Nita Lowey

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, we have all come to accept that we now live in a global society. One remarkable woman who recognized this fact long ago is Judy Mello. I wish to pay tribute to her today. Since 1994, Judy has served as President and CEO of World Learning, an organization committed to helping develop the knowledge, skills, and attitudes needed to contribute effectively to international understanding and global development. World Learning currently runs over 220 programs in 120 countries, providing direct program services to more than 300,000 individuals. World Learning runs a School for International Training and important cultural exchange programs. Prior to her appointment at World Learning, Judy made her mark in the world of international banking. She ran her own firm, J.H. Mello Company, which provided financial advisory services to clients, and subsequently served as Managing Director of Cambridge International Partners, an investment banking firm in New York City. Formerly, she polished her international credentials and leadership skills at the International Division of Citibank, Marine Midland Bank, First Women's Bank, New York, Lehman Brothers, and American Express. Throughout her career, Judy has worked to help prepare America to compete in the global marketplace. The list of her commitments is long and distinguished: she served on the Board of World Education; the Board of Directors of the New York Business Development Corporation; the advisory board of the Nitze School of Advanced International Studies; the Johns Hopkins University Bologna Center; and the Board of Overseers of the NYU Graduate School of Business Administration. I am also extremely grateful for her efforts to foster the careers of aspiring women. She is a founding member and past director of the Committee of 200, an organization of women CEOs, and a founding member and co-chair of the Capital Circle, which mobilizes capital for women- run businesses. She is a member of the Women's Forum, and a past member of the Women's Economic Round Table. Her dedication to the advancement of women in the corporate world is paving the way for the women CEOs of today and tomorrow. I am delighted that the National Association of Breast Cancer Organizations will honor Judy Mello next week with their distinguished ``Celebrate Life Award'' for exhibiting the willingness to take control of her life, and the courage to determine her own destiny. I am so proud of her and I am hopeful her example serves as inspiration to all women--and all Americans.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise today to recognize the invaluable contributions of Mrs. Melva Bucksbaum. Mrs. Bucksbaum has distinguished herself as a strong supporter of the arts and through her numerous accomplishments has earned the honor of being recognized at the Jewish Museum's ``Festa do Brazil'', a masked ball in celebration of Purim. Melva has promoted art throughout the United States and Israel, with a particular dedication to contemporary art and artists. Her generosity toward The Jewish Museum's Legacy Campaigns helped make possible the Museum's expansion and renovation, as well as the creation of a vital endowment fund. In addition to sitting on the Boards of the Jewish Museum and the Des Moines Art Center, Mrs. Bucksbaum serves with a number of other distinguished institutions: the Graduate School of Design, Harvard University; the International Committee of the Tate Museum, London; the Whitney Museum; American Friends of Israel Museum; Save Venice; the Independent Curator's Association; the Kennedy Center's National Committee for the Performing Arts and the International Council of the Museum of Modern Art. Since 1995, Mrs. Bucksbaum has actively managed the Martin Bucksbaum Family Foundation, which is listed as one of the founders of the United States Holocaust Museum. Mr. Speaker, on March 4, Melva will be recognized by the Jewish Museum for her years of community service as this year's Purim Ball honoree. It is an honor and a pleasure for me to join the Museum in honoring Melva Bucksbaum on this very special occasion.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I wish to pay tribute to Donald L. Shapiro in honor of the dedication of his portrait at the Harvard Club of New York City. He is a man of character, ambition, and faith. Few Americans have been as successful as Donald Shapiro. A graduate of Harvard College and the Harvard Graduate School of Business, Donald Shapiro has served as Vice President of Real Estate for Levitt & Sons, and subsequently as Executive Vice President of Peerage Properties. He was also President of the Roosevelt Field Shopping Center on Long Island. In 1974, Donald co-founded Vector Real Estate Corporation. As President, he guided the firm in development, acquisitions, and joint- ventures on residential, commercial, and retail properties. In 1989, Donald began a tenure as director of the New York Federal Savings Bank; three years later, he became its CEO. Last year, he negotiated the sale of New York Federal Savings Bank to Flushing Savings Bank and became a Senior Vice President. It should also be noted that Donald Shapiro has helped guide several other enterprises in the New York area. He is a former board member of the Community Bankers Association of New York State and is currently a director of the Associated Builders and Owners of Greater New York. But, Mr. Speaker, Donald Shapiro has done so much more. Religion, education, and family have played significant roles in his life. I particularly respect and admire his religious commitment. He is Vice Chairman of the Board of the Reconstructionist Rabbinical College in Philadelphia and Chair of the West End Synagogue. His leadership has helped these institutions thrive. I also commend him for his loyalty to the educational institutions that helped him grow. He recently completed a term as an Alumni Trustee of the Phillips Academy, and is currently Chair of the Academy's Campus Design Review Committee. Donald Shapiro has embraced life. In addition to his business and volunteer ventures, he enjoys swimming and playing squash, and is an aficionado of theater and music. The New York Giants and New York Mets can count him as one of their biggest fans. He has three adult children--a rabbi, a poet, and an actor. He is married to Arlene, a real estate broker, and they reside in New York City. From 1993 to 1996, Donald Shapiro served as President of the Harvard Club of New York City. Next week, the Club will dedicate his portrait. On this joyous occasion, I want to acknowledge his achievements and wish him happiness and success in the future.

Mrs. LOWEY

Mrs. LOWEY. Mr. Chairman, I thank the gentleman for yielding me this time. Mr. Chairman, I rise in opposition to this legislation. This bill would stop the development of voluntary testing dead in its tracks. It would block cities and States from pursuing a new tool in our efforts to make our schools the best in the world. These tests are not about history, not about science curriculum, they are about the ability to read and write, to add and subtract. Mr. Chairman, there are just no politics in the A, B, Cs; no hidden agendas in the 1, 2, 3s. Mr. Chairman, an agreement on Federal support for voluntary Federal testing was reached last year. That agreement permits limited test development but not its implementation. It was my understanding that the gentleman from Pennsylvania approved that compromise. Why are we wasting time revisiting an issue that we resolved just a few short months ago? Last year six of the Nation's seven largest cities accepted the challenge of voluntary national tests, including New York City, Chicago, Philadelphia, Los Angeles, Atlanta and Detroit. These communities have decided that voluntary national performance measures can help them determine what is working and what needs fixing. Mr. Chairman, I would urge my colleagues to permit limited test development to move forward and move on to debate ways to repair crumbling schools, reduce class size and keep schools open after hours. Let us talk about ways to promote educational reform and excellence, not slow it down. Vote ``no'' on this legislation.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise to introduce a resolution to protect Winnie the Pooh and his friends from being taken away from their safe and comfortable home at the New York Public Library. For 10 years Winnie the Pooh has held court in the New York Public Library, delighting millions of New Yorkers. But in recent days a member of the British Parliament has been expressing her intention to take them away from their home. As a mother of three and a grandmother of two, I am determined to keep Winnie the Pooh right where he belongs in New York City. Quite frankly, the British have their heads in a honey jar, if they think they are taking Winnie the Pooh out of New York City. Mr. Speaker, Christopher Milne, son of the creator of Winnie the Pooh and the real life model for Christopher Robin, gave his blessing to the New York Public Library's display of his childhood friends before his death 2 years ago. Winnie the Pooh, Tigger, Eeyore, Kanga and Piglet belong in New York, and this resolution will ensure that they stay there. H. Con. Res. -- Whereas Winnie-the-Pooh, Tigger, Eeyore, Kanga, and Piglet have lived safely and comfortably in a climate-controlled, bulletproof case at the New York Public Library for ten years. Whereas they bring happiness to the 750,000 people who visit them each year. Whereas Christopher Milne, the model for Christopher Robin, gave his blessing to the New York Public Library's public display of his childhood friends before his death. Resolved by the House of Representatives (the Senate concurring), That the Congress of the United States expresses its strong support for the residents of Pooh Corner to remain at the New York Public Library.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, the loss of Edna Kelly, life-long New Yorker, is a great one. Mrs. Kelly represented Brooklyn--and was the first woman to do so--for 19 years. She was an effective and articulate expert on both foreign affairs and domestic issues. A champion of NATO and an expert on Soviet Bloc countries, Mrs. Kelly also sponsored measures to help refugees and displaced people after World War II and helped create the Peace Corps program. She advocated for equal pay for equal work for women and for better women's access to child care, credit, pensions, housing and educational opportunities. Mrs. Kelly's accomplishments were all the greater for the fact that she operated in an almost exclusively male political world. Her intelligence and tenacity earned the respect and admiration of her colleagues. We will all miss her.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I thank the gentleman for yielding. I was just walking by and I heard my distinguished colleagues referring to the important initiatives that are going to be discussed in the State of the Union, and I wanted to thank them because these issues are what people really care about. We all are coming back today, and most of us have had discussions in our district with seniors, visited schools, had many meetings, hearings on Medicare, on child care, on issues of concern to real people. My constituents wanted us to come here and solve problems. That is what this is all about. We are here to solve problems. My colleague referred to the terrible conditions of some of our schools. We talk about educating youngsters. We talk about standards. We talk about more teachers. But if the school buildings are falling apart, then it is pretty difficult to focus attention on the agenda in those buildings. I have visited some schools where there is plastic on the ceiling holding up the walls. These roofs have been leaking for years. And children are sitting in classrooms under conditions that I certainly do not think most of us would want our children to be in. So I was particularly pleased that, after all of us have been working many, many years to build support for partnership with local governments on school construction, that the President is taking a strong position to assist local governments to repair our schools. Again, this is a partnership. The Federal Government is not just going to go in and say, here you are, here is the money. These are partnerships. And if we can develop partnerships in highways and prisons and a whole myriad of uses, then it seems to me we should be investing in our school construction. I was very pleased to see that in the President's initiatives. Also, when it comes to child care, many of us understand that if we are going to put people to work, we have a responsibility to be sure that our children, our future, are well-taken care of. And, again, I want to congratulate this administration in putting forth the proposal to really invest in child care and making sure there are enough slots for the children in all of our communities and also to be sure that there are regulations in place so a mother who put her child in child care or a father who puts his child in child care knows that those children will be safe. So child care is another proposal that we all have to rally around. And Medicare extension. This is a problem that is brought up to me all the time. Why should people not be able to buy into Medicare to be sure that they have the health care that they need? This is brought up in the senior centers, in casual meetings, in the supermarkets. People are worried about health care, and this is a very important proposal. I was very pleased that my colleague, the gentleman from New Jersey (Mr. Pallone), that he tried to quiet the fears of many people that Medicare is going broke. We have reformed, we have strengthened Medicare since its founding in the 1960s. Yes, we have to make changes. We have to be sure that Medicare and Social Security are solid programs when the baby-boomers come of age. But Medicare and Social Security are not going broke in 1 year or 5 years or 10 years. We have to address the challenges ahead, make sure there are programs for our baby-boomers so we can give them the benefits of these great, great programs. But let us not frighten seniors. They are worried and they are worried for the children and for the children's children. So I know my colleague is committed and I am committed and we are committed to work to continue to strengthen Medicare, to strengthen Social Security. But let us not set off the alarm. I am very concerned that there are people on the other side of the aisle that are doing just that. Let us maintain our solid positions that these are important programs, but we have to move ahead constructively and not set the alarm bells. So education, child care, health care, these are all things that people care about; and that is why I am so enthusiastic about the State of the Union this evening. I look forward to hearing it. We just talked about a few of the proposals. But food safety, genetic discrimination, this is a State of the Union message that is solid, and it is dedicated to the people of this country. I want to thank my colleague, the gentleman from New Jersey (Mr. Pallone), again for discussing the State of the Union. I know we are committed to making sure that this will be a productive session, that we are here to focus on what really matters to real people to solve their problems, and this is a good kickoff to an agenda that matters to real people. I thank my colleague again for leading this special order.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise today to recognize the extraordinary accomplishments of Dr. David Kessler. Dr. Kessler is known to many of us through his service as Commissioner of the Food and Drug Administration. By almost every account, he transformed that once moribund agency into a dynamo of public health leadership and policy development. Quite simply, Dr. Kessler redefined the role of FDA Commissioner, setting a standard that his successors will surely admire and strive to attain. Dr. Kessler's courageous efforts to identify the dangers of smoking and to encourage a broad public dialog on tobacco usage may prove to be his most lasting legacy. His authoritative presentation of medical fact and resolute defiance of those who would deny the grave effects of tobacco smoke made him a familiar figure to millions of Americans. And his efforts, in particular, to protect children from tobacco smoke, may potentially save thousands of lives. Smoking remains an urgent public health challenge, but Dr. Kessler's work undoubtedly established a strong foundation on which future efforts to curb smoking can be built. Of course, Dr. Kessler's accomplishments do not end with tobacco. Under this leadership, the FDA streamlined the approval process for life-saving and life-improving drugs. He helped make possible a revolution in the treatment of HIV and other illnesses. And he boosted the morale and professionalism of an organization too long adrift. Since leaving the FDA, Dr. Kessler has continued his distinguished career at Yale, where he serves as the dean of the school of medicine. Mr. Speaker, on November 19, Dr. Kessler is to be honored by the League of Women Voters of New York State with the prestigious Carrier Chapman Catt Award. I am very pleased to join the league and so many other grateful citizens from my district and State in saluting Dr. Kessler and in recognizing his profound contribution to our Nation's health and future.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise today to pay tribute to my dear friends, Rabbi Norton and Baila Shargel, the spiritual leaders of the Jewish Community Center of Harrison, NY. On December 7, the extended family of JCC of Harrison will host a gala brunch honoring Rabbi and Mrs. Shargel and benefiting the Jewish Theological Seminary of America. It is entirely fitting that the Shargels and the seminary be recognized together for their shared values and for their profound contribution to the Jewish community. I have had the great pleasure of knowing Rabbi and Mrs. Shargel since moving to Westchester County and joining their congregation more than a decade ago. But their inspiring leadership predates our acquaintance. Indeed, for 25 years, the Shargels have enriched Harrison with their thoughtful philosophical insights and immense personal warmth. Rabbi and Mrs. Shargel are pillars of the community. They are as giving of their time and effort to broad and numerous causes as they are quick with wise counsel for the members of their temple. Their activities evidence a deep commitment to humanitarian ideals and to the spirit of compassion and generosity at the very heart of Jewish teaching. The Shargels' commitment to the Jewish Theological Seminary is every bit as powerful. Indeed, JCC of Harrison has spearheaded several events of great importance to the seminary, including the seminary's conferring of the Herbert Lehman Award, a special occasion for leaders of Judaism's conservative movement. Personally, I have always valued the advance and spiritual guidance of the rabbi and his wife. I hope and believe that their example has made me a better public servant. Rabbi and Mrs. Shargel honor us with their deeds and their work. I am delighted that JCC of Harrison has chosen to celebrate this wonderful couple and so pleased to record my admiration in this record of the Congress of the United States of America.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise in strong support of H.R. 2159. In deference to our chairman, I will be very brief. I want to thank our distinguished chairman and the ranking minority member for the really outstanding work they did in bringing together a strong bipartisan bill. We appreciate their efforts. It has been long, and it has been hard, but we are glad that it is coming to conclusion, because this bill does strike a delicate balance on a number of very controversial issues. I thank them for their leadership. This bill includes, Mr. Speaker, the full $3 billion aid package for Israel, the critical $80 million for refugee resettlement assistance. Although the development assistance account is lower than the administration requested, it does include a critical $15 million increase for international microcredit programs. Microcredit is a critical tool in the fight to eradicate poverty worldwide, and it enjoys bipartisan support in the Congress and this administration. Providing these small low-interest loans to the millions of low- income entrepreneurs around the world would be a major step toward the eradication of poverty. This is especially true among women, who are very often the heads of households and benefit tremendously from microcredit programs. This is a critical time for microcredit. We have come a long way this year alone, but we must do more, and the increase in this bill will allow us to help thousands of people pull themselves out of poverty. Mr. Speaker, I just want to say that I do remain concerned about several accounts in this bill. The critical population assistance account includes onerous restrictions, including monthly metering and a freeze at last year's level that I oppose. I know that our chairman and the chairman of the full committee have worked very hard to come to a satisfactory solution to this issue. I am also concerned that the administration has not been given the critical new arrangements to borrow that it has sought for the International Monetary Fund. However, Mr. Speaker, on the whole, this bill represents a good compromise between the gentleman from Alabama, Chairman Callahan, the ranking member, the gentlewoman from California [Ms. Pelosi and all the members of this subcommittee. Again, I want to thank them for the cooperation, and I strongly urge passage of the bill.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, today I am introducing the Postsecondary Adult Vocational Education Act [PAVE] to promote vocational and higher education as a means of helping welfare recipients to become self- sufficient. Last year, Congress enacted a sweeping welfare reform law with my support. The new welfare system is designed to provide needy families with job preparation, work, and support services to enable them to leave the welfare program and become self-sufficient. In particular, it permits a limited number of adult welfare recipients to pursue vocational educational training--but only for 1 year. I believe this provision is inadequate. The fact is, nearly half of all jobs in the 21st century will require some postsecondary education. That is why I have introduced the PAVE Act. This legislation would permit more welfare recipients to attend institutions of higher education for up to 2 years--enough time to earn a vocational or community college degree. In addition, those who attend college while on welfare would be permitted to fulfill their additional work requirements through college work-study. Working on campus will cut down on the time and expenses of commuting that make it so difficult for single mothers to meet their work and family responsibilities. In my district there are a number of effective higher education programs that are helping welfare recipients find and keep good jobs, including the JobSTAR Program at Westchester Community College and the CLOUT Program at Pace University. Programs around the country are having similar success. By expanding the vocational and higher education opportunities available under the new welfare law, the PAVE Act will enable more welfare recipients to gain the knowledge and employment skills they need to support their families on their own and leave the welfare rolls once and for all. The Postsecondary Adult Vocational Education Act is a commonsense proposal that will help pave the road to self-sufficiency. I invite my colleagues to join me and cosponsor this important legislation.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, today I am very pleased to join my good friend and colleague from Connecticut, Mrs. Johnson, in introducing the Community Employment Partnership Act of 1997. This bipartisan legislation will provide communities across the country with a significant new tool in moving millions of Americans from welfare to work by establishing tax incentives for not-for-profit employers. The central challenge of the new Federal welfare reform law is to help millions of public assistance recipients enter the work force. However, currently only profit-making employers are provided with the tools, principally in the form of the work opportunity tax credit, to recruit, hire, and train long-term welfare recipients. Across the Nation, not-for-profits such as hospitals, nursing homes, universities, and community-based organizations remain a major untapped resource for hiring people on welfare. Many not-for-profit employers that are in need of entry-level workers are located in cities with high concentrations of welfare recipients and easy access to mass transit. This helps eliminate one of the major impediments to welfare recipients keeping a job: the cost and time of getting to and from work. It is clear that if we want to ensure the maximum level of participation from all employers in moving people from welfare to work, we must pass legislation that expands the work opportunity tax credit program to include not-for-profit employers. Our legislation will do just that through a graduated tax credit to reduce not-for-profits' Federal payroll tax liability. Specifically, this legislation will provide a 20-percent tax credit on payroll taxes from the date of hire for the first $6,000 in wages for those working 120 to 399 hours each calendar year quarter and a 30-percent credit for the first $6,000 in wages for people working 400 hours or more. I know first-hand that in the New York metropolitan area, including hospitals, universities, and other not-for-profits in the welfare-to- work effort will not only help tens of thousands of welfare recipients become self-sufficient, it will also give these institutions the financial means to better support their communities and meet their own pressing labor needs. That is why the Community Employment Partnership Act has been endorsed by the Non-Profit Coordinating Committee of New York. Mr. Speaker, our legislation is clearly a win-win situation for communities across the Nation. I urge my colleagues to join us in this effort.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I am pleased to introduce today the Clinical Research Enhancement Act of 1997. This legislation will better enable us to translate basic science discoveries into improvements in medical treatment. I am pleased to be joined by Congresswoman Nancy Johnson as the primary cosponsor of this important legislation. The difficulties faced by clinical researchers and their patients threaten progress in medicine and our country's international competitive edge in biomedical science. We are losing a generation of physician scientists because of limited research funding, medical tuition indebtedness, and obstacles created by our increasingly competitive health care system. While the Clinical Research Enhancement Act of 1997 cannot address all these problems, it can help us to recruit and retain talented clinical investigators to insure that advances in basic biomedical science are more readily translated into improvements in patient care. In 1994, the Institute of Medicine [IOM] issued a groundbreaking report outlining the crisis facing clinical research. The IOM report found that numerous obstacles confront clinical researchers at various points in their careers. Furthermore, the IOM concluded that we simply are not training the number of clinical scientists necessary to address the rapid discoveries occurring in basic biomedicine. Studies by the National Research Council, National Academy of Sciences, and the National Institutes of Health have also highlighted the problems facing clinical research. The Clinical Research Enhancement Act of 1997 will improve Federal support of clinical research by: Improving the peer review process for clinical research grants and establishing innovative science awards that will be reviewed by scientists who are particularly knowledgeable about clinical research; Strengthening the general clinical research centers [GCRC's] which now serve as the hub of NIH-supported extramural clinical research activity; Enhancing the career development of clinical scientists by creating new awards that will be similar to existing NIH career awards but focused on clinical investigators who pursue initial research projects with a mentor prior to independent pursuit of research; Creating innovative medical science awards for more established researchers in order to improve funding for projects involving potential clinical applications of a basic discovery which are tested on a small number of patients; Providing support for scientists seeking advanced degrees in clinical investigation in order to address the need for structured, academic training in clinical investigation; and Expanding the existing loan repayment program available to clinical researchers who are based at the NIH campus to make it available to NIH-supported clinical scientists at centers around the country. The Clinical Research Enhancement Act of 1997 has the support of over 100 medical, scientific, and academic organizations. I want to especially commend the American Federation for Medical Research for their leadership on this important issue. I urge my colleagues to cosponsor this legislation which will help to ensure that our Federal investment in basic biomedical science is translated into improvements in medical care. I request that the accompanying materials be included in the Record. As a coalition of organizations concerned about improving the quality of health care, the National Health Council strongly supports the Clinical Research Enhancement Act. As you know, it has been more than three years since the Institute of Medicine (IOM) documented the major challenges confronting clinical research in our country. Your bill would implement a number of the IOM recommendations for addressing these problems. It is critically important that the NIH move forward as rapidly as possible with these initiatives. The NIH is the major funding source in the United States for basic biomedical research. However, the major dividends from this investment are discoveries that improve our ability to prevent, effectively treat, and cure disease and disability. The NIH must foster not only the basic research that begins this process but also the translational research through which a basic science discovery is applied to a medical problem. There is generous industry support for clinical research and clinical trials aimed at the development of new products. However, private funding is extremely limited for initial translational research that may have little or no commercial product potential. Examples of such research include studies of nutritional therapies, new approaches to disease prevention, transplantation techniques, behavioral interventions, and studies of off-label uses of approved drugs. In the past, such research was often subsidized from patient care revenues to academic medical centers. However, competition in the health care marketplace has begun to erode this source of funding; therefore, NIH must play an expanded role in providing support for this research. The Clinical Research Enhancement Act would foster NIH funding opportunities for this type of research through the establishment of ``innovative medical science awards.'' Such studies will focus on translating basic research discoveries into tools that health care professionals can use to cure disease and relieve suffering. In addition, we support provisions of the bill that would foster opportunities for physicians to pursue careers in clinical research. There is ample evidence that American physicians are opting out of careers in science for a variety of reasons. Steps must be taken to rebuild our nation's supply of well-trained physician scientists if the United States is to continue its leadership of the world in medical science. Finally, the bill would direct the NIH to improve the peer review of patient-oriented research. Studies have documented the fact that clinical research proposals are at a disadvantage when reviewed by NIH study sections because of NIH's primary focus on basic biomedical research. This must be changed, as proposed in your bill, so that scientific opportunities to improve medical care are not lost. The undersigned organizations are extremely grateful for your leadership in addressing the problems confronting clinical research. We support your initiative to assure that the NIH invests in the translational research that holds the key for patients around the country who are waiting for a cure. We are pleased to endorse the Clinical Research Enhancement Act. Alzheimer's Association, American Autoimmune Related Diseases Association, American Diabetes Association, American Kidney Fund, American Paralysis Association, Digestive Diseases National Coalition, Epilepsy Foundation of America, Foundation Fighting Blindness, Juvenile Diabetes Foundation International. Glaucoma Research Foundation, Myasthenia Gravis Foundation, National Alopecia Areata Foundation, National Multiple Sclerosis Society, National Osteoporosis Foundation, National Tuberous Sclerosis Association, Paget Foundation, Sjogren's Syndrome Foundation, Tourette Syndrome Association.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I am proud of this conference report. The committee, under the strong leadership of the gentleman from Illinois, Chairman Porter and the ranking member, the gentleman from Wisconsin [Mr. Obey], along with our Senate colleagues, succeeded in producing a bill which reflects our shared priorities. We worked very hard on this bill, and this bill truly reflects a real bipartisan effort. Again, I want to thank the chairman and the ranking member for creating the atmosphere and the commitment among all of us to work together. I also want to thank the staffs on both sides who have been so very helpful and cooperative in reaching our goals. Mr. Speaker, this conference report recognizes the clear need for an increased investment in our children's education. I am pleased that we were able to provide $3.2 billion more than last year in funds for education. In particular, I am pleased that $40 million in new funds have been provided to keep our schools open after hours in order to provide a safe haven for our youth and to improve reading and other academic skills. We increased the maximum Pell grant by $300 per student and overall Pell funding by $1.4 billion. The bill also includes language expanding the eligibility of independent and dependent students for Pell grants. In addition, we were able to restore funding to the SSIG student aid program which helps so many young people get that education. We made a number of significant increases in health programs. We were able to provide the National Institutes of Health with a 7 percent increase over last year. This will allow the National Institutes of Health to increase funding for breast cancer research and other dreaded diseases so that advances in prevention and treatment will continue. Funding for AIDS drug assistance has been increased by $119 million more than last year. This will help to provide life-sustaining medicine to AIDS patients across the country. I am also very pleased that we provided $268 million for job training. In part, these funds will help to assist those on welfare so they can better obtain decent-paying jobs. While I am disappointed that the Hyde amendment restricting access to abortion for low-income women is still in this bill, I am very pleased that we were able to prevent a radical expansion of this prohibitive restriction. The bill also repeals the $50 billion tuberculosis giveaway. Of course, there are some programs that I wish we could have expanded even more: Worker protection, title I education, and Centers for Disease Control are among those programs. However, on balance, I believe that this is a very good bill that meets so many of the important needs of our constituents, and I urge my colleagues on both sides of the aisle to support this bill.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise today to honor the memory of Miriam Jackson, an extraordinary woman who devoted her life to community service and social justice. Miriam possessed an unusual combination of qualities. She was, first, a vigorous and forceful advocate, quick to stand up for principle, to express a point of view, and to fight for a cause. It was this steely resolve in the face of challenge and adversity which allowed her to run for county-wide office despite overwhelming odds, to delve into campaigns, and to confront the most daunting community problems with an unflinching determination to succeed. And it was undoubtedly this same resolve which enabled Miriam to become one of only two women ever to chair a major political party in Westchester County. Miriam was also a profoundly tender woman. She forged deep and meaningful relationships with countless individuals, whom she treated almost as adopted children. With time, this circle of friends and admirers grew to cross every imaginable boundary. A proud and observant Jew, Miriam counted as her closest friend a Roman Catholic nun, Sister Miriam Therese Peppin. And Miriam delighted always in pulling young people under her wing, while preserving deacdes-old relationships with their elders. There was no admission requirement to this privileged court, save for a warm heart, a ready laugh, and an engaging personality. And from her friends, Miriam would withhold nothing: neither love, nor support, nor effort--nor a bit of pointed, well-phrased, and somewhat more than friendly advice. There was a great tenderness also at the heart of her politics. This was a woman who identified at the most basic level with the least fortunate among us--who struggled to uplift the downtrodden, to achieve fairness for the victims of prejudice, to bring peace in times of strife, and, in her later years, to secure dignity for the elderly. Miriam stood instinctively at the side of the underdog and recognized always that our character as individuals and as a community was measured by our compassion. Miriam's legacy includes a host of Westchester leaders, ranging from city council members to party officials to Members of Congress. It includes a stronger network of community services, especially Meals-on- Wheels of New Rochelle, which Miriam co-founded with her very close friend, Sister Miriam, and the Hugh Doyle Senior Center to which Miriam Jackson was totally devoted. It includes the city of New Rochelle itself, blessed by her presence since she moved there in 1931. And it includes two remarkable granddaughters whose lives honor Miriam's values and spirit. Mr. Speaker, Miriam Jackson knew great tragedy in her life. More than 30 years ago, she lost her only child and, in 1992, she mourned the death of her beloved husband, Murray. But Miriam refused to surrender to grief. Her heart was large enough to accept and draw meaning from even the most painful experience and generous enough to share that meaning with others. In the end, she was a source of unbridled joy and inspiration to those who knew her or knew of her. We are poorer now for Miriam Jackson's passing, but forever richer for her life.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise in strong support of this bill. All of us in this House, whether pro-choice or pro-life, joined together in sending a very clear message to the Chinese Government that the United States will not tolerate a policy of forced abortions and sterilizations. As a mother of three and a grandmother of two, I cannot imagine anything more abhorrent. This policy is anathema to all of us who celebrate the beauty of life. Members in this House who support abortion rights believe very, very strongly that every woman in the world should have the basic right to choose, a woman should have the information they need to make their own decisions. I would urge my colleagues who are on the floor today supporting the right of Chinese women to control their own bodies to accord the same rights and respect to American women. Let us support reproductive choice in China and in the United States. Forced abortion must be condemned. I urge my colleagues to support this bill.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, pursuant to clause 2 of rule IX, I hereby give notice of my intention to offer a resolution which raises a question of the privileges of the House. The form of the resolution is as follows: Whereas, Loretta Sanchez was issued a certificate of election as the duly elected Member of Congress from the 46th District of California by the Secretary of State of California and was seated by the U.S. House of Representatives on January 7, 1997; and Whereas A Notice of Contest of Election was filed with the Clerk of the House by Mr. Robert Dornan on December 26, 1996; and Whereas the Task Force on the Contested Election in the 46th District of California met on February 26, 1997 in Washington, D.C., on April 19, 1997 in Orange County, California and October 24, 1997 in Washington, D.C.; and Whereas the allegations made by Mr. Robert Dornan have been largely found to be without merit: charges of improper voting from a business, rather than a resident address; underage voting; double voting; and charges of unusually large number of individuals voting from the same address. It was found that voting from the same address included a Marines barracks and the domicile of nuns, that business addresses were legal residences for the individuals, including the zoo keeper of the Santa Ana zoo, that duplicate voting was by different individuals and those accused of underage voting were of age; and Whereas the Committee on House Oversight has issued unprecedented subpoenas to the Immigration and Naturalization Service to compare their records with Orange County voter registration records, the first time in any election in the history of the United States that the INS has been asked by Congress to verify the citizenship of voters; and Whereas the INS has complied with the Committee's request and, at the Committee's request, has been doing a manual check of its paper files and providing worksheets containing supplemental information on that manual check to the Committee on House Oversight for over five months; and Whereas the Committee on House Oversight, subpoenaed the records seized by the District Attorney of Orange County on February 13, 1997 and has received and reviewed all records pertaining to registration efforts of that group; and Whereas the House Oversight Committee is now pursuing a duplicate and dilatory review of materials already in the Committees possession by the Secretary of State of California; and Whereas the Task Force on the Contested Election in the 46th District of California and the Committee have been reviewing these materials and has all the information it needs regarding who voted in the 46th District and all the information it needs to make judgments concerning those votes; and Whereas the Committee on House Oversight has after over nine months of review and investigation failed to present credible evidence to change the outcome of the election of Congresswoman Sanchez and is pursuing never ending and unsubstantiated areas of review; and Whereas, Contestant Robert Dornan has not shown or provided credible evidence that the outcome of the election is other than Congresswoman Sanchez's election to the Congress; and Whereas, U.S. taxpayers have spent over $500,000 on this investigation--money that could have been better spent providing 110 children with 1 year of Head Start; Whereas, the Committee on House Oversight should complete its review of this matter and bring this contest to an end and now therefore be it: Resolved, That unless the Committee on House Oversight has sooner reported a recommendation for its final disposition, the contest in the 46th District of California is dismissed upon the expiration of November 7, 1997.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise today to honor Walter Capps. Those of us in this House were privileged to know and serve with Walter this past year. This institution is diminished by his passing. Just recently Walter and I worked together in an effort to prevent imported assault weapons from flooding our streets. Walter was undeterred by the political risks involved with taking on this issue because he was here not merely to occupy a seat--but to make a difference. As a professor, he understood the value of education and the importance of history. He brought thoughtful convictions and a gentle manner to an institution too often characterized by bluff and bluster, and reminded us all of the importance of decency and integrity. My thoughts and prayers go out to Lois and her children. Walter made a real impact here and he will be missed.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, we have made progress in the war on breast cancer and the tragedy it causes. Early detection and aggressive treatment have enabled countless women across our Nation to survive this terrible disease. Yet, so much more remains to be done. Women continue to face a one in eight chance of developing breast cancer during their lifetimes. It remains the most frequent major cancer in women and the second leading cause of cancer deaths among women. Last year, an estimated 182,000 women were diagnosed with breast cancer and nearly 50,000 died of the disease. The Federal Government's support for breast cancer research has grown significantly in the past 10 years. The grants funded by the National Cancer Institute are on the cutting edge of science and have made important contributions to our understanding of this complex disease and to treatment. But because of a lack of funding, the National Cancer Institute is able to fund only a small percentage of the outstanding applications for research it receives. An estimated one out of every four grants that has been approved for funding by NCI's expert panels goes unfunded because of budgetary constraints. This is simply unacceptable. We must increase our investment in breast cancer research. We know very little about how to prevent the disease and treatment options are too few. At least two-thirds of breast cancers occur in women with no known risk factors. For example, we must gain a better understanding of the genetic basis of breast cancer, including more about the BRCA series of genes in Jewish women and others. Another important area of research is the link between breast cancer and the environment. We need to know more about so-called endocrine disruptors that are used to make pesticides, and other products. We also need to improve breast cancer detection. There are promising developments in new detection technologies such as magnetic resonance imaging and ultrasound which could eventually save countless lives. Each woman affected by breast cancer is a mother or a daughter or a sister or an aunt. And by that standard, breast cancer has torn apart the lives of literally millions in our country. Promising research remains unfunded and important questions are going unanswered. Yet, breast cancer is the most common cancer in women and the cause of so much anguish. H.R. 1070, would increase breast cancer funding at the National Cancer Institute from $410 to $590 million, an increase of 40 percent. This is a bipartisan bill which I introduced with Connie Morella. We have 57 cosponsors and the list grows every day. The bill is supported by both the American Cancer Society and the National Breast Cancer Coalition. In addition to the vital work of the National Cancer Institute, the war against breast cancer is being fought by other Federal agencies. The excellent, innovative breast cancer research program at the Defense Department deserves continued congressional support. We have increased access to and improved the quality and safety of mammography screening. I am pleased that on October 1, the FDA issued its final rules on the Mammography Quality Screening Act, a bill enacted in 1992 with the strong support of the Congressional Women's Caucus. All facilities should now be in compliance with the act and women should no longer need to worry about the quality of their mammogram. In addition, the Federal Government has provided low-cost breast cancer screening for over 1 million women through the Center for Disease Control's breast and cervical cancer screening program. The budget for this program has increased from $50 million in 1992 to $140 million in 1997. It's now available in all 50 States and is supported by private partners such as Avon and the YWCA. Of course, we need to continue to expand the program and target those women who are the most difficult to reach because of language and cultural barriers. No women in our Nation who needs a mammogram should go without one. Another important development at the national policy level has been the involvement of breast cancer advocates in decisions about how to allocate precious Federal research funds. Both at NIH and the Defense Department, advocates are adding a fresh perspective to review panels, helping scientists and administrators look at their research portfolios in important new ways. The National Cancer Institute has recently taken a significant step in this regard by involving advocates in its new breast cancer progress review group or PRG. But we must also turn our attention to legal protections for breast cancer patients and other women who may develop breast cancer. I have introduced a bill, H.R. 2275, with Representative Lazio to outlaw discrimination by employers on the basis of genetic discrimination. Louise Slaughter is doing an outstanding job fighting insurance discrimination based on genetic information. Employment discrimination poses another threat to those women who want to be tested for the breast cancer gene but fear that the information will be used against them. Our bill would amend title VII of the Civil Rights Act to permit a cause of action for those who have been discriminated in the workplace on the basis of genetic information. Congress also needs to act on legislation which would provide a minimal standard of care for women undergoing a mastectomy. The DeLauro bill provides a 48-hour minimal hospital stay. The Eshoo and Kelly bills provide reconstructive surgery. Insurers must not turn women out on the street involuntarily after a major procedure such as a mastectomy and they must not see reconstructive surgery as merely cosmetic surgery. Unfortunately, Congress has yet to hold hearings on any of the bills dealing with this issue and that's simply not acceptable. Let's applaud the progress we have made in ending the scourge of breast cancer but now turn our attention to the many battles ahead.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I thank the distinguished gentleman for yielding me this time. I rise in strong support of the substitute amendment to renew and rebuild our Nation's public schools. As the sponsor of the Rebuild America's Schools Act with 115 cosponsors, I am keenly aware of our school building crisis. Last year, the GAO confirmed what students and teachers already knew, that too many of our Nation's public schools are literally falling down. How much will it cost to repair them? The GAO says $112 billion. It is shameful that we have let the problem grow so severe. Children cannot learn in overcrowded or makeshift classrooms. They cannot learn when ceiling leaks or when walls are tumbling down. Mr. Speaker, we have let our children down. Now we have to make amends. The Rebuild America's Schools Act would make it cheaper for States and school districts to raise capital for school building and repair. The Rangel substitute takes a similar approach. It makes $4 billion available to provide interest-free bonds to our Nation's public schools. The money raised by these bonds would help repair buildings, build new classrooms. It would purchase computer equipment, develop teaching materials, train teachers. The Rangel substitute would also harness the knowledge, ingenuity, resources of the business community to help prepare our students for the rigors of the new global economy. It asks corporate America to step up to the plate and go to bat for our children. This is something each and every one of us must do. Local school districts are overwhelmed. The local tax base just cannot keep up with routine maintenance costs, let alone the costs of easing overcrowding or upgrading schools for 21st century learning. The fact is, local bond issues fail regularly. We can only address the abysmal condition of our Nation's school buildings with the concerted effort of every level of government. We need a real partnership. The Federal funds are but a small fraction of what is needed to solve this urgent problem. It does not mean that we in Washington do nothing. We must do our fair share. I ask for support of the Rangel substitute.

Mrs. LOWEY

Mrs. LOWEY. Mr. Chairman, I rise in opposition to this bill for several important reasons, and I want to congratulate the gentleman from Virginia [Mr. Moran], the ranking member of this committee, on his substitute. First, the bill contains a very harmful private school voucher provision. I am very concerned that private schools that receive Federal funding would not be held accountable to the taxpayers. I am also very concerned that funding private religious schools with public money is a clear violation of the constitutional principle of state- church separation. As we all know by now, the funding for the bill would provide vouchers for approximately 3 percent of all D.C. students. Mr. Chairman, I ask my colleagues, what about the other 97 percent who do not win this educational sweepstakes? What kind of message does a random lottery send to our youth? It tells them that their future is based on the luck of the draw, not their effort and ambition and not equal opportunity for all. Mr. Chairman, in my judgment, the answer is not a limited voucher program, it is tougher academic standards, safer school buildings, smaller classes, more teacher training. This bill also repeals the Davis-Bacon law for D.C. school construction projects. This repeal will not improve the District's crumbling schools but will discriminate against the District's construction workers. These workers deserve to earn a decent wage. A recent study, in fact, comparing school construction costs in five States with State prevailing wage laws and four States without such laws found that costs were actually lower in those States governed by State prevailing wages. If those on the other side really care about the District's crumbling schools, they should support H.R. 1104, the Partnership to Rebuild America's Schools, which would provide the District with $15 million to rebuild its schools and $5 billion nationwide.

Mrs. LOWEY. Mr. Chairman, I rise in strong support of this amendment. Repealing the Davis-Bacon law for D.C. school construction projects will not improve the district's crumbling schools. It will discriminate against the District's construction workers. These workers deserve to earn a decent wage. In fact, a recent study found that school construction costs were actually lower in those States governed by State Davis-Bacon laws. The Federal Government has a responsibility to help our local communities address the crisis of crumbling schools, but not by denying hard-working construction workers and their families a decent wage. The Members who support this Davis-Bacon repeal say they want to help the District's crumbling schools. If they really care about crumbling schools, support my bill that would provide $5 billion nationwide and $15 million to rebuild the schools in the D.C. school district.

Mrs. LOWEY

Mrs. LOWEY. Mr. Speaker, I rise in opposition to the bill, and I yield myself such time as I may consume. This is the fifth time that the House will vote on this issue. Unfortunately, it won't be the last. As my colleagues know, the President will veto this legislation because it does not contain an exception to ensure the health of American women. So we will be back here again next year. We have repeatedly tried to offer a health amendment to the bill on the floor of this House--and the Republican leadership has consistently blocked us. We offered to sit down and work with the Republican leadership to craft a health exception that we could all accept. The Republican leadership refused. The President will sign this legislation if it contains a health exception--but the Republican leadership won't even give us the chance to put one in. The GOP leadership doesn't want to ban this procedure--it wants a political issue. Republicans would rather debate this again and again and again rather than send the President a bill that he can sign into law. But don't take my word for it--take Ralph Reed's. On May 21, he told the New York Times that this was a quote, winning gold-plated issue going into the 1996 elections. No pious words about the defenseless unborn, no handwringing over moral decay. Just a winning gold-plated issue. This is pure politics, plain and simple. My colleagues, you will hear a great deal today about the AMA and its endorsement of this bill. You will hear that changes made to this bill in the Senate have improved it. Nonsense. The Senate amendments are window dressing that provide cover to doctors while leaving women out in the cold. Sadly, the AMA struck a very cynical bargain with the Republican leadership to endorse this bill. Thankfully, Mr. Speaker, the AMA is not the final word on this issue. The American College of Obstetricians and Gynecologists, ACOG, the health professionals who actually deliver babies and care for women, oppose this legislation. And let's not forget, my colleagues, that the AMA represents doctors--not women. So while the changes made to this bill in the Senate may make it marginally more difficult to throw doctors in jail, they will do nothing--absolutely nothing--to save the lives or preserve the health of pregnant women. So, we are left with the same bill that we have voted on four times before. The same bill that puts the lives and health of women at risk. The same bill that violates the Constitution and tramples on the rights of American women. Women from around the Nation testified before Congress that this procedure protected their lives and health. Women like Tammy Watts, Claudia Addes, and Maureen Britel. Women who would have been harmed by this bill. These women desperately wanted to have children. They had purchased baby clothes. They had picked out names. They did not abort because of a headache. They did not choose to abort because their prom dress did not fit. They chose to become mothers and only terminated their pregnancies because of tragic circumstances. Who in this body will stand in judgment of them? Which of you will stand in the operating room and limit their options? Who, at the agonizing moment, will decide--the Congress of the United States or the women and families of America? The courts have been very clear on this question, and have consistently found bills of this type to be unconstitutional. Lawsuits have been filed in 10 States challenging State statutes similar to the bill before us. In 10 States, courts have ruled that the laws were unconstitutional and struck them down, limited their scope, or enjoined them. Mr. Speaker, when the House debated this issue in March the distinguished gentleman from Florida assured us that this bill was constitutional and consistent with Roe. Since then this ban has been struck down, changed, or enjoined on constitutional grounds in 10 States. Ten States. States have moved ahead and passed these bans--and they have been struck down, again and again. The courts have clearly spoken: This bill violates a woman's constitutionally protected right to choose. Unfortunately, we know that the anti-Choice majority won't allow a little thing like the Constitution to stand in the way of their abortion ban. Mr. Speaker, the anti-Choice Republican leadership has been waging war on the reproductive rights of American women since taking over this House in 1994. In the last Congress alone the GOP leadership voted to limit abortion rights more than 50 separate times-- a new record. It is clear that the Republican leadership wants to ban every abortion, procedure by procedure, trimester by trimester. They want to roll back Roe versus Wade and push women into the back alley. We have a different vision. We will continue to fight to ensure that women are able to obtain safe, legal abortions. And we will work to reduce the number of abortions by providing women with greater access to family planning and contraceptives. We will work to empower women to make responsible choices about their own bodies. The Republicans have chosen to make our bodies their battlegrounds. They will not succeed. Mr. Speaker, I submit the following for printing in the Record: American Medical Association, Chicago, IL, May 19, 1997. Hon. Newt Gingrich, U.S. House of Representatives, Capitol Building, Washington, DC. Dear Speaker Gingrich: On behalf of the 300,000 physician and medical student members of the American Medical Association (AMA), I am writing to express our strong concern with the level of Medicare payment cuts proposed in the budget agreement with the Administration, as well as many of the specific physician payment changes included in the Administration's 1998 budget proposal. A balanced budget and solvent Medicare Trust Fund are important goals which the AMA supports. However, we strongly object to reducing Medicare spending by $115 billion over five years almost entirely from cuts to physicians and other providers. It is clear that physician spending is not the problem with Medicare's overall growth. Physician spending growth is already well below overall Medicare growth and below the growth rate for any other major sector of Medicare. The Congressional Budget Office (CBO) estimates that under current law, physician payments per service will fall below current payment rates, while hospital and other Part B services are projected to rise. In fact, physicians are the only provider group who already face payment reductions in Medicare under current law. More importantly, the combination of payment cuts under consideration, combined with pending payment changes, could seriously undermine the quality of care physicians deliver to Medicare patients and ultimately reduce beneficiary access to care, as low payment rates have resulted in access problems for Medicaid patients. CBO stated last month that ``if payments are too tightly limited, beneficiaries could encounter difficulties in getting care from some providers or might not be able to obtain certain services.'' It is critical that any proposed budget cuts be considered in conjunction with other already pending physician payment changes, including the implementation of the resource-based practice expense, as discussed below. The AMA believes Congress and the Administration should enact fundamental reforms to the Medicare program, such as those included in the Balanced Budget Act of 1995, instead of merely reducing payments and making minor modifications to the program. We have developed a comprehensive proposal, Transforming Medicare, which addresses both the short and long-term problems with Medicare, without relying on failsafe or lookback provisions. Our plan modernizes traditional Medicare, eliminating the need for Medigap, while preserving the security and quality of care beneficiaries now receive. It would create a broad menu of health plan choices of Medicare beneficiaries to choose from, including Provider Sponsored Organizations (PSOs) and Medical Savings Accounts (MSAs). It includes needed regulatory reforms to fraud and abuse and self-referral provisions, as well as cost-saving professional liability reforms. It also ensures that a healthy Medicare is available for future generations. We are pleased to enclose a copy of our Transforming Medicare proposal for your consideration. improving the physician payment system There is widespread agreement that the current method of updating physician payments, the Medicare Volume Performance Standard (MVPS) system, is fundamentally flawed. The Congress, the Administration, and the Physician Payment Review Commission (PPRC) have all proposed replace the current MVPS update formula with a sustainable growth rate (SGR) formula, which uses a real per capita gross domestic product (GDP) formula to adjust for volume and intensity. In general, the AMA supports implementing the SGR approach as a needed correction for the MVPS. Fundamentally, the question for policymakers is determining the level of annual spending growth for physician services that best balances patient care needs and the federal budget. Under the current MVPS physician update formula, Medicare payments for physicians are actually projected to be rolled back, while hospital and other provider payment rates go up. Although these non-physician services are unlikely to see their full projected increases, their budget savings will be charged against this rising baseline, while further savings from physicians require even deeper cuts. Physician practice costs, as measured by the Medicare Economic Index (MEI), continue to rise while physician reimbursement under Medicare is projected to fall. While we believe that MEI is the appropriate goal for physician updates, we understand that budgetary constraints may not presently allow for a full MEI update for physicians. We would be willing to accept GDP+2 under an SGR system, as was provided in the Balanced Budget Act of 1995, if there were assurances that this could be increased to cover MEI once the necessary Medicare savings were obtained. In contrast, under GDP+0 as the Administration proposes, physician payments would continue to fall well below MEI, as the chart below indicates. Physicians are willing to do their part to put Medicare's fiscal house in order, as we have repeatedly done in the past. Physicians, who accounted for 32% of combined physician and hospital Medicare spending from 1987 to 1993, absorbed 43% of Medicare provider cuts over the same time. We are only asking for the opportunity to have Medicare payments keep up with the costs of providing care to Medicare beneficiaries, and are willing to accept the challenge of maintaining low volume growth. Budget reconciliation for Medicare should reflect the fact that physician spending is under better control than any other major Medicare segment. Physicians should not be penalized for having done the right thing in the first place. Single Conversion Factor The Administration's 1998 budget also proposes moving to a single conversion factor and payment update for the physician fee schedule. Medicare payments to physicians are set through a conversion factor that translates the resource-based relative value scale (RBRVS) into dollars. Currently, there is a conversion factor for each of three types of physician services: for 1997 these are set at $40.96 for surgery; $35.77 for primary care; and $33.85 for other services, as well as a separate conversion factor for anesthesiologists discussed below. The AMA strongly supports the move to a single conversion factor, in conjunction with improvements to the flawed MVPS formula. However, we believe Congress must set the single conversion factor at an adequate level and provide for a reasonable transition in order to minimize the negative financial impact on surgical services and reduce potential financial disincentives for providing care for Medicare patients. We believe that, at a minimum, the conversion factor for 1998 should be set no lower than the default update under the current MVPS formula, and a single conversion factor should be fully phased-in no earlier than the year 2000. Medicare reimburses anesthesiologists by a different conversion factor methodology than that applied to other physicians services. For 1997, the anesthesiology conversion factor is set at $16.68, and is therefore about 46% of the $36.24 average of the other three 1997 conversion factors. For purposes of determining the annual update, anesthesiology was assigned to the ``other nonsurgical'' category until 1996 when it was moved to the ``surgical'' category. The Administration has proposed to reduce the anesthesiology conversion factor by the same percentage as surgical services when surgery, primary care and other nonsurgical services are combined into a single conversion factor. However, that would clearly be inequitable since the cumulative increases over the life of the RBRVS are almost 17% higher for surgery than for anesthesiology. The AMA therefore supports PPRC's recommendation that in the move to a single conversion factor, the current ratio (46:100) should be maintained between the anesthesiology conversion factor and the new single conversion factor for other specialties. Resource-Based Practice Expense As mentioned above, many physicians face additional extreme payment reductions due to the implementation of the resource- based practice expense in 1998. The Social Security Act Amendments of 1994 requires the Health Care Financing Administration (HCFA) to implement a ``resource-based'' practice expense component of the Medicare fee schedule by January 1, 1998. That is, the payment for this component-- which represents over 40 percent of the payment for physician services--is to be based on the actual expenses incurred in delivering each service. Currently, the practice expense allowance is derived from a formula based on the prior reasonable charge payment system. The AMA supports resource-based practice expenses so long as they reflect actual practice expenses, but is seeking a one-year extension of the implementation date. The 1994 legislation said that HCFA should ``recognize the staff, equipment, and supplies used in the provision of various medical and surgical services in various settings.'' HCFA contracted with Abt Associates to conduct a two-part study of 3,000 physician practices expenses. When the survey was pulled back due to poor response rates, HCFA was left without adequate data to meet the intent of the law. HCFA is now relying primarily on data derived from clinical practice expert panels, or CPEPs. Early review of the recently-released CPEP findings suggest that they contain a number of errors. HCFA has even rejected certain direct costs that its expert panels found were part of the cost of surgery when doctors supply their own staff and supplies in hospital operating rooms. The AMA and medical specialties are working to identify and correct those flaws but more time is needed. The cuts HCFA projected in January are so extreme that they would nearly eliminate practice cost reimbursement for some procedures and specialties. Many inpatient surgical procedures and two specialties could suffer cuts of more than 80% in their practice expense values, and at least 40% in their total payments. Under HCFA's projections, payments for many surgical procedures would fall below Medicaid levels. Thus, there is good reason to fear that if Medicare makes deep cuts in its payments for complex procedures, doctors performing these services may find that they can no longer afford to accept Medicare patients. PPRC has advocated that HCFA should use a three year transition in phasing-in the new resource-based practice expense values in order to reduce the impact. The AMA believes that using a transition is pointless if the underlying data and methodology is invalid. Others argue that any problems can be corrected later through a refinement process similar to the one used when new work values were implemented in 1992. We strongly oppose this approach because we believe it is inappropriate to attempt to correct fundamentally flawed data. HCFA invested nearly three times as much time and money on the design of new work values as it has spent to revise practice expense values. Whereas thousands of doctors were surveyed to come up with the work values, in the end, there has been no broad survey of practice expenses. Opponents of an extension also maintain that there is no point in waiting another year because the demise of the indirect cost survey shows that it will be possible to collect this information independently. We believe that with another year, HCFA could develop alternative relative values that bear some relationship to actual practice expenses. There would be adequate time to validate and correct the CPEP data. Better indirect cost allocation methodologies could be developed and tested. Missing data could be collected, perhaps through an expansion of existing surveys. The AMA urges Congress to: (1) extend the resource-based practice expense implementation date by one year to January 1, 1999; (2) require HCFA to develop a new proposed rule to be published at least 8 months before implementation, with 90 days for public comments; (3) direct HCFA to use a new approach to data and methodology which recognizes all staff, equipment and supplies (not just those which can be tied to specific procedures); (4) require that the proposed rule include detailed impact projections which compare proposed payment amounts to data on actual physician practice expenses; and (5) require HCFA to consult with organizations representing physicians regarding resource-based practice expense methodology and data in order to ensure that sufficient input has been received from the affected physician community. Other Physician Payment Issues Assistants at Surgery The Administration is proposing to save $400 million over the next five years by making a single payment for surgery. This means that the additional payment Medicare now makes for a physician assisting the principal surgeon in performing an operation would no longer be made. Instead, the payment amount for the operation would have to be split between the principal surgeon and the assistant at surgery. We believe this provision dangerously imposes financial disincentives for the use of an assistant at surgery and inappropriately interferes with physician medical decision-making. The AMA supports efforts to develop guidelines for the appropriate use of assistants at surgery, but believes that patient care should not be compromised in search of Medicare savings. The professional judgment of surgeons regarding the need for an assistant at surgery for a specific patient must be recognized, even for operations in which an assistant ordinarily may not be required. Congress has considered and rejected this proposal in the past, and we urge you to reject it again. High Cost Medical Staff The Administration proposes to reduce Medicare payments for so-called high cost hospital medical staffs. This proposal is not new. In its 1994 Annual Report to Congress, the PPRC concluded that such a ``provision's disadvantages . . . outweigh its advantages.'' The Commission went on to note that such a provision: ``May have unintended effects on physician behavior, including a shifting of admissions away from hospitals with the high-cost designation. The provision would also increase the cost and complexity [of] administering the Medicare program.'' In some cases, the physicians responsible for a hospital's medical staff being designated ``high cost'' for a given year might simply take their patients elsewhere, leaving the remaining physicians on staff to bear the financial consequences, with potentially serious repercussions for the affected hospital. Finally, the proposal could inappropriately reduce payments to physicians who treat a sicker patient population. In the absence of a sound methodology to measure differences in the severity of illness of the patient population being treated by the medical staff, it is too risky to put in place a formula-driven process that could inappropriately lower payments for treating patients who are more expensive to treat because they are sicker. Centers of Excellence The Administration proposes to expand what it calls the ``Centers of Excellence'' demonstration project, under which Medicare makes a bundled payment to participating entities covering both physician and facility services for selected conditions, such as coronary artery bypass operations. We are concerned that these demonstration projects do not offer a potential increase in quality and cost-effectiveness, and that these ``centers of excellence'' in fact emphasize cost- cutting rather than excellence. We also find the name ``centers of excellence'' inappropriate in that it implies that institutions participating in this payment arrangement provide higher quality services than non-participating institutions. Outpatient Drug Payments The Administration also proposes to reduce payments for drugs administered in physicians' offices. Today Medicare pays the average wholesale price for these drugs, which include a number of therapies for treating patients who are critically ill with cancer and kidney disease. Under the President's plan, however, payment would be based on a complicated ``actual acquisition cost'' methodology. Specifically, payment would be based on the lowest price that the physician paid for that type of drug in the previous six month. In addition, payment would be capped at the national median of prices paid for the drug in a period 6 to 18 months earlier. In other words, the so-called ``actual acquisition cost'' has nothing to do with the ``actual cost'' of the drug provided to an individual patient. By definition, the half of all practices above the national median will be paid less than their purchase price for these drugs. Since all payments will be based on prices that are six to 18 months old, physicians will be forced to undertake a burdensome new tracking system and to absorb any increases imposed by drug manufacturers or wholesalers during that time. More important, patients could suffer as physicians, unable to recover the price of the drug let alone other associated costs, might be forced to discontinue providing the drug in their offices, requiring patients to have their drugs administered in hospitals where costs to the patient and Medicare may be higher. For all these reasons, the AMA urges Congress to reject this unfair and impractical proposal. fraud and abuse The AMA strongly opposes the Administration's efforts to repeal the fraud and abuse safeguards included in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Specifically, the Administration has proposed to eliminate the obligation of the Departments of Justice and Health and Human Services to issue advisory opinions on the anti- kickback statute, reduce the government's burden of proof for civil monetary penalties, and repeal the risk sharing exception to the anti-kickback statute. Fraud and abuse has no place in medical practice and the AMA is committed to setting the highest ethical standards for the profession. The incidence of misconduct can be greatly reduced by setting standards of appropriate behavior, disseminating this information widely, and designing and implementing programs to facilitate compliance. HIPAA provides new and much needed guidance by requiring HHS to establish mechanisms to modify existing safe harbors, issue advisory opinions, and issue special fraud alerts. This guidance will allow physicians, hospitals and insurers to develop efficient and effective integrated delivery systems that will benefit Medicare, Medicaid and the private health care marketplace. In the area of civil monetary penalties (CMPs), HIPAA requires that the Inspector General establish that the physician either acted ``in deliberate ignorance of the truth or falsity of the information.'' The AMA, along with many Members of Congress, fought long and hard to preserve this clarified standard in the face of strong opposition. This standard makes the burden of proof for imposing CMPs under HIPAA identical to the standard used in the federal False Claims Act, and there is no reason that two enforcement tools designed to address the same fraudulent behavior should have different standards of proof. Moreover, this section provides important protection for physicians who may unwittingly engage in behavior that is impermissible. The AMA also strongly opposes the Administration's proposal to eliminate the new risk sharing exception to the anti- kickback law provided in HIPAA. The expansion of managed care in today's health care market requires additional exceptions to the anti-kickback laws so that more flexibility in marketing practices and contractual arrangements is afforded. The future of the Medicare and Medicaid programs depends upon the ability of competing plans to offer quality alternatives to the existing program. HIPAA provides a much needed exception to the anti-kickback law for certain risk- sharing arrangements which will facilitate the development of innovative and cost-effective integrated delivery systems. Finally, the AMA has concerns with some of the proposals in the Administration's ``Medicare/Medicaid Waste, Fraud and Abuse Act of 1997.'' While we have not seen any legislative language on the proposals, we are concerned that some of the provisions are overreaching and could impose unwarranted penalties on unwary physicians. Physician Self-Referral The AMA supports reforms for physician self-referral laws (Stark I and II) to remove barriers to arrangements among physicians in the developing health care marketplace, including the development of Provider Sponsored Networks (PSNs). These laws were designed for the fee-for-service world, but now deter the development of risk sharing arrangements where there is no incentive for inappropriate referrals. In addition, inappropriate referrals of Medicare and Medicaid patients to outside laboratories and other designated diagnostic facilities are already prohibited under the federal anti-kickback law. Congress recognized the need for these reforms when it passed the Balanced Budget Act of 1995. We ask you to include these same needed reforms in Medicare legislation in the 105th Congress. Provider Sponsored Organizations The AMA strongly supports federal legislation which would facilitate the development of Provider Sponsored Organizations (PSOs). We believe PSOs should be subject to federally developed standards which account for the distinctions between provider networks that deliver services directly and insurers that purchase health care services and resell them, while also providing tough consumer protection standards for patients. By developing a federal framework, Congress will continue its precedent of encouraging innovative new ventures that stimulate competition and provide cost-saving efficiencies. The 1973 HMO Act created a federal regulatory scheme for HMOs, preempting state laws that interfered with their formation and operation. HMOs argued successfully then, as did the Blue Cross plans previously, that they represented different products and should be evaluated by different standards. In addition, we support PSO standards which allow as much flexibility as possible in the ownership and management structure of a PSO and which do not favor one provider group over another. Professional Liability Reform Medicare reform should also include the professional liability reforms that have been so successful in California, including a limit on non-economic damages of $250,000. Health care liability costs are built into the Medicare system in the form of physicians' and hospitals' liability premiums, defensive medicine, and coverage for distributors of medicines, blood services, and medical devices. In 1995, CBO scored $200 million in federal government savings over 7 years in physician malpractice premium costs alone, without considering similar hospital, HMO and medical supplier liability costs. These are millions of dollars that could go to patient care and extending the life of the HI Trust fund, instead of paying attorney fees and insurance premiums. Graduate Medical Education The AMA believes that because all patients benefit from our nation's graduate medical education (GME) system, the private sector should participate in the funding of GME through the development of an ``all payer'' fund. In addition, GME funds should be carved out of Medicare's payments to HMOs (i.e. AAPCC), with all direct medical education (DME) funds paid directly to the entity that incurs the costs of training, whether that entity is a medical school, hospital, nursing home, or ambulatory clinic. However, federal support in the form of the indirect medical education (IME) adjustment should continue to be provided to teaching hospitals which incur higher costs than non-teaching hospitals in providing training and unreimbursed patient care. Finally, a national physician workforce advisory body should be established to monitor and periodically assess the adequacy of the size and specialty composition of the physician workforce in the context of the changing needs of the evolving health care delivery system and evolving patterns of professional practice by non- physician health professionals. conclusion Congress can no longer postpone tackling fundamental reform of the Medicare program. Failure to do so is certain to prove even more costly for the millions of Americans who expect to be able to rely on this program in the future, as well as those working Americans who are called upon to help finance it. Chopping away at physician payments in hopes of getting more services for less money will ultimately divorce the Medicare system and its beneficiaries from the mainstream of American medical care. However Medicare is reformed, it will be our overriding goal to ensure that the change not damage the essential elements of the patient-physician relationship. Above all, reform should not break the bond of trust between a patient and physician that makes medicine unique. We look forward to working with you and the 105th Congress to enact urgently needed structural reforms to protect Medicare for our seniors and save it for our children. Sincerely, P. John Seward, MD.

Mrs. LOWEY. Mr. Speaker, I yield 2 minutes to the gentlewoman from Oregon [Ms. Furse].

Mrs. LOWEY. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise in strong opposition to the bill. This is the fifth time that the House will vote on this issue. Unfortunately, it will not be the last. As my colleagues know very well, the President will veto this legislation because it does not contain an exception to ensure the health of American women, so we will be back here again next year. We have repeatedly tried to offer an amendment to protect the health of the mother to this bill on the floor of this House, and the Republican leadership has consistently blocked us. We offered to sit down and work with the Republican leadership to craft a health exception that we could all accept. The Republican leadership refused. The President will sign this legislation if it contains an exception that would protect the health of the mother, but the Republican leadership will not even give us a chance to put one in this legislation. The Republican leadership does not want to ban this procedure. Unfortunately, it wants a political issue. Republicans would rather debate this again and again and again, rather than send the President a bill that he can sign into law. Mr. Speaker, do not take my word for it. Let us listen to the words of Ralph Reed. On May 21 he told the New York Times that this was, and I quote, ``A winning, gold-plated issue going into the 1996 election.'' No pious words about the defenseless unborn, no hand-wringing over moral decay, just a winning gold-plated issue. This, Mr. Speaker, sadly, is pure politics, plain and simple. Mr. Speaker, we will hear a great deal today about the AMA and its endorsement of this bill. We will hear that changes made to the bill in the Senate have improved it. Nonsense. The Senate amendments are window dressing that provide cover to doctors while leaving women, frankly, out in the cold. The AMA struck a very cynical bargain with the Republican leadership to endorse this bill. Thankfully, Mr. Speaker, the AMA is not the final word on this issue. The American College of Obstetricians and Gynecologists, ACOG, the health professionals who actually deliver babies and care for women, oppose this legislation. The American College of Obstetricians and Gynecologists oppose this legislation. Let us not forget, Mr. Speaker, that the AMA represents the doctors, not the women. So while the changes made to this bill in the Senate may make it marginally more difficult to throw doctors in jail when they are making these very difficult decisions, they will do nothing, absolutely nothing, to save the lives or preserve the health of women. So we are left with the same bill that we have voted on four times before, the same bill that puts the lives and health of women at risk, the same bill that violates the Constitution of the United States of America and tramples on the rights of American women. Women from around the Nation testified before Congress that this procedure protected their lives and their health, women like Tammy Watts, Claudia Addes, Maureen Britel, women who would have been harmed by this bill. These women, Mr. Speaker, desperately wanted to have children. They had purchased baby clothes. They had picked out names. They did not abort because of a headache. What an insult, Mr. Speaker. They did not choose to abort because their prom dress did not fit. They chose to become mothers, and only terminated their pregnancies because of tragic circumstances. Mr. Speaker, who in this body will stand in judgment of them? Which of the Members will stand in the operating room and limit their options? Who, at the agonizing moment, will decide? That is the question? Who is going to make this decision, the Congress of the United States, or the women and families of America? The courts have been very clear on this question, and have consistently found bills of this type to be unconstitutional. Lawsuits have been filed in 10 States challenging State statutes similar to the bill before us. In 10 States courts have ruled that the laws were unconstitutional, struck them down, limited their scope, or enjoined them. Mr. Speaker, when the House debated this issue in March, the distinguished gentleman from Florida [Mr. Canady] assured us that this bill was constitutional and consistent with Roe. Since then this ban has been struck down, changed, or enjoined on constitutional grounds in 10 States, 10 States. States have moved ahead, passed these bans, and they have been struck down again and again. The courts have clearly spoken. This bill violates a woman's constitutionally protected right to choose. Unfortunately, we know that the antichoice majority will not let a little thing like the Constitution of the United States of America stand in the way of their abortion ban. Mr. Speaker, the anti-choice Republican leadership has been waging war on the reproductive rights of American women since taking over this House in 1994. In the last Congress alone, the leadership voted to limit abortion rights more than 50 separate times, a new record. It is clear that this leadership wants to ban every abortion, that is the ultimate goal, procedure by procedure, trimester by trimester. They want to rollback Roe versus Wade and push American women back into the back alley. Mr. Speaker, we have a different vision. We will continue to fight to ensure that women are able to obtain safe, legal abortions, and we will work as hard as we can to reduce the number of abortions by providing women with greater access to family planning and contraceptives. We will work to empower women to make responsible choices about their own bodies. Unfortunately, Mr. Speaker, the Republicans have chosen to make our bodies their battleground, and they will not succeed. Mr. Speaker, I am pleased to yield 3\1/2\ minutes to my colleague, the gentleman from Virginia [Mr. Scott], the distinguished ranking member of the Subcommittee on the Constitution.