Steve Buyer

Mr. BUYER

Mr. BUYER. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5835) to amend title 38, United States Code, to improve information management within the Department of Veterans Affairs, and for other purposes, as amended.

Mr. BUYER

Mr. BUYER. Mr. Speaker, today I am proud to introduce H.R. 6096 the Disabled Warriors' Family Education Act of 2006. I am especially pleased that the Ranking Member of the Veterans Affairs Committee Honorable Lane Evans, and the Chairman and Ranking Member of the Subcommittee on Economic Opportunity Honorable John Boozman and Honorable Stephanie Herseth join me as original cosponsors. The Disabled Warriors' Family Education Act of 2006 would allow spouses and dependent children to access their Survivors' and Dependents' Education Assistance under chapter 35 of title 38, U.S.C. prior to the severely injured servicemember being discharged from active duty. Many of our disabled warriors have spouses who find themselves faced with being the breadwinner of the family. It is important that these individuals have access to their education benefits to improve their ability to compete in the job market. Therefore, once the servicemember receives a VA rating stating that their injuries are permanent and total in nature, the servicemember's spouse, and college-aged dependent children may begin their education during the servicemember's convalescence period, which in some instances may be 2 years. Mr. Speaker, this is an important piece of legislation that will help families of our servicemembers who have sacrificed so much for the safety of our nation in the Global War on Terrorism, and I urge my colleagues to support the Disabled Warriors' Family Education Act of 2006.

Mr. BUYER

Mr. BUYER. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material relative to H.R. 5815, as amended.

Mr. BUYER

Mr. BUYER. I yield to Mr. Feeney of Florida 2 minutes. (Mr. FEENEY asked and was given permission to revise and extend his remarks.)

Mr. BUYER. I thank the delegate for his work on this bill. I yield 1\1/4\ minutes to Mr. Stearns of Florida

Mr. BUYER. Mr. Speaker, will the gentleman yield?

Mr. BUYER. Mr. Speaker, I yield myself such time as I may consume. H.R. 5815, the Department of Veterans Affairs Medical Facility Authorization Act of 2006, would ensure that we will act officially and provide the right facilities at the right places given the current veteran populations that we can expect in the coming years. I thank my colleagues, Henry Brown, the chairman of our Subcommittee on Health, and Mike Michaud, the subcommittee ranking member, for their hard work on a bipartisan bill that deploys new models for providing health care. These models show great promise for veterans who want cutting-edge care as close to their home as possible. Mr. Speaker, the very nature of health care delivery has changed dramatically over the last 15 years, yet the VA has not built a single hospital in that time. Some challenges ahead of us deal with, for example, in New Orleans the damage by Hurricane Katrina and that along the coast of Mississippi. Some put a price tag on a new New Orleans VA facility at around $600 million. I recently toured a new cutting-edge tertiary care hospital in Indiana built for about $280 million. So trying to figure out how we build new hospitals for the government and at the same time trying to do one that is cost effective is the challenge. When we look at the VA, the VA has some aging infrastructure and we must replace some facilities, not only the ones damaged by the hurricanes, but also we need to modernize others. This bill will help rationalize the work, including the actions necessary along the Gulf Coast where we restored the VA medical centers in Biloxi and in New Orleans. We will also move forward with construction in Charleston, South Carolina, with regard to delivering a new model, and Mr. Brown will be talking about that in a moment. We will be purchasing property in Denver. We will work toward a facility in San Juan, Puerto Rico. The bill would authorize the construction of 17 major facility projects authorized in the last session of Congress, including Las Vegas and Orlando, all of which align with the demand projected for the next two decades. Mr. Speaker, after World War II, the VA faced a huge influx of returning service members and a worrisome shortage of doctors. Responding to the challenge, the VA in 1946 formed its affiliation program with medical schools. A wise decision at the VA, made two generations ago by some far- seeing leaders, among them Army General Omar Bradley, a post war VA administrator, enabled the agency to avail itself of the country's best doctors and nurses, and opened VA to the country's best health care practices, ensuring it had the capacity to care for millions of new patients. According to VA, more than 150 VA facilities have affiliations with more than 100 medical schools, dozens of dental schools and more than 1,200 other schools across the country. VA trains 50,000 students and residents each year, more than half of the physicians practicing in the United States, and a similar portion of nurses, I might add, have experienced parts of their professional education in the VA health care system. The VA has built up considerable experience leveraging service and quality throughout this collaboration. As the visionaries of 1946 dared to look beyond the familiar patterns, we must now be willing to consider the possibilities that new ideas generate. These new ideas can also generate controversy. Some veterans are concerned that some form of collaboration may dilute the ``veterans' identity'' of a VA hospital. That is not an intention on our part at all. Mr. Speaker, the facts show that the last 50 years of affiliation have meant better VA care for veterans. If a veteran in the Capital area went to Washington, DC Veteran Center for an emergency, that veteran would likely be seen by a doctor also on staff at the George Washington University Medical Center. A veteran being seen at the Ralph Johnson VA Medical Center in Charleston, South Carolina, is almost certain, the chances are about 90 percent, to be seen by a doctor also on staff with the Medical University of South Carolina. You do not hear complaints from veterans about these arrangements. H.R. 5815 would position VA to leverage existing affiliation relationships with top notch medical universities and build a new relationship with these universities, while preserving the veterans' identity through a collaboration of shared facilities. In Biloxi, the bill would take advantage of the joint-use facility being shared with Keesler Air Force Base in Biloxi. Veterans in the New Orleans area would benefit from a new agreement that we are most hopeful could have fruition with Louisiana State University for the construction and operation of a collocated joint-use medical facility. In Charleston, South Carolina, we would move forward with the building and operation of a joint-use facility with the Medical University of South Carolina. Mr. Speaker, this legislation would authorize the purchase of a site in Denver for the ultimate replacement of the medical facility there and would require the VA to report to us and our Senate counterpart on the viability of engaging in a public-private partnership that would reduce taxpayer burden as construction begins. Mr. Speaker, resources are not on the side of isolated facilities. Enhanced collaboration means that the most expensive equipment, such as medical imaging devices, could be shared between VA and university facilities. As new technology becomes available with its inevitable steep price tag, it could be more easily acquired through these collaborative efforts. Sharing expensive capital assets reduces duplication and waste. Physicians can more easily travel from the university facility to the VA's facility. That, in turn, means that the veterans will get quality care much faster. This logic has appealed to veterans advocates with whom I have spoken. This bill would also help the VA grow the expertise that has gone fallow over the past decade and a half, since VA's last construction project. H.R. 5815 would establish within the VA a senior Civil Service position whose role would be to provide department-wide executive leadership over all construction and facility management. Mr. Speaker, the total cost of this legislation is approximately $2.4 billion. Shortly I will turn to my distinguished colleague, Mr. Brown of South Carolina, chairman of the Subcommittee on Health, for a detailed explanation of the bill. Mr. Speaker, I reserve the balance of my time

Mr. BUYER. Mr. Speaker, at this time I yield 2\1/2\ minutes to the delegate from Puerto Rico (Mr. Fortuno).

Mr. BUYER. Likewise, you do such good because you are a genuine human being, and I want to thank you for your leadership. And it was a treat and joy to work with you and Chairman Brown on this, along with your staff. I appreciate you also recognizing the staff. Mr. Tucker who is sitting there next to you, when I think of his work, and Mr. Weekly and Ms. Dunn, but also that of Jim Lariviere, Jim who now has been activated as a colonel in the Marine Corps in Afghanistan, Kelly Craven and Jim Holley who is also here on the floor for their hard work. But I also want to pause and, if I might, this is a pretty large bill and we have had to work with a lot of different Members. So if I might, I would like to thank, in particular, Mr. Michaud for your work. I want to thank Mr. Evans for his bipartisanship and his good work and his leadership. I also want to thank Chairman Brown for his work on the Charleston project, Mr. Fortuno for his work in Puerto Rico, Ms. Berkley in Las Vegas, Mr. Beauprez in Denver, Mr. Baker for New Orleans. And we got a full court press when it came to Orlando. We had leadership of Mr. Stearns, Mr. Feeney, Ms. Brown, Chairman Miller, Mr. Keller, Chairman Bilirakis, and Ms. Ginny Brown-Waite. So we got the full court press when it came to Orlando; we got the message. And it was just a real treat in working with all of them, and I thank the gentleman for recognizing them.

Mr. BUYER. Mr. Speaker, H.R. 5815 is a well-thought-out bill. It is the product of thorough bipartisan collaboration. I urge my colleagues to act favorably now and move this legislation to the Senate so that we can give our veterans the assurances of new and improved medical facilities

Mr. BUYER. Mr. Speaker, I yield 6\1/2\ minutes to the gentleman from South Carolina (Mr. Brown).

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

Mr. BUYER. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5815) to authorize major medical facility projects and major medical facility leases for the Department of Veterans Affairs for fiscal years 2006 and 2007, and for other purposes, as amended.

Mr. BUYER

Mr. BUYER. Mr. Speaker, I thank Mr. Edwards for yielding to me and having this conversation. This is important. Members are going to be walking in here, Mr. Edwards, and they are not going to know completely what happened with this debate. It would not be right for Members to walk in here and think I will vote for Mr. Edwards' motion to instruct because I will help a military retiree lower his drug cost when he goes to the retail pharmacy. That is just not true. So I want the offices that are listening to this debate to understand that. My greatest concern is opening up the Federal Supply Schedule. So I do not want to open up the Federal Supply Schedule to other departments or agencies of government, whether it is DOD, whether it is the Medicare or Medicaid program, and we can debate each of those. We might disagree on things. That is the only point I wanted to make. The plausible arguments in defense of your motion, I disagree with what you are trying to do here today, and I just wanted to make sure that I made that point.

Mr. BUYER. Mr. Speaker, I only wanted to respond to Mr. Edwards' comments that he understands there is a lawsuit because the drug companies do not want to give discounts on their drugs to the retail pharmacies, paraphrasing what I believe you said. That is not what the lawsuit is. That is not what the lawsuit is about. What the lawsuit is about, as I understand this, is that DOD created a virtual depot, and they created this virtual depot or warehouse because they had no authority under the statutes to do this. They needed to create a warehouse so they could obtain access to rebates that are being done out in the private sector. So it was clever. It was smart and clever, but they had no authority to do this. I warned DOD, and I spoke to Dr. Winkenwerder. I said, please don't do this. If you do this, there are going to be lawsuits because you have no authority to do this at all. He felt that he did. That is what the lawsuit is about.

Mr. BUYER. Would the gentleman yield?

Mr. BUYER. Would the gentleman yield?

Mr. BUYER. The rebates go to the government, they do not go to the military retiree. Therefore, the price is not affected by the military.

Mr. BUYER. Mr. Speaker, will the gentleman yield?

Mr. BUYER. Mr. Speaker, I am just now reading this. Mr. Edwards, this is a very bad idea. If you support increasing the cost of medications to veterans, then support this motion to instruct. If you support increasing the cost to veterans to obtain access to their drugs, support this motion to instruct. Over the years, those of us have guarded, guarded the Federal Supply Schedule. Now, why did Congress pass the Federal Supply Schedule? Because we said, you know, we have said to veterans out there, whom are disabled, we recognize that they are a precious part of our society, so we create the Federal Supply Schedule, which is really the government mandating a particular price, and then we jealously guard that. We jealously guard that. Why? Because everybody wants to gain access to the FSS, the Federal Supply Schedule. I have to come to the floor, as chairman of the Veterans' Affairs Committee, appalled, appalled. I am just dumbfounded that we are, what, going to vote on a motion to instruct that we should accept what the Senate does? It seems that some people in this body are possessed in their fight against drug companies. Oh, my gosh, these drug companies are trying to seek all kinds of profits. I like to beat up on drug companies, until you get sick yourself, and then you want to gain access to all these types of drugs whether it is for Medicare pricing or Medicaid pricing, DOD. I created the retail TRICARE pharmacy program. It took me 3 years to do that. If I ever intended for FSS pricing to be included, I would have included it in the bill. It is a retail program. As a matter of fact, I created the out-of-network retail pharmacy network to give these veterans a choice, the military retirees, so that they can gain access to some new blockbuster drug and pay a little bit more money for it. But, please, my colleagues, do not, just before an election, open up the Federal Supply Schedule. Do not do this. We do this to protect very important members of our society who have been injured, and the disabled. Now, what has been challenging to us is that Congress then, subsequent to having passed this, the Federal Supply Schedule, to gain access to lower cost medications for these disabled veterans, we opened up access to the VA. You have individuals who have gained greater access into the VA. That begins an erosion. I understand that. Now we say, oh, my gosh, if these veterans are gaining access to the Federal Supply Schedule, then what about members to DOD. Oh, by the way, let's do it for Medicare and let's do it for Medicaid. As you increase the pool of people, you are increasing the price of the medications to the very same people that you originally sought to protect. This is one of those moments where you have to scratch your head and say, what are we doing? I make an appeal. I come to the floor and appeal to your good conscience and to your senses: Do not support this motion to instruct. Now, I warned the Department of Defense. I knew that if they didn't have authority to do what they wanted to do, they wanted to gain access to rebates, I understand what they sought to do. You see, I put it in the bill that asked them to go after best business practices. Well, the best business practices, they then interpret that is that they get the same types of rebates that they get in the private sector. So they created something called a warehousing, a virtual warehouse. They had to create the virtual warehouse because we in Congress gave them no authority, no authority to warehouse to gain access to the rebates under the Federal Supply Schedule. It just blows my mind. I warned DOD about this. I had my conversations with Dr. Winkenwerder. But, you know what, he felt like he was on solid ground. I believe he built a house of cards. It has all fallen around him. He bet on the budget. He is short. He turns to Congress. He asks all of you to try to help him out of the jam he has got himself in. I knew a lawsuit was coming. I knew that a lawsuit was going to come because the DOD was doing this without any express authority of Congress. So let me just include an appeal, once again, to the good senses of my colleagues: Do not extend FSS pricing to other departments or agencies of government. Protect the veterans; protect those who are disabled. I just appeal to you. Don't do this. Actually, Mr. Edwards, I would ask you to withdraw the motion to instruct.

Mr. BUYER. That is a valued argument from your position, given how you have drafted the motion to instruct. That is a valued argument. I would just ask of the gentleman that when we extend price controls to a greater population, as we contend, whether it is military retirees as you are talking about or whether we go to Medicaid or Medicare, what happens is we begin, at some point, we begin to dull our efforts on research and development and going after whatever the new blockbuster drug is that presses the bounds of science that our society gets to enjoy, improves the quality of our lives.

Mr. BUYER. Mr. Speaker, will the gentleman yield?

Mr. BUYER. I follow the logic of your argument until you say it is going to help the military retirees because the military retirees don't get a specific benefit. I concur with you when you say, Steve, let DOD gain access to FSS pricing, let them get their rebates. I get DOD savings, and with those savings, I can buy equipment and other things. That's your argument. To say it is going to help the military retirees gain access through the formulary to lower drug prices is not true.

Mr. BUYER

Mr. BUYER. Madam Speaker, the United States has a long history of supporting the state of Israel and the strong example of democratic values it has brought to the Middle East. The recent events that have enveloped the region will not waiver the resolve of our relationship. Israel has found itself strained on two fronts. It is battling both Hamas and Hezbollah, backed by Iran and Syria, nations known to sponsor terrorism and dedicated to the destruction of Israel. While the ferocity of Israel's response to the kidnapping of its soldiers by these terrorist groups may be in question, Israel has only acted to defend its way of life and the intrinsic right for a nation to defend its very existence. Easing tensions in the region will require that neighboring nations take an active role to stabilize the conflict. Egypt and Lebanon must have the fortitude to take a leadership role to pursue regional stabilization. They must grasp this opportunity to demand that immediate steps are taken to resolve the conflict and work to bring peace to the region.

Mr. BUYER

Mr. BUYER. Mr. Speaker, I rise today in strong support of H. Con. Res. 427, which will provide the use of the Capitol rotunda for the recognition of the 75th anniversary of the Department of Veterans Affairs. It is altogether fitting to use the rotunda, which is reserved for only the most special and solemn occasions, to commemorate the establishment in 1930 of an agency charged ``to care for him who shall have borne the battle and for his widow, and his orphan.'' Those words, spoken in 1865 by Abraham Lincoln in his Second Inaugural Address, have been adopted by VA as the department's motto. When President Herbert Hoover signed the executive order establishing the Veterans Administration, and consolidating and coordinating federal support of veterans, America had 4.7 million living veterans. The new VA administered 54 hospitals with 31,600 employees. Today, VA cares for our veterans and their families with 235,000 dedicated professionals who operate and manage the largest health care system in the Nation. These public servants, helped by more than 130,000 volunteers, provide high-quality health care to more than 5 million patients in more than 1,300 sites of care, including 154 medical centers. The VA provides about 3 million veterans with disability compensation and pension payments, and nearly 600,000 spouses, children and parents of deceased veterans receive benefits. Our revered dead lie in honored repose in 123 national cemeteries administered by VA in 39 States and Puerto Rico. VA also provides grants to States to encourage the development of State cemeteries; funds have been awarded for 63 operating State cemeteries, and 5 more are under construction. VA research has won the Nobel Prize and it has been instrumental in developing the CT scan, the pacemaker, and improvements in artificial limbs. The Nation's first liver transplant was conducted by a VA surgeon, and VA has pioneered treatments for schizophrenia, high blood pressure, and tuberculosis. Many veterans know VA best for its able administration of the 1944 GI Bill. Veterans Administration educational benefits have to date sent more than 21 million veterans, service members and family members to college, many of whom have also used VA loans to buy a home. The GI Bill essentially created the modem American middle class that has brought this country unparalleled prosperity and global leadership. Today our Nation is engaged in a global war on terror. As they have for generations before them, VA's professionals and volunteers are at their stations in hospitals, rehabilitation centers, offices, and clinics ensuring that our newest veterans and their families have the best support possible. The contribution of VA and the importance of support for America's veterans were officially recognized on March 15, 1989, with VA's establishment as a Cabinet-level department. Hailing the creation of the Nation's 14th cabinet-level position, President George H.W. Bush said, ``There is only one place for the veterans of America, in the Cabinet Room, at the table with the President of the United States of America.'' Madam Speaker, there is only one place to celebrate the 75th anniversary of this remarkable agency. That is in the rotunda of the Capitol of the United States of America, and I urge my colleagues to join me in support of this resolution.