Floor Statements

I thank the gentleman for yielding. Yes, certainly I do. Here is one, and I quote, from President Clinton:

``Iraq repeatedly made false declarations about the weapons that it had left in its possession after the Gulf War. When UNSCOM would then uncover evidence that gave a lie to those declarations, Iraq would simply amend the reports.''

Another quote, again from President Clinton:

``And someday, some way, I guarantee you he'll use the arsenal, and I think every one of you who has really worked on this for any length of time believes that, too.''

Here are another couple of quotes. Again, President Clinton:

``We want to seriously reduce his capacity to threaten his neighbors.''

President Clinton again:

``We have learned through harsh experience that the only answer to aggression and illegal behavior is firmness, determination and, when necessary, action.''

Just listen to former, actually Senator Gore at the time and former Vice President Gore in a speech, a major policy speech made on September 29, 1992 by then Senator Al Gore, and I quote:

``He, Saddam, had already launched poison gas attacks repeatedly and Bush''--referring to Bush I--``looked the other way.''

The Senator running for Vice President.

Absolutely.

I will finish that quote:

``He, Saddam, had already conducted extensive terrorism activities and Bush looked the other way. He was already deeply involved in the effort to acquire nuclear weapons and other weapons of mass destruction and he, President Bush, looked the other way.

``Well, in my view the Bush administration was acting in a manner directly opposite to what you would expect with all of the evidence that it had available at the time. Saddam Hussein's nature and intentions were perfectly visible.'' Again, a major policy speech made by then Senator and Vice Presidential candidate Al Gore, September 29, 1992.

If the gentleman will yield, continuing on, then Secretary of State Madeleine Albright as quoted in the Chicago Tribune, November 16, 1997: ``Hussein's weapons will not discriminate if and when they are used, and therefore it is important for the region to understand that he is a threat.''

Mr. Speaker, I think it would be informative to people who are paying attention, and I think all Americans are paying attention and they are listening to a lot of political rhetoric during this Presidential election year and the criticism that they are hearing not only from the leaders of our military, from the chairman of the Joint Chiefs, but especially to the Secretary of Defense, the honorable Donald Rumsfeld.

Listen to what former Secretary of Defense William Cohen had to say: ``Noted again Tuesday that in the past Iraq imported enough material to produce up to 200 tons of the deadly chemical agent VX, `theoretically enough to kill every man, woman, and child' on earth. Finding and eliminating all such chemical and biological warfare stocks must be an international priority.'' L.A. Times, November 26, 1997, Secretary of Defense William Cohen under the Clinton administration.

Mr. Speaker, this next quote from former President Bill Clinton, I think, really speaks to it as much as any that we have given tonight, and here is the quote: ``In the next century, the community of nations may see more and more the very kind of threat Iraq poses now, a rogue state with weapons of mass destruction, ready to use them or provide them to terrorists, drug traffickers, or organized criminals who travel the world among us unnoticed. If we fail to respond today, Saddam, and all those who would follow in his footsteps, will be emboldened tomorrow by the knowledge that they can act with impunity, even in the face of a clear message from the United Nations Security Council and clear evidence of a weapons of mass destruction program.''

And what was done then, Mr. Speaker? It was just drawing lines in the sand and then another line in the sand and another line in the sand and a dare and a double dare and a double-dog dare, and nothing was happening to deal with this until, of course, we had to strike the strike on 9/11 that resulted in over 3,000 lives lost.

Mr. Speaker, continuing on the line of reason the gentleman from Michigan is presenting, again Secretary of State Madeleine Albright in 1998, in fact, November 23, and this was in Time Magazine: ``Up to now we've had diplomacy backed by force. Now we need to shift to force backed by diplomacy.''

And listen to what she says less than a month later: ``Month after month we have given Iraq chance after chance to move from confrontation to cooperation, and we have explored and exhausted every diplomatic action. We will see now whether force can persuade Iraq's misguided leaders to reverse course and to accept at long last the need to abide by the rule of law and the will of the world.''

These were remarks made by Secretary of State Madeleine Albright on the night of the air strikes, the very limited air strikes, against strategic targets in Iraq, her comments made December 16, 1998.

What happened over the next 2 years? Nothing. These limited air strikes did nothing, and Saddam continued with his weapons of mass destruction, his terrorism on his own people, his refusal to let the weapons inspectors come back into the country and make sure he was complying with the U.N. resolutions.

Mr. Speaker, if the gentleman from Michigan will allow me, I would just like to shift a little bit now and talk about the testimony and put it in the right, proper context that we are hearing from David Kay.

Well, Iraq continued to plan and sponsor international terrorism in 1999. Although Baghdad focused primarily on the anti- regime opposition, both at home and abroad, it continued to provide safe haven and to support various terrorist groups.

Many press reports stated that according to a defecting Iraqi intelligence agent, the Iraqi Intelligence Service had planned to bomb the offices of Radio Free Europe in Prague. Radio Free Europe offices include Radio Liberty, which began broadcasting news and information to Iraq in October of 1998. The plot was foiled when it became public in early 1999.

The Iraq opposition publicly stated its fears that the Baghdad regime was planning to assassinate those opposed to Saddam Hussein. A spokesman for the Iraqi National Accord in November said that the movement security organs had obtained information about a plan to assassinate its secretary general, Dr. Allawi, and a member of the movement's political bureau, as well as other Iraqi leaders.

Iraq continued to provide safe haven to a variety of Palestinian rejectionist groups, including the Abu Nidal Organization; the Arab Liberation Front, ALF; and the former head of the now defunct 15 May Organization, Abu Ibrahim, who masterminded several bombings of United States aircraft.

Iraq provided bases, weapons and protection to the MEK, an Iranian terrorist group that opposes the current

Iranian regime. In 1999, MEK cadre based in Iraq assassinated or attempted to assassinate several high-ranking Iranian government officials, including Brigadier General Ali Sayyad Shirazi, deputy chief of Iran's Joint Staff, who was actually killed in an assassination attack.

Well, Iraq planned and sponsored international terrorism in 2002, that is what they did. Throughout the year, the Iraqi Intelligence Service, IIS, laid the groundwork for possible attacks against both civilian and military targets in the United States and other Western countries. The IIS reportedly instructed its agents in early 2001 that their main mission was to obtain information about United States and Israeli targets. The IIS also threatened dissidents in the Near East and Europe and stole records and computer files detailing anti-regime activity.

In December of 2002, the press claimed Iraq intelligence killed Walid Ibrahim Abbas al-Muhah al-Mayahi, a Shi'ite Iraqi refugee who was living in Lebanon and a member of the Iraqi National Congress. Iraq was a safe haven, a transit point and an operational base for groups and individuals who direct violence against the United States, Israel and other countries.

Baghdad overtly assisted two categories of Iraqi-based terrorist organizations, Iranian dissidents devoted to toppling the Iranian Government and a variety of Palestinian groups opposed to peace with Israel. The groups include the Iranian Mujahedeen-e-Khalq and the Abu Nidal Organization, although Iraq reportedly killed its leader.

The Palestinian Liberation Front, PLF, and the Arab Liberation Front, ALF. In the past year, the PLF increased its operational activities against Israel and sent its members to Iraq for training for future terrorist attacks.

Baghdad provided material assistance to other Palestinian terrorist groups that are in the forefront of this intifadah. The Popular Front for the Liberation of Palestine General Command, Hamas, and the Palestine Islamic Jihad are the three most important groups to which Baghdad has extended outreach and support efforts. Saddam paid the families of Palestinian suicide bombers to encourage Palestinian terrorism, channeling $25,000 since March through the ALF alone to families of suicide bombers, both in Gaza and on the West Bank. Public testimonials by Palestinian civilians and officials and cancelled checks captured by Israel in the West Bank verify the transfer of a considerable amount of Iraqi money.

The presence of several hundred al Qaeda operatives fighting with the small Kurdish Islamist group Ansar al Islam in the northeastern corner of Iraqi Kurdistan where the IIS operates is well documented. Iraq has an agent in the most senior levels of Ansar al Islam as well.

In addition, small numbers of highly placed al Qaeda militants were present in Baghdad and areas of Iraq that Saddam controls. It is inconceivable that these groups were in Iraq without the knowledge and acquiescence of Saddam's regime.

In the past year, al Qaeda operatives in Northern Iraq concocted suspect chemicals under the direction of senior al Qaeda associate Abu Mussab Zarqawi; and they tried to smuggle them into Russia, Western Europe, and the United States for terrorist organizations and operations. Iraq is a party to five of the 12 international conventions and protocols relating to terrorism.

That is what Iraq has been doing in the year 2002.

I think what the gentleman so clearly pointed out is the previous administration made the case against Saddam Hussein. They made the case based on the intelligence that they were receiving at that time. What they did is they talked the talk, and we have spent some time here this evening giving you some quotes, various members, including the President, the Vice President, the Secretary of State.

Absolutely. The point I was going to make is they were willing, the previous administration, to talk the talk; but what they were not willing to do was to walk the walk.

This administration has walked the walk; and because of that, this world is a safer place with the capture of Saddam Hussein.

If the gentleman will yield further, one of the most preposterous facts is that during of the previous administration in the late 1990s, Osama bin Laden was offered up to our country, and we refused to accept him saying that he was not that much of a threat. We did not need him.

Mr. Speaker, I thank the gentleman for yielding. No question, when we keep drawing lines in the sand and making threats and dares and double dares, as was done by the previous administration, attack after attack after attack, the other side is rightly going to assume that you are just so much bluster, that you are no threat. So they continue in their terroristic ways, and that really is essentially what has happened. Thank God that this President, our 43rd President, George W. Bush, had the courage to finally say, enough is enough.

Well, no question. And of course it reminds me, thinking back, of I think it was the Clinton administration had decided that they wanted to have a nicer, a nicer, kinder, gentler intelligence agency; and anybody that was ever known to have jaywalked or spit on the sidewalk, they were not eligible to be an intelligence officer because they did not project that image.

I am going to tell my colleagues right now, it is clear that when the going gets tough, the tough get going; and we need tough people. And as the gentleman from Michigan was saying, we cut down on the number of personnel involved in intelligence operations and the kind of people that we need to deal with these people on an international basis. This is dangerous work, and we need tough, dangerous people to fight fire with fire. We did not have that in the previous administration.

Mr. Speaker, there is no question that I am sure there were no Eagle Scouts. When we are dealing with an international terrorist, a brutal, rogue dictator like Saddam Hussein and the terrorists associated with him, the only thing they understand is an eye for an eye and a tooth for a tooth. And it is like our military leaders have said many times in testifying before Congress, before committees, before the Committee on Armed Services, if the die-hards insist, they are going to die hard, and we have given it to them. I commend the President for that, and I think this world is a safer place because of it. It is not over, and we do not need to be thinking about an exit strategy until it is over. Our men and women deserve better than that. Many of them have paid the ultimate sacrifice, and they deserve a victory, and we shall have a victory.

Mr. Speaker, in regard to that, I just wanted to point out, and I started to mention this a little bit earlier, that Dr. Kay was a consultant to the Iraqi Survey Group. The Iraqi Survey Group is 1,300 individuals in Iraq continuing, as we speak tonight, continuing to look for weapons of mass destruction. The Iraqi Survey Group is not led by consultant Dr. David Kay; the Iraqi Survey Group is commanded by Lieutenant General Keith Dayton. Dr. Kay worked for General Dayton as a consultant, and General Dayton told a group of us when we were in Iraq over the Christmas season that Dr. Kay had been out of Iraq for over a month, and I do not think that Dr. Kay has been back in Iraq since that time.

So it is very possible that he does not actually know what the Iraqi Survey Group is doing and what they are finding right now. I will tell my colleagues one thing that they are finding. We talk about weapons of mass destruction. If we want to very narrowly define that as chemical weapons or nerve gas or biological anthrax, that is one definition of weapons of mass destruction.

But I am going to tell my colleagues, the ultimate weapon of mass destruction was found in Iraq; and he was in a little hole just south of Tikrit, and we got rid of him. And in the process of looking for these other weapons of mass destruction, what have we found? Hundreds, literally hundreds of mass graves with thousands, hundreds of thousands of people, his own people that Saddam had gassed, and also untold numbers of caches of weapons of conventional destruction. My colleagues tell me one of these road-side devices is not a weapon of mass destruction or a shoulder-mounted SA-7 rocket from Russia or a grenade launcher? Absolutely. We are finding and destroying as we continue to seek, and I truly believe that we will find those chemical and biological weapons.

Mr. Speaker, this is a comment, speaking of Dr. Kay's report, here is what Dr. Kay says, among many things that Dr. Kay is saying. There is something to link them, Saddam, to weapons of mass destruction, and that is the equipment. The equipment was on the prohibited list that had to be declared. The fact that they did not declare the equipment, not only did they not declare it, it was imported equipment. A lot of it we dated was imported from after 1998 in spite of U.N. sanctions.

He went on to say, another quote from Dr. Kay: ``We tend to, when we analyze a failure, look at our own failures and forget there is another side to the equation.''

Again, this is Dr. Kay: ``I am convinced the Iraqis tried to deceive us and, in part, they tried to deceive us and others into believing that they really did have those weapons.''

He went on to say, and again this is part of the Dr. Kay's report, ``The surprising thing we have found in the biological program is a vast network of laboratories. It is now over two dozen labs that were not declared to the U.N. even though they had equipment and were clearly conducting activities that were declarable. Now, quite frankly, we are not sure fully what they were doing right now. They had biological and chemical production equipment in them. Most of them are relatively small by historic Iraqi standards. They are mostly in houses and residential areas. Some are in business establishments. One was in a hospital. These are facilities that at the minimum carried out research and development and kept the scientific skill level.''

When you think about the fact that it took us months and months to find Saddam in the country, a country the size of California, buried in a six-by-three-foot hole south of Tikrit, and probably would not have found him without accurate, absolutely, the most accurate human intelligence, I do not think it is surprising that we are having difficulty finding these weapons of mass destruction.

There are any number of things that he could have done with them, from shipping them out of the country, to destroying them, to burying them, to putting them in very small vials. It does not take a footlocker to store some of these weapons of mass destruction. They are easily hidden.

So we need to keep looking, absolutely. The Iraqi Survey Group under General Dayton will continue that search.

Mr. Speaker, I come to the floor tonight in honor of the 93rd birthday of one of our greatest Presidents. Ronald Reagan was elected in 1980 on the promise of a new America. His fearless determination in the face of the Iron Curtain gave America the hope for a better tomorrow.

Reagan's vision inspired the promise of future leaders and guided our country away from big government, high taxes, and economic stagnation towards international strength and fiscal responsibility.

Born February 6, 1911, President Reagan studied economics at Eureka College, took a job as a sportscaster, and found his way to Hollywood where he appeared in 53 films. One of the most famous films was ``Knute Rockne--All American,'' where Reagan played legendary Notre Dame star George Gipp. ``Win one for the Gipper,'' Knute Rockne proclaimed as he inspired his players to defeat Army for their last and only one of the season. This line later became the campaign motto for our 40th President.

Reagan embarked on his journey into politics as president of the Screen Actors Guild, and he soon realized his talents were needed in the political arena. Reagan went on to become the Governor of California in 1966, campaigned for President in 1972 and 1976, and was elected President of the United States in 1980, winning 489 electoral votes.

Amidst high inflation at home and hostages abroad, Americans longed for renewal, sweeping Ronald Reagan into office. Sixty-nine days after his inauguration, Reagan was shot by a would-be assassin. As doctors rushed him to surgery, Reagan stated, ``I hope you are all Republicans,'' only to hear his doctor reply, ``Today, Mr. President, we are all Republicans.''

Reagan returned balance and exuberance to our government. Suddenly, there were two political parties working together towards meaningful legislation to renew our economy with tax cuts. Reagan's America was a place where all Americans were self-reliant. Reagan showed that big government was not the answer, but the problem. Reagan's agenda was to reduce the size of our government, cut spending, and reinvigorate our economy.

The success of President Reagan's economic strategy has given us direction on how to restore an economy recovering from a recession. In 1986, Reagan overhauled the income tax code, which eliminated millions of people with low incomes from the tax rolls. He knew that the best way to encourage economic growth was to give money back to the people. Reagan's tax cut sparked one of the most ambitious and fastest-growing economies in our history. We are beginning to see similar results under President Bush's tax cuts. Reagan proved that tax cuts could spark the necessary investment for a new economy.

In foreign policy, Reagan's motto was ``peace through strength,'' as he embarked on a quest to end the Cold War, reunite Germany, reduce nuclear arms, and fight terrorism. Reagan is credited for winning the Cold War and setting the stage for the fall of the Berlin Wall. Although the birth of America's new economy in the 1980s is his economic legacy, people that remember the Reagan era recall a spirit of patriotism like no other. People rallied behind the banner of American ideals in the face of Communism and international insecurity.

After the threat of terrorism in the late 1970s and early 1980s, our Nation needed a reason to feel unity and security. Reagan was there to lend his wit and his hope in our Nation to all Americans. He gave us hope and promise when we needed it most, and Reagan's true legacy is the restoration of the dream that is America.

Happy birthday, Mr. President.

I thank the gentlewoman for yielding me this time.

Mr. Speaker, I want to remind my colleagues from the other side of the

aisle that just as in childbirth, our labors in the Congress often start in the morning sunshine and after long hours of painful work in the full light of day then result in a delivery of a beautiful baby in the dark of night. Had this debate commenced in the dark of night, then the delivery would no doubt have been in the light of day.

In any regard, Mr. Speaker, in passage of the Medicare Modernization and Prescription Drug Act of 2003, this President and the leadership of this House have delivered on a promise made to our beloved seniors. Indeed, Mr. Speaker, we, the Republican majority, are the promise keepers on this issue. I am proud to have voted as a physician Member of this body in the affirmative.

The gentleman from South Carolina talked about hearing from his constituents. Mr. Speaker, I have heard from my constituents as well, things like is it true that in this bill the neediest of our seniors, those who are living at or near the poverty level, are helped the most? Is it true that the new Medicare beneficiaries will begin to receive for the first time ever a complete physical examination? Is it true that in order to help save Medicare for our children and grandchildren, the wealthiest seniors will have to pay for the first time more of their part B premium? And finally, Mr. Speaker, is it true that it has taken 38 years to finally provide seniors with prescription drug coverage?

I answer to those seniors a resounding guilty as charged. I am proud of this bill. I thank the gentlewoman for giving me the opportunity to speak.

Mr. Speaker, I rise today in support of the rural package provided for in the House-Senate Medicare agreement. The package corrects existing inequities for rural and small town hospitals and providers by equalizing the disproportionate reimbursement payments they have been experiencing in the past.

Rural hospitals' base payment rate will be permanently extended by 1.6 percent to match the urban hospital payment rate and the amount of disproportionate share payments will be more than doubled to 12 percent of total Medicare inpatient payments.

The bill additionally pays cost plus 1 percent to the Critical Access Hospitals to ensure that they can improve access and services.

And that, Mr. Speaker, is exactly the purpose of the rural package: To provide immediate help to rural area and small city hospitals so that they can provide sustained access and quality service to their patients.

Our seniors deserve nothing less than that, and I urge my colleagues to vote in favor of our Nation's rural hospitals. Pass the Medicare conference report.

Mr. Speaker, I thank the gentlewoman from Ohio for yielding me this time, and I promise to tone down the rhetoric just for a couple of minutes.

Mr. Speaker, I rise today in support of the rule for the Medicare agreement. Today, we face a Medicare reality, a reality that requires change, reform, and willing leadership.

Though not a perfect solution, the Medicare agreement is a big step in the right direction, a step in the right direction by providing our seniors with

assistance to pay for the rising cost of prescription medications, medications that will help them live longer and help their lives; a step in the right direction by supplying appropriate reimbursement updates for hospitals, and updates to ensure that hospitals sustain the ability to provide needed goods and quality services for their patients; a step in the right direction by blocking the proposed cut in Medicare reimbursements to physicians and, instead, provide a positive update, reimbursements that will allow physicians to properly serve their patients and curb the trend of reduced access.

I urge my colleagues to take this step to help our seniors, our hospitals, and our physicians and adopt this rule so we can pass the Medicare conference report.

Mr. Speaker, I rise tonight in support of the House- Senate Medicare agreement. For those of us who had hoped that this bill would contain more reforms or greater cost constraints, I agree. We did not accomplish all that we had hoped. But as a physician, I realize the medical reality of the bill, a medical reality that the prescription drug benefit itself is fiscally responsible and a potential cost-saver for Medicare.

By providing a prescription drug benefit, providers will be able to take the necessary preventive action to potentially stave off or treat an illness in an earlier stage, making it easier to control the cost of treatment.

The medical reality is that prescription medication can help seniors live longer, healthier lives, while saving a tremendous amount of money on treatment by avoiding costlier options.

Although I hope the future will bring about more changes and modernization to Medicare, the Medicare agreement will be a great start. And I urge my colleagues to take this fiscally responsible step and pass the Medicare conference report.

Mr. Speaker, I thank the gentleman from Louisiana (Mr. Tauzin) for yielding me this time.

Mr. Speaker, 35 million senior Members of AARP, 330,000 physician members of the American Medical Association who are providing care to hundreds of millions of Americans and 40 million Medicare beneficiaries, the American Hospital Association, the Rural Hospital Association, the United States Chamber of Commerce; Mr. Speaker, with so many for a prescription drug and Medicare modernization for our beloved seniors, who could be against it, and why?

The answer to that first question is pretty obvious, obstructionist Democrats. And why? Because they are more interested in attempting to embarrass President Bush and the Republican leadership of this House than they are in doing the right thing, the compassionate thing.

To suggest that this bill is nothing but a windfall for the pharmaceutical industry is like suggesting that Medicare Part A is nothing but a windfall for the hospital. Who is going to provide the prescription drugs, the chocolate chip cookie company? Give me a break.

But I say to my colleagues on the other side, stop the alliteration, stop the bizarre logic, the Mediscare rhetoric. Vote with us, vote for our seniors and make this truly a bipartisan victory.

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

Mr. Speaker, once again we are debating a motion to instruct Medicare conferees. I find it odd that we are doing so after a bipartisan group of Medicare conferees has reached an agreement that has been strongly endorsed by numerous organizations, including AARP and 35 million seniors.

This motion to instruct conferees, as the gentleman from Florida (Mr. Bilirakis) said, like so many that the minority has offered before, serves no useful purpose in this debate. It is a solution in desperate search of a problem. They are simply political tools used in a desperate attempt to divert attention away from the fact that the Republican House will, in a matter of days, deliver on its commitment to providing seniors with access to meaningful, affordable, and comprehensive prescription drug coverage.

Mr. Speaker, I support properly reimbursing physicians and hospitals. The House bill does that, as does the bipartisan Medicare conference agreement, which is why it is supported by a number of organizations, including the American Medical Association, the American Hospital Association, and the Federation of American Hospitals.

I also believe it is a false choice to suggest that we need to choose between properly reimbursing providers and finding a way to ensure Medicare's long-term financial viability, because this bill does both. The AMA agrees with me, and here are some of its thoughts on a motion that was offered earlier this week by the gentlewoman from Nevada (Ms. Berkley).

``The American Medical Association strongly supports passage of the Medicare prescription drug conference report, which currently includes historic and critical provisions for improving choice and access for Medicare seniors and disabled patients.

``In addition, the conference report would halt 2 years of impending Medicare payment cuts to physicians and other health professionals and replace these cuts with payment increases of at least 1.5 percent per year.

``Because the Medicare conference report includes these critical provisions for improving choice and access, the AMA strongly opposes the Berkley motion to instruct and urges Congress to pass the pending Medicare conference report before they adjourn.''

Let me just say this, Mr. Speaker. If the gentleman from Washington is serious about wanting to help our Nation's providers, let me suggest and urge to him to reconsider his opposition to medical liability reform legislation, tort reform, such as H.R. 5, the HEALTH Act, a bill that was strongly supported by the American Medical Association. Mr. Speaker, I am sure that the physicians in the State of Washington would be very appreciative of that support.

While we should all be pleased about the fact that we are about to provide our seniors with Medicare prescription drug coverage, I would note for my colleagues that spending on Medicare is projected to nearly double over the next decade just as our baby boomers begin to retire. Social Security, Medicare and Medicaid currently comprise more than 40 percent of the Federal budget. By the year 2030, the General Accounting Office estimates that these three programs, once again Social Security, Medicare and Medicaid, could consume 75 percent of the Federal budget if we make no changes and we keep Medicare as we know it. This level of entitlement spending is unsustainable and it will crowd out other essential functions of government. Reforms must be made to ensure that Medicare continues to exist for future generations, the children and the grandchildren that the gentleman from Washington was talking about. As we add a $400 billion drug benefit to a program that already has $13 trillion in unfunded liabilities, we must enact real reforms that will place the program on sound financial footing for the future.

To modernize Medicare and ensure its long-term fiscal viability, the bipartisan Medicare conference agreement will provide for a limited pilot project that will help test to see if the competitive reforms included in the House bill will help to ensure the long-term viability of this program. Under the bipartisan Medicare conference agreement as under the original House-passed bill, seniors retain complete freedom to choose a private plan or remain in the traditional as we know it fee-for-service program. Medicare will continue to offer every beneficiary with access to Medicare's defined benefit.

Mr. Speaker, I strongly support the bipartisan Medicare conference agreement which we will soon consider on the House floor. This motion to instruct no longer serves any purpose and the gentleman from Washington knows that. Indeed, the provisions relating to Medicare competition that the gentleman references in his motion are not even part of the final conference report.

I urge my colleagues to join me in rejecting this motion to instruct and supporting in a bipartisan fashion the final Medicare conference agreement.

Mr. Speaker, it is good to be back tonight to talk on an issue that is really very, very dear to my heart. We have got an exciting day. In fact, I do not think I could even, though it is a late hour, I do not think I could go home and sleep tonight in anticipation of a historic moment tomorrow when we will finally deliver on a promise that has been made to our seniors, and that is a prescription drug benefit under Medicare.

Mr. Speaker, I would like to start out by maybe addressing some of the remarks that I just heard made from the other side, and it is the kind of remarks which I would really refer to as ``Mediscare'' comments. I just heard the gentlewoman from Texas refer to the government not being able to set prices. I think that is exactly what the Democrats tried to do in 1993 under ``Hillary care.'' They wanted the government to set prices. They wanted a one-size-fits-all, essentially a national health insurance program, and the people of this great country rejected that.

Another comment I have heard them say just repeatedly is this business about, well, who is going to benefit from this prescription drug availability for our seniors, who is going to benefit the most, and they keep saying, well, it is the drug companies, the evil, greedy drug companies. Well, of course, no duh. Who makes the drugs? Who has made this country the greatest Nation on Earth in regard to having access to life-saving drugs? The pharmaceutical industry. Who do we expect? Who does the other side expect to provide these drugs? The chocolate cookie company or the potato chip factory? No, it is the pharmaceutical industry, of course.

Did they say the same thing in 1965, 40 years ago when Medicare was first enacted, that gosh, you know, we cannot do this, this program because who is going to benefit the most from Medicare part A, the evil hospitals, the evil skilled nursing homes; or who is going to benefit the most from Medicare part B, the doctors? Absolutely the doctors. They are the ones that provide health care.

So this argument about the drug company being the big beneficiary, it is absolutely bogus. Sure they are going to provide drug coverage, sell more drugs certainly, but the price of those drugs, Mr. Speaker, is going to come down. Their profit margin per sale is going to be drastically reduced. So, again, we hear these arguments over and over again, and it truly is nothing but ``Mediscare.''

Another argument we hear, and we have been hearing it today, we will probably hear it all day tomorrow and as long as this debate goes on, is the

Republicans want to take Medicare away; they want to destroy Medicare as we know it. Of course, they like to throw in the infamous ``P'' word. As far as destroying Medicare as we know it, let us talk just a little bit about Medicare as we know it and what my seniors in the 11th Congressional District of Georgia have told me about Medicare as we know it.

It is a good program. It served us well, but it is not 21st-century medicine; and I say that, Mr. Speaker, because, first and foremost, there has never been a prescription drug benefit under Medicare. There has really never been any real meaningful, preventive care under Medicare. It is all episodic. If you get sick, you get to go to the doctor, and the visit is paid for. If something catastrophic happens to you, like a heart attack or a stroke, you get to go to the hospital, and you certainly have the benefit of that hospital stay. If you have a family history of heart disease or you have high cholesterol and you develop coronary artery disease, sure, you get admitted to the hospital; and there is some coverage for you to have that open heart surgery.

It is the same thing for a diabetic patient who unfortunately under Medicare, many of those patients cannot afford to buy their insulin, cannot take their medication, glucophage, something to lower that blood sugar, to keep that disease under control. So they end up going to the hospital; and, yeah, it is paid for, if they have to have a leg cut off or they have to go on dialysis for years because of end-stage renal disease that probably would not have occurred if that diabetes had been checked with timely medication.

So when my colleagues talk about destroying Medicare as we know it, I want to just say to my colleagues on the other side of the aisle and who are opposed to this bill in contradistinction to the opinion and the feeling of 35 million seniors who are members of the American Association of Retired People, the AARP, of which I am proudly a member, they can talk all they want to about burning their membership cards and sounds like back in the 1960s, the people burning their draft card or burning the flag. I mean, if they want to do that, that is fine, but I will guarantee my colleagues that the seniors in this country respect that organization, as we all do and should, because they have certainly delivered for seniors and have a proven track record, and we are not talking about an organization, Mr. Speaker, that is necessarily a bastion of conservatism, that is known for their deep and unending support of Republican issues. That is not true at all. We all know that. The other side knows that, but they are talking about again ``Mediscare,'' trying to scare people when clearly what we are trying to do is not destroy Medicare, but just improve it, improve it with a prescription drug benefit that is long overdue.

The other way we are going to improve it, Mr. Speaker, is we are going to finally put some emphasis on preventive care. We are going to give our seniors a chance to get into a managed care system, an HMO or a PPO, really very similar, in fact, exactly what 435 Members of this House of Representatives and probably 100 Senators in other Chamber, the kind of health care they have. It would be interesting to take a poll and see what they do have. I will guarantee my colleagues, it will be 95 percent or higher have that kind of a coverage where they can go in or their wives or their spouse can go in and have screening tests done for high cholesterol, elevated lipids, osteoporosis screening, colonoscopies, timely mammograms. These are the kinds of things that until just recently none of that was covered under Medicare as we know it, and there still is not really any catastrophic coverage for part A and part B.

Unfortunately, a senior goes into the hospital in any one episode of illness and can only stay a certain number of days. There is a very high copay, but once you have exhausted those days in the hospital or, God forbid, in a skilled nursing home, it happens so often, if a patient has had a stroke, then what happens to our seniors who have worked all of their lives to save up and hope and pray that they will be able to leave a little something to their children or more likely their grandchildren, so that their lives would be a little easier? For the seniors to lose all of that and end up in poverty and end up basically as a ward of the respective States because they have gone broke because of a long stay in a hospital or skilled nursing home, Mr. Speaker, there is something wrong with that picture.

Democrats on the other side of the aisle, they can complain all they want to and try to scare our seniors and talk about taking away Medicare as we know it. We are not taking away Medicare. Traditional Medicare, fee-for-service, that option will remain. It will be there for our seniors, and I am sure there are some that kind of get used to the old system, and they may not want to change. I think we all understand that. Do not for a minute think that they will not have the option to also get this prescription drug benefit if they stay in traditional Medicare.

That is what the other side is trying to do. They are trying to scare seniors into thinking that if they do not move into managed care or Medicare+Choice or advantage type program, that they will not be eligible; they will not get the prescription drug benefit. Mr. Speaker, we know on this side of the aisle, we absolutely know that that is not true.

Again, this is one of the greatest times of my life, and I am so much looking forward tomorrow to this historic piece of legislation and voting enthusiastically for it and for its passage. Make no mistake, I feel every confident that it will pass, and I think at the end of the day we are going to have our colleagues from the other side, no, not all of them, but I think this will be a bipartisan-supported bill because I know that they love the seniors as much as I do.

I am often asked in the districts, Dr. Gingrey, you had a great medical practice and you delivered all those babies, and do you miss it? The answer is, of course I miss it, absolutely. In fact, just yesterday on the floor of this House, my cell phone rang on the silent mode, on the vibrate mode, and I went out to take the call, and it was from the husband of one of my patients whose two children I had delivered. She is now pregnant with their third in about 8\1/2\ months and was starting to have some problems, and he just wanted to call Dr. Phil, even though she has got a great doctor, one of my former partners, back home in Marietta, Georgia. I talked to him, an old friend and a patient about his wife. It, of course, made me realize once again how much I do miss that, but this opportunity to come to the Congress of the United States, this 108th Congress and be a part of this great body and have an opportunity tomorrow to cast a vote, to give finally a prescription benefit and to modernize Medicare for 40 million seniors, a third of whom are probably living right at or below the poverty level, who have nothing, nothing, Mr. Speaker, to live on other than Social Security and no health care except basic Medicare. They cannot afford Medigap or their former employer did not offer a health care plan.

So that is what it is all about. That is why I am so excited to be here, and even though I miss my practice, I feel in many ways that this is a high calling, and I am really proud to be here, proud of being part of this majority and working with the leadership of this Congress, with our great Speaker and our great leader and answering the call of President George W. Bush when he said, Men and women of the Congress, we have got to keep this promise.

We tried so hard last year to do that, tried so hard to pass this bill last year, and it did pass the House with the Republican leadership, but what happened on the Senate side? It gets over to the Senate where the Democrats had control, and again, I heard one of my colleagues just a few minutes ago talking about, well, we need to send this bill back for more study, it needs more study. Well, we can study things to death. That is exactly what they did last year. They studied it to death, and we had no bill until we finally now have the leadership in both the House and the Senate, and I think we are going to get the job done this time.

It is like the president of AARP, Mr. Bill Novelli, said, We cannot wait for a perfect bill. There are no perfect bills. Seniors need our help now. They have been needing it for a long, long time.

And this business about waiting for the perfect bill is a total farce. This is

a good bill. It is not perfect, but it absolutely is a good bill.

Mr. Speaker, I would now like to yield to one of my colleagues and good friends, the gentleman from Colorado (Mr. Beauprez), who has worked very hard on this bill, and I know he is just as excited about its impending passage as I am.

Reclaiming my time, Mr. Speaker, for just a moment, I wanted to touch on that point and maybe get the gentleman to elaborate, because I think he really, really hit the key point here, and that is that the major emphasis, as we understand the bill, the major emphasis is on those who need it most.

Well, Mr. Speaker, I appreciate the gentleman stating that, but, of course, it works both ways, and the gentleman from Colorado is a former farmer and very successful banker and successful businessman. Of course, we physicians need to understand that we are businessmen and women, but far too few of us do understand that.

I will be glad to answer any questions on the medical issues that the gentleman might have, but I am going to ask him some business questions, particularly in regard to the health savings accounts. And he knows a lot about that, having employed a lot of folks. But, yes, I will be happy to respond to any questions the gentleman might have on medical issues.

Well, the gentleman is so right, Mr. Speaker, and physicians who take Medicare patients really do so out of great compassion. I do not think they would be doctors if they did not love people and want to care for them. But, of course, as I just mentioned a few minutes ago, they are businessmen and women and they have got practice overhead, not the least of which, as the gentleman knows, is the high cost of malpractice insurance.

We tried to address that issue, did we not, earlier, way back in February or March; trying to get some meaningful tort reform; just trying to balance the playing field? And we got practically no help from the other side. And with those kinds of escalating expenses and decreases in Medicare reimbursement, as the gentleman knows, I think the physicians were scheduled in 2004 and 2005 to take another 4.5 percent cut in Medicare reimbursement for each of those 2 years, on top of what has already happened in a downward trend when their practice expenses are going up.

I have often said to people that ask me about this, the excitement about getting a prescription benefit under Medicare, and the reason why we cannot just do that as a stand-alone part D of Medicare, if you will, run by the government and price setting by the government, the reason we cannot do that is because we just cannot afford it. We

literally cannot afford that. And if we do that, and we continue to cut the reimbursements to the physicians, what will happen is there will be no physicians out there, except in Medicare patients.

The primary care physicians, the general internists, and these are the physicians who are on the lowest income scale of our profession, they are just going to throw up their hands and say we cannot continue to lose money doing this, and all of a sudden our patients, our seniors, have prescription benefits but nobody to write the prescriptions.

So I am so glad the gentleman asked the question, because in this bill that is part of the modernization piece. We are going to make sure that we keep these doctors in the system.

Are they getting rich off of Medicare patients? Absolutely not. The other side wants to suggest that there are winners and losers in this modernization of Medicare and the prescription drug benefit. I suggest to them that we are all winners. Very modest winners. The major one, of course, as it should be, are our seniors, and especially our neediest seniors.

Well, Mr. Speaker, the gentleman is asking a great question. And, of course, what they are saying too, as the gentleman from Colorado has asked, is what is it going to do; what is this bill going to do to their patients? Not so much their bottom line, but the patients who are stricken with cancer.

And, of course, a lot of those cancer patients have been here, have been to Washington, and some of them, God bless them, in the midst of their chemotherapy; having lost their hair and maybe not looking as good as they would like to look physically. They got on that plane, flew up to Washington, and a lot of them came along with their doctors and talked to us about that. They wanted to make sure that we understood that, yes, they agree that certain changes needed to be made in regard to how they were reimbursed for cancer care, but they wanted to make sure, though, that they could keep their offices open and continue to provide that community cancer care. Because if they could not, if they had to close their doors and be denied the opportunity to see those patients, where would they go? Would they go back to the hospital? I am not sure. I think it is very likely that many of them would not get care; would not get care in a timely fashion.

So we have worked very closely with and we have listened to these patients, patients suffering from leukemia and breast cancer and bone cancer. We know, of course, that today there are medications that in some instances can yield a long remission for these patients and, with the help of God, occasionally a cure. Here again, years ago, when Medicare first started, there was no cancer chemotherapy. That just did not exist. And it would be a shame today if one of these seniors who is receiving chemotherapy, and that is actually one of few drugs that is covered under current Medicare Part B, because it is administered by a physician in an intravenous fashion, but if we did not have these kinds of benefits, what would happen? These patients would die, pure and simple.

So we have listened to the doctors, we have listened to their patients, and the answer to the question the gentleman from Colorado is asking is, I think they are pretty satisfied. They are going to take a significant hit on this bill, but I think they understand that for the overall good, for the greater good, they are willing to make those sacrifices. So I think they are going to be fairly pleased with the bill.

Mr. Speaker, I am glad that the gentleman asked about that because in the hospital payment system, there has been this disparity for a long time. The rural hospitals and the rural physicians, those doctors who are practicing in an area outside of a metropolitan service area or a big city, they are reimbursed for the exact same service at a lower rate than a doctor who might be practicing in Boston or Atlanta or Denver, and there is just something wrong with that system. Again, that has been addressed.

In fact, if the gentleman will allow me to read here, there are hospitals referred to as disproportionate share facilities, by that I mean a disproportionate share of Medicare and Medicaid patients in their population. Some of these hospitals are in small towns, and I know in my district and probably the gentleman's district, but I know for sure in southwest and northwest Georgia, the 17 counties that I represent, in some of the towns in the county, the hospital is the major employer in town. It is the only source of revenue and health care. When they are seeing mostly Medicare and Medicaid patients, and there is not much industry so there is not much good, private health insurance, they do not have full pay rather than deeply discounted pay that we have under Medicare and Medicaid, and if we continue to treat them in an unfair manner, not only does health care go away, but jobs go away as well.

Here is one thing that I wanted to read in regard to what we are doing about this problem: ``The bipartisan agreement modifies Medicare's payments for those hospitals that furnish care to a disproportionate share of low-income and uninsured patients. Currently, the disproportionate share hospital adjustment paid to rural and small urban hospitals is capped at 5.25 percent. The bipartisan agreement increases the rural and small urban cap to 12 percent.''

As Members know, the gentlewoman from Connecticut (Mrs. Johnson) is the chairman of the

Subcommittee on Health on the Committee on Ways and Means. What many Members may not know is her husband is a retired OB-GYN physician. She is very knowledgeable about this issue. I have told Members if they do not understand the bill, and it is 1,100 pages, parts of it are arcane, and it is not necessary for every Member to understand every bit of minutia, but of course they need to understand the things that are important, and the gentlewoman has been a great resource to me.

In regard to medication, let me get personal. I had open heart surgery right after I won my election, just a month before we were sworn in. I think back and wonder if a senior, I am not there yet, I am getting pretty close, but if a senior at age 65 who was used to managed care and that attention, which has been described as prevention, not just episodic, let us say that they had the same kind of coverage that most Members of Congress have today, all of a sudden they turn 65 and Medicare, as we know it, and we have heard it before, we will hear it tomorrow, I am sure, and Medicare as we know it is taking over their care, and they have been on a cholesterol-lowering drug, we call them statins, or maybe they have been on something to prevent osteoporosis, and then all of a sudden they do not get that. All of a sudden they are on Medicare, and Medicare is primary. They do not have Medigap. Their employer did not give them health care in their retirement, and all of a sudden they are on Medicare and they have no coverage. Those are the very patients that were getting the benefit of the drug for osteoporosis prevention or to lower cholesterol. I am telling Members within 5 to 10 years, they will end up with coronary artery blockage. And when they go in the hospital then, sure, it will pay for open heart surgery. Or if they fall and break their hip and have an extended stay in the hospital, it will pay for that, but who wants that? That is why I have said a lot of times about this bill in commending the President for bringing this to us, this is compassionate conservatism, and I emphasize compassionate in its finest hour.

Mr. Speaker, that is exactly right. The gentleman was talking about rural hospitals, and we talked about the disproportionate share, and I explained that, but let me just read a letter that was written to our Speaker from the Rural Hospital Coalition in regard to the gentleman's question earlier: `` Dear Speaker Hastert, The Rural Hospital Coalition, which is comprised of more than 150 rural hospitals in America, applauds your leadership in working in a bipartisan fashion to achieve a compromise Medicare bill. We support your efforts to modernize Medicare and give senior citizens a prescription drug benefit that they deserve.

``Most importantly, this bill strengthens health care in rural America. For that alone, you should be proud.

``We urge all Members of Congress to support the compromise Medicare Prescription Drug and Modernization bill. It reforms a Medicare system that has for far too long reimbursed rural hospitals at a lower rate than their urban counterparts for the exact same services. Passage of this conference report will give rural physicians, nurses, clinics, and hospitals a fair shake when it comes to the Medicare payments. It will create a financially stronger hospital for rural communities, provide more jobs, and provide more services.

``Thank you again for your leadership to get this legislation this far. The Rural Hospital Coalition appreciates your strong leadership on rural health care issues and looks forward to working with you to see it is enacted into law in the very near future.

``On behalf of the Rural Hospital Coalition, sincerely yours, William F. Carpenter, senior vice president.''

This is really exactly where we are. And I said when we began our colloquy that I wanted to ask the gentleman from Colorado (Mr. Beauprez) an important question as well. As a businessman, having been in the banking business and very successful in what he does, I wanted to get his opinion about the health savings accounts. There are a lot of things in this bill that people do not want to talk about; they do not want to talk about the good. They want to just kind of confuse folks with, as I say, ``Mediscare'' rhetoric; but there are so many things in this bill, we could probably talk about it for 2 hours. But would the gentleman tell us a little bit about health savings accounts and what he thinks that will mean to the uninsured in this country.

Mr. Speaker, it is my understanding too that in these accounts, that money that the gentleman described is growing at compound interest, the tax on that is deferred, and that this money of course can be used, as I understand it, for anything related to health. I mean, it can do the things that a lot of people are now spending money on for the so-called Medigap insurance. It could take care of that. It is my understanding also that one could pay for long-term care, to purchase a long-term care policy out of that account. Is that also the gentleman's understanding?

Mr. Speaker, as the gentleman points out, we are saying that this Medicare Prescription Drug and Modernization conference committee report of 2003, which we are going to vote on tomorrow, it is not just to the benefit of our seniors. Of course that is very important to provide this prescription drug benefit, as the gentleman pointed out, especially to the neediest. But it helps our younger workers as well, does it not? I think there are maybe 40 million, maybe it is 43 million now uninsured. I started to say unemployed, but the truth is 65 percent of the uninsured, no health insurance, are employed. They have got jobs. They are working hard. They go to work every day. But their employer, maybe it is a small shop, five, 10, 15 people, they cannot go out in the marketplace and afford to buy that policy, that first dollar coverage or $500 deductible. It is just too expensive, and they cannot individually afford to do it either.

But this opportunity the gentleman describes is going to be a tremendous help to our workers at whatever age and, finally, they are going to get an opportunity to get health care. As the gentleman pointed out, or I heard someone say earlier in the week that in the history of the rental car industry, nobody has ever paid to have their oil changed. And, of course, what they are implying is that if you do not have some ownership, you are not going to be as good a shopper, you are not going to do the due diligence, you are not going to take care of yourself quite as well as if it is your money and it is growing and it is in that account, and you know that later on you might need that for, as the gentleman pointed out, long-term health insurance. So you are going to shop. You are going to go out in the market. You are going to make sure that you find the best doctors and the best hospitals. And just because they are lower-priced, that does not mean they are not good. In many instances, lower is better.

Of course, certainly.

Mr. Speaker, absolutely. The gentleman is asking about the choice issue, and that is what is so important.

Mr. Speaker, back in 1988, we were not here. We just got here as freshmen. But I do remember when there was some attempt to include catastrophic coverage under Medicare. I think that was an important thing to look at. But the mistake that Congress made at that time is they passed a law that included, for the first time, catastrophic coverage. But there was no choice. All seniors had to have that coverage. Their Part B, Medicare Part B premiums just went through the roof. And there was much, much concern about that. We learn lessons.

This program, this Medicare modernization and prescription drug program, is all about choice. It is all about choice. In fact, a senior, and I am sure some will, will decide to stay in traditional Medicare, something they have been used to; maybe they turned 65 20 years ago and they just do not want to go to the trouble, if you will, and get out of their comfort zone. They may decide not to even take the prescription drug benefit. Certainly they can; they have that option, as well as the option to remain in the Medicare fee-for-service, the traditional Medicare program.

But as the gentleman points out, and I am so glad he asked the question, it is all about choice. We know that a third of our 40 million plus Medicare beneficiaries, they do not have any health insurance. They do not have that employer plan. They are not retired military. They do not have Tricare. They cannot afford Medigap insurance. Their only income is a Social Security check, and their only health coverage is your basic, traditional fee-for-service Medicare.

So we are giving them the opportunity, and I think under the circumstances it is so important that the gentleman brings that up. That is what is going to make this program so successful. It is not a one-size-fits-all. We are not forcing anybody into anything.

Now, certainly, I would love to see seniors, and when I turn 65, I am going to look very carefully at a managed care, Medicare advantage where I know that I can go and get disease management benefits and a lot of screening for things and, hopefully, some catastrophic coverage.

So the gentleman is absolutely right. The keystone of this thing is choice, from start to finish.

Mr. Speaker, I thank the gentleman from Colorado for being with us and helping to bring a little bit sharper focus on this bill. Because our seniors need to know, they need to be well-informed, and I think they are going to feel a lot better, those who have a little insomnia tonight and maybe had an opportunity to watch this late-night show on the medicare modernization and prescription drug act.

Mr. Speaker, there are so many people that are supporting this bill, so many organizations. As I mentioned earlier, the AARP and 35 million seniors; the American Medical Association, which represents 330,000 physicians. But even more important than that, they treat 280 million Americans and lots of seniors.

Listen to this letter. I want to real briefly read this letter. Real quickly, this is one from the United States Chamber of Commerce. Here is what they say:

The United States Chamber of Commerce applauded word that House and Senate leaders, along with the administration, have reached an agreement to bring a Medicare conference bill to the floor for a final vote. Quote: ``With employers being the source of retirement health care for 12 million seniors, it is critical this bill allows businesses the flexibility to integrate the new prescription drug benefit to their existing retiree health benefits, while allowing opportunities to partner with Medicare. The Chamber is pleased this bill is nearing final approval and welcomes

congressional and administration action to modernize the Medicare program and ensure its long-term viability for future generations. The final Medicare conference report is expected to include significant reforms to modernize the Medicare program structure and delivery system by emphasizing quality care, establish a much-needed prescription drug benefit, and offer preventive health care services and disease management.''

Mr. Speaker, in conclusion, as I said last night, this bill, this bipartisan effort; and yes, it is bipartisan, and we will have support on both sides of the aisle, this is all about compassion. We hear concerns about cost and certainly we are all concerned about cost and wanting to keep that down as much as we can. But this $400 billion new benefit under Medicare, I say this: it is going to only cost $400 billion if it does not work, and this is what I mean by that. You spend the money on taking timely prescription medications, and some of our neediest seniors need three or four pills a day, could be spending $600, $700 a month on prescription drugs. But if that will keep them out of the hospital, if that will prevent them from having a stroke; we heard earlier tonight from the Congressional Black Caucus talking about the fact that African Americans are more prone to have high blood pressure. Well, they ought to be so enthusiastic about this bill, we ought to have 100 percent support from the Congressional Black Caucus, because it is true, it is true that they suffer, particularly African American males, more from hypertension. And what happens? They end up in too many cases, far too many cases suffering from a stroke. What kind of life is that, no matter how long they live after, possibly not able to move one side of their body or utter a word.

So as this President has said to us, Mr. Speaker, this is all about compassion and caring, and caring for the most precious seniors that are so important to all of us. So, yes, I am very excited. I will probably leave here in a few minutes and go home and lay awake for another couple of hours because I cannot wait to vote for this bill tomorrow. I am an OB/GYN physician, and I want to be able to say to my constituents and to the seniors of America, The real Dr. Phil, he delivered.

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

Mr. Speaker, I rise today in support of the market basket update to hospitals provided for in the House-Senate Medicare agreement. This legislation will supply a full update for hospitals that submit data for a set of 10 quality indicators.

Those hospitals that do not submit data would receive updates of 0.4 percent less than the market basket level.

It is imperative that our hospitals and especially, Mr. Speaker, our rural hospitals receive this full update in order to ensure that they maintain the ability to provide needed goods and services.

I stressed the importance of this issue by offering a letter to the Medicare conferees urging them to reject the proposed market basket reduction to hospitals and ensure that the final Medicare legislation delivers unfettered improvements for rural health

care and a full market basket update for hospitals. Over 120 of my colleagues joined me in that effort.

I urge my colleagues to continue to back this provision in the final version of the bill and show support for our hospitals by its passage.

Mr. Speaker, I want to thank my colleagues on this side of the aisle for joining with me tonight in discussing over the next hour one of the most important issues to come before this great body, this United States House of Representatives, probably in the history of the Congress, and I am talking about, Mr. Speaker, the impending passage of the bipartisan Medicare Prescription Drug and Modernization Act of 2003.

Mr. Speaker, Medicare is a good program. Medicare had done a lot of things since its inception, of course, when it was first put into place almost 40 years ago, but it is not perfect. Medicare, although it is a good program, is not perfect. Two of the main problems, Mr. Speaker, with Medicare are these: number 1, it has never had a prescription drug benefit. Yes, it covers

hospital expenses. Yes, it covers major surgery and, certainly, it allows some time to be spent in a skilled nursing home if that is necessary. But it has never had any emphasis on preventive therapy which, of course, is what prescription drugs is all about.

Now, maybe back in 1965, when I was a freshman in medical school, we were not prescribing as many drugs. There were not as many lifesaving drugs on the market. In fact, back then, there was a penicillin antibiotic if you had an infection. There was a heart medication called digitalis if your heart was not beating properly. There was maybe codeine if you had a bad headache. But there were not the lifesaving drugs that are available to us today in the 21st century.

Medicare also does not do anything about preventive care, and there is no catastrophic coverage, Mr. Speaker. Under part A of Medicare, after a patient has expended a certain number of days in the hospital for a covered illness, then everything is out-of-pocket, and the same is true for an extended stay in a nursing home. That is why so many of our seniors find themselves in their twilight years having to go on Medicaid, having to become literally wards of the State because of this lack of catastrophic coverage.

So, Mr. Speaker, the main two problems have finally been addressed in the Medicare Prescription Drug and Modernization Act. We are finally going to deliver on a promise to our seniors and include under Medicare a prescription drug benefit, and also make sure that our seniors have an opportunity to get the preventive care and disease management they need.

Mr. Speaker, not covering for a prescription and covering for major surgery is really akin to having a service contract on your car that covers to have the transmission replaced, but not to have the oil changed. It makes absolutely no sense. So finally, Mr. Speaker, we have come to the point in the history of Medicare where we have got to change, we have got to bring it into the 21st century.

Other people, Members of Congress, the health coverage that we have, has a strong emphasis on prevention and wellness and, in the long run, this is less expensive. Certainly, managed care understands that, that it is in their best interest to keep people healthy. When we think about it, so many of us; in fact, most of our citizens who are on that type of plan, including probably all Members of Congress, they are used to that preventive care. They have that catastrophic coverage. And, all of a sudden, they turn 65, and Medicare becomes primary, and if they cannot afford, or if they do not have an employer-provided health benefit for a retiree or a very expensive maybe Medigap plan and they are just relying on Medicare, then they have gone from a coverage that gave them protection, that gave them catastrophic protection and, all of a sudden, at age 65 and beyond, they do not have that anymore, and that makes no sense at all.

The point is, Mr. Speaker, that we have not modernized Medicare, and that is what we are going to do here within the next couple of days in this 108th Congress. I am very proud, as a Member and as a physician Member, to be a part of this historic time in our Congress.

I am, as I say, very pleased that members of my caucus are here with us tonight in this late hour, but they understand the importance of this issue, and they understand the need to make sure that the public and, hopefully, some are watching tonight, especially our seniors, have an opportunity to see exactly what we are going to do for them with this passage of this historic piece of legislation.

At this time, Mr. Speaker, I yield to the gentleman from South Carolina (Mr. Wilson), just across the border from my home State of Georgia, my good friend and colleague.

Mr. Speaker, I thank the gentleman from South Carolina (Mr. Wilson). I especially am grateful for him sharing that very personal anecdotal information with us about his son.

Mr. Speaker, what the gentleman from South Carolina (Mr. Wilson) is talking about is so true, that medications that are available today we did not have in 1965. God forbid maybe if his son had had that leukemia in 1965, he would not be alive today. I know my mom who was suffering from cancer several years ago would not be alive today if it were not for the chemotherapy that basically completely put her cancer in remission.

Just imagine now, just imagine someone that is in their late 60s or maybe even mid-70s that has no insurance coverage for prescriptions who comes down with cancer that could very well be successfully treated if only they could afford, if only they could afford to take a very expensive medication that would cure that cancer, put that cancer in remission, and let them continue to live and enjoy life. So that is why it is so important in this 21st century that we finally have a coverage for prescription drugs.

It gives me a lot of pleasure at this point, Mr. Speaker, to yield time to the gentleman from Georgia (Mr. Burns), my colleague and friend from the 12th Congressional District.

Absolutely.

I am so glad that the gentleman asked that question, and I have actually been speaking on the floor of this House for the last month on a weekly basis talking about that very thing that the gentleman speaks of.

Physicians have been suffering severely over the last several years. They have taken deep cuts in Medicare payments, and the projected cuts for the next 2 years were 4.5 percent, 4.5 percent less per year in Medicare reimbursement at a time when their practice expenses, especially the cost of malpractice premiums, are literally going through the roof; and the answer to my colleague's question is that under this bill, physicians not only in the next 2 years will not suffer that 4.5 percent cut, but in fact, they will have a 1.5 percent increase.

Mr. Speaker, that is correct.

Another great question, and I am sure the gentleman from the 12th, from southeast Georgia, as he has had town hall meetings in his district all the way from Augusta to Savannah, is hearing the same concerns that I have been hearing. In fact, these were the major concerns and have been the major concerns of the AARP, and that is, what happens to these retirees who have had a great health insurance plan after their retirement that includes a very generous prescription drug benefit from their employer. There was this great fear, has been a great fear, that all of the sudden employers may, since there is an opportunity, an option under Medicare, drop their plans; and so we have made sure that we incentivize employers to keep those plans, to keep providing for those men and women who in some instances have worked 40 years for the company, very loyally working for the company. This Medicare Modernization and Prescription Drug Act actually gives 28 percent, 28 percent of coverage up to $5,000 per individual to employers, a tax-free supplement to incentivize them not to drop those plans. The AARP and its 35 million seniors are quite happy with that, and I think we have solved that problem.

As the gentleman said at the beginning of his remarks, the most important part of this legislation is that it helps our needier seniors. It gives them probably the greatest benefit.

Most of our seniors who are not low income, yes, they get significant help with this bill, particularly in regard to catastrophic coverage when they get above $3,600 out of pocket in any 1 year, but the point the gentleman is making is such a good one. It is so important for the public to understand, and that is that we are taking care of our neediest seniors first. If they have an income, an individual, of less than $12,000 give or take a few dollars per year or a couple at the $16,000 income level per year, then they pay nothing for their deductible. They do not pay a copay. They do not have to pay those monthly premiums. All of that is taken care of, and they are only liable for maybe a dollar for a generic drug or $3 for a brand-name medication or, if they are above 135 percent of the Federal poverty level, that goes to $2, $5. So minimum, and that is where the emphasis is, as the gentleman from the 12th is pointing out, on our most needy seniors.

Mr. Speaker, I thank the gentleman from Georgia for those very, very timely and accurate comments in regard to this bill. In fact, the gentleman from Georgia mentioned the health savings account, and I think that is one of the many parts of this bill that is so good. It is something that we have waited for a long time to have what we might call a universal health savings account opportunity.

Mr. Speaker, at this point, I would like to yield to my colleague and friend, the gentleman from Indiana (Mr. Chocola), who is a small businessman and understands this issue just about as good as anybody that I have discussed it with.

Mr. Speaker, I thank the gentleman from Indiana. I think this is such an important aspect of this bill and I appreciate his discussing that with us.

Mr. Speaker, there are probably 40 million people in this great country of ours who have no health insurance at all, and 60 percent of them, maybe more than 60 percent, have jobs. They are not unemployed. Maybe they work for a small shop of five to 10 to 15 people and that employer just cannot go out in the marketplace and get a volume discount, so they just cannot afford it. It is a benefit they cannot afford.

This health savings account will give these employees that are working but do not have the opportunity for group health insurance to put up to $5,000, up to $5,000 a year, Mr. Speaker, tax deferred and will have an opportunity for that account to grow, as the gentleman from Indiana so vividly pointed out.

I want to shift gears, Mr. Speaker, for just a minute. We have heard a lot of discussion tonight during this time about the AARP and how very supportive they are of this Medicare Modernization and Prescription Drug Act, this bipartisan conference committee report. Let me just read a letter, Mr. Speaker, from the President of AARP, Mr. William Novelli, and here is what Mr. Novelli says about this bill.

``Some people are surprised by AARP's support of the Medicare prescription drug legislation now before Congress. They shouldn't be. Our decision is not based on political calculation or allegiance to rigid ideology, but solely on what this will mean for our members and the health of all older Americans.

``There are many reasons for our endorsement. First, this bill will provide prescription drug coverage at little cost to those who need it most: People with low incomes, including those who depend on Social Security for all or most of their income. Second, it will provide substantial relief for those with very high drug costs and will provide modest relief for millions more.

``Finally, we are pleased to see a substantial increase in protections for retiree benefits. That fairness is maintained by upholding the health benefit protections of the Age Discrimination and Employment Act.

``On July 14, in a letter to congressional leadership, we outlined our concerns and our expectations for a bill that we could support. Among them was our opposition to what is commonly known as ``premium support,'' a new structure requiring traditional Medicare to compete against private plans, which could very likely result in

higher out-of-pocket costs for those who choose to stay in traditional Medicare.

``As a result of negotiations, this was scaled back to a demonstration project that is very limited in scope that doesn't begin until 2010, that exempts low-income beneficiaries and limits any premium increases. This will not,'' and I repeat, Mr. Speaker, ``this will not jeopardize traditional Medicare'' as we know it.

``Of real concern to our members and millions of older and disabled Americans was the prospect that by gaining a Medicare benefit, they might lose their current employer-retiree coverage.'' We talked about that earlier. ``We said that the final agreement should provide adequate incentives for employers to maintain their current plans. The proposed legislation includes an unprecedented $88 billion in subsidies to ensure that people who have good private coverage do not lose it.

``This bill is not perfect, but millions of Americans cannot wait for perfect. They need help now. And, finally, help is on the way.

``This is an issue too important to be held hostage to the status quo. As the late civil rights leader Whitney Young once said, `We have no permanent friends or enemies, just permanent interests.' Our interests are what is best for our members and for all older Americans.

``In the coming days, we will do all we can to help the American people understand how important this legislation is to them and to convince Members of Congress to work in a bipartisan,'' absolutely a bipartisan ``fashion to pass it now.'' William Novelli, President of the American Association of Retired Persons.

Mr. Speaker, at this time I would like to yield to my colleague and good friend from the great State of Alabama. Our districts butt up against each other at the State line, and I know that the people that he represents in his district in Alabama have the same needs, life experiences, and concerns that my folks do in the 11th District of Georgia.

So it gives me a great deal of pleasure at this time, and I thank the gentleman from Alabama (Mr. Rogers) for joining us tonight.

Mr. Speaker, I thank the gentleman from Alabama, and before I introduce the last member of our team tonight, I would like to read a letter from the President of the American Medical Association, and he says:

``Dear Mr. Speaker, the American Medical Association is proud to support the Medicare Prescription Drug and Modernization Act of 2003 conference report. Congress listened to America's patients and the physicians who serve them.

``The AMA gave Congress a set of principles for a sound prescription drug policy. We asked that the pharmaceutical drug benefit be fully funded as a separate new part of the Medicare program and provide for adequate accounting so that drug program expenditures can be tracked separately from all other expenditures. We asked that it be targeted to reduce hardship for those with low incomes and those with catastrophic costs and that patients be offered a choice of insurance options. The conference report meets all of these requirements.

``We asked for help with the drastic 4.5 percent physician payment cuts that physicians and other health care providers will face beginning in less than 2 months. We said that cuts in Medicare payments jeopardize access to medical care not only for seniors but also for military retirees and their dependents. The conference report provides a 2-year increase in payments for 2004 and 2005 of at least 1.5 percent each year,'' not, Mr. Speaker, a 4.5 percent cut. ``It also provides a mechanism to begin correcting the flawed payment formula in an effort to stabilize those payments over time.

``We asked for relief from regulatory burdens imposed on physicians and other health care providers when dealing with the Centers for Medicare and Medicaid Services, CMS. Using many components of the AMA model bill, the conference report guarantees physicians certain due process rights in Medicare appeals and targets education dollars promote.

``We asked important flexibility and assistance in moving toward electronic prescribing technology. The conference report provides incentive grants to small, rural, and low-volume practices instead of mandating that all providers use electronic prescribing technologies in a short time frame. It also provides for `safe harbors' for group practices and others in an effort to make these technologies more widely available.''

``We asked to retain the coding system that makes sense for American physicians, not to move to a new, untested system. The conference report

removed language that would have imposed new, regulatory burdens in payment coding systems that physicians use every day. Moving physicians from some 7,000 codes to some 170,000 codes could only mean less time spent with patients.

``We ask that geographic disparities in payments between rural and urban areas be diminished. The conferees worked out a compromise to increase payments in this regard and to thoroughly study patient access to physicians, as well as retention and attraction of physicians to scarcity areas.

``The status quo is unacceptable to patients and their physicians. The Medicare conference agreement includes numerous provisions that will improve seniors' access to medical services. We worked closely with Congress to do the right thing for American's seniors, and Congress heard us. We pledge to wholeheartedly support the Medicare Prescription Drug and Modernization Act. Sincerely, Michael D. Maves,'' president of the American Medical Association.

Mr. Speaker, I think this is a perfect segue into the introduction of my colleague from Texas who not only is my freshman colleague in this Congress, but he also is my colleague as a physician and further as a specialist in obstetrics and gynecology. I yield to the gentleman from Texas (Mr. Burgess).

Mr. Speaker, I thank the gentleman from Texas (Mr. Burgess) and the other Members for joining us tonight. An hour goes by very quickly. I think we need about three to really talk about everything that we need to talk about.

In conclusion, let me say that we proudly support this Medicare Modernization and Prescription Drug Act of 2003. We talk about compassionate conservatism, and that is a pledge upon which our 43rd President ran, and he promised that we would deliver. And some pun intended, I might add as an OB-GYN, but the President promised, and this leadership promised, this Republican Congress promised that we would deliver. Finally, at long last we have overcome a lot of obstructionism to get to the day that we are going to deliver to American seniors, and they deserve it.

It is compassionate because there are people in this society who through absolutely no fault of their own need our help, and that is what compassionate conservatism is all about. Mr. Speaker, I say this is its finest hour. Let us get this bill passed with support from both sides of the aisle and make this truly a bipartisan success for our seniors.

Mr. Speaker, I rise today in support of the Medicare conference report. This is a historic step in the right direction for our Nation's senior citizens. We are positioned to pass legislation to help seniors pay for the rising costs of prescription medications. Low- income seniors will be able to obtain the help they need and every senior will have the peace of mind of knowing that out-of-pocket catastrophic costs will not bankrupt them.

This legislation will provide the largest comprehensive rural package ever considered and updates and sets hospital payments at appropriate levels for 2005. The conference report also blocks a proposed 4.5 percent Medicare reimbursement cut to physicians for the years 2004 and 2005, and instead provides a 1.5 percent positive update for these 2 years.

The Medicare conference report has received the strong support of our health care community and the AARP, representing 35 million seniors.

Mr. Speaker, I urge my colleagues to vote in favor of our senior citizens and pass this bill.

Mr. Speaker, I thank the chairman, the gentleman from Ohio (Mr. Ney) for yielding. I stand tonight to support the gentleman from Georgia (Mr. Lewis), my colleague, the honorable and distinguished Representative from the 5th District. I want to say how proud I am to, as a freshman Member, to be able to support what he has been working on for these past 15 years and supporting H.R. 3491, the creation of a National Museum of African Culture and History. And I thank the gentleman from Ohio (Mr. Ney) and the gentleman from Connecticut (Ranking Member Larson), and the gentlewoman from the District of Columbia (Ms. Norton) for their support in trying to bring this long- term effort of this great Member of Congress to fruition.

And I just want to tell the gentleman how much I appreciate what he has done and how much respect I have for him. When we go back and talk to our spouses sometimes at the end of the week about what the experience was up here, I have said often to her that the gentleman from Georgia (Mr. Lewis) has been one of the nicest and kindest Members of this body to me, a freshman, reaching out on many occasions to make me feel warm and accepted. So I do take great pleasure in standing here tonight and supporting this.

I hope some day that I will be able to bring my grandchildren through that museum, and I hope he is there to explain to them some of the history that he knows so well, better than so many people, because he has experienced it, and he has brought more to racial healing than hardly anybody I can think of in this country. I commend him for it. I wholeheartedly support this bill.

Mr. Speaker, I thank the gentlewoman from New Mexico for yielding time to me.

Mr. Speaker, there they go again. They do not like the message so they start trashing, trashing the messenger, and in this case, the messenger just happens to be 35 million seniors who are members of the AARP. Excuse me, 35 million less one. The gentlewoman from California just told us that she resigned.

This is a solution, Mr. Speaker, in desperate need of a problem. The motion to instruct conferees, like so many that the minority has offered before, serves no useful purpose in this debate. They are simply political tools used in a desperate attempt to divert attention away from the fact that the Republican House will in a matter of days deliver, it will deliver on its commitment to providing seniors with access to meaningful, affordable and comprehensive prescription drug coverage.

Mr. Speaker, I support properly reimbursing physicians. The House bill did that and so does the bipartisan Medicare conference agreement which is why it is supported by a number of medical societies, including the American Medical Association.

Listen to what they say: ``The American Medical Association strongly supports passage of the Medicare prescription drug conference report, which currently includes historic and critical provisions for improving choice and access for Medicare seniors and disabled patients. In addition,'' Mr. Speaker, ``in addition, the conference report would halt 2 years of impending Medicare payment cuts to physicians and other health professionals and replace them with payment increases of at least 1.5 percent per year. Because the Medicare conference report includes these critical provisions for improving choice and access, the AMA strongly opposes the Berkley motion to instruct and urges Congress to pass the pending Medicare conference report before they adjourn.''

If the gentlewoman from Nevada is serious about wanting to help our Nation's providers, our physician providers, and I trust that she is, I would urge her to reconsider her opposition to medical liability reform legislation such as H.R. 5, the HEALTH Act, the tort reform bill, a bill that was strongly supported by both the AMA and the Nevada Medical Association. The other body has not acted yet, so the gentlewoman will have yet another chance to truly support physician providers.

Mr. Speaker, I strongly support the bipartisan Medicare conference agreement, and we will soon consider this on the House floor. This motion to instruct no longer serves any purpose. Indeed, the provisions related to Medicare competition that the gentlewoman references in her motion are not even part of the final conference committee agreement.

I urge my colleagues to join me in rejecting this motion to instruct and supporting the final Medicare conference agreement.

Mr. Speaker, I rise again today, as I have a number of times before, to call attention to declining Medicare reimbursements for physicians.

Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedule, face at least a 4.5 percent cut in reimbursements.

Mr. Speaker, I have been outspoken on this issue and have described several instances in which the citizens of Georgia and our Nation will be negatively affected by this cut. There is a staffing issue within the trauma center at Grady Memorial Hospital in Atlanta.

Dr. Harry Sherman in Augusta is contemplating retirement due to a lack of adequate Medicare reimbursement and the high cost of liability premiums. And more specifically, I demonstrated the decreasing reimbursement for, and thus the eventual reduction in access to very common procedures provided to Medicare recipients.

I would like to bring the attention of my colleagues to a survey conducted by the American Academy of Family Physicians. This survey is not necessarily scientific, but I believe it is indicative of the problem we are facing. AAFP found that 24 percent of family physicians no longer accept new Medicare patients. After the 4.5 percent cut was announced, AAFP surveyed again to find out what its members would do if the cut takes effect. As detailed in a release from the American Academy of Family Physicians, only 36 percent said they would take new Medicare patients if these new cuts occur.

Mr. Speaker, come January, doctors are going to take a cut in their reimbursement for treating our Nation's most needy individuals. There is an old saying, however, that the night is always darkest just before the dawn. With a physician-reimbursement disaster looming, Congress is on the verge of a breakthrough. Housed within the Medicare modernization bill is temporary relief for the medical community. House and Senate negotiators have announced an agreement that will potentially bring this legislation before the Congress this week. I thank the gentleman from California (Mr. Thomas) and the subcommittee chair, the gentlewoman from Connecticut (Mrs. Johnson), and those from the other Chamber, such as Senators Frist, Grassley, Baucus and Breaux, who have worked so hard to get us to where we are today.

I encourage all of those involved in this process to continue to act in the best interests of the American people, but especially our seniors and the medical community on which they so desperately depend. Let me be clear, as a physician Member of the United States House of Representatives, I believe that we must pass the Medicare conference report now. For nearly 40 years, Medicare has provided necessary health care to millions of patients across this country. Another steep cut in reimbursement rates would have been devastating for the physicians who care for Medicare patients; but with the language that has been crafted, the physician-reimbursement update would be a positive 1.5 percent.

This chart is representative of the positive impact the current Medicare legislation will have on Medicare providers throughout the country. For example, New York will see a benefit of $865 million; Washington State benefits $155 million; Texas, $641 million; and most important to me and my colleagues from Georgia, our State will benefit $254 million. All 50 States will see a positive impact from the current version of the Medicare conference report.

I cannot overstate the importance of just this one piece of the overall Medicare bill. It is my hope this will allow for the continued access to quality health care for our seniors. I am proud that as the door was slamming shut on our seniors' health care, this Congress stood up, and will stand up, in a bipartisan fashion and hold this door open.

Mr. Speaker, one of the greatest achievements of the Medicare program is the access to high-quality care it has brought to our Nation's seniors and disabled patients. This level of access is more likely to continue in light of this temporary fix. This legislation will allow Congress and the Center for Medicare Services the time to work together to finally find a more permanent solution by revamping the Medicare payment formula.

Doctors are the linchpin of the Medicare program. Let me say that a prescription drug plan is no benefit at all unless there are physicians willing to accept Medicare patients and to write those prescriptions. We need to pass this conference report and pass it now.

Mr. Speaker, I rise today in strong support of the conference report on H.R. 1588, the National Defense Authorization Act for Fiscal Year 2004. This critically important legislation provides our brave men and women in uniform the tools they need to accomplish their missions, but it also contains many provisions to improve their quality of life.

This bill increases the combat capabilities of our Armed Forces with appropriate levels of spending for readiness, procurement, research and development. It funds programs such as the M1 Abrams tank and Bradley fighting vehicles that are used in current conflicts, and transforms our military to meet the threats of tomorrow with futuristic systems like the Air Force's F/A-22 Raptor. The bill provides funding to make our homeland safe by combating terrorism at home and abroad and continuing to develop a ballistic missile defense system.

Most important in this legislation, however, are the provisions aimed to benefit our current and past servicemembers. H.R. 1588 provides a 4.1 percent pay raise, and it increases imminent-danger pay. It also funds important military family housing, education and military facilities. H.R. 1588 directs improvements to the TRICARE system and survivor benefit, and it contains many other provisions for members of the National Guard and the Reserves.

I thank the chairman of the Subcommittee on Total Force, the gentleman from New York (Mr. McHugh), for his tremendous dedication to these quality-of-life issues.

This bill also recognizes the inherent unfairness that disabled military retirees have their retirement benefits offset by the amount of their disability benefits by providing concurrent receipt for more veterans than have ever been covered before.

Finally, I thank the gentleman from California (Chairman Hunter) and the ranking member, the gentleman from Missouri (Mr. Skelton), for not only their leadership of our committee but also for their work in shepherding this bill through the legislative process. They recognize that we owe all of our freedom and safety to our brave men and women in uniform and that Congress can help them in a major way with the passage of this bill. They also know how important this bill is to my district and Fort Benning in Columbus, Georgia, the home of the infantry where 37,000 active duty troops go to work every day.

In conclusion, I urge my colleagues to vote in favor of H.R. 1588.