Thomas Coburn

Mr. COBURN

Mr. COBURN. I yield to the gentleman from California.

Mr. COBURN. I thank the Chair.

Mr. COBURN. Mr. Chairman, I also would want to make a parliamentary inquiry as to the number of unauthorized pieces of legislation that have been voted on in this bill associated with this, to prove the point.

Mr. COBURN. Mr. Chairman, I wish to withdraw my words as to speaking out of both sides of one's mouth, and offer apology to the gentleman from Wisconsin [Mr. Obey] for that statement.

Mr. COBURN. Mr. Chairman, just to answer that. I am not saying that is not a good goal, but that is only a part of what this amendment does. This amendment violates the very sincere and straightforward principles that we have learned about addiction. I want to read to my colleagues about a participant who drove up, did not have to give her name in a free New York needle exchange program. Here is what she said: I made a personal visit to the ``exchange'' and without one dirty needle to exchange, I was supplied with 40 clean needles, alcohol wipes, cotton balls and cookers, along with a graphic description of the proper way to shoot up so as to protect my health and prevent my loved ones from knowing I was using drugs. Her instructions were, ``Don't shoot up in your neck. If you get bad dope, your head can explode.'' I was also provided a needle exchange card making me exempt from arrest or prosecution if I were to be stopped by police and found to be carrying clean needles, a felony under New York law. I lied in response to every question and purposely reported I had been shooting up for only 6 months in the hope they would lean on me to come for counseling. In parting, I asked the worker whether I had to return the needles he had supplied me in order to get more. He said, no, I don't have to bring the needles back, but advised me to discard the used syringes in an opaque container so no one would see them. The sheer willingness to supply me with 40 syringes without expecting anything to be returned leaves a grave unanswered question: What happens to those 40 dirty needles?

Mr. COBURN

Mr. COBURN. If the other gentlewoman from California might yield for a moment, first of all, I was one of the Republican conservatives who voted against the B-2 bomber, and I have every time. I would love to see that money.

Mr. COBURN. Mr. Chairman, I move to strike the last word. Mr. Chairman, it is important, the whole purpose for this bill is to make sure that we have a fair and open and honest debate on what is occurring in this bill. I have been standing at this point patiently trying to be polite as we read this bill, wishing to be recognized and not interrupting. Although I may not have followed the exact protocol of the House, nevertheless I have been standing here prepared to offer this amendment which was preprinted, which was available. This is an amendment that should be considered by this House. The reason it should be considered is there are several thousand people in the United States who are HIV positive who will not be able to get drug treatment. This amendment brings money for those people. If this body wants to on a technical error deny people triple drug therapy that will prolong their life and delay the onset of AIDS, then so be it. But it is a shameful act if in fact we do not consider a debate or a characterization of this amendment. Amendment No. 34 Offered by Mr. Coburn

Mr. COBURN. Mr. Chairman, I ask unanimous consent that this amendment be heard and considered on the floor of this House. Lives are depending on it, thousands of lives are depending on it. It is unconscionable that we would not even debate additional moneys for people who will die should this therapy not be available to them. I would beg and plead with the gentleman from Wisconsin that he would allow consideration of this amendment.

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

Mr. COBURN. Yes, Mr. Chairman, I do.

Mr. COBURN. Mr. Chairman, I offer an amendment.

Mr. COBURN. Mr. Chairman, this amendment would shift $35 million from various programs that have been funded above the President's request, programs that have been funded above the President's request in the State AIDS drug assistance programs. The funds would be redirected primarily from administrative accounts that do not directly benefit people into an ADAP program which directly benefits hundreds of thousands of people infected with HIV. As assistance to those who have HIV, this program provides medicine for lower income, uninsured individuals who are HIV positive but do not qualify for Medicaid. Pressures on the State ADAP groups have led 35 States to implement emergency measures in the last year leaving 23 States to cut patients or restrict their access to medically necessary drugs in fiscal 1997. In 1996, for the first time in the history of the HIV epidemic, AIDS deaths declined. They declined because of triple drug therapy. Unfortunately, that decline was not manifested or recognized in women. AIDS deaths actually increased. Unfortunately, that decline was not recognized in minority populations or in children. Those deaths actually increased. What this amendment is designed to do, although the chairman of this committee has worked hard to increase the funding, there will still be between 30,000 and 70,000 Americans who are HIV infected, who are uninsured and low income, who will not have availability of these drugs. When I am in Oklahoma, at least once a month I work in a free clinic. Routinely we cannot have available funds through ADAP for people with HIV to receive triple drug therapy. Does this solve all the problem? No. The moneys that are taken for this program are coming from moneys that have been appropriated above what the President of the United States requested for the various areas which it has been taken and are moved to help those people who otherwise will not have an opportunity to have this drug therapy. I said earlier, if this was any other disease other than HIV, where a million people were infected and did not know they were, where 350,000 Americans have died and another 350,000 are living with AIDS, there would be no question that this body would fund medicines for every one of them. To oppose this amendment on the basis of saying we have done enough is not a good enough answer to the people in Oklahoma, to the people in New York, to the people in Florida who do not have this therapy. They deserve to have this therapy, regardless of how they contracted this disease. It can prolong their life. It can vastly improve the quality of their life. Let us talk about where this money comes from: $2 million comes from the Agency for Health Care Policy and Research overhead associated with that; refugee and entrance assistance, $22 million comes from that. Do we have more of an obligation to those coming into our country than we have to our citizens born here and infected with this virus that we are not going to have available drugs for? Finally, it comes from the Office of the Secretary of Health and Human Services, General Department, Management and Policy Research, a total of almost $10 million. I would ask this body to consider this question: If you had a friend who could not afford to spend the $6,000 to $7,000 a year to buy these drugs and we are spending money in other areas in this bill, we are increasing bureaucratic overhead, we are increasing salaries of bureaucrats while those, the poorest of the poor, those with the inability to pay for themselves are dying because we choose not to fund this appropriately. Mr. Chairman, had I been able to find moneys, other moneys funded above the President's request, this request would have been much larger. And it breaks my heart that we cannot find the moneys to take care of the people in this country that have this dreaded disease. I beg this House to support this amendment, to not listen to the AIDS action groups who want to continue to fund their programs as long as their little group is funded when those who are of minority status, when those who are women who have done nothing to contract this disease do not have available to them a way to have this disease treated. We all hope some day for a cure for this disease. We do not have a cure. But we certainly have a way to buy time for those that cannot afford these medicines. I beg the Members of this body to not say we have done enough. We have not done enough. Tell that to the first person who is not going to get this treatment.

Mr. COBURN. Mr. Chairman; will the gentleman yield?

Mr. COBURN. Mr. Chairman, will the gentlewoman yield?

Mr. COBURN. I would be happy to answer that. I was involved in trying to get an across-the-board cut in every appropriations bill in 1996. The purpose for that is to try to control the spending so we could balance the budget. There is no question it affected priorities of mine just like it affected priorities of other people who voted on that. The decision that I made was simply, is it a more valiant effort to try to save money so we will have money to spend in something like this in the years to follow. The fact is we are going to steal another $300 or $500 billion from our children over the next 5 years in this supposed balanced budget agreement.

Mr. COBURN. Mr. Chairman, I thank the gentleman for yielding. I want to frame this issue for what it really is. We have a lot of money out there being spent for AIDS treatment, AIDS programs, for people with AIDS. But we do not have a lot of money out there for people who have HIV right now, who do not have AIDS yet. As a matter of fact, we do not even know who half a million of them are. The purpose of this amendment is for those people that we do know who they are. This is for 6,000 people who know they have HIV, who cannot get drug treatment. That is what this is about. The contrast is we have a group that says we have done enough. How much is doing enough when somebody is going to die between now and next year? When 6,000 people are going to die? If this was not this epidemic that got such a tainted reputation from its start because it was associated with life-styles and it became associated with life-styles, this is a disease, it does not care if you are gay or straight, if you are a man or a woman, or what color your skin is, if you are a newborn baby or an older woman, it does not like us. To say we have done enough, that 6,000 people between now and this time next year are not going to get the drugs to prevent them from converting to full-blown AIDS, I think it is just regrettable. It is regrettable that we are going to use the argument, we are going to let the politics of AIDS guide what we do on this, the politics that allow an extra 500,000 people to become infected, the politics that says we are not going to treat this as an epidemic and treat it in public health standing. We are not going to allow that to happen.

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

Mr. COBURN. Mr. Chairman, I think it is a great question. Are we going to support 3,000 to 4,000 Montagnards or are we going to allow 6,000 people to have HIV drugs that will prevent them from having AIDS? That is a legitimate debate, I do not deny that. But the questions that were raised a moment ago that this money was taken from deserving programs, let us talk about where the money is coming from again. Almost $10 million from the Office of the Secretary, the General Department of Management and Policy Research. That is a good thing for Americans to spend their money on, while 6,000 people die? I agree that if this body thinks that that is what we should do, then that will be the will of the House. I do not believe that is what the minority party believes. They do not believe we ought to spend $10 million additional, above what the President requested, on general policy research and general department management, instead of spending extra money to help people live with HIV and prevent them from dying. So we are really not contrasting deserving programs. We are talking about people who do not have available to them drugs, and, because they do not, they will not be with us a year from now. Mr. Chairman, I do not want to leave this body saying I voted to spend money on a bureaucrat and let 6,000 people die in the streets of this country from AIDS, when we could have prevented it. That is what the real debate is. The debate is about people with HIV and whether or not they ought to get help versus bureaucrats and the spending of the money on the government on things that will not impact someone's life. So, again, I would ask consideration for this. I would yield back to my friend from Georgia, [Mr. Norwood], and thank him for allowing me the time to speak.

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

Mr. COBURN. Mr. Chairman, I guess I would just like to inquire, is it the gentleman's belief that there are not people in our country today under the funding proposal we are putting forward who are not going to get treatment for HIV that cannot afford triple drug therapy?

Mr. COBURN. Mr. Chairman, if the gentleman will yield further, according to the National ADAP monitoring project, there will be 280,000 individuals eligible for this. The cost is $6,000. So what we are really talking about is we need well over $1 billion, if we are going to truly offer it to everyone that needs it.

Mr. COBURN. Mr. Chairman, I ask unanimous consent to have an amendment that I have at the desk read.

Mr. COBURN. Mr. Chairman, I knew the gentleman had redeeming qualities.

Mr. COBURN. Yes, Mr. Chairman, page 25, 26, and 37.

Mr. COBURN

Mr. COBURN. Mr. Speaker, coming before us today is a bill that has an allowable thing for the Secretary of Health and Human Services to control, and it is called free needle exchange programs. The reason I am up here talking about it is we know a whole lot about how to help people succeed. Our Government is getting ready to spend our tax dollars to help people fail by enabling drug addicts to have needles available to them, to violate the law, to use our tax dollars to have clean needles. There have been two studies in North America on this subject. Both of them show there is an increased transmission of HIV associated with free needle exchange programs and that there is an increased usage of drugs. We know that that happens. We know that in alcoholism. One of the precepts in treating alcoholism today in our country is do not enable the patient to fail by enabling their alcoholism. We need to apply that same thing when it comes to drug addiction in this country. I hope that my colleagues will support this limitation on using American tax dollars for free needle exchange.