Floor Statements

Mr. Speaker, I rise today to share with the Members of the House and the American people my experiences visiting Walter Reed Army Medical Center yesterday. I had the pleasure and the honor of visiting some true American patriots who were severely injured in Operation Iraqi Freedom and are currently recuperating at Walter Reed. I was especially pleased to meet with Sergeant Terry Jones, a reservist, from Columbus, Georgia, Fort Benning, who served bravely in Operation Iraqi Freedom.

Mr. Speaker, my visit to Walter Reed was one of the most moving things I have done since coming to Congress in January. I felt it was important to let these heroes of Operation Iraqi Freedom know how much we in Congress appreciate their sacrifices. I wanted to relay to them my belief that through their heroic deeds, they have made the United States a safer place for all Americans and brought precious freedom and democracy to the people of Iraq.

Mr. Speaker, yesterday I also had the pleasure to meet with Sergeant Sean Driscoll of Clarksville, Tennessee, and his wife Georgette. Sergeant Driscoll was recently wounded in Iraq as part of his operations serving in the Army's 101 Airborne Division.

Mr. Speaker, I could talk at great length about Sergeant Driscoll's dedication and sacrifice to his Nation during a 15-year career in the Army, as well as about my immense gratitude for all that he has done to advance freedom across the world. But I think that his 18-year-old daughter, Antoinette, has paid tribute to her father much better than my words could.

Therefore, Mr. Speaker, I would like to read the following testimonial written by Antoinette Driscoll about her father, Sergeant Sean Driscoll, so that it can be placed into the Congressional Record.

It is titled ``Hero.''

``Words cannot express how proud I am to be able to say that my Dad is a HERO. There are people who have parents that are doctors that save and rehabilitate people everyday, but my Dad is far greater. Some parents save others from fiery buildings or patrol the streets at night, but my Dad is far more dignified. Those people may be heroes in their own way, but my Dad is far more superior than they. For my Dad is a soldier, defending our wonderful nation, putting in countless hours of sweat, tears, and selfless sacrifice and service for those who live in the United States.

``My Dad is the one who fights and risks his own life for us privileged Americans. He makes sure that doctors have a place to educate themselves and practice. He makes sure that everyone has the opportunity to find a job, and has a home and an education, and makes sure everyone can sleep safely at night. I can't think of any other who is greater than he. I am proud and honored to be able to love someone like this.

``I can only hope that I will one day follow in his footsteps and defend my country. He has taught me a couple of things which I feel every American should know. One, freedom is not free, and there is no greater Nation than the United States of America. He has served many years and has shed blood for my freedom. I could never thank him enough for all that he has done. Not just for me, but for my family, friends, and people who he doesn't even know. I hope that one day I'll be able to fight for him, so he can live safely and rest when he comes home. I love him for these reasons and many more.''

Mr. Speaker, I think this statement from Antoinette Driscoll poignantly demonstrates her love and admiration for her father. It is also important to note that Antoinette will soon enter the United States Air Force herself, and her younger 16-year-old brother will join the service in a few years as well.

The Driscoll family has demonstrated to me great resolve in the face of difficult circumstances. Even though Sergeant Sean Driscoll was severely wounded in Operation Iraqi Freedom and he has spent many months away from home, his family remains undaunted in its commitment to serving our Nation. They can teach all of us a valuable lesson in sacrifice and dedication to the American ideal.

Mr. Speaker, my Washington Waste Watcher colleagues and I, Republican members of the freshman class, have come to the floor tonight to devise new and innovative ways for trimming the fat out of government. I believe we owe it to the American taxpayer to hold Washington bureaucrats accountable for wasteful spending and to discover new ways for reducing fraud in government at all levels. A great American from Ellijay, Georgia, Mr. Joe McCutchen, reminds me of this at least once a month.

Mr. Speaker, after spending 28 years as an OB-GYN doctor, it should be no surprise that part of my legislative agenda is to reorganize and revamp this Medicare program, which is currently responsible for billions of dollars of waste, fraud and abuse. The General Accounting Office has estimated that one of every 10 dollars is wasted because our current Medicare system is open to poor management and fraud. Dishonest individuals find new and more creative ways to cheat our Medicare system every day, burdening Americans with higher taxes, higher premiums, and higher copays.

For example, according to the Bureau of National Affairs in an April 25, 2003, article of ``Health Care Daily,'' a Florida woman was sentenced for her role in a scheme that allegedly billed Medicare and Medicaid more than $25 million worth of false claims for, get this, wheelchairs, alternating pressure mattresses, and other durable medical equipment; $25 million of taxpayer money that is lost and unrefundable, money that could have been used to improve our schools or aid our soldiers in Iraq or provide health care for the uninsured.

Another example comes from the Health and Human Services Inspector General report to Congress, April 2000. It was reported that Medicare paid an estimated $20.6 million for services that started after the posted death dates of certain recipients. My good friend and colleague, the gentlewoman from Florida (Ms. Ginny Brown-Waite), just a few minutes earlier mentioned the same thing. Of this amount, $8 million was paid, despite the fact the Department had already noted their deaths in the main database.

These are just examples of the mismanagement of time and resources that are costing Americans billions of dollars every year. In these times of war and emphasis on homeland security, we cannot afford to spend another dollar on wasteful programs, and we must save money by eradicating fraud against and within the Federal Government.

Mr. Speaker, it is time to restore responsibility and accountability to government programs by rooting out this waste, fraud and abuse in our government. I urge my colleagues to help pass needed Medicare reform.

Mr. Speaker, I want to thank my colleague from Pennsylvania for introducing H. Res. 414. I think it is a positive step in addressing our trade discrepancies with the People's Republic of China.

My district of western Georgia has a rich history of manufacturing textiles, from Milliken and Company, Incorporated, and Bon L. Manufacturing in LaGrange, Georgia, to Mount Vernon Mills in Trion, Georgia, which has been in business since the 1840s. The textile industry has provided good-quality jobs for the citizens of Georgia's 11th Congressional District, with good health care benefits and good retirement. I make this point because people in my district have established a culture and a community around the textile industry.

I am deeply concerned that our country is not properly enforcing our trade policies which are slowly eliminating an entire way of life. When ratifying trade agreements, it is important to encourage both free and fair trade. China is not playing fair because they are manipulating their currency in order to gain an unfair advantage. This currency manipulation is costing people jobs. Between March 2002 and March 2003, 50 textile plants have closed and 40,000 people have lost their jobs, including 100 jobs just last week in Trion, Georgia.

We cannot afford to lose jobs, especially due to the unfair practices of currency manipulation by the Chinese Government. Mr. Speaker, I encourage the passage of House Resolution 414 to encourage China to comply with their trade obligations.

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

I rise very much in support of H. Res. 378, and I commend the author, the gentlewoman from Texas (Ms. Granger), for bringing this bill forward. If I

did not know anything about the bill, after seeing that beautiful grandchild, Logan, in that portrait, I think I would be supportive of this effort. It is very, very persuasive, and I commend the gentlewoman for that.

But, seriously, this bill is a great bill. I have a private college in my 11th District of Georgia, Berry College, a wonderful private college in Rome, Georgia, that is part of these 200 private colleges and universities participating in this plan. As has been pointed out by the previous speakers, the cost of college has been rising so much, since 2001 something like $16,000 a year on average to go to a private college or university.

This opportunity for our families that want to send their children to these schools to go ahead and invest and save that money at a tax advantage and lock in that tuition so it is not rising at double the rate of inflation, I think is a very important thing to do.

I commend the gentlewoman for this bill and give it my strong support. I urge all of my colleagues to support this great resolution.

Mr. Speaker, I move to suspend the rules and agree to the resolution (H. Res. 395) recognizing the importance of chemistry to our everyday lives and supporting the goals and ideals of National Chemistry Week.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on H. Res. 395.

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

Mr. Speaker, today I am pleased that we are considering this resolution recognizing the importance of chemistry in our everyday lives. This resolution supports the goals and the ideals of National Chemistry Week, and it recognizes the important contributions of chemical scientists and engineers to technological progress and the health of many industries. In addition, it encourages the people of the United States to observe National Chemistry Week, which this year is October 19 through 25. As a graduate of the Georgia Institute of Technology with a Bachelor's Degree in chemistry, I enthusiastically support this effort.

The chemical sciences provide an enabling infrastructure that delivers the foods, fuels, medicine and materials that are part of our everyday lives. The contributions of chemical scientists and engineers are central to the technological progress of many areas that affect our everyday lives.

I commend the American Chemical Society for establishing National Chemistry Week in 1987. During National Chemistry Week, volunteers from across the United States will teach children about our air, the atmosphere and the solar system. The theme in 2003, Earth's Atmosphere and Beyond, was chosen to honor the 100 anniversary of Orville and Wilbur Wright's flight from Kitty Hawk, North Carolina.

It is important to stimulate children's interest in the chemical sciences so that they will consider careers in these fields and potentially discover the innovations for our future.

I urge all of my colleagues to support this resolution, and thus recognize and support the goals and ideals of National Chemistry Week.

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

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

Mr. Speaker, I have no other speakers, but I continue to reserve the balance of my time.

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

Mr. Speaker, I am honored to present this resolution supporting the ideals of National Chemistry Week. And I want to commend the co- authors, the gentleman from Michigan (Mr. Ehlers) and the gentleman from New Jersey (Mr. Holt), the Ph.D. physicists, for bringing this bill forward.

So this Member who has a bachelor of science, a meager bachelor of science degree in chemistry, is humbled in their presence, but this is a wonderful bill, and I am very, very supportive of it.

Mr. Speaker, I think I have got a little bit of time left, and I see that the gentleman from Michigan (Mr. Ehlers), of whom I just spoke, the distinguished gentleman from Michigan, that Ph.D., one of those Ph.D. physicists of which I just spoke, has just arrived.

Mr. Speaker, I am very happy at this time to yield such time as he may consume to the gentleman from Michigan (Mr. Ehlers).

(Mr. EHLERS asked and was given permission to revise and extend his remarks, and include extraneous material.)

Mr. Speaker, I have no other requests for speakers but, again, in conclusion, let me just say that I commend the gentleman from New Jersey (Mr. Holt) and the gentleman from Michigan (Mr. Ehlers) for bringing forward this resolution. And I urge all of my colleagues to support its adoption.

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

Mr. Speaker, I rise again this week as I have done in previous weeks to call attention to declining Medicare reimbursement for physicians. Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedule face at least a 4.2 percent cut in reimbursements.

For nearly 40 years, Medicare has provided necessary health care to those millions of patients across this country. Another steep cut in reimbursement rates is now forcing many physicians who care for Medicare patients to make very difficult choices. Complicating the situation, Mr. Speaker, further, is the fact that doctors in some areas are experiencing double and even triple-digit percentage increases of their liability premiums. In a host of States, like my State of Georgia, surgeons are scrambling to find affordable liability insurance, if it is available at all.

When doctors are forced out of practice, patient access to care is further compromised. Fewer doctors overall translates into greater difficulty obtaining an appointment for every patient but especially those who rely on Medicare.

Earlier this year we passed H.R. 5, the HEALTH Act to combat the problem of increased liability premiums at the Federal level. Unfortunately, this commonsense legislation has now languished in the Senate. I reiterate my support for this bill, and I urge its swift passage by the entire Congress so that President Bush can sign it into law this year.

Until that time, however, one of the main costs of running a medical practice for many high-risk specialists, including general surgeons, will continue to be liability insurance. Looking at this chart, you can easily see that increases in liability premiums have grossly outpaced Medicare reimbursement.

Using information collected by the independent trade publication Medical Liability Monitor, this chart compares the average liability premiums for general surgeons to the Medicare physician payment update. In 2001, physicians received a 5.1 percent Medicare payment update. During that same period liability premiums increased 14.6 percent. Then the next year Medicare physician payments were cut 5.4 percent. While doctors are trying to manage this cut, their liability premiums spiked to an additional 29 percent. There is no doubt that at least with respect to liability premiums, Medicare reimbursement continues to fall far behind the cost of doing business.

As an OB/GYN myself, I can assure you that a physician's practice is indeed a small business. When faced with decreasing income and soaring expenses, doctors cannot simply increase the cost of patient visits. To keep medical practices open, doctors make tough choices. Some doctors delay the purchase of new equipment; others reduce the size of the staff. Many increase the percentage of non-Medicare patients they see, leaving insufficient time in a busy schedule to see a sufficient number of Medicare patients.

Mr. Speaker, I would like to relay a story that demonstrates just how the cuts in physician reimbursements are affecting medical practices in my home State of Georgia. Dr. Harry Sherman, former president of the Georgia chapter of the American College of Surgeons, has lived in Georgia for more than 70 years. He remembers when Congress first enacted Medicare. Now, about 40 percent of his surgical patients are Medicare.

I recently had an opportunity to speak with Dr. Sherman at the American College of Surgeons annual meeting in Chicago. During our conversation, it became clear to me that Dr. Sherman obtains a great deal of personal satisfaction from treating Medicare patients.

As a physician myself, I understand that unique bond that develops between doctor and patient, but as the cost of doing business continues to increase and the level of reimbursement drops, further and further, he admits that it influenced his decision about when to retire.

Dr. Sherman is one of Georgia's most seasoned surgeons. He was born and raised in Georgia, and is truly an asset to his community and his patients. When continued Medicare payment cuts are forcing good surgeons like Dr. Sherman to retire for financial reasons, something is badly wrong.

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 cannot be expected to continue in the face of deep Medicare cuts and growing liability premiums.

Mr. Speaker, doctors are the linchpin of the Medicare system. Let us not force them out of the system. Stop the 4.2 percent Medicare physician cut; help doctors help those who need their care the most.

Mr. Chairman, I rise today to discuss the amendment offered by the gentleman from Indiana, Mr. Pence. This is a well- intentioned amendment that would strike a balance between one of the most deeply debated issues involved in H.R. 3289, the Supplemental Appropriations Act for FY 2004.

Mr. Pence's amendment would have made the first 50 percent of Iraq Reconstruction funding available immediately as a grant. This $9.3 billion amount would have given priority consideration to the emergency purposes of security, electric sector infrastructure, oil infrastructure, public works, water resources, transportation and telecommunication infrastructures, and other emergency needs. It would

have withheld the final 50 percent of the reconstruction funding until a democratically elected government in Iraq has been established. Once the Bush Administration informs Congress that such a government exists, the balance of the funding would have been made available in the form of loans from the United States Government, under terms determined by the President.

Mr. Chairman, for several weeks I have internally debated the question of whether this reconstruction funding for Iraq ought to be in the form of a direct grant or a loan repayable at a future date. I have listened to my constituents, asked questions at committee hearings, and thought through all of the arguments on both sides of this debate. I did so because this issue is so important to both the people of Iraq and the people of the United States.

Mr. Chairman, after much deliberation, I saw the validity and accuracy of some of the arguments in favor of a directly granting these reconstruction funds. I believe that debt repayments could become a destabilizing political issue in postwar Iraq and could easily be exploited by anti-American factions. Furthermore, a loan burden also could likely stifle any significant economic development in Iraq.

However, I also believe that we have a responsibility to be conscientious stewards of the American taxpayers' money. We currently have a significant national debt at the federal level, and have several important priorities that are going unmet. Finally, Iraq is not a poor nation. In fact, it has natural resources that are unmatched in that region of the world.

Mr. Chairman, in light of these realities, I would have supported the thoughtful amendment by my colleague, Mr. Pence. I believe that it would have provided adequate reconstruction funds that are needed in the near term. This is money that would have been used for emergency and immediate purposes fro the most important needs of security, electric and oil infrastructure, public works, and transportation. This $9.3 billion would have built on and expanded the successful work that the Coalition Provisional Authority has already done in a few short months in Iraq. It would have provided the CPA with the resources it needs to make the quality of life in Iraq better than it ever was under the terrible regime of Saddam Hussein.

Finally, Mr. Chairman, the Pence amendment would have permitted the American taxpayers to be partially refunded once a democratically elected government is established in Iraq. Once this governing authority is present in Baghdad, which is expected to occur within a year, Iraq would have been able to use its considerable natural oil reserves to repay a portion of the money we are debating today. To me, this appeared to be a fiscally responsible manner by which to approach the subject.

Mr. Chairman, again let me reiterate my support for the Pence amendment. I believe that it was a responsible compromise solution for both the people of Iraq and the people of America. Because I believe Congress has a responsibility to both of them, I would have supported the Pence amendment as a sensible, middle ground approach to this difficult question.

Mr. Chairman, I rise in strong support of this emergency appropriation to pay for this ongoing war in Iraq.

The gentleman that spoke before me talked about taking exception to some of the comments that were made, and I want to do the same thing. As I sat here and listened and continue to listen to the debate, over and over again I hear this phrase, Mr. President, what is our exit strategy? Mr. President, what is our exit strategy? To me, exit strategy is nothing more than a euphemism for cut and run.

I do not think we need to remind the Florida Marlins last night that if they had an exit strategy at the end of the seventh inning, they would not have won that ball game. You do not pull your team off in the third quarter or the seventh or eighth inning of a ball game, no matter how far you are ahead. You are not thinking about an exit strategy; you are thinking about the determination and the will to win. That is really what we are talking about here in making this emergency appropriation to continue until victory is ours.

I am strongly in support of both parts of this bill. The $66 billion for our troops, giving them the resources necessary to succeed in the war on terror and protect them from terrorist attacks, including, as an example, armored Humvees to better protect our forces, lifesaving body armor, equipment, weapons, ammunition, better housing for our troops, yes, and to continue the increased monthly rate of imminent danger pay and family separation allowances that this bill calls for. And then $18.6 billion for the continued relief and reconstruction of Iraq. I do not think that this is any less important. As my colleague, the gentleman from Georgia, said earlier in his remarks, this is an investment in democracy, security and law enforcement, justice, public safety, and a civil society, infrastructure, water resources, electrical generation, distribution infrastructure, roads and bridges, health care; and, yes, Mr. Chairman, it is important, as the distinguished chairman of the Committee on Foreign Relations, the gentleman from Illinois (Mr. Hyde), mentioned at the outset of this discussion, this needs to be a grant and not a loan; and he gave us a good history lesson, as did the gentleman from Minnesota (Mr. Kennedy).

A loan with possible interest fees risks serious harm to America's image

in the Middle East and Iraq. Heavy debt repayments could become a destabilizing political issue in postwar Iraq and could easily be exploited by anti-American factions. It is likely that the Iraqi people will view the loan as a way for the profiteering American invaders to make money off of Iraq. A loan burden also would likely stifle any significant economic development in Iraq. With the added burden of interest payments to the United States, the Government of Iraq will be limited in its ability to invest in its new market-based economy.

Mr. Chairman, we cannot expect the Iraqi people to pick themselves up off of the ground if we have got a boot at the back of their neck. It is very important that this be a grant and not a loan. We cannot expect other countries that are debtor nations, some which are owed $8 billion and $10 billion from Iraq, and we can say that, well, that debt was with Saddam Hussein. Well, it was not Saddam Hussein who signed a personal note to secure that debt; it was the country of Iraq.

So I just want to say in closing, Mr. Chairman, that the people in the eleventh district of Georgia that I represent are very supportive of not only the ongoing military effort, and that will continue until we win the battle and then we will talk about an exit strategy, but they are also in favor of reconstructing the country of Iraq. I am fully supportive of this emergency appropriation, and I urge all of my colleagues to support it.

Madam Speaker, I rise again today, this week, to continue the discussion regarding the 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 4.2 percent cut in reimbursements.

For nearly 40 years, Medicare has provided necessary health care to those millions of patients across the country, some 40-something million this year. Another steep cut in reimbursement rates is now forcing many physicians who care for Medicare patients to make difficult choices. The scheduled January 1 cut in the reimbursement rate is just one of a string of Medicare payment reductions for physicians. Due to problems in the formula used to set Medicare payments for physicians, this 4.2 percent cut taken with the 5.4 percent decline in 2002 contributes to successive pay cuts reaching more than 10 percent.

To illustrate the Medicare payment history for surgical services, let us take a look at this chart comparing the Medicare economic index to physician payment update. The Center for Medicare and Medicaid Services, CMS, uses this Medicare economic index, or MEI, as a proxy for inflation in the cost of operating a medical practice. The largest component of the MEI is change in hourly earning for the general economy. A proxy for physicians' own time is in this index.

Additionally, the MEI accounts for office expenses, medical materials and supplies, professional liability insurance, now that is a good one, professional liability insurance, and we know what is happening to that, medical equipment expenses and other benefits and various professional expenses.

Here the yellow line shows a steadily increasing MEI, up about 2 to 4 percent every year starting in 1996. Every year extending out to the present time, a 2 to 4 percent increase.

Now look at the red line. The red line charts an annual Medicare payment update for physicians resembling some sort of a roller coaster starting in 1996 and 1997 with surgical payments slightly under the MEI, and then in 1998 we have a tremendous drop. Look at this drop in 1998, which rebounds the next year, the only year, I point out, that the MEI and the increase in payments are actually matched. Then we have a slight increase in physician payments until we start a disaster downward trend of payment cuts before congressional intervention in 2003.

When I look at this chart, it is clear to me that Medicare is not funded appropriately to ensure access to America's elderly and disabled patients. Without doctors' high levels of participation, the Medicare program would not have been able to serve millions of patients over these last 4 decades.

Madam Speaker, I would like to read and include in the Record a letter I received just 2 days ago. Madam Speaker,

the letter is from two doctors who practice in my home State of Georgia: ``Dear Representative Gingrey, although we continue to see Medicare patients in our practice, we are no longer accepting new Medicare patients. Further cuts in payments to physicians treating Medicare patients will undoubtedly result in a mass exodus of medical providers and secondarily limit access to medical care for the Medicare recipients. We have already noticed that many Medicare patients are having difficulties getting routine care. Despite the fact that we are physiatrists treating musculoskeletal problems, we find ourselves ordering routine care to working-up medical problems that their internists or primary care providers no longer have time to address. Unfortunately, we do not have the time to address these other issues either.

``Please help this situation by averting additional Medicare pay cuts. The courtesy of a response is appreciated.

``Sincerely, Amy M. Long, M.D. and Daryl L. Figa, M.D.''

Madam Speaker, the courtesy of a response has been requested. What is our answer? Will we abandon those doctors who treat our most needy? Madam Speaker, we must stop, we must stop the 4.2 percent Medicare physician payment cut. Help our doctors help those who need their care the most. Madam Speaker, we must not forget doctors are the linchpin of the Medicare program.

OrthoRehab,

Lawrenceville, GA, October 13, 2003.

Hon. Philip Gingrey,

House of Representatives,

Washington, DC.

Dear Representative Gingrey: Although we continue to see

Medicare patients in our practice, we are no longer accepting

new Medicare patients for treatment. Further cuts in payments

to physicians treating Medicare patients will undoubtly

result in a mass exodus of medical providers and secondarily,

limit access to medical care for the Medicare recipients.

We have already noticed that many Medicare patients are

having difficulties getting routine care. Despite the fact

that we are physiatrists treating musculoskeletal problems,

we find ourselves ordering routine care to working-up medical

problems that their internists or primary care providers no

longer have time to address. Unfortunately, we do not have

the time to address these other issues either.

Please help this situation by averting additional Medicare

pay cuts.

The courtesy of a response is appreciated.

Sincerely,

Amy M. Lang, MD.

Daryl L. Figa, MD.

Mr. Speaker, I rise today to congratulate a company located in the 11th district of Georgia which I represent.

Mr. Speaker, we all know the dangers our men and women of the Armed Forces are facing during the operations of Enduring Freedom. During combat operations several of our Apache helicopters took enemy fire and were damaged to the point they could no longer operate in the combat theatre. As one can imagine, it was imperative these helicopters were repaired and returned to the theatre of operations as soon as possible.

On April 2, 2003, the men and women of Engineered Fabrics Corporation in Rockmart, Georgia, got the call to assist our Nation's warfighters. Within 24 hours 28 new Apache fuel tanks were on their way to the combat theatre.

In recognition of this excellent, incredible effort, Engineered Fabrics received the Commander's Medallion for Outstanding Warfight Support from the Defense Contract Management Agency.

Specifically, I would like to thank and congratulate Mr. Carl Simmons, Contracts Manager, and Sheila Smith, Shipping and Receiving Manager, both with Engineered Fabrics. These two individuals were instrumental in ensuring that contract and shipment requirements were completed on or ahead of schedule.

Mr. Speaker, Engineered Fabrics is an outstanding company in my 11th District of Georgia and a great example of the American spirit and will to succeed.

Mr. Speaker, I rise today to call attention to the decline in Medicare reimbursement for physicians. Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedules face at least a 4.2 percent cut

in reimbursements. For nearly 40 years, Medicare has provided necessary health care to millions of patients across this country. Another steep cut in reimbursement rates is now forcing many physicians who provide for Medicare patients to make difficult choices.

We only need to look at this chart, compare in 2004 Medicare payment for the various types of Medicare providers to understand the physicians' plight. Reimbursements for outpatient services up 3.8 percent. Inpatient services up 3.4 percent. Payment for inpatient rehabilitation up 3.2 percent. Likewise, payments to skilled nursing facilities up 3 percent. Then we come to our physicians, down 4.2 percent.

Interestingly, payments to all of these other providers are going up and payments to physicians are getting cut again.

Opponents to increase funding for physicians' payments often cite the high participation level in the Medicare program as evidence that physician reimbursement rates are at least adequate. True, most surgeons and doctors continue to treat some Medicare patients even as rates continue to fall. It is difficult for physicians to sever long- standing relationships with their patients. Having practiced OB-GYN for 27 years, I can tell you that the bond between doctor and patient is truly unique. It is a difficult relationship to be forced to end.

On the other hand, I would invite you to take a look at the number of physicians accepting new Medicare patients into their practices. As more and more doctors curtail the time they devote to Medicare patients, seniors and disabled patients will wait even longer to visit a specialist. Moreover, they will struggle to find physicians available for referrals for follow-up chronic care.

The problem associated with decreasing reimbursements is especially acute within the surgical community. The number of physicians who elect to practice surgery is going down. Many variables enter into a medical student's choice of speciality. Among these factors is the viability of maintaining a practice. As reimbursements decline, so too do the number of applicants wishing to pursue surgery. Never are the consequences more dire than for trauma patients in underserved areas. The inability to sufficiently staff hospitals in emergency situations is one of the ripple effects of cutting physician reimbursements.

One of the greatest achievements of the Medicare program is the access to high-quality care it has brought to the Nation's senior and disabled patients. This level of access cannot be expected to continue uninterrupted in the face of continued Medicare cuts and ballooning liability premiums.

Mr. Speaker, we must stop, we must stop the 4.2 percent Medicare physician payment cut. Help our doctors help those who need care the most. Mr. Speaker, we must not forget, we must never forget that doctors are the linchpin of the Medicare program. It will do no good to provide a prescription benefit for our seniors, a $400 billion plan, which I am very much in favor of, if we have no physicians willing to accept Medicare patients and write those prescriptions because of these continued Medicare payment cuts.

Mr. Speaker, I thank the gentlewoman from North Carolina for yielding time to me; and Mr. Speaker, let me just say in regard to some of the comments that the gentleman from Virginia just made in regard to this ban on partial-birth abortion only eliminating one method of a late-term abortion, and he said he would not describe some of the other procedures of late-term abortion, and I wish maybe he had because I, as a physician, as an OB/GYN physician, do not know of any other procedures, late-term procedures that would result in the death of a child at this stage of pregnancy, and we are talking about infants, that are well past the point of viability.

We are talking about, in some instances, 4\1/2\-, 5-pound babies, that that pregnancy cannot be terminated, and resulting in a dead baby without doing a destructive procedure known as partial-birth abortion. It literally is the only option left for a woman who wants to choose death for her child in the third trimester. If you do a cesarean section, you have got the problem of delivering a live child. If you induce labor, you have the problem of having a live child, and that problem means that you cannot perform an abortion.

This is what it is all about, and the gentleman from Texas on the other side spoke a few minutes ago about the dirty little secret, the dirty little secret of this not banning late-term abortion. It certainly does when we eliminate this abhorrent procedure known as partial-birth abortion.

This question that keeps coming up about the health exception, how in the world could anybody consider that it would be a healthy thing to put a mother through this kind of procedure in the third trimester. It is not healthy. It is totally unhealthy. It is a complete farce.

I urge the adoption of the rule, and let us get on and pass this ban. It is time.

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

Mr. Speaker let me just say this. What we are hearing from the opposition over and over again is that this is an attack on Roe v. Wade. It is not an attack on Roe. I will stand here and tell the Members that I think that January 22, 1973, will live on as a day in infamy, and I wish it had never happened, but this is not an attack on Roe v. Wade. This is an attack on one procedure, one abhorrent procedure called partial-birth abortion.

The other side wants to say that there is no medical terminology of ``partial-birth abortion.'' It is as much a medical terminology as to say taking somebody's appendix out or a gallbladder out is medical terminology. I do not know what euphemism they want to use for this procedure, but this is a partial-birth abortion. Someone said earlier that it is akin to infanticide. I am not a legal scholar, but to me it is infanticide because when one delivers that human outside the mother's womb, and it has a beating heart, it no longer is a fetus. It is an infant, and if they kill it at that point, and that is what partial-birth abortion is, then that is infanticide.

Vote for this conference report, both sides of the aisle.

Mr. Speaker, I thank the gentleman for yielding and giving me an opportunity tonight as a physician Member, and particularly as an

OBGYN physician Member, just like my colleague from Texas.

During my campaign and these 9 months that I have served in Congress since the election, back in the district probably the most frequent question that I am asked is ``Phil, do you miss it? Do you miss your practice? You gave up a great profession, and you delivered all those babies, over 5,000 during a 27-year career.'' And the answer to them is, of course, I miss it. I miss it tremendously. What a wonderful opportunity and a calling it was to be a physician, and, in particular, to bring life into the world. And I am very proud, of course, to say that in all those 27 years, I have never once performed an abortion. But maybe God, and I guess, Mr. Speaker, it is okay for me to say ``God'' in this Chamber, maybe God had a higher calling for me, wanted me to have an opportunity to do something even greater, Mr. Speaker, than bringing a precious life into the world.

One of my supporters during the campaign, when I asked him for help in helping me get elected, he said, ``Phil, I am going to support you if you promise to do one thing. I want you to promise me that you will just do good when you get to the Congress.''

I know now tomorrow, I have an opportunity to do something very good, an opportunity to vote to ban an abominable procedure known as partial- birth abortion, and I do not know how many years of life I have got left, but when I cast that vote tomorrow, and I have that privilege, that honor, that distinction of being one of 535 Members of this Congress out of some 275, 280 million people to make that vote, and when we pass this bill, yet once again for the third time, we have a President in George W. Bush who is committed to finally end this abomination. And I just cannot help but think about all the lives that now I have an opportunity to save forever, and maybe it will be far more than the 5,200 that I have already delivered.

We have heard from other Members on this issue and seen the graphic description of this procedure, and I will not go into that again, but I can tell my colleagues as a physician, there is no reason, there is never a reason for the health of the mother to perform an abortion in the third trimester of pregnancy. We are talking about, for those who do not understand trimester, we divide a pregnancy into thirds, but when one gets into that third trimester, we are talking about children, fetuses if they want to call them that, but literally who are 4\1/2\ to 5 pounds, fully capable of life outside the womb. And what people are doing in this procedure is, literally, killing these children, as the gentleman from Texas (Mr. Burgess) indicated, so that they are born dead, and, therefore, are characterized as an abortion, but what they are doing is no different than taking, literally, a child that is lying there in the bassinet at 4\1/2\ pounds and sticking a knife through his chest. It is the exact same effect. One is legal and one is not legal. One is called an abortion. The other is called murder, but there is no difference and make no mistake about it. What the mother is put through in this process of partial-birth abortion in the interest of preserving her health is one of the most dangerous medical procedures one could possibly do.

It is something that is so clear in my mind as a physician, as a compassionate human being, that I cannot really understand how anybody could not vote to ban this procedure. And I say to my colleagues on both sides of the aisle, men and women, this is not about Roe v. Wade. This is not even so much pro-life and pro-choice, although the Members of this body that are speaking tonight are passionately pro-life. But this procedure needs to be banned because it is nothing more than murder in a so-called legalized fashion, and it does nothing to protect the health of the mother.

So I am very proud to tell my colleagues tonight that my vote will be very strong to ban this abomination known as partial-birth abortion, and I want to thank the gentleman from Minnesota for giving us this time tonight to talk about this procedure and, specifically, giving me time to address it.

Mr. Speaker, I rise to express my condolences to the family of Speaker Gingrich. His mother, Kit Gingrich, died Tuesday night in Harrisburg, PA, at the age of 77.

Having lost a parent myself, I know personally the pain that such a passing brings. My heart goes out to the speaker and to his siblings, who lost a loving and devoted mother. Speaker Gingrich's sister, Susan Gingrich, said nothing brought her mother more pleasure than her family. One of her proudest moments was watching her son, Newt, sworn in as speaker of the U.S. House of Representatives in January 1995.

Speaker Gingrich is from Cobb County, which is my home county, and I represent some of the areas that he formerly represented. In Cobb County and throughout Georgia, the speaker remains a beloved and revered figure for his great leadership and his contributions to our state and to our nation.

On behalf of the people of Georgia's 11th District, I want to let the Gingrich family know they're in our thoughts and prayers during their time of loss.

Mr. Speaker, I thank the gentleman from Minnesota. The gentleman has actually been to Iraq, he has been to Baghdad, and he has seen on the ground many of these things of which we are speaking about tonight. As the gentleman points out, we are not really getting, if you rely just on 24-hour news and the newspapers and coverage, we are not really getting the whole picture, the full picture. I am glad that the gentleman was part of a group that recently was in Iraq who could see for themselves and understand that, as he points out, how much progress is being made.

Mr. Speaker, there is a lot of discussion, of course, about where the weapons of mass destruction are, where is Saddam Hussein, and, of course, we want answers to those questions. But what the public needs to understand is that progress is definitely being made. Nobody denies the existence of Saddam Hussein, and I think we will ultimately find him. But let me just point out a little bit of information that I think is important on this issue.

The Iraq Survey Group is tasked with the search for the weapons of mass destruction. The ISG has between 600 and 800 personnel in Iraq and is headed by former U.N. inspector David Kay. The Iraq Survey Group's highest priority is the hunt for weapons of mass destruction. They have formed quick reaction teams to explore sites indicated by intelligence. The Coalition Provision Authority has actually offered a reward of up to $25 million for the capture of Saddam Hussein. And, of course, this same type of incentive is what led to the finding and the killing of Uday and Qusay.

So a lot of progress is being made. We have the inspectors on the ground, and we are following up on every lead. This is just one of the things that I wanted to point out, and the gentleman from Minnesota, of course, knows that because he has been there and he has seen it.

Mr. Speaker, if the gentleman will yield, yes, and I am so glad the gentleman from Minnesota (Mr. Kennedy) brought that up, because there are some 240-some hospitals in Iraq, and many of them are being brought back on line, and there is a lot of work that is being done. The gentleman points out the fact that schools are being built, hospitals are being reopened. Much of the infrastructure is markedly improved.

Electricity is an example. I think currently there are 3,200 megawatts of electricity being generated. The prewar level was 4,000. The national demand is estimated to be 6,000, but the Coalition Provision Authority plans to reach 4,000 megawatts by August. Baghdad is receiving, the city of Baghdad, 1,200 megawatts. Prewar levels were 2,500, averaging 3 hours on and 3 hours off each day.

So we are definitely making progress, as the gentleman points out, and not only in the infrastructure, but, as he also mentions, in health care, and in water as well. Much of Iraq is at prewar water level supply levels now. There is no critical shortage of water.

Mr. Speaker, I think the gentleman has pointed out something that is very important in regard to the fact that Saddam Hussein, at the outset of the conflict, just opened the prison doors. I mean, he just literally opened those prison doors and turned all of these bad guys, and when I say bad guys, I am talking about murderers, onto the streets of Baghdad, particularly in the population center. Now, one can just imagine if we did that in this country. In my home State of Georgia, if we just all of a sudden opened that Federal penitentiary in Atlanta and let all of these people out on the street, the number of attacks, assault, battery, assault with a deadly weapon, murder, rape that would occur in the city of Atlanta, and one can understand. One begins to get, I think, a better picture.

But as the gentleman points out, there is not mass chaos in Baghdad. We have, yes, some very difficult things to deal with, as the gentleman from Minnesota (Mr. Kennedy) points out, Mr. Speaker. But let me give my colleagues this information about security and force protection that we have begun to restructure.

Coalition forces are on the offensive. They are putting constant pressure on the enemy to disrupt some of these attacks. The coalition forces are also deterring attacks with aggressive patrolling, cordons, and raids based on actionable intelligence. I do not think anything is more important than intelligence, and we are beginning to get that.

Currently the Coalition Provisional Authority has actually hired some 32,000 police officers nationwide, and 28,000 are already on the streets. The ultimate goal, by the way, is some 61,000. The police are conducting joint patrols with coalition forces.

So this picture that is being painted of mass chaos and everything on the backs of our brave American fighting force, they are doing a great job; they are doing a great job, but they are not doing it completely on their own. As I point out, we are hiring, we are putting Iraqi security forces on the street, and ultimately they will do the job. They will restore order for their own country.

Mr. Speaker, I am glad the gentleman mentioned about the heroism of our troops and of course some 130,000; and of course, he also pointed out that there are about 25,000 from other countries, indeed some I think the gentleman said maybe 20-or-so other countries, obviously the Brits, the Pols, and that is growing every day; but there is just no question that the commitment of the coalition forces and our own troops is strong.

They know what the mission is; and obviously, loved ones back home, spouses, parents, grandparents, they are concerned. Their youngsters, their loved ones are in harm's way. Sure, they want them to come back home and they will come back home; but they know what their mission is, just as our men in World War II and the Korean conflict and other wars that we have been engaged in, they are committed and they will stay the course. I just could not be prouder of the job that they are doing there.

Mr. Speaker, I wanted to talk a little bit about the cost. Of course, the President is coming to Congress now and asking for a supplemental appropriation to continue the efforts to win this war on terrorism, not only in Iraq and Baghdad but also in Afghanistan and really in the entire world. We hear a lot of discussion obviously about, well, how can we afford 87 additional billion dollars to continue this effort, and I want to just talk to the gentleman a little bit about that and maybe get into a discussion about cost and putting this in its proper perspective.

Obviously, $87 billion is a big number and the question comes up, we hear it all the time, can the United States afford this war and continue to do everything else the President calls for? The answer is yes, in my opinion. We cannot afford not to do what is necessary to win the war against terror, ensure a sustained economic recovery, and secure the homeland. The funding for the war is necessary and significant; but keep in mind, it is a temporary cost, and the cost of fighting the war is well below the cost of previous conflicts. In fact, $87 billion is less than 4 percent of the entire Federal budget.

I think it is important, Mr. Speaker, that people understand the total cost of the 9/11 attack. We are talking about hundreds of billions of dollars in costs just from that act of terrorism, and one study even pegged the cost to our economy of well over $2 trillion. So we know that this effort that we are conducting in Iraq, this war against terrorism there, better there than on our own soil, and our continued expenditures for homeland security, it is a big number but it is small in comparison to what it would cost us and the devastating effect on this economy should we have another 9/11 occur anytime soon.

So I think it is real important that we put that in perspective, and I would like for the gentleman to speak to that if he would.

The gentleman is so right, and of course, people want to

say, well, we have not found any weapons of mass destruction, we have not killed or captured Saddam Hussein, so we have not accomplished the mission, the reason we went there; but of course, that was never the reason. As the gentleman from Minnesota points out, the reason for being there was to rid that part of the world of a dictator, of a tyrant; and of course, although we have not found a cache of weapons of mass destruction, in the process of looking, we have certainly found lots of evidence of mass destruction, that is, bodies, mass graves, where Saddam Hussein has murdered his own people.

As the gentleman points out, the main purpose is to bring some stability to the Middle East and to that part of the world as we effect this regime change; and make no doubt about it, that mission has been accomplished, and I wanted to just speak a little bit more, continue in that vein on cost, and it is actually estimated that since the Gulf War 10 years ago that the cost of containing Saddam Hussein, and that cost would be continuing if we were not rid of him, that cost over that 10- year period cost Americans at least $30 billion, $30 billion from the end of the Gulf War to the beginning of Operation Iraqi Freedom, for the military forces stationed in the Persian Gulf, patrols over the no- fly zone and, of course, associated costs.

So just appeasing, or if we want to say containing, Saddam and maintaining the status quo, as so many of our allies of the United Nations, countries who have been our friends and I think will continue to be our friends, that appeasement, that stance of do nothing and taking a chance and letting a sleeping dog lie was costing us, over a 10-year period of time, $30 billion; and those costs were just going to escalate.

Well, Mr. Speaker, if the gentleman will yield, I think it is important to point out that in Iraq we are not talking about a Third World country. We are talking about what we formerly knew as Mesopotamia, the land between the Tigris and Euphrates. It is one of the oldest nations on the face of the earth and has had beautiful civilizations.

This is a situation where a brutal dictator was suppressing, indeed even killing his own people. And not only his own people, but also the neighboring countries, where we have moderate Muslim countries that are friendly and understand the value of life, like Turkey, as an example, and we mentioned Kuwait, and, of course, other neighbors of Saddam Hussein. Under this dictator, this regime and its reign of terror, if you will, these other countries lived in constant fear. And until we rid Iraq of Saddam, there would never be any opportunity for people to feel secure.

I am real pleased that the gentleman from South Carolina joined us this evening, and I commend him. He is one of maybe only 25 percent of the Members of Congress who is actually a veteran. I know his three sons also served in the military, and no doubt his teenage boy one day will. And it is really good to hear in these colloquies, and I know the gentleman from Minnesota would agree with me, to hear from people like the gentleman from South Carolina (Mr. Wilson) who knows the

military, understands, and who was part of a group that just recently returned from Baghdad, along with the gentleman from Minnesota, and with his own eyes, and your own eyes, saw the tremendous job that our troops, our well-trained troops, our modern technology was able to perform. They were able to inflict maximal damage with minimal collateral damage; with laser precision attacks, protecting as many innocent men, women and children as possible and I commend you.

Mr. Speaker, if the gentleman will yield, pointing out the attack on the U.N. Embassy in Baghdad where most of the deaths were Iraqi citizens, and, of course, the Ambassador from Brazil who had spent his entire professional life in trying to promote humanitarian efforts not just in Iraq, but in many, many countries, and for them to just come in and blow up that U.N. Embassy, and what was the U.N. doing in Baghdad? They were not a fighting force, they were just there for humanitarian reasons, that is all; in fact, so humanitarian that they refused to defend that facility. They did not want it to be guarded. They did not want it to appear that they were in any way there as a fighting force. And look what happened to them.

As the gentleman from Minnesota (Mr. Kennedy) has pointed out, this killing is wanton, it is indiscriminate, and so they are not just attacking our fighting men and women, the United States troops, it is their own people. And it is this reign of terror that we are having to deal with, and it is something that just could not stand, and we had to bring an end to that, and we are going to have to continue.

The President has come to the Congress, and I talked earlier about the cost, and trying to put it in the proper perspective. And I think the gentleman from South Carolina (Mr. Wilson) and the gentleman from Minnesota (Mr. Kennedy) would agree with me, none of us like deficits. We do not like debt. We would love to have a balanced budget. We are all fiscal conservatives, and $87 billion is a lot of money, but let us talk about cost and try to put it in its proper perspective.

I have heard this statement: The $87 billion is far more than what we spend on education or other priorities. How can we justify that? That is absolutely wrong. Of course it is a lot of money, but remember this: This is a temporary expenditure. This is an investment in America's security.

In contrast, the government's sustained commitments to domestic priorities are dollars spent every year, and they grow over time which appropriately dwarf this incremental cost.

Let me just give some comparisons in the fiscal year 2004 budget: Social Security spending, $492 billion in fiscal year 2004 and growing; Medicare, $259 billion; Medicaid and the Children's Health Insurance Program, $187 billion; veterans expenditures, $57 billion; education K- 12, $53 billion; the amount of money this country spends and we will be appropriating this year for higher education in the way of Pell grants and student aid loans to our neediest students so they can go to college, $90 billion.

Again, $87 billion, and I love to get the input from the gentleman from Minnesota (Mr. Kennedy) and the gentleman from South Carolina in regard to this overall cost and putting it in the right perspective. We hear over and over that people are more concerned about jobs than they are about homeland security. Members have heard that. We see it on some of the news shows at night. But while jobs, jobs, jobs are very important, and the President has brought to us an economic growth package that is going to grow those jobs, yes, there is a little bit of lag in the policy before those small business men and women can create those jobs, but just keep in mind, and I want to throw this out to put it in the right perspective, on September 11, 2001, some 2,875 men and women that went to work that morning at the Twin Towers at the Trade Center, they had jobs. They had good jobs. They had good jobs with good benefits, and they went to work that day feeling secure. Unfortunately, they were not secure. They no longer have jobs. They no longer are with us. They lost their lives that morning.

So while jobs are extremely important, and we need to do everything we can to stimulate this economy, and I commend this President and this administration and this leadership in what we are doing, Mr. Speaker, in trying to grow those jobs, they are not worth a tinker's darn if we cannot assure these workers when they go to work every day that they are going to come home to their loved ones in the evening. So we have to put it in its proper perspective.