Phil Gingrey

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the gentleman from Indiana. I think this is such an important aspect of this bill and I appreciate his discussing that with us. Mr. Speaker, there are probably 40 million people in this great country of ours who have no health insurance at all, and 60 percent of them, maybe more than 60 percent, have jobs. They are not unemployed. Maybe they work for a small shop of five to 10 to 15 people and that employer just cannot go out in the marketplace and get a volume discount, so they just cannot afford it. It is a benefit they cannot afford. This health savings account will give these employees that are working but do not have the opportunity for group health insurance to put up to $5,000, up to $5,000 a year, Mr. Speaker, tax deferred and will have an opportunity for that account to grow, as the gentleman from Indiana so vividly pointed out. I want to shift gears, Mr. Speaker, for just a minute. We have heard a lot of discussion tonight during this time about the AARP and how very supportive they are of this Medicare Modernization and Prescription Drug Act, this bipartisan conference committee report. Let me just read a letter, Mr. Speaker, from the President of AARP, Mr. William Novelli, and here is what Mr. Novelli says about this bill. ``Some people are surprised by AARP's support of the Medicare prescription drug legislation now before Congress. They shouldn't be. Our decision is not based on political calculation or allegiance to rigid ideology, but solely on what this will mean for our members and the health of all older Americans. ``There are many reasons for our endorsement. First, this bill will provide prescription drug coverage at little cost to those who need it most: People with low incomes, including those who depend on Social Security for all or most of their income. Second, it will provide substantial relief for those with very high drug costs and will provide modest relief for millions more. ``Finally, we are pleased to see a substantial increase in protections for retiree benefits. That fairness is maintained by upholding the health benefit protections of the Age Discrimination and Employment Act. ``On July 14, in a letter to congressional leadership, we outlined our concerns and our expectations for a bill that we could support. Among them was our opposition to what is commonly known as ``premium support,'' a new structure requiring traditional Medicare to compete against private plans, which could very likely result in higher out-of-pocket costs for those who choose to stay in traditional Medicare. ``As a result of negotiations, this was scaled back to a demonstration project that is very limited in scope that doesn't begin until 2010, that exempts low-income beneficiaries and limits any premium increases. This will not,'' and I repeat, Mr. Speaker, ``this will not jeopardize traditional Medicare'' as we know it. ``Of real concern to our members and millions of older and disabled Americans was the prospect that by gaining a Medicare benefit, they might lose their current employer-retiree coverage.'' We talked about that earlier. ``We said that the final agreement should provide adequate incentives for employers to maintain their current plans. The proposed legislation includes an unprecedented $88 billion in subsidies to ensure that people who have good private coverage do not lose it. ``This bill is not perfect, but millions of Americans cannot wait for perfect. They need help now. And, finally, help is on the way. ``This is an issue too important to be held hostage to the status quo. As the late civil rights leader Whitney Young once said, `We have no permanent friends or enemies, just permanent interests.' Our interests are what is best for our members and for all older Americans. ``In the coming days, we will do all we can to help the American people understand how important this legislation is to them and to convince Members of Congress to work in a bipartisan,'' absolutely a bipartisan ``fashion to pass it now.'' William Novelli, President of the American Association of Retired Persons. Mr. Speaker, at this time I would like to yield to my colleague and good friend from the great State of Alabama. Our districts butt up against each other at the State line, and I know that the people that he represents in his district in Alabama have the same needs, life experiences, and concerns that my folks do in the 11th District of Georgia. So it gives me a great deal of pleasure at this time, and I thank the gentleman from Alabama (Mr. Rogers) for joining us tonight.

Mr. GINGREY. Mr. Speaker, I thank the gentleman from Alabama, and before I introduce the last member of our team tonight, I would like to read a letter from the President of the American Medical Association, and he says: ``Dear Mr. Speaker, the American Medical Association is proud to support the Medicare Prescription Drug and Modernization Act of 2003 conference report. Congress listened to America's patients and the physicians who serve them. ``The AMA gave Congress a set of principles for a sound prescription drug policy. We asked that the pharmaceutical drug benefit be fully funded as a separate new part of the Medicare program and provide for adequate accounting so that drug program expenditures can be tracked separately from all other expenditures. We asked that it be targeted to reduce hardship for those with low incomes and those with catastrophic costs and that patients be offered a choice of insurance options. The conference report meets all of these requirements. ``We asked for help with the drastic 4.5 percent physician payment cuts that physicians and other health care providers will face beginning in less than 2 months. We said that cuts in Medicare payments jeopardize access to medical care not only for seniors but also for military retirees and their dependents. The conference report provides a 2-year increase in payments for 2004 and 2005 of at least 1.5 percent each year,'' not, Mr. Speaker, a 4.5 percent cut. ``It also provides a mechanism to begin correcting the flawed payment formula in an effort to stabilize those payments over time. ``We asked for relief from regulatory burdens imposed on physicians and other health care providers when dealing with the Centers for Medicare and Medicaid Services, CMS. Using many components of the AMA model bill, the conference report guarantees physicians certain due process rights in Medicare appeals and targets education dollars promote. ``We asked important flexibility and assistance in moving toward electronic prescribing technology. The conference report provides incentive grants to small, rural, and low-volume practices instead of mandating that all providers use electronic prescribing technologies in a short time frame. It also provides for `safe harbors' for group practices and others in an effort to make these technologies more widely available.'' ``We asked to retain the coding system that makes sense for American physicians, not to move to a new, untested system. The conference report removed language that would have imposed new, regulatory burdens in payment coding systems that physicians use every day. Moving physicians from some 7,000 codes to some 170,000 codes could only mean less time spent with patients. ``We ask that geographic disparities in payments between rural and urban areas be diminished. The conferees worked out a compromise to increase payments in this regard and to thoroughly study patient access to physicians, as well as retention and attraction of physicians to scarcity areas. ``The status quo is unacceptable to patients and their physicians. The Medicare conference agreement includes numerous provisions that will improve seniors' access to medical services. We worked closely with Congress to do the right thing for American's seniors, and Congress heard us. We pledge to wholeheartedly support the Medicare Prescription Drug and Modernization Act. Sincerely, Michael D. Maves,'' president of the American Medical Association. Mr. Speaker, I think this is a perfect segue into the introduction of my colleague from Texas who not only is my freshman colleague in this Congress, but he also is my colleague as a physician and further as a specialist in obstetrics and gynecology. I yield to the gentleman from Texas (Mr. Burgess).

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the chairman, the gentleman from Ohio (Mr. Ney) for yielding. I stand tonight to support the gentleman from Georgia (Mr. Lewis), my colleague, the honorable and distinguished Representative from the 5th District. I want to say how proud I am to, as a freshman Member, to be able to support what he has been working on for these past 15 years and supporting H.R. 3491, the creation of a National Museum of African Culture and History. And I thank the gentleman from Ohio (Mr. Ney) and the gentleman from Connecticut (Ranking Member Larson), and the gentlewoman from the District of Columbia (Ms. Norton) for their support in trying to bring this long- term effort of this great Member of Congress to fruition. And I just want to tell the gentleman how much I appreciate what he has done and how much respect I have for him. When we go back and talk to our spouses sometimes at the end of the week about what the experience was up here, I have said often to her that the gentleman from Georgia (Mr. Lewis) has been one of the nicest and kindest Members of this body to me, a freshman, reaching out on many occasions to make me feel warm and accepted. So I do take great pleasure in standing here tonight and supporting this. I hope some day that I will be able to bring my grandchildren through that museum, and I hope he is there to explain to them some of the history that he knows so well, better than so many people, because he has experienced it, and he has brought more to racial healing than hardly anybody I can think of in this country. I commend him for it. I wholeheartedly support this bill.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the gentlewoman from New Mexico for yielding time to me. Mr. Speaker, there they go again. They do not like the message so they start trashing, trashing the messenger, and in this case, the messenger just happens to be 35 million seniors who are members of the AARP. Excuse me, 35 million less one. The gentlewoman from California just told us that she resigned. This is a solution, Mr. Speaker, in desperate need of a problem. The motion to instruct conferees, like so many that the minority has offered before, serves no useful purpose in this debate. They are simply political tools used in a desperate attempt to divert attention away from the fact that the Republican House will in a matter of days deliver, it will deliver on its commitment to providing seniors with access to meaningful, affordable and comprehensive prescription drug coverage. Mr. Speaker, I support properly reimbursing physicians. The House bill did that and so does the bipartisan Medicare conference agreement which is why it is supported by a number of medical societies, including the American Medical Association. Listen to what they say: ``The American Medical Association strongly supports passage of the Medicare prescription drug conference report, which currently includes historic and critical provisions for improving choice and access for Medicare seniors and disabled patients. In addition,'' Mr. Speaker, ``in addition, the conference report would halt 2 years of impending Medicare payment cuts to physicians and other health professionals and replace them with payment increases of at least 1.5 percent per year. Because the Medicare conference report includes these critical provisions for improving choice and access, the AMA strongly opposes the Berkley motion to instruct and urges Congress to pass the pending Medicare conference report before they adjourn.'' If the gentlewoman from Nevada is serious about wanting to help our Nation's providers, our physician providers, and I trust that she is, I would urge her to reconsider her opposition to medical liability reform legislation such as H.R. 5, the HEALTH Act, the tort reform bill, a bill that was strongly supported by both the AMA and the Nevada Medical Association. The other body has not acted yet, so the gentlewoman will have yet another chance to truly support physician providers. Mr. Speaker, I strongly support the bipartisan Medicare conference agreement, and we will soon consider this on the House floor. This motion to instruct no longer serves any purpose. Indeed, the provisions related to Medicare competition that the gentlewoman references in her motion are not even part of the final conference committee agreement. I urge my colleagues to join me in rejecting this motion to instruct and supporting the final Medicare conference agreement.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today in support of the Medicare conference report. This is a historic step in the right direction for our Nation's senior citizens. We are positioned to pass legislation to help seniors pay for the rising costs of prescription medications. Low- income seniors will be able to obtain the help they need and every senior will have the peace of mind of knowing that out-of-pocket catastrophic costs will not bankrupt them. This legislation will provide the largest comprehensive rural package ever considered and updates and sets hospital payments at appropriate levels for 2005. The conference report also blocks a proposed 4.5 percent Medicare reimbursement cut to physicians for the years 2004 and 2005, and instead provides a 1.5 percent positive update for these 2 years. The Medicare conference report has received the strong support of our health care community and the AARP, representing 35 million seniors. Mr. Speaker, I urge my colleagues to vote in favor of our senior citizens and pass this bill.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise again today, as I have a number of times before, to call attention to declining Medicare reimbursements for physicians. Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedule, face at least a 4.5 percent cut in reimbursements. Mr. Speaker, I have been outspoken on this issue and have described several instances in which the citizens of Georgia and our Nation will be negatively affected by this cut. There is a staffing issue within the trauma center at Grady Memorial Hospital in Atlanta. Dr. Harry Sherman in Augusta is contemplating retirement due to a lack of adequate Medicare reimbursement and the high cost of liability premiums. And more specifically, I demonstrated the decreasing reimbursement for, and thus the eventual reduction in access to very common procedures provided to Medicare recipients. I would like to bring the attention of my colleagues to a survey conducted by the American Academy of Family Physicians. This survey is not necessarily scientific, but I believe it is indicative of the problem we are facing. AAFP found that 24 percent of family physicians no longer accept new Medicare patients. After the 4.5 percent cut was announced, AAFP surveyed again to find out what its members would do if the cut takes effect. As detailed in a release from the American Academy of Family Physicians, only 36 percent said they would take new Medicare patients if these new cuts occur. Mr. Speaker, come January, doctors are going to take a cut in their reimbursement for treating our Nation's most needy individuals. There is an old saying, however, that the night is always darkest just before the dawn. With a physician-reimbursement disaster looming, Congress is on the verge of a breakthrough. Housed within the Medicare modernization bill is temporary relief for the medical community. House and Senate negotiators have announced an agreement that will potentially bring this legislation before the Congress this week. I thank the gentleman from California (Mr. Thomas) and the subcommittee chair, the gentlewoman from Connecticut (Mrs. Johnson), and those from the other Chamber, such as Senators Frist, Grassley, Baucus and Breaux, who have worked so hard to get us to where we are today. I encourage all of those involved in this process to continue to act in the best interests of the American people, but especially our seniors and the medical community on which they so desperately depend. Let me be clear, as a physician Member of the United States House of Representatives, I believe that we must pass the Medicare conference report now. For nearly 40 years, Medicare has provided necessary health care to millions of patients across this country. Another steep cut in reimbursement rates would have been devastating for the physicians who care for Medicare patients; but with the language that has been crafted, the physician-reimbursement update would be a positive 1.5 percent. This chart is representative of the positive impact the current Medicare legislation will have on Medicare providers throughout the country. For example, New York will see a benefit of $865 million; Washington State benefits $155 million; Texas, $641 million; and most important to me and my colleagues from Georgia, our State will benefit $254 million. All 50 States will see a positive impact from the current version of the Medicare conference report. I cannot overstate the importance of just this one piece of the overall Medicare bill. It is my hope this will allow for the continued access to quality health care for our seniors. I am proud that as the door was slamming shut on our seniors' health care, this Congress stood up, and will stand up, in a bipartisan fashion and hold this door open. Mr. Speaker, one of the greatest achievements of the Medicare program is the access to high-quality care it has brought to our Nation's seniors and disabled patients. This level of access is more likely to continue in light of this temporary fix. This legislation will allow Congress and the Center for Medicare Services the time to work together to finally find a more permanent solution by revamping the Medicare payment formula. Doctors are the linchpin of the Medicare program. Let me say that a prescription drug plan is no benefit at all unless there are physicians willing to accept Medicare patients and to write those prescriptions. We need to pass this conference report and pass it now.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today in strong support of the conference report on H.R. 1588, the National Defense Authorization Act for Fiscal Year 2004. This critically important legislation provides our brave men and women in uniform the tools they need to accomplish their missions, but it also contains many provisions to improve their quality of life. This bill increases the combat capabilities of our Armed Forces with appropriate levels of spending for readiness, procurement, research and development. It funds programs such as the M1 Abrams tank and Bradley fighting vehicles that are used in current conflicts, and transforms our military to meet the threats of tomorrow with futuristic systems like the Air Force's F/A-22 Raptor. The bill provides funding to make our homeland safe by combating terrorism at home and abroad and continuing to develop a ballistic missile defense system. Most important in this legislation, however, are the provisions aimed to benefit our current and past servicemembers. H.R. 1588 provides a 4.1 percent pay raise, and it increases imminent-danger pay. It also funds important military family housing, education and military facilities. H.R. 1588 directs improvements to the TRICARE system and survivor benefit, and it contains many other provisions for members of the National Guard and the Reserves. I thank the chairman of the Subcommittee on Total Force, the gentleman from New York (Mr. McHugh), for his tremendous dedication to these quality-of-life issues. This bill also recognizes the inherent unfairness that disabled military retirees have their retirement benefits offset by the amount of their disability benefits by providing concurrent receipt for more veterans than have ever been covered before. Finally, I thank the gentleman from California (Chairman Hunter) and the ranking member, the gentleman from Missouri (Mr. Skelton), for not only their leadership of our committee but also for their work in shepherding this bill through the legislative process. They recognize that we owe all of our freedom and safety to our brave men and women in uniform and that Congress can help them in a major way with the passage of this bill. They also know how important this bill is to my district and Fort Benning in Columbus, Georgia, the home of the infantry where 37,000 active duty troops go to work every day. In conclusion, I urge my colleagues to vote in favor of H.R. 1588.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today to share with the Members of the House and the American people my experiences visiting Walter Reed Army Medical Center yesterday. I had the pleasure and the honor of visiting some true American patriots who were severely injured in Operation Iraqi Freedom and are currently recuperating at Walter Reed. I was especially pleased to meet with Sergeant Terry Jones, a reservist, from Columbus, Georgia, Fort Benning, who served bravely in Operation Iraqi Freedom. Mr. Speaker, my visit to Walter Reed was one of the most moving things I have done since coming to Congress in January. I felt it was important to let these heroes of Operation Iraqi Freedom know how much we in Congress appreciate their sacrifices. I wanted to relay to them my belief that through their heroic deeds, they have made the United States a safer place for all Americans and brought precious freedom and democracy to the people of Iraq. Mr. Speaker, yesterday I also had the pleasure to meet with Sergeant Sean Driscoll of Clarksville, Tennessee, and his wife Georgette. Sergeant Driscoll was recently wounded in Iraq as part of his operations serving in the Army's 101 Airborne Division. Mr. Speaker, I could talk at great length about Sergeant Driscoll's dedication and sacrifice to his Nation during a 15-year career in the Army, as well as about my immense gratitude for all that he has done to advance freedom across the world. But I think that his 18-year-old daughter, Antoinette, has paid tribute to her father much better than my words could. Therefore, Mr. Speaker, I would like to read the following testimonial written by Antoinette Driscoll about her father, Sergeant Sean Driscoll, so that it can be placed into the Congressional Record. It is titled ``Hero.'' ``Words cannot express how proud I am to be able to say that my Dad is a HERO. There are people who have parents that are doctors that save and rehabilitate people everyday, but my Dad is far greater. Some parents save others from fiery buildings or patrol the streets at night, but my Dad is far more dignified. Those people may be heroes in their own way, but my Dad is far more superior than they. For my Dad is a soldier, defending our wonderful nation, putting in countless hours of sweat, tears, and selfless sacrifice and service for those who live in the United States. ``My Dad is the one who fights and risks his own life for us privileged Americans. He makes sure that doctors have a place to educate themselves and practice. He makes sure that everyone has the opportunity to find a job, and has a home and an education, and makes sure everyone can sleep safely at night. I can't think of any other who is greater than he. I am proud and honored to be able to love someone like this. ``I can only hope that I will one day follow in his footsteps and defend my country. He has taught me a couple of things which I feel every American should know. One, freedom is not free, and there is no greater Nation than the United States of America. He has served many years and has shed blood for my freedom. I could never thank him enough for all that he has done. Not just for me, but for my family, friends, and people who he doesn't even know. I hope that one day I'll be able to fight for him, so he can live safely and rest when he comes home. I love him for these reasons and many more.'' Mr. Speaker, I think this statement from Antoinette Driscoll poignantly demonstrates her love and admiration for her father. It is also important to note that Antoinette will soon enter the United States Air Force herself, and her younger 16-year-old brother will join the service in a few years as well. The Driscoll family has demonstrated to me great resolve in the face of difficult circumstances. Even though Sergeant Sean Driscoll was severely wounded in Operation Iraqi Freedom and he has spent many months away from home, his family remains undaunted in its commitment to serving our Nation. They can teach all of us a valuable lesson in sacrifice and dedication to the American ideal.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, my Washington Waste Watcher colleagues and I, Republican members of the freshman class, have come to the floor tonight to devise new and innovative ways for trimming the fat out of government. I believe we owe it to the American taxpayer to hold Washington bureaucrats accountable for wasteful spending and to discover new ways for reducing fraud in government at all levels. A great American from Ellijay, Georgia, Mr. Joe McCutchen, reminds me of this at least once a month. Mr. Speaker, after spending 28 years as an OB-GYN doctor, it should be no surprise that part of my legislative agenda is to reorganize and revamp this Medicare program, which is currently responsible for billions of dollars of waste, fraud and abuse. The General Accounting Office has estimated that one of every 10 dollars is wasted because our current Medicare system is open to poor management and fraud. Dishonest individuals find new and more creative ways to cheat our Medicare system every day, burdening Americans with higher taxes, higher premiums, and higher copays. For example, according to the Bureau of National Affairs in an April 25, 2003, article of ``Health Care Daily,'' a Florida woman was sentenced for her role in a scheme that allegedly billed Medicare and Medicaid more than $25 million worth of false claims for, get this, wheelchairs, alternating pressure mattresses, and other durable medical equipment; $25 million of taxpayer money that is lost and unrefundable, money that could have been used to improve our schools or aid our soldiers in Iraq or provide health care for the uninsured. Another example comes from the Health and Human Services Inspector General report to Congress, April 2000. It was reported that Medicare paid an estimated $20.6 million for services that started after the posted death dates of certain recipients. My good friend and colleague, the gentlewoman from Florida (Ms. Ginny Brown-Waite), just a few minutes earlier mentioned the same thing. Of this amount, $8 million was paid, despite the fact the Department had already noted their deaths in the main database. These are just examples of the mismanagement of time and resources that are costing Americans billions of dollars every year. In these times of war and emphasis on homeland security, we cannot afford to spend another dollar on wasteful programs, and we must save money by eradicating fraud against and within the Federal Government. Mr. Speaker, it is time to restore responsibility and accountability to government programs by rooting out this waste, fraud and abuse in our government. I urge my colleagues to help pass needed Medicare reform.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I want to thank my colleague from Pennsylvania for introducing H. Res. 414. I think it is a positive step in addressing our trade discrepancies with the People's Republic of China. My district of western Georgia has a rich history of manufacturing textiles, from Milliken and Company, Incorporated, and Bon L. Manufacturing in LaGrange, Georgia, to Mount Vernon Mills in Trion, Georgia, which has been in business since the 1840s. The textile industry has provided good-quality jobs for the citizens of Georgia's 11th Congressional District, with good health care benefits and good retirement. I make this point because people in my district have established a culture and a community around the textile industry. I am deeply concerned that our country is not properly enforcing our trade policies which are slowly eliminating an entire way of life. When ratifying trade agreements, it is important to encourage both free and fair trade. China is not playing fair because they are manipulating their currency in order to gain an unfair advantage. This currency manipulation is costing people jobs. Between March 2002 and March 2003, 50 textile plants have closed and 40,000 people have lost their jobs, including 100 jobs just last week in Trion, Georgia. We cannot afford to lose jobs, especially due to the unfair practices of currency manipulation by the Chinese Government. Mr. Speaker, I encourage the passage of House Resolution 414 to encourage China to comply with their trade obligations.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I have no other speakers, but I continue to reserve the balance of my time.

Mr. GINGREY. Mr. Speaker, I have no other requests for speakers but, again, in conclusion, let me just say that I commend the gentleman from New Jersey (Mr. Holt) and the gentleman from Michigan (Mr. Ehlers) for bringing forward this resolution. And I urge all of my colleagues to support its adoption. Mr. Speaker, I yield back the balance of my time.

Mr. GINGREY. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I am honored to present this resolution supporting the ideals of National Chemistry Week. And I want to commend the co- authors, the gentleman from Michigan (Mr. Ehlers) and the gentleman from New Jersey (Mr. Holt), the Ph.D. physicists, for bringing this bill forward. So this Member who has a bachelor of science, a meager bachelor of science degree in chemistry, is humbled in their presence, but this is a wonderful bill, and I am very, very supportive of it. Mr. Speaker, I think I have got a little bit of time left, and I see that the gentleman from Michigan (Mr. Ehlers), of whom I just spoke, the distinguished gentleman from Michigan, that Ph.D., one of those Ph.D. physicists of which I just spoke, has just arrived. Mr. Speaker, I am very happy at this time to yield such time as he may consume to the gentleman from Michigan (Mr. Ehlers). (Mr. EHLERS asked and was given permission to revise and extend his remarks, and include extraneous material.)

Mr. GINGREY. Mr. Speaker, I move to suspend the rules and agree to the resolution (H. Res. 395) recognizing the importance of chemistry to our everyday lives and supporting the goals and ideals of National Chemistry Week.

Mr. GINGREY. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on H. Res. 395.

Mr. GINGREY. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, today I am pleased that we are considering this resolution recognizing the importance of chemistry in our everyday lives. This resolution supports the goals and the ideals of National Chemistry Week, and it recognizes the important contributions of chemical scientists and engineers to technological progress and the health of many industries. In addition, it encourages the people of the United States to observe National Chemistry Week, which this year is October 19 through 25. As a graduate of the Georgia Institute of Technology with a Bachelor's Degree in chemistry, I enthusiastically support this effort. The chemical sciences provide an enabling infrastructure that delivers the foods, fuels, medicine and materials that are part of our everyday lives. The contributions of chemical scientists and engineers are central to the technological progress of many areas that affect our everyday lives. I commend the American Chemical Society for establishing National Chemistry Week in 1987. During National Chemistry Week, volunteers from across the United States will teach children about our air, the atmosphere and the solar system. The theme in 2003, Earth's Atmosphere and Beyond, was chosen to honor the 100 anniversary of Orville and Wilbur Wright's flight from Kitty Hawk, North Carolina. It is important to stimulate children's interest in the chemical sciences so that they will consider careers in these fields and potentially discover the innovations for our future. I urge all of my colleagues to support this resolution, and thus recognize and support the goals and ideals of National Chemistry Week. Mr. Speaker, I reserve the balance of my time.

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

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise again this week as I have done in previous weeks to call attention to declining Medicare reimbursement for physicians. Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedule face at least a 4.2 percent cut in reimbursements. For nearly 40 years, Medicare has provided necessary health care to those millions of patients across this country. Another steep cut in reimbursement rates is now forcing many physicians who care for Medicare patients to make very difficult choices. Complicating the situation, Mr. Speaker, further, is the fact that doctors in some areas are experiencing double and even triple-digit percentage increases of their liability premiums. In a host of States, like my State of Georgia, surgeons are scrambling to find affordable liability insurance, if it is available at all. When doctors are forced out of practice, patient access to care is further compromised. Fewer doctors overall translates into greater difficulty obtaining an appointment for every patient but especially those who rely on Medicare. Earlier this year we passed H.R. 5, the HEALTH Act to combat the problem of increased liability premiums at the Federal level. Unfortunately, this commonsense legislation has now languished in the Senate. I reiterate my support for this bill, and I urge its swift passage by the entire Congress so that President Bush can sign it into law this year. Until that time, however, one of the main costs of running a medical practice for many high-risk specialists, including general surgeons, will continue to be liability insurance. Looking at this chart, you can easily see that increases in liability premiums have grossly outpaced Medicare reimbursement. Using information collected by the independent trade publication Medical Liability Monitor, this chart compares the average liability premiums for general surgeons to the Medicare physician payment update. In 2001, physicians received a 5.1 percent Medicare payment update. During that same period liability premiums increased 14.6 percent. Then the next year Medicare physician payments were cut 5.4 percent. While doctors are trying to manage this cut, their liability premiums spiked to an additional 29 percent. There is no doubt that at least with respect to liability premiums, Medicare reimbursement continues to fall far behind the cost of doing business. As an OB/GYN myself, I can assure you that a physician's practice is indeed a small business. When faced with decreasing income and soaring expenses, doctors cannot simply increase the cost of patient visits. To keep medical practices open, doctors make tough choices. Some doctors delay the purchase of new equipment; others reduce the size of the staff. Many increase the percentage of non-Medicare patients they see, leaving insufficient time in a busy schedule to see a sufficient number of Medicare patients. Mr. Speaker, I would like to relay a story that demonstrates just how the cuts in physician reimbursements are affecting medical practices in my home State of Georgia. Dr. Harry Sherman, former president of the Georgia chapter of the American College of Surgeons, has lived in Georgia for more than 70 years. He remembers when Congress first enacted Medicare. Now, about 40 percent of his surgical patients are Medicare. I recently had an opportunity to speak with Dr. Sherman at the American College of Surgeons annual meeting in Chicago. During our conversation, it became clear to me that Dr. Sherman obtains a great deal of personal satisfaction from treating Medicare patients. As a physician myself, I understand that unique bond that develops between doctor and patient, but as the cost of doing business continues to increase and the level of reimbursement drops, further and further, he admits that it influenced his decision about when to retire. Dr. Sherman is one of Georgia's most seasoned surgeons. He was born and raised in Georgia, and is truly an asset to his community and his patients. When continued Medicare payment cuts are forcing good surgeons like Dr. Sherman to retire for financial reasons, something is badly wrong. One of the greatest achievements of the Medicare program is the access to high-quality care it has brought to our Nation's seniors and disabled patients. This level of access cannot be expected to continue in the face of deep Medicare cuts and growing liability premiums. Mr. Speaker, doctors are the linchpin of the Medicare system. Let us not force them out of the system. Stop the 4.2 percent Medicare physician cut; help doctors help those who need their care the most.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the chairman for yielding me time. I rise very much in support of H. Res. 378, and I commend the author, the gentlewoman from Texas (Ms. Granger), for bringing this bill forward. If I did not know anything about the bill, after seeing that beautiful grandchild, Logan, in that portrait, I think I would be supportive of this effort. It is very, very persuasive, and I commend the gentlewoman for that. But, seriously, this bill is a great bill. I have a private college in my 11th District of Georgia, Berry College, a wonderful private college in Rome, Georgia, that is part of these 200 private colleges and universities participating in this plan. As has been pointed out by the previous speakers, the cost of college has been rising so much, since 2001 something like $16,000 a year on average to go to a private college or university. This opportunity for our families that want to send their children to these schools to go ahead and invest and save that money at a tax advantage and lock in that tuition so it is not rising at double the rate of inflation, I think is a very important thing to do. I commend the gentlewoman for this bill and give it my strong support. I urge all of my colleagues to support this great resolution.

Mr. GINGREY

Mr. GINGREY. Mr. Chairman, I rise today to discuss the amendment offered by the gentleman from Indiana, Mr. Pence. This is a well- intentioned amendment that would strike a balance between one of the most deeply debated issues involved in H.R. 3289, the Supplemental Appropriations Act for FY 2004. Mr. Pence's amendment would have made the first 50 percent of Iraq Reconstruction funding available immediately as a grant. This $9.3 billion amount would have given priority consideration to the emergency purposes of security, electric sector infrastructure, oil infrastructure, public works, water resources, transportation and telecommunication infrastructures, and other emergency needs. It would have withheld the final 50 percent of the reconstruction funding until a democratically elected government in Iraq has been established. Once the Bush Administration informs Congress that such a government exists, the balance of the funding would have been made available in the form of loans from the United States Government, under terms determined by the President. Mr. Chairman, for several weeks I have internally debated the question of whether this reconstruction funding for Iraq ought to be in the form of a direct grant or a loan repayable at a future date. I have listened to my constituents, asked questions at committee hearings, and thought through all of the arguments on both sides of this debate. I did so because this issue is so important to both the people of Iraq and the people of the United States. Mr. Chairman, after much deliberation, I saw the validity and accuracy of some of the arguments in favor of a directly granting these reconstruction funds. I believe that debt repayments could become a destabilizing political issue in postwar Iraq and could easily be exploited by anti-American factions. Furthermore, a loan burden also could likely stifle any significant economic development in Iraq. However, I also believe that we have a responsibility to be conscientious stewards of the American taxpayers' money. We currently have a significant national debt at the federal level, and have several important priorities that are going unmet. Finally, Iraq is not a poor nation. In fact, it has natural resources that are unmatched in that region of the world. Mr. Chairman, in light of these realities, I would have supported the thoughtful amendment by my colleague, Mr. Pence. I believe that it would have provided adequate reconstruction funds that are needed in the near term. This is money that would have been used for emergency and immediate purposes fro the most important needs of security, electric and oil infrastructure, public works, and transportation. This $9.3 billion would have built on and expanded the successful work that the Coalition Provisional Authority has already done in a few short months in Iraq. It would have provided the CPA with the resources it needs to make the quality of life in Iraq better than it ever was under the terrible regime of Saddam Hussein. Finally, Mr. Chairman, the Pence amendment would have permitted the American taxpayers to be partially refunded once a democratically elected government is established in Iraq. Once this governing authority is present in Baghdad, which is expected to occur within a year, Iraq would have been able to use its considerable natural oil reserves to repay a portion of the money we are debating today. To me, this appeared to be a fiscally responsible manner by which to approach the subject. Mr. Chairman, again let me reiterate my support for the Pence amendment. I believe that it was a responsible compromise solution for both the people of Iraq and the people of America. Because I believe Congress has a responsibility to both of them, I would have supported the Pence amendment as a sensible, middle ground approach to this difficult question.

Mr. GINGREY

Mr. GINGREY. Madam Speaker, I rise again today, this week, to continue the discussion regarding the declining Medicare reimbursements for physicians. Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedule face at least a 4.2 percent cut in reimbursements. For nearly 40 years, Medicare has provided necessary health care to those millions of patients across the country, some 40-something million this year. Another steep cut in reimbursement rates is now forcing many physicians who care for Medicare patients to make difficult choices. The scheduled January 1 cut in the reimbursement rate is just one of a string of Medicare payment reductions for physicians. Due to problems in the formula used to set Medicare payments for physicians, this 4.2 percent cut taken with the 5.4 percent decline in 2002 contributes to successive pay cuts reaching more than 10 percent. To illustrate the Medicare payment history for surgical services, let us take a look at this chart comparing the Medicare economic index to physician payment update. The Center for Medicare and Medicaid Services, CMS, uses this Medicare economic index, or MEI, as a proxy for inflation in the cost of operating a medical practice. The largest component of the MEI is change in hourly earning for the general economy. A proxy for physicians' own time is in this index. Additionally, the MEI accounts for office expenses, medical materials and supplies, professional liability insurance, now that is a good one, professional liability insurance, and we know what is happening to that, medical equipment expenses and other benefits and various professional expenses. Here the yellow line shows a steadily increasing MEI, up about 2 to 4 percent every year starting in 1996. Every year extending out to the present time, a 2 to 4 percent increase. Now look at the red line. The red line charts an annual Medicare payment update for physicians resembling some sort of a roller coaster starting in 1996 and 1997 with surgical payments slightly under the MEI, and then in 1998 we have a tremendous drop. Look at this drop in 1998, which rebounds the next year, the only year, I point out, that the MEI and the increase in payments are actually matched. Then we have a slight increase in physician payments until we start a disaster downward trend of payment cuts before congressional intervention in 2003. When I look at this chart, it is clear to me that Medicare is not funded appropriately to ensure access to America's elderly and disabled patients. Without doctors' high levels of participation, the Medicare program would not have been able to serve millions of patients over these last 4 decades. Madam Speaker, I would like to read and include in the Record a letter I received just 2 days ago. Madam Speaker, the letter is from two doctors who practice in my home State of Georgia: ``Dear Representative Gingrey, although we continue to see Medicare patients in our practice, we are no longer accepting new Medicare patients. Further cuts in payments to physicians treating Medicare patients will undoubtedly result in a mass exodus of medical providers and secondarily limit access to medical care for the Medicare recipients. We have already noticed that many Medicare patients are having difficulties getting routine care. Despite the fact that we are physiatrists treating musculoskeletal problems, we find ourselves ordering routine care to working-up medical problems that their internists or primary care providers no longer have time to address. Unfortunately, we do not have the time to address these other issues either. ``Please help this situation by averting additional Medicare pay cuts. The courtesy of a response is appreciated. ``Sincerely, Amy M. Long, M.D. and Daryl L. Figa, M.D.'' Madam Speaker, the courtesy of a response has been requested. What is our answer? Will we abandon those doctors who treat our most needy? Madam Speaker, we must stop, we must stop the 4.2 percent Medicare physician payment cut. Help our doctors help those who need their care the most. Madam Speaker, we must not forget doctors are the linchpin of the Medicare program. OrthoRehab, Lawrenceville, GA, October 13, 2003. Hon. Philip Gingrey, House of Representatives, Washington, DC. Dear Representative Gingrey: Although we continue to see Medicare patients in our practice, we are no longer accepting new Medicare patients for treatment. Further cuts in payments to physicians treating Medicare patients will undoubtly result in a mass exodus of medical providers and secondarily, limit access to medical care for the Medicare recipients. We have already noticed that many Medicare patients are having difficulties getting routine care. Despite the fact that we are physiatrists treating musculoskeletal problems, we find ourselves ordering routine care to working-up medical problems that their internists or primary care providers no longer have time to address. Unfortunately, we do not have the time to address these other issues either. Please help this situation by averting additional Medicare pay cuts. The courtesy of a response is appreciated. Sincerely, Amy M. Lang, MD. Daryl L. Figa, MD.

Mr. GINGREY

Mr. GINGREY. Mr. Chairman, I rise in strong support of this emergency appropriation to pay for this ongoing war in Iraq. The gentleman that spoke before me talked about taking exception to some of the comments that were made, and I want to do the same thing. As I sat here and listened and continue to listen to the debate, over and over again I hear this phrase, Mr. President, what is our exit strategy? Mr. President, what is our exit strategy? To me, exit strategy is nothing more than a euphemism for cut and run. I do not think we need to remind the Florida Marlins last night that if they had an exit strategy at the end of the seventh inning, they would not have won that ball game. You do not pull your team off in the third quarter or the seventh or eighth inning of a ball game, no matter how far you are ahead. You are not thinking about an exit strategy; you are thinking about the determination and the will to win. That is really what we are talking about here in making this emergency appropriation to continue until victory is ours. I am strongly in support of both parts of this bill. The $66 billion for our troops, giving them the resources necessary to succeed in the war on terror and protect them from terrorist attacks, including, as an example, armored Humvees to better protect our forces, lifesaving body armor, equipment, weapons, ammunition, better housing for our troops, yes, and to continue the increased monthly rate of imminent danger pay and family separation allowances that this bill calls for. And then $18.6 billion for the continued relief and reconstruction of Iraq. I do not think that this is any less important. As my colleague, the gentleman from Georgia, said earlier in his remarks, this is an investment in democracy, security and law enforcement, justice, public safety, and a civil society, infrastructure, water resources, electrical generation, distribution infrastructure, roads and bridges, health care; and, yes, Mr. Chairman, it is important, as the distinguished chairman of the Committee on Foreign Relations, the gentleman from Illinois (Mr. Hyde), mentioned at the outset of this discussion, this needs to be a grant and not a loan; and he gave us a good history lesson, as did the gentleman from Minnesota (Mr. Kennedy). A loan with possible interest fees risks serious harm to America's image in the Middle East and Iraq. Heavy debt repayments could become a destabilizing political issue in postwar Iraq and could easily be exploited by anti-American factions. It is likely that the Iraqi people will view the loan as a way for the profiteering American invaders to make money off of Iraq. A loan burden also would likely stifle any significant economic development in Iraq. With the added burden of interest payments to the United States, the Government of Iraq will be limited in its ability to invest in its new market-based economy. Mr. Chairman, we cannot expect the Iraqi people to pick themselves up off of the ground if we have got a boot at the back of their neck. It is very important that this be a grant and not a loan. We cannot expect other countries that are debtor nations, some which are owed $8 billion and $10 billion from Iraq, and we can say that, well, that debt was with Saddam Hussein. Well, it was not Saddam Hussein who signed a personal note to secure that debt; it was the country of Iraq. So I just want to say in closing, Mr. Chairman, that the people in the eleventh district of Georgia that I represent are very supportive of not only the ongoing military effort, and that will continue until we win the battle and then we will talk about an exit strategy, but they are also in favor of reconstructing the country of Iraq. I am fully supportive of this emergency appropriation, and I urge all of my colleagues to support it.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today to congratulate a company located in the 11th district of Georgia which I represent. Mr. Speaker, we all know the dangers our men and women of the Armed Forces are facing during the operations of Enduring Freedom. During combat operations several of our Apache helicopters took enemy fire and were damaged to the point they could no longer operate in the combat theatre. As one can imagine, it was imperative these helicopters were repaired and returned to the theatre of operations as soon as possible. On April 2, 2003, the men and women of Engineered Fabrics Corporation in Rockmart, Georgia, got the call to assist our Nation's warfighters. Within 24 hours 28 new Apache fuel tanks were on their way to the combat theatre. In recognition of this excellent, incredible effort, Engineered Fabrics received the Commander's Medallion for Outstanding Warfight Support from the Defense Contract Management Agency. Specifically, I would like to thank and congratulate Mr. Carl Simmons, Contracts Manager, and Sheila Smith, Shipping and Receiving Manager, both with Engineered Fabrics. These two individuals were instrumental in ensuring that contract and shipment requirements were completed on or ahead of schedule. Mr. Speaker, Engineered Fabrics is an outstanding company in my 11th District of Georgia and a great example of the American spirit and will to succeed.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I rise today to call attention to the decline in Medicare reimbursement for physicians. Effective January 1, 2004, physicians and other providers paid pursuant to the Medicare physician fee schedules face at least a 4.2 percent cut in reimbursements. For nearly 40 years, Medicare has provided necessary health care to millions of patients across this country. Another steep cut in reimbursement rates is now forcing many physicians who provide for Medicare patients to make difficult choices. We only need to look at this chart, compare in 2004 Medicare payment for the various types of Medicare providers to understand the physicians' plight. Reimbursements for outpatient services up 3.8 percent. Inpatient services up 3.4 percent. Payment for inpatient rehabilitation up 3.2 percent. Likewise, payments to skilled nursing facilities up 3 percent. Then we come to our physicians, down 4.2 percent. Interestingly, payments to all of these other providers are going up and payments to physicians are getting cut again. Opponents to increase funding for physicians' payments often cite the high participation level in the Medicare program as evidence that physician reimbursement rates are at least adequate. True, most surgeons and doctors continue to treat some Medicare patients even as rates continue to fall. It is difficult for physicians to sever long- standing relationships with their patients. Having practiced OB-GYN for 27 years, I can tell you that the bond between doctor and patient is truly unique. It is a difficult relationship to be forced to end. On the other hand, I would invite you to take a look at the number of physicians accepting new Medicare patients into their practices. As more and more doctors curtail the time they devote to Medicare patients, seniors and disabled patients will wait even longer to visit a specialist. Moreover, they will struggle to find physicians available for referrals for follow-up chronic care. The problem associated with decreasing reimbursements is especially acute within the surgical community. The number of physicians who elect to practice surgery is going down. Many variables enter into a medical student's choice of speciality. Among these factors is the viability of maintaining a practice. As reimbursements decline, so too do the number of applicants wishing to pursue surgery. Never are the consequences more dire than for trauma patients in underserved areas. The inability to sufficiently staff hospitals in emergency situations is one of the ripple effects of cutting physician reimbursements. One of the greatest achievements of the Medicare program is the access to high-quality care it has brought to the Nation's senior and disabled patients. This level of access cannot be expected to continue uninterrupted in the face of continued Medicare cuts and ballooning liability premiums. Mr. Speaker, we must stop, we must stop the 4.2 percent Medicare physician payment cut. Help our doctors help those who need care the most. Mr. Speaker, we must not forget, we must never forget that doctors are the linchpin of the Medicare program. It will do no good to provide a prescription benefit for our seniors, a $400 billion plan, which I am very much in favor of, if we have no physicians willing to accept Medicare patients and write those prescriptions because of these continued Medicare payment cuts.

Mr. GINGREY

Mr. GINGREY. Mr. Speaker, I thank the gentlewoman from North Carolina for yielding time to me; and Mr. Speaker, let me just say in regard to some of the comments that the gentleman from Virginia just made in regard to this ban on partial-birth abortion only eliminating one method of a late-term abortion, and he said he would not describe some of the other procedures of late-term abortion, and I wish maybe he had because I, as a physician, as an OB/GYN physician, do not know of any other procedures, late-term procedures that would result in the death of a child at this stage of pregnancy, and we are talking about infants, that are well past the point of viability. We are talking about, in some instances, 4\1/2\-, 5-pound babies, that that pregnancy cannot be terminated, and resulting in a dead baby without doing a destructive procedure known as partial-birth abortion. It literally is the only option left for a woman who wants to choose death for her child in the third trimester. If you do a cesarean section, you have got the problem of delivering a live child. If you induce labor, you have the problem of having a live child, and that problem means that you cannot perform an abortion. This is what it is all about, and the gentleman from Texas on the other side spoke a few minutes ago about the dirty little secret, the dirty little secret of this not banning late-term abortion. It certainly does when we eliminate this abhorrent procedure known as partial-birth abortion. This question that keeps coming up about the health exception, how in the world could anybody consider that it would be a healthy thing to put a mother through this kind of procedure in the third trimester. It is not healthy. It is totally unhealthy. It is a complete farce. I urge the adoption of the rule, and let us get on and pass this ban. It is time.