Phil Gingrey

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise tonight to talk about one of my favorite subjects, health care, and in particular to talk about the Medicare Prescription Drug and Modernization Act of 2003. I am surely thankful this evening that I have this opportunity to talk about something which truly should be a bipartisan issue, the health of our Nation. I am particularly pleased that it is bipartisan on a day like today, when I learned before boarding a plane to come back to the Congress that a great man in Georgia had fallen. Former mayor, three-term Mayor Maynard Jackson has died. And I stand here tonight with a great deal of humility following some of the speakers who have already paid tribute to Mayor Jackson: the minority leader, the gentlewoman from California (Ms. Pelosi); the gentlewoman from California (Ms. Watson); the gentlewoman from California (Ms. Waters); and my colleagues and friends from the Georgia delegation, the gentleman from Georgia (Mr. Lewis); the gentleman from Georgia (Mr. Bishop); the gentleman from Georgia (Mr. Scott); and the gentlewoman from Georgia (Ms. Majette). Maynard Jackson was a great Georgian and a great American. For me to stand up here this evening and talk about the many things that he has accomplished would be a little bit redundant. I could talk about his efforts to bring the Olympics to the city of Atlanta in 1996, and he of course played a great part in that; but that is just a small thing that Mayor Jackson has done, and it would be not nearly enough just to point to that. My colleagues have done a wonderful job tonight in describing him and their deep friendship with him. Let me just say that all Georgians mourn tonight the passing of Mayor Maynard Jackson, and we extend our heartfelt sympathy to his family. I would like to actually take just a few seconds of my time tonight for a moment of silence in tribute to Mayor Maynard Jackson. I thank my colleagues. Mr. Speaker, America has the world's best health care system because it relies on innovations of the private sector. A competitive free market system provides incentives to develop better drugs, better treatments, better care, and better forms of health care delivery. The President's framework for Medicare reform would apply the best practices of the private health care market to Medicare. As successful as Medicare has been, it has not kept pace with dramatic improvements in health care because it is a government program, immune to many market forces. Medicare still does not provide seniors with an out-patient prescription drug benefit, full coverage for preventive care, or limits on high out-of-pocket expenses. As a result, our seniors lack many of the choices and benefits available to millions of Americans who have private health insurance. Mr. Speaker, I would like to call on some of my doctor colleagues in this body who are with me tonight to talk about Medicare and the reform that we are going to pass in H.R. 1. So at this time I would yield to my colleague, the gentleman from Pennsylvania (Mr. Murphy), to address this topic.

Mr. GINGREY. Mr. Speaker, to the gentleman from Texas, I appreciate that. And that is exactly right, when we extrapolate that, and I have gotten verification of these numbers from the gentlewoman from Connecticut, the chairman of the Health Subcommittee under the Committee on Ways and Means who has done so much work on this bill, and I really commend her leadership. She has indicated to me that defensive medicine is costing the Federal Government and indeed the taxpayers of this country $14 billion estimated over the next 10 years. That would go a long way toward paying for this prescription benefit that we are going to be offering this year. Mr. Speaker, the gentleman from Texas was talking earlier about the cost of prescription drugs and what we can do about that. Of course we are going to be providing a good prescription benefit for not just our neediest seniors. Of course the program is weighted toward them as well it should be, but we are providing a benefit for all of our seniors. But along with that, along with that, as the gentleman pointed out, it is very, very important that we address this issue of the cost of prescription medication. I think most people in this country, certainly the seniors that have to go and purchase those expensive drugs, know that it is just too much; and we need to continue to work very hard, as the gentleman from Texas points out, to get the market forces working to bring the price down, to make the pharmaceutical industry compete, as well they should and they are doing; and that is what we want. We do not want government price controls. We want the market to determine, and we want of course these businesses, pharmaceutical businesses to have an opportunity to make a fair profit to recover, as the gentleman from Texas pointed out, the tremendous cost involved in research and development; and that of course is something that I think is extremely important. But we definitely feel that the competitive forces of the marketplace will bring prices down. And certainly, as we pointed out earlier, when a senior is part of a group, as we know, with the wonderful organization many of our seniors have memberships in AARP and they have a drug discount card. In fact, I would like to just point out if I can get everyone's attention on one of the posters to my left, this is the typical medical prescription card which seniors will have, and they will be issued by a number of organizations. And with those cards if we did nothing else, and we are doing much more, as we pointed out earlier, but if we did nothing else, just the opportunity to buy as a group and the force of the marketplace, it is going to bring down the price of prescription drugs for all Americans but especially for our seniors. Mr. Speaker, I wanted to spend a little bit of time talking about the Medicare program; and of course the gentleman from Texas mentioned a little earlier that the gentleman from Georgia, myself, was there from the inception of Medicare, and my wife told me to be sure to let the Members of this body know that of course I was there from the inception. I was just a very precocious first grader, but I do remember very well in 1965 when the Medicare bill was first passed, and the emphasis then in most health care was seeing one's physician, occasionally of course being admitted to the hospital for a needed surgical procedure. Nobody thought too much really in 1965 about the fact that here in 2003 that people would be on maybe four or five drugs. The average person 75 years old could be on that much medication. So there just really was not the emphasis in 1965, but things changed. Things have changed in many other aspects of our society. When I was in college, we used a slide rule. Nobody even knows what a slide rule is today. Our automakers gave us an Edsel, and now we have the new and improved and revised and beautiful Thunderbird. We need to do that with Medicare. We truly need to do that with Medicare. I have been practicing long enough to see some significant changes; and I have seen managed care, health maintenance organizations with a great emphasis on preventative healthcare, preventative healthcare; and I applaud that because it is extremely important. If we wait to treat people when an episode of poor health or an accident has occurred, then it is so expensive, not to mention the tragedy and the suffering and the loss of life that occurs, but just the expense of waiting until a person is so sick and they show up in the emergency room, that paradigm has got to shift. That paradigm has got to shift. I tell my colleagues in the House, Mr. Speaker, of my experience recently of going through so-called open heart surgery that I was faced with right after winning this election to the Congress, and now I am on five prescription medications every day. I am not a senior citizen yet. I am not Medicare-eligible. But I know they are very, very expensive, very expensive; and it just makes me think how important it would have been for me and how important it is for our seniors who maybe just turned 65 to be able to get the medications that they need to strengthen their bones, to prevent osteoporosis, to lower that blood pressure so they do not have a premature heart attack or a stroke and end up in a nursing home for the rest of their lives. So things are changed. Society has changed. And now I do not think there are many physician colleagues of mine in this great United States who would not agree that a prescription benefit is every bit as important as a hospital benefit or a surgical benefit, and we have got to make that change. And that is what this President is doing. That is what this administration, that is what this leadership, what the gentleman from Illinois (Speaker Hastert) and the gentleman from Texas (Mr. DeLay) and the chairmen of our committees of jurisdiction, the gentleman from California (Mr. Thomas) of the Committee Ways and Means and the gentleman from Louisiana (Mr. Tauzin) of the Committee on Energy and Commerce, and their subcommittee Chairs are bringing to us. They are bringing not just this prescription benefit, but they are also bringing an option for change so that our seniors can get the same health care benefit that we, Members of Congress, have available to us and that all Federal employees have available to them, to be able to go to enhanced fee for service or a Medicare advantage plan where there is an emphasis on preventative health care, where they can get a routine physical done, where they can get their blood screened for lipid profile and cholesterol so that we will know early, early on, if they are at great risk for developing one of these serious illnesses. That is what it is all about. Colonoscopies, mammograms, things that will keep people healthy and prevent them from getting so far down the line with an illness that they cannot recover. So that is what we call, Mr. Speaker, compassionate conservatism. That is what this President and this administration and this Republican majority and this leadership is all about, and that is what we are going to bring to the seniors of this country. We are going to bring a prescription benefit that is weighted toward the needy, that has a catastrophic cap; and, yes, that cap is going to vary depending on a person's income or net worth, as well it should. I think it is only appropriate that we take care of our neediest first, but all seniors need the same kind of benefit that I enjoy and other Members of Congress and Federal employees enjoy. So that is a very, very big part of this program. It is not just providing a prescription benefit but also giving our seniors an opportunity and an option. Of course, they can remain in traditional Medicare, which we all know about a comfortable pair of shoes and we get used to something and change is difficult. I know change was difficult for me when I gave up a medical career to join the Congress and get on this rather steep learning curve. It is scary. It is scary, and maybe some of our seniors will decide to stay in traditional- fee- for-service Medicare, but they will have a prescription drug benefit. They will have the same prescription drug benefit. What they will not have in that traditional paradigm is they will not have any catastrophic coverage. They will still have catastrophic coverage of course for the prescription benefit, but not for other costs involved like hospital stay or nursing home stay; and that is what we are trying to avoid by giving them an opportunity to join one of these other options where it is a competitive environment and an opportunity for these plans to compete against each other and lower the cost at the same time they are providing this preventative health care benefit like I mentioned, routine physicals, routine screening, and, yes, indeed, catastrophic coverage so that people who have worked all of their lives to build a little nest egg not become destitute and burdens on society in their senior years. That is not right. That destroys their dignity. And if I do anything in this Congress, I am going to work hard to make sure that that does not happen to our seniors. So in conclusion, Mr. Speaker, I want to thank my colleagues who are with me tonight to discuss this tremendously important issue. We do not have the perfect plan. Yes, bills can be improved, and that is what the committee process is all about. That is why we have two committees of jurisdiction and very intelligent people working on this bill to perfect it. This is so much better, Mr. Speaker, this is so much better than what we have currently. I am just very proud of our leadership, and I am very proud to be supportive of the Medicare Prescription Drug and Modernization Act of 2003.

Mr. GINGREY. I wanted to ask the gentleman, I am glad he brought that point up, about medical malpractice premiums and what it is doing and, of course, has resulted in a lot of defensive medicine practiced not just by our physicians like myself and the gentleman from Texas, Mr. Speaker, but also by the hospitals, by our facilities who are forced to protect themselves, to order in many instances a lot of tests that they really feel are not absolutely necessary but it is done in the interest of defending themselves against possibly a frivolous lawsuit that could be devastating to either that individual practitioner or to that little rural hospital in our small communities, and like my 17 counties in the 11th Congressional District of Georgia, many of these hospitals as an example, these rural hospitals, disproportionate-share hospitals that see so many Medicare and Medicaid patients, they are going to end up closing their doors. And I really appreciate the gentleman from Texas, that Lone Star State mecca where actually, as he pointed out, every day is a good day to be in Texas, not just during retirement years. But I wanted to ask the gentleman from Texas about the cost and what kind of estimates, if any, do we have on the cost of defensive medicine without getting a good tort reform bill passed?

Mr. GINGREY. I thank the gentlewoman. Mr. Speaker, no Member of this body understands this better than the gentlewoman from Florida. The Sunshine State is where all of us want to go to retire and live out a very, very healthy life there in that beautiful State of Florida. She has got probably a disproportionate number of her constituents who are our beloved senior citizens. She knows of what she speaks. I really appreciate her bringing that to us. I would like to at this time recognize once again my physician colleague in the House, the gentleman from Texas.

Mr. GINGREY. I thank the gentlewoman from Florida. The gentlewoman from Florida brought up a couple of, I think, really, really good points, and that is the fact that our seniors who are not on a plan, and they are probably close to 30 percent, by anybody's estimate, probably 30 percent of our seniors have absolutely no coverage whatsoever. They do not have so-called MediGap or supplemental insurance. They are not getting a retirement health benefit that includes prescription medications from their employers. Thank goodness, many in that group are not poor enough to be dual eligible; that is, eligible for both Medicare and Medicaid. Those dual eligibles, of course, have a prescription benefit. And so we do have maybe 65, maybe 70 percent of our seniors do have a prescription drug benefit, but even those, Mr. Speaker, probably spend at least 50 percent out of pocket, what they have to pay. That 50 percent when you are talking about being on four or five or six pills a day and some of them costing $9 and $10, that mounts up in a hurry and that is where you get into these situations where people are having to choose between groceries and their medications. That is a very sad, dangerous situation. I really appreciate the gentlewoman from Florida bringing up the fact that when these seniors go to their internist, to their primary care physician, indeed, yes, occasionally to their OB-GYN and get a prescription, but sometimes it is not just one prescription. They have these multi-system diseases. Sometimes there are two or three things that are failing at the same time. It takes these medications to keep our seniors healthy and well. So when they go to that pharmacist, as kind, as caring, as loving as the local corner druggist may be, they have got a handful of prescriptions, they do not have a plan to help them get a discount with volume purchasing and that sort of thing. There is no pharmacy benefit manager for them. They are paying sticker price. Our seniors know it. They are paying sticker price. It is pretty painful when they go back to that car and maybe they were only able to get half of that prescription filled or as we pointed out earlier, I think, one of the speakers mentioned that our seniors sometimes will ask for double the dose or maybe quadruple the dose so they can go home and get out that little pen knife and cut that pill in half or in quarters so they can stretch the budget, if you will. It is a very dangerous situation. Mistakes can be made, sometimes catastrophic, tragic mistakes. The gentlewoman from Florida is bringing out a very important point, that these seniors are getting no breaks in the marketplace. We need to give it to them. That is what we are going to do in this prescription drug benefit under Medicare modernization.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, on rollcall No. 294, the voting machine did not properly record my vote. I would have voted ``nay.''

Mr. GINGREY. Mr. Speaker, I rise in strong support of the Small Business Health Fairness Act, H.R. 660, and against the amendment. By anybody's estimate, 41 million uninsured Americans is entirely too many, and the Bureau of the Census has estimated that over 60 percent of those uninsured Americans are employed. They are not unemployed. They are just working for small businesses, small employers that cannot afford to go into that small market and purchase health insurance, which is rising at least 14 percent a year. The AHPs, with a minimum pool of 1,000 or more employees, spreads the risk, and it gives them the opportunity to get that same volume discount that the Fortune 500 companies and the large labor unions enjoy. But maybe the most important savings and the reason that the premiums are lower is that they are not bound now by each and every of the 50 States with their multiple mandates. The other side wants to talk about how unfair it is that these plans could not include a routine screening mammogram or could not exclude the fact that some plans have so-called drive-through deliveries, and that patients might not be able to stay overnight when they had a radical mastectomy. Mr. Speaker, these plans that are being offered under ERISA protection have all of these provisions in them. What we are talking about, and I know this as a physician member of the State legislature, and the demands to include one mandate after another, things like coverage or screening for chronic adult fatigue syndrome, or carpal tunnel syndrome, or a blood test for this or a blood test for that, pretty soon they will be requiring routine screening for fissle phosphate levels in everybody's blood. It just goes on and on and on, and it becomes absolutely ridiculous and prohibitively expensive. So that is why we need this bill. That is why we need these AHPs. I think we will insure not 330,000 more people, but probably over 2 million.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the gentleman from Georgia (Mr. Burns) for yielding me the time. Mr. Speaker, as I listen to this debate, of course I stand here fully in favor of H.R. 8 and against the Pomeroy amendment because it is really not about who has received and who has not this double taxation, this so-called death tax. The other side says that there is a $3 million exemption under the Pomeroy substitute, that 99.6 percent of estates would be exempted from the death tax. I personally do not need that $3 million exemption or even the $600,000 exemption. I would probably be fine with a $300,000 exemption; but the point is, it is a double taxation and it is wrong. It is wrong to tax anybody twice on the same income. These people, no matter what their net worth, they have paid taxes. They have paid at the highest marginal tax rate; and it is totally wrong, as the gentleman from Missouri (Mr. Hulshof) said, to have to worry about paying taxes after death.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the gentleman from Texas (Mr. Sessions) for yielding me this time. Mr. Speaker, I have to admit, of course, as a freshman legislator, I am here to speak in favor of the rule for the conference agreement to S. 342, the Keeping Children and Families Safe Act of 2003, and to speak in favor of the overall piece of legislation. But I stand here and I am listening to the other side and all of the discussion I hear is about a tax bill, and it just makes me wonder if the speakers from the other side plan to vote against this bill, if they are opposed to keeping children and families safe for the foreseeable future. I am, as most of my colleagues know, a physician Member, Mr. Speaker, of this body; and, in particular, I am an OB-GYN doctor. As such, over the past 28 years, I have delivered over 5,000 precious children. Unfortunately, I wish I could say they were all born healthy and well and in the best of circumstances, but unfortunately, some were not. I think that my passion for this type of legislation, for protecting children and making sure that every child has an opportunity to be well born and in a healthy environment and going into a healthy family situation, that is what this legislation is all about. We can talk about the child tax credit and tax issues ad infinitum, but we have already had that debate. What we are talking about here today on the floor of the House is this conference committee report and the reauthorization of the Child Abuse Prevention and Treatment Act, the Adoption Opportunities Program, the Abandoned Infants Assistance Act, the Family Violence Prevention and Services Act. That is what this debate is about. I would hope and trust that the Members of the other side will support unanimously this legislation, because we desperately need to protect those of our society, the most precious and vulnerable members of our society; and that is what this great piece of bipartisan legislation is all about. I am very proud to serve on the Committee on Education and the Workforce and to serve under my subcommittee chairman, the gentleman from Michigan (Mr. Hoekstra), who brings this bill to us, this reauthorization. It was an honor, it was an honor indeed for this freshman Member of Congress to be appointed to the conference committee on this bill. In fact, the gentleman from Michigan (Mr. Hoekstra) said to me, he had been here 10 years before having an opportunity to be appointed to a conference committee. So it is indeed a privilege. I think it shows a lot of respect for me as a physician Member and someone who is often in that delivery room seeing these children who may be very possibly born in a situation where the mom has been on substance abuse or drugs during the pregnancy and we, many times, are highly suspicious of that situation because of the condition of the child, the irritability of the child during the physical examination. These children have a certain physical appearance which is very suggestive in some instances of alcohol or substance abuse. And to just simply go from that delivery room to the next one or the next one, or go from there to a surgical procedure, and then back to the medical office where you might see an additional 30 patients a day would be unconscionable. So this bill calls for, among other things, reporting these instances. I cannot tell my colleagues how supportive I am of this legislation, and I am proud of the leadership for bringing it to us.

Mr. GINGREY

Mr. GINGREY. Madam Speaker, I rise today to address the House in support of the Medicare Modernization and Prescription Drug Act, which will be marked up in the Committee on Ways and Means and the Committee on Energy and Commerce this morning. Modernizing Medicare with a prescription drug benefit puts a down payment on a healthy future for Americans. The House has an historic opportunity to bring up to date our health care system for millions of seniors. The bill that will soon be before this House reflects the compassionate conservatism of my party. It is compassionate because it is providing much needed prescription drug coverage to Americans on a fixed income. It is conservative because prescription drugs often provide the ounce of prevention that beats the pound of cure. It is conservative because this legislation will serve the people today without breaking the bank tomorrow. It makes no financial sense to cover astronomically expensive surgery and not cover drugs that could have prevented that surgery. We have promised a benefit to our seniors for years. This year, this year, Madam Speaker, it is time to deliver.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, if the gentleman will further yield, this is so important, and I am glad the gentleman from New Hampshire has brought this out because we hear sometimes from constituents proffering the argument that, well, why should we provide a prescription benefit for all seniors, many of whom already have a prescription drug benefit, either through their Medigap supplemental health insurance plan or possibly through their former employer? And I think the statistic that I have heard quoted is it may be up to 65 percent of seniors that have some type of coverage, and I think the gentleman from New Hampshire agrees with me on that. But explain to us why it is still necessary, even though 65 percent have some coverage, that there are certainly some gaps in their coverage. Would you not agree?

Mr. GINGREY. Mr. Speaker, I just wanted to ask the gentleman from New Hampshire to go over once again because it is so important. His comments were so important in regard to our senior citizens fully understanding what is in this proposed legislation in regard to the neediest, and if the gentleman does not mind kind of repeating himself for emphasis in regard to those needy seniors and what they would have to pay, and what is the cap, if you will, above which they would not have to pay anything for those additional drugs?

Mr. GINGREY. I thank the gentleman, my colleague from Georgia, Mr. Speaker. I really want to thank him for reserving this time tonight to give us this opportunity to present during this past hour what it is that we are all about. I think my colleague did an excellent job of emphasizing something that is so important for all of us to keep in mind, which is that this is first of all an option that seniors have. And as the gentleman from Georgia was talking about, it would do very little good, in fact, it may do some harm to try to pass a stand-alone prescription benefit even for our neediest of seniors, even for our neediest of seniors, without bringing along with that in this Medicare modernization bill some significant changes. The gentleman from Georgia talked about that and talked about the Medicare Advantage, which was the old Medicare+Choice, a new and enhanced Medicare+Choice, if you will. He talked about enhanced Medicare fee-for-service. These are the kinds of options that this President, this leadership, is bringing to the American public and bringing to our seniors. But as the gentleman from Georgia emphasized, it is a choice. If a senior wants to stay in traditional Medicare, certainly they could do that, but they would be staying in a traditional health care delivery system which gave them no reimbursement for preventive health care and gave them no protection, as the gentleman from Georgia (Mr. Burns) pointed out, from a catastrophic illness that could literally put them out of their home. I wanted to ask the gentleman from Georgia to explain to us in the remaining few minutes in regard to the prescription benefit for those seniors who are scared to move into the Medicare Advantage or the enhanced Medicare, which I think would be a better service for them. But let us say they do want to stay in that traditional Medicare, it is an old shoe, it is comfortable, they are nervous about it initially, what benefit, what prescription drug benefit will they get? Is there a difference in the traditional Medicare and these enhanced plans?

Mr. GINGREY. Well, I thank the gentleman from Texas. Some of the things I think that we need to point out is that, as I mentioned in my remarks earlier, in 1965, when this plan was devised, there was not a great emphasis on drug therapy. It seemed back then that the main emphasis on health care was the opportunity, of course, to see a physician, to see a health care provider; and many people did not do that because of lack of access, and there just was not that great emphasis on preventive health care certainly. Then a lot of things were cured, quite honestly, by the surgical approach, and as we know today, surgery is extremely important, and our surgeons and our subspecialty surgeons do a great job, but thank goodness a lot of people today, and I think the gentleman from Texas (Mr. Burgess) would agree with me, we would love to keep people out of the hospital. We would love to be able to prevent very expensive surgery, and I can certainly give a personal testimony to that, having recently undergone open heart surgery. Maybe if 15 years ago I had been taking that drug to lower the cholesterol and improve that so-called lipip profile, or if I had been taking a little bit of a blood thinner or something to lower my blood pressure a little bit, I would not have had to undergo that very, very expensive somewhat dangerous and definitely painful surgical procedure. That is why today it is so important, it is so important that our seniors at least have an opportunity not just to go to the emergency room to treat that episode of health emergency care or to be admitted to the hospital after a motor vehicle accident or those who need to after an extended period of stay go to a nursing home, they need prescription medication to keep them out of the hospital. In the final analysis, we know the CBO, the committee on Medicare and Medicaid service and their actuarial services, we know that this prescription benefit, Mr. Speaker, will save money in the long run.

Mr. GINGREY. Mr. Speaker, if the gentleman will yield, my wife told me not to dare admit that, but I did it anyway.

Mr. GINGREY. Mr. Speaker, I thank the gentleman for yielding. Mr. Speaker, as a physician Member of this 108th Congress, I just want to say that I practiced medicine, an OB-GYN practice, for over 28 years; and, of course, most of my patients were fairly young, in the child-bearing age range, and I did not really see a lot of Medicare patients. However, if I were back in that practice today and doing just the gynecology part of that specialty, my practice would be predominantly Medicare patients like my precious 85-year-old mom who has been on Medicare now for 20 years. This program, as we all know, came to us in 1965. I was a freshman medical student in 1965. I really did not understand the system too well. But I knew that back then, prior to Medicare, physicians gave away a lot of their services. They made a lot of house calls. They took a bushel of corn sometimes in lieu of any other financial payment for their services; and they were glad to do that, especially for the neediest of our citizens, many of them seniors. In 1965, Medicare, in a way, was good for these doctors. They were able to get paid for some of this care that they were rendering and at least maybe break even. Over the past 25, 30, 35 years, of course, medicine has changed very much now. And it is extremely difficult, especially for our primary care physicians, our family practice specialists, our general internists, our physicians who are treating cancer, our medical oncologists who see a lot of the seniors. They are not able to continue to provide this care. It is costing too much. The reimbursements are not there. And so many of our physicians, these primary care doctors that are so essential to our precious senior citizens, no longer can they afford to take Medicare patients. So as we go forward and talk about a prescription benefit for our seniors, we need to keep in mind that there have to be providers there, there have to be primary care physicians there to write these prescriptions. So that is why I say that in this 108th Congress, of which I am proud, of course, to be a Member, a freshman Member, this President; this administration; this leadership; this Speaker of the House, the gentleman from Illinois (Mr. Hastert); this majority leader, the gentleman from Texas (Mr. DeLay); this majority Republican Party, and, yes, hopefully the minority party and their leadership, we are ready. We need to address this issue, not only of providing a prescription benefit, especially for the neediest of our seniors, but also of reforming and revitalizing Medicare and bringing it from 1965 to the 21st century. We are dealing now really with what is the equivalent of an Edsel. It is time to get a Thunderbird on the market in regard to health care. Let me just tell my colleagues, Mr. Speaker, and to all of the seniors who are out there, hopefully, listening to this great C-SPAN program tonight, let me tell my colleagues what is wrong with Medicare as it exists today. Not only did we not have any prescription benefit, no prescription benefit whatsoever in 1965, also there was no emphasis on preventive health care. One cannot go to the doctor today under traditional Medicare and have a routine screening physical examination done. One cannot go under Medicare and have a routine cholesterol screening, lipid profile to determine if you are on the verge and at risk of having a serious heart attack or a stroke. If you get that service, you pay for it out of your pocket. And, of course, many of our seniors can ill afford to do that. And the other thing, and maybe most significant in regard to Medicare, is there is absolutely no catastrophic coverage. These seniors, maybe they can, many of them, afford to pay $2,000, $3,000, possibly $5,000 a year in out-of-pocket expenses for a prescription benefit. But once they get to the point of needing four or five or six medications, very expensive medications, I might add, just to sustain the quality of life and to relieve them from suffering, they can no longer afford that. And pretty soon, yes, they do reach the point where they have to choose between paying the rent, buying the groceries, paying the utilities, or getting their prescription drugs filled. So this is the situation that we find ourselves in today. It is imperative that we do something for our seniors. This issue has been with us for several years, long before I became a Member of this Congress. But I am proud to stand here today as part of this majority, realizing that they understand the big picture. The gentleman from California (Mr. Thomas), the gentleman from Louisiana (Mr. Tauzin), the gentleman from Florida (Mr. Bilirakis), and the gentlewoman from Connecticut (Mrs. Johnson), they understand what needs to be done and they realize that this is not just one leg of a stool, but that there are three legs to this stool; and it includes not only a prescription drug benefit for our seniors, but of course it includes a reform of this outdated, antiquated, 1965-era health care system that looks nothing like what my colleagues and I and other Members of Congress have available to us under our Federal health insurance benefit plan. We do not have to worry about being put in the poor house once we get into a situation of serious illness. We have prescription coverage after a copay. So this is the same thing that we want to offer to our seniors. I am proud of the commitment that we have this year, this year, today, hopefully within the next several weeks, that we will have a bill on President Bush's desk that he can sign to give this very, very important relief to our seniors and to reform of the Medicare system. Mr. Speaker, I appreciate this opportunity to present this information tonight and to talk especially, especially to our senior citizens, our moms and dads, our grandparents and, indeed, us in the very near future. It is critical. We need to do it now, and we are going to get the job done. Announcement by the Speaker Pro Tempore

Mr. GINGREY. Mr. Speaker, if the gentleman will yield, just as a follow-up to what the gentleman from Texas (Mr. Burgess) was saying about this other issue, and as everybody knows, we dealt with the HEALTH Act of 2003 earlier in this 108th Congress, H.R. 5, the Medical Malpractice Tort Reform Accountability Act, and of course, we hope that the other body will soon pass that and we will have that legislation before our President. He is so much supportive of this. Let me tell my colleagues the reason why he is so supportive. The savings from bringing a level playing field, we are not in any way wanting to take away the right of anybody to have a redress of their grievances if they have been harmed by their medical care that they received at the practice, either from the physician or from the facility is below the standard of care. Absolutely, they should have their day in court, but just trying to level that playing field, and the estimation, Mr. Speaker, is that there would be $14 billion in savings to the Federal Government on what we pay reimbursement for Medicare and Medicaid and military and veterans benefits because, as the gentleman from Texas (Mr. Burgess) pointed out, the number of unnecessary and duplicate tests that are ordered and procedures that are done, the doctors know they are not necessary, but they are forced into a position because of this risk, this tremendous risk of the next case putting them out of practice or causing that hospital, that rural hospital, to have to close its doors. That is the reason defensive medicine is being practiced, and it is costing us $14 billion. That is 5 percent of our estimated cost of this prescription benefit for our needy seniors. Announcement by the Speaker Pro Tempore

Mr. GINGREY

Mr. GINGREY. I do not believe there is another way to terminate a pregnancy in late term.

Mr. GINGREY. It is the only way to terminate a pregnancy without delivering a live born child. These pregnancies can be terminated by injecting saline or they can be terminated by performing a cesarean section, but the problem there is it is a live child.

Mr. GINGREY. Mr. Speaker, I rise in strong opposition to this substitute amendment. The Greenwood-Hoyer substitute, make no doubt about it, will gut this bill to ban late trimester pregnancy termination just as surely as the procedure itself barbarically guts the life out of nearly born healthy children. There are physicians who, unfortunately, and for a generous consultation fee, will readily certify that a woman's health is endangered by the pregnancy. In fact, the coauthor just a few minutes ago said that health exceptions would include psychological syndromes such as, you name it, extreme anxiety, as well as nebulous physical syndromes, such as chronic adult fatigue. So, in essence, the mother's health exception could be claimed literally in every one of these cases if we approved this substitute amendment and we would have no bill. You talk about the fact that the Supreme Court could possibly rule this ban on partial-birth abortion as unconstitutional. If we vote in support of this substitute amendment, the bill dies right here tonight. In fact, the so-called consultant that I mentioned theoretically could come into the delivery room and declare the woman's health to be endangered within minutes of a spontaneous live birth. The gentlewoman from Connecticut talked about sepsis. I have actually seen these tools that are used to perform this abominable procedure called partial-birth abortion. And you talk about the risk of sepsis developing after that type of a procedure. The gentleman from Virginia talked about the loving parents who would want to terminate the life of a child who was not going to be born perfect. A loving parent will allow that child an opportunity for life no matter how short it may be.

Mr. GINGREY. The gentleman from Texas earlier talked about other late-term pregnancy termination procedures other than this one we know as partial-birth abortion. I do not know exactly what he or you are referring to.

Mr. GINGREY. In those instances, the child would be alive.

Mr. GINGREY. If the gentleman will yield, will the gentleman mind repeating that question?

Mr. GINGREY. I am sorry. I am not understanding you.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, today I am introducing the Ready to Teach Act of 2003 to reauthorize teacher quality provisions under Title II of the Higher Education Act through fiscal year 2008. The first in what will be a series of bills to reauthorize the Higher Education Act, the Ready to Teach Act seeks to meet the call of the No Child Left Behind Act to place a highly qualified teacher in every classroom by making improvements that will help ensure teacher training programs are producing well-prepared teachers to meet the needs of America's students. The caliber of teacher education programs at institutions of higher education has come under increased scrutiny over the past several years. Among other things, teacher preparation programs have been criticized for providing prospective teachers with inadequate time to learn subject matter; for teaching a superficial curriculum; and for being unduly fragmented, with courses not linked to practice teaching and with education faculty isolated from their arts and sciences faculty colleagues. Accordingly, the Ready to Teach Act authorizes competitively awarded grants to: (1) increase student academic achievement; (2) improve the quality of the current and future teaching force by improving the preparation of prospective teachers and enhancing professional development activities; (3) hold institutions of higher education accountable for preparing highly qualified teachers; (4) and recruit highly qualified individuals, including minorities and individuals from other occupations, into the teaching force. As in current law, funds for these grants will be distributed in the following manner: 45 percent of the funds are reserved for State grants; 45 percent of the funds are reserved for partnership grants; and 10 percent of the funds are reserved for teacher recruitment grants. State grants under the Act must be used to reform teacher preparation requirements, coordinate with teacher activities under Title II of the No Child Left Behind Act, and ensure that current and future teachers are highly qualified. Programs administered through state grants would focus on effective teacher preparation, placing a renewed emphasis on the skills needed to meet the highly qualified standard: the use of advanced technology in the classroom, rigorous academic content knowledge, scientifically based research, and challenging state student academic content standards. In addition, states are authorized to use grant funds for innovative methods for teacher preparation programs, such as charter colleges of education, which can provide an alternative gateway for teachers to become highly qualified. Teacher advancement and retention initiatives will also be created, such as merit-based performance systems and professional growth opportunities. These activities will help ensure that schools are able to recruit highly qualified teachers while having the necessary flexibility to remove incompetent or unqualified teachers. The Ready to Teach Act authorizes partnership grants so educational entities can combine expertise and resources to improve teacher training. Each eligible partnership must include at least: (1) a high quality teacher preparation program at an institution of higher education; (2) a school of arts and sciences; (3) a high need LEA; and (4) a public or private educational organization. Among other things, partnership activities will help to ensure that teachers are able to use advanced technology effectively in the classroom, address the needs of students with different learning styles (particularly students with disabilities), and receive training in methods of improving student behavior in the classroom. Teacher recruitment grants under the Ready to Teach Act will help bring high quality individuals into teacher programs, and ultimately put more highly qualified teachers into classrooms. The Ready to Teach Act recognizes the need to ensure that high need local educational agencies are able to effectively recruit highly qualified teachers, and will help answer that need by increasing the number of teachers being trained. Additionally, this legislation places a priority on applicants that will emphasize measures to recruit minorities into the teaching profession. Current law provisions in Title II of the Higher Education Act include annual reporting requirements to hold states and teacher preparation programs accountable for producing a competent teaching force. The Ready to Teach Act strengthens these reporting requirements to ensure complete and effective information is available to determine the effectiveness of teacher preparation programs. Under this legislation: States must report annually to the Secretary of Education on the percentage of students passing state certification or licensure and rank the quality of all teacher preparation programs in the state. The Secretary of Education must analyze teacher qualifications and preparation in the United States, providing: a comparison of states' efforts to improve teaching quality; and the national mean and median scores on any standardized test that is used in 1 or more state for teacher certification or licensure. Institutions of higher education with teacher preparation programs must report on the number of students passing state certification requirements, with improved reporting requirements that will prevent ``gaming'' of data that leave results without meaning. Additionally, institutions must compare both pass rates and average scores of their program participants with those of other programs in the state, making effective comparison data available to measure program quality. The Ready to Teach Act of 2003 will improve the quality and accountability of our nation's teacher preparation programs. I ask my colleagues to support this legislation and look forward to working with the distinguished Chairman of the Subcommittee on 21st Century Competitiveness, Mr. McKeon, and the Ranking Member of the Subcommittee, Mr. Kildee, to move this bill so we can ensure our children are receiving a world class education.