Phil Gingrey

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today in support of National Prematurity Awareness Day. I stand with parents and physicians, organizations and associations around our country that are working to draw attention to the serious and growing problem of premature birth. Nearly 500,000 babies will be born prematurely this year. In my own State of Georgia, 342 premature babies will be born this week. It is a serious problem, one that is far too common. Unfortunately, in most cases, we do not know why it happens. From my experience as an OB-GYN physician for nearly 30 years, I know the anxiety, confusion, frustration and concern that premature birth places on both the families as well as the medical system. That is why I am a proud cosponsor of H.R. 2861, the PREEMIE Act, which was introduced by my friend and colleague from Michigan (Mr. Upton). Mr. Speaker, I am here today not only to encourage my colleagues to cosponsor this important piece of legislation but also to let the women in our country know how important it is to talk to their doctors about the risk factors associated with pre-term birth. Together, we can work to find a solution to this very costly crisis.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I have an hour as the designee to talk about the subject that I want to bring to my colleagues, but I think I need to take at least a few seconds of my time from this side of the aisle to express my and our heartfelt sympathies to our colleague, the gentlewoman from California (Ms. Roybal-Allard), on the death of her father. I spent the last 15 minutes listening to their special hour and learning about that great, great American who represented the State of California so well in this body for 30 years; and I want to express my sympathy to my colleague from California. Mr. Speaker, today, November 15, is a historic day and not just because it is my wife Billie's birthday, which it is. Happy birthday, honey. But really the historic aspect of today is the roll-out and the sign-up today for the first of a 6-month window of opportunity for our seniors to voluntarily sign up for the Medicare part D prescription drug plan which this Congress made available to them in December of 2003. So indeed, Mr. Speaker, today, November 15, is indeed a historic day. I have seen clips of the original signing of the Medicare legislation back in 1965 when President Lyndon Baines Johnson signed that bill into law. Actually, the very first person to sign up for the other voluntary part of Medicare, the part B which is applicable to the physician care and outpatient testing, not the hospital part but the voluntary part, the first individual to sign up for that was former President Harry Truman, that being 40 years ago. Here we are now finally, Mr. Speaker, after all of these years, offering something that was left out of that original program, I guess for a fairly good reason. Maybe back then, I was a freshman in medical school, I barely knew who was happening, but there was not quite the emphasis then on prescription drug treatment. We had some good prescriptions but not nearly what is available to our public and our seniors today; and there was much more emphasis on trying to get hospital care and needed surgery, emergency room care, indeed long-term care, skilled nursing home care for people who had, as an example, suffered a stroke. So this was all very, very important in the program; and I know my colleagues on both sides of the aisle would agree with me it has been a great success. There was some concern, though, I remember this much about it as I was working as a scrub technician during the summertime hearing the doctors at the scrub sink before they went into surgery, talking about this new law that was going into effect, this Medicare bill. There was some naysayers, no question about it, and some were downright opposed to it. But so many seniors were living in poverty and not getting needed health care, and it at that time was a Godsend for them. Mr. Speaker, I will say this. I think today, starting today, November 15, 2005, some 40 years later another Godsend is coming to our seniors, brought to them by this Congress and this President, this administration, and that is the Medicare part D prescription drug coverage. It is especially a Godsend for those seniors who are living at or near the Federal poverty level, and I say that because heretofore they have not been able to afford prescription drugs. They go to their doctor and get maybe a handful of prescriptions because many of our seniors who are living just off of a Social Security check are the very ones that have what are called co- morbidities, more than one disease, maybe high blood pressure, heart disease and diabetes; and they need to take four or five or maybe six prescriptions a day. They are the very ones who cannot afford it, not that they do not want to. They want to take care of themselves, but they also want to eat, and they want to have a roof over their head, and they have to pay their utility bills, so this program is so necessary for them. In the past, Mr. Speaker, what has been happening is they would put off taking care of themselves because they have could not afford the prescriptions. Then, when some catastrophe would occur, they would finally get care, whether it was in the emergency room because their high blood pressure led to a stroke or whether it was on the operating table because their blood sugar, their diabetes was out of control and led to a limb becoming gangrenous and needed an amputation or maybe even because of high cholesterol they would have to have open heart surgery. We have finally begun this prescription drug part D sign-up as of today, and that is what makes November 15, 2005, so historic. I want to spend most of my time then talking about this aspect of the Medicare Modernization Act of 2003. There are other things that I think are going to be tremendously helpful. I will mention just briefly, Mr. Speaker, the fact that with this change in the law, for the first time a senior can actually go to his or her internist or family practitioner, we call them primary care specialist, and get a complete, thorough physical examination when they turn 65, if you want to call it an entry-level physical examination. In the past, that was not paid for, and a lot of these diseases that I have already spoken of in their earlier stages have no symptoms at all, and people really do not know, but with this new program, they get an opportunity to go have that physical exam. Also included in the modernization piece is the coverage for a lot of screening tests that were not included in the original Medicare. I am talking about things like mammograms, screening for breast cancer obviously; colonoscopies, screening for colon cancer; PSA blood testing, screening for prostate cancer. I am talking about checking blood sugar. I am talking about getting a cholesterol level to see if the patient needs to be on one of these statin drugs that do such a great job of hopefully preventing heart attacks. All of this is now available to our seniors. I am not going to spend a lot of time, as I say, Mr. Speaker, on that aspect of the bill because I really do want to spend most of the hour talking about the prescription drug part because it is so important. I have got a few posters here, and we will be referring to them from time to time. I also have some of my colleagues that have worked so hard and been so supportive of this legislation and are working hard in their districts as we roll out this program. As they go home, usually we get back into the district on Thursday or Friday morning, and I know a lot of our colleagues on both sides of the aisle are holding town hall meetings and trying to explain to the seniors and assure them that although this is somewhat complicated, there are people there to help them through the process and encouraging them, especially the low- income individuals that I spoke of, to sign up and sign up early. They do have 6 months to do it. It starts November 15, today, and goes until May 15 of 2006. They have that window of opportunity; but it would be a real mistake, particularly for our low-income seniors, not to get signed up before the end of the year because the program really starts, Mr. Speaker, and I know my colleagues are aware of this, it starts on January 1. So if they wait till the last minute into May of 2006, they will have actually missed 5 months of opportunity, in many instances, to get their prescription drugs with hardly any cost, and I will repeat that, with hardly any cost except maybe $1 if their medication is a generic drug and $3 to $5 if it is a brand-name prescription drug. So I will have a number of my colleagues joining me, and we will be calling on them in just a few minutes. I want them to take as much time as they would like to talk about what they are doing in their districts, how they feel about this program, what sort of feedback they are getting from their seniors, and then maybe we will engage also in a little bit of colloquy. Let me call my colleagues' attention to this first slide, which I think begins to tell the story: ``Helping seniors get the medicine they need to stay well.'' That is what it is all about. It is not an emphasis on episodic treatment and maybe trying to catch the horse after the barn door has been left open when some catastrophe occurs. It is so much more difficult, rather, to get the medicine they need to stay well. I do not think we can really emphasize that too much. Now, Medicare helps seniors prevent disease in addition to treating it. I said at the outset, in 1965, all of the emphasis was on treating it, and that was good, but not the 21st century medicine. We need to emphasize the prevention of disease. Medicare part D, it is important that our seniors know that this option, prescription drug coverage, really is for all seniors. It is not just the low-income. I mentioned them, and we will talk about throughout the hour, but no matter what a person's income, if they are a Medicare recipient, either because they are 65 years old, and that is probably 36 or 37 million in this country, or because of a disability at a younger age, and there are probably 6 million or 7 million of our citizens who are on Medicare because of a disability, but all of them, no matter what their income level, they are eligible for Medicare part D. As I point out in this next slide, it is a voluntary program. Seniors must choose to enroll. They will be getting lots of information and have gotten lots of information, whether it is public service announcements on television or mail pieces that have come from CMS, the Committee on Medicare and Medicaid Services, information maybe they obtained from a senior center, from their physician's office or, indeed, from their Member of Congress' office, either in Washington or in the district, but they do have to make that decision. It cannot and will not be made for them. There are going to be many plans. Seniors will have a choice of plans. We estimate that the monthly premium, and it is premium-based just like Medicare part B, Mr. Speaker, is a premium-based and an optional program. By the way, I would guess that I am accurate in saying that 98 percent, maybe more, of seniors have chosen and will continue to choose to enroll in that premium-based part B that covers the doctor's expense and outpatient testing and surgery because it is a very good deal. We will talk a little bit later about what percentage of seniors we think will want to sign up for the Medicare part D, the prescription drug part; but it will be a substantial number. We are estimating that the monthly premiums for that monthly benefit will be about $25 on average, some plans less, some plans more, depending on what the coverage is. All Medicare-approved plans cover both prescription and generic drugs, and they are accepted at local pharmacies. That is very important because people want to know if they can continue to go to that corner druggist. In no way am I suggesting that the chains, the Eckerds, the Walgreens, the CVSs that do such a great job, are not a wonderful place to go and get prescriptions filled. They are. Many of our seniors will choose that type of location, but others who have a pharmacist friend that they have known for many years, they call them doctor and go to church with them, a lot of times they are able to charge their prescriptions and pay a little bit along, the kind of service that only a small corner druggist can give. That is very important that they know that they will be able to continue as part of this program to be serviced by those great pharmacists that we call corner druggists. Mr. Speaker, before I call on my colleague, the gentleman from Texas (Mr. Carter), for his remarks, I want to just present one more poster; and, again, I do not think we can emphasize this too much, that is, this issue of the dates; and I have already mentioned several times that today is the starting date, November 15, for enrollment. This little icon, if you will, shows an hourglass, and that means that starting today the sands of time, that 6 months, is ticking away. Of course, the program, if you get signed up right away, you reap the benefits starting January 1. Then if you sign up before May 15, that 6- month window, then you incur no penalties; but after that, there are some penalties for signing up late. Again, I am sure some of my colleagues will talk about that. At this time, I am very happy to see the gentleman from Texas (Mr. Carter) with me again to share one of these hours on health care issues. The judge knows a lot about legal issues and the judiciary, but he also knows a lot about health care. So I am honored at this time to yield to the gentleman from Texas (Mr. Carter).

Mr. GINGREY. Mr. Speaker, reclaiming my time, I thank the gentleman from Texas for being with me. I appreciate his comments tonight. I welcome him to, if possible, to stay around and maybe we can get involved in a colloquy or I can respond to his questions and yield to him. Mr. Speaker, the thing that he pointed out, that little anecdote, true story, about that little lady in Round Rock, that is why it is so important. I appreciate Judge Carter mentioning that, because this is real, and the emphasis that he put in his remarks on how important it is to get signed up is real. Thanksgiving is going to be upon us pretty soon. I think I am correct in saying a week from Thursday. And what comes the day after? Well, I call it ``black Friday,'' Mr. Speaker. That is that big shopping day, the first day of the Christmas season when everybody hits the malls. I think that would be a great day for families, children, grandchildren to sit down with their grandparents, children to sit down with their parents and help them. That would be a wonderful day. It would save money as well, probably. The retailers may not like me very much, Mr. Speaker, for mentioning that, but that would be a great day to just sit down and say, look, I am pretty good at the computer, Mom, Dad, and let us go on-line, let us get on www.Medicare.gov. If I tried to do that, that computer would start smoking, and everybody in my office knows that. Anytime I need to do anything on the computer, they have to hold my hand. So I understand the need and the fear of computers. But really for the younger people especially, it is a challenge. It is pretty easy for them. They have learned it in high school and college, and some of them even work in the industry. So help is readily available, as Judge Carter said; and it is not that difficult. I called this morning. I think it was about 8:30, and I decided I was just going to call 1-800-Medicare just to see how long it took to get somebody on the telephone. Mr. Speaker, I had a response in about 3 minutes. The first time I dialed, I got a busy signal, and so I immediately, within a matter of seconds, dialed again and got right through and began the process. Now I am not quite 65, and I did not have a card and a number, so at some point I had to quit. I had to hang up. It was a bogus call. But I was very impressed. Of course, CMS has hired and trained, and that is very important, not just hired but trained probably by a factor of four the number of employees that they normally have responding to these calls. So, as Judge Carter said, that information, that help is there, whether it is by the telephone or on the Web site, and we will get into the specifics of how a senior prepares themselves for this process. There is something called worksheets that are available through CMS. Those are easily obtained, and people just kind of go through that worksheet. We will talk about it a little later in the hour, so that when those questions come up, and, again, they are not difficult, they know the answers, and we can help them through the process. Mr. Speaker, I see that we have been joined by another of our colleagues and not just any colleague because this is my good friend and fellow physician, indeed a fellow OB-GYN physician who came in in the 108th Congress with Judge Carter and me, the gentleman from Texas. So I yield to the gentleman from Texas (Mr. Burgess) to give us a little of his insight into this program and what he is doing in his district.

Mr. GINGREY. Mr. Speaker, one thing that the gentleman from Texas (Mr. Burgess) mentioned was the fact that if a senior is interested in a mail order opportunity, then as they go through that list, the litany of companies that provide a benefit, they may want to choose one that would allow them to get their drugs in a mail-order fashion. So that option is available. I had mentioned earlier in the evening talking about the worksheet and what a senior would need to have if they are dialing the 1-800 Medicare number or dialing the Web site with or without assistance at www.Medicare.gov, or coming to one of the congressional offices to get help, they need that work sheet and that work sheet should include and should already be filled out. Again, it is information that the seniors know. First and foremost, it should include a list of the prescription drugs that you are currently taking, including the dosage, the milligram, the strength, if you will, and how often you are taking those drugs. Secondly, information about any prescription drug coverage you currently have, be it employer or union-sponsored or a Medigap policy. Or maybe you are a veteran and have TRICARE for Life, or possibly you are retired State or Federal employee and you have coverage that includes a prescription drug benefit. You need to have that information so we can put that into the formula and help you decide whether you want to continue with that program or opt for the Medicare part D program, whichever is better, whichever really is the best deal, unique to your situation. And of course the name and address, as Mr. Burgess and Mr. Carter both said, the name of the local pharmacy that you use to fill prescriptions. So we will need your ZIP Code as well and the out-of- pocket amount you spend on prescription drugs each year currently. Again, I know our seniors know that because they are real good accountants. They have to watch every dollar, and it is important that we know that. And then last but not least, your Medicare enrollment information, your Medicare number and your address and all of those particulars, whether you are on traditional Medicare or Medicare Advantage under an HMO or PPO-type program. Mr. Speaker, I see that we are joined by another health care professional, the gentleman from Pennsylvania (Mr. Murphy). Mr. Murphy has been with us on just about all of these hours that we have done on health care and this particular issue.

Mr. GINGREY. Mr. Speaker, I call on the gentleman from Texas (Mr. Burgess) and enter into a colloquy with you on that issue.

Mr. GINGREY. If the gentleman from Pennsylvania would yield for just a second in regard to that issue. As you go through the Web site, it is important that our colleagues know to let their seniors understand that there is a page there, and Mr. Murphy was referencing that, where you are able to compare the different plans. Let us say you have several in your community that are available to you, and you narrow it down by the process of whether or not they allow mail order, if they have good discounts for all of the drugs you are on or three out of the four, and then you finally narrow it down maybe to three or four that you want to choose from. As you go through this process, and again there is someone right there to guide you through it, you can see really what your cost per year, as Mr. Murphy was referring to, what each plan would be and then make that intelligent choice, based on a lot of factors, but not the least of which, of course, is that cost factor.

Mr. GINGREY

Mr. GINGREY. Reclaiming my time, Mr. Speaker, I will simply close by recognizing the hard work and the incredible effort of Subcommittee Chairman Wolf and all of the House and Senate conferees. Reconciling differences between the two Chambers is rarely a simple task, but I believe they have once again risen to the occasion and they have produced a conference report that may not please everybody with everything, but it gets the job done by appropriately balancing our spending needs with our budget. Mr. Speaker, the American people demand and they expect responsible spending to support law enforcement, strengthened diplomacy which builds upon our competitive edge. Today, it is my hope that we have delivered. So I ask my colleagues for their full support of the rule and this underlying bill. Mr. Speaker, I yield back the balance of my time, and I move the previous question on the resolution. The previous question was ordered.

Mr. GINGREY. Mr. Speaker, on that I demand the yeas and nays.

Mr. GINGREY. Mr. Speaker, I reserve the balance of my time.

Mr. GINGREY. Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Massachusetts (Mr. McGovern), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only. House Resolution 538 waives all points of order against the conference report and against its consideration and provides that the conference report shall be considered as read. Madam Speaker, I rise today in support of House Resolution 538 and the underlying conference report for H.R. 2862, the Science, State, Justice, Commerce and Related Agencies Appropriations Act of 2005. This conference report provides $57.85 billion, $2.5 billion less than the President requested, to fund the Departments of Justice, Commerce and State along with NASA, the National Science Foundation, the Federal Communication Commission, FCC, the Securities and Exchange Commission, SEC, the Legal Services Corporation, and the Small Business Administration, SBA. In recognition of the continual requirement to reassess our security and law enforcement needs, this conference report establishes responsible priorities to enable law enforcement to meet threats abroad and at home in order to secure our communities. Madam Speaker, this conference report provides $5.8 billion for the FBI, an increase of $547 million above fiscal year 2005 and $15 million above the President's request. It provides $1.7 billion for the Drug Enforcement Agency, the DEA, and this is a $48 million increase above fiscal 2005, and it is $8 million below the President's request. It provides $802 million for the United States Marshals Service, and this is an increase of $42 million from fiscal year 2005 and actually $12 million above the President's request. Additionally, included in the conference report is $924 million for the Bureau of Alcohol, Tobacco, Firearms and Explosives, an increase of $41 million above fiscal year 2005, and it is the same as the President's request. Further, this conference report contains $2.7 billion for assistance to State and local law enforcement for crime-fighting initiatives, $1.1 billion above the President's request and actually $287 million below fiscal year 2005. This amount includes $405 million to reimburse States for criminal alien detention costs, $387 million for violence against women prevention and prosecution programs, $416 million for the Edward Byrne Discretionary Grants program, $340 million for juvenile delinquency prevention and accountability programs. It includes $109 million to eliminate DNA analysis backlogs, $140 million for law enforcement technologies and interoperability, $64 million for methamphetamine hotspots, and $40 million to reduce gang violence. Madam Speaker, this conference report appropriates $6.6 billion for the Department of Commerce, marking a decrease of $37 million from fiscal year 2005 and a $2.9 billion increase from the President's request. Recognizing the importance of space exploration that has fascinated minds for generations and provided many breakthrough technologies, this conference report matches the President's request of $16.5 billion to NASA, the National Aeronautics and Space Agency, and this is $260 million above fiscal year 2005. The bill provides funding for space exploration and the space shuttle program, restoring the aeronautics research program. Additionally, the National Science Foundation would receive $5.65 million of much-needed funding to drive American research and education, thereby keeping this country on the cutting edge of advanced technology and research. This conference report also provides $9.6 billion for the State Department and the Broadcasting Board of Governors, including $1.6 billion to continue worldwide security improvements and replacement of vulnerable embassies; $4.4 billion for diplomatic and consular programs; and $652 million for international broadcasting, including expanding broadcasting to the broader Middle East. Finally, Mr. Speaker, this conference report includes $456 billion for the Small Business Administration, $290 million for the Federal Communications Commission, $888 million for the Securities and Exchange Commission, and $331 million for the Legal Services Corporation. While this conference report is not perfect, all in all it adds up to better protection for our communities, stronger law enforcement at home, more vigorous diplomacy abroad, and improved scientific research and technology. This is the kind of fundamental support that Americans expect from this Congress. These are true national priorities, balanced with our budgetary restrictions and with fiscal responsibility in mind. Therefore, Mr. Speaker, I would like to ask my colleagues' support of the rule and the underlying conference report. Mr. Speaker, I reserve the balance of my time.

Mr. GINGREY. Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 538 and ask for its immediate consideration.

Mr. GINGREY. Mr. Speaker, I agree with my colleague, the gentleman from Massachusetts, regarding some of the statements he made about torture. Certainly the provision in this bill concerning that prohibits funds, as he pointed out, from being used in any way whatsoever to support or justify the use of torture by any official or contract employee of the United States Government. I know the gentleman was not suggesting that this President or any Member of this Congress condones torture. Mr. Speaker, I had the opportunity, not once but twice, to visit the detention facility at Guantanamo Bay, and on each occasion I was accompanied by a Member from the other side of the aisle, a respected Democratic member on the Armed Services Committee. This was long before, Mr. Speaker, the occurrence at Abu Ghraib in Baghdad. Again, I say I went on two different occasions and at no time did I see any evidence whatsoever of torture. What I did see was the International Committee of the Red Cross there interviewing the detainees in privacy, without any detention officers or any member of our military present. So these detainees had every opportunity to complain, and certainly complain they did. I know as a matter of fact, Mr. Speaker, that a number of our troops were reprimanded because they overreacted on occasion when they were cursed and spat upon and had human excrement, feces, and urine tossed in their face. But this is not cruel and inhumane punishment. I know the gentleman from Massachusetts is a great advocate of human rights, and I think he is right on what he is standing up for. And, again, the unfortunate occurrence at Abu Ghraib at Cellblock 1 on the night shift by a few miscreant Reservists is deplorable and intolerable, and it will not be tolerated. I know that our military responded and responded in the correct way. So, certainly, I just want to say I agree with the gentleman on his comment that we cannot tolerate that.

Mr. GINGREY. I yield to the gentleman from Massachusetts.

Mr. GINGREY

Mr. GINGREY. Madam Speaker, I also rise today to pay tribute to America's veterans, whose brave efforts have safeguarded those values we hold dear: freedom, liberty, democracy, and the American way of life. This week, as we celebrate Veterans Day, I hope all Americans will take the time to thank a veteran for his or her service to our country. From our Nation's founding days, we have appreciated and recognized the sacrifices and valor of our veterans. General George Washington noted in 1776 that American soldiers ``have done all I have asked you to do, and more than can be reasonably expected.'' Our veterans today rise to this same challenge. America's veterans fought to preserve our great Nation, to liberate the oppressed, and to hold fast to the idea that freedom and liberty are universal rights worth fighting and, yes, sometimes dying for. I want to thank all of our veterans for their selfless service. From Omaha Beach and the Pacific seas, to the jungles of Vietnam and the sands of the Middle East, we live every day with the gift of liberty because you secured our freedom and the freedom of generations to come.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 540 and ask for its immediate consideration.

Mr. GINGREY. Mr. Speaker, for purposes of debate only, I yield 30 minutes to the gentlewoman from California (Ms. Matsui), pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for purposes of debate only. Mr. Speaker, House Resolution 540 is a structured rule which provides 1 hour of general debate equally divided and controlled by the chairman and the ranking minority member of the Committee on the Judiciary. It waives all points of order against consideration of the bill. It provides that the amendment in the nature of a substitute recommended by the Committee on the Judiciary and now printed in the bill shall be considered as an original bill for the purpose of amendment and shall be considered as read. It waives all points of order against the committee amendment in the nature of a substitute. It makes in order only those amendments printed in the Rules Committee report accompanying this resolution. It provides that the amendments made in order may be offered only by a Member designated in the report, shall be considered as read, shall be debatable for the time specified in the report, equally divided and controlled by the proponent and an opponent. It shall not be subject to amendment or a demand for division of the question in the House or in the Committee of the Whole. It waives all points of order against the amendments printed in the report and provides one motion to recommit with or without instructions. Mr. Speaker, I rise today to speak on behalf of House Resolution 540 and the underlying bill, H.R. 1751, the Secure Access to Justice and Court Protection Act of 2005. First, I want to extend my gratitude to the gentleman from Wisconsin (Chairman Sensenbrenner) of the Committee on the Judiciary. I also would like to thank the ranking member, the gentleman from Michigan (Mr. Conyers) as well as the gentleman from Texas (Mr. Gohmert), the author of this important piece of legislation. As I previously noted in my opening statement for the rule on H.R. 420, the Lawsuit Abuse Reduction Act of 2005, this past month has ushered in the passage of very meaningful and very significant legislation to reform and strengthen our courts both procedurally and substantively. Today we have an opportunity to strengthen our courts in a more literal sense by protecting them against a rising tide of violence that has harmed and claimed the lives of innocent individuals charged with enforcing and upholding our laws. It was only a number of months ago that tragedy struck the Fulton County courthouse in Atlanta, my home State of Georgia. There, as most of America watched and sorrowfully remember, on March 13 a cold-blooded killer took the lives of four innocent people, forever robbing their families and depriving our legal system of the distinguished service of Fulton County Superior Court Judge Rowland Barnes, age 64; his court reporter, Julie Anne Brandau, age 46; Fulton County Sheriff Deputy Hoyt Teasley, age 43; and Federal agent David Wilhelm, age 40. Mr. Speaker, law and order, not violence, should permeate our courts. Accordingly, H.R. 1751 would take important steps to deter and punish those who would exact revenge because they were caught in a criminal activity. First, this bill will further punish any individual who would seek to influence, impede, or retaliate against a judge, a prosecutor, a law enforcement officer, or their families by increasing the penalties and providing new mandatory minimums such as 30-years-to-life mandatory minimum for kidnapping. Additionally, each and every day men and women in law enforcement and public safety across this country proudly don their uniforms, fully recognizing that they represent their cities, States and their country; and they proudly assume a substantial amount of personal risk to do so. Therefore, H.R. 1751 would establish as a new category of criminal offense the killing, the attempted killing, or conspiracy to kill any public safety officer for a federally funded public agency. This legislation defines ``public safety officer'' as an employee or officer of the judiciary, a firefighter, a law enforcement officer, or any other State or local employee. This bill would also crack down on the disclosure on the Internet of personal information of judges, court personnel, law enforcement and safety officers, jurors, and witnesses. Mr. Speaker, I would also like to emphasize H.R. 1751's protections for jurors, witnesses, victims, and informants. The reality is that criminals or their associates can have the means to intimidate victims, and especially witnesses, essentially muscling them out of the courtroom. Accordingly, this bill goes a long way to ensuring the safety of witnesses and victims in order to keep their testimony in the court and keep the criminals behind bars. This legislation expands the current framework between the United States Marshals Service and the Administrative Office of the United States Courts to facilitate consultation and cooperation in the development of security standards and requirements for our courthouses. It prohibits the possession of a dangerous weapon, including a firearm, in a Federal court facility; and it creates opportunities for State courts to improve security through discretionary Byrne grants. Mr. Speaker, in recent debates, some of my colleagues have unfortunately called into question the importance of legal reform in this country to the point of insinuating that such reforms are not worth this House's time for consideration. Well, Mr. Speaker, the judicial branch affects the lives of every single American and almost every aspect of American life from conception to natural death, and sometimes even after death. Therefore, I think legal reform has and will continue to be a very appropriate matter for consideration and a good use of this Congress' time, especially when we are dealing with the safety of those men and women involved with our all-important third branch of government. Again, Mr. Speaker, I look forward to the consideration of this rule. I ask my colleagues to support it and the underlying bill. Mr. Speaker, I reserve the balance of my time.

Mr. GINGREY. Mr. Speaker, I yield such time as he may consume to the gentleman from California (Mr. Dreier), the chairman of the Rules Committee. (Mr. DREIER asked and was given permission to revise and extend his remarks.)

Mr. GINGREY. Mr. Speaker, I would like to close in celebration of the men and women who put their lives on the line every day, whether by working the beat, extinguishing a four-alarm fire, or ensuring equal justice under the law by means of the gavel. As I mentioned earlier, when these individuals put on their uniforms, they become representatives of the community in service of the community. They are not enforcing their own will; but they are, rather, seeking guidance from and working to uphold the laws of the land. Mr. Speaker, while there are some individuals who are occasionally accused of abusing their power, the vast majority, the vast majority, of these civil servants are only doing their job admirably; and, therefore, there is absolutely no justification for an accused or guilty individual to ever attach their anger to or seek revenge against these individuals who are only doing their duty. Unfortunately, the increase of violent activities against judges, and we talked about that here during this hour, court officers, witnesses, victims, and law enforcement has made this bill not only necessary but also a top priority in the preservation of our system of law and justice. Mr. Speaker, I look forward to the discussion of H.R. 1751 and the numerous amendments this rule has made in order. As always, I urge my colleagues to support the rule and the underlying bill. Mr. Speaker, I have no further requests for time, I yield back the balance of my time, and I move the previous question on the resolution. The previous question was ordered.

Mr. GINGREY. Mr. Speaker, on that I demand the yeas and nays.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today to encourage all Americans to take the time to prepare an advance directive. November is National Hospice and Palliative Care Month, and this month should serve as a reminder for individuals to take the time to discuss with their loved ones important end-of-life and medical decisions. As people discuss their end-of-life health care wishes, there are two legal documents that can help. The first is a living will. Living wills are probably the most recognizable and familiar document to aid individuals in communicating their wishes. However, Mr. Speaker, today I would like to draw the attention of the American public to a different type of advance directive, a medical power of attorney. A medical power of attorney, or health care proxy, allows you to appoint a person whom you trust to serve as your health care agent. Each State government has a medical power of attorney form that a citizen can fill out and have witnessed. This then authorizes the appointed agent to make health care decisions on an individual's behalf. Mr. Speaker, people should not be scared away by these forms; they are written in plain English, and they are very easy to fill out. I have brought with me an example from my home State of Georgia in order to illustrate how easy this process can be for the American public. The form is simple and straightforward, and is only 6 pages long. I have highlighted two sections for us to look at today. First is the portion where you identify yourself and then name your power of attorney, and I call my colleagues' attention to the first poster. It may be a little bit difficult to read from the back of the Chamber but basically, Georgia's statuary short form durable power of attorney for health care. And the instructions, again, pretty simple. Print the date, print your name and address, print the name and address of your agent. It is that simple. This authorizes the individual to act for you and, as my colleagues can see, in Georgia, you have the opportunity to initial the statement also. This is the second poster, Mr. Speaker, to check the box really that best reflects your wishes, and there are three. It is just a simple, initial process. The first one is, I do not want my life to be prolonged, nor do I want life-sustaining or death-delaying treatment, et cetera. The second check box: I want my life to be prolonged, and I want life-sustaining or death-delaying treatment to be provided, under certain circumstances. And then the last box, and again, a simple check: I want my life to be prolonged to the greatest extent possible without regard to my condition, the chances I have for recovery, or the cost of the procedure. It is as simple as that. In addition to State government and public health departments, many organizations and hospitals around the country have advance directives available for patients and loved ones who may find themselves facing these tough decisions. Mr. Speaker, executing living wills and powers of attorney are so important, I plan to introduce legislation next week that encourages all Americans at all stages of life to prepare these advance directives. My legislation will offer a one-time, refundable tax credit to those individuals who prepare an advance directive. The refundability of this tax credit is essential in incentivizing lower-income Americans, who often are unaware or unable to adequately prepare for end-of-life medical decisions, to prepare advance directives to ensure that their wishes are honored and valuable health care resources are used where they are needed and wanted. Mr. Speaker, it has been shown that medical care at the end of life consumes almost 15 percent of our country's health care budget and nearly 30 percent of the Medicare budget. In addition, according to an article in the Journal of the American Medical Association, it has been estimated that hospice care and advance directives can save between 25 and 40 percent of health care costs just during the last month of life. Mr. Speaker, the Federal Government needs to provide an incentive to the American people to have these conversations and to take these important actions. It is not only in the best interests of patients and families, but also our country's health care system and the American taxpayer. Mr. Speaker, I would like to encourage my colleagues on both sides of the aisle to join me in cosponsoring this important piece of legislation.

Mr. GINGREY. Mr. Speaker, I ask unanimous consent to speak out of turn.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I appreciate the gentlewoman from Tennessee for yielding, and I do want to speak a little bit about the Medicaid program. The gentlewoman from Tennessee and the struggle that that State has had with their Medicaid program and TennCare, the cutbacks that have been necessary, she understands as well as anybody how important it is to make sure that these programs work the way they were intended to work, Mr. Speaker. As the gentlewoman from Tennessee (Mrs. Blackburn) points out, we are not talking about cutting anything. We are talking about reforming government. I mean, this Republican majority has a plan to reform government, to effect savings for our taxpayers and to spend their money wisely and efficiently and to spend it for those who have the need and to eliminate all this waste, fraud and abuse that is so rampant in government and certainly in the Medicaid program. But as the gentlewoman from Tennessee (Mrs. Blackburn) points out, this is no cut. The reduction in the growth rate is what we are talking about, Mr. Speaker. Medicaid, over the last 5 years and in this current fiscal year, is growing at 7.3 percent a year, 7.3 percent a year growth rate. So we have in this plan to cut that growth rate by three- tenths of 1 percent, cut it from 7.3 percent to 7 percent over the next 5 years. Today, in fiscal year 2006, before this cut, we are spending $200 billion with a B on the Federal part of Medicaid. Over a 5-year period, in 2010, because of that 7 percent rate of growth, we will be spending $260 billion. So our colleagues on the other side, they want to say, oh, you are cutting, you are cutting to the bone, you are taking away. They call it Robin Hood taking away from the poor and giving to the rich. This program, Mr. Speaker, will continue to grow at a healthy 7 percent rate, but we are talking about cutting waste, fraud, and abuse. Yes, we are going to cut that. We are going to cut out this situation where people are gaming the system and it happens. It happens in every State, including my own. What is so tragic about that is that then you end up taking money away from those people, those pregnant women, those young children, those aged and infirm that really, really need our help. With this plan and these savings that we can effect, that is who the help will go to, exactly where it is needed. I want to take a little time to explain one thing that I think is so important that my colleagues and anybody who might be listening to these proceedings tonight understands very clearly. With long-term care in this country, we have a huge problem; and it is shocking when you find out that probably 70 percent of nursing home care is paid for with Medicaid dollars. Some of those people who are in long-term care facilities, a skilled nursing home is what I am referring to, they clearly are low income. They do not have the financial wherewithal once their Medicare benefit runs out, and it does pretty quickly; and they need to have that Medicaid benefit. But 70 percent of all expenditures for skilled nursing home care is coming out of the Medicaid program. Something is wrong with that, and what it is is people and maybe it is not the individual so much as a smart lawyer figuring out a way to game the system. So in this reform, Mr. Speaker, we are saying that if a person, an individual, has more than $500,000, I believe that is a half a million if my math is correct, if an individual has more than $500,000 equity in their home, then they are not going to be eligible for Medicaid to pick up the tab for nursing home care. What is happening, and we are going to eliminate this, is that families, and I guess in a way I can understand their thinking, but it is just not right, they do not think about the fact that it is taking needed dollars away from people that really need this benefit. As an example, say mom or dad needs to go into a nursing home, a skilled nursing home, and is going to be there for a long time. They may have $750,000 in equity in their home. So all of a sudden they figure out a way to transfer the ownership to a son or a daughter or a first cousin and let mom or dad rent the house and live in the house or pay out of their Social Security check. That is totally wrong. I think my colleagues understand that, and I think the American people understand that. So we, again, are not talking about cutting benefits to people that really need them. We are trying to make sure that in this reform we get the dollars where they need to be. That is really what it is all about, cutting out waste, fraud and abuse and spending the money efficiently and effectively. That is what we are doing. I really appreciate the gentlewoman from Tennessee for leading this hour and giving me the opportunity to talk about this. You see, I spent 30 years practicing medicine and seeing some of these patients and writing prescriptions for those who need that Medicaid benefit. So I know how important it is to do it the right way, and I commend my leadership in the Republican majority for facing up to the problem we have. I can remember, and I will say this in closing, Mr. Speaker, when we were trying to bring some sense in solvency to the Social Security program for our needy seniors, the other side of the aisle said, Well, you know, you do not need to be doing this because the need is in Medicare and Medicaid. It is going to run out of money much quicker; you need to reform that. Why are you all spending your time on Social Security? So here Social Security seems to have been pushed off to the back burner, much to their satisfaction, and we are trying to deal with the problems of Medicare and especially Medicaid. Every one of our 50 States is suffering. Governor Huckaby, Republican Governor from Arkansas, and Governor Warner, Democratic Governor of Virginia, both agreed with a bipartisan governors' report that we need to do this. So this is what we are talking about. And with that, I will yield back to the gentlewoman from Tennessee.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, next week, on November 15, senior citizens across America will have the opportunity to sign up for a benefit that is long overdue, and that is prescription drug coverage. The initial sign-up date for Medicare part D runs from November 15, 2005, through May 15, 2006. Coverage starts January 1, 2006, so the sooner seniors sign up, the sooner they can start saving. Here is what seniors should know about Medicare part D. It is available to all Medicare beneficiaries. The benefit is voluntary, so seniors will need to choose to sign up. They will have a choice of plans with a low monthly premium, and all Medicare-approved plans will cover both generic and brand-name prescription drugs and will be accepted at pharmacies close to home. There are several ways seniors can sign up for Medicare part D. Watch the mail for information from Social Security and Medicare; call 1-800- Medicare, where trained staff can answer questions and help you sign up 7 days a week, 24 hours a day; or visit the Web site www.medicare.gov. If our seniors have access to affordable prescription drugs, they will reap the benefits of modern medicine and live healthier lives.

Mr. GINGREY

Mr. GINGREY. Well, let me repeat that, because I know it sounds unbelievable. It is even more unbelievable than the gentleman from Texas just stated. Medicaid once paid $5,000, not $1,000, but $5,336 for a prescription that only cost the pharmacist $88 to obtain. Now, was that a mistake on the part of the pharmacist? Possibly. We are not trying to single out any individual. But the point is that there is so much waste, fraud, and abuse; and this oversight is needed. We absolutely need it.

Mr. GINGREY. Mr. Speaker, I thank the gentleman from Texas for controlling the hour, for bringing this important information to us, and for allowing me to weigh in on it. Mr. Speaker, it is kind of interesting that the other side of the aisle, when we had a plan to reform another mandatory, big, mandatory spending part of our budget, and that is Social Security, they wanted to say that, no, we do not need to be addressing that right now, because we have other more serious problems, we have the serious problem with the mandatory spending in Medicare and Medicaid. So while they did not want to address the needed reform, good reform to save money and sustain that program for our seniors, for their retirement, now we want to try to come forward, this Republican leadership, with a plan, a good plan of government reform, so that we can effect meaningful savings, and that is exactly what we are here to talk about this afternoon. I thank my colleague for giving me an opportunity to weigh in on one of those items in particular, and that is the Medicaid program. The Medicaid program is so out of control that it is rapidly approaching 50 percent of our State budgets. Within another 5 years, if we do not do something to control and to reform Medicaid spending, Mr. Speaker, then we will be up to 80 percent, and it will not be in the too distant future that it will absorb the total amount of our State budgets. We cannot let that happen. In fact, the Governors Conference did great work on this. I want to commend the Democratic Governor of Virginia, Governor Warner, and the Republican Governor of Arkansas, Governor Huckabee, who together took this as an ad hoc committee that took on this responsibility and made some very, very significant, needed suggestions to reform Medicaid. A perfect example would be in those States who are under a waiver program, Mr. Speaker, that allow Medicaid coverage for people up to 150, 185 percent of the poverty level, at those higher levels to start having a little bit of a copay, just a little bit of a copay, maybe $3 on a generic drug or $5 on a brand-name prescription that their physicians feel that they need, and possibly even, yes, for the higher- income people under the waiver program to have a little bit of a deductible, to ask them, to ask these beneficiaries to show a little bit of responsibility for their own health, for their own health care, and how the spending is utilized. The gentleman from Texas is absolutely right: We desperately need Medicaid reform. Just listen to this: We want to put Medicaid on a more sustainable path; grow it, yes, absolutely. We are not here today to talk about cutting. Our colleagues on the other side of the aisle, they are always wanting to scare people, the poor, the elderly, the infirm: These greedy Republicans are on the verge of cutting your benefits. Not at all. It is just reducing the growth rate by one-tenth of 1 percent. We need to do that. Who would argue that we need to root out waste, fraud, and abuse from the Medicaid program or, in fact, the Medicare program? We want to make sure that we give flexibility to the States to enact, if need be, some copays and some deductibles. But pharmaceutical spending is out of control, as it certainly is. Listen to this: Medicaid once paid $5,336 for a prescription that only cost the pharmacist $88 to obtain. The Department of Health and Human Services Inspector General found, this was back in 2002, that Medicaid reimbursements exceeded pharmacists' true costs during that year, 2002, exceeded the actual cost by $1.5 billion. Every dollar wasted on overpayment is a dollar that does not go to the patients who truly need that benefit.