Gene Green

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise to pay tribute to a dedicated educator, a role model for countless students and a good friend. In June, after 14 years as superintendent of schools and 34 years as an educator in the Aldine Independent School District, M.B. ``Sonny'' Donaldson will retire. Sonny Donaldson has spent his career working tirelessly on behalf of all children. He has always promoted what was best for school children, never forgetting that their best interest was his driving force. Superintendent Donaldson has held the position of Superintendent of Schools since 1986. Prior to his service as superintendent, he held the positions of teacher, coach, assistant principal, principal, athletic director, and assistant superintendent, all with Aldine ISD. He is an active member in numerous professional associations and organizations and a committed civic leader dedicated to public service. Among his numerous honors and awards, Sonny was selected Superintendent of the Year in 1994 and 1996 for Region IV, which includes 57 school districts in the Houston area. He was also one of five finalists for Texas Superintendent of the Year in 1994 and 1996. The Success of the Aldine ISD does not happen by accident. Sonny Donaldson has created and fostered an environment that demands quality and dedication from both teachers and students. When Texas A&M University evaluated the test scores of minorities in districts with more than 15,000 students, Aldine ranked first in the state. In addition, researchers at the University of Texas said that Aldine is one of a handful of districts showing impressive successes with students from disadvantaged backgrounds. Because of the emphasis placed on education by the administrators, the teachers, the students and the parents, Aldine ISD has received a ``recognized'' rating from the Texas Education Agency for the last four years. Of the district's 48 schools rated by the state, four are exemplary, 28 recognized and 16 acceptable. American historian and writer Henry Adams once stated that ``a teacher affects eternity; he can never tell when his influence stops.'' For Sonny Donaldson, the lives he has touched over his many years in the education field will ensure that his influence carries on far into the future. I ask my colleagues to join me in honoring the career of one of Texas' education heroes. Sonny, we wish you and your wife Suzanne well.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise to speak tonight to discuss a report that was just released yesterday from the National Institute for Health Care Management Foundation, which stated that spending on prescription drugs has increased almost 19 percent in the last year. I am deeply troubled by this report, as it underscores a critical need for this Congress to modernize Medicare to include a prescription drug benefit. Spending on retail outpatient prescription drugs rose almost 19 percent in 2000, from $111 billion to $131.9 billion. Approximately half of that spending increase can be attributed to just 23 prescription drugs or pharmaceuticals. Among those drugs are the blockbuster ones we hear about, Vioxx, Lipitor, Celebrex and Glucophage, which I am not pronouncing correctly, but the very drugs that seniors rely on every day to treat chronic long-term illnesses such as diabetes, arthritis or high cholesterol. In fact, my mother-in- law, of those four drugs, actually takes three of them every day. For the seniors that have no prescription drug coverage, they simply have no choice but to pay top dollar for these expensive medications or go without; and that is what they are doing every day, they are going without, because they cannot afford them. Fully one-third of our Medicare beneficiaries, and these are old numbers, because that was before so many of our Medicare HMOs withdrew from the market, at least one-third of them have no prescription drug coverage at all. I hear from constituents literally every day who have to make these tough choices on whether to pay their electric bill or their prescription drugs. In fact, I have a letter I just received today from a constituent who tells me: ``I am holding off on some of my medications until my Social Security checks are deposited in the bank on the 3rd, and I am out of some of them already.'' Seniors are struggling literally from Social Security check to Social Security check hoping they have enough medication until the end of the month. Another constituent of mine was hospitalized for a severe infection. When she was dismissed from the hospital she was given three new prescriptions, one which cost more than $700. Imagine an 85-year-old woman being asked to pay $700 for one prescription. The other two cost her an additional $150, bringing her grand total for these new prescriptions, only new ones for this current illness, to $850 on one trip to the pharmacy. Talk about adding insult to injury. Unfortunately, the high costs of prescription drugs are only getting worse. The recent government study predicts that the mapping of the human genome, the aging of the baby boom generation that I am a part of, and the increase in spending on biomedical research will lead to the introduction of more and more prescription drugs. This is the good part of it, because we are living longer and healthier, but this is sometimes a mixed blessing from a policy perspective. The influx of these drugs can only mean new treatments and therapies for what are now incurable and serious diseases, but it also means that the demand for these drugs and also the cost of these drugs will rise. Congress cannot sit idly by while our seniors, our parents and our grandparents, are forced to pay more and more of their hard-earned retirement on prescription drugs, and they cannot afford it. Unfortunately, we have seen little action during this Congress. We have actually had one or two hearings in the Subcommittee on Health of the Committee on Energy and Commerce, but we have not gone any further. For the past 100 days, all we have heard about is a tax cut. What we need to do is start addressing prescription drugs for senior citizens, those 40 million hard-working Americans who now rely on Medicare. The $300 billion I understand that may be in the budget that will actually come out of the Medicare reform legislation for prescription drugs is just not adequate. The real problem for our seniors is every time I go to the grocery store at home or a town hall meeting or visit with my seniors, I am approached on what we can do about prescription drugs for seniors. They want to know why in Washington we are not doing something about it, because they see it as an imperative that if it is not a problem today, it has been a problem for over a year and we have not addressed it. Mr. Speaker, I urge my colleagues on both sides, the majority and the minority, we need to pass a prescription drug benefit that is part of Medicare. Just like a doctor or hospital, our prescription drugs should be paid for for our seniors as part of Medicare. We may not be able to afford the 80 percent that we do now for doctors and hospitals, but we ought to be able to grow into that. Mr. Speaker, $300 billion is a start, but we have a long way to go. It is a crisis now for our senior citizens. It is a crisis for our parents and our grandparents, and we need to do something about it now.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, on that I demand the yeas and nays.

Mr. GREEN of Texas. Mr. Speaker, pursuant to clause 1, rule I, I demand a vote on agreeing to the Chair's approval of the Journal.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I am glad to follow my colleague from Texas. With a Texan in the chair, I hope we are not overdoing it today on this bill. Mr. Speaker, I rise in support of H.R. 10, the Comprehensive Retirement Security and Pension Reform Act, and congratulate our sponsors for their persistence in this effort, not only this year, but last year. Mr. Speaker, the private pension plans are crucial to the retirement security of millions of Americans, and yet only half of our private sector employees have any kind of pension, and only 20 percent of the small businesses offer their employees retirement benefits. Currently, Americans save only 4 percent of our income, the smallest amount among industrial nations. If this trend continues, young Americans will be ill-prepared for their retirement years. That is why it is important that our current system not only does not reward enough to encourage savings; it is in dire need of reform. The legislation we are considering today makes a number of important changes and encourages individuals to save for their retirement. We all know that saving $2,000 a year for your IRA is not enough. It raises it to $5,000. It raises the 401(k) limit to $15,000. It also addresses the needs of older workers, allowing people 50 years or older to make that annual catch-up, $5,000, for years that they could not do it. It helps, particularly the provision for women who have left the workforce and then come back, to be able to catch up on their retirement effort. There are a number of important components. Of course, the bill is not perfect and there are things we could do, particularly for lower-wage workers, and I know there is an amendment, the Rangel-Neal substitute, that will add that. I encourage folks not only to vote for that substitute, but ultimately, the bill, Mr. Speaker.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today, along with my colleague Mr. Burton, to introduce the National Health Promotion Resolution of 2001. This resolution recognizes the importance of health promotion and disease prevention, and expresses the sense of Congress that more should be done to integrate lifestyle improvement programs into national policy, health care workplaces, families and communities. Modifiable lifestyle factors such as smoking, sedentary lifestyle, poor nutrition, unmanaged stress, and obesity account for approximately half of premature deaths in the United States. Spending on chronic diseases related to lifestyle and other preventable diseases accounts for an estimated 70 percent of total health care spending. With the pending retirement of the baby-boom-generation, the financial burden of these preventable diseases will further threaten the solvency of the Medicare program. Health promotion programs have the potential to improve health, improve quality of life, reduce health care costs, and boost productivity. The Institute of Medicine has recommended that additional research is required to determine the most effective strategies at the individual, organizational, community, and societal level to create lasting health behavior changes, reduce medical utilization and enhance work-place productivity. Unfortunately, a very small percentage of health care spending, is devoted to health promotion. The National Health Promotion Resolution of 2001 expresses the sense of Congress that more must be done in this area. In light of the pending crisis facing our Medicare system, the federal government stands to benefit greatly from the potential reduction in costs associated with an aggressive health promotion agenda. This bipartisan legislation has forty original cosponsors, including the gentleman from Indiana, Mr. Burton, who has worked closely with me and my office to shape this into a meaningful resolution. It is my hope that we will continue to work together to further our commitment to health promotion and disease prevention. I urge my colleagues to join us on this important resolution.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today to continue what is a series of speeches or Special Orders on the need to reform our Nation's managed care industry. In the past I have discussed external and internal appeals processes, medical necessity, and the need for accountability. Today I would like to discuss patient access to specialty care. Specialists fill an invaluable role in our Nation's health care system. And many of us have sought the services of a specialist because of high blood pressure, a broken arm, or migraine headaches. But oftentimes, HMOs refuse patients access to specialists because they do not have such specialists in their network or they are across town or literally unavailable. Such is the case of Sarah Peterson from San Mateo, California. She was born with a brain tumor that required her to see a physician who specialized in brain tumors. But her HMO, which was obtained through her father's employer, told her mother that she would not be able to see a pediatric specialist. She was told, what difference does it make, cancer is cancer. Well, it does make a difference if you are the parent of a child with a potentially deadly tumor. While Sarah was fighting for her life, her parents were fighting an HMO to get her the quality health care they were paying for. This situation could have had dire consequences; but fortunately for Sarah, her parents changed plans during the middle of this medical crisis. Sarah is now 8 years old and is doing well. But she still has a tumor and will still need to see a specialist. Hopefully, her health insurance will let her continue to see that specialist. The prognosis is not as promising for young Kyle of Bakersfield, California. Kyle began having ear problems when he was 6 months old. After months of corrective measures, antibiotics, infections, and finally a ruptured eardrum, Kyle's HMO referred him to an ENT. The ENT performed surgery to put tubes in Kyle's ears which would allow for the drainage of the infected fluids, but that surgery was too little too late. After 10 days, Kyle's ears began to bleed. Had the HMO followed the advice of the ENT, they would have given Kyle a CAT scan to provide evidence of cholosteatoma, a severe infection that destroys the bone in the inner ear. But again, the HMO denied this vital test, and Kyle's ear problems continued along, undiagnosed. Finally, after losing all patience with the HMO, his parents changed plans and were advised that their son needed this exploratory surgery. It was then that they learned of the severe nature of the cholosteatoma and that Kyle would need another surgery. After all of the waiting, surgeons had to remove all of the bones in Kyle's middle ear. Because of the delay in specialty care, combined with the HMO's denial of a simple test, Kyle's doctors anticipate he will suffer significant hearing loss as he reaches his adolescence. A denial of specialty care was deadly for Glenn Neally, who lost his life because an HMO denied him direct access to specialty care. When Glenn's employer changed plans in March 1992, he made sure that the managed care plan would continue to cover treatment of his cardiac condition, unstable angina. His cardiologist had prescribed a strict regime of nitrates, calcium blockers, and beta blockers. He was assured that he would be able to see his cardiologist. But his HMO required him to obtain a referral for follow-up treatment by his cardiologist. Bureaucratic paperwork problems gave Glenn the run-around for 2 months, while he tried to get the proper ID cards, referrals and pharmacy cards. Even after obtaining all of this paperwork, his HMO formally denied his request that he receive follow-up visits with his previous cardiologist and instead was forced to see their participating cardiologist in May of that year. That turned out to be one day too late for Glenn. He died of a massive heart attack on May 18, leaving behind his wife and two sons. Mr. Speaker, I stand here today and tell story after story of the damage that occurs when people are denied access to specialty care. But what this really tells us, we need managed care reform on a national basis like the Bipartisan Patient Protection Act, H.R. 526. This legislation ensures that patients who need specialty care can reach that specialist. It would ensure that children like Kyle and Sarah have direct access to their pediatrician. This plan could have helped Glenn Neally because it would have ensured that plans cover specialists even outside the network. It ensures that patient care is continuous, and if provider networks change, a patient is not forced to change doctors in midstream. These provisions are not abstract, legal, or political. These are real protections that make a real difference in saving people's lives. I hope my colleagues will consider how vital specialist care is for those who do not have access and join me in supporting H.R. 526, the Bipartisan Patient Protection Act.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I was unavoidably detained just a few minutes ago on Rollcall No. 83. If I had been present, I would have voted ``aye.''

Mr. GREEN of Texas. Mr. Speaker, I thank the gentleman from New York (Mr. Rangel) for yielding the time to me. Mr. Speaker, I thought it was appropriate that our colleague from California (Mr. Waxman) talked about this, that what we are talking about today is the people's money, and it is the gold. Mr. Speaker, I rise in opposition to H.R. 8 and in support of the substitute. And like my colleagues, I am troubled by the stories that families have to sell their farms and businesses because they cannot afford the estate tax; but we must reform it now, and not 10 years from now. We must continue the long-standing American tradition of families passing their businesses on from generation to generation. We can do this in a financially responsible manner that alleviates the burden for most of those small businesses and farms now instead of 10 years from now. Again, my Republican colleagues would have us repeal the estate tax 10 years from now. They support this bill we are talking about today. There is an east Texas saying that says it is called a wink, a prayer and a promise that is 10 years from now. That is all this is, Mr. Speaker. In 10 years, this bill would provide tax relief for still less than 2 percent of the people. Let us have a tax cut for the other 98 percent of Americans not 10 years from now.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I thank the ranking member on the Committee on Ways and Means for yielding me this time. Mr. Speaker, I rise in opposition to H.R. 6 today. But I support marriage penalty relief because it does not make sense for married people to pay more taxes just because they are married. That being said, we in Congress have a lot of tough choices we have to make. The Republican budget we passed yesterday and the tax cut we are working on today make it clear that their priorities are cutting taxes for the few instead of supporting programs that benefit the many. In fact, opposing this today, my wife will tell me, wait a minute. You are taking away our tax cut for Members of Congress, because my wife teaches school. I said, yes, but it is still wrong. We should not have it for people who have higher incomes. I support repealing the marriage penalty, but our Democratic proposal actually goes further than H.R. 6 to address marriage penalty corrections. But I also support a prescription drug benefit for seniors, investing in our schools, shoring up Social Security, and making sure the United States is strong as can be. Mr. Speaker, we need to heed the warning signs of our economy. We should not charge forward with huge tax cuts, because we need to look at the current numbers and what the projections were for last year. They say a fool and his money are soon parted. We owe the American people more than to be foolish with their money. Americans have worked hard for the last 8 years to achieve the surpluses we are now enjoying. Instead of heeding the economic warning signs, we are charging forward with a huge tax cut that, even Alan Greenspan has argued, will do very little to spur the economy. Like a gambler who bets the farm on one hand, this Congress is risking it all--with no guarantee that they'll cash in.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, at the end of his current term Harris County Commissioner Jim Fonteno will retire. Commissioner Fonteno is currently in his 26th year as Precinct Two Commissioner. He was first elected in 1974 and has won re-election terms in 1978, 1982, 1986, 1990, 1994, and 1998, On April 12, 2001, the South Houston Chamber of Commerce will honor him, and I am proud to join them in paying tribute to Commissioner Fonteno for his dedication and commitment to public service. For most of his life, Commissioner Fonteno has served both his country and the residents of Harris County. He is a veteran, having, served in the United States Army and in the Merchant Marine. He also served as a Municipal Court Judge for the City of Baytown from 1957 to 1958. Later, he served two terms 1970-1974, as Port Commissioner, Port of Houston Authority, but resigned the position to seek the office of County Commissioner. Jim Fonteno is also a licensed auctioneer and has used his skill to raise over $4 million for various non-profit charitable events, churches, clubs and organizations. Commissioner Fonteno is committed to his constituents. Not only does he touch the lives of many underprivileged boys and girls, he has an unwavering commitment to our senior citizens. He is the founder and developer of various outstanding senior citizen programs in Harris County's Precinct Two, including East Harris County Senior Citizens, a non-profit corporation. The East Harris County Senior Citizens sponsors various activities throughout the year, including, trips to sporting events and the Houston Livestock Show and Rodeo. Another popular activity is the Senior Citizen Olympics, which is held annually. These fun-filled events have provided both social and physical interaction among senior citizens. In addition, 280 food baskets are provided to senior citizens during the holiday. Commissioner Jim Fonteno also spent much time in developing the the well-being of our youth. The East Harris County Youth Program, which he founded, is dedicated to serving, the needs of Harris County Precinct Two youth. The program originated as a pilot program comprised of a summer camp at J.D. Walker Community Center and an after-school program at Cloverleaf Elementary School. The single most important role of the East Harris County Youth Program is to serve as a vehicle that makes learning fun. Designed to be a resource, not a substitute for school systems, the program is a strong proponent of students staying in school. Although academic achievements receive top priority, the East Harris County Youth Program also puts an emphasis on physical activity. Mr. Speaker, it is clear that we will have a tremendous void as the result of Commissioner Fonteno's retirement. I am sure that I speak for many when I say that his tireless work will not soon be forgotten, and we are all thankful to him. I would like to personally wish him and his wife JoAnn well in this new stage of their lives, and hope that he continues to be a strong presence in Harris County.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, it is with great honor and profound sadness that I rise to pay tribute to the life of Emmett O. Hutto of Baytown, Texas. After living a remarkably accomplished life that spanned 82 years, Mr. Hutto passed away on March 14, 2001. He was born in Bertram, Texas on August 29, 1918 to Elbert and Clara Hutto. Mr. Hutto graduated from Robert E. Lee High School and then attended Lee College and the University of Texas before joining the Army Air Force during World War II. As a bomber pilot, he flew 38 missions over Nazi targets in North Africa and Europe. Mr. Hutto was awarded the Distinguished Flying Cross, the air medal, and an oak leaf cluster, along with a citation for bravery in action. Emmett Hutto had many interests. He was a successful businessman, having owned and operated a restaurant, a hotel and a real estate business. He was also active in city politics, serving on the Baytown City Council from 1975 to 1978 and then serving as Mayor of Baytown, Texas. He was a longtime member of the Baytown Boat Club. And he was a registered diving instructor, having taken up scuba diving in his sixties. In fact the Professional Association of Diving Instructors awarded him the title of ``Eldest Active Divemaster in the World.'' Mr. Hutto was preceded in death by his parents, Mr. and Mrs. E.R. Hutto; his wife, Awline Hix Hutto; and his brother, Leon Hutto, who was shot down in the South Pacific during World War II. He Is survived by his wife, Betty Bailey Hutto; sons, Dr. Rodney Hutto and his wife, Norma Jean; Dr. Richard Hutto and his wife, Diane; Dr. Dean Hutto and his wife, Gena; daughter, Cynda Brooke Hutto; brother Orvel and his wife, Ruth; six grandchildren and four great-grandchildren. It has been said that the ultimate measure of a person's life is the extent to which they made the world a better place. If this is the measure of worth in life, Emmett Hutto's family and friends can attest to the success of the life he led. Mr. Speaker, I ask all the Members of the House to join me in paying tribute to the life of Emmett Hutto. He touched our lives and our hearts, and he will be greatly missed.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I would like to join the gentleman from Arizona (Mr. Hayworth) because, last year, the city of Houston lost two firefighters. It is appropriate that we remember the Tarver family and their sacrifice, because having experienced two fire fighters' loss of life last year and again having fire fighters up here this week with us, we join in that. I rise today, though, to talk about the energy crisis affecting our country and steps that need to be taken to increase our exploration, production, and delivery of energy. I want to try and cool some of the rhetoric that I believe is slowing down the process of trying to find a comprehensive energy solution. First, at this moment, insufficient supplies of natural gas are threatening to produce widespread shortages, not only in California and the West, but throughout our country this summer. This shortage can be traced to the oversupply of natural gas 2 years ago. Everyone likes to point the finger at energy producers when prices are high; but no one seems to care when, a year or two ago, we could not even give natural gas away. Those extremely low prices 2 years ago stopped exploration activities and forced many natural gas producers to cap marginally-producing wells. The laws of supply and demand work, and it did not stay out of balance for too long. We thought that cheap natural gas would last forever in the building spree; and with our encouragement, because it is safer and cleaner, new natural gas generators highlighted this belief that natural gas would be cheap. So today around our country, the demand for natural gas has far outstripped the supply, and we need to respond to this shortfall. Staying in front of our energy needs is the key to avoiding high cost. Exploration and production of domestic energy sources are the keys to staying in front along with more efficient use of our domestic energy. While we are behind on natural gas production, I need to remind everyone we will soon also be behind on oil production as well. Last summer's high gasoline prices are only a taste of what is to come. Already we have heard that OPEC plans to cut production in an attempt to maintain a stable world oil price. Demand in this country easily outstrips the supply, and we have no cushion to fall back on during times of a tight supply. It is for these reasons that we must take steps to stay ahead of our oil curve and tap more domestic sources of production. Specifically, I have agreed to cosponsor H.R. 39, the Arctic Coastal Plain Domestic Energy Security Act of 2001. The coastal plain of the Arctic Natural Wildlife Refuge, known as ANWR, is said to contain between 5.7 and 16 billion barrels of recoverable oil. If the upper 16 billion barrels of recoverable reserve can be extracted, it represents 20 years of oil which we will not have to import from other parts of the world. I want to emphasize that these reserve numbers are also considered very conservative. As a Member of Congress from Houston, Texas, I know firsthand that the drilling technologies have continued to improve. In fact, we have been and continue drilling and production in the Gulf of Mexico. Technology has allowed us to go deeper and also do it more efficiently and safely. As equipment and techniques advance, the percentage of recoverable oil will also increase. Industry now has the technology to reduce the amount of land impacted by new oil development. North Slope drillers routinely drill directional wells that reach out 4 miles from the surface of the rig. That means that one production pad on the surface can produce from 64 square miles of subsurface oil fields. So you do not have the imprint of that facility. The decision to support drilling in ANWR was not made just on the need to utilize energy resources alone. I have been to ANWR. I have seen the environment and have witnessed firsthand the diversity of life that lives there, even during August, Mr. Speaker, and met with the Alaskans that live the closest to the ANWR refuge. I would not support this legislation if I did not feel that we could confidently with our ability safely extract oil in an environmentally sound manner. Careful development of ANWR under strict regulatory guidelines can provide our Nation with a vital resource while minimizing the environmental impact on the coastal plain and its wildlife. Our experiences on Alaska's North Slope provide strong evidence that oil and gas development in nearby ANWR would pose little threat to the ecology of the coastal plain. The record is clear. Air quality is good. The drilling wastes have been well managed, and wildlife and their habitat have been minimally impacted. The debate on this issue has been heated and will get even more heated. But many of the arguments being made in opposition to opening ANWR were raised at the time Prudhoe Bay and the North Slope development was being considered. Today we are much better than we were those many years ago. Most experts have acknowledged that Prudhoe Bay has been, and continues to be, a success story. I keep going back to the same point, we can extract this vital resource while at the same time safeguarding the environment and other resources in that region. After careful consideration, the answer should be yes. Extracting oil from ANWR will have positive benefits for American consumers. I do not dismiss the concerns in the environmental community, but many of the arguments again were made at the same time when we were doing it for North Slope. The environment has been safeguarded on North Slope. I believe with advances in drilling technology, we will be safer with ANWR. Mr. Speaker, I hope my colleagues will join me in cosponsoring H.R. 39. It is time to move towards energy independence in our country.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I would like to congratulate my colleagues, the congressional women, for making this effort today for special orders for women's health care. I would like to associate myself with their remarks, because everything they have said on a bipartisan basis is so important. The reason I am here today, Mr. Speaker, is that the third time I have talked about the importance of managed care reform, real managed care reform, 3, 4 weeks ago I talked about the independent review process, and the accountability 2 weeks ago, and today I want to talk about medical necessity. Every patient in America deserves to have important medical decisions made by his or her doctor, not by an HMO bureaucrat. Unfortunately, managed care personnel, who often have no substantial medical training, are determining what is medically necessary. This practice endangers patients, threatens the sanctity of the doctor-patient relationship and undermines the foundation of our health care system. Most managed care companies base treatment decisions on professional standards of medical necessity. But we often hear cases where HMO plans write their own standards into their contracts, and these standards often conflict with the patients' needs. The case of Jones v. Kodak clearly demonstrates how a clever insurance health plan can keep patients from getting the needed medical care. Mrs. Jones' employer provided health insurance coverage for in- patient substance abuse treatment. Unfortunately, the health plan determined that she did not qualify for this treatment. Even after an independent reviewer stated that the plan's criteria was too rigid and did not allow for tailoring of case management, Mrs. Jones was still denied treatment. To add insult to injury, the courts stated that the health plan did not have to disclose its protocols or its rationale for making that decision. A health plan's decision does not have to be based on sound medical science, standard practices or even basic logic. In fact, a health plan can make medical necessity decisions using this child's toy called the Magic 8 Ball and not have to disclose the rationale, and when you turn this around and it says what do they suggest you are going to do, this is no way to practice medicine in our country. Mr. Speaker, unless Congress enacts meaningful patient protection legislation, the outlook will not be good for our patients. H.R. 526, the Bipartisan Patient Protection Act will ensure that treatment decisions are based on good medical practice and take individual patient circumstances into account. This legislation will protect patients from arbitrary and capricious decisions and will put health care decision-making back in the hands of the doctors and the patients. The patients should not have to be behind this eight ball when it comes to their health care, and we should not have to depend on the system that is patterned after this Magic 8 Ball when it says do not count on it for adequate health care treatment. Congress must act now to protect them.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I thank the gentleman for yielding me this time. Despite our President's promises to end the partisan tenor in Washington, our congressional Republicans continue to use the same old tactics. This does not match the procedure the President stated as his goal. For the last 2 days, Congress has debated two extremely divisive issues. Yesterday, after 1 hour, we undid job-safety standards we had been working on for 10 years; and today we are considering a tax bill that could wipe out the current surplus and our effort to reduce our $5 trillion national debt. What is worse, we are doing this without a budget. We do not know what else we are doing with the people's money. We do not have any contingency funds. We are just racing around this process with the hope that when we are finished we will still have some money left over. We should have a budget in place before we start either spending or cutting revenue. We need to protect Medicare, Social Security, we need to pay down the debt, and we need to make sure there is money for our children's education, health care costs and energy bills. We can cut taxes, but we need to look at it responsibly, Mr. Speaker. I support a broad and even retroactive tax cut. I do not want our citizens too overburdened by a tax system any more than our Republican colleagues do, but we know the priorities of our citizens is not immediately to have a tax cut.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, last night, we heard our President talk all about accountability. He wants our schools and our teachers to be more accountable to their students and the parents. This literally patterns after what is in a lot of our State laws and in the State of Texas. He wants government to be more accountable to its citizens, and I think we all agree with both of those premises. Mr. Speaker, I also appreciate the President's support for HMO reform, and hopefully similar to what the law is in the State of Texas. HMOs should be accountable to their patients, just like schools should be accountable to their students and parents, and government should be accountable to the taxpayers and citizens. President Bush told us last night that he wants to promote quality health care through a strong, independent review organization, and I agree. The independent review organizations had been instrumental in the success of the Patients' Bill of Rights in the State of Texas. But the independent review organizations, the IROs, are powerless if health plans can ignore their recommendations without consequences. By providing legal remedies in State courts, patients have a layer of protection that ensures health plans will do the right thing. As much as the President talks about frivolous lawsuits, we have not seen that thing in Texas called a frivolous lawsuit. In fact, after 3 years on the books, our patient protections there have been less than five lawsuits filed in 3 years, less than five. That is hardly the glut of lawsuits that opponents of patient protection seem to fear. The Texas plan for HMO reform has worked because the binding independent review protects health care plans from being held liable for punitive damages. You can provide that protection in there. But on the flip side, the HMO plans, the health plans know that if they ignore those independent review organization recommendations, they will have to answer in State court. That is a powerful incentive to do the right thing. The Bipartisan Patient Protection Act includes these important accountability provisions, while still protecting employers and health care plans from frivolous lawsuits. The Bipartisan Patient Protection Act ensures that HMO plans who follow the recommendations of that external review board cannot be held liable for punitive damages. It also limits the amount of damages that can be awarded so that the plans are not forced to pay arbitrary sums. Without accountability provisions, though, patients are defenseless against their HMO plans. They have no remedy if an HMO ignores the recommendation of the review board or acts in bad faith. Without accountability, a Patients' Bill of Rights provides no protections at all. We have to have accountability, just like we do from the government to our taxpayer. Mr. Speaker, managed care plans seem content to write the rules, but they cry foul when we want them to play by those same rules. It is time we level the playing field on the Federal level, just like a lot of our States have done, and ensure that HMOs provide the medical care that they agreed to do. That is why we should pass the Bipartisan Patient Protection Act.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today in support of legislation which urges Congress to increase federal funding for Type I diabetes, also known as juvenile diabetes. Type I diabetes is a devastating illness that affects over 1 million Americans, many of whom are diagnosed as children. This serious disease robs children of their innocence and independence, and burdens its victims with a lifetime of finger-sticks, shots, and fear of dreaded complications. Even with a strict regimen of insulin injections, blood-glucose monitoring, diet and exercise, people with Type I diabetes are at severe risk for blindness, kidney failure, amputations, heart disease and stroke. The burden of diabetes is felt by all Americans. Americans spend $105 billion each year on the direct and indirect costs of this disease. One of every four Medicare dollars is spent on beneficiaries with diabetes, and one in ten health care dollars overall are spent on individuals with this serious disease. There is great promise that a cure for Type I can be found in the near future. Advancements in genetic research, transplantation and immunology, and research into potential vaccines all hold the potential to eliminate Type I diabetes. But if we are to find a cure, we in Congress must find the money to pay for it. The Diabetes Research Working Group (DRWG), a Congressionally appointed panel of experts in diabetes research, issued a report in 1999 that indicates the need for a significant increase in diabetes research. The DRWG recommended a $4.1 billion increase for diabetes research over a five year period. Congress must heed this report. This legislation I am introducing today recognizes the particular burden of Type I diabetes, and the need to follow the recommendations of the DRWG. It also recognizes the importance of our partners in the private sector, such as the Juvenile Diabetes Research Foundation, which has donated more than $326 million to diabetes research since 1970 and will give $100 million in FY 2001. Mr. Speaker, full funding for diabetes research will help eradicate this devastating illness, save billions of health care dollars, and end the unnecessary suffering of millions of Americans. I urge all of my colleagues to join me in our fight to cure Type I diabetes.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today in support of the Labor Relations First Contract Negotiations Act. The National Labor Relations Act guarantees the right of employees to organize and bargain collectively to improve living standards and working conditions. The right to organize is a basic civil right, and unions are an avenue to equity, fair treatment, and economic stability for working people. Free enterprise includes the freedom to organize as a unit to bargain collectively. Often, current law hinders this ability. That is why I have introduced the Labor Relations First Contract Negotiations Act. This bill requires mediation and, if necessary, binding arbitration of initial contract negotiation disputes. Under this proposed bill, if an employer and a newly elected representative have not reached a collective bargaining agreement within 60 days of the representative's certification, the employer and the representative will jointly select a mediator to help them reach an agreement. If they cannot agree on a mediator, one will be appointed for them by the Federal Mediation and Conciliation Service. In the event that the parties do not reach an agreement in 30 days, the remaining issues may be transferred to the Federal Mediation and Conciliation Service for binding arbitration. Let's make sure that everyone has a fair opportunity to negotiate a collective bargaining agreement. I urge my colleagues to join me in cosponsoring this legislation.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today as an original cosponsor of the Bipartisan Patient Protection Act, which was introduced last week by the gentleman from Michigan (Mr. Dingell), the gentleman from Iowa (Mr. Ganske), Senator John McCain, and Senator Ted Kennedy. I am proud to be part of the bipartisan coalition that hopefully will finally enact a strong Patients' Bill of Rights. Mr. Speaker, Americans have been clamoring for a Managed Care Reform for a number of years. They want Congress to enact legislation that puts medical decision-making back in the hands of doctors and patients. They want legislation that provides meaningful accountability. In short, they want the Dingell-Ganske Bipartisan Patient Protection Act of 2001. This legislation provides patient protections that are very similar to those that have been the law in my home State of Texas since 1997. A recent article in Texas in the magazine ``Texas Medicine'' outlines the success of the independent appeals process as part of the HMO reform. As the article references, a provision of the law has been particularly effective in providing patients with real protections. When the Texas legislature passed Managed Care Reform in 1997, it included an external appeals provision allowing patients to appeal the decisions of their health care plans. These appeals are not brought through expensive and time-consuming legislation but through quick reviews by State-certified independent review organizations called IROs. IROs are made up of experienced physicians who have the capability and authority to resolve disputes for cases involving medical judgment. Their decisions are binding on both the patients and the plans. These provisions have been successful, not only because they protect patients, but also because they protect the insurers. Plans that comply with the IRO's decision cannot be held liable for punitive damages. So if a decision goes against the patient, that patient can still go to court. But we will talk about that later on the lack of litigation under the Texas laws since 1997. This plan has worked real well. Since 1997, more than 1,000 patients and physicians have appealed the decisions of the HMOs. The independence of the process is demonstrated by the fairly even split in the decisions resulted. In 55 percent of the cases, the independent review organizations, the IRO, fully or partially reversed the decision of the HMO. So in 55 percent of the cases, they were found for the patient or the physician than the original decision. Now, during the debate on HMO reform in Texas, there was concern that managed care reform would be very costly and would lead to a flood of unnecessary and expensive litigation. But that has not been the case in Texas. To my knowledge, less than five cases have been filed since patients' protection became law in 1997. I believe that the external appeals process has been instrumental in the success of the Texas plan and has given patients what they really want, access to timely quality medical care while protecting insurers from costly litigation. The process works so well that, despite the U.S. Fifth Circuit Court of Appeals ruling that the external appeals were in violation of the ERISA, Aetna and other HMOs agreed to voluntary submit disputes to the IROs for resolution. Finally, Mr. Speaker, I would like to point out that these protections have not lead to dramatic premium increases as some of our naysayers said. In fact, in Texas, the premium increases have been consistent with, and in some cases actually lower than premium increases in other States with substantially weaker patient protections. Mr. Speaker, it is time for Congress to enact a Bipartisan Patient Protection Act. Our President is supporting it. Hopefully we will be able in the House and the Senate to put a plan together that will give patients the protections that they need. I urge my colleagues to join me in supporting it. Mr. Speaker, I include the article from the magazine ``Texas Medicine'' that I referenced earlier as follows: [From Texas Medicine, Jan. 2001] Second-Guessing the Insurers independent review process appears to be working (By Walt Borges) Since late 1997, more than 1,000 Texas patients and physicians have challenged decisions of health maintenance organizations (HMOs), insurance companies, and third-party administrators (TPAs) to deny payments for treatments that the insurers deemed medically unnecessary or inappropriate. The challenges were not brought through expensive and time- consuming litigation, but through quick reviews conducted at no cost to patients and physicians by three state-certified entities known as independent review organizations (IROs). A Texas Medicine analysis of Texas Department of Insurance (TDI) statistics covering the first 2\1/2\ years of the IRO system's operation found that the IROs reversed insurers' decisions in whole or in part in more than 57 percent of the 1,007 cases that were reviewed. HMOs' decisions were reversed or modified in 55 percent of the 515 reviews, while decisions by insurance companies and TPAs were overruled in 60.5 percent of 481 reviews. Eleven other reviews were for health care entities that did not have an identifiable status in the TDI databases. Even though the TDI databases can be analyzed to show how individual insurers fared in independent review, the findings offer limited insights into the quality of care and decision- making because of large variations in the number of reviews of each health care entity. Attempts to index the reversals to claims or covered lives failed because of variations in enrollment over the three-year period and because TDI does not track the number of policyholders for health insurance companies. ``There are a huge number of patients and a huge number of claims, so reversal rates are tiny,'' said Paul B. Handel, MD, of Houston, chair of Texas Medical Association's Council on Socioeconomics. ``But only 8 to 10 percent of the cases involve areas [of treatment] where the patients need the [extensive] technology and medication. We should be looking at how that population fares.'' IROs were a key feature of a law passed by the Texas Legislature in 1997 that gave Texas health plan members the right to sue their HMOs for denying medically necessary treatments. But unlike that controversial provision, which acted as a lightning rod for insurance industry opposition and prompted lawsuits claiming it conflicted with federal law, establishment of independent reviews drew the public support of consumer advocates, insurers, and doctors alike. In June, a three-judge panel of the U.S. 5th Circuit Court of Appeals in New Orleans upheld provisions authorizing suits against managed care organizations. However, the court ruled that independent reviews of HMO decisions violated the Employee Retirement Income Security Act (ERISA), the federal law that reserves regulation of employer-funded benefit plans to Congress. But the appeal of the IRO process is such that Aetna, whose subsidiaries filed the suit, and other major HMOs announced after the decision that they would continue to voluntarily submit disputes to the IROs for resolution. That came well before TDI told insurers and health plans that it would consider the system intact until the completion of court rehearings and appeals. Despite popular support for IRO process, some physicians and IRO officials think many questionable decisions have been left unchallenged because of a lack of public knowledge that the system exists. ``The sense is that doctors and patients are not really aware of the IRO process,'' said Dr. Handel. ``This is something we've talked about at the council level.'' Gilbert Prudhomme, secretary director of Independent Review Inc., one of the Texas IROs, said he was ``absolutely astounded how few people know about it.'' Mr. Prudhomme says that as recently as last summer the insurance department at The University of Texas M.D. Anderson Cancer Center was unaware of the IRO process. ``A lot of people think ERISA preempts the system,'' said Mr. Prudhomme. ``They tell me they didn't know if it was still valid or they thought it had stopped working. There's a cloud over it by virtue of the ERISA controversy.'' IRO official Kathryn Block, administrator of Envoy Medical Systems, said, ``The hospitals don't understand what we are. They seem to think we're some kind of insurance company when we ask for records.''

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today in support of H.R. 2, the Social Security and Medicare Lockbox Act. This legislation aims to protect the Social Security and Medicare trust funds by establishing points of order against bills that would produce a deficit in the non- Social Security portion of the budget. While this legislation won't do any harm, it certainly won't do any good. There are gaping loopholes in this legislation which would allow for raiding the trust funds if it is done under the cloak of ``reform.'' But this bill is not serious about either reforming or protecting the Social Security and Medicare trusts funds. In a few short years the baby boom generation will start to retire. The addition of these 75 million Americans is a looming threat to the Social Security and Medicare programs. Congress must act now to ensure the long-term solvency of these valuable programs. This bill is not a serious, long-term solution for our problems. Congress must make some very careful choices in the coming months about our budget surpluses, and how best to use them. Anyone reading the papers in the last couple of days knows where the president stands on tax-cuts. Now, I support broad tax cuts. I think that we in Congress can work together to relieve the tax burdens of Americans. But I cannot support a tax-cut plan that endangers our economic stability, or the futures of the Social Security and Medicare programs. According to some estimates, the president's plan could cost as much as $2.3 trillion over ten years. That's almost eighty-five percent the projected on-budget surplus. This plan leaves almost nothing behind to pay down the national debt, strengthen our national defense, improve our children's education, or, as we're aiming to do today, ensure the solvency of Social Security and Medicare. Mr. Speaker, I assure you that this legislation will pass almost unanimously. All Members of Congress can agree that Social Security and Medicare funds should be spent only for those purposes, or for the purposes of paying off the national debt. But it's time to make some tough choices about the on-budget surplus, and whether or not Congress is serious about protecting Social Security and Medicare. We must do more than pay lip-service to these programs. Its time to put the on- budget surplus money where our mouth is. Mr. LaFalce. Mr. Speaker, I rise in support of H.R. 2, the Social Security and Medicare Lock-Box Act of 2001. In the midst of tax cut fever, when the federal government seems to be awash in black ink, this legislation serves as a sobering reminder that we are, in fact, facing a fiscal time bomb within the next twenty years. With the retirement of the baby boomer generation, we will face an unprecedented fiscal challenge, created largely by the demands on social Security and Medicare. The Social Security and Medicare Lock Boxes draw a line in the sand, saying that, if we are to fund a large tax cut this year, then we must do so without raiding the Social Security and Medicare Trust Funds. Establishing this imperative for the current tax cut debate is absolutely critical. In recent weeks, some Republicans have been inching away from the commitment to protect the Medicare Trust Fund, led by statements from the Administration. But it is clear that Medicare faces the same long-term funding problems that face Social Security. In fact, Medicare will face them sooner than Social Security. Raiding the Medicare Trust Fund to pay for tax cuts, then, should be absolutely unacceptable to this Congress. Some might argue that it is unreasonable to allow concerns of 20 years hence to have too much influence over today's policies. But this kind of thinking is akin to a family facing a balloon mortgage payment who nonetheless budgets nothing for it, and worse yet, goes on a spending spree in the years lending up to the balloon payment. Lest anyone doubt that we are facing a long-term fiscal crisis, consider this: today, the United States has 5 workers supporting each of its retirees; by 2030, we will have just 2 workers for every retiree. The fiscal implications of this demographic shift are enormous, and easily overwhelm the surplus numbers we have been debating the past few weeks. Mr. Speaker, today's legislation is a good first step in acknowledging the true fiscal outlook. I hope we will also recognize the true costs associated with meeting the full obligations of Social Security and Medicare to all of tomorrow's retirees--costs that are daunting no matter what versions of Social Security and Medicare reform you favor. In recognizing these costs, it should be clear to everyone that the President's tax plan is simply not affordable.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, today I congratulate Prime Minister- elect Ariel Sharon for his recent victory over Prime Minister Ehud Barak. Israel is facing a very difficult situation in trying to pursue peace with the Palestinians while at the same time trying to protect the people of Israel from the forces seeking their destruction. I am hopeful that Prime Minister-elect Sharon will continue to explore options for peace with Chairman Arafat, but there must be a secession of hostilities before any new peace negotiations can commence. The Middle East peace process is at a crossroads. As we saw by the election returns, the Israeli people do not feel secure in their own homes and communities. Chairman Arafat is responsible for this feeling because it is his followers who are pursuing the course of violence. Prime Minister-elect Sharon will have to confront this violence with whatever means necessary to restore some semblance of order. However, it is my hope that more violence will not be necessary to move the peace process. Both the Palestinians and the Israelis have the ability to inflict serious damage on one another, but what would that accomplish? I believe Prime Minister-elect Sharon knows this and is willing to restrain his forces if Chairman Arafat will do the same. At this point, the Middle East needs to remember what was accomplished in Oslo and try to rebuild the trust and respect developed there. To Mr. Sharon, I wish him the best of luck as he moves forward trying to form his coalition government. To Mr. Arafat, the ball is in his court. He will never achieve anything for his people pursuing the path of violence and terror. There has to be a compromise and I hope what Chairman Arafat was not able to reach with Prime Minister Barak, he can bridge with Prime Minister- elect Sharon. The United States stands with the people of Israel as they struggle forward to make peace with all their Arab neighbors.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, vaccines have made dramatic improvements in the lives of children and adults in the last century. Scourges such as polio and small pox have been eradicated thanks to advancements in vaccine research. Childhood vaccinations prevent nine serious infectious diseases. Thanks to immunizations, children no longer have to suffer from the dangers of polio, measles, diptheria, mumps, pertussis (whooping cough), rubella (German measels), tetanus, hepatitis-B, and Hib (the most common cause of meningitis). Immunizations are not only sound medicine, they're sound public health policy. Over $21 are saved for every dollar spent on the measles/mumps/rubella vaccine. Almost $30 are saved for every dollar spent on diptheria/tetanus/pertussis vaccine. Unfortunately, many children do not have access to these life-saving vaccines. In fact, one third of two-year-old children are under- immunized, and in some cities and urban areas, more than 50 percent of children are not fully immunized. Part of the problem is that nearly one in five employer-sponsored health plans do not cover immunizations for infants and children. Nearly one in four children in Preferred Provider Organizations and indemnity plans do not have coverage for immunizations. The Comprehensive Insurance Coverage of Childhood Immunization Act of 2001 would addresses this problem by requiring ERISA governed health plans to cover vaccines for children under 18 years. Vaccines recommended by the Center for Disease Control and Prevention's (CDC) Recommended Childhood Immunization Schedule must be covered. The federal government provides this benefit for its own workers, and twenty-four states have enacted laws to require state-regulated plans to cover vaccines. Unfortunately, ERISA plans do not have to comply with state laws. This legislation will ensure that all children, regardless of the type of insurance they have, will receive life-saving vaccines. I hope my colleagues will join me in supporting immunization coverage for all children.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today in support of the Community Access to Health Care Act of 2001, legislation I am introducing to help our states and communities deal with the crisis of the uninsured. More than 42 million Americans do not have health insurance and this number is increasing by over a million persons a year. Most of the uninsured are working people and their children--nearly 74 percent are families with full-time workers. Low income Americans, those who earn less than 200 percent of the federal poverty level or $27,300 for a family of three, are the most likely to be uninsured. Texas is a leader nationally in the number of insured, ranking second only to Arizona. About 4 million persons, or 26.8 percent of our non- elderly population, are without health insurance. The uninsured and under-insured tend to be more expensive to treat because they fall through the cracks of our health care system. The uninsured and under-insured often can't afford to see the doctor for routine physicals and preventive medicine. Consequently, they arrive in the emergency room with costlier, often preventable, health problems. Research by the Kaiser Family Foundation underscores this problem. Nearly 40 percent of uninsured adults skip a recommended medical test or treatment, and 20 percent say they have needed but not received care for a serious problem in the past year. Kaiser also reports that uninsured children are at least 70 percent less likely to receive preventive care. Uninsured adults are more than 30 percent less likely to have had a check-up in the past year, uninsured men 40 percent less likely to have had a prostate exam and uninsured women 60 percent less likely to have had a mammogram than compared to the insured. This broken health care system yields dangerous, sometimes deadly results. The uninsured are at least 50 percent more likely than the insured to be hospitalized for conditions such as pneumonia and diabetes. Death rates from breast cancer are higher for the uninsured than for those with insurance. Our Nation's health care safety net is in dire need of repair. Communities across the country are identifying ways to better tend to the uninsured, to provide preventive, primary and emergency clinical health services in an integrated and coordinated manner. This kind of service can only be accomplished, however, if our safety net providers have the resources to improve communication to better reach this target population. The Community Access Program (CAP) promotes this kind of interagency coordination and communication. It stems from a very successful Robert Wood Johnson Foundation-funded project that demonstrated how community collaboration can increase access to quality, cost-effective health care. The Community Access to Health Care Act of 2001 provides competitive grants to assist communities in developing programs to better serve their uninsured population. Funding under CAP can be used to support a variety of projects to improve access for all levels of care for the uninsured and under- insured. Each community designs a program that best addresses the needs of its uninsured and under insured and its providers. Funding is intended to encourage safety net providers to develop coordinated care systems for the target population. The Clinton Administration created a $25 million CAP demonstration project in FY 2000. More than two hundred applications were submitted by groups from 46 states and the District of Columbia. Applications were evenly distributed between urban and rural areas; and six were submitted by tribal organizations. Funding in FY 2000 provided grants to 23 communities. An increase to $125 million in FY 2001 will make grants available to an additional 55 projects. While this increase has helped communities get their program off the ground, more can be done to ensure that future funding is available. I would like to highlight one program, the Harris County Public Health and Environmental Services Department, in my hometown of Houston, TX. This program is a good example of how CAP funds can improve a community's health care network. Harris County, Texas is the third most populated county in the nation and the most populated county in the state with approximately 3.2 million residents. The Texas Health and Human Services Commission estimated that in 1999, 25.5 percent of the total population in Harris County--834,867-- was uninsured. Harris County's CAP project aims to assist three populations: Those with incomes under 200 percent of the Federal poverty level; those with incomes over 200 percent of the Federal poverty level; and those who are under insured. The primary focus of this project is to improve the interagency communication and referral infrastructure of major health care systems in the city. This will improve their ability to provide preventive, primary and emergency clinical health services in an integrated and coordinated manner for the uninsured and under insured population. Harris County will place particular emphasis on the development and/or enhancement of the existing local infrastructure and necessary information systems. In addition to expanding the number and type of providers who participate in collaborative care giving efforts, Harris County would establish a clearinghouse for local resources, care navigation and telephone triage to increase accessibility and reduce emergency room care. The clearinghouse will receive referrals of uninsured patients from health service providers and patient self-referrals. The consortia will give special attention to health disparities in minority groups. It will establish a database for monitoring, tracking, care navigation and evaluation. In Harris County, it is expected that this initial support from grant funds would become self-sustained through contributions from participating providers, especially smaller primary care providers who can rely on the centralized triage program for after-hours response. Harris County will also develop a plan to allow private and public safety-net providers to share eligibility information, medical and appointment records, and other information. The program will beef up efforts to make sure families and children enroll in programs for which they might be eligible, including Medicaid and the Children's Health Insurance Program (CHIP). In addition, Harris County would facilitate simplified enrollment procedures for children's health programs. Fortunately for my constituents in Houston, Harris County's program is eligible for a grant through the FY 2001 demonstration project. They have completed their site visit, and are in the final stages of having their program approved. Unfortunately, communities who weren't fortunate enough to receive grants are still searching for ways to improve the health of their uninsured. We in Congress have argued for years about the federal government's role in ensuring access to affordable health care. I believe that some type of universal care should be a priority for the long term. For the short term, however, authorizing the CAP program will place much-needed funds in the hands of local consortia who, working together, can help to alleviate this crisis--town by town and patient by patient.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I would like to join in the remarks of my colleague. The gentleman from Pennsylvania (Mr. Shuster) has been very fair and worked on transportation not only, obviously, in Pennsylvania but all over the country. His presence will be missed. Mr. Speaker, I rise today, though, to talk about a bill I just introduced, the Consumer Online Privacy and Disclosure Act. Unprecedented numbers of American consumers are flocking to the Internet to transact business and tap the nearly limitless informational databases that are available. The explosion in Internet usage, however, is not without its problems. Unlike shopping in a mall or browsing through a library where individuals travel anonymously through the merchandise racks and library stacks, the Internet is becoming less and less anonymous. Direct marketing firms are now trying to identify individuals as they surf the Web to isolate where they visit and what they are viewing. This new data collection practice is most often described as Internet profiling. Internet profiling describes the practice of joining a consumer's personal information with that of his or her Internet viewing habits. To develop this detail profile, a ``persistent cookie'' must be attached to the consumer's cookie as they move through a Web site. A persistent cookie is a small text file copied for varying lengths of time to consumers' computers to track their movements while they are online. It is almost like somebody following you on the street, Mr. Speaker; and we have protections against that. My legislation would prohibit Internet Service Providers (ISP) and Web site operators from allowing third parties to attach these persistent cookies to a consumer's computer without his or her knowledge and consent. And that is the biggest purpose. If someone wants to give their consent, then that is their business. For example, we have these grocery cards all over the country that gives us a discount. We understand that by taking that discount that Safeway or Kroeger's or someone else is actually seeing what we buy at the grocery store. We agree to that in a way. The legislation requires the Federal Trade Commission, the FTC, to promulgate rules specifying that all operators of a Web site or online service provide a clear and conspicuous notice of their privacy policy in clear, non-legalistic terms. The bill also requires a Web site or online service to provide consumers with an option to prevent the use of their personal information for any activity other than the particular transaction. And finally, the privacy policy must clearly state how any information, collected information will be shared or transferred to an external company or third party. While my legislation gives consumers more information and control over how they use the Internet, I have also included a provision that will hold e-commerce companies to their privacy policies. With insolvency of many dot-com companies, oftentimes the only tangible asset left to satisfy creditors is a consumer's transaction and personal information. The global use of the Internet is beneficial only so long as the information traveling through cyberspace remains private. Consumers will pull back from this burgeoning information and commerce tool if they believe their privacy is being invaded. While I understand there are many differing approaches to the use of Internet privacy, I believe this legislation addresses a critical component of Internet privacy debate; and I look forward in working with this Congress, Mr. Speaker, also to make sure that our constituents have that privacy that they expect and also that they will think they have.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today to introduce the Children's Access to Technology Act to provide the disadvantaged children of this country with the technology they need to succeed in life. My legislation is intended to provide Title I schools with additional financial resources to modernize their Internet delivery tools. Specifically, this legislation will utilize up to $100 million in unspent e-rate funding to provide Title I schools with a maximum $25,000 award to modernize their Internet labs. Mr. Speaker, the e-rate program has been very effective in bringing the Internet to libraries and classrooms across America. As a strong supporter of that program, I was disturbed to learn that crucial e-rate funding was going unspent because recipients were not following through with their paperwork confirming receipt of service. According to a recent General Accounting Office (GAO) report, almost $1.3 billion has gone unspent during the first two e-rate program years. The Universal Service Administrative Company (USAC) has not yet been able to explain this discrepancy between funds authorized and funds allocated. Because any unspent e-rate funding is lost at the end of each program year, my legislation will create a new funding mechanism, up to $100 million using any unspent monies, that will allow Title I schools to update their computer hardware. Specifically, the legislation directs the Federal Communications Commission (FCC) to establish a lottery system for Title I schools to enter and be eligible to receive up to $25,000 to modernize their computer hardware. In light of President Bush's commitment to strengthen and streamline the e-rate program, I believe we must ensure that all funding made available through the USAC be spent on improving our children's access to new and innovative technology. While I intend to seek clarification from the USAC concerning the large amount of unspent funds and the reason for these problem, I believe there will always be some unallocated funding at the end of each program year. In these instances, my legislation will provide an additional benefit to truly needy schools that are struggling to improve the delivery of Internet services to their students. Our children are our future; without innovating new approaches to provide better tools in our classroom, the now-passable digital divide will become an impenetrable digital barrier, unbreachable no matter how much funding we throw at the problem. Mr. Speaker, this is a complimentary piece of education legislation when compared with President Bush's proposals and will further enhance the educational opportunities of our children.