Michael Burgess

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to commend Patricia M. Anderson for being selected as a 2007 National Merit Scholarship Awards winner. Patricia is a student at Liberty Christian School in Argyle, Texas. The National Merit Scholarship Program is an academic competition held annually. Students are initially evaluated by their performance on the Preliminary SAT/National Merit Scholarship Qualifying Test. Of the approximately 1.4 million entrants, only about 8200 students are selected as finalists. In this first announcement of 2007 winners, about 1,000 high school seniors are awarded scholarships from various companies, foundations, and businesses. These organizations fund the scholarships to help some of our Nation's most capable students reach their potential. I wish to offer my congratulations to Patricia. I would also like to recognize her parents and the faculty of Liberty Christian for their outstanding commitment to Patricia's education. I wish her even greater success as she continues her education, and I am proud to represent her in the 26th District of Texas.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, it's my feeling that this bill should have been brought to the floor under a rule to perhaps allow additional improvement and amendment, as pointed out by Mr. Stearns. There is the opportunity, perhaps in conference, to further improve the bill. I don't think our work is quite done. One improvement that I was able to effect in our committee, the Committee on Energy and Commerce, is the exclusion of title II for covered entities already subject to regulation under HIPAA statutes, the Health Insurance Portability and Accountability Act statutes. Dual regulation of communications, uses, disclosures and other aspects and activities, subject to regulation, currently regulated by the Department of Health and Human Services, by GINA, would have had disastrous consequences for coordination of care. We need to make clear that providing health services is not the same as hiring, firing or job promotion. Genetic information is medical information and is not restricted under the House bill for employer- sponsored services that are covered in entities under HIPAA. Also, nothing in this bill affects the practice of medicine. That is not the intention, and this is among the principles that I have sought to ensure. I would note that the current HIPAA regulations are extremely sophisticated. They are the result of over 5,000 communications and comments. We are not going to trump those regulations under title II, and that will prevent the possibility for enormous disruption and adverse consequences. Failure to address this issue would have been calamitous, for efforts of using health information, new efforts for using health information technology. Medical information systems cannot be burdened with legal requirements that would, in effect, force complicated segregation of genetic information from other medical information and health care, including those in employer-sponsored clinics. Still, with all of those caveats, I will be voting in favor of the bill today. I do look forward to making certain that these modifications survive in conference and perhaps there will be the opportunity to even make things a little bit better in that process.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I come to the House tonight to talk about something that isn't number one or number two or perhaps even number three on the list of things that people are concerned about, it is number four, it is health care, health care in our country that is provided by the private sector, that is provided by the public or the government sector. It is a debate that we will be hearing a lot more about as we get deeper into a year that's going to be consumed by presidential politics. Right now in our country we have an amalgam, if you will, of health care, part paid by the government, part paid by the private sector. I am oversimplifying for the purposes of debate, but the public or government sector, in pure dollar amounts, accounts for about 50 percent of the health care expenditures in this country. The private is sector insures about 160 million Americans, and that is roughly 50 percent of the lives covered by private insurance in this country. And we will have the debate, as the presidential year unfolds, more government, more private sector. But tonight, what I really want to do is focus on the physician workforce, the physician workforce that we have now and the physician workforce that we might expect to have in the future. Alan Greenspan, about a year and a half ago, right as his last days at the Fed were winding down came and talked to a group of us one morning, and inevitably the question came up about Medicare. In fact, we saw the trustee's report yesterday; everyone is concerned about the funding for Medicare, the future obligation that is there in Medicare. And Mr. Greenspan was pretty circumspect, he said, ``At some point I expect the Congress to deal with the problem of funding.'' And then he went on to say, ``What concerns me more is will there be anyone there to provide the services when you want them?'' That really struck a cord with me. And in fact last month, the month of March, back in my home State of Texas my Texas Medical Association puts out a periodical every month called ``Texas Medicine,'' and the cover story was in fact dedicated just to that concept, ``Running Out of Doctors.'' And the thrust of the article is how do we keep the medical students that we graduate from Texas schools, how do we keep them practicing in Texas, particularly in the high-need areas in Texas? And concentrating on the physician workforce is what I want to do during this discussion, in the time that I have available for the discussion this evening. My perspective, of course, 30 years ago I graduated from medical school in Houston, Texas, so I do have the perspective of looking back over the last 30 years. But I also want us to look over the horizon to the next 30 years. What about the young man or woman who is graduating from medical school this year, what kind of world do they want to find themselves practicing in? What type of practice environment do they want to see that we have laid out for them 30 years from now? It is going to be important that we take the correct steps today in order to provide the correct practice environment 30 years from now. Since we're talking about the physician workforce, the part that the government pays for is paramount, that is critical. And really the thing that I want to focus on of that government sector is the pricing and the payment schedule in the Medicare program itself. Medicare, a good program, just celebrated its 41st or 42nd birthday. We had the second anniversary of the prescription drug benefit part D, which in my first year here we passed in 2003 and was added on in the year 2006. Medicare is an integrated program. Part A is the hospital, part B is the doctor's care, part C is the Medicare, what is now called the Medicare Advantage Plans or the HMOs, and part D is the prescription drugs. But while it is an integrated program, the funding for Medicare actually exists in funding silos. If we look at the comparative payment updates from the year 2002 to projected 2007, you see that there is something wrong with this picture. And what is wrong with the picture is that physician reimbursement in part B is significantly lagging behind the payment updates for the Medicare Advantage Plan's hospitals and nursing homes are shown on this graph. And there is a reason for that. It is really not a very difficult reason: Medicare Advantage Plan's hospitals and nursing homes receive every year essentially a cost-of-living update. It is a market-basket update that they receive based on the cost of inputs from the previous year. CMS has actuaries that go back and figure this out: What did it cost the hospitals to provide the care that they delivered to our seniors? Part B is calculated differently. Part B is what is described as a volumetric formula. It weights volume and intensity. But basically you have a fixed amount of money, a finite pie, that if more and more people are submitting claims, the slices get progressively smaller. And in 2002, you can see there was a big drop. The reason 2003, 2004, 2005 are not a downward projection is because in fact at the last minute, Congress swept in and said we are going to do something to prevent this from happening. And, in fact, doctors got a modest update in 2003, 2004, 2005. 2006 doesn't really show up because that was a zero percent update. Now, Madam Speaker, I have not been in Washington all that long, but I have learned some of the parlance and the lexicon that we use here. And in any other Federal program or any other federally funded program, if you are held to a level funding or a zero percent update for that year, anyone else would regard that as a cut. But we told the doctors that was great, you are going to get a zero update for that year and you will be happy for it. Projected for 2007, if we don't do something, is going to be a substantial decrease. Once again, we may very well ride in at the last minute and do something to blunt the effect of that; but year in and year out, this problem continues; and the real insidious part of this is the dollars to fix the problem get higher and higher every year. Last year I introduced a bill to just simply do away with the SGR and replace the SGR with a market-basket update. It is called the Medicare Economic Index. And it is not my idea; a group called MedPac, a Medicare Payment Advisory Commission, worked this out in actuarial fashion some years ago. And the Medicare Economic Index would in fact provide a 2 to 2\1/2\ percent update for most years based on the cost of input for the physicians providing the services to the patient. The cost last year scored by the Congressional Budget Office of replacing the SGR formula with the Medicare Economic Index was $218 billion. Clearly, that is a lot of money, and it disrupts any budget that either party might put up there. So, as a consequence, I didn't get a lot of activity on that bill last year. It is still important to do. And every year that we delay doing something, and even those years that we come in and it looks like we fixed it a little bit, we actually just compound the problem and make it worse in subsequent years. So in just very general terms for this evening's talk, we have got a lot of people who are going to be joining the Medicare generation. As the baby boomers age and retire, the demand for services is going to go nowhere but up. And if the physician workforce trends continue as they are today, we may be not talking about funding a Medicare program, we may be talking about there is no one there to take care of the seniors. In my home State of Texas, the number of physicians between 1995 and 2005 increased by 46 percent or nearly 5,000. Okay, that is good, it went up. However, the State is still below the national average, the national average being 230 physicians per 100,000 population. In Texas the ratio, even with the increase, is 186 to 100,000 residents. The American Academy of Family Physicians predicts serious shortages of primary care doctors in five States, including Texas, and says that all States will have some level of family physician shortage by the year 2020. The Council on Graduate Medical Education, a congressionally authorized entity, estimates that after 2010, growth in the physician workforce will slow substantially; and after 2015, the rate of population growth will exceed the rate of growth for the number of doctors. In other words, we won't be keeping up anymore. At the same time, the demand is only going to increase year over year, resulting in critical shortages, particularly in primary care, but the reality is all specialties may well be affected. So my thesis, my proposition, is that Congress needs to approach this sort of as a three-pronged attack or a three-pronged solution to mitigate this shortage for the future, to improve payments to current doctors, keep them in practice longer, improve Federal assistance to medical students, encourage students to go into high-need specialties, and increase the number of residency training programs, particularly in rural and suburban areas, and keep the physician pipeline open. To do that, I am going to be next week introducing three bills to deal with those three areas. The first, to insure the physician workforce, really deals with the Medicare funding and the SGR. You talk to doctors my age, those who graduated from medical schools 30 years ago, and their concerns are really consistent. They are concerned about the liability environment, which is not part of tonight's discussion but one that we certainly need to have and I hope we do have in this Congress this year. Their concern is the year-over-year reduction in payment that the Center for Medicare and Medicaid Services comes up with for physician reimbursement. And it is not just a question of doctors wanting to make more money; it turns to be a real patient access problem, because there is not a week that goes by that I don't get a letter or fax from someone who says, you know what, I have just had enough and I am going to retire early, I am no longer going to see Medicare patients in my practice, or I am going to restrict the procedures that I offer Medicare patients. Unfortunately, I know that is happening because I saw it in the hospital environment before I left the practice of medicine to come to Congress. But I also hear it in virtually every town hall that I do back in my district. Someone will raise their hand and say, How come on Medicare, you turn 65 and you have got to change doctors? And the answer is, because their doctor found it no longer economically viable to continue to see Medicare patients because they weren't able to pay the cost of delivering the care, let alone making any money on top of it. They weren't able to cover the cost of providing the care. So in the bill to address that, the bill that I introduced last year, again, just simply repealed the SGR outright. The difficulty that I had with that was, again, just the cost was too high. But if we do that over time, perhaps we can bring that cost down to a level where it is manageable. Getting the payment policy right in Medicare is going to be the first order of business for preserving the physician workforce. Paying physicians fairly will extend the careers of many physicians who are now in practice who would otherwise opt out of the Medicare program, seek early retirement, or restrict those procedures that they offer to their Medicare patients. It also has the effect of insuring an adequate network of doctors available to older Americans as this country makes the transition to the physician workforce of the future. In the bill, the SGR formula, this volume-based formula would be repealed in 2010, 2 years from now, but also provide incentive payments based on quality reporting and technology improvements to protect the practicing physician against that 5 percent cut that is likely to happen in 2008 and 2009. That would be voluntary. No one would be required to participate in the quality program or the technology improvement, but it would be available to those doctors or practices who wanted to offset the proposed cuts that will occur in physician reimbursement in the 2 years until the formal repeal of the SGR happens. Now, why do it that way? Why not just bite the bullet and let's go ahead and get the SGR out of the way and get it repealed? Remember, it costs a tremendous amount of money to do that. Another problem that we have in Congress is we are required to submit all legislation to the Congressional Budget Office to find out how much it costs. If we are going to be spending the taxpayers' money, how much are we going to spend? Over what time will we spend it? So that is not unreasonable, but because of the constraints of the Congressional Budget Office, we are not allowed to do dynamic scoring. We all knew, for example, when we began the prescription drug benefit 2 years ago, that if you deliver medications in a timely fashion, the timely treatment of disease, you are going to get better patient outcomes. And, in fact, that is what the trustee's report for Medicare that was released yesterday, although it still shows that we have got a big problem in paying for Medicare, the actual outlays for Medicare were down. And the reason they were down, I suspect, is a compendium of things; but part of it is treating disease in a timely fashion, not always catching it at the end stage but treating it at the beginning, you are going to end up with more functional individuals, to be sure, so they are going to continue to be productive in society. But the overall cost of Medicare is going to go down. Unfortunately, we can't do that look-ahead with the Congressional Budget Office and say, you know, I think if we do this, we are going to save some money. So give me credit for that against that SGR score that you always rate my bill with. They won't and they can't do that. So by postponing the repeal of the SGR by 2 years' time, taking the savings that occurs during that time and applying it to the SGR formula, actually may give us a number that is doable as far as releasing the SGR and replacing it with the Medicare Economic Index. One of the main thrusts of this bill is to require the Center for Medicare and Medicare Services to look at their top 10 conditions that drive the highest percentage of payments in Medicare part B, and require CMS to adopt reporting measures relating to these conditions that have already been developed. It is not reinventing the wheel. The AMA Physician Consortium has already developed those reporting measures that drive that spending so high. You know, the old famous bank robber Willie Sutton when he was asked why do you rob the bank, he said that is because that is where the money is. Let's go to those top 10 things where the greatest amount of money is spent, because that is where the greatest amount of savings can occur. If we can deliver care in a more timely fashion and if we can improve outcomes, we are actually going to spend less. And by focusing on those top 10 programs, at least initially, that will be the greatest return on investment for CMS and ultimately will be the greatest return on investment for retiring the SGR. The same considerations may apply to the Medicaid program as well, so it will be a very useful exercise to go through that and identify those top 10 conditions. And where cost savings may be most easily gathered, not only will it have an improving effect on Medicare, but I suspect on Medicaid as well. We are going to establish quality measures focusing on these core conditions, and that is where the add-on payment for those 2 years, that is where half of it will come from. A 2\1/2\ percent update for those physicians who do voluntarily report quality measures on those top 10 conditions, that is where the protection from the continuation of the SGR for 2 years, that is where that protection will derive from. We are going to report back to doctors on what their volume and intensity is. This information will not be made generally public, but it will be made available to the individual physician so they can see how they are doing, how they are doing relative to other doctors in their practice, other doctors in their community, other doctors around the country. But the important point here is these are voluntary measures that will protect the physicians from the cuts that are inevitably going to occur as a result of the SGR program until the SGR can actually be repealed. But, physicians can opt to take advantage of the bonuses, and it is going to return some value back to their businesses and return value to the taxpayer. Again, there may be an unintended benefit for the parallel Federal program to cover poor Americans under the Medicaid program if some of these programs deliver the benefit back that it is anticipated that they will. The quality measures are going to be built around these high-cost conditions, and strive to improve the quality of care not only for those conditions and patients, but to drive down the cost of delivering Medicare. There is also going to be a provision in the bill to help physicians' offices to bring their information technology, their infrastructure, hardware and software, bring it up to a standard where it will begin to derive benefit to not only the patient and the practice but to the Medicare system in general. The percentage add-on payment is proposed to be 2\1/2\ percent, so those two bonus payments in aggregate would be 5 percent. And again, that is designed to be a protection against what are the anticipated reductions in payments that would occur in 2008 and 2009. The provision will also create a safe harbor that will allow clinics, physicians' offices, and hospitals to share health information technology platforms, and the standards will be established and available to physicians' practices so they will understand how they need to comply with this. The standards must be established no later than January 1, 2008. Madam Speaker, I wasn't always a big proponent of things like electronic records. I wasn't sure if it would deliver the payoff that people said it would. But here is a picture of the medical records department in Charity Hospital in New Orleans. This picture was made in January 2006, about 4 or 5 months after Hurricane Katrina and the downtown flooding that occurred. It is the medical records room. These records are ruined. You can see, this is not smoke or soot damage, this is black mold that is growing on the records. You look there and it almost goes on to infinity, tens of thousands, hundred of thousands of records that were active, ongoing charts of people's medical conditions absolutely now unavailable. No one is going to get into that medical records department and risk inhaling the spores from the mold that is covering those charts. This is the kind of problem that you can get into with a paper medical record. Of course the youngsters of today, the college students of today, the young physicians of today, they understand this very well. They are all connected and wired in. They would no more imagine turning in or doing a paper for one of their classes where they just had a single copy, a single paper copy, the old adage ``the dog ate my homework,'' most students will have a paper on a disk, on a flash drive and readily accessible and retrievable in many forms. We should do no less with our medical records. But it costs money to do this. It is going to require a push for the private sector. I prefer to think as a bonus payment as being an inducement, an enticement for physician's offices to participate in this type of program. But it is also just good medicine. It is good patient care. We all heard about the troubles at Walter Reed Hospital a few months ago. I went out to Walter Reed probably the week after the story broke in the Washington Post and talked to this young man who took me around Building 18. Yes, there was some concern. It was a crummy building. But his biggest concern was spending hours and hours with his medical record, his service record, going through the various parts of that and highlighting things. He had a yellow marker, a highlighter, highlighting parts of his medical record because this is how he was going to establish the benefits that he was going to receive in the VA system for his disability. He said I can spend 20 man-hours putting this medical record together and it ends up on someone's desk and it doesn't get picked up, and then no one can find it and I have to start all over again. That was his main message to me that day. Now the VA system has been indeed very forward-thinking in its embrace of electronic medical records and its investment in information technology. The problem is the medical records from the Department of Defense and the Department of Veterans Affairs do not possess the interoperability necessary to make this type of activity unnecessary. So clearly delivering value to the patient, particularly a patient in that situation, is of paramount importance. And it is my contention that if we do make the bonus payment generally available to physicians, this will be something that they will embrace. There is a learning curve, to be sure. It is going to slow people down a little bit initially. But ultimately, the rapidity of the system will be impressive. And even in a smaller physician's office the ability, just think, never having to wait while they find your medical record because somebody didn't put it back in the right place. I know it happened in my medical practice, and I suspect it happens in offices across the country on a regular basis. If nothing else, you will save that time and embarrassment of not being able to locate a patient's record. One of the problems last year when we dealt with trying to provide the health information technology bill that we passed here in the House and were never able to come to agreement with the Senate, part of the difficulty was being able to have the hospital and the clinic and the physician, there may need to be some relaxation in what are called the star clause to allow safe harbors so that these conditions can be met. But the reality is that once people become used to this technology will embrace it. The other unintended consequence, the other unintended benefit of this is the rapidity with which the system can learn. When I say the system, the entire health care system because wouldn't it be nice to know which treatments deliver on the promise of getting people better faster at a lower cost. Wouldn't it be great to have that information and know what treatments were effective and what treatments were only marginal? That information can be literally at a physician's fingertips with the right type of computer architecture and technology environment. I believe the time has come that we do need to embrace that. So the bill will include a Federal incentive to implement health information technology along with provisions providing safe harbors for the sharing of software, technical assistance and hardware, as well as the creation of consortiums. Now, it is not just about physicians my age, because we have got to also concentrate on helping the younger doctors with residency programs. The funny thing about doctors is we to have a lot of inertia. A lot of us tend to practice very close to where we did our training. So the idea to get more training programs in areas that are underserved, rural areas, inner city areas, to get more training areas where the doctors themselves are actually needed. So the second bill or the second prong of this three-pronged approach would be to develop a program that would permit hospitals that do not traditionally operate a residency training program, allow them the opportunity to start a residency training program to build the physician workforce of the future. This bill would create a loan fund available to hospitals to create residency training programs where none has operated in the past. The programs would require full accreditation and generally be focused in rural, suburban, inner urban or frontier community hospitals. On average, it costs $100,000 a year to train a resident and that cost for a smaller hospital can be prohibitive. The other issue is in 1997 the Congress passed what was called the balanced budget amendment and within that there is a residency cap that also limits resources to nontraditional residency hospitals such as smaller community hospitals. For the purposes of this bill, the loan amount to any institution would not exceed $1 million, and the loan itself would constitute start-up funding for a new residency program. And the start-up money is essential. Since Medicare graduate medical education funding can be obtained only once a residency program is firmly established, the cost to start a training program for a smaller, more rural or suburban hospital can be cost prohibitive because these hospitals operate on much narrower margins. The overall bill would authorize a total of $25 million to be available over 10 years. The fund, of course, would be replenished because these are constructed as loans and the Health Resources Service Administration may make the loans available to new loan applicants or extend loans to increase the number of residency slots available at existing programs or a loan to continue newly established residency programs to hospitals that have been approved. To be eligible, a hospital must demonstrate that they currently do not operate a residency training program, have not operated a residency training program in the past, and that they have secured preliminary accreditation by the American Council on Graduate Medical Education. Additionally, the petitioning hospital must commit to operating an allopathic or osteopathic residency program in one of five medical specialties, or a combination of these specialties: Family medicine, internal medicine, emergency medicine, obstetrics and gynecology, or general surgery. Again, the hospital may request up to $1 million to assist in the establishment of this new residency program. Funding could be used to offset the cost of the residents' salaries and benefits, faculty salaries and other costs directly attributable to the residency program. The bill would require the Health Resources Services Administration to study the efficacy of this program in increasing the number of residents in family medicine, internal medicine, and primary care, and whether the program led to an increase in the number of available practitioners in these specialty areas, particularly in underserved areas. The loans would be made available beginning January 1, 2008, and the program would be sunsetted in 10 years time, January 1, 2018, unless Congress elected to reauthorize the program. The third prong of the physician workforce for the future would be ensuring the availability for adequate future physicians, and provide medical students with assistance and incentives to practice in shortage specialties and shortage areas. The third bill would establish a mix of scholarships, loan repayment funds, and tax incentives to entice more students to medical school and create incentives for those students and newly minted doctors to become primary care, family physicians, general surgeons, OB/GYNs and practice in shortage areas such as rural or frontier areas. This bill would provide additional educational scholarships in exchange for a commitment to serve in a public or private nonprofit health facility determined to have a critical shortage of primary care physicians. Such scholarships will be treated as equivalent to those made under the National Health Service Corps Scholarship Program and penalties apply for those that take advantage of the scholarships but do not go into one of those practice areas. This will be a 5-year authorization, authorizing these loans and grants to be $5 million a year. The scholarship amounts will not exceed $30,000 per year. The scholarship amounts may be adjusted based on financial need, geographic difference and educational costs. Again, this is going to be administered through the Department of Health and Human Services, specifically through the Health Resources Service Administration. This program will have an established repayment program for students who agree to go into family practice, internal medicine, emergency medicine, general surgery, or OB/GYN, and practice in underserved areas. Again, HRSA will administer and promulgate the requirements. Recipients must practice in the prescribed specialty and prescribed area, which is designated as an underserved area, and the practices may include solo or group practices, clinics, public or private nonprofit hospitals. Again, a 5-year authorization at $5 million per year. This will establish the Primary Care Physician Retention and Medical Home Enhancement grants to help ensure that primary care physicians continue to provide coordinated medical care to patients in underserved areas or high-risk populations. Now, I know we can all think of areas like that in our home districts and home States. Also, in an area such as the gulf coast area where so many physicians left after the devastating twin hurricanes of Katrina and Rita a year and a half ago, it has been very hard on doctors in those areas. Many doctors have left. It is going to be difficult to attract doctors back to that area, and this will be yet one more tool, one more way, to get doctors to consider practicing in an area where the need is great. This encourages States to establish Physician Workforce Commissions, especially in rural areas and in certain practice specialties such as family medicine, again basically primary care, by exempting from income tax any amount paid by the Physician Workforce Commission in the form of salary to a physician who has signed a contract with the political subdivision to practice in that area for any amount of time, no fewer than 4 years. Every year there would be a report back to Congress about the effectiveness of this program, that is, once again, are we spending our dollars wisely, are we getting what we thought we would get when we initiated that program. So, Madam Speaker, those are three bills that, again, I will be introducing during the week next week after we get back. I think these, while they may not be the answer to all the problems, certainly focus on where the problem areas exist, that is, physicians who are my age, 50 years plus or minus a little bit, who are in the Medicare program but looking to drop out or opt out because they can no longer continue their practices because we in Congress are cutting reimbursements to the point where we are no longer paying our fair share. We are no longer paying the freight on taking care of Medicare patients, but in addition to that, looking over the horizon to the future, being sure that we have the physician workforce of the future, to provide care for the baby boomers who are getting older, but just being able to provide that care in general. In fact, we are not even talking about just the Medicare population here. We are talking about doctors who are going to work in primary care in a medically underserved area in a specialty which is in short supply in that area. That dual approach of increasing the number of residency slots, again, doctors tend to go into practice and stay in practice where they trained, and the other, a loan forgiveness program and a tax incentive program to young physicians getting out of school, may have several hundred thousand dollars in debt from their undergraduate and then their medical school training, this is a way for them to begin their careers without having that incredible debt load to carry with them, a loan forgiveness, a tax incentive program, provided they are willing to give back some time in a medically underserved area in a specialty that is in high medical need. I believe that by taking these three steps, Madam Speaker, we really will go a long way towards alleviating the physician shortage. There is no question that we are going to need to devote a lot more time and energy to how we approach the problem dealing with health care in this country and dealing with the uninsured. I expect to have many more hours on subsequent evenings in the coming weeks to talk about just this problem and just what are some of the approaches that may be taken. We had a fairly long hearing in committee this morning, in my committee, the Health Subcommittee of Energy and Commerce, hearing from a variety of people about how to provide additional care for the uninsured. Again, it is going to be a lively debate, what happens in the private sector or do we just simply give it over to a government program, perhaps bring the age for eligibility for Medicare down lower and lower, expanding the SCHIP program higher and higher, and then the two programs will meet in the middle and provide coverage for everyone in the country. I do not think that is necessarily a good way to go. I think there are some reasons that the private practice of medicine does bring value to the entire American medical system. There is no question we have no shortage of critics in this country and around the world about the system of health care in this country, but my opinion, it is the American system that stands at the forefront of innovation in new technology, precisely the types of system-wide changes that are going to be necessary to efficiently and effectively provide care for Americans in the future. There was an article in the New York Times published October 5, 2006, by Tyler Cowan. He writes, ``When it comes to medical innovation, the United States is the world leader. In the past 10 years, for instance, 12 Nobel prizes in medicine have gone to American-born scientists working in the United States, three have gone to foreign-born scientists working in the United States, and just seven have gone to researchers outside of the country.'' But he does go on to point out that five of the six most important medical innovations of the past 25 years have been developed within and because of the American system. The fact is the United States is not Europe. American patients are accustomed to wide choices when it comes to hospitals, physicians, and pharmaceuticals. Because our experience is unique in this country, because Americans indeed are exceptional and we are different from the types of programs that are in other countries, this difference should be acknowledged and embraced, whether we are talking about public or private health insurance programs. Madam Speaker, it has been a long day and we have gone fairly late into the evening. I appreciate the time.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I move that the House do now adjourn.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate Texas Wesleyan University on the completion of the new Ed and Rae Schollmaier Science and Technology Center. This new learning center will facilitate access to genomic databases for use in biology, chemistry and computer science courses at Texas Wesleyan. The technology center will be a valued resource for students and faculty working in the disciplines of biology, chemistry, physics, computer science, and math. Texas Wesleyan science educators will be able to provide state-of-the-art learning opportunities to its diverse student body. Undergraduate students at Texas Wesleyan will be provided with scientific research opportunities that are typically available only to graduate students. Founded in 1890 in Fort Worth, Texas, Wesleyan University is a United Methodist institution dedicated to the education of students in the region and beyond. The University offers a wide range of degrees for undergraduate and graduate students and educates international students from 28 countries I congratulate Texas Wesleyan University as it continues to progress as a distinguished and diverse educational institution, and I am proud to represent them in Congress.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate the Marcus High School men's soccer team for winning the University Interscholastic League (UIL) 5A Soccer State Championship. The Marcus Marauders defeated Plano West Senior High School to win the school's first men's soccer state championship. Glen Marshall scored a goal to send the game into overtime, as time was about to expire. After two scoreless overtime periods, a winner would be decided by a shootout. Eric Frazier, Jon McMullen, and Sam Garza scored in the shootout for the Marauders, and goalkeeper, Matt Chidsey, blocked three of PIano West's shots to win the championship. Andres Angulo was named the game's most valuable player. Angulo assisted on both of the Marauders' goals. The Marauders finished their season with a perfect record of 30-0, outscoring their opponents 114-17. In the process, they recorded a school record 16 shutouts. The team is coached by John Gall. I would like to offer my sincerest congratulations to the Marcus soccer team, Coach Gall, the parents, and all of Marcus High School for this great achievement. I wish them continued success in the future, and I am very proud to represent them in the 26th District of Texas.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate the girls soccer team at The Colony High School on winning the class 4A Girls Soccer State Championship. The Cougars of The Colony High School defeated Friendship High School by a score of 1-0 to win the class 4A Girls Soccer State Championship on Saturday, April 14, 2007. Junior midfielder Amanda Fancher scored the winning goal on a 22-yard free kick near the end of the first half. Amanda was also named the championship game's most valuable player. The Colony finished the season with a record of 23-3-4, including shutouts in 11 of their final 12 games. The team has also beaten every soccer record ever set by the school. I would like to offer my sincerest congratulations to coach Nicole Jund, the team, the parents and all students of The Colony High School for their great achievement. I wish them success in the future, and I am very proud to have them in the 26th District of Texas.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate Jacob West of Marcus High School for his recognition as a 2007 Presidential Scholar. The Presidential Scholar Commission honors up to 121 graduating seniors each year for outstanding academic achievement. This award is one of our Nation's highest for high school students. Jacob is being honored as a Presidential Scholar for his exceptional performance on the SAT. At Marcus High School, Jacob is a member and leader within the Marcus band, who won a State championship this year. He is also involved in the Junior Classical League, the National Honor Society, and other organizations. He has received a plethora of academic awards at Marcus and was a National Merit finalist. Jacob is a notable example of how the education system in Texas is committed to fostering growth in students and giving them the skills they need to achieve. Congratulations to Jacob, his family, and Marcus High School for this outstanding achievement.

Mr. BURGESS

Mr. BURGESS. Mr. Chairman, I thank the ranking member for yielding me this time. I appreciate Mr. Hensarling's comments as well. My comments this evening are going to be directed toward the entitlement program known as Medicare. It does seem that the budget, before this evening, the budget we are debating, does lack a lot. It has a significant deficiency. The gentleman from Texas (Mr. Hensarling) has already pointed out the lack of any real entitlement reform; but there is a missed opportunity in this budget which is disturbing. Yesterday in the Rules Committee, I offered an amendment which was not made in order. This amendment was relatively simple. It would have provided for reconciliation instructions, require the House Judiciary Committee to take up and report to the full House a bill that would reform our medical justice system, and limit the number of lawsuits of questionable merit in order to achieve an overall savings of $2 billion over 5 years. By capping noneconomic damages at $250,000 per provider, $500,000 per case for noneconomic damages, the CBO estimates that this amendment would save nearly $2 billion over 5 years, $4.5 billion over 10. Because the practice of defensive medicine is so pervasive, this amendment would establish a liability safety net for many States. It would also insulate providers from lawsuits of questionable merit while ensuring just compensation for those who have been truly injured. Defensive medicines increases the cost of medical care. It reduces access for patients, and increases the cost of programs like Medicare and Medicaid for the United States taxpayer. This is doubly important as costs increase in Medicare and Medicaid year after year, and we seek savings to make certain that these programs are solvent and viable for those who depend on them now and well into the future. Medicare and Medicaid represent a growing expenditure of over $600 billion a year for the Federal Government. As the medical liability crisis grows, a large fraction of these dollars will be spent on inefficient health care services provided more to protect the provider from a lawsuit than to improve the patient's health. Effective medical liability reform would constrain the growth of vital programs such as Medicare and Medicaid, and ensure their long- term viability. I am happy that the Republican substitute addresses this issue in a responsible manner. Once again, it is an example of a missed opportunity by the budget before us tonight. I urge my colleagues to vote ``no'' on the budget and ``yes'' on the Republican substitute.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate Caroline Hamilton of Lewisville High School for her recognition as a 2007 Presidential Scholar. The Presidential Scholar Commission honors up to 121 graduating seniors each year for outstanding academic achievement. This prestigious award is one of our nation's highest for high school students. Caroline is being honored as a Presidential Scholar for exceptional performance on the SAT. She earned a perfect score of 2400. At Lewisville High School, Caroline is 2nd in her class and a leader in the band, as well as a member of National Honors Society and various other organizations. Outside of school, she is a member of our Congressional Youth Advisory Council and has received many well deserved accolades in Lewisville and Denton County. Caroline is a notable example of how the education system in Texas is committed to fostering growth in students and giving them the skills they need to achieve. Congratulations to Caroline, her family, and Lewisville High School for this outstanding achievement.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, as we have just heard, this is an important bill. Trauma is one of the most expensive illnesses that we treat in this country. I am so pleased today to stand in support of H.R. 727, the Trauma Care Systems Planning and Development Act of 2007. In 1990, the Trauma Care Systems Planning and Development Act created title XII of the Public Health Service Act. This program was borne out of a report in which it was found that severely injured individuals in a majority of both urban and rural areas of the United States were not receiving the benefit of trauma systems, despite considerable evidence that a trauma system would improve survival rates. H.R. 727 requires the Health Resources and Services Administration to work with each State to help establish advanced trauma life support systems and to train EMS personnel for rural areas. Likewise, the program will help to make improvements in communication and coordination with the larger State trauma systems. For Americans between the ages of 1 and 44, trauma is the leading cause of death. Traumatic injury in the United States, largely due to motor-related trauma, totals $260 billion in costs. By reauthorizing this program, we will achieve the goal of ensuring that all areas of the United States have appropriate emergency medical services. As the legislation is structured, entities, either States or independent agencies, may compete for planning and development grants to help improve the trauma system and coordination in a given region. That is a distinct difference from the trauma bill that existed before. This bill is an improvement over the previous authorization because it will allow both States and other political subdivisions to work cooperatively to improve trauma systems. This bill also represents a more realistic authorization that will essentially act as start-up Federal funding for enhanced communication, enhanced coordination and data collection for States and other eligible grantees. Certainly, I need to join my colleague from Texas in thanking Congressman Barton and Congressman Dingell for their hard work on this legislation. Mr. Speaker, this has been a work in process for some time. My personal staff, Josh Martin, worked diligently on this bill last year. There were a number of issues with the other body which took some time to resolve, but happily they were resolved before the end of the year. We are now able to support H.R. 727 in this Congress, get the bill passed and get this coordination of service where it is so badly needed. Mr. Speaker, I yield back the balance of my time.

Mr. BURGESS. Mr. Speaker, at this point, I yield such time as he may consume to the gentleman from Louisiana (Mr. Boustany), who has intimate, firsthand knowledge of this issue.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, through the course of these three bills being brought by the Energy and Commerce Committee tonight, we have heard a number of stories. People have shared with us their personal stories. I saw on the news wires just this evening where a good friend of our committee, Jack Valenti, had been hospitalized with a stroke earlier this week. My own father suffered a stroke, May 23 of 1989. He, unfortunately, died 2 years ago this week. He spent the last 16 years of his life living with a disability as a result of that stroke. The day that it happened, he lost the ability to speak and never regained it prior to his death. Stroke treatment is so important and it has evolved over time. It wasn't too many years ago where it was just simply a question of being certain about the diagnosis, making certain the stroke patient was stable, and then making arrangements for their rehabilitation. But so much more can be done now. And we heard about the golden hour when talking about the trauma bill. Actually, for stroke victims, if treatment is rendered within the first 3 hours of a clot occurring, anti-clot medications, clot-busting medications, thrombolytic agents can be administered to restore significant function to that and prevent injury to that part of the brain that has been injured by, or been placed in jeopardy by, the presence of a clot. Other strokes are caused by bleeding and blood vessel malformations within the brain; and one of our colleagues in the other body, indeed, suffered such an injury earlier this year. The treatment is vastly different. Clearly, those patients should not be treated with clot- inhibiting agents because they would be placed at greater risk. So the diagnosis of the type of stroke at the time of the stroke becomes critical, and that is where the funding placed for the education and the medical research becomes so important. Further, it is my feeling that, as time goes forward, we will indeed improve the ability to help individuals who have been afflicted by a stroke. Additionally, the bill calls for the Secretary of Health and Human Services to establish programs educating the public about stroke prevention. And thanks to my good friends at mayoclinic.com, I would like to take just a moment to run through, to enumerate those things that should be done for stroke prevention. And the number one issue is, if a person has hypertension, that hypertension needs to be controlled. If a person has high cholesterol, that needs to be lowered, either by modifying diet, a diet low in fat or a cholesterol lowering medication such as a statin. No one should smoke in the United States today. If you are diabetic, control your blood sugar. Maintain a healthy weight. Exercise regularly. Avoid stress. Don't serve in Congress. Oh, that wasn't on the list. Avoid stress. And if you do use alcohol or illicit drugs, perhaps you ought to think of another activity. These are very commonsense recommendations. They have been developed by, again, our good friends at Mayo Clinic. And I urge all Americans to consider incorporating those into their lifestyle. This is important legislation. I urge my colleagues to support the legislation. Mr. Speaker, I yield back the balance of my time.

Mr. BURGESS. Mr. Speaker, I am pleased to rise in support of H.R. 477, the STOP Stroke Act. By passing this legislation, we are drawing attention to the dangers of stroke and heart disease. As we have already heard, stroke is the third leading cause of death in this country, preceded by cardiovascular disease and cancer, but clearly an important cause of death in this country. It is the most common cause of adult disability. As we have already heard, each year, more than 700,000 Americans suffer stroke, and 160,000 die from stroke-related causes. It is important to increase awareness and knowledge about stroke and stroke prevention. One of the key components of this legislation is that it allows the Secretary of HHS to establish programs for education about stroke prevention. Additionally, the STOP Stroke Act provides federally funded grants to health care professionals at qualified entities to help educate them about the need for prevention, diagnosis, treatment and rehabilitation. Lastly, the legislation before us today includes a 5-year pilot program that provides grants to States and public-private entities for coordination of health care through telehealth networks. I want to thank Congresswoman Capps and Congressman Pickering for their work in bringing this legislation to the floor tonight. I urge my colleagues to support the STOP Stroke Act. Mr. Speaker, I reserve the balance of my time.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, I yield such time as she may consume to the gentlewoman from North Carolina (Mrs. Myrick), the cosponsor of this legislation.

Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume. Let me also add my congratulations to the girls' basketball team at Brooklyn Thomas Jefferson High School. That is quite an accomplishment. Mr. Speaker, I rise tonight in support of H.R. 1132, the National Breast and Cervical Cancer Early Detection Program. The National Breast and Cervical Cancer Early Detection Program has had many proven successes in screening low-income, minority and uninsured women for little or no cost. The Centers for Disease Control estimates that between 8 and 11 percent of women nationwide are eligible for participation in this program. Since its inception in 1991, the early detection program has served almost 3 million women, providing more than 6.9 million screening examinations, and has diagnosed almost 30,000 breast cancers, 95,000 precursor cervical lesions, and 1,800 cervical cancers. There is a direct link between these statistical figures and the lives that have been saved. The Susan G. Komen Breast Cancer Foundation and the American Cancer Society have been instrumental in promoting the successes of the early detection program. I would also like to commend the gentlewoman from Wisconsin (Ms. Baldwin) and the gentlewoman from North Carolina (Mrs. Myrick), a breast cancer survivor herself, who have worked tirelessly in bringing this legislation to the floor of the House and eventually to the President's desk to be signed into law. I urge my colleagues' support of this legislation. Mr. Speaker, I reserve the balance of my time.

Mr. BURGESS. Mr. Speaker, the gentlewoman from Oregon is indeed correct: this is important, life-saving legislation. Early detection expands the treatment options available to women who are afflicted with this disease. With that, I yield back the balance of my time.

Mr. BURGESS. Mr. Speaker, I yield 4 minutes to the distinguished gentleman from Indiana (Mr. Burton).

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate students of Marcus High School for their remarkable performance in the state Academic Decathlon competition. This is a competition that includes some of the brightest students in the State of Texas. Academic Decathlon is a nation-wide competition which tests high school students in the following 10 academic events: speech, interview, essay, super quiz, language and literature, economics, art, music, social science, and math. The competition takes place at a regional, state, and national level. The theme for this year's categories was ``China and its Influence on the World.'' The team from Marcus High School finished 3rd at the regional competition and 18th overall at the state competition. Jonathan Neal was awarded a gold medal in the language and literature category. Other contestants from Marcus were Jake Burley, Chelsea Carroll, Preston Hale, Robert Handley, Matthew Henry, Jacqueline Hurlbutt, Emily Robertson, and Tyler Stevenson. Lou Ann Kemper and Dorrie Loughborough were the coaches for the team. I would like to recognize Principal Kevin Rogers and the entire Marcus High School faculty for their dedication to education. It is also necessary to honor the parents of these students for the active role that they have taken in their children's education. I commend all of the participants for their diligence and commitment to academic achievement. I wish them the best as they continue onward, and I am very proud and honored to be their Representative in the 26th District of Texas.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to congratulate students of Flower Mound High School for their remarkable performance in the State Academic Decathlon competition. This is a competition that includes some of the brightest students in the State of Texas. Academic Decathlon is a nation-wide competition which tests high school students in the following 10 academic events: speech, interview, essay, super quiz, language and literature, economics, art, music, social science, and math. The competition takes place at a regional, state, and national level. The theme for this year's categories was ``China and its Influence on the W orId.'' In Flower Mound High School's first appearance at the State competition, they finished in 10th place with 41,288 points. Juri Hur, Josh Patterson, and Jamie Choate received gold medals for their outstanding performances. They were joined in the competition by teammates Jonathan Angel, Danielle Bevers, Melissa Bevers, Kayla Gilliard, Leah Higginson, and Heather Snedeker. The team was coached by Judy Kelmer and Julie Tipton. I would like to recognize Principal Jack Clark and the entire Flower Mound High School faculty for their dedication to education. It is also necessary to honor the parents of these students for the active role that they have taken in their children's education. I commend all of the participants for their diligence and commitment to academic achievement. I wish them the best as they continue onward, and I am very proud and honored to be their Representative in the 26th District of Texas.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to recognize the outstanding achievement of the University of North Texas basketball team on defeating Arkansas State University, by a score of 83-75, to win the school's first ever Sunbelt Conference title. The Mean Green's 23 wins this season are the most in team history. Furthermore, this most recent win clinched North Texas a spot in the prestigious NCAA Tournament for the first time since the 1987-88 season. Senior Calvin Watson, who had 24 points and six 3-pointers, was named the Sunbelt Conference Tournament's Most Outstanding Player. Guard Ben Bell was also named to the all-tournament team. This victory was a combined effort and would not have been possible if it was not for the incredible work ethic demonstrated by these athletes and coaches. I extend my sincere congratulations to Head Coach Johnny Jones, University of North Texas President Gretchen M. Bataille, as well as the members of the UNT Men's Basketball Team. I am proud of these young men--their victory in Sunbelt Conference and their efforts during the NCAA tournament. Not only am I honored to serve as their U.S. Representative, but I am proud to be a University of North Texas alumnus.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to honor David Ivory, former Fort Worth city manager, who passed away on Friday, March 9, 2007. Mr. Ivory was known by many as a loyal, trustworthy, and dedicated public servant. Mr. Ivory served his country for two years in Korea, achieving the rank of Lieutenant. In 1973, he received his master's degree in public administration from Brigham Young University. He also served in the Utah state legislature for a brief time. After moving to the City of Fort Worth, Mr. Ivory served in many City Hall positions, ultimately being named city manager in 1989. His achievements include involvement in numerous economic developments, such as the annexation of the Perot Group's 5600 acres in North Fort Worth and the creation of Alliance Airport. Mr. Ivory was 62 years old, at the time of his passing. He is survived by his wife, Margery; his son, Charles; and his daughter, Angela. I would like to extend my sincerest condolences to the Ivory family; my thoughts are with them as they endure this difficult time. The City of Fort Worth has lost a devoted public servant and a great man.

Mr. BURGESS

Mr. BURGESS. Mr. Speaker, I thank the gentleman for yielding. I thank him for convening this hour this evening. I think it was extremely important, extremely timely that we have this discussion on the House floor, and I am especially glad that we have been joined by such prestigious members on the House Armed Services Committee because I think their words certainly add much more than what I would be able to bring to the subject. I will just have to say I went to Walter Reed this afternoon, asked to go last week, because I thought it was important as one of the medical professionals in Congress that I go out and just look and see is there anything that causes me grief, that causes me concern. I will have to say I was not upset about the things that I expected to be upset about, and I was upset about things that never would have occurred to me to be upset about, and let me elucidate that a little bit if I can. Of course I read the stories in the newspapers last week, and I expected to be upset about the physical condition of the building, and the building in question, Building 18, which is just across the street from the Commanding General's residence at the Walter Reed Medical Garrison there in Northeast Washington. Indeed, the building is not the nicest of buildings in Washington, D.C., and I am sure there has been some attention to some of the problems that had already been rendered to the building in the week between the time the story broke and the time that I got out there, but in general, if you stop and think about what this housing was designed to do, it was obviously to provide a place for soldiers to stay while their medical conditions were evaluated, but while they decided do they stay in the military, do they get out, if they are able to undergo the physical processes for rehabilitation or allowed to stay in the military, how much time is going to be required. This location, Building 18, being outside the medical garrison of Walter Reed Hospital, had some appeal because it was outside the garrison, and as a consequence there was perhaps a little more freedom, a little more freedom of movement. There is a parking garage underneath it, not quite the same level of restriction that you have within the medical garrison itself. So the actual physical condition of the building, again, I am sure it had received some attention between the time the story broke and I got out there, was less distressing to me than some of the things that I heard that our wounded soldiers have to go through. I snapped a picture while I was out there. The gentleman talked about the massive amounts of regulation and red tape. Here is a gentleman going through his medical records. I do not think this picture does it justice, but this is about the size of the Dallas phonebook that he has got in front of him. These are his medical records he has got spread out on the table, and he is trying to put them in some semblance of order so he can make his case for the time he gets out of the military to assess his degree of disability if he were to wish to stay in, to be able to make the argument that he would be able to stay in the military. But an individual such as this, and this individual, in fact, was part of the Medical corps, you can see on his shoulder patch there. So he had some knowledge of the types of record he was reviewing on his own behalf. Just imagine someone without any medical expertise having to go through these numbers of records, and then what if it all gets lost, which unfortunately happens. Twenty-four hours total time that he spent in assembling these records, and unfortunately, he told me, it is not an infrequent occurrence, it is not just that a soldier's appointment would be canceled, that they expected for a few weeks time. It is not just that the ride to the hospital did not materialize, but this amount of work going into essentially what will define his future could be misplaced, and in this day and age, when we talk about the computerization of medical records, we talk about the VA system being on an electronic medical records system, there is no way right now for these medical records generated by the Department of Defense to talk to the medical records in the VA system. So it is a lot of work that we ask these folks to go through on their own behalf, and unfortunately, it can occur that after putting all those hours in this record ends up on the wrong place on someone's desk, and when the time comes to retrieve it, it cannot be found. That was a one of the things, again, I never expected to see today when I went to the hospital but certainly caught my attention when I visited. I would stress, and just like the chairman, just like my friend from Texas, I too have been to Landstuhl Hospital in Germany, spent a good deal of time on two separate occasions at the field hospital in Balad, Iraq, and spent some time at the Ebosina Hospital in downtown Baghdad last summer. In fact, that is the hospital where the famed Baghdad ER show was taped, and I would have to say through all of that exposure to the medical care available to our soldiers in the field, the so-called down range exposure, their medical care is top notch. I had an emergency room physician, an orthopedist in Balad, Iraq, tell me he had medicines and treatments at his disposal out in the field that he would never have had available to him in downtown Cincinnati. It is that training, that expertise that he gains dealing with those new treatments and those new therapies that will then make him a better physician, and he acknowledged this. I will be a better doctor when I go back to take care of the civilians in Cincinnati, Ohio, than I was before I left because of my experience here in Balad. I have heard other people refer to it, but certainly we have many, many dedicated men and women in the medical staff, the nursing staff at Walter Reed Hospital and our other fine military hospitals, and it does pain me somewhat to think that these individuals are also reading these stories. They go to work every day to do their best work. They go to work every day to take care of the genuine American hero, and then they hear their efforts and their professions demeaned in the press. I know how disheartening that can be and I would say to those individuals working in the Medical corps in our military hospitals and the Nursing corps in our military hospitals, God bless you. Thank you for what you do because individuals like this who, in another time and another place, might not have had such a happy outcome, he, in fact, is looking forward to a return to civilian life and being quite productive thanks to the expert care that he received at Walter Reed Hospital. One thing that I do want to bring up because it is terribly important, the Wounded Warrior Transition Brigade, which was just announced last week and has been formed this week. Major General Eric Schoomaker, who is the new command at Walter Reed Hospital, this establishes essentially a patient advocate in uniform, patient advocacy within a military context. This is one of the things, when we hear about the failures of leadership that resulted in some of the problems that have surfaced at Walter Reed Hospital, this was the type of leadership that was lacking. So these small brigades, which will now be composed of one leader with 17 men or women under his command in those units who are awaiting a medical decision on their military future, certainly tightening up that ratio between leader and the number of men and women in the cohort will significantly improve things, I think, as far as the advocacy for our heroes. So the gentleman from Texas was very kind to call me down and let me participate in this. I thank you very much for your leadership on this. It is extremely timely and extremely important.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to recognize student volunteers with the Lewisville-Flower Mound Teen Court, who were named ``Best Overall Prosecution Team'' and ``Best Overall Defense Team'' at the inaugural North Texas Teen Court Training. The event was held on March 3, 2007, at the Texas Wesleyan University School of Law in Fort Worth, Texas. Volunteer youth attorneys, bailiffs, clerks, and jurors are given an opportunity to conduct trials of actual cases with Class C misdemeanor defendants from local Teen Courts. Over 200 teens, adult volunteers, and judges were involved in the competition. Seth Duban, of Marcus High School, and John Maksym, a home-schooled student, were members of the winning prosecution team. Lewisville High School students Sarah Abdel and Jennifer Stanley, along with Lexia Chadwick of Huffines Middle School, composed the competition's winning defense team. The North Texas Teen Court Training is a great event for the students, the community, and the Texas Wesleyan University School of Law. These exceptional young men and women had the opportunity to see and act out the judicial process in a way that they could not have otherwise. I would like to extend my congratulations and best wishes to the five winning students, and to all other participants. I am honored to represent such intelligent and academically driven students.

Mr. BURGESS

Mr. BURGESS. Madam Speaker, I rise today to announce the dedication of Dr. Pillow Park in North Richland Hills, Texas. This newly refurbished park is named in recognition of Dr. David Pillow who served the city of North Richland Hills and much of north Texas since founding the Pillow-Rush Medical and Surgical Clinic in 1955. As the success of his business grew over the years, additions doubled the size of the hospital. Dr. Pillow also serves as the Medical Director for UT Southwestern University Hospital's Chest Pain Center. Dr. David Pillow was also the chairman of the board of trustees in 1983, when the North Hills Hospital had its dedication ceremony. On August 28, 2006, the Naming Board of the city of North Richland Hills unanimously approved a resolution for Little Bear Creek Neighborhood Park to officially be named ``Dr. Pillow Park.'' The new Dr. Pillow Park is a 6.5 acre neighborhood park and has a Texas Mission theme. Included are a hike and bike trail, a covered picnic area, and a playground. I would like to express my best wishes to the Pillow family and the entire North Richland Hills Community on this special occasion. It is an honor to represent a fellow physician in Congress.