Sherrod Brown

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentleman from Rhode Island (Mr. Kennedy).

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentleman from Louisiana (Mr. Jefferson). (Mr. JEFFERSON asked and was given permission to revise and extend his remarks.)

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentleman from Pennsylvania (Mr. Hoeffel).

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentlewoman from California (Mrs. Capps), a member of the Subcommittee on Health and Environment.

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentleman from Ohio (Mr. Strickland), also a member of the Subcommittee on Health and Environment.

Mr. BROWN of Ohio. Mr. Chairman, I yield such time as she may consume to the gentlewoman from the Virgin Islands (Mrs. Christensen). (Mrs. CHRISTENSEN asked and was given permission to revise and extend her remarks.)

Mr. BROWN of Ohio. Mr. Chairman, I yield 3 minutes to the gentleman from Michigan (Mr. Bonior), the Democratic whip.

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentleman from Tennessee (Mr. Tanner).

Mr. BROWN of Ohio. Mr. Chairman, I yield 2 minutes to the gentlewoman from North Carolina (Mrs. Clayton).

Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentleman from Wisconsin (Mr. Barrett), a member of the Subcommittee on Health and Environment.

Mr. BROWN of Ohio. Mr. Chairman, I yield myself the balance of my time. Mr. Chairman, this substitute undoes the good bipartisan work that the gentleman from Michigan (Mr. Dingell), the gentleman from Georgia (Mr. Norwood), and the gentleman from Iowa (Mr. Ganske) did to craft this very positive strong legislation. Similar legislation is working in Texas where insurance companies are held accountable when they make medical decisions. The Boehner substitute, however, is not a serious legislative effort. It does not hold insurance companies accountable when they make medical decisions that harm people. For all the discussion and all the talk, Mr. Chairman, about lawyers taking over the health care profession, the Boehner substitute would hand the lawyer, not the doctor, the power to decide whether a case needs a medical evaluation. Mr. Chairman, the majority of Members support the Norwood-Dingell- Ganske bill. Vote ``no'' on the Boehner substitute.

Mr. BROWN of Ohio. Mr. Chairman, I yield 4 minutes to the gentleman from Georgia (Mr. Norwood).

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from New Jersey (Mr. Andrews). (Mr. ANDREWS asked and was given permission to revise and extend his remarks.)

Mr. BROWN of Ohio. Mr. Chairman, I yield myself 2 minutes. I am going to vote for the Norwood-Dingell-Ganske bill and against all the substitutes, and here is why: The Norwood-Dingell-Ganske bill is the product of negotiations among three Members of Congress who believe in patient protections so strongly that they have devoted more than 3 years to the passage of comprehensive reform. They know what they are doing, and the Norwood- Dingell-Ganske bill gets it. To protect patients we just cannot fix discrete problems as they pop up. We would be at that task forever. We need to make it in HMO's best interest to do the right thing without hand holding or without prompting. That is what accountability is all about; that is what the Norwood-Dingell-Ganske bill does. As most of my colleagues know, Texas allows its citizens to sue managed care plans in State court. This bill says that all Americans should have that same right as people in Texas do. Most of my colleagues probably also know that there have been only five cases in the 2 years since the Texas law went into effect. One of those cases should silence every single opponent of the Norwood-Dingell-Ganske bill. It involves a doctor who refused to refer his patient to a specialist. Why? It turns out that the patient's HMO told this doctor that if he referred even one more patient to a specialist, he would be kicked out of the provider network permanently and financially penalized. Apparently, Mr. Chairman, he had passed his quota. Managed care organizations take huge gambles that they perceive as benign business decisions at our expense. We need to raise the stakes. That is what the Norwood-Dingell-Ganske bill does. If we want to protect patients now and in the future, it is the bill we should all vote for. Mr. Chairman, I reserve the balance of my time.

Mr. BROWN of Ohio. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from New Jersey (Mr. Pallone), who worked incredibly long hours in support of this legislation.

Mr. BROWN of Ohio. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from Massachusetts (Mr. Tierney).

Mr. BROWN of Ohio. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from New York (Mr. Engel).

Mr. BROWN of Ohio. Mr. Chairman, I yield 2 minutes to the gentleman from Massachusetts (Mr. Markey), a member of the committee.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to my friend, the gentleman from Guam (Mr. Underwood).

Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in support of H.R. 1794. In addition, I would like to thank my numerous colleagues, especially the gentleman from Nebraska (Mr. Bereuter), who have given their support to this bill, also including the gentleman from California (Mr. Cox), the gentleman from Ohio (Mr. Chabot), and others. Two weeks ago, Mr. Speaker, Taiwan was struck by a devastating earthquake. It is not hard for us to empathize with the thousands of Taiwanese people who found themselves trapped under rubble, praying that someone would come to their rescue; that someone would respond to their cries for help; or for us to imagine how we might react if our family members were trapped under these buildings. Yet, in the aftermath of this disaster, unlike the immediate offers of help to the victims of the earthquakes in Greece and Turkey, international relief efforts were actually dragged out and postponed while scores of Taiwanese were fighting for their lives. And we know why they were forced to wait for help, even though they themselves, the Taiwanese as a people, have provided hundreds of millions of dollars in assistance to victims of wars and famines and disaster all over the world. That is because even in Taiwan's darkest hour, the United Nations first had to receive permission from the People's Republic of China before they could help Taiwan. That is the reality of the One China policy. No matter how dire the situation, the human rights and the Taiwanese people take a back seat to Cold War geopolitics that frankly no longer serve any useful purpose. Unless we start doing something about it, unless we start to stick up for what is right, unless we start helping Taiwan instead of hindering it, then we will wind up letting China's dictators think they can continue to deny their people and the Taiwanese people their fundamental human rights. Today we are taking a step in the right direction, because regardless of the One China policy, access to first-rate medical care is a fundamental human right. I said it before, and I will say it again. Children cry the same tears whether they are in Lorain, Ohio, or Taipei, Taiwan. Denying them access to the latest medical innovations that can ease those tears is just as criminal as violating their other basic rights. H.R. 1794 is a step in the right direction and recognizes that human suffering obviously transcends politics. For the first time ever, Congress is requiring the State Department to find a role for Taiwan in the most beneficial of all international institutions, the World Health Organization, an outfit that is dedicated to eradicating disease and improving the health of people around the world regardless of the conditions imposed on them by any of the world's governments. Its achievements in this regard are nothing short of remarkable. In this past century, smallpox claimed hundreds of millions of lives, killing more people than every war and epidemic put together. Because of the tireless efforts of the World Health Organization, this scourge has been totally eradicated. In 1980, only 5 percent of the world's children were vaccinated against preventable diseases. Today, the WHO has vaccinated more than 80 percent of the kids in the world, saving the lives of three million children each year. These diseases include polio, a virus unparalleled in its cruelty and suffering. The WHO has eradicated it from the Western Hemisphere. Similarly, measles, a killer of a quarter of a million children worldwide each year, is targeted for eradication by 2001. Infectious disease and sickness are not limited to political borders, and the results of Taiwan's exclusion from the WHO have been tragic. Young children and older citizens who are particularly vulnerable to a host of emerging infectious diseases, such as the Asian Bird Flu, are without the knowledge and expertise shared among the member nations of the WHO. With increased travel and trade among many members of our global village, these diseases do not stop at national borders. So why should we erect boundaries to shared information which would help improve the health of Taiwanese children? Mr. Speaker, denial of Taiwanese participation in the WHO is an unjustifiable violation of its people's fundamental human rights. Good health is a basic right for every citizen of the world, and Taiwan's admission to the WHO would help foster that right for its people. I call on all of my colleagues to support H.R. 1794 and Taiwan's right to participate in the World Health Organization. Mr. Speaker, I reserve the balance of my time.

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. BROWN of Ohio. Reclaiming my time, Mr. Speaker, 2 weeks ago the Office of Personnel Management announced that premiums for the Federal Employees Health Benefit Plan would increase by 9 percent next year, the third straight year of large increases. Last month, final figures were in for the number of seniors that will be dropped from their Medicare managed care plan come January 1: 395,000 elderly Americans. Last year, 400,000 were dropped. Most of the remaining plans are curtailing or eliminating prescription drug benefits. Those are the numbers. Here are the stories. Last month, I received a letter from a 71-year-old widow in Sheffield Lake, Ohio, who had taken a part-time job to help pay for her prescription drugs. Until United Health Care pulled out of her county and left her without a health plan, she had some drug coverage, but just one of her medications, lipitor, absorbed the entire benefit. I spoke with a woman recently in Elyria, Ohio, who spends $350 out of her $808 monthly Social Security check on prescription drugs. What is the common thread here? The high cost of prescription drugs. Prescription drug spending in the U.S. increased 84 percent between 1993 and 1998. The American public is right to wonder why we are not doing something about that in this Congress. The truth is, what has held us back is a threat. The drug industry says if we do not leave drug prices alone, they will not produce any new drugs. I believe it is time we use market forces, and by that I mean good old-fashioned competition, to challenge that threat. We can introduce more competition in the prescription drug market and still foster medical innovation. We need information to examine the industry's claims that U.S. prices are where they need to be. I introduced last week a bill, the Affordable Prescription Drug Act, that addresses these issues head on. Drawing from intellectual property laws already in place in the United States for other products in which access is an issue, such as pollution control devices under the Clean Air Act, my bill would establish product licensing for prescription drugs. If, based on criteria by the Department of Commerce, a drug price is so outrageously high that it bears no resemblance to pricing norms for other industries, the Federal Government could require drug companies to license their patent to generic drug companies. The generic companies could sell competing products before the brand name patent expires, paying the patent holder royalties for that right. The patent holder would still be amply rewarded for being first in the market, and Americans would benefit from competitively driven prices. Drug prices would then come down. The bill would require drug companies to provide audited, detailed information on drug company expenses. And given that these companies are asking us to accept the status quo, in terms of high drug prices, the status quo that has bankrupted seniors and ignited health care inflation, they have kept us guessing about their true cost for all too long. This is not some brand new untried proposal. Product licensing works in England. It works in France. It works in Israel. It works in Germany; it has worked in Canada. But there is another part of this issue. Through the National Institutes of Health, American taxpayers finance 42 percent of the research and development that generates new drugs. Private foundations, State and local governments, and other nonindustry sources kick in another 11 percent. So the drug industry funds less than half of the research and development of new drugs. In addition, the dollars that the drug companies do spend on research, the U.S. Congress has bestowed generous tax breaks on those dollars for the drug companies. At the same time, drug prices in the United States are twice or three times or four times what they are in every other country in the world. So get this. Half the cost of prescription drug research and development is borne by U.S. taxpayers. U.S. taxpayers then give tax breaks for the money that they do spend for the research on prescription drugs by the drug companies. And American taxpayers are then rewarded by the drug companies by being charged the highest prices in the world, double, triple, four times what those prices are. Mr. Speaker, it is time this Congress pass the Affordable Prescription Drug Act.

Mr. BROWN of Ohio. Mr. Speaker, before I begin my special order on prescription drugs, I yield to the gentleman from New Jersey (Mr. Holt) if he would like to finish his thought.

Mr. BROWN of Ohio

Mr. BROWN of Ohio. Mr. Chairman, I agree. I concur with what the gentleman said. This is a by and large technical amendment that we worked on together as we worked on the bill together, and I ask my colleagues to support the Bilirakis amendment.

Mr. BROWN of Ohio. Mr. Chairman, I yield myself such time as I may consume. I am pleased that the gentleman from Florida (Mr. Bilirakis) and I could work together to introduce the Health Research and Quality Act and pass it out of the Committee on Commerce. We hold similar views on why this issue is important. It is important because research is important. The U.S. health care system is far from transparent. In fact, in many ways it is not even a system. It is a complex set of relationships influenced by science, demographics, politics, money and cultural trends. Whether the focus is on health care financing or health care delivery, common sense alone rarely explains what is going on. In fact, it often throws policymakers off track. If we want to improve on the status quo in health care, we have to get a realistic picture of what the status quo is. By conducting and supporting health services research, AHCPR helps paint that picture for us. If we want to improve on the status quo in health care, we have got to find out what improvement actually means. By conducting and supporting outcomes, effectiveness and cost effectiveness research, AHCPR helps us determine the best way to spend the limited health care dollars that we do have. And if we want to improve on the status quo in health care, we need to get the word out to the people in the institutions, in the agencies and the industries that somehow keep the whole thing running. By disseminating research and data broadly, AHCPR helps ensure that our investment in data collection, health services research and biomedical research pays off. This reauthorization makes research and broad dissemination of information AHCPR's main focus. We could definitely use more of both. I urge support of this important legislation. Mr. Chairman, I reserve the balance of my time.