Frank Pallone

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I wanted to start this afternoon by talking about the President's plan to modernize and strengthen Medicare for the next century which he announced at a press conference that was held at the White House yesterday; and let me say, Mr. Speaker, if I can, that I strongly welcome this proposal. I think it is a very good proposal and specifically with regard to the new prescription drug benefit, the effort to eliminate copayments and deductibles for preventive care, the fact that it also includes the Medicare buy-in for the near elderly, those who just are below the age of 65, and the fact that by using 15 percent of the projected surplus that Medicare is fully funded for a much longer period of time than would be the case under current conditions. All these things I think are a strong indication that this is a very good proposal which certainly the Democrats support and which I am hopeful that the Republicans and the Republican leadership will support as well so that we can get a bill out of committee to the floor and passed in this Congress. Let me just talk a little bit about some of the most important aspects of this Medicare proposal in my opinion. I think probably the most important aspect is the new voluntary Medicare Part B prescription drug benefit that is affordable and is available to all beneficiaries. We all know that when you talk about Medicare the biggest gap, if you will, that exists in the Medicare program now is the lack of a prescription drug benefit. When Medicare was started under President Johnson as a Democratic initiative back in the 1960s, over 30 years ago now, prescription drugs were not that much a part of the average senior citizen's budget. Medicine then was not so much emphasizing preventive care, particularly prescription drugs; and, frankly, a lot of the prescriptions that we have now had not even been invented. So it was not an important issue. It was not included in the Medicare package at the time. But as time went on over the last 30 years the lack of a prescription drug benefit has been a major gap causing senior citizens to expend a lot of money out of pocket, in some cases several thousand dollars a year. And so the President's response in trying to include a modest prescription drug benefit is commendable, it is fully paid for, and I think it will go far towards helping senior citizens and the disabled under Medicare to deal with this problem. I just wanted, if I could, to outline some of the high points of this. There is no deductible. And, well, basically the way it applies is that you contribute initially $24 a month as the premium that you pay for this new Part B; and Medicare, once you participate, pays half of your drug costs from the first prescription filled each year up to $2,000 a year when the program begins. And eventually that will be phased in to be up to $5,000 a year in drug costs. And, of course, the premium will go up as well and could, when fully phased in by 2008, be as much as $44 per month. But what it would mean is that, when the program starts, is that if you pay $24 a month and you have as much as $2,000 in prescription drug costs for the year, half that will be paid by Medicare. And there is no deductible, there is no copay, so to speak, so that starts with the first prescription, that half of it is paid for by Medicare. The other thing that is important is that this program, if you participate in this new Part B benefit, will insure the beneficiaries a discount similar to that offered by many employer-sponsored plans, which is estimated to be, on average, over 10 percent. So even if you go above the $2,000 per year, you are still benefiting in the discount, and of course the discount is your floor. So you are going to get a discounted price before you are even starting to pay for the prescription drugs. The cost I mentioned initially is $24 per month beginning in 2002 when the program is set to begin. I would also point out that for those beneficiaries, for those Medicare recipients who are below a certain income level, there would be no premium. Beneficiaries with incomes below 135 percent of poverty, and that is $11,000 for a single individual or $17,000 for a couple, would not pay premiums or cost sharing. Those with incomes between 135 and 150 percent of poverty would receive premium assistance as well. So in many ways this is modeled after the so-called QMB program with Part B of Medicare where, if you are below a certain income, you do not pay the premium at all, and then there is assistance for those a little bit above that level to pay part of the premium. Finally, I wanted to mention with regard to the prescription drug benefit that it would provide financial incentives for employers to retain their retiree health coverage if they provide a prescription drug benefit to retirees that was at least equivalent to the new Medicare outpatient drug benefit. This would save money for the program. So we would encourage those who already provide or have a prescription drug benefit as part of their pension or retirement health benefits, that would be incentives for employers to keep that benefit. Now some may say, ``Well, how many Medicare recipients would actually benefit from this prescription drug program and would see fit to opt for it because it is voluntary?'' And we estimate, the President estimates, that most Medicare beneficiaries will choose the drug option because of its attractiveness and affordability. Older and disabled Americans rely so heavily on medications that about 31 million beneficiaries would benefit from this coverage every year. So there are about 31 million, which is the majority of Medicare recipients, who would find that if they pay this premium per month, or if they were eligible to not have to pay the premium, that they would end up saving money and opt for the Part B prescription drug benefit. Now let me talk a little more about some of the other major aspects of this, the President's Medicare proposal, that I think are worthy of note. One of the things that is changing, and I think for the good with regard to health care, and that is not only for seniors and the disabled, for everyone, is the renewed emphasis on prevention. A few years ago, preventive medicine was not really in vogue. Some people did it, some people did not, but it was not thought about a great deal. But increasingly we know that if people take preventive measures, and prescription drugs are really part of that, I mean then they avoid hospitalization, they avoid nursing home care, they avoid expensive treatment. Well, the President, when he unveiled his Medicare expansion and modernization proposal yesterday at the White House, said that it would include the elimination of all cost sharing for preventive benefits in Medicare, and that means basically that there would be no copayments and deductibles for preventive services covered by Medicare. And just to give you examples, that would include cancer screening, bone mass measurements, pelvic exams, prostate cancer screening, diabetes self- management benefits, mammograms. Anything that is preventive we would eliminate the deductible and the co-payment. I think that is significant, not maybe as significant as the drug benefit, but kind of that goes along with it, because what it means is we do not want to discourage people because they have to shell out a certain amount of money into not taking preventive measures, and the reason makes sense, not only for them individually, but also because it saves the government money because, if they do these types of screenings, maybe they avoid hospitalization and expensive operations that Medicare would have to pay down the road. So I think it makes a lot of sense, and let me just mention two other things. One is the Medicare buying proposal. This is something that is not new. The President proposed it in his State of the Union address, but he is reiterating it once again, and it will be part of this legislation that is sent up to Congress. And that says that Americans between the ages of 62 to 65 would be able to buy into the Medicare program for approximately $300 per month if they agree to pay a small risk adjustment payment once they become eligible for the traditional Medicare at 65. So people in those years would be able to buy into Medicare. Displaced workers between 55 and 62 who had involuntarily lost their jobs and insurance would buy in at a slightly higher premium, about $400 a month, and retirees over age 55 who had been promised health care in the retirement years would be provided access to COBRA continuation coverage if their old firm reneged on their commitment. So, again, we are reiterating this buying proposal for the near elderly, very important because so many of those people do not have health insurance. And last thing, and then I would like to yield to one of my colleagues, is that the President reiterated once again that he will dedicate 15 percent of this growing surplus over 15 years to Medicare, and that will ensure the life of the Medicare trust fund until at least 2027. So we are extending the life of the Medicare trust fund. It means that Medicare remains solvent for almost another 30 years, terribly significant. So many senior citizens come up to me and say that they are worried about, as my colleagues know, whether Medicare is going to be there, and of course younger people as well. It is probably more of a problem for younger people than it is for senior citizens right now. But this proposal which the President put forward would keep Medicare intact and fully paid for until the year 2027. So I think it is a great idea. I am sure going to see a lot more Democrats coming up and saying that they support it, and hopefully we will get support from the Republican leadership as well. Madam Speaker, I wanted to go into some more details about the President's Medicare plan because I think that it is so important. Many people, many Members of Congress, I am sure, hear from their constituents about the problems that their constituents have because of gaps in Medicare, particularly with regard to the prescription drug benefit. But the bottom line is that the President's plan is seeking to modernize and strengthen Medicare in a lot of different ways, as my colleagues know. And if I could just highlight some of the other things that were mentioned yesterday by the President when he had the press conference at the White House? A lot of the Medicare modernization program that he has put forward seeks to modernize and strengthen Medicare by making it more competitive and efficient. I know that those are words that are often thrown out around here and people mention that all the time, but I think that it is important to kind of stress some of the efforts that the President is putting forth that would also make the Medicare program more competitive and efficient, if I could at this time. One of the things that he stressed was giving traditional Medicare new private sector purchasing and quality improvement tools. The proposal would make the traditional fee-for-service program more competitive through the use of market-oriented purchasing and quality improvement tools to improve care and constrain costs. It would provide new or broader authority for competitive pricing, incentives for beneficiaries to use physicians who provide high quality care at reasonable costs and coordinating care for beneficiaries with chronic illnesses and other best practice private sector purchasing mechanisms. Essentially, what he is trying to do is to make Medicare more competitive, more efficient, by bringing in some private sector tools. That is estimated to save about $25 billion over 10 years. The second area where this competitiveness comes into play is by extending competition to Medicare managed care plans by establishing a competitive defined benefit while maintaining a viable traditional program. The competitive defined benefit proposal would, for the first time, inject true price competition amongst managed care plans in Medicare. Plans would be paid for covering Medicare's defined benefits, including a new subsidized drug benefit which we mentioned, and would compete by offering lower cost and higher quality. Price competition would make it easier for beneficiaries to make informed choices about their plan options and would, over time, save money for both the beneficiaries and the program. The competitive defined benefit would do so by providing beneficiaries with 75 cents of every dollar of savings that result from choosing lower cost plans. Beneficiaries opting to stay in the traditional fee-for-service program would be able to do so without an increase in premiums. There is a savings from that of $8 billion over 10 years starting in the year 2003. Then there are two more points, if I could, and then I would yield to some of my colleagues who I see are joining me on the floor to discuss this. The third point is that the President's proposal constrains outyear program growth but more moderately than the balanced budget amendment which we adopted in 1997. To ensure that program growth does not significantly increase over most of the Medicare provisions of the Balanced Budget Act, which expire in 2003, the proposal includes outyear policies that protect against a return to unsustainable growth rates but are more modest than those included in the Balanced Budget Act of 1997. I do not want to keep going into all of the details of this, but I think that the President again should be commended for trying to bring a more competitive and efficient approach into the Medicare program. And that is one of the reasons that we are able to save some money. So, in essence, what he is doing here is bringing a significant amount of the surplus, 15 percent, into the Medicare program to make sure that the program is solvent, to expand the benefits to include the drug benefit, but at the same time trying to make the program more competitive and efficient and saving money. That would be also brought back into the program for these extra benefits like prescription drugs, as well as to keep the program solvent until the year 2027. Obviously this is the type of thing that is very important, and I think only helps in the overall effort to strengthen and modernize the Medicare program. It is interesting because many of us on the Democratic side have been talking about the need to include a prescription drug benefit, and our effort, and I see my colleague, the gentleman from Maine (Mr. Allen) is here, actually goes back to, I think it was sometime in May, around Mother's Day, when there was a report put out by the Older Women's League, OWL, and I had come to the floor at that time to specifically point out how the gaps in the Medicare program have a particularly negative impact on older women, which the OWL report highlighted. Most of what was discussed was the problem in terms of out-of-pocket costs for prescription drugs. The other thing that the OWL report pointed out is that many of the lowest income senior citizens again are women and those are the very women who would benefit most from this prescription drug benefit and would not have to pay at all because they fall below the poverty level and would not even have to pay the $24 monthly premium. So all in all, this is a great program.

Mr. PALLONE. They were mentioned. My understanding is that because of the savings, as well as the money that is going to be made available in the surplus, because of the surplus, some of those concerns can be addressed.

Mr. PALLONE. The gentleman did not mention, but I could add, it took almost 2 weeks in the other body, the Senate, for the Democrats to insist that the Patients' Bill of Rights be brought up. They almost had to filibuster in order to make sure that the bill was brought up. I understand that when we come back after the recess that there is an agreement to bring up the Patients' Bill of Rights in the Senate, but there were two weeks wasted because the Republican leadership would not bring it up. It remains to be seen whether they actually do when we come back.

Mr. PALLONE. I just wanted to thank the gentleman from Maine. He has been the leader on this whole issue of the high cost of prescription drugs. He introduced a bill, I think he gave us the number, but I call it the Allen bill, because he is the prime sponsor. I am a cosponsor of that bill. I think it is a very important piece of legislation in terms of the effort to try to control prices of drugs, which are out of hand, particularly for senior citizens. I am really glad that the gentleman talked about how the President's bill, even though it is different, or the President's proposal, even though it is different, tries to get at the costs. One of the things we mentioned was this whole discount that would be available, as well as the competitiveness. The gentleman's proposal as well as this one I think kind of follow on each other in an effort to try to achieve the same goal. I just wanted to say, I wanted to yield to the gentleman from Texas, but I know a lot of people, and I have already heard that from some of the Republicans, and I am not saying all of them, because I think we are going to actually get some Republican support on this, and hopefully a lot of it. But I have heard the same thing, this does not help everyone, this only helps 50 percent of the people. The President said yesterday, this was a modest proposal. This was not a proposal to try to cover everyone, but it is modest and it is paid for. That is the main thing. He went out of his way in the document that was presented to us yesterday and in the discussions we have had since then to show in detail how every penny of this thing is paid for. I think that is important, because we know that everything is not endless around here and we have to pay for things. The fact of the matter is something like 31 million seniors would benefit from this program, a majority. To me that is a strong beginning, and something that we should support. I appreciate what the gentleman said. I yield to the gentleman from Texas (Mr. Doggett).

Mr. PALLONE. I think the answer is very simple. That is that the Republican leadership in the case of the Patients' Bill of Rights, the HMO reform, simply does not want to bring up the bill because they do not want it to pass. They know if the Patients' Bill of Rights, the HMO reform, comes up and it is considered, it will pass, so they exercise their leadership by not bringing it up. I think the reason they do it is very simple: They are beholden to the insurance companies. They are beholden to the HMOs. They spend, the HMOs spend millions of dollars on advertising and influencing congressional races. They do not want this legislation brought to the floor because they know it will pass.

Mr. PALLONE. I do not think anybody can make the argument that we do not have the time. As the gentleman very well pointed out, we did not meet Monday, we met yesterday very briefly, today we adjourned at 2:30.

Mr. PALLONE. I appreciate the gentleman bringing this up. When the President unveiled his plan yesterday, and we were there, that was the reason he cited why he was dealing with this prescription drug benefit, because he said that when he was first elected he was hearing a chorus from different senior groups about how they had to decide between whether they were going to eat and have proper nourishment as opposed to paying for their prescription drugs. He vowed that he was going to make sure that something was done about it so people did not have to make that choice. Mr. Speaker, I yield to the gentlewoman from Florida (Ms. Brown).

Mr. PALLONE. I know that concerns have come up with home health care, with some of the outpatient services, and also with teaching hospitals that have been concerned about the limitations on the amount of money that they have available with research. What the President said, and I do not have the details in front of me, was that because of the infusion of funds from the 15 percent of the surplus, which is a growing amount now that would be dedicated to the Medicare program, and because of the cost savings that he was putting in place with the new efficiency and competitive proposals that I mentioned previously, and others, that more money would be available to address some of these problems. Yesterday he did not specifically mention which ones would receive a certain amount of money, but a lot of things the gentlewoman mentioned, including the home health care.

Mr. PALLONE. I agree. I have to be honest, for the 12 years that I have been in Congress, I guess it is 11 years, the thing that always bothered me the most was how we did not provide any incentives for preventative care. Forgetting the health aspects, which of course we do not want to forget, that is the most important thing, but just looking at it from a financial perspective, every one of the things that the gentlewoman mentioned, if that manages to catch something before it gets worse it is going to save us so much money, because down the road we would have to pay for the operation, the hospital care, the nursing home care, astronomical costs that can be saved because somebody does some kind of preventative screening or testing. So what the President proposed makes sense. Why penalize people or discourage them from having those kinds of preventative measures? I totally agree. I think that was one of the best aspects.

Mr. PALLONE. I agree. One of the things, one of the reasons I think it is so important that we have these kinds of outreach programs, is my own experience in my district. My district runs from very wealthy to very poor. A lot of the seniors who are below a certain income and eligible for what we call the QMBY program, where their Part B benefit was paid and they did not even have to put out a premium, were not even aware that that was true. They did not know that they were eligible to not have to pay the premium for the Part B doctor's bills. The same is going to be true with this program. Once we put this into place, this new part D, if they are below a certain level, I think I mentioned $11,000 for a single or $17,000 for a couple, they would not even have to pay the premium. So for the group of people that are in that category, this is a Godsend in my opinion. So it is important to get out there and, as the gentlewoman from Florida (Ms. Brown) says, and talk to people about it. Because a lot of people are not even aware of the benefits that are there for them now, let alone once we pass this new benefit.

Mr. PALLONE. Absolutely.

Mr. PALLONE. Exactly. Madam Speaker, if the gentlewoman would bear with me, I mentioned earlier OWL, which I think stands for Older Women's League. They put out this report around Mother's Day this year that we were talking about on the floor at the time to try to get some of the changes that the President has now proposed. There were just three examples. They gave some real life examples that were mentioned at that time. If I could just briefly mention them, because I think they really illustrate why this is so important. This is a woman from Montgomery, Alabama, Clusta, I do not know if I am pronouncing it right, C-L-U-S-T-A, I guess is her first name. She is 77, widow of 15 years, lives alone. Social Security is her sole source of income. Her Medicare Part A hospital coverage is supplemented by Blue Cross/Blue Shield. She pays her Medicare Part B premium as part of the specified low income Medicare beneficiaries. So that means that she does not get it all free, but she gets some assistance. So she does not pay the whole thing. But she goes on to talk about how valuable Medicare is, but she says it is not enough. She spends as much as $3,000 a year on her health, most of which goes for medicine. She takes 15 different medications, some twice a day. Of course, she lives in subsidized housing. In order to be in that slim B category, she is probably making maybe, I do not know, $12,000, $13,000 a year. She is spending $3,000 of that on prescription drugs. I mean, it is ridiculous. My colleagues can see how this would benefit her. There is this other woman, Joan, from southern Connecticut. She is 67, retired social worker, and I am going to skip a lot of this stuff. But she has an illness which she explains as too many infection fighting T cells that attack her internal organs and her nerve cells. She goes on to describe her illness, but she has a supplemental insurance policy which covers 80 percent of her medication. Otherwise, prescription drugs would cost her $3,500 annually. But this policy, which is a Medigap policy, is said to expire, and she is now looking to replace it. Now, again, I think the gentleman from Maine (Mr. Allen) was pointing out that there has been some suggestion, well, a lot of seniors get prescription drugs because they have Medigap, supplemental insurance that they pay, so what is the big deal? Well, the big deal is that, in many cases, they cannot afford to buy Medigap because it is getting more and more expensive. A lot of people cannot get the coverage. In this woman's case, she knows it is going to expire. She obviously cannot continue it. I mean, she would benefit in a major way, $3,500 a year in prescription drug benefits. It is unbelievable. Then I just want to mention one more, and this is a woman, Rhoda, from suburban Minnesota. She is 70. Her late husband and her both suffered from chronic disease. She is a breast cancer survivor. She talks about the value of Medicare. She said that her and her husband spend closes to $300 a month on prescription drugs. They take three prescription medications apiece everyday, and her husband took two insulin shots each day as well. The couple pay out of pocket for various things. I mean, again, I do not want to get into all the details, but there are just so many people out there that are in this category. That is why we need this program. I yield to the gentlewoman from Florida (Ms. Brown).

Mr. PALLONE. Madam Speaker, I have to say I know that we have been very disappointed with the Republican leadership on a number of health care initiatives, most importantly the Patients' Bill of Rights that they refuse to bring up, so that now we have got to actually sign this discharge petition and try to get it to the floor. So far, there has not been a lot of criticism of the President's proposal on Medicare. I am hopeful, I am sort of crossing my fingers here and hoping that, at some point, we will see an expression of support for this.

Mr. PALLONE. I hope so. Madam Speaker, again, I just keep pointing out that the only reason that we start to agitate as Democrats is because we cannot get some of these good proposals brought forward. That is certainly true with the Patients' Bill of Rights. But, hopefully, it does not have to be the case with this Medicare proposal. I know that, initially, there was Republican resistance to the idea of taking 15 percent of the surplus and using it for Medicare. I hope that they will go along with that. I hope that they will go along with the prescription drug proposal and some of these other very significant changes in Medicare that the President has proposed.

Mr. PALLONE. Madam Speaker, I yield to the gentleman from New York (Mr. Serrano).

Mr. PALLONE. We will continue and bring this up on a regular basis. Madam Speaker, I yield to the gentleman from Washington (Mr. Baird). Provisions For Landslide And Mud Slide Victims

Mr. PALLONE. I yield to the gentleman from Maine, who came down here to join me and discuss this.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, what I would like to do now, if I could, and I will not take up the whole time, but I wanted to sort of change the subject and talk about two foreign policy areas which I am very concerned about. The first one involves U.S. relations with India, which I often speak about as a member of our bipartisan India Caucus. It references legislation that I am introducing today with regard to the so-called ``entities list'' against both India and Pakistan. The legislation I am introducing, Mr. Speaker, is a concurrent resolution aimed at getting the administration to review its so-called ``entities list'' with regard to India and Pakistan. The Bureau of Export Administration has created a blacklist of private and public entities in the two countries, subjecting them to a near complete prohibition on all exports, including paperclips and paper cups, without regard to their specific use or whether these items contribute in any way to nuclear weapons or missiles. In effect, the entities list imposes a trade embargo against nearly 300 companies and agencies with little or no direct connection to nuclear weapons programs. In practice, this is an essentially punitive list. Besides punishing the Indian and Pakistani entities, the list also ends up hurting U.S. firms and U.S. research organizations that have ties with them. Mr. Speaker, the administration, I believe, has cast too wide a net in listing entities, including private companies and research institutions, that do not threaten U.S. security interests. There are a total of 196 entities from India and 92 from Pakistan on the list. This compares with a total of only 13 named entities from China and 13 from Russia. There are some truly absurd examples of entities that have been included in this list. For example, medical equipment cannot be supplied to a cancer unit that comes under the administrative jurisdiction of an atomic research center. The trade restrictions are actually more permissive with regard to military than civilian entities. It is indicative of policies that I think have lost touch with the spirit of the laws that they were meant to implement. Thus, I have introduced today my sense of the Congress resolution, similar to a provision approved in the other body, the Senate, as part of the fiscal year 2000 defense appropriation legislation. It states that export controls should be applied only to those Indian and Pakistani entities that make direct and material contributions to weapons of mass destruction and missile programs, and only those items that can contribute to such programs. The entities list was adopted, I think I mentioned, by the Bureau of Export Administration last year in the wake of the imposition of unilateral U.S. sanctions pursuant to the Glenn Amendment to the Arms Export Control Act. The sanctions were invoked automatically, pursuant to the Glenn Amendment. However, the naming of the Indian entities on the list is not a mandatory Glenn Amendment sanction. I would say that the list goes way beyond the intent of Congress when it enacted the Glenn Amendment in an effort to prevent nuclear detonations by what were termed nonnuclear powers by the Nuclear Non-Proliferation Treaty. Furthermore, the entities list is not subject to suspension or waiver. Mr. Speaker, in the Omnibus Appropriations Act of the last fiscal year, there was a provision granting the President the authority to waive certain Glenn Amendment sanctions. This year both houses of Congress, both the House and Senate, are moving legislation to further waive or to suspend the sanctions, but the entities list would not be affected by these efforts. It is a discretionary measure imposed by the administration above and beyond what the Glenn Amendment provides for. Mr. Speaker, I have repeatedly made the point that I have concerns about this discretionary approach in general. Personally, I would like to see the sanctions permanently repealed. I would at least favor suspension of the sanctions for some period of time, 5 years is provided for in the Senate language, rather than continuing to use the sanctions in a carrot and stick strategy to force concessions. With the entities list, we have seen this discretionary approach taken to its logical extreme. Instead of controlling exports that have a direct bearing on nuclear or missile programs, the list is simply a broad technological embargo against non-weapons related private and commercial activities. Mr. Speaker, I made the point that this list is punitive, but the real question is, whom does it punish? The named entities can generally find alternative suppliers from other countries. The real victims are the American companies, their employees, and suppliers. Furthermore, the list is open-ended. The named entities from India and Pakistan are not accused of violating any law or commitment. There is nothing the entities can do to get delisted, since there was nothing really they did to get put on the list in the first place. I have come to this floor on many occasions in the last year to express my concern that the sanctions regime against India has severely damaged the burgeoning economic relations that have been opened up since India undertook historic market reforms in the early 1990s. The sanctions have forced the U.S. to oppose major projects funded by the World Bank and other international financial institutions. We have had to abandon nonhumanitarian aid, including technical assistance programs that were helping India establish the kind of viable financial institutions that it would allow for much-needed infrastructure and other development projects. The sanctions not only deprive the people of India of important opportunities, they also serve to cut the U.S. private sector out of one of the world's major emerging markets. I am glad to see Congress is working on a bilateral and bicameral basis to lift the sanctions. Mr. Speaker, these efforts would not affect the Administration's entities list. It is up to Congress, working with the American private sector entities that have been hurt by this counterproductive policy, to speak out and urge the administration to reconsider. I hope we can enact this legislation that I am introducing today, Mr. Speaker, and that the administration will respond in a meaningful way by removing entities from this list that simply do not belong there. Mr. Speaker, I also wanted to take a few minutes, about at the most 5 minutes, to talk about something that I read about over the weekend in the New York Times that again indicated very strongly the Turkish government's intransigence with regard to the continued occupation of Cyprus. I have a number of Cypriot constituents. I know the Cypriot Americans as a community have been to many Members of Congress, both Democrats and Republicans, many times to express their concern over the lack of progress in resolving the continued Turkish occupation of Cyprus. This year, actually July 20 of this year, next month, will mark the 25th anniversary of this illegal Turkish invasion and occupation of Cyprus. The problem is that the Turkish side continues to refuse to come to the negotiating table with the intention of negotiating in good faith. Hundreds of attempts to solve this problem have been made, yet to date the islands is divided and remains one of the most militarized places on the face of the Earth. Mr. Speaker, to its credit, following the leading role it played in bringing NATO's role with Serbia to an end, the group of eight major industrialized nations, the G-8, agreed to press for a new round of negotiations recently on the Cyprus issue. The Secretary General of the U.N. endorsed the G-8's plan and subsequently announced he was prepared to invite the Greek and Turkish Cypriots to hold comprehensive peace negotiations. The Turkish side, however, did not waste a second in reaffirming its disrespect for the will of the international community. Turkish president Rauf Denktash, he is the President of the Turkish occupied part of Cyprus, quickly dismissed the U.N.'s proposal for a new round of peace talks as nonsense. After nearly 25 years of Turkish belligerence and intransigence over the Cyprus issue, this latest refusal to allow the peace process to move forward is hardly a surprise. I am certainly not surprised. But I nonetheless wanted to come down here to discuss this particular example on the House floor because, frankly, the U.S. Government is simply not doing enough to help bring Turkey to the negotiating table. In my view, pressure by Members of Congress who support a just resolution to the Cyprus problem must be turned up. The justification the Turkish leader provided to Reuters News Agency for rejecting a new round of peace negotiations is absolute garbage. Denktash told Reuters he would not attend any negotiations at which the democratically- elected president of Cyprus, Mr. Clerides, represented the Cyprus government. According to Denktash and his patrons in Ankara, the Cypriot government does not have any official jurisdiction or authority over the portion of the island that has been illegally occupied by Turkish troops for almost 25 years. Adding to this absurdity, the Reuters report also noted that Denktash and Turkey claimed that ``decades of talks on an inter-communal basis have failed to acknowledge the existence, in effect, of two separate governments on the island.'' Mr. Speaker, these ridiculous claims were made by Denktash for the sole purpose of killing a new round of negotiations before they have a chance to succeed. That is what he is up to. Clerides, President Clerides, is recognized internationally as the President of Cyprus, and Turkey is alone in its recognition of the so-called Turkish Republic of Northern Cyprus. No other country in the world recognizes the portion of Cyprus that the Turks have illegally occupied for 25 years as an independent state. The Turkish suggestion that peace negotiations must be between leaders of independent nations from the same island is way outside the realm of reality. Mr. Speaker, the international community recently reaffirmed its position on the Cyprus issue. In December of last year, the U.N. Security Council passed a number of resolutions on the Cyprus situation, including Resolution 1217 which reiterates all previous resolutions on the Cyprus problem. Those resolutions state that any solution to the Cyprus problem must be based on a State of Cyprus with a single sovereignty and international personality and a single citizenship, in a bi-communal and bi-zonal federation, with its independence and territorial integrity safeguarded. So on the one hand we have the international community taking steps to reaffirm its commitment to a peaceful and just settlement to the Cyprus problem, and on the other hand, the Turks are only hardening their position and thumbing their nose at whatever the international community suggests. Their claim that a new basis for negotiations is needed because the negotiations over the last 2\1/2\ decades, which they have worked systematically to undermine, have failed to produce any results essentially says it all. Rejecting all reasonable and peaceful overtures and substituting unreasonable and unworkable conditions in their place is not an approach that will move the peace process forward. Sadly, that is precisely why they make the suggestions. If the Turks were truly interested in moving the peace process forward, they would come to the table and abandon their belligerent and unreasonable conditions for negotiations. They could also accept the standing offer from the Cypriot government to demilitarize the islands in an effort to reduce tensions, as well as the Cypriot government's offer to pay for the costs of the peacekeeping force following any such demilitarization. The fact of the matter is that the Turkish side could do any of a number of things to reduce tensions and put the peace process back on track if Ankara, where the real decisions about Cyprus are made, allowed it to happen. History has shown we should not expect that to happen any time soon, and that is why the U.S. has to do more to make it happen. Mr. Speaker, I just wanted to say that in my view, it is long past time to stop focusing public and private efforts on the Turkish Cypriots and intensify American efforts to move the peace process forward on the Turkish military, which has real and substantial influence on decision-making in the Turkish government. To that end I would reiterate what I and many other Members of Congress have said publicly and privately to the administration. The United States government must stop spinning its wheels and convey to Ankara in forceful and unequivocal terms that there will be direct consequences in U.S.-Turkish relations if Ankara does not prevail upon the Turks to come to the negotiating table in good faith. Almost 25 years have passed since Turkey invaded Cyprus. The recent comments by Denktash, who is now taking his orders from the very same Prime Minister in Ankara who presided over Turks 1974 invasion, suggest it might as well have been yesterday. Mr. Speaker, finally, I think it is clear that the people of Cyprus have waited far, far too long for their freedom. It is my unshakable belief that the U.S. should immediately take the appropriate course of action against the Turkish government to help the Cypriot people attain their independence and their freedom and the cause of a united Cyprus without further delay. I do think these international issues are important.

Mr. PALLONE. Madam Speaker, this evening I would like to talk about two significant health care issues that the Democrats have made a major thrust, if you will, of their agenda for this Congress. One is the Patients' Bill of Rights, which is our HMO reform, our patient protection reform; and the second one is the effort that was announced today by President Clinton at the White House to modernize and strengthen Medicare and, most importantly, to provide a prescription drug benefit for all Medicare recipients for the first time. As Members know, when Medicare began in the 1960s under President Johnson, there was not a prescription drug benefit. As part of the effort to modernize Medicare and strengthen Medicare, the President today went far towards coming up with a prescription drug benefit that I think is a wonderful way for this Congress to show that it really does care about our senior citizens. Let me start this evening by talking a little bit about the Patients' Bill of Rights. I have said over and over again on the floor of the House of Representatives, both this session and previous sessions, that the most important issue, the issue that I hear the most from my constituents about and the issue that I think our constituents feel we should address immediately, is reforming HMOs. Because so often Americans who have managed care, whose insurance policy is essentially a managed care or HMO type of policy, find that there is not adequate protection under the law for them to receive quality care when they need it. The horror stories have been recounted many times about Americans who need a particular operation and are told that the HMO will not pay for it or need a particular type of equipment and are told that the HMO does not cover that or who need to go to an emergency room and want to go to the closest one nearby to where they live or where they happen to be hurt and are told that they cannot go to that emergency room because that particular hospital does not come under the HMO plan. All we are seeking to do with the Patients' Bill of Rights is to provide sufficient protections, what I call common-sense protections under the law, under Federal law, that get rid of these horror stories. Essentially, the Patients' Bill of Rights has two focuses. One is to make sure that the decision of what kind of medical care you receive is made by the doctor and the patient, not by the insurance company; and the second focus is that there be an opportunity, if you are denied care by the HMO, that you have some sort of appeal, external appeal, as well as the right to bring suit in court to make sure that your grievance is heard and that that incorrect decision can be overturned if it should be. Those are the two focuses of our legislation. But there are a number of other things that come up in the context of the Patients' Bill of Rights. I would like to go into a little bit some of the objectives tonight. I say that there are four central objectives of the bill: Patients should have access to needed care, doctors should be free to practice medicine without improper interference from HMOs and insurance companies, the health plan's decision to deny care can be appealed by patients to an independent entity, and health plans are held accountable for their medical decisions that lead to harm. Let me get into some of the specifics, because I think that they are important. As I mentioned, patients today face numerous obstacles as they seek access to doctors and needed health care services in the context of managed care. These barriers to quality health care range from managed care companies' refusal to pay for emergency room services without prior authorization to restricting patients' access to specialists. These are the most important provisions that I am going to go through in the Patients' Bill of Rights that will provide patients with access to the care that they need when they need it. First, access to emergency room care. The Patients' Bill of Rights allows patients to go to any emergency room during a medical emergency without having to call a health plan first for permission. Emergency room physicians can stabilize patients and begin to plan for poststabilization care without fear that health plans will later deny coverage. Access to needed specialists. We hear many times about the fact that, under HMOs, patients have been told, ``Well, you can't go to a particular specialist.'' The Patients' Bill of Rights ensures that patients who suffer from a chronic condition or a disease that requires care by a specialist will have access to a qualified specialist. If the HMO network does not include specialists qualified to treat a condition, such as a pediatric cardiologist to treat a child's heart defect, it would have to allow the patient to see a qualified doctor outside its network at no extra cost. And the Patients' Bill of Rights also allows patients with serious ongoing conditions to choose a specialist to coordinate care or to see their doctor without having to ask their HMO for permission before every visit. Another important provision in our Patients' Bill of Rights is access to an OB/GYN. The Patients' Bill of Rights allows a woman to have direct access to OB/GYN care without having to get a referral from her HMO. Women also would have the option to designate their OB/GYN as their primary care physician. The other thing, because, as I mentioned earlier, one of the major concerns right now is access to prescription drugs, well, under the Patients' Bill of Rights, it requires that needed prescription drugs be available to patients. Currently, many HMOs refuse to pay for prescription drugs that are not on their preapproved list of medications. As a result, patients may not get the most effective medication needed to treat their condition. The Patients' Bill of Rights ensures that patients with drug coverage will be able to obtain needed medications even if they are not on the HMO's approved list. Now, before I go on and talk a little more about the Patients' Bill of Rights, let me stress that what the Democrats have faced in this Congress is the fact that the Republican leadership refuses to bring up the Patients' Bill of Rights. They refuse to have a hearing in committee, they refuse to mark it up in committee, they refuse to bring it to the floor of the House of Representatives. This has been going on now since the beginning of this session, and we faced the same problem in the previous session of Congress. So what do we do? Well, what we did last week is we started a petition process. There is such a thing as a discharge petition which Members can sign on the floor of the House of Representatives; and if a majority of Members of this House sign the discharge petition, then that forces the Republican leadership to bring the bill to the floor to have a debate, to have a vote, to have the American people see us have the opportunity to vote on this bill. What we started last week was this petition drive. As of Friday, we had 180 signatures to our discharge petition, all Democrats. We are hoping, though, that we can eventually get some Republicans to join us; and we went through the same process last year in an effort to get the Patients' Bill of Rights to the floor. I assure my colleagues that over the next few weeks we will do our best to get to that magic number of 218 which will bring the Patients' Bill of Rights to the floor, if we can get that number, and I think we can, because I think there is a huge groundswell, if you will, of public opinion that wants to see this legislation brought to the floor. Let me just say a few more things about the Patients' Bill of Rights, what the legislation does. I stressed in the beginning this notion that doctors need to be free to practice medicine. Accountants, insurance companies, insurance company bureaucrats, should not be making medical decisions and deciding what type of care you receive. Yet some managed care organizations interfere with doctors' medical decisions and even go so far as restrict open communication between patients and doctors. I think that most people are surprised to find out that if the HMO does not cover the particular type of procedure or operation that your doctor thinks you need, that the HMO can actually tell the doctor that he or she is not allowed to tell you what that procedure is. It is called a gag rule, because, essentially, the doctor is denied his or her freedom of speech, their first amendment rights. That is just the most egregious example, and one of the things that the Patients' Bill of Rights does is to prohibit insurers, HMOs, from gagging doctors. But even more important is the idea that the decision about what is medically necessary, what is defined under the insurance policy to be medically necessary, is defined by standards within that particular specialty of care. In other words, right now if you have an HMO and the HMO decides that a particular procedure or a length of stay in the hospital, for example, is not what they want to cover, they will simply say that what is medically necessary for you does not include that. They will define what is medically necessary. What we do in the Patients' Bill of Rights is we say no, the decision about whether a particular cardiac procedure is medically necessary is defined, is made by the board of specialists for cardiology. The decision about whether a child should stay in the hospital, as my colleagues know, a certain number of days or the mother should stay in the hospital a certain number of days after the baby is born is not defined by the HMO, the insurance company, but defined by the specialist for pediatric care or for obstetrics, whatever happens to be that specialty defines what the level of care, what the treatment, what the equipment, what the number of days in the hospital should be. And that is very important because right now even if your HMO allows you to appeal the denial of care in a particular circumstance, that usually goes to a review board either within or outside the HMO that limits its review to whether or not the insurance policy is allowing you a procedure that they would normally allow. In other words, they allow what is medically necessary themselves, and all that the appeals process can do is to review whether they stood within the confines of their own definition of what is medically necessary. That is not the way it should be. It should be that those standards are defined by the doctors, by the specialist in that particular area and that that is what is reviewed when it goes to an external review board or when it goes to a court of law, and it is a very important part of all this. All we want to do is make the HMOs accountable for their actions. Some people have said to me, well, as my colleagues know, if you let an external review take place of whether or not someone should have been denied that particular procedure or if you let that person go to court and have the court decide, as my colleagues know, whether or not that denial of care was appropriate, you are going to have, as my colleagues know, endless lawsuits and the costs are going to go up and all this kind of thing. Well, none of that is true. I see my colleague from Texas has joined me tonight, and he has pointed over and over again how Texas has enacted a Patients' Bill of Rights, and none of those concerns about extraordinary costs or a lot of litigation have come true. But what we are really saying is that there has to be accountability, that the HMOs, just like anyone else has to be accountable for their actions, and, if you have an external review process that is independent, that does not have people from the HMO making those decisions, or if you allow someone to go to court to overturn a denial of care or to have someone recover because the care was not provided and they suffered damages, then in the long run the HMO will be more accountable. They will do the right thing from the beginning because they will be fearful that their decision, their wrong decision, will be overturned or that they have to pay damages in a court of law. So we are not really trying to do anything I think that most people do not already think should be the case, but, unfortunately, it is not the case. And I would point out that what we are seeing now on the Republican side, because I think they understand that this is a major issue and that they cannot keep denying us the opportunity to consider the Patients' Bill of Rights on the floor or in committee is that they have come up with their alternatives, what I call a piecemeal approach. They have introduced eight different bills to cover some aspects of the Patients' Bill of Rights, but those eight bills are woefully inadequate in terms of the kinds of protections that are needed, they do not look at this problem in a comprehensive way, and most importantly, the Republican bills that are put out there, these eight bills, do not define medical, what is medically necessary in a way that leaves it up to the physician and the patients to make that decision. They essentially leave it up to the HMO, and they do not have any kind of accountability because they do not have an external independent review process and they do not allow you to sue in a court of law. So we are going to go through this process, we are going to see the Republican leadership trying to say that they are going to do HMO reform, but hopefully our discharge petition will eventually force the Republican leadership to bring the Patients' Bill of Rights to the floor, and then we will have a full debate and a vote on the bill. I wanted to tonight also go into what happened today at the White House where the President unveiled his plan to modernize and expand Medicare and, of course, the prescription drug benefit that is so important as part of that. I think my colleague from Texas may have already discussed that to some extent tonight, but maybe what we can do, if I can yield to him, is we can talk somewhat about the Patients' Bill of Rights, and then we can go into the Medicare prescription drug benefit as well because I think it is so important, and I yield to the gentleman from Texas.

Mr. PALLONE. I want to thank the gentleman for his comments. Madam Speaker, I just wanted to comment on some of the remarks that my friend, the gentleman from Texas (Mr. Green), made because I think they are so significant. First of all, with regard to the Patients' Bill of Rights, the gentleman has set forth not only tonight but on many occasions, including last week when we had our Democratic Health Care Task Force hearing, on the fact that there is no question that under the Texas law, which is very similar to what we have, that some of the concerns that have been expressed about HMO reform legislation, like the Patients' Bill of Rights, have just not materialized. The fact that there have been almost no lawsuits, the fact that the cost increases have been really a few pennies, really, per month, and I think that is important because as much as we realize a lot of these criticisms are not justified, many of the insurance companies, many of the HMOs continue to make these criticisms and in many cases spend a lot of money trying to advertise potential problems that might exist with the Patients' Bill of Rights; and the Texas legislation, which has been in force now for about 2 years, shows rather dramatically that those criticisms are not legitimate. The problem, of course, is that this Texas law and the New Jersey law, which we have in my State, and all the State laws do not apply to the majority of the people who fall under a Federal preemption because their insurance is essentially Federal because their employer is self- insured or some other things that might bring them under Federal preemption. So we do need the Federal law, and I think we will get the Federal law if we keep pressing. I did want to switch because I did not hear the gentleman this evening but I knew that he was talking about the announcement that the President made today, and I think that we are going to see that his proposal for Medicare reform and expansion, albeit modest, is something that the majority of the people will become very supportive of. And we hopefully will not have to press the Republican leadership to bring that up for the vote; but if we have to, we will. If I could just talk briefly about the prescription drug benefit, I guess the hallmark of it, from what I understand, is that it will pay for half the cost of prescription drugs up to a total cost annually of $5,000 when it is fully in force, which I guess is in the year 2008. But initially when it goes into force, it will at least cover up to $2,000 annually, and we are talking about a premium which I think is about $24 a month beginning in the year 2002. So if this went into place the first time in 2002, one would be paying $24 a month; and this would apply to anybody who wanted to. It is a voluntary system, a new part B benefit, that anybody who wants to could pay the $24 a month, and they would be guaranteed in that year up to $2,000 of prescription drugs that they might incur. A thousand of that, half of that, would be paid for by Medicare. Then that premium would eventually go up, I guess, to $44 a month when fully phased in at 2008, but at that point it would cover up to $5,000 in costs. Now I say it is modest because I am sure some people will say, well, why is it not paying the whole cost? Why is it we only get 50 percent and we still have to put up the other 50 percent? I think we have to look at the realities of the situation. We know that everything costs money and that the Federal budget is not infinite. The President is basically saying that he is going to put 15 percent of the surplus into Medicare, and this will be one of the benefits of that. When I think of most of the seniors that I know, they would be very glad to pay that $24 a month and to have half of their drug costs subsidized by Medicare. The other thing which I do not think was heralded so much today but I am sure will be brought out as this unfolds is for beneficiaries with low incomes, below 135 percent of poverty, which I guess is defined as $11,000 for a single person or $17,000 for a couple, they would not pay premiums or cost sharing. Those with incomes between 135 and 150 percent of poverty would receive premium assistance as well, in the same way that we do with part B that covers the doctors' bills. I guess it is called the QMB. I have forgotten what QMB stands for, but these are people with low income who do not have to pay the premium. So between that and this $24 cost that anyone else wants to pay on a voluntary basis, I think it is a pretty good deal. I would like to see it go further, but I think it is a very good beginning and something that hopefully we can get bipartisan support for. I would yield to the gentleman from Texas (Mr. Green).

Mr. PALLONE. Madam Speaker, I want to thank the gentleman from Texas (Mr. Green) for his remarks. I know that we just heard about the details of this proposal today, but I am sure that over the next few weeks or few months we will be going into the details a lot more and basically pointing out the good points of the program. I just wanted to mention, it is estimated that about 31 million Medicare beneficiaries would actually benefit from the coverage that the President outlined today. The reason there are so many is because so many older and disabled Americans rely so heavily on medication. In other words, somebody who is younger might say, well, will I even incur $25 worth of prescription drug costs per month? But for people who are over 65 or the disabled that are covered by Medicare, most of them incur prescription drug costs that are well over the $24 premium per month. As I said, about 31 million people would benefit if they took advantage and opted into this new part B prescription drug benefit that the President has outlined. The other thing I would say about it is that the way the President is structuring this Medicare prescription drug benefit, it ensures beneficiaries discounts similar to that offered by many employer- sponsored plans estimated to be, on average, over 10 percent for each prescription purchased. That has nothing to do with the limit. In other words, it has built into the prescription drug program these kinds of discounts; and, of course, the Medicare subsidy to pay half the cost is beyond the discount that one would also get. So I think that is another very significant aspect to it. The other thing, there were a number of other things that the President mentioned today as part of the Medicare expansion that he unveiled, and I just wanted to mention a few of these because I think they are significant. Very significant is that his proposal eliminates all cost sharing for preventive benefits in Medicare and institutes a major health promotion education campaign. Let me just talk a little bit about that preventive aspect. One of the biggest criticisms that we have had over the years, not only of Medicare and Medicaid but just health care in general, is that we do not encourage prevention. Prescription drugs essentially are prevention. It used to be 30 years ago when Medicare was started that prescription drugs were not important because the emphasis on health care then was if one was in the hospital and if they had to have an operation they had the operation, and that was the way to cure them. Prescription drugs have become more available and more prevalent over the last 30 years since the 1960s when Medicare began because it was a preventive measure. One takes the prescription drugs to prevent getting further sick or having to be hospitalized or having the operation, but there are other preventive benefits in Medicare that are just as important. By eliminating existing copayments and deductibles for these kind of preventive services, I think the President goes far, combined with the prescription drug program, in stressing prevention as part of the Medicare program which is so important. He said today, just to give an idea of the kind of preventive services that would no longer have those copayments and deductibles, just to give some examples of the cancer screening, bone mass measurements, pelvic exams, prostate cancer screening, diabetes self- management benefits, mammograms, these are the kinds of preventive measures that I think should not have the copayment deductible because we want everybody to take advantage of them, a significant part of his proposal today. The other thing is he reiterated as part of his Medicare proposal today the Medicare buy-in for the near elderly. The plan includes the President's proposal to offer any American between the ages of 62 and 65 the choice to buy into the Medicare program for approximately $300 per month; displaced workers even at a lower age. Displaced workers between 55 and 62 who had involuntarily lost their jobs and insurance could buy in at a slightly higher premium, approximately $400 per month. So what we are seeing here is an effort by the President to expand Medicare to the near elderly at no additional cost because this would be the cost of having those people enter into the Medicare program. I think that is also significant. The last thing I wanted to mention on the President's Medicare proposal today, I think my colleague, the gentleman from Texas (Mr. Green) already touched on it, but I wanted to reiterate that his proposal extends the life of the trust fund, the Medicare Trust Fund, until at least 2027. A lot of my constituents come up to me and say, is Medicare going to be there in a few years? Well, the answer is that if the President's plan is adopted, it will be. It will be there at least until 2027. He does that by dedicating 15 percent of the surplus, which is $794 billion over 15 years, to Medicare, to insure the financial health of the trust fund through at least the year 2027. We will go into this more, Mr. Speaker, as we get a chance to look at his proposal in more detail over the next few weeks. On Turkish Intransigence and Concerns Regarding the Entities List Against Turkey and Pakistan.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, in this day of managed care and health maintenance organizations, it is easy to lose sight of the dedicated individuals in the medical profession who have devoted their lives to the care of others. Tomorrow night, the staff at Monmouth Medical Center will honor just such an individual. Dr. Herbert Edward Poch will be retiring as director of Newborn Nursery at the hospital. His departure means the loss to Monmouth Center of a deeply-caring, personally-involved and highly-skilled pediatrician. To the nurses on staff, Dr. Poch is ``a grandfatherly figure who watches over us like a hawk and is never too busy to buy us lunch.'' on a daily basis, he provides the extra touches that turn a building of stone and glass and antiseptics into a congenial work place for staff, and a wonderful, state-of-the-art welcome center for new babies and their parents. Dr. Poch's professional expertise combined with his warm and engaging manner have made those first fragile days of life and parenthood easier and safer for thousands of families. In addition to being an outstanding physician and administrator, Dr. Poch is a teacher of medical students and physician assistant students in the nursery and the outpatient departments. He has shared his knowledge with others in many lectures and symposiums. By virtue of serving as the model for the Monmouth Medical Center Advertising Campaign and being featured on billboards, bus posters and print ads, Dr. Poch is a familiar figure and symbol of the many find medical practitioners throughout Central Jersey. Dr. Poch earned his bachelor's degree from Columbia College--where he was captain of the Varsity Basketball Team--and his medical degree from the Columbia University College of Physicians and Surgeons. He interned at Kings County Hospital in Brooklyn, N.Y., and completed his residency at Babies Hospital, Columbia Presbyterian Medical Center. He was the medical director and original founder of the Make-A-Wish Foundation of New Jersey in the early eighties and was honorary trustee of the Ronald McDonald House of Long Branch from 1992 to 1998. Throughout his career, he has been very active in many community, athletic and public service endeavors. To my friend and neighbor, Dr. Poch, I say congratulations on an outstanding career in medicine and a well-deserved reputation as a man of great character and compassion.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I commend my New Jersey colleagues on both sides of the aisle and in both Chambers for introducing this bill and for helping to bring it to the House floor so rapidly. Mr. Speaker, this bill is important, because the State of New York has once again attempted to declare war on New Jersey. First, New York was dumping its garbage in New Jersey, then it was contaminating our shores with its dirty water and, after that, its needles were washing up on our beaches. Now, the New York Legislature has once again tried to harm New Jersey residents--this time, by discriminating against many of our hard-working residents trying to earn a living by working in New York City. The New York law would have repealed a commuter tax for New York residents, but not for non-residents. Foutunately, last Friday, the New York State Supreme Court ruled that the New York law is indeed unconstitutional. I am pleased at this outcome, but not surprised. This was such a blatant attempt at discrimination; I don't know how anyone could have ruled otherwise. In addition, several earlier court cases have ruled that there must be equality between states, and that states cannot discriminate between residents and nonresidents. I am pleased that the Court has ruled justly on the cases pertaining to the New York legislation. However, we must work to prevent this type of discrimination in the future and prevent any attempt to appeal this ruling. And, rather than discriminating against New Jersey residents, Governor Pataki should welcome New Jersey residents and other out-of- state commuters with open arms. Our residents help New York businesses to thrive, and thereby foster the growth and prosperity of New York City and the entire State, in turn. Moreover, these New Jersey residents generate revenue for New York by eating in restaurants, shopping in stores, and engaging in other local commerce. Repealing the commuter tax for New York commuters alone is blatant discrimination that would only discourage New Jersey residents from supporting New York's businesses. And, we all know that New York residents enjoy the beaches and recreational opportunities New Jersey offers. New Jersey does not unfairly discriminate against New York residents taking advantage of our wonderful natural resources. Nor do we intend to do any such thing. For these reasons, I am here today to join my colleagues in protesting New York's attempt to repeal this commuter tax for in-state residents only. This repeal for in-state residents alone violates the Interstate Commerce Clause and amounts to discrimination for out-of- state residents, primarily in my home state of New Jersey as well as Connecticut. I will not tolerate discrimination of residents in my home state--or anywhere--and will stand by those who protest this type of discrimination. I pledge to do my part to permanently resolve this problem. That is why I have cosponsored the anti-discrimination legislation before us, H.R. 2014, that would prohibit a state--in this and in all cases--from imposing a discriminatory commuter tax on nonresidents. I urge my colleagues to join me in supporting this bill, which I hope will pass overwhelmingly in the House and Senate.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, last Sunday one of the newspapers in my home State of New Jersey, the Newark Star-Ledger summed up the outcome of the Kosovo conflict in an insightful editorial. The headline of the editorial says it all, in my opinion: ``NATO Got It Right.'' I would like to read a few passages from the editorial. It begins, and I quote, The case for our intervention in Kosovo is still being made. The evidence turns up daily corpse by corpse, mass grave by mass grave, massacre by massacre. Claims of ethnic cleansing were treated with a certain skepticism when the bombing went on. Were the atrocities really that bad or was this just a case of war-time exaggeration? We now have our answer. The editorial goes on to cite an estimate by the British Foreign Office that 10,000 Kosovars were the victims of mass executions by the Serbs. Then the editorial poses perhaps the most important question of all, and I quote, ``Still, how much worse would it have been if NATO had not intervened? The dimensions of unchecked genocides are a matter of guesswork.'' What we have seen, Mr. Speaker, in Kosovo is a genocidal campaign by the Serb forces that was halted by NATO's intervention. Moreover, the success of our military intervention resulting in the quick withdrawal of the Serb forces has allowed for the genocide to be documented essentially in real time. Yes, there were some crude efforts by the Serbs to conceal the evidence of the atrocities that they had committed, but the grizzly discoveries being made every day by the allied troops offer compelling proof, irrefutable testimony of what happened. It will be difficult for future revisionist historians to deny what happened in the villages and fields of Kosovo. Mr. Speaker, this is an extremely important development. Throughout the 20th century genocide has occurred while the world looked the other way. It is, of course, impossible to conceal all evidence of the mass murders of thousands or millions of people. But in past cases of genocide, the world only found out what happened after the fact. For example, in the years during and after World War I, 1.5 million Armenians were massacred by the Ottoman Turkish Empire. At that time the term genocide had not yet been coined to describe mass murder of a civilian population as part of a government policy. During the Armenian genocide, word started to filter out about mass atrocities and a flood of refugees into neighboring countries offered firsthand testimony. Relief operations were set up, but the Ottoman forces were able to cover up much of the evidence, not only while the genocide was occurring but also after the fact. After the collapse of the Ottoman Empire, there was no allied occupation. The killing fields remained under the control of those who committed the genocide. To this day, Turkey still denies that the Armenian genocide took place. Mr. Speaker, during the Second World War there were strong indications that the Nazi persecution of European Jews had reached a new level of barbarism. There are many indications that the allied governments were largely aware of the Nazi holocaust while it was going on, although this information was not known to the general public. With the defeat and occupation of Germany and the liberation of the concentration camps, it became apparent for the world to see what had occurred was a degree of mass murder so extreme a new word had to be invented, the word genocide. The evidence of the holocaust was documented. The world was utterly shocked by what happened and the international community solemnly vowed: ``Never again.'' The genocide was documented, but only after 6 million Jews and millions of other victims had been murdered. What we have seen in Kosovo may represent a major historical turning point. Not only have we documented genocide as it occurred, but we have acted to prevent more widespread slaughter. And I hope this will serve as a precedent for our future resolve and commitment. More important, I hope our action in Kosovo will deter a future Milosevic before he imbarks on a policy of genocide. To quote again from the Star-Ledger editorial: Our intervention in Kosovo demonstrates our internationalist tradition is still in place and that a multi-national intolerance of mass murder has developed. While we cannot be policemen to the world, we are also not willing to see this type of barbarism prevail, particularly in an area that was a battleground for two world wars. Mr. Speaker, America's military intervention, with our NATO allies, on behalf of the people of Kosovo, was a just and a moral cause, a noble effort. The successful campaign in the Balkans, like so many of our country's international triumphs, was motivated both by idealism and by our national interests. There was clearly an altruistic motive in stopping the Serb dictator Milosevic from carrying out his plans to drive the ethnic Albanians from their homes in Kosovo. But there was also the pragmatic recognition that instability in the heart of Europe threatens American interests. We fought two world wars on European soil, and held the line against Soviet expansionism for nearly half a century. We have learned the lesson of history, that a murderous, aggressive, genocidal regime must be stopped before causing widespread instability and death. We can be very proud of the courage and professionalism of our men and women in uniform who carried out this operation. We can be proud of the American technology that allowed us to achieve our objectives so successfully with no combat casualties. And we should also be proud of our political leaders for taking a stand against aggression and ethnic cleansing, and for staying the course when a successful outcome appeared far from certain. President Clinton and his national security team deserve great credit for their leadership. The leaders of some of the allied nations faced difficult internal opposition but still showed great resolve, for which they deserve our respect and gratitude. Mr. Speaker, in the past few months, there has been a shocking lack of support for our commander-in-chief on the floor of this House, as members of the Republican Party, including some in very senior leadership positions, have talked about the Kosovo campaign as the ``Clinton-Gore War,'' trying to score cheap political points while our armed forces were involved in combat operations. I don't want to cast this debate in purely partisan terms; there were some members of the Republican Party who strongly supported this operation, while other Republicans at least had the decency and good taste to express their reservations in more restrained language. And there were also members on this side of the aisle who expressed misgivings about the operation. Fair enough; this is a democracy and this House should be a place of vigorous, sometimes partisan debate. But now that we have clearly achieved a military victory and are implementing our political objectives, I would have hoped that the opponents of the Kosovo operation would offer at least grudging support. Instead, during the recent debate on the Defense Authorization bill, there were some in this House who, because of their animosity for our President, still saw fit to criticize the President and his national security advisers and to try to argue that the Kosovo operation was not a success. I guess you have to accept a certain amount of partisanship, but I still remember the days when our differences ended at the water's edge. You only have to go back to the early part of this decade, to the Gulf War. I voted to support President Bush's decision to use force to oust Iraqi forces from Kuwait. Many in my party did not support that decision. But once the conflict began, there was bipartisan support-- not only for the troops and the operation, but for the President himself and his national security team. After our victory in the Gulf War, President Bush, a Republican, received an enthusiastic, triumphant reception here from a Democratic Congress. I hope we can get back to that kind of bipartisan consensus when it comes to our nation's international commitments. Mr. Speaker, I did want to cite one positive development that came out of the human tragedy in Kosovo. Thousands of Kosovar refugees have been given temporary shelter at Fort Dix in my home state of New Jersey. The outpouring of support from the community has been extremely impressive. I think it says a lot about the true character of the American people, about our willingness to help out those who are in need. Mr. Speaker, it's true: NATO did get it right. We still have a lot of hard work ahead of us. Slobodan Milosevic and his henchmen must be held accountable for their crimes. The challenges of rebuilding Kosovo are enormous. Likewise, helping a post-Milosevic Serbia get re-integrated into the family of civilized nations is a daunting, but urgent challenge. I am very hopeful that we can move forward as a nation--with the support and commitment of our European allies--to achieve these goals. In the half-century since the Holocaust, we have said ``Never again.'' In Kosovo, we finally proved that we meant it. Mr. Speaker, I provide for the Record the complete article I referred to earlier. [From the Sunday Star-Ledger, June 20, 1999] NATO Got It Right The case for our intervention in Kosovo is still being made. The evidence turns up daily--corpse by corpse, mass grave by mass grave, massacre by massacre. Claims of ethnic cleansing were treated with a certain skepticism while the bombing went on. Were the atrocities really that bad or was this just a case of wartime exaggeration? We now have our answer. As NATO troops entered Kosovo, they found each day substantial evidence of widespread slaughter. Much came from eyewitnesses, but there was accompanying testimony from those who could not speak, the dead, buried in mass graves. The assessment by the British Foreign Office that 10,000 Kosovars had been the victims of mass executions by the Serbs is chilling. Still, how much worse would it have been if NATO had not intervened? The dimensions of unchecked genocide are a matter of guesswork. The international war crimes tribunal has begun its forensic investigation in Kosovo, and it will not be hard to find further proof of such atrocities. While the war may have been bungled and the assumptions that prompted our tactics were sometimes naive, there now should be little doubt that our resolve that action had to be taken was well-founded. Our intervention in Kosovo demonstrates that our internationalist tradition is still in place and that a multinational intolerance of mass murder has developed. While we cannot be policemen to the world, we also are not willing to see this type of barbarism prevail, particularly in an area that was a battleground for two world wars. There is one more step to be taken. Yugoslav President Slobodan Milosevic has been cited as a war criminal by an international tribunal. We must see that he, along with the other butchers of Bosnia and Kosovo, answers to these charges.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I once again would like to call on the Republican leadership to bring up the Patients' Bill of Rights. I think many know that on Wednesday of this week, the Democrats initiated a discharge petition on the Patients' Bill of Rights, and as of yesterday afternoon, we had over 180 Democratic Members who had signed that petition to bring this HMO reform bill to the floor. Yesterday also in the Senate, there was major action on the part of the Democrats to try to bring up the Patients' Bill of Rights, and also I should point out that the AMA, the American Medical Association, had a vote the other day which strongly indicated why we need HMO reform. I think it is abundantly clear that the American people, the Democrats and even some of the Republicans other than the Republican leadership are very supportive of HMO reform in a comprehensive way that essentially would be brought about most effectively by the Patients' Bill of Rights. It is time to bring this up. It is time to stop talking and have some action on this issue which is so critical to the American people. More people contact my office about the problems that they have with managed care and the lack of patient protections than any other issue, and the horror stories continue. We must take action.