Pete Stark

Mr. STARK

Mr. STARK. Madam Speaker, I rise to a point of order.

Mr. STARK. Madam Speaker, may I be heard on the point of order?

Mr. STARK. Madam Speaker, I would just ask for clarification.

Mr. STARK. And the bill pertains to Medicare and Medicaid and health care in general; doe it not?

Mr. STARK. I see, and the area of jurisdiction is what?

Mr. STARK. And to what does that pertain, Madam Speaker?

Mr. STARK. Madam Speaker, I wish to be heard on the point of order. Madam Speaker, under the point of order could the Speaker define for us what is the topic before us and wherein we may speak within the parameters set by the distinguished Speaker?

Mr. STARK. Madam Speaker, I thank the gentleman for yielding. I would say at the very outset that the gentlewoman from Nevada [Mrs. Vucanovich], the gentleman from California [Mr. Waxman], and the gentleman from Florida [Mr. Bilirakis], are to be congratulated, as well as the gentleman from Ohio [Mr. Brown], for a bill that fixes a problem that we should have attended to some time ago. Madam Speaker, today is corrections day, part of a new dawning, part of a revolution here in this Chamber. And I do not disagree with any item that my Republican colleagues have brought to the floor today. But, boy, do we need corrections. If one wants to talk about errors that need fixing, the Republicans have created or are about to create errors that boggle the mind; errors, I might suggest, that are going to destroy the Medicare system and leave senior citizens without any health care. So I would just like to talk about errors that the Republicans are ignoring and errors that they are creating. This is a whole game of errors. There are not any hits or any runs. As a matter of fact, there are not any players on the field. I do not notice a Republican member of the Committee on Ways and Means on the floor, and they have jurisdiction over some of this. They did not even bother to come here today. Now, on corrections day, let us talk about a major error in the making in the Republican plan for Medicare and Medicaid. Last month the Republican majority rammed through their Medicare and Medicaid bills, and, despite repeated calls from Democrats, only one hearing was held. Today we understand why they had to ram those plans through in the dead of night, with secret meetings in the Speaker's office with major lobbyists from the American Medical Association. The number of uninsured Americans will increase 50 percent, from 40 million to 66 million, by the year 2002. There is an error that the Republicans ought to think about correcting before they even get out of the gate. Let me say that once again. As a result of the Republican plans to slash Medicare and Medicaid spending by $450 billion over the next 7 years, the number of uninsured Americans will rise by 50 percent; 26 million more Americans will be uninsured. Now, this is the finding of the Council on Economic Impact of Health Care Reform, a nonpartisan group with membership of leading Republican and Democrat health care experts. There, Madam Speaker, is an error that must be corrected before it is enacted into law. Where are the Republicans? Where are you on corrections day to correct your own heinous mistakes? Now, a second item, according to press reports, is that in your budget, your Republican budget, you Republicans are planning to extend the health insurance deduction for self-employed to 50 percent. Now, is that not nice? But did you not also mean to include individual employees who buy their own health insurance as well? It seems to be a significant oversight that we would extend this tax subsidy for health insurance to self-employed lawyers, doctors, CPA's, but not their secretaries and nurses. Could it be that the doctors and the lawyers are all rich Republicans, and the hard working secretaries and nurses who allow them to function are Democrats, and you do not care about low-income people? So if you are giving away all this money to rich self-employed, why not a little worry about the average working person in the small business who is denied health insurance by their less than munificent boss, who is probably a Republican, and why not extend this to the lower paid workers? Now, that is not enough. We have got corrections? Boy, have we got corrections. I understand that the Republicans agreed last night to leave the disabled out of the Medicaid plan. Now, is that not fine? What are you going to do for all the people who are disabled? You are going to kick them out of the Medicaid plan. There is no guarantee that all the disabled people who get Medicaid coverage today will be covered under the Republican plan. Now, that needs correction. That is heartless. That is cruel. What are you going to do, break up their crutches and give them to the rich for their fireplaces? Come on. Can you not find, when you are cutting $450 billion out of a budget to pay for tax cuts to the rich, can you not find enough to maintain or require that Governors under these block grants keep disabled people in the Medicaid plan? That is not enough. You want corrections? You want egregious errors? You want problems that the Republicans are creating that have to be corrected? Another item in the Medicare is the copayment. Beneficiaries today pay up to 53 percent in copayments when they have an outpatient procedure. These are Medicare beneficiaries who are not supposed to pay those kinds of copayments. Why, a beneficiary could pay, say, $3,000 out-of-pocket for an outpatient procedure. How do you fix [[Page H 12208]] it? You give the hospital back the money, but you make the beneficiary keep paying the $3,000. So much for your fixing Medicare. You are sticking it to the seniors and making them pay these outrageous charges. Should that not be corrected? Where are you? Where are these great correctors of the errors they are creating? They are probably in the back room right now trying to give away more money to the rich, to the doctors, to the hospitals. Currently, a provision in the law referred to as COBRA was written in 1986. Forty-one million Americans are extending their health care insurance when they become disabled or laid off or have been divorced at no cost to the Federal Government, not a penny to the Federal Government. And today there are 3.5 million people abroad in the land who are about to have their COBRA benefits expire. And, yo, Republicans voted not to extend that. In the Committee on Ways and Means, every Republican voted not to extend COBRA benefits, at no cost to the Federal Government. Here is a correction that does not cost a penny to anyone. All it takes is a little concern. All you got to do is care about people who have lost their jobs and are losing their health care insurance, and you would not even let them pay for it out of their own pocket. Talk about heartless, cruel, awful people. The people who would turn their backs on the disabled, on the unemployed, certainly do not deserve to be in here saying they are going to correct errors. They are creating errors faster than we could correct them if we met all week. In other Medicare and Medicaid plans, Republicans plan to turn nursing home regulations over to States. Now, there is an error in the making that you want to look for. Why, you may not be aware that States do an awful job monitoring the quality of nursing home care. As studies come to light that find when States monitor nursing homes, they find about 5 percent of the nursing homes are in violation. When Federal regulators inspect these nursing homes, they find almost 14 percent in violation. Should not we have decent nursing home standards, so that we do not handcuff poor, old people to their beds, let them die of bed sores, so we do not give them tranquilizers to make vegetables out of them? Where is your compassion? Why are you destroying Medicare and Medicaid nursing home regulations to the detriment of the seniors? You want an error you are creating? You can fix it right now. Finally, in your Medicare reform plan you only catch 1 percent of the fraud estimated to take place currently. Now, surely you all want to be tough on crime. I have heard that from your side. You want to build jails. You do not want to have any welfare to prevent people from going to jail, but you are sure going to build jails. Well, let me tell you, what you are doing allows 1 percent of finding Medicare fraud and reforming it. One percent? Come on, a blind pig could find a pearl rooting in the barnyard faster than you all can find fraud the way you are going about this. So, Madam Speaker, as we talk about corrections, a corrections day, how about a corrections week, or a corrections month? And for the Republicans, I might suggest a corrections institution, because you are destroying the institutions of this country that the seniors have counted on, that the poor and children have counted on, for over 30 years. With one ill-thought-out bill, with one ill-thought-out budget reconciliation, you are destroying the health care of the seniors. You are taking away the support system for the disabled. You are cutting back on children's education and school lunches. Surely, that needs correction. So if you are closing hospitals and pumping up the fees that we pay to doctors, how about dealing with some of the errors that you are creating and that you are doing nothing to correct. Yes, sir, this is a bill worth voting for, but it is such a piddling splatter on the platter that needs correcting. Would you please think about the people you are harming, the disabled, the senior citizens, the 26 million you are going to add to the uninsured, the children who will be denied medical care, the crippled, halt and lame you are kicking off the rolls? What are you going to do to collect your Speaker's bill that none of you have had any impact in? There are the corrections that really need correcting. There are the errors the Republicans are creating. There is humanity that is lacking. There is an indifference to the problems of the people in this world. That is what this institution should be doing.

Mr. STARK

Mr. STARK. Mr. Speaker, today I take great pride in introducing legislation authorizing Federal involvement in the design and construction of a water reuse project in southern Alameda County. The Alameda County Water District and the Union Sanitary District provide drinking water supplies and wastewater treatment services respectively to the California cities of Newark, Fremont, and Union City. By the year 2030, the combined service area water demands are expected to increase by 44 percent. The anticipated increase in demand, the scarcity of available water supplies, and an increased awareness of the importance of protecting our natural resources led the two districts to form a joint program to develop and implement the Alameda wastewater reuse project. In order for this project to proceed, a limited amount of Federal assistance will be required. It is for this reason that I, today, am introducing legislation authorizing the water reuse project for Federal assistance under title XVI of Public Law 102-575. In 1991, the Alameda County Water District and the Union Sanitary District jointly sponsored a water reuse survey to determine the potential for use of reclaimed water in southern Alameda County. The survey concluded that a water reuse project would provide an environmentally sound water resources management program, facilitate continued economic activity and general growth in the communities, and also serve as a model for other urban joint projects throughout the arid west. No less important, this project will complement other Federal, State, and local government efforts to restore San Francisco Bay's water quality. In 1993, the two districts developed a reclaimed water master plan. Based on the plan, the two districts determined that design and construction of the Alameda County wastewater reuse project would be feasible and would meet the objectives of ensuring a sound and growing economy while promoting sound stewardship of limited water resources. Specifically, the project would: Reduce demand on potable water supplies that could be used more efficiently for human consumption and natural resource needs; Reduce wastewater discharges into the San Francisco Bay, thereby complementing regional, State, and Federal efforts to improve the bay- delta's water quality; Ensure a reliable water supply for industry and other nonpotable purposes that will not be subject to cutbacks mandated by Federal and State requirements during periods of drought; and Reduce the need for expansion of current drinking water and wastewater treatment facilities' capacity. Based in part on the successful test of a pilot scale facility, this project enjoys broad support from the cities, school districts, and numerous industries, including high technology companies that depend on a reliable water supply. The project is also endorsed by the Association of California Water Agencies. As I said before, water demands are expected to increase significantly over the next several years. With almost 85 percent of southern Alameda County's water supply imported it is important that we recognize that we need to leverage every possibility we have to maximize our local water resources. The Alameda County wastewater reuse project provides us with that opportunity. The reclamation project has undergone necessary studies and it is ready to proceed to design and construction. Only with Federal assistance can the project take the next step and my legislation puts that in motion. I look forward to working with my colleagues on the Resources Committee on the legislation and hope they can support this key component of the San Francisco Bay area's water resource management program.

Mr. STARK

Mr. STARK. Madam Speaker, I would like to ask the distinguished gentleman from Texas, as this bill deals with Senate bill 790, eliminating and sunsetting acts, and there is a subtitle, F, Department of Health and Human Services; this does not under any circumstances accede to the wishes of Speaker Gingrich and sunset the Medicare bill, by any chance, does it? Points of Order

Mr. STARK. I thank the Speaker. If the gentleman from Texas would yield further to enlighten this gentleman on the content of the bill and the intent of S. 790 and particularly subtitle F, eliminating reports of the Department of Health and Human Services, this is a report on Medicare treatment of uncompensated care that is eliminated. Now, I believe that uncompensated care will increase as the uninsured increase as a result of the Republican bill for destroying or attempting to destroy Medicare and there will be a 50 percent increase in uninsured. The uninsured in this country will go from 40 million today to 66 million by 2002. Those people will still be entitled to treatment in an emergency room, and normally if they were Medicare patients, that emergency room would, in the normal course of business, reimburse these hospitals. [[Page H 12229]] Now, if we do not know the effect of all of these additional 20 million uninsured as caused as a result of the Gingrich Medicare bill, which attempts to destroy it, how will we be able to know whether the Government is fairly reimbursing the local hospitals which will have to have the increased burden of the Medicare treatment for those who no longer have insurance, particularly those poor seniors whose incomes are under $7,000, who will be cut out of the Medicaid Program if we do not have that information? Will that not necessarily impact very seriously on those disproportionate-share hospitals who depend on the Medicare payment for uncompensated care? Without this report, how can we possibly know the horrendous effects that the changes, the Republican changes that they are trying to make to the Medicare bill to fund their tax cuts to the rich, how will that under S. 790, will there be a replacement? Will we be able to get that information so that we can compensate those hospitals?

Mr. STARK. If the gentleman will yield further, we are led to believe that, further addressing S. 790 and the reports, that the amount of uncompensated care could rise to $33.5 billion, under one scenario, as much as $43 billion, and, further, that teaching hospitals could see the biggest increase of uncompensated care. Now, without this information, I know that it is of no matter to the Republicans and to Speaker Gingrich, who does not care if we close our centers of excellence as he begins to destroy Medicare over time, but S. 790 was one way, through the reports on Medicare treatment of the uncompensated care under subtitle F, that we would know what was happening. The hospitals are going to have to hold their annual cost increases to less than half of inflation, and many of the hospitals are likely to close, and they are the ones most likely to close, are those serving a high number of Medicare and Medicaid patients and the uninsured. When there is a correction needed, I certainly would support it, and as the gentleman suggests, supporting S. 790 is a good thing. But the unintended consequences, or perhaps the intended consequences, if you would take the Speaker's speech at face value that he would like to destroy Medicare, and most of us do not want to, the Republicans do, the Democrats do not, but if the Republicans continue to prevail, then we will not even, under this bill, under subtitle F, have a report on the Medicare treatment on uncompensated care. And I ask the gentleman from Texas if that was intended. Following that, I would like for us get on to the next report that assists the homeless. Could the gentleman respond to my question in terms of treatment of uncompensated care, how it will impact and require closing of community hospitals, all as a result of Speaker Gingrich's Medicare changes?

Mr. STARK. The gentleman makes an excellent point.

Mr. STARK. Madam Speaker, if the gentleman will yield, that is inhumane.

Mr. STARK. No. I just indicated I had the time when the gentleman rose.

Mr. STARK. Madam Speaker, point of order. I believe I was on his time.

Mr. STARK

Mr. STARK. Mr. Speaker, Republicans are crowing today that they have discovered that the failed Clinton health care plan cost $14 million to develop. Yes, that was a waste. It should have been done differently, in the open, and with more congressional consultation. Some $14 million, Mr. Speaker. That's about the cost of care for 14 very premature babies that could have been prevented if people had health insurance. That's about the cost of 28 cancer cases that could have been detected earlier if people had health insurance. Yesterday, the Robert Wood Johnson Foundation estimated that the Republican Medicaid cuts would increase the number of uninsured by 50 percent. We already have 40 million uninsured. With their cuts it will rise to 68 million. There is the true waste, Mr. Speaker. People will die; families will be destroyed; children will suffer because of the budget actions of the Republican majority. Some $14 million was wasted--and it will be nothing, nothing, compared to the waste and death and pain that their budget bill will impose on the Nation.

Mr. STARK

Mr. STARK. Mr. Speaker, will the gentleman yield briefly?

Mr. STARK. Mr. Speaker, if the gentleman will yield, I would ask the gentleman, was it considered for the screening of mammography and colorectal? Many of these people would be dead by the time they get to take this drug, because in our committee the Republicans voted against colorectal screening and mammography, which, of course, would negate some of these drugs being administered at the point at which it is too late.

Mr. STARK. Mr. Speaker, this is to ask if the gentleman would describe that Medicare provision.

Mr. STARK. Mr. Speaker, I thank the gentleman from Ohio for yielding and would inquire of the gentleman from Colorado, precisely my reason for inquiring, if he could explain the Medicare coverage of certain anticancer-drug treatments, an issue on which we never had hearings or never discussed, and could the gentleman enlighten us as to what exactly this amendment is other than the written bill which does not describe the bill, or how much it would cost, or why it was in there?

Mr. STARK. Mr. Speaker, will the gentleman yield? [[Page H 11993]]

Mr. STARK. Mr. Speaker, I would like to just talk about this so- called Medicare coverage of anticancer drug treatment. It is important to know that in the Committee on Ways and Means, the gentleman from Nevada, [Mr. Ensign], the gentleman from Pennsylvania [Mr. English], the gentleman from Nebraska [Mr. Christensen], and the gentlewoman from Connecticut [Mrs. Johnson], all voted to deny women annual mammograms. They all voted to deny colorectal screening because they said they did not have the money. This was at the same time when the Speaker was cutting a deal to give $3 billion to the American Medical Association, and these people did not have the money. Now they come in at the behest of some drug company in a payoff, slip in two pharmaceutical treatments that will not do you any good if you do not discover the cancer in time, and say they are trying to help seniors. Thanks. My mother does not need that kind of help. The seniors need to find out in a timely fashion when they get cancer, and the Republicans, in an effort to pay for a huge tax cut for the rich, are denying the seniors the chance to have the screening and the testing that the American Cancer Society says is necessary. You should be ashamed of yourselves. You have no compassion, no willingness to help treat the seniors. All you want is to waive the capital gains tax for a few rich Republicans and give a payoff to a pharmaceutical company who has made huge contributions to the Republican coffers. That is criminal.

Mr. STARK

Mr. STARK. Mr. Speaker, the gentleman who preceded me in the well began to sell the preposterous issue that they voted to protect seniors or they will in this bill. It is wrong. That gentleman that was in the well and all Democrats, save one, voted to cut out an increase in prostate cancer screening to the level required by the National Cancer--because they want the extra $3 billion to give to the doctors in a late-night payoff that Speaker Gingrich was making to the AMA. They vote against giving women annual mammograms, as required, because they did not have the money, and they come here and tell us that in this CR they are going to help the seniors. Nonsense. Pay the piper? They are paying off the rich Republicans in tax cuts. That is why they need to increase $300 a year in the part B premium to the average senior in this country, and it will happen on January 1, 1996. None of that increase goes to save the Medicare trust fund. It all goes to pay tax cuts for the rich. None of the part B premium increase goes into the trust fund. Let us get it straight. This is a sneaky way to increase the part B premium on the seniors. It kicks up their premium to $104.30 a month. It is more than even in the House-passed Republican reconciliation bill. They did not have enough money at the last minute. Mr. Speaker, they cannot add straight, they cannot get to 20 with their shoes and socks on, they cannot run the Government, and they do not understand Medicare, so when they fail, they stick it to the seniors once again, and they stick it to the poorest of the seniors unfairly. They cut out their cancer screening so they could pay off the doctors big time. They increase the amount that poor seniors will have to pay so they can give tax cuts to the rich. It has got to stop. We cannot let them get away with this in the dead of night, trying to sneak these increases through on a continuing resolution. Vote down the rule. Make them run this place the right way. make them tell the seniors how they are gouging them up front, how they are cutting back on their cancer screening, and how they are raising this money for tax cuts for the rich, and let us see if they dare vote up front to raise the part B premium for tax cuts for the rich. They do not have the nerve to vote for that. Vote down the rule.

Mr. STARK

Mr. STARK. Mr. Speaker, today I take great pride in reintroducing the Gift of Life Congressional Medal Act of 1995 along with our colleagues Floyd Spence, Joe Moakley, James Walsh, Gerald Kleczka, Nancy Pelosi, Karen Thurman, George Brown, Randy Cunningham, Martin Frost, and Victor Frazer. I believe the enactment of this legislation will not only honor the individual organ donor and their loved ones, but will also heighten the awareness of the organ shortage--ultimately resulting in more organ donation. Despite the numerous problems that organ donation programs have faced and conquered over the years, a major problem still exists--an undersupply of available and suitable organ donors. Currently, there are 40,000 individuals waiting for an organ transplant in the United States. A new name is added to the national patient waiting list approximately every 18 minutes. Last year alone, more than 3,000 adults and children died while waiting for an organ. Just yesterday, approximately eight individuals, suitable for a transplant operation, died while waiting for a transplantation. The demand for organs will continue to grow with the improvement of medical technologies, and without expanded efforts to increase the supply of organ donation, the supply of suitable organs will continue to lag behind the need. According to some researchers, it may be possible to increase by 80 percent the number of organ donations in the United States through incentive programs and public education. A congressional medal recognizing donors and their families can play a very important and effective role in our efforts to encourage such donation. Our proposed Gift of Life Medal Program will be administered by regional organ procurement organizations (OPOs) and managed by the entity administering the Organ Procurement and Transplantation Network. Once the very difficult decision to donate an organ has been made, the donor or the family member of the donor will be asked by the regional OPO whether participation in the Gift of Life Medal Program is desired. The OPO will give each donor or family of the donor the option of receiving a Gift of Life Medal, recognizing that some donors and families may not want to participate. If the donor or the family of a donor requests, a public presentation will be made to honor the donor. A presentation by a local official, community leader or Member of Congress would be a tremendous opportunity to increase the awareness concerning the desperate need for organ donation. Every action has been taken to insure that the issuance of the Gift of Life Medals results in no net cost to the Government. In addition, I am proud to report that the legislation has the strong support of the United Network for Organ Sharing (UNOS) and the National Kidney Foundation. It is with great pleasure that I ask our colleagues to join with us as cosponsors of the Gift of Life Congressional Medal Act of 1995 and recognize the enormous faith and courage displayed by organ donors and their families. They offer others a second chance by providing the most precious gift imaginable--the gift of life.