Thomas Coburn

Mr. COBURN

Mr. COBURN. Mr. Speaker, I ask unanimous consent to substitute for the gentleman from Colorado (Mr. Bob Schaffer).

Mr. COBURN

Mr. COBURN. Mr. Speaker, I want to comment on the tone that we heard from the gentleman from Connecticut. I am a physician. I still practice. What we were supposed to have received from Mr. Gejdenson was that the problems in the health care field today have come about because of this Congress. They have come about because of a law called ERISA that this Congress a number of years ago passed. And the thing that strikes me rather peculiarly is what we hear as HMO attacks instead of attacks on physicians who are not doing their job. The number one job of a physician is to do no harm. I want to tell my colleagues, if I do an outpatient surgery, which I do almost every weekend, and my patient is not ready to go home, I fight and fight and fight, but I do not give up. My patient stays there until they are ready to go home. Do you know what? I win those battles with HMOs. I do not lose those battles. What we are really hearing is the inability of physicians to have backbone to stand up. The law that created the situation that we have today was created several years ago, not by a conservative Republican Congress, but by a rather liberal Democrat Congress. I do not usually say anything partisan on this floor, but the tone of the speech is inappropriate for this august body. To not challenge that tone will do more to destroy this institution than anything I know. We passed a bill, it is called the Patient Protection Act. It is not designed to put more lawyers at work and increase health insurance costs by lining the pockets of people who are going to challenge HMOs through the court system. There is no question we have to make changes. Those changes are being made. They have been made with this Congress. But the very idea that this Congress, this Republican Congress, is responsible for the emotional diatribe that we just heard is anything but the truth. The truth is, we have tremendous cost pressures on health care in this country. HMOs have done a lot to help us solve those problems. Are they perfect? No. Have they made mistakes? No. Is there any physician before HMOs were created that has not made a similar mistake of letting someone go home too soon? No. So we can emotionalize these issues. We can try to make them a campaign issue, but what we do is serious damage to the real problems that we have to solve in this country. And my heart is broken that we have the kind of discourse that we have in this House that creates a false paper tiger and then sets it down. To the American public, I apologize for what we heard in the past 30 minutes from the gentleman from Connecticut. It is my hope that we can carry on conversations in this House that come up to the level of integrity, honesty and maturity that this House deserves.

Mr. COBURN

Mr. COBURN. One key point. We heard that the Republicans had not done anything for municipal bond funding for schools. The President vetoed a tax cut for schools in terms of their ability to float bond issues. He vetoed it from his own desk. So to claim that we did not do it, we did it, we passed it, we sent it to him and he vetoed it. So the misdirection. One of the things you do when you are on offense, if things are not going real well is you misdirect. You go a different direction. That is what we see on the football field. That is what we are seeing in terms of playing with the truth.

Mr. COBURN. I want to identify with a few of your remarks. Being from Oklahoma, I went to all the public schools, all of my kids went to public school. I have, my third daughter, my youngest daughter is now a senior at Oklahoma State University. Public schools is something that we need to enhance, and nobody here is saying we should not. The question is, how many of the dollars are spent on the children and how many of the dollars are spent in the classroom and how many of the dollars are sent there for a merit raise for an outstanding teacher versus how many of the dollars are spent above that school all the way back to Washington? The fact is only 60 percent of the dollars are getting to our children. Why should not our teachers be some of our highest paid professionals? Why? Because it is getting chewed up in administrative costs from Washington before it ever gets there. It is interesting, not long ago they published a study done in Massachusetts, an 8th grade literacy test, 40 percent of the teachers in the State of Massachusetts could not pass an eighth grade literacy test. That is not an affront from me towards the teachers of Massachusetts, but it brings to bear the very real problem. We put the dollars in the wrong place. If we want excellence, then we have to concentrate the dollars in the classroom. I hope you will yield me about 4 or 5 minutes. There is an area that, another area in Washington that I would like to address and just take a little break here for a minute, if I could. It has to do with the Office of Inspector General. This is an office that was created to create a balance. The Inspector General in all the different departments in this country was designed to be a balance, to look at, to make sure, to both report to Congress and to the Secretaries that, under the laws, that each of those departments were running properly. It was established to promote economy, efficiency, effectiveness, to prevent fraud, waste and mismanagement in the programs that each of those agencies operate. There is a particular inspector general, Ms. Susan Gaffney. She was nominated for the HUD Inspector General post in 1993 by President Clinton, was sworn in and confirmed by the Senate. This lady is somebody we can be proud of. She is a career lawyer who has worked to expose fraud and abuse and to expose those who perpetrate and steal the very tax dollars that people bring to the operation of this government. She has been in the housing industry since 1970. She has had the following awards: the Presidential Meritorious Rank award, the Distinguished Honor award, the Joint Financial Management Improvement award for distinguished leadership, and because of those awards, she was appointed and placed to be the watchdog over the housing programs in this country. She came in under Secretary Cisneros' tenure and had a great relationship, developed good input and had a wonderful course, where she helped that agency control the dollars and made sure that fraud and abuse were not present. However, I am sad to report that at this time the situation at HUD is very much different. There is no question that Secretary Cuomo and Ms. Gaffney share the same strong commitment to HUD's mission. However, the department appears very uncomfortable with the concept of an independent Inspector General who has dual reporting responsibility to both the Secretary and to this Congress. I believe that Inspector General Gaffney wishes to do the job to the best that she can and to bring accountability to HUD, its programs and the taxpayers who support it. Over the past couple of years a series of events suggests that there have been efforts to tarnish her superb reputation, her record and to limit her ability to do her job. I want to share some of those for the record. Number one, the Acting General Counsel of HUD, a key aid to the Secretary, asserted that the OIG audit reports should be issued only through the Office of the Secretary, violating the laws that we have set on the books. The OIG was not authorized to have its own office of counsel. The OIG was violating its memorandum of understanding with the HUD General Counsel. These actions contradict the concept of an independent counsel and an independent Inspector General. A deputy general counsel at HUD stopped a routine investigation of an Equal Employment Opportunity complaint against the Inspector General and instead contracted with two law firms outside of the agency to do a wide-ranging investigation of the complaint. A typical EEO investigation costs $3,000. HUD is paying $100,000 to outside lawyers for the investigation that is ongoing. Number three. On two occasions, the Secretary has cut the office of Inspector General's budget request without notification, without consultation. In February of this year, the Secretary advised Ms. Gaffney to take care in reporting on his program initiative HUD 2020 in the OIG's semiannual report to Congress. The Secretary stated that he was having HUD 2020 evaluated by outside private sector program consultants and their reviews would be very positive. The Secretary said that he did not want Ms. Gaffney to be humiliated by filing a report at odds with the others, regardless of what the truth was. In fact the Secretary spent $412,000 contracting for outside reviews which the Inspector General had a parallel review going on at the same time. One of the reasons is they gave very different results. Despite authorizing language in the Inspector General Act of this government and precedent and other offices of the Inspector General throughout the government, HUD's general counsel opined that the HUD Inspector General not establish its independent personnel function without the approval of the Secretary. Congress has decisively resolved this issue by inserting language in the Senate- House conference report in the omnibus bill on the HUD's 1999 appropriation. The reason I stand here and share this with you is the apparent assault on government accountability and the apparent assault that this Inspector General is under. When I was elected in 1994, the majority who voted for me wanted a change. They wanted sunshine, they wanted open government, they wanted less government and they wanted more efficient government. They wanted an accounting of the tax dollars that is coming out of their paycheck every day. One of the ways we achieve a goal like that is to make agencies accountable. One of the greatest assets that I have as a Congressman is the Inspector General's office. They have an expert knowledge of governmental areas and critiques of programs. I think the gentleman from Florida would agree when we have Cabinet secretaries undermining the position that was placed there to hold them accountable in the first place, that we have something very wrong ongoing. It is my charge through this House that the Secretary let the Inspector General do her job, that she would not be harassed, she would not be limited and that her exemplary record be used to make sure that our tax dollars are used in an appropriate way for those that are depending on our assistance for housing. With that, I change the debate back. I think that is something that needs to be said. It is unfortunate that we see this many times coming out of this administration. This is not the only area where we have seen this type of coercion take place in trying to move the government in a way other than sunshine and other than light. I thank the gentleman for yielding.

Mr. COBURN. I have a question for the gentleman. Where did the $1.6 trillion of IOUs that are in the Social Security bank account now come from?

Mr. COBURN. I will finish up with this. As I travel around my district, every time I encounter a teacher I ask them two questions. Is it the system that is the problem or the kids? If you could discipline in the classroom and you had the time, would our kids do better? Uniformly, every time, they say, I do not have the time to fill out the paperwork and teach the kids. I do not have the ability to instill the discipline in my classroom without the support of the structure of law to make it that I am not sued every time I try to control the environment in my classroom. So what we are really asking teachers to do is to teach with both arms tied behind them. We take half their time away filling out paperwork and then another third of their time trying to control discipline in a positive way that eliminates any ability for corporal punishment or significant absence of privileges if in fact you do not participate and behave. One of the things we have to do is dollars to the classroom. The block-granting of education programs have to go directly to the school districts. And individual school districts have to spend that money on the kids, on the teachers. The only other thing we can do is we can download the paperwork burden for our teachers, and that starts right here, by eliminating programs, eliminating departments so that paperwork is not generated in the first place. If we do that, we will see changes just like we saw in welfare reform. If we will start using a commonsense approach that is based on proper incentives and proper punishments when behaviors are not right, then we will see the kind of response in education that we all want from our public school system.

Mr. COBURN

Mr. COBURN. Mr. Speaker, first of all, let me thank the gentleman from California (Mr. Thomas) and the gentleman from Florida (Mr. Bilirakis) for addressing this issue. There is no question, many things needed to be done to straighten out the problems in home health care. There are still problems with this bill. I am going to support this bill, and it is my hope that this will come through. With the interim payment system, there is no recognition of the need for the chronically ill, dependent senior for home health. We need outlier protection for those firms who really take care of our seniors, who have proven that they will not dump a senior just because the money wears out. Unfortunately, with HCFA and their administration of the Balanced Budget Act, not the amendment, but the act, the administration of that act has, in my State, penalized the best and helped the worst. This will go a long way towards changing that. It, however, does not do anything with the 15 percent cut that is to go into effect October 1 of 1999, which has to be addressed if we are going to keep these firms viable and care for our seniors. In closing, I have two people in my district that I would like to thank who have worked tirelessly, without ceasing, to try to solve some of these problems with great new ideas. Their names are Mark Lemmons and Steve Money. One is a former bank examiner, and the other is a former businessman. They are not home health care people, but they know costs, and they care for seniors. We have to make sure something happens on this before we leave this town.

Mr. COBURN

Mr. COBURN. Mr. Chairman, I am happy to yield 45 seconds to the gentlewoman from North Carolina (Mrs. Myrick).

Mr. COBURN. Mr. Chairman, I yield 15 seconds to the gentleman from Illinois (Mr. Manzullo).

Mr. COBURN. Mr. Chairman, I yield 2 minutes to the gentleman from Florida (Mr. Weldon).

Mr. COBURN. Mr. Chairman, I yield 1 minute and 15 seconds to the gentlewoman from Idaho (Mrs. Chenoweth).

Mr. COBURN. Mr. Chairman, I yield 1 minute to the gentleman from Michigan (Mr. Barcia).

Mr. COBURN. Mr. Chairman, first of all, let me thank the gentleman from Illinois (Mr. Porter) for the way he worked with us this year. He has my utmost respect. I also want to say that the gentleman from Pennsylvania (Mr. Greenwood) and I have become good friends through this because we have both learned something from one another. I do not doubt anybody's motives here, but I definitely doubt the gentleman's knowledge of the facts. I am in the real world every day dealing with teenagers who are pregnant and have a sexually transmitted disease. Do you know what? Two-thirds of them have already been to the Title X clinic. We enabled them to fail. At the time we have this debate today, 32,000 Americans will get a new sexually transmitted disease, and of that, 17,000 have already been to a Title X clinic. So the question is, what are the real facts? I agree, if we put in the Istook language, some additional young women will get pregnant; some will get a sexually transmitted disease. But what about all those children now who are going to a Title X clinic or using birth control pills and do not use them right because it is not talked to by their parents? They do not even brush their teeth at night, let alone remember to take a pill. Here is the science on oral contraceptives. This is married couples taking the pill, here is what we can expect: 12 to 16 percent of them get pregnant in the first year. Why would we think a 12 or a 16 or 18 year old would not? That does not have anything to do with sexually transmitted diseases, of which human papilloma virus is growing like gangbusters, and herpes, now 40 percent of our population has herpes. Oral contraceptives do not protect; a condom does not protect. What are we going to give our children for the two greatest sexually transmitted diseases that we have today? The only thing that we can give them is the knowledge of involving their parents back with them in this decision. I agree, there will be young women who will choose not to go but there will be hundreds of thousands of young women who do have an opportunity to have a relationship with their parents renewed and discuss this issue. If they choose to continue to take oral contraceptives, they will have a parent there saying be sure and take your pill; be sure and do not be indiscriminate; let us teach you how to do it. The idea of the gentleman from Pennsylvania (Mr. Greenwood) on counseling, I agree. Title X, for those under 18 years of age, in my opinion, is one of the biggest causes of failure of our children. It is not a help. The facts do not show that it is a help. We like to say it is a help because of all of the problems we see. I give teenage girls oral contraceptives. I practice in this area. But before they walk out of my office, after I have tried to talk them out of it, I make sure they know everything about it, everything about it. The real world is, is there are some wonderful Planned Parenthood clinics that do a good job but the real world on Title X clinics is they do not. They hand them a book of pills and a piece of paper and say, go. They never say the first thing about they are not going to be protected against a sexually transmitted disease. Finally, my colleagues need to know about the NIH study. Ninety thousand teenagers, 1993, we sponsored the study, here is what it says: The number one way to keep teenagers from getting pregnant or getting a sexually transmitted disease is to connect the parent to the teenager. It is called parental connectedness. Why would we not want to have a government policy that follows the largest study ever done in our country on this issue? It is an easy, simple thing. We all want the same thing. We do not want our kids to get pregnant. We do not want them to get a sexually transmitted disease. The difference is, there is a base of knowledge and if we will really look at it we will all go to the same point. We are not 100 percent right or 100 percent wrong.

Mr. COBURN. Just one, Mr. Chairman.

Mr. COBURN. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from Oklahoma (Mr. Istook).

Mr. COBURN. Mr. Chairman, I yield 2 minutes to the gentleman from Pennsylvania (Mr. Pitts).

Mr. COBURN. Mr. Chairman, I reserve the balance of my time.

Mr. COBURN

Mr. COBURN. Mr. Speaker, if the gentleman from Wisconsin will yield, which I would be happy to share with those who feel that position from your side of the aisle.

Mr. COBURN. Mr. Speaker, I thank the gentleman for yielding to me. We have two issues before us, one which the gentleman from Oklahoma (Mr. Istook) supports, one which many people oppose; and we have the amendment of the gentleman from Pennsylvania (Mr. Greenwood) which he supports, but many on our side oppose. If we divide the time as the gentleman has suggested, those equally opposing each amendment will not have equal share of the time.

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

Mr. COBURN. Mr. Speaker, reserving the right to object.

Mr. COBURN

Mr. COBURN. Mr. Chairman, there is not anybody in this House that I respect more than the gentleman from Utah (Chairman Hansen). There are a ton of good things in this bill, especially for Western States. I support those things. But this bill steps on property rights as much as anything in the 4 years that I have been here. We cannot continue in Washington to decide that we are going to take private property rights away from people, that we are just going to unilaterally do it. Let me give a couple of examples in this bill. We are going to create an American Discovery Trail across the Nation, probably a pretty good idea, and right now it says it is going to be voluntary, or government land. What is going to happen next year, when the voluntary land and the government land is there, and one of my farmers is right in the middle, or one of the farmers in Kansas is right in the middle? What is going to happen? We are going to take their land away from them. It is going to go away, for us to complete the trail. Two-thirds of that land is going to come from private property owners. There is also in this bill an area called the Sudbury, Assabet, and Concord Wild and Scenic Rivers provision. The agreement to have that done was an agreement that there would be no takings associated. There was a piece in the original bill that would protect private properties. That has been excluded from this bill. The Antiquities Act. I know, it is out. The Antiquities Act is out. It is one of the things that in fact precludes the President from taking 1.7 million acres in Utah. And because he objects, we are going to take it out. The gentleman from Utah (Mr. Hansen) and the gentleman from Alaska (Mr. Young) both have my respect. I am probably wrong on the issue that overall this bill may be better for us than it is bad for us, but I cannot see that we have such great wisdom that we once again are going to take private property away from those American citizens who worked hard to earn it without their permission.

Mr. COBURN

Mr. COBURN. Mr. Speaker, tonight I am going to be talking about a subject that is rarely talked about from this chamber, and one of the reasons I am doing so is because the Federal agencies that have been charged with this duty have failed in their duty. In the time that I take to talk about these issues, what will happen is in the next hour, 1,300 people in this country will contract a sexually transmitted disease. Mr. Speaker, 500 of those people will never be cured of that disease. In the next hour, 30,000 Americans will be exposed to a sexually transmitted disease, and in the next 24 hours, 30,000 Americans will actually contract a sexually transmitted disease, of which 12,000 will be entirely incurable. What we have today in our country is an epidemic of sexually transmitted diseases that is covered up, that is not talked about, that nobody wants to know the information about. This knowledge is valuable. It is powerful for us as parents, as a Nation, to see the consequences of the sexual revolution of my generation of the 1970s. So we are going to be talking about sexual health today. We are going to be exploring the past, we are going to be talking about preserving the future, and we are going to talk about how we do that. How we do that with our children, how we do that in terms of our relationships. Today, as I mentioned, 32,000 people are going to become infected. Mr. Speaker, 370,000 Americans have died of AIDS since this epidemic started, and 2,700 teenagers between the ages of 15 and 19 will become pregnant in the next 24 hours. That is 1 girl every 31 seconds. The most common sexually transmitted disease, human papillomavirus, causes almost every bit of cervical cancer in this country. Women die routinely from this disease. Is it treatable? Yes. Will one ever lose the virus that causes this disease? No. It is important for us to recognize that there has been a historical trend and growth in this epidemic. In 1960, syphilis and gonorrhea were the only major sexually transmitted diseases that were counted and recognized as contributing to this malady. In 1976 I was in medical school, and our professors laughed at the Swedes when they said chlamydia was a sexually transmitted disease. What we know today is it is the number 1 sexually transmitted disease that is caused by a bacteria. In 1981 AIDS was identified and HIV was identified. In 1982, genital herpes became more common. One of 5 Americans between 15 and 74 years of age in our country today is carrying genital herpes. Genital herpes is incurable. It is not preventable if one in fact is exposed to the virus. In 1992, what we saw statistically was pelvic inflammatory disease. One million women in the United States experienced an infection in their abdomen and reproductive organs secondary to sexually transmitted disease, and over 200,000 teenagers are now annually diagnosed with this disease. Pelvic inflammatory disease. What is it? It is when these organisms invade and not only infect and harbor the reproductive tract, but cause damage and grow and are irreversible in terms of their damage. We can cure and treat pelvic inflammatory disease, but the scar tissue that is left there leads to infertility and pelvic pain which is the number 1 reason, the number 1 reason, pelvic pain is the number 1 reason why we have hysterectomies in this country. In 1997, 8 new sexually transmitted pathogens have been identified since 1980, including HIV. Actually that is 9, because hepatitis C now infects 4 million Americans, 4 million Americans. There are 4 times as many people infected with hepatitis C as there are infected with HIV in our land. Twenty-one percent of those cases are transmitted sexually. The outcome from hepatisis C is one either gets a liver transplant or one dies, one or the other. That is the long-term consequences of hepatitis C. There are now 25 significant sexually transmitted diseases. There will be 12 million Americans that get a new sexually transmitted disease this year. Some people may say as they hear me talk about this that this is the opinion of one physician. That is not true. My colleagues will see on all of these charts and everything that I have referenced either the Institute of Medicine, the National Institute of Health, the CDC, the American Medical Association, the Journal of the American Medical Association. These are not opinions. Those are absolute facts of where we stand with an epidemic today. Two-thirds of all the sexually transmitted disease infections occur in people under 25. So if there is 12 million a year and we think of our population of being 260 million of which only 45 million to 50 million are under 25, what does that tell us? That we have a large percentage of people under 25 that are carrying a sexually transmitted disease. Eighty-seven percent of all reportable communicable diseases in the U.S. are caused by chlamydia, gonorrhea, HIV, syphilis and hepatitis B. The largest sexually transmitted disease, human papillomavirus has not even been asked to be reported by the Center for Disease Control, the virus that is incurable, that causes cervical cancer, causes cancer of the reproductive organs of men as well is not a reportable disease. Genital herpes. What has happened? What we have seen is these diseases are infecting a lot more people today than they ever have in the past. From 1976 to 1994, 30 percent more Americans across ethnic groups are infected with herpes today than were just 15 years ago. There has been a 500 percent increase in the number of white teenagers infected in the past 15 years. When we break it out and look at it by categories, by race, by socioeconomic background, what we see is this is going across all trends, all classes, all socioeconomic backgrounds, and all races in our society. What is important for us to learn as a Nation is to dispel a lot of the safe sex messages that are out there. It is not safe to have indiscriminate sex in this country regardless of what message others might say. I hope that my colleagues will see as we go through this tonight why that is so. This chart is extremely important. Sexually transmitted diseases are broken down into those that are viral, a virus like a common cold virus, that type of organism, or a bacteria, or something somewhat in between, which chlamydia happens to be. On viral sexually transmitted diseases, there is no cure. We cannot eliminate it from the body. We have no ability to kill the virus. We can treat the virus. We can slow down the virus, but we cannot kill the virus. Condoms are somewhat effective. They are more so effective for some; and those will be HIV, hepatitis B and hepatitis C. But on herpes what we know now is essentially condoms are not effective. On human papillomavirus, the number one virally sexually transmitted disease today, we know that condoms are hardly effective at all. But that message is not out there. There are good studies that show that. We also know with human papillomavirus that, if you are infected with it and you are pregnant, the amniotic fluid around the baby has the virus in it. We also can culture many times this same virus in a newborn child born to a mother who has this virus. So not only is this a sexually transmitted disease, it is a disease that is transferred from mother to child. If my colleagues look over on the other side, and they look at chlamydia and gonorrhea, what they see is we can fix it. We have got great antibiotics. We can solve that infection. But the damage that those organisms do to the reproductive track we cannot solve without eliminating those reproductive organs. Condoms are fairly effective in chlamydia and gonorrhea, but they are not 100 percent effective. Once you get infected, then it will require treatment, and there will be consequences of that infection. There are others that we will not go into. One other point that I would like to make is how are they contracted. If my colleagues look at this first group, body fluid contact. The other is direct contact. You have to have direct contact with these to become infected. Yet, at the same time, we talked about the ineffectiveness of condoms even though you have to have direct body contact. That is because this virus is not just in the reproductive organs, and so, therefore, it can be transmitted regardless of condom or not. Chlamydia. Eighty-five percent of women who are infected with chlamydia have no symptoms whatsoever. And 40 percent of men who have this bacterial sexually transmitted disease are asymptomatic. Chlamydia is the most common nonviral sexually transmitted disease in the United States with an estimated 4 million new infections a year. It is one, along with gonorrhea, of the number one causes of infertility in the United States for which we spend millions of dollars trying to achieve pregnancy for many women, not all, but many women who have silently been infected with a sexually transmitted disease, never to their knowledge, and have become incapable of conceiving a child because of that sexually transmitted disease. The other thing that is important about chlamydia as well as gonorrhea is that it is the major cause of pelvic inflammatory disease, pelvic pain, ectopic pregnancy, and infertility. Gonorrhea. We have all heard of this disease. It causes a significant difficulty for men. It may result in strictures and other problems with urination. Females, it could cause pelvic inflammatory disease. It can cause an inflammatory arthritis that has long-term consequences, and most physicians have seen it. It also causes pelvic pain and other problems. Teens 15 to 19 are most often infected with gonorrhea, higher than any other group. Human papillomavirus. At least 2.5 million Americans each year are newly infected with this virus. This virus is incurable. Once you contract this virus, you will have it the rest of your life. Does everybody who gets this virus get cervical cancer? No. But of the people who had cervical cancer, over 90 percent of them had it caused by this virus. It causes genital warts. It also causes the cancer, as mentioned. Herpes. We mentioned this earlier. One in five Americans is now positive for what we would call genital herpes in our Nation. It is not curable. It is treatable. We spend a significant amount of money each year treating genital herpes. What we now know that we did not know 10 years ago is you can be infected and never be symptomatic until the first episode. You can carry the virus for 10 years and never have a difficulty with this virus. This virus is a significant cause for morbidity in pregnancy in that women are subjected to cesarian section if, in fact, they have an active lesion associated with this virus at the time they go into labor. This is a much higher risk if this is their first episode of herpes. It is fairly low. But most women do not want to take the chance of delivering a child when they have an active infection because of the high mortality and morbidity associated with this disease. Almost everybody in America knows about HIV and AIDS. We know that there are somewhere around 900,000 Americans living with HIV. We know that HIV almost always results in AIDS, the end stage of the infection of that virus. We know that AIDS is a fatal disease. We know that we made major strides of slowing down the progression of infection of the virus to the full-blown disease. What we do know is HIV is preventable. It is an absolutely preventable disease. We now spend, Federal money, $7 billion a year on either HIV research, treatment facilities, and drugs to help those people who have that. The Congress of the United States in terms of mandated spending at the CDC spends about $650 million just on HIV. But every other disease that I have listed here we spend less than $150 million. That is why Americans do not know about these diseases. We need to know about these diseases. Hepatitis B. We are now immunizing our children at birth and at very young ages against hepatitis B. We do not have an immunization right now against hepatitis C. Hepatitis B we know is passed from mother to baby and can be. We are very careful. We test all pregnant women for hepatitis B. We do not test all pregnant women for hepatitis C, and yet we know there are 4 million out there. Five thousand Americans each year die from hepatitis B. Hepatitis C. We have talked about this. Four times as many Americans are infected with hepatitis C as HIV. It has the same prognosis. You will either have to have a liver transplant or you will ultimately die of liver failure or carcinoma of the liver. Twenty percent, somewhat over 20 percent of the people who contract this virus contract it from a sexual relationship. Ten thousand Americans die each year of associated cirrhosis or liver cancer with this. So this is a long-term, chronic, fatal disease of which 800,000 of the 4 million people who have it in our country today contracted it because they did not know it was a sexually transmitted disease. What do the studies tell us? There has been a wonderful NIH study recently that the gentleman from California (Mr. Waxman) asked for in 1993, and it tells us a ton about what parents can do with their children and sexual activity. Here are some things that we know. We know at the age of first sexual activity by a young girl, if she is less than 16 years old, her number of lifetime partners being one partner is 11.3 percent. The number of young girls that will have more than five partners is 58 percent. As we progress, what we see is what we would expect to see is, as we mature, we make better decisions. What we see is that these numbers completely reverse if in fact we tell our children to wait. If in fact we tell our children that monogamy and abstinence is protective of their health, not just their emotional health but of their health. What about teenagers and sexually transmitted diseases? A sexually active 15 year old has a one in eight chance of getting pelvic inflammatory disease. That is not getting them infected just with one of these organisms. That is requiring antibiotics to treat a painful, sick, infected, and oftentimes hospitalized adolescent female. Whereas, if the same young person is 9 years older, the risk decreases by tenfold for a lot of reasons. One from every four people newly infected with HIV is under the age of 22 in our Nation today. Under the age of 22. What do we think their life expectancy and what do we think their life is going to be like? Approximately 20 percent of sexually active teens acquire a new sexually transmitted disease every year. In other words, one out of five sexually active teenagers are getting a new infection at least every year. We spend hundreds of millions of dollars with family planning clinics, with clinics to help our children make these choices, and they are failing. We would not see this statistic if they were successful. They are failing. The top reason for hospitalization of teenage girls is that they are pregnant and they are delivering. That is a national tragedy for us. Oftentimes it is a national tragedy for the children. One million females under 20 experience a pregnancy each year. One-third of those end in an abortion. Regardless of your position on abortion, nobody who has undergone an abortion thinks it is a great thing. It is never a great experience. So we have to be dedicated to preventing pregnancies with our teenagers. Seventy-two to 76 percent of births to teens are to unmarried teens and that goes all the way up to 19-year-olds. What happens to our teenaged daughters who get pregnant? Seventy percent of them drop out of school. What happens to the fathers of these children? They never attain, a large portion of them never attain the education, living standard, or earning power of somebody who was not a father of a child as an adolescent. The teenaged sons of adolescent mothers are 2.7 times more likely to spend time in prison than the sons of mothers who delay childbearing age until their early twenties. We know as we get older, we make better decisions. Why is our government enabling our children to make poor decisions? Why are we allowing this epidemic to continue? The teenaged daughters of adolescent mothers are 50 percent more likely to have a child out of wedlock than children of nonadolescent mothers. What about older fathers? What we know is with adolescent pregnancy is most of the time the father is over 21 years of age. When was the last time we heard of a district attorney prosecuting for statutory rape of an underage female in any city in this land? Where are our district attorneys? It is against the law, but we do not see it prosecuted. Seventy-one percent of all births among teenaged girls are fathered by men older than 20. The mean age was 22.8 for fathers and 16.4 for teen mothers, 6.4 years average age difference. What about condoms and pregnancy prevention? There are some great studies and these are just two. There are ranges in these studies, but it is important to know that published peer review scientific data says something different than what the government says about condom effectiveness. What it says, of 100 couples using condoms, how many will get pregnant in the first year? Here is a study from 1992 published in ``Family Planning Perspectives'': 16 percent. One in five, one in six. Hatcher, ``Contraceptive Technology'' this year, 14 percent. They are really effective in stopping pregnancy for our children when 14 to 17 percent of them are going to get pregnant in the first year, when that is how we teach them to protect themselves. How about condoms and human papilloma virus and infertility? The data on the use of barrier methods of contraception to prevent the spread of human papilloma virus is controversial, but it does not support a condom as an effective way to prevent the number one virally transmitted sexually transmitted disease that causes cervical cancer. And I would say that most Americans do not know that, and most teenagers do not know that, and most doctors do not know that. Infertility. Spermicide, used alone, had no significant effect on risk for tubal infertility, whereas condom use alone decreased the risk, but to a significant extent. Even with the things that they are teaching our children, they are still just as likely to have infertility as a consequence of their activity. What about condoms and HIV and AIDS? There is no question that a condom markedly reduces the risk of the transmission of HIV, but it is one of the lower risks in terms of numbers in terms of sexually transmitted disease. But does it reduce it 100 percent? No. Does it reduce it to 90 percent? Some studies say yes. Some studies say only 60 percent. The question is, if it is a fatal disease, why would we want anything other than 100 percent effectiveness? These studies were conducted with married couples who one partner had HIV and the other did not, and they were trained specifically how to use effectively what we are teaching our kids to use, yet a significant percentage contracted HIV using these methods perfectly. What about other sexually transmitted disease? Condoms must be used consistently and correctly to have any chance. They work best against, protecting against HIV and gonorrhea. They are much less effective for herpes, trichomonas, and chlamydia. Condoms are little or no protection against bacterial vaginosis and human papilloma virus. Our teenagers say, ``We cannot get pregnant because we will take the pill.'' What do the specific studies say about teenagers taking the pill? What it says is all women under typical use, the number that are not taking the pills correctly, 7.3 percent; unmarried teens, between 6 and 13 percent; unmarried women between 20 and 29, 5.9 to 15 percent. That is the number of women who get pregnant during the first year using oral contraceptives. Mr. Speaker, it is not hard to figure out. Adolescent females often have trouble remembering to brush their teeth, let alone remembering to take a pill at the same time each evening. Some people say, ``Dr. Coburn, you're a prude. Abstinence is not realistic.'' Abstinence is the only thing we have to offer our children that is safe, the only thing that we have to offer our children that will stop this epidemic, this epidemic that has taken the lives of thousands of our fellow citizens and is causing tremendous costs in terms of operative expense, causing cancer. What is happening? What we saw, and actually released today by the CDC, is that we are seeing a marked shift now that we are talking about abstinence. Our teenagers are listening. 1988: Men, young men 15 to 19, 40 percent were abstinent, were pure. 1995: 45 percent. Today, over 50 percent, as released today by the CDC, of our young men between 15 and 19 are virgins. What about young women? Forty-five percent, now 50, now 52 percent. So we are starting to make some headway, but we cannot deny the fact that we have an epidemic of proportions that we have never seen that will complicate the lives, if not take the lives, of our young people. What are the top risk factors? This study that I referred to, what we know about sexual activity in our youngsters is the number one risk factor is alcohol use. Number two is a steady boyfriend or girlfriend. That makes sense. Number three, no parental monitoring. If the parents are not involved in the activity of their children, they are much more likely to be sexually active. And fourth and most important, if a parent is accepting of adolescent sexual activity, is condoning it, it will happen. If they are not, it will not. It is the number one factor. What are the behavioral risks associated with virginity and nonvirginity? What we know is if they are abstinent, they have all these other risk factors that are markedly reduced. In regard to alcohol, 20 percent of the kids who are not sexually active use alcohol. Of the kids that are sexually active, almost 65 percent do. And these are males. We can go down the line. Dropping out of school, threefold increase. Use of other drugs, 4\1/2\ to 5 times increase if they are sexually active. They are five times more likely to use an illicit drug than if they are not sexually active. What is the number one connection here? It is how well are they connected to their parents or parent, and we know that. We see similar patterns just with this on females. We see the same pattern if our youngsters are abstinent, that the risk factors for other risks that will markedly impact their life goes way down. So it is an indicator of what they are going to be exposed to and what other risks are going to be put on them in their life. What we saw from this adolescent study from 1993 is that when the relationship was good with mom, and mom was opposed to premarital sex, and when discussions of birth control, of how to not get pregnant, are decreased, not increased, they were 12 times more likely to have a youngster that would not be sexually active than ones whose parents talked about, ``Here is how you protect yourself and it is okay to be sexually active.'' So what we have done is set a trap for our kids. If we are accepting of a behavior that puts them at risk and we talk about how to minimally protect them, what we are doing is dooming them to failure and to a sexually transmitted disease. So what are the other factors that we found? Parent connectedness, parent disapproval of sexual activity, parent disapproval of sexual adolescent contraceptive use. School is real important. The school connectedness is related to parent connectedness, attending a parochial school or school with high average daily attendance. What are the individual factors? We have seen through programs like ``True Love Waits'' and ``Best Friends,'' that a commitment to remain sexually pure works wonderfully. Our children respond to it. High grade point average. A religion. Jewish, Muslim, Protestant, Catholic. The fact that the faith is impacting their life. So, what is the answer? We have 12 million new sexually transmitted diseases a year. We have a million people with AIDS, with HIV. We have had nearly a half million die from it. We have 4 million people that are going to die from hepatitis C or they are going to get a liver transplant. What is the answer? What is the answer for our children? Mr. Speaker, it is time for a new sexual revolution. It is time for the revolution of the 1960s and the 1970s to die. Why? Because it is morally wrong. But there are consequences to morally wrong behavior. And the morally wrong behavior is that we have an epidemic that is out of control in our Nation. Abstinence until entering into a committed, lifelong, mutually faithful, monogamous relationship. That is called marriage. Marriage is a wonderful institution. It does us well as a society. We should do everything we can to support that institution, because that oftentimes protects us. Abstinence until marriage and faithfulness in marriage that is supported by our society. That is supported. That is condoned by our society. Where our society stands up and says, Stay together. Do not violate the principle. Who benefits from character-based abstinence education? The answer is all of us. It is them and it is us. It is our Nation. It is our budget. It is the life, health, and well-being of our children. Mr. Speaker, I say: America, wake up. Twelve million new infections every year and none of them have to be. Let us ask for the truth. Let us ask the CDC to do its job. Let us make sure we teach our children what the risk factors are. Let us make sure we talk about that there are consequences to sexual activity outside of marriage, and many of them are very, very grave. Mr. Speaker, I yield back the balance of my time.

Mr. COBURN

Mr. COBURN. Mr. Speaker, I object to the vote on the ground that a quorum is not present and make the point of order that a quorum is not present.

Mr. COBURN. Mr. Speaker, there is no question that our agricultural community is in danger. One out of three farmers in Oklahoma this year is at risk, one out of three ranchers, but what this proposal portends to do is to take money that we do not have and take it off the balance sheet and say, children, you pay for this later. Social Security, we will take it out of you again. What we have to do is to recognize that we have a need in the agricultural community. That need does not obviate our need to be fiscally responsible in other areas of our government budget. I am going to support lots of things to help our farmers and additional monies, but it is incumbent upon us to pay for it, to not just say, here is money, we are going to just add it to the debt, our children are going to pay it back, or, better yet, the money that is there we are going to steal from the Social Security surplus that is coming right now, because that is what this instructs our conferees to do, to take the money away from our children or away from the seniors. My question is: Is there not some place in the Federal grandiose budget that we can say we can cut so we can help our farmers? The question is not about whether or not we can help our farmers, and the question is not whether or not we should. The question is: Who are we going to hurt to help our farmers? The assumption is if we cannot do that, if it is not possible for us to do that, then what we are saying is this government is running efficiently, there is no waste, there are no areas that we should be able to rescind to be able to pay to help our farmers. I think that the vast majority of the farmers in this country, the farmers and cattle ranchers in this country, want us to find it somewhere else. They do not want to put this money off on their children because that is exactly where it would go. The American public should know that declaring it an emergency means we do not have to pay for it. The hard work of being a Member of this body to find out the most efficient way to run this government is thrown out the door, and we just add it to the debt. So we have two problems. One is, our farmers and ranchers are in trouble. We need to help them. The second problem is, we do not help them at all in the future by taking the money from our children or from the Social Security trust fund. That is exactly where this money will come from. Let us find it. Let us do the hard job that we are paid to do to find the money to solve the problem for our farmers. We can do it. We can do it in a bipartisan manner. We can find this money and we can serve our farmers and ranchers well. I will be asking for a recorded vote on the previous question in order to enable that we can offer a way to offset these funds.