Gene Green

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, on October 20, 2000, the Association for the Advancement of Mexican Americans (AAMA) will be celebrating the 30th year of service to the Hispanic community. This is a tremendous achievement, and I wish them continued success. Founded in 1970 in Houston, Texas, AAMA is the largest Hispanic nonprofit service provider in Texas. This community organization was founded to advance the needs of Hispanic families that are coping and struggling to beat back the grip of poverty, poor health and family planning, and low educational attainment. Today, AAMA provides services in Houston and across South Texas. In my congressional district, AAMA operates the George I. Sanchez Charter High School, which provides at-risk Hispanic youth with an alternative educational environment. Today, the school is one of the largest and most successful charter schools in Texas. In addition to these education services, AAMA also operates many social service programs, including three gang intervention programs, two HIV and AIDS counseling programs and several drug and alcohol abuse programs throughout Texas. With these programs in place, it is easy to see why AAMA is the largest social service provider in Texas. AAMA is also involved in community development. The AAMA Community Development Corporation is dedicated to the revitalization of Houston's inner-city through the development of affordable and decent housing. The AAMA Community Development Corporation recently completed and leased a new 84-unit affordable living center in Houston's East End. I am proud of everyone associated with AAMA. They work tirelessly on behalf of our communities. I ask every Member of the House of Representatives to join me in celebrating AAMA's 30th year of service and in wishing them continued success.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I hope we quickly pass this conference report and send it on to our colleagues in the Senate and hopefully the President will sign this vital piece of legislation. Mr. Speaker, I want to thank the gentleman from California (Chairman Packard) not only for this particular bill, but the service to our Nation for many years, and thank the gentleman from Indiana (Mr. Visclosky), our ranking member, along with the conferees for the work on this report. Mr. Speaker, I especially want to thank the gentleman from Texas (Mr. Edwards), my colleague and friend, for his dedication and hard work and especially appreciate his advice during this process. Because of the vision of the conference committee and the Subcommittee on Energy and Water Development, the Houston-Galveston Navigation project will receive $53.5 million needed to continue the construction schedule for the deepening and widening of the Houston Ship Channel including the safety effort in barge lanes. The continued expansion of the Port of Houston is important on many levels. More than 7,000 vessels navigate the ship channel each year. The port provides $5.5 billion in business revenue and creates indirectly and directly 196,000 jobs. It is anticipated that the number and size of vessels will only increase. So this important project is definitely needed for, not only for the port, but for the city of Houston and Harris County. In addition to the Houston Ship Channel, there are several other flood control projects that the Army Corps of Engineers, in partnership with the Harris County Flood Control, have undertaken. The Hunting Bayou project and the Greens Bayou project will protect many square miles of watershed and provide protection for hundreds of homes. Mr. Speaker, again, citizens of Houston and Harris County appreciate the work of the conference committee and our Subcommittee on Energy and Water Development.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I thank my colleague from New Jersey for again requesting this time this evening to talk about the importance of prescription drugs for our seniors. One of the biggest issues our country is facing today is a lack of prescription drug benefit for our seniors. Prescription drugs are expensive for everyone. It is just that our seniors cannot go out and work a little more overtime to pay for their prescriptions. They are so often limited in their ability to increase their earnings. I am disappointed that once again this Congress has chosen to delay this important issue. We have known for years but especially during the last 2 that there has been a problem with prescription drug coverage for seniors. I remember in my first town hall meetings I had in 1993 every once in a while a senior would come up and talk about the problems they were having. It was not as big I guess as it has been the last 2 or 3 years because of maybe the escalation in cost for seniors and maybe the success of our health care system, we are actually getting more prescriptions written to help people. But for at least the last 2 years we have noted it. Yet here we are again a few days before we either recess or adjourn this congressional session and we have not made any serious attempt to help those who have worked so hard to make this country so successful. As Tom Brokaw said, the greatest generation, we should not let that greatest generation be forgotten. We simply cannot afford to sit on this issue any longer. We need a prescription drug benefit that is part of Medicare. The gentleman made that point. It is an integral part of Medicare. Over one-third of our Medicare beneficiaries will incur costs of more than $1,000 for prescription drugs this year. More than half have costs more than $500. The average total drug cost per beneficiary is projected to be $1,100 for our seniors. Yet nearly two-thirds of our Medicare beneficiaries have no prescription drug coverage or have coverage that is unreliable, inadequate or even costly. Medicare beneficiaries without drug coverage purchase one-third fewer drugs but pay nearly twice as much out of pocket for their drugs that they need. This summer, the Republican leadership forced through a prescription drug benefit bill that provides more political cover than it does coverage for our Nation's seniors because all it was was an insurance policy, and the gentleman addressed that very adequately. The legislation was designed to benefit the companies who make the prescription drugs and not the seniors. Even the insurance industry, as the gentleman stated, said that such policies will not work and they would not offer them. We simply cannot rely on insurance companies to have a drug-only policy available for 13 million beneficiaries who now currently have no drug coverage. They do not want to cover it. The gentleman mentioned again the State of Nevada that tried this, not one company applied to sell that insurance coverage. As Democrats, we introduced legislation that works. It is cost effective and it provides key consumer protections so that seniors will not lose benefits if an insurance company goes out of business. But instead of working with us, our Republican leadership passed that flawed bill earlier this year that will just add more cost to seniors but give them even less than what they have. It is no secret that the pharmaceuticals are pressuring our Republican colleagues not to allow any progress on this issue this year, hoping that ultimately it will just die down next year, but I am here to tell you that it will only get worse if we do not do something this year. It will get much worse. For many seniors, next year is too late. It is not fair that the pharmaceutical companies continue to discriminate against American patients. It is not fair that countries in Europe and across the world benefit from international price competition for pharmaceuticals and yet we do not. Whether it is western Europe that is basically a free market economy like we have or Japan, their pharmaceuticals are so much cheaper than ours in our country. Seniors are having to choose between paying their utility bills or their food bills or buying their medication. Oftentimes they will skip their medication to make it last that much longer. We have heard that many times not only at our town hall meetings but from our colleagues all across the country. We should be putting the benefits in the hands of seniors and not pharmaceutical manufacturers. We should be providing a secure, stable and reliable benefit instead of watered-down legislation that does nothing to address the problem. It should be included in Medicare. Let me talk about that a minute. If we were creating Medicare today, there is no way on this Earth that we would not have a prescription drug benefit in there. It should be standing on the same level as a doctor and a hospital bill for our seniors that it did in 1965. We would not do it. That is why we need to modernize Medicare to include prescription drugs. I hope that in this Congress, we can work across party lines. We did have some of our Republican colleagues support us and develop a bipartisan bill that ensures an affordable, available, meaningful Medicare prescription drug benefit option for seniors, so that again it is voluntary but it is part of Medicare. It is just nothing but common sense and fairness, and I have said this many times before, and I would hope if our seniors have to wait until after November 7 for it, that they will remember on November 7, because they need to know who really wants to provide prescription drugs as an integral part of their health care, and not something they would have to purchase out from an insurance company, like they do their Medigap policies that they have now for their 20 percent not covered by Medicare. So we need to do that as part of Medicare. Again, I thank the gentleman for continuing to make sure that fire is burning. I see our colleague from Maine here, which part of our bill includes the pricing that we need to be able to do so they can purchase and take advantage of the free market system and negotiating for price benefits. The gentleman from Maine (Mr. Allen) actually introduced the bill, along with the gentleman from Texas (Mr. Turner) and a number of people, I think I was a cosponsor of it, to make the prescription package part of Medicare so we can actually save our seniors their prescription drug benefits.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, during the August district work period, I sponsored a senior citizens forum with invitations to representatives from the Social Security Administration and the Health Care Financing Administration, and they participated. Seniors do want a prescription drug benefit as part of Medicare, but Houston seniors are worried because, at the end of December, they will be losing our biggest HMO provider for Medicare, NYLCare-65, one of our largest. They have given notice that they are not going to serve the Houston market. HCFA advised the over 100 seniors in attendance, some of whom are currently enrolled in NYLCare-65, not to worry, not to do anything until after October 1. That way they would have 3 months to decide where they would go before the end of the year because the contract lasted until December 31. This included enrolling in the one sole remaining HMO in the Houston market, Secure Horizons. Yesterday, I found out that HCFA has granted a temporary capacity waiver to Secure Horizons, which basically freezes their enrollments effective October 1 for 120 days to February 1. This temporary capacity waiver will keep seniors from being able to have the opportunity to select the one remaining HMO. HCFA should have notified us; and they gave my constituents false information in August.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I want to thank the gentleman from New York (Mr. Crowley) for yielding to me and putting together this special order. It is frustrating here we are at almost 5 o'clock on Eastern Time, 4 o'clock Central Time, and the House is not working on this legislation. We are spending an hour talking about it. It is amazing too that our seniors who work very hard to make this country prosperous and successful do not have access to affordable drugs. H.R. 1885, the International Prescription Drug Parity Act is one way that we can make it available to them by financial relief so they can buy the medication they need to maintain their health. It is widely reported that prescription drug prices are lower in foreign countries. In fact, studies in my own district show from Houston, Texas, we can go down to Mexico and get the same drug for lower costs; in fact, half the price. Mr. Speaker, I know that myself, because I have done that myself. When I have been traveling in Latin America, Mexico, Costa Rica, I can buy the same drugs that I buy in the United States for significantly less. While I would have hoped that by now we would have passed a prescription drug plan that works, why not let us reimport these drugs. My colleagues on the other side of the aisle say that it is unsafe to bring these drugs from other countries. Well, that is jut outrageous, because, frankly, these drugs are made and under FDA standards, and we imported $12.8 billion worth of drugs in the United States in 1997. Mr. Speaker, that is not about safety, it is about profits and what we need to do is make sure that pharmaceuticals who are opposing this bill know that either they need to support a real prescription drug benefit for our seniors as part of Medicare or we are going to find a way to get cheaper prescriptions for our seniors, including bringing drugs in from other countries that meet FDA approval. It is not fair that countries in Europe and Japan and other parts of the world have so many more cheaper drugs than our own seniors and yet they have the same standard of living. If I go to Mexico, because Mexico does not have the standard of living we do, so the prescription drugs are cheaper, but if we go to Europe, who has the same standard of living, or Japan, there the drugs are so much cheaper. I would hope, Mr. Speaker, that we would see that we would have a real prescription drug benefit passed, otherwise we need to support the International Prescription Drug Parity Act so we can have these pharmaceuticals reimported in our country for our seniors. I'd like to thank Congressman Crowley for putting together this special order. It amazes me that our seniors, who worked very hard to make this country prosperous and successful, do not have access to affordable drugs. H.R. 1885, The International Prescription Drug Parity Act is one way that we may be able to provide them financial relief so that they can buy the medication they need to maintain their health. It has been widely reported that prescription drug prices are lower in many foreign countries than in the United States. Studies conducted in my district confirm that seniors can buy the same drug in Mexico at a lower cost. However, I didn't need a study to tell me that. I've talked to the seniors in my district who travel to Mexico and I've been to Mexico myself and know that the same drugs were significantly cheaper in Mexico. While I would have hoped that by now we would have passed a prescription drug plan that works, why not let us reimport those drugs, that patients from all over can buy at lower cost. My colleagues on the other side of the aisle claim that it is unsafe to bring drugs from other countries and that this legislation will pose a safety risk to consumers. This is false. These FDA-approved drugs, manufactured in FDA facilities. Under H.R. 1885, pharmacies and wholesalers importing drugs would still have to meet the same standards set by FDA, which allowed 12.8 billion dollars' worth of drugs to be imported into the United States by manufacturers in 1997. This is not about safety--its about profits and helping special interest groups. Pharmaceuticals are pressuring them not to allow this because they know that they will lose business very soon. It is not fair that pharmaceutical companies continue to discriminate against American patients. It is not fair that countries in Europe and across the world benefit from international price competition for pharmaceuticals. Many of these drugs were researched in the United States and funded by our Federal dollars. This summer, the Republican leadership forced a prescription drug bill that provides more political cover than insurance coverage for our Nation's seniors. The legislation was designed to benefit the companies who make prescription drugs--not seniors. Instead, they passed a flawed piece of legislation which will cost seniors more each year, but it gives them less. I have met with many seniors in my district who are in serious financial hardship due to the high costs of their prescription drugs. They have shown me their prescription drug bills and let me tell you, I don't see how they can survive. Seniors are having to chose between paying their bills or buying their medication. Some skip their medication to make it last longer. We should be putting benefits into the hands of senior citizens, not pharmaceutical manufacturers. We should be providing a secure, stable, and reliable benefit--instead of watered down legislation that does nothing to address the problem. We should be building Medicare up, not trying to tear it down. I hope this Congress will work across party lines and develop a bipartisan bill that ensures an affordable, available, and meaningful Medicare prescription drug benefit option for all seniors. In the meantime, lets support the International Prescription Drug Parity Act, to level the playing field for American patients as well as businesses who are struggling to continue providing employees and retirees with quality, private sector coverage for prescription drugs. This is about fairness and common sense.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise in support of the Obey motion. The Labor, HHS Education bill should provide the highest level of funding possible for the Department of Education. We have flexibility under current law for school districts to do what we want, what we do not want is to have local school districts take Federal money and put Astro turf on the football field instead of providing for kids in those classrooms. My wife is a high school algebra teacher. I trust my local school districts. But I also know that if we tax folks, we ought to know where the money is going and not just send a blank check home. In Texas, 76 percent of our schools need repairs just to reach ``good'' condition, 46 percent need repairs and building features such as plumbing, air conditioning, heating and cooling, 60 percent have at least one environmental problem. That is why we have need to provide as high a funding as the Obey motion calls for the Department of Education. Over the next decade, we will see our schools grow even more and more. We have to provide the funding through this motion and not just send a blank check to everybody in the country.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, this summer we stood on this floor and pleaded with our Republican leaders not to enact reckless tax bills without securing the future of Medicare, Social Security, education, and to focus on paying down our debt. During the recess I am sure that they, like I, talked to lots of people in our own districts who said that, yes, we would all like to have a tax cut, but we want to make sure we take care of business first. Last week the leadership changed their stand and joined the Democratic concern to pay down the debt. But time is running out. Now we need to look at other Democratic priorities like affordable prescription drug benefits for our seniors who cannot buy the medication they need to maintain their health, investing in education to fix our crumbling schools and overcrowded schools so our children have a healthy environment to learn in, building our national defense, and taking care of our veterans who risked their lives to protect our country, and real managed care reform like we passed on this House floor, and most importantly, making sure Social Security is there not just for my dad's generation and my generation but our children's generation. I have been listening to my constituents, and these are issues they want us to address, and I hope we will these last few weeks in session.

Mr. GREEN of Texas

Mr. GREEN of Texas. Madam Speaker, it has been 3 long years and Houston once again has a professional football team, an NFL team. That name last week was decided to be the Houston Texans. Since 1997, when the Oilers left Houston to go on to Tennessee, football fans have hoped and dreamed for this moment. In Houston it was a long and hard road. Even though it is only 3 years, it seems like many more. I want to thank the owner who brought the NFL back to Houston, Bob McNair. Without his hard work, dedication and effort, we would not have this possible, but also to the people of Houston and Harris County who voted to build the new stadium right next to the eighth wonder of the world, the Astrodome. As any Texan can tell us, football is more than just a sport or game, it is a religion in Texas. Texans are crazy about football, and Houstonians are now crazy about the Houston Texans. Professional football has a long history in my hometown. In the early days of the AFL, the Houston Oilers were a powerhouse, winning the championships in 1961 and 1962; and when they merged the AFL and NFL, Houston was competitive each year. Such great players as Dan Pastorini, Earl Campbell, and Billy ``White Shoes'' Johnson led our team to the brink of the Super Bowl. Houstonians continue to stand by their team in good times and in bad, and now we are ready for the professional Houston Texans. Madam Speaker, I look forward to the on-field debut of the Houston Texans in 2002. I am eager to resume our annual Governor's Cup with a victory over the Dallas Cowboys.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, today I want to talk about legislation that I have been working on. It is H.R. 1323. H.R. 1323 deals with breast implants, an issue that has been the subject of many court cases now for a number of years. On Monday, the Food and Drug Administration, the FDA, hosted a meeting to discuss research on silicone gel-filled implants, and I am grateful for the FDA in their willingness not only to meet with my own constituents but also other people on my staff on this issue and hopefully will continue to dialogue with the FDA to ensure that women get the information they need on the safety of the implants. However, the research indicates that platinum salts have been released by silicone gel-filled implants. This is significant information because the platinum salt in certain form is known to be toxic. New technology has allowed scientists to determine that the platinum used as a catalyst in making the gel and the shell of the gel- filled breast implant is being released into the body of women in a harmful toxic form. Last week, the FDA released information on their web site citing breast implant complications. This is a victory for the consumer advocates who have been working to provide more information to women who are considering implants. However, the information provided in this web site does not include the recent findings on the toxicity of platinum salts found in gel-filled implants. Women need to know how harmful the release of platinum in their body and to their children who may be nursing can do to them. It has come to my attention that children who breast-feed from mothers with silicon brevity implants may also experience harmful body excess from the toxicity symptoms of exposure of platinum salts. Symptoms of exposure to platinum in a reactive form can also cause fatigue, dry eyes, dry mouth, joint inflammation, hair loss and also rashes. As a sponsor of the Silicon Breast Implant Research and Information Act, I believe that the need for more research is especially compelling in light of the FDA's own study on the rupture of silicone breast implants. On May 18 of this year, Dr. S. Lori Brown's research showed that 69 percent of the women with implants had at least one ruptured breast implant. The FDA concluded that the rupture of silicon breast implants is the primary concern although the relationship of the free silicon to the development or progression of the disease is unknown. We do know there is a rupture of silicon into the body, but we do not know the impact. That is why we need more research by the FDA. I heard from my own constituents over the last number of years and literally women across the country, Mr. Speaker, who have suffered from the long-term consequences of reconstruction and cosmetic surgery. They have experienced infections, chronic pain, deformity and implant rupture, inaccurate mammography readings due to the implant concealing breast tissue and difficulties in getting health insurance to pay for the high costs of repeated surgeries. The cost of faulty implants is paid by all of us in the system even if it is not covered by insurance. The Institute of Medicine estimated that by 1997, 1.5 million to 1.8 million American women had breast implants with nearly one-third of these women being breast cancer survivors. The American Plastic and Reconstruction Surgeons cited breast augmentation as the most popular procedure for women ages 19 through 34. In 1998, nearly 80,000 women in this age bracket received breast implants for purely cosmetic reasons. By 1999, an additional 130,000 women received saline breast implants. In spite of the escalating numbers, very little is known about the long-term effects of silicone or platinum in the body. Few patients understand that even when they opt for saline breast implants, the envelope of the implant is made of silicon. Following the FDA's decision to approve saline breast implants, the agency did warn women of the potential risk. FDA officials called upon implant manufacturers and plastic surgeons to ensure that thorough patient information is provided to women before they undergo the surgery. Mr. Speaker, with the FDA approval process behind us, the only course of action to safeguard the future of women is that of an informed consent document. Somehow, a piece of paper cannot make up for a manufacturer's insufficient data or the retrieval analysis. It cannot make up for inaccurate labeling and even risk estimates. There is so much we do not know, and yet the one government agency mandated to safeguard the public's food, drug and medical devices is moving so slow on this issue that could jeopardize women with a medical device that has alarmingly high failure rates. In spite of the agency's call for post-market studies, the FDA approval of saline breast implants provides no incentive for the manufacturers to make data better or a safer medical device. Mr. Speaker, hopefully the FDA will continue their research.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I thank my colleague from New York and our ranking member for yielding me the time. Mr. Speaker, I rise in opposition to the motion to override the President's veto of the marriage penalty tax relief. I support real marriage tax relief, but this bill is fiscally irresponsible. This bill would cost $292 billion over 10 years, $110 billion more than our House version. Despite its appealing name, more than half the tax cut would benefit couples who not only do not pay marriage penalty but actually get a marriage bonus. And we are not talking about the ones who may have a second home. Now, having been married for over 30 years, as much as I would like to get a bonus for having been married that long, I would like to work our tax policy differently, Mr. Speaker, and just correct the problem of the marriage penalty and not the marriage bonus. Let us deal with that marriage bonus. Let us reward people, stay-at- home moms or stay-at-home fathers, in a separate piece of legislation and not confuse the issues. We are talking about marriage penalty relief. In addition, the Republican bill allows many couples are denied tax relief because of the interaction between the alternative minimum tax with the increase in the standard deduction in the bill. About half the total tax cuts in this bill would benefit only the top 10 percent couples who have incomes over $92,500. We did have an alternative plan. A Democratic proposal gave $10 billion more in marriage penalty relief to couples and it was not burdened by all the other problems this bill has. But the Democratic bill also cost half as much as this bill even though it added $10 billion more to marriage penalty relief. My Republican colleagues have designed a bill to give the tax breaks to the highest income couples even if they do not suffer from the marriage tax penalty. Tax relief is important but so is protecting and strengthening Social Security, Medicare, investing in education, providing for a prescription drug benefit under Medicare, and also making sure our national defense is paid for, paying off the debt accumulated during the 1980s and early 1990s. We have to balance it, and that is why we need to correct the marriage penalty. The Democratic alternative provides for a middle- class tax cut and still protects our vital national priorities.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise in opposition to the motion to override the President's veto of H.R. 8. Estate taxes do place a burden on American small businesses and farmers, but this vote is nothing more than a back-door attempt to enact the first installment of the $2 trillion tax cut that my Republican colleagues want to do. I guess it is frustrating, Mr. Speaker, because I wonder where our Republican progressives have gone to in seeing these kinds of tax cuts. Let me read a quote that I picked up over the weekend: ``I do not believe that any advantage comes either to the country as a whole or to the individuals inheriting the money by permitting the transmission in their entirety of such enormous fortunes as have been accumulated in America. The tax could be made to bear more heavily upon persons residing out of the country. Such a heavy progressive tax is of course in no shape or way a tax on thrift or industry, for thrift and industry have ceased to possess any measurable importance in the acquisition of the swollen fortunes of which I speak.'' I will not read the rest, but that was by Theodore Roosevelt, a progressive Republican who knew what it was not to let the richest people in this world save taxes where it should be spent. America is about a democracy, about saying, hey, let us give everybody a chance. Sure, we can take care of the family farms, of the small businesses, and in parts of the country where our homesteads and houses have accumulated, that would be done. But the Republican strategy is going to fail because it means that there will be no estate tax relief this year or next year for small businesses and farmers. Our colleagues, if they were serious about an estate tax, they would have worked with some of us and said, hey, we had an alternative that took care of all the problems we hear about, whether it is the local auction or not. But does Bill Gates really need a tax cut anymore than the Rockefellers did in the last century? No. The Republican plan helps the wealthiest 2 percent of the American families and does nothing for the 98 percent of Americans who are still out there. What we need to do is pass real estate tax relief that will help the small estates, family farms, and the people who have their family homes. That is what we need to do. I would hope that we would override this veto, because then it takes a big chunk out of trying to also pay down the debt, take care of social security, Medicare, the defense of our country, everything else we want to do. Let us do something reasonable. We can make estate tax cuts part of the package before the end of this year, but we need to do it after we sustain this President's veto.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, to follow up on my colleague from Erie, Pennsylvania, where he said this is the last gasp, this is the last gasp to try to make sure we do not raid the Medicare Trust Fund. I know the argument from my colleagues on the other side said there is no difference in the substitute and the bill. There is a big difference, that each year that the Medicare Trust Fund, they have to be certified that is there is a surplus that can go into the trust fund, not automatically tax cuts and then hope there is money to pay for the trust fund. The same would apply to the Social Security Trust Fund, Social Security surplus that we are building up now. We would not use the Social Security surplus to take it out of one senior's pocket and put it in the other for a tax cut. That is just wrong. Our seniors in our country know better than that, Mr. Speaker. That is why the substitute should be adopted. We need to make sure that we give seniors a tax cut, but we do not raid the Medicare Trust Fund or take it out of their social security surplus that not only they paid but we are all paying.

Mr. GREEN of Texas. Mr. Speaker, I want to thank the gentleman from North Dakota (Mr. Pomeroy) and the gentleman from Massachusetts (Mr. Capuano) for working together on this substitute. I think it offers a sensible and cost-effective substitute for the Republican plan. I share some of the concern of my Republican colleagues because we do have a surplus. Let us give some of it back. The difference is the Democratic substitute does that. It raises the caps from $34,000 to $80,000 for individuals and from $44,000 per couple to $100,000. It retains some of the money in the Medicare trust fund. But even better, even better than just talking about the tax cuts, these cuts will not be taken out of the Social Security surplus. We have a problem in Washington because oftentimes we pay for tax cuts and spending with Social Security surplus funds. We are no longer doing that, thank goodness. But in adding even more so better than the Republican bill, we make sure that the Medicare trust fund is whole every year. Instead of just a promise that every year it will go in there, it requires that certification. The issue my colleague from Florida brought up, I do my own taxes and my taxes are not due until April 15. The IRS does not send me my form until the end of December. So I would assume during that year somewhere the certification would be made. Our proposal will relieve middle-income seniors of the burden of the tax without busting the Federal budget. While I did not agree wholeheartedly with the imposition of the tax, I think cutting it now would have an adverse effect on both the budget and the Medicare program as a whole. Rather than eliminating the tax for all seniors, our legislation again only leaves it to the 5 percent of the wealthiest compared to the 20 percent who pay it now. Let me say it again, that our bill allows the tax cut to take place only if there is a surplus to pay for it in the Medicare trust fund. Unfortunately, at the rate my Republican colleagues are spending it as my colleague showed, there is not going to be any of that surplus left, so this is just a wink for the Medicare trust fund. Between spending $739 billion in tax cuts plus entitlement and discretionary spending, we will be $88 billion in the hole. Mr. Speaker, I urge a vote for the Democratic substitute.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise in support of the rule and thank my colleagues on the Committee on Rules, both the Democrats and Republicans, for providing an opportunity to have an alternative to the Social Security tax cut. I have to admit, though, only in Washington- speak would the 1993 tax be called the Clinton-Gore tax and yet the 1983 tax that was 50 percent is not called the Reagan-Bush tax. Mr. Speaker, I think our folks are smart enough to understand that. The argument, our Committee on Ways and Means chairman said yesterday, at the Committee on Rules is so correct, the argument we have is, We have a surplus; let's provide some tax cuts. Now that we have that surplus, let's do that. Well, that is great. The problem is this bill does not do that. What this bill does is it takes the money out of the Medicare trust fund and it says, over the next year, we will try to put it back in, but each Congress is going to make that decision. That is why the substitute is the best way to go. There are a number of reasons for that. The Republican bill is financially irresponsible. It takes money away from the Medicare trust fund, and it does not give any assurances that that money that it takes out will be put back. The Democratic substitute we have is more cost effective. It costs about $46 billion less than the Republican bill; but what it does is actually, as my ranking member on the Committee on Rules said, it raises the amount from $30,000 to $80,000 for individuals and from $44,000 to $100,000 for couples. We are taking away those low tax brackets for seniors and that is great. But my Republican colleagues never talk about the 50 percent that they are still going to be paying. The Democratic substitute is more responsible. It provides a targeted tax cut to those who need it most, and it does not bust the Federal budget like a lot of their tax cuts do. It is a financially responsible middle ground. The so-called surplus mentioned by the Republicans is based on current law, not the billions that we have seen pass this House over the last number of months. My concern is that this year's surplus is already spent with the current Republican spending rates. The Democratic substitute protects Social Security and Medicare. It does not pretend to give seniors one thing out of one pocket and take it away from them in the other. We prohibit the use of the Social Security trust surplus for this tax cut. So oftentimes in Washington we do that. We use Social Security money to pay for lots of things, including tax cuts. The other thing it does is it makes sure that that money will go to Medicare. It will go to the Medicare trust fund. I want a tax cut. All of us want a tax cut. But let us not punish the seniors who depend on Medicare. I have to admit to my colleague from Texas, I do not represent any tax collectors. He probably represents more IRS employees than I do. He has a higher income district. I represent lots of taxpayers, but there are also a lot of people who depend on Medicare to make sure they can survive.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today in support of the Community Access to Health Care Act of 2000, legislation I am introducing to help our states and communities deal with the crisis of the uninsured. Over 44 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. Ten percent of the uninsured are in families with at least one part-time worker. Low income Americans, those who earn less than 200% 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 uninsured, ranking second only to Arizona. About 4 million persons, or 26.8 percent of our non-elderly population, are without insurance. The uninsured and under-insured tend to be more expensive to care for. They fall through the health care cracks. They put off going to a doctor until it is too late--and then they go to the emergency room. Instead of having available the wide variety of preventive measures and checkups that those of us with insurance take for granted, the uninsured often ignore the symptoms of what might be larger problems because they simply cannot afford to go to the doctor. According to research done by the Kaiser Family Foundation, nearly 40% of uninsured adults skip a recommended medical test or treatment, and 20% say they have needed but not gotten care for a serious problem in the past year. Uninsured children are at least 70% less likely, Kaiser reports, to receive preventive care. Uninsured adults are over 30% less likely to have had a check-up in the past year, uninsured men 40% less likely to have had a prostate exam and uninsured women 60% less likely to have had a mammograrm than compared to the insured. The uninsured are at least 50% more likely than the insured to be hospitalized for conditions such as pneumonia and diabetes. Unfortunately, the uninsured are more likely to be diagnosed with fatal diseases at significantly later stages than are those with insurance. Death rates from breast cancer are higher for the uninsured than for those with insurance. In many American cities, towns and rural areas, there is general agreement that--something needs to be done to track, monitor and serve the uninsured. We all pick up the tab for the uninsured in the end--why not have communities join forces to attack this problem on a local level? Why not spend our tax dollars wisely and invest in prevention rather than spend them foolishly paying for emergency room visits or lengthy hospitalizations? The Community Access Program (CAP) embodies this idea; it stems from a very successful Robert Wood Johnson Foundation-funded project that showed that community collaboration increased access to quality, cost- effective health care. Last year, the Clinton Administration proposed and Congress passed the Community Access Program as a $25 million demonstration effort. This year, over 200 applications were received for approximately 20 grants. Obviously, the need for and the interest in this program is great. The Community Access to Health Care Act of 2000 will authorize the Community Access Program for five years. It gives competitive grants to communities to help more uninsured people receive health care and to ensure that communities join forces to map a strategy for counting and dealing with the uninsured. 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 the uninsured and under insured and the providers in their community. Funding is intended to encourage safety net providers to develop coordinated care systems for the target population. The majority of the CAP funds will be used to support expenses for planning and developing an integrated health care delivery system. A small portion of the funds may be used for direct patient care if there are gaps to putting together an integrated delivery system. Applications for the CAP demonstration project were due this past June; 208 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. About three fourths of applications came from communities with rates of uninsured persons higher than the national average of 14%. Half of applications came from communities with rates of uninsured persons greater than 20%. Close to 90% of applications target all uninsured persons in an area. Perhaps the best way of explaining how CAP can improve a community's health care networking is to paraphrase from the application submitted from a group in Houston. The lead applicant, Harris County, is the third most populated county in the nation and the most populated county in Texas with about 3.2 million residents. Close to 50% of our residents are Anglo, about 18% are African American, about 27% are Hispanic and about 5% are Asian. The Asian population is the fastest growing, followed by Hispanics and African Americans. According to Harris County's proposal, ``population growth and an economic boom have enhanced the overall wealth and employment opportunities of the community. It has, however, also resulted in greater economic disparities between the privileged and the economically disadvantaged. The numbers of uninsured and under insured are on the rise.'' The Texas Health and Human Services Commission estimated that in 1999, 25.5% of the total population in Harris County--834,867--was uninsured. Of this total number, the applicants have targeted three populations: First, they will target those with incomes under 200% of the federal poverty level (428,369 persons). Second, they will target those with incomes over 200% of the federal poverty level (301,000 persons). Third, they win target those who are under insured (328,183 persons). According to Harris County, 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 Childrens' Health Insurance Program (CHIP). In addition, Harris County would facilitate simplified enrollment procedures for childrens health programs. Among those participating in the Harris County group are the Asian American Health Coalition, the Baylor College of Medicine's Department of Family and Community Medicine, Communities Conquering Cancer, Community Education and Preventive Health, the Dental Health Task Force of the Greater Houston Area, the Gulf Coast CHIP Coalition, the Harris County Budget Office, the Harris County Hospital District, the Harris County Public Health and Environmental Services, the HIV Services Section, the Homeless Services Coordinating Council and the Houston Health and Human Services Department. Also part of this consortia are the Mental Health/Mental Retardation Authority of Harris County, the Ryan White Planning Council, The Assistance Fund, The Rose, and the University of Texas's Health Science Center's Department of Internal Medicine. What does this group hope to accomplish? It has four goals. 1. Establish a county-wide communication and referral system accessible to Community Health Partners, Affiliates, Clients and Funding Resources. 2. Document referrals from the Community Health Access Clearinghouse to Community Health Partners, Affiliates and Funding Resources. 3. Decrease the rate of non-emergency use of emergency rooms. 4. Increase the numbers of low-income persons with insurance coverage. This group's plan--and it's a great one--is just one of 208 that were submitted to HRSA this June. Unfortunately, since funds exist only for about 20 projects, Houston and other cities and rural areas may get turned away unless Congress acts to pass the Community Access to Health Care Act of 2000. Putting together the CAP application was the first step in building new collaborative efforts for many groups. I have heard of instances where providers serving the same populations in the same towns had never sat down at the same table together. Once they do, and once they begin to exchange information and ideas, great things can happen. 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. I am pleased to note that this legislation has also been included as part of Rep. Dingell's FamilyCare Act of 2000, of which I am a cosoponsor. In closing, I would like to recognize a person whose dedication to this effort has led to the introduction of this legislation today. Dr. Mary Lou Anderson, from the Health Resources Services Administration, actually came out of her retirement to oversee the CAP demonstration project. Her dedication to this project, and to the health of America's families and children, is commendable.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise in support of H.J. Res. 99 and oppose the granting of the waiver for Vietnam. Mr. Speaker, I do not believe Vietnam has made significant improvements in allowing political express or religious freedom. I intend to support today's resolution opposing the waiver of the Jackson-Vanik provisions of the 1974 Trade Act. The Communist government in Hanoi still clings to the belief that any form of individualism is a threat to their grip on power. Every year the House is asked to make exceptions to the countries who consistently oppress political dissent and religious freedom. When is the United States going to say enough is enough? I understand that we are here today because of the tremendous economic opportunities that are available in Vietnam. I understand that. Vietnam has the cheap labor and lax environmental regulations that we seem to favor to produce our clothes and our shoes. What would we get in return for waiving the Jackson-Vanik provisions of the 1947 Trade Act? Are we going to get more help in locating our missing servicemen? The legacy of the Vietnam War will remain open and festering without a higher level cooperation from the government in Hanoi. I hope that next year, if we repeat this process, the United States is not running a huge trade deficit with Vietnam. Injecting large amounts of foreign investment in Vietnam to bring about social change is a flawed theory. We have been doing that with China for years, and it still suppresses religious expression, and it still sells weapons to some of the most unstable nations in the world. It is interesting that the companies and businesses who are successful in our country because of the freedom of individualism and initiative want to take advantage of a society that suppresses it to the point, and that is the very reason that our society and our government is successful because, individually, we have the right to succeed. Mr. Speaker, I urge my colleagues to support the resolution.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, the complex health problems of aging require specially-trained physicians in order to adequately care for frail older persons. Geriatrics is the medical specialty that promotes wellness and preventive care; these specialists are first board certified in family practice, internal medicine or psychiatry and then complete additional years of fellowship training in geriatrics. With an emphasis on care management and coordination, geriatricians help patients maintain functional independence, thus improving their overall quality of life. An emphasis on coordination also limits unnecessary and costly hospitalization or institutionalization. Despite the increasing number of Americans over age 65, there are fewer than 9,000 geriatricians in the United States today. In Texas, there are only about 225 geriatricians--and we are one of the top ten states nationally. Texas has four geriatric training programs; Baylor College of medicine in Houston, the University of Texas at San Antoino, the University of Texas Medical Branch at Galveston (where, I am proud to say, my daughter is a third-year student) and the University of Texas Southwestern. The Baylor program, in my Congressional District, has been operating for over 15 years. It trains six fellows now and is unable to increase this number because of a Congressionally-mandated Graduate Medical Education (GME) cap. I am told that there are plenty of applicants interested in geriatrics who are being turned away because our Medicare program will not allow them to be funded. Why is there a cap on the number of new geriatricians? The Balanced Budget Act of 1997 established a hospital-specific cap based upon the number of residents in the hospital in the most recent cost reporting period ending on or before December 31, 1996. Under the cap, the number of residents for direct graduate medical education payment purposes is based upon a three-year rolling average, except for Fiscal Year 1998, when a two-year average was used. The implementation of this cap has adversely impacted geriatric programs in Houston and elsewhere. As geriatrics is a relatively new specialty, the cap has resulted in either the elimination or reduction of geriatric programs. Because a lower number of geriatric residents existed prior to December 31, 1996, these programs are under- represented in the cap baseline. Thus, new geriatric training programs are severely limited and existing training programs tend not to increase funding, or even decrease funding, for geriatric slots. There is a well-documented shortage of geriatricians nationwide. Of the approximately 98,000 medical residency and fellowship positions supported by Medicare in 1998, only 324 were in geriatric medicine and geriatric psychiatry. At the same time, the number of physicians needed to provide medical care for older persons has been estimated to be 2.5 to three time higher in 2030 compared to the mid-1980s, according to the federal Health Resources and Services Administration. Unfortunately, the pace of training is not meeting this need. The actual number of certified geriatricians has declined, as approximately 50% of those who certified in 1988 did not recertify in 1998. This has occurred just as the baby boomers have started reaching the age of Medicare eligibility. To correct this problem, I am introducing the Geriatric Workforce Relief Act of 2000 today to allow an increase in the number of person studying geriatrics at our medical schools. In order to be fiscally responsible, my legislation does not completely lift the cap. Instead, it allows hospitals to increase the cap by 30%. This will allow for a few more students at most programs. My legislation defines approved geriatric residency programs as those approved by the Accreditation Council of Graduate Medical Education. My legislation, which will also be introduced in the Senate today by Senator Reid, is modeled upon a similar provisions that was enacted last year for rural hospitals. It is a sensible and reasonable proposal and one that allows us to meet the needs of Medicare patients. I encourage my colleagues to support it.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, first I would like to thank the gentleman for organizing this Special Order tonight on the issues of the tax cuts. I just came in to talk about the fairness and what we are not funding, because I think that is important. But my colleagues in North Dakota and Florida and the two of us from Texas, we recognize what is important, that we are considering a budget and a marriage tax penalty and an estate tax proposal that only benefits the wealthiest of Americans and does nothing to help the working folks in my district. I have to admit, we do not have any farmers in urban Houston, but we do grow our backyard gardens, we have tomato plants and peppers, but with this heat, they are all dead now. But I think the graph and the distribution that our colleague from North Dakota has, and I have the smaller version of it, shows almost 60 percent of the marriage tax penalty benefits and the estate tax will go to those percentage of 130,000 or more, the top 5 percent of the income brackets. That is what that shows. I think it is frustrating. We want the opportunity to show the American people that we can work together on a bipartisan basis and agree on a tax resolution and a budget that is fair. The gentleman mentioned the democratic alternative on the estate tax. Mr. Speaker, $2 million per person in Texas, $4 million because it is a community property State, although I know it affects every other State now, is not that huge tax cut for the wealthy, it will benefit the small business people, a machine shop owner in Houston who may be on a third generation who has built up his machine shop to where it may be substantially beneficial, or the rancher or farmer in west Texas or North Dakota, $2 million is a lot of money individually. We wish we could get to that point. My concern about the Republican plan, and the gentleman has mentioned it, if we do this, we will see higher interest rates and force huge deficits, go back to those deficits, and we will see these tax increases in the future on our children and our grandchildren. So before we hastily rush into these bills, we need to make sure that we realize that there are certain programs that we have to do and talk about what we may not be funding. But all of us are for tax cuts, Democrats and Republicans, who just need to be reasonable. I think the difference, though, is that we are concerned about making sure we have money to pay the service personnel, the defense of our country, to save Social Security, modernize Medicare, pay down our national debt, as the gentleman mentioned, how important that is for our own tax rates, for people who are going out and buying cars or mortgaging a house, or even that small businessperson going out on the market and saying hey, I need an inventory loan. By paying down the national debt, we are lowering our taxes. Educating our children, making sure that businessperson has qualified employees that will come in. Educating our children is not free. It is expensive, it costs local and State dollars, but it also requires Federal resources to help so we can bridge that gap on what local and State resources cannot do. So I have met lots of my constituents over the last few months, and the number one concern I think is insolvency of Social Security and a prescription drug benefit for our seniors. We need to make sure that we balance that. We can have reasonable tax cuts and yet still make sure that we support those programs, the defense of our country, Medicare prescriptions, and Medicare itself, and the education of our children, that will not be a balanced budget-buster, like what we will see if all of these are passed, and thank goodness the President will veto them. Mr. Speaker, I cannot help but mention one project, because my colleague from Waco knows the Port of Houston project. We have critical projects all over the country. With the gentleman's help, we have been able to make sure the Port of Houston project is on line to be completed in the time frame. That is not free, but it will pay down the line, it will pay in customs duties, it will pay in local taxes that we will ultimately pay back. There are times we are going to have to say no, we cannot do these infrastructure projects that will ultimately pay more than if we give these huge tax cuts now. So I want to thank the gentleman for his effort on the Port of Houston project and also thank him for tonight, in making sure that we have the opportunity to give our side of it and say, we are for tax cuts, we are for reasonable ones that also take care of Medicare, Social Security, infrastructure and education for our children, and paying down the national debt.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, Internet spam will never go away. However, by passing this legislation we will be taking the first steps towards limiting its impact on the overwhelmed e-mail users everywhere. It is my hope, as the provisions of this legislation begin to take effect, that private industry will continue to develop better and more effective software to combat spam. Our ultimate goal is to intercept and delete spam before it ever reaches the consumer's mailbox, if that is the consumer's decision. If it does make it to the recipient, then filtering software on our personal computers can take care of it. This bill, though, will not affect those consumers who wish to receive commercial solicitations over the Internet. For those of us who are tired of opening innocent looking e-mails only to find an advertisement for a porn site, this legislation will hopefully curb those unwanted and objectionable messages. Mr. Speaker, I again thank my colleague, the gentlewoman from New Mexico (Mrs. Wilson), for her efforts on this legislation; and I hope the other body will act quickly to pass this important consumer protection measure. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. GREEN of Texas. Mr. Speaker, I rise in strong support of H.R. 3113, the Unsolicited Electronic Mail Act. As one of the principal authors of the legislation, along with the gentlewoman from New Mexico (Mrs. Wilson), I am very pleased that the House of Representatives will act on this important piece of Internet legislation today. Over the last decade, Americans have witnessed the development of the Internet and the many associated applications that now make our daily lives easier and more efficient. However, this movement to cyberspace has not occurred without problems. As more and more people move online, their need for privacy and data management becomes paramount. Just as the Internet provides a personalized window looking out to work and shop through, it can be used by strangers to look into our personal habits and information. H.R. 3113 will be the first line of defense against people trying to look into our private lives. The legislation's primary function is to stop individuals and companies from forcing unwanted e-mail messages on to our computers. Typically, these messages are advertisements for anything from dog food to pornography and, in many cases, come in disguised formats that make the consumer believe the message contains innocent information, as the gentlewoman from New Mexico (Mrs. Wilson) mentioned. It is only after these messages are delivered and opened that the consumer realizes they have just received a junk e-mail or better known as spam. Because the Internet provides a low-cost method of advertising, many advertisers tap this technology to send millions of unwanted messages to consumers through the Internet service providers, the ISP. While these messages may cost the sender almost nothing to initiate, the ISP and the consumer both lose time and money carrying and deleting these messages. H.R. 3113 limits the ability of spammers to force their messages by forcing spammers to have a clear and conspicuous label on their messages so consumer and ISPs have an easier time identifying and deleting these messages; making sure spammers send clear and accurate router and return address information on their messages so consumers can respond to their message to opt out of future advertisements; providing consumers with the option to opt out reinforced by the ability to seek civil damages for any future violation. Once a consumer requests that their name be taken off whatever list a spammer is using, any further spam messages could result in court action. Allowing ISPs and consumers to initiate civil actions to seek damages from spammers is our last effort. Taken as a whole, all these provisions empower consumers and our ISPs with the ability to protect both their privacy and their resources. One point I want to make very clear is spam is not free. Millions of spam messages dumped into an ISP can degrade the system speeds while the servers and routers try to deliver this mail, and consumers waste, must waste time and energy deleting these messages from their computer. For those Members that may be concerned with the legislation's impact on the first amendment to the bill, it deals only with unsolicited commercial e-mail. This bill would not have any effect on nonprofit fund-raising or any other type of e-mail communications that is not commercially related. Mr. Speaker, since the problem spam was brought to my attention several years ago in a town hall meeting in my own district, I made it a priority to try and correct the problem we have with the Internet and return it back to my constituents. H.R. 3113 is a tool that can now be used to filter and stop unwanted intrusions in our home and offices. Mr. Speaker, I would like to join the gentlewoman from New Mexico (Mrs. Wilson) in thanking many of the members and the staff particularly for their work on this. I would like to thank the gentleman from Virginia (Chairman Bliley) and the gentleman from Michigan (Mr. Dingell), our ranking member, for all of their support in getting this legislation passed out of the full Committee on Commerce by unanimous consent. This is an important piece of legislation. I urge my colleagues to vote in favor of stopping Internet spam. Mr. Speaker, I reserve the balance of my time.

Mr. GREEN of Texas. Mr. Speaker, I yield myself such time as I may consume. (Mr. GREEN of Texas asked and was given permission to revise and extend his remarks.)

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, we are considering another tax cutting scheme aimed at benefiting only the wealthiest Americans and does little to help the working families in my district. The scheme we are looking at now will benefit 5 percent of the wealthiest Americans with 60 percent of the tax cuts. The Republican plan is fiscally irresponsible that could lead to higher interest rates and force huge deficits or tax increases on our children and our grandchildren. Everybody wants a tax cut. I would like to see it particularly around April 15. The difference between the two parties is Democrats, we want to save the money enough to build our national defense, save Social Security, modernize Medicare, and pay down the national debt instead of ignoring these issues until they become a crisis, giving a tax cut now and make it a crisis later. I met with so many of my constituents in the last few months, and they recognize our number one priority is to safeguard our own country, protect Social Security, and provide for prescription drugs for our seniors. The failure to address these issues today will make them be paid for tomorrow. As Democrats, we want to make sure we do that and still have the tax cut.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Chairman, I join my colleagues, and I appreciate the work of the Subcommittee on Foreign Operations, Export Financing and Related Programs. This is money well spent, because if we do not deal with tuberculosis nationwide, literally in Texas, we are seeing it cross our border. So I thank the subcommittee for their work. Mr. Chairman, I rise in strong support of this amendment, which I am pleased to have cosponsored along with Sherrod Brown and Representatives Heather Wilson and Connie Morella. Seven years ago, the World Health Organization declared Tuberculosis to be a global emergency. TB is an emergency in Africa--in Asia--in Latin America--in the Caribbean. TB could soon be an emergency in the United States. No area has been more harmed by the epidemic than Asia. In the past ten years there have been over 35 million cases in South and South-East Asia. In East Asia and the Pacific there have been over 21 million cases. In India, over 1.8 million new cases are diagnosed each year. In China, 1.4 million. In Bangladesh, half a million. While the majority of Tuberculosis cases are found overseas, this is disease that could be passed on to you . . . or to anyone in your family. TB is highly contagious and spreads just like the common cold-- through hand-shaking, coughing, or contact. With the increase in international travel we are seeing more and more cases of TB right here in North America--and those cases will continue to increase unless we act now. Our amendment increases funding for TB control by $40 million. Much, much more is needed but to comply with budget rules we are only proposing a $40 million boost. Our amendment is offset by reducing funding to the Asian Development Bank by an equal amount. The Asian Development Bank has not been effective. Its lending for health has averaged just 1.5% of total lending annually from 1978-1998. This level of lending for health is much lower than any other multilateral development bank despite the fact that the majority of deaths globally from TB and many childhood infectious diseases occur in Asia. While the amount of its lending for the health sector has increased since 1978, the proportion of total lending devoted to health has stayed the same at about 1.5%. This low number cannot be accounted for simply because the Bank does not make low-interest loans to India or China while, for instance, the World Bank has. Even excluding China and India, World Bank lending for health in Asia and the Pacific in 1996 was 7.3% of lending, more than 4 times the Asian Development Bank's lending. The $40 million we are taking away from the Asian Development Bank is better spent combating the adverse economic impacts of TB. TB has had a devastating social and economic impact on Asia and other regions. Because patients lose an average of 3 to 4 working months a year, they lose 20 to 30 percent of the family's income. Seventy five percent of TB infections and deaths are people between the ages of 15 and 54--most of them workers. In India, the annual cost to that nation's economy is $3 billion. About 70% of households went into debt because of health care bills related to TB. This is not surprising when you consider that, in India, the cost to patients for treatment is about $125 U.S. dollars, more than half the annual income of a daily wage laborer. By using this $40 million to combat TB we will keep hundreds of thousands of folks working and that has a direct impact on Asia's economy--an impact that cannot be matched by the Asian Development Bank. We need to battle TB abroad because it is appearing on our borders. That's a sound investment--and one we should all support.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, life is about choices and priorities. Like a lot of Democrats, and I am not one of those 48 and I am proud of it, that supported the Republican plan, I do support eliminating the marriage tax penalty. But there is a reasonable way to do it. That is one choice we can make. That is a priority. It is not the only priority we have on this floor. Sometimes I think the majority forgets that these days are not days in an end. We have to look at the whole picture. But one cannot have it both ways. One cannot increase the defense spending like they want to do, provide veterans benefits that we all want to do, to provide health care, do what we need to do about education, providing smaller class sizes and actually buildings that are safe, provide prescription drugs for our seniors and not a fake plan that just gives them an insurance policy, and really safeguard Medicare for the next generation. One cannot do all that and still promise the world in tax cuts. One cannot do it without going back to the deficit spending that they all say they are against. One could go back to that spending that says we are going to spend $200 billion more a year than what we are doing, than what we are taking in. That is what is wrong with the Republican plan for marriage tax penalty. We need to eliminate it. We need to eliminate it on a reasonable basis. But we need to make sure we continue our priorities as not just tax cuts, tax cuts, tax cuts. Now that we have a budget in balance and actually a surplus, we need to make sure we take care of what the American people want us to do. Those same people that the gentleman from New York (Mr. Fossella) said a while ago have a few bucks in their pocket, they want to take maybe an extra vacation. I will tell my colleagues what they would rather have is prescription drugs for their parent than maybe have that money in their pocket, because those are the choices we are making on this floor today. We need to make sure that we provide education for those children that the gentleman from New York (Mr. Fossella) wants to take care of, veterans health care, prescription drugs for seniors. Maybe they ought to listen to their Senator from Delaware who wants to make it part of Medicare. Medicare providers need assistance, Mr. Speaker. Life is about choices and priorities, and hopefully we will make the right one today.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I want to thank the gentleman from Texas (Mr. Turner), my good friend and former Texas State representative, and I served with the gentleman from Texas (Mr. Turner), Texas State senator, former mayor, and now Member of Congress, for putting together this Special Order tonight. This is not a national security issue where everybody is only going to have to listen to folks from our part of the country tonight. We have the gentlewoman from Connecticut (Ms. DeLauro) and also the gentleman from New Jersey (Mr. Pallone), so they will not have to hear Texas and Arkansas accents all this evening on this important issue. But it is a national issue. I know people just like to hear us because we talk a little slower. But no matter how we talk, I think we are united on this one issue because we know that, from Texas, we call it buying a pig in a poke. I think what the House passed the week before the 4th of July was a travesty. It was something that the seniors can see through, and we said that on the floor. That is why I think it only passed by three votes as the gentleman from Texas said. I am glad we are using this time to continue to explain the fallacy of that bill that was passed, that our Republicans colleagues had succeeded in passing a prescription drug benefit that provides more political cover than it provides for prescription coverage for our Nation's seniors. The legislation was designed to benefit the companies who make the prescription drugs and not necessarily our seniors. Just like the Patients' Bill of Rights and education funding, my colleagues on the other side of the aisle are using their same old strategy. They water down legislation. They pass a caption that sounds good, but it does not have any benefit to our folks. Ultimately, it will be a failure because all they want to do is get them past the November election. Congress, our own budget office, concluded that more than half of our Medicare beneficiaries who do not have drug coverage today would not be covered by the Republican private insurance plan. I cannot stress that too much. It is an insurance plan. Like the gentleman from Texas said, it is like buying insurance against haircuts. Everyone of us needs one, although I have to admit some of us do not need as many as we did a few years ago, but we still get them even though we do not need them as much. What is more frustrating is we did not even get the chance to offer an alternative plan. Again, not only is their plan bad, but they were so afraid to defend it that they thought maybe an alternative plan, and again we have a Democratic plan I will talk about in a minute, but any alternative they did not even want to have a vote on. So not only do they pass a bill that I think is hurting seniors, but they are even subverting our process here in the House. All of us ought to have an opportunity to give choices. In fact, it is interesting, I believe in free enterprise, just like my colleagues on the other side of the aisle, but I believe in competition. On the prescription drug benefit they did not want to have competition on their bill because it could not hold water to the alternative plan we had. The Democratic proposal provided both a universal and voluntary benefit to seniors. It was a cost effective and reliable benefit. Under the Democratic plan premiums would be lower for seniors and coverage would be higher. That is why they did not want that competition they are always talking about. Instead, the House of Representatives, by three votes, as the gentleman said, passed a flawed piece of legislation that will cost our seniors more each year and give them less. Some say the premiums could even double because it is a straight subsidy to the insurance industry who know that they cannot make money selling it, and it would be little benefit to our middle income seniors, seniors who just barely are above the poverty line and cannot afford the prescriptions that they have now. It allows insurance companies to decide which drugs they would cover and how much they would charge. It would not be a guaranteed benefit and it would not be any standard benefit that our seniors could depend on. So our seniors would have to go back to their insurance company every time. I have talked to lots of seniors over the last couple of years about this issue and they really want their prescriptions. They do not want an insurance policy. That is the frustration. I have met with seniors in my district, like the gentleman has in his district, and they have serious financial hardships due to the high cost of prescription drugs. They have been able to plan, as best they can, for their retirement, with Social Security as probably the biggest part of their income. They may have a little savings, a little pension, but they cannot afford $400 or $500 prescription medications. They have shown me their prescription drug bills at our town hall meetings, and I do not see how they survive. These seniors have to choose between paying their bills, their utilities in the summer, and in Texas you cannot turn off the air conditioner or you will die of heat stroke. Just like those in the north, in the winter, would die of freezing. We do not want seniors to have to choose between turning off their air-conditioning or buying their prescriptions, or saying they will only take that blood pressure medicine every other day instead of every day, or even skimping on the food that they eat. I know I will be meeting with these seniors again and again over the next few months, and it is frustrating because I will have to tell them, yes, they may have a benefit, but only if their insurance company decides they can have it. Again, it is going to depend on the insurance company. We should be putting benefits in the hands of senior citizens and not the pharmaceutical manufacturers. We should be providing a secure and stable and reliable benefit instead of creating a new bureaucratic nightmare. The Republican plan created a new Federal bureaucracy. Not only insurance but it created a new Federal bureaucracy. Instead of using the current bureaucracy that we want to make more cost effective, we should be building up Medicare instead of tearing it down. Seniors deserve more than just a voucher. They need to have a real workable prescription drug benefit plan. I hope this Congress ultimately will work across party lines and develop a bipartisan bill. We could not do it in the House. Maybe the U.S. Senate will take the leadership and provide a bill similar to the bill that we tried to offer. In the Senate they have more democratic rules than we do here in the House. That is with a little ``d'' not partisan ``d.'' Hopefully, the Senate will allow an alternative plan and it will have a meaningful Medicare prescription drug benefit for all our seniors. Again, I could stand here all night, but we have our colleagues from New Jersey and from Connecticut here. Again, I appreciate the gentleman's leadership on providing this special order tonight. We need to keep beating that drum, because, frankly, that bill would not have been on the floor 2 weeks ago if it had not been for us talking about it over the last 2 years. We need to keep that up, because not only do we need the bill on the floor but we need real legislation that will help our seniors. I thank the gentleman for this time tonight.