Floor Statements

I thank the gentleman from Pennsylvania, my cochair on this team, for yielding.

Once again we are bringing to our colleagues, Mr. Speaker, the issue of health care. This is something that we have committed to do, those of us who are in the health care field and interested, as our previous speaker, the gentleman from Louisiana (Mr. Jindal), who worked in the administration prior to being elected to Congress from the great State of Louisiana and specifically worked within the Medicare system.

There are a lot of people, Mr. Speaker, on our side of the aisle who understand the issue of health care. It is disturbing to me as a physician/Member when I hear the other side in the Social Security debate, as we hear some of these Special Orders in the evening from the other side criticizing the President, criticizing the Republican leadership, the Republican majority for wanting to make some meaningful changes to a 70-year-old system that needs to be brought into the 21st century. Of course, I am talking about Social Security.

But we are hearing from the other side, and I hear this in my district. A lot of times it seems like they encourage people to come to these listening sessions or town hall meetings and say, why are you Republicans so concerned about Social Security when you are not doing anything about Medicare? What they fail to tell these good folks in our districts, usually seniors, that in December of 2003, we historically passed the Medicare Modernization and, yes, Prescription Drug Act, Part D of Medicare, and really made some significant, meaningful changes to this program. Admittedly, Medicare, and Medicaid as well, are very expensive programs, and as our seniors are living longer and, of course, putting more of a strain on the Social Security system, the same thing is happening in Medicare. But to suggest that we in the majority or this President has ignored meaningful changes, modernization indeed, in just this past December of 2003, trying to address that problem, and for us to say that we have done nothing, and to try to divert our attention away now from trying to do the same thing to bring Social Security into the 21st century, I think, is a paper tiger on their side of the aisle.

What we have done, and I thank my colleague from Pennsylvania for putting this special hour together tonight, besides the prescription drug part, which is significant, and I will not spend my time talking about that, but I want to talk a little bit about the modernization part of Medicare in that historic 2003 bill.

Medicare was a little later coming to us than Social Security. Social Security came along in 1935, 1936, and it was not until 1965 that the Medicare bill as part of Social Security was offered to our seniors. It has been a great program, but at its outset it was all about episodic care. Part A was hospital treatment, nursing home, a little bit of home health care; and Part B, of course, the optional part, the premium- based part of Medicare, was for the provider services, the physician or outpatient hospital procedures, durable medical equipment, certain drugs, as the gentleman from Louisiana pointed out earlier, but only those that are administered by an injection, not something that you could get by a prescription.

The original Medicare, and as the argument against it, again, from the other side of the aisle back a year and a half ago, was they are about to take away Medicare as you know it. Well, thank God if we did that. Thank God, and thank the Republican majority, because now instead of treating people when they have a heart attack, when they fall over at home in the shower having had a stroke because their high blood pressure was never treated, never even recognized until it is too late, and then you get into the really, really expensive part of health care, that long-term hospital stay, that ambulance trip to the emergency room, that nursing home stay until you have exhausted all of your benefits, and all of a sudden you end up destitute and covered by Medicaid, no senior wants to be in that situation.

But what we did in the modernization part, most of the attention, yes, was the prescription drug benefit, the optional Part D benefit that was finally delivered by this President, finally fulfilled, a promise that had been made and broken really by so many previous Congresses and administrations.

But the modernization part, if my colleague will further yield, Mr. Speaker, I wanted to talk about that because we never got the opportunity to just go to the doctor and have a physical exam. As I said, it was always if one has got chest pain, if they got a nose bleed, if they have a stroke, then they get covered under Medicare.

But with the modernization program that we passed in December of 2003, when a person turns 65 and first becomes eligible for Medicare, now Medicare will pay for a complete, a complete head-to-toe thorough physical examination by a primary health care provider, a family practitioner or a general internist; and these are the diagnosticians. A lot of times people will refer to those specialists as diagnosticians; and, indeed, they are. They are the real medical sleuths that can detect disease before the patient has any idea that something is going amiss in their body. I am talking about a slight elevation of blood sugar or a slight elevation of blood pressure or maybe a person is getting a little short of breath and that internist or primary care doctor knows that they need some specific tests to rule out things like coronary artery disease or to institute some prescription medication.

Those physical examinations in the past were not covered under Medicare. It seems ridiculous, but back when we started the system, nobody really thought that that was that important, just as they did not think that prescription medication was so important. But we know now today that if we can detect these diseases as they are starting before the patient has had a significant complication, to treat it, to treat it, as we say, medically with, yes, prescription drugs, that now these seniors can finally afford, and those that are at or near the Federal poverty level, they can literally get prescription medications to treat one of these diseases at its inception by paying $1 or $3 or maybe at the maximum a $5 co-pay for a prescription that may have cost hundreds of dollars if they did not have this benefit.

So I am very pleased to be here tonight as part of this hour, this Special Order, with my colleagues, many of

them health care providers, to remind our colleagues on both sides of the aisle what we have already done in regard to trying to fix the Medicare program and in the process, of course, to provide much greater care, a better standard of care, 21st-century medicine, to our seniors who deserve that and have been waiting really so long for it.

They get that entry-level physical examination so that some of these catastrophic things do not happen to them, and if they choose in January of 2006 to have signed up for the optional part D, as 96 percent have signed up for the optional part B, the doctor part, then I think we are going to see some cost-shifting in this program.

Yes, it is an expensive program. And certainly the prescription drug part is going to be a big expensive number. I do not know exactly what it is, but what I do know is that the number crunchers, whether it is within the Centers for Medicare & Medicaid Services or whether it is the Congressional Budget Office or the Office of Management and Budget from the administration that have given us a number, and we heard $400 billion over 10 years and then we heard $520 billion over 10 years, and now we are hearing 750 or 950. I do not know.

But I do know this, that no credit is given for the possibility, the distinct possibility, that because of the prescription drug benefit, because of the initial complete physical when a senior turns 65, because of the multiple screening tests that are now paid for under Medicare on an annual or every-2-year basis, and I am talking about cholesterol screening, I am talking about pap smears for women to detect early cervical cancer or ovarian cancer, I am talking about colon cancer screening, Flexible Sigmoid tests or colonoscopies, I am talking about osteoporosis screening, doing all of these things, bringing Medicare into the 21st century is going to prevent some of these catastrophic, very expensive things from occurring.

So while we are spending a little bit more money on that and maybe a lot more money finally offering a prescription drug part, we are going to save money on hospitalizations. We are going to save money on fewer days in a nursing home. We are going to prevent people from ending up with a stroke, and, yes, indeed, maybe being in a vegetative state for 15 or 20 years, and we just talked about that last week in the Congress and know how expensive that kind of care is.

So really what we have done, and I am going to close with this, Mr. Speaker, and yield back to the gentleman from Pennsylvania (Mr. Murphy), but what we have done in modernizing Medicare and not ignoring it, as the other side would suggest, is we have done the right thing, we have done the compassionate thing for our seniors, and we have done the cost-effective thing.

And I thank the gentleman from Pennsylvania (Mr. Murphy) for yielding to me tonight during this hour and for our continuing to do these health care initiatives on a regular basis.

Mr. Speaker, in response to the remarks a few minutes ago from the gentleman from Massachusetts, I want to say that I am not sure whether or not I am on C-SPAN, but I am absolutely sure that I am not playing doctor, for indeed I am one.

Mr. Speaker, I want to thank my colleagues for returning to Washington on Palm Sunday to take up this very important issue. As my colleagues know, we are here today in an attempt to safe the life of Terry Schiavo. I particularly want to thank the gentleman from Illinois (Speaker Hastert), the gentleman

from Texas (Mr. DeLay), the gentleman from Wisconsin (Chairman Sensenbrenner), and the gentleman from Florida (Mr. Weldon) for their leadership on this issue. Although Congress cannot heal Terri, we do have the ability to save her from an inhumane death from forced starvation and dehydration.

Mr. Speaker, since Terri Schiavo's brain injury 15 years ago, she has been profoundly disabled. She is not, however, in a coma. She responds to the people around her; she smiles and she can feel. Terri is very much alive.

Mr. Speaker, listen to the words spoken just one year ago by Pope John Paul II to the International Congress of Catholic Physicians on life-sustaining treatments and the vegetative state: ``A man, even if seriously ill or disabled in the exercise of his highest functions, is and always will be a man, and he will never become a vegetable or a man animal. Even our brothers and sisters who find themselves in the clinical condition of a vegetative state retain their human dignity in all its fullness. The loving gaze of God the Father continues to fall upon them, acknowledging them as his sons and daughters, especially in need of help.''

The tragedy of this situation is that with proper treatment, now denied, Terri's condition can improve. Even though Terri's parents object to the removal of her feeding tube, the courts have rejected their pleas, and at this point it appears that all legal efforts to save her life have been exhausted, unless Congress acts swiftly.

Mr. Speaker, I believe we have a duty as Members of Congress to uphold a culture of life and compassion.

Terri has been incapable of making relevant decisions, particularly concerning her medical care, since she collapsed due to a potassium imbalance in 1990 at age 27, just a few years after her marriage to Michael Schiavo. Terri's parents want her to live. The governor of Florida, her state of residence, and many in the state legislature want her to live; however, the Florida Court system has ruled the husband's guardian rights should prevail. Unfortunately, his wishes have set his wife on a course of dehydration, starvation, and death.

It is important to note that Terri never had the opportunity to plead her own case in court and she never executed an advanced directive or living will in writing.

Terri responds to verbal, auditory, and visual stimuli, normally breathes on her own and can move her limbs on command. As a result of her parent's love, they have fought for years to prevent her court ordered death and have expressed their willingness to take care of her for the rest of her life.

Since the Florida state court has issued an order prohibiting Terri from even being given food or water by her mouth, once her tube is pulled she will not die from any disease, but from starvation and dehydration.

Florida law prohibits the starvation of dogs, yet will allow the starvation of Terri Schiavo. Florida law does not allow for physician assisted suicide or euthanasia, nor does my compassionate God fearing state of Georgia. Although I am not a neurologist by specialty, my basic courses in medical school taught me that dehydration is a horrific process.

It is a process that only the cruelest tyrants in history have used to ``cleanse'' populations. The patient's skin cracks, their nose bleeds, they vomit as the stomach lining dries out, and they have pangs of hunger and thirst. Starvation is a very painful death to which no one should be deliberately exposed.

The tragedy of this situation is that with proper treatment, now denied, Terri's condition can improve. Even though Terri's parents object to the removal of her feeding tube, the courts have rejected their pleas and, at this point, it appears that all legal efforts to save her life have been exhausted unless Congress acts swiftly.

Mr. Speaker, I believe we have a duty as Members of Congress to uphold a culture of life and compassion. It is important that we act today to save Terri Schiavo's life and uphold the moral and legal obligation of our nation, indeed this poor woman's Constitutional right to life.

In our nation of checks and balances, I believe it is time for Congress to check the Florida court's decision and pass this life saving measure.

I encourage bipartisan support of this legislation because we are here, at this ``11th hour,'' quite literally, to save Terri's life.

Madam Speaker, I thank the chairman of the Committee on the Judiciary for yielding me time, and for bringing this bill, H.R. 1334, the Protection of Incapacitated Persons Act, to the floor, and I thank the gentleman from Florida (Mr. Weldon), my physician colleague, as coauthor of this bill.

I think part of the question here is whether or not Terri Schaivo is truly in a persistent vegetative state. I practiced medicine for 26 years, and in my opinion, no, I have not examined Ms. Schaivo, but I trust my colleague the gentleman from Florida (Mr. Weldon). I agree that she is not in a persistent vegetative state. The pictures of her, we have seen them on television, the balloon that she followed with her eyes, the smiles, the recognition of her family.

I think this lady deserves the right to live, and as a physician Member of this body, I feel very compelled to stand up here and passionately support this bill, and I hope my colleagues on the other side will join us because I think it is the right thing to do.

Mr. Speaker, I rise today to honor the memory of several Georgia residents who were shot and killed last week while doing their jobs at the Fulton County Courthouse in Atlanta.

Friday afternoon a gunman opened fire on the courtroom killing Superior Court Judge Rowland Barnes, Deputy Sergeant Hoyt Teasley, and Court Reporter Julie Ann Brandau. In his attempts to escape police capture, Mr. Nichols also shot and killed Federal Agent David Wilhelm.

The loss of these citizens is felt throughout the Atlanta community. While I am relieved the shooter has finally been captured, his actions leave me deeply saddened and angry.

There is no silver lining in a horrific event like this, but I hope these shootings will encourage other communities in Georgia and across this country to take a long hard look at the security measures in their own public buildings. By ensuring the safety of our public workers, we can help prevent terrible tragedies like this from ever happening again.

Mr. Speaker, I ask that you join me in mourning the deaths of these Atlanta citizens.

Mr. Speaker, today, I rise to introduce an important piece of legislation, H.R. 1215, ``The Green Chemistry Research and Development Act of 2005.'' When I introduced this legislation during the 108th Congress as H.R. 3970, many of my colleagues wondered, what is green chemistry? So again I will start with a brief explanation. Chemical manufacturing is the source of many products upon which we depend such as medicines, plastics, fuels, and fabrics. However, chemical manufacturing has at times resulted in harm to the environment and human health. The goal of green chemistry is to minimize or, ideally, to eliminate this potential harm. It is defined as chemistry and chemical engineering that designs chemical products and processes that reduce or eliminate the use or generation of hazardous substances while producing high quality products through a safe and effective manufacturing process. By factoring the elimination of hazardous byproducts into the design of products and processes, chemists can design chemicals to be safe, just as they can design them to have other properties, such as color or texture.

Many private sector industries have recognized the potential of green chemistry. Along with its inherent human health and environmental advantages, green chemistry can offer many economic advantages. Since the costs of separating waste from products, complying with regulations, disposing of hazardous wastes and liability protection can be large, preventing pollution and waste in the first place is often cheaper than mitigating and cleaning it up later.

In my home state of Georgia, Shaw Industries, Inc. is showing tremendous returns on their investment in green chemistry. Shaw produces carpet tile from their EcoWorxTM compound, which is made from non-toxic starting materials. The carpet tiles are fully recyclable, and Shaw has started to receive the first generation of carpet tiles, introduced in 1999, back in the factory for recycling. Shaw has found that the cost of collection, transportation, and recycling is less than making new carpet tiles from virgin raw materials. Even before Shaw recycled a single carpet tile, they benefited from their investment in green manufacturing. By switching from traditional carpet tile backing to EcoWorx TM, Shaw cut the energy needed to produce carpet tiles in half.

Green chemistry offers other advantages in the areas of worker safety and public safety. For example, many chemical processes are conducted at extreme temperature and/or pressure, two conditions that present a risk for workers. Also, many chemical processes involve toxic substances. Green chemistry aims to design processes that can be conducted at or near room temperature and pressure, and that use benign materials. Both of these steps improve working conditions for employees. Chemical factories also pose a potential threat to public safety because of the possibility of an accidental release of toxic materials into the surrounding communities. Green chemistry seeks to replace these toxic substances with safe ones, which would not pose a threat to the public if accidentally released.

Yet despite all of the promise of green chemistry, the Federal government invests very little in this area. The most notable effort is a small grant program run jointly by the Environmental Protection Agency (EPA) and the National Science Foundation (NSF). Green chemistry research in this program is funded at about $4 million per year. The Department of Energy (DOE) and National Institute for Standards and Technology (NIST) also do a small amount of green chemistry research, however the Federal investment in green chemistry is minimal as compared to the overall investment in chemistry. In addition, each of these agencies has an important role to play in developing green chemistry technologies and facilitating their adoption, however, right now, there is little coordination among agencies.

The Green Chemistry Research and Development Act of 2005 establishes an interagency research and development (R&D) program to promote and coordinate Federal green chemistry research, development, demonstration, education and technology transfer activities. The Program would support R&D grants, including grants for university- industry partnerships, support green chemistry research at Federal labs, promote education at the undergraduate and graduate levels, and collect and disseminate information about green chemistry. NSF and EPA would lead an Interagency Working Group to coordinate these activities. The Working Group would also include DOE and NIST, as well as any other agency the President designates. The program is authorized at $33 million in FY06 rising to $38 million in FY08 from sums otherwise authorized to be appropriated. This bill does not authorize the expenditure of new money.

This bill provides modest and prudent funding in an area that deserves greater Federal attention. During the 108th Congress, H.R. 3970 passed the House on April 21, 2004 with a strong bipartisan vote of 402-14. I expect similar support this Congress in the House and am pleased to report that Senator Snowe and Senator Rockefeller plan on introducing identical legislation in the Senate very soon. I look forward to working with my colleagues in the House and the Senate, as well as with the Administration, and all other interested stakeholders to enact this important legislation.

Mr. Chairman, I thank the gentleman from Arizona (Mr. Shadegg) for yielding me time.

Mr. Speaker, I rise in support of the gentleman's amendment. I believe that the Federal government and the Congress need to be part of the solution to cities around the country that are in non-attainment status.

This amendment is a good step in providing relief for cities such as Columbus, Georgia, in Muskogee County, part of my 11th Congressional District, that only recently has been designated non-attainment, and it is non-attainment of this PM-2.5 that the gentleman from Arizona (Mr. Shadegg) was just talking about, these tiny 2.5 or below microparticulate matter.

We can save for another day, I guess, the debate over particulate matter non-attainment and whether cities such as Columbus should be designated as such. But today, I would like to say thank you to the gentleman from Arizona (Mr. Shadegg) for offering this amendment that will allow funding to be provided to these cities.

I understand the gentleman may withdraw the amendment. I appreciate the ranking member being willing to work with him on trying to resolve this. But on behalf of the people of Muskogee County and the City Columbus and Phoenix City, Alabama, as well, I think this is a good idea and I commend the amendment.

Mr. Speaker, tonight, as part of the Republican Health Care Public Affairs Team, my co-chair, the gentleman from Pennsylvania (Mr. Murphy), and I are here with a couple of our colleagues to talk about, over the next hour, one of the most important things to the people of this great country, and that is health care and our health care system.

We have a great system, without question, probably the greatest health care system on Earth. But we are not going to just stand up here during this next hour or as we go forward with our Health Care Public Affairs Team and on a monthly basis, talk about different health care issues that are so important to this Nation and pat ourselves on the back. We are not going to do that. We are going to talk about some problems that exist.

Tonight, we are going to focus primarily on the civil justice system and trying to solve a problem in regard to medical liability insurance and the lack of access to care. But there are so many other issues that we will be talking about as we go forward in this series of 1-hour discussions with our colleagues, Mr. Speaker. Things like Medicaid. Obviously, we have got a serious problem with Medicaid. We need to reform that system, and the President talked about many of these things in his State of the Union address. We addressed, of course, Medicare modernization and the prescription drug act last year. In fact, December of 2003 is when that bill was signed by President Bush.

But we will continue to focus on Medicare in realizing that it is not a perfect system. It is a good system. It has served our people well, but it is not perfect.

Then, of course, the issue of the uninsured, some 43 million in this country. Many of them, Mr. Speaker, have jobs. They work. They are not unemployed, but they are underemployed and, in many cases, are not insured at all. They do not have the opportunity to purchase health insurance. Maybe it is not even offered by their employer, or if it is, they cannot afford to purchase that insurance. And my colleague, the co-chairman of this Republican Health Care Public Affairs Team who is with us tonight, will be speaking in just a few minutes. We will be talking about, also, just the issue of electronic medical record keeping and how important that is to reduce the number of errors, medical errors that we know cause far too many injuries and, yes, in some cases, loss of life in this country. The gentleman from Pennsylvania (Mr. Murphy) will talk about that.

The main emphasis tonight, of course, as I stated, Mr. Speaker, will be to talk about this issue of medical liability and why it is causing such anguish in our country and resulting in the lack of timely and necessary access to health care.

I am often asked, I am a physician Member, I think, Mr. Speaker, you know that, and my colleagues are aware of that. I came to this body after practicing OB-GYN medicine in my district, the 11th district of Georgia, the City of Marietta, Cobb County of Georgia, where I delivered over 5,200 babies. And it was tough to give up that practice. But without question, I was beginning to feel a lot of stress, a lot of anxiety, frustration in my medical practice as I watched those medical liability insurance premiums just continue to skyrocket and get up to the point where it was awfully difficult to be able to afford that.

So this is really what a lot of my colleagues are going through. I have also had people back in the district say, now, I think you have a lot of doctors and a lot of health care providers in the Congress now. Did we not elect a few more? In fact, we did in this 109th Congress. We grew our numbers a little bit, Mr. Speaker. We went from a grand total of seven M.D.'s to ten in the House, and of course, we have a number of other health care providers, be they nurses or dentists or pharmacists or psychologists, but it is still a small number.

When we look at 435 Members, and maybe we have something less than 20 who have a background in health care, in the health care professions, and on the Senate side, we increased our number over there by 100 percent this time. We went from one to two. And, of course, I am speaking of the majority leader of the Senate, Dr. Frist, and also, now, Senator Coburn from the great State of Oklahoma.

But we are determined to talk about this health care issue and make sure the American people know that, while we might not be large in numbers, we are going to discuss these issues. We are going to do it on a regular basis.

The Republican hour tonight, of which we are managing, we are going to get this issue in front of our colleagues, in front of the public and let them know that we care about this. It is a tremendously important issue, and it should not be partisan.

When you think about it, health care, when you have a patient, you never ask them if they are a Republican or a Democrat. And believe you me, they do not ask their doctor either. President Reagan joked about that when he was shot and went to the hospital and looked up just before they put him to sleep, looked up at the anesthesiologist and said, I sure hope we got some good Republicans in here. But truly, we have, as I say, there are ten M.D.'s in the House, three on the Democratic side, seven on the Republican side. But we are not going to let this be a partisan issue.

We are going to just talk to our colleagues and make sure that everybody understands that we need to do this for the good of the country and not for the good of a party or, in particular, not with our vision, our focus on the next election.

The issue of medical liability and the crisis that we are in, Mr. Speaker, I would like to call attention to this first slide that we have that shows the United States of America and the number of States that are either in crisis in regard to this issue or they are getting darn close.

I know that my colleagues on the other side of the aisle do not like the word crisis. And we are talking about another issue, of course, in regard to that, but let us say a serious, a very serious problem. But I think indeed a crisis.

In my State of Georgia, along with about 13 others depicted here in red, indeed a State in crisis, and something like 25 other States depicted in yellow, showing serious problems in regard to this issue. In fact, there is just only a handful of States, maybe less than six or eight, that are not either in crisis or near crisis. And what do I mean by that?

If you think about the fact that, when people go to the emergency room

with an injured child, and maybe it is a head injury, maybe that child is unconscious, they at that point do not need a family practitioner. They do not need an OB-GYN. They do not need an oral surgeon. They need a neurosurgeon. They need someone who can immediately assess the condition of that child and if there is a serious head injury. And certainly, if the child is unconscious, that is very likely.

If there is no neurosurgeon there that can act in a very timely manner and in some instances get that child to surgery, the damage that can be done is irreparable damage and it cannot be undone.

So we know that we have physicians like neurosurgeons, and I mentioned my specialty, OB/GYN. Doctors who are involved in high-risk specialties are the ones that are getting absolutely killed by runaway medical liability premiums and that constant threat. They are willing, through compassion and love of their profession and their patients, to take on those tough cases, those high-risk obstetrical cases.

I will use the word ``toxemia.'' I am sure most of my colleagues, Mr. Speaker, do not know what that is, but all of the OB/GYNs certainly know what I am talking about, a life-threatening complication of pregnancy. If a doctor is not available to treat that condition, these people could not only lose their child but they could lose their lives. So we have some real serious problems, and I think it is just time to talk about it.

I am very thankful that my State, as I showed my colleagues on the first slide, is one of the 13 or so that is in crisis, did during this session of their General Assembly just pass a really good, a significant piece of tort reform legislation that I think is going to bring some relief. When I say bring some relief, I am not hardly even talking about the doctor's income. I am talking about keeping them in practice, keeping them performing those cases, seeing those patients that are high risk, rather than hanging up that stethoscope and trading it in for a fishing rod or whatever, because they just no longer can stay in practice under that environment. So it is a huge, huge problem.

Let me just talk about why we at the Federal level, I said Georgia passed tort reform, Florida did, Texas did, California of course gave us the model of tort reform back in 1978, the bill called MICRA, which stabilized malpractice insurance premiums so that doctors did not leave California, did not stop their practices, continued to see those high- risk patients, without these premiums going just totally through the roof, and it worked and it worked because of one thing primarily and that is a cap, a cap of $250,000 on noneconomic damages, so-called pain and suffering.

It has nothing to do whatsoever with economic damages. It is just to say that without a cap that number could be infinity. It could be tens of millions of dollars, and that is wrong and that is what is driving those rates up so high. That is the model that was passed in Georgia, and that is basically what we are trying to do here in the Congress.

My colleagues might say, well, just let the States take care of it; why worry about it at the Federal level. Well, many of the States, in fact most of the States, have not taken care of this.

There are a lot of reasons why you may think that we cannot get tort reform. The trial lawyer lobby is a very strong lobby. There is no question about it. We have passed tort reform legislation, the Health Act of 2003. We passed it again here in this body, Mr. Speaker, last year in 2004; and now we have reintroduced it in the 109th in 2005, and we will pass it again. We will pass it again in this body with bipartisan support; but when it gets to the other Chamber, it has been just almost impossible.

Again, I mean, it should not be a partisan issue, but for some reason it always seems to be, and I continue to have hopes. I am not going to give up on the other body. I think that, Mr. Speaker, we have got some different faces over there this year, and I have always said to my doctor friends that say, well, what can we do, and I say to them, if you cannot change their minds, you need to change their faces. Fortunately, Mr. Speaker, in this last election cycle we changed a few faces, and indeed, we elected another doctor to the United States Senate and I mentioned Dr. Coburn earlier.

So I continue, hope springs eternal, but we want to continue to make sure that we tell our colleagues about this and make sure the American people understand how serious a problem this is.

At the Federal level, and let me just frame it just for a minute, the amount of money that is spent on health care, I just want to focus my colleagues on this particular chart.

Nearly 45 percent of all mandatory spending is on health care. Let me say that again: nearly 45 percent of all mandatory spending is spent on health care. This pie chart, this part over here, 55 percent is nonhealth care mandatory spending; but when you talk about those numbers and I can just throw out a few, $176 billion, this is fiscal year 2004, and these numbers continue to grow. Medicaid spending, $176 billion; State children's health insurance program, the CHIP program, $5 billion; Social Security disability, $73 billion, that is 6 percent; Medicare, $297 billion, 24 percent of mandatory Federal health care spending. No small numbers.

The Federal outlay for health care continues to rise. Nearly one- third of all Federal spending goes toward health care, nearly one- third, and just look at this slide. I would like my colleagues to pay close attention to this.

Starting in 1965 going forward to 2004, the percent of total Federal outlays, this is total Federal outlays, not just mandatory but also discretionary, 1965, Federal health care spending as a percent of our budget, 2.6 percent; 2004, all the way to the right, 29 percent.

We have a problem, and we have to solve it at the Federal level.

I hope that my colleagues can appreciate the magnitude of this, and I am very, very pleased to be, as I said at the outset, co-chairing the Republican Health Care Public Affairs Committee as we bring these issues, like the need for medical liability reform, before my colleagues. My co-chairman on this committee is the gentleman from Pennsylvania (Mr. Murphy).

We appreciate him being with us tonight, and at this time I would like to turn it over to him and let us hear about some of those issues of concern in regard to medical errors and what we can do about that.

Mr. Speaker, I thank my colleague from Pennsylvania for bringing those points to us, because what is important for our colleagues to know is that while physicians in this country, health care providers are in a crisis situation, as we said at the outset, because of the need to practice defensive medicine, inability to pay for liability premiums that have gone through the roof, what Dr. Murphy, my co-chair, has brought to us is to say physician, health care provider, heal thyself, heal thyself.

And that is important. We cannot say that we are not going to do things to try to make sure that there are less errors and less accidents. People must know that we are determined to reduce those medical errors that the gentleman from Pennsylvania was talking about.

I am very pleased to introduce the next Member, my colleague from Georgia. We talked at the outset about the number of physicians in the House and the fact that we picked up a few. While it was indeed, Mr. Speaker, a great pleasure to me that one of those three new Members in this body is not only a colleague from Georgia but also a colleague from my own County of Cobb and represents the district that adjoins mine. We both have a part, a significant part of Cobb County.

The gentleman from Georgia (Mr. Price), Representative Price, Congressman Price is an orthopedic surgeon, one of my great mentors when I was a member of the Georgia Assembly, so I am very proud to introduce him tonight. He is going to talk about some of the unique problems in regard to physician workforce in our great State of Georgia.

Mr. Speaker, we thank the gentleman from Texas (Mr. Burgess) for the doctor's timely remarks, and appreciate the gentleman being here with us.

Again, I point out the fact that even though they have some relief in Texas and now we have a little relief, good legislation in Georgia, why are we so concerned. He said it so well, and that is as I had pointed out earlier in the hour that the total percentage of nonmandatory spending in this country that goes to health care, Federal dollars is like 45 percent.

I remember during the most recent Presidential campaign, I do not know which one of the three debates, I think maybe the last one, the President talked about this, talked about the issue of needing to do something about medical liability insurance rates and his opponent, Senator Kerry, said the insurance premiums for physicians so they can continue to practice is a minuscule amount. President Bush was so correct when he said, yes, that is a big cost per individual physician; but in the overall picture it is not a big cost, but the cost, of course, as the gentleman from Texas pointed out, is all of the tests and procedures, the defensive medicine that is being practiced. That is why we cannot sustain that and we need to do something about it. It is not just the cost, as my co-chair talked about during his time, and I want to have further discussion about that. It is a safety issue. It is very definitely a safety issue.

Mr. Speaker, I would like to ask the gentleman from Pennsylvania (Mr. Murphy) if he would continue to discuss that with us a little bit.

Mr. Speaker, the gentleman is so correct. I would hope, and I think that some of my colleagues probably did a little bit better job in keeping accurate records and neat charts, even though I learned to write and my penmanship was developed by the Catholic nuns at a very strict parochial school, but what the gentleman from Pennsylvania (Mr. Murphy) is talking about is you have a chart, it is in the office. The doctor sees a patient maybe a couple of times a year over a long period of time. The chart gets thicker and thicker. Sheets are put in, not tabbed, they are out of order. The doctor may not know even when the patient was last seen if they are not a good historian.

The gentleman from Pennsylvania talked about this earlier, about medical errors. The gentleman from Texas mentioned it, and I think the gentleman from Georgia, too; that the Institute of Medicine statistics, hopefully they are not accurate, because that is an astronomical number of deaths and injuries that they say occur each year because of medical errors. But as the gentleman pointed out, even one is too many. A lot of it is because of this sloppy medical recordkeeping. So, yes, it is definitely a problem and needs some immediate attention.

The point of all of that is that you know with that electronic medical recordkeeping, you can be anywhere in the world literally, a patient, if we have a way with a swipe card or maybe a radio frequency identification card which would look very much like a typical credit card, about the same size and thickness, but an individual would have a particular code that was unique to him or her and would have access through a very secure fire wall system to their medical records anywhere in the world, so that if you were in another country, on vacation, and this happens a lot, far too often, when a person gets sick, has a heart attack, in an automobile accident, in a remote place, the language is not the same, the communication is poor and the treatment is just not adequate. So when we get to that point, and we are there. I know the gentleman has talked about some systems. I have talked to a lot of people who are developing these cards. The President has talked about the need to go to a system like that. We have talked tonight about medical liability reform and needing to give our healthcare providers some relief so they can continue to practice medicine and our patients

have access to that great health care system, but we have also spent a good bit of time tonight saying that we understand that, as I pointed out earlier in my statement, physician, heal thyself. We know there are some problems. I think one of the biggest problems in regard to the error rate is this issue, as the gentleman from Pennsylvania points out, of poor medical recordkeeping, the traditional system, the 20th century recordkeeping, if you will. It is time to make these changes. The technology is there. We need to incentivize. My colleague from Pennsylvania asked the question, what can we do in our individual office, how can we get doctors, either individuals or groups, to go to that kind of a system? It is going to be costly. That is going to be a disincentive, I think, for a lot of them to do that. But we need to move toward a system of reimbursement, maybe under the Medicare or Medicaid program, Federal match and 100 percent pay on Medicare. We need to be able to incentivize individual doctors and groups to go to this system.

There is no question about how important that is, because, as the gentleman from Pennsylvania pointed out, when you cannot even read the prescription, it is bad enough, but in many instances, a doctor is not going to know. Maybe the particular patient is sick in the emergency room, high fever, not at their best mentally, they are not going to be able to relate that information. That is why these cards are going to be so important so that, when you write that prescription, even if your penmanship is absolutely perfect, you need to make sure that you are not giving them a medication that would react with maybe two or three other things that they are on and could cause a serious problem.

Tonight, as we wrap up, and I am so thankful to be doing this with my cochair, the gentleman from Pennsylvania, and we will continue to bring subjects, healthcare issues, probably do an hour like this on a monthly basis, this team of Members, Republican Members, who are either healthcare providers or extremely interested in this issue for the good of the Nation.

In closing, I want to make sure that my colleagues understand that most healthcare providers, if a patient is injured because of someone practicing below the standard of care, then we want them to recover. It is not about taking away anybody's right to a redress of grievances. I look forward to the discussion with my colleagues next month.

Mr. Speaker, I offer a resolution (H. Res. 139) and I ask unanimous consent for its immediate consideration in the House.

Mr. Speaker, I rise to honor Colonel William Glen Gustafson of Marietta, Georgia, who sadly passed away last Tuesday.

Throughout his life, Colonel Gustafson served his country and his community. He was a master parachutist and troop commander during two tours of duty in Vietnam. He worked for the American Defense Preparedness Association here in Washington. He served on the academy review committees of former Georgia Senator Sam Nunn and former House Speaker Newt Gingrich. And from 1991 to 1997, he served three terms as chairman of the Cobb County Republican Party.

In all these capacities, Colonel Gustafson exemplified the virtues of honor, dignity, and leadership. His death is a great loss not only for his family but for the entire Cobb community as well. I will always remember the enthusiasm he brought to his work and his commitment to solving every challenge he faced. I will greatly miss his charisma, his leadership, and, most of all, his friendship.

Mr. Speaker, I ask that my colleagues join me in honoring Colonel Gustafson.

Mr. Speaker, I rise today in honor of the gentleman from Georgia (Mr. Lewis), who celebrated his 65th birthday last week. It was appropriate that the gentleman from Georgia's (Mr. Lewis) birthday fell during Black History Month because his involvement in politics began when he was a student activist working to spread the message of nonviolence preached by the Reverend Martin Luther King, Jr. The gentleman from Georgia (Mr. Lewis) was later involved in some of the most important civil rights events in our Nation's history: The Freedom Rides, the Selma March, and countless other gatherings that helped this country end the era of segregation and move toward an equal and a just society.

Even today, the gentleman from Georgia (Mr. Lewis) is known for his dedication and persistence. Although we sit on opposite sides of the aisle, I am often inspired by his passion and determination on issues of importance to his constituents.

Mr. Speaker, I ask that the Members join me in congratulating the gentleman from Georgia (Mr. Lewis) on the occasion of his 65th birthday.

Mr. Speaker, I rise today in honor of an extraordinary member of my community, Clara Jenkins. In the 1950s, Clara helped advance the Civil Rights movement in Georgia by breaking down color barriers at a local hospital.

On August 20, 1951, Clara was hired as the first black nurse at Kennestone Hospital in Cobb County. Now, 1951 was not an easy time to be a black nurse among all-white colleagues. The Brown v. Board of Education ruling, that mandated separate but equal was inherently unequal, was still 3 years away. In 1951, Kennestone Hospital was segregated by floor and ward. Black patients and white patients received their care separately and in unequal surroundings.

But Clara did not let segregation deter her goal of providing care for the sick and the needy. Through her determination and talent, she proved to her colleagues that skill, not skin color, was what mattered most.

Despite having earned a nursing degree right here in Washington, D.C., Clara was not initially allowed to work with white patients. However, over time, doctors and nurses noticed her skill, especially her ability to insert IVs into patients with thin or hard-to-find veins. Clara said her work on parents with darker skin made her adept at finding veins by touch, not sight, a skill the other nurses lacked. Increasingly, white doctors and nurses began asking for Clara's help.

After the 1954 Brown versus Board ruling desegregated Kennestone Hospital, Clara was assigned to several special hospital units. She was asked to head up Kennestone's very first IV team, and later became the only black nurse on the hospital's first coronary team. These were amazing feats for a woman who only a few years earlier had not been allowed to even care for white patients.

As a physician, I had the privilege of working with Clara at Kennestone Hospital. And let me tell you, she is just as respected and beloved now as she was then. In fact, she was one of my favorite nurses. And working with her on the floor, and later when she was a supervisor, always gave me confidence in her ability, her compassion, and her leadership.

I am inspired by Clara Jenkins' ability to prove herself in the face of segregation and discrimination. Clara had a sense of determination and courage that should serve as an inspiration for us all. By asking others to judge her based on skill, not race, she helped break down color barriers for black professionals in Cobb County.

Clara also opened doors for other black nurses. She was once offered a position as head pediatric nurse at Kennestone. But when she turned down the job, another black nurse was selected to head that unit. She brought a greater equality to our hospital.

Clara Jenkins is a skilled nurse and an important member of the Cobb community. Mr. Speaker, I ask that you join me in honoring her legacy.

Mr. Speaker I rise today to honor Lance Corporal David Payton, a 21-year-old Marine who was injured while serving our country in Iraq.

On January 30, the same day that millions of Iraqis voted in the country's first free and successful elections, Corporal Payton's compound in Fallujah was hit by a rocket-propelled grenade, which left him with severe burns and scarred lungs from chemical inhalation. He was released from the hospital last week and is continuing his recovery at home in Powder Springs, Georgia, in my 11th Congressional District.

I had the opportunity to visit with Corporal Payton on Friday, and I was impressed by his courage and commitment to this country. Corporal Payton is a former high school wrestling champion; and let me tell you, he is a fighter. He exemplifies what it means to be a soldier, willing to put your life on the line so others can be free.

The Iraqi people are now on the path of freedom and democracy, and Corporal Payton and all of our war fighters deserve our deepest gratitude for the work they have done to secure America and to spread liberty throughout the world.

Mr. Speaker, I ask that Members join me in wishing Lance Corporal David Payton a speedy recovery.

Mr. Speaker, in 1979, Congress passed the Taiwan Relations Act to ensure our friends on the island of Formosa would not be isolated because of our Nation's ``One China'' policy. The Taiwan Relations Act sent a strong message to Communist leaders on mainland China, saying we will conduct business with their country but will not tolerate Communist aggression against a sovereign people.

It is important to emphasize our commitment to the democratically represented citizens in the Republic of China, because recent reports indicate mainland China is about to enact an anti-secession law with the purpose of reuniting China under Communist dictatorship. This action will not only destroy the goodwill between the peoples of Taiwan and China, it will also provoke unnecessary tension in the Taiwan Strait.

By unilaterally changing the status quo, Communist China is also challenging America's will to stand behind the Taiwan Relations Act. After diplomatic improvements in recent years, I believe the anti- secession law is wrong for the region's stability and is a potential misstep that needs to be addressed.

Mr. Speaker, I want to remind my colleagues, especially for those on the other side of the aisle, that this Broadcast Decency Enforcement Act does not change the definition of decency, and it is not about censorship. It is about increasing the penalties and the fines for those entertainers and owners of radio and television stations that knowingly and willfully violate, and do it in a repeated manner, what we already know is a definition of decency.

So it is disingenuous to suggest that we are trying to impose censorship or redefine what has already been well defined in regard to decency. I want to give, Mr. Speaker, an example. The Member from the other side of the aisle, the gentleman from Virginia (Mr. Moran) had an amendment, and I do not want to dwell on this too much because he is here and I think he may be speaking about that. But he brought an amendment to the Rules Committee concerning a certain ad that we see many times on prime-time hour on television. And he had great concerns about that. And many members of the Rules Committee on both sides of the aisle, both Republicans and Democrats, agreed that this advertisement was possibly a little on the tacky side, but that amendment was not approved by the Rules Committee because of that question of a redefinition of what is decent.

So I just want to remind my colleagues that this is not about censorship or redefining decency on the airwaves, it is making sure that those who continue to abuse their privilege of broadcasting on our public airwaves, that they pay a significant fine and one that hopefully will disincentivize them from continuing this activity.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 96 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Massachusetts (Mr. McGovern), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only.

Mr. Speaker, House Resolution 96 is a structured rule providing 90 minutes of debate for consideration of S. 5, the Class Action Fairness Act of 2005. The rule waives all points of order against consideration of the bill, makes in order one amendment in the nature of a substitute, it waives all points of order against this amendment, and it provides one motion to recommit with or without instructions.

Mr. Speaker, I urge support for the rule because we have before us a fair rule. I could say an excellent rule. The previous gentleman from Massachusetts was rating these rules. But this is fair in both senses of that term, a fair rule that gives Members on both sides of the aisle a chance to discuss their ideas on class action reform. I believe there is a general consensus that our system for class action litigation is flawed.

As demonstrated by the other body, there is bipartisan support for the measure that will be coming before us. In fact, the other body passed this measure by a vote of 72 to 26 with strong bipartisan support. Even with that bipartisan support, however, there are differences of opinion on how to reform our class action system. This bill through granting consideration of a substitute amendment will allow us to openly discuss these opinions and ideas.

Mr. Speaker, our general tort system costs American businesses $129 billion each and every year. Even our smallest companies pay collectively about $33 billion a year, or 26 percent of the overall tort costs to businesses borne by our smallest companies. Class action reform is a first step in litigation reform aimed at providing relief for these small businesses. I am pleased that we are finally seeing the light at the end of the tunnel. This Chamber has passed class action litigation reform on four previous occasions. It is about time that we sent a reform package to the President's desk for his signature.

The underlying bill will make several key reforms including expanding Federal jurisdiction over large interstate class actions as originally intended by our Founding Fathers, create exceptions that keep truly local disputes in State courts, provide an end to the harassment of local businesses as part of this forum shopping game, and create a consumer class action bill of rights.

Mr. Speaker, I would like to again urge my colleagues to support this rule which passed out of the Committee on Rules without objection and to vote in favor of the underlying bill which will provide this much needed reform.

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

Mr. Speaker, I yield 2 minutes to the gentlewoman from West Virginia (Mrs. Capito), my colleague on the Committee on Rules.

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

Mr. Speaker, in response to some of the comments that were made by the gentleman from Massachusetts, I want to share with my colleagues some facts.

The Class Action Fairness Act contains several provisions specifically designed to ensure that class members, not their attorneys, class members, not their attorneys, are the primary beneficiaries of the class-action process.

For example, the act, number one, requires that judges carefully review all coupon settlements and limit attorney's fees paid in such settlements to the value actually received by the class members.

Second, it requires careful scrutiny of ``net loss'' settlements in which the class members end up losing money.

Thirdly, it bans settlements that award some class members a larger recovery just because they live closer to the court.

Lastly, it allows Federal courts to maximize the benefits of class- action settlements by requiring that unclaimed coupons or settlement funds be donated to charitable organizations.

In addition, the bill would require that notice of proposed settlements be provided to appropriate State and Federal officials, such as State Attorneys General.

Let me also address one other issue raised, and I think this is very important.

This myth is being circulated that the Class Action Fairness Act would move all or virtually all class actions to Federal courts, overwhelming Federal judges and denying State courts the ability to resolve local disputes. Well, a recent study examined class actions in the State courts of Connecticut, Delaware, Maine, Massachusetts, New York and Rhode Island, to determine what effect the bill would have on the class actions filed in those respective States.

Here is what they found in regard to the State of Massachusetts. Sixty-one percent, 30 out of 49 of the reported class actions, would have presumedly remained in State court. At least 10 of the 19 Massachusetts cases that would be affected by this bill, the Class Action Fairness Act, involved nationwide classes, cases primarily involving citizens living in other states.

Mr. Speaker, I am proud to yield 2 minutes to the gentlewoman from Tennessee (Mrs. Blackburn) a former member of the Committee on the Judiciary and an original cosponsor of this bill in the 108th Congress.

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

I want to address the remarks of the gentlewoman from Texas. I want to remind her that the Committee on Rules voted unanimously in favor of this rule and granted an amendment in order in the form of a substitute that includes each and every one of the provisions that she just spoke of. I also would like to remind my colleagues that each and every one of those amendments were also proffered in the other body, and each and every one of those amendments were voted down in a strong bipartisan vote.

So to suggest, Mr. Speaker, that this is something that had not been looked at and we have not talked about, I would remind my colleague that it was addressed in the 105th Congress, in the 106th Congress, in the 107th Congress, in the 108th Congress, and finally we are here, and we are going to get this rule passed and this bill passed and on to the President for his signature.

Mr. Speaker, I yield 3 minutes to the gentleman from Oklahoma (Mr. Cole), my colleague on the Committee on Rules.

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

In response to the gentlewoman from Texas, the Committee on Rules has jurisdiction, and anybody that knows the history of this body knows and understands that the Committee on Rules certainly has jurisdiction.

Let me just give a little history for my colleagues and particularly for the gentlewoman from Texas in regard to this bill. Again, in the 105th Congress, Senate bill 2083, the Class Action Fairness Act, Senate held hearing, reported by subcommittee. House Resolution 3789, Class Action Jurisdiction Act of 1998, committee hearing and markup held, reported from the House Committee on the Judiciary, 17 to 12.

Mr. Speaker, in the 106th Congress, H.R. 1875, Interstate Class Action Jurisdiction Act of 1999. Committee hearing and markup held, passed floor 222 to 207.

In the 107th Congress, H.R. 2341, Class Action Fairness Act of 2001. Committee hearing and markup held; passed floor, 233 to 190.

In the 108th Congress, H.R. 1115, Class Action Fairness Act of 2003, committee hearing and markup held, passed floor, 253 to 170.

No hearings? Indeed.

Mr. Speaker, I yield 3 minutes to the gentleman from Florida (Mr. Keller).

Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. Westmoreland), the former minority leader of the Georgia House of Representatives.

Mr. Speaker, how much time do I have remaining?

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

Mr. Speaker, the gentleman from Massachusetts (Mr. McGovern) presented that case; and I want to present the real crux of this problem, and let me read a suit, Shields, et al v. Bridgestone/ Firestone, Incorporated in Texas, a suit in Texas.

This suit involves customers who had Firestone tires that were among those that the National Highway Traffic Safety Administration investigated or recalled but who did not suffer any personal injury or property damage. After a Federal appeals court rejected class certification, plaintiffs' counsel and Firestone negotiated a settlement which has now been approved by a Texas State court. Under the settlement, the company has agreed to redesign certain tires, a move that was already underway irrespective of the suit, and to develop a 3-year consumer education and awareness campaign, but the members of the class received nothing. The lawyers, they got $19 million.

Mr. Speaker, I yield 2 minutes to the gentlewoman from Pennsylvania (Ms. Hart), a former member for 4 years of the Committee on the Judiciary and an original co-sponsor of H.R. 1115.

(Ms. HART asked and was given permission to revise and extend her remarks.)

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

Mr. Speaker, this is a fair rule for legislation that will help restore fairness and common sense to the current class action system.

Like H.R. 1115, which overwhelmingly passed the House last Congress, S. 5 expands Federal diversity jurisdiction over interstate class actions in a manner consistent with the framers' constitutional intent that Federal court preside over controversies between citizens of different States. S. 5 also protects consumers from these bogus coupon settlements that reward trial lawyers with millions in windfall fees while clients who never hired them get coupons in the mail.

Mr. Speaker, I want to call attention to this slide before me. This is from the Washington Post, November of 2002. The Washington Post is not exactly the most conservative newspaper in the country: ``The clients get token payments while the lawyers get enormous fees. This is not justice. It is an extortion racket that only Congress can fix.''

The Senate's overwhelming passage of S. 5 by a vote of 72 to 26 just last week reflects a strong bipartisan consensus in favor of reforming a class-action system that is prone to systematic abuse. Of those 26, 18 were Democrats, and each one of those provisions in that amendment in the nature of a substitute were offered in the Senate, and each one of them were voted down in a bipartisan fashion.

I think we all, in both the Senate and the House, and both Republicans and Democrats, we want to do the right thing here, and we want to make sure that, as the Washington Post says, that we eliminate this extortion racket and bring some fairness to this class-action system. After all, it is the injured person, it is the plaintiff that deserves a fair and just settlement, and it should not be just a lottery windfall for lawyers who venue shop, looking for places like, and we have heard it during this hour's discussion, Madison County, Illinois, the epicenter of this class-action lawsuit abuse. What happens in Madison County, Illinois, affects the whole country.

So I encourage my colleagues to vote for the rule, vote for S. 5 tomorrow.

Mr. Speaker, I yield back the remaining portion of my time.