed out, Madam Speaker, the board, the IPAB board, 15 bureaucrats, have not even--not even one of them, their salary has been set, I think they're scheduled to make $150,000 a year and probably have a car and a driver and health insurance and retirement plan, and not too bad a gig if you can get it, but not so far I don't think any have been appointed. And so that's what Dr. Roe, Madam Speaker, was referring to when he said there's not standing yet. If you went to the Supreme Court, they would say the case is not ripe. I'm standing here as a physician trying to sound like an attorney, and I'm going to get myself in a lot of trouble here in a minute, Madam Speaker, and Dr. Roe explained that very well, but I do agree with him, colleagues. I do agree with Dr. Roe that that will be challenged and certainly should be struck down. You look at the Constitution, our fifth and sixth graders probably could make that decision, and it wouldn't be a 5-4 split decision; it would be 9-0.

I thank the gentleman, Madam Speaker. And as he talked about his mom, I stand here thinking about my own mom, who's 95 years old. Her body is getting a little frail, but Mom's mind is perfect. Perfect, Madam Speaker. She has enjoyed the benefit of Medicare and Social Security for many years. Many years. So these legacy programs are hugely important. They're hugely important to our side of the aisle.

Madam Speaker and my colleagues, all of this Mediscare stuff, and things that you get all of this rhetoric about, they don't care about seniors and they're going to push somebody's grandmother over the cliff in a wheelchair, that's just a bunch of bull. I think every Member of this body and every Member of Congress cares about seniors and cares about these programs.

But I also, Madam Speaker, have 13 grandchildren. I have 13 grandchildren, and I want this Medicare program to be there for them some day, just like it has been there for Mom all these years.

So as we talk about these issues, we would do nothing to harm current recipients of Medicare and Social Security. We used the term, the phrase I guess you'd say, ``hold harmless.'' Hold harmless. Any changes that we would make, whether it is the payment system to our doctors and our hospitals for providing the care, it would not take away any benefit. It would not cause our current seniors to have to pay a higher premium or copay or deductible. All we're doing is trying to come up with something that would save the program for them, but, most importantly, for these youngsters that are coming behind us, the next two generations. So that's what we're all about.

My colleague, if he has some more comments, I would like to refer back to him, the gentleman from Tennessee.

I thank the gentleman.

Madam Speaker, as we get near the closing of the hour, I wanted to just mention several things. Dr. Roe has alluded to these, talking about the Medicare Advantage and what a beneficial program that was. Unfortunately, it's now been gutted, literally gutted, cut at least 12 percent, $130 billion, to create this whole new program that we call PPACA, or ObamaCare.

Medicare Part D, Madam Speaker, the gentleman from Tennessee is talking about the prescription drug part of Medicare that we did my first year, when I first came here in 2003, the Medicare Modernization and Prescription Drug Act.

Seniors, for many, many years, have wanted to be able to get their prescription drugs covered by Medicare but they couldn't. And of course, when you have to go to the drugstore and get five prescriptions filled, and most of them, brand name, not generic, some generic, maybe, but these brand name drugs are so expensive. And so we finally did this for our seniors.

Now, we spent what--I don't know, maybe $750 billion--creating that program, and we got criticized for it because it wasn't paid for. We didn't offset by cutting spending somewhere else. And I think maybe that criticism, under the current system, is legitimate.

But really, when you think about it, if you scored dynamically, and you realize that if people, seniors, all of a sudden could take their blood pressure medicine and not have to worry about a stroke, could take their diabetes medicine and not have to worry about eventually having renal failure from diabetes or an amputation, in the long run, what I'm saying, Madam Speaker, is this program, Medicare Part D, Medicare Advantage, electronic medical records, if we scored things in the right way, dynamically, at the end of the day, 10 years, 20 years, whatever, we're going to save money because people are not going to have coronary bypass surgery, they're not going to have to have these amputations, they're not going to end up the rest of their lives in a nursing home because they've had a catastrophic stroke that has left them totally incapacitated.

I'm going to yield back to the gentleman from Tennessee to close us out.

I thank my colleague.

And Madam Speaker, I thank you, and I thank the leadership of the Republican Party for allowing us to bring this information to our colleagues in a bipartisan way.

We are all about solving these problems. We talked basically about the sustainable growth formula, the way we pay doctors for a volume of care.

Clearly, we're going to have to go to paying for quality of care. We don't have time to get into all the details of that today, but in the next Special Order hour that the Doctors' Caucus leads, we'll get into more details about what we're going to recommend to our committees, to our leadership, to both sides of the aisle in regard to solving this program.

And with that, I yield back the balance of my time.

I thank the gentleman from Tennessee for yielding to me. He has already alluded to some of the things that I am going to say in my remarks but the most important thing that he stated: On Tuesday night, President Obama stood here in this Chamber and he gave his State of the Union address and said:

Patients enjoy stronger protections than ever before.

Already, the Affordable Care Act is helping to slow the

growth of health care costs.

Well, President Obama obviously didn't get the memo. We must not have read the same CBO report, Mr. Speaker. ObamaCare is not slowing the growth of health care costs. ObamaCare is driving up the costs, jeopardizing insurance coverage, and placing excessive burdens on small businesses, limiting their potential for growth.

In 2010, President Obama and the Democrats assured us that their health care law would lower costs, it would cover millions of uninsured Americans. Well, as Dr. Roe said, fast forward 3 years and we have seen nothing but broken promises and this enormous pricetag. Just last week, the CBO--the Congressional Budget Office--the unbiased scorekeeper that works for Congress, reported that under ObamaCare--PPACA, health care costs will increase and 7 million Americans will lose their coverage. These are the facts, despite any State of the Union rhetoric.

Young Americans will also be severely impacted with an exorbitant rise in health insurance premiums due to a provision in ObamaCare. A lot of people are not aware of this, Mr. Speaker. This provision requires insurance companies to reduce their rates for seniors--a laudable goal. Premium costs for individuals under the age of 40, though, are going to significantly rise to even out that balance. By limiting these--we call them age ban discounts--that are called for in ObamaCare, a 3-to-1 ratio. So someone, let's say as an example, that is in their very early sixties and they're not eligible for Medicare at age 65, and they already possibly have multiple systems diseases, as we say in medical parlance, and are on many prescription drugs, expensive drugs--they're a much greater risk in regard to an insurance premium coverage of busting the ceiling on that every year. But under ObamaCare it says their premiums cannot be more than three times the premium of someone who is 28 years old, 10 feet tall, and bulletproof.

As a result, these are some of the problems that that creates within these exchanges. It will absolutely discourage the younger people from buying insurance. They'll pay the fine. They will not pay those higher premiums so that they stay within that 3-to-1 ratio. It will likely force young healthy individuals out of the insurance market. That's some of those 7 million we're talking about that are going to lose their insurance because of this.

Let me just give a real specific, and then I'll yield back to the gentleman so he can yield time to our other colleagues. For a 27-year- old earning $33,500 a year, premiums are expected to jump from $2,400 a year to almost $3,200 a year. This is an outrageous increase in costs that young people can't afford. If they get a job in this current climate where we've had 7.6 percent or higher unemployment--the entire time that President Obama has been in office--they're not going to be able to afford these premiums. And they clearly are not going to pay for them. ObamaCare is negatively impacting the insurance market on two fronts: it forces rising premium costs on the young, and it increases the total uninsured population, as I stated earlier.

So at this point I'll yield back to the gentleman from Tennessee and I hope to remain with my colleagues for the remainder of the hour as we continue this colloquy.

Mr. Speaker, the gentleman from Tennessee is generous with his time. I did want to follow on to what the gentleman doctor from Maryland is just talking about in regard to tort reform. Yes, he covered that very, very clearly and pretty completely.

But there are other things in this law, the so-called Affordable Care Act--well, Patient Protection and Affordable Care Act. And, yes, I think President Obama proudly likes to have it called ObamaCare. Maybe he hopes that one day that will be his legacy. There are provisions that, particularly in these exchanges that are being set up in all 50 States, the States that are doing it, the territories and the District of Columbia, that basically say what best practices are for the different physician specialties, including the specialty of obstetrics and gynecology which Dr. Roe and I practiced many years. But in these descriptions of what's the best practice for a general surgeon or an internist or a pediatrician, in some cases, they're not a carbon copy of what our specialty societies recommend. The American College of Obstetricians and Gynecologists, as an example, does a wonderful job of making sure that each one of their members gets a monthly bulletin and current updates on what the best practices are for our specialty. It's based on science by the best and brightest. And, yet, this law may ask us to do something that goes against that.

I have introduced a bill, Mr. Speaker, to protect our physicians. If they are following the guidelines of their specialty, or, on the other hand, if they're following the guidelines of the government that some government bureaucrat says is the best standard of care, if they're doing that and they have a bad outcome, this provider shield would protect those physicians from liability. It's something that's desperately needed because of this law.

There is another bill that I have introduced called the SCOPE Act. SCOPE is an acronym for the Safeguarding Care of Patients Everywhere. What would prevent the Secretary, Ms. Sebelius, or whomever, from saying what qualifies a physician to be on a provider group in one of these exchanges? Is it what she says or what their specialty society says?

So, again, these are things that we're working on very hard to correct, I think, a very bad situation. We members of the Doctors Caucus, we on this side of the aisle will continue to fight for that. I thank the gentleman.

Again, I thank the gentleman from Tennessee for yielding because I wanted to follow on in this line of discussion with regard to costs.

The way doctors were paid by Medicare in 1965 was, to my understanding--I think I'm correct on this--just like private insurance: an 80/20 indemnity kind of coverage, and the cost was accelerating.

Then in 1998, I believe, the Balanced Budget Act of 1997 put in this formula to control Medicare spending, particularly the spending that goes to the health care providers, which by the way is only about 12 percent of total Medicare spending.

In any regard, that seemed to be the greatest concern, controlling how much the doctors were getting paid. So they put in this formula that's called SGR, sustainable growth rate, based on some calculus. But it was flawed. It was flawed badly. And for the last, I would say, 10 years, when you calculate that formula for the expenditures for doctor fees for the previous year, the formula would call for a cut of 1 percent, 2 percent, 4 percent. Over those 10 years, it's up to 26.5 percent. Well, thank goodness Congress, we Members of Congress on both sides of the aisle, have the ability to mitigate that; and we have done that because we know the formula is flawed and it needs to be repealed and replaced. Yet we have not been able to do that.

I'll tell you this, though: in this House of Representatives, in this 113th Congress, with Republican control under Speaker Boehner and Leader Cantor and committee chairmen like Fred Upton in Energy and Commerce and Dave Camp on Ways and Means, we are going to fix that flawed formula once and for all. We're not going to keep putting Band- Aids on it, mitigating a little bit at a time, and kicking the can down the road. That is our pledge to the American people.

I hope our colleagues in the other Chamber, controlled by the Democratic Party, will go along with us on this because what we realize is that all of the doctors in the House and in the Senate, they understand that if you enact those cuts that will come due again at the end of this year, almost a 30 percent cut in what you reimburse for Medicare providers, then there will be no doctors. People will have a Medicare card, but they will not be able to find a physician to take care of them.

This ObamaCare bill did nothing except, in fact, enact a provision, which I know my colleague from Tennessee wants to talk about, that makes it worse, that doubles down on it. We need to repeal SGR and figure out a better way to reimburse, to pay physicians based on quality of care, rather than volume. I think that's a good idea. But there's a provision in ObamaCare that could trump all of that and make all of our efforts in that direction go for naught.

So I want to end here so the gentleman from Tennessee can explain what I'm talking about because he has the repeal bill for that.

Mr. Speaker, I rise today in support of S. 3202, the Dignified Burial of Veterans Act and particularly section 303 of this bill, which designates the Department of Veterans Affairs facility in Carrollton, Georgia as the ``Trinka Davis Veterans Village.''

Katherine ``Trinka'' Davis was a businesswoman from Carroll County who founded the Trinka Davis Foundation in 2004 after realizing the struggles many service men and women faced upon return from Iraq and Afghanistan. Though not a veteran herself, through her generosity, Ms. Davis performed an outstanding service for the veterans of Northwest Georgia.

Mr. Speaker, Trinka made note of the reports of difficulties that many returning veterans and their respective families were facing: loss of limbs, traumatic brain injuries, PTSD, unemployment, and loss of their homes.

Although she is no longer with us, her memory lives on. Trinka left almost her entire estate--over $18 million--to the Foundation, which has used it to construct a first class health facility to aid our wounded warriors in their recovery and treatment.

Mr. Speaker, with a war in Afghanistan, a recent one in Iraq, and unrest around the globe, the United States has more than 196,000 active duty service men and women that put their lives on the line--night and day--to protect our families and our freedoms. These men and women accepted the call of duty, leaving behind their loved ones and life as they know it to protect the lives of others.

When our soldiers return from battle, sometimes they do not get the support and assistance that they deserve. Simply put, we owe them more. Just as they have answered the call to serve our country, we must answer the call to serve them. This is what Trinka Davis did.

Thanks to Trinka's generosity and the tireless dedication of her foundation, the new clinic was donated to the Department of Veterans Affairs in August. The doors were opened for veterans to receive outpatient treatment on September 24, and in the coming months the clinic will also include a 42 bed community living center.

While providing a variety of services including primary care, physical therapy, and outpatient mental health services, the facility will serve 3,000 veterans and will allow them to receive treatment closer to home.

Mr. Speaker, I believe that like our veterans, Ms. Davis is a hero. She recognized the needs of our veterans and worked tirelessly to meet them. The Trinka Davis Foundation ensured that Ms. Davis's commitment to the veterans and their families in the Carrollton community and beyond would be preserved through construction of the health facility.

I ask my colleagues to join me in recognizing Trinka's selfless actions and those who have bravely served our Nation by supporting S. 3202.

Mr. Speaker, I rise today to honor the distinguished career of someone who is a friend to me and my colleagues, and that's Jay Pierson.

For 34 years, Jay has been a mainstay of the House and the floor. He began his congressional career back in 1978 with then-Republican leader John Rhodes. Throughout his tenure, he has worked for Speakers Newt Gingrich, Dennis Hastert, and now John Boehner.

Since I came to the House in 2003, I have known Jay to be a true student of this institution. He has helped me personally--and countless other Members--learn how this body works, and he has been quick to assist a Member with any question about the floor, or even a good book recommendation.

Mr. Speaker, what most people may not know about Jay is that, in addition to a bachelor's degree from Westmont College and a master's degree from California State University, he earned his Ph.D. from the University of Maryland.

In his upcoming retirement, I want to thank Jay for his service to this great institution. I wish he and his wife, JoAnne, all the best in their future endeavors. My friend, Jay Pierson.

Mr. Speaker, I rise in support of the underlying bill, H.R. 6684, the Spending Reduction Act of 2012, because as Chairman Ryan said, we are not only facing a fiscal cliff, but as he put it, we're facing a fiscal abyss. Indeed, if you will, a fiscal Grand Canyon.

I want to address my remarks to title IV of the bill, which was just referenced by the chairman of the Energy and Commerce Committee, the gentleman from Michigan. That's the Help Efficient, Accessible, Low- cost, Timely Healthcare Act of 2012, or the HEALTH Act, to implement reasonable, comprehensive, and effective health care liability reforms; indeed, exactly what the President has been calling for for the last 5 years, even in the first election when he was campaigning and speaking to the American Medical Association in Chicago.

As a physician for over 30 years, I fully understand the importance of finding balance in medical liability by keeping doctors and hospitals accountable for their actions while limiting the frivolous lawsuits that contribute to inflated health care costs and rising insurance premiums. We need to reform the system so that patients who have been duly wronged receive a deserved settlement but, at the same time, protect our Nation's physicians who work hard every day to ensure that their patients receive quality care.

Therefore, I once again introduced the HEALTH Act in this 112th Congress to ensure that those who have valid liability claims are supported while, at the same time, discouraging the practice of jackpot justice.

If enacted, this title in H.R. 6684 would make health care delivery more accessible and cost effective in the United States by limiting the amount of patient awards that are available for plaintiff attorney's fees. Among other things, the legislation would ensure that all settlements against medical providers are proportional to their responsibility for the patient's injury.

Mr. Speaker, the nonpartisan Congressional Budget Office has stated that if the HEALTH Act were enacted, the Federal Government alone would save $48 billion over the next 10 years. Other studies have shown the savings to be much higher, some as high as $200 billion annually over all of health care, which indeed constitutes, as my colleagues know, nearly one-fifth of our entire economy.

Tort reform will also help end the practice of defensive medicine, which is one of the largest cost drivers of health care. When physicians are forced to order these excessive tests simply to avoid malpractice suits, health care costs go up and patient safety goes down.

I thank the gentleman.

I wholeheartedly believe that the HEALTH Act takes an important step to improve health care delivery in this country. This is the kind of commonsense, market-based reform that a health care system requires.

Mr. Speaker, I fully support H.R. 6684 and, more specifically, the immense benefits that the HEALTH Act will not only have on the Federal budget but on the health of our Nation.

Madam Speaker, I thank the chairman for yielding.

The gentleman from New Jersey just gave attributions to so many members, both Republicans and Democrats, from the Energy and Commerce Committee that worked so long and hard on this legislation back originally in 2006 and now in the reauthorization of S. 1440, the PREEMIE Act.

There are a lot of statistics that some people may not be aware of. One is the fact that about two-thirds of all infant deaths in the first year of life are among the preterm infants. In 2008, 12.3 percent of all live births, over 500,000 babies, were born preterm.

Madam Speaker, let me put it a little bit in context. Prematurity or preterm birth is by definition a birth earlier than 37 weeks. Those children are usually not the problem. They're not the ones that end up with permanent disabilities. But there is a subset of prematurity, maybe sometimes referred to as ``immaturity,'' children that are born as early as 20 weeks, all the way up to 37 weeks. Those children are the ones that very often, if they survive, are left with permanent long-term disabilities. We see a lot of folks on the Hill coming down the halls of our office buildings, and sometimes they're in wheelchairs, sometimes they're visually impaired, sometimes they're hearing impaired, but so many of those adults and children that we see on Capitol Hill were born prematurely. So a piece of legislation like this is hugely important.

I'll end my remarks by just making it a little personal. My wife, Billie, and I, Madam Speaker, have 13 grandchildren, and the oldest will be 15 years old in about 3 weeks. And they were born at 26 weeks-- they each weighed 1 pound and 12 ounces. Thank God they are virtually unimpaired today and in the eighth grade and doing well. It tugs at your heartstrings. This is something that is hugely important.

The graduate medical education piece is very important because these children's hospitals, they see so many of these young kids. In fact, 50 percent or more of their patient population are Medicaid, and they need this funding for continuing medical education for pediatric residents.

I will just conclude with that and say how proud I am to be supportive of such a great piece of legislation.

Mr. Speaker, I rise today in recognition of honoring Gardner Wright, a community leader who has served Rome and Floyd County throughout his entire lifetime.

Gardner is affectionately known as the Grandfather of Floyd County, a name befitting the man whose great-great-grandfather, Colonel Daniel R. Mitchell, gave Rome its name.

Gardner served 23 years in the armed services, rising from a private in the U.S. Marine Reserves all the way to the rank of captain in the Army Reserves. He ultimately retired as a sergeant in the Army National Guard.

Mr. Speaker, Gardner exemplifies service and leadership in his community through his work for the American Cancer Society, Boy Scouts of America, and countless local philanthropies.

I am proud to call him a fellow Georgian, but more importantly, a friend.

Mr. Speaker, I stand before you today to recognize the retirement of a wonderful woman and true champion of constituent service, Jeanette Hutchinson. For more than 30 years, Jeanette Hutchinson has worked tirelessly assisting constituents from both Georgia and Iowa. As many of you know, we would not be able to accomplish nearly half as much as we do without the help of our congressional staff--especially employees like Jeanette. Her career in constituent services spans 2 states and includes three Congressman, two Senators, and thousands of grateful constituents.

Jeanette launched her congressional career in the Hawkeye State with the offices of Congressman Cooper Evans and Senator Chuck Grassley. Following years of service to the people of Iowa, Jeanette moved to Atlanta and began serving the people of Georgia with Senator Paul Coverdell's office. Former Congressman Bob Barr claims he ``stole'' Jeanette from Senator Coverdell's office in 1995, and upon his retirement I was fortunate to have Jeanette join my staff. For the past 10 years, Jeanette thoroughly managed my constituent case work and my case work staff.

Jeanette's job is not for the light hearted. It requires great attention to detail, an immeasurable amount of patience, and the determination to cut through bureaucratic red tape. But this did not dissuade Jeanette. She approached each constituent case as if it were her own, providing Georgians with service that was second to none. Whatever the case may be, Jeanette knows who to ask for, which form to complete, and each deadlines she must comply with. I doubt there is a government agency Jeanette has not called.

Public service has always been a staple in Jeanette's life. Her late husband, Thomas Sellner, to whom she was married for 28 years, served our country as a pilot for the U.S. Navy. Jeanette and Thomas raised six children together, and as many selfless military families do, lived in numerous States and foreign countries fighting for our freedoms. Her ability to adapt to different environments and handle a variety of situations with ease has been reflected throughout her career. Following the loss of her husband, Jeanette wed Marion Hutchinson and began her congressional career.

Jeanette has been an instrumental member of my staff and we will miss her dearly. Mr. Speaker, I wish Jeanette Hutchinson the best of luck in her retirement and thank her for her hard work over her extensive career.

Mr. Speaker, I rise to recognize a man whose commitment and contributions to our community were second to none, and whose legacy will long be remembered.

Winston ``Strick'' Strickland devoted his life to mentoring children and caring for senior citizens in Marietta, Cartersville, and surrounding communities. His service was, and remains, inspiration to us all. He was deeply loved and will be forever missed.

Mr. Strickland was the embodiment of the American Dream and served as an inspiration to many. The son of sharecroppers, his family instilled the value of hard work and integrity at a young age. These principles guided him throughout his successful business career. Strickland became the owner of S&M Enterprises, the umbrella company of three local ``staples'': Strick's Barber Shop, Strick's Grill and S&M Laundromat.

In a 2009 interview with the Marietta Daily Journal Mr. Strickland said, ``My mother taught me that you work hard, treat people right and when you find something's wrong, you straighten it out. Do good in anything that you put your hand into, and in the meantime you've got to give back to the community.''

Inspired by politics and social work, Mr. Strickland wanted to make a difference in peoples' lives and in 1990, he founded the Blacks United for Youth-Cobb. BUY-Cobb, a foundation created to mentor our community's youth, has assisted more than 2,000 students through its mentor programs and scholarship fund. To date, the foundation has contributed more than $300,000 dollars in scholarships to youths in our community.

Mr. Strickland was the consummate family man and is survived by a loving family: his wife of 47 years, Rosetta Strickland; two children Monique Strickland Hall and Michele Strickland, and his two grandchildren of whom he was extremely proud: Jaden MacArthur Hall and Janai Hall.

Mr. Speaker, we mourn the loss of a community leader and role model. His unwavering service and memory will forever live on in Bartow and Cobb County and the great state of Georgia.

Mr. Speaker, I stand before you today to recognize the retirement of a lifelong civil servant, Clarence Brown. Clarence has selflessly served the citizens of Bartow County for more than 38 years, and his tenure as Bartow County Commissioner is the longest to date.

Clarence began his service with a plan and vision for Bartow County, and under his leadership it has flourished. Some highlights of his public service are the implementation of the county's growth management plan in 1996, the completion of Georgia Highlands College, and the development of the nation's first county-wide Environmental Management System.

Each of these accomplishments shaped Bartow County, but Clarence's legacy of leadership is truly defined by his character. He paid extraordinary attention to public input and cared deeply for the people he governed.

In recognition of Clarence's selfless service and commitment to the community, the county named the conference center in Cartersville in his honor. However, this was not an easy task given Clarence's humble nature!

It took the community, a judge, and Clarence's wife to convince him to agree to the dedication. To this day when asked about the Clarence Brown Conference Center, Clarence will humbly reply, ``It's just a name on a building.''

Through his philanthropic and civic contributions, Clarence's impact on our community is immeasurable. He has, and will, continue to lead our community with integrity and honor.

Clarence represents the best of the 11th District, the best of Georgia, and indeed the best of public servants. I am proud to call him a friend,

Mr. Speaker, I rise today in support of H.R. 6374, a bill to designate the Department of Veterans Affairs facility in Carrollton, Georgia, as the Trinka Davis Veterans Village.

Mr. Speaker, much of what I'm going to say has already been said by the distinguished chairman of the Veterans Affairs Committee, the gentleman from Florida (Mr. Miller), as well as the ranking member, the gentlewoman from Florida (Ms. Brown), but I thank them for giving me the opportunity to repeat and maybe elaborate a bit because it deserves to be said.

Katherine--better then known as Trinka--Davis, was a businesswoman from Carroll County who founded the Trinka Davis Foundation back in 2004 after realizing the struggles many servicemen and -women faced upon returning from both Iraq and Afghanistan. As has been stated, though not a veteran herself, through her generosity, Ms. Davis performed an outstanding service for the veterans of northwest Georgia.

Mr. Speaker, Trinka made note of the reports of difficulties that many returning veterans and their respective families were facing: loss of limbs, traumatic brain injuries, post traumatic stress syndrome, unemployment, and loss of their homes.

Although she is no longer with us, her memory lives on. Trinka Davis left almost her entire estate, over $18 million, to this foundation, which has used it to construct a first-class health facility to aid our wounded warriors in their recovery and treatment. I've been there. I've seen it. I was there at the ribbon cutting ceremony just this past year. It's a beautiful facility in my district in Carrollton.

Mr. Speaker, with the war in Afghanistan, a recent one in Iraq, and unrest around the globe, the United States has more than 196,000 active duty servicemen and -women that put their lives on the line night and day to protect our families and our freedoms. These men and women accepted the call of duty, leaving behind their loved ones and life as they know it, to protect the lives of us and so many others.

When our soldiers return from battle, sometimes they don't get the support and the assistance that they deserve. Simply put, we owe them more. Just as they have answered the call to serve our country, we must answer the call to serve them.

This is what Trinka Davis did and why I rise today, and I am so honored to be a part of the naming of this Carrollton VA facility in her honor.

Thanks to Trinka's generosity and the tireless dedication of her foundation, the new clinic was donated to the Department of Veterans Affairs just this past August. The doors were opened for veterans to receive outpatient treatment on September 24, 2012, and in the coming months the clinic will also include a 42-bed community living center. While providing a variety of services, including primary care, physical therapy, and outpatient mental health services, the facility will serve 3,000 veterans and will allow them to receive treatment closer to their homes.

I believe that, like our veterans, Ms. Davis is, indeed, a hero. She recognized the needs of our veterans, and she worked tirelessly to meet them. The Trinka Davis Foundation ensured that Ms. Davis' commitment to the veterans and to their families in the Carrollton community and beyond would be preserved through the construction of this health facility.

I ask my colleagues to join me in recognizing Trinka Davis' selfless actions by supporting H.R. 6374.

Mr. Speaker, we are here today to honor and celebrate our veterans, American heroes, who have bravely served their country, to open a first class health facility to aid our wounded warriors in their recovery and treatment, and to honor the legacy of the woman who made it all possible--Katherine ``Trinka'' Davis.

With a war in Afghanistan, a recent one in Iraq, and unrest around the globe, the United States has more than 196,000 active duty servicemen and women that put their lives on the line, night and day, to protect our families and our freedoms. These men and women accepted the call of duty, leaving behind their loved ones and life as they know it to protect the lives of others.

When our soldiers return from battle, sometimes they do not get the support and assistance they deserve. Simply put, we owe them more. Just as they have answered the call to serve our country, we must answer the call to serve them. That is what Trinka Davis did and why we are gathered here today.

Trinka Davis was a businesswoman from Carroll County who founded The Trinka Davis Foundation in 2004 after realizing the struggles many servicemen and women faced upon returning from Iraq and Afghanistan. The Foundation exists to support veterans and their families. Though she is no longer with us, her memory lives on. Thanks to her generosity and the tireless dedication of her foundation, the Community Foundation of West Georgia, and the Georgia Department of Veterans Services, we are here today to open the Trinka Davis Veterans Village.

This facility will serve 3,000 veterans, and allow them to receive treatment closer to home. Prior to construction, veterans were often forced to drive two hours or more for treatment.

The facility will offer primary health care, mental health services, physical and occupational therapy, health and wellness counseling, and social services. I am happy to report that veterans began receiving outpatient treatment at the Trinka Davis Veterans Village on Monday.

In the coming months, the facility will also include a 42-bed community living center for veterans needing inpatient rehab in a ``homelike, family-oriented, atmosphere.''

Like our veterans, Ms. Davis is a hero, who recognized the needs of veterans and worked tirelessly to meet them. The Trinka Davis Foundation ensured that Ms. Davis's commitment to the veterans and their families in our own community and beyond would be preserved through construction of this facility.

The USO has a motto, ``Until everyone comes home.'' Trinka realized that our work did not end there. She is an example to us all.