Allyson Schwartz

Ms. SCHWARTZ

Ms. SCHWARTZ. The American people received much-needed good news last week. Job loss is slowing. In November the number of jobs lost was 11,000, quite a contrast to the 700,000 lost in January 2009. While no one should underestimate the challenges ahead or the struggles of far too many families whose wage earners are unemployed, this news shows that the policies of the Democratic majority are working. The economy is turning around. Last Friday I joined President Obama in Allentown, Pennsylvania, to talk with and hear from business leaders and college students and veterans about how to create new jobs and grow the economy. The President laid out a jobs plan that will spur small business hiring, improve infrastructure, and encourage energy efficiency. We need to take action on this plan that builds economic opportunity for the long term, new jobs that are sustainable for years ahead, in rebuilding our infrastructure, creating new energy sources, and developing new technology and innovative products and services that we and the world want to buy. We are committed to rebuilding America's economy, putting Americans back to work and ensuring our Nation's economic future.

Ms. SCHWARTZ

Ms. SCHWARTZ. I rise today to recognize the importance of the Fire Grants Reauthorization Act. These grants are a prominent demonstration of the Federal support for our Nation's first responders by enhancing their ability to protect the public from fire and related hazards. The Assistance to Firefighters and SAFER grants included in the act will help ensure that our first responders get the critically needed personnel, equipment, protective gear, emergency vehicles, training, and upgraded facilities they need to protect the public and the emergency personnel from fire and related hazards. Every day our Nation's firefighters risk their lives to keep our communities safe. From 30,000 fire departments in the United States, a firefighter responds to a fire every 20 seconds. Philadelphia is home to one of the oldest fire companies in the country, dating back to 1736. The Philadelphia Fire Department is one of the busiest emergency management systems in the country, handling 260,000 responses in 2006. Throughout my time in office, I have fought to ensure that our firefighters receive the respect and resources they so keenly require. I am proud to support the reauthorization of these grants and to support our firefighters in the efforts to support our communities and families.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, finding a uniquely American solution to ensure that all Americans have access to meaningful, affordable health coverage has been an unfulfilled goal for decades. Today, we have the opportunity to make this moral and economic imperative a reality. The Affordable Health Care for America Act meets the goals of health care reform: enhanced consumer protections for those with health coverage; new, affordable choices for individuals and small businesses; strengthening Medicare for our seniors, with better prescription drug coverage and access to primary care; improved delivery of services with better health outcomes for all Americans; and the containment of rapidly rising costs of health coverage. It builds on America's public-private system, and it is paid for now and into the future. The status quo is unaffordable and unsustainable. Health care reform benefits all of us: families, seniors, businesses, and the Nation. I am honored to have been a part of bringing this bill to the floor, to this historic moment, and I look forward to voting for this landmark legislation and meeting the goals of health care reform for all Americans. Now is the time to act.

Ms. SCHWARTZ

Ms. SCHWARTZ. Thank you, Mr. Chairman. Finding a uniquely American solution to ensure that all Americans have access to meaningful, affordable health coverage has been an unfulfilled goal for decades. Today we have the opportunity to make this moral and economic imperative a reality. I want to acknowledge the extraordinary leadership of our chairman and of the cooperation of three committees in the House and all of the Members who were so engaged in developing the bill before us today. The Affordable Health Care for America Act meets the goals of health care reform: enhanced consumer protection for those with health coverage, eliminating preexisting condition exclusions; new, affordable choices for individuals and small business; strengthened Medicare for our seniors with better prescription drug coverage and greater access to primary care; improved delivery of care with better health outcomes for all Americans; and the containment of rapidly rising costs of health care. It builds on America's public-private system and is paid for, now and into the future. The status quo is unaffordable, unsustainable and unacceptable. Now is the time to act on behalf of the millions of Americans without insurance and the millions more who are underinsured, on behalf of small and large businesses who struggle every day to pay the rising cost of insurance for their employees, on behalf of seniors. In fact, on behalf of all Americans who worry about our families getting the health care they need and then being able to pay for it, today is a great day for America.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, central to finding a uniquely American solution to America's health care challenges is strengthening Medicare for our Nation's seniors. Our health care reform effort renews our commitment to the health and security of American seniors by ensuring the long-term fiscal health of Medicare and improving the quality of care that seniors receive. The House bill adds valuable new benefits for seniors and improves access to primary care. Seniors now pay up to 20 percent of the cost of preventive services like mammograms and colonoscopies and vaccines. As of January 1, 2011, seniors will no longer have to pay any copay for preventive services. This is a major win for America's seniors. Health care reform also sets us on a path to close the coverage gap in Medicare part D, known as the doughnut hole. In 2011, Medicare will pay $50 more for seniors to get drugs, and they will receive a 50 percent discount on brand name drugs. Health care is good for our seniors. Health care is good for America. Now is the time to act.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, finding a uniquely American solution to ensuring that all Americans have access to meaningful, affordable health coverage has been an unfulfilled goal for decades. Action now is both a moral and economic imperative for our Nation. Health care legislation before the House builds on the hard work done by three health care committees over many months and responds to feedback from the American people. It builds on America's public- private system. And it is paid for. The legislation meets the goals of health reform: enhanced protection for those with health coverage; new, affordable choices for individuals and small businesses; strengthened Medicare for our seniors; improved delivery of care with better health outcomes for all Americans; and the containment of rapidly rising costs of health care. The status quo is unaffordable and unsustainable. Passing health care reform benefits all of us: families, seniors, businesses, and the Nation. I look forward to voting for this historic legislation and meeting the goals of health care reform for all Americans. Now is the time to act.

Ms. SCHWARTZ

Ms. SCHWARTZ. Central to finding a uniquely American solution to our Nation's health care challenges is a focus on strengthening Medicare for our Nation's seniors. Our health care reform efforts renew our commitment to the health and security of America's seniors by ensuring the long-term fiscal health of Medicare and improving the quality of care for our seniors. The House bill adds valuable new benefits for our seniors and improves access to primary care. I strongly advocated for ending the copayment that seniors pay for preventive services. Right now seniors pay up to 20 percent of the cost of services such as mammograms, colonoscopies, and vaccines. As of January 1, 2011, seniors will no longer have to pay the copay for preventive services. This is a major win for America's seniors. Health care reform also sets us on a path to close the coverage gap in the Medicare part D prescription drug plan known as the ``doughnut hole.'' In 2011, Medicare will pay $500 more and will continue to add benefits until we eliminate this gap in coverage for drug services. Health care reform is a win for seniors. Now is the time to act.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, as I sit here and listen to one after another of the Republicans here in Congress finding reasons not to move ahead, not to find that uniquely American solution to helping every American have access to health insurance, the fact is that we have to do more. We have to act right now to ensure that every American has access to insurance coverage; that that insurance coverage is affordable, and that it is meaningful; that it covers preexisting conditions and provides for ongoing care for chronic diseases; that we can ensure that Americans get quality care and the right care, including for our seniors. Legislation we have coming before us protects seniors, makes sure that they see lower copayments for primary care, that they see lower copayments for prescription coverage. The fact is that we can contain costs and help enable every American to have access to health insurance coverage. This is a moral imperative. It's an economic imperative for our families and for our businesses and for our Nation. Fifty million Americans without health insurance, 14,000 a day being uninsured. It's time to get this done. It's time to act.

Ms. SCHWARTZ

Ms. SCHWARTZ. I appreciate the opportunity to speak on this resolution. Madam Speaker, I rise in support of three young American citizens who have been detained by the Government of Iran for nearly 3 months now. On July 31, 2009, Joshua Fattal, Shane Bauer and Sarah Shourd were taken into custody after purportedly crossing into the Iranian territory while hiking in Iraqi Kurdistan. It is a peaceful region of northern Iraq which has become increasingly popular as a hiking destination for many Westerners. During the hike, it seems they accidentally crossed over an unmarked border into Iran. As a result, these three young Americans, all graduates of the University of California-Berkley, have since been detained in Iran. While Swiss diplomats were finally permitted access to Josh, Sarah and Shane on September 29, the three have still not been allowed to have any contact with their families. In response to this action, I have sponsored in the House--and Senator Arlen Specter has spearheaded in the Senate--Senate Concurrent Resolution 45, which encourages the Government of Iran to allow Josh, Shane and Sarah to communicate by telephone with their families in the United States. More importantly, it also encourages the Government of Iran to allow them to reunite with their families here in the United States as soon as possible. This resolution was unanimously passed by the Senate on October 6. Josh, whose family is from Montgomery County, Pennsylvania, which I represent; Sarah; and Shane did not commit any malicious acts. They were three young Americans who have traveled extensively throughout the world seeking to learn about different societies and different cultures. Unfortunately, they made a single mistake: They got lost. For that they have been held for nearly 3 months with almost no contact with the outside world. As a mother, I can well imagine the pain and frustration the families of the three young adults feel as they wait, hoping, doing all that they can but with little power to compel action by Iran to free their children. I know, especially through my conversations with Mrs. Fattal, how important this resolution is to them and their families. I urge the Government of Iran to reunite Josh, Sarah, and Shane with their families, and I ask my colleagues to support this concurrent resolution and the strong but compassionate plea for action that it contains.

Ms. SCHWARTZ

Ms. SCHWARTZ. I rise today to recognize National Save for Retirement Week, which started on Sunday and will last until Sunday, October 25th. This week encourages Americans to prioritize the important responsibility of saving for their retirement. I am proud that earlier this year the House of Representatives passed my resolution marking the importance of this week. Not enough Americans are putting money away for retirement. While more Americans started to save recently, we do not know yet whether this will be sustained. According to the Employee Benefit Research Institute, less than two- thirds of workers or their spouses are currently saving for retirement, and the actual amount of retirement savings lags behind the amounts families will need to fund their retirement years. The average 401(k) account has just over $45,000, far below the amount needed to finance retirement for most Americans. So even in these challenging financial times, this week serves as an important reminder that for all of us it is never too early or too late to begin to save for retirement.

Ms. SCHWARTZ

Ms. SCHWARTZ. Madam Speaker, on rollcall No. 790, had I been present, I would have voted ``yea.''

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, I rise in support of H. Res. 754, which honors the Pennsylvania National Guard's 56th Stryker Brigade Combat Team on its return to the United States from its deployment to Iraq. The 56th Stryker Brigade is comprised of more than 4,000 citizen soldiers from across the Commonwealth. The 56th served North of Baghdad and conducted more than 800 operations with the Iraqi Security Forces. These soldiers served their country with great distinction, and it is my great honor to represent them in Congress. I would also ask the House of Representatives to extend its deepest condolences to the families of two members of the 56th who gave the ultimate sacrifice while serving in Iraq. Staff Sergeant Mark C. Baum, 32, of Quakertown, was killed when hit by small arms fire on Feb. 21 and Specialist Chad A. Edmondson, 20, of Williamsburg, was killed by an improvised bomb explosion on May 27. Passing this resolution today honors the memory of these brave soldiers of the 56th Stryker Brigade and marks the significant contribution that this unit has made to defend our Nation.

Ms. SCHWARTZ

Ms. SCHWARTZ. Madam Speaker, I rise today to honor Kimberly B. Sievers, Colonel, United States Air Force on her retirement from active duty service on October 1, 2009, after serving for 27 years in uniform in defense of our country. In 1982, Colonel Sievers reported to the U.S. Air Force Academy. She graduated in 1986 and began training as an intelligence officer at Lowery Air Force Base in Denver, Colorado. She spent the next several years directly supporting flying operations, providing intelligence and training to pilots at the fighter squadron level--including the 80th Tactical Fighter Squadron in Kunsan Air Base, Republic of South Korea, and the 50th Tactical Fighter Wing in Hahn Air Base, Germany. Colonel Sievers continued to develop her analytical and leadership skills at Ramstein Air Base in Germany at both the 7450th Tactical Intelligence Squadron and the European Command staff, ending her time at Ramstein as the Team Leader for Intelligence Force Management. She returned to Korea for a second tour at the operation level, leading the Intelligence Plans and Manpower section at 7th Air Force and then the Analyst Element at the 607th Air Intelligence Squadron. From there, Colonel Sievers moved to the Pacific Air Force staff in Hawaii where she directed the liaison efforts between the staff and intelligence elements of all the Air Force squadrons in the Pacific. Colonel Sievers was then selected to serve in the first of what would be many future leadership positions, as the Director of Operations for the Pacific Intelligence Squadron. She spent a year in residence at the Air Command and Staff College at Maxwell Air Force Base in Montgomery, Alabama. From there, she was selected to command the Intelligence Division at the elite USAF Weapons School at Nellis AFB in Las Vegas, Nevada. Colonel Sievers was herself one of the very first intelligence officers to graduate from the Weapons School and only the second ``home grown'' Intelligence Weapons Officer to command the division. Building on that experience, Colonel Sievers was selected to command the 93rd Intelligence Squadron at Lackland AFB in San Antonio, Texas. The 93rd is the largest intelligence squadron in the Air Force with over 800 personnel. Following that successful command, the Air Force sent Colonel Sievers back to school at the National Defense University, here in Washington, DC. During times of war the best and brightest are needed to lead our young men and women and the Air Force turned to Colonel Sievers to serve as the forward Director of Intelligence for the entire Air Force component under Central Command. Deployed forward to Al Udeid Air Base in Qatar, Colonel Sievers directed the efforts of all intelligence personnel supporting combat operations in both Iraq and Afghanistan. Returning to the U.S., Colonel Sievers utilized her war experience to help guide the Department of Defense intelligence, surveillance and reconnaissance enterprise as the Collection Requirements Division Chief at the Joint Functional Component Command for Intelligence, Surveillance and Reconnaissance. This would be her final assignment as both she and her husband have chosen to retire from active duty. I am proud to represent Colonel Sievers in the U.S. Congress. She has forged many new paths within both the intelligence career field and the Air Force, and has led thousands of men and women in both peace and war. Our nation is safer because of her dedication. Colonel Sievers is a unique leader, inspiring those around her to perform at the very highest levels in pursuit of mission accomplishment, yet at the same time possessing the compassion to ensure that those in her charge--and their families--are cared for properly. Madam Speaker, I ask that my colleagues join me in recognizing and thanking Colonel Sievers for her exemplary service, leadership, dedication, and sacrifice to our nation.

Ms. SCHWARTZ

Ms. SCHWARTZ. Since 2000, families in Pennsylvania have seen a 100 percent increase in their health premiums. Nearly one in five Pennsylvania families pay more than 10 percent of their income on health care. This is simply unaffordable for middle class Americans. As we advance health care reform, we must ensure that Americans have access to meaningful, affordable health coverage, and we can do that by expanding private and public insurance options available to individuals and small groups so meaningful coverage is more affordable; by establishing consumer protections, including ending preexisting condition exclusions; setting commonsense policies to expand options for insurance coverage, including allowing young adults to stay on their parents' insurance policy; ensuring that Americans know what their insurance coverage truly means, by eliminating confusing terminology which results in consumers paying for expenses that they thought were covered, and putting a reasonable limit on insurer overhead and profits so that more of our premium dollars are used on health care. The status quo is unaffordable. That is why the President and Congress are committed to passing a health care reform that benefits all of us.

Ms. SCHWARTZ

Ms. SCHWARTZ. Finding a uniquely American solution to our Nation's health care challenges means expanding health access to health coverage, containing costs, improving quality, and achieving better health outcomes. To reach these goals, we have to be open to new ways to bridge the current system's fragmentation, encourage coordination, and promote collaboration. As part of health care reform, we are demanding greater quality and value. We should challenge our health care providers and civic leaders around the country to implement delivery system innovations that work for their communities. We should push them to work together and take responsibility for the health of people in their area across a full spectrum of health services. They can best determine how to integrate their community's health care system to make it patient- centered, efficient and result in better care and improved health status. We must establish clear expectations and accountability, offer financing flexibility and incentives to collaborate to meet patient and community needs, then monitor the results. I have introduced the Health Care Innovation Zone Program Act to spark these initiatives. Done right as part of health care reform, we will all benefit in saved lives and saved money.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, I rise to address the importance of primary care in comprehensive health care reform. As we find a uniquely American solution for all Americans to have access to affordable, meaningful health coverage, we must remember that insurance coverage alone means little if patients do not have access to health care providers or health care services. Primary care providers are on the front line of the health care system, treating acute and chronic conditions and keeping costly conditions from worsening. Despite this essential role, it is primary care where we face the most acute shortages. Since 1998 the percentage of internal medicine residents choosing primary care has dropped from 50 percent to 20 percent. By 2025, America will have a shortage of 46,000 primary care providers. I have championed efforts to bolster our primary care workforce, including new loan-repayment programs and increasing payments for primary care providers, as well as elimination of copayments for preventive services for seniors and strengthening their ongoing relationship with their doctor. I am proud that the health care reform bill includes this essential reform. I look forward to action on health care reform that addresses primary care.

Ms. SCHWARTZ

Ms. SCHWARTZ. Thank you. I rise today in support of the Himes-McCarthy-Schwartz amendment which strengthens the financial literacy provisions in the Student Aid and Fiscal Responsibility Act. As our country emerges from a recession that has starkly exposed the need for good financial planning and fiscal responsibility for individuals, for corporations and for the Nation, supporting financial literacy education is more important than ever. That is why I'm proud to work with my colleagues, Mr. Himes and Mrs. McCarthy, on this amendment before us. The amendment makes several commonsense additions that will encourage financial literacy education for students; and importantly, it will reach students early, well before they enter college so that early financial planning and counseling can positively impact students' views that college is possible, that it is financially accessible. And it will enable students to develop sound financial habits that they will carry with them through college and beyond. The Student Aid and Fiscal Responsibility Act addresses important issues of college affordability, including how students and their families plan, save and borrow for college. This amendment will strengthen the financial literacy provisions, and I am very pleased to see its inclusion in this bill.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, today, the House will vote to save taxpayers nearly $90 billion in making the Federal college loan system more efficient. This action, the Student Aid and Fiscal Responsibility Act, is the greatest investment in higher education ever. This bill increases Pell Grants for students; it enables States to improve their early education system, and it reduces the Federal deficit by $10 billion. It improves our Nation's education system for all children. The Early Learning Challenge Fund supports safe efforts to invest in high-quality, integrated early education and to care for children birth through 5. Early education pays huge fiscal and social dividends in the long run, and this is an important step forward. The College Access and Completion Innovation Fund promotes innovative strategies to improve student success in college, and this bill provides funding for much-needed school modernization and repair, which will be done in an environmentally energy-efficient manner by including legislation we approved earlier this year. The Democratic majority is committed to stabilizing the economy, to lowering our deficit and to ensuring that America is economically competitive in the future. This plan helps us achieve these key goals.

Ms. SCHWARTZ

Ms. SCHWARTZ. Madam Speaker, I rise today to honor and congratulate The Northeast Times for 75 years of community journalism. From its modest beginnings, The Northeast Times has served as an important chronicle for the people of Philadelphia's Northeast neighborhoods, providing them with a forum for information and dialogue on critical issues and fostering a sense of local history, community pride, and citizen empowerment. In 1934, Temple University journalism student, Richard Thorpe Lawson, launched the Mayfair Times. With just a handful of pages in each issue, the paper covered local news and was supported by advertising from mom and pop stores in the area. Lawson eventually expanded his staff, purchased better printing equipment, and moved into a building on Frankford Avenue. The newspaper expanded to cover additional neighborhoods in the Northeast, including Frankford, Tacony, and Holmesburg. After Richard Lawson's death in 1961, his wife Eleanor Smylie succeeded him in the business, expanding to almost 100 employees. She computerized operations, changed the publication's name to The Northeast Times, and updated the format to a smaller tabloid size. In time, Eleanor's children, Robert and Tim, became responsible for publishing and advertising sales. The Northeast Times continued to grow in the 1980's and 1990's, expanding throughout the Northeast and extending into some suburban neighborhoods in Bucks and Montgomery counties. The Northeast Times continues to inform and give voice to the people, businesses, and community organizations of the Philadelphia's great Northeast on significant issues, as it has since 1934. Both the local coverage and opportunity for civic participation provided by The Northeast Times builds and maintains communities. I ask that my colleagues join me in celebrating this milestone 75th year and recognizing the critical role played by The Northeast Times in our city.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, I ask unanimous consent that the Committee on Ways and Means be discharged from further consideration of the resolution (H. Res. 662) supporting the goals and ideals of ``National Save for Retirement Week'', including raising public awareness of the various tax-preferred retirement vehicles as important tools for personal savings and retirement financial security, and ask for its immediate consideration in the House.

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Chair, on rollcall No. 661, had I been present, I would have voted ``yea.''

Ms. SCHWARTZ

Ms. SCHWARTZ. Mr. Speaker, on rollcall No. 676, had I been present, I would have voted ``yea.''

Ms. SCHWARTZ

Ms. SCHWARTZ. Well, thank you, Mr. Chairman. I have to say, it has been an honor and a privilege to serve on the Ways and Means Committee. I knew when I sought a position on the Ways and Means Committee that it would be always interesting, and we would always be doing important work, always sort of being in the mix of really the principal work that we do in Congress. I'm not sure I could ever have anticipated the opportunity that we've had over the last 7 months to work on the major issues facing this country. Really, there are few issues as important as the health care of Americans. I think we have seen in the Ways and Means Committee, under your guidance and your leadership, the fact that people bring their own experiences with health care. I think what is unique about talking about health care is that each and every one of us have our own experiences, both good and bad. We bring certainly the experiences of our constituents, the concerns of our constituents, and I think our hopes and our dreams for this country of how great it could be, if under your leadership and under our watch, to participate in finding that uniquely American solution to health care, affordable, meaningful health care for all Americans. It's really both I think an attainable goal and a big goal. It is one that the President has set out when he ran for the presidency. He sent us out, both on the committee and to Congress, to say, Now is the time to do this. I think each and every one of us can share stories that we hear from our constituents. I will tell just one, if I may. I have some statistics about the number of Pennsylvanians who don't have health insurance, but I think sometimes it's helpful to bring it down to a personal story. I was asked to visit one of the colleges in my district, Penn State, which is obviously well known. Its center campus is not in my district, but we do have a satellite campus in Abington, a wonderful commuter campus. I met with a group of students who wanted to talk about health care. There was a young woman who talked about the fact that she was raised by a single mother, and she was on CHIP. I think all of us are very proud of the Children's Health Insurance Program. She said her mother made $20,000, $25,000 a year. She didn't get health insurance through her work, and there was no way that she was able to afford it on her own. She got CHIP, and she was always grateful that her kids had health insurance. Well, this young woman was over 21. She no longer had access to CHIP. But she was working full time, was a full-time student; and because of the commuter campus, doesn't either require or offer a way for students to buy health insurance, she looked for it, but it was unaffordable for her. There was no way. She actually tried to find an affordable health policy but couldn't find one. So she took a chance. She had said just a short while before she had gotten sick; and friends of hers felt that she was sick enough that she ought to go to the emergency room; and she went to the emergency room and ended up with a $7,000 bill. I don't know if she was held overnight. We didn't get into the details of what care she received. But she was healthy. She was doing fine. But suddenly she is faced with $7,000 in a bill. She had no idea how she was ever going to pay that $7,000, stay in school and continue on her path. She had a promising future ahead of her. It was going to ruin her credit rating. All of these things. There were consequences; and yet she still said to me, Well, how can we be in this great country and not be able to help her out? I think that's why we're here. It is for the 50 million Americans without health coverage, certainly for the many, many more millions of Americans who have health coverage who find that if they go to the hospital, something's not covered, that they have a pre-existing condition and are not able to find the coverage, even though they have health insurance. This is why we're here. I had one small business owner tell me, ``I want to be able to provide health insurance, but I can't afford it,'' or ``I provide it, but one of our small group of employees got a serious illness, and we saw a rate increase of 40 percent from one year to the next.'' We talk about double-digit inflation. We know that in the last 8 years, we've seen health premiums double in price; and of course we are concerned about the Federal Government as well. We have a deep concern about absolutely maintaining our commitment to seniors in this country under Medicare. They rely on it. Imagine our seniors not having access to health care. This is something that we did 35 years ago--not you and I, but any of you who were here--to get Medicare coverage for all seniors. But again, we see the unsustainable growth in costs. So what are we going to do about it? We actually have a bill before us. We passed it out of the Ways and Means Committee, it was voted on by the Education and Labor Committee; and of course, as we speak, the Energy and Commerce Committee is going through the bill. What it does is it addresses just the issues, the concerns and the realities of the families that I talked about. It finds a way to bring down the costs under Medicare by really instilling in our system a goal of quality and the value of our dollars, encouraging primary care. Part of the bill that I want to, again, thank the chairman, his staff and other Members for including in this bill is for the increased opportunity for loan forgiveness and debt repayment so physicians and nurse practitioners can go into primary care. Increased reimbursements in primary care. A new category of medical homes so that if a primary care physician, nurse practitioner or physician's assistant wants to be able to provide ongoing care between visits, make that phone call to see how somebody, like an early diabetic, is doing, make sure they get the kind of care that they need, make sure that they followed up on their prescriptions and that they're following the instructions, that they understand the diet and the exercise that they have to engage in so that they don't end up on renal dialysis years later, lose sight or any of the number of things that can happen with untreated diabetes, is just one example. We actually encourage payments that are bundled--that is our term--but it really basically says, We're going to look out for what happens to you in the hospital and when you go home. New possibilities of encouraging physicians to get together and provide both primary care and specialty care and to keep people out of the hospital. These are life saving and cost saving for the government. We have got almost $500 billion in savings that have been already included in the bill that we have before us. And of course we have found ways to help small businesses with tax credits, to be able to provide health coverage for their employees and encourage all employers to cover health care. Then for the group that is already insured, to say, You're never again going to have preexisting condition exclusions; you are never again going to have to worry about the insurance companies finding a reason to deny coverage because of a health condition; that you won't again have to worry about going bankrupt because we will say, You don't have to pay any more than 10 percent or 12 percent of your annual salary. You will never again have to lose your home or go bankrupt over health costs. These are just some of the consumer protections that we are going build for people who already have insurance. And of course if you lose your job or you are between jobs--and many Americans change jobs every 3 or 4 or 5 years--that you will have that continuity of coverage. And last, but by no means unimportant, we are going to find a way to help all those 50 million Americans who don't have access to affordable coverage through a new marketplace called an exchange; and we're going set them in a benefits package; and we are going to provide some subsidies for lower income, working folks. At the end of the day, we're going to do what the President told us he wanted to do, and that is to contain costs for government, for businesses and for families. We're going to make sure that insurance is meaningful, and we're going to make sure that every American has access to health coverage. At the end of the day, it's going to be a great day.

Ms. SCHWARTZ. Right. It's a really good question. Of course not. We are not in any way telling people where they have to get their coverage or where they have to buy their insurance. If in fact people get a subsidy--and, really, understand that everyone is going to have to pay something. We're not giving away too much free here, everyone is going to pay their share. We're going to help people. But we're saying to the insurance companies, fine, come in and compete. That's great. We're going to create a marketplace where you can offer new products to another 30 million, almost 40 million people, and then each of those individuals or families or very small businesses will be able to choose between private insurance companies and a public option. I see that the public option is an opportunity to ensure that there really is competition, because I think in many of the markets across the country we have one major insurance provider, that's it; so not a lot of competition. If you believe in the free market system, you need a little competition there. If you only have one product to buy, and it's very expensive, you don't have a lot of choices. The insurance companies--I'm not here to beat up on insurance companies, but I will say, they have said if everyone's in, they want to be able to have the opportunity to sell a good product to people. That's fine; we're fine with that. We want them to step up to the plate and offer new insurance products to individuals and small groups. And again, as Mr. McDermott said, make sure it covers certain benefits, it doesn't exclude people, it doesn't cherry-pick, as you say. There are going to be rules. And we are going to make sure that consumers are protected under these rules. That is very important. But no one is going to be told to go into the public option, no one. They can choose the insurance.

Ms. SCHWARTZ. Right. And understand that subsidies are provided. Poor people in this country do get Medicaid, and we're expanding that. These are really people who work--and many poor people do as well--every day and simply don't make enough money to be able to afford the high rates of insurance. That's part of it. We want to bring down the cost of the insurance. Again, we hope that the private insurers step up to the plate and help us do that, but they haven't done a great job of containing costs over the last number of years which is why we're in this situation. But once people have insurance, we are really working hard to make sure that the delivery system, all those doctors and nurses and--well, you can name all the other health providers--are both available and that we're training enough. We anticipate that if we don't do something about the lack of primary care physicians, in 2025 there will be 46,000 too few primary care doctors. That is pretty astounding. A lot of us are getting older--all of us are getting older, I guess--neither of you are, of course--but we also want to make sure that we have the kind of care for every age. And we're not getting the quality out of the system that we know we should, and that also is an issue that we have taken up in this legislation. We want to encourage our hospitals and our doctors, through financial carrots--there might be some sticks, but mostly we are really creating incentives for our doctors and our hospitals to improve quality. One of the examples that many of us are becoming aware of is infections that you get in a hospital, or when you leave the hospital after surgery, that you don't have the right kind of followup once you get home and you end up back in the hospital. That's not only really hurtful for the person who is affected, who's sick, but it's also very expensive for all of us. So if we can, and our hospitals can, if we can encourage our hospitals--and in fact insist upon our hospitals really making sure that they reduce the number of infections and readmissions, we would all be better off. And that's what we're trying to do. There are many pages of what we call delivery system reforms, ways in which we are encouraging everything from home visits after a baby is born to a family, to, as I talked about, primary care, medical homes, and ways that doctors will be able to organize themselves in a way that is much more efficient in quality. And we're setting out a real goal of changing some of the ways we pay doctors and hospitals, to encourage them to really look at quality and to save dollars and improve health outcomes. That is one of the most discouraging things; for all the dollars we spend, $2.5 trillion--not all government, half of it's in the private sector--we don't have the kind of healthy Americans that we should. And that is part of our goal, here, to extend coverage, for the government to be smarter in the way we finance it, and for people to take more personal responsibility in their own health care as well.