Charlie Rangel

Mr. RANGEL

Mr. RANGEL. Mr. Speaker, I yield 2 minutes to the gentleman from Nebraska [Mr. Bereuter]. (Mr. BEREUTER asked and was given permission to revise and extend his remarks.)

Mr. RANGEL. No, Mr. Speaker, I am not.

Mr. RANGEL. Mr. Speaker, I yield myself the balance of my time. Let me thank my colleagues that have come to the floor in support of this bill. Listening to the debate, one might believe that Cuba is a threat to our national security and now the CBI is a threat to our national economy. We are dealing with friends. Someone said that should not matter, that we are dealing with trade. But when we deal with friends, if they have a problem with the economy, we have been known to provide leadership in this hemisphere, even to the point that the American people and this Congress has seen fit to send troops to this part of the world in order to maintain peace. For decades, we have sent money there in terms of aid. Now they are coming and saying that in lieu of these things, they just want to be trading partners with us. Mr. Speaker, for those who visit the islands, going into a retail store is like going into a store in the United States if they are looking to see where the products have been manufactured, where they have been shipped from. I suspect after this debate is over, we soon will be hearing from those American companies that hire American workers that export these retail goods to our friends in the Caribbean. We have just been hit hard with the crisis that they have had with bananas, where we have taken the case to the WTO, the World Trade Organization, which gave a negative decision as relates to the Caribbean. They work hard every day. These are not people that are known to have slave labor. These are independent countries, literate countries. They work hard, they have labor unions, and there are provisions in the bill that provide for labor rights. But something that concerns me, too, is that these small islands out there in the Caribbean are really vulnerable to the international drug traffickers. They have fought against this and their countries have not succumbed as we have to become addicted to these drugs, even though corruptions have hit some part of the countries as relates to transshipment of drugs. The gentleman from New York [Mr. Gilman] and I have traveled in this part of the world and we have seen the impact. It seems to me that we just do not slap friends in the face at a time like this when so much of their own money has been protecting their borders against drugs coming in which is basically consumed by us. Mr. Speaker, I ask my colleagues to support this bill. It is the right thing to do. It is the fair thing to do. The President wants it. I think we owe it to the people in that part of the world.

Mr. RANGEL. Mr. Speaker, I rise in strong support of H.R. 2644. As the gentleman from Illinois [Mr. Crane] pointed out, in 1983 we saw fit to go into a trade agreement with the small island countries. It was really an emotional experience, as the Committee on Ways and Means visited island after island, to see the love and affection that the people of these countries had. Even though some of them had just first started enjoying democracy, most all of them, then as now, are living through very fragile economies. There were a lot of Members who thought that we would be big losers in this trade, but as it turned out, and the gentleman from Illinois [Mr. Crane] has pointed out, we have had a tremendous increase in exports to these countries, over 150 percent over the last 12 years. But the most exciting thing to see when you do visit these countries is, every place you go it says, ``Made in the U.S.A.'' It is ``Made in the U.S.A.'' because we have been more than just trading partners, we have really been friends, and this friendship is now being tested as we see the devastating effects that the North American Free Trade Agreement has had on these small countries. I know that NAFTA had been controversial when it was first passed. I know it is controversial today. I know some Members, when they see NAFTA, they want to vote against anything that looks like an extension of it. But if they would just pause and see that what has happened is that the passage of NAFTA has caused the advantages, or the parity, that we had hoped to give to the people on these islands to put them at a definite disadvantage as we find that trade that normally we would be doing with these Caribbean countries is now going on in Mexico. So it means that friends of the Caribbean and the United States that have promised that we were going to give them a level playing field are now coming today saying, ``I do not like NAFTA.'' It seems to me that we should not hold these small countries hostage because of a disadvantage that they are now suffering because of legislation or trade agreements that some Members may have. Please remember that we are not talking about North Vietnam. We are not talking about North Korea. We are not talking about Communist China. We are talking about traditional friends that are going through some very hard economic times, that we have never had to beg for their friendship, we have never had to pay for their friendship. When the whole world seemed like they were going against us, including Europe, we always had our friends in the Caribbean. So I hope that the United States domestic politics does not override the fact that we should be doing the right thing. Please remember, we are not talking about giving them any advantages. We are talking about keeping our promise that we made to these very small island countries when we entered into the 1983 agreement. It is good for the people in the Caribbean; it is good for the United States. It is good for the free world to see a leader like we are take care of our friends who may not be as big and may not be as powerful but, to me, and I hope to my colleagues, they are just as important. Mr. Speaker, I reserve the balance of my time.

Mr. RANGEL

Mr. RANGEL. Mr. Speaker, I am proud to stand before you today to highlight and honor the work of community health centers [CHC's] and the vital role they play in meeting the unmet health care needs of the less privileged individuals in America. Tailoring their services to meet the needs of the entire family, CHC's provide a full range of family-oriented, culturally appropriate, preventive and primary care services. Currently, over 3.5 million or approximately 44 percent of the individuals receiving services at CHC's are children from newborn infants to adolescents 19 years of age, including 1 million uninsured children. Living in economically depressed, underserved communities, these children and their families are at risk for multiple health and social problems. CHC's are the entry point for these vulnerable populations. These centers provide health care services at more than 2,200 sites across the country. Each year, in my home State, New York, more than 60 free-standing CHC's provide comprehensive medical and support services to 1.5 million of the State's poorest residents. Perhaps the greatest testimony to the importance of CHC's are their attack on spiraling health care costs through constant innovation and its effective use of preventive health care measures. The public/ private partnerships formed by these CHC's have been successful at reducing morbidity and mortality among high risk individuals. While infant mortality rates among the black population remains high, the rate has been sharply reduced in health center catchment areas and, more, dramatically, among health center patients. Additionally, CHC's have stepped forward and taken a leadership role in designating cost- effective, culturally competent care for Latinos, Asians, and other hard to reach minority populations. With the enactment of the welfare reform law, we cannot underscore the importance of these community health centers. Not only do they provide managed care efficiently and competently, CHC's make sure that they respond to the local and cultural needs of their patient populations. In today's new world of measuring the effectiveness of every Federal dollar spent, CHC's stand out as a shining example of Federal investments that pay off in both health and community impact. Also evident is the economic impact made by CHC's. In many cases, these CHC's have been a major force in reinvigorating entire communities. Not only are jobs created through CHC construction, and the hiring and training of community residents, but partnerships are forged between health centers and local businesses--producing startling effects in many communities. Finally, let me take this opportunity to thank all community health centers across the country, but especially those centers in the 15th Congressional District in New York which everyday exemplify partnerships of people, governments, and communities working together to meet local health care needs in the most effective and efficient way possible.

Mr. RANGEL

Mr. RANGEL. Mr. Speaker, on Wednesday, October 22, five of us introduced H.R. 2701, a bill to ``carve out'' disproportionate share hospital [DSH] payments from the amount Medicare pays managed care organizations, and provide it directly to the DSH hospital when an MCO patient uses that DSH hospital. Today, I am adding Representatives Matsui, Coyne, and McDermott to the list of cosponsors. To help explain the purpose of the legislation, I would like to include in the Record below a press release from the American Hospital Association in support of this legislation ``which helps hospitals caring for large numbers of poor Americans.'' I want to thank the Greater New York Hospital Association, the American Hospital Association, and the Healthcare Association of New York State for their early support. AHA Applauds Bill Which Helps Hospitals Caring for Large Numbers of Poor Americans Washington (October 22, 1997)--The American Hospital Association (AHA) added its strong support to legislation introduced today by Rep. Charles Rangel (NY) to ensure that Medicare payments meant to help hospitals caring for large numbers of low-income Americans actually reach those institutions. Other original co-sponsors included Rep. Pete Stark (CA), Rep. Benjamin L. Cardin (MD), Rep. John Lewis (GA) and Rep. Xavier Becerra (CA). Within the Medicare program, hospitals that provide care to a large number of low-income Americans receive special payments to help serve these patients. Currently, these hospital payments are included in the rates Medicare pays managed care plans. Typically, these payments are not passed along by plans to hospitals that provide the care. The Rangel bill separates those payments from Medicare managed care plan payments and directly pays them to the institutions that deliver this vital care in communities. ``This bill gives credit where it's due,'' said Rick Pollack, AHA's executive vice president. ``Nearly 1,900 hospitals care for large numbers of the poor and are due these payments. This bill gives many hospitals the financial underpinnings necessary to continue providing such quality health care. It's an important step to ensure access to care for the poor.'' A similar approach was included in the recent budget bill. Under the budget deal, Medicare payments to cover the costs of teaching our nation's physicians are passed directly to the hospitals that incur these expenses, and not folded into Medicare payments to managed care plans. The AHA strongly supported that measure. An AHA-supported proposal, similar to the Rangel bill, was discussed during the budget debate, but ultimately not enacted. ``We look forward to quick passage of this important legislation,'' said Pollack. In addition, Pollack noted that AHA will continue to seek repeal of the guaranteed 2 percent increase in Medicare managed care payments to help smooth out the still considerable variation in payment rates across the country. The AHA is a not-for-profit association of health care provider organizations that are committed to health improvement of their communities. The AHA is the national advocate for its members, which includes 5,000 hospitals, health care systems, networks, and other providers of care. Founded in 1898, AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information visit the AHA, web site at www.aha.org.

Mr. RANGEL

Mr. RANGEL. Mr. Speaker, I yield 30 seconds to the gentleman from California [Mr. Cunningham].

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

Mr. RANGEL. Mr. Speaker, there is nothing in this bill that gives one nickel to the teachers, one nickel to the schools, one nickel to equipment. It gives the parent, whether the kid is in private or public school, that has enough money to put in the bank an opportunity to use the interest on the money.

Mr. RANGEL. I believe it is good for all parents. It has nothing to do with education. Mr. Speaker, I yield 1 minute to the gentlewoman from California [Ms. Sanchez].

Mr. RANGEL. Mr. Speaker, I yield 2 minutes to the gentlewoman from New York [Mrs. Lowey]. (Mrs. LOWEY asked and was given permission to revise and extend her remarks.)

Mr. RANGEL. Mr. Speaker, I yield 3\1/4\ minutes to the gentlewoman from Texas [Ms. Jackson-Lee]. (Ms. JACKSON-LEE of Texas asked and was given permission to revise and extend her remarks.)

Mr. RANGEL. What time remains, Mr. Speaker?

Mr. RANGEL. Mr. Speaker, I yield 2 minutes to the gentleman from Texas [Mr. Stenholm]. (Mr. STENHOLM asked and was given permission to revise and extend his remarks.)

Mr. RANGEL. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Illinois [Mr. Davis].

Mr. RANGEL. Mr. Speaker, I yield myself the balance of my time. Mr. Speaker, for those who say that we are talking about bureaucracy, the amendment would indicate that all we are trying to do is improve the public school system in the areas that it is failing, if they can cooperate with the private sector to improve the curriculum and make the students more productive, to give them the skills to work with. No, we do not give away money, interest-free money to those that have this disposable income. We believe the systems that are not working should be reinforced, make them productive, make them effective and get more people out of the jails and into the workplace.

Mr. RANGEL. Mr. Speaker, I yield 1 minute to the gentlewoman from Connecticut [Ms. DeLauro].

Mr. RANGEL. Mr. Speaker, I offer an amendment.

Mr. RANGEL. Mr. Speaker, on that I demand the yeas and nays.

Mr. RANGEL. Mr. Speaker, I yield 2 minutes to the gentlewoman from Oregon [Ms. Furse].

Mr. RANGEL. Mr. Speaker, I yield 2 minutes to the gentleman from New York [Mr. Owens]. (Mr. OWENS asked and was given permission to revise and extend his remarks.)

Mr. RANGEL. Mr. Speaker, I object to the vote on the ground that a quorum is not present and make the point of order that a quorum is not present.

Mr. RANGEL. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I encourage Members' support for my amendment, which merely is an expansion of existing law that was incorporated in the recent tax package, with the support of the leadership of the Democrats, the Republicans, as well as the President of the United States. What it does is to allow those public school systems that are failing us in areas of extreme poverty to get their acts together by realizing that they have to do something better. And what they do better is to have to reach out to form partnerships, to form academies with the private sector leadership in these communities, and to sit down with the teachers and with the parents, the business people and the local officials, and to come up with a curriculum, not just one that they feel good about, not one that comes from the State capital, but one in which the private sector can say that these are the skills that we are going to need in this community if your kids are going to go to college or if your kids are going to get a job. So there is no special bank accounts. What it amounts to is it allows these communities to be able to go to the public market and to borrow the funds with interest-subsidized bonds so that they would be able to supplement the public budget by providing funds for scientific equipment, scientific books, things that would be approved by this partnership, to rehabilitate the buildings, to make the repairs, and to have the type of academies that excel in those communities that they are not doing well in. It just seems to me if one takes a look at some of these communities, one would find that the budgets to keep kids in jail far exceeds the budgets that keep kids in school. In the city of New York, we pay $84,000 a year to keep a kid in a detention center, and we are fighting now as to whether $7,000 is a sufficient amount of money to keep that same kid in school. All this is saying is that as we concentrate on the next century and having people with the intellect and the technology to keep America in the forefront, do not try to move forward and leave millions of people behind without the skills to work with. I encourage Members to consider this. It cannot be called partisan. It borrows from the same concepts of funding as our Republican majority. The concept has been supported, it is in existing law, and I just hope that you would believe that this is really a more effective way to improve the quality of education for those kids who do not have the option to go to private school, but have this as the only network, as I and the gentleman from Iowa [Mr. Nussle], had when we were kids, and that was that public school system. We are not saying there is an attack on that system, we are saying that it is in a critical stage today, and we are asking Members in the Congress not to let that go, because for many of us, we never had the option to go to a private school. Mr. Speaker, I reserve the balance of my time.

Mr. RANGEL. Mr. Speaker, I yield myself 30 seconds. Mr. Speaker, we do not know as we debate this bill what a special need is, but we can imagine and hope that Treasury will come up with something. And if the gentleman is talking about a lifetime, I do not know why he sunset the bill in 5 years, but I am sure he will have enough time to explain that. Mr. Speaker, I yield 2 minutes to the gentleman from California [Mr. Fazio].

Mr. RANGEL. Mr. Speaker, so that we can make certain that we confine our remarks to what is in the bill, does the gentleman have any idea where a child with special needs would be in the bill before us? I would urge the gentleman, please, not to place his arguments on special needs, because there is absolutely no description in this legislation as to what is a special needs child, which means that every parent, I would like to believe, would believe that their child has special needs and there is no way in the world to disprove it.