Frank Pallone

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from Ohio (Mr. Brown), the ranking member of our Subcommittee on Health.

Mr. PALLONE. Mr. Speaker, I yield 3 minutes to the gentleman from Texas (Mr. Turner).

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I am just pointing out that the $11 million figure and the 40 percent that goes to HMOs still stands. The gentleman was trying to contradict that and he cannot. Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Green). (Mr. GREEN of Texas asked and was given permission to revise and extend his remarks.)

Mr. PALLONE. Mr. Speaker, will the gentleman yield?

Mr. PALLONE. Mr. Speaker, I yield myself 30 seconds. Mr. Speaker, what the gentleman from Louisiana (Mr. McCrery) is not mentioning is that there are buried or hidden indirect pass-throughs which are actually part of that chart. In other words, what happens is that money goes to the providers like the hospitals; and then it is passed through to the HMOs, about one-sixth of what goes to hospitals and other providers. So it is still $11 million, and it is still 40 percent of the total no matter how you cut it, and that is outrageous given that there are no strings attached. Mr. Speaker, I reserve the balance of my time.

Mr. PALLONE. Mr. Speaker, if the gentleman will continue to yield, no.

Mr. PALLONE. Mr. Speaker, I yield 3 minutes to the gentleman from New York (Mr. Ackerman).

Mr. PALLONE. Mr. Speaker, the bottom line is that the HMOs are getting $11 million, 40 percent of the total, no matter how you cut it.

Mr. PALLONE. Mr. Speaker, I yield myself 5 minutes. Mr. Speaker, the motion I am offering is an amendment to inject some needed accountability into the Medicare+Choice program. It instructs the conferees to support language that would require HMOs participating in the Medicare+Choice program to stay in their given markets for 3 years. In addition, it instructs the conferees to support language that requires HMOs to provide all the benefits they promised to beneficiaries when they enrolled in Medicare HMOs. Last week, the Republican leadership passed a Medicare refinement bill that is really nothing more than a special interest giveaway to the managed care industry. Over 40 percent of the money in this bill is given to the managed care industry, and it is given to the industry with virtually no strings attached. Mr. Speaker, there is nothing in this bill that passed last Thursday that guarantees any stability for seniors or that the plans will stay in a given area. The only thing that is guaranteed is that the managed care industry will be granted a massive government windfall. I suppose it is a reward of sorts for the managed care industry from the Republican leadership for their effective campaign to prevent the patients' bill of rights from reaching the President's desk. Unfortunately, the managed care industry's gain translates into a significant loss for Medicare beneficiaries and the entire spectrum of Medicare providers in the health community. Every Member in this Chamber has heard from providers in their districts, be it hospitals, home health care providers, nursing homes, hospices, community health centers and others, that are being crushed by the unintended financial burden of the balanced budget agreement. Despite last year's BBA refinement package, there are countless Medicare providers around the country whose ability to provide care to Medicare beneficiaries is precarious because of the lack of adequate reimbursement. In my district, I have already seen a hospital forced to close its doors. Mr. Speaker, it would have been infinitely more appropriate to spread what money has been set aside in the budget for Medicare refinements more evenly throughout the program than to give a disproportionate sum to an industry that has a clear record of putting profits ahead of patients. Working with the White House, we will continue to fight for a more equitable distribution of funds so that the Medicare beneficiary, not the HMO executive, will come first. It would have also been appropriate to require that the HMOs are held accountable for the care they are supposed to provide beneficiaries in exchange for the windfall the Republican leadership wants to give them. As we saw a few days ago, and as we have seen for the last several years, the Republican leadership is unwilling to break its special interest bond with the managed care industry. They remain steadfastly opposed to any measure that would require the managed care industry to act in a more responsible manner that Medicare beneficiaries and all patients have been demanding. Mr. Speaker, let me also say that my motion is not an attempt to hamstring the managed care industry or weaken it in any way. I want to preserve it and make it stronger for all seniors who may want to enroll in HMOs for their care. In fact, I have introduced legislation myself that would restore funding to Medicare HMOs. I am not, however, willing to simply give HMOs untold billions and then allow them to continue to pull the rug out from underneath seniors who are lured into HMOs with the promise of extra benefits. And this latter point about benefits is very important. Medicare beneficiaries are not just destabilized when their HMOs pull out of the market. They are oftentimes destabilized when their HMO stays and their HMO just rescinds the extra benefits that attracted the beneficiaries in the first place, the most popular example of that being prescription drug coverage. Seniors should be afforded some peace of mind and be able to know that when they enroll in an HMO for prescription drug coverage or whatever extra benefits they enroll for, they are going to get those benefits. If the Republican leadership remains wedded to giving the managed care industry multibillion dollar special interest giveaways at the expense of all other Medicare providers, the least the Congress can do is require that seniors are going to get what they are promised. If my colleagues on the other side are as committed as they purport they are to providing seniors with a Medicare prescription drug benefit, they should have no opposition to requiring managed care companies to agree to provide what they promised beneficiaries they will provide for at least a 3-year period. I do not think that is a lot to ask for and that is what this motion to instruct is all about. Mr. Speaker, I reserve the balance of my time.

Mr. PALLONE. Mr. Speaker, I rise to offer a motion to instruct.

Mr. PALLONE. Mr. Speaker, I demand a recorded vote.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I would like to congratulate the Belarusan- American Foundation on the auspicious occasion of its 50th anniversary. I am very proud of the fact that Central New Jersey is home to a significant Belarusan-American community. I happen to be very close to one particular member of the Belarusan-American community in this area: my wife, Sarah. While we are here to celebrate, we must also recognize that Belarus has not made the successful transition to democracy like Poland, Slovakia, and as recently as this month, Serbia. Over nearly a decade of independence, the promise of democracy, freedom of expression and association, and the flowering of a national identity have not come to pass for the Belarusan people. The fault for this sad state of affairs rests, as all of us know, with President Aleksandr Lukashenka. The President has illegally extended his term of office beyond the legally mandated expiration date. Throughout his tenure, President Lukashenka has monopolized the mass media, undermined the constitutional foundation for the separation of powers, used intimidation and strong- arm tactics against the political opposition, suppressed freedom of the press and expression, defamed the national culture, maligned the national language and eroded Belarus's rightful position as a sovereign nation. Worse, just two days before the Parliamentary elections held on October 15, President Lukashenka issued a fresh denunciation of market reforms. And, I am disappointed and disturbed that the Parliamentary elections almost exclusively involved candidates who back Lukashenka. Clearly, not a single OSCE condition for free and fair elections was met. This past week, Representatives Gejdenson and Smith introduced a Resolution condemning the October 15 elections. I will try to ensure that this bill reaches the House floor in the remaining days of this Congress. And today, I again express my strong condemnation of these ``sham'' elections. For at least four years, I and other Members of Congress have been working to address Lukashenka's abuses of power. In 1996, I introduced a Resolution expressing concern over the Lukashenka regime's violations of human and civil rights in direct violation of the Helsinki Accords and the constitution of Belarus, and expressing concern about the union between Russia and Belarus. That Resolution also recognized March 25 as the anniversary of the declaration of an independent Belarusan state. A year later, I worked with leaders of the International Relations Committee to include language in the State Department Authorization bill, which passed the House, calling for our President to press the Government of President Lukashenka on defending the sovereignty of Belarus and guaranteeing basic freedoms and human rights. For years now, the Belarusan-American community has been trying to inform the American people about the truth in Belarus, that President Lukashenka's actions do not have widespread support and his regime has lost any sense of legitimacy it once may have had. I want to thank the Belarusan-American community in New Jersey and throughout the nation for continuing to speak the truth about events in the land of their ancestors. Earlier this year, I joined Congressman Gejdenson and others in introducing yet another Resolution that condemns the continued egregious violations of human rights in the Republic of Belarus, and the lack of progress toward the establishment of democracy and the rule of law in Belarus to continue to put pressure on Lukashenka. The Resolution also calls on President Alyaksandr Lukashenka's regime to engage in negotiations with the representatives of the opposition and to restore the constitutional rights of the Belarusian people, and calls on the Russian Federation to respect the sovereignty of Belarus. Obviously, President Lukashenka has not been moved by these expressions of concern by the United States and the international community. But we must not give up. We must continue to go on record condemning the abuses that have taken place and that continue to take place in Belarus. We must urge our President and State Department to keep the pressure on President Lukashenka--and also on Russian President Vladimir Putin. I congratulate you for this occasion and for all of your efforts. I look forward to continuing to work together to pursue real democracy, and truly free and fair elections that comply with OSCE principles and the Helsinki Accords.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, pursuant to clause 7(c) of House rule XXII, I hereby notify the House of my intention tomorrow to offer the following motion to instruct House conferees on H.R. 4577, a bill making appropriations for fiscal year 2001 for the Departments of Labor, Health and Human Services, and Education. The form of the motion is as follows: Mr. Pallone moves that the managers on the part of the House at the conference on the disagreeing votes of the two Houses on the Senate amendment to the bill H.R. 4577 be instructed, in resolving the differences between the two Houses on the funding level for program management in carrying out titles XI, XVIII, XIX, and XXI of the Social Security Act, to choose a level that reflects a requirement on Medicare+Choice organizations to offer Medicare+Choice plans under part C of such title XVIII for a minimum contract period of three years, and to maintain the benefits specified under the contract for the three years.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I move that the House do now adjourn.

Mr. PALLONE

Mr. PALLONE. I want to thank my colleagues for joining me tonight.

Mr. PALLONE. Yet the Republican plan and his plan is a voucher. It is not under Medicare. It a voucher that you get if you are below a certain income, not for most people, but if you are below a certain income, to go out and try to find an HMO or somebody to cover your prescription drugs. So, to even suggest that somehow this is a Medicare plan is not accurate. It is not under Medicare. I think that is a major distinction between the Democrats and the Republicans on this issue, that we want to use traditional Medicare for the prescription drug benefit, and the Republican leadership does not. That is a key difference here, no question about it.

Mr. PALLONE. I listened to that third debate between the two presidential candidates, and I was very upset to hear Governor Bush say he was providing a Medicare prescription plan. I believe he used the term Medicare.

Mr. PALLONE. I appreciate the gentleman's comments. I know we do not have a lot of time left and I want to yield to the gentleman from Maine, but I wanted to say the issues of abuses by the HMO affect everyone, by insurance companies. I had a situation myself, and I have not mentioned it for a while because we now have the law that we passed in the previous Congress that says that for the drive-through deliveries, you have to allow at least 24 hours, I think is it is now 2 days for normal delivery, and maybe 4 days for a C-section, when a you have a baby. They had changed the rules in between my daughter being born and my son being born, when they were both born by C-section. We were actually at Columbia Hospital for Women here in D.C. between the two births. The law had changed, or at least the insurance company changed it, and when my son was born, after the second day, they said my wife had to come home and he had to come home from the hospital. It was only because there was a law in D.C., and I do not think it exists in a lot of states, that says before the child goes home he has to be examined by a pediatrician for certain things, and they found he was jaundiced. So they let the two of them stay, my wife and son stay, an extra day in the hospital. Then we passed the law to prohibit the drive-through deliveries. But these abuses impact everyone. It is across the board. I yield to the gentleman from Maine.

Mr. PALLONE. Mr. Speaker, I just want to follow up on what the gentleman from Maine said. First of all, I have to say to my colleague from Texas that he is always so good at bringing these issues down to the average person and how it affects his hospitals and how it affects his seniors. I want to keep saying over and over again, that is why we are here talking about this because it directly affects our constituents. But I wanted to go back to the GAO report that the gentleman from Maine (Mr. Allen) mentioned. Because I mean, he just brought that out so well. I mean, the problem here with this tax bill that the President is going to veto, we are giving all this money to the HMOs and they are already costing the Federal Government more than the traditional Medicare fee-for-service. And I can think of at least three reasons why. First of all, what do they do with that money? They are taking it and they are paying for political ads against the people that do not support their interests. They are using the money to pay for the administrative costs of their CEOs' bill salaries, vacations, who knows what. The other thing that I was thinking about, too, is advertising. In my district I have been to some of these meetings where they do all of this huge advertising in the papers. I remember once there was a local diner and they had all the seniors come to the diner and they were giving them lobster dinners if they came to the diner to sign up for the HMO. So that is where all that money is going for all these other costs. The amazing thing is that the hospitals and the nursing homes and the home health care agencies that are not getting the money from this tax bill, or getting much less, they are more direct providers. I mean, that money is going almost directly to them. Medicare fee-for-service has very little overhead. So they are just paying the money to them to take care of the people's health needs as opposed to all this other nonsense that the HMOs are doing.

Mr. PALLONE. Mr. Speaker, I want to develop what my colleague said a little bit if I can maybe go back and forth a little here because I think it is so true and so important. First of all, with regard to this special interest money, I wanted to say and I have said many other times on the floor that I was a victim of this 2 years ago in 1998 when I was running for election. At the time, of course, I was an advocate for HMO reform and I was an advocate for the health care agenda that we have talked about here tonight. And as a consequence, a group was formed and at that point they did not have any disclosures, which the gentleman is pointing out now about how they have to disclose and he has those documents from the FEC was not true before. Basically, a group was formed to do an independent expenditure against me that was primarily financed by the health insurance industry, by the HMOs and by the pharmaceuticals. And they spent about $5 million in these independent ads, about $3 million on New York TV, which is the most expensive market in the country. And of course, even though they were financing it, they did not talk about the health care issues. I do not even remember what they talked about. I think it was that I was raising taxes or something unrelated, if you will, to the health care issues. I had to bring out the fact that this money was coming from the health care industry, from the pharmaceutical industry, and why they were doing it because I was supporting HMO reform and supporting a prescription drug benefit and supporting the things that we talked about this evening. No disclosure. Corporate money, what we call soft money, not the individual kind of contributions. If people want to contribute to us, they have to make an individual contribution, they have to disclose it. The maximum is a thousand dollars. This was all corporate. This was hundreds of thousands of dollars adding up to $5 million. This goes on all the time. I mean, I still think that even with the disclosure that the gentleman is talking about there is still a lot ways to get around this under current law.

Mr. PALLONE. That is true, we do not.

Mr. PALLONE. Mr. Speaker, I want to thank the gentleman from Texas. I think that when he talks about the substance of all this, and obviously that is crucial and that is why we are here tonight, but more than anybody else the gentleman has brought home to us, with the things he has done in his district, about how this is really something that affects the average person, and that our constituents are suffering, that our seniors are having problems getting prescription drugs because of the price and because of the price discrimination. We are not just talking about something that is pie in the sky. This is something that is real for the average citizen. I will now yield to my other colleague, the gentleman from Maine (Mr. Allen), and just point out that he, probably more than anybody else, has brought out this whole issue of price discrimination, not only between different Americans but even by comparison to prices abroad. So I yield to the gentleman.

Mr. PALLONE. Mr. Speaker, this evening I would like to take to the well again and talk about health care issues, because I do believe that when we talk about health care issues, that this is really the unfinished agenda that this Republican Congress has not addressed. Of course, there is still time. We are still here. We are here over the weekend, are probably going to be here a good part of next week. There was an effort yesterday when the tax bill was brought up by the Republican leadership, to suggest that somehow some of the health care issues were being addressed in some minor way. Mr. Speaker, what I wanted to begin tonight was talk about how that bill really does not accomplish anything significant to help the average American with the health care problems that they face and with the hospitals and the nursing homes and the home health agencies that are trying to provide quality health care. Then after that, I would like to get into the three major issues that most of my constituents and most Americans talk to Members of Congress about, and that is trying to reform HMOs, trying to provide a prescription drug benefit for seniors, and trying to deal with the 42 million Americans who now have no health insurance. Let me start with this tax bill that was voted on and that the Republican leadership brought up, because they suggested, I think inaccurately, that what they were trying to accomplish was to deal with some of the problems that occurred with the Balanced Budget Act which was passed a few years ago which cut back significantly on the money that was going to hospitals, to home health care agencies, to nursing homes, and to HMOs, and that the reimbursement rate from the Federal Government, from Medicare, Medicaid, and some of the other Federal programs that provide funding to these facilities or to these programs that provide health care services, needed to be readdressed. That there was too little of a reimbursement rate under Medicare and Medicaid and that more money needed to go back to these programs or facilities if they were going to provide a quality health care. The problem, though, was that in making these adjustments in this tax bill, the Republican leadership essentially gave most of the money to HMOs in a fashion that I find totally objectionable, because the HMOs were not only getting huge amounts of money back from the Federal Government, but were really not caused to do anything for the average American in order to receive those funds. I said today in a press conference that we had outside on the lawn of the Capitol with some of my Democratic colleagues that the reason this was happening, the reason why the tax bill was so favorable to the HMOs, is because basically the Republican leadership has bought into the HMOs and the special interests that are associated with the HMOs and supports them because of the special interest funding that is made available. What we see the HMOs doing is that the HMOs are leading the battle against the Medicare prescription drug benefit and leading the battle against HMO reform. The Democrats and some Republicans have tried to pass a bill called the Patients' Bill of Rights. We know it as the Norwood-Dingell bill. It is bipartisan, but it is opposed by the Republican leadership. The Norwood-Dingell bill would make significant reforms to address the abuses of the HMOs. But the HMOs are fighting that tooth and nail as well as the prescription drug benefit. So I think that basically what happened here is the Republican leadership sides with the HMOs because they are basically against the Medicare prescription drug benefit and against the Patients' Bill of Rights. We also see that the HMOs are spending a lot of money funding negative ads against those individuals, Democrats and against some Republicans who support the Patients' Bill of Rights, who support HMO reform, who support having a prescription drug benefit under Medicare. So this is the sort of unholy alliance here that manifested itself yesterday with this tax bill to give more money back to the HMOs. Now, let me talk a little bit about this bill because I just want to show how unfair it was and how little it would accomplish in terms of addressing the health care needs that Americans face today. First of all, and just to give my colleagues some figures about the amount of money that was going to the HMOs, the Republican plan, this tax bill, increases payments to Medicare HMOs by over $10 billion over 5 years and over $30 billion over 10 years, despite the fact that only 16 percent of Medicare beneficiaries are enrolled in HMOs right now. We know that what the HMOs have been doing is they have been dropping senior citizens left and right. As of July 1, I think there are over 700,000 seniors across the country that have been dropped by HMOs to provide their Medicare benefits over the last few years. So a lot of these HMOs got into the Medicare program, and then they dropped the seniors. Yet, over one-third of the allocation in this tax bill, over one- third of the allocation for health care, that goes back to health care providers, goes to HMOs. Only 16 percent of Medicare beneficiaries are enrolled in HMOs. My colleagues get some idea there of the inequity here. Now, in addition to that, we know that a lot of these HMOs have dropped out of Medicare, so one might say to oneself, well, if they are making an argument they need more money to stay in Medicare, then why, when we give them this windfall, these billions of dollars, this 30 percent of this overall budget, then why do we not require that they come back into Medicare and provide certain benefits? Well, that makes sense. But that is not what the Republican leadership did. There was no guarantee that these HMO plans will not drop out of communities or Medicare altogether when it is no longer in their interest to remain, as many of them have. There is no guarantee that they will put new money towards maintaining benefits rather than shoring up their bottom line. So we could have said, okay, we will give HMOs all this money in the tax bill, but they have to sign a contract saying they are going to stay in Medicare for 2 years or 3 years or even 1 year. We could have said, okay, we will give them this money, but they have to make sure that they provide at least a level of benefits and prescription drugs for these 16 percent of seniors that are on Medicare that they are providing now. But we do not have that in the bill, nothing like that. Just give them the money, and that is fine. They can continue to drop out of the program if they want to. It is blatantly unfair. It is just basically pandering to special interests. Now, let me go beyond that to the next issue. Why is it that so much of this money is going to HMOs again when so few seniors are in HMOs that are in Medicare? We know that we have greater needs in a lot of other areas. The hospitals do not get that much. Hospitals, many have closed. I had one in my district in South Amboy that closed within the last year or so. Nursing homes. Many nursing homes are bankrupt. I visited with some. I went to a nursing home last week, one of the days, and talked to some of the residents. I found out from the operators that there are, I do not know what the percentage is, but a significant percentage of the nursing homes in the State of New Jersey are now bankrupt, and some of them are closing. Home health care agencies, very little money under this tax bill. These are the providers. Remember, the HMO is an insurance company. They are getting this money now from this windfall from this Republican tax bill, and they are going to go out and they are going to pay the hospitals or they are going to pay the nursing homes or they are going to pay the providers of health care services. They are not providing the services. But, yet, we shortchange the providers. We do not give the money to the hospitals, some of which are closing. We do not give the money to the nursing homes, some of which are closing. We do not give the money to the home health care providers who are directly providing services. It makes no sense. It makes no sense at all unless one looks at it from the point of view that the HMOs are special interests that are doing the Republican leadership a favor and that are railing against HMO reform and a Medicare prescription drug benefit. Now, let me go to the last thing, then I am going to get off the issue of this tax bill, but I do think it is important; and that is that the Republican leadership said, well, one of the things we are going to do in this tax bill is we are going to try to address the problems of the uninsured by giving what we call an above-line deduction for health insurance, a tax deduction. Okay. Well, we know that there are 42 million or so Americans now that do not have health insurance. Now, these are working people because, if one is really poor and one is not working, one is eligible for Medicaid, and the Federal Government pays for one's health insurance. But if one is in a low-income bracket but one is working, or even middle-income bracket, it depends, and one is working, a lot of times one's employer will not provide one with health insurance because maybe it is costing him too much, or whatever the reason, and one has to go and try to buy one's health insurance on the private market, or maybe the employer has some kind of a plan, but it is very expensive. Whatever the reasons, these 42 million people are pretty much working people that do not have health insurance on the job or cannot afford to buy it in the private market. So what the Democrats have been saying, what Vice President Gore and President Clinton have been saying, let us gradually try to address some of the groups that make up this uninsured. We know the largest group is the children. We know the second largest group is near elderly people, between 55 and 65, that are not eligible for Medicare yet. These are some of the groups. What the Democrats have been doing, and we actually did get the support of the Republicans eventually, we had to drag them along on this, but we eventually did get the support of the Republicans to pass a kids health initiative a couple years ago that gradually has been getting to the point where we think about half of the children that are uninsured will have some sort of insurance with money paid for by the Federal Government. Well, what Vice President Gore has been saying is that he wants to increase the income eligibility so that, right now, if one is, say, 200 percent of poverty and one is eligible for this kids care program, we will raise it to 250 percent of poverty or 300 percent of poverty and try to get more of these lower middle class people who are working and their kids into this CHIP or kids care program. Well, we found, of course, that the Republican leadership does not want to do that. That would have been the logical thing to do in this tax bill would be to expand eligibility for the kid care program. Or another thing that we could have done, and this is another thing that Vice President Gore has proposed and the Democrats here in the House, is to enroll the parents of those kids in the health insurance program, because we know that those parents, if they cannot get health insurance for the kids other than through the Federal Government, they are not able to get it for themselves. In this tax bill, we could have put a provision there for the near elderly. What the Democrats have been saying is they would like to see the people between 55 and 65 be able to buy into Medicare. At their own expense, they would buy into Medicare. But, no, the Republican leadership does not want to do any of those things. This is what they said. They said, we are going to give you an above-line tax deduction. I am not going to get into all the details of that, but basically that has two problems. First of all, very few of the people who are now without health insurance, who are sort of lower middle class category, very few of them will be able to take advantage of this deduction and go out and buy health insurance, first of all, because most of them do not have incomes where that deduction is significant enough to be able to use it to buy a health insurance policy which in the private market may be $3,000 to $4,000 a year. Secondly, what we find with this above-line deduction is that it creates a disincentive for employers to provide health insurance. As a consequence, a lot more employers may decide not to provide health insurance and, instead, actually increase the ranks of the uninsured. The only people that really are able to take advantage of this are people that already have health insurance that are making a decent income and can take advantage of the deduction. But if one is trying to increase the number of insured people and take the uninsured off the rolls, this accomplishes virtually nothing. It just helps people who are in a higher income bracket and who already have health insurance. Again, it sounds so critical. The Republican leadership brought up this bill yesterday, or the day before when they brought it out here; and they said, we are going to try to do all these things. We want to address some of the health care concerns of the American public with this bill. But whether it is the question of the uninsured, it is ineffective. Whether it is the question of addressing the prescription drug prices, it is ineffective, because it does not provide any guarantees one is going to get prescription drugs under any kind of HMO plan. Certainly it does not even address the effort to reform the HMOs with the Patients' Bill of Rights that the Democrats have been talking about. So I just want to say, once again, we see the Republican leadership aligned with the special interests, the drug companies, the HMOs, the health insurance companies, not doing anything that is going to help the average American. Now, I wanted to talk a little bit, because I think it is important, I mentioned before earlier that there are three major health care issues that are not being addressed by this Congress. We only have a few more days. Every one of these issues could have been addressed and could have come to the floor. The Democrats have been pushing for them, for these issues, and for legislation to address these concerns to come to the floor. It appears in the dying days of this Congress that these issues are simply not going to be addressed. They should be. It is not fair. It does not address the concerns of the average American. Now, the first one I want to talk about is the Patients' Bill of Rights, HMO reform. We know from our own constituents, I can certainly say for my constituents, that one of the biggest problems people face is, if they are in an HMO, oftentimes they are denied access to the care that they need, that their physician says that they need. Now, that may be the individual who goes to the hospital and finds that the doctor says to them that they need to stay a couple extra days in the hospital after recuperating from a particular operation. Or it may be the individual who has the need for a particular operation, and the HMO says they are not going to pay for it, they are not going to cover it. There are so many situations. There are situations where people, their HMO plans say that they cannot go to the local hospital, they have to go to a hospital 50 miles away. They may be in a situation where they want to go to the local emergency room, and they have to go to the one 50 miles away; otherwise, it is not covered. These are the kinds of abuses that we see, not every day, but on a fairly regular basis. A lot of people come to my office and complain about these things. Now, what the Democrats said is, well, we want to address these abuses. Generally, the plan that the Democrats put forth, with some Republicans, the Patients' Bill of Rights, the Norwood-Dingell bill, has two major ways of correcting the abuses in sort of an overall sense. One is that it provides that, if a decision has to be made about what kind of care one is going to get, that that decision, rather than being made by the insurance company, is made by the physician and the patient. The definition, if you will, of what is medically necessary, the hospital stay, the particular operation, of what is medically necessary is made by the physician and the patient, and not by the insurance company. The second thing it does in a broad sense is the Patients' Bill of Rights says that, if one is denied care because the insurance company says one cannot have that operation, for example, then one has to have an ability to redress that grievance. The Patients' Bill of Rights does it in essentially two ways. One, it says that one can go to a board outside the jurisdiction or outside of the umbrella of the HMO, an independent review board that will look at the case and decide whether the HMO made the wrong decision in denying one that care. Absent that or sort of an appeal from the review board is that one can go to court and one can bring suit. These are really very simple things. Basically what happened here is that the Democratic leadership, the Vice President, the President got together, and we were able to get some Republicans on the other side, initiated by Republicans that were physicians, the gentleman from Georgia (Mr. Norwood), the gentleman from Iowa (Mr. Ganske) and some others, to join us and put together the Patients' Bill of Rights, the Norwood-Dingell bill. The Republican leadership opposed it. The Republican leadership did not want to bring it to the floor. We went out and got a discharge petition, which is a way of coming up to the well here and getting almost a majority of the Members to sign a petition saying we want it brought to the floor. The Republican leadership eventually brought it to the floor. It passed with almost every Democrat and maybe a third of the Republicans. It went over to the Senate where it was killed by the Senators who will not even let it come out of conference between the two Houses. But, again, this is an important piece of legislation, just as important as a prescription drug benefit under Medicare, just as important as trying to address the problems of the uninsured; and we find that the Republican leadership in this House of Representatives simply will not let any of these good measures move forward. They have stopped them, and they are still stopping them in the waning hours of this Congress. I see I have been joined this evening by two of my colleagues who have been out front on all of these issues over the last 2 years, and even beyond that, and I am very pleased to see them here. I will first yield to my colleague from Texas (Mr. Turner), who has done so many things, but I think probably the best example I saw was the period of time in his district where he spoke to the different senior groups and had them bring in their prescription drugs and tell him about the problems that they faced with prescription drugs, and actually brought the pill bottles down here, and suggested the rest of us do the same, and we very dramatically showed, along with the gentleman from Texas, about what kind of problems the average senior faces in Texas and in all of our districts. So I yield to the gentleman from Texas at this point.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, let me just say to my colleague on the other side from California, there is really no purpose to this resolution whatsoever. I think he has been trying to justify it, and I know he is trying by suggesting that somehow this puts the report or the recommendation into the Record, but the resolution does not even accomplish that. There is a FERC order from October 26 that says that the commission will place in the public record the report. So not only is this just a sense of Congress which accomplishes nothing, but the report would be put in the Record, anyway, it would be made a public record that anybody would have access to. There is nothing here. Mr. Speaker, I would urge opposition to this resolution. It is bad policy, it is bad process. I want to back up what the gentleman from California (Mr. Filner) said. The bill was introduced last night, it has not seen the light of day let alone any proper committee process. Essentially the bill does nothing. It is purely political. The FERC is expected to come out with its findings and recommendations regarding California's energy price spikes on November 1. This bill just asks the FERC to release its findings 1 day sooner. It is already a matter of public record once it comes out. And California already has legislation in place to freeze energy rates. Now, I say this is an exercise in futility not only because it is, and I want to bare the reality of it here tonight and support what the gentleman from California (Mr. Filner) said but also to stress that in the meantime, the House Republican leadership is not bringing other measures to the floor that would truly address California and the Nation's rising energy costs. In fact, the tax package that we debated today eliminates important energy conservation and alternative energy measures that would save energy and money for our businesses and consumers and would protect our environment. For example, the tax package does not include $400 million for electricity produced from renewable sources. The package also does not include tax credits for alternative fuel or hybrid vehicles. We all know that oil and gas prices have been higher than in previous years. If the average fuel economy of the 131 million cars driven in 1998 were to have been increased by just one mile per gallon, we would have conserved 3.2 billion gallons of gasoline that year. Furthermore, if we now were to increase the fuel efficiency of vehicles by just three miles per gallon, we would save one million barrels of oil per day. I say this because I would like to preclude the need for even suggesting the drilling in ANWR, the Arctic National Wildlife Refuge which Governor Bush and the Republican leadership in Congress also are advocating. Unfortunately, we do not see any measures being brought to the floor by the Republican leadership that would encourage greater fuel efficiency in vehicles. The point is this bill is futile. It is bad policy. It accomplishes nothing. We should be doing a lot more important things.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I want to stress that my opposition to the rule and this bill is not based on any ideology or any politics, Democrat or Republican. The problem here is that this bill is not going to help the average American. And that is what we are all concerned about, and we are all united to try to help the average guy. I heard the chairman of the Committee on Rules say that he supports this bill because it is going to help the investor class or get more people in the investor class. Well, let me tell my colleagues, if I am a person that does not have health insurance and I am not getting it through my employer, I am the little guy, I am not going to be able to take advantage of whatever tax deduction is in here to buy health insurance and to get myself an insurance policy. It is not going to happen. The bottom line is that we know that the reason why most people do not have health insurance today who are employed is because the employers do not provide the insurance. There is a disincentive with this above-the-line health insurance deduction for the employer to continue or to expand health insurance for their employees. So we are going to have more people join the ranks of the uninsured. This notion that somehow they are going to be able to take this deduction and buy health insurance is a lot of garbage. It is not going to happen. Secondly, let me talk about the hospitals that are suffering. I had a hospital in my district that closed and others that have the potential to close because they are not getting enough money from Medicare from the Federal Government. Do not tell me that we are going to give this money to the HMOs, something like 40 percent of the funds, and we are not going to help our hospitals, our home health care agencies, our nursing homes. Many of them are bankrupt and closing. If we are going to do anything to help with the reimbursement rate, it should be to those providers, the hospitals, so they do not close. What about the HMOs? The HMOs that are benefiting from this bill are having no strings attached to the extra money that they are getting. They do not have to stay in the Medicare program. And many of them have moved out of it. Something like 700,000 seniors who were in HMOs have been dropped by HMOs in the last couple years. So no strings attached. They get the money. They do not have to stay in the Medicare program. Nor do they have to do anything about their benefits. They do not have to guarantee they are going to provide prescription drugs. They do not have to do anything to increase the benefits. The HMOs are getting a sweetheart deal, and they are doing nothing for the American people in return. Vote against this rule. Vote against this bill. It does not help the average guy. Forget the ideology. It does not help the average American.