Rob Andrews

Mr. ANDREWS

Mr. ANDREWS. Mr. Chairman, I thank the gentleman from Maryland for yielding me this time. Mr. Chairman, I rise in opposition to the amendment because it does the wrong thing in the wrong way. Federal contract officers ought to have clear guidance when a contract competitor has engaged in a pattern and practice of disregard or violation of the law. People who engage in a pattern and practice of violation are bad risks, and they subject the taxpayers to the risk of poor performance or overpayment. Moreover, this is done, I believe, in the wrong way. The administration has carefully looked at the policy issues involved in this, and I do not believe that a brief debate in the context of an appropriations bill is also a place to overturn that judgment. With all due respect, the Committee on Education and the Workforce could and should take a look at this. I believe we will reach the same conclusion the administration did. It is bad business to do business with those who do that business badly. Mr. Chairman, I urge defeat of the amendment.

Mr. ANDREWS

Mr. ANDREWS. Mr. Speaker, I thank my friend from Massachusetts (Mr. Neal) for yielding the time to me. Mr. Speaker, I rise in support of the underlying legislation. I also support the Democratic substitute because I believe that it more fairly targets the benefits of the legislation. I commend the gentleman from Massachusetts (Mr. Neal) and his colleagues for offering it, and I look forward to voting for it. But I want to say to my friend, the gentleman from Maryland (Mr. Cardin), and the gentleman from Ohio (Mr. Portman) that they have demonstrated that people can come together on very contentious issues and do good for the country. Mr. Speaker, I very much appreciate the work they have done on this bill. Americans are going to have more years of retirement and, therefore, need more income, and that is a great thing; but it is a thing we need to be prepared for. Mr. Speaker, I support this bill for four significant reasons. First of all, it repeals what I view as a very strange provision that makes it illegal for employers to put too much into the pension plan for their employees. That makes no sense at all. This will result in more money being put away for employees. Second, I support this because I believe it is great news for people who have left the labor force for a while, usually to raise children, and then rejoin the labor force and want to catch up for those years when they could not put money away. Very frequently women are in this position, although it is not only women. And this is very strong news for those who will benefit from that provision. Third, this legislation corrects what I believe is a glaring inequity and anomaly in the Internal Revenue Code with respect to pension payments made to people very often associated with the building trades or other unions or other crafts who have earned their pensions and because of a quirk in the law had been unable to collect them fairly. This bill corrects that. Finally, the increase in contributions that would be made to individual retirement accounts are a benefit to the economy, as well as to the families who will benefit from those. To the gentleman from Maryland (Mr. Cardin), who has shown great leadership on this, and to the gentleman from Ohio (Mr. Portman), I am pleased that our committee, chaired by my friend, the gentleman from Ohio (Mr. Boehner), has been able to help shepherd this legislation along. I rise in support of it and look forward to its adoption by this House.

Mr. ANDREWS

Mr. ANDREWS. If the gentleman will yield briefly, under the facts as the gentleman just outlined them, let us say the patient had a $1,000 hospital bill, as legitimately presented, and the HMO only paid $800. Under the terms of the contract, the patient would be liable for one quarter of that $800: $200. But the way the bill was being presented to the patient, the patient would pay $250. Now, $50 is a lot of money to people, but it is not enough money to retain an attorney and file suit and pursue the claim. Those kind of claims only get meaningfully pursued through class actions. If thousands of people are owed $50, the economic incentive exists for someone to file suit and pursue the claim. But if a patient cannot do that through a class action, person after person after person who is defrauded out of their $50 will never pursue a legal remedy. And that is another deficiency in the Senate bill.

Mr. ANDREWS. The gentleman has just very eloquently described what in sports we call the home field advantage. Imagine if the home football team got to pick the referees for every game at its stadium without any consultation with the visitors or with the conference in which they play. The home team would win a lot of the games. If you were an external reviewer, external reviewer A has a track record of favoring the HMO three-quarters of the time and external reviewer B has a track record of favoring the HMOs one-quarter of the time, and the reviewers get paid according to the number of reviews that they do and the HMO gets to pick the reviewer, you can imagine which reviewer is going to get more work and what message is going to be sent out to the reviewers. That is a home field advantage if I have ever heard of one and it renders the Senate external review procedures to be farcical in my opinion.

Mr. ANDREWS. If the gentleman would yield, let me first begin by commending him for his tireless advocacy night after night, week after week, year after year on behalf of health care and patients in our country. My friend from Iowa is a physician first and a Member of Congress second, and I say that as a compliment. He has carried his Hippocratic oath to the halls of this chamber and he has done so, Mr. Speaker, with great distinction, and I want to commend him as a Member of the opposite party, as a Democrat, commending my friend from Iowa, as a Republican, for his work on this issue. I was listening to him tonight, Mr. Speaker, and I wanted to just supplement what he so very ably is saying in two ways, because I too have read the legal analysis that my friend from Iowa makes reference to. I am proud that it was produced by, in part by two scholars from my district, from the Rutgers University School of Law in Camden, New Jersey, Dean Rand Rosenblatt and Professor David Frankford were among two of the three authors who did such an outstanding job on that, and Sara also was fabulous and I do not want to omit her, from George Washington University. Let me say, first of all, the remedy that is in the bill in the other body is a remedy in form only. It would not have the compensatory or deterrent effect that a real remedy has. And I believe, frankly, it is designed to be deficient in those ways. It would make people less than whole. A person who is denied the ability to see an oncologist and contracts a form of debilitating cancer would not be made whole by the bill in the other body. A person who is advised that he or she needs a test and does not get that test and suffers a fatal or debilitating injury will not be made whole by the bill in the other body. The damage limitations are arbitrary and capricious. The second problem is the lack of a deterrent effect. The value of the real accountability that is in the bill that passed this House authored by our colleagues, the gentleman from Georgia (Mr. Norwood), by the gentleman from Michigan (Mr. Dingell), and by the gentleman from Iowa (Mr. Ganske), the value of that bill is not the lawsuits that would be brought under it, it is the lawsuits that would never have to be brought as a result of it because a managed care company making an arbitrary and unreasonable decision contrary to the best medical interest of the patient would be held strongly accountable. And when that managed care company weighs the balance that it has in front of it, it would more than likely choose the side of granting the care. It would choose the side of following the duly-given advice of the professionals who gave the advice in the first place. It would restore the primacy of the doctor-patient relationship to American medicine. And that is what this is about. The third point that I would make is that we very often hear from the opponents of the Patient's Bill of Rights and from the supporters of the Senate ersatz version that our bill would lead to a flood of litigation; that it would put lawyers in the place that doctors ought to be. And there is a certain superficial appeal to that argument. I understand, Mr. Speaker, that Americans do not want the right to sue, they want the right to the treatment they have paid for and deserve. But without the right to sue, without the right to hold people accountable in a meaningful way, that care and treatment is going to continue to be arbitrarily and unreasonably withheld by the oligarchs of the managed care industry. And people are not going to sit and wait for us to do something about it. Instead, they are already marching to the courthouse door in State and Federal Courthouses around this country. As a result, we are now witnessing what I would call a crazy patchwork quilt of legal decisions all designed to get around this unreasonable barrier that exists in the present law that says that under the normal law of tort, under the normal law of responsibility, managed care companies are immune from that responsibility. So we have theories about unauthorized practice of medicine, and we have theories about civil racketeering, and we have theories about unlawful conspiracy, and we have theories about denial of quality of care. To those who fear a flood of litigation if the Norwood-Dingell-Ganske bill becomes law, I would say that that fear is misplaced; that if the Norwood-Dingell-Ganske bill does not become law, we can be assured that there will be a flood of litigation by dissatisfied Americans. And instead of that litigation being predictable, under a clearly established set of legal rules and principles written in the statute by us as the duly-elected representatives of the people, instead those rules will be written on an ad hoc, case-by-case basis by State and Federal judges around this country. So I would suggest that that is the flood of litigation that people should most fear. So I want to thank my friend for yielding his time. I again salute him for his truly heroic and tireless work on this issue, and I assure him that the day is coming when his efforts will bear fruit and this bill will be signed into law.

Mr. ANDREWS. If the gentleman will yield one more time, I want to conclude my remarks by saying that the gentleman is not a member of the conference committee that is negotiating the final version of this bill. I am privileged to be a member of that. I suspect that the gentleman is not a member of the conference committee because he holds, as do dozens of his Republican colleagues, the views that he has expressed tonight. This bill passed the House with 61 percent of the Members of the House voting for it, a broad bipartisan coalition. This is not a Republican or Democratic issue. I am hopeful as a conferee that we will return to the conference table, we will do so under the scrutiny of the public and the media, that we will discuss the issues that the gentleman has raised tonight, and that we will resolve our differences and give the President a bill that he can sign. I have been on this conference since it initiated in March, and I said a few weeks ago that someone on the other side said the conference was sailing right along, and it was sailing right along smoothly and I said that they had used the wrong nautical analogy, that the conference was not sailing right along, that it reminded me more of the legislative equivalent of the Bermuda triangle, that good ideas go into the conference and are never heard from again. The gentleman has many good ideas. I commend him again for his good work and look forward to working with him to make this the law.

Mr. ANDREWS. There is another grave danger here. And, that is, that the HMOs will certainly take the position that even if there is not an explicit statutory definition of medical necessity in State law, that the State laws which permit them to incorporate their insurance companies carry with them the implicit right of the HMOs to fix by contract the definition of the terms of their contract. To sort of unpack that and put it in less legalese, they will take the position that State laws implicitly give them the right when they organize themselves to declare what definitions in their contracts mean, that it is a matter of contract. And I assure you that every HMO worth its salt will then put a boiler plate clause in their contract that says medical necessity means whatever we say that it means. So if your child's pediatrician thinks that it is medically necessary for your child to have an MRI but the reviewer for the HMO does not think so because the statistics show that very few 7-year-olds have a tumor problem, the HMO wins. That is a loophole that is very subtle but very disingenuous and very dangerous.

Mr. ANDREWS. If the gentleman will yield, I want to explain the consequences for what he has just correctly stated for constituents in my State. In my State of New Jersey, an individual buying family health insurance would pay in the neighborhood of $10,000 a year. But the price that would be offered through the group plan would be considerably less, probably $6,500 to $7,000 a year picked up by the employer. So let us say the employer gives the employee a $6,500 voucher toward the purchase of health insurance. The choice that my constituents would face under this Senate bill that my friend talks about would be to either have the right to hold the HMO accountable and pay $3,500 for that privilege, which the constituent clearly would not have, or not have the right to hold them accountable. Now, that is like saying to someone that we are going to give everyone in America the right to buy a Mercedes Benz for $75,000. Nice right to have in theory, but if a person does not have the money to afford it, they cannot do it.

Mr. ANDREWS

Mr. ANDREWS. Mr. Speaker, today I rise to praise 15 tremendous students in Mrs. Tracy Clemente's class at the Wenonah School. Mrs. Clemente's class has done a magnificent job of excelling in their school work. This is a splendid group of children and I wish the best of luck and continued success to Phillip Anzaldo, Ashley Archambo, Kevin Barnes, Daniel Barton, Nicholle, Cesarano, Ashley Cuthbert, Davied D'Alesandro, Christopher Goldhill, Chloe Grigri, Shane McHenry, Stephen McNally, Drew Peters, Edgar Seibert, Rachel Sole, and Matthew Thompson.

Mr. ANDREWS

Mr. ANDREWS. Mr. Speaker, I submit the following proclamation for the Record. Congressional Commendation Hon. Robert E. Andrews, U.S. House of Representatives, First District, New Jersey Whereas, The Rutgers University School of Law-Camden, New Jersey and the First Congressional District of New Jersey commend and honor the Honorable Joseph H. Rodriguez for 15 years of distinguished service on the federal bench; and Whereas, United States District Court Judge Joseph H. Rodriguez embarked on his distinguished legal career immediately after graduating from Rutgers University School of Law where he was admitted to practice law and became a member of the bar of the State of New Jersey; and Whereas, in 1985, the President of the United States of America, President Ronald Reagan, nominated Judge Rodriguez to the federal bench in Camden, New Jersey where he has continued to establish a standard of excellence in the legal profession; and Whereas, over his distinguished legal career, Judge Rodriguez has received numerous awards recognizing him for his accomplishments which include his induction into the Rutgers University Hall of Distinguished Alumni in 1996; and Whereas, this Member of the 106th Congress recognizes Judge Rodriguez for his outstanding contributions to the legal profession where everyday of his legal career he has continued to render legal decisions fairly and upheld the law always in the interest of justice; and Whereas, Judge Rodriguez's exceptional achievements and constant efforts to create a positive difference throughout our communities serves as an inspiration for the legal profession and for the citizens of the United States of America. Now therefore, Be it Known that the undersigned Member of the United States Congress, the Honorable Robert E. Andrews of the First Congressional District of New Jersey hereby commends and congratulates United States District Court Judge Joseph H. Rodriguez as he is recognized as the ``Gentleman Judge'' by Rutgers University School of Law for his outstanding accomplishments, and in honor of his legal achievements, hereby officially proclaims today, Wednesday, June 7, 2000 to be the Honorable Joseph H. Rodriguez Day throughout the First Congressional District of New Jersey.

Mr. ANDREWS

Mr. ANDREWS. Mr. Speaker, today Senator Harkin and I are pleased to introduce legislation to create an Office of Pension Participant Advocacy within the Department of Labor. This is an idea whose time is long overdue. Over the last several decades, and particularly since Congress enacted the Employee Retirement Income Security Act of 1974, our pension system has grown increasingly complicated and less ``employee-friendly''. Even in the best of circumstances, pension law is complex. But, when employees or retirees have questions or problems, understanding and maneuvering through our pension system can be a nightmare. I, and many other members of Congress, have long believed that individuals need a single easy place that they can turn to when they have problems with our pension system. Currently, pension issues are handled by a variety of agencies, including the Department of Labor, Department of Treasury, Internal Revenue Service, Pension Benefit Guaranty Corporation, as well as several other agencies. Finding the right agency itself can be a challenge. In addition, these agencies often are not set up to help with individual problems and concerns. The IRS and Treasury Departments primarily focus on tax abuses, not individual inquiries. For many years, the Department of Labor had little or no staff to help individuals with specific problems. Even though the Department has worked hard in the past five years to develop a team of ``benefit advisers'', there is no clear statutory mandate for this program, nor clear directive that the Department should provide an easy and accessible entry point for individuals with pension problems. The American people need a simple place to go to address their pension concerns. There is no need or reason to seek out expensive lawyers when an individual has a particular pension problem which may involve a small amount of money dollar-wise, but mean the difference between a decent and an impoverished retirement to that person. The Office of Pension Participant Advocacy would establish a clear Congressional mandate that the Department of Labor should be the entry point for individuals with their pension problems. We are not talking about creating a new bureaucracy, but streamlining and improving the existing system. Under our legislation, the Department of Labor would establish an Office of the Pension Participant Advocate that would be headed by a senior executive with demonstrated expertise in pension participant assistance. The Office would evaluate the efforts of existing entities to assist pension plan participants and promote the effectiveness of our pension system by increasing awareness of the importance of pensions and ensuring that the pension benefit rights of individuals are protected. The Pension Participant Advocate annually would report to the Administration and Congress on policy issues it has encountered and make recommendations for resolving them. We hope this bill will receive widespread bipartisan support. Over the past several years, a bipartisan group of members and outside organizations has expressed concern about the shortcomings of our current pension assistance system. We hope this bill will provide a meaningful and cost effective solution to the system's current inadequacies and look forward to working with our colleagues towards its enactment.

Mr. ANDREWS

Mr. ANDREWS. Mr. Speaker, I rise today to commemorate a great day, on which 30 sixth grade students from Shady Lane Elementary School reached all of the appropriate levels on their Terra Nova test. Ms. Pat Campanile's sixth grade class is an outstanding group of young people. I wish the best of luck to the following group of sixth graders: Pedro Alvarez, Angelica Beltran, Jeffrey Clement, Da Juane Collins, Shannon Costro, Casaundra Davis, Erin Feeney, Julia Fluke, Kalem Francis, Lacey Hall, Matthew Hanratty, Gina Hinchliffe, Darrell Jenkins, Sachi Jonas, Lauren Jordan, Debbie King, Jonathan Lawrence, Robert Murninghan, Brittney Nock, Christopher Perez, Jenna Perez, Andre Robinson, Charmel Sippio, Amanda Smith, Krystle Snyder, Michael Solvibile, Patricia Stout, Prunell Thurman, Philip Washington.

Mr. ANDREWS

Mr. ANDREWS. I yield to the gentleman from New York.

Mr. ANDREWS. Mr. Chairman, reclaiming my time, I thank the gentleman from New York, my friend. In our economy, actors are regulated either by litigation, regulation or competition. None of those three things applies to the oligarchs of the managed care industry. This Congress, I am confident, is going to take a step to impose the quality control of litigation through the Patients' Bill of Rights. This bill is a very important step in imposing some competition in the health care market for the first time in a long time. This really is about leveling the playing field. It is about reining in the conduct of the oligarchs of managed care. For that reason, I strongly support the legislation and commend the gentleman from California (Mr. Campbell) and the gentleman from Michigan (Mr. Conyers), my friend, for offering it.

Mr. ANDREWS. Mr. Chairman, I rise in opposition to the Cox amendment. Those who are sympathetic and in support of the underlying purpose of this bill will surely see their intention defeated if this amendment is adopted. Because no rational-thinking physician would proceed to try to organize and bargain collectively if this amendment became law, because those leaders in the collective bargaining process would bear all the risk, and there is considerable risk of going up against the managed care companies, considerable risk of being ostracized, considerable risk of being leveraged in the marketplace, considerable risk of suffering professional and economic harm. Those who would be the first to step forward would bear all the risk, and then those who sat and waited to see how it turned out would yield all the benefit if they so chose. No one, Mr. Chairman, would embark on that kind of risky venture if he or she was not assured that those who would benefit from the hard- won bargain would have to pay to support the process of winning the hard-won bargain. So this is an amendment that if it became law would act as a significant disincentive for anyone ever stepping forward and taking advantage of the rights that are contemplated in the underlying bill. If one is sympathetic to the principles of the underlying bill, one should oppose this amendment.

Mr. ANDREWS

Mr. ANDREWS. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I rise in support of the amendment offered by the gentleman from Maryland (Mr. Gilchrest), and in respect to my colleagues from Maryland, who will be the experts in dealing with the Maryland problem, but I rise in support of the principle that we all have an obligation and responsibility to defend the interests of our own district. I have great respect for my friend, the gentleman from Maryland, who is doing that I think very eloquently. Mr. Chairman, I yield to the gentleman from Maryland (Mr. Gilchrest).

Mr. ANDREWS

Mr. ANDREWS. Mr. Chairman, will the gentleman yield?

Mr. ANDREWS. Mr. Chairman, at what point in the bill is the Clerk now reading?

Mr. ANDREWS. Mr. Chairman, I have an amendment to section 607; is that in order at this time?

Mr. ANDREWS. Mr. Chairman, parliamentary inquiry?

Mr. ANDREWS. Mr. Chairman, I commend the gentleman from Georgia (Mr. Kingston) for this effort. We are embarking on a long national nightmare about security in this area. It is not a Republican problem or a Democratic problem. It is a national problem. It deserves a heightened degree of attention, and I commend my friend, the gentleman from Georgia (Mr. Kingston) for giving it that attention. Parliamentary Inquiry

Mr. ANDREWS. Mr. Chairman, I yield myself the remainder of my time. The bill as it presently is constituted is spend first, think later. I think we should do the opposite, think first and then maybe spend later. We are being asked to invest nearly $30 million into a project that is not economically proven, that is environmentally risky, and that is fundamentally unfair to the people of southern New Jersey. Think first, then maybe spend later. Join with us and join with the League of Conservation Voters, Citizens Against Government Waste, Republicans and Democrats in support of this amendment. Mr. Chairman, at this point I will insert into the Record reports from the GAO which study other similar projects. Report by the Comptroller General of the United States: Montana's Libby Dam Project: More Study Needed Before Adding Generators and a Reregulating Dam The U.S. Army Corps of Engineers has not shown that its proposed project to add more generators to the Libby Dam and a reregulation dam downstream is economically justified or the best alternative for meeting Pacific Northwest electricity peaking needs: GAO questions the Corps method of calculating the project's benefits. The Corps plans to reassess the benefit-cost ratio using a better method and submit the results to the Congress by early 1980. Neither the Corps nor the Bonneville Power Administration has adequately studied other was of meeting forecasted peak power shortages. Combustion turbines, cogeneration, power exchanges, load management, and peak pricing options should be evaluated before the proposed project proceeds. This report responds to a request from Senator Baucus.

Mr. ANDREWS. Mr. Chairman, I yield myself 20 seconds. Mr. Chairman, I would say to my friend, the gentleman from New Jersey (Mr. Frelinghuysen), that the New Jersey legislature has failed to yet appropriate its match for this project because of the very concerns that I made reference to. Mr. Chairman, I yield 2 minutes to the gentleman from Maryland (Mr. Gilchrest), my friend and coauthor. The gentleman from Maryland is one of the leading environmentalists of this Congress who will reflect some of the reasons that the League of Conservation Voters, the Sierra Club, the U.S. Public Interest Research Group, National Wildlife Federation and others so strongly support this amendment.

Mr. ANDREWS. Mr. Chairman, I offer an amendment.

Mr. ANDREWS. Mr. Chairman, I demand a recorded vote.