John Sarbanes

Mr. SARBANES

Mr. SARBANES. We are in a terrific place now where we have the opportunity not just to do the right thing for the environment but, at the same time, to create a tremendous number of jobs and economic opportunities for the workforce out there. It's a wonderful alignment, and it's one that we need to take advantage of with smart legislation.

Mr. SARBANES

Mr. SARBANES. I want to thank my colleague for yielding and for introducing the Ocean, Coastal, and Watershed Education Act, H.R. 3644, and for working to maintain the Bay-Watershed Education and Training programs, watershed approach for environmental education. In my own State of Maryland, the Chesapeake Bay B-WET was the first B-WET that was established for the country, and it serves as a national model of watershed-based environmental education. Earlier this fall, I was pleased to join with Congressmen Kratovil and Wittman to introduce and then see passage in the full House of Representatives legislation that reauthorizes the Chesapeake Bay B-WET program. The bill before us will codify other existing B-WET programs around the country and provide NOAA the authority to create new B-WETs in various watersheds throughout the country and the territories. So I want to again thank Congresswoman Capps for her leadership. One of the things that this does, this education and training for the next generation, is that it encourages our kids to become comfortable with science; to look at the world through an empirical lens; to make decisions based on data and facts, not just opinion. And that's a skill that we really need to encourage in the next generation. It occurs to me as we talk about this health care bill, I wish more people would be bringing a lens of empiricism and fact-based review to the health care bill, because if you look at the health care bill through that lens, if you look at the facts of this health care bill, then it is clear why it responds to all of the grievances that so many Americans have had with the current health care system for decades. Fact: Not only does it pay for itself, it reduces the deficit. So this suggestion that somehow it's not being paid for is misplaced. Not only does it pay for itself, but over the next 10 years, the independent Congressional Budget Office, the CBO, has projected that there will be savings and a reduction to the deficit of about $132 billion. And then in the next 10 years they've projected that it will reduce the deficit by $1.2 trillion. So all those people out there that want to reduce the deficit, this is your bill. The health care bill is a major vehicle for accomplishing that. That's fact number one. Fact number two: It's going to make Medicare stronger--not weaker-- because it's going to crack down on fraud and abuse. It's going to take those savings and--this is another piece of misinformation that's going on, that somehow the savings we're taking from Medicare are going to go off into the ether. We're taking the savings from Medicare, and we're actually putting them right back into the Medicare program by closing the doughnut hole, by making available to our seniors primary care opportunities and preventive care measures that currently they have to pay out of pocket for. But now, because it makes a lot of sense, those things will be covered. So we're taking the savings, we're putting it right back into the Medicare program. Fact number three: Thirty-two million people who today do not have health insurance coverage, when this bill is passed, will be on their way to getting that coverage. Ninety-five percent of Americans will be covered ultimately when the provisions of this bill take full force. In fact, the last fact I'd just like to point out, which is this, is finally, after decades in which the health insurance industry has pretty much run the show--it's been a health insurance industry takeover of the health care system in America. That's who's taking over the health care system, the private health insurance industry. This bill finally fights back against the health insurance industry and says no longer will you discriminate against people based on preexisting conditions, no longer will you terminate their coverage right at the moment when they need it most. Finally, instead of us living in your world, by your rules, you're going to start living in our world by our rules. That's what this health care bill accomplishes. And that's why we're ready to support it. Again, I want to thank my colleague for her work on the B-WET, and I strongly support that bill as well.

Mr. SARBANES

Mr. SARBANES. Mr. Speaker, I ask unanimous consent to have my name removed as a cosponsor of H.R. 1255.

Mr. SARBANES

Mr. SARBANES. I thank the gentleman for yielding. Madam Speaker, today, I rise to honor the 189th anniversary of Greek Independence Day. We are also celebrating today Greece's entry into the U.S. Visa Waiver Program, which is a strong affirmation of the close ties between our two nations. The American people and the people of Greece have been united by common values from the very beginning. Democracy, liberty, freedom, and the idea that the individual should have a say in the workings of society are the values we share and are the foundations upon which both of our great nations have been built and have prospered. It is no coincidence, therefore, that Greece and the United States have stood by each other's side in every major struggle. After all, our two great nations are the historical pillars of democracy: Greece as creator and America as promoter. By passing this resolution today, we commemorate the struggle of the Greek people to secure their freedom and to establish the modern Hellenic Republic. Today, as we know, Greece is facing particularly difficult challenges. Yesterday, as part of his 4-day visit to the United States, the Prime Minister of Greece, George Papandreou, delivered an address at the Brookings Institution in which he described those challenges and emphasized the important role the United States can play in ensuring that global speculators do not take further advantage of what remains a very fluid situation. America and Greece must stand together to ensure that the global economic system is restored, to support European democracy, and to foster peace and prosperity around the globe. We are strong allies and are up to the task. In that spirit, our country today congratulates Greece on the celebration of its independence, and we look forward to strengthening our mutual ties in the days to come.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I rise today to introduce the bipartisan National Discovery Trails Act of 2010. This legislation seeks to connect existing trails, greenways, and country roads to form the American Discovery Trail a unique coast-to-coast, non-motorized, multi- use trail accessible to urban and rural areas alike all across the country. Americans have utilized our nation's trail system for more than 40 years for outdoor recreation, exercise, historic study, and general enjoyment of the natural beauty this country has to offer. The American Discovery Trail will connect people to small towns, historic sites and natural wonders along a coast-to-coast route. It will provide millions of people greater access to a trail system that can be utilized for two hours, two days, two weeks, two months or longer giving users the flexibility to explore the trail for as much or as little time as they want. Numerous studies have shown that the presence of trails and greenway corridors positively impact quality of life, but also real estate property values, small businesses, tourism, and even some corporate relocations. The National Trails System currently has two categories of significant long-distance trails. The first category is the National Historic Trail, which are famous historic routes, such as the Santa Fe Trail, Pony Express Trail, and the Lewis & Clark Trail. The second category is the National Scenic Trail, which are classic wilderness- only routes meant for hiking far from civilization, such as the Appalachian Trail, Pacific Crest Trail, and Continental Divide Trail. The National Discovery Trails Act of 2010 would add a third long- distance national trails category called National Discovery Trails. National Discovery Trails would tie together historic and scenic trails and connect them with population centers from small towns to big cities in a way that will increase access to and awareness of our national trail system. The legislation would also designate the American Discovery Trail as the first National Discovery Trail. The American Discovery Trail route--the first non-motorized way to cross the entire country--would utilize already existing right-of-ways on public land. It would be a patchwork quilt of the country's east-west pathways, including National Park hiking trails, National Forest logging roads, sections of historic routes, historic canal towpaths, rails-to-trails conversions, state and county park trails, country roads, small town sidewalks, and big city greenways--all stitched together to form one trail from the Atlantic to the Pacific. The National Park Service supported creation of the National Discovery Trail designation in a comprehensive feasibility study in 1996. Madam Speaker, it is time to expand the national trails system and establish American Discovery Trails, linking community to community and providing trail users the opportunity to journey into the heart of all that is uniquely American--its culture, heritage, landscape, and spirit. I hope my colleagues will join me in supporting of this legislation.

Mr. SARBANES

Mr. SARBANES. Mr. Speaker, in the last few weeks, I have been going around my district visiting main streets and talking to small businesses, and they have been appreciative of the efforts we have made with the American Recovery and Reinvestment Act. But they recognize something else, and that is, even if the economy begins to come back, and we hope that that's happening, they understand that as small businesses, they're still grappling with the high cost of purchasing health insurance coverage. In fact, if you look at the 45 million Americans who currently lack insurance coverage in this country, about 28 million of them are employed by small businesses or are the proprietors of small businesses. That's why I'm glad that the President's health care proposal building on the ideas in this Chamber addresses this important grievance that small businesses have and is designed to give them more access to an affordable health insurance market. That is absolutely critical for their long-term economic stability.

Mr. SARBANES

Mr. SARBANES. I thank the gentleman for yielding. I strongly support the Kanjorski-Frank-Sarbanes-Cohen amendment to the bill. This would restore critical investor protections for those who invest in publicly traded companies. And what are those? Number one, that the management establish internal controls with respect to the financial operations of the company; and, number two, that they get an outside audit to validate the soundness of those controls. Now, those who oppose this say that the smaller publicly traded companies can't handle the burden of compliance. The costs have come way down, particularly because the SEC has been careful to work with these smaller companies to make sure that that burden is not too heavy. The fact of the matter is that if you are an investor, it doesn't matter to you whether you are investing in a smaller company or a larger company. What you want to know is that that company is not cooking the books. If we don't pass this amendment, then almost half of the publicly traded companies in this country will be exempt from these basic transparency requirements. That's why I urge support of it.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I would like to commend Kim Jakovics, a social studies teacher at Annapolis High School in Maryland, for winning the Milken Educator Award. Since 1987, this prestigious award has been given annually to honor teachers who have distinguished themselves in their incredibly important and challenging field. Of the fifty-three teachers across the nation to be awarded this prize, she is the sole recipient from Maryland. Mrs. Jakovics was selected because of the immeasurable impact she has had on her students. Michael Milken, co-founder of the foundation, said of her instruction, ``Students' self-image changed, their aspirations changed. Students were different after that experience.'' For the past six years, Mrs. Jakovics' dedication to her students has made them feel more confident to aim for loftier goals. She has been effective in leading classrooms full of students at different skill levels and embraced the challenge of teaching diverse groups. Because of teachers like Mrs. Jakovics, Annapolis High School has experienced a dramatic improvement in student results. For five years the school failed to meet state testing standards. Over the last two years, however, the school has met standards and been removed from Maryland's troubled schools watch list. The dedication of teachers like Mrs. Jakovics is what makes such a dramatic turnaround possible. I hope Mrs. Jakovics will inspire other talented individuals to enter the field of teaching. Once again, I congratulate Mrs. Jakovics and wish her the best of luck.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I rise today to re-introduce legislation that would strengthen and expand the Army Corps of Engineers' role in Chesapeake Bay restoration--a mission they first began in 1996. This legislation would provide the Corps with continuing authority to engage in this work; expand the Corps' work to all six States in the Bay watershed and the District of Columbia; and provide flexibility for the Corps to work with other Federal agencies, State and local governments, and not-for-profit groups engaged in Bay cleanup. As the Congress begins to consider the reauthorization of the Water Resources Development Act, we must take this opportunity to strengthen the role that the Army Corps of Engineers plays in Chesapeake Bay cleanup. We must turn the tide in the Bay cleanup effort so future generations can continue to enjoy the cultural, historic, and recreational benefits of the Bay and so it can continue to be an economic driver for the Mid-Atlantic region. The Corps can play an important role in that effort. The Chesapeake Bay Environmental Restoration and Protection Program, which was established in section 510 of WRDA 1996, authorizes the Army Corps of Engineers to provide design and construction assistance to State and local authorities in the environmental restoration of the Chesapeake Bay. These projects range from shoreline buffers to oyster reef construction. As it is currently structured however, the program has been limited in its scope for several reasons. First, the Corps' restoration efforts have been limited to Maryland, Virginia, and Pennsylvania, which has precluded a comprehensive, watershed-wide plan that adequately prioritizes projects. Second, unlike all other major Federal agencies engaged in Bay restoration, the Corps has no small watershed grants program that engages State and local governments or non-profits in small scale restoration projects. This limitation is compounded by the Corps' intricate procurement processes. Finally, the matching fund requirements of the section 510 program does not allow for the use of in-kind services or contributions, which limits collaboration. The Chesapeake Bay Commission, a multi-State legislative assembly dedicated to the restoration of the Bay, has previously identified these deficiencies and has recommended the several improvements to the program that are the basis for this legislation. For these reasons, I believe the bill would strengthen the section 510 program so that the Army Corps of Engineers can continue to be a strong partner in Chesapeake Bay cleanup. I hope my colleagues will continue to support this legislation through the upcoming WRDA process.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I rise today to introduce the Property Assessed Clean Energy, PACE, Tax Benefits Act. This legislation supports efforts by state and local governments to help homeowners and businesses install energy efficiency upgrades. PACE projects are an innovative way to finance energy efficiency investments like insulation and home sealing projects, energy efficient appliances or renewable energy generation systems. These programs provide homeowners or businesses the upfront capital to pay for the improvements and allow them to finance repayment through the property assessment taxes they pay to state or local government. Because PACE financing offers real savings immediately and in the long term, homeowners and business owners are much more likely to pursue energy efficiency improvements. The legislation I am introducing will make it easier for state and local governments to raise capital for PACE programs by making the interest earned on PACE-related bonds tax free. For example, under current law, when government bodies issue bonds for the construction of roads, schools, or other infrastructure, their investors receive tax free interest payments. The PACE Tax Benefits Act will ensure that energy efficiency projects are treated in the same manner--allowing state and local governments to raise adequate capital and providing the low cost financing to property owners that will make PACE programs more widespread. This is an innovative and cost-free mechanism to encourage energy efficiency. The potential for economic growth and energy savings is vast if we establish a framework that allows for them to expand more broadly. By doing so, we will create thousands of new jobs; save billions of dollars in energy costs for consumers; and make significant progress in our efforts to reduce greenhouse gas emissions.

Mr. SARBANES

Mr. SARBANES. Mr. Speaker, I thank the chairman for yielding me this time. I just want to say to all of the seniors in my district and seniors across the country who have expressed anxiety over the last few months, and really for longer than that, that this physician payment cut would go into effect, that we heard what you were saying and we will take action today. Many of you are concerned because your doctors have been telling you that this payment cut is coming. Frankly, these physicians don't feel they are treated as professionals when we jerk them around at the end of a string every year. That is why we want to permanently fix this problem. We make sure that physicians are reimbursed properly and fairly so they will have an incentive to remain in the Medicare program, and that way there will be a good, robust supply of physicians to serve the Medicare population. That is why we are doing this today.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I would like to commend the winners of the 2009 Nobel Prize in Medicine, particularly Dr. Carol W. Greider, a professor of molecular biology and genetics at Johns Hopkins University School of Medicine, for discovering how chromosomes are protected by telomeres and the enzyme telomerase. The research of Dr. Greider, along with her colleagues Dr. Elizabeth H. Blackburn and Dr. Jack W. Szostak, has created a greater understanding of how chromosomes protect themselves from degrading when cells divide. This has unlocked mysteries about the human aging process and will have an enormous impact on fighting cancer and many other inherited diseases caused by telomerase defects. I applaud Dr. Greider's outstanding achievement as it reflects many years of study and hard work, a deep commitment to scientific innovation, and a desire to have a positive impact on peoples' lives. Her achievement is all the more significant in that only 8 of the 192 individuals to receive this prize have been women. I hope her success will inspire young women to enter the field of science. Congratulations to these scientists for their groundbreaking work in the field of medicine and for their extraordinary contributions to humankind.

Mr. SARBANES

Mr. SARBANES. Mr. Speaker, every day millions of people wake up with a knot in their stomach because they have anxiety and fear that they may lose their health care coverage or they don't have it to begin with. They need this health care bill. We in this Chamber are conscious of the sweep of history, but the people in my district and millions more across the country have a much less ambitious perspective. They just want to know is this a good bill, does it make sense, and will it help them and their families. Well, if you are a senior, the answer is yes. We're going to begin closing the doughnut hole. If you are a young person, the answer is yes. You can now stay on your parents' policy through age 26. If you are a working adult, the answer is yes, because we're going to curb the abusive practices of the health insurance industry. So what I want to say to people in my district and to others is this is a good bill, it makes sense, and it will help millions of Americans across this country. I urge its passage.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I rise today to reintroduce the Benefit Rating Acceleration for Veterans Entitlements Act of 2009 or BRAVE Act. The BRAVE Act will cut through unnecessary red tape so that our most disabled veterans receive the benefits they deserve. It would make a common sense change to allow veterans receiving a rating of total disability from the Veterans Administration to also receive Social Security disability benefits without going through a separate and duplicative medical evaluation process, a process that can take years to navigate. In early 2007, when I was first elected to Congress, a veteran- constituent contacted my staff to obtain assistance with his application for social security disability benefits. This veteran had already received a 100 percent disability rating from the Veterans Administration but had been waiting for more than a year to be approved for benefits at the Social Security Administration. The Social Security Act states that disability means the ``inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.'' By regulation, the Veterans Administration defines total or 100 percent disability as ``any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation.'' Despite the fact that these definitions are virtually the same, many veterans including my constituent endure two complicated and time consuming processes to prove the same condition. The Commission on Veteran's Disability Benefit found that only 61 percent of those granted Individual Unemployability and 54 percent of those rated totally disabled by the Veterans Administration are receiving Social Security Disability Insurance. The Commission further explained that ``it is apparent that that either these veterans do not know to apply for SSDI or are being denied the insurance.'' The Veterans Disability Benefits Commission concluded that ``increased outreach should be made and better coordination between VA and Social Security should result in increased mutual acceptance of decisions.'' It is for these reasons that I first introduced the BRAVE Act, with broad bipartisan support, in the 110th Congress. The legislation was supported by a range of veteran service organizations including the American Legion, the Iraq and Afghanistan Veterans of America, and the Paralyzed Veterans of America. The bill is all the more important at a time when we face significant increases in Social Security applications as a result of the aging baby boomer generation and as veterans of the wars in Iraq and Afghanistan come home. Madam Speaker, our Nation's veterans don't deserve a bureaucratic runaround when they return home. I hope my colleagues will join me in support of the BRAVE Act.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, today, November the 2nd, marks the 18th anniversary of the enthronement of Ecumenical Patriarch Bartholomew, who as the first among equals, presides over a spiritual communion of self-governing churches that represent 300 million Orthodox Christians from around the world. Throughout the eighteen years of his ecumenical ministry, Ecumenical Patriarch Bartholomew has asked all of us to act with sensitivity and understanding towards our brethren and towards our natural environment. When the Iron Curtain came down, His All Holiness provided spiritual and moral support to those traditionally Orthodox countries that suffered religious persecution under the yoke of communism. And after years of historical tension, Ecumenical Patriarch Bartholomew and Pope John Paul II earnestly pursued upon the reconciliation of the Roman Catholic and Orthodox Christian Churches. In 1997, recognizing Ecumenical Patriarch Bartholomew's robust activity and positive influences upon the world, this House awarded him with the Congressional Gold Medal. And when our country was attacked in New York and in Washington, His All Holiness assembled a group of international religious leaders to produce the first joint statement with Muslim leaders that condemned the 9/11 attacks as ``anti-religious.'' Although His All Holiness speaks English, French, German, Greek, Italian, Latin and Turkish, he is more widely known for his efforts at promoting interfaith dialogue. As a Christian leader of global significance who is domiciled in a country with a population that is 99 percent Muslim, Ecumenical Patriarch Bartholomew's everyday life experience gives him a unique, mature and realistic perspective for engaging in this interfaith dialogue. And it is from these everyday life experiences that the moral timber of His All Holiness shines brightest, where even in the face of Turkish government sanctioned discrimination, oppression and outright physically threatening provocations, he steadfastly remains committed to interfaith conciliation, and supports peacemakers of all religions and stands firm upon his conviction that war in the name of religion is war against religion. Beyond urging humanity to seek peace in fraternal harmony, Ecumenical Patriarch Bartholomew has more than any other religious leader promoted the spiritual dimension of environmentalism. In 2008, Time Magazine named Ecumenical Patriarch Bartholomew to its list of the world's 100 most influential people, where the Archbishop of Canterbury Rowan Williams acknowledged that ``This brave and visionary pastor has given a completely new sense to the ancient honorific [Ecumenical Patriarch]; his work puts squarely on our agenda the question of how we express spiritual responsibility for the world we live in.'' For his unparalleled spiritual commitment to the natural environment, His All Holiness has been dubbed the ``Green Patriarch.'' The Green Patriarch has challenged people of faith to acknowledge that ecological questions are spiritual matters of concern for all humanity and that ``a world in which God the Creator uses the material stuff of the universe to communicate who he is and what he wants is one that demands reverence from human beings.'' Just last week, His All Holiness presided over the Religion, Science and the Environment Symposium entitled Restoring Balance: The Great Mississippi River, and just last night, His All Holiness arrived at Andrews Air Force Base for a weeklong visit to our Capitol city. I offer my congratulations to His All Holiness for his good deeds in the pursuit of interfaith peace and reconciliation, for his concern with our natural environment and for his activism that has brought him to the shores of America to help draw attention to the need to restore our environment, such as the need to restore to health the great Mississippi River. It is a wonderful honor that His All Holiness is here in America upon the day of the 18th anniversary of his enthronement as Ecumenical Patriarch during his visit to our country.

Mr. SARBANES

Mr. SARBANES. I appreciate it. I want to just echo what my colleagues are saying in terms of strengthening the Medicare program. The savings that we're going to get out of the current program which come from being smarter--one way to do it is to be smarter on about how we deliver care and how we manage care, and we can realize savings that way. The other way, and I'm sure this has been addressed in part already, is to go after some of the fraud and waste and abuses there. I mean, ``60 Minutes'' did a story recently where they talked about that. Well, you've got to put some resources in to crack down with enforcement. There was an article a few weeks back about the producer of these motorized wheelchairs that cost them $1,000 to make these things. They're selling them to the Medicare program for $4,000. Well, that doesn't make any sense. That recalls the imagery of the $600 toilet seat that the Pentagon used to buy before we cracked down on that kind of thing. So there are things that we can do, very legitimate things we can do to find savings in the Medicare program. But what's important to understand, and seniors need to understand this, is that much of the savings we're taking, we're not taking that and putting it somewhere else. We're actually reinvesting it back into the Medicare program. So, in other words, the savings we get from these important steps that we take, we can take the benefit of that and we can invest it in things like closing the doughnut hole. We can invest it in things like more preventative services on the front end so people stay healthy instead of getting sick and then it costs more to treat them later in the process. There is plenty of research that shows that if you cover preventive services, if you get rid of that copayment, which we plan to do for things like the initial exam, for glaucoma screening, and for other preventive services, and you provide that to our seniors, it is going to benefit them and it is also going to save a lot of money in terms of the system in the long run. So it is very important for our seniors to understand that when we go looking for savings in the Medicare program, we do that with the goal of taking those savings and reinvesting them back into the Medicare program to make it stronger. And why wouldn't we want to make it stronger at a time when we have this baby boomer demographic wave that is coming into the country. Every 11.5 seconds, somebody turns 60 in this country. So we know that infrastructure has to be strong, and we have to do everything we can to invest in it going forward. That is what this bill does. That is why if you are a senior, you ought to be behind it 100 percent because it does all of the things that make sense for our seniors out there. Let me yield to my colleague from Florida.

Mr. SARBANES. I want to just pick up because when we talk about the uninsured, we are talking about 1 out of 7 Americans, and their plight is more obvious than the plight of the underinsured, which is another whole group of Americans. These are people who have purchased an insurance policy. They have been paying their premiums, month in and month out. Then they get sick, and it is at that point that they discover that the policy they have doesn't come anywhere near covering the treatment that they need because there may be a cap on how much the insurance company is willing to pay in terms of the medical expenses. Or it has high copayments and deductibles associated with it. So there you have a situation where people actually purchase coverage. They thought that they were in pretty good shape if an illness came into their family. But then when that situation confronts them, they discover that they are still at severe economic risk. And there are thousands of examples of families out there who had insurance and then somebody got sick and they have to go into personal bankruptcy because they can't afford to make the payments. Now, if you were to add together the people who are underinsured with the people who have no insurance at all in this country, you are starting to get up to about one out of three people in America who are at risk in this way. So that means close to 100 million people are getting up every morning and they have a knot in their stomach because they don't know whether some illness is going to hit them in a way that will pitch them over the economic brink. You can't function as a society that way. What I marvel at is look at how much we have achieved as a Nation, even while carrying around this broken health care system on our back. Think about what we could accomplish in terms of productivity and other things if we could fix this system once and for all. That is what this reform effort is all about. There is an industry out there that has got to be pushed to do the right thing. The health insurance industry has asserted that voluntarily they will change their practices when it comes to preexisting conditions and coverage exclusions for that, when it comes to rescinding policies based on some technicality that occurred at the time somebody was applying, when it comes to making their rates more reasonable and pocketing less profits by recognizing that they should put more into the medical expenses on behalf of their enrollees than they should into their own profits. They have told us time and time again, we can fix this problem on our own.

Mr. SARBANES. But we have seen, and coming in every day is evidence that they can't restrain themselves, they can't really discipline themselves. At precisely the moment in this debate when you would think they would want to demonstrate restraint and show that they can forgo some of those sizable profits, I'm going around my district and hearing from businesses and employers who just now have gotten the notices on what next year's premium increases are going to be. They are looking at premium hikes of 20 percent, 25 percent, 30 percent. Now if a company that is only spending 75 cents of the enrollees' dollar on medical expense is turning around and sending out a premium notice that says we are going to raise your rates by 25, 30 percent next year, something is wrong with the picture. This shows that left to their own devices, they cannot help themselves. That is why we have to move forward and put in place these best practices and put competition in place for that industry. I have said a number of times, and I will repeat it again today, to me this is all about whether we are going to go on living in the health insurance industry's world, by their rules, or whether they are going to start living in our world by our rules--and they will live in our world, they'll do just fine--because we need health insurance in this country. But they have to start getting with the program in terms of what ordinary Americans need and deserve with respect to health care.

Mr. SARBANES. Well, in August, when we had all this noise and commotion that was going on, the other side began to predict the demise of the health reform effort. But then September came and October came, and a funny thing happened on the way to that demise, and that is that people started asking the public again, what do you think, and discovered that they weren't about to let go of this thing, that they've waited too long to see these reforms. If you look at what's in the health reform proposal that we have developed in the various committees in the Senate and the House, it's almost a checklist of all the things that need to be done to address decades of grievances on the part of the American people. I mean, it's all there--strengthening Medicare, dealing with the problem of those who have no insurance coverage or are underinsured, creating a better health care delivery system, focusing on our health workforce and making sure we're getting people in the pipeline, improving the public health system in this country--which we understand oh so well today we have to strengthen when we look at the H1N1 outbreak and the infrastructure that we need to put in place. These are all things that for decades people have been calling about, and we've never been able to achieve the reform. Finally, now it is within our grasp. When we were that close to it and the story line began, the narrative started to be put out there that this isn't going to happen, that's when the quiet majority out there, the American people, said, No, no, no, wait a second; we're not giving up on this thing. We've come too far to turn back. That is why you see, as was mentioned by our colleague, you see in every single survey that's conducted that the American people want us to act. Only 20 percent of Americans when asked say that the Congress should not act on health care reform. Only 20 percent say we should just leave things the way they are, because they know that it's time to be liberated from the current system and to embark on a system that looks after people, that keeps people healthy, that doesn't confront them at a moment when they least should be thinking about whether they can pay, whether it will bankrupt them. At that moment, when they get sick and they need the care, that's when they should be able to rely on it. And so many millions of Americans can't do that. So when I hear this discussion about, Let's hit the reset button, let's start over again--the American people don't want to start this process over. We started back in January of this year with hearings, and we did hearings in three committees in the House and two committees in the Senate. We gave the public a chance to understand what was in this bill and get their input. And here we are 10 months later, it's within our grasp, and if we keep pushing, we're going to deliver this for the American people.

Mr. SARBANES

Mr. SARBANES. Hang on, America. Help is on the way. Mr. Speaker, a bill that will create insurance coverage for millions of people who have no insurance coverage now is on the way. A bill that will provide better coverage for those who are underinsured and that will deal with preexisting condition exclusions from coverage provisions is on the way. A bill that will strengthen Medicare is on the way. A bill that will improve our delivery system is on the way. A bill that will strengthen the health care workforce is on the way. That is what is coming. The simple proposition we need to test here and what Americans want to know is, when it comes to the insurance industry, are we going to go on living in their world and playing by their rules or are they going to start living in our world and playing by our rules? That's the question here. The bill we're putting forward is finally going to make the insurance industry adhere to good practices. That's why we're going to pass this bill. We're going to do it for the citizens of this country.

Mr. SARBANES

Mr. SARBANES. I thank the gentleman for yielding. Madam Speaker, I rise in support of H. Res. 838. It is, indeed, a privilege to join with my colleagues in welcoming to the United States and honoring His All Holiness Ecumenical Patriarch Bartholomew, Archbishop of Constantinople and New Rome. I want to thank Congressman Bilirakis for his leadership in developing this resolution. As Ecumenical Patriarch, His All Holiness is the spiritual leader of the world's Orthodox Christians. Orthodox Christians constitute the second largest Christian domination in the world, numbering some 300 million. From the Phanar, located in modern day Istanbul, the Ecumenical Patriarch has challenged all of us through his unparalleled work in interfaith dialogue to respect each other's faiths and cultures. He is a true messenger of peace and justice. Each day, the Ecumenical Patriarch reminds us through his good deeds and good words that we must reach beyond the value of material goods and look at one another as the brethren of a single family. The role of pastor to the world, the Ecumenical role of His All Holiness arises from the fact that he is the successor of the Apostle Andrew, who established the church in Rome's eastern provinces while his brother, Peter, established the church in Rome. Unfortunately, while the Ecumenical Patriarchate in Istanbul is more than 1,700 years in existence, today, its survival is threatened because of the continued denial of religious freedom and human rights that is perpetuated by the government of the Republic of Turkey. The plight of this ancient and noble religious center exemplifies the ongoing struggle for international religious freedom that so many people of so many faiths continue to endure. The United States must call upon its ally Turkey to restore the full rights of the Patriarchate, including property rights, and to reopen the Halki Theological Seminary. I am particularly drawn to the Patriarch's efforts to promote environmentalism. He has been called the Green Patriarch for his powerful commitment to restoring our planet. He initiated a joint declaration that it is man's duty to protect the Earth, signed by himself and Pope John Paul--the spiritual leaders of nearly one out of every five people in the world. The moral force of his message is unassailable. Humankind must ensure that it exists in a world where there is fresh air to breathe, clean water to drink and pure soil from which to harvest our food. From the Phanar, the Ecumenical Patriarch has inspired millions of Christians, Jews, Muslims, and people of all faiths with his call upon humanity to honor its responsibility as a steward of the Earth's natural bounty. We are so privileged to have Ecumenical Patriarch Bartholomew in the United States and to honor him for his continuing efforts to achieve a more peaceful and harmonious world.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, the State of Maryland and the American people lost a great educator and civil rights icon when Philip L. Brown Sr. passed away at his home in Annapolis, Maryland on October 16 at the age of 100. I rise to honor this man who was pivotal in the desegregation of our Nation's public schools. My heart goes out to his wife of over 77 years, Rachel; his sons Philip L. Brown Jr. and Errol E. Brown Sr.; his four grandchildren; his 10 great-grandchildren; and his six great-great-grandchildren during this very difficult time. Philip L. Brown served as a teacher and administrator in the Anne Arundel County school system for more than 40 years. His commitment to civil rights began early in his career. In 1938, Mr. Brown and his wife, Rachel Hall Brown, formed the Colored Teachers Association which promoted equal pay for African American teachers. Their civil rights struggle helped change history in 1940 when Mr. Brown became part of a successful lawsuit seeking equal pay for Anne Arundel County teachers. This was one of several cases that laid the legal foundation for Brown v. Board of Education, the Supreme Court case that forced integration of our Nation's schools. Thurgood Marshall represented the teachers, arguing their case before a federal court in Baltimore. Mr. Brown was born in Annapolis in 1909 and earned an elementary teacher's certificate in 1928 from the Bowie Normal School, now Bowie State University. He and his wife earned bachelor's degrees from Morgan State and master's degrees from New York University. After his retirement in 1970, Mr. Brown wrote four books on the subject of African American history in Anne Arundel County. Let us honor Philip L Brown Sr. as an educator and civil rights pioneer and for his determination in bringing about equality in America.

Mr. SARBANES

Mr. SARBANES. Mr. Speaker, more evidence is coming in every day that the health insurance industry cannot help itself when it comes to pocketing profits at the expense of the American people and American businesses. At precisely the moment when you would think the health insurance industry would want to demonstrate some restraint, because it's been telling us for months that it can accomplish voluntarily all the things that we want to try to impose in terms of better regulation on their practices, putting competition in place in terms of a public option, at precisely that moment when they have an opportunity to demonstrate restraint, I've been going around my district and hearing from businesses and employers who are just now getting the notices, the renewal notices on what the insurance premiums are going to be starting in January; and they're looking at 20 percent increases, 25 percent, 30 percent. So that sends a strong message that the insurance industry voluntarily is not going to do the right thing. That's why we've got to get a good, strong insurance reform in place that puts best practices in place with respect to that industry and provides some competition. That's what we're working for right now.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, as Congress works to extend health insurance coverage and improve the quality of care for all Americans, I would like to commend the Johns Hopkins Center for Innovative Medicine and their Aliki Initiative, an effort to restructure medical education with an emphasis on patient-centered care, for creating an innovative program that puts patients first. The Center for Innovative Medicine, launched five years ago by Dr. David Hellmann and Mr. Richard Paisner, has three goals: getting doctors to know their patients as people, members of families and communities; encouraging collaboration among all members of the Johns Hopkins Bayview campus; and creating a culture where everyone on the Bayview campus feels like a part of something special. The Center's Aliki Initiative focuses on the first goal and has been called the most important innovation in graduate medical education in a generation by the renowned historian Dr. Kenneth Ludmerer. As described in Pharos, the journal of Alpha Omega Alpha, the honor society of medical schools, the Aliki Initiative seeks to train young doctors to get to know their patients as people. Through the generosity of Mrs. Aliki Perroti, internal medicine residents care for patients hospitalized at Johns Hopkins Bayview Medical Center under the direction of Dr. Roy Ziegelstein and Dr. Cynthia Rand. This initiative emphasizes that optimal medical care can only be delivered if medical treatments are tailored to the individual patient, and this can only be done if doctors get to know patients better as people, which sometimes involves visiting them at home after hospital discharge. Dr. Charles B. Green, Surgeon General of the Air Force, circulated the Pharos article to all Air Force Medical Service personnel and said, ``It [the article] emphasizes the necessity for all of us to understand that health care must be patient-centric. We must know our patients and ensure schedules provide time for care teams to spend with patients. We must focus on the patients to help them achieve new levels of health.'' Madam Speaker, I commend the hardworking people at Johns Hopkins Bayview Medical Center, the Center for Innovative Medicine and the Center's Aliki Initiative. Their work should be seen as a model for improving the quality of care for all Americans. I'd like to enter the full text of the Pharos article into the Record. Teaching Residents to Know Their Patients as Individuals the aliki initiative at johns hopkins bayview medical center Neda Ratanawongsa, MD, MPH; Cynthia S. Rand, PhD; Cathleen F. Magill, MD, MHS; Jennifer Hayashi, MD; Lynsey Brandt, MD; Colleen Christmas, MD; Janet D. Record, MD; Eric E. Howell, MD; Molly A. Federowicz, MA; David B. Hellmann, MD; Roy C. Ziegelstein, MD Ms. P: Case summary Ms. P is a fifty-year-old woman with a history of hypertension who presented to the hospital with a severe allergic reaction to over-the-counter pain medications. During her hospitalization, Ms. P admitted to the intern that she had experienced the same allergic reaction before and felt ashamed that it had occurred again. In discussing how Ms. P organizes her medications, she also admitted that she only intermittently takes her blood pressure medications. She revealed that she is a busy caregiver for her mother and son, both of whom live with Ms. P and have complex medical problems of their own. The intern, consulting with her resident and attending, wondered how she can best help Ms. P return home safely and avoid future problems with her medications. Sir William Osler, if reincarnated and the attending for Ms. P, would have taken this opportunity to teach his residents the importance of knowing her as a person, for it was he who famously observed, ``It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.'' Despite increasing evidence that knowing the patient as an individual improves patient outcomes, graduate medical education (GME) pays little attention to affording residents the opportunity to know their patients well. If you ask the members of an inpatient ward team what keeps them from knowing their patients, most--from students to residents to attendings--say, ``We don't have enough time.'' Medical historian Kenneth Ludmerer laments the recent focus of residency training on service over education, with residents caring for greater numbers of patients for shorter periods of time. He argues that a fundamental educational principle of traditional medical education requires that residents learn deeply from and about fewer patients, citing the landmark report by Abraham Flexner: ``Men become educated by steeping themselves thoroughly in a few subjects, not by nibbling at many.'' Hippocrates wrote, ``Healing is a matter of time, but it is sometimes also a matter of opportunity.'' At Johns Hopkins Bayview Medical Center, we are seizing the opportunity to give residents the gift of time to allow them to become healers and know their patients in the way Osler recommended. The Aliki Initiative--a new educational program named for philanthropist Mrs. Aliki Perroti, who supports our efforts-- reduces residents' workloads and creates new opportunities for residents to know their patients more fully both inside and outside the hospital. The program provides residents the time both to get to know their patients and to learn from the reflect with their teachers. the importance of patients' narratives The opportunity to know patients as individuals is one of the greatest rewards in medicine. The narratives of our patients' lives fuel our passion for this work and keep us grounded in the art and humanity of medicine. By allowing us into their lives--whether through a single, brief interaction in the hospital or an enduring relationship over decades-- patients bestow on us a special privilege. Beyond this, however, our capacity to know patients as individuals allows us to translate the best evidence-based medicine into the highest quality, personalized care. In 1977, George Engel exhorted physicians to break free from the constraints of the biomedical model to understand ``the patient as well as the illness'' by uncovering the psychological and social aspects of patients' lives and life views. This patient-centered framework of care is associated with improved patient outcomes, including better quality of life, improved adherence, pain reduction, and improved blood pressure control. Despite its demonstrated benefits, the widespread failure of the health care system to provide individualized, patient- centered care is directly linked to suboptimal patient outcomes. A survey of 39,090 patients by Consumer Reports published in 2007 shows that fifty-eight percent of them feel their doctors do not know them as individuals. Another report in zoos indicates that, on discharge from the hospital, fewer than half of patients can list or explain the purposes and side effects of their medications. A study by D. R. Calkins and colleagues published in 1997 shows that physicians, on the other hand, tend to overestimate the quality of their discharge instructions. A 2007 paper by Derjung Tarn and coworkers noted that physicians prescribing new medications only stated the name of the medication seventy-four percent of the time and addressed adverse effects and duration of therapy about one-third of the time. This failure by physicians to communicate critical elements of medication use may contribute to failure by patients to take medications as directed. Similarly, Sunil Kripalani and colleagues in an article published in 2007 report that communication between hospital physicians and primary care physicians is often lacking or suboptimal in detail, affecting the quality of care in twenty-five percent of follow-up visits. Patient centeredness--one of six core aims for improving the quality of health care in the United States The Institute of Medicine (IOM) report Crossing the Quality Chasm highlights patient-centeredness as one of the six core aims for improving the U.S. health care system. The report defines patient-centeredness as: ``Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.'' Toward that goal, the IOM in the follow-up report Health Professions Education: A Bridge to Quality proposes that skills in providing patient- centered care should be a central competency for health professionals. Unfortunately, traditional GME is not prepared for this imperative. The goal of GME is not only to provide trainees with the knowledge and skills to care for patients like Ms. P, but also to inculcate in them the core values of the medical profession. GME today, however, is largely driven by the service needs of medical centers instead of thoughtful educational priorities. Residency graduates emerge from three years of stressful, demanding training ill-equipped to provide the type of patient-centered, quality care Ms. P deserves. Rather than learning to care for patients collaboratively across transitions and in the greater context of their lives, health care is both practiced and taught in ``silos.'' At the same time, the structure and financing of GME elevates the business of medicine over the vocation of medicine, creating a hidden curriculum in which ``the values of the profession are becoming increasingly difficult for learners to discern.'' Medical school curricula at many schools show an increased emphasis on patient-centered care and the value of effective patient-provider communication. However, once these physicians-in-training enter the typical residency program, they find that their training experiences do not reinforce this emphasis and are not structured to allow them to know and understand their patients as individuals. Unlike proficiency in traditional medical knowledge or clinical judgment, the skill of knowing one's patient as an individual may decline under the influence of a hidden curriculum that may not promote humanistic care. Duty hour reforms limiting the number of hours without adjusting the volume of work may lead some residents to make conscious decisions about how to spend their time, as voiced by one resident in a 2005 survey: ``It is harder to have as much time to speak with and really get to know patients, which impacts the ability to have shared decisions and understand patient perspectives.'' Finally, GME leaves little time for reflective learning. Reflection allows physicians-in-training to think about the meaning of their experiences with patients and how these experiences are influencing their own overall professional development. Although medical educators promote the potential value of self-reflection through activities like critical incident reports and portfolios, trainees' capacity for reflection may decline with the workload and fatigue of residency training. Thus today's young physicians-in-training may master the mechanics of delivering medical care, yet never have the opportunity to learn the art of healing. Creative philanthropy--key to success of the Rockefeller Foundation At the turn of the twentieth century, Frederick T. Gates advised John D. Rockefeller to establish an institute of medical research focused on medical education reform. Rockefeller's $32 million endowment of the General Education Board comprised the largest gift to higher education up to that time. In 1905, Henry Pritchett of the Carnegie Foundation commissioned Abraham Flexner to study the state of medical education in North America and to make recommendations to improve it. This effort resulted in the publication of the Flexner Report, perhaps the most influential document in the history of American medical education. These achievements a century ago represent striking examples of the ways creative philanthropy can both reform and shape medical education to meet the needs of society. The need for educational reform is once again upon us, but the funding constraints of a market-driven health care environment hamper innovation by hospitals and educators. Reform in the twenty-first century may require educators to consider again the potential of partnering with the public. The Aliki Initiative is a program designed to create physicians who treat all patients with compassionate, competent, and personalized care. The Aliki Initiative aims to develop caring doctors who have a genuine and deep appreciation of the importance of knowing each patient's unique personal circumstances and who make patient care recommendations that apply the best evidence to the individual patient. The program reduces the number of patients assigned to each resident, providing residents more time to spend with patients during and after their hospitalizations, and thus offering new opportunities for residents to learn from and about their patients. The Johns Hopkins Bayview Medical Center is an academic medical center serving 8700 medicine inpatients per year; twenty percent are poor. Patients hospitalized on the medical service receive care either from a hospitalist service or from one of four house staff teams. Teams contain one resident, two interns, two students on basic medicine clerkship rotation, a faculty attending, and a case manager. A traditional team admits ten patients every fourth night on ``long-call'' and four patients during an intervening ``short-call.'' In October 2007, one team became an Aliki Team, admitting five long-call patients and two short-call patients. Hospitalists care for the patients who would otherwise be admitted by this house staff team. Lower patient load enables more teaching to the Aliki Team With this reduced census, the Aliki Team has the time to participate in teaching sessions and mentored experiences designed to foster appreciation of knowing each patient as a unique person and understanding each patient's psychosocial circumstances. This begins from the admission encounter, when house staff learn to elicit a more meaningful, detailed history that includes patients' understanding of their illness and their health. By engaging in this dialogue with patients, their caregivers, and their outpatient health care providers, house staff learn who and what patients have left behind when they arrive at the hospital, an often forgotten but equally important transition time. Residents also learn how to provide counseling and treatment to match patients' needs and concerns. One key component of the Aliki Initiative is learning to assess and overcome potential barriers to medication adherence, particularly by tailoring evidence-based treatment to the patients' particular preferences and resources. During each day of the hospitalization, house staff continue these conversations, honing their skills in patient education and joining with patients in shared decision making about diagnostic or therapeutic options. Leading up to and on the day of discharge, house staff prepare patients and their caregivers for the transition to home, rehabilitation centers, or other settings in the patients' communities. In contrast to usual practice following discharge, residents call all patients within a few days of discharge to answer questions, check their understanding of the hospitalization and treatment recommendations, review their understanding and ability to adhere to the discharge treatment regimen, and offer assistance with any problems that have arisen in the transition. Finally, the Aliki Initiative provides the most powerful learning opportunity of all: team members learn to know their patients as individuals within their own homes and communities. Five or more patients per month give residents permission to visit them after discharge in their homes or subacute care facilities. Often, patients allow residents to photograph or film these visits, so the house staff can teach their colleagues about these rich, rewarding experiences during a monthly Aliki morning report conference. Outcome--narrative medicine yields better patient care Since October 2007, over half of our house staff have participated in the Aliki rotation. During hospitalizations, residents spend more time at the bedside with their patients and patients' loved ones, discussing medications and other treatments and coordinating care with outpatient providers. Interns and residents say they gain their greatest insights during their time with patients after discharge, when they call all of their patients and visit five or six patients at their homes or subacute care facilities. In addition to enhanced time with patients, team members have the time to reflect on their professional and personal growth, both individually and as a team. Each month, faculty and attendings working with the Aliki house staff meet to debrief the team about their experiences. The most striking and consistent observation is how often house staff report ``being surprised'' by what they have learned about their patients. Prior assumptions about a patient's preferences, barriers, abilities, or concerns are regularly challenged when residents take the time to know patients individually. This deeper insight, in turn, has repeatedly led to opportunities to provide better patient care. Below we present some examples of ``assumption-challenging'' Aliki experiences and how they impacted patients and house staff. Ms. P: The Home Visit A few days after discharge from the hospital, the Aliki Team intern and attending visited Ms. P at her home, learning more about her home situation and meeting her mother and son. They discovered that--in an attempt to remind herself to take her medications--Ms. P keeps her medications on her dining room table. Otherwise, she reported, the medications are ``out of sight, out of mind:' The intern realized that both Ms. P's mother and her son also keep their prescription and over-the-counter medications in the same location, increasing the chances that any of them could take the wrong medication. The intern also learned about the ways Ms. P copes with caring for her family, including the supports she receives from her community. Together, the intern and Ms. P brainstormed about how to organize her medications more safely and help her remember how to take them. From the home visit the intern learned more about the challenges of integrating a complex medical regimen into a person's daily life and ways to engage patients in finding solutions to these challenges. Ms. P expressed appreciation that the intern took the time to come to her home: ``They treated me like I was someone special.'' This learning experience is just one of many. Other examples of Aliki experiences include: An intern spent significant time with a man facing a difficult decision about treatment for pancreatic cancer. The patient initially told him, ``I'll do whatever you say, Doc.'' Nevertheless, the intern patiently spoke with him every day to learn about his goals of care and preferences. He wasn't sure he was making any difference until one day the patient told him, ``Doc, I don't want any of those things. I want to go home.'' The intern helped him transition to home hospice, and felt certain that this was ``the right thing to do for him.'' A former Aliki resident working as the urgent care doctor for the clinic described ``an Aliki moment'' during which he discovered that a patient with gastrointestinal bleeding was unable to afford his proton pump inhibitor after hospitalization. Experience on an Aliki Team gave him the skill and confidence to ask the patient explicitly and thoughtfully about all barriers to adherence. The resident switched the patient to a generic medication covered by the patient's insurance and spent time counseling the patient about the rationale for this therapy. An intern visited a patient with urinary retention in a subacute care facility and learned that the patient's Foley catheter had been removed despite notations not to do so in the ``hospital course'' section of the discharge summary, and despite the patient's own recall of their recommendations. The team resolved that in the future they would document more explicit instructions with the medications list at the end of discharge summaries and call ahead to subacute care facilities for similar important follow-up issues. Although residents were initially concerned that fewer patients would mean less opportunity for traditional medical learning, in fact, they report having more time for evidence- based and bedside teaching. One team decided to focus on physical diagnosis skills. The teaching attending physician on this team described the experience as ``the first time I am sure that the interns really knew how to examine a patient by the end of my weeks with them.'' The supervising residents also relished the additional time to search the literature for articles and prepare teaching for the team. House staff participating in the Aliki team feel greater pride and more fulfilled in their work. In the words of one intern, ``It's given me time to be the kind of doctor I've always wanted to be and do the things I should be doing for all my patients.'' Ms. P: Epilogue Asked about the home visit, Ms. P said, ``I thought those days were over. You know, how the doctors used to come to your house. They came down, sat down to talk, to see how I was getting out of the hospitalization. And that made me feel good because some doctors don't have that interest or do a follow-up to find out how the patients are doing . . . That's letting the patients know that someone else cares. That made me feel that I was important, and they're learning from me! . . . They treated me like I was the only patient they had to see that day. They treated me like I was someone special.'' Where from here? More opportunities for innovative medicine Our early experience suggests that the Aliki Initiative has the potential to increase residents' skills and motivation to deliver patient-centered care. Ongoing and planned evaluations of the program's outcomes include: An assessment of Aliki residents' self-assessed behaviors, attitudes, and skills before and after participation in the experience. Trainees' perceptions and understanding of medication adherence and cost. An audit of the medical records of patients cared for by an Aliki team, compared with patients cared for in other settings, to evaluate prespecified aspects of inpatient care, transitions of care, and the quality of discharge documentation. In addition, we will examine the impact of the Aliki Initiative on such patient outcomes as hospital length of stay, quality and safety of the transition from hospital to home or to another care team at a skilled nursing facility, rates of rehospitalization, patients' knowledge about their medical conditions and medications, and patients' perspectives about the quality of their care and health care providers. These evaluations may help educators at other institutions determine what parts of this curriculum to try at their own institutions, and to secure grant funding to support such efforts. In addition, such evaluations may prove helpful to policy makers as they shape the future funding structure of GME. Like the Flexner Report a century ago, the Aliki Initiative resulted from private philanthropy directed to improving medical training for the public good. When doctors and private citizens together view medicine and medical education as a public trust, everyone benefits. It also reminds medical educators that we cannot accept the status quo and need to show the public what our vision for patient-centered care can and must be. As Molly Cooke and her coauthors write, ``No one would cheer more loudly for a change in medical education than Abraham Flexner. . . . He would undoubtedly support the fundamental restructuring of medical education needed today. Indeed, we suspect he would find it long overdue.'' Acknowledgment: The Aliki Initiative is funded through the Johns Hopkins Center for Innovative Medicine, thanks to the generosity of Mrs. Aliki Perroti.

Mr. SARBANES

Mr. SARBANES. Madam Speaker, I am pleased to note that on June 27, 2009, our distinguished former colleague in the House of Representatives, Dr. John Brademas, was awarded the honorary degree of Doctor of Laws by The American College of Greece. John Brademas was the first Greek-American elected to the United States House of Representatives and as such this honorary degree from The American College of Greece has particular symbolic resonance. I add, however, that this is the 55th honorary degree received by Dr. Brademas. Madam Speaker, the remarks of Dr. Brademas at The American College of Greece on June 27, 2009 follow. June 27, 2009. Remarks of Dr. John Brademas, President Emeritus, New York University, Neo Faliro, Peace And Friendship Stadium, Athens, Greece Father Constantinos, President Horner, Dr. Sue Horner, Consul General McKeever, Chancellor Bailey, chairman Peter Thun of the Board of Trustees, Senior Vice President Protopsaltis, fellow honorees, members of the faculty and graduating students of The American College of Greece. It is for more than one reason that I count the award I have just received among the great honors of my life, and I'm especially pleased that my wife, Mary Ellen, a practicing physician, was able to break away from New York City to join us here. In the first place, this is a degree from The American College of Greece. As you know, my late father, Stephen J. Brademas, was born in Greece--in Kalamata--and my two brothers and sister and I were all raised to be deeply proud of our Hellenic heritage. ``Be proud that you are an American'', my father used to say, but ``be proud, too, that you are a Greek!'' All four of the Brademas children were deeply conscious of the importance of our Greek background. Here let me say how pleased I am that my cousin, Anna Bredima, General Counsel for the Union of Greek Shipowners, is here today with her two children, Evangelo and Ersiliana. Anna, by the way, is a graduate of Pierce College. Although my mother was not of Greek descent she was, like her father, a teacher--and that fact emphasizes another dimension of his Greek ancestry that my father used to press upon his children--the importance of learning, of knowledge, of education. A second dimension of the history of Greece that my father and I often discussed was democracy. ``We Greeks invented democracy!'' my father reminded us, and said that some of us should still practice it. Accordingly, after graduating from Harvard University and one year of postgraduate study there, I went to England, on a Rhodes Scholarship, to study at Oxford University. At Oxford, I wrote a doctoral dissertation on the anarchist movement in Spain but I like to note that although I studied anarchism, I did not practice it! For on my return to my hometown in Indiana, I immediately plunged into politics and became a candidate for election to the Congress of the United States. Just old enough--25--under our Constitution to be a candidate, I lost my first race by half a percent. Naturally, I ran again, two years later, but lost a second time. Undaunted, I was first elected, on my third attempt, and then ten times reelected. So I served as a Member of Congress for 22 years. In the House of Representatives, I gave particular attention to writing legislation to support schools, colleges and universities; and the students who attend them; to measures to help libraries and museums; and the arts and the humanities, generally. In my last four years as a Member of Congress, I was the Majority Whip of the House of Representatives, an assignment that brought me every other week, with Speaker of the House of Representatives, ``Tip'' O'Neill of Massachusetts, and the other Democratic Leaders of the House and Senate to breakfast at the White House with President Jimmy Carter arid Vice President Walter Mondale. All Democrats, we talked politics and policy. It was, of course, while a Member of Congress that I became deeply involved in the issue of Cyprus, a matter that continues to preoccupy me. I worked closely then with my valued friend, also a Rhodes Scholar at Oxford, and the first Greek-American elected to the United States Senate, Paul S. Sarbanes. And I'm pleased to note that Paul's son, John Sarbanes, now serves in the United States House of Representatives. As I am the son of a Greek immigrant, I am pleased to call your attention to another son of Greek immigrants, both his father and mother. I speak of Peter C. Peterson, the highly successful and highly respected American business leader and public servant. Peter G. Peterson, co-founder of Blackstone Group and former Secretary of Commerce, has just published a fascinating book, The Education of an American Dreamer, which I am pleased to present to President Horner for the College library. Your faculty and students will find the story of this remarkable son of Greek immigrants inspiring, I am confident. More modestly, I am pleased also to present a book of my own to The American College of Greece, The Politics of Education, in which I describe my experience as a Member of Congress in writing legislation to assist schools, colleges and universities; the students who attend them; and measures to assist libraries and museums. I move ahead, In 1980, as a result of the landslide victory of Ronald Reagan, I lost my race for reelection to a twelfth term. Shortly thereafter, I was invited to become president of New York University, the largest private, or independent, university in the United States. In 1991 I became president emeritus, my present responsibility, so now I'm only going some twelve hours a day! If I were to single out one dimension, of my commitment to strengthening New York University, it would be that I gave particular attention to building our programs for the study of other countries and cultures, not only through programs in New York City but centers abroad as well. Much of the responsibility of an American university president focuses on fundraising, both from the Federal government and private sources. So I pressed hard, and, I believe, effectively, to bolster the financial situation of New York University. I must add just a word about my present initiative, another strongly shaped by my Greek origins, the establishment at NYU of the John Brademas Center for the Study of Congress, of Congress as a policy-making institution. Let me explain that unlike parliamentary institutions in Europe, the Congress of the United States has great power, in addition to that of the President of the United States, to make national policy. But with 100 Senators and 435 Representatives and without the party discipline characteristic of parliamentary systems, it is not easy for even informed Americans to understand Congress. So we are, with the establishment of the John Brademas Center for the Study of Congress at New York University, creating an institution that will bring together Senators, Representatives, scholars and citizens to discuss the ways in which our national legislature makes national policy and ways of improving the system. Now, ladies and gentlemen, from what I have told you, I hope you can see that I have inherited from my Greek father at least two dimensions of the extraordinary contributions of Hellenic civilization to today's complex world: first, respect for learning, for education; and second, respect for politics, for democracy. So even as I pay tribute to two distinguished persons you are also honoring here today, Andrew Athens, a valued friend of many years and an outstanding leader of the Greek-American community; and Mikis Theodorakis, musician, scholar, public servant, I reiterate how deeply touched I am to receive an honorary degree from The American College of Greece.