Sherrod Brown

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, I thank the gentleman from Massachusetts for yielding me the time. Mr. Speaker, I rise to oppose the rule. Mr. Speaker, sometimes I wonder whether the Republican leadership in this Congress reports to the Congress or reports to the prescription drug industry. The public is sending a clear message that they are sick of unjustifiably high and blatantly discriminatory prescription drug prices. Democrats offer a proposal featuring an optional Medicare drug benefit. The Democrats offer a proposal to discount drug prices using the collective bargaining power of 39 million Medicare beneficiaries. The Democrats offer a strategy for undercutting international price discrimination with the ability to reimport prescription drugs. Republicans refuse to even consider price discounts for seniors. They emasculate the reimportation proposal. Then they sunset this phoney bill before the provisions even have a chance to kick in. A watered down drug reimportation bill is marginally better than no bill at all; But, Mr. Speaker, I do not want a single American to be fooled into thinking the Republican leadership has been responsive to the prescription drug crisis. The only constituency that they have been responsive to is the prescription drug industry. Vote no on the rule.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, sometimes I wonder whether the Republican leadership of this Congress reports to the public or to the prescription drug industry. The public sends a clear message that they are sick of unjustifiably high and blatantly discriminatory prescription drug prices. Seniors are particularly vulnerable to overwhelming prescription drug expenses. Democrats offer a proposal featuring an optional Medicare drug benefit, drug prices discounted to reflect a collective bargaining power of 39 million Medicare beneficiaries, and a strategy for undercutting international price discrimination, the ability to reimport prescription drugs. Republicans refuse to even consider price discounts for seniors, they emasculate the reimportation proposal, and then they sunset those weak provisions before they even have a chance to kick in. A phony watered-down drug reimportation bill is marginally better than no bill at all, but I do not want a single American to be fooled into thinking that Republican leadership has been responsive to the prescription drug crisis. The only constituency they have been responsive to is the prescription drug industry.

Mr. BROWN of Ohio

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

Mr. BROWN of Ohio. Mr. Speaker, I yield 1 minute to the gentleman from New York (Mr. Towns).

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman from New Jersey (Mr. Pascrell). (Mr. PASCRELL asked and was given permission to revise and extend his remarks.)

Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I want to commend the gentlewoman from Florida (Mrs. Meek) for her dedication on the issue of lupus and her successful effort to put together widespread support for this bill in Congress. This bill has special meaning for my colleague, and I am proud to be one of the bill's 243 cosponsors. H.R. 762 provides a blueprint for combating lupus, a complex and lethal autoimmune disorder for which there currently is no cure. Lupus affects nine times more women than men, disproportionately more blacks, Hispanics, more Asians, and is most commonly diagnosed in individuals between the ages of 15 and 45. The ability of lupus, as well as other autoimmune diseases, to strike someone as young as 15 years old speaks to the need for expanded research. Lupus is not universally fatal. Young people with lupus are capable of living active lives, but diagnosis is difficult. There is not a test for lupus, and young people will continue to suffer and die from lupus without our help. I am pleased that autoimmune disease research was included in the children's health bill now awaiting the President's signature. Autoimmune diseases are unique. Research on one, like lupus, can benefit many others in a synergistic sort of way. The bill sponsored by the gentlewoman from Florida is a responsible investment in our Nation's health, and I urge its passage. Mr. Speaker, I yield 5 minutes to the gentlewoman from Florida (Mrs. Meek), the author of this bill, who has fought on this issue for months and months and years and years. (Mrs. MEEK of Florida asked and was given permission to revise and extend her remarks.)

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman from Texas (Ms. Jackson-Lee). (Ms. JACKSON-LEE of Texas asked and was given permission to revise and extend her remarks.)

Mr. BROWN of Ohio

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

Mr. BROWN of Ohio. Mr. Speaker, I yield myself 2 minutes. Mr. Speaker, I am pleased to support the Drug Dealer Liability Act; and I commend its author, my colleague, the gentleman from Iowa (Mr. Latham). H.R. 1042 would subject individuals who participate in illegal drug activity to civil liability. The civil justice system is an important deterrent to unlawful activity and an effective avenue for compensating individuals and organizations harmed by illegal activity. No illegal activity inflicts more harm than the illegal drug trade. Illegal drugs fuel crime, siphon public and private dollars into prevention and treatment programs. They undercut productive lives. They undermine entire communities. They kill our children. The criminal justice system is giving the drug problem its primary attention. Its counterpart, the civil justice system, should be brought into the fight. Individuals who engage in the drug trade should know that they will be held financially liable for the harm they cause. Manufacturers and distributors of these drugs should bear the costs associated with their illegal activity, including the costs of medical treatment or drug rehabilitation. Taxpayers currently bear most of that burden. That is not the way it should be. This legislation gives us another weapon in the war against drugs. I am pleased to support it.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Madam Speaker, last year I introduced modest legislation that would allow seniors in managed care plans to return after a hospitalization to the retirement community they know, instead of a network HMO nursing home somewhere else. I offered the Right to Go Home Act on behalf of seniors who had been needlessly separated because of HMO rules from their loved ones and from their usual source of care. It is difficult to believe a health plan would treat a hospitalized senior this way, until you speak to Medicare+Choice enrollees, privatized Medicare, if you will, who experienced it firsthand. Take, for example, a couple in New Hampshire, separated after the husband's hospitalization because the HMO required him to be discharged to a nursing home in Maine, a 40 minute drive from the community where he and his wife had lived. Or a couple in Florida separated when their HMO required the wife to recuperate from a hospital stay in a nursing home 20 miles away from the retirement community. The husband had difficulty visiting her, and she died later at the HMO member facility. A retirement community, a nursing facility, is more than just a health care provider; it is a home. Forced relocation means moving vulnerable patients, taking them away from providers experienced in these individual's chronic care needs. It places them in new, strange surroundings during that fragile period of recovery. It separates them from emotionally supportive family and friends. Under our legislation, HMOs would not be required to pay a dime more for care provided at the beneficiary's retirement facility than in a network facility. What my bill would do is what HMOs should not need our prompting to do; that is, it allows hospitalized nursing home patients to recuperate near their loved ones. Yet the HMO industry opposes this legislation. They lobbied for changes in the bill that effectively would exclude all but a small subset of seniors. Fortunately, the Committee on Ways and Means did not buckle under the pressure of the HMO industry. They included their legislation in their Balanced Budget Act Restoration proposal. If the HMO lobby does not kill it, this legislation may make it into law. But the fact that Congress has to take action to ensure the well- being of hospitalized seniors in Plus Choice plans and the fact that the HMO industry would lobby against this bill should tell us something. Those are facts Congress and the public should keep in mind as George W. Bush promotes commercial health insurance, as he promotes commercial health maintenance organizations, as a replacement, as a replacement, for Medicare. George W. Bush believes Medicare should be turned over to private insurers. That is not conjecture, that is fact. Visit his web site. His plan is to establish a 4 year commission to restructure Medicare so that it is no longer a ``one-size-fits-all big government plan.'' Translate that into English. It means simply turning Medicare over to the private insurance industry. HMO's do some things well, but putting Medicare beneficiaries first is not one of them. How many times do we have to intervene with a managed care plan or other insurer on behalf of our constituents before the industry's loyalties become clear to us? Their loyalty is to their stockholders. No surprise there. It is verified every time managed care plans make decisions that fly in the face of good medicine. Unshakeable loyalty to the bottom line results in decisions often not in the best interests of Medicare enrollees. Unconditional loyalty to the bottom line is what creates the need for a Patients' Bill of Rights. Unwavering loyalty to the bottom line explains why health insurers market to the healthiest individuals, the most profitable, and do everything in their power to avoid the rest; let government do that. It explains how private managed care plans contracting with Medicare can enroll seniors one year, make money from them, and then cavalierly drop them the next when they are not quite as profitable. They promise supplemental benefits they cannot deliver; they blame the government then for problems that they, the insurance company-HMOs, create. It explains how the managed care industry has the nerve, the outright arrogance, to lobby against legislation that costs them nothing and means the world to seniors in nursing homes. It is a disgrace. The traditional Medicare program is different. It is universal, it is reliable, it is accountable to the public. Medicare's loyalty is to beneficiaries and to taxpayers. It is an undiluted commitment. Medicare offers choices in ways that actually make a difference in terms of health care quality in patient satisfaction. Medicare does not tell beneficiaries which providers they can see; HMOs do. Medicare does not dictate which hospitals and nursing homes are permissible; HMOs do. Medicare does not discriminate between beneficiaries based on their health status; HMOs do. Medicare offers reliable coverage that does not come and go with the stock market. So before voting for George W. Bush, I urge every American to think carefully about the wholesale changes he has in mind for Medicare.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in strong support of H. Res. 163, which focuses on a condition that has not received the attention that it deserves. I want to commend my colleagues, the gentleman from Georgia (Mr. Kingston) and especially the gentlewoman from California (Mrs. Capps), for introducing this resolution. The gentlewoman from California (Mrs. Capps), a nurse, is one of the most knowledgeable and active members of the Subcommittee on Health and Environment of the Committee on Commerce. I feel privileged to work with her in the subcommittee, and I am proud to join her as a cosponsor of this resolution. The gentlewoman from California's district is home to Postpartum Support International, an advocacy and support group founded by Jane Honikman. Jane is a pioneer in this field, and I know the gentlewoman from California would want to acknowledge her important contribution, as we do here today. Each year, 400,000 American women, 20 percent of those who give birth, experience some postpartum depression caused by chemical imbalance. Hundreds of thousands more experience some of the symptoms, which can include such impairments as disorientation, memory impairment, profound anxiety, and heightened fatigue. This is not an exhaustive list. It is tragic that so many new mothers are robbed of the joy at such a miraculous time in their lives, and it is tragic that postpartum depression is so often ignored or stigmatized when it should be aggressively treated. The first months of life are critical for a newborn and profoundly challenging for new mothers. This resolution recommends several important steps the Nation can take to help new mothers and to help their families cope with postpartum depression. It recommends providing women with information on postpartum depression before they take their babies home from the hospital so that women affected by this condition recognize the symptoms and seek help as soon as possible. It recommends providing training so health professionals know what signs to look for in new mothers. Doctors should be encouraged to screen new mothers for symptoms prior to discharging them from the hospital and when they bring their babies for early checkups. And it also recommends we begin to collect data on postpartum depression in the United States. To effectively target public awareness and treatment, it is important to track the incidence and the prevalence of this condition in different subpopulations. Again, I applaud the gentleman from Georgia (Mr. Kingston) and the gentlewoman from California (Mrs. Capps) for offering this resolution, and I urge its passage.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, earlier this year a confidential document prepared for House Republicans somehow found its way into the public realm. It was not big news at the time, just some talking points prepared by Republican polling firms on the Democrats' Medicare prescription drug plan. According to their analysis, one way to create opposition to the Democratic plan is to call it a one-size-fits-all plan or a big government plan. One cannot blame the public for bristling at those phrases. I do not know anyone who likes big government for big government's sake. However, one can blame politicians for exploiting those terms instead of confronting the fundamental differences between the Democratic and Republican prescription drug plans. One can blame the drug companies and the chamber of commerce for spending $40 million already and promises of another $40 million on phony groups on television such as Citizens for Better Medicare. The Democrats plan would add an optional drug benefit to Medicare. The Republican plan, the drug company plan, would bypass Medicare and subsidize private, stand-alone insurance plans. So is the Democrats' Medicare prescription drug coverage a one-size- fits-all program as the Republicans and the prescription drug companies tell us? I do not think so. It is difficult to conceive of a program offering more choice than Medicare. The Medicare program covers medically necessary care and services. Beneficiaries can see the health care professional and go to the facility of their choice. Similarly, under the proposed drug benefit, enrollees can go to the pharmacy of their choice. FDA-approved medications prescribed by a physician would be covered under the Democrats' Medicare prescription drug plan. Given this level of flexibility, how would a legion of new private health plans enhance the beneficiary's choice in any way that matters? It is more likely that the Republican plan, the prescription drug company plan, like any other managed care product, would restrict choice and add to the insurance and drug company's bottom lines. Medicare is a single plan that treats all beneficiaries equally, provides maximum choice and maximum access for patients and doctors. The Democrats' prescription drug coverage proposal embraces the same principle. Is that a one-size-fits-all program? Under the Republican prescription drug proposal, under the drug companies' plan, Medicare beneficiaries would have to choose among private stand-alone insurance company prescription drug plans. They say that enables seniors to tailor their prescription drug coverage to their particular needs. None of these private plans, however, will provide more choice to the Democrats' plan than the Medicare plan in terms of which medications are covered since the Democrats' plan covers all Medicare doctor- prescribed medications. None of these private plans could provide a broader choice of pharmacy since the Democrats' plan does not restrict access to pharmacies. Under the Republican plan, under the prescription drug company plan, it appears that choice is actually code for ``wealth.'' Higher-income seniors could, in fact, afford a decent prescription drug plan, one with the same level of coverage as would be available to all beneficiaries under the Democrats' Medicare plan. Lower-income enrollees, however, would be relegated to restrictive alternatives. Some choice. Is the Democrats' prescription drug coverage plan a big government program as the Republicans and the prescription drug companies' executives tell us? Hardly. Medicare is a Federal Government program with the beneficiary population of 39 million. It is definitely big. But Medicare is also one of the most enduring popular public programs in the Nation's history. Medicare far outranks both employer-sponsored and individually purchased private insurance as a trusted source of health care coverage. So when opponents of the Democrats' prescription coverage plan berate it for being one size fits all or big government, they, in fact, are berating Medicare itself. In fact, the Republican prescription drug proposal, the plan from the big drug companies, which ignore Medicare to establish new private insurance policies, is an insult to the Medicare program. Their plan pays homage to those Members of Congress who favor privatizing Medicare. Parenthetically, I have to say I have not yet met anyone outside of Washington who wants to privatize Medicare. It is no coincidence that the only way a Medicare beneficiary could avoid carrying multiple health insurance policies under the Republican plan, under the prescription drug company plan, is to join a private- managed Medicare-managed care plan. As Congress and the presidential candidates debate the merits of competing prescription drug coverage proposals, watch for allegations to be thrown around like one size fits all and big government program. Because when applied to insurance coverage offering maximum choice in matters that matter, choice of provider access to medically-necessary care, which is what Medicare is all about, those, those threats, those accusations of one size fits all and big government program, those terms simply fall flat. Bear in mind that more than the structure of prescription drug benefit is at stake. The future of Medicare hangs in the balance.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman from Illinois (Mr. Davis). (Mr. DAVIS of Illinois asked and was given permission to revise and extend his remarks.)

Mr. BROWN of Ohio. Mr. Speaker, I yield 4\1/2\ minutes to the gentleman from California (Mr. Waxman) who played a very central role in the negotiations on this bill.

Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may consume. I first want to commend the gentleman from Oklahoma (Mr. Coburn) and the gentleman from California (Mr. Waxman) for their outstanding work on the Ryan White CARE Act Amendments of 2000. I also want to acknowledge the gentlewoman from California (Ms. Eshoo). Her constituents should know she worked exceptionally hard on this bill, particularly on those provisions with particular significance to San Francisco. The same can be said of the gentlewoman from California (Ms. Pelosi). She deserves a great deal of credit and praise for her ongoing involvement and input on these provisions. This bill required a tremendous amount of work and negotiation. Staff members Paul Kim and Roland Foster put in a staggering number of hours, and it shows in the quality of the final product. John Ford, Marc Wheat, Karen Nelson, Eleanor Dehoney also deserves our thanks, as well as Stacey Rampey and Scott Boule. Over the last several years, much has been written about ``The changing face of AIDS.'' This is not a wholly accurate characterization. HIV/AIDS is not a moving target. It does not leave one population when it moves to another population. Instead, HIV/AIDS expands to absorb new populations while continuing its progression in groups already affected by the virus. When the AIDS epidemic surfaced in this country 19 years ago, white gay males were the at-risk population. That has not changed. The population still is at an elevated risk. But the epidemic has expanded its reach dramatically in these 2 decades. The latest HIV/AIDS statistics show that African American and Latino communities are significantly over-represented in the number of new HIV infections. African Americans comprise 12 percent of the population but accounted for more than 50 percent of the estimated 40,000 new HIV infections in 1999. The aggressive nature of this virus calls for an equally aggressive response, and it speaks to the importance of updating and reauthorizing the Ryan White Act. Ryan White programs get information and services to the people who need them. They combat the illness as well as the alienation and isolation that can be one of its most disabling effects. If HIV/AIDS is a war, and it is set to kill more people worldwide than World War I, World War II, Korea, and Vietnam combined, then the Ryan White programs are this Nation's front line defenses. The act was created in memory of Ryan White, a young teenager who became a national hero in the fight against HIV/AIDS. Ryan wanted to attend school. He wanted to be treated like other young people. Those seem like modest goals, but he had to overcome tremendous obstacles to achieve them. Ryan was a hemophiliac and contracted HIV through a bad blood transfusion. But he fought against ignorance, he fought against fear, he fought against prejudice on behalf of all individuals with HIV/AIDS. Ryan died on April 8, 1990, at the age of 18. Ten years after his death, the law named after him carries on his legacy. The Ryan White CARE Act has made a tremendous difference in the lives of people living with HIV/AIDS. In my district, which includes much of Ohio's only title I-eligible metropolitan area, so-called EMA, Ryan White programs provide primary care and support services and the kinds of medications that can tame HIV/AIDS into a chronic, rather than an acute, illness. There is more to do, and the Ryan White Act will continue to play a pivotal role. In Ohio, while AIDS deaths have declined, the incidence of HIV/AIDS has increased dramatically. After declining steadily, the incidence of HIV/AIDS among young gay males is again on the rise. HIV/AIDS is expanding into new populations while continuing to spread in those populations originally at risk. Prevention is vital; treatment is vital; Ryan White programs are vital. During the 13th International AIDS Conference held in Durbin, South Africa, scientists shared some amazing research findings. These findings provide sorely needed hope for developing nations ravaged by HIV/AIDS. The research indicates that the so-called AIDS cocktails, which have revolutionized HIV/AIDS treatment in the U.S. and other industrialized nations, can be successfully used even in countries lacking a sophisticated health care infrastructure. That does not mean it will be easy. There must have been times when Ryan White himself felt overwhelmed by the intransigence, the callousness, and the hatred that he encountered. This Nation should fight AIDS here and abroad with that sense of commitment that he had. Reauthorizing Ryan White is part of that commitment, and I urge its passage. Mr. Speaker, I reserve the balance of my time.

Mr. BROWN of Ohio. Mr. Speaker, I yield 5 minutes to the gentlewoman from California (Ms. Pelosi), who has been one of the real leaders in this whole process in pulling this bill together.

Mr. BROWN of Ohio. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman from California (Mrs. Capps) who is a registered nurse and has been a real leader on all kinds of public health issues.

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the distinguished gentlewoman from the District of Columbia (Ms. Norton).

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman from California (Ms. Woolsey). (Ms. WOOLSEY asked and was given permission to revise and extend her remarks.)

Mr. BROWN of Ohio. Mr. Speaker, I yield myself the balance of my time. I again ask for this House's support for the Ryan White CARE Act. It is a tremendous testament to bipartisanship support and the negotiating skills of the gentleman from Oklahoma (Mr. Coburn) and the gentleman from California (Mr. Waxman) and their staffs. I ask for unanimous support from this House for this very good legislation that will make a big difference in dealing with this dreadful disease.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, I rise today to celebrate the 26th anniversary of the Community Development Block Grant Program. This program put local development decisions in the hands of those who know best, those who live and work in our community. This long-term commitment to responsible flexibility has paid off. The average housing program leverage is $2.31 for every Federal dollar spent. Unfortunately, the Republican leadership has chosen to commemorate 26 years of job creation and increased affordable housing and water improvements by stripping the block grant program of $300 million in the fiscal year 2001 VA-HUD bill. In Lorais, Ohio, a community in my district struggling with the loss of industry and experiencing rents as much as 50 percent of income, these cuts translate into a loss of jobs, jobs that would have been created next year through construction projects, small business developments, and retraining programs. This program is simple, it is effective, it is efficient. Communities in northeast Ohio and across the country are depending on it. Proposed 2001 funding levels will, unfortunately, hang them out to dry. I urge my colleagues to continue our commitment to improving people's quality of life. Let us support the President's request and increase funding for the Community Development Block Grant Program.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman from New York (Mrs. McCarthy).

Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of this resolution. Breast cancer, as the gentleman from Wisconsin said, is a formidable threat. Complacency is a luxury that we cannot afford, not when 180,000 women are diagnosed with breast cancer each year in this country, not when one in eight women will be diagnosed during their lifetime, not when 46,000 women die each year from this disease. I am proud to be an original cosponsor of H. Res. 278 which underscores how important it is to combat breast cancer with every tool at our disposal. It means early detection, it means education and efforts to raise public awareness, it means research, it means access to treatment. It is going to take this momentum of what all the people around the country are doing and a commensurate response from the public sector to fight and win this battle. It is also going to take a Congress which does its job, not just in reminding the public that education, that early detection, that prevention, all of those are important but it is also going to take a Congress which does its job by passing a prescription drug bill which this Congress has failed to do, by passing the Patients' Bill of Rights which the House-Senate conference committee has locked up, with passing the Ryan White bill, with passing other legislation that really matters in the fight against breast cancer. Mr. Speaker, I yield back the balance of my time.

Mr. BROWN of Ohio. Mr. Speaker, I yield 1 minute to the gentleman from Wisconsin (Mr. Barrett).