Jim Ramstad

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I am pleased to join today with Mr. Shaw and Mr. Stark and other colleagues on the Ways and Means Committee from both sides of the aisle in introducing legislation to extend structured settlement rules under section 130 of the Internal Revenue Code to workers' compensation. I am a strong supporter of structured settlements. I have seen firsthand in Minnesota how structured settlements can help victims of severe physical injuries put their lives back together in the wake of a disabling injury, help support their families, and instill some hope for the future. Structured settlements give crucial financial security to victims and their families by providing an assured stream of payments into the future to cover medical expenses and basic living needs. Structured settlements also save taxpayer dollars by ensuring that injury victims will not be required to seek indigent care. For all these reasons, Congress has sought to promote the use of structured settlements through specific tax rules that have been enacted in the Internal Revenue Code. Extending the Code section 130 structured settlement rules beyond physical injuries caused by torts to include physical injuries under workers' compensation would provide the same financial protection to victims who have suffered serious, long- term physical injuries in the workplace. I understand the Treasury Department testified before Ways and Means in the last Congress that it does not oppose this proposal and sees no distinction for purposes of the structured settlement tax rules between physical injuries suffered from torts and physical injuries suffered in the workplace. I also understand the Joint Committee on Taxation estimated in the last Congress that the proposal would produce only a very minimal revenue loss. I join with my colleagues in urging prompt enactment of this legislation.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, new technologies like electronic mail and the Internet have helped bring people closer than ever to the events in Congress. But one of the most instrumental groups in keeping people in touch with their representative, National Write Your Congressman, relies on technology that is as old as this country itself--the U.S. Postal Service. National Write Your Congressman was founded in Dallas, TX, in 1958. For nearly 40 years, this important organization has helped constituents voice their opinions with monthly mailings that present both sides of controversial issues. Constituents are then asked to mark a ballot in favor of or against a legislative proposal, and return the ballot to their Representative. National Write Your Congressman conducts frequent polls of its membership and informs Representatives of their results. They also keep Representatives' voting records on file, and frequently update their membership on the performance of the men and women who represent them. I am particularly grateful to LeRoy and Erika Larson of Burnsville, MN, in my congressional district, who visited my office this week. LeRoy and Erika's tireless efforts on behalf of National Write Your Congressman have enabled my Minnesota constituents to voice their opinion on legislation that directly affects their lives. At the same time, they have been proactive participants in the education of our citizenry, which helps build a more responsible America. Mr. Speaker, I want to thank National Write Your Congressman for their ongoing efforts to inform citizens of our activities in Washington and to inform us of our constituents' concerns. They are truly helping empower the people of this country and returning the government to the people it was created to serve.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Chairman, I thank the gentleman for yielding to me. Mr. Chairman, I would like to also thank my colleagues, the gentleman from Michigan, Mr. Dave Camp, and the gentlewoman from Connecticut, Mrs. Barbara Kennelly, for their leadership on this bill. No child should be denied the opportunity to grow up in a loving environment. That is why I strongly support their legislation.

Mr. RAMSTAD. Mr. Chairman, if the gentleman will continue to yield, my own family has been blessed through adoption. I am the proud uncle of three beautiful adoptive children. I cannot imagine my life without them or my four adopted cousins. There is nothing more important than for a child to grow up in a loving home. I know there are 500,000 children in foster care, many of them awaiting adoption by a loving family. So something must be done to reform the system. Last year we gave States and localities more authority to run social programs than they have had in 50 years. That is why I was concerned about the amendment offered by my colleague, the gentleman from Kansas [Mr. Tiahrt] and my colleague, the gentleman from Indiana [Mr. Burton], and I am very, very pleased that they withdrew the amendment. I understand that the authors of this amendment were trying to help children get into loving, adoptive homes as soon as possible, but I wanted to point out that nothing in this legislation prohibits the State from freeing children for adoption before 18 months. State agencies and courts need flexibility to ensure the most appropriate response can be developed for each individual child. This amendment would have established an absolute trigger that I believe is unrealistic. So we need to let those who know best, those who administer programs at the State and local levels, have the flexibility to do their job and the authority to do what is best for children. I thank my colleagues for withdrawing this amendment.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I thank the gentleman for yielding to me. I also want to thank my friend, the gentleman from North Dakota, Earl Pomeroy, and recognize his efforts; the gentleman from Minnesota, Collin Peterson, who represents the Seventh District; our colleague, the gentleman from South Dakota, John Thune; the gentleman from Minnesota, Gil Gutknecht, who is from southern Minnesota. For you people, your districts have been most directly impacted by the horrible floods of 1997, and they all have represented their people so well at the time of their greatest need. I also have never been more proud of the people I represent in the Twin Cities suburban Third District. They have also been there, and they are there, they are going to remain there in support of our friends in North Dakota and South Dakota. Last weekend there were sandbagging operations around the clock at a correctional facility in Hennepin County there, with inmates working hand in hand with high school students, and 500 people from the Mormon Church and other churches; volunteers coming out to help sandbag and send the sandbags up north; food banks, many food banks helping. There is one I am familiar with, Lake Country Food Bank, Hy Rosen, the executive director. Right now as we speak, I talked to him earlier today, they are loading eight or nine semis of dry food to send up to people in need; The churches, sending choirs to cheer up the people in these flood- devastated areas; The schools, young schoolchildren, trying to cheer up other young people who have been so devastated; Families pitching in, corporations. My colleague, the gentleman from South Dakota, mentioned several corporations. Northwest Airlines offered free transportation to get emergency supplies up. The State bar association, I know the 16 law firms, major firms in Grand Forks, were wiped out, 8 by the fire, 8 by the flood; everything destroyed, all their books, records, wiped out. Cheryl Ramstad Voss, who happens to be my sister and president-elect of the State bar, she has assembled a group tomorrow in the afternoon of the 50 big law firms in the Twin Cities to get together and help jump start those firms. The Governors have been tremendous. The National Guard, General Andreotti in Minnesota, the Salvation Army has been there. Also I want to thank FEMA Director James Lee Witt, Jim Franklin, who is the emergency management director in Minnesota, and the local officials; the mayors as well. Mr. Speaker, I do not want to take all my 5 minutes, I know there are other speakers. But I just want to conclude by saying that I strongly support the President's call for a $488 million Federal relief package. One-half is emergency dollars which the President has already committed during his visit, and $200 million of it depends on a special appropriation from us here in Congress. We need to continue to work together in a bipartisan way over the next week or two to finish the job of getting this relief money to those people who so desperately, desperately need it. I know the gentleman from Louisiana [Mr. Livingston] from the Committee on Appropriations said yesterday that he expects strong bipartisan support and quick action, and the people of those devastated areas certainly deserve nothing less. I am also, in conclusion, grateful to the Speaker. I know the gentleman invited him to tour the area to see firsthand how bad it is. I appreciate the invitation to go along with the Speaker. My favorite cousins had to evacuate their homes in Grand Forks. In fact, their daughter and her husband and little baby do not know what they have to come back to. It is in the area that is hard hit. We do not know for sure at this time. But I know the Speaker has made a commitment to support whatever is necessary to get this flood-ravaged area repaired and restored, and to help the people in the short term as well. We will be there with the full cost of emergency rescue and cleanup. We will be there for the permanent repair and restoration of facilities, as well as the short-term assistance, the disaster unemployment relief, the disaster food stamps. Then, over the longer term, we will be there with a Federal task force; a Marshall plan, as the President called it, for flood-ravaged areas. I thank my friend, the gentleman from North Dakota for yielding to me, and for the tremendous job that he has done in serving his people well.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, just 1 week ago, I stood here on the House floor and shared the pride and excitement my fellow Minnesotans are experiencing this winter as our University of Minnesota men's basketball team won the Big Ten Championship for the first time in 15 years. Today, I stand doubly proud. Last Saturday evening, following the basketball team's home celebration of the Big Ten title, the University of Minnesota men's hockey team clinched the Western Collegiate Hockey Association Conference Championship with a hard fought 7-3 win over Wisconsin. In a matter of just two weeks, the Minnesota Golden Gophers have--for the first time ever--won conference championships in these two major sports in the same season. Hockey success surely has not been rare during head coach Doug Woog's 12-year tenure as coach. Coach Woog last led his team to the WCHA championship during the 1991-1992 season and has coached each of his teams into the very selective NCAA tournament. The difference, Mr. Speaker, is this was expected to be a rebuilding year. After losing 10 players to graduation last year, including the Nation's top scorer and half of the team's defensive corps, the young Gophers dedicated themselves to improvement to the point they were in the position to win a share of the conference title on the last day of the season. Mr. Speaker, this achievement is especially gratifying as the University of Minnesota celebrates 75 years of Golden Gopher hockey. Coach Woog has continued our State's steep hockey tradition, one started by the father of American hockey, John Mariucci, by fielding an entire team of Minnesota-born players. This team truly is Minnesota's pride on ice. Mr. Speaker, this overachieving team is characterized by four dedicated, hard-working seniors who eagerly place team above self. Speedy cocaptain Nick Checco, nicknamed ``Mr. March,'' has had a knack for scoring goals at crunch time and during tournament play. Checco, along with forwards Dan Woog and Danny Hendrickson, paced a stingy penalty killing unit that led the conference and is seldom outworked in the gritty business of controlling the corners. Defenseman Brian LaFluer, who missed 6 weeks with a shoulder injury, returned at the same level when he left, igniting the offense with his transitional play and solidifying the young defense. The offense was led by All-American defenseman junior Mike Crowley, who tied for the conference scoring title. Junior sharpshooter Ryan Kraft led the team with 24 goals scored, while freshman Dave Spehar, the all-time leading high school scorer, quickly adjusted to college hockey by leading the team in game-winning goals and all WCHA freshman in points. A talented group of sophomores have contributed to this team's success: Mike Anderson, Reggie Berg, and Eric Rasmussen--the first American selected in last year's National Hockey League amateur draft. Eric teamed with forward Wyatt Smith and freshman Ben Clymer to help lead the U.S. Junior National Team to a silver medal finish in the World Junior Tournament last December. The silver medal marked the best finish ever for a U.S. Junior National Team. It is often said championships are won with defense. Junior goaltender Steve DeBus' play truly inspired this young team. DeBus led the conference in wins, was among conference leaders in save percentage and goals against. His calm under intense pressure and cat-quick reflexes gave his teammates confidence they had a chance in every game. Mr. Speaker, the Gophers celebrated their championship in grand hockey tradition; 25 student-athletes, circling the ice, each holding the MacNaughton Cup and proudly hoisting it high over their head. With this show of unity, the contributions of forward Casey Hankinson are proudly displayed. Casey, a junior co-captain, is the glue that held this team together. An emotional leader, his hard work in practice, at game time, and fiery intermission orations combined to inspire his teamsmates to strive for excellence. Mr. Speaker, today I want to offer my heartfelt congratulations to the University of Minnesota hockey team, true champions of the heart as well as the Western Collegiate Hockey Association.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, it has been a long, hard winter in Minnesota, with record cold temperatures and snowdrifts so high they obscured barns and houses. But last night, the University of Minnesota men's basketball team warmed the heart of every Minnesotan as the Golden Gophers won their first Big 10 Conference Championship since 1982. Minnesota, hats off to thee. Today, we salute Coach Clem Haskins and his 1997 championship team as well as the assistant coaches, managers, training trainers, and the best fans anywhere in the Nation. We are Big 10 Champions and proud of it. Mr. Speaker, last fall none of the experts picked our Golden Gophers to win the title, but they persevered. They won the close games. They personified teamwork. They fought back. They stuck to the game plan. They listened to their coach, Clem Haskins. One night this week, Coach Haskins told the story on the local television news of running into a woman in his neighborhood grocery store. This woman was accompanied by her young son in a wheelchair. Clem could hardly speak as he recounted that woman's words to him in that grocery store: ``Your basketball team has totally captured my son's attention,'' she said. ``The Gophers have inspired my son to walk one day.'' Fighting back tears, Coach Haskins told the reporter: ``That's really what the world is all about, if you can give people some hope.'' Coach Haskins, you and your team have given us hope, and a whole lot more. Under Clem Haskins' guiding hand, this marvelous mix of young men has rewritten University of Minnesota basketball history: The first Big 10 title in 15 years, only the third conference championship in the past 60 years;. A school record for the number of victories in a single season, 25 wins, with three regular season games and the NCAA tournament remaining. The school's highest national ranking ever, No. 2 in both major polls. The best road record in memory. Undefeated at home, in the ``Barn'', our beloved Williams Arena. And, if justice prevails, a No. 1 seed in the NCAA tournament. Coach Haskins, now in his 11th season at Minnesota, has mentored hundreds of true champions. Not all of them have won Big 10 titles, to be sure, but they have been winners in the classroom and they have been winners in our community. Coach Haskins, who served as assistant coach of the 1996 men's Olympic basketball team, has assembled a very special group of young men in this championship season. They all deserve a tribute for the way they came together to surprise the experts and win the Big 10 title. All Big 10 guard Bobby Jackson, who ranks among the big 10 leaders in steals, assists, scoring, free-throw percentage, field-goal percentage and rebounding. Minnesota's other guard, Eric Harris, the defensive specialist and most improved player on offense, to be sure; Eric provided the steady leadership only a 3-year starter can. Minnesota's own Sam Jacobson, a constituent of mine, one of the great natural talents, with the long, arching outside shots which broke open so many close games. And John Thomas, another native Minnesotan, of the inside force, whose key rebounds and clutch free-throws also won so many nail-biters this season. The other big man in the middle, Courtney James, a major factor in this glorious title run, with his strong rebounding and scoring in the paint when we needed it the most. But perhaps the team's greatest asset, Mr. Speaker, is its bench, the players who accept their backup roles and come through in the clutch: Quincy Lewis, with his amazing shooting touch; Trevor Winter of Slayton, MN, with his rebound and baseline jumper; sophomore Charles Thomas, a southpaw whose specialty is the 3-point bomb, and who always comes through when we need it the most; Miles Tarver, another sophomore whose leaping ability ruled the boards when the other players' legs had tired; freshman guard Russ Archambault, who provided fans with many thrills with his speed, ball handling, and his slashing style on the court; also Jason and Jermaine Stanford and Aaron Stauber, who work so hard every day. Yes, Coach Haskins, you and your team have put Golden Gopher basketball back on the map. Congratulations, Minnesota, on winning the Big 10 Championship, and best of everything the rest of the way. Go, Gophers.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, since first coming to Congress, I have worked closely with our former colleagues Bill Emerson and former Senator Harold Hughes and many other current Members to address the epidemic of alcoholism and substance addiction in our country. During the last session of Congress, I introduced legislation, which actually was prepared by former Senator Hughes and our colleague Bill Emerson, to establish a National Commission on Alcoholism to develop a pragmatic, comprehensive and effective strategy to deal with this fatal and insidious disease. That effort continues this year, although as our colleagues all know, Bill Emerson went to be with his higher power, as did former Senator Hughes last year, but I know that those two great men are smiling down from heaven on us as we continue this very, very important effort. Next week I will introduce a bill to establish this National Commission on Alcoholism, a volunteer 2-year commission, to be narrowly focused, to streamline and better coordinate existing Government programs, treatment programs, prevention programs and education programs, to increase public and private sector cooperation, to evaluate the cost-effectiveness of treatment, and to improve alcoholism research and medical school training on this pressing public health epidemic. Instead of trying to find one big picture solution to alcoholism, Mr. Speaker, like we have done in the past, this commission will develop specific cost-effective and practical recommendations and then disband in 2 years. So unlike Federal commissions of the past that have met periodically to hold sparsely attended meetings and have given us reports that nobody reads, this commission on alcoholism will meet for a finite period, consist exclusively of volunteers, and will submit a final report to the President and the Congress of their recommendations. As policymakers at the Federal level, Mr. Speaker, we must address alcoholism as a possible health issue. On the average, untreated alcoholics incur health care costs that are 100 percent higher than nonalcoholics. At the same time there are no Federal and few, if any, State requirements to even study alcoholism in our medical schools. Members of this commission, Mr. Speaker, as I said, all volunteers, will include treatment and other health care professionals, educators, NIH officials, academics and also recovering people to give this commission and to give us in Congress a real-world perspective. We must address alcoholism as a public safety issue as well. According to the Justice Department, 36 percent of convicted murderers were under the influence of alcohol at the time of their homicide, while 13 percent used alcohol with another drug. Mr. Speaker, in addition, and I say this as a grateful recovering alcoholic myself of some 15\1/2\ years, I know that alcoholism must be addressed as the painful private struggle it is, with the staggering public cost. Last year alone, alcoholism killed more Americans than all illegal drugs combined, ripped apart families across this land, and the financial cost, Mr. Speaker, of alcoholism last year alone, 1996, 1 year, the financial cost, $85.8 billion. I am very grateful, Mr. Speaker, for the bipartisan support that this legislation received last year when I introduced it. We tried to lay the groundwork for passage this year. And so now it is my hope that we can pass this into law, get the National Commission on Alcoholism established, develop that comprehensive national strategy to deal with this costly, deadly disease. I urge my colleagues, Mr. Speaker, to join me, join our bipartisan effort in cosponsoring this critically important legislation.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I am happy to report that this legislation before us today represents a bipartisan and unanimous effort on the part of the Committee on Ways and Means to find an immediate solution to the very real crisis threatening the solvency of the airport and airway trust fund. In my home State of Minnesota, the Metropolitan Airports Commission was seriously concerned when the trust fund was expected to run out of money in June or July of this year. Now that we know the expected date of insolvency is March, there is absolutely no time for delay. And I just want to say, Mr. Speaker, as the No. 1 ranked Member of Congress last session by the National Taxpayers Union, I take a back seat to nobody when it comes to protecting American taxpayers. And as this letter I have, which I will submit for the Record, from Grover Norquist of Americans for Tax Reform clearly states, this is not a tax increase, as the chairman also stated. It is the reinstatement of an existing and necessary tax. Mr. Speaker, it is also worth noting that this is a temporary measure. A transportation task force, in fact, of the Committee on Ways and Means is working hard right now in developing fair alternatives to the present excise tax, and I hope a fair funding mechanism will be developed later this year in the context of FAA funding and our larger budget negotiations. But while we consider the equities of reforming the system, it is absolutely crucial for national air safety that we temporarily and immediately restore the aviation excise taxes. Our Nation's safety depends on this action, and it is too important, Mr. Speaker, to fall victim to political posturing or political grandstanding. I urge my colleagues to do the right thing for Americans who travel by air, and support this bill. The letter referred to is as follows: Americans for Tax Reform, Washington, DC, February 24, 1997. Congressman John Boehner, House Republican Conference. Dear John: I sincerely appreciate your commitment to the Pledge and all of the work that you have done to uphold and strengthen it. You have been one of the leaders in the House of Representatives concerning the Pledge, and I wanted you to know that your efforts are recognized. I would also like to thank you for your question regarding the pledge and the air ticket tax. Although ATR does not support renewing this tax, voting for it will not violate the Federal Taxpayer Protection Pledge, because it does not ``increase the marginal income tax rates for individuals and/ or businesses,'' and it does not ``reduc[e] or eliminat[e] deductions and credits.'' In addition, ATR will not include this vote in our next rating of Congress. If you have any further questions or concerns, please do not hesitate to contact me. Thanks again for all of your help! Sincerely, Grover G. Norquist, President.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, as a strong supporter of home- and community-based services for the elderly and individuals with disabilities, I rise to introduce legislation I sponsored in the 104th Congress to extend the demonstration authority under the Medicare program for Community Nursing Organization [CNO] projects. CNO projects serve Medicare beneficiaries in home- and community- based settings under contracts that provide a fixed, monthly capitation payment for each beneficiary who elects to enroll. The benefits include not only Medicare-covered home care and medical equipment and supplies, but other services not presently covered by traditional Medicare, including patient education, case management and health assessments. CNO's are able to offer extra benefits without increasing Medicare costs because of their emphasis on primary and preventative care and their coordinated management of the patient's care. The current CNO demonstration program, which was authorized by Congress in 1987, involves more than 6,000 Medicare beneficiaries in Arizona, Illinois, Minnesota, and New York. It is designed to determine the practicality of prepaid community nursing as a means to improve home health care and reduce the need for costly institutional care for Medicare beneficiaries. To date, the projects have been effective in collecting valuable data to determine whether the combination of capitated payments and nurse- case management will promote timely and appropriate use of community nursing and ambulatory care services and reduce the use of costly acute care services. Authority for these effective programs was set to expire December 31, 1996. Mr. Speaker, while I was glad to Health Care Financing Administration [HCFA] extended the demonstration authority for the CNO projects using administrative means, I was disappointed this extension was only for 1 year. HCFA stated that the authority was extended to allow them to better evaluate the costs or savings of the services available under the program, learn more about the benefits or barriers of a partially capitated program for post-acute care, review Medicare payments for out-of-plan services covered in a capitation rate, and provide greater opportunity for beneficiaries to participate in these programs. Frankly, in order to do all this analysis of the program, we need more than one year. We need to act now to extend this demonstration authority for another 3 years. This experiment provides an important example of how coordinated care can provide additional benefits without increasing Medicare costs. For Medicare enrollees, extra benefits include expanded coverage for physical and occupational therapy, health education, routine assessments and case management services--all for an average monthly capitation rate of about $21. In my home State of Minnesota, the Health Seniors Project is a CNO serving over 1,500 patients in four sites, two of which are urban and two rural. These demonstrations should also be extended in order to ensure a full and fair test of the CNO managed care concept. These demonstrations are consistent with our efforts to introduce a wider range of managed care options for Medicare beneficiaries. I believe we need more time to evaluate the impact of CNOs on patient outcomes and to assess their capacity for operating under fixed budgets. Mr. Speaker, it is important to recognize that the extension of this demonstration will not increase Medicare expenditures for care. CNOs actually save Medicare dollars by providing better and more accessible care in home and community settings, allowing beneficiaries to avoid unnecessary hospitalizations and nursing home admissions. By demonstrating what a primary care oriented nursing practice can accomplish with patients who are elderly or disabled, CNOs are helping show us how to increase benefits, save scarce dollars and improve the quality of life for patients. Mr. Speaker, I urge my colleagues to consider this bill carefully and join me in seeking to extend these cost-savings and patient-enhancing CNO demonstrations for another 3 years.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I rise today to introduce legislation to respond to an issue of great importance to Medicare beneficiaries and health care providers in my district and throughout the country-- reforming the payment for Medicare risk-based managed care plans. Currently, Medicare payments to risk-based health care plans are calculated on the basis of Medicare spending in each county's fee-for- service section--medical care outside of managed care plans. The variation in the adjusted average per capita cost [AAPCC] formula reflects different utilization of health care services. In 1996, Dr. John E. Wennberg, the director of the Center for the Evaluative Clinical Studies at Dartmouth Medical School, published ``The Dartmouth Atlas of Health Care.'' The atlas shows that the rates of hospital beds and physicians per 1,000 residents determines how much care Medicare beneficiaries use. Revising the highly variable AAPCC payment formula will result in greater equity for Medicare beneficiaries regardless of where they live, allowing choices among plans and more equitable distribution of out-of-pocket costs and additional benefit packages. Because of the need to correct the inequity in the AAPCC payment formula for millions of Medicare beneficiaries, I strongly supported changes to the formula during consideration last session of the Medicare Preservation Act. Regrettably, congressional efforts to reform the geographic disparity and inequities in the AAPCC formula were denied by the stroke of the President's veto pen. The legislation I am introducing today narrows the AAPCC payment gap between rural and urban areas in a budget neutral fashion. At a minimum, a county would receive 80 percent of the national input-price- adjusted capitation rate. This change helps reflect the true cost of doing business, taking into consideration uncontrollable factors such as wage rates or supply costs. The language also implements a 3-year average for the baseline rather than 1 year. This change provides greater representation of historical health care costs for an area. This bill is based on the Physician Payment Review Commission's ``1996 Annual Report to Congress.'' When the Health Care Financing Administration [HCFA] released the 1997 payment rates for Medicare managed care plans, the agency told us that payments nationally to Medicare-managed care plans would increase an average of 5.9 percent as of January 1, 1997--significantly lower than the 1996 national average increase of 10.1 percent. This is good news in terms of the solvency of the Medicare trust fund--we need to slow the rate of growth of Medicare spending to stave off its imminent bankruptcy. The bad news is that this average increase reflects wide variation in percentage increases from county to county. Four counties: Valencia, N.M.; and three New York State counties Bronx, Monroe and New York, actually will receive negative growth--real decreases. Because the actual dollar variations are also extreme, many low-payment areas get a double whammy--lower percentage increases off a lower base. This situation continues a trend inherent in the flawed payment formula. The following table illustrates the vast variation between counties across the country. I believe it is important to point out that even though the 1996 AAPCC payment increased an average of 10.1 percent not all counties shared in the bounty of that increase. The same is also true for the 1997 AAPCC payments. Counties that typically lost ground were those in efficient markets and rural counties with historically lower reimbursement rates. Because of these lower payment rates and lower annual increases, these regions will continue to lack the ability to attract managed case options to their area or offer enhanced health care benefits often found in higher payment communities.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I rise today to pay tribute to the members of the Minnesota Veterinary Medical Association and its members' 100 years of faithful service to Minnesotans. Over the years, the members of the association have provided exceptional animal health care, food safety, and public health services through the adherence to the highest professional standards of veterinary medicine. The association was founded in 1897 by 13 veterinarians to further cultivate the science and art of comparative medicine and to promote livestock production as a branch of the agricultural industry. They also worked to protect high educational and ethical standards within their profession and to promote educational opportunities for the veterinarians of Minnesota. Mr. Speaker, the veterinarians of Minnesota have been a crucial health care provider for the animal population in my State for the last 100 years--making consumers, pets, their owners, and the rural economy of our State a healthier place. I wholeheartedly applaud the 1,400 current members of the association for their dedication and service to the people of Minnesota.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, throughout the 104th Congress, many Medicare concerns have been raised that have a significant impact on access to health care throughout Minnesota and ultimately to the health and well-being of our Nation's health care system. Today, I rise to share some thoughts on an issue which knows no distinct, definable boundary. It is an issue of great importance to Medicare beneficiaries and health car providers in my disrict-- reforming the payment for Medicare risk-based managed care plans. But, before I delve into my statement, I want to take a moment to salute and thank my good friend and colleague from western Wisconsin, Steve Gunderson. I commend him for his tireless commitment to improving access to and delivery of quality health care in rural communities. During this Congress, as cochair of the Rural Health Care Coalition, Steve literally took the bull by the horns to respond to a variety of health care issues, especially the need to reform the payment formula for Medicare risk-based managed care plans. Currently, Medicare payments to risk-based health care plans are calculated on the basis of Medicare spending in each county's fee-for- service section--medical care outside of managed care plans. The variation in the adjusted average per capita cost [AAPCC] formula reflects different utilization of health care services. Dr. John E. Wennberg, director of the Center for the Evaluative Clinical Studies at the Dartmouth Medical School recently published ``The Dartmouth Atlas of Health Care.'' The Atlas definitely documents that the rates of hospital beds and physicians per 1,000 residents determines how much car Medicare beneficiaries use. Revising the highly variable AAPCC payment formula will result in greater equity for Medicare beneficiaries regardless of where they live, allowing choices among plans and more equitable distribution of out of pocket costs and additional benefit packages. Because of the need to correct the inequity in the AAPCC payment formula for millions of Medicare beneficiaries, I strongly supported changes to the formula during the Ways and Means Committee consideration of the Medicare Preservation Act. Regrettably, progress may be by this Congress to reform our Medicare Program, including the geographic disparity and inequities in the AAPCC formula, was vetoed by the President. Since that time, I have continued to be concerned about this issue and am an original cosponsor of Mr. Gunderson's H.R. 3753, the Rural Health Improvement Act. This legislation incorporates a number of rural health care reforms including improvements to the AAPCC payment formula. Title I of this legislation narrows the AAPCC payment gap between rural and urban areas by ending the practice of basing the formula on utilization rates, and it does so in a budget neutral fashion. At a minimum a county would receive 80 percent of the national input-price- adjusted capitation rate. This change helps reflect the true cost of doing business--uncontrollable factors, such a wage rates or supply costs. The language also implements a 3-year average for the baseline rather than 1 year, which was in the Balanced Budget Act of 1995. This change gives greater representation of historical health care costs for an area. This provision of H.R. 3753 is based on the Physician Payment Review Commission's ``1996 Annual Report to Congress.'' Realizing reforms to the AAPCC formula are not doable in the remaining days of this Congress, it is helpful to know where the debate will begin in the 105th Congress. About a week before this hearing, the Health Care Financing Administration [HCFA] released the 1997 payment rates for Medicare managed car plans. What HCFA told us was nationally Medicare risk payments will increase an average of 5.9 percent as of January 1, 1997--lower than the 1996 national average increase of 10.1 percent. In terms of the solvency of the Medicare trust fund this is good news--slowing the growth of Medicare. The bad news is that this average increase reflects wide variation in percentage increases from county to county. Four counties: Valencia, NM; and three New York State counties, Bronx, Monroe, and New York, actually will receive negative percentage decreases. Because the actual dollar variations are also extreme, many low-payment areas get a double whammy--lower percentage increases off of a lower base. This situation continues a trend which is inherent in the flawed payment formula. The table below illustrates the vast variation between counties across the country. I believe it is important to point out that even through the 1996 AAPCC payment increased an average of 10.1 percent, not all counties shared in the bounty of that increase. The same is also true for the 1997 AAPCC payments. Counties that typically lost ground were those in efficient markets and rural counties with historically lower reimbursement rates. Because of these lower payment rates and lower annual increases these regions will continue to lack the ability to attract managed case options to their area or offer enhanced health care benefits often found in higher payment communities.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, the purpose of this legislation, H.R. 1031, is to reunite a family that has been ripped apart. This bill is not about policy or politics. It is about bringing back a father for two adorable little boys, ages 3 and 6, who have missed their dad so much that they have cried every day for almost 2 years. It is about bringing together a loving husband and wife who have been devastated for almost 2 years. Mr. Speaker, this bill deals with the human side of government--the side that directly impacts families, mothers, fathers, and children. Mr. Speaker, my staff and I have worked to help the Oscar and Sharron Velazquez family of Plymouth, MN, for more than 3 years. For the past 2 years, we have worked to reunite Sharron Velazquez and her two young sons, Rico, 6, and Nicolas, 3, who have been separated from their husband and father, Oscar Velazquez. Oscar was deported in early 1995 and has been forced to live far away from his family in Mexico. Mr. Speaker, this is truly a case of undue hardship that justifies the return of Oscar Velazquez. Because Sharron Velazquez has a special medical condition that predisposes her to Reiter's Syndrome, a crippling disease with no cure, doctors have forbidden her from joining or even visiting her husband in Mexico. According to medical experts who have examined Sharron Velazquez extensively, she has the antigen for Reiter's Syndrome, which would be triggered by organisms in the food and water in Mexico. The unique circumstances facing this family certainly merit passage of this bill. This has been a long and tortuous struggle for the Velazquez family and their extended family, Jim and Julie Libby, Karen and Ron LePage, Ted and Therese Salonek, Rich and Becky Farniok and Patricia Morrison, and their many wonderful friends who have never lost faith that justice and fairness would prevail. Mr. Speaker, I want to express my gratitude, on behalf of the Velazquez and Libby families, to several people whose assistance was crucial in moving this bill. Our colleagues from the Judiciary Committee, especially Chairman Hyde, Chairman Lamar Smith and Mr. Sensenbrenner, were key in moving this bill through the Immigration and Claims Subcommittee and the full Judiciary Committee. On the other side, ranking member Bryant was also very supportive. Also, special thanks to Cindy Blackston of the Immigration and Claims Subcommittee and Karin Hope of my staff, who worked so hard on this bill and whose expertise and counsel have been invaluable. Finally, I am grateful to Senator Hatch and his staff, who have also been very helpful. Mr. Speaker, a loving family awaits Oscar Velazquez, his employer eagerly awaits his return, and the members of this church, who have been holding nightly vigils, are praying for Oscar's return. Let us put politics totally aside here and do the right thing for the Velazquez family. Let us right a wrong. Let us reunite the Velazquez family by passing H.R. 1031. The bill was ordered to be engrossed and read a third time, was read the third time, and passed, and a motion to reconsider was laid on the table.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I rise with mixed feelings about this conference report. I am concerned about both the integrity of our legislative process and the narrowness of our mental health care debate. Earlier this year, I supported the House-passed version of the fiscal year 1997 VA/HUD appropriations measure. Since then the Senate has incorporated into this funding package three new health care mandates--in fact, it may be more appropriate to now refer to the bill before us as the VA/HUD/HHS appropriation bill. These three new public health provisions are not small and technical in nature, but rather significant changes that will affect the delivery of health care for hundreds of thousands of Americans. To my knowledge, none of these new health care provisions have been reported out by any of the House committees of jurisdiction, nor reached the floor for a vote. I trust this leap frogging of our established legislative process, with the significant public policy implications it entails, is not a practice this body should encourage. My second concern is that by passing the fiscal year 1997 VA/HUD conference report, this Congress will take an important, but incomplete step toward a more equitable relationship between mental and medical health benefits. Like the initial Senate-passed mental health parity provision in the Health Insurance Portability and Accountability Act, the provision before us again ignores all substance abuse--alcohol and drug-- treatment services, which are clearly badly needed to help combat our Nation's No. 1 public health care problem. Silence and inaction are not golden. I speak from first-hand personal experience about the benefits that alcohol treatment can bring to millions of Americans and their families. Today, alcohol and other drug addictions affect 10 percent of American adults and 3 percent of our youth. Untreated addictions last year alone cost our country nearly $167 billion. For alcoholism alone, the public is paying $86 billion a year in direct and indirect costs attributed to the disease. Untreated alcoholics incur health care costs at least double that of nonalcoholics. Yet, most of our Nation's medical schools do not even require future health care professionals to study the disease of alcoholism. When will Congress stop ignoring the disease of alcoholism? As a recovering alcoholic, I know many Members of Congress need to be educated on this rampant public health problem. Only then will we be in a position to change our Nation's response to this costly, fatal disease. To help begin our national education on alcoholism, I have introduced H.R. 3600, legislation to establish the Harold Hughes Commission on Alcoholism. By establishing this 13-member volunteer commission for 2 years, this Congress can set into motion a commission with the task of studying methods to better coordinate existing Government programs responsive to alcohol abuse, increase public and private sector cooperation, step up the education of health care professionals on the disease of alcoholism, heighten research on alcoholism, and evaluate the cost effectiveness of treatment methods and services. In the remaining days of this Congress, I strongly urge my colleagues to help begin our national awakening and education on the disease of alcoholism with the enactment of H.R. 3600. I also challenge the 105th Congress to continue the important national dialogue begun this year to respond to our Nation's escalating alcohol and drug problem. We must review the importance of providing the same kind of parity we have before us today on substance abuse benefits. By working in a pragmatic, bipartisan fashion on parity and other important alcohol issues and drug concerns, we can achieve the balance between affordable health care insurance coverage, treatment and equity.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I rise today to praise a true Minnesota hero, whose athletic exploits in the all-American game of baseball have dominated headlines from coast to coast in recent days. But as big a hit as Paul Molitor has been on the field for nearly two decades, Paul Molitor has been an even bigger hero to children and fans all across this great country for the person he is. Mr. Speaker, it is common for this most uncommon man to stand for hours at a time and sign autographs for all comers, fans young and old. Paul Molitor of Minnesota and the Minnesota Twins is as classy a person as his classic swing. A devoted family man who always answers the call of community organizations to help people in need, Paul Molitor gives us all much to admire. He visits to hospitals to cheer up suffering children in cities all across this great country are rarely covered in the newspapers. But the lives he has touched, the spirits he has raised are reason enough to celebrate this great American hero. Joining only 20 of the greatest players in the history of the sport, Paul Molitor became a member of one of major league baseball's most exclusive clubs on Monday, September 16 in the fifth inning of a game at Kauffman Stadium in Kansas City, MO. Showing his classic, never-give-up hustle, Molitor became the first player to enter the 3,000-hit club with a triple and an all-out, head- first slide into third. And showing his strong love of family, Molitor immediately located his wife, Linda, and daughter, Blaire, in the stands and embraced them warmly. Overcoming injury after injury, Paul Molitor's relentless pursuit of perfection and team goals has set a shining example for all of us in our everyday lives. A fellow alumnus of the University of Minnesota, Paul Molitor has stolen our hearts with his heart for the game--just like he once stole second, third, and home in a single inning. His accomplishments in the game are already the stuff of legend. This St. Paul native was the most valuable player of the 1993 World Series and scored the series-clinching run. His 1987 hitting streak of 39 games is the fifth longest in modern big-league history. In the first game of the 1982 World Series, he set a record with five hits. From his sandlot days on the same playgrounds in St. Paul that produced--within just a few years--other future Hall of Famers Dave Winfield and Jack Morris, to his emergence as a star at the University of Minnesota, Paul Molitor has been gathering fans all across America. In Milwaukee, Toronto, and Minnesota, Paul Molitor has collected a legion of loyal admirers who are devoted to our native Minnesota son as much for his character as his clutch fielding and hitting. Mr. Speaker, we can all take a lesson from what Paul Molitor has done on and off the field: never give up; bear down at each and every opportunity; stay mentally tough; keep your eyes on the goal; don't let some bad breaks deter you from your objective; look out for your teammates; remember what's truly important. Paul Molitor, the baseball player, is still going strong at age 40. He's leading the league in hits. But, more importantly, Paul Molitor, the person, is proving that Leo Durocher was wrong. Nice guys do finish first.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I rise today to praise Trinity School at River Ridge, located in my district in Bloomington, MN, for being named winner of the U.S. Department of Education's prestigious Blue Ribbon Award. The Department of Education could not have selected a more deserving school for this highly coveted honor. When it comes to a comprehensive and successful approach to excellence in teaching, student achievement, leadership, and parental involvement, Trinity School at River Ridge has, in just 10 short years since its opening, set a lofty standard. Mr. Speaker, this high distinction was well earned. Everyone at Trinity played a role in achieving this extraordinary level of educational excellence. Trinity was the only private school in Minnesota to receive the Blue Ribbon designation, and 1 of only 50 private schools selected nationwide. Under the visionary leadership of a most remarkable man, Headmaster William Wacker, Trinity School has flourished. Always there for each and every student, William Wacker provides at all hours of the day a willing ear, an understanding shoulder, and a marvelous source of advice and encouragement. The board of trustees, under the leadership of Louis Grams and full of caring and committed individuals, has selflessly devoted the time, talent, and energy necessary to make Trinity School at River Ridge one of the best in all of America. Trinity School at River Ridge's special mission and educational approach are perhaps best described in the words of John Buri, a psychology professor at a private college in our area and member of the school's board of trustees: ``In a national educational system where acquisition of job skills is of primary importance, it is good to see recognition of an institution where truly human qualities are valued and where there is an effort to educate the whole person. Trinity School is about the task of what is truly education.'' Trinity School at River Ridge calls its approach ``An Education in Truth, Beauty and Goodness.'' Forming a true community of learners through the active involvement of students, Trinity School at River Ridge has instituted a common, coherent, and integrated curriculum that helps students apply their knowledge more effectively. The constant evaluation of students at Trinity School is a critical part of this unique education. Students, teachers, and parents know where resources and energy need to be focused. This historic designation was accomplished through the pioneering and innovative contributions of a truly dedicated administrative staff and dynamic collection of committed teachers. Their deep and unwavering commitment to the students forms the foundation for a very special relationship with the young people at Trinity School at River Ridge. The teachers and staff have gone above and beyond all reasonable expectations to help kids. Mr. Speaker, another key ingredient in the overwhelming success of Trinity School at River Ridge has been the precedent-setting and inspiring level of involvement by parents. In this day and age when we in Congress hear so much blame being placed on the lack of participation by parents in their children's education, Trinity parents stand out as shining examples of the miracles that can happen when adults take the time to help out at their schools. But, Mr. Speaker, the No. 1 reason Trinity School at River Ridge has been chosen as a Blue Ribbon Award winner is its spirited students. This student body is focused in a most impressive way on real achievement and a relentless pursuit of the highest standards of excellence. The students have worked hard to create a safe, supportive, and drug-free environment. They have worked hard to establish a record of academic excellence across the board. From student leadership to participation in public service projects to help people in need in the community, from the heavy emphasis on scholastic achievement to the enthusiastic way they revel in the success of their classmates, the students of Trinity School at River Ridge deserve to claim this national honor as their own. The students at Trinity are the kind of young people any parents would be proud to call their own. Mr. Speaker, please join me in congratulating everyone at Trinity School at River Ridge on a job well done and for setting such a powerful example of what can be accomplished by a school if everyone pitches in and strives to do their best. Today we salute Trinity School at River Ridge for proving that schools all across America can succeed if everyone puts their minds and hearts into the effort.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Speaker, I rise to express my support for H.R. 447, the bill to establish a toll free number to assist consumers in determining if products are American made, and House Concurrent Resolution 120, in support of the independence of sovereignty of Ukraine and the progress of its political and economic reforms. Due to a delayed flight because of inclement weather, I was unable to be here for roll call votes number 402 and 403. But had I been here I would have voted in favor of the above bill and concurrent resolution.

Mr. RAMSTAD

Mr. RAMSTAD. I yield to the gentleman from Texas.

Mr. RAMSTAD. Mr. Speaker, I thank the chairman for yielding, and I rise today to enter into a brief colloquy with the gentleman from Texas [Mr. Archer]. First of all, I want to commend the gentleman for his outstanding leadership in bringing this legislation to the floor. I am concerned, however, about regulations that were just issued by the IRS in May regarding the section 936 possession tax credit therein. I believe these regulations will have an unfair impact on companies during the phaseout of section 936 because they cast aside regulatory rules upon which companies have relied for many years permitting arm's- length pricing in the purchase of components. They produce a discriminatory result that an arm's-length third party price can be used to value outbound sales of components but not inbound purchases by the possession company for purposes of the section 936 calculation. Mr. Speaker, I believe that a fair and workable solution can be developed to address these concerns, and I would ask that the chairman join me in strongly encouraging the Treasury Department to seek such a solution.

Mr. RAMSTAD. Mr. Speaker, I thank the gentleman for his agreement and also for his leadership.

Mr. RAMSTAD. Mr. Speaker, I rise in strong support of the Small Business Job Protection Act and to discuss a related issue regarding the tax treatment of independent contractors. The Ways and Means Oversight Subcommittee, on which I serve, has been aggressively working to rationalize the tax laws governing independent contractors. As we learned from the White House Conference on Small Business and through testimony before the subcommittee, sound rules covering employee classification are sorely needed. I commend Chairman Archer for the improvements in the bill before us, as they are an important first step in achieving this goal. I do, however, want to speak to one improvement that is needed to ensure the proper balance between consumer protection and appropriate application of employee classification laws. I was pleased to see that in the recently issued IRS Worker Classification Training Manual, the Service acknowledged the importance of balancing competing regulatory demands--those designed for consumer protection purposes and those driven by tax considerations. The training manual made significant progress by stating that rules imposed by a business on its workers in order to comply with Governmental agency requirements should be given little weight in determining a worker's status. Unfortunately, the manual goes on to state that if the business develops more stringent guidelines for a worker in addition to those imposed by a third party, more weight should be given to these instructions in determining whether the business has retained a right to control the worker. As you know, the amount of control exercised over a worker is indicative of that employee's status with respect to classifying workers as independent contractors. It is this second portion of the rule that could unintentionally compromise consumer protection. For example, in the securities industry, the Securities and Exchange Commission [SEC], the National Association of Securities Dealers [NASD] and State regulatory agencies' regulations are broad in scope and require securities dealers to exercise significant discretion in their implementation. I am concerned that this ambiguity may force businesses to comply with only the most minimal standards in order to avoid potential conflict with the tax laws. It makes no sense to place companies that exercise higher standards of due care in meeting their regulatory obligations at a greater tax risk than more lax competitors. I do not believe this was the intention of Congress. I urge the IRS to revise its guidelines so that no weight is given to any business policies or procedures that are reasonably designed to achieve compliance with applicable laws and regulations of Government or self-regulatory organizations, including the supervision of activities of workers and associated person to ensure compliance thereto. I would like to thank both Chairman Archer and Subcommittee Chairwoman Johnson for their leadership in this area. I look forward to working with them to develop rational employee classification tax rules in general, and also to ensure that our Nation's complex regulatory laws are not undermined by the Tax Code.

Mr. RAMSTAD

Mr. RAMSTAD. Mr. Chairman, will the gentleman yield?

Mr. RAMSTAD. Mr. Chairman, I thank the gentleman for yielding me the time. I rise today in strong support of the Mollohan-Fox amendment to restore critical funding for the Legal Services Corporation. I think it is important, Mr. Chairman, that we put this in perspective. The bill before us today contains a 50-percent cut for legal services. This 50-percent cut follows on last year's cut in funding of 33 percent. These cuts, Mr. Chairman, are extreme and they are unconscionable because they mean that our poorest and most vulnerable citizens will be unable to have legal representation in civil matters. In Minnesota alone, Mr. Chairman, these cuts meant that 25,000 eligible people who needed legal help have already been turned away. Because of last year's cut, Legal Services in Minnesota will close 4,000 fewer cases. Some claim that the private bar can step in and make the difference. Well, Mr. Chairman, in Minnesota, over 3,000 attorneys last year donated over 30,000 hours of legal services. The Minnesota lawyers and firms contributed over $500 thousand, but they cannot meet these critical legal needs alone any more than doctors can meet the critical medical needs of indigent people across this country. Many government entities are not known for efficiency. We all know that, and charges have been made today by opponents of this amendment. Let me tell you the facts. Mr. Chairman, 97 cents of every LSC dollar goes directly to the delivery of legal assistance, and Federal oversight accountability of these dollars is ensured. I take a back seat to nobody in this body in terms of cutting wasteful spending. Last year it was announced, or this year rather, that I have the best rating from Citizens Against Government Waste for cutting wasteful spending. Mr. Chairman, we are not talking about cutting wasteful spending here. We are talking about honoring those words on the front of the Supreme Court across the way, ``Equal justice under law.'' There has been overheated rhetoric from those who want to kill legal services for the poor. I would just remind my colleagues that the restrictions are in place from last year. Some of these anecdotal references refer to horror stories in the past. There have been abuses; we all know that. But the following restrictions are in place: No class action suits by LSC, no lobbying, no legal assistance to illegal aliens, no political activities, no prisoner litigation, no redistricting representation, no representation of people evicted from public housing due to drugs. That is all in the past. Those restrictions are on LSC as a result of last year's bill. Mr. Chairman, I plead with Members of this body, do not gut the words etched on the Supreme Court building, ``Equal justice under law.'' Support basic fairness and equality under the law. Support the Mollohan-Fox amendment to restore legal services funding. Let us do the right thing.

Mr. RAMSTAD. I thank the gentleman for yielding. Mr. Chairman, I rise in support of the Deutsch amendment to provide additional funding for a national training initiative to improve the law enforcement response in cases of missing and exploited children. As the author of the Jacob Wetterling Crimes Against Children Act, which became law in 1994, I feel a special burden for children who are vulnerable to crime. The Wetterling Act provides for the registration of convicted child sex offenders and violent sexual predators. The Wetterling Act is a critical resource for law enforcement for investigating child abduction and molestation cases. But more needs to be done. The subject of this amendment, the Jimmy Ryce Law Enforcement Training Act, has three crucial components that will provide needed training to law enforcement in missing and exploited children cases. Adequate funding is absolutely critical for each of these initiatives. I understand a promise has been made to fight for increased funding for this initiative in conference committee, and I am very grateful to Chairman Rogers for his commitment. Mr. Chairman, I look forward to continued progress on making our communities a safer place for our kids to grow up.