Charlie Norwood

Mr. NORWOOD

Mr. NORWOOD. It is my understanding and the intent of this bill that, first of all, we have a Federal cause of action for denial of care or the delay of care in State court. We intend, and it is going to be this way before we get it out of that conference if there is any question about it, because the gentleman knows how it is with lawyers: ``is'' doesn't mean ``is.'' One lawyer says it means this; another lawyer says it means that. But our intent is not to preempt any cause of action at the State level.

Mr. NORWOOD. In some States that presently have a managed care, an HMO reform bill, we are going to have a preemption and a replacement in that.

Mr. NORWOOD. The key word here is ``may.'' We do not believe that it does that. We do not intend for it to do that. And I do not intend for it to do that when we have the opportunity to get into conference.

Mr. NORWOOD. Mr. Chairman, I yield 2 minutes to the gentleman from Georgia (Mr. Isakson).

Mr. NORWOOD. Mr. Chairman, it is my pleasure to yield 1 minute to my friend, the gentleman from New York (Mr. Houghton).

Mr. NORWOOD. Mr. Chairman, it is a pleasure to yield 1\1/2\ minutes to the gentleman from Tennessee (Mr. Hilleary). (Mr. HILLEARY asked and was given permission to revise and extend his remarks.)

Mr. NORWOOD. Mr. Chairman, I yield 1 minute to the gentleman from Texas (Mr. Culberson), a new Member of Congress who, I think, is a great addition to this Chamber.

Mr. NORWOOD. Mr. Chairman, I yield myself such time as I may consume.

Mr. NORWOOD. Mr. Chairman, this is not the ideal process I would have designed for this debate today. I am disappointed that some of my colleagues have allowed their passionate feelings about process to lead them into making dubious statements about substance, because this debate most assuredly should be about substance. I would like to remind my colleagues of what my amendment provides for injured patients. A patient who is injured when an insurer makes a negligent denial of claim for benefits will have the opportunity to hold that insurer accountable in State court. The patient will have access to the State courts that we have together supported for years. The patient will hold the insurer liable under the same State rules and procedures that a doctor will be held accountable under. Is not this what we have been fighting for all these years? My amendment includes those protections to prevent frivolous lawsuits that we have all fought to include in a bill. All of us. My amendment protects employers by allowing them to choose a designated decision- maker, so very important to all of us. My amendment requires patients exhaust all administrative remedies. My amendment also includes a rebuttable presumption in favor of the plan if the reviewer rose in favor of the plan. While I know my friends have raised concerns about this provision, I continue to raise just one simple question: If an expert reviewer says an insurer was right in denying care, how was the insurer negligent in denying care? Should not they have some extra consideration? My amendment includes limitations on damages. There is a $1.5 million cap on noneconomic damages. There is a cap on punitive damages of $1.5 million. That is only available when an insurer ignores an external reviewer. I believe personally in limitation of damages. Some of my colleagues do not, obviously. This is a legitimate area for debate, is it not? Mr. Chairman, these issues I have raised are issues we should be debating. I am sorry that the debate has deteriorated some. I am disappointed that they feel that they have not been given adequate time for a debate. I will understand if they feel they cannot support my amendment solely because of process, because they have heard me complain before of similar things. But before Members cast this vote against this bill, I ask them to consider what the amendment actually does; and more importantly, I want Members to support who supports this bill. The President has committed to signing our bill with this amendment. I have been working for 5 years to get a bill signed into law, not just pass another bill. Like it or not, we have to work with this President who has to sign this bill. I think my colleagues are deluding themselves, maybe, if they think we can force a bill down this President's throat. It is simply not going to happen with this honorable man from Texas. So I accept the President's offer to bridge the gap. I know this is not the final bill, and so do the Members. I know there are words that need to be changed. I think my colleagues are missing the boat by treating every interpretation of a problem in my amendment, real or imagined, as a life-or-death decision. Instead, we should be looking at the underlying offer and asking ourselves, is this an offer that accomplishes what we set out to do in creating a real remedy for patients? Mr. Chairman, the answer to that question is yes. I encourage my colleagues, all my colleagues, to join me in accepting the President's offer of a compromise to go into conference. I would encourage my colleagues who will vote no today to set aside their feelings and ask themselves, what are they holding out for? What is it that they need to say yes to, once and for all changing the law of this great Nation to protect patients? Mr. Chairman, I have found the answer, I believe. The working answer is in this amendment and in a conference. I would encourage my colleagues to join me in supporting this amendment. I am saddened deeply that it will not be bipartisan; and I know it will not, because I believe now and I have believed for years the true answer to this is a bipartisan solution. I want to take a minute of personal privilege to thank all the Members. Many Members on both sides of the aisle have worked as hard as I have. I know who they are. I have worked as hard against my friend, the gentleman from Kentucky (Mr. Fletcher), as anybody I know; but by golly, he has worked hard in his own way to protect patients, too. Nobody I know has been around this issue consistently and constantly and every time I turn around more than my friend, the gentleman from Arizona (Mr. Shadegg). He has added tremendously to this debate in many ways, which I do not have time to go over right now. I want to say to all of my Democratic colleagues, I believe them very much when they say they want a patient protections bill. I believe that our Members do, too. I know how hard they have worked. I know who they are, too. I have had a few hours with them to try to work this out. I just have to point out to all the Members, I want Members to know who Bridget Taylor is, a lady that I have the greatest respect and admiration for who has worked her little heart out for the benefit of patients of this Nation. I want to say to my staff, I thank them. I know what I have done to them. My friend, Rodney Whitlock, has been with me 7 years; and I do not know many people who have taken a worse beating on my behalf than Rodney Whitlock in the last 2 weeks. I thank him. And to my friend, the gentleman from Michigan (Mr. Dingell), he knows I love him and respect him, and I know where he wants to go. He knows where I want to go. It has been a great honor working with the gentleman from Michigan. I appreciate his efforts on behalf of patients, too. Lastly, I want to say to my friend, and I do mean that, to the gentleman from Iowa (Mr. Ganske), I do not know anybody, including me, that has worked as hard as the gentleman has. I admire the gentleman so. I know he is trying to do the right things for his patients. God knows, there is nobody more persistent and tough and stubborn and willing to fight and stand up, and I have admired the gentleman so, because he has taken some tough hits. I know the people of Iowa need to be grateful to have you as their Representative in Congress. Lastly, I want to say to all of the Members about the President of the United States, I do not make any bones about it, I love this man. I have gotten to know him. I have the greatest respect in the world for him. Whatever Members may think of him, I promise them, the President and his staff have worked me good for the last 2 weeks. What they have been trying to do is to get a patients' protection bill out that they can agree with. I thank them for their efforts and thank all of the Members. I hope that at some point tonight we will have a bipartisan vote.

Mr. NORWOOD. Mr. Chairman, I am pleased to yield 2 minutes to the gentleman from Ohio (Mr. Portman).

Mr. NORWOOD. Mr. Chairman, I offer an amendment.

Mr. NORWOOD. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I rise today to bring before the House an effort at bridging the gap on this very difficult and contentious issue. I realize that my decision to bring forth this amendment is a controversial one, but I hope my colleagues will set aside for an hour their bitterness and consider the substance of our proposal. I have heard some of my colleagues come to the floor to say that my amendment was written by the insurance industry. It is just silly, I think, for people to say that. The insurance industry cannot stand me. They have had me on dart boards for years, and everyone in the House knows that. So let us set aside those insane accusations. Instead, Mr. Chairman, let us talk about the substance of the amendment. My amendment is consistent with the principles of the underlying bill. My amendment creates a cause of action for a negligent denial of a claim for benefits. This cause of action against insurers will be heard in State court. So does the underlying bill. The amendment protects employers by allowing them to have a designated decisionmaker to be liable. So does the underlying bill. It requires all administrative remedies be exhausted before a case can go to court. So the underlying bill, my amendment only allows punitive damages in cases where the insurer refuses to follow the determination of the external reviewer. So does the underlying bill. There are, however, some significant differences. My amendment caps liability at $1.5 million for noneconomic damages. Punitive damages are capped at $1.5 million. I argued long and hard with almost every friend I have against putting caps in a bill for 4 years because we had a President who said he would veto a patient protections bill with caps. Now we have a President who says he will veto a bill without caps. This compromise is a simple recognition of political reality. I have made a compromise to create a rebuttal presumption in favor of the insurer when the external reviewers rule in favor of the plan. I have listened to my colleagues complain long and loud about the inequity of that, but I have one simple question in response: If the external reviewer says the plan was right in turning down a treatment, how could the plan have been negligent in turning down a treatment? I know some of my colleagues feel I have made a significant change moving away from the simple lifting of the ERISA preemption, but before Members condemn differences because they are changes, think about what has really changed. Under my amendment, a patient will have a cause of action against an insurer in every State in America, in a State court using State rules and procedures. Is that significantly different from the underlying bill? I know some of my colleagues believe that the language of my amendment preempts the direction of current case law. We worked deep into the night last night on that language. I am not completely satisfied with the provision in our bill that protects State law, and I pledge to Members to work to further clarify the language in conference because I know Members know my intent. But before Members offhandedly reject the language, I think they should explain to us how Americans will be left without a remedy under this amendment. Mr. Chairman, the key difference between the amendment I am bringing before Members today and the underlying bill is that the President has agreed to sign the bill with the amendment I am bringing today. With all due respect to the gentleman from Kentucky, the amendment I bring today is a significant departure from the Fletcher bill. The President has moved our way. I know this is not the ideal way to offer a potential hand of compromise. I really would not blame Members if they voted against the amendment, our Democratic friends, solely because of the process issue. But before slapping away the hand that is being extended to us, Members, I hope, will consider the substance and realize how close we truly are to a law, not a bill. We have done that, folks. But a law. Mr. Chairman, I reserve the balance of my time.

Mr. NORWOOD. Mr. Chairman, I yield 30 seconds to the gentleman from Arizona (Mr. Shadegg).

Mr. NORWOOD. Mr. Chairman, I yield 3 minutes to the gentleman from Minnesota (Mr. Peterson). (Mr. PETERSON of Minnesota asked and was given permission to revise and extend his remarks.)

Mr. NORWOOD. Mr. Chairman, everybody knows that the New York Times is not all of our Bible. They get it wrong frequently. They even reported I lost 60 pounds; and you know darn well it was 40, so they do not get it right. Mr. Chairman, I yield 2 minutes to the gentleman from Texas (Mr. Barton). (Mr. BARTON of Texas asked and was given permission to revise and extend his remarks.)

Mr. NORWOOD. Mr. Chairman, I yield 2 minutes to my lawyer, the gentleman from Arizona (Mr. Shadegg).

Mr. NORWOOD. Mr. Chairman, I am pleased to yield 1 minute to the gentleman from Georgia (Mr. Deal), a good friend of mine.

Mr. NORWOOD. Mr. Chairman, it is a pleasure to yield to the gentleman from Ohio (Mr. Boehner), the chairman of the Committee on Education and the Workforce.

Mr. NORWOOD

Mr. NORWOOD. Mr. Chairman, I am always stimulated to respond when my friend, the gentleman from California (Mr. George Miller), stands up and does always such a good job, but maybe a little clarification would be in order. I think all of you know that the good work in the bill that has been done by all of us solves a lot of problems because just of the external review. You get most things corrected there, which has always been our intent. But to say that a patient that has been denied care and is then harmed has no recourse through our amendment is just not true. If they are denied care through our amendment, they have a cause of action and they have a cause of action, most of them, in the States, which is where we want to be, they have a cause of action for the denial or the delay of care. Let me further say to you, and I think I can say this also for the President, we want to be as sure as we possibly can we do not preempt other causes of action at the State level. I know that can be debated whether the language actually does that or does not, but that is pretty common as I understand it between lawyers for one set of lawyers to believe language says one thing and another set of lawyers believes language to say the other, but you just need to know my intent is to make sure at every way I can do that we do not preempt other causes of action at the State level and that is going to be my intent through conference. I am happy that the President agrees that that is our intent. If for some reason when we get into conference that that language is not worked out, I am going to be in there slugging out for it, because that is my intent as well as it is your intent. Just do not say there is no recourse for a patient who is harmed, that is denied care or delayed care. There is recourse.

Mr. NORWOOD

Mr. NORWOOD. Mr. Speaker, today we approve important legislation in honor of Paul Coverdell, a sterling example of what a U.S. Senator should be about. And this measure we pass is more than a gesture, it is legislation of substsance. I believe Senator Coverdell would be quite pleased with that fact. We honor his memory by designating that Peace Corps Headquarters be named in his honor. We honor his legacy of achievement by appropriating funds for the completion of a state of the art health research center at the University of Georgia, one that will provide benefits for all the people of America for generations to come. Why do we so honor this man? Paul Coverdell provided the kind of leadership for Georgia, America, and the world, that will be sorely missed. Paul Coverdell was unshakable in his resolve to support the right policies for Georgia and America. Yet in 6 years of serving with him in Congress, I never heard him utter an unkind word toward an opponent. He was a man of reason and principle, and provided a shining example of civility in action in the arena of public debate. He never backed down on principle, yet he held his ground with dignity and respect for the positions of those who disagreed. And he never gave up. Since coming to Washington in 1993, Senator Coverdell fought to improve the education of America's children. That fight continues today. Because of his efforts, I believe that fight will eventually be won. When it is, the final product will have the fingerprints of Paul Coverdell on every page. Senator Coverdell was likewise a champion of those who have served this country in our armed forces. When Congress forgot the promises made to our veterans, Paul Coverdell reminded us all of those commitments. His legislation to restore those promises is still pending in both chambers. In this House, 305 members have cosponsored this legislation, The Keep Our Promises To America's Military Retirees Act. The finest tribute we could all pay to this true statesman would be to pass that measure into law before this session ends. Today, I recommit myself to helping make that happen. There are far too many issues to mention in which Senator Coverdell played a decisive role. But we do need to reflect on Paul Coverdell's public service before he became a Senator, for it reflects a lifetime of public service. He began adult life by serving America in the U.S. Army in Okinawa, Korea, and the Republic of China. He served his State in the Georgia Senate for nearly two decades. He served America and the world as Director of the Peace Corps, where his leadership in building democracy was vital in reclaiming much of Eastern Europe from the dictatorship of communism. Paul Coverdell can no longer be with us in body. But the wisdom, generosity, civilty, patriotism, and dedication that he brought to this Congress will never die. We honor his memory today through enactment of this important legislation. But I say we should continue to honor his life's work by seeing his missions through--from giving our children a choice in education, to restoring the health care of the defenders of America. Mr. Speaker, let us pay tribute to a great leader, by not only passing this bill today, but also redoubling our efforts to see all the reforms of Senator Paul Coverdell enacted into law.

Mr. NORWOOD

Mr. NORWOOD. Mr. Chairman, I thank the gentleman for yielding me this time, and I rise to strongly oppose this amendment. However, I agree with the makers of the amendment and what they are trying to do. We all do, indeed, want to see the price of medications come down, especially for our senior citizens. But this is simply the wrong way to do it. I am very fond of, for example, the President's initiative on a senior citizen's discount card. We should turn over every leaf to try to lower it. But the most expensive drugs there are are drugs that do not work. Let us be very clear what this amendment would do to drug safety in America. This amendment would allow anyone, individuals and import companies, to import any drug with no FDA inspection for alteration, misbranding, or strength. Any company in the country, in the world, could ship any product in a bottle, label it any way they wanted, be totally fraudulent in their claim, while we sit here and ban the FDA from doing anything about it. If my colleagues liked the Mexican strawberries that poisoned our schoolchildren, then they are going to love the Red Chinese sugar pills labeled amoxicillin that allows the child's strep throat to become heart disease. When a drug is prescribed, a doctor or dentist has to know with absolute certainty that the drug is precisely what he ordered. This bill will destroy that certainty and undermine the safety of American patients. Vote ``no,'' then let us work together on a real effort to try to reduce the cost of prescription drugs for our senior citizens.

Mr. NORWOOD. Mr. Chairman, I thank the gentleman for yielding me time. Mr. Chairman, we all want to do whatever we can do to lower the prescription drug costs for patients, and the sponsors of this amendment obviously intend to do just that. My friend the gentleman from Minnesota (Mr. Gutknecht), that is what he is after. But there is more to this than just lowering the cost. The corresponding cost to public safety under this amendment is simply unacceptable. Under this amendment, overseas scam artists can counterfeit a label, claiming their product is a brand name, and we ban the FDA from even investigating? Would you vote to ban the FDA from investigating medications prescribed in this country? Even when they suspect exactly what is happening, the FDA is banned from investigating. Mr. Chairman, I, too, wrote a lot of prescriptions as a practicing dentist for 25 years before I came here. I can tell you, America's health providers must know beyond any doubt that the medicines that they give their patients are what they say on the label. Now, I know that some medications can come in, and it does save some people some money. But I do not want it imported through the port of Savannah to be spread out through my State, not knowing what is in that medicine.

Mr. NORWOOD

Mr. NORWOOD. Mr. Chairman, pursuant to the rule, I offer amendment No. 13.

Mr. NORWOOD. Mr. Chairman, I yield myself 1\1/2\ minutes. Mr. Chairman, as it stands now, Federal law requires schools to have two different discipline policies for those who bring a weapon to school or engage in aggravated assault, one policy for special needs students and another for nonspecial needs students. A special needs student receives preferential treatment when it comes to being punished for outrageous behavior. For all practical purposes, a special needs student could be suspended for no longer than 55 days, for all practical purposes, and even then must be provided educational services. Nonspecial needs students, on the other hand, can be and often are suspended for longer periods of time, and then without educational services. My amendment will finally change that. It gives schools the authority to have a consistent discipline policy for all students. It allows special needs students to be disciplined under the same policy as nonspecial needs students in the exact same situation. My amendment also contains safeguards. My amendment contains safeguards to ensure that no special needs student is unjustly punished or singled out. This amendment sends clear messages that weapons and violent assaults at school will not be tolerated. My colleagues, let's send that message today by passing this amendment. Mr. Chairman, I reserve the balance of my time.

Mr. NORWOOD. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from Missouri (Mr. Graves).