Pete Stark

Mr. STARK

Mr. STARK. Mr. Speaker, I yield 1 minute to the gentleman from California (Mr. Sherman).

Mr. STARK. Mr. Speaker, I yield 4 minutes to the gentleman from Tennessee (Mr. Tanner). (Mr. TANNER asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I yield the balance of my time to the gentlewoman from California (Ms. Pelosi).

Mr. STARK. Mr. Speaker, I yield 2 minutes to the gentleman from Massachusetts (Mr. Tierney). (Mr. TIERNEY asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I yield 4 minutes to the gentleman from Texas (Mr. Doggett).

Mr. STARK. Mr. Speaker, I yield 3 minutes to the gentleman from Michigan (Mr. Levin). (Mr. LEVIN asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I yield 2 minutes to the gentleman from Maryland (Mr. Cardin).

Mr. STARK. Mr. Speaker, I yield 3 minutes to the gentleman from Massachusetts (Mr. Neal). (Mr. NEAL of Massachusetts asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I reserve the balance of my time.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise just to comment. My colleagues will hear a lot of people talking about our friend Bob Matsui and his legislative accomplishments. I want to remind everybody that his name on this Federal courthouse will remind people that it was 6099 that interned Japanese Americans in the 1940s in violation of what we then thought were human and civil rights. As we proceed to violate people's human and civil rights under the PATRIOT Act, I think it will be appropriate that the Matsui courthouse will be the place where, hopefully, these rights will be corrected and restored to the American citizens and residents who deserve them. I think it is most fitting that this building is named for Robert Matsui.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise to remember and honor my friend and distinguished former colleague Bill Lehman. Bill Lehman represented South Florida in the House of Representatives for twenty years beginning in 1972. Bill and I came to Congress together that year. It is with sadness that I stand to pay tribute to him today as one of the last remaining members of the class of '72. Though Bill left Congress in 1993, he and I kept in touch. It was less than a month ago when we last corresponded. He noted my name in an article in the Miami Herald and wrote to encourage me to keep up the fight. I'm going to miss those notes and his many years of friendship. Bill was unique. He was special among those who've served in this institution. He was an individual of great principle and compassion beloved by the community he represented. As his hometown paper the Miami Herald eulogized him, Bill Lehman was a ``legendary figure of South Florida politics considered a visionary on racial issues and public transit.'' Bill Lehman was legendary in this House where he served ten years as Chairman of the powerful Appropriations Subcommittee on Transportation. He was a tireless advocate of progressive causes at home and abroad, known for taking principled stands on international and constitutional issues. Bill Lehman had another distinction, too. He's the only politician I ever met that, when compared to a used car salesman, he was proud to be a used car salesman. Born in Selma, Alabama in 1913, he took the moniker ``Alabama Bill'' when he moved to South Florida and opened a used auto dealership in Miami in 1936. Playing country music in his advertising, ``Alabama Bill'' earned a modest reputation as a country western singer. That original business has grown into one of South Florida's largest auto dealerships carried on today by his son Bill Lehman, Jr. After nearly 30 years in the used car business, Bill Lehman went off to Oxford University. In the early 1960s, he returned to Miami and began a second career teaching high school English. In 1966, he began yet a third career running for and winning a seat on the Dade County School Board and went on to serve as Board Chairman in 1971. A year later he was elected to Congress. I was greatly saddened to hear of Bill Lehman's passing on March 16 of this year and commend my colleagues for dedicating this evening in his honor. My thoughts are with Bill's wife Joan, to whom he was married for 66 years, their two sons Bill Jr. and Tom, and their 6 grand children and 2 great-grandsons. Bill's years of dedicated public service in this House will never be forgotten. His spirit and the principle and compassion he brought to the job will continue to be greatly admired by those of us who knew him.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to recognize Linda Wood, upon her retirement as Alameda County, California's top librarian. After 14 years at the helm of the county library system, with 10 branches and an annual budget of $21 million, Ms. Wood is stepping down from an extraordinary career. She has been working in the library field for almost 40 years and states, ``I'm proud of my accomplishments, but I'm ready to move on to the next phase of my life.'' Ms. Wood began her library career reshelving books. After earning her degree in library science from the University of Washington, she graduated to reference librarian and went up the ladder from there. She has taken on many duties, from serving as branch manager to administrator in libraries from Oregon State to the cities of Riverside and Los Angeles. Ms. Wood leaves the Alameda County library system a lot bigger than she found it. Since being hired as county librarian in 1991, she has helped open two new branch libraries--in Albany, California in 1994 and Dublin, California in 2003 and has obtained seed funding and a patch of land for a new branch in Castro Valley, California. The county library system, with over 200 full-time employees, also includes branches in Fremont, Newark, Union City and unincorporated San Lorenzo, a bookmobile and services for jail and juvenile facility inmates and literacy and senior outreach programs. Ms. Wood has overseen a full-scale modernization of library services and fought to maintain services through ups and downs in funding. She fought for library services not only in Alameda County but also throughout the State of California. Today's collections have expanded from books and periodicals to include movies, CDs, DVDs and books on tape. Old card catalogues have given way to databases and now vast Internet services where patrons can research library holdings day and night. Throughout her illustrious career, Ms. Wood has demonstrated her longtime advocacy for libraries. Her advocacy has made a positive difference in strengthening many library systems for the public's education and enjoyment. I join Linda Wood's colleagues, friends and admirers in expressing good wishes as she retires and thank her for her contributions to our communities through libraries.

Mr. STARK

Mr. STARK. Mr. Chairman, I rise in strong opposition to the Republican budget. It's dishonest. It's immoral. It's wrong for America's future. Republicans dishonestly proclaim their budget is fiscally responsible. The only way their numbers work out is if you use slick accounting gimmicks or fuzzy math. Let me give you some examples of their clever sleight of hand: The Republicans' top priority to privatize Social Security through private accounts will cost billions of dollars. You'd think that'd be accounted for in this budget? No. The billions of dollars that will be needed for the Iraq war. In the budget? No. The cost to our children of extending the massive Bush tax cuts to the wealthy that will balloon our massive deficit? You guessed it. Not in the budget. Even as they leave out all this massive spending, Republicans still claim fiscal responsibility. Don't be fooled. They're lying to the American public. The true costs of this budget are far higher than Republicans claim and our children and grandchildren will pay the tab for this deceit for decades to come. This budget isn't just dishonest--it's immoral. It imposes deep cuts to vital programs that Americans depend upon. As our weak economy is forcing more people to rely on Medicaid's health safety net, Republicans are cutting the program by $20 billion. Income support programs that keep low-income families afloat economically are being axed. Some 48 education programs, vital environmental protections, community development grants and veteran's health care programs are being gutted. If you're an average American family this will affect you and your economic security. But, while you're tightening your belt watching funding for child's education and your family's health care diminish, billions of dollars are going to big business and special interests. While every other priority is sacrificed in the GOP budget, billions of dollars more are being funneled into the bloated defense contracts or frittered away in corporate tax giveaways. Mr. Speaker, the federal budget is supposed to be a statement of our nation's priorities. This budget is a punch line to a sick joke being played on the American people. I urge my colleagues to oppose this dishonest, immoral and irresponsible budget.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise to congratulate the 2005 ``We the People: The Citizen and the Constitution'' class of Fremont, California's Irvington High School in my district for winning the state championship in January. The We the People competition is an educational program administered by the Center for Civic Education of Los Angeles and funded by the U.S. Department of Education. The main focus of the program is to commemorate the framing and adoption of the Constitution and the Bill of Rights and to revitalize educational programs on the Constitution in our Nation's schools. It provides a course of instruction on the basic principles of our Nation's constitutional democracy and the history of the Constitution and the Bill of Rights. Participants then enter into competitive simulated congressional hearings following the course of study. Students who wish to participate in the program must go through an interview process the year prior to the start of the class. The applicants must answer questions similar to the ones they will be asked during competition. Accepted applicants learn and familiarize themselves with current event topics along with curriculum taught in the class. There are six different areas that are taught in the course and each participant must become an expert in each and every area. The participants prepare for several months before testifying to a panel made up of judges representing the community. The judges ask detailed follow-up questions regarding the presentation, which require the students to think quickly and provide spontaneous answers. They compete first at two competitions at the local level before going to the state championships. Those who win at the state level go on to compete nationally. In January, students from ten schools representing various areas of California came to Sacramento to compete in the state We the People championship. I am proud to say that the Irvington High School team, coached by their teacher Mrs. Cook-Kallio, won the competition and will be representing California during the national finals, which will be held from April 30th through May 3rd here, in Washington, DC. The victory reflects the hard work and dedication these students put together after about nine months of preparation. The Irvington team spent countless hours in and out of class getting ready for the competition. Most groups stayed past 10 p.m. on some nights to take part in practice sessions where their teacher, Mrs. Cook-Kallio, along with other teachers and alumni of Irvington High School, drilled them on their subjects to try and simulate the environment of the competition. I applaud the We the People class, Mrs. Cook-Kallio, and Irvington High School in reaching the national finals and am honored to have them represent the state of California at the national level. I join with other admirers and members in the community of Fremont in wishing the team luck. I hope to be giving another congratulatory speech once they become National champions.

Mr. STARK

Mr. STARK. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I would like to inquire how long has it been since we have really had any fun around here, and would it not be a lot better if we just cut out this leaking underground storage tank stuff; we are talking about a LUST bill. I thought we might as well get that on the record and endure whatever the smirks are, because it is really an important bill. It is not controversial. It is a straightforward extension for 6 months, and I got a smile from Mr. Speaker. It is a 0.1 cent per gallon excise tax. It will go to clean up drinking water and the environment. I appreciate the support of the gentleman from Indiana (Mr. Chocola) for this bill and look forward to its passage.

Mr. STARK. Mr. Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. STARK

Mr. STARK. Mr. Chairman, I cannot support the President's request to spend billions more for this protracted war in Iraq. It's time to bring our troops home. Next week we will commemorate the second anniversary of the war and U.S. occupation. Over 1,500 American lives have been lost along with countless numbers of Iraqi civilians. Over 11,000 Americans have been wounded. The world is still not a safer place. What have we gained? I disagree with those who claim a vote for this bill is a vote to support our troops. I stand behind these brave Americans and believe they ought to have every resource to protect them. How is it supporting our troops to keep them in harms way without a plan to win this war? How is it supporting our troops when we continue to allow the Bush administration to spend hundreds of millions of dollars at will on no bid Government contracts with no oversight? How is it supporting our troops when we don't provide for mental health services for those troops traumatized in combat? For all of these reasons, I'm voting ``no'' on the President's $81.3 billion supplemental request. It is time for a plan to bring our troops home, not give the President another blank check.

Mr. STARK

Mr. STARK. And now, Mr. Speaker, with a final note that the California Democratic delegation of 33 members is now 55 percent nonmale, I want to introduce our newest Member, the Honorable Doris Matsui.

Mr. STARK. Mr. Speaker, as dean of the California congressional delegation, it is my distinct honor to introduce the newest Member of the House of Representatives, the Honorable Doris Matsui. She was elected Tuesday, leading a field of 11 candidates with more than 69 percent of the vote, and I think that is just spectacular. Just very quickly, Doris was raised in the small Central Valley town of Dinuba, California. She has pursued a life of public service and civic leadership ever since. She was deputy assistant to President Bill Clinton. She has put service to her community and Nation foremost in her career and has a deep commitment to improving people's lives. She worked to give voice to concerns of children, the elderly and equality for women and minorities. As a member of President Clinton's transition team and during her tenure at the White House, she played a key role in developing important policy initiatives. She increased the number of public school teachers, expanded health care for children and made college more affordable. Appointed by President Clinton to chair the Nonprofit Liaison Group, she worked to coordinate the efforts of the Federal Government and nonprofit organizations. She serves as a trustee of the Woodrow Wilson Center which seeks to bring scholars and public policymakers together on major public and international issues. She has been an advocate for professional international exchange programs between the United States and 140 nations. In all Doris' efforts, she had a strong partner in Bob, who would be proud to see her carry on the Matsui tradition of public service. We welcome the Matsui family, Doris' son Brian; his wife, Amy; and granddaughter Anna. Both sides of the aisle have their own dean. I think the other one may be somewhat older than I am, but he is still the dean; and it is my distinct pleasure to yield to the Honorable Jerry Lewis, the dean of the Republican delegation from California.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to recognize an excellent article recently published in the New Republic. It has been apparent for years that free market solutions will do nothing to ameliorate the healthcare crisis in our nation. This article, authored by Arnold S. Relman, M.D., the former editor of the New England Journal of Medicine, shows us exactly why market forces hinder, not help our attempts to reform the system. In his article, Dr. Relman explains how free market approaches-- focused on consumer driven health care and individually purchased high deductible health plans--will only exacerbate the problem of the uninsured. The only thing that is empowered by these solutions is blatant discrimination against the sick and poor who will not have affordable access to care. We already have 45 million uninsured in this country, and according to Dr. Relman that number will only continue to grow if we continue down this dangerous path. Dr. Relman proposes a solution that isn't politically popular but would fix the myriad problems in our current system. It starts with a ``tax-supported national budget for the delivery of a defined and comprehensive set of essential services to all citizens at a price we can afford.'' This universal system would rely on networks of not-for- profit providers supplying all the care covered under the national plan. A new federal agency would administer the plan, generating huge economies of scale and reducing spending by billions. This is the only real solution to our current crisis, and I commend Dr. Relman for taking a tough stand on this difficult issue. It is with pleasure that I submit the attached excerpts from the article, ``The Health of Nations,'' for inclusion in the Congressional Record. The article originally appeared in the March 7, 2005 edition of the New Republic. [From the New Republic, March 7, 2005] Excerpts From: The Health of Nations (By Arnold S. Relman) In this past election season, our dysfunctional and extravagantly expensive health care system was pushed off the front pages by concerns about the candidates, the fight against terrorism, and the war in Iraq. And yet the health system's problems will not go away; sooner or later we will have to solve them or face disastrous consequences. Over the past four decades (starting just before the arrival of Medicare and Medicaid), both the system itself and ideas about how it should be reformed have changed a lot, but an equitable, efficient, and affordable arrangement still eludes us. During the past four decades our health policies have failed to meet national needs because they have been heavily influenced by the delusion that medical care is essentially a business. This delusion stubbornly persists, and current proposals for a more ``consumer-driven'' health system are likely to make our predicament even worse. I wish to examine these proposals and to explain why I think they are fundamentally flawed. A different kind of approach could solve our problems, but it would mean a major reform of the entire system, not only the way it is financed and insured, but also how physicians are organized in practice and how they are paid. Since such a reform would threaten the financial interests of investors, insurers, and many vendors and providers of health services, the short-term political prospects for such reform are not very good. But I am convinced that a complete overhaul is inevitable, because in the long run nothing else is likely to work . . . . . . In 1963, a seminal analysis of the medical care system as a market was published in the American Economic Review by the distinguished economist Kenneth J. Arrow. He argued that the medical care system was set apart from other markets by several special characteristics, including these: a demand for service that was irregular and unpredictable, and was often associated with what he called an ``assault on personal integrity'' (because it tended to arise from serious illness or injury); a supply of services that did not simply respond to the desires of buyers, but was mainly shaped by the professional judgment of physicians about the medical needs of patients (Arrow pointed out that doctors differ from vendors of most other services because they are expected to place a primary concern for the patient's welfare above considerations of profit); a limitation on the entry of providers into the market, resulting from the high costs, the restrictions, and the exacting standards of medical education and professional licensure; a relative insensitivity to prices; and a near absence of price competition. But perhaps the most important of Arrow's insights was the recognition of what he called the ``uncertainty'' inherent in medical services. By this he meant the great asymmetry of information between provider and buyer concerning the need for, and the probable consequences of, a medical service or a course of medical action. Since patients usually know little about the technical aspects of medicine and are often sick and frightened, they cannot independently choose their own medical services the way that consumers choose most services in the usual market. As a result, patients must trust physicians to choose what services they need, not just to provide the services. To protect the interests of patients in such circumstances, Arrow contended, society has had to rely on non-market mechanisms (such as professional educational requirements and state licensure) rather than on the discipline of the market and the choices of informed buyers. Of course, another conclusion could have been drawn from Arrow's analysis (though he apparently did not draw it). It is that medical care is not really a ``market'' at all in the classical economic sense, and therefore that the basic theories of economics are not relevant to the discussion of the first principles of health care. But our society assumes that market economics applies to virtually all human activity involving the exchange of goods or services for money, and this dogma is rarely questioned. Most economists would acknowledge that medical care is an imperfect or idiosyncratic market, but still they believe that it is a market, and that it should therefore obey economic predictions . . . . . . In 1980, in The New England Journal of Medicine, I described this changing face of American health care as the ``new medicalindustrial complex.'' The term was derived, of course, from the language that President Eisenhower had used (``military-industrial complex'') when warning the nation, as he was retiring, about the growing influence of arms manufacturers over American political and economic policies. Referring to Arrow's analysis, I suggested that market-driven health care would simply add to the explosion of medical expenditures and the growing problems of inequity and variable quality. I was also worried that this uncontrolled industrial transformation would undermine the professional values of physicians, which are surely an essential ingredient of any decent medical care system. Financial incentives were replacing the service ethic of doctors and hospitals, as the providers of care began to compete for market share and larger income. Yet competition on the basis of the price and quality of services--an essential characteristic of most free markets--was little in evidence, demonstrating again the truth of Arrow's argument that the medical care market was different . . . . . . In an increasingly profit-driven and entrepreneurial medical market, piecework payment for specialized outpatient services stimulated an even greater fragmentation of medical care and a greater use of individually billable items of outpatient technological service. Less attention was given to the continuity and the integration of care, and to preventive medicine. Decreased payments to primary-care physicians and increased pressure on them to see more patients reduced the time that they spent with each patient. As a consequence of all these developments, the quality of primary care suffered, and the difference between the quality of average medical care and the best medical care widened, even as per capita expenditures rose and the number of uninsured and underinsured patients increased. This quality ``gap'' was the subject of a major report in 2001 from the Institute of Medicine of the National Academy of Sciences, which described the many deficiencies in the way patients were being treated and suggested how their medical care could be improved. Unfortunately, the experts preparing the report were not asked to consider how the system itself might be restructured to facilitate the needed improvements. And so we now live with a seriously defective medical care system, based more heavily on market incentives than the health care regime of any other country in the world. The commercial tone is set by investor-owned insurance companies (the major share of the private insurance market), investor- owned hospitals (about 15 percent of all community hospitals), and investor-owned ambulatory-care facilities and nursing homes (the great majority of both these markets). The behavior of many of the so-called ``not-for- profit'' health care facilities is not much different from that of their investor-owned competitors, because they have to survive in the same unforgiving marketplace, which is indifferent to the social values that originally motivated most health care institutions. As for American physicians, their attitude toward their profession has also been changed by the new medical marketplace. To a degree greater than anywhere else in the world, our doctors think of themselves as competitive business people. As such, they own or invest in diagnostic and therapeutic facilities (including specialty hospitals), they form investor-owned medical groups, and they advertise their services to the public . . . . . . Our failure to address the glaring deficiencies and inequities in our health care system is nothing to be proud of. A growing number of people are losing their private health insurance. There are now more than 45 million Americans without coverage. Much of this is due to the loss of good jobs, but high costs are also a significant factor. The financial burdens of those who are insured increase steadily, as hard-pressed employers reduce covered benefits and increase the fraction of insurance costs being shifted to beneficiaries. Rising health costs are threatening the financial stability and competitiveness of many American businesses, and are discouraging the hiring of new full-time workers. The government is also shifting insurance costs to Medicare beneficiaries, as exemplified by the recent large increase in the premium charged for coverage of outpatient medical services and physicians' care (``Part B''). What really astonishes me is that so many conservative business and health policy experts continue to hold an unshakable faith in a market solution for our system's major problems. They believe that market forces have not been allowed to contain costs or to improve access and quality because of government regulation, and because of badly designed insurance that prevents consumers from playing an appropriate role. They think that the consumers of medical care in both public and private insurance systems have not had enough influence on the supply of services and have not been sufficiently involved in price negotiations with providers. These days the ``free market'' is held to be the solution to most social and economic problems, and it is commonly believed that in health care the most important missing ingredient of a free market is the traditional consumer who has the incentive and the ability to bargain for the desired price and quality of services. So it shouldn't be surprising that the idea for improving our health care system that is currently most popular is so called ``consumer-driven health care,'' or CDHC. The term ``consumer-driven health care'' is used to mean a market for medical care in which patients, as the ``consumers'' of medical services, would have a lot more responsibility for choosing those services and would share more of the costs. In the most fully developed proposals, providers of medical care (physicians, hospitals, clinics, and so on) would compete for patients on the basis of quality, price, and convenience--not simply for market share, as they do now. Patients, like consumers in any service market, would have access to all the information they need to make their own health care choices. They would choose and own their insurance plans. They would select not only their health care providers, but also the particular medical services they want. Since they would share more of the costs, they would have an incentive to make prudent choices and to demand higher quality. The net result, it is claimed, would be a better, less expensive health care system . . . . . . The assumption of the CDHC system is that such a plan would moderate health care inflation by encouraging patients to become more prudent consumers of elective and non- catastrophic health services, because they would be spending money they otherwise could invest in their savings account. It is also assumed that in competing for business, the providers of medical care would try to make their services more attractive to patients by improving quality and convenience, as well as by moderating their prices . . . . . . There are compelling reasons, I think, to predict that they will not. For a start, high-deductible insurance is not likely to produce reductions in expenditures, except among low- and modest income families, who would feel financial pressure to cut their doctor visits and their use of other medical services. There is good experimental evidence that high deductibles have such selective effects, which expose the most vulnerable patients to greater health risks. Higher earning beneficiaries would not feel such pressure and would continue to use all medical services freely. Whatever reductions in total expenditures might occur would be achieved largely through reducing services to those with lower earnings. Adjusting the size of the deductible in approved plans to the income of the beneficiaries might ameliorate that injustice, but it would add to administrative costs and would be virtually impossible to do properly--given the difficulties in making fair assessments of financial need. If people were allowed to select whatever insurance plan they wanted, the inequity would probably increase in another way. Healthy, young families would choose the least expensive plans with the highest allowable deductible, and those with health problems would be forced to choose plans with the lowest allowable deductibles but higher premiums. The premiums or the required co-payments of the latter plans would spiral upward because of the greater use of services by sicker beneficiaries, so it would become even harder for those with the greatest need for insurance to afford coverage. In this way, one of the most important values of insurance--the sharing of risks over a broad population base--would be lost. Adjusting the contribution of employer or government to the health status of the beneficiaries has been suggested as a means of avoiding this problem, but the relatively primitive state of the art of risk adjustment and the difficulty in applying it to families make this solution unlikely. It also would add greatly to administrative costs . . . . . . The CDHC plans that are now being advocated by believers in the magic of markets shift to patients not only a large part of the responsibility for being their own doctors, but also the burden of paying more of the cost--and that burden would be heaviest on the poorest and sickest of our citizens. This is surely a denial of the ethical principle underlying universal coverage and the sharing of costs. But the major payers, government and employers, are no longer willing or able to shoulder health care's rising costs, and so they are promoting CDHC. They may justify their views by arguing that it makes sense to shift more of the costs to patients because patients are in the best position to put the brakes on health cost inflation. This might be a reasonable argument if medical care were like other services in other markets--but it is not. For all these reasons, then, ``consumer-driven'' plans are unrealistic and unfair, and they are not likely to be politically viable in the long run. There is some understandable support for the idea that individuals should be more responsible for the cost of elective or optional medical services, but most people believe that the availability of needed services should not depend on ability to pay. We are a wealthy society, and decency requires that we make equitable arrangements to ensure at least minimally adequate health care for all--a goal that is beyond the scope of market forces. . . . . . . When that time comes, we should be prepared to replace a failed market-based system with a better one that can deliver the health care we need. What kind of system might that be? The question cannot be confidently answered in any detail before the market-based system has run its course, and before there has been some preliminary experience with non-market-based models--perhaps at first in a few states. Still, a few general principles and objectives can be proposed now, based on what we have learned from our experience during the past four decades and on what we know about the essential nature of medical care. First, since we cannot rely on the free play of markets to control costs or guarantee universal coverage, we should establish a tax-supported national budget for the delivery of a defined and comprehensive set of essential services to all citizens at a price we can afford. Employers should pay an appropriate part of the tax for their employees. These services should include both acute and long-term care, and they should be exclusively reimbursed through a single-payer national insurance plan, with other elective and non- essential services paid out of pocket or through privately purchased insurance. No services covered by the national plan should also be covered by private insurance plans, but the latter could insure services, such as ``aesthetic'' plastic surgery and private hospital rooms, that would not be covered by the national plan. There should be no billing by providers and no piecework payment in the single-payer plan, thus eliminating the huge business costs and the colossal hassle of the present billing and payment systems in multiple public and private insurance plans. Second, not-for-profit, prepaid multi-specialty groups of physicians should provide all necessary medical care on the approved list of insured services. The physicians in the groups should be paid salaries from a pool of money that would be a defined percentage of the total patient income received by the group from the central payer. The groups should be privately managed but publicly accountable for the quality of their services, and they should be expected to use standardized information technology that could be integrated into a national data system. They should be indemnified against losses due to adverse selection or other costs beyond their control, assisted with start-up and technology expenses, and exempted from antitrust restrictions. They should compete for patients on the basis of the quality of their services. All groups should be open to all citizens, although the number of members for a given-sized group should be regulated to ensure an appropriate ratio of doctors to patients. Third, patients should be free to choose their own physician group and to switch membership at specified intervals, but everyone must be included in the national plan and belong to a group--including politicians. (Lawmakers are unlikely to neglect the needs of a health care system that provides care for themselves and their families.) Physicians should be free to join any group that wanted them and to change their affiliation, but they should not provide services outside the national system that are covered by the latter. Fourth, all health care facilities (whether privately or publicly owned) that provide services covered by the central insurance plan should be not-for-profit, and should compete on the basis of national quality standards for patients referred by the physicians in the medical practice groups. Facilities should be paid, and monitored for their performance, by the central plan. They should have no financial alliances with the physicians or the management of the medical groups. Teaching facilities should be separately funded by the national plan and be paid for their extra costs, including education. Budgets in all facilities should include salaries for full- and part-time clinicians providing essential services. Fifth, the health care system should be overseen by a National Health Care Agency, which should be a public-private hybrid resembling the Federal Reserve System. It should be independently responsible for managing its budget and establishing administrative policy, but should report to a congressional oversight committee and to the public. It is essential that the plan be sufficiently independent of congressional and administration management to be protected from political manipulation and annual budgetary struggles. . . . . . Our present medical care system lacks the structure and incentives to improve the quality of care. A not-for- profit system of salaried physicians, who work together in groups that have no financial incentive to do more or less than is medically appropriate, who compete with other medical groups only on the basis of quality and their attractiveness to patients, and whose results are publicly accountable, could be expected to deliver the kind of health care we need. The quality of care would also be improved by a system of competing not-for-profit facilities that are held to national standards. As for access and equity, the plan outlined here would guarantee universal coverage for all essential services and would allow employers and individuals to share in the costs through an earmarked and graduated tax. The government would be expected to pay the costs of today's uninsured, as well as the contributions it now makes to government insurance programs. Given the large savings expected in this system, the change in net costs to government should be minimal. . . . . . A real solution to our crisis will not be found until the public, the medical profession, and the government reject the prevailing delusion that health care is best left to market forces. Kenneth Arrow had it right in 1963 when he said that we need to depend on ``non-market'' mechanisms to make our health care system work properly. Once it is acknowledged that the market is inherently unable to deliver the kind of health care system we need, we can begin to develop the ``nonmarket'' arrangements for the system we want. This time the medical profession and the public it is supposed to serve will have to be involved in the effort. It will be difficult, but it will not be impossible.

Mr. STARK

Mr. STARK. Mr. Chairman, I rise today in opposition to H.R. 27, the so-called Job Training Improvement Act of 2005. Today's bill has nothing to do with improving job training for our workforce--far from it. Instead, this bill actually weakens worker protections, opens the door to hiring discrimination, and dismantles the employment service program that helps unemployed workers find jobs. Apparently the Republicans haven't monitored the weak job market numbers. How else can you explain being so cruel and unfair as to pull the rug out on our nation's unemployed? Let me remind my Republican colleagues that there are still fewer jobs available in America than when President Bush came to office. Inflation is still growing faster than the average earnings of workers--a fact that is particularly true for low-skilled and low- income workers. Confronted with such evidence, this Congress should be doing everything we can to bolster workforce investment. Yet, this Republican bill cuts employment and re-employment services at the time they are needed most. It underfunds the Employment Service, Adult, and Dislocated Worker programs by consolidating them into a single block grant. This puts a greater financial burden directly on the states, exacerbating their budget deficits and perversely triggering layoffs among the very state employees who administer these programs. Yet, much worse, it forces unemployed workers and welfare recipients to fight it out for a share of these limited funds. To add insult to injury, the Republicans give states the right to waive basic worker protections that allow employees to seek redress when they've been treated unfairly. They even allow religious organizations to engage in hiring discrimination in an unholy attempt to turn back a half-century of progress in preventing workplace discrimination. Current law prohibits employers participating in federal job training programs from discriminating based on race, color, religion, sex, national origin, age disability, or political affiliation or belief. The Republican bill would allow the taxpayer dollars that pay for these job-training programs to go to religious organizations that blatantly discriminate in hiring based on religious beliefs. What next? Will the next Bush initiative include allowing discrimination based on race, sexual orientation or political affiliation? The vital civil rights provision barring federally-funded religious discrimination has never been controversial and has never been a partisan issue. In fact, the provision was first included in the federal job training legislation that former Senator Dan Quayle sponsored. It passed through a committee chaired by Senator Orrin Hatch and was signed by President Ronald Reagan. Throughout its 23-year history, this civil rights provision has not been an obstacle to the participation of religiously affiliated organizations in federal job training programs. Currently, many religious organizations participate in the federal programs and comply with the same civil rights protections that apply to other employers. But suddenly, under the leadership of the White House, we are being asked to forget the principle of equal opportunity on which our country was founded. Now is not the time to be rolling back civil rights protections and it certainly isn't the time to be short-changing the unemployed. Congress ought to be creating solutions to make it easier for folks to find jobs, not more difficult. This Republican bill is clearly not a solution. I urge my colleagues to vote ``no'' on H.R. 27.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to pay tribute to Robert (Bob) Harrison Glaze. Bob Glaze served honorably on the City Council of San Leandro, California from 1984 to 2004. He was the youngest Vice Mayor in the city's history. Bob Glaze was born in Oakland, California, and moved to San Leandro in 1963. He is a graduate of Chabot College and Marina High School, where he served as Athletic Commissioner and Curriculum Council member. Alameda County and the San Leandro community have benefited from Bob's activism and commitment to make a positive difference. During his tenure on the San Leandro City Council, he served on a variety of Council Committees, including Finance, the Cherry Festival, Quality of Life, School Liaison, Revenue Sharing, Long Range Fire Planning, School Safety, Technology and Policy. Bob is an Alameda County Fire Commissioner and an alternate member of the Alameda County Transportation Committee, Alameda County Waste Management Authority, Association of Bay Area Governments and the Congestion Management Authority. He is a member of the governing board of the Associated Community Action Program and the Alameda County Training and Employment Program. His community service extends far and wide. He continues to be active in all areas of Scouting, serving as Scoutmaster, Merit Badge Counselor, District Committee Member, District Finance Chairman, District Chairman as well as Exploring North Commissioner. He was 1993 Scout Jamboree Selection Chairman. Other organizations that have benefited from Bob's leadership include Washington Home Owners Association, Washington Manor Lions' Club, San Leandro Human Resource Commission and the Optimist Club of San Leandro. Bob Glaze is truly an involved and model citizen. His commitment is exemplary. I join the citizens of San Leandro who will pay tribute to him on his retirement from the City Council and thank him for his countless contributions.

Mr. STARK

Mr. STARK. Mr. Speaker, as a graduate of Wauwatosa High School in a Wauwatosa, WI, I rise to pay tribute to Myron C. Nutting, a mural artist, whose work has been restored and will be rededicated on March 6, 2005, at my alma mater. Myron Chester Nutting was born on October 18, 1890 in Panaca, NV, but moved to Milwaukee in 1934 to work as an art instructor at Layton School of Art under the Federal Arts Program. Before coming to Milwaukee, Nutting had lived and studied in Paris with expatriate artists and writers whom history has been labeled as the ``lost generation.'' At the time, Nutting was considered among the top 15 Wisconsin artists with training both in America and Europe. Nutting left Milwaukee in 1939, moving to southern California where his artistic life and reputation grew. He was a recognized portrait artist of many southern California clients, a critic and writer, and flourished as a lithographer, oil and water color artist. He died in Los Angeles in 1972. Nutting had a close relationship with the controversial Irish writer James Joyce as evidenced by portraits he painted in the early 1920s of James Joyce's wife, Nora, their daughter Lucia, and the unfinished portrait of James Joyce himself. All three pieces as well as Mr. Nutting's other art work and personal papers are in collections at Northwestern University, the University of California at Los Angeles, the American Art Archives at the Smithsonian in Washington, and in dozens of smaller museums, galleries, and archives throughout the world. With regard to his work in Wisconsin, Nutting was commissioned by Charlotte Partridge, State director of the Federal Arts Project at the time, to design and paint two oil-on-canvas murals at the then recently constructed Wauwatosa Senior High School. The work was started in January 1934 and completed the following June. The murals were originally hung on March 2, 1935, but were covered up during a renovation at the school in the mid-1970s. For unknown reasons, the murals were left unsigned. They remained covered up for 30 years until restoration work began 2 years ago when they were rediscovered. On March 6, 2005, at Wauwatosa High School, the Wauwatosa Historical Society and the school district office will rededicate these two murals that have been beautifully restored in the main lobby of the school. These two 14, by 4, murals have been restored to their original museum quality and will be an important educational tool for the school's present and future generations. More than 190 Wauwatosa High School alumni, as well as many members of the community, have donated more than $125,000 to restore these historical art pieces. These murals remain the property of the Federal Government and will be registered with the General Services Administration's office of fine arts, which acts as a steward for the preservation of these art pieces. I join in honoring all alumni, students, the community of Wauwatosa, the many volunteers who have worked for many months to bring these artifacts back to their former glory, as well as the artist, Myron C. Nutting, for all their contributions to work and restoration of the mural pieces. These are all wonderful contributions to the school's valued history and tradition.

Mr. STARK

Mr. STARK. Mr. Speaker, I am pleased to join my colleague, Congressman Jesse Jackson Jr., to introduce an amendment to the US Constitution to guarantee health care as a right in this nation. The current state of our health care system, if you want to call it a ``system,'' is bleak. Yet, Congress and the White House continue to ignore the problems we face, or worse yet, offer ideological solutions that only exacerbate our current ills. Making changes to the tax code will do nothing to extend high-quality health care to the millions who are left outside of the system today. I am frustrated, as many Americans are, with the lack of leadership on this issue. This is why I have come back to an idea I had more than a decade ago--to force Congress to provide health care of equal high quality for all by guaranteeing this right in our Constitution. The problems we see today are the same that have been with us for the past century. While some claim that the U.S. has the best health care system in the world, the high-tech medical technologies that are available to some in this country are out of reach to the 45 million uninsured--including eight million children--and millions more who are underinsured and cannot afford this care. Even when people do have health insurance, bare-bones policies with high out-of-pocket costs help force millions of families into bankruptcy each year. Access to ``the best medical care in the world'' shouldn't be determined by your income tax bracket. And for all the praise of the advanced medical technologies available in this country, high-tech does not necessarily equate to high quality. Although the U.S. spends far more than any other nation on medical care, we do not have the best health status. Studies have shown that overall Americans receive the recommended treatment only 50 percent of the time. Inequities in our system are not only based on what people can afford or where they live. Perhaps the most disturbing finding in recent years is the disparities in access, treatment, and outcomes that exist for people of color. It is unconscionable that the quality of health care may be determined by skin color, rather than need or proven medical practice. An individual's health is the key to their ability to achieve the unalienable rights of life, liberty, and the pursuit of happiness that this nation was founded on. To ensure these rights are conferred, we must be certain that everyone--regardless of their income, race, education, or job status--can access health care of equal, high quality. Today, only prisoners in the U.S. enjoy this right. Other countries--both developed and undeveloped--recognize the importance of health care and have guaranteed the right to health care through their constitutions, including Afghanistan, the European Union, Iran, Libya, Saudi Arabia, Somali, and South Africa. Even the provisional constitution of Iraq--written in part by the current Bush Administration--guarantees health care as a right. It is shameful that the U.S., the shining example of prosperity and democracy throughout the world, still leaves so many people on their own when it comes to health care. For more than 30 years I have served in this body as an advocate for health care for all people. Unfortunately, time and time again I have seen efforts to expand and improve access to health care squashed under the weight of special interests protecting their individual fiefdoms. I firmly believe that until all people have an equal right to high- quality health care guaranteed through the Constitution, their interests will continue to be ignored as those who profit off the existing system maintain their opposition to reform. It's time for a grassroots movement to put the interests of the people first! I look forward to working with the advocacy community to make the shared vision of quality health care for all a reality. On a final note, I am introducing this amendment today to extend a specific right to all people, which is the purpose of such amendments. Unfortunately, this Congress is likely to consider other amendments to our Constitution that will remove rights and codify discrimination against certain groups of people. Our Nation's most sacred document must never be amended to set aside certain rights for select groups, while barring others from ever realizing these rights. I can only hope that my colleagues take their responsibility to protect equal rights for all people in our democracy as seriously as I do.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to oppose this misguided legislation to limit the ability of average Americans to seek redress for injury and harm caused by corporate malfeasance. Don't be fooled by the title of this bill. Congress is not standing up for the average American under this bill. It's not fixing inequities in our judicial system. It's making those inequities worse by giving the upper hand to big corporations. I won't vote for this Republican-sponsored hoax. It unfairly threatens the very people we are all elected to protect. When the so- called party of local control makes it a top priority to move class action cases from State to Federal court, there's an ulterior motive. Don't believe the myth my Republican colleagues want to sell you. Class action suits aren't frivolous. They allow average Americans financially unable to launch a judicial battle on their own the means to seek redress for injury or death of a loved one. They empower consumers to challenge wrongdoings by wealthy corporations who would otherwise ignore their appeal. I don't think that the American public would be satisfied knowing that if this bill passes, the accountability of companies like Eron would be held less accountable. And the makers of Vioxx and other dangerous drugs would be held less accountable. It is truthful, law-abiding citizens who will lose if this bill becomes law, Apparently, in America today, we have government for, by, and of corporate interests and not the people. I ask my colleagues to stand up for real people and vote against this shameful bill.