Gene Green

Mr. GREEN of Texas

Mr. GREEN of Texas. Let me get back to our managed care issue. Sometime we can have a discussion on the floor on that. I know I have some other colleagues who are going to be here. Mr. Speaker, let me talk about some of the numbers that we have seen. I quoted earlier the Kaiser Harvard study of doctors. Almost 90 percent of doctors report denials by managed care plans of services they requested for their patients. We can see how many, over 80 percent overall portion of doctors saying their request for some type of health, 87 percent; 79 percent portion saying their request for prescription drugs had been denied; 69 percent portion say their requests for diagnostic tests have been denied. Sixty-nine percent of the doctors are saying they have had experience with that. Again, that is why we need to make sure that doctors can talk to their patients and have the freedom of speech when they talk to their patients. That is why it is so important that we pass the conference committee work as diligently as we can, but that they make sure they do not send us out a fig leaf, they do not send us out something in an election year that is just saying the House and the Senate passed a managed care reform. We need a real Patients' Bill of Rights, real HMO reform. This House took the bold step last year and passed, on a bipartisan vote, the Dingell-Norwood bill. That is a strong bill that was patterned after what States have found successful. I see my colleague from Houston, the gentlewoman from Texas (Ms. Jackson-Lee). We share Houston, Texas, and I would like to yield time to her.

Mr. GREEN of Texas. That is just for people who qualify for Medicaid.

Mr. GREEN of Texas. That is the history of managed care reform in Texas. There are things that I am proud to be a Texan always; but obviously we have not done as well as we should on the CHIPs program and those prescriptions that you talk about on Medicaid; I think our seniors in Texas only receive three prescriptions. That is better than none, obviously, if you are poor and on Medicaid.

Mr. GREEN of Texas. You remember when the legislature passed the HMO reform bill or managed care reform bill in Texas and it was passed by the legislature and it became law this time, though; but the governor did not veto it, he did not sign it, it became law without his signature.

Mr. GREEN of Texas. Were you in the legislature in 1997?

Mr. GREEN of Texas. In 1997 you were elected to Congress in a special election, I believe.

Mr. GREEN of Texas. In 1995, the State of Texas passed the first strong managed care reform bill, HMO reform bill, passed both the House and the Senate and the governor vetoed it in 1995.

Mr. GREEN of Texas. I thank the gentleman from Texas (Mr. Rodriguez) for being here today. In fact you have covered so many issues that are important. TRICARE obviously even in Houston where we do not have an Army medical hospital, a Navy hospital or whatever, we have a VA but we have a lot of veterans. It is an issue there. You were in the state legislature and a State House member in 1995.

Mr. GREEN of Texas. Mr. Speaker, I want to compliment the gentleman from Arkansas (Mr. Berry) for his leadership on this issue not only here on the House floor tonight but for the last over a year with our moderate-conservative coalition of Democrats, our Blue Dog Coalition. And I will not ask you what a Blue Dog is, but your leadership has helped a great deal. Mr. Speaker, I yield to my colleague from San Antonio, Texas (Mr. Rodriguez), a former roommate for a year and served with him in the State House when I was in the legislature.

Mr. GREEN of Texas. Mr. Speaker, I thank our Democratic leader for allowing us to take the first hour tonight to talk about the Patients' Bill of Rights. I know that we have been talking about this for many years now it seems like, not only the last Congress but also last year and this year. We actually have a conference committee that is meeting now and had their first meeting. The concern has been expressed. It took that conference committee a good while to meet since it was appointed last year, and the concern was that the conference committee was not reflective of the final vote on the House floor. But be that as it may, that is the way life is. And so now a number of us are trying to make sure that we continue the effort to have real managed care reform in this Congress, not next year, because the issues are so important. American people support the need for real HMO reform. In fact, last year, with the bipartisan support of the Norwood-Dingell Patients' Bill of Rights bill, I think most Americans felt like we were going to see some Federal consumer protections. And yet, what we have seen is a bill passed in the Senate that was much weaker even than current law but that the American people supported. The Kaiser Family Foundation shows that 58 percent of Americans are very worried and somewhat worried that if they become sick their health care plan will be more concerned about saving money than providing the best treatment. According to the Kaiser Family Foundation, a full 80 percent of Americans support comprehensive consumer protections. That is up from 71 percent last year. So the support is building; it is not decreasing. The Dingell-Norwood bill is so strongly supported by Americans, by moderates in both political parties, because it holds five principles that are so important. A person that buys insurance should get what they pay for, no excuses, no bureaucratic hassles. A lot of people think bureaucracy is just a function of the Federal Government. That is not the case. We can have insurance company bureaucracy that just cause hassles for people. What we need is an appeals process, independent external appeals, that if an insurance company or HMO company decides that you should not have a certain procedure, then you should be able to go to someone, an outside appeals process, that will work and be swift. Because if it is not swift, then they will just delay the coverage; and health care delayed is health care denied, Mr. Speaker. In an experience in Texas, and we have had an outside appeals process since 1997, so we have had over 2 years of experience in Texas with an independent appeals process, and frankly a little over half the appeals are being found for the patient. My constituents in Texas say, well, we would rather have better than a chance of a flip of a coin when somebody is making a decision on our health care. So we need to have an independent external reviews process that is timely. And again, the Texas experience shows that it is not that costly. In fact, it has actually cut down on lawsuits; and I will talk about that later. But it is being found in favor of the patient over half the time. And that is what is important, the people are getting their health care that they deserve quickly. The second issue is that we need to eliminate gag clauses from insurance policies, that physicians can communicate openly and freely with their patients. A lot of companies are already doing that. And that is great. I want to congratulate them. But we also know that that standard does not only need to go from A-B-C company to X-Y-Z company, it needs to be a standard that everybody ought to feel comfortable with no matter who their insurance carrier is. They ought to be able to go to their physician and be able to have that physician tell them the best possible treatment. Now, whether their company covers it or not, that is not the case. It is the physician that ought to be able to talk to their patient. Third, a person who buys insurance ought to be able to have access to specialists. Women and children who are chronically ill should not need to get a referral every time they go see a physician. If you are a cancer patient or if you are a heart patient, or whatever, you should be able to go to your cardiologist or your oncologist without having to go back to your gatekeeper every time. Because, again, that is bureaucracy thrown up by the private sector, not the public sector, to ultimately limit people's ability to go to the doctor. The access to specialists is so important. I have a situation in my own district. I have a young lady who is in Humble, Texas, the northeast part of my district, and she was getting treatment at a local hospital complex that was close to her; and, all of a sudden, that doctor in that complex lost their contract; and so she was sent across town to Pasadena, Texas, which is also in our district. And that is great; I like them to go in our district. But, Mr. Speaker, for a person to go from one community to the other community because the HMO provider changed the contract is just wrong. Because, again, they were making her travel a great distance to get that specialist care that she needed. The fourth issue that needs to be included is that, when someone buys insurance, they need to know that they can get emergency treatment, they can go straight to the hospital. We all know the reason HMOs are successful. They go to providers and say, we guarantee you a thousand or 5,000 or 10,000 patients; and so they will go to the doctors, the hospitals, and emergency rooms and say, we will put you on our preferred list and that way you will get patients. The problem is that when someone has an emergency, they need to be able to go to the closest emergency room possible. And again, I use the example and have used on the floor here of the House many times that, if I am having chest pains in the evening, how do I know that it is not a heart attack and it may just be the pizza I had. I need to go to the closest hospital or the closest health care provider. And then once the decision is made, then you can go on to your hospital that has a contract with your HMO provider. But you need to be able not to have to pass by emergency rooms to go to an emergency room that may have a contract. So that is important. Also, oftentimes you cannot always get preauthorization for emergency room treatment. The last thing people need is to have the toll-free number and to be put on hold while they are having their chest pains or whatever illness or emergency they may be having. Fifth, a person who buys insurance should be assured that an insurance company is accountable if that insurance company is making decisions in the place of a health care provider or doctor. And we need to make sure that the decision maker is the one responsible and that the decision maker be held accountable if that patient is harmed by that decision. I would like to tell a story. I spoke a couple of years ago to the Harris County Medical Society, Mr. Speaker; and after it was over, during the speech, I talked about my daughter who had just started medical school. She had been in medical school for 2 weeks. And I laughed and I said, my daughter is in medical school. She has been there for 2 weeks, but she is not ready to be in competition to do brain surgery. After I finished talking about Social Security and the budget and everything else, the first question was a doctor said, you know, your daughter, after 2 weeks in medical school has more training than the people who are telling me how to treat my patients. That is wrong, and that is what we need to change. And that is why real HMO reform is important. If doctors are being second guessed by a decision-maker who may not have the training that they need, that decision-maker needs to be accountable. Hopefully, they do have some training and they are. I know the ideal for HMOs and managed care is it can work. But what we have seen in our country is that the managed care issue and the companies have gone from providing whole-person coverage to actually denying coverage in a lot of cases. That is why one of the most important parts of the bill that passed this House with an overwhelmingly bipartisan vote was the decision- makers need to be accountable. If doctors are accountable, then decision-makers need to be if they are telling those doctors how to practice medicine. Now, what we will hear from the insurance company, and we have heard it when this passed that bill last year, is that we are going to have the cost increases, that we will see the cost of insurance going up. Well, Mr. Speaker, we had increases in HMO costs this last year and that bill had not even become law yet. So I think we are seeing increases where that happens. Again, going back to my own experience in the State of Texas. The State of Texas passed what I consider and I think a lot of folks around the country consider the best managed care reform in the country in 1997; and there had been no overwhelming increases other than what happened based on HMOs increasing everywhere. Dallas, Ft. Worth, Houston, Harris County, there have been no increases based on Texas law as compared to other parts of the country that do not have it. Typically, they have increased the same. So we have not seen a huge number of lawsuits or cost increases. The other thing they say, well, you are opening up the court system to lawsuit. Again, after 2 years' experience in Texas, we have not seen but four or five lawsuits filed. In fact, three of them are filed by one attorney in Ft. Worth, Texas. What we have seen, though, is that if you have strong accountability and strong independent reviews, the independent reviews actually will take the place of having to go to the courthouse. In fact, people do not want to go to the courthouse. They typically want the health care. And if you have an external appeals process that is swift and fast, that will save people from having to go hire an attorney and go to the courthouse. Again, in the State of Texas, because over half the cases of the appeals are being found for the patient and the insurance companies are saying, okay, we will pay for that, there is no reason to go to the courthouse. Frankly, if the insurance company is found to be okay, their decision had some medical benefit, then that gives that patient a little saying, well, sure you can go hire your attorney, but now we know when everything is on the table. So we have not had that overwhelming cost increase. One other thing I want to mention is the concern about employers being sued. In fact, in our debate last year and even as recently as last week, I had an employer express concern that, I do not want to be sued. In the Dingell-Norwood bill, or the Norwood-Dingell, depending on which side you are on, I guess, there is specific language in there that prohibits an employer being sued unless this employer is making medical decisions. Again, I use the example of my own experience of purchasing insurance before I was elected to Congress for a small company. And we contracted with three different insurance companies, or contacted them to get prices, and we were not in the position of making those medical decisions or saying to deny coverage. Now, we could buy a Chevrolet plan or we could buy a Cadillac plan. But employers should not be held responsible. In the bill that passed this House, employers are not responsible, although we are hearing that thrown up by a lot of these associations here in Washington, and sometimes I think they mostly want to raise funds and get membership instead of actually address the problem of people having real health insurance that their employers buy. And, as an employer, we paid for that insurance. And I wanted to make sure that my employees received the insurance that we paid for, and oftentimes I felt like I was the arbitrator between the insurance company and my own employees because oftentimes they did not want to pay. We have some great Texas experience over the last 2 years. I know other States have passed legislation like what Texas has passed that set the groundwork. It is ideal. We have used the States as a laboratory. We see it has worked in Texas in a large, urban State with both rural and urban area, both poor and wealthy population. It is something we can do on a national basis to make sure that every insurance policy, not just those that are licensed by the State Board of Insurance in the State of Texas or the Insurance Commission, but all insurance policies are covered. The reason we have national legislation is that over two-thirds of the insurance policies in my own district in Houston are not covered by State law. They are covered under ERISA. They are covered under Federal law. And that is why we need to pass Federal law to complement what the States can do. I see that my colleague, the gentleman from Texas (Mr. Rodriguez), is here and my colleague, the gentleman from Arkansas (Mr. Berry), is here. It is great to have two Members from our part of the country who do not have accents speaking. Mr. Speaker, I yield to my colleague, the gentleman from Arkansas (Mr. Berry).

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise to celebrate the 50th Anniversary of the Blessed Hope Missionary Baptist Church, located in Houston, Texas. Almost 50 years ago, Rev. Jesse E. Green first sought to hold a revival in Wallisville Garden Addition. With the counsel of Brother James Anderson and assistance from the Noble Smith family, a meeting place was found at 3741 Colvin Street. On May 1, 1950, the first services were held at this location. With 19 congregants in attendance, Rev. Green preached, appropriately enough, from John 1:15 with the theme ``Jesus Turns on the Lights.'' With the support of ministers from across the Greater Houston area, the week-long revival services were a success. On May 10, Rev. T.T. Anderson of Beaumont, Texas, called a special meeting of those who had attended the revival and organized a church with the temporary name of ``The Wallisville Garden Station.'' Bros. Anderson and N. Smith were elected deacons, with Bro. Anderson also elected Sunday Church School Superintendent. Sister M. Anderson became Mission President, and Rev. Green was officially elected Pastor of the congregation. One week later, a permanent name for the church was selected and the Blessed Hope Missionary Baptist Church was officially born. Over the first 20 years, the church prospered, growing to include not only the original building, but many additions as well. In 1970, the membership decided that a new building was necessary, and so on March 7, 1971, Blessed Hope moved into its second official home. Again, the church was blessed with growth, both spiritually and numerically. On August 7, 1993, Rev. Green proudly led the congregants into the third home for the church, where services are still held today. As they celebrate both the new millennium and 50 years of praising God, the members of Blessed Hope reflect on the past and look ahead to the future. Rev. Jesse E. Green, founder, longtime pastor, humble servant, and good friend, has been called home by our Lord. The new pastor, LaKeith D. Lee, and the congregation have worked hard to pay off the church mortgage, honor Rev. Green with a new library building, and have completed a Youth Education Building. Further, Blessed Hope has managed to expand its ministry to include outreach, education, evangelism and young adults, just to name a few. Mr. Speaker, I congratulate the members of the Blessed Hope Missionary Baptist Church on their successes over the first 50 years, and look forward to the many more years of good works and holy worship to come.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I thank not only the gentleman from California (Mr. Matsui) but also the members of the Committee on Ways and Means for allowing me to speak. I rise in support of the Senior Citizens' Freedom to Work Act, a legislation that I am proud to be a co-sponsor of and will vote for today. It seems hard to believe that our tax law actually punishes people for working. Yet under the current law, 48,000-plus Texans lose all or part of their Social Security payments each month simply because they want to work. Now if one can work after one is 70 years old, one is not penalized. Seniors who have worked hard their whole lives and paid into the Social Security system for decades should get their Social Security benefits regardless of whether they continue to work. This important legislation puts an end to the inequitable treatment of seniors. My only concern, Mr. Speaker, is that, hopefully, this is not a step toward increasing the retirement age, Congress already did that once, instead of using 65. So hopefully this will not happen. This is a clean bill. It is not loaded down with other provisions. So it does not bust the Federal budget caps that we have talked about. Hopefully, this Congress can address other senior citizens issues, providing prescription medication for seniors, because allowing them to work still may not pay for it.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, on the floor today we will be considering the Senior Citizens' Freedom to Work Act. It allows seniors to work, continue to work without affecting their Social Security. It seems hard to believe that our tax law would actually punish people for working. I am pleased that my colleagues on the Republican side after 6 years have finally decided to help seniors who want to continue working. This is the first we have had a clean vote on this issue. These are the very same seniors, the ones who cannot afford their medication or their prescription because our Medicare system does not cover it. I am glad that we are actually going to let them now work and earn that money so they can pay for their prescriptions, because this Congress has not passed a bill on that. Mr. Speaker, it is estimated that approximately 45 percent of seniors have no prescription benefit. These are the seniors who choose every month between buying food, paying their bills, or buying their medication. Some have to buy their medication but skip days just to make it longer. I am disappointed that this Congress has not moved aggressively on prescription medication for seniors. But at least by passing this bill, we will let them continue to work so they can afford their medication.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, tomorrow is a special day in Texas because tomorrow, March 2, is the first Texas Independence Day of the new millennium. In 1836, 164 years ago today, the Republic of Texas was born. Let me set the stage for what happened 163 years ago. On March 1, 1836, 54 delegates representing settlements across Texas gathered for the Convention of 1836 at the small farm village of Washington-on-the- Brazos. From the beginning, it was an event marked by haste and urgency. Mexican forces under Santa Anna were closing in on the defenders of the Alamo. On March 2, the day after the opening of the convention, the delegates declared the independence of Texas from Mexico. Within days of that announcement, the Alamo would fall, the first in a chain of defeats for the small Texas Army, which would nevertheless emerge victorious at the battle of San Jacinto, 6 weeks later, on April 21. Mr. Speaker, what were these brave Texans fighting for? Up to the point when they gathered at Washington-on-the-Brazos, it was simply to restore the Mexican Constitution of 1824, which had been suspended by Santa Anna. On the night of March 1, however, a group of five men stayed up late into the night, drafting the document that would be approved the next day by the full convention. This document, which echoed the lines of its American counterpart, was the Texas Declaration of Independence. It started off in much the same way, with the words, ``When a government has ceased to protect the lives, liberty and property of the people.'' It spoke of the numerous injustices inflicted upon the settlers of the state of Coahuila y Tejas: the elimination of the state's legislative body, the denial of religious freedom, the elimination of the civil justice system, and the confiscation of firearms being the most intolerable, particularly among Texans. Finally, it ended with the declaration that, because of the injustice of Santa Anna's tyrannical government, Texans were severing their connection with the Mexican nation and declaring themselves ``a free, sovereign, and independent republic . . . fully invested with all the rights and attributes'' that belong to independent nations; and a declaration that they ``fearlessly and confidently'' committed their decision to ``the Supreme Arbiter of the destinies of nations.'' Over the next two weeks, a constitution was drafted and an interim government was formed, despite daily reports from the front detailing the collapse of the Alamo and subsequent advance of the Mexican Army through Texas. On March 17, 1836, the government was forced to flee Washington-on-the-Brazos on the news of the advance of Santa Anna. Just over a month later, however, independence would be secured in the form of a victory over that same army by Sam Houston, a delegate at the very convention, and his courageous fighters at the battle of San Jacinto. Mr. Speaker, let me remind folks from Tennessee that Sam Houston served in this Congress from the State of Tennessee. I have at times told my friends from Tennessee ``The best of Tennessee immigrated to Texas in the 1830's.'' From that point on, Texas was firmly established in the community of nations; and for 10 years she stood as an independent nation, until President James K. Polk signed the treaty admitting Texas to the United States in 1845. Mr. Speaker, I hope the Congress and the whole country will join us in a day that in Texas we celebrate, our schoolchildren celebrate, Texas Independence Day.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, this Congress should have an open floor debate on legislation to help seniors afford the high cost of prescription drugs. We cannot sit on this issue any longer. It is estimated we have 13 million seniors who do not have prescription drug coverage, and the number is increasing rapidly, almost as rapidly as the cost of the drugs they need. These seniors worked hard and paid into the system their entire lives, but now must choose between buying their prescriptions or their groceries. Seniors tell me they have to skip their medication to make it last longer. I recently sent out a questionnaire to constituents in my District in Houston to learn what they think Congress' priorities should be. I received many responses from seniors saying Congress must act immediately to help them with the high cost of prescription drugs. I heard from seniors like Norma Keyes of Houston who writes, ``I need help with my prescriptions. I spend over half my Social Security on prescriptions. I can't get enough money to pay for my house and taxes.'' Joyce Belyeu wrote, ``I am now retired after 53 years of working. I have Medicare and a supplement, but no prescription drug benefit at all. I can't afford the $250 per month for prescription drugs, so I can not take the prescription daily. I skip days.'' We need to do better, and this Congress must do it.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I stand here today wanting to support a reform of the marriage tax penalty. It is wrong that we would punish people for being married, and that is why I would hope that we could support a bill that would be bipartisan. But what we have today is the Republican bill that is really a Trojan horse. I heard it referred to as the Hope Diamond, but it is really a Trojan horse, because half of those benefits in this bill go to people not subject to the marriage tax penalty right now. Let me repeat that, half the benefits of this bill go to the people who do not have any marriage tax penalty. That is what is wrong with this bill. It is irresponsible in size and cost, the GOP bill, its willingness to neglect the long-term needs of our country, Social Security, Medicare, paying down our debt, and even national defense. Later this year we will hear about how they want to do stuff for national defense. Well, you cannot give away the store now and expect to pay for it later. $182 billion would use the surplus in addressing American's priorities by paying down the national debt, Social Security and Medicare. Let me say as a Member of Congress, I would benefit. Like my colleague from Texas, I have a working spouse in Texas who is a schoolteacher. I would benefit from the Republican bill. But it is wrong to do that for the income level we have. It ought to go to the people who really need it, and that is what is wrong with this bill. So Members of Congress should really vote against it, because it benefits us too much. Half the benefits, again, will go to the taxpayers who have no marriage tax penalty. According to the Citizens for Tax Justice, the Republican bill would give the lion's share of the tax cut to higher income families. Two-thirds of the tax relief would go to 30 percent of the married couples with incomes over $75,000 due to the large tax bracket. Let me also say we have a Democratic plan that scales it down and really addresses marriage tax relief. Understand, it works with the alternative minimum tax, so it does not give you with one hand and take it away with another. Their bill does. Over the last few months I have had a chance to do town hall meetings. We were out for 2 months. We did a newsletter. I know I am going to hear in a few minutes from my Republican colleague about how many people will not benefit. Let me tell you, I have 322,000 taxpayers in my district who pay into Social Security, and they want it there 30 and 40 years from now instead of giving away the store now. I have 55,000 recipients on Social Security and Medicare now. They want that benefit now, not given away in a tax cut that is irresponsible. We sent out a newsletter, and let me talk about it. Mr. Barrera from southeast Houston, ``It is so important that you remember, we need to pay down the debt, strengthen Social Security, a prescription drug benefit, fund education, and then give me a tax cut.'' That is from southeast Houston. We have a young lady from north side Houston, Ms. Kubala. She said, ``You need to show more concern for the not-so-rich people instead of catering to the rich.'' I do not think that I have a better statement than my constituent for this bill today. We have a gentleman from the North Shore area of northeast Houston. ``It isn't that we do not want a tax cut, but there are other things more important.'' Mr. Speaker, I cannot say it better than my own constituents.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I share the concern of my colleague from North Carolina on our military pay. Hopefully we made a down payment last year and will continue it this year. My concern, Mr. Speaker and Members, and what I want to talk about today is, we are marking the 4th anniversary for one of the longest lockouts in U.S. history that is in my district. On February 5, 1996, the management of Crown Central Petroleum ordered the union workers to leave its refinery in Pasadena, Texas, and lock the gates behind them. By the next day, the company had replaced all 252 union members with lower cost and inexperienced temporary workers. What caused the lockout? The only possible reason is Crown Petroleum wanted to break the union. During the contract negotiations, the union stated they had no intentions of striking. In fact, Crown Petroleum's reaction was to order an immediate lockout. Before negotiators for the employees had a chance to react, they were escorted out of the refinery. Crown tried to justify the lockout by saying that they had committed actions of sabotage, and yet Crown later invited these same employees to return to work provided they agreed to the company's demands. The concern I have, Mr. Speaker, is if someone did sabotage the plant, they need to be prosecuted under the laws, but management should not use it as a reason for not allowing these people to come back to work who had been there many years. If they agreed to the company demands, it would have been an elimination of over 40 percent of the work force. These highly sensitive jobs, that are now performed by temporary and less skilled workers, were issues at the negotiating table that were very contentious. The company was trying to rewrite the entire union contract and eliminate a third of the employees and eliminate the worker protections for older employees. The employees were willing to negotiate, but Crown not only wanted to have their demands met, they opted for a lockout. Four years, Mr. Speaker, is one of the longest lockouts in history. Four years later, friends and neighbors, my constituents, are still not working. Their lives have been radically changed for standing up and insisting on safe and fair working conditions. Employees like Marshall Norman, a 16 year employee, had his medical insurance canceled while his wife was pregnant and his daughter was diagnosed with leukemia. Another constituent, John Grant, served his country in Vietnam and as a Marine guard in the White House. He has only worked sporadically since the lockout. Hardy Smith, a 25 year employee, lost his credit and went from making $18 an hour to $6.50 an hour. Henry Godbolt, a 24-year employee, is struggling to make ends meet for his family, including paying for his daughter's education. He is working odd jobs like mowing lawns and washing windows. These are good and honest hard working Americans who are being forced to struggle because their employer locked them out. We need to have an end to this madness. For the last year, Mr. Speaker, I have tried to work and offer whatever assistance my office could to sit down and work it out between the plant owners and the employees, and we have not had any luck. Despite many years of hardships and fighting back to reclaim their lives, the Paper, Allied-Industrial and Chemical Energy Workers Union, PACE, which used to be the Oil Chemical and Atomic Workers Union, is the union that represents these locked out workers, along with the AFL- CIO, and they have been boycotting the Crown gasoline stations and convenience stores. The locked out workers have traveled to Maryland, Virginia, North Carolina and South Carolina, Georgia and Alabama to promote this boycott and have urged union members as well as other concerned citizens to support them. The boycott, or the ``Don't Buy Crown Gasoline'' campaign is endorsed by groups ranging from the Rainbow/ Push Coalition to the Environmental Defense Fund to the Labor Union Women. This is only a small sample of a long list of groups who have supported this boycott. With the employees' hard work and persistence, along with the support of many groups and individuals, the boycott has been successful in decreasing the sales of Crown gasoline and its products. The boycott may become our only hope to bring reason back to this issue. I would hope that the management and the owners of Crown would realize that not only my constituents but their former employees want to work and want to do a good job and make that a producing plant. Let us end this nightmare. Mr. Speaker, this Saturday, February 5, from 11 a.m. to 2 p.m., many of these hard working employees will mark the 4th anniversary of the lockout at the PACE local union at 704 Pasadena Freeway. Mr. Speaker, I was home last week and met with a few of the members, and, believe me, I bought this T-shirt because they could not afford to give it to us, but it talks about trying to end the lockout at Crown Petroleum. I would hope that through this special order today that we could encourage not only the employees but also the management to sit down and get these people back to work.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I follow my colleague from Florida in saying that I agree that we should work together. In fact, last year this House passed and worked very hard on a bipartisan Norwood-Dingell bill, on managed care reform, but we have not seen any action in months. We should stop the delay in managed care reform. We do not need gimmicks or watered down proposals that wind up doing nothing for patients. In my home State of Texas, we passed these protections in 1997 included in the Norwood-Dingell bill, and there have been no massive premium increases or mass filing of lawsuits that are used against the bill. What Texas residents do have is elimination of gag clauses, open access to specialists, timely appeals processes, coverage for emergency care and holding the medical decision maker accountable. We do not need any more delays. We need to act this year on a bipartisan basis and pass this bill. Hopefully, the conference committee will at last meet after all these months and pass real HMO reform, and today we will have that opportunity with the motion to instruct the conference committee. We need HMO reform now.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, in closing, I would like to say, sure, I would like to talk about access, prescription medication for seniors, medical mistakes. Let us take it one step at a time.

Mr. GREEN of Texas. Well, just in closing, because I think this is important, the first day we have actually had votes, other than a rollcall vote last week, the HMO reform bill is literally the top priority for us. Sure, we have to deal with the budget and we need to deal with medical mistakes, and there are hearings in the Senate going on, because access is important; but let us deal with one issue at a time. I think the American people understand that if someone is opposed to something and they do not really want to oppose it, they will throw up something else. It is kind of like juggling balls. If I throw the red one over here, maybe my colleague will look at that instead of what I am really doing. That is what concerns me after the debate today. I would hope that that conference committee would meet. I am concerned because of the number of members on it who did not vote for the bill that passed the House. And there were lots of Republican Members who voted for the bill, but, again, it looks like it is stacked and it is weighted against a real HMO reform bill, particularly when we look at what the Senate passed and what the Senate side will be doing. But I hope the American people understand that we will continue to talk about this over the next few months unless we have a vote. And even if we have a vote, if they come back with a weak milquetoast piece of legislation, and next year let us pass something that sounds good, then I will be up here saying, no, it is not good. Let us not pass something that is really a fake, this is a fig leaf. After 4 months of delay, I would think that now we may see some action. And if they come back, well, let us throw something out there and we want something that is really HMO reform patterned after what success that has happened not just in Texas but with States all over the country, we have a pattern that has worked. For example, when we talk about the external appeals process, the external appeals work in Texas is they have the right to go to court afterwards. Fifty-two percent of the appeals are found in favor of the patient. Now, sure, half of them, a little less than half, are found in favor of the insurance company. And so, if I as a patient take an appeal in the external appeals process and I am not entitled to that type of service or that type of treatment, then I am probably not going to go to the courthouse. But I tell my colleagues, if 52, better than half, of the people in the insurance company are wrong the first time and if we do not pass a strong appeals process with a backup of the right to go to the courthouse, then those half of those people in Texas who are finding now, or more than half, that they really have some good coverage and they have that treatment that they need, they will be lost. And so, that is why this issue is so important not just for those of us who run for office and serve here but for the people we represent. I represent both Democrats and Republicans, like my colleague; and I have found that in my district, I do not ask people whether they are Democrat or Republican when they call me, but it is interesting when the people who do call, we have a lot of people who say, I am a Republican but I need to have help with my HMO problem. So I think it is an issue that cuts across party lines. It is important. The polls have shown that, not only Republicans and Democrats, but Independents. And that is why we had the vote and will continue this effort.

Mr. GREEN of Texas. Madam Speaker, over the next hour, we will be hearing from lots of Members talking about not only the vote we took today on the motion to instruct conferees, but talk about the need for managed care reform and HMO reform. Because Congress, being out of session since late November, and having passed the managed care reform bill actually in early October, here we are February 1 and we are back in session with no hope in sight of the conference committee actually meeting. They have not met for 4 months. Madam Speaker, that is the concern we have. That issue is still on the front burner for the American people. That is why today there was a great deal of time spent on H.R. 2990, instructing conferees on managed care that was authored by the gentleman from Arkansas (Mr. Berry) who was trying to move that issue further along. In fact, since the motion to instruct passed, Madam Speaker, we hopefully will see our conference committee meeting not maybe at the end of February or March, but hopefully in the next 10 days; instead of seeing the delay, delay, delay that we have seen over the last 4 months, and not just over the last 4 months but over the last number of years whenever the House has considered managed care reform, even if a strong bill passes like it did this last time. And, particularly, when we see that the conference committee appointees from the majority side, not one of them voted for the bill that passed this House in early October. So it kind of makes us a little suspicious that the bill that we worked so hard to pass on the bipartisan bill, Norwood-Dingell, and it is not as bipartisan as I would like, although it passed the House on a very bipartisan vote. And after months of negotiation we reached a consensus, again to have that bipartisan vote. It has been 4 months since we passed that bill, but we have not seen any action on the Norwood-Dingell HMO reform bill. Our Republican leadership continues to, I do not know, maybe because we were out of session, but it seems like they delay. And when we talk about gimmicks and watered down proposals to take away the strength from a real managed care reform bill or HMO reform bill, because we heard today the bill that was actually considered had lots of different health care issues in it, including access. I would like, as a Democrat, particularly to talk about access. We have 44 million Americans without some type of health insurance coverage. But I know we have 48 million Americans who have self-insured employer plans that do not have the protections that we need to have in this HMO reform bill. So let us take it one step at a time and have it. Let us pass an HMO reform bill so those 44 million Americans, when they do get some type of insurance, hopefully we will pass some tax incentives and some encouragement for people to do it so that they will have a policy that will mean something instead of a worthless piece of paper. Again, we have not had one meeting of the conference committee on the managed care reform bill. And I think this is unacceptable for not only those of us who voted in the majority, but those 44 million Americans who belong to the self-insured health insurance plans that oftentimes have little protections from neglectful and wrongful decisions made by their insurance plans. My colleagues on the other side of the aisle, hopefully they are not choosing to ignore the will of the American people, because I have seen the poll numbers and they have been consistent for over a year. The people want a strong Patients' Bill of Rights and managed care reform bill so when they go to the doctor or to the hospital, that they will know that they have some protections. They will be able to choose to talk with their physician. Our bill eliminates the gag clauses to where a physician and a patient can actually talk to each other without the managed care provider or the insurance company saying, No, we do not cover that procedure so you cannot even tell the patient that that is available; allows open access to specialists for women and children; gives patients timely access to an appeals process. And, again, health care delayed is health care denied. And if we do not have a swift and sure appeals process, then we are actually delaying health care and actually denying that health care. It provides coverage for emergency care, and I see my colleague the gentleman from New Jersey (Mr. Pallone) is here and he and I have talked for many months here on the floor that Americans should not have to drive by the closest emergency room to go to the one on their list. They ought to be stabilized at the closest one and then be transferred once they know whether the chest pains they are having is really the pizza they had last night or may actually be a heart attack. So we need to have the emergency care as soon as possible. Ensure that patients can continue to see the same health provider, even if their provider leaves the plan or their plan changes. One of the concerns that we have is the continued changes in the plans. Physicians and providers go in and out of the plan, and also facilities, and the patients are the ones that seem like they are being whipsawed around and they are losing that health care in there. One of the most important things that makes everything else in this laundry list important is the medical decision maker has to be held accountable. We have the health care provider, the doctor, held accountable under tort law. But if that doctor is being told by someone in Hartford or Omaha, No, you cannot do that, then that person needs to be responsible. There is a fear that we have heard that employers are going to be sued. But in the bill that passed the House, that was not in the intent or the language of that bill, unless that employer is making that decision. But if an employer goes out and buys insurance and says, yes, I can afford this plan and I am going to pay for this plan, and turns it over to their carrier to make those decisions, then that carrier is the one, not the employer. And if there is better language to insulate the employer from being sued, I would hope the conference committee would consider it and hopefully even pass it. In my home state of Texas which passed many of the patient protections included in the Norwood bill, there has been no premium increases based on HMO reform and there has been no mass lawsuits that have been filed, some of the things that we heard last year in some of the opposition. What Texas residents do have are health care protections that were in the Norwood-Dingell bill that we need to expand to all Americans, not just Texans who happen to have a policy that is licensed under the laws of the State of Texas. In fact in my district in Houston, it is estimated that 60 percent of the people have an insurance plan which comes under ERISA or federal law and not under State law. So it does not do any good for the legislatures of all 50 States to pass these bills if 60 percent of the people are covered under Federal law. That is why I think it is important that we have all these protections in the bill; that a conference committee meet and come back with a strong bill as strong as that which passed the House. Again, there may be some small nuances that need to be changed, but not something like what passed the U.S. Senate because that one I would hope would be vetoed. The Senate bill actually overturns some of the State laws that have been passed. That is why I was pleased when the gentleman from Arkansas (Mr. Berry) offered a motion to instruct conferees to begin meetings and pass a bill that provides real protections for patients. However, Madam Speaker, we should not have to resort to those tactics to have any action on managed care reform. We ought to be able to do it because it is right. We should not have stonewalling on a conference committee that actually should have been meeting for the last 4 months but has not. The American people have asked us to pass a real HMO reform bill and it should be at the top of our agenda and we should do it without any more delays. The conference committee needs to meet and promptly decide on a bill that protects patients and pass real HMO reform. With that, I yield to the gentleman from New Jersey (Mr. Pallone), the chair of our Health Task Force in the Democratic Caucus. And I understand each conference has a task force and I am glad the gentleman is chair of ours.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, it has been 4 months since we passed the bipartisan Norwood-Dingell bill and nothing has been done. We have worked hard to reach that consensus, but the opposition continues to delay the real reform with gimmicks and watered down proposals that will wind up doing nothing for patients. Not only is the conference committee stacked with Members who voted against the bill, Mr. Speaker, there has not been one meeting since the bill was passed 4 months ago. This is unacceptable, Mr. Speaker. We have 48 million Americans who belong to self-funded health insurance plans that have very little protection from neglectful and wrongful decisions made by their insurance plans. Now, I would like to have access like my colleague from Arizona talks about, but it does not do any good to have access if we do not have a plan that is worth anything, it is not worth the dollar that their employer or they pay for it. It is not worth it. We cannot stand by and allow the delay and the maneuvering to continue to pass a weak bill. Millions of people need help and are suffering from the consequences and decisions not made by doctors but made by clerks. What I have heard is that some of the folks who are making those decisions do not even have the training that a first-year medical student may have even before they enter. So we need to pass a strong bill. I am pleased that my colleague from Arkansas is offering this motion to instruct conferees. We are going to be here every week until we see some action from the conference committee. And 4 months is too long.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, it is no secret that I greatly admire President Lyndon B. Johnson. Beginning last year, I have submitted, for the Congressional Record, several well written articles regarding the accomplishments of this historic Texan. Even today, his domestic agenda still influences our lives. On December 31, 1999, the Houston Chronicle published an article written by Stuart Lutz in which he makes the case that President Johnson should be considered the most influential American of the past 50 years. In his article, Mr. Lutz writes that ``the 36th president, in his 62-month term, radically advanced civil rights, initiated dozens of progressive federal programs to eradicate poverty and train new workers, expanded a small war in Southeast Asia and caused Americans to question the integrity of the presidency.'' He concludes by stating that ``it is hard, however, to see that anyone has had a greater influence on Americans' everyday lives over the past 50 years than the Texas giant, Lyndon Johnson.'' Mr. Speaker, I would like to conclude my remarks by including, in its entirety, this very important article The Case for a Texas Giant as Man of the Half Century (By Stuart Lutz) The Great Society, the Civil Rights Act of 1964, the Gulf of Tonkin, Medicaid, the credibility gap, Vietnam and the War on Poverty. These actions and events are among the most powerful of the second half of the 20th century. They also all have the indelible stamp of Lyndon Baines Johnson, the most influential American of the past 50 years. The 36th president, in his 62-month term, radically advanced civil rights, initiated dozens of progressive federal programs to eradicate poverty and train new worker, expanded a small war in Southeast Asia and caused Americans to question the integrity of the presidency. His forceful actions that greatly changed America for the better and worse came in four distinct areas: civil rights; Vietnam; governmental lying; and progressive domestic legislation. Let's examine them one by one: Civil rights. Johnson desperately wanted to be remembered as the president who did more for African-Americans than anyone since Abraham Lincoln. Using his trademark legislative maneuvering in the wake of the Kennedy assassination, he secured passage of the 1964 Civil Rights Act. In a few pen strokes, he outlawed segregation in employment and public accommodations, thus giving Dr. Martin Luther King Jr's goal of racial equality a legislative framework. To further his commitment to civil rights, LBJ signed the 1965 Voting Rights Act that banned literacy tests, encouraged minority voter registration and empowered the federal government to enforce its provisions. He also appointed Thurgood Marshall as the first African-American Supreme Court justice. Johnson's actions changed voting blocs and paved the way for minority Cabinet members, mayors and governors. Most importantly, to America's youth today, ``Colored'' signs and segregated accommodations are antiques of the foggy past. Vietnam. This was the most important and influential American event in the second half of the 20th century. Johnson turned a small conflict into a war involving over 500,000 American troops. After the manufactured Gulf of Tonkin ``incident'' in August 1964, Johnson secured the right to wage virtually unlimited war on North Vietnam and knowingly lied about the war's failing results. Vietnam assumes such overriding importance in the second half of the century because it is the defining and dividing event for the baby boom generation, since virtually all males needed to decide whether to be drafted, evade the military either legally or illegally, or flee to Canada. Since Lyndon Johnson's war, the American public has been reluctant to allow presidents to send troops abroad--whether to Grenada, Iraq or Bosnia. Vietnam caused American foreign policy to become more isolationist and made Americans reconsider Teddy Roosevelt's vision of our role as the world's policeman. Government lying. When Johnson was inaugurated at Dallas' Love Field following John Kennedy's assassination, Americans respected and generally believed their presidents. By early 1968, LBJ's self-created ``credibility gap'' forced him to give speeches only at military bases, and he chose not to run for re-election. Johnson's falsehoods about Vietnam led Sen. Robert Kennedy of New York, his challenger for the Democratic nomination, to state that Johnson ``tells so many lies that he convinces himself he's telling the truth.'' Although Richard Nixon was the only president to resign, LBJ's administration set the stage. Since Johnson's term in office, the American public has never fully believed the statements of succeeding presidents, whether it was Ronald Reagan's poor recollection of the Iran-contra scandal or Bill Clinton's ``I didn't inhale'' statement. Progressive legislation. Lyndon Johnson wanted to be best remembered as ``the president who educated young children . . . helped to feed the hungry . . . and helped the poor to find their own way.'' Johnson's progressive domestic legislation, popularly known as the Great Society, included Medicare and Medicaid, the Job Corps, Head Start, the Water Quality Act, the Clean Air Act, the Fair Packaging and Labeling Act and the Highway Safety Act. These laws not only increased the power of the federal government and made it a watchdog for citizens, they provided a safety net for all, particularly the poor, elderly and disadvantaged. With the exception of Franklin Roosevelt, no other 20th- century president has passed so much influential domestic legislation. Today, Johnson's three-decade-old vision is hotly debated on Capitol Hill as Congress tries to decentralize welfare and keep Medicare afloat. Many Americans have had a profound effect over the past half century. It is hard, however, to see that anyone has had a greater influence on Americans' everyday lives over the past 50 yeas than the Texas giant, Lyndon Johnson.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today to celebrate the 20th anniversary of the Latino Learning Center and to express my appreciation to everyone associated with this wonderful organization. The Latino Learning Center was founded in November 1979 to provide employment and educational needs in our community and is governed by a 15-member board of directors comprising of community, civic and corporate leaders. This mission of the Latino Learning Center is to see that all low-income people in Houston, specifically the residents of near East End and near North Side communities, have the opportunity for education and human support services. Since its inception, the Latino Learning Center has dutifully provided these services and has positively impacted the lives of our citizens. The Latino Learning Center's success is widely known and has resulted in more than 6,000 individuals graduating from its training programs. The Latino Learning Center has a very interesting history. It was established as a Texas nonprofit organization. It received a donation of land and buildings in 1981-82 from the Magnolia Business Center, Inc. Since the buildings were previously used as warehouses, significant renovation was necessary in order to upgrade the facility. The Latino Learning Center's founders embarked upon an aggressive fundraising campaign to secure the initial $150,000 necessary for the renovation process. As the result of the boards diligence, sufficient charitable gifts from the private sector were obtained to structurally transform the building and acquire adjacent parking space. Due to generous philanthropic participation of many Houstonians, private sector support and some public sector funds, the Latino Learning Center became an established reality. In July 1984, an open house ceremony was held and classes and community services began within the year. Over the past 20 years, the Latino Learning Center has established strong ties with the community by serving as a Multipurpose center. The Latino Learning Center is utilized by many civic organizations including LULAC, the American GI Forum, the Mexican-American Sheriff's Organization, the Union of Hispanic METRO employees, the Hispanic Organization of Postal Employees--HOPE, and many others. It is also used to conduct meetings, plan events of benefit for the community, conduct community/media press conferences, and perform special events such as dispensing food baskets for the poor during the holiday season. Mr. Speaker, I am proud to congratulate the Latino Learning Center on its 20th anniversary, and I hope they remain in our community for many years to come. I also ask that my colleagues in the House join me in expressing our appreciation for the services and the commitment of everyone associated with this wonderful center.

Mr. GREEN of Texas

Mr. GREEN of Texas. Mr. Speaker, I rise today to ask my colleagues to join me in honoring Dr. Charles H. McCollum. Dr. McCollum has been selected by the Houston Surgical Society to receive their ``Distinguished Houston Surgeon'' award for 2000. Dr. McCollum has a long and honorable list of achievements and service to both our nation and our local community. Dr. McCollum was born in Fort Worth, TX in 1934. He graduated from the University of Texas in Austin with a bachelor of arts degree in 1955. Dr. McCollum then continued his education at the University of Texas Medical Branch in Galveston, where he received his medical degree. Soon after completing his residency at the University of Pennsylvania, Dr. McCollum was promoted to captain of the U.S. Army Reserve, where he served until 1969. In 1975, he was named president of the Texas Chapter of American College of Chest Physicians. In 1977, he was named an officer with the Michael E. DeBakey International Surgical Society, a position he held until 1992. He has also been president of the Houston Surgical Society, Southwestern Surgical Society, and the Texas Surgical Society. Dr. McCollum has also held several appointments with Baylor College of Medicine including his present position as professor of surgery. Mr. Speaker, this is only a brief glimpse of Dr. McCollum's illustrious career in serving our community, State, and country. I ask that my colleagues join me today in honoring Dr. Charles H. McCollum.