Thomas Coburn

Mr. COBURN

Mr. COBURN. Mr. Chairman, I would say to the gentleman from Wisconsin [Mr. Obey], there is no question that I am not a career legislator, and there is no question that I do not have the Parliamentary skills of a skilled, long-term legislator like the gentleman. But there is nothing wrong with the intent of my heart and my desire to bring forth an issue that has to do with life and death, although my skills as a legislator are somewhat less.

Mr. COBURN. Mr. Chairman, I move that the Committee do now rise.

Mr. COBURN. Mr. Chairman, may I ask how much time remains?

Mr. COBURN. I would like to continue discussing this amendment.

Mr. COBURN. Mr. Chairman, this debate is characterized by the gentleman from Wisconsin [Mr. Obey] as a way to delay this bill. That is completely false and not true. This amendment comes at the heart of everything that I have been trying to do on the HIV epidemic in this country, and to not allow an amendment to offer additional treatments, lifesaving treatments, is wrong. Yes, this committee did increase that funding, but there still are going to be 30,000 Americans who will not have triple drug therapy available to them. Unfortunately, most of them will not be associated with what we most often identify with, because many of the ones that have been in programs that have been there long-standing will have the treatment. The people that will not get this treatment are going to be African- American women, they are going to be IV drug users, they are going to be people who have no means whatsoever to fend off this disease. We have spent billions of dollars researching this disease, and now we bring forth an amendment. I stood at this stand trying to be polite, failing to interrupt. My mistake, there is no question, I would say to the gentleman from Wisconsin [Mr. Obey], but I did not intend to go around the rules of this House. I did not intend to be an obstructionist. I intended to offer this amendment to save the lives of people who will not, will not, have these drugs available to them. If, in fact, this House says that we should not offer this amendment because we did not interrupt at the proper time while somebody else was speaking in an attempt to be orderly and to be appropriate, then so be it. I find that disgusting. I find it unconscionable that our House would not consider this amendment, if in fact it is unimportant to this body to treat everyone in this country who has HIV. If it was any other disease that was killing people, the No. 1 killer between 25- and 44-year-old people in this country, this body would not have any question about considering any amendment at any time to make sure that that took place. The fact that this is viewed as only an obstructive amendment and is not taken for the purposes for which it was offered is offensive to me, but, most importantly, it is offensive to those poor people who will not be treated. Mr. Chairman, this is a genuine amendment. It takes money from programs and brings them down to the President's own request. It takes no money below anything that the President asked for. It uses those moneys that were in excess to help people who do not have insurance, who are unaided by any other way, to allow triple drug therapy for them in the treatment of this deadly and dreaded disease. I would beg the House to reconsider the position. I would ask the gentleman from Wisconsin [Mr. Obey] once again to reconsider his position. If not, then I will be resigned to the will of the House, but I am embarrassed and ashamed of the position of the House.

Mr. COBURN. Mr. Chairman, I have a parliamentary inquiry.

Mr. COBURN. Mr. Chairman, if I might inquire as to when in the debate amendments would be allowable that are restraining amendments or limiting amendments or blocking amendments as far as prohibitions. Could we have a ruling of the Chair?

Mr. COBURN. Manzullo-Coburn in terms of needle exchange. Coburn in terms of CDC, use of funds.

Mr. COBURN. Might we have a decision as to an amendment that prohibits the use of Federal funds on needle exchange programs; should that come at the end of title II as well?

Mr. COBURN. May we have a ruling that that is where that would come?

Mr. COBURN. It is Coburn, and I believe it is 35.

Mr. COBURN. I thank the Chair. Mr. Chairman, there is another amendment, a Coburn-Ackerman amendment, that prohibits the use of CDC moneys for blind testing for infants for HIV testing.

Mr. COBURN. I believe so.

Mr. COBURN. Mr. Chairman, I think everybody involved in this debate is genuinely concerned that we reduce transmission of sexually transmitted diseases, that we reduce teen pregnancy in this country. We all want the same thing. We want a result. What our debate is about is how do we get there. As somebody who has delivered 1,500 teenagers, I hope Members will take the time to hear what I have to say. I am not talking about opinions, I am talking about the experience of 15 years of dealing with teenagers. This weekend I delivered two 16-year-old girls. I delivered babies for them. I want to tell the Members what the real truth is. First of all, out of those million teenage pregnancies that occur in this country, over half occur because of statutory rape; people, adult men, having intercourse with minors, illegally violating the law in every State in this country. So half of them result because we have not decided that we are going to enforce that regulation. That is No. 1. No. 2, if you have a teenager who goes to any type of family planning clinic, 12 percent within the first year will be pregnant, with the best training, the best conditioning, because teenagers uniformly are irresponsible. Even if they have been taught what we know about how to prevent pregnancy, they do not concentrate as hard as they should. Many of them fail to remember to brush their teeth, let alone to take the birth control pill that was given to them at that clinic. For those young women who are going to be sexually active, we should provide it. But there are some other things we ought to know. As we do that, we have over 12 million new cases of sexually transmitted diseases in this country every year. Last year NIH released that data. Of that, 3 million occur in our adolescent teenagers in this country. Two-thirds of those diseases are incurable. A condom offers no protection against human pappiloma virus, the No. 1 sexually transmitted disease. CDC cannot even get a handle on it, it is so pervasive. At California, Berkeley, they did a study just of the coeds there. Forty percent of the women there are infected with this disease. That was in 1992. That was in 1992. So we have a big problem. I do not want to challenge anybody's motivation in how we solve this. I think we need to redefine the debate. Let us redefine this debate on how we solve this problem, and look at the different components of this. Part of it is we need to start enforcing the statutory rape laws. We ought to talk about that. Should the Government be in the place in terms of alcohol consumption? Should we start an alcohol consumption clinic funded by the Federal Government to prevent our children from consuming alcohol as adolescents, because some parents are not going to do a good job of that? I do not like title X because I do not think it is effective. As a doctor who asks patients who come into my practice when they are teenagers, I had a 14-year-old I saw Saturday morning, pregnant. I asked her, had she used anything. She had been to the health department and had gotten everything they had wanted her to, but she still got pregnant. But regardless of that, we are going to have title X. This body has decided that. But should we not say, parents, your child has made a decision to become sexually active, and we are going to help them? But we want them to know that. So we have a great opportunity for intercedence in a parent. Will it always be positive? No. Is there opportunity for negative, that they might not come back? Yes. Is there a greater opportunity that we might help those children? I think there is. I think we should decide on the side of doing, at least having the faith to give the parents the opportunity to do it. If it does not work, we can always change it. We can change it in 1 year. In 1996 we said, we were going to do a study to find out if family planning works. Guess what, it is 2 years later from the 1995 debate. We all talked about it and said we will do this. We have not done a study, so everybody is going on the basis of opinion. There is not a study. The gentleman from New Jersey [Mr. Frelinghuysen] mentioned a study. I said I wanted to see the study. I wanted to read it. I have read everything I can on sexually transmitted diseases and teenage pregnancy. I have never seen any study like that, not in a reputable journal anyway. Everybody's intentions are the same thing. No matter what happens on this vote, let us resolve to all get together on this debate and design something so we know what the facts are, rather than go on our opinion or our gut or whatever. I may be dead wrong because my patient population may be wrong, but let us get together. Let all of us get together and work together to solve this problem. We can do it, and we should.

Mr. COBURN. Mr. Chairman, I demand a recorded vote.

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

Mr. COBURN. Mr. Chairman, I think there are some very basic questions we have to ask in this country. We have an epidemic that involves well over 1 million people, almost one-half of 1 percent of our population. We talk about priorities, for example, how many Montagnards are going to come into the country this year? The funding level is $3 million above last year. I doubt that one new Montagnard will come into the country this year that the gentleman from Wisconsin [Mr. Obey] explained that that money was for. The fact is that this money will treat 6,000 people. It will prevent them from dying. Now, we hear that the AIDS Action Council and NAPWA and NORA oppose this. They are the groups that have the money. They do not have any problem because they are taking care of their groups. This is for money to go to States to buy drugs for those people who are not currently being served by any of these organizations. Yes; they are outside of it. They are the people that are the least advantaged in this program. The question I would like to ask is, Why is it not good enough to fund this for everyone who has HIV that cannot get treatment? I cannot use his name, because I am a doctor bound not to divulge, but I have a patient and he cannot get treated. The drug companies have been very beneficial in trying to get us medicines, so this young man, 27 years of age, is going to die in less than a year because he has moved from HIV to full-blown AIDS because he cannot, George cannot have the money because Oklahoma is out of money, because the money is not available for him to have it. Despite what we do for the hundreds of people that come in that have HIV, that do not have the material means to get it, the drugs, we do not have enough. To say that we are cynical and that we are exploiting the very people that we are trying to help, I have been a practicing physician for 15 years, I have delivered babies, and one of my most favorite patients, 8 years old, just died of AIDS. Her mother was HIV positive when she was born. We did everything to try to save her life. It sorrows me greatly that my intentions are questioned, that I would be accused of exploiting people, that my honor in terms of trying to correct this epidemic and the efforts that I have made, that my motives would be questioned. I think it is very unfortunate that a statement such as that is made on the floor of this body. Never have I accused anyone in this body who has, from their heart, tried to make changes in the laws of this country to help people, accused them of being exploitative. I think it leads us away from where we need to be. There are 1 million people with HIV in this country. We have an obligation in this epidemic to do everything to stem the tide, and that means treat these 6,000 people who presently do not have the medicine. That is all we are talking about, 6,000 lives that will not be here next year when we decide we need to get more money. Six thousand lives, give them a chance to live. Give them the same opportunity that somebody that is hooked in with NAPWA, that is hooked in with NORA, that is hooked in with some of the preexisting, set organizations. The fact is, there are a lot of people running out there that do not have that ability, do not have that access. It is working well in the communities that have a large number of people with HIV. It is not working well in the communities that do not. In the States that are lower population, there are tons of people who are not getting treatment.

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

Mr. COBURN. Mr. Chairman, so the question that comes is, are there people that are going to be out there that are not going to have available treatment? Mr. Chairman, the gentleman from Illinois, Chairman Porter has done a wonderful job in increasing this, there is no question. But I do not think we have gone far enough. I am willing to join with the other side to find further ways to fund it. If we could transfer money from the B-2 bomber to do this, I will vote for it. Unfortunately, as you all well know, we cannot do that. So I would say this is not cynical. This is not some sleight of hand. The fact is there are people out there that are not going to get treated, and we ought to rise to the occasion and do it.

Mr. COBURN

Mr. COBURN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I rise this evening to support this amendment and the question that I think is before us is not workers' safety versus education. The question before us is, Can we be efficient and prudent with the tax dollars that the taxpayers of this country give us and demand that the bureaucracies in Washington expend that money in an efficient and proper manner? When we talk about putting money into vocational education and in light of the new welfare bill, it seems prudent to me that we would want to put as many dollars into vocational education as we can, especially as we reach down to those who do not have an education, who do not have a high school education. I want to share what happens in Oklahoma with vocational education. We have had a marked reduction of those number of people that are on our welfare rolls, those people who are getting supplements. One of the reasons that we have is because we have a vocational education department and system in Oklahoma that makes a difference for people. If somebody does not have a high school education, our vocational education gets them a GED and then teaches them computer skills. It teaches them a job skill and then lands them in a job. We take those dollars for people who would have been receiving dollars from the Federal Government and make them into productive, tax-paying citizens. The other thing that we ought to talk about is in 1969, I believe that is correct, when OSHA was created, the annual death rate per 100,000 workers was declining. It was 18. The rate has continued to decline, but it has declined much more slowly since OSHA was implemented than beforehand. No one on this side of the aisle and no one supporting this amendment thinks we should do away with OSHA, but we do think there ought to be a redirected purpose to do what OSHA was intended to do, and that is to preempt and secure workplace safety. That ought to be done in the most straightforward, comprehensive, and collaborative manner that we can secure. I would like to give you a few examples of some of the things that OSHA is doing currently and see if, in fact, we all agree that maybe OSHA might spend their money in a more prudent way, and, therefore, not need increased funds from the Federal Government to carry out their job. Just for example, OSHA fined a roofing company in California for failure to have a fire extinguisher in the proper place, in spite of the fact it had been moved to prevent it from being stolen by passersby as three other fire extinguishers had been done in the three previous days. Each day they would put a new fire extinguisher out there; it was stolen. Each day they would put another one out; it was stolen. So they put it in a place where everybody knew where it was but could not be stolen, and yet they were fined for trying to conceal the fact there was a fire extinguisher. North Carolina, a construction site was inspected by the State OSHA. Citations were subsequently issued for unprotected rebar, the steel that reinforces concrete, to have a rubber cap on the end of that. All of it was covered, except where they were pouring the concrete, which had inadvertently been knocked off as they poured the concrete. Never mind. They were fined for not having a rubber cap on the end of two or three pieces of rebar. Pennsylvania, an apparel maker was recently inspected by OSHA. At the conclusion of the inspection, the OSHA official told the company that they had an excellent record, they did a great job, they found two minor infractions. The company immediately corrected the minor infractions, sent the picture to OSHA demonstrating they had corrected the minor infractions, and, instead of congratulating the company, OSHA sent them a fine of $3,895. They spent their money on things that do not have anything to do with workplace safety. Their fines had been increased sevenfold to increase revenues to the Federal Government, not to enhance workplace safety. Florida, a company in Florida stated OSHA has a antibusiness attitude and is using its Agency power to lower its cost of operation through levying unfair citations and fines completely out of line for the violation. Here is the example: A company in business for 25 years without one violation received a fine of $1,715 because out of 352 electrical outlets in the building, one had a broken plastic faceplate on it. One. The citation also noted that the outlet box was near a varnish dip tank. The owner of the company noted the outlet box was hidden from view and protected by steel plates to protect it from potential electrical spark. In addition, the outlet was near a varnish tank. This type of varnish had no explosive nature whatsoever. It did not matter that it was not really a significant thing to change it. They fined them anyway.

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

Mr. COBURN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I wanted to talk about IDEA for just one moment. As a practicing physician, I have three patients that are very dear to me. One of them is Brandon Jones. I delivered Brandon about 9 years ago and he has a syndrome called Vader Syndrome. He has pulmonary hypertension. He wears oxygen all the time. He has a limited life expectancy, and yet in the public school system in Muskogee, OK, he has to, by Federal mandate, be offered every opportunity to do what every other child can do. The costs for him are approximately $100,000 a year, just for his education. There is Felicia Fallegey. At 2 years of age, she was shaken by a babysitter and now has severe, severe cerebral atrophy and damage, yet, by mandate and by right gets to attend school. The cost for this child, who cannot move, who cannot move any extremity, who is bedfast, the cost to care for her in terms of her educational assessment is significant. Finally, there is Courtney Johnson. Courtney was born with a cerebral accident of malformation at birth. Her developmental abilities have been limited. She is now 13 years of age and is required to have every opportunity for an education that any normal child can have. What is the problem with all that? We are $500 million short, Mr. Chairman, of what we should have in the IDEA program. And what we need to do is to look at the school system in Muskogee, OK, that is running a deficit this year. They will not be able to educate all the normal children in our district because we have multiple numbers like these children who deserve this opportunity. But the Federal Government, the U.S. Congress, refuses to send the money that rightfully should go to the individual school district. When we vote on this amendment, I hope my colleagues will remember Courtney and I hope we will remember Brandon and I hope we will remember Felicia for the positive things IDEA will do for them. But I also hope we will remember the rest of the children who will not get the things they need because we have mandated a policy and we are not willing to pay for it. Remember Brandon, remember Felicia, and remember Courtney.

Mr. COBURN. Three percent. I am talking about OSHA.

Mr. COBURN. We are going to spend the money, we have all agreed to that. I did not vote for the budget, but that was the will of this House. The President and the Congress decided to do that. There is nothing wrong with having a debate about where we ought to spend it. We are not spending enough money on IDEA. We can achieve better efficiency within the bureaucracies. We can. To say we cannot, we should give up and go home now. That is what we are asking.

Mr. COBURN. In Muskogee, Oklahoma, we would be happy to have the $700 that would come to our school district since we have a deficit, and one of the reasons we do is because of the mandate of IDEA on us to educate all our children, not those with just special disabilities. This debate is about priorities. We are going to spend the money.