Frank Pallone

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I want to thank the gentleman. If I could just follow up on a couple of things that he said. We had today in the Committee on Commerce a subcommittee hearing on the question of independent and external review, which again I was somewhat critical of the fact that the Committee on Commerce, which has the major jurisdiction over health care in the Congress, has not had a hearing on the Patients' Bill of Rights but now again is sort of taking this piecemeal approach and looking at little pieces of this. But I would say that the issue of holding managed care companies responsible for denial of care with a real, reliable, and enforceable appeal and remedy is an important issue. One of the things that came up was we had testimony from someone who was involved in the Texas law, and Texas has a very good law on the books that incorporates a lot of the patient protections that we have in the Patients' Bill of Rights, but one of the points that she made was exactly what the gentleman from Minnesota (Mr. Vento) made, which is that this is great for Texas but the majority of Texans do not take advantage or cannot because of the ERISA Federal preemption that we have as a matter of Federal law. One of the things that was stressed was that when Texas imposed an independent external review process, if they had been denied a particular treatment, one of the Federal courts has recently actually ruled that Texas did not have the power to do that at all because of the ERISA Federal preemption. So it just, once again, brings home the fact of why we need action on the Federal level. The other thing that I thought was interesting was that I thought it was sort of painfully obvious at this hearing that there were several Republican Members who really supported a comprehensive approach and essentially agreed with all the Democrats that this is what we should be doing, yet it was very obvious that the Republican leadership had no intention of doing that. So again, there are some Members that will join us on the other side and, hopefully, will sign our petition so we get to the 218. But so far, the Republican leadership has slammed the door and said, there is no way we are going to consider this Patients' Bill of Rights, and that is very unfortunate and what we have to keep fighting for. I want to just briefly, if I could, mention some of the key things that we are fighting for in the Patients' Bill of Rights. And then maybe I will yield to one of my colleagues that are here joining me this evening. The two most important things that I would say, one is this whole issue of providing for real enforceability. What happens now with many HMOs is that if they deny them care or particular treatment, the only review or appeal they have is an internal one within the HMO. And of course, they, being very prejudiced in most cases, will simply deny the appeal. What we are saying is that there has to be an independent external appeal outside the HMO; and, in addition to that, there has to be ultimately the right to sue the HMO, which does not exist today under the Federal preemption. That is one of the most important aspects of the Patients' Bill of Rights. The other one that is linked to that is the definition of ``medical necessity.'' Right now the insurance company decides what is medically necessary; and if they define that and all that happens once they are denied care or treatment is that that is reviewed, their own definition of what is medically necessary, then, even if they have a good independent appeal or the right to sue, it will not necessarily help them because they are using their definition. What we say in the Patients' Bill of Rights is that the decision about what is medically necessary, what kinds of care they should receive should be made by the physician and the patient based on standard norms within the medical community for that particular specialty or whatever it happens to be and not by the insurance company. Those are the two key aspects that are not included in any of these eight piecemeal bills that are being circulated by the Republicans in the House or the legislation that the Republicans are bringing up in the Senate. Neither of those key points are included. Mr. Speaker, I yield to the gentlewoman from California (Mrs. Capps), who has a background as a nurse and who has been on the floor many times talking about this issue in very real terms because of her own experience.

Mr. PALLONE. Mr. Speaker, I thank the gentleman. I know our time has run out, but I think the gentleman said it well about using the Texas example to show how what we are proposing here works and has worked in Texas over the last two years.

Mr. PALLONE. Absolutely, and it was not just done to me; it was done to others as well. And the irony of it is what you just said which is that, you know, if you look at what we are actually asking be done, it is not going to put them out of business. In fact, today in the Committee on Commerce we had someone come in who was responsible and put together the Texas law which is very similar to our Patients' Bill of Rights, and as my colleagues know, one of the things she said was that all the debate in the State legislature in Texas about this, all the managed care and HMOs were saying we are going to be out of business, there will no longer be any managed care in Texas. In fact just the opposite is true. They have not suffered at all. There are more managed care options in Texas today in fact than in a lot of other States even though they have a very similar law on the books. So we are not hurting them, but obviously they perceive that we are, and they are wrong, but we just have to keep making the point, so I want to thank you again for coming down. And I would like to yield now to the gentleman from Maine who has not only been outspoken on this issue, but also on the issue of the cost of prescription drugs in a bill that he has sponsored to try to correct that problem, and he has been concentrating on these health care issues that impact all Americans. I yield to the gentleman.

Mr. PALLONE. I want to thank the gentlewoman. One of the things that I have noticed about newer Members like yourself is that you are always trying to get the public more involved through the Internet process. That is really great. I assure you that you are going to get all kinds of people contacting you, because the number one issue that I get contacted about in my district offices are problems with HMOs and managed care. Again, I just stress what I said before, which is that we are not coming at this out of some cloud or pie in the sky notion. This is just what people are telling us on a regular basis. People are shocked when you tell them as the gentlewoman from California brought up and talked about the gag rule. I have told some of my constituents, the way the law is, the insurance company can tell the doctor that they cannot discuss with you a mode of treatment that is not covered by the insurance, even though they think you should have it. They cannot believe it. They think that that is a violation of the first amendment or un-American. Of course it is, all those things, but they are just shocked to find out that that is okay under the law. Really we are just talking about common sense proposals that are coming to us. You will get a lot of them, I am sure, on the web site. Mr. Speaker, I yield to the gentleman from New York (Mr. Serrano) who again has joined me quite often in the past on this and other issues and I am pleased to see him here tonight.

Mr. PALLONE. I want to thank the gentleman, and if I could just comment on what he said about why the Republicans will not bring it up. I sound so cynical in saying it, but I believe strongly that it is the power of the insurance industry and the power of the insurance lobby, and I, as my colleagues know, witnessed that myself. I mean they spend millions and millions of dollars on TV ads talking about why the Patients' Bill of Rights and HMO reform should not take place. In fact, in my last election about $4 million was spent in independent expenditure by, primarily by, the HMOs to try to defeat me because they see me as a spokesman on the issue. So they are willing to spend all this money.

Mr. PALLONE. Madam Speaker, let me say that this evening my plan is to discuss the Democrats' Patients' Bill of Rights. I think many of my colleagues know that within the Democratic party we have, for several years now, highlighted and prioritized HMO reform as one of the major issues that we would like to see addressed in the House of Representatives, and our answer to the need for managed care/ HMO reform is a bill called the Patients' Bill of Rights. And we call it the Patients' Bill of Rights essentially because it is a comprehensive way to provide protections to patients against some of the abuses that we have seen within managed care and within HMOs. The reason I am here tonight, Madam Speaker, is because I want to highlight the fact that once again in this session of Congress, and just like the last session of Congress, Democratic Members, including myself, have been forced to resort to a petition process, what we call a discharge petition, that many of us signed. Today we started the process, this morning, and I believe now there are 167 Members, Democratic Members, who have signed a discharge petition at this desk over here near the well, because we have not been able to get the Republican leadership, which is in charge of the House of Representatives, to have a hearing or have a committee markup or bring to the floor the Patients' Bill of Rights. That is an extraordinary procedure, to move to the discharge petition. It is something that the minority usually is not required to do because the majority party allows debate, or should allow debate, on issues that are of importance to the average American. But in this case, once again, I would suggest that the reason is because the Republican leadership is so dependent on the insurance industry and so determined to carry out the will of the insurance industry that they have been unwilling to let the Patients' Bill of Rights be considered in committee or come to the floor. In fact, what we saw last year in the House and what we are seeing again this year in the House is essentially a three-pronged strategy by the Republican leadership to deny a full debate and vote on the Patients' Bill of Rights. First of all, they simply delay for 6 months, since January, by not allowing the bill to be heard in committee or marked up in the committee. And then, when that seems to fail because the pressure gets too strong that they have to do something, they come forward with what I call a piecemeal approach. Just the other day, about a week ago, in the Committee on Education and the Workforce, one member of the Republican leadership brought eight individual bills that were purported to deal with the need for HMO or managed care reform. But those were individually bills or collectively bills that did not add up to much in terms of adequate protections for patients in HMOs. And I would say that, once again, this piecemeal approach is a way to avoid having the comprehensive bill, the Patients' Bill of Rights, heard. In fact, when the ranking member, the senior Democrat on the Subcommittee on Postsecondary Education, Training and Life-Long Learning, that sought to bring up the Patients' Bill of Rights, he was essentially gaveled down and told that he was out of order in trying to raise the Patients' Bill of Rights in committee. And what happened today, my understanding is, that even some of the Republicans on the committee, who are not in the leadership and basically did not support the Republican leadership, threatened if they were not allowed to bring more comprehensive patient reform or HMO reform to the full Committee on Education and the Workforce, that they would basically support the Democrats and ask that the Patients' Bill of Rights or a more comprehensive approach be brought up. They essentially defied the Republican leadership. It is nice to know that there are some Republicans here that are willing to defy the leadership over this very important issue of HMO reform. But, unfortunately, the leadership is still in charge and they simply postponed the markup on those HMO reform bills. Now, the next step is, because we are signing this discharge petition, because so many of us will eventually sign this discharge petition, the next step in the effort to stifle managed care reform was what we saw last year in the Republican Congress, which is they then bring up a bill which is so loaded down with nongermane issues, like medical malpractice, medical savings accounts, health marts, that it obscures the basic patient protection legislation and causes such mucking up of HMO reform that the bill ultimately dies of its own accord. So I do not know what the Republicans are going to do this year, but from what I can see they are simply stalling, refusing to bring up the Patients' Bill of Rights, and we are all, Democrats and friendly Republicans, going to have to keep pushing and pushing with our discharge petition. I would like to yield now to a member of the Committee on Education and the Workforce, the gentleman from Minnesota (Mr. Vento).

Mr. PALLONE. I want to thank the gentleman, and I am glad you brought up the point about the drug formularies as well because there is that aspect of the bill as well, and the other thing I wanted that you brought up and I want to stress again is that, as my colleagues know, in some ways maybe we are fortunate in that we had to move this discharge process very late in the session last time. Even though 6 months have passed, if we are able to get not only all the Democrats to sign on to this discharge petition, but also able to get a few of our Republican colleagues, we still do have some time left to try to get this to the floor, and hopefully we will be successful, and we are certainly going to keep trying until we are successful and we do bring the bill to the floor. So I want to thank the gentleman again, and I also want to yield now to the gentleman from Texas (Mr. Green), my colleague on the Committee on Commerce, and he has been really outstanding in particular in pointing out how in his home State of Texas where they have actually enacted significant patient protections and what a positive impact that has had on the State even though it does not apply, of course, to so many people that have been preempted by the federal law. I yield to the gentleman.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, as both Houses of Congress work to lift the unilateral American economic sanctions on India and Pakistan, an effort I strongly support, another dangerous issue has been introduced into the mix, threatening stability in South Asia. Mr. Speaker, a provision in the defense appropriations bill, recently approved by the other body, the Senate, would suspend for 5 years the sanctions imposed last year on India and Pakistan after the two countries conducted nuclear tests. Last week, in this body, legislation was approved that would continue for 1 year the President's authority to waive the sanctions. These are worthy initiatives that I hope we can build on. But, Mr. Speaker, the Senate legislation also includes language that would repeal the Pressler amendment prohibition on U.S. military assistance to Pakistan. In 1985, Congress amended the Foreign Assistance Act to prohibit all U.S. aid to Pakistan if the President failed to certify that Pakistan did not possess a nuclear explosive device. Known as the Pressler Amendment, after the distinguished former Senator who sponsored the provision, this law arose from the concern that Pakistan was ignoring U.S. concerns about proliferation, despite promises of billions of dollars of U.S. assistance. In 1990, President Bush invoked the Pressler amendment to block aid to Pakistan. Now, the Senate has acted to repeal the Pressler amendment. Mr. Speaker, I believe this is a serious mistake, as nothing has changed to justify the repeal of the Pressler amendment. Indeed, in recent weeks we have seen strong indications of Pakistani support for militants who have infiltrated into India's side of the line of control in Kashmir. Besides the so-called political and moral support for the militants that Pakistan acknowledges, there is growing evidence that Pakistan is providing material and logistic support for the militants, and that Pakistani army regulars are actually taking part in breaching the internationally recognized line of control in Kashmir. This is really in a cynical bid to ratchet up the tensions between India and Pakistan, and at such a time it does not seem prudent, in my opinion, to renew military transfers to Pakistan. Mr. Speaker, given the long and well-documented history of Pakistani support for and collaboration with the militants who have been perpetrating a reign of terror in Kashmir, there is every reason to believe that providing U.S. arms to Pakistan would result in these American weapons being funneled to the militants. By arming Pakistan, we would be arming the militants responsible for the deaths of thousands of civilians in Kashmir, and who are now contributing to the escalating tensions with India. Mr. Speaker, there was an article in Saturday's New York Times entitled ``Kashmir Militants Seek Islamic State,'' and it describes how Islamic militants from several different nations are working to transform Kashmir from a tolerant secular democratic state, that people from many faiths call home, into an area under strict Islamic religious rule. I wanted to quote from this article by Times reporter Steven Kinzer. He says, The campaign is in part a legacy of the proxy war the U.S. waged against Soviet forces in Afghanistan during the 1980s. The article describes how having succeeded in driving the Soviet forces out of Afghanistan and establishing a form of religious rule there under the Taliban, these warriors are now turning their attention to Kashmir. And quoting again from the Times article, it says that, In Srinigar, the summer capital of Kashmir, militants from countries as far apart as Indonesia, Sudan and Bahrain have given interviews asserting that they learned the art of war from Americans and are now using their skills to fight the Indian Army. Many are evidently using not only tactics that Americans taught them, but also weapons Americans gave them. In fact, the article notes how an Indian helicopter was shot down by an Islamic guerilla using an American made stinger missile, and that about a dozen more stingers, each capable of shooting down a plane or a helicopter, are unaccounted for in the region. The U.N. envoy in Srinigar is quoted as saying that, Weapons provided for Afghanistan with large help from the Americans and CIA are now in the hands of the militants. An Indian Army colonel states that, ``The militants are using not only small arms that they got from the Americans, but also Stinger missiles and American anti-tank weapons. It's not only weapons, but also battle-hardened troops. It's a direct result of the American policy in Afghanistan.'' Mr. Speaker, the Soviet defeat in Afghanistan was an important turning point contributing to the collapse of the Soviet Empire. Yet, one of the unintended consequences has been the creation of a radical movement of armed terrorists, mercenaries and militants who have imposed a repressive regime in Afghanistan, are trying to take over Kashmir, and who seem to have a great deal of influence within the Pakistani government and armed forces. Mr. Speaker, I just want to say that during the Cold War our fear of Soviet expansionism led us to embrace regimes like Pakistan that do not share our values of democracy and tolerance. But in the post-Cold War era, there is no justification for militarily propping up such a regime. Maybe we cannot completely stop the militants who threatened Democratic India as well as American and western interests, but we can at least make sure we do not give them what they want most, and that is American arms. Sending military assistance to Pakistan amounts to a guaranty that these American weapons will be funneled to the militants. And given this sad reality, we must not repeal the Pressler amendment.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, on Saturday, June 26, the Saint Peter Society (San Pietro Apostolo) of Long Branch, NJ, will pay tribute to one of our leading citizens, Mrs. Angeline Bonforte. It is a great honor for me to join in recognition and raise of someone who has contributed so much to our community. Angie Bonforte's motto is ``never stop.'' Seeing all that she has accomplished, and continues to do, makes it clear that these are the words she lives by. The daughter of Dominick and Florence Pingitore, Angeline was born in Little Falls, NY. The family moved to Long Branch, and Angeline graduated from Long Branch Senior High School. She went on to earn a B.S. degree from Trenton State Teachers College, and then pursued a distinguished career as an elementary school teacher at Star of the Sea School in Long Branch for 25 years. In addition to being a teacher, she also became a real estate agent. Angeline married Rocco Bonforte and they have two daughters, Mary Ann and Carol Lynn. Mr. Bonforte is also one of Long Branch's best known and most celebrated citizens, having served as Police Commissioner of our City. While steadfastly supporting her husband's political endeavors, Angeline Bonforte has been a leader in her own right. He served as President of the Women's Auxiliary of the Amerigo Vespucci Society, President of the Women's Democratic Club of Long Branch and the Women's Democratic Club of Monmouth County. She has also served as a Trustee of the Long Branch Public Library and has been associated with several civil and local clubs and activities. While Angeline is ``officially'' in retirement now, she is still extremely active, including her involvement on a daily basis in Carol Lynn and Don Chetkin Art Gallery in Red Bank, NJ. When here in the nation's capital, she is at work in her granddaughter's business. Mr. Speaker, it's a privilege to include in the pages of the Congressional Record some of the achievements of Angeline Bonforte on the occasion of her being honored by San Pietro Apostolo.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, yesterday, in the other body, the Senate, the Appropriations Committee, marked up the foreign operation appropriations legislation for fiscal year 2000. The legislation reported out yesterday addresses several key issues concerning U.S. policies and priorities for the Caucasus Mountain region of the former Soviet Union, an area of vital and growing importance for the U.S. in the 21st century. Here in the House, action on the foreign operations bill is not expected until later this summer. I wanted to take a few minutes to cite some of the key provisions in the Senate legislation that I hope the House will address, as well as to cite some additional areas where the Senate did not act, but I hope the House will. As cochair of the Congressional Caucus on Armenian Issues, I plan to put my suggestions into a letter to the House Subcommittee on Foreign Operations, and that subcommittee, I should point out, has many good friends of Armenia, and I look forward to working with them. First, the good news, Mr. Speaker. The Senate Foreign Operations bill earmarks $90 million in assistance to the Republic of Armenia. This represents an increase over the slightly less than $80 million that was reported in fiscal year 1999, and is certainly an improvement over the $71.5 million requested by the administration in its budget. I believe it is important for the United States to maintain our support and partnership with Armenia, which continues to make major strides towards democracy, as evidenced by last month's parliamentary elections, as well as market reforms and increasing integration with the West. However, Armenia's strides towards providing a better life for its people at home and being a partner for peace and stability with the West continue to be challenged by the blockades imposed by the neighboring countries, Azerbaijan and Turkey. Provisions of U.S. support provides at least some relief from the difficulties imposed by the blockades and represents a moral statement by our country that we should try to offset the effects of the illegal blockades imposed on Armenia by its neighbors. I would urge the House subcommittee to provide the same $90 million earmark that has been included by the Senate. Mr. Speaker, another area where I will be working to have the House follow the Senate language is with regard to something that is not there, and that is repealing section 907 of the Freedom Support Act, which restricts aid to Azerbaijan until that country lifts its blockade of Armenia and Nagorno Karabagh. Last month, Secretary of State Albright called on the Senate appropriators to repeal section 907. When the Freedom Support Act was adopted in 1992, establishing our post-Cold War U.S. foreign policy for the Newly Independent States of the former Soviet empire, section 907 was included as a way of holding Azerbaijan accountable for the blockade of its neighbors. Azerbaijan has continued its strategy of trying to strangle Armenia and Nagorno Karabagh. I am glad the Senate appropriators resisted the administration's proposal to lift section 907. As I just indicated, Azerbaijan's blockade is against both the Republic of Armenia and the Republic of Nagorno Karabagh. Nagorno Karabagh is an historically Armenian-populated region that Stalin's mapmakers included as part of Azerbaijan. Because Nagorno Karabagh's independence has not been officially recognized by the United States, it was a tremendous breakthrough when Congress approved $12.5 million in assistance for Nagorno Karabagh in the fiscal year 1998 legislation. Unfortunately, much of that assistance has yet to be obligated, and while the Senate is silent on this issue, I will be working with my Armenia issues caucus colleagues to ensure the House bill also provides report language directing the Agency for International Development to expedite delivery of this assistance. Another area where the Senate bill is silent is on the issue of the peace process for Nagorna Karabagh. The U.S. has been one of the countries taking the lead in the peace process under the auspices of the Organization for Security and Cooperation in Europe. And late last year, the U.S. and our negotiating partners put forward a proposal known as the Common State Proposal as a basis for moving the negotiations forward. Despite some serious reservations, the elected governments of both Nagorno Karabagh and Armenia have accepted this Common State Proposal to get the negotiations moving forward, but Azerbaijan has flatly rejected our peace proposal. I will work, Mr. Speaker, to include language in the House foreign operations appropriations bill to urge the administration to stay the course in the Nagorna Karabagh peace process and not let the rejectionist policies of the Azerbaijan cause us to back down in the search for a just and lasting solution to this conflict, providing for the full self-determination of Nagorno Karabagh. I do appreciate the fact that the Senate did not buy into the administration's inexplicable proposal to increase aid to Azerbaijan and decrease aid to Armenia. As I indicated, the Senate language provides for an increase in assistance to Armenia. It does not provide any specific mention of aid to Azerbaijan. With the break-up of the Soviet Union, as the countries of the collapsing empire attained their independence, Azerbaijan attempted to militarily crush Nagorno Karabagh and drive out the Armenian population. But the Karabagh Armenians ultimately won their war of independence, and a cease-fire was signed in 1994. American humanitarian assistance to Azerbaijan, via Non-Governmental Organizations (NGOs) has not been affected by Section 907. In recent years, further exemptions to Section 907 have been carved out. It is important that, at a time when Azerbaijan continues to reject good- faith efforts to achieve a negotiated settlement to the Nagorno Karabagh conflict, while illegally blockading supplies of fuel, food and other essential supplies to its neighbors, that we not reward this country with additional U.S. assistance. Mr. Speaker, I look forward to working with my friends on the Subcommittee on Foreign Operations, Export Financing and Related Programs to craft legislation that supports Armenia.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, in my home state of New Jersey, at this very moment, children and their parents are starting to pack for their weekend at the Jersey Shore. And they are imagining the beautiful beaches and ocean waters that await them and all the fun and good memories that the coming weekend holds. Most of these weekend visitors take the Jersey Shore for granted, not realizing that there are people who devoted their lives to protecting and maintaining the shoreline for all to enjoy. Foremost among these coastal champions was Charles Rooney, the mayor of Sea Bright, N.J., from 1988 until his death this year. This Sunday, June 20, the people of Sea Bright will rededicate Swing Bridge Park in Sea Bright, N.J., in his honor. The Sea Bright residents who will attend know well how hard Mayor Rooney worked over a 20-year period--first as a Councilman and then as Mayor--to get the state and federal funds to protect Sea Bright from the many ``Nor'easters'' that threatened the lives and property of residents. Over the years, these seasonal storms, with their ferocious winds and pounding surf, robbed Sea Bright of its protective seawall and buffer beaches to the point that the town might not have survived another storm season. My colleagues, you know more about Mayor Rooney and Sea Bright than you realize, because it was to Sea Bright that the New York and national television stations would go for some fearsome footage whenever a hurricane came up the East Coast. Each time, I would talk to a very concerned Mayor Rooney on the phone and later meet him on a tour of the damage and we would agree to press harder and speed up the schedule to repair the seawall and reconstruct the beaches. And, colleagues, it was your vote, year-after-year that helped us finally make the repairs that resulted in the completion of the multi-million dollar Army Corps of Engineers Shore Protection Project along much of the coastline of my district. Charles Rooney was a man who served his community like no other I know. His eight years as union representative in the Steel Workers Union helped prepare him for the leadership and coalition building skills he would later utilize as Councilman and Mayor. He served as president of the local chamber of commerce and established the senior citizens club, the borough recreation center and the youth program. In November, he was inducted into the League Municipalities ``Mayors' Hall of Fame'' and in January into the ``Elected Officials Hall of Fame'' for having served more than 20 years in local government. There was an amazing personal side to Charles Rooney. He had tremendous character and was himself a character. He used to say that when he took office, the town of Sea Bright was famous for having twenty-one liquor licenses and to reverse the common attitude of ``let's party in Sea Bright,'' somebody had to be tough. It was that toughness that turned Sea Bright back into a beautiful family resort as it was during the glory days at the turn of the century. It was also his political toughness, combined with his middle-aged entry into long distance running that gave him the nickname of ``Iron Man Rooney.'' Starting at the age of 48, he ran in 17 career marathons, inspired by another shore legend, Dr. George Sheehan, ``The Running Doc'' of Rumson. Mayor Rooney ran the entire length of the New Jersey Atlantic Coastline, from Sandy Hook to Cape May in just over four days. As the sponsor of local marathons, ``he always cheered the loudest for the people coming in last. He'd be there for the lady running 13-minute miles, when no one else was there. He'd put the biggest smile on her face, making her feel like she'd just won the race,'' said his son, Charles Rooney III. It was appropriate that the dedication of Charles Rooney Swing Bridge Park is taking place on Fathers Day, because Mayor Rooney was the father of so many wonderful environmental improvement projects that enhanced the quality of life in Sea Bright for its residents and others to enjoy. He was also a tremendous role model, not only for his son and daughter, but for all of us in public service who could learn so much from the warm and wonderful way he served the people of Sea Bright.

Mr. PALLONE

Mr. PALLONE. I yield to the gentleman from New York.

Mr. PALLONE. Mr. Speaker, I want to thank the gentleman from New York for his leadership on this issue and agree with what he just said about the need to move more towards what the Senate has proposed in most respects. Let me just say briefly, if I could, Mr. Speaker, that I believe that giving the administration waiver authority does not fully accomplish the goal of getting the U.S.-India relationship back on track and restoring confidence in the future of that relationship. The problem with the waiver authority that we have had in the last year is that the broad discretion given to the President means more of the same incremental carrot and stick approach. In other words, one of the requirements of the Glenn amendment is that the United States oppose World Bank loans to India that do not meet the strict definition of humanitarian needs. World Bank projects have the ability to improve the health and welfare of the people of India, and we should support those. Similarly, USAID projects in India that do not meet strict humanitarian criteria but which still make a huge difference for the quality of the life of people have been blocked by the President's refusal to grant the waiver, and we should not allow these important development projects to be held hostage to our diplomatic considerations. I just wanted to mention that I have introduced legislation to permanently repeal the sanctions. I am also drafting a sense of the Congress resolution similar to the provision in the Senate bill that states that export control 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. I have long been critical of the administration's so-called entities list which has targeted a wide range of commercial and government entities in India but have no bearing on nuclear proliferation or other national security concerns but which have been prohibited from contacts with U.S. entities. Now I wanted to say one thing, and I do not know what the position of the gentleman from New York (Mr. Gilman) is on this, but one negative provision in the Senate bill in the Brownback amendment, which I hope we do not include in the House, is the language to repeal the Pressler amendment which bans U.S. military assistance to Pakistan. I think we should retain the Pressler amendment since nothing has changed to justify its repeal, and I do want to emphasize that I do support removing the economic sanctions on Pakistan, but not military cooperation. Mr. Speaker, as is demonstrated by the Senate action last week and today's action in the House and a statement by our chairman, the gentleman from New York (Mr. Gilman) there is bipartisan and bicameral support for putting the U.S.-India relationship back on track, and I just want to thank both the chairman and the ranking member for their leadership and look forward to working with them for continued progress.

Mr. PALLONE. Mr. Speaker, the legislation introduced by the distinguished chairman of the Committee on International Relations, the gentleman from New York (Mr. Gilman), contains an important provision regarding the sanctions that were imposed last year on India and Pakistan following the nuclear tests conducted by the two south Asian nations. The legislation would extend for another year the waiver authority provided for under the Omnibus Appropriations Act for Fiscal Year 1999, giving the President the authority to waive the unilateral U.S. sanctions that were imposed pursuant to the Glenn amendment of the Arms/Export Control Act. Mr. Speaker, I want to thank both the gentleman from New York (Mr. Gilman) and our ranking member, the gentleman from Connecticut (Mr. Gejdenson), for their leadership on this issue. They have clearly been working for progress on resolving the sanctions issue. I would, however, stress that I believe we should be going further than the 1-year extension provided for in this legislation. Last week the other body, the Senate, approved an amendment to the fiscal year 2000 defense appropriations bill that would suspend for 5 years the sanctions against India and Pakistan, and I would note that our chairman already indicated in the speech that he made just prior to mine or earlier today that he, too, would like to go much further.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, late last month Secretary of State Madeleine Albright renewed the administration's unfortunate and misguided effort to repeal Section 907 of the Freedom Support Act. Section 907 restricts direct U.S. Government assistance to the Government of Azerbaijan until the President certifies that Azerbaijan has taken demonstrable steps to lift its blockades of Armenia and Nagorno Karabagh. Azerbaijan's illegal blockades of its neighbors has resulted in the disruption of supplies of vital goods to Armenia and Nogorno Karabagh, causing severe economic hardship and real human suffering. Mr. Speaker, Section 907 was good law when it was passed, and it remains good law 7 years later. Azerbaijan has done nothing to merit the repeal of Section 907, and despite these facts, the administration, with the strong backing of some of the major oil companies, is trying to urge Congress to repeal Section 907. Mr. Speaker, the Caspian Sea, which Azerbaijan borders on, is believed by some to contain vast oil reserves. The tantalizing prospect of a new source of petroleum resources has caused the administration to look the other way in terms of Azerbaijan's poor human rights record, its corrupt and undemocratic government, and its pattern of regional aggression. In written testimony submitted to the Senate Appropriations Subcommittee on Foreign Operations, Secretary Albright stated that the administration would renew its request to repeal Section 907. Presumably, the foreign operations bill which we will be debating later this summer would be the vehicle for repealing Section 907, just as was attempted last year. But, Mr. Speaker, I am proud to say that we succeeded in taking that language out of the bill on the House floor. A bipartisan coalition of Members of this House kept Section 907 as the law because it was the right thing to do. Mr. Speaker, I would say that it would be even more imprudent and unjustified now to repeal Section 907. As I mentioned, Azerbaijan's blockade is against both the Republic of Armenia and the Republic of Nogorno Karabagh. With the breakup of the Soviet Union, as the countries of the collapsing empire attained their independence, Azerbaijan attempted to militarily crush Nogorno Karabagh and drive out the Armenian population. But the Karabagh Armenians ultimately won their war of independence, and a cease-fire was signed in 1994. The U.S. has been one of the countries taking the lead in the peace process under the auspices of the Organization for Security and Cooperation in Europe. Late last year, the U.S. and our negotiating partners put forward a proposal known as the Common State Proposal as a basis for moving the negotiations forward. Despite some serious reservations, the elected governments of both Nogorno Karabagh and Armenia have accepted this Common State Proposal in a spirit of good faith to get the negotiations moving forward. And what was Azerbaijan's reaction to the proposal from the United States and our negotiating partners? An unqualified no. Yet, Mr. Speaker, unbelievable as it sounds, our State Department is trying to push Congress to reward Azerbaijan, a country that rejects our peace plan, by repealing Section 907, to the serious detriment of Armenia and Karabagh, the countries that accept our proposal. Furthermore, the administration's budget request actually proposes increasing aid to Azerbaijan and decreasing aid to Armenia. What kind of a message does that send? That rejecting peace is okay? Current law, Section 907, makes good sense and is morally justified. Section 907 does not prevent the delivery of humanitarian aid to the people Azerbaijan; to date, well over $130 million in U.S. humanitarian and exchange assistance has been provided to Azerbaijan through NGOs, nongovernmental organizations. The blockade of Armenia and Nogorno Karabagh has cut off the transport of food, fuel, medicine, and other vital supplies, creating a humanitarian crisis requiring the U.S. to send emergency life assistance to Armenia. The bottom line, Mr. Speaker, is that Azerbaijan has failed to live up to the basic conditions set forth in the U.S. law pursuant to Section 907, and that is: ``Taking demonstrable steps to cease all blockades and other offensive uses of force against Armenia and Nogorno Karabagh.'' Mr. Speaker, I just hope that Secretary Albright and the State Department will reconsider their plan to repeal Section 907. And if not, Mr. Speaker, I hope that Congress will reject this effort as we have done now for several years. Mr. Speaker, late last month Secretary of State Madeleine Albright renewed the Administration's unfortunate and misguided effort to repeal Section 907 of the Freedom Support Act. What is Section 907? And why is it so important? Section 907 restricts direct U.S. government assistance to the government of the Republic of Azerbaijan, until the President certifies that Azerbaijan has taken demonstrable steps to lift its blockades of Armenia and Nagorno Karabagh. Azerbaijan's illegal blockades of its neighbors has resulted in the disruption of supplies of vital goods to Armenia and Nagorno Karabagh, causing severe economic hardship and real human suffering. When the Freedom Support Act was adopted in 1992, establishing our new, post-Cold War U.S. foreign policy for the newly independent states of the former Soviet Empire, Section 907 was included as a way of holding Azerbaijan accountable for its blockades of its neighbors. Ideally, it might have been hoped that the Section 907 sanctions would prompt Azerbaijan to lift the blockades. But Azerbaijan has stubbornly maintained its counterproductive strategy of trying to strangle Armenia and Karabagh. Mr. Speaker, Section 907 was good law when it was passed, and it remains good law seven years later. Azerbaijan has done nothing to merit the repeal of Section 907. Despite these facts, Mr. Speaker, the Administration--with the strong backing of some of the major oil companies--is trying to push Congress to repeal Section 907. You see, the Caspian Sea, which Azerbaijan borders on, is believed by some to contain vast oil reserves. Much of these reserves remain unproven, and recent disappointing test drillings have prompted several international oil consortiums to pull out of Azerbaijan. But the tantalizing prospect of a new source of petroleum resources has caused the Administration to look the other way in terms of Azerbaijan's poor human rights record, its corrupt and undemocratic government, and its pattern of regional aggression. In written testimony submitted to the Senate Appropriations Subcommittee on Foreign Operations, Secretary Albright stated that the Administration would renew its request to repeal Section 907. Presumably the Foreign Operations bill, which we will be debating later this summer, would be the vehicle for repealing Section 907--just as was attempted last year. Last September, as we were working to finish up the appropriations bills before adjourning for the Congressional elections, a provision was included in the fiscal year 1999 Foreign Operations bill to repeal Section 907. But I'm proud to say, Mr. Speaker, that we succeeded in taking that language out of the bill on the House floor. A bipartisan coalition of Members of this House kept Section 907 as the law, because it was the right thing to do. Mr. Speaker, I would say that it would be even more imprudent and unjustified now to repeal Section 907. As I mentioned, Azerbaijan's blockade is against both the Republic of Armenia and the Republic of Nagorno Karabagh. Nagorno Karabagh is an historically Armenian-populated region of the Caucasus Mountains (known as Artsakh to the Armenian people) that Stalin's map-makers included as part of Azerbaijan--although even in Soviet times its distinctiveness and autonomy were officially recognized. With the break-up of the Soviet Union, as the countries of the collapsing empire attained their independence, Azerbaijan attempted to militarily crush Nagorno Karabagh and drive out the Armenian population. But the Karabagh Armenians ultimately won their war of independence, and a cease-fire was signed in 1994. Although the shooting war has essentially ceased--except for occasional sniper fire from Azerbaijan's soldiers against the defenders of Karabagh--a more permanent peace has been elusive. The United States has been one of the countries taking the lead in the peace process, under the auspices of the Organization for Security and Cooperation in Europe (OSCE). Late last year, the U.S. and our negotiating partners put forward a proposal, known as the ``Common State'' proposal, as a basis for moving the negotiations forward. Despite some serious reservations, the elected governments of both Nagorno Karabagh and Armenia have accepted this Common State proposal in a spirit of good faith, to get the negotiations moving forward. And what was Azerbaijan's reaction to the proposal from the United States and our negotiating partners? An unqualified ``no.'' In other words, Armenia and Karabagh have agreed to work with the U.S. for peace in this strategically vital region of the world. Azerbaijan has rejected American efforts to achieve peace and stability. Yet, Mr. Speaker, unbelievable as it sounds our State Department is trying to push Congress to reward Azerbaijan, the country that rejects our peace plan, by repealing Section 907--to the serious detriment of Armenia and Karabagh, the countries that accept our proposal. Furthermore, the Administration's budget request actually proposes increasing aid to Azerbaijan and decreasing aid to Armenia. What message does that send? That rejecting peace is okay? Current law, Section 907, makes good sense and is morally justified. Section 907 does NOT prevent the delivery of humanitarian aid to the people of Azerbaijan; to date, well over $130 million in U.S. humanitarian and exchange assistance has been provided to Azerbaijan through NGOs (non-governmental organizations). The blockade of Armenia and Nagorno Karabagh has cut off the transport of food, fuel, medicine and other vital supplies--creating a humanitarian crisis requiring the U.S. to send emergency life-saving assistance to Armenia. Armenia is land-locked, and the Soviet-era infrastructure routed 85 percent of Armenia's goods, as well as vital energy supplies, through Azerbaijan. That life-line is now cut off. Despite these disadvantages, Armenia has established democracy and market reforms, and is trying to integrate its economy with the West. But the bottom line, Mr. Speaker, is that Azerbaijan has failed to live up to the basic condition set forth in U.S. law, pursuant to Section 907: ``taking demonstrable steps to cease all blockades and other offensive uses of force against Armenia and Nagorno Karabagh.'' I hope that Secretary Albright and the State Department will reconsider their plan to repeal Section 907. If not, I hope Congress will reject this effort, as we have done for years.

Mr. PALLONE

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

Mr. PALLONE. Madam Speaker, I just want to thank my colleague the gentleman from Rhode Island (Mr. Kennedy) for organizing this special order. I want to add my voice to his tonight because we share the view that H.R. 1598 is a misguided and bad piece of legislation. One of the most pressing issues on Congress' agenda this year, if not the most pressing issue, has been looking for a way to make prescription drugs more for all Americans, and seniors in particular. It is unfortunate, however, that there is a movement in this body to do just the opposite. And let there be no mistake about it, the ``Patent Fairness Act of 1999'' is an attempt by some in the pharmaceutical industry to protect market share, and force consumers to continue to pay the highest possible price for prescription drugs. The brand name industry is well aware that generic competition has a dramatic impact on pharmaceutical costs. When a generic comes to market, it typically costs 30 percent less than the brand name version. After two years on the market, the prices drop further to 60 or 70 percent of the brand name drug. The price of some generic drugs drop by as much as 90 percent. While these competitively priced alternatives are good for consumers, employers, government purchasers, and particularly the elderly, they are not good for the brand name producer trying to maintain monopolistic pricing. If there is no generic alternative available, consumers who need medicine have no choice but to buy the available brand drug and pay whatever it costs. It is for precisely this reason that a few brand name drug companies have been working so hard to get the so called ``Patent Fairness Act of 1999'' signed into law. A patent extension is the only way to protect the windfall profits these blockbuster drugs have been generating. In addition to keeping low cost, generic alternatives out of the reach of consumers, the ``Patent Fairness Act'' of 1999 is bad public policy for two other reasons. The first is that it turns the whole intent of the drug patent system on its head. The purpose of the patent system is to promote the research and development of new drugs. By granting patent extension above and beyond what is called for in current law, the Patent Fairness Act would create an anti-competitive environment, which is precisely opposite the intention of the 1984 Hatch-Waxman bill. That bill, which is in part named after my colleague from California, Henry Waxman, was designed to lower drug prices through competition, not to protect monopolies. It has been enormously successful in achieving that objective and Congress should not carve out a special exemption for a few companies seeking to squeeze a few more billion dollars out of American consumers. Secondly, it would also affect the federal government's ability to control health care costs. There are a number of legislative proposals that have been introduced to add a prescription drug benefit to Medicare, which is essential to modernizing the program. Indeed, the President is expected to unveil his plan to achieve this goal before the month is out. Carving out special exemptions for companies seeking to extend patents on blockbuster drugs for no good reason will complicate efforts to include a prescription drug benefit by driving up costs for the federal government. If the ``Patent Fairness Act'' becomes law, every major drug producer in America will be knocking on Congress' door for a patent extension, and the fight Democrats are already waging to include a meaningful prescription drug benefit in Medicare will get that much harder. Congress' energy would be much spent trying to make prescription drugs more affordable, not more expensive. I urge all of my colleagues in the House to recognize the Patent Fairness Act of 1999 for what is and oppose this misguided and ill-conceived effort to charge the American people billions of dollars to line the pockets of a few pharmaceutical companies.

Mr. PALLONE. Madam Speaker, if the gentleman would continue to yield, I appreciate that; and I agree.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, last week in the other body, the Senate, an amendment to the fiscal year 2000 defense appropriations bill was approved that would suspend for 5 years certain sanctions against India and Pakistan. The sanctions were imposed pursuant to the Glenn amendment to the Arms Export Control Act, more than a year ago, after the two south Asian nations conducted nuclear tests. I want to express my support for the approval of this amendment which was offered by Senator Brownback of Kansas. I have introduced similar legislation to lift the sanctions, although my proposals would permanently repeal the sanctions as opposed to the 5-year suspension provided for by Senator Brownback's amendment. There is one other critical difference between the legislation I have introduced and the provision approved in the Senate last week, and that is the Senate bill includes language to repeal the Pressler amendment which bans U.S. military assistance to Pakistan. I support retaining the Pressler amendment which was adopted in the 1980s and was invoked by President Bush in response to Pakistan's nuclear proliferation activities. Nothing has changed to justify repeal of the Pressler amendment. Thus, I will work for the Pressler amendment to be retained and will urge my House colleagues to maintain this vital provision of law. Mr. Speaker, in the past few weeks, we were again reminded of why the Pressler amendment should remain in effect, as we have seen Pakistani support for the militants who have infiltrated territory on India's side of the line of control in Kashmir. It is clear that Pakistan is the country that is promoting instability in this current conflict as they have often done so in the past. Pakistan's involvement in supporting the militants who continually infiltrate India's territory is an example of how Pakistan promotes regional instability and commits or supports aggression against its neighbors. India is not involved in these kinds of hostile destabilizing activities. This is no time to be renewing military cooperation with Pakistan. Indeed, the Cox report, whose recommendations were implemented last week in this House as an amendment to the defense authorization bill, contain several references to transfers of nuclear technology and missile technology between China and Pakistan. India's nuclear program, on the other hand, is an indigenous program, and India has not been involved in sharing this technology with unstable regimes. This is an extremely, an extremely important distinction. But, Mr. Speaker, I want to stress that our priorities should be to do what we can to promote stability and economic opportunities in south Asia. The best way we can do that is to lift the sanctions imposed under the Glenn amendment as the Senate has done. Mr. Speaker, I would also like to mention that the Senate amendment has an important sense of the Congress provision stating that the 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. I have long been critical of the so-called ``entities list'' which has targeted a wide range of private and government entities in India that have no bearing on nuclear proliferation concerns, but which have been prohibited from contacts with U.S. entities. As the Senate language states, and I quote, ``The broad application of export controls to nearly 300 Indian and Pakistani entities is inconsistent with specific national security interests of the United States, and that this entities list requires refinement.'' I hope we can enact a similar provision here on this side of the Capitol and that the administration will respond in a meaningful way by removing entities from this list that really do not belong there; thereby reopening important bilateral contacts that benefit both sides. To that end, I am drafting a sense of the Congress resolution which I hope to introduce this week. Mr. Speaker, repealing the sanctions would have a positive impact on the people of India. But I also want to stress that the remaining sanctions are causing American companies to lose opportunities to do business in India, while our economic competitors in Europe and Japan gain a major foothold in this great emerging market. Finally, Mr. Speaker, we must get beyond the unproductive approach of confrontation and work towards policies that will promote improved opportunities for cooperation between the world's two largest democracies. Last week's action in the Senate, in the other body, certainly will contribute to that process.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, the managed care issue was left unfinished in the last Congress. On the House side, the Patients' Bill of Rights was defeated by just five votes when it came to the floor and it was considered on the floor as a substitute to the Republican leadership's managed care bill which did pass and in my opinion was a thinly veiled attempt to protect the insurance industry from managed care reform. I want to say, Mr. Speaker, that support among Democrats for passing the Patients' Bill of Rights is as strong as ever and it certainly needs to be. The Republican leadership in the House has reintroduced a bill that is virtually identical to what it moved last year, and on the Senate side earlier this year a Senate committee approved what I considered a sham managed care bill that does not allow patients to sue insurance companies but does allow insurance companies, not doctors and patients, to define medical necessity. Mr. Speaker, what the Democrats are trying to do in the next week or so is to bring the Patients' Bill of Rights to the floor, and because of the fact that we have been unable, as in the last session of Congress to get any hearings or committee action on the bill in the House, we have already put in place a procedure known as a discharge petition which will probably ripen next week and which will allow Members to come down to the floor and sign the petition to essentially force the Republican leadership to bring up a vote on the Patients' Bill of Rights. In many ways it is unfortunate that we are reduced to that. The bottom line is that the Republicans are in the majority in this House, not the Democrats, and if the Democrats cannot get a bill brought up in committee because they are not in the majority, they do not chair the committees, then the only recourse they have is to resort essentially to the discharge petition process and hope that we can get a majority, all the Democrats and some Republicans, to force a vote on the Patients' Bill of Rights. I wanted to say, Mr. Speaker, that another disturbing development has apparently taken place in the House over the last week, and that is that a few months ago we had heard that there were rumors that instead of moving a comprehensive managed care reform bill, the Republicans might try to bring up bits and pieces of patient protection. In other words, instead of bringing the comprehensive Patients' Bill of Rights to the floor, they would bring up bills that only deal with emergency room care or external appeals or whatever. I just wanted to say that this approach should concern anyone who really cares about managed care reform. I think it is being considered as a means by which the Republicans hope to avoid the debate, a real debate on the whole comprehensive issue of managed care reform, particularly the right to sue and the issue of medical necessity. What I think the Republicans may try to do is to bring up these individual bills in this piecemeal approach and then give the impression that somehow they are doing something on the issue of managed care reform or patient protection, when in fact they are not. If this piecemeal approach is adopted, I think the concerns of the American people are certain to be ignored, the issues they care about the most will be left off the table in order to appease the insurance industry, and those pieces of patient protection that do get to the floor will be riddled with loopholes and all kinds of escape clauses. Healthcare problems and the deaths and the serious injuries and serious problems that we have seen that have occurred because of the inability of patients to get a particular procedure, an operation, to be able to stay in the hospital, these things will continue to happen unless we have comprehensive managed care reform like the Patients' Bill of Rights. I have a number of my colleagues here with me tonight to join in this special order, and I should say that every one of them has been involved in a major way, either as a member of our Democratic Health Care Task Force or members of the Committee on Commerce, or one of my colleagues from New Jersey's case, the ranking member on the Subcommittee on Education and Labor that deals with managed care reform, and I am pleased they are with me. Mr. Speaker, I yield to my colleague from Arkansas, who has been one of the leaders on the issue of managed care reform. He is a cochair of our Health Care Task Force. It was he who last year brought up the Patients' Bill of Rights as a substitute on a motion to recommit and allowed us to consider the bill on the floor of the House.

Mr. PALLONE. The other thing, too, is the insurance industry keeps saying, why do we have to do this if the States are doing it? Why do we have to do it on the Federal level? Of course, as the gentleman points out, most plans do not come under the State law because a lot of plans are preempted by ERISA. So if the company basically has its own insurance, which a lot of big companies do, they are not covered by the State law. So we do need the Federal legislation. I want to thank the gentleman again for his input. I yield to the gentleman from New Jersey (Mr. Andrews), the ranking member on the Subcommittee on Employer-Employee Relations. I know the gentleman is going to give us some information about this piecemeal approach we think some of the Republicans are trying to pursue right now, which goes very much against the comprehensive approach of the Patients' Bill of Rights. I yield to the gentleman from New Jersey.

Mr. PALLONE. I want to thank my colleague, the gentleman from New Jersey, and particularly for the references he made to this effort in the gentleman's subcommittee to do this piecemeal approach, if you will. I understand what the gentleman is saying, which is that finally at least there is going to be some discussion or perhaps some action on HMO or managed care reform in the subcommittee. But the gentleman rightly points out that this piecemeal approach is really not the right way to go. The problem is that it would allow the Republicans to essentially pick and choose what kind of patient protections they want us to consider. My fear is that they will ignore important parts of the Patients' Bill of Rights, such as the right to sue, or even, just as important, the really good definition of medical necessity. We have talked about medical necessity a little tonight, but I do not know that we have really described it that much. Basically, the core of the Patients' Bill of Rights is this idea that the doctor, or I should say the health care practitioner, because our next speaker is of a nursing background, and I want to make it clear, we are not just talking about physicians but also nurses. But the core of the medical necessity idea is that the decision about what kind of procedure, operation, or length of stay in the hospital, as the gentleman from New Jersey (Mr. Andrews) mentioned, is determined by the patient and their health care practitioner, their doctor or nurse, not by the insurance company. That is one of the things that I am convinced would never see the light of day if this piecemeal approach were adopted. So I am glad to see that the gentleman as the ranking member and the other members, the Democrats on this committee, are taking this position and going to have this press conference tomorrow. I thank the gentleman. I yield to the gentlewoman from Texas (Mrs. Eddie Bernice Johnson). She is a nurse by background, and I think that brings a lot to this whole debate, because once again we are looking at this from a practical point of view. One of the things that I notice when I go and talk to my constituents is that the reason there is overwhelming support for the Patients' Bill of Rights is because people understand that on a day-to-day basis that this is what is needed. This is real. This is not pie in the sky. This is not ideological. This is what is happening day-to-day. Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Eddie Bernice Johnson).

Mr. PALLONE. Mr. Speaker, I want to thank the gentlewoman from Texas and particularly when she points out that, from the practitioner's point of view, whether it is the physician or the nurse, that essentially they cannot practice medicine because of the straight jacket essentially that has been put on them many times by HMOs, managed care organizations. I think a lot of people do not understand that. It is important.

Mr. PALLONE. Mr. Speaker, I want to thank the gentlewoman from Illinois. It is funny when we talk about this discharge petition process. It is extraordinary to think that here we are as the elected Representatives, normally petitioning is something that I think of as the citizens have grievances so they have to sign a petition and send it to us as their Representatives. I do not think most people ever imagine that their elected Representatives from Congress have to sign a petition to get a vote on a piece of legislation, because I think most of our constituents figure that is the normal procedure, that we get to vote on bills, not that we have to petition to vote on them. I wanted to just compliment the gentlewoman also because I think that that letter that she brought forward really says a lot about why this Patients' Bill of Rights is so important. One of the things I think about the most is how difficult it is when a person is seriously ill or has cancer, as is the example that the gentlewoman gave, and how difficult it is for them at that time when they are not feeling well to have to go through all of the hoops that these managed care companies often make them go through. Like if they are not allowed to have a certain treatment, they are not strong, in a position to appeal that or to try to seek redress because they are not feeling well at the time. And it is really like the worst time for a person to have to worry about whether they are going to have access to treatment or how they can get access if it is denied. And I think that letter really points out why it is so important to have these protections that we are seeking. So I thank the gentlewoman again. Now I see that my colleague from the district next door to my west is here tonight, the gentleman from New Jersey (Mr. Holt), and one of the first things that that gentleman did when he was first elected and took office in January was to come to Monmouth County and have a town meeting on the Patients' Bill of Rights because, obviously, he thought it was so important. So I want to commend him for all he is trying to do in his district and here on this issue, and I yield to the gentleman.

Mr. PALLONE. Mr. Speaker, I thank the gentleman, and just again reiterate that the only way we were able, as you know, to get the Patients' Bill of Rights to the floor in the last Congress was because of the discharge petition that we filed. I think we ended up with almost 200 signatures on it. Even with that the Republicans brought their essentially sham managed care reform bill to the floor, and it was only through the efforts of the gentleman from Arkansas that we were able to do a motion to recommit and have full consideration of the Patients' Bill of Rights. We need to do that again, unfortunately, because again the Republican leadership in the House has refused to have hearings or any kind of a markup in committee of managed care reform, so once again we are forced to go the route of the discharge petition in order to have the bill considered. Mr. Speaker, I just want to stress again, if I could, how this is an extraordinary procedure. As elected members of the House of Representatives, we should not have to resort to signing a petition essentially to get a bill considered, but that is where we are. Mr. Speaker, I now yield to another colleague on our Health Care Task Force and a member of the Committee on Commerce and has been dealing with this issue for a long time as well. (Mr. GREEN of Texas asked and was given permission to revise and extend his remarks.)