Gene Green

Mr. GREEN

Mr. GREEN. Mr. Speaker, for months we have heard and been hearing about how expensive the Patients' Bill of Rights is. The insurance industry, managed care organizations, HMOs, and big business have repeatedly tried to scare the American public, saying that the bill would dramatically raise premiums and force employers to drop health insurance coverage for their employees. Last week we found out how much dramatically really is. The nonpartisan Congressional Budget Office, after thoroughly analyzing each section of the Dingell-Ganske Patients' Bill of Rights, has determined that the bill would cost beneficiaries only $2 a month. That is right. For the cost of a Happy Meal at McDonald's, patients in managed care would have what they need: accountability; access to specialists; no gag rule on their providers; and a swift insurer appeals process. It is the simple, most logical provision in the Patients' Bill of Rights because it puts the HMOs on the same level as every other industry in this country. They have to be accountable for their actions and their decisions. The bottom line is if you are making medical decisions, you should be held accountable. If you are not making medical decisions, you should not be accountable.

Mr. GREEN

Mr. GREEN. Mr. Speaker, I rise today to pay special tribute to a community leader, a friend, and a legend in Houston's labor movement. Don Horn became a union member in 1945 when he joined the International Brotherhood of Electrical Workers in Houston. Don's leadership positions in Local 716 included President, member of the Executive Board, and Business Representative. In recognition of his hard work and dedication to the members of Local 716, the Harris County AFL-CIO Executive Board elected him as Secretary-Treasurer in 1965, a position he held until his retirement in 1995. During his 30 years as Secretary-Treasurer, he also served the Texas AFL-CIO, both as a member of the Executive Board and as a Trustee. Don has not only been a leader in the labor movement, he has been a leader in the community. He served for many years on the United Way Board of Trustees and as a Boy Scout Leader. In addition, Don served 10 years on the Harris County Hospital Board and was instrumental in the creation of the Neighborhood Health Centers, which have brought quality medical care to all parts of Harris County. Don continued his work for quality health care as Consumer Representative of the Texas State Health Board. In fact, he once took former Texas Lieutenant Governor Bill Hobby with him on an unannounced inspection of a nursing home, a trip which led to a statewide reexamination of nursing home practices. Don is a graduate of the University of Houston. Currently, he serves on the City of Houston's Ethics Committee. Three years after his retirement, he is still active in the labor movement and still organizes union retirees for the Harris County AFL-CIO. Mr. Speaker, Don's work as a labor leader and as a community leader have earned him a special place in the hearts of all Texans. The Nation could use more people like Don Horn.

Mr. GREEN

Mr. GREEN. Mr. Speaker, you were correct in saying that the people in the gallery cannot express their opinion for or against those of us who speak on the floor. They have to wait until November to give their opinion on it. That is why I am here to say that I am disappointed to see that after 6 months of debating managed health care, we now see a weak version introduced by the Republican leadership. The proposal falls short of addressing the health care needs of the American people. It is clear that the concerns of the American people are being ignored again. The proposal that has been introduced is a fake and (it is) a sham. Real managed care should guarantee a fast appeals process, patient access to specialists, coverage for emergency services without having to call in first, patient choice of plans at their own expense, and also make the people who make those irresponsible medical decisions accountable for those decisions. That is why the American people in November are going to make that decision, and not necessarily in the gallery of the House today. We need real managed care reform. We need to hold insurance companies accountable for their decision-making, just like we held welfare mothers accountable during the welfare reform bill.

Mr. GREEN

Mr. GREEN. Mr. Speaker, I find it ironic that the same people that preached and lectured this Congress about the importance of personal responsibility and accountability for one's actions during the welfare reform bill are taking the opposite position on managed care reform. This is really about the same thing: being accountable for the decisions we make. We should be responsible for our actions, whether one is a Member of Congress voting, a welfare recipient looking for work, or an HMO deciding not to pay for a test or a procedure that the doctor says is medically necessary. Why should HMOs be given preferential treatment and held to a different standard than the doctors they employ or the patient that they are supposed to serve? The Republican managed care bill will not hold HMOs accountable when they make these medical decisions. One thing this decision does is clearly define where everyone stands on the issue. We should be fighting for a bill that requires timely internal and external appeals; access to specialists or special needs; point of service choice for employees and the patients; open communication between patients and their doctors; no gag rule; and accountability of the medical decision-maker. We need real health care reform, not a false hope.

Mr. GREEN

Mr. GREEN. Mr. Speaker, I rise in strong support of H.R. 3223, A Bill Designating the J.J. ``Jake'' Pickle Federal Building in Austin, Texas. This is a fitting tribute to an unique Texan and former Member of Congress. Congressman Pickle is a legend even by Texas standards. He put himself through college during the Depression, worked for President Roosevelt's National Youth Administration, served in the Pacific during World War II, started a radio station in Central Texas, and represented Texas' Tenth Congressional District from 1963 to 1995. During his long and distinguished career in the Congress, Jake Pickle prided himself as a protector of small businesses and a specialist in the Social Security system. Over the years, Congressman Pickle managed to involve himself in every major issue that confronted the Ways and Means Committee, from Social Security to trade to the complete revision of the tax code. During the 98th Congress, Jake Pickle chaired the Ways and Means Social Security Subcommittee. As chairman of that subcommittee, he was convinced that the way to save the Social Security system from a long- term collapse was to raise the retirement age. Democratic leaders, including Thomas P. O'Neill and Claude Pepper, wanted to solve long- term financing problems with eventual increases in the payroll tax. Few expected Pickle would prevail on the floor, but he did. Through months of argument over what to do about Social Security, Pickle and Pepper were the spokesmen for two diametrically opposite points of view. During floor consideration, the House chose Jake Pickle's approach, which later became law. This victory represents the culmination of a long personal struggle for Jake Pickle to put the Social Security system on a sound personal footing. Most everyone knows Jake Pickle as a political protege of President Lyndon B. Johnson. Congressman Pickle was a campaign manager and a Congressional aide to Johnson before World War II and an advisor in Johnson's 1948 Senate campaign. Jake always spoke reverently about President Johnson and his commitment and dedication is a testament to their friendship. Congressman Pickle is also known for his storytelling ability. In 1997, shortly after his retirement from the United States House of Representatives, Jake Pickle wrote a book with his daughter in which he recalled some of the many adventures he has had during his political career. One of my favorite is featured in Chapter 35 of Jake: In 1957 or 1958 Governor Price Daniel and I were in El Paso attending a state democratic Executive Committee meeting. About that time the state of Chihuahua and Texas were instigating a program to eradicate the yellow boll weevil. So the Governor was in El Paso to officially give credence to the boll weevil eradication program as well. Jean Daniel was in El Paso with her husband. Our party stayed at El Paso's Del Norte Hotel, the finest in town. One night after our meeting, Price and Jean, Hazel and Bob Haynsworth, and I decided to go across the border to Juarez. The Haynsworths knew a bar in Juarez with a good band and a floor show, and Bob Haynsworth called ahead to speak to the manager. The Manager was told that the Governor of Texas would be in our party, and we wished no publicity. The manager said we did him a great honor. Absolutamente! He would respect our privacy. When our group arrived at the bar, we were seated at a big table near the band. Now, Governor Daniel was a Baptist and a teetotaler. Officially, he never drank. But he liked Cokes. Every time we went someplace people would offer Daniel a drink, and he'd always decline, saying, ``Well thank you, but I don't drink.'' People expected this, but always felt they had to offer the governor a drink anyway. But sometimes Daniel would add, ``I'll take a Coke, though. Jake, why don't you get me a Coke?'' And I would--but I'd have the bartender pour a shot of bourbon in it. Daniel never mentioned the bourbon--but he always asked me to get his Cokes. It was a little game we played for years, one which allowed Daniel to follow his religion, but enjoy a little socializing with a clear conscience. However, Coke or no Coke, the last thing Daniel wanted was to be recognized in a bar, even a Mexican bar with no constituents. Everything went fine for a few minutes. Then the band, which had been playing lively Mexican melodies, suddenly stopped, then executed a drum-roll flourish. The Governor and I looked at each other and thought, ``Uh oh.'' He sank lower in his seat. Then the bandleader announced into the mike, ``We are proud to have with us tonight the Governor of the State of Texas''--Another drum roll--``the honorable Price Daniel!'' Amid the fanfare, a white spotlight swept the dark bar and came to rest on our table. Nobody moved. Daniel kept his head down. Again, the announcer said, ``Damas y caballeros, permitanme presentarles el gobernador del estado de Tejas!'' Another drum roll and the bright spotlight on our table. Still no movement from Price. With the spotlight still on us, a third time the announcer called, ``Please! Will the Governor of Texas stand and be recognized?'' Finally Jean leaned over and whispered urgently, ``Jake, for goodness sake, will you do it?'' And Daniel said, ``Jake, I bet you've always wanted to be Governor--here's your chance.'' So I got to my feet and grinned and waved to thunderous applause, as the band struck up ``The Eyes of Texas.'' I must admit, I got a great reception. Boll weevils and politicians. We're jus' lookin' for a home. Mr. Speaker, I am proud to have served with Congressman Jake Pickle and will be forever grateful for his friendship. This designation is only a small token of our appreciation to a dedicated public servant. Mr. Speaker, I rise in strong support of H.R. 3223, to designate the federal building located at 300 East 8th Street in Austin, Texas, as the ``J.J. `Jake' Pickle Federal Building.'' It is a well deserved honor for a man who selflessly served his country in a multitude of ways over many years. I was pleased to serve alongside Jake not only as a member of the Texas Congressional Delegation, but also on the Ways and Means Committee. His integrity, compassion and unswerving sense of right and wrong remain as sterling examples of the standard to which every public official should strive. I join my colleagues and the American people in gratefully honoring the life, the contributions and achievements of Jake Pickle, a cherished friend, a loyal Texan and a selfless public servant.

Mr. GREEN

Mr. GREEN. Madam Speaker, it took months of drafting and redrafting and threats and rejection, but last night we got our first look at the Republican managed care proposal. While the final details will not be worked out for another month, the rough draft is not very promising. Most of the outlined provisions in the bill are too weak to help people like in the story in yesterday's Washington Post. It was a father of five with liver cancer. He already had access to an appeals process that he actually won. Unfortunately for him, it took 5 months for his doctor to be told that he needed a liver transplant and the HMO was ordered to pay for it. But, Madam Speaker, he died right after they were given that permission. What he needed was a timely appeals process and an HMO knowing that they would be responsible for the denial of that coverage. The Republican bill would not help the Houston police officer who, after 30 years of service and not missing a day for illness, was diagnosed with cancer and it took him months to get to a specialist. The proposal would be just about as effective as using a Band-Aid for a deep flesh wound. The provisions in the GOP bill would do nothing to stop HMOs from making major decisions based on profits instead of patients.

Mr. GREEN

Mr. GREEN. Mr. Speaker, in today's Washington Post there is a front page article that illustrates the immediate need for our Patient's Bill of Rights. In February of 1997, doctors told a 52-year-old local resident, father of five, that a liver transplant was his only chance to beat liver cancer. The executives of the HMO disagreed and denied coverage for this lifesaving treatment. Over the next five months this local resident wrote three letters to his HMO, and each was ignored. Finally, five months after his doctors originally told him he needed a transplant, he won an external appeal. The HMO was ordered to pay for the transplant. Five days after he won that appeal, he was too sick to receive that transplant and he died. Mr. Speaker, how many people have died because of delay in medical care because of this law we have now? If we had a Patient's Bill of Rights that included timely internal and external appeals; access to specialists; point of service options; open communications between patients and providers; and, accountability for these medical decisions, these Americans would not be dying because they are being denied medical care. Mr. Speaker, we need a Patient's Bill of Rights now.

Mr. GREEN

Mr. GREEN. Mr. Speaker, it is time to bring managed care reform legislation to the floor. The quality of medical care for our citizens has declined considerably, and it is time to act now. Some patients are not getting the best medical care possible. Medical decisions are being made by insurance company bureaucrats, not by medical providers. If you are badly injured or severely ill, you should not have to worry about your insurance coverage. Patients should be able to obtain quality health care, whether or not they have acquired preauthorization for emergency room treatment. We need to focus on an anti-gag rule, which allows physicians to talk to their patients, an external-internal appeals process, employee choice of insurance, access to specialty care and decision-maker responsibility, which will make the managed care plan that authorizes or fails to authorize health care procedures, be as accountable as medical providers. Managed care is not inherently bad, but I do believe protections are needed immediately to protect the American people.

Mr. GREEN

Mr. GREEN. There is both positive and negative reinforcement in this tour. Another stop will be at Columbia Lighting, represented by the IBEW, International Brotherhood of Electrical Workers Local 716. The company tried to decertify, but they lost the election and so that company shut down that plant. That is so wrong at Columbia Lighting. The workers will talk about that company's attempt to get rid of the union. They failed on decertification but now they are just shutting the plant down. We have a long way to go. We have a lot of success, a great history in our country of recognizing workers, their right to organize. We have a long way to go. I want to thank the gentleman from Michigan (Mr. Bonior) for his effort tonight and look forward to continue working with him to make sure that not only do we fight for justice all over the world for workers but we also recognize we have to fight for it in our own country.

Mr. GREEN. Mr. Speaker, I thank our Democratic whip for organizing this special order in recognition of June 24, when American workers will use the day to celebrate victories we have had in protecting the right to organize and bargain collectively to improve living standards and working conditions. This is an important day I think we need to remember but also recognize we still have a long way to go. The right to join a union is a basic civil right, and unions are an avenue to equity, fair treatment, and economic stability for working people. I know hearing my colleagues tonight, and the gentleman mentioned it earlier, around the world, the right to bargain collectively and independently is so important to industrialized democracies; in Poland, the success of the solidarity union. Around the world, in China and some of our, both competitors and countries we try to work with, the right to organize and bargain collectively is so important. Let me just give a small commercial. I have a bill, H.R. 2848, the Labor Relations First Contract Negotiations Act. The bill was introduced to allow rights of employees to organize and bargain collectively for living standards. This bill would require mediation and ultimately arbitration if an employer and newly elected representative had not reached a collective bargaining agreement within 60 days. We have time after time in our country right now where there is an election, yet there is no contract months and months afterwards. Yet the workers have voted to have union representation. That bill is important. I would like to see if we had a bill this session I could at least have a debate on that piece of legislation so we can move that further, so they do not necessarily get bogged down in NLRB by both sides oftentimes, and either management or labor could exercise that right. Let me talk about something that is happening in Harris County, in Houston, Texas on the 24th. Our Harris County AFL-CIO is having a Justice Bus Tour. Let me talk about the five stops they are going to have. One of them is our new baseball stadium that a lot of us supported in downtown Houston that is being predominantly built by nonunion labor. The building trades are fighting for fair wages and a voice for those workers. In fact, the International Union of Operating Engineers is currently conducting an organizing campaign with the crane operators there at that site. All of us love baseball. I know the gentleman does, too. I love the Houston Astros. We would like to make sure that the people building that stadium are being paid a fair wage. The second stop is not actually in my district, where the Oil, Chemical and Atomic Workers Union, Local 4-227 has been locked out of Crown Petroleum for 2 years. I have been out there for those anniversaries of that lockout, I have spoken at the union hall about Crown Petroleum's not being able to negotiate with their workers who are my constituents and live all over Harris County but the plant is actually in my district. That is so wrong for those workers there. The third stop will be at Union Tank Car Company. Last April, the United Steel Workers won an election for the workers by a two to one margin. The company disregarded the workers' choice and used delaying tactics and legal challenges to overturn the election. The workers there will speak to the fact that Union Tank Car disrespected the decision made by its workers and is using a variety of tactics to keep the union out. Over 100 workers are expected to meet that justice bus there at that location. The event is also being coordinated with one of the company's headquarters in Chicago, so between Houston and Chicago hopefully we will get Union Tank Car's attention. The fourth stop will be at a Kroger grocery store represented by United Food and Commercial Workers, both Locals 408 and 455. The grocery store workers will award Kroger for being such a good employer that respects their workers. They will also thank Kroger for its support for the United Farm Workers in their organizing efforts for the strawberry workers in California.

Mr. GREEN

Mr. GREEN. Mr. Chairman, first of all, I would like to thank both the gentleman from Pennsylvania (Chairman McDade) and our ranking member, the gentleman from California (Mr. Fazio), for the service not only that they have provided to their districts over the years, but also to our great Nation. We will miss them, all of us will. I am not saying that just because they have been kind to the Port of Houston for a number of years, even before I was involved in serving in Congress. But Mr. Chairman, I rise in support of the bill. It is a second year appropriation for the deepening and widening of the Port of Houston, and the committee, in its wisdom, with our only Texan on the committee, the gentleman from Texas (Mr. Chet Edwards), provided for $60 million for the deepening and widening of the Houston ship channel. It is so important, not just for Houston but for all of America, because it generates $300 million annually for America in customs fees, and $213 million annually for local taxes. The expansion of the Port of Houston and the Houston ship channel is important not only because it is the busiest port in foreign tonnage, and second in domestic tonnage, with more than 6,435 vessels navigating the channel annually. Again, this is a second year appropriation of $60 million. Again, I would like to thank both the chairman and the ranking member for their service, but also the gentleman from Texas (Mr. Edwards), a neighbor of ours from Waco, Texas, for his efforts.

Mr. GREEN

Mr. GREEN. Mr. Speaker, June 13, my staff and I hosted our Fourth Annual Citizenship Day Event. This is a one-stop application processing opportunity for residents who wish to become U.S. citizens. With the help of local volunteers, elected officials, and community- based organizations, we were able to help 350 residents take their first step to becoming a U.S. citizen. The Citizenship Day process consisted of completing INS forms, taking photographs, and having attorneys and INS representatives review the application. Upon completing this process, the application is photocopied for the applicant and immediately mailed to INS. Every year, I am amazed at the number of people who attend this event. While some of us to tend to take for granted that we live in a great a country, others wait in line all night long simply to submit an application to become a U.S. citizen. Although an event like this takes many months of coordinating and planning, the rewards are remarkable. Not only does it provide a service to our community, but it also increases awareness among legal residents about the importance of becoming a citizen. Moreover, it's encouraging to see volunteers return every year to contribute their time and effort. I am extremely thankful of the following volunteers, groups and organizations who assisted in making this event possible: Houston Community College--Northeast Campus, Harris County Constable Victor Trevino, Immigration and Naturalization Service, United States Postal Service, Houston Industries, League of United Latin American Citizens, National Association of Latino Elected Officials, Hispanic Women in Leadership, Rio Posada Restaurant, Fiesta Mart, Inc., Hispanic Organization of Postal Employees, Houston Coca Cola Bottling Co., Pizza Hut, Chase Bank, Telemundo--Channel 48, Univision--Channel 45, College Democrats @ University of Houston, Quan, Burdette & Perez, Attorneys at Law, Esther Alaniz, Alicia Almendariz, David Airhart, Artie Blanco, Delia Barajas, Debra Barnes, Yasmine Cadena, Mary Closner, Mitchell Contreras, Romero Cruz, Hector De Leon, Anselmo Davila, Armando Entenza, Arthur Flores, Charles Flores, Dr. Margaret Ford, Celia Garcia, Cyndi Garza, Juan Garcia, Rosa Garcia, Reynaldo Garza, Victor Gonzalez, Juana Gonzalez, Priscilla Gonzalez, Manuel Gonzalez, Mary Guerrero, Rebecca Guerrero, Joe Granados, Ben D. Huynh, Ana Maria Lopez, Dorothy Ledezma, Alfred Martinez, John Martinez, Benny Martinez, Margaret Mata, Edward Melendez, Josephine Mendoza, John Meyer, Diana Morales, Sally Morin, Mercedes Nassar, Janie Munoz, Frances Munoz, Art Murillo, Ana Nunez, Sandra M. Orellana, Juan Padilla, Cesar De Paz, Richard Perez, Candy Perez, Andre Rodriguez, Jesse P. Ramirez, Francisco Rodriquez, Mayor Cipriano Romero, Juana Rosales, Rosa Ruelas, Yeannett Salazar, Thomas Sanchez, Olga Soliz, Diana Trevino, Marco Torres, Vera Vasquez, Suzanne Villareal, Patricia Valdez, Ralph Vazquez, and Shahid Waheed.

Mr. GREEN

Mr. GREEN. Mr. Speaker, when are we going to get serious about real reform? Republicans in the Senate have killed tobacco legislation which would have helped to reduce teen smoking, and House Republicans are refusing to allow real managed care reform to come to the floor. The majority is allowing the quality of medical care for our citizens to decline considerably while allowing the tobacco industry to jeopardize our children's health. It is estimated that 3,000 young people start smoking every day. One- third of these children will eventually die from tobacco-related diseases. We need to stop the next generation from becoming addicted to tobacco. We need to establish guidelines and protections for patients to give them access to quality health care. The American people have asked us to protect their children from smoking and are demanding top quality medical care. We need tobacco reform, we need managed care reform. Eighty percent of Americans want a patients' bill of rights and tobacco reform. The Republican majority in Congress is denying Americans these important rights.

Mr. GREEN

Mr. GREEN. Let me give the gentleman another example. One of the concerns I have as to why we need to put these into law is oftentimes, as a Member of Congress, we have constituents call us and explain to us situations, and we treat them like constituent work and the staff calls the hospital or the HMO, and oftentimes we can get that decision changed. But we represent 600,000 people, and not everyone is going to call their Member of Congress to get it corrected. That is why these reforms needs to be in place for everyone. I have an example of an elderly gentleman who was in a hospital in Pasadena, Texas, part of my district, and the doctor came around that the family did not know, and the patient was terminally ill with cancer. And the doctor said, you will have to be checked out and you cannot come back to this hospital. So the family checked with the other medical staff there and they called this person the HMO doctor. And so the family called our office and I talked with them and I said, well, we will check and see. And this was within 2 days, and he was not out of the hospital yet. And in working through the bureaucracy, that HMO said, sure, that is not a problem; that they wanted him to go to a different facility but they actually worked out an agreement to where the facilities were the same cost. And that ``HMO doctor'' came in and apologized 3 days later. This gentleman has since passed away. But to put a family through that, who already has a terminally ill father, or husband, and to say, no, you have to be checked out of here and go somewhere else, it is just inhuman. And not everyone will think to call their Member of Congress, and that is why these reforms are so important, so we can put a human face on managed care and make some rational decisions instead of what we are seeing out there in the marketplace now. So that is why I would hope that this session of Congress that we would not only be able to vote this bill out of the House but also the Senate and be able to have it signed by the President so we can put these reforms into place for the benefit of the people we represent and people all across the country. This is one of the most important bills that we can consider this year. And I want it to be a strong piece of legislation, too. I worry that because of the 80 percent support that the polls are showing for this, we might just see lip service paid to it and pass one or two. Let us make sure we do the job thoroughly and not just a partial job. So I would hope that my colleagues on the Republican side would cosign some of the bills and ultimately make the decision, if we have to, to sign that discharge petition to bring that bill here to the floor. I do not like to do that, because I believe in the committee process. But we have seen time after time during this session of Congress bills coming immediately to the floor without the committee hearings anyway, brought by the leadership. So let us do something right for the American people and pass this legislation. It is a strong piece of legislation.

Mr. GREEN. Mr. Speaker, I think that is ironic, because the gentleman and I know, as Democratic Members of Congress, oftentimes we have been accused of not trusting the States and local control. I bring to Congress 20 years of service in the Texas legislature, and I know that these halls do not have infinite wisdom, although there is not infinite wisdom in the halls of the legislature either, but I also like the idea of 50 States being able to make that decision on lots of things and particularly in this area. Let us let the State liability law provide for the people that are covered by ERISA. Doctors and health care providers should be in charge of medical care decisions. When patients need immediate care, doctors need to be able to provide that quality health care. I believe that these basic protections are fundamental to maintain a high quality medical care in our country. I do not believe that managed care is inherently bad. In fact, I think it has reduced a cost increase, as we have seen over the last few years, but I believe that, like any other system, you have to provide some protections, patient protections, so managed care does not just throw out the baby with the bath water, so to speak; that we have the benefits of managed care with the cost containment, but we also have the benefits of quality health care and physician and health care provider contact with their patients. Let me give another example, and sometimes I know we are accused of passing legislation by analogy. But, again, as a Member of Congress or any elected official, you try and solve problems. That is our job is to solve problems. We have a constituent like earlier, the knee problem, we have our constituents write us letters. I have a Houston police officer who, again, is under a managed care system, and let me just read his letter. I want to thank you for your concern over the managed care issue, to many of us, the term NYL-Care, if it is appropriate. I worked for the City of Houston for over 30 years as a police officer and walked in harm's way more than once and I have not missed a day of work due to illness for over 20 years. I never worried about health care. When the city took away any choice of doctors, I was concerned, but not too alarmed. Last August, my worst fears became a reality. I went for a routine screening, was told by a doctor at Baylor that I needed additional tests for cancer. At this point, I found out what my HMO was really about. My very first attempt in getting medical help was a fiasco. My primary care doctor was out of town. My very first visit to a specialist was rejected because the referral was not the correct color. I did get to see the doctor after several buck-passing phone calls and more trips to the primary doctor. I found that the toughest battle was not with the disease, but with the HMO. As I am writing this letter, I have been trying for 2 weeks to see another specialist. The mental strain is tremendous. I offer you my experience and will testify and write letters to anyone that support your legislation. That is by a 30-year Houston police officer. We can come up with lots of examples of how people are being denied health care today. A Houston police officer, a teacher at the Houston independent school district, these are people who are serving our children and making our community safer. Yet, he needed that specialist for cancer care. The gentleman and I know that when you are diagnosed with cancer, you need to see that specialist immediately because the quicker the better. You need the treatment, but you do not need to wait another week or 2 weeks or 6 weeks or a month to be able to see that specialist or quality specialist. That is why it is imperative that this Congress pass managed care reform, and it is imperative that my Republican colleagues quit denying that there is a need out there, the majority of them, because we have a great many of them who are really working and trying to pass legislation, but we need a majority of them to say, if we have to, let us take the discharge petition, let us get a bill here on the floor and pass it before this Congress leaves in early October, because it is so important for this Houston police officer and it is important for all our constituents who are being denied care right now.

Mr. GREEN. Mr. Speaker, that is so important just to open the lines of communication. Again, HMOs have cut the cost of medical care, and they have done a great job. But we can have some guidelines for them to where we can have better quality care and still have the cost controls that are there. Another one of the five concepts is the internal and external appeals process. A lot of the HMOs already provide this. But that would be a reasonably timed appeals process, reasonably timed so you do not have to, again, have medical care delayed is medical care denied, both internal and external appeals process; the opportunities for the employee choice which would provide employees with the opportunity to get health care coverage outside their managed care system for an additional cost. The gentleman and I know that the reason managed care is popular with a lot of our companies who pay for the insurance is that they have also placed cost controls on it. But if an employee in a company says, okay, the company says I can pay X amount of dollars per month, and that will buy you this HMO, a lot of employees, both government employees and private employees, private employers will do that. But there ought to be a requirement that a health care provider would offer a little better plan. So that employee could say, yeah, the HMO is great, but I would really like to have a little better plan, and I will pay $10, $20, $30, $50 a month more to make sure that I can have more flexibility in my plan, a requirement that gives that choice to the patient and to the employee. We are not asking for businesses to pay more money, we are just asking for insurance companies to be able to say, hey, I can sell you a better Ford and actually maybe make more money. One of the other important parts of it is access to specialty care which guaranties the patient's right to see a specialist who can diagnosis and treat a patient's specific medical needs. Again, I have some great examples of medical care delayed and denied in my own district and with my own family. They went to a doctor in February; that doctor, for example, in this one case drained the knee. There was a knee injury. Drained the knee and shot cortisone in it, did not request an MRI under a managed care plan until finally this constituent actually went back to the doctor at the end of May and had to wait 2 weeks for an appointment because there were only two doctors on the plan that were orthopedic, and finally got an MRI that said we need to have surgery. So that constituent is having surgery this Friday morning to be able to correct that torn cartilage in the knee that could have been done in February if they would have taken the time and been able to have to go to a specialist. The fifth important decision I think, and this is one that is very controversial, but, again, States have already done it, and particularly Texas, decision-maker responsibility. Make managed care plans that authorizes or fail to authorize medical procedures accountable as much as the health care providers. So if my doctor or my provider is subject to a lawsuit because they do something wrong, then if a health care insurance company or an HMO denies coverage, then they ought to also be subject to the same responsibility that that health care provider is. Again, this is not something that is a major change. The State of Texas, again, in 1997 passed that as part of the bill. Liability legislation is made. They call it in this article the Doomsday Weapon because it makes the responsibility go with the person who is ultimately responsible. If someone says no to a procedure, then they may have to answer in a court of law just like a health care provider would have to.

Mr. GREEN. Mr. Speaker, I thank the gentleman from New Jersey (Mr. Pallone) for yielding and I appreciate his request for this special order this evening so we can talk about managed care and bring it to the attention of the American people, although they know about it even better than we do because they are the ones who are being subjected to the harsh decisions being made every day. They brought it to our attention. That is our job as Members of Congress and elected officials, to respond to our constituents' problems. The gentleman mentioned that we are not doing things that are outlandish or outrageous. There is an article that I would like to show that was in the Wichita Falls Times newspaper in Texas, and it said, ``Texas leads the way as States tackle HMOs.'' Mr. Speaker, our Texas legislature last year passed an HMO reform bill in 1997. They passed the bill in 1995, but the governor at that time vetoed them. But in 1997, he saw the error of his ways, I guess, like we all learn, and he let them become law. But Texas and New Jersey, the gentleman's home State, have passed legislation for HMO reform. The reason we are having to do it in Washington, because I would love to be able to let the States take care of their own problems and our States are doing that, Texas, New Jersey, 40 States across the country, the reason we have to do something in Congress and why it is so important is that so many of the insurance policies that are in effect for group insurance are covered by Federal law and not State law. So no matter what the State law in Texas says or New Jersey says or anywhere else, if it is under ERISA exemptions and under Federal law, no amount of protections in State law will help them. We have to have those protections on a national scale to be able to supplement what the States are already doing. So we are not talking about earthshaking legislation here. We are just talking about reforms that the States have done over the last few years. We have learned from both the success and also some of the errors in the States to be able to come up with the bills that are being considered. I know the Democratic Task Force, that the gentleman from New Jersey is a leader in, has legislation that we have worked on. Mr. Speaker, I am concerned about this issue because the quality of medical care that our citizens are receiving has declined considerably. Some patients are not getting the best medical care that they have become accustomed to in our country. Medical decisions are being made by insurance company bureaucrats as opposed to their medical providers. If we are badly injured or seriously ill, we should not have to worry about our insurance coverage. Our first concern should be our health care or, particularly if it is for a parent or a child, our first concern should be to get them to the health care that they need. These are just two of the examples of problems that patients are facing when they need medical care. We owe it in our responsibility as elected officials to respond to the American people to give them access to top quality medical care. They should be able to obtain quality health care, whether or not they are required preauthorization for emergency room treatment. One of the other problems, and I have used the example before and we have heard it, if I right tonight begin having chest pains, how do I know it is not a heart attack? It might be the pizza we had this evening waiting for our special order, but I cannot diagnose myself. I need to go to an emergency room. And yet we have had cases where the HMO has said, ``No, you had indigestion and not a heart attack. You should have called in first.'' Health care delayed can also be health care denied. So that is the worry that we have that is affecting all of our constituents. As a member of the Democratic Health Care Task Force, I have worked with the gentleman and a lot of Members on trying to establish guidelines and direction to improve managed care. I currently cosponsor three proposals. One of them is the Patient's Access To Responsible Care Act, the Patient's Bill of Rights that the Democratic Task Force has put together, and also the Patient's Choice and Access to Quality Health Care. These bills are all bipartisan bills. They are cosponsored by Republicans and Democrats, although predominantly Democrats on some of them, but we do have Republican Members who are leading in trying to get these bills passed, members of our Committee on Commerce on both sides of the aisle. Each of these bills provides varying degrees of access to specialists, improved quality, and accountability of managed care and timely internal and external appeals process when a consumer feels a claim was denied inappropriately. The focus of these bills, and we have developed five key concepts, that whatever bill we pass, it does not have to have Gene Green's name on it. I would be glad to have my colleagues on the Republican side have these concepts in their bill, and I will speak for it and vote for it. So there is no pride of authorship in needing to have these bills passed and the President sign it. One is the antigag rule which would allow physicians to discuss with their patients the most appropriate course of treatment even if it is not covered by that HMO. A doctor or provider ought to be able to have a two-way conversation with their patients. That is just right.

Mr. GREEN. Mr. Speaker, I thank my colleague for yielding, and the gentleman from New Jersey understands, we have waited here for our hour to be able to talk about managed care, and I think that is much more important. But I need to respond after listening to some of the debate. We are in a long-term debate, I guess, on campaign finance reform. We call it ``death by amendment,'' because the seriousness of the campaign reform issue is so important, and yet our colleagues on the Republican side are the ones that have 300 amendments they want to bring up and they are really delaying it. In real life out there, Republicans outspend Democrats two, three, four and five to one in campaigns. We need campaign finance reform to get the money out of politics. They are too busy attacking working people and not really talking about campaign finance reform. But I want to talk about managed care and how important it is to the people that we represent. Maybe they will be serious about managed care reform, because that is something that affects people every day. I will be glad to work with the gentleman from New Jersey for the next 30 minutes or hour to talk about how important health care reform and managed care reform are to our constituents and all Americans.

Mr. GREEN

Mr. GREEN. Mr. Speaker, too often from these microphones we hear what is wrong with our country, and today I want to talk about what is right with our country. In Houston this week we are celebrating the kickoff of the 1998 Jimmy Carter and Habitat For Humanity work project, the largest Habitat for Humanity project ever attempted. Throughout this week volunteers from all across the country will be building 100 houses in Houston and at least 40 in the congressional district that I am honored to represent. One hundred families will have a roof over their heads as well as an affordable place to live and raise their families. The Jimmy Carter work project will give Houston families an opportunity to buy a home where there is no profit included in the sales price and no interest charged on the mortgage. On Monday morning not only myself, but my staff and I, joined in this project putting up that house, and all this week staff and volunteers are working on our house to have a safe and decent home for our family, Francisco and Claudia Villanueva and their five year-old child, Ana. This home is being built as a House that Congress Built project that is being built nationwide across all Members of Congress, 435. I am glad to have this opportunity to directly provide a house in our district, but also participate nationwide. Mr. Speaker, that is what is right with our country.

Mr. GREEN

Mr. GREEN. Mr. Speaker, last Saturday, on June 13, my staff and I hosted our Fourth Annual Citizenship Day Event. This is a one-stop application processing opportunity for residents who wish to become U.S. citizens. With the help of local volunteers, elected officials, and community- based organizations, we were able to help 350 residents take their first step to becoming a U.S. citizen. The Citizenship Day process consists of completing INS forms, taking photographs, and having attorneys and INS representatives review the application. Upon completing this process, the application is photocopied for the applicant and immediately mailed to INS. Every year, I am amazed at the number of people who attend this event. While some of us tend to take for granted that we live in a great country, others wait in line all night long simply to submit an application to become a U.S. citizen. Although an event like this takes many months of coordinating and planning, the rewards are remarkable. Not only does it provide a service to our community, but it also increases awareness among legal residents about the importance of becoming a citizen. Moreover, it's encouraging to see volunteers return every year to contribute their time and effort. I am extremely thankful of the following volunteers, groups and organizations who assisted in making this event possible: Houston Community College, Northeast Campus; Harris County Constable, Victor Trevino; Immigration and Naturalization Service; United States Postal Service; Houston Industries; League of United Latin American Citizens; National Association of Latino Elected Officials; Hispanic Women in Leadership; Rio Posada Restaurant; Fiesta Mart, Inc.; Hispanic Organization of Postal Employees; Houston Coca Cola Bottling Co.; Pizza Hut; Chase Bank; Telemundo, Channel 48; Univision, Channel 45; College Democrats @ University of Houston; Quan, Burdette & Perez, Attorneys at Law; Esther Alaniz; Alicia Almendariz; David Airhart; Artie Blanco; Delia Barajas; Debra Barnes; Yasmine Cadena; Mary Closner; Mitchell Contreras; Romero Cruz; Hector De Leon; Anselmo Davila; Armando Entenza; Arthur Flores; Charles Flores; Dr. Margaret Ford; Celia Garcia; Cyndi Garza; Juan Garcia; Rosa Garcia; Reynaldo Garza; Victor Gonzalez; Juana Gonzalez; Priscilla Gonzalez; Manuel Gonzalez; Mary Guerrero; Rebecca Guerrero; Joe Granados; Ben D. Huynh; Ana Maria Lopez; Dorothy Ledezma; Alfred Martinez; John Martinez; Benny Martinez; Margaret Mata; Edward Melendez; Josephine Mendoza; John Meyer; Diana Morales; Sally Morin; Mercedes Nassar; Janie Munoz; Frances Munoz; Art Murillo; Ana Nunez; Sandra M. Orellana; Juan Padilla; Cesar De Paz; Richard Perez; Candy Perez; Andre Rodriguez; Jesse P. Ramirez; Francisco Rodriguez; Mayor Cipriano Romero; Juana Rosales; Rosa Ruelas; Yeannett Salazar; Thomas Sanchez; Olga Soliz; Diana Trevino; Marco Torres; Vera Vasquez; Suzanne Villareal; Patricia Valdez; Ralph Vasquez; and Shahid Waheed.

Mr. GREEN

Mr. GREEN. Mr. Speaker, last week, we learned about the upcoming resignation of Navy Secretary John Dalton. I have known Secretary Dalton for many years, and consider him to be both a friend and among the finest Navy Secretaries our Nation has ever had. He understood Houston's long Naval and Maritime history. Secretary Dalton has served his country with distinction and with honor. Although he was born and raised in Louisiana, we consider him a true Texan. He moved to Texas during the 1970's, and since then, has served as a Chairman and President in various associations in his business career. He was nominated by President Clinton in 1993 and confirmed that same year to become the Secretary of the Navy. Under his guidance, the Navy has expanded opportunities for both women and minorities. Through his leadership, Secretary Dalton exemplified the Navy's Core Values of Honor, Courage, and Commitment. Secretary Dalton has had a long career of achievements as well as accomplishments. He graduated from the U.S. Naval Academy where he served as a Deputy Brigade Commander, a finalist in the Rhode Scholar competition as well as Lieutenant Commander during his years in the U.S. Naval Service. In 1997, he was given the recognition of the prestigious International Security Leadership Award. This was in recognition of his leadership and promotion of American seapower and bipartisan maritime strategy. Secretary Dalton has served with energy, conviction, and dedication at a challenging time for the Navy. In the midst of these challenges, John Dalton has ensured that the Navy remains a national priority. Secretary Dalton has shown an unwavering commitment to our nation, and deserves our recognition and our appreciation.

Mr. GREEN

Mr. GREEN. Mr. Speaker, as a Member of the House Commerce Subcommittee on Health, I am committed to ensuring patients have complete and comprehensive access to information before they make a decision about a medical procedure. I am rising today as the House sponsor of the Silicone Breast Implant Research and Information Act because I believe it is critical to the advancement of women's health and is the first step towards answering the many questions about the safety and efficacy of silicone breast implants. By introducing this bill today, Senator Boxer and I hope to draw attention to an issue that has been either neglected or out right ignored for too long. It is estimated that as many as two million women have received silicone breast implants over the last thirty years. Unfortunately, the information provided to these women before they elected to have silicone breast implants has been both incomplete and even inaccurate. Moreover, results from past studies have only raised more questions about possible negative effects that ruptured or leaking silicone breast implants may have on breast milk, connective tissue, autoimmune diseases and the accuracy of breast cancer screening tests. Our legislation ultimately seeks to change this by focusing on three critical points--information, research, and communication. First, and in my opinion most importantly, this bill will ensure that information sent to women about silicone breast implants contains the most up to date and accurate information available. Current information packets sent to women do not accurately describe some of the potential risks of silicone breast implants. While recent studies by the Institute of Medicine indicate the rupture rate may be as high as 70 percent, information sent to women suggests the rupture rate is only 1 percent. Second, this bill encourages the director of the National Institutes of Health to expand existing research projects and clinical trials. Doing so will compliment past and existing studies and will hopefully clear up much of the confusion surrounding the safety and efficacy of silicone breast implants. Finally, this bill establishes an open line of communication between federal agencies, researchers, the public health community and patient and breast cancer advocates. Women, especially breast cancer patients, want and deserve full and open access to silicone breast implants. Therefore, it is critical that these products are safe and effective, and that women are provided complete and frequently updated information about the health risks and benefits of silicone breast implants. While I unequivocally support a woman's right to choose to use silicone breast implants, I believe we have a responsibility to support research efforts that will provide the maximum amount of information and understanding about these products. I hope each of you join me in support of this important legislation.

Mr. GREEN

Mr. GREEN. Madam Speaker, I thank my colleague from Virginia for yielding time to me. I rise in opposition to the Istook amendment. It is uncomfortable to be opposing it because I think a lot of Members on both sides of the aisle, on both sides of this issue, feel uncomfortable in talking about prayer because prayer has often been such a private matter. I believe in the power of prayer and I know it works, and that is why it is uncomfortable to be opposing it because I worry, just like my colleague from Indiana, that the Istook amendment goes much further and does things that maybe they do not realize. Frankly, we already have prayer in our schools. My district, I have a number of public school districts in my district and my wife is a high school teacher. She has been teaching since 1969. She teaches math. And in the last 3 years, ever since the Department of Education sent out their guidelines, ``Dear Superintendent,'' I have this here, if there is a school board member or administrator that is watching today or if some Members want this, they need to ask the Department of Education, August 10, 1995, where it takes the guidelines from the court opinions and where we do have prayer in our schools. At my wife's high school, Aldine High School, there is Bible study for teachers on their own time. It is voluntary. In the mornings, around the flag pole, that is one of those 10,000 at my wife's high school, 10,000 student groups around the country have the ability to pray every morning voluntarily. There is not an administrator, there is not a teacher there, but it is organized. I have been honored for a number of years to give prayers at our football games because in the district my kids went to school in, we have four high schools. Obviously, in Texas football is important so we obviously pray for a win. But I have been honored to do. We have prayer at our schools. I worry the Istook amendment goes much further than we want. The Washington Post on May 7, an article talked about in public schools, religion thrives. We have religious expression in the public schools. That is why it is so important that we defeat the Istook amendment today.

Mr. GREEN

Mr. GREEN. Mr. Speaker, I have no problem with that. They have that right. But they do not have the right to stand up in an algebra class and do it. But they have the right to pray on their own. And so we have to have some reasonableness applied to it. We have prayer in the public schools now.

Mr. GREEN. Mr. Speaker, will the gentleman yield?