Frank Pallone

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, Temple Beth Torah of Ocean Township, New Jersey will be losing a leader, friend, and rabbi of over 36 years to retirement next weekend. Rabbi Jacob Friedman has been with Temple Beth Torah since its establishment and has seen his congregation expand to well over five hundred area families. Rabbi Jacob Friedman was born in Jersey City, New Jersey on January 14, 1933. After graduating high school, he received his rabbinical education from the Rabbi Jacob Joseph School at Yeshiva University in New York City. After five years of service as Chaplain with the army and army reserves, Rabbi Friedman returned to his birth city to become the youth director and assistant rabbi at the Congregation Sons of Israel. Then, in 1965 he relocated to Ocean Township and has since served as rabbi of Temple Beth Torah. During his years in Ocean Township, Rabbi Friedman has been the President of the Shore Area Board of Rabbis, a member of the board of the Monmouth Jewish Federation, and Vice President and President of the American Association of Rabbis. As a member of the Jewish War Veterans, he worked his way from Post 125 Chaplain to New Jersey Department Chaplain to National Deputy Chaplain, and finally served as National Chaplain from 1985 to 1986. While never losing sight of the importance of Jewish youth, he served on the Youth Commission, International Youth Commission, and the International Kadime Commission at the United Synagogues of America from 1966 to 1981. Using education as his tool to reach out to young people, he was a founding member of the Solomon Shechter Academy of Monmouth and Ocean Counties and served as dean of the academy from 1971 to 1974. I ask my colleagues to join me in congratulating Rabbi Jacob Friedman for his hard work and dedication to his community and congregation.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I come to the House floor this afternoon to discuss some disturbing developments in the Nagorno-Karabagh peace process among Armenia, Azerbaijan and Nagorno Karabagh. In April, the leaders of two of these nations, Armenia and Azerbaijan, met in Key West, Florida, and all indications were that they were getting closer to reaching a peace agreement. Despite such indications, Azerbaijan's president, Jeydar Ailyev, has effectively called a halt to the peace process, and now declares that Azerbaijan is ``ready for war at any time it is needed''. Obviously, Mr. Speaker, this statement not only does not promote peace, but actually serves to increase tensions. If Azerbaijan's leader is serious about ending the conflict between his country and Armenia, he should stop catering to militant factions within his country. This conflict has been going on for over 10 years now and is being unnecessarily drawn out by Mr. Ailyev. Mr. Speaker, the United States is one of the co-chairs of the Minsk Group, the body under the Organization for Security and Cooperation in Europe, the OSCE, charged with facilitating a negotiated settlement to this dispute. Besides the political investment in the peace process, our Nation also has a vested interest to bring about stability in this region. In order to achieve this, Azerbaijan and Armenia must embrace greater economic integration, development of infrastructure and cooperation in other areas. This is the path that President Ailyev must be encouraged to follow. Indeed, the benefits to his country would be significant by opening his nation to substantially more trade, investment and assistance. However, any kind of economic cooperation between the two countries must begin with Azerbaijan lifting a decade long blockade on Armenia. Mr. Speaker, section 907 of the Freedom Support Act makes the United States' position on this blockade very clear to Ailyev, and he has tried unsuccessfully to demand repeal. What section 907 does is to effectively limit some forms of direct American aid to Azerbaijan until that country lifts its blockades of Armenia and Karabagh. It is important to know that this law has no effect on humanitarian aid, democracy building measures, as well as OPIC, TDA and Ex-Im engagement. Mr. Speaker, I would also like to strongly encourage Mr. Ailyev to drop the refusal to accept direct participation of representatives from Nagorno Karabagh in the negotiations. The Nagorno-Karabagh conflict is not only a bilateral dispute between Armenia and Azerbaijan. While these countries must obviously be part of the negotiations and the final settlement, the people of Karabagh, who have their own democratically elected government, must have a seat at the table. After all, it is their homeland and their lives that are at stake in this peace process. No one else should be allowed to make life and death decisions for them. Armenia and Nagorno Karabagh have continued to reiterate their commitment to the peace process even in the face of stalling and the ongoing threatening comments coming from Azerbaijan. These tactics are nothing new. In November of 1998, the OSCE submitted a comprehensive peace proposal to Armenia, Azerbaijan and Nagorno Karabagh. Despite serious reservations, both Armenia and Nagorno Karabagh accepted a peace proposal as a basis of negotiations. Azerbaijan summarily rejected it. On June 14, 1999, the Azeri military attacked Karabagh's defensive forces along the Mardakort section of the Line of Conflict between Azerbaijan and Karabagh. Representatives of the OSCE, who visited the area, confirmed this act of aggression. Mr. Speaker, Armenia's Foreign Minister, Vartan Osakian, said this past week that Armenia was ready to resume talks. He also urged Azerbaijan not to deviate from the ``Paris principles'', the understanding developed by the Armenian and Azerbaijani presidents during two rounds of talks in the French capital in January and March, and in Key West in April this year. According to Ambassador Carey Cavanaugh, the U.S. representative to the Minsk Group, these negotiations have made real progress. He stated in an interview with the U.S. Department of State that both presidents felt that, after their last meeting, that substantial progress had been made that exceeded both their expectations. Mr. Speaker, Armenia and Nagorno Karabagh are ready to settle this dispute. They have fully committed to peace and have fully cooperated at every turn with OSCE representatives. They have taken risks for peace despite a decade-long blockade of their countries and frequent acts of Azerbaijani aggression. I strongly urge President Ailyev, if he is serious about peace, to come back to the negotiating table, cease all calls for military action, and end the oppressive blockade against Armenia and Nagorno Karabagh.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I would like to call attention once again to a group of women who never cease to amaze me. This month marks the tenth anniversary of The Thornton Sisters Foundation, Inc. I have been following these women's struggles and accomplishments for a long time now, and after a decade of success I feel it an honor to formally salute these women a second time. On Sunday June 10, 2001 the Thornton Sisters Foundation held an awards ceremony for the twenty-five finalists of the Donald and Itasker Thornton Memorial Scholarship and their family members. The Grand View Ballroom at the Jumping Brook Country Club in Neptune, New Jersey hosted this occasion. The Thornton Sisters have an interesting history that led to the creation of this foundation. Their parents, Donald and Itasker, moved in 1948 from Harlem New York City to Long Branch, New Jersey. The Thornton move was so that their children would be able to receive a better education. After purchasing a lot on Ludlow Street, Mr. Thornton became the first African-American man in the area to receive a mortgage. Mrs. Thornton having given birth to six children, all of whom are girls, became a domestic. Mr. Thornton worked three jobs at Fort Monmouth, Eatontown to provide for his children. Mrs. Thornton was unable to attend college herself. However, she pushed all of her daughters to accomplish something that she would never be able to do. Mrs. Thornton was correct in her foreseeing that women of the future would need to be able to be financially stable on their own. With the help of scholarships and a weekend family music group all six daughters graduated from Monmouth University in Long Branch. Their music ensemble was well known and packed the house of the Apollo Theatre in Harlem. Having learned early on the importance of an education, these six sisters now want to give the same opportunity they had to other young women. This story has special significance to me, as I am a citizen of Long Branch. Rita Thornton and I both attended Long Branch high school at the same time and actually participated in speech and debate together. I could tell, even back then, that her and her sisters share a true commitment to education and excellence--now knowing all of them received straight A's throughout high school. These women are truly a group that needs to be admired and praised. I want to personally thank the Thornton sisters on their ten years of providing scholarships for young minority women of the state of New Jersey.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I rise today to ask that my colleagues join me in supporting legislation I introduced today that would ensure that our nation's playgrounds are safe and properly constructed throughout America. As the school year ends and summer begins, children all around the United States will be spending more time outside playing with friends at our community playgrounds. While most kids enjoy horsing around at the playground, it can be a dangerous place if the equipment is either broken or not up to code. Every year more than 200,000 children are injured on America's playgrounds, and, according to the U.S. Consumer Product Safety Commission (CPSC), 147 children died between 1990 and 2000 from playground equipment-related injuries. In a 1998 survey, U.S. playgrounds received an overall grade of C- when rated on the presence of physical hazards and behavioral elements, including supervision and age-appropriate design. Mr. Speaker, many may think that this is an acceptable grade because states, counties and local communities don't have any specific standards to follow when building playgrounds. However this is not true. For the past several decades, the CPSC has written a very detailed national code to help states and local governments build the safest possible playgrounds. Unfortunately, only five states require that all public playgrounds in their respective communities abide by these standards. My legislation, the Safe Playgrounds Act, would urge states to pass a law that assures that all playgrounds are safe for our kids. The Safe Playgrounds Act will provide $1 million grants to states that enact statewide laws regulating public playgrounds according to the CPSC's Handbook for Public Playground Safety. States could use these funds to either build new playgrounds or bring older ones up to code. Mr. Speaker, I urge my colleagues to join me in protecting our kids from playground accidents by cosponsoring this bill. Playground accidents will always be a reality, but by making these grounds as safe as possible, we can reduce those accidents that are not the fault of the child but of the playground itself.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I would like to express my strong support for H. Con. Res. 145. I commend my colleague Mr. Engel, for introducing this important piece of legislation that condemns the Taliban for requiring Hindus and non-Muslims in Afghanistan to wear identifying symbols. The Taliban regime's policies are inhuman, and clearly resonate Nazi tactics used to stigmatize Jews during the Holocaust. The Taliban policies are reprehensible, and not only should this Congress and the international community condemn the Taliban for their action against Hindus, I also call upon Pakistan to take a stand and use its influence with the Taliban to end these reprehensible policies. The Taliban's record on human rights and support for terrorism have been documented in several reports, including the U.S. State Department's Patterns of Global Terrorism 2000 Report. The findings in these reports on the Taliban exemplify a clear pattern of basic human and civil rights to the Afghan people, especially women, minorities and children. The statistics of violence against women and girls is simply overwhelming. Not only is the Taliban's record on human rights atrocious, the State Department's Patterns of Global Terrorism reports that ``The Taliban continued to provide a safehaven for international terrorists, particularly Osama bin Laden and his network, in the portions of Afghanistan it controlled.'' Not only does the Taliban house Osama bin Laden, the Taliban allows Afghanistan to be used for a base of operation for worldwide terrorist activities and training. The people of Afghanistan are being held hostage in their own country under the terrorist regime of the Taliban. Their recent policy of requiring Hindus to wear identification badges, mandating Hindu women to fully cover themselves in veil, demanding Hindu homes to be identified, and prohibiting Muslims and Hindus to live together all further exacerbate the current situation and indicate that the Taliban is trying to implement a genocide against their own people. I urge Pakistan to step up to the plate and use its influence to allow Afghan Hindus to continue to live their lives and practice their religious beliefs and I urge all of my colleagues to support this important resolution.

Mr. PALLONE

Mr. PALLONE. I want to pick up on the gentlewoman's point there about how as the prescription drug part of health insurance, as the cost continues to rise, and you have, as you say, either cutbacks in other areas or just costs that make it prohibitive for employers to cover their employees, that is the crux of the problem. We had as a percentage of the population fewer people that were uninsured a few years ago than we do now, mainly because the primary way that people were insured historically in this country was through their employer, on the job. And when you create a situation where those employers can no longer cover their employees, that is where the crisis comes with the uninsured. Again, I do not want to look at it ideologically. In my view I would love to have everybody covered by their employer and not have to have any Federal program. But we know that the problem now again is not people who are on Medicaid or people who are low income, who are not working because they are disabled or they cannot find a job, the problem is for people who are working. The uninsured, that 45 million people, they are almost all people that are working. Again I say, I have been as strong an advocate as the gentlewoman of expanding some of these Federal programs to the uninsured, as most of the Democrats have. We initiated the CHIP program for kids, which basically gives money to the States so that they can insure children, and we have advocated as Democrats that we would like to see CHIP expanded to the parents so that the parents who are working do not just enroll their kids but can enroll themselves. Again, we have had the Republican leadership and the President, I would not say oppose it completely, but certainly not been supportive. They have granted waivers to certain States in a minimal way to do it, but most States do not have waivers. What we really need is a program that covers everybody who is eligible for the CHIP program, be they a parent or even a single person. I do not think they should have to be a parent either. I think even a single person who is in that situation. Again, I do not advocate that because I think that the government should run health care or because I want a government program to provide insurance, but simply because the employers cannot do it anymore. That is why we have had this shift to so many people who do not have health insurance. I agree with the gentlewoman that the drug companies, to the extent that they are making these big profits, they are contributing to the inability of employers to pay for health insurance or to make a significant enough contribution to make it so that employees can take advantage of it.

Mr. PALLONE. Mr. Speaker, I want to thank my colleague from Ohio, and I apologize that I came here late; but I am so glad the gentlewoman took the time so we did not lose it. The dialogue that the two gentlewomen were having was really excellent. I know she has to leave; but I want to continue on, if I could, with my colleague from Florida on this generic issue, because I think it is so crucial, but I do thank the gentlewoman.

Mr. PALLONE. I noticed that my colleagues were talking about what I call the GAAP bill, Greater Access to Affordable Pharmaceuticals Act, or GAAP. I think it is important, and I want to kind of give my New Jersey perspective on this, because I agree with the gentlewoman completely when she said that the greater use of generics is certainly a way to address the affordability issue. We have been talking in our health care task force and amongst Democrats about trying to put together a Medicare prescription drug benefit, and we have certain principles that we want to be universal: everybody should have it, should be voluntary, and it should be affordable. Because if it is not affordable, it is not much use to anybody. I agree with my colleague that in many ways, and I am not saying the two of us, but I think a lot of our colleagues have not paid enough attention to the whole issue of how generics and more widespread use of generics could really address that affordability issue in a major way. Now, I say the New Jersey perspective because I have been kind of outraged by the fact that in my State, as the gentlewoman knows, there are a number of the brand-name drug companies, and I am very happy they are in my State, and we have a lot of people employed by them, but many of them over the years have approached me and other colleagues to try to put in these patent extensions. I have refused to sponsor patent extensions because I think it is wrong. I think what it effectively does is it postpones the day when the generics come to market, and it keeps the price artificially high using these brand names that have actually expired even under the law. These things usually do not pass as stand-alone bills, as my colleague knows. They usually get stuck into some omnibus appropriations bill at the end of the session or some reconciliation or something else, and nobody even knows what they are voting on because it is a little paragraph somewhere in a bill that is 2 feet high on the desk. So that is something that has to stop, and the GAAP bill tries to address that. The other thing we get is this whole issue of trying to change the patent. In other words, I will give an example. This is one of their favorite tactics that we get from some of the brand-name companies, and the gentlewoman may have already mentioned this, and I apologize.

Mr. PALLONE. They make essentially insignificant changes to the product, and they get a new patent just as the original patent is set to expire; and then they go on for years with essentially the same patent.

Mr. PALLONE. And the way the current law reads, and I do not think it was really intended that way, but it has been basically utilized in the wrong way, that once that presentation is made with this new patent, for 30 months the generic cannot come to market. That is 30 months. We are talking about 2\1/2\ years, which is incredible; and we correct that in the bill that we talked about. In the GAAP bill we correct that.

Mr. PALLONE. Mr. Speaker, I do not have them with me, but in the last 6 months we have seen a lot of stocks tumble, generally in Internet and other areas. The drug stocks have stayed pretty good, primarily because they are making record profits. We are capitalists in America. And we do not have a problem with people making money, but they are making money at the expense of these seniors who cannot afford to pay for these prescription drugs. And as the gentlewoman says, it is a life-or- death situation. During the course of the last Presidential campaign, as well as congressional races, we saw the current President, as well as many of our Republican colleagues, run on a platform that they were going to address prescription drugs and have some kind of benefit. We are not seeing it. At one point, the President said that he wanted to do a low-income benefit. We are not sure if that is what he ultimately will say that he wants the Congress to do. At this point, I wish he would do anything. The idea of doing a low-income benefit is not what I am hearing from my constituents. The people that are coming to me are not the people that are eligible for Medicaid, but the people in the middle-income bracket that do not have a benefit because the HMO does not provide it, or they want to buy some Medigap which does not cover it. They are going without. They are doing as the gentlewoman from Ohio and the gentlewoman from Florida said, they are cutting back or taking half a pill or just not getting any pill. I agree with the gentlewoman that generics is one way to address this, but we need a benefit package. We have to say that everyone that is covered by Medicare, regardless of income, gets a prescription drug benefit. We figure out how to do it and whether there is going to be a co-pay and what the catastrophic is. I do not see that happening with the Republican leadership. I do not see any movement in that direction.

Mr. PALLONE. Mr. Speaker, that is a block grant. As the gentlewoman says, every one of these proposals that the Bush administration comes up with, the people that they are supposed to help say they are not going to work. My own State, Mr. Speaker, if an individual is eligible for Medicaid and is very low income, they usually get their drugs. There are problems, I am not saying it is easy, but generally they have access. Because we have casinos, there is revenue that is generated by the casinos that goes to the State, and we use that to finance a lower income prescription drug benefit that is above the people eligible for Medicaid. Right now I think that is maybe as high as, for a family of 2, maybe up to $19,000 or $20,000 annually; and that is very good because you only have to pay $5, I think, for each prescription.

Mr. PALLONE. Mr. Speaker, the State does with the casino revenue funds. That has been going on for awhile, but that does not cover the majority of seniors or the majority of middle-income seniors. Those are the people I hear from. New Jersey has a high cost of living. When one talks about $16,000, $17,000, $18,000, $19,000, one cannot live on it in most cases. As the gentlewoman said, we have heard two things from the Republicans. One is the Bush proposal which is the Helping Hand. I have in front of me, he says that the measure establishes block grants for States to provide prescription coverage for some low-income seniors. His plan limits full prescription coverage to Medicare beneficiaries with incomes up to 35 percent above the poverty level, up to $11,600 for individuals and $15,700 for couples. That is below what New Jersey is already offering with the casino revenue. We would not benefit at all, and that is obviously why in our State nobody is in favor of this. Mr. Speaker, the other thing that we are getting was this idea about the Republican proposal last session which is the drugs-only policy. In other words, rather than have prescription drugs as a benefit under Medicare for everyone, which the gentlewoman and I propose, and the Democrats propose, they would just give a certain amount of money and you go out with a voucher and buy a drugs-only policy. But as the gentlewoman said, no insurance company says they are going to write it. Mr. Speaker, I know in Nevada they actually did that about a year ago. For 6 months they could not get anybody to write it. Then somebody wrote it, but I do not think that they covered even 100 people. It was a total failure. So these approaches, it is almost like let us do whatever we can not to guarantee this under Medicare because Medicare is somehow evil or government. I do not have any patience for people who get into the ideology of whether it has to be government run or not. The only thing I care about is whether it works practically. I do not care about the ideology myself.

Mr. PALLONE. Mr. Speaker, the gentlewoman is correct.

Mr. PALLONE. Mr. Speaker, that is an important point. The problem with the block grant, if you use my State, you can write into this language that would not allow this, but there is the danger that you send the block grant to the State and they use the money to fund the program already there. You can try to avoid that through legislation, but it is always going to be a problem. If there is not enough money, they use it for the existing program and do not expand it to include anybody else.

Mr. PALLONE. Mr. Speaker, the gentlewoman is correct that so much money has been spent, and of course New Jersey does have a lot of the brand name drug companies. But if you talk to people on the street in my State, their attitude is not any different. They do not have any better access or ability to purchase the drugs than anybody else; so the problems are the same wherever you are.

Mr. PALLONE. I agree. I want to thank the gentlewoman for being here tonight as she has so many times. I think all we are really trying to do is what is right for the average American. These health care issues are really crying out for a solution. It is not pie in the sky, it is real, day-to-day lives that people are living and it impacts on their lives.

Mr. PALLONE. I will be honest with the gentlewoman, I am totally convinced that anything that comes to the floor somehow procedurally, the majority's will will prevail and we will be able to get a good bill. Even if the Republican leadership comes with a bad bill to the floor, we will do amendments, we will do substitutes, we will do whatever and we will be able to overcome it and come up with a good bill. I am just afraid we never see it. That I think is again the special interest, the health insurance industry, which unfortunately does not want to see the changes that this bill does. Basically what the bill does, if you want to sum it up in maybe one or two sentences, is it says that decisions about what kind of medical care you are going to get, what is medically necessary, are made not by the insurance company but by the physician and the patient. They do not want that. The second thing is that if you are denied, as you mentioned, that you have a legitimate way to express your grievance, either through an independent, outside board or to go to court, and they do not want that, either. Naturally the insurance companies are going to oppose this and they are going to try to do whatever they can to prevent it from coming up here in a fashion that we really can vote as a majority for what we think is good for the country. But we will just keep speaking out as we have until we see something come forward that we know is good for the American people.

Mr. PALLONE. I wanted to point out, and the gentlewoman said it earlier on, but I want to reiterate it, and again I am being very partisan, but I have been very frustrated because if there was one health care issue that during the course of the presidential campaign the current President, then candidate George W. Bush, said was that he wanted to pass a Patients' Bill of Rights and even mentioned how in the State of Texas that they had a Patients' Bill of Rights. He forgot to mention that he did not sign it and he let it become law, but we will forget about that for the time being. The bottom line is that the first thing that many of us did who supported a Patients' Bill of Rights, the first day we were here in session in January, on a bipartisan basis, there were just as many Republicans as Democrats, put in the bipartisan Patients' Bill of Rights, exactly the same as the Texas law, and said, ``Okay, here is the bill. Let's get it going. Let's get it signed.'' The gentleman from Michigan (Mr. Dingell) took the lead on the Democratic side, the gentleman from Iowa (Mr. Ganske) on the Republican side. I guess I am not supposed to mention the other body, but I will say it was bipartisan in the other body as well. Six months have passed almost and what has happened? Nothing. I understand that the other body is going to take this up because of the change in the party, Democrats are now in control in the other body and they supposedly are going to take this up, but we should not have to wait for a party change for that to happen. And what is wrong with doing it here in the House of Representatives? As you said, this bill, the Ganske-Dingell bill, is almost exactly the same as what passed overwhelmingly here in the last session with almost every Democrat and I think about a third of the Republicans, and the President now says, ``Well, I don't like it too much. I may want to change which court you sue in.'' He has got a couple of things. In my opinion, they are relatively minor. I honestly believe that if you took the proponents of the two parties on this issue and you sat them down in the well here tonight, they would be able to iron out their differences in an hour and we could bring the bill up tomorrow. The President is really dragging his feet on this and the Republican leadership is dragging their feet because they do not want it to be brought up because they know if it does as last year, it will be passed overwhelmingly. I hear, though, that there is a movement on, and I will not get into too many details but some of the Republicans on the Committee on Ways and Means, the gentlewoman's committee, to try to come up with an alternative bill that is a lot weaker, that actually does not cover everybody, covers a smaller group, not everybody or does not even provide some of the basic protections. I would hate to see any watering down in that respect, because we clearly have a majority here that wants a strong, real Patients' Bill of Rights. We need to keep everybody's feet to the fire and say, ``That's a bill that's going to get out of here.''

Mr. PALLONE. Because they were told that if they have so many tests or if they have too many costs, then they are going to not be part of the plan and they will not be able to practice medicine essentially. It is very sad.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, once again this evening, as we are back from the Memorial Day break, I would like to take up the issue of health care. As my colleagues know, I have been down here with many of my Democratic colleagues many times over the last few months since the session began and since this new administration began in January, basically speaking out on three major health care issues that have not been addressed, in my opinion, by the President and the Republican leadership in the Congress, and that is the need to reform HMOs and the need to pass a Patients' Bill of Rights that would reform HMOs. There are so many problems that people now have with their HMO or their managed care organization in not having proper access to care, not being able to go to the hospital of their choice, not being able to, if they have a grievance, have an independent review of the decision by the HMO to deny them care; and I will get into this more this evening. The second issue is the need for a Medicare prescription drug benefit. When I go home, and I was home for the last 10 days in New Jersey, my seniors and my constituents complained more about the high cost of drugs and how they cannot pay for prescription drugs and that it should be included in Medicare. I agree, and that needs to be addressed. The third issue is access for the uninsured. More Americans every day have no health insurance. Most of those are working people, and we need to find ways to address those concerns and have them insured and covered for their health care. My point tonight, and I would like to yield now to some of my colleagues, but my point tonight is that we really face, I hope, a different situation tomorrow here in the Congress, here in Washington, because of the change in the other body, in the Senate. I have watched over the last 4 or 5 months, and during the course of the campaign, President Bush mentioned many times that he was going to pass a Patients' Bill of Rights and reform HMOs, that he was going to have a prescription drug benefit, that he was going to address the problem of people who do not have health insurance. Yet over the last 4 or 5 months of this administration, these issues have not come to the floor, they have not been moved in committee in either House. The Republican leadership, in conjunction with the Republican President, have simply dropped the ball on these issues. I was heartened to find that during the break with the changeover in the Senate to Democratic control tomorrow, that the leaders in that body, the Democratic leaders in that body have said that the first order of business when they come back next week most likely, next week is going to be to move the Patients' Bill of Rights in the other body, and that that will be followed soon with these other health care issues. So finally now we may have an opportunity to get legislation passed, at least in the other body, on some of these issues by the Democrats that will come over here and force the hand, I hope, of the Republican leadership here and the Republican President. With that, Mr. Speaker, I would like to yield to the gentleman from Rhode Island (Mr. Langevin).

Mr. PALLONE. Mr. Speaker, I want to thank my colleague from Texas. And I do appreciate the fact that the gentleman is going to spend the hour later this evening talking about AIDS and what we need to do further. There has been a lot of attention paid to the fact, and during the break over the last week I read a number of articles, about the increased incidence of AIDS, particularly amongst African American gay men; that there was just an incredible increase in the incidence of AIDS and HIV. People think that the crisis has subdued somewhat in the United States but it is still out there, and in many communities it is actually getting worse. The other thing if I could, I am so glad the gentleman mentioned the uninsured, and I know that the gentleman has mentioned it many times and the need to address that issue. Once again, I want to point out that even though the President talked about this problem during the campaign, I do not see any effort on the part of President Bush or the Republican leadership to address the issue. One of the things that the President talked about was this idea of a tax credit. The basic design of the Bush plan was an individual credit of $1,000 for those with an annual income up to $15,000. That phases down to zero at $30,000, and a family credit of $2,000 with income up to $30,000 that phases down to zero. That sounds good in theory to get a $1,000 credit toward health care insurance, but it will not solve the problem of the uninsured. First, I do not see the President trying to accomplish this. He talked about it during the campaign, but there is nothing happening. We do not see it moving in committee or any effort being made. Beyond that, it is available only to those not enrolled in employer- sponsored insurance or Medicaid policy and available only to those who purchase nongroup insurance. Basically we are talking about an individual who has to be able to afford to buy insurance in the private individual market, and that individual is going to get $1,000 tax credit. That is not going to solve the problem. Mr. Speaker, people who do not have health insurance, it could cost them $5,000 or $6,000 a year to buy a policy; and they are not able to shell $4,000 or $5,000 out of pocket because they are going to get a $1,000 tax credit when their income is somewhere under $30,000 a year, basically under 15, and it phases down to 30. It is not going to happen. This policy will not accomplish something. I do not want to be critical of something that is being proposed, I wish it would move; but what needs to be done is to expand the number of people that can get health insurance through some of the government programs. Mr. Speaker, we looked at the problem of the uninsured in our task force, and the biggest group were children and the second group was near elderly, people over 65 but not eligible yet for Medicare. We tried to adjust the problem of the children through the CHIP program, and that basically provides health insurance at government expense and it has been great. It has enrolled millions of kids around the country that did not have health insurance. Now you have to expand that program to the adults. In other words to households, to the adult parents, if you will, of those children, to other people in those lower-income brackets that are working but are not eligible for Medicaid regardless if they have children. That is the type of thing that should be done: expand on the CHIP program to include the parents, and even include single people who cannot afford to buy health insurance in the private individual market and are not going to be able to do it with a $1,000 tax credit. That is what the Democrats have been proposing. I do not see any movement in that respect. The other thing that the Democrats have said, with regard to the near elderly, the people between 55 and 65, is that they be able to buy into Medicare for a standard premium every month or every year. That is another way of trying to address that problem. But if we keep getting hung up on the ideology that the Republicans and the President have that everything the government does is not good, and the only answer is to throw a tax credit here or there, we are not going to cover any more of the uninsured. That is my fear right now. I know that we have other things to get to tonight, and certainly the AIDS issue is super-important. Mr. Speaker, I do want to say in conclusion, these health care issues, we as Democrats are going to continue to bring up frequently over the next few weeks because we do want to see action, and we are not seeing it on the part of the Republican leadership or the President.

Mr. PALLONE. Mr. Speaker, I was not aware, and I will not cite that again. The point I am trying to make, though, is that we really need a good Patients' Bill of Rights. I suspect I am going to be hearing more about it later this evening from my colleague, the gentleman from Iowa (Mr. Ganske), and I think I will stop with that particular issue for now. I did want to spend a little time tonight, though, talking about the problem of the uninsured, the number of people who are uninsured. That number continues to grow and needs to be addressed as well here in the Congress. Mr. Speaker, I see one of my colleagues, who has been very active on the health care issue, and who is a member of our health care task force on the Democratic side, is here; and I would like to yield to him at this point.

Mr. PALLONE. Mr. Speaker, I want to thank the gentleman from Maine (Mr. Allen) for what he said this evening. I think it is so important. I am amazed because I watched the Republican leadership and the Republican President, and it just seems sometimes I think that they are motivated, as the gentleman said, just because of special interests. In other words, the health insurance companies give a lot of money to their campaigns, so they want to support them. Other times, I think they are just stuck in this sort of right-wing antigovernment idealogical cloud of some sort, that they are just not thinking about what is practical. They just think anything that the government does has to be bad because idealogically they do not believe in the government. So when we have a good program like Medicare, traditional Medicare fee-for-service that works as effective and is actually saving money is a bargain, they do not want to use it, they want to tear it down. Whether it is their ideology, which I think is very backward, or it is the special interest money they are getting from the insurance company, the bottom line is they are just not being practical. If my colleagues remember last session in the previous Congress, the House Republican leadership tried to establish what they call a prescription drug-only insurance policy. In other words, rather than expanding Medicare and have a guaranteed benefit under Medicare for prescription drugs, they wanted to give people money so they can go out and buy a prescription drug-only policy which, again, harkens back to this ideology that government and Medicare cannot do the job. The insurance companies came before the various committees of jurisdiction and said, well, we do not want you to do that. We are not going to sell you that insurance. We had an example in the State of Nevada which basically did that, Republican-controlled legislature, that passed a bill and said, we will give you money, you go out and buy these drug-only policies, and nobody would sell them. So for the life of me, I cannot understand what they are up to. The same thing, as the gentleman from Maine said, with the HMOs. The HMOs we know are getting out of the Medicare business. They are either dropping seniors, or they are increasing out-of-pocket cost for prescription drugs so that the prescription drugs are unaffordable even for seniors that have the HMO. Why in the world would we want to go out and encourage HMOs as the way to address the need for prescription drug benefit? Why in the world would we want to suggest these insurance policies that only cover prescription drugs? I have not heard much about that in this Congress. I guess maybe they dropped that; although I am sure there are some out there that still want to do that. I mean, what the Democrats have been saying is that we want Medicare to be expanded to include prescription drugs as a guaranteed benefit, universal benefit. When I go and talk to my seniors in New Jersey, they are not interested in this low-income benefit because most low-income seniors get some kind of drug benefit if they are covered by Medicaid. And in a lot of States now, not all, but many States have expanded coverage to cover the low income even a little bit above Medicaid, as is the case in New Jersey. The problem, though, is for the middle class, the middle-class senior who does not get Medicaid, is not covered by their State program because their income is a little too high or they do not have a State program, and at the same time cannot get a decent HMO policy that is going to cover their prescription drugs. So when the President says that he wants to do this low-income benefit, I think he calls it the helping hand, immediate helping hand, and it establishes block grants for States to provide for prescription coverage for some low-income seniors and some seniors with catastrophic drug costs, he would limit full prescription drug coverage to Medicare beneficiaries with incomes up to 35 percent above the poverty level, which is $11,600 for individuals, $15,700 for couples, and seniors with out-of-pocket prescription spending of over $6,000 per year. Again, this is not the problem. The middle-income senior falls above that $11,000 for individual, $15,000 for couples in most cases, and they do not have the out-of-pocket catastrophic expenses of over $6,000 per year. Most seniors are not going to benefit from this, even if it got passed. I do not even see any movement on the part of the Republican leadership in either House or the President to move this anyway, so I do not even know why I am talking about it, because he talks about it during the campaign, but I do not even see an effort to move that. Hopefully with the Democrats now in the majority starting tomorrow in the other body, in the Senate, we will now see a decent prescription drug benefit move, get passed in the other body, and come over here where we can try to persuade the House Republican leadership to take it up. Let me just, Mr. Speaker, if I could give a little indication of what the Democrats here in the House and in the other body would like to see as a prescription drug benefit. We have certain principles that we have been espousing. First of all, this prescription drug benefit must be part of Medicare. Medicare works. It is cost effective. Let us include a guaranteed benefit for those who want it under Medicare. Secondly, it should be voluntary, just like one opts and pays a premium so much per month for one's doctor bills, for one's coverage of one's doctor bills, expenses. We would have this be a voluntary program where one pays a certain premium and one gets one's prescription drugs. Thirdly, the Democrats have been saying that the prescription drug benefit for seniors has to be affordable. Obviously, the premium has to be fairly low per month. One cannot be expected to pay a significant amount of money out of pocket when one goes and gets each individual prescription. It goes back to what my colleague from Rhode Island was saying about affordability for seniors. I also think it is important that this benefit be defined. In other words, Medicare beneficiaries, regardless of where they live, should be guaranteeing access to a defined drug benefit at the same standard premium. You know, people have to know that the prescription drugs they need are included in the program. This is what the Democrats have been talking about. And we also want to build into our proposal an end to price discrimination. We talked a little before about the bill of my colleague, the gentleman from Maine (Mr. Allen); about how he wants to link the price more towards that charged in other countries that are developed countries like the United States. There are ways of dealing with the price discrimination issue, and that is certainly one of them. Another is to basically have the government, through benefit providers in each region, purchase and negotiate prices for the drugs so that we are getting volume discounts. That is certainly another way to try to deal with the price issue. This has got to be done. I was home again last week, for the last 10 days, and this is what our seniors are talking about. We need to take it up. Hopefully, now that the Democrats are in the majority in the other body, they will send a bill over here; and we will be able to pressure the Republican leadership here in the House to take up a prescription drug bill that helps all Medicare recipients. Now, I wanted to talk, if I could, Mr. Speaker, before I conclude this special order this evening, about two other health care issues which I mentioned at the beginning of this special order, and one of them, because of what is happening in the Senate, in the other body, is likely to move even quicker than a prescription drug benefit. And that is fine, I would like to see these important health care issues and this legislation get over to the House as soon as possible, and that is the Patients' Bill of Rights, or HMO reform. Again, when I talk to my constituents, regardless of age, about HMOs, because many people in New Jersey are in HMOs and they have become very concerned because many times they are denied the care that they think they need. Either they cannot go to a particular hospital in an emergency, they cannot get access to a specialist, or they are denied a particular operation or procedure because the insurance company, the HMO, says that it is too innovative. What they really mean is it is too expensive and they do not want to pay for it. The two issues that I think are so important with HMO reform, and which are addressed in the Patients' Bill of Rights in sort of a general way, is the definition of what is medically necessary; who is going to define whether an operation, a procedure, a hospital, a stay in a hospital is necessary; is it going to be the insurance company, which wants to save money; or is it going to be the patient and the physician. Because, after all, you and your physician care about your health. Basically, what the Patients' Bill of Rights does is to say that in general that decision is made by the physician, the health care professional, and the patient, not by the insurance company. They are the ones that that decide what is medically necessary. The second is if someone has been denied care, the HMO says they cannot have a particular procedure, they have to leave the hospital, what then does that individual do; how do they redress their grievances; where do they go. Now, unfortunately, in many cases, they can only go to the HMO, who have said, no, we made that decision and too bad. We want a procedure which allows an individual to go to an independent board outside the HMO that has the power to overturn that decision or we want to be able to go to court as a last resort. Now, let me just talk about some of the little more specific although still general points about the Patients' Bill of Rights and the real Patients' Bill of Rights. And I do not want to put him on the spot, but I see one of my heroes over here on this issue, the gentleman from Iowa (Mr. Ganske), and he along with the gentleman from Michigan (Mr. Dingell), a Democrat, and this is really a bipartisan effort because there are some Republicans that support this bill, a lot of them frankly, but, unfortunately, not the leadership in the Republican Party, have put together a bill called the Dingell-Ganske bill, or the Ganske-Dingell bill, which is the real Patients' Bill of Rights that I would like to see and that most if not all Democrats would like to see passed. Just to give you an idea of some of the principles that are in here, first of all it has to protect all patients with private insurance, not just some. Some of the Republican bills only protect certain types of people. All patients with private insurance. There has to be the ability to hold the plans accountable, which I discussed. There has to be a fair definition of medical necessity, which means that it has to be up to the physician and the patient to determine that. There has to be guaranteed access to specialists, access to out-of- network providers. If there is not someone available who can handle a patient's situation, they can go out of the network. There also has to be a prohibition on improper financial incentives. The HMO cannot encourage the doctor to deny care or not provide certain care and get some sort of financial incentive to do so. There has to be access to clinical trials. There has to be a prohibition on gag rules. In other words, some of the HMOs say that the doctor cannot tell a patient if they need a particular treatment in his or her opinion because it is not covered. So if it is not covered and he or she thinks a patient needs it, they are not allowed to tell because the insurance company will not pay for it. That is ridiculous. Emergency room access if it is needed. If something happens, an individual has a heart attack, they have an accident, that that person can go to the nearest emergency room rather than go to one 50 miles away and die or become seriously injured on the way. And the list goes on. What I am fearful of, and I guess I am a little less fearful now that the Democrats are in the majority in the other body, is that even though President Bush said he would support a Patients' Bill of Rights and said in fact that he would support a Patients' Bill of Rights very similar to what they have in the State of Texas, he has essentially said that he opposes the Dingell-Ganske bill, which in the other body, the Senate, is sponsored again on a bipartisan basis by Senator McCain and Senator Kennedy. The President has been variously quoted over the past few months saying this bill that so many of us support in the House and in the other body is too costly and that he would veto it. He said his primary objection to these bills currently in the Congress is that they do not contain reasonable caps on damage awards against health insurance organizations or insurance. He wants to have caps, and not very high caps in terms of the amount of money that a person can recover if they go to court. And then he has other concerns; that he does not like the particular court that should be allowed to sue under the Dingell-Ganske bill. The point of the matter is, Mr. Speaker, that the President and the Republican leadership in both bodies have been fiddling with this issue for the past 4 or 5 months. They say they are for a patients' bill of rights, but they do not articulate exactly what they want. All they do essentially is say they do not like the bill that most of us support, the Dingell-Ganske bill. I am hopeful now that the other body becomes Democratically controlled tomorrow, that as the new majority leader, Mr. Daschle, said, this is going to be on the agenda probably next week. Now, if and when it passes over in the other body and it comes over here, that will allow us to pressure-- Announcement by the Speaker Pro Tempore

Mr. PALLONE. Mr. Speaker, I want to thank my colleague, the gentleman from Rhode Island, for his statement. If I could just mention two things that he brought up, which I think are so crucial, the whole issue is affordability. Prescription drug affordability is really of the utmost importance to seniors and to people with disabilities. This is what I have heard back at home the last 10 days, the last week or so, that seniors that have major financial problems with purchasing their necessary medications, they have to choose between paying the rent or buying food, and it is basically because of growing out-of-pocket expenses. Even people that have some sort of limited coverage because they are in an HMO or because of some kind of benefit they received on the job that they get in their retirement are finding that the out-of-pocket costs just continue to rise exponentially every year. We have done a number of studies with the Committee on Government Reform with the gentleman from California (Mr. Waxman) in various States, in various congressional districts, that have shown that drug manufacturers engage in widespread price discrimination, so that seniors are paying significantly more for their drugs than they would if they were in another country. I want to thank our colleague, the gentleman from Rhode Island (Mr. Langevin), for what he brought up. I think it is so important. I know our colleague, the gentleman from Maine (Mr. Allen), has a bill called the Prescription Drug Fairness Act or Fairness for Seniors Act that would link the price to the average farm prices in certain countries. Maybe he might discuss that. I yield to the gentleman from Maine (Mr. Allen) to have him talk about that. I know he has other health care issues to bring up as well.