Jim Talent

Mr. TALENT

Mr. TALENT. Yes, they did.

Mr. TALENT. I will reclaim my time. I am sorry for stepping on the gentlemen's comment there, but they said it had to be a significant claim. Then it left that up to the Department of Labor to define. We said any claim that you feel you are not getting coverage on that you have been promised coverage, you can go to external review.

Mr. TALENT. That is absolutely correct. I thank the gentleman for raising the point. We all know on that task force it was the gentleman through his efforts who made sure that this bill did not have a threshold. Then again, after external review if the plan still does not pay, you go to court immediately. You do not have to wait until your child has lost his hearing. You do not have to wait until somebody has got really sick and died and then maybe 4 or 5 years later after you have run the gauntlet in the State court system you can try to sue for recovery later on, you can sue right away for penalties up to $250,000 in addition to attorney's fees, court costs and the cost of the treatment. There are others who want to speak on this bill, Mr. Speaker. I am eager to have them do it.

Mr. TALENT. There is a major difference. Under our bill, you do not have to die first. You can sue to get the treatment that you need. Because the emphasis here, and I appreciate the gentleman's comments, I say, in all good faith, the emphasis here is on giving people the care they need when they need it. We want people in the treatment room, not in the courtroom. I would anticipate that very few people would have to go to court. Because we have changed the incentives in this bill for these HMOs. For the very same reason that they have been denying care in the past, they are going to be granting care now because they are going to know, it is going to end up costing them more money if they deny the care up front. So I would anticipate that few people would have to go to court. But that hammer is there. If they spin people along, if they do not pay when they are supposed to pay, you go to court right away. In fact, as the gentleman knows, you can go to court up front in an emergency situation to get an injunction, an emergency injunction to order them to pay. Florence Cochran, the very unfortunate lady who had a high-risk pregnancy and her doctor wanted her to go into the hospital and the HMO said, ``No, we don't think it's all that high risk a situation,'' she could have gone to court under our bill, got an injunction to allow her to go into the hospital right away and then because it was an emergency gone through this internal and external review procedure within about a week to establish the right that she had the right to have that hospital care paid for.

Mr. TALENT. Yes.

Mr. TALENT. And it would have been up to her physician to decide whether it was emergency or urgent care which then triggers the time limits in the bill. Moreover, if the plan had denied coverage after the external review panel had said it was covered, as the gentleman knows, the $250,000 penalty is a per diem penalty, a per day penalty. Every day they do not pay, they would be liable for up to $1,000. Why? Because we are not trying to promote litigation in this. We want the treatment covered when the physician has recommended it. And so what we are saying to the HMOs, ``Pay and don't delay because the longer you delay the more you're going to have to pay after a few weeks or months.''

Mr. TALENT. It would be borderline because under the law today you are allowed attorney's fees. So it would be a borderline type of situation. In many cases the lawyer would just say and the patient would say, ``It's not worth it.'' Why do I want to go years and years and years in court with the plan having every incentive to spin out the case as long as possible? So ours is an improvement in a number of different respects. First of all, the $250,000 penalty, which is triggered by delay, we are saying to the plans, ``Every day you delay it costs you more. We want you to pay when this panel has said you should pay.'' In addition, you can go to court right up front to get an emergency injunction in those cases where a life is really at stake. Any judge is going to say, ``The treating physician has recommended this care, it's an emergency situation, there's some kind of a contract dispute, I'm going to put this person in the hospital while you take the necessary week or 10 days or whatever it is to resolve this matter.'' So we have expedited the process, it is low cost to the patient as the gentleman knows, it is swift, it is sure, it is certain, it is a way of getting people the care that they need. I will just say to the gentleman, then I will close and yield to the gentlewoman from New York to discuss a different aspect of the bill. I was asked during this debate on the bill by somebody who said to me: Look, suppose they have this situation. A person has an infected leg, and his plan physician recommends institutional care in a hospital. The plan turns it down, the infection gets worse, the persons loses the leg, what can they recover? Under your bill, what could they recover from the plan? And I said, ``Well, they can get attorney fees, they can get costs, they can get $250,000 in penalty, they can get the cost of the treatment, and they get their leg because that leg is not lost.'' And that is the whole point. Nothing I think differentiates the different approaches that were before this House in that example. We have written this as air tight as you can write it, and where that care is medically necessary, where the treating physician recommends it, the person is going to get the care that they need. That is what America wants, and they want it without litigation, they want it without big government, they want people in treatment rooms, not in courtrooms, and, as in most cases, the American people got a lot of good common sense in this. That is what this bill would have given to them. I am very glad it passed the House. I think it is the starting point for legislation next year. And I am very happy to yield to the gentlewoman from New York (Mrs. Kelly) for any comments she may wish to make.

Mr. TALENT. Mr. Speaker, it is my pleasure now to yield to the gentleman from Florida (Mr. Bilirakis) for such comments as he would wish to make, and I will just add in yielding to him that Mr. Bilirakis has been a leader in this field both of health care reform and patient protection and access to health care for a number of years and did outstanding work in this task force, and it is a pleasure to yield to him.

Mr. TALENT. Mr. Speaker, I appreciate the gentleman's comments, as always, about this bill which would have expanded the reach of private health insurance to millions of people who currently do not have it and then help to guarantee that those who do have health insurance get the care they need when they need it, when their physician recommends it and done that without big government. It was a good bill. It is a shame we could have closed ranks behind it. Mr. Speaker, nobody did more to fight for this bill and to fight for the interests of people who currently do not have health insurance than the gentleman I am pleased to yield to next, the gentleman from Illinois (Mr. Fawell), and I just want to say about him that he has fought tirelessly year after year after year to make association health plans a reality, he has talked to small business people, he talked to employees of small business people and he knows that patient protections are not worth anything if you do not have health insurance, as the gentleman says. And so it is a pleasure to yield to him for such comments as he might wish to make.

Mr. TALENT. The gentleman's comments are very kind. I just have to say it is the gentleman's efforts year after year that have brought this to the floor and I hope bring it to fruition next year. It comes down to this: If you are an employee of, let us say the Boeing Company, and Boeing has a very important division in my district with a former McDonnell Douglas company, with tens and tens of thousands of people working for them, it is a great company, so that company is big enough and has this huge group of people and the group is an efficient group and they can put out money and sell funds, so in effect they do not have an insurance company except maybe to administer different aspects of the plan. As a result, they can stay in control, they can provide the kind of coverage that their employees want, and they have these kinds of economies of scale. Is not the whole issue why should not small employers be able to band together as groups to offer the same thing to their employees? They want to do it, their employees want it. There are tens of millions of people who do not have private health insurance. Why should they not be able to do that? Can you think of a reason?

Mr. TALENT. That is the other question. Who was it that opposed this provision? Let us be up front about it. Was it not the insurance company who opposed this provision?

Mr. TALENT. I thank the gentleman for his comments. Mr. Speaker, it is curious that this bill was opposed in this House and the other body by people on the grounds that it was too nice to insurance companies and they opposed the provisions in it that the insurance companies were fighting, and that can only happen in Washington. Unfortunately, it happened here. I am happy to yield to the gentleman from Georgia, whose efforts it is I think quite correct to say are the reason why this bill, a bill on this issue, was before the House. He has labored long and hard and against opposition sometimes from a lot of different quarters, and he has it here, and there is nobody I respect more and nobody who worked harder on behalf of patients. I yield to the gentleman from Georgia (Mr. Norwood).

Mr. TALENT

Mr. TALENT. Mr. Speaker, I thank the gentleman for yielding me this time. Mr. Speaker, I admire and appreciate the gentleman's eloquence and that of the gentleman from Maryland (Mr. Cummings), and I do not know that there is a lot I can add. I just think that this resolution is important for a number of reasons. They have commented, and I think it bears repeating, on the class that Mark McGwire had throughout this whole season as he chased this record. He showed the affection that he has in his heart for his son; he showed the regard that he has for his competitor, Sammy Sosa; and that was returned time and time again. I really appreciate the gentleman from Maryland (Mr. Cummings) remark because that showed how far baseball has come from the days of Jackie Robinson. Mark McGwire showed the respect that he has for baseball and for the way that he treated the Maris family, and I think all of those things justify this resolution. I had a personal reason as well for filing it. I was able to share that evening with my 8-year-old son, and to share that moment with him when Mark McGwire hit the 62nd home run, and it struck me that the experience we had together and the way I felt afterwards when my son said it was the best night of his life, was probably shared by millions and millions of families around the country who were together watching this achievement, watching Mark McGwire chase this with such class and achieve it on that night, and they shared that memory then and they will share that memory forever. I think it deserves this memorial. This is a class individual. None of it was a put-on. It is just the way he is. I am glad the House is taking a few moments to recognize him. I am sure everyone will support this resolution.

Mr. TALENT

Mr. TALENT. I yield to the gentleman from Kentucky.

Mr. TALENT. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, this amendment will add slightly over $7 million to the Business Loan Program Account for the Small Business Administration. The purpose is to add that funding for the purpose of the Small Business Investment Program. H.R. 4276 currently appropriates $13.1 million for the SBIC program, which is well below fiscal 1998. This amendment will raise funding to an amount equal to this year's level. That is necessary to create a level kind of funding stream. We anticipate, Mr. Chairman, increased demand for the program, and this amount guarantees that sufficient funding will be available for the SBIC program. Mr. Chairman, the SBIC program is a Small Businesses Venture Capital program, really the only one that we have. It provides venture capital lenders with leverage funds for the purpose of equity and long-term investment in small business. The participants in the SBIC program look to the Congress for clear signals of our support and consequently our commitment to funding venture capital for small businesses. By adding these funds, we will maintain this program at a level equal to that of previous years and send a clear message of our support for this program. The gentleman from Kentucky (Mr. Rogers), the subcommittee chairman, has spoken with me about the program and understands our concern about possible serious negative impact on private capital commitments to the program. He has expressed his support for the program and my amendment and I want to thank him for his support. I want to mention also at this point, before yielding to the chairman, that the gentlewoman from New York (Ms. Velazquez), the ranking member of the Committee on Small Business, also supports the amendment. And I want to thank her for her help and her consistent aid on behalf of small business. I will add also that the amendment is supported by the Small Business Legislative Council, an organization representing over 80 small business groups. I ask my colleagues for their support for this amendment, as well.

Mr. TALENT. Mr. Chairman, reclaiming my time, I appreciate the sentiments of the gentleman and the distinguished chairman of the subcommittee.

Mr. TALENT. I yield to the gentlewoman from New York.

Mr. TALENT. Mr. Chairman, I appreciate the support of the gentlewoman from New York and also of course the distinguished gentleman from Kentucky, the chairman of the subcommittee. I would ask my colleagues for their support of the amendment. Mr. Chairman, I reserve the balance of my time.

Mr. TALENT. Mr. Chairman, I yield back the balance of my time.

Mr. TALENT. Mr. Chairman, I offer an amendment.

Mr. TALENT

Mr. TALENT. Mr. Speaker, I move that the House do now adjourn.

Mr. TALENT

Mr. TALENT. Mr. Speaker, I thank the gentleman for yielding me this time. I am very pleased to rise in strong support of the Patient Protection Act because it is the only bill on the House floor today that will provide health care coverage to millions of people, hard-working Americans who currently do not have it. It is the only bill that will ensure that Americans who have health care coverage get the coverage their physician recommends when they need it, before they get sick, and it is the only bill that does what it does without big government and big bureaucracy. First, access to the uninsured. Mr. Speaker, there are 42 million Americans today who do not have health care coverage. Most of them work for small employers who, because of the high administrative costs and the low buying power with small pools, cannot afford to provide them health insurance. If they worked for IBM, they would have access to a variety of different options. So what our bill does is allows those small employers to pool together and get the buying power of a pool. It will cover millions of people with good, private sector health insurance and provide many more choices to millions of those who currently only have one choice or two. What does the Dingell bill do? What does it do for the uninsured? Well, according to a cosponsor from the other body, not much. In fact, the ``not-much'' plan is worse than not much, because according to the CBO, it will drive costs up to the point that 1.6 million people who now have health insurance will be thrown off the health insurance rolls. Our bill also ensures that people will get the care they need when they need it, and does it without big government. It provides swift, certain, low-cost access for somebody whose physician has recommended care whose plan has turned it down to get that decision reversed. First internal review has to be before a physician, not a health care professional, not a nurse. That is a difference from the Dingell bill. Second, automatic appeal has a right to an external review before physicians. The Dingell bill does not have that. We get people in the treatment rooms, not waste billions of dollars that should be spent on health care in the courtrooms. Mr. Speaker, all of us who have dealt with this issue have dealt with the stories about people who have needed coverage and have had it denied by their managed care plans. Those are not just horror stories, they are horrible stories. Tales of human misery, of pain, of loss of babies, loss of limbs; that should not happen. Under our bill and only under our bill those stories would not have happened and will not happen in the future. That is what this debate today is about, that is what this bill is about. It should not be about politics, it should not be about an issue for November; it should be about helping the people to get the care that they need when their physician recommends it. That is why I rise in strong support of the Patient Protection Act.

Mr. TALENT

Mr. TALENT. Mr. Speaker, I rise today to pay tribute to Jesuits of the Missouri Province as they celebrate the 175th anniversary of the arrival of Jesuits to the St. Louis area. It is a true privilege for me to recognize the many important accomplishments and achievements which have marked the Jesuit presence in the St. Louis area and throughout the entire Midwest. In May of 1823, a small group of Belgian Jesuits completed their journey from Maryland to St. Louis, to take possession of a farm given to them by the Bishop of the Territory, William Louis Valentine DuBourg. They had originally come here to assist Bishop DuBourg in the establishment of an Indian School, an effort which was endorsed by President Monroe and Indian Commissioner General William. Although the Indian School proved to be an unsuccessful venture, the school was converted into the St. Stanislaus Seminary and would train young Jesuits until 1968. In 1840, the Jesuit brothers and priests began work on a permanent structure made of limestone. This structure, known as the ``Rock Building,'' still stands today and is the current home of the Jesuit Museum. The Jesuit Museum houses memorabilia of numerous Jesuits who have lived there since 1823. One of the more famous residents of the site was Father Peter John DeSmet, who served as a missionary with many Indian tribes in the plains and northwest. Among his many accomplishments, was a detailed map he provided the U.S. Department of the Interior indicating the location of various Indian tribes. Other famous Jesuits include Fr. Peter Verhaegen who became president of St. Louis University, and Fr. John Elet, who also served as president of St. Louis University and was the founder of Xavier University in Cincinnati. Countless other Jesuits of the Missouri Province have made a lasting impact in this region by serving as missionaries and founding a number of parishes in the lower Missouri River Valley. Little did that small group of Jesuits realize that their arrival in 1823, would lead to the expansion of the Jesuit presence throughout the Midwest. Mr. Speaker, I ask that you join me in congratulating the Jesuits of the Missouri Province on their 175th anniversary in St. Louis. I also ask that you join me in thanking them for their countless contributions to this region. Their efforts are truly an inspiration and source of pride for all residents of Missouri.

Mr. TALENT

Mr. TALENT. Mr. Speaker, I rise today to pay tribute to the Hindu Temple of St. Louis and recognize their efforts to celebrate Kumbhabhisheka Mahotsava. I wanted to take this opportunity to enclose the text of some brief remarks I made on Friday, July 3, 1998, which recognizes this outstanding occasion. Since the Hindu Temple of St. Louis opened in 1991, it has become an integral part of the community. The recent expansion program has resulted in a spectacular temple with architectural roots in the 500- year-old temples of India. I congratulate the Temple and the community on your success and am honored to share in the excitement of Kumbhabhisheka Mahotsava, the consecration of the Temple. The traditions and rituals steeped in centuries of custom make this a unique and special opportunity for the St. Louis Hindu community. I wish you peace and joy on this great occasion. May God bless you and your families as you share in the beauty of Kumbhabhisheka. Mr. Speaker, I ask that you and my colleagues join congratulating the Hindu Temple of St. Louis and wish them all the best on this very special event.

Mr. TALENT

Mr. TALENT. Mr. Speaker, I thank the gentleman for yielding this time to me. Mr. Speaker, I want to begin my comments here today by quoting something Lyndon Johnson said, but before that, the Bible said it. He said: ``Let us reason together.'' That is what I hope we can do in this debate. I do not want to bash the District of Columbia schools. I think we owe these kids and their parents who care so much about this debate the truth. I think we should be candid. I think we should reason, then, about the truth. The truth of the matter is that the District of Columbia schools are not safe, and the kids are not learning, and everybody knows it. The longer they stay in the District of Columbia schools, the less they learn. The longer high school students stay in the D.C. schools, the more their test scores drop below the national average. Thirty-three percent of the third graders in the D.C. public schools score below basic levels in reading and math, and 80 percent of the fourth graders score below basic levels in reading and math. For kids who come from these neighborhoods and have as few options as these kids have, if they are not learning how to read, it means they are ending up in gangs or on drugs or many of them dead. That is what it means to these kids. Those are facts that annihilate all these other facts and the rest of this debate. Let us tell the truth about the situation these kids are in. If we cannot give them anything else, let us give them the truth. The second point, Mr. Speaker, this bill will help at least these kids. Do not show disrespect to their parents, who are lining up by the thousands for these scholarships, by saying it is not going to help them. They know it is going to help them. It is exactly what any of us would do. That is the reason they wanted the scholarships. So we know the schools are failing. We know we can help these kids. Then the other argument, which I respect because we have got to do something about the public schools, is what about the other kids? What about the rest of the public schools? This is not the way to help them. Mr. Speaker, this may be the only way to help them. This kind of choice program is operating in other schools, and that is what they are telling us. This is what the former superintendent of Milwaukee public schools says: So what I am arguing is that we have got to support the changes that will make the difference for kids both inside and outside the existing system. But it is the existence of an option outside that will help you fight, make the improvements inside, because no matter what people say rhetoric-wise, I can tell you, you can stand up and talk all you want about what needs to be done, but if people know this is the only game in town, there is absolutely nothing you can do other than run your mouth off about what needs to happen. It is not going to happen for the majority of kids. This is exactly the kind of leverage that will support the reformers and give them the opportunity to change a system that is bogged down in bureaucracy and entrenched interest. The District of Columbia schools have three times as many administrators per teachers as other city schools around the country. What else can we do if we do not do this? I will just close by saying this: We appointed a general as the czar of the District of Columbia public schools, and he tried for a year, and he quit. This is a program that addresses a need we all know exists. It will help the kids who get these scholarships, and it is going to help the kids who remain. Let us do something for these kids. Let us reason together about this process, and then send this bill to the President.