Floor Statements

Madam Speaker, I would like to take this opportunity to express my strong support for S. 2430, the Great Lakes Fish and Wildlife Restoration Act of 2006 (GLFWRA), which passed the House yesterday. This important legislation makes available critical federal dollars allowing state and tribal management agencies to take significant strides to address the challenges threatening Great Lakes fish and wildlife resources and habitats. This bipartisan bill passed the Senate by unanimous consent and I am hopeful will be signed by the President soon. I believe the reauthorization of the GLFWRA will go a long way to help protect the environmental and economic health of one of our nation's most unique and splendid natural treasures: the Great Lakes.

In both size and ecological diversity, there is no other freshwater system which matches that of the Great Lakes Basin. The Great Lakes are simply magical. They offer outstanding recreational and tourism opportunities. The Great Lakes are a source of drinking water for millions of residents and provide a safe and efficient mode of transportation in the region. Obviously, the Great Lakes also provide habitat for our fisheries and wildlife. Ohioans know what Lake Erie means for the state's economy. Lake Erie alone produces more fish for human consumption each year than the other four lakes combined. And, Lake Erie supports a $1 billion a year sport-fishing industry and one of the largest freshwater commercial fisheries in the world. There is no question that restoration and protection of one of our nation's most unique and precious resources, the Great Lakes, warrants the level of federal commitment reauthorized under S. 2430.

I am pleased that S. 2430 is consistent with the Great Lakes Regional Collaboration's (GLRC) Strategy to Restore and Protect the Great Lakes. The GLRC is a tremendous effort to coordinate the pathway forward for the restoration, protection, and sustainable use of our Great Lakes. I am pleased that passage of the Great Lakes Fish and Wildlife Restoration Act will advance the GLRC goals which were developed through extensive collaboration of federal, state, tribal, and local partners.

The challenges facing the Great Lakes will not be solved overnight, but the GLRC process has designed a unifying strategy forward, and I strongly support S. 2430 as one part of that strategy to restore and protect our invaluable Great Lakes.

Mr. Speaker, I thank the gentleman for yielding, and, Mr. Speaker, I rise in strong support of

H.R. 5013, the Disaster Recovery Personal Protection Act of 2006. This good bipartisan effort will protect individuals' rights to maintain their personal firearms during an emergency.

Unfortunately, we know what happened just a few months ago in the aftermath of Hurricane Katrina. Many in the gulf coast region had their personal firearms confiscated by authorities. Many families lost valuable heirlooms this way. H.R. 5013 would allow individuals in future disasters to maintain possession of their personal property, including their firearms.

I urge all of my colleagues on both sides of the aisle to support this commonsense and much-needed legislation.

Mr. Speaker, on rollcall 378, which I missed as a result of my being detained at the airport, I indicate for the Record that I would have voted ``nay'' had I been here for that vote.

Mr. Chairman, I rise today in strong support of H.R. 9, the Coretta Scott King, Fannie Lou Hamer, and Rosa Parks Voting Rights Act Reauthorization and Amendments Act of 2006. I can think of no better way to honor the legacies of Mrs. King, Mrs. Hamer, and Mrs. Parks than to pass this good, bipartisan bill.

Like most of my colleagues, I remember vividly the passage of the original Voting Rights Act of 1965. This landmark piece of legislation served as a significant milestone in the Civil Rights Movement. However, as we act to reauthorize this bill, it is all too obvious that the struggle for equal voting rights for all Americans is not over. Sadly, we know that we still need the VRA because we continue to hear reports of election-day abuses and violations.

Now is not the time to weaken or water-down the VRA. Some of my colleagues will offer amendments under the guise of modernizing the VRA. I believe that these proposed changes to the legislation will strip out some core protections that are still necessary. I urge all of my colleagues to oppose any amendments to H.R. 9, and to overwhelmingly pass a clean Voting Rights Act Reauthorization.

Mr. Speaker, I ask unanimous consent to have my name removed as a cosponsor of H.R. 2048.

Mr. Speaker, on behalf of the National Academies of Practice I would like to submit the National Policy Concerning Privacy of Health Care Records Paper to the Congressional Record.

National Policy Concerning Privacy of Health Care Records

Summary

Confidentiality--the understanding that information given

in confidence will be held in confidence--has characterized

the patient-practitioner relationship for the last 2400 years

or more. It has been an essential component of the

professional's promise to be a conscientious fiduciary, a

promise that has been the cornerstone of patient trust in the

health care system.

Privacy--the right of the individual ``to be left alone,''

a liberty of personal autonomy that the Supreme Court has

held to be protected by the 14th Amendment--has been emerging

over the last several decades as a salient issue in health

care. This emergence is driven by technological changes that

have radically altered the ability of confidentiality pledges

alone to assure the security of sensitive personal

information. Privacy is related to confidentiality but has

differing implications that need to be understood.

An effective health care system requires sound public

policy that sensitively addresses privacy and confidentiality

issues in ways that do not jeopardize the crucial patient-

professional relationship and do not impair the

practitioner's ability to justify the trust of his/her

patients.

Introduction: This paper is a brief description of the

issues involved in health care confidentiality and in

statutory regulation of patient privacy rights. It suggests

the direction that national policy should take in addressing

these issues. It reflects the perspective of the National

Academies of Practice (NAP), a multidisciplinary body of

distinguished health care practitioners that was founded to

distill the wisdom of the practice community into functional

national health policy.

Confidentiality: Confidentiality is the assurance that

information received in confidence will be held in

confidence. As part of their ethical commitment,

professionals have promised confidentiality of patient

information from as long ago as approximately 400 BC, with

the introduction of the Hippocratic Oath: ``All that may come

to my knowledge in the exercise of my profes-

sion . . ., which ought not to be spread abroad, I will keep

secret and will never reveal.'' A similar confidentiality

promise has been incorporated into almost every ethics code

of almost every health care profession since that time.

Trust, based in part on assurance of confidentiality, is

necessary to achieve open communication and cooperation.

Without such trust, professional effectiveness is severely

limited or impossible. The National Consumer Health Privacy

Survey of 2005 (California HealthCare Foundation) suggests

that this trust is severely stressed in our modern health

care system.

Privacy: Privacy, in the words of Justice Louis Brandeis in

1890, is the ``right to be left alone.'' This right has been

held to be supported by the 14th Amendment, and partially

supported by the 1st, 4th, and 5th Amendments. In varying

degrees, the right has been extended to certain personal

records and other information; however, case law and judicial

holding about the right to privacy of personal information is

still in flux. The November 2, 2005 ruling on No. 04-2550 in

the United States Court of Appeals for the Third Circuit,

Citizens for Health v. Leavitt, suggests that such right may

depend more on individual statutes than on constitutional

protection.

Privacy was not a traditional consideration in health care,

but has become one. The patient does not want to be ``left

alone'' in the treatment relationship, but does want his or

her health information to be held in confidence.

Traditionally, when only the professional had access to the

record, usually a hand-written notation in his or her private

file, privacy of the record itself was automatic so long as

confidentiality was maintained. Today, good health care

requires that the professional's findings be entered into a

permanent health care record that is available to multiple

other parties. When that happens, the professional loses

control of the information, and only protection of the record

itself can assure professional confidentiality. That

protection is directly dependent on privacy policies or laws

that fall under statutory rather than professional control.

Adjudication of privacy rights under law, especially the

extension of those rights to health record information, did

not have its origin in health care concerns. herefore, people

writing privacy policy tend to be unfamiliar with the

tradition of health care and confidentiality, just as health

care providers, steeped in the tradition of confidentiality

as an ethical commitment, tend to be uninformed about the

nuances of privacy law. The hazard is great that health care

practitioners, with the wisdom of the ages behind them in

building necessary patient trust, will be ignored in the

development of privacy law and that those who develop privacy

policy will be insensitive to the critical nature of the

patient-practitioner relationship. At risk is the

functionality of health care delivery, one of the most

humanely important and economically significant enterprises

in the country.

Cultural Shift from Confidentiality as Sole Protector of

Privacy: The Joint Commission on Accreditation of Healthcare

Organizations (JCAHO) and other groups require accredited

facilities to have in place patient's rights regulations that

protect sensitive health information. As noted, the safety of

such records can no longer depend on confidentiality

agreements alone. Privacy of the health care record itself

has to be assured. Extensive national policy positions have

recently been established to address the privacy issue. The

most notable is the Health Insurance Portability and

Accountability Act (HIPAA), which laudably adds many

necessary patient protections. Health care professionals

nevertheless find HIP AA to be both ineffective and

burdensome in certain key respects. Future refinements are

clearly needed. Understanding the shift from exclusive

reliance on confidentiality to the need for privacy laws

can point toward effective solutions. Four trends warrant

highlighting.

Numerous health care professionals, third party payers,

employers, and support personnel are routinely involved in

today's health care system. The health care record has become

the medium of communication among these involved groups. The

health care professional can neither functionally withhold

sensitive information from the record nor control the use of

that information by others. The old promise of

confidentiality is therefore no longer adequate protection of

the sensitive information.

Technology has greatly increased the amount of sensitive

information that directly enters the record, information that

is not directly under the practitioner's control. These data

include X-rays, blood chemistries, and numerous other

laboratory or technologist-based findings. At the same time,

the need for these laboratory personnel and technologists, as

well as insurers, consultants, and others, to have access to

health care information increases. All of these developments

magnify the importance of controlling the health care record

itself and its use by everyone with access to it.

The growing complexity of the health care system places

increasing demands on the health care record. In response,

the information age is replacing traditional multiple written

records with a single electronically encoded one that can be

accessed by almost any properly prepared person almost

anywhere on earth. This shift to an agglomerated record in

electronic format greatly magnifies the utility of the record

as an aide to effective health care. At the same time, it

creates a nightmare for control of privacy of the information

it contains. Not only are confidentiality pledges inadequate

but so also are privacy laws that cannot prevent hacking and

other forms of electronic information theft.

The primary ingredient of effective health care over the

last 2400 years or so has been the commitment of health care

professionals to be conscientious fiduciaries. That continues

to be the primary ingredient, but one that is being

increasingly obfuscated by the shift from guild control to

legal control of health care practice. As already noted, laws

are necessary to implement privacy rights. Similarly, legally

enforced licensing laws have replaced guild control of code

of conduct issues, and the growing complexity of the health

care system has interfaced health care with the legal system

as never before. The result has been a tendency to raise both

public and regulatory expectation that legal mandate can

guarantee professional integrity. In fact, laws can

supplement but cannot guarantee or replace professional

integrity, which is as critical today for effective health

care as it ever was. How far this muddying of the critical

importance of the professional relationship will go remains

to be seen. In the mean time, it creates a pressure for the

professional to shift away from ``caring'' practice to

``safe'' practice and for the patient to shift away from a

``trusting'' attitude to a ``litigious'' attitude. Both of

these trends are often at the expense of effectiveness of

treatment and economy of service delivery. The shift toward

legal regulation is

inevitable, so the sensitivity with which policies and laws

are drafted is absolutely critical for the future health of

the nation.

The foregoing are dramatic changes in long-accepted

traditions. Privacy of the health care record, legally

regulated, is the visible ``new kid on the block.'' Unlike

professional confidentiality, it has little ``wisdom of

history'' behind it. Not surprisingly, there is a tendency to

address privacy by tactics that might work for

confidentiality but do not work for privacy, by placing heavy

penalties on professional breaches. This is ineffective when

little attention is given to the leaky-sieve aspects of the

health care record system itself. In fact, it can be severely

counter-productive if it poisons the traditional trusting

relationship between patient and professional. The urgent

need is for highly sensitive and highly enlightened health

care policy that preserves the wisdom of the past.

Tentative Answers to Complex Questions: Five questions

arise in the context of the new privacy era in health care.

1. How extensive should the health care record be? The

health care record will, and should, become increasingly

complex and extensive. Information technology allows the

retention and utilization of vast quantities of information.

The future health care record will almost certainly be in

electronic form. With electronic data manipulation

techniques, even an extensive record can be efficiently

sorted to allow quick decisions about immunizations,

allergies, past responses to specific treatment approaches,

drug interaction risks, excessive or inappropriate drug use,

and similar questions of care. Aggregated data across a given

problem or disease spectrum could identify both promising and

ineffective treatment approaches. The potential gain from

having such records is impressive indeed, and the technology

for collecting, preserving, and utilizing them is already

largely in place.

2. Who should have access to what information? Portions of

the health care record should be accessible by every health

care practitioner with whom each client will potentially

interact. Other portions should be accessible by insurers,

managed care officials, and similar non-health-care personnel

who have a direct and necessary ``need to know.'' Portions

should be available for malpractice monitoring and similar

purposes. Portions should be available to research programs,

perhaps stripped of data identifying the individual source.

The number of people who should have legitimate access, in

the interest of improving the health of both our individual

citizens and the nation itself, will inevitably grow.

3. How can access be made easy on a ``need to know'' basis?

In this electronic age, partitioning the record for limited

access is technologically easy. For example, a school nurse

needing to certify an immunization record neither needs nor

wants to sort through the entire record. An electronic

summary of immunizations can be programmed into the record

and be made immediately available to a coded request by a

``school health worker.'' Similarly, current health status

and current proposed or completed treatments can be

electronically isolated for benefit of reimbursement or

managed care assessments without exposure of the entire

chart. The mental health record can be sequestered, with

access limited to those with legitimate interest in that

area. In general easy electronic access to appropriate

data can be designed into the system, provided

inappropriate policies do not frustrate legitimate access

in the name of security.

4. How can inappropriate access be prevented? Any effective

solution requires that the electronic record itself be

designed from the beginning to incorporate essentially fail-

proof security features. In the past, ``loose lips'' were the

primary problem, people with legitimate information

intentionally or unintentionally leaking that information.

Control of people was the primary solution. Within the health

care professions, lapse of confidentiality has long been

addressed by guild ethics and by licensing laws that regulate

the actions of the professionals. Outside of the health care

professions, especially in the economic sector, abuse of

confidentiality still needs to be addressed more effectively.

Although important, loose lips are not the primary problem.

They usually endanger only one person at a time, rather than

thousands whose data may be accessible in the electronic

record. Limiting access to the electronic record to those

with a legitimate need to know is the most significant key to

guaranteeing privacy. Electronic data can be hacked, copied,

transported, collected, sold, and otherwise manipulated in

ways that are difficult to detect by people who are hard to

identify. Passwords and other access codes, encryption, and

the like may be essential, but they are not enough. The

Internet, the primary platform for current electronic data

portability, has not yet achieved the levels of security that

are necessary.

A workable system might involve a completely separate

health information network operating out of a centralized

data bank and accessible only through authorized terminals.

Security might involve requiring bioelectronic screening for

palm prints, iris patterns, voice prints, or the like prior

to system access. Electronic ``footprints,'' or audit trails,

could preserve a record of all data accessed and for what

purposes. An alarm system could alert a central information-

monitoring group when an unauthorized access was attempted or

when an unusual pattern of access was detected. Such steps

would make unwarranted penetration of the system rare, access

to the system by authorized persons easy, and apprehension of

violators probable.

5. Who should control the privacy information? Privacy

rights should guarantee that health care information is held

confidential within the health care system, except as the

patient explicitly opts out of the privacy agreement. It is

the patient's knowledge that his or her own sensitive

information will be used only for health care purposes that

assures the trust necessary for effective cooperation.

Circulation of the information within the legitimate health

care system is necessary and functional, but circulation

outside of that system, without explicit and uncoerced

patient consent, should be taboo. Public knowledge of

personal health problems can be severely damaging. One only

has to recall Eagleton's vice-presidential nomination.

A few legally mandated requirements, such as the duty to

protect or the duty to alert authorities of abuse of helpless

patients, currently require exceptions to confidentiality.

Perhaps other exceptions are warranted, but professional

experience suggests that they should be rare and very

carefully crafted. We suggest that they should be limited

to those circumstances that pose an explicit future threat

to others or an abuse against which a patient is not

capable of protecting himself/herself.

While a patient may voluntarily choose to waive some

privacy rights, perhaps in exchange for convenience or other

benefits, waivers that are determined by law as part of

health care policy, as in certain sections of HIPAA, are

often more disclosure notices than they are matters of

voluntary consent. Without true voluntary consent, there is

no choice and no trust. These complexities reflect the early

growing pains of privacy law and can have serious unintended

consequences.

It is in these areas of developing health care policy and

related privacy law that health care practitioners can make

some of their most important policy contributions. The danger

is that others who determine such policies may either fail to

understand or simply disregard the practitioner perspective,

at great harm to the nation's health.

Conclusions: Practitioner work is anchored on two premises

that have stood the test of time: patient trust, which is

necessary for essential communication, and the guarantee of

confidentiality of information, which requires that the

health care record be used exclusively for health care

purposes. The National Academies of Practice recommends that

information in the health care record should be exclusively

available for health care purposes and that the record should

be protected from access for any other use.

Maintaining privacy with an ever expanding and easily

accessible electronic health care record, in an ever more

complex health care delivery system, requires new approaches.

These approaches must be integrated into the record keeping

and service delivery systems themselves, through

technological safeguards. Health care practitioners cannot

control the privacy of the health record and do not control

privacy policy, but our long experience with confidentiality

issues and our pragmatic wisdom concerning the treatment

process offer understanding that should be an essential part

of policy development.

Some present trends in national privacy policy are

threatening the integrity of the practitioner/patient

relationship. A sensitive and sophisticated privacy policy

for health care records that does not jeopardize the

necessary trust of the patient is critical to assure the

effectiveness of health service delivery. Health care

professionals that represent the wisdom of the

multidisciplinary practitioner community are an indispensable

resource for such policy development. Failure to incorporate

them, visibly and functionally, into the policy making

process risks jeopardizing the millennia-long practitioner

tradition of establishing consumer trust on which the

effectiveness of health care depends.

Mr. Speaker, it is with great pleasure that I rise here on the floor of the people's House to congratulate Dodie Ditmer on her retirement from the Communication Workers of America after over 43 years of service to the union and to our Nation.

Dodie was born in Clairfield, Tennessee. She was one of eleven children. She later married Gregory Kent

Ditmer, and together they have one daughter, Tamara Kaye, and one granddaughter, Emily.

On February 13, 1963, Dodie became an operator at Ohio Bell in Dayton, Ohio. She became a member of CWA Local 4311 on that same day. She was appointed as a steward in the union in 1964, going on to be elected local president from 1973 through 1988. On May 1, 1988, Dodie was appointed to CWA staff representative. Dodie also has the distinction of becoming the first woman to be appointed as assistant to the vice president of district 4 in October of 1994. She also served the union as director of education and the COPE political director.

Dodie returned to Dayton, Ohio, in August of 2005 to work with the IUE-CWA and various other locals. Dodie has served the membership extensively on various union, community and political boards and committees.

I have had the great privilege of working with Dodie across the years. Together, we have fought and won many battles on behalf of working men and women, and I have always appreciated her thoughtfulness, her candor and her good humor. I am confident that she will not retire quietly, but I think that she will continue to be an active person in her community.

Ohio has many outstanding citizens, and Dodie Ditmer is certainly one of Ohio's finest. I congratulate her tonight on her retirement, and I wish her Godspeed in the days, weeks and months to come.

Mr. Speaker, will the gentleman yield?

I thank my friend for yielding, and it is true that as the folks gather there in Youngstown, Ohio, we will not be able to be with them, but our thoughts will be with them as we honor veterans. And especially we will remember the Tuskegee Airmen.

The Tuskegee Airmen have the distinction of never having lost an American bomber under their escort. The Tuskegee Airmen overcame the enormous challenges of prejudice and racial discrimination that existed within our country, and they inspired revolutionary reform within the entire Armed Forces of our Nation.

The Tuskegee Airmen, with their courage and their dedication, paved the way for the full racial integration of our Armed Forces. The Tuskegee Airmen were not only heroes serving to protect American rights that did not extend to them as Americans, but they were also among the very first to challenge our Nation's segregationist policies. Because of them, because of the standard they set, because of the success they enjoyed through their hard work and commitment to this country, our Nation became a better country.

As we honor all veterans, we especially are thinking of these wonderful men who set such an example for all the rest of us. I yield back to my colleague.

Mr. Speaker, we gathered here in the People's House today to provide some financial assistance to those who have suffered as a result of this natural disaster. I think it is important for us to remember that those who are suffering most are those who are the poorest among us.

I was reading the New York Times, and I read this comment from an engineering professor at the State University of Louisiana who has served as a consultant on Louisiana's State evacuation plan. He said that little attention had been paid to the evacuation of New Orleans' low mobility population, the elderly, the infirm and the poor without cars or other means of fleeing the city, about 100,000 people.

We knew this disaster was upon us days before it reached our shore. In fact, the President went on television and urged people to evacuate the city. We saw the TV pictures of cars lining the freeways as they were heading northward out of harm's way. But apparently there were many in New Orleans and elsewhere along the hurricane's path that did not have cars, that did not have credit cards, that had no means of renting an automobile for transportation, that could not afford a bus ticket, that simply were left behind. These were the poorest among the city's population.

Then the flooding came, and these, the sickest, the poorest, the oldest, along with many children, have died; and the sad truth is that many have died unnecessarily. Many have died simply because they lacked for water, they lacked for food, they lacked for timely medical attention.

We are the greatest, most advanced Nation on the face of the Earth. We have at our disposal every resource that is known to mankind. Yet when disaster hit our own country, when our own citizens were without food and water and medical care, we did not respond in a timely manner, so many lost their lives. And those who lost their lives were primarily black and they were primarily poor, and that should strike at the conscience of every one of us.

We are all a part of a great human family, but we are also a part of a great national family; and when tragedy strikes any of us, all of us should feel affected.

Mr. Speaker, the House has done a good thing today in providing initial relief resources, but there is much more that needs to be done in the days and months ahead. One of the things that must be done is for us to examine ourselves as a Federal Government and as a people. Why is it, why is it that it is the poor, the minority, the child, the elderly and the infirm who are most likely to suffer in times of disaster,

whether they be of man-made proportions or of a natural occurrence?

Mr. Speaker, we should all pray that those who are in need of assistance at this hour receive it as quickly as possible, but we should also hold those accountable who are responsible for making sure that that assistance is available in a timely manner.

Mr. Speaker, pursuant to Senate Concurrent Resolution 51, 109th Congress, I move that the House do now adjourn.

Mr. Speaker, over the last few days I had the privilege of visiting in the home of John Bocerri. John Bocerri is a young Ohio State representative. He is the husband of Stacy, the father of two young daughters and just 3 days ago brought to his home from the hospital his third child, born 8 pounds, 8 ounces, young Matthew Bocerri.

I was in that home as John gave that young infant into the arms of his young daughters for the very first time. John is a pilot in the Air Reserves flying out of the Youngstown Air Base. He flies the large C- 130 transport planes.

On Thursday of this week, tomorrow morning, at 10 o'clock, John Bocerri leaves his wife, leaves his two daughters and his new infant son to go to Iraq for the fourth time. For the fourth time. John Bocerri represents the hundreds, yea, the thousands of young Americans who are serving this country with honor and distinction. It is sad that John Bocerri's children will pay for the cost of this war.

Mr. Speaker, I thank the gentleman. It is good to be with my colleagues as we talk about this important issue.

I would like to share with my colleagues an experience I had over the weekend involving a real person, a real American. Representative John Bocerri, a young State representative from my State of Ohio, serves in the State legislature. He is also in the Air Reserves, and he has previously been to 3 deployments in Iraq. He flies these big C-130 transport planes.

John has a wonderful wife and 2 young daughters, and just about 4 days ago his third child was born. A little guy named Matthew Bocerri. They brought him home the day before yesterday, and I was there as this wonderful family gathered around this newborn, sisters holding him for the first time.

John Bocerri is leaving Thursday of this week for his fourth deployment to the war zone. A young father with a child recently home from the hospital for the fourth time is being sent by this country to the war zone to fly transport in and out of Iraq from Qatar.

When you talk with someone like John Bocerri, when you see his little daughters and his newborn child and you talk to his wife you understand what this war is doing to Americans, to families, to community. The President has some explaining to do to all of us.

I have here an e-mail from a Marine Corps Civil Affairs officer who is currently in Ramadi, Iraq. This Marine has received his master's degree in international policy from Stanford University. He is a bright guy obviously. And I would just like to read briefly from his e-mail and then I will be happy to hear from the rest of my colleagues.

This young Marine writes, ``As an Iraq War veteran, I disagree with how President Bush has assessed the war and how we should be conducting it. The President has mischaracterized the debate as a simplistic black and white challenge. Is the sacrifice worth it? That is the question. But this mischaracterization clouds the debate and avoids 2 essential questions: What are the real conditions on the ground and what must be done to win this war?''

He continues, ``Unfortunately,'' he says, ``the President obscures the truth of the current conditions in Iraq. My personal experiences in Iraq confirm statements made by numerous officers there, including General John Abizaid, Commander of the U.S. Central Command, that the insurgency shows no signs of weakening and its numbers continue to grow. The Bush administration must first recognize this serious problem in order to rectify it.''

``Denial,'' says this young Marine, ``is not the path to success. As a Marine Corps Civil Affairs officer serving for 7 months in Ramadi, a hotbed of the Iraqi insurgency, my job was to cultivate economic, governmental and civil society development. This work was part of a strategy to inculcate Iraqis with the desire and capacity to defeat the insurgents themselves, allowing America's withdrawal.''

Then he concludes his e-mail with this sentence. ``The gap between President Bush's rhetoric and the reality that I saw on the ground is enormous.'' It is time for some truth telling from this President and this administration. The American people can deal with the truth. But I say to my friend from Hawaii (Mr. Abercrombie), the American people are sick and tired of exaggerations, of distortions, of mischaracterizations, of twisted and distorted intelligence.

The American people and young Americans like John Bocerri that I just talked about earlier deserve to hear the truth from this President.

I thank the gentleman for allowing me to join him for these moments. It is good to be back with my fellow colleagues as we talk about these important issues.

Announcement by the Speaker Pro Tempore

Mr. Speaker, as a parliamentary inquiry, does that mean that I cannot make characterizations about actions that are taken by this administration?

May I say that the President mischaracterized the intelligence?

I thank the Speaker.

I would clarify my statement by saying that I believe the President has mischaracterized the intelligence and that, in fact, has led us into a war that in my judgment has not been justified.

Mr. Speaker, looking at this picture, it almost makes me nauseated. What you are telling me is that Americans work hard, pay their taxes, and this administration, knowing that this kind of terrible torture and human rights abuses are occurring, still continues to give our tax dollars to this leader simply because he is willing to say he is our partner in the war in Iraq?

That is terribly, terribly disturbing, and I think it does point out what you said earlier, a hypocrisy that discredits us in the eyes of much of the world.

Mr. Chairman, I rise today in support of the en bloc amendment which includes my amendment regarding VA mental health services. My amendment will make sure that soldiers returning from Iraq and Afghanistan know about the mental health services available to them by requiring that they be fully informed of these services when separating from active duty.

Our men and women are returning from deployments with very high rates of mental and emotional disorders. And as we know, there is often a stigma regarding mental health treatment, especially in the military. That is why we need to clearly communicate to our returning troops that they are entitled to receive help in dealing with problems resulting from their service to our country. Whether they are struggling with PTSD, depression or any other mental disorder, there is treatment available for them at our VA facilities. My amendment would simply require that those mental health treatment options are presented to our soldiers so that they can make informed decisions as they return to civilian life.

I appreciate that this amendment was made in order, and I encourage my colleagues to support the en bloc amendment. Our men and women are bearing great physical and mental burdens from the operations in Iraq and Afghanistan. The very least we can do is to inform them of the benefits they have earned.

Mr. Speaker, Thursday, May 19, 2005 I was in Mingo Junction, Ohio and missed rollcall votes No. 190-199. Had I been present, I would have voted ``yea'' on rollcall votes No. 191, 194, 196, 198 and 199. I would have voted ``no'' on rollcall votes No. 190, 192, 193, 195 and 197.

Mr. Speaker, I am pleased to lend my support for House Resolution 250, supporting the goals and ideals of a National Hepatitis B Awareness Week.

We possess the weapons to combat hepatitis B, including vaccination and treatment. For those infected, treatment options exist that are designed to stop the progression of liver disease and reduce liver damage. It is encouraging that educational programs like the ``Aim

for the B'' campaign during National Hepatitis B Week will raise awareness about chronic hepatitis B. I am also impressed with community forums scheduled this week to educate those currently living with the disease as well as their doctors about new and improved methods that can prevent its transmission and progression to liver disease.

As we recognize National Hepatitis B Awareness Week, I encourage Americans who may be at risk for chronic hepatitis B to get tested for the disease and to understand there is a large group of patients who do need treatment right now. With increased awareness, education and treatment for the disease, we can help stop the progression of hepatitis B to liver damage and liver disease.

Mr. Speaker, I join my colleagues in reflecting on the importance of the work being done to combat chronic hepatitis B and recognize the fact that this is a preventable and treatable disease. I appreciate the opportunity to convey my support for House Resolution 250 and to recognize the need for more federal attention on hepatitis B.