Tim Murphy

Mr. MURPHY

Mr. MURPHY. Mr. Speaker, I ask unanimous consent that the Committee on Energy and Commerce be discharged from further consideration of the resolution (H. Res. 250) supporting the goals and ideals of National Hepatitis B Awareness Week, and ask for its immediate consideration in the House.

Mr. MURPHY

Mr. MURPHY. Mr. Speaker, imagine this: A person in a nursing home receives a prescription for a 90-day supply of medication. A few days later, the physician changes that. What happened with those unused drugs? They are thrown away. Millions of Federal and State dollars could be saved by restocking unused prescription drugs that are often thrown away by long-term care facilities when a patient changes prescriptions, passes away, is discharged or transfers. What if these drugs could be restocked and safely used? It has been estimated that restocking unused medications may save as much as $1 billion among the elderly Americans each year and up to $380 million in long-term care facilities alone. The FDA issued an informal opinion allowing the restocking of drugs that meet safety guidelines; however, there is still wide disparity between what the States are doing. This confusion is costing the States and the Federal Government money. Rather than flushing drugs down the drain each month and wasting money, I urge my colleagues to work with me and the States on uniformed standards for restocking drugs and to examine the new savings that can save money, improve lives, and improve health care. For further information, I ask my colleagues to check out my Web site at murphy.house.gov of ways we can continue to save lives and money.

Mr. MURPHY

Mr. MURPHY. Mr. Speaker, during rollcall vote No. 144 on H.R. 748, my vote was incorrectly recorded as a ``no'' vote when it should have been recorded as a ``yes'' vote.

Mr. MURPHY

Mr. MURPHY. Madam Speaker, study after study associates untreated depression with increased rates of chronic illness and increased health care costs. For cancer, heart disease, asthma, arthritis, diabetes the incidence of depression can be double that of the general population. Untreated depression complicates treatment and can double health care costs. Untreated depression can cost employers $51 billion per year. Depression management programs, however, can save employers an average of $2,600 per employee through increased productivity and reduced absenteeism. The time has come to improve health care by integrating and coordinating medical and mental health services for more effective diagnosis and treatment. Rather than just cut the payments for health care, Congress can lead the way to saving lives and money through integrated care. Science supports this, and I look forward to working with my colleagues to transform our health care system through innovation, information, and incentives to lower health care costs for every American. I ask my colleagues to learn more about integrated care by visiting my website at Murphy.house.gov.

Mr. MURPHY

Mr. MURPHY. Mr. Chairman, natural gas prices have risen by over 300 percent since 1998. And while we are concerned about jobs going overseas, let us be reminded that we pay 25 percent more than China and 14 percent more than Europe. We have lost some 3 million manufacturing jobs in this Nation related to higher natural gas prices since 1999. In the last 5 years, 90,000 jobs from the chemical industry alone have been lost because of higher natural gas prices. We have doubled the price of fertilizer which increases the price for farmers which is passed on in higher food costs. Homeowners have seen a 55 percent increase in natural gas prices in their home. This is the issue of the law of supply and demand. If we want to increase the supplies, if we want to lower the cost, if we want to save jobs in America that so many people talk about here all the time, we have to have more natural gas in this country, which means we should be opening up safe opportunities, allow States to monitor this, all of which is in the energy bill. I recommend my colleagues oppose this amendment so we can keep jobs and keep natural gas prices lower.

Mr. MURPHY

Mr. MURPHY. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on the resolution currently under consideration.

Mr. MURPHY. Mr. Speaker, I rise to speak on a resolution that I have introduced with my colleague from Pennsylvania, Congressman Michael Doyle, and the Honorable Ranking Member of the U.S. House Energy and Commerce Committee, Congressman John Dingell of Michigan, to recognize the 50th anniversary of the discovery of the Salk polio vaccine and the efforts of the University of Pittsburgh, Dr. Jonas Salk, the University of Michigan, and Dr. Thomas Francis, Jr., which has virtually eliminated the disease and its devastating effects. Polio is a disease that can attack the motor nerves in the spinal cord, leaving one paralyzed. In the most severe cases, the muscles of the respiratory system and throat are affected, impairing speech, swallowing and breathing, which can lead to paralysis or even death. While polio is still present in varying degrees, the discovery of the Salk polio vaccine was a monumental achievement in reducing the effects of the disease and preventing any significant reemergence of the disease in the western hemisphere. Prior to moving to the University of Pittsburgh, Dr. Jonas Salk, who was the first member of his family to attend college, served in an appointment at the University of Michigan for 5\1/2\ years during World War II, where he became known for his expertise on the immunology of influenza. In 1947, Dr. William S. McEllroy, Dean of the University of Pittsburgh School of Medicine, recruited Dr. Salk to develop a virus research program at the University of Pittsburgh where Dr. Salk set up a research laboratory in the Municipal Hospital for Contagious Diseases, now Salk Hall at the University of Pittsburgh. Others were confined to wheelchairs or could only walk with the assistance of steel braces and crutches. Along with the disease fear spread in many parents which led communities to close down theaters, public swimming pools and other public places. In 1952, a marked increase in polio saw tens of thousands confined to iron lungs to be able to breathe. During this time, Dr. Salk's research continued. In 1953, human trials of the developing Salk polio vaccine were extended to include almost 500 children and adults, the majority of whom were residents of Allegheny County, PA. It was not until 1955 that Dr. Salk and his researchers discovered the actual polio vaccine at the University of Pittsburgh. That same year, at the University of Michigan's Rachkam Auditorium, Dr. Salk's mentor, Dr. Francis, announced the results of the most comprehensive field trial ever conducted in the history of public health, involving 1,830,000 children in 217 areas of the United States, Canada, and Finland, indicating the vaccine was safe and effective. As a result of Dr. Salk's innovative vaccine, the incidence of polio in the United States fell by 85-90 percent during the first 3 years of vaccination use. Some 450 million doses were administered worldwide. The effectiveness of this vaccine is responsible for not only international immunization, but also for the suppression of polio in most of the world in 1962. Dr. Salk's team brought under control an escalating health problem and a dreaded virus, which is why the Salk polio vaccine is considered one of the most significant medical achievements of the twentieth century and has effectively safeguarded the world from the menacing virus for 50 years. The March of Dimes raised millions for research and treatment of Polio. In addition, Rotary International pledged $120 million in 1985 to fund the Polio Plus program to immunize the world. The money the Rotary has contributed so far exceeds $600 million. A model of public- private partnership to eradicate polio worldwide, Polio Plus delivered vaccine across the globe on camel, by helicopter and motorbike. Arguably, the Salk Polio vaccine and the public-private efforts to eradicate polio are among the greatest public health achievements in the history of the world. I am particularly proud of the role my alma mater has played in this great public health achievement and we in Congress join in this celebration. I would also like to express my high esteem and appreciation to the Chairman of the U.S. House Energy and Commerce Committee, the gentleman from Texas Mr. Joe Barton (R-TX) and the Ranking Member, the gentlemen from Michigan Mr. John Dingell (D-MI), for agreeing to consider this important resolution to recognize Dr. Salk, Dr. Francis, the University of Pittsburgh and the University of Michigan on the fiftieth anniversary of the discovery of the Salk polio vaccine. In addition, I would also like to thank my colleagues for their support in helping to bring this resolution to the House floor to recognize this medical breakthrough that has protected, prevented and saved countless numbers of lives from the ravages of polio. I encourage my colleagues to adopt the resolution, and Mr. Speaker, and I reserve the balance of my time.

Mr. MURPHY. Mr. Speaker, I move to suspend the rules and agree to the resolution (H. Res. 208) recognizing the University of Pittsburgh and Dr. Jonas Salk on the fiftieth anniversary of the milestone discovery of the Salk polio vaccine, which has virtually eliminated the disease and its harmful effects, as amended.

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

Mr. MURPHY. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise to speak on a resolution that I have introduced with my colleague, the gentleman from Pennsylvania (Mr. Doyle), and the honorable ranking member of the U.S. House Energy and Commerce Committee, the gentleman from Michigan (Mr. Dingell), to recognize the 50th anniversary of the discovery of the Salk polio vaccine and the efforts of the University of Pittsburgh, Dr. Salk, the University of Michigan, Dr. Thomas Francis, Jr., which has virtually eliminated the disease and its devastating effects. Polio is a disease that can attack the motor nerves and the spinal cord leaving one paralyzed. In the most severe cases, the muscle of the respiratory system and throat are affected, impairing speech, swallowing and breathing which can lead to paralysis or even death. While polio is still present in varying degrees in at least six countries, the discovery of the Salk polio vaccine was a monumental achievement in reducing the effects of the disease and preventing any significant reemergence of the disease in the Western Hemisphere. Prior to moving to the University of Pittsburgh, Dr. Jonas Salk, who was the first member of his family to attend college, served in an appointment at the University of Michigan for 5\1/2\ years during World War II, where he became known for his expertise on the immunology of influenza. In 1947, Dr. William McEllroy, dean of the University of Pittsburgh School of Medicine at the time, recruited Dr. Salk to develop a virus research program at the University of Pittsburgh where Dr. Salk set up a research laboratory in a municipal hospital for contagious diseases, now Salk Hall at the University of Pittsburgh. In 1952, a marked increase in polio saw tens of thousands confined to iron lungs unable to breathe. Others were confined to wheelchairs and could only walk with the assistance of steel braces and crutches. Along with the spreading disease each summer, there was an increasing spreading fear in many parents and also within communities to close down theatres, public swimming pools, and other public places in hopes of reducing this disease. During this time, Dr. Salk's research continued. And in 1953 human trials of the developing Salk polio vaccine were extended to include almost 500 children and adults, the majority of whom were residents of Allegheny County, Pennsylvania. It was not until 1955 that Dr. Salk and his researchers discovered the actual polio vaccine at the University of Pittsburgh. That same year at the University of Michigan's Rachkam Auditorium, Dr. Salk's mentor, Dr. Francis, announced the results of the most comprehensive field trial ever conducted in the history of public health, involving 1,830,000 children in 217 areas of the United States, Canada and Finland, indicating the vaccine was safe and effective. As a result of Dr. Salk's innovative vaccine, the incidence of polio in the United States fell by 85 to 90 percent during the first 3 years of vaccination use. Some 450 million dosages were administered worldwide. And the effectiveness of this vaccine is responsible for not only international immunization but also for the suppression of polio in most of the world, even by 1962. Dr. Salk's team brought under control an escalating health problem and a dreaded virus, which is why the Salk polio vaccine is considered one of the most significant medical achievements of the 20th century, and has effectively safeguarded the world from the menacing virus for 50 years. The March of Dimes has raised millions of dollars for research of polio. In addition, Rotary International initially pledged 125 million back in 1985 to fund the Polio Plus program to immunize the world. But the money the Rotary has contributed so far exceeds 600 million. These models of public-private partnership to eradicate polio worldwide, Polio Plus and the March of Dimes, have delivered vaccine across the globe on camel, helicopter, and motor bike. Arguably, the Salk polio vaccine and the public-private efforts in the eradication of polio rank among the greatest public health achievements in the history of humankind. As we celebrate this 50th anniversary, I am particularly pleased that I remain an adjutant associate professor at the University of Pittsburgh School of Medicine and the University of Pittsburgh School of Public Health. I am particularly proud of the role my alma mater has played in this great public health achievement, and we in Congress join in this celebration. I would also like to express my high esteem and appreciation to the chairman of the U.S. House Energy and Commerce Committee, the gentleman from Texas (Mr. Barton); and the ranking member, the gentleman from Michigan (Mr. Dingell), for agreeing to consider this important resolution to recognize Dr. Salk, Dr. Francis, the University of Pittsburgh, the University of Michigan on the 50th anniversary of the discovery of the Salk polio vaccine. In addition, I would like to thank my colleagues for their support in helping to bring this resolution to the House floor to recognize this medical breakthrough that has protected, prevented, and saved countless numbers of lives from the ravages of polio. I encourage my colleagues to adopt the resolution. Mr. Speaker, I reserve the balance of my time.

Mr. MURPHY. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. MURPHY

Mr. MURPHY. Tonight Republican Members of Congress will be talking about Medicare. Now, as we are getting into this, what I want to make sure that we first look at here is that many talk about is the Federal Government doing much with regard to health care? And Medicare, Medicaid, veterans benefits, and other programs that the Federal Government pays for consume a massive amount of the Federal budget. And I wanted to point out, just to begin with, if we can look at this, that about 45 percent of all mandatory spending, all mandatory spending we spend, is on health care, and about 15 percent of all discretionary spending is spent on health care. If we look at mandatory spending here in health care, we see that the section here which is Medicare is $297 billion, or about 24 percent overall; Social Security disability is in this category here, too, about 6 percent; State Children's Health Insurance Programs, about $5 billion or 4 percent; and Medicaid is $176 billion, or about 14 percent of overall mandatory spending. So we see that for those seniors and disabled who receive the benefits of Medicare is a large part of the Federal budget and one that has a history of providing good benefits for our seniors; benefits we are proud of, benefits we are pleased to continue to offer them. But tonight we are going to talk about a number of things happening in Medicare. Some of these will be issues that are staying with Medicare; some will be some positive changes, areas that are growing; some of the new parts that have to do with prescription drug benefits; some some actions on waste, fraud, and abuse; some on new programs that deal with prevention and new physicals for Medicare; and many, many other parts of this we will be talking about tonight. The overall purpose here is that as we look at the amount of money we spend and the services that we provide, it is Congress' responsibility to be constantly reviewing this and saying can we do it better to provide quality health care that is accessible for our seniors in America? And those who are not seniors yet recognize that about 2.9 percent of wages, half from you and half from your employer, goes to fund Medicare. Thus, every taxpayer is concerned with how this money is spent and what quality is associated with it. Now, being the first speaker tonight, I want to talk a little bit about one area that I am introducing a bill on to improve Medicare, although it provides a lot of services in many areas of health care. One of those that I believe we need to see some changes in is in mental health coverage. As a practicing psychologist myself for many years, I recognize that when you integrate the care of mental illness in with other aspects of medical care, it actually is something that reduces the cost of health care and improves health overall. Let me describe to you now what Medicare does in all this. Currently Medicare beneficiaries pay about a 20 percent copayment for all outpatient health services except for mental health providers, where they have to pay a higher copayment of 50 percent. According to the National Institutes of Mental Health, nearly 2 million Americans over the age of 65 suffer from depression. The 1999 Surgeon General's Report on Mental Illness found that 20 percent of Americans 55 and older experience mental disorders that are not considered a normal part of aging, such as anxiety, alcoholism, and various other disorders. As many as one in two residents of nursing facilities are at risk for depression. A June 2002 MED-PAC report, that is the Medicare Payment Advisory Committee that recommends changes to Congress, stated that ``Medicare beneficiaries are apparently having difficulty in obtaining needed mental health services. Despite the availability of proven treatments, one recent analysis found that of those beneficiaries over 65 with need of treatment, 63 percent did not receive it.'' And it goes on to say, ``Beneficiaries face a 50 percent coinsurance for most outpatient mental health services compared with 20 percent for most other outpatient services. Equalizing cost-sharing for outpatient mental health and other outpatient care would reduce the financial barrier to mental health care and provide parity to beneficiaries with mental disorders and those with other illnesses with a small increase in Medicare spending. This change would also simplify Medicare's cost- sharing structure.'' Now, here I am talking about the cost of Medicare and talking about something here which on the surface would appear that we are proposing more spending. And oftentimes when proposals come before Congress, they are scored in terms of what the increased spending would be, but not necessarily scored or reviewed in terms of what the savings would come from this. Let me describe what happens when you have untreated mental illness. Patients suffering from untreated depression, for example, use health care services more often; pay one and a half to two times more for health care costs that they accrue. They also tend to have increased lengths of hospital stays. Untreated depressed parents tend to have decreased adherence to life-style changes needed for health improvement. Depression also complicates the treatment of those with heart disease. And those with increased psychological stress or depression have increased platelet reactivity to thrombosis or blood clotting, which can complicate heart disease. Now, as a result of this, I have introduced the Medicare Mental Health Copayment Equity Act to reduce the copayment for mental health services to seniors on Medicare to match the standard 20 percent rate. With such a high amount of seniors afflicted with mental illness, that discriminatory Medicare copayment rate must end. When we look at ways such as integrating the care for our seniors with something that afflicts so many, such as mental illness and depression, by using such innovative approaches, we can actually save cost and provide better care for our seniors in America. Now, in addition to some of these things we can look at improving, and we will be talking more about them tonight, a number of aspects, it is important to also recognize that Congress is also being a watchdog of some problem areas for Medicare. What happens sometimes is people see this as a system that they can abuse. Whether it is providers or patients or others, they see this as a way they can get health care that perhaps is not needed, or we have a mechanism that sometimes, quite frankly, just pays too much. To talk about this issue tonight, I will call upon my colleague, the gentlewoman from Florida (Ms. Ginny Brown-Waite), and she will be discussing waste, fraud, and abuse in Medicare, and I yield to her now.

Mr. MURPHY. Mr. Speaker, reclaiming my time, I thank the good doctor from Georgia for his comments, as well as the gentleman from Georgia (Mr. Price), the gentlewoman from Florida (Ms. Ginny Brown-Waite), and the gentleman from Louisiana (Mr. Jindal) for their comments tonight. And noting that what we have discussed tonight as we recognize that Medicare is a program that albeit is expensive in terms of what it costs the Federal Government and taxpayers to pay for it, we believe it is worthwhile to protect and ensure the health and health care of our elderly; but we also have to note here, as even the best of programs can use better care, in this case the best of care, what we want to make sure that Members do on both sides of the aisle is work towards eliminating waste, fraud and abuse, updating the Medicare program to make sure it is providing that high-quality care, recognizing that there have been changes in how health care is provided since the 1960s when this program began, and we need to make those things work better. We need to apply some of the changes that were recommended by the Commission on the Future of Medicare. We need to make sure that care is integrated together with examples of what I presented before, with such things as mental health care integrated with other aspects of care; making sure that we improve the system so that we have electronic prescribing that we would reduce the many medical errors that occur, reduce the about 16 million errors that occur on prescriptions every year that are written in part because we still use an old system of paper and pencil where someone may misspell a word or not be able to review it correctly or a physician cannot possibly know all the medications the patient is on, all of those things to be corrected with the major moves that were in the Medicare bill that we voted on a couple of years ago, but will begin to take effect in January of next year. These are positive changes that I believe will help reduce the thousands of deaths, the millions of errors that occur with prescription drugs, and work for the betterment of health care in America to save lives, to save money, and to improve that.

Mr. MURPHY. Mr. Speaker, I thank the gentleman from Georgia (Mr. Price) for his important information about other areas of care. As we continue on this evening, I want to turn to one of our colleagues, the gentleman from Louisiana (Mr. Jindal), who is an expert on Medicare. He wants to talk about the need to address premium cost and recommendations of the National Bipartisan Commission on the Future of Medicare.

Mr. MURPHY. Mr. Speaker, what we have to make sure is understanding in a budget that is approaching $300 billion for Medicare overall, and when people are concerned is it providing enough coverage, the issues that the gentlewoman from Florida (Ms. Ginny Brown-Waite) brought forth is an area where every senior and their family member can help deal with the spiraling cost of health care. I have a chart here, and notice how health care costs are spiraling up. Notice the growth in terms of Federal outlays and how much it has climbed over the years. It is quite dramatic. The area of waste, fraud and abuse has grown with it. I would like to advise that one of the messages that we as Members of Congress need to get out to constituents is understand how we can help our constituents find and report waste, fraud and abuse. Sometimes Medicare fraud is purposely billing for services never provided, billing Medicare and another insurer for services someone never received, for equipment because you received equipment different from what you are billed for, and using another person's Medicare card to get medical care, supplies or equipment, and billing Medicare for home medical equipment after it has been returned. I have heard of constituents who have reported these kinds of things, and it is important that we do this as a mechanism to save government money, save taxpayer money, and make sure that money goes towards care. People also need to be suspicious. Anytime a provider tells you a test is free, they only need your Medicare number for their records, and the provider may state that the cost to the person with Medicare is free, be wary if tests are being provided and the patient is told they are free, make sure you understand why they are being done and what they are. Or if the provider says Medicare wants you to have the item or service, Medicare does not recommend services, it is up to the physician and health care provider to recommend services. Or if someone says I know how to get Medicare to pay for it, again, the questions family members and Medicare recipients should be asking is I want to know what I really need, and do not be afraid to get other opinions. Sometimes people say the more tests you have, the cheaper they are; or the equipment or service is free, it will not cost you anything. But be aware, and Members need to educate their constituents that anytime someone is offering that, this is taxpayer money being spent on services that may or may not be needed. And it is important that we encourage Americans to review that and determine if it is medically necessary. There are ways that you can prevent Medicare abuse, and there are ways you can report this: by contacting the inspector general of Medicare, by looking at the Medicare Web sites to report specific information. It is a way that every American citizen can be a watchdog and can lead to cost savings for Medicare and make sure that care goes to patients. I would like to turn toward the gentleman from Georgia (Mr. Price), an orthopedic surgeon, a good friend to the health care caucus and one who has been very diligent in dealing with health care costs. He will be addressing patient choice and satisfaction with the Medicare program. Mr. Speaker, I yield to the gentleman from Georgia (Mr. Price).

Mr. MURPHY. I thank the gentleman from Louisiana not only for the depth of his knowledge in Medicare, but his service before to our country. Certainly if we are able to implement some of the changes he has spoken about so eloquently tonight in changing not only the waste, fraud and abuse, but making Medicare work more effectively, we can make it last longer. The points made here about when we think about Social Security hitting its financial demise sometime around 2042, when they talk about Medicare, if we do not make some changes to improve the system, again that is what we are talking about, improving the system, it may face its own demise in 2024, some 20 years ahead of Social Security, not because the difference in more people retiring at faster rates and less money going in, but because of the waste, fraud and abuse that is in the system and because of inefficiencies. It is so important that we work together in a bipartisan way to improve the efficiency of Social Security so that money goes to care for our seniors in ways that we need to make sure they get that care. I would like to turn to another one of my colleagues for the wrap-up in our session tonight, and that is the gentleman from Georgia (Mr. Gingrey), who is no stranger to speaking on health care issues. He and I chair this conference team on dealing with health care issues. He is as dedicated as they come to working on this.

Mr. MURPHY. Mr. Speaker, I thank the gentlewoman from Florida (Ms. Ginny Brown-Waite), and could the gentlewoman repeat how much waste, fraud and abuse is estimated? I believe it is over $20 billion a year.

Mr. MURPHY

Mr. MURPHY. Madam Speaker, let me talk about something good for America. Community health centers offer primary and preventive health care services to everyone, including low-income, underinsured and uninsured families. While low-income individuals have access to Medicaid and the elderly and the disabled have access to Medicare, uninsured and underinsured families often delay seeing a doctor or turn to emergency departments where treatment is several times more expensive. Community health centers, however, provide comprehensive and preventive care that adjusts charges for patient care according to family income. The Federal Government spends over $23 billion a year to offset losses incurred by hospitals for patients unable to pay their bills, and the Department of Health and Human Services tell us that medical care at community health centers cost only about $1.30 per pay per patient served. In fact, medical care at community health centers is around $250 less than the average annual expenditure for an office- based medical provider. In short, community health centers offer an affordable source of quality health care, but the problem is we need more of them. The President has proposed a $304 million increase for community health center programs to create 1,200 new or expanded sites to serve an additional 6.1 million people by next year. In order to meet that goal, the centers must double their workforce by adding double the clinicians by 2006. Hiring that many doctors would be costly, but encouraging more to volunteer would help to meet this need. While many physicians are willing to volunteer their services at these centers, they often hesitate due to the high cost of medical liability insurance. As a result, there are too few volunteer physicians to meet our health care needs. By comparison, volunteer physicians at free health clinics and paid physicians at community health centers already receive comprehensive medical liability coverage under the Federal Tort Claims Act, or FTCA. Accordingly, I am introducing the Community Health Center Volunteer Physician Protection Act of 2005 to extend the medical liability protections of FTCA to volunteer physicians at community health centers. These protections are necessary to ensure that the centers can continue to play an important role in lowering our Nation's health care costs and meeting the needs for affordable and access quality health care. The Community Health Center Volunteer Physician Protection Act of 2005 is supported by the National Association of Community Health Centers, the American Medical Association and the American Osteopathic Association. I would encourage my colleagues to cosponsor this important piece of legislation to ensure access to health care for those who need it most.

Mr. MURPHY

Mr. MURPHY. Mr. Speaker, I thank the doctor from Georgia for his comments. It is very important, the point that he made, which is that the issue of health care, when you do not have health care providers practicing, is really something that leads to many problems and, quite sadly, deaths. One of the statistics that I quoted before from the Institute of Medicine is a study done a few years ago that threw out some broadbased numbers; somewhere between 44,000 and 100,000 people die a year from medical errors. This study has come under some question, but it is one that is often quoted by attorneys when they bring up the concern for why one needs to focus on lawsuits in order to try and change these. Some have said that no patient has ever been cured by a lawsuit. And certainly, even if it is just one, that is too many, but I would like to call upon our colleague now, the gentleman from Texas (Mr. Burgess), who oftentimes refers to himself as a country doctor from Texas. He has delivered many babies in his OB-GYN practice, and so I wonder if he, as he begins to talk, whether he can talk about making sure we have more accurate approaches to tracking and understanding errors as a means of improving on patient safety.

Mr. MURPHY. The gentleman also well knows that doing these kinds of things saves money. The Center For Information Technology leadership estimated that, if we move towards electronic health records, it could save about $78 billion a year, or 5 percent of the Nation's total annual healthcare cost. And in a time when so many businesses have seen their health care costs climbing, sometimes up into the double-digit amounts per year, it can do a great deal. I know we only have a few minutes left, but one other thing just to whet the appetite with which we will need to come back to at another time is electronic prescribing. No offense to the good doctor, but very often, it is tough for someone to read a physician's handwriting. This can also lead to errors. Pharmacists estimate about 140 million times a year they will have to call back the physician because they may not understand the medication; they may question the dose. The pharmacist may be aware of other medication that patient is on, but the physician may not be aware. They may be aware of other allergies or reactions. Electronic prescribing, however, is another tool where doctors, at the moment they write the prescription, they can access that prescribing information. I wonder if the gentleman could comment on the importance of that.

Mr. MURPHY. Mr. Speaker, I thank the good doctor from Georgia for yielding. What I would like to do is lay out a couple of issues here and also turn it over to a couple of other colleagues who are here tonight and review some of these issues of why it is so important, and I thank the gentleman for pointing out some of the issues of the Federal outlay of health care. The Federal spending for health care, it is so important to note that it is growing immensely, that it has grown and continues to grow, that the numbers out there, about 45 percent of mandatory spending, is in the area of health care, and it is probably going to climb to 49. By ``mandatory'' we mean spending and these are not necessarily the things we vote on and change every year but other outlays that take place. I want to point out as we are going towards this that as we are talking about such things that are brought up about liability, and tort reform issues are so important, that part of what we also have to pay attention to is patient safety. I would like to bring up a couple of points, and one of these is the issue, the Institute of Medicine in a landmark study in 1999 pointed out, this study was called ``To Err is Human,'' stated that over 7,000 people die every year from medication errors alone with 44,000 to 98,000 deaths every year from medical errors in hospital practices. Now, this touched off a great concern across the Nation. The government and many efforts, President Bush and then-Secretary Tommy Thompson started investigations to see what happened, why this was so. A great deal of research and other efforts took place in hospitals and physician offices and medical schools across the country to find out what this is about. What stood out, however, is even more alarming: that we really do not know how many of these deaths occur every year because they typically may not get reported. This has led to a situation where many health care providers simply do not talk about the problem because they fear legal retribution. In other words, hospitals, we should have them tracking all errors, all suspected errors, and in every case, lead to a program within that hospital and with health care practice in every level of that hospital to review what that was for. Many times the concerns could be if those records were kept there or if they were reviewed this will simply be another source of suits. What we have to be moving for in this Nation is a goal of zero medical errors, zero patient errors. Anything beyond that I believe is too high. It is too high of a cost for our Nation's health care facilities, and we should not embrace a goal of 1 percent or 2 percent or 3 percent. Imagine a situation here if a factory had a goal of perhaps reducing their safety errors and injuries to their workers down to this 3 percent or 1 percent of the workers, how many injuries that would be, how many lost work days, how many deaths that would be. Would you want to go to a hospital that had a goal of perhaps only 98 percent or 99 percent success? Certainly, every one of us in the health care field wants to aim towards 100 percent success, and given the chart that we saw before about the great increases in health care spending in the Federal Government, it is very important that we look at controlling health care spending, Mr. Speaker, not just from the idea of accounting moves to cut down on some of those rates but also making some major changes in what we are paying for, not just who is paying. Let me touch off on a couple of areas here before I turn it back over. One is the Pittsburgh Regional Health Care Initiative reported that the United States has the world's second highest methasone- resistant staphylococcus rates with more than 50 percent of these infections resistant to antibiotics. They also went on to say that the Pittsburgh Regional Health Care Initiative reported that these hospital-acquired infections affect 5 to 10 percent of all patients, or about 2 million, per year who are admitted to acute care facilities at a cost overall in this Nation of $4.5 billion. Many of these infections could have been prevented by simply having physicians wash their hands, using anti-bacterial scrubs; and I will use other techniques here to make sure we had a system that was working better. Now, the reason I bring these up, they seem almost too simple, but there are a couple of areas we recognize as we are moving towards the issue of medical liability reform. I want to make it clear here to our colleagues, we are not just excluding that, not just saying this is not just an issue of caps on punitive damages. This is not just a legal issue. This is one that we need to recognize as a Congress and as a Federal Government embracing truly changes in how we handle errors. Many hospitals and doctors are concerned about this, but we also see that there are recommendations for open and meaningful communication with health professionals about medical errors. It should be open to discussions of what takes place. I believe the Federal Government can be a major factor in moving these forward; and as we continue on this evening, I will be coming up with more examples. At this point, I would like to turn it back to my colleague, the gentleman from Georgia (Mr. Gingrey), to proceed as we go through this evening and look at other ways that this liability crisis is affecting our Nation and how patient safety needs to work hand in hand with working to reduce some of these liability issues, and that will be something that not only keeps more doctors practicing but quite frankly will save a lot of money and save a lot of lives.

Mr. MURPHY. What the President has proposed here is to make some changes to entice hospitals throughout the Nation and from medical practice to go towards electronic medical records. Let me try and describe that for our colleagues. This is a system which could be kept in place within the hospital itself, so that, any time a physician needed to access, or any medical provider within that hospital network, needed to access the patient's file, they could call upon this. Think about all the times you have been to see the doctor and you have to fill in the history sheet all over again and your address. You hope you remember all the places you have gone and all of the medication you have been on and all the illnesses you have had, but chances are, for the most part, a person cannot. In fact, some studies have looked at that, just looking at some of the paper charts that occur, that there are omissions and doctors acknowledge that because there are omissions in there, if they had further information, they would have made some different recommendations for tests, for diagnoses and that, in turns, saves money. Electronic medical records are a way of keeping this. Some have even proposed having either on a card or a patient may have some other device which could be plugged into a computer when they go to visit the doctor or the hospital, they can update those records. But the whole thing is really keeping these secure and confidential. I know the University of Pittsburgh Medical Center, for example, is investing literally hundreds of millions of dollars in this. Information Weekly magazine rated them as the top medical center in the Nation in terms of making this move into electronic medical records. I am not sure if the gentleman from Georgia has seen one of these at work, but I am wondering perhaps if he could describe what happens and changing from that paper-dependent system which is very time consuming, requires a great deal of time for the doctor to keep track of what is in there as well as research those, what happens when you move towards an electronic medical records system and what that does for patient safety.

Mr. MURPHY. Mr. Speaker, I thank the gentleman from Georgia (Mr. Gingrey) for continuing to bring up these points. I want to talk about a couple of things and have you comment as a member of the medical profession. First, I want to point out that this is an issue that the Federal Government should be driving. The Federal Government is the largest purchaser of health care in our Nation, even among very large companies that may have hundreds of thousands of employees and retirees spending billions of dollars on health care. Looking at our chart again, 45 percent of mandatory spending that the Federal Government spent on health care, it is expected to climb to 49 percent, and this chart here shows the Federal outlays are climbing over time. That being the case, if we are dealing with liability issues, it is inseparable from patient safety. There are a couple of issues that President Bush has offered to be moving forward, and they are ones which I am hoping all of us can embrace. The President has included $125 million in this year's budget to help meet the goal of ensuring that most Americans have electronic medical records within the next 10 years. Patient records are usually kept on record on paper. I know when I worked in hospitals, if we needed to call upon a patient's file, sometimes that would take a good deal of time. Whether it was half an hour or hours, that could have an effect on some of the decisions. I ask the gentleman to describe the cumbersome system in terms of what we are trying to move away from.

Mr. MURPHY

Mr. MURPHY. Madam Speaker, according to the Institute of Medicine, over 7,000 people die and $29 billion are wasted every year due to medication errors. Electronic prescribing can change lives and save money. Medication errors are caused when physicians confuse the names of similar drugs, assign inappropriate dosage levels, issue redundant medications, or lead to harmful drug interactions, and allergic reactions. Electronic prescribing allows doctors to automatically and securely transmit a prescription to a patient's pharmacist. This technology eliminates the human errors caused by unreadable handwriting and improves the quality of care to patients. Electronic prescribing saves lives by immediately checking a patient's records to alert the physician of potential conflicts with other medical conditions, known allergies, interactions with other active prescriptions and duplicate therapies. Electronic prescribing also saves money by providing information to physicians and patients about lower-cost medications like generics, lets the doctors know which drugs are covered by their health plan, provides valuable access to research, and streamlines billing information and reduces administration costs. Madam Speaker, we need to make patient safety our national goal and make zero errors with medications a priority in health systems throughout the country. E-prescribing is one tool we can use to make this a reality in saving lives and saving money.

Mr. MURPHY

Mr. MURPHY. Mr. Speaker, we need to explore new technologies that will decrease health care costs and improve patient safety. Electronic medical records, also known as EMRs, are a technological solution to an antiquated paper system. Often, patient records are scattered between multiple hospitals and doctors' offices, resulting in the likelihood that important medical records could be lost and that valuable data is unavailable to the physician when he needs it. Time is wasted trying to obtain paper medical records, especially in cases of emergency care, and patients sometimes provide incomplete medical histories which often omit or distort important data. Tens of thousands of lives and hundreds of billions of dollars are lost every year due to medical error, and EMRs would go a long way to reducing these costs. The electronic medical record centralizes all records on a patient and can instantly communicate this information to any health care provider in a secure and confidential manner. EMRs also have a number of other advantages. They eliminate the need for duplicate tests. They reduce the search time for medical histories and limit instances of lost files, patient recall or unaccessible files. They can instantly search for symptoms, findings, treatments, diagnoses and health care providers involved with patient care. They can reduce the need for additional staff and the expansive storage space needed to maintain paper files. When complications occur, medical records of an electronic type can allow providers to retrace the exact steps through the process to see if a different approach was needed. They can prompt providers to pursue certain avenues of treatment based upon their diagnosis, and they can automatically generate bills and reimbursements that reduce billing errors. Some concerns regarding electronic medical records have been raised about the cost. However, the key to implementing an electronic medical record is not to have the Federal Government pick up the whole tab. Health information technology companies, hospitals and medical practices must share information to improve the process and recommend standards for the industry. Let me give my colleagues an example of how this is done. This process can be expensive to implement at this stage, and the University of Pittsburgh Medical Center accomplished their EMR system via private investments that will total some $500 million. By implementing electronic medical records, the University of Pittsburgh Medical Center has already decreased the need for repeat laboratory, radiology or other invasive and expensive tests because the data and X- rays are easily shared by authorized users. UPMC is ranked number one in the United States and health care industry, and number five among all industries in the use of information technology, according to Information Week 500. We need positive examples from the business community to make the case for health information technology today and tomorrow. Examples of successful electronic medical records such as these provide the leadership necessary to ensure that health information technology becomes a reality. The President has already shown his commitment to health information technology by committing $125 million to the Office of the National Health Information Technology Coordinator. Now we need to work with private industry to continue to make the case for successful implementation of health information technologies. Mr. Speaker, if Congress accomplishes one thing this year to improve health care, we should work to develop incentives for hospitals and providers to successfully implement a secure and interoperable electronic health record. This will save money; it will save lives. As the cochairman of the 21st Century Health Care Caucus, which I cochair with the gentleman from Rhode Island (Mr. Kennedy), we will continue to work on a bipartisan basis to fully implement electronic medical record systems and to reach this important goal of using this as a mechanism to improve health care in America.