Bill Thomas

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume. As I indicated, I moved to suspend the rules on H.R. 2303 with an amendment, and there was no discussion of the amendment, so I will briefly for the Members review the amendments. There were three. One, based upon the number of cosponsors and an indication that we want to extend it to every person who has had an affiliation with the House, whether they be Member or Delegate, that the oral history portion may in fact be of a considerable length, and so in the amendment, one of the items is that ``in consultation with the Committee on House Administration'' was added so that there could be some minimal institutional control over the history in terms of its overall purport and direction. Secondly, there was a provision of changing ``may'' to ``shall.'' The language was that ``the librarian may use private funds'' and it was changed to ``the librarian shall use private funds.'' One only need pick up current newspapers and examine the way in which ``may'' and ``shall'' will be of significance. There was to be an event in Lisbon, Portugal which was to be funded by private dollars. It turns out that they became public dollars, including an $18,000 a month apartment for former Member Tony Coelho who headed that operation, and that was one of the reasons we stressed ``shall'' instead of ``may.'' And then finally, based upon the description about what folks thought was important in presenting this legislation to the Members, the third amendment, and probably ultimately the most important amendment, required that on the Internet, not, as the bill originally stated, excerpts of the history would be presented but, in fact, the entire history. It seems as though as time goes on, people tend to have their own particular view of what was important and what was not, of who was important and who was not. And to ensure that no future majority is able to distort the full history of the House of Representatives, the third item was added, and I think all Americans will be supportive of the fact that the entire history is made available, not someone's version of what the history of the House of Representatives ought to be. And so with those amendments, I am pleased to support the measure.

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

Mr. THOMAS. Mr. Speaker, on that I demand the yeas and nays.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I yield back the balance of my time.

Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I have been a supporter of the House Child Care Center since its initiation. Actually the wife of one of our former colleagues, Al Swift, Mrs. Swift, was instrumental along with others, both staff and Members and spouses, in initiating the House Child Care Center. However, today, eligibility for that center is restricted, first to the children of House employees, then to the children of employees of the Senate, and other legislative branch agencies. While clearly the supportive costs were initiated by the House, this has become a self-funding structure. One of the concerns that we have is that this not be in direct competition with the private sector but that it be able to have a broad enough scope to sustain itself. And so this measure provides for the extension of the House Child Care Center to a third category, which would assume its position below the others in terms of a prioritization of admittance of students, and that would be children of other employees of the Federal Government, i.e., the executive branch. This expansion of eligibility was requested by the board of directors, supported by the chief administrative officer and as evidence of our general support here on the floor of the House today. As I said, there is no direct subsidy from the House of Representatives today, and, frankly, the budget for the House Child Care Center is one that is very tight. It performs a needed and very useful service to the legislative branch, and we would not just want this useful and needed service to fail because of our failure to extend it to other areas of the Federal Government. When a request for this change was made, the board of directors wrote this: ``If we are allowed to fill vacancies with children of other Federal agencies, our budget will be augmented, more children and families will get high quality services, and no House family will be worse off. This new policy, then, will produce lots of winners and no losers.'' It seems to me that a Child Care Center closely associated with the place of work is a winner to begin with, but it also must be financially viable. The step that we take with this bill today ensures indeed that we will continue to be winners. Mr. Speaker, I reserve the balance of my time.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on the subject of H.R. 3122, the bill just passed.

Mr. THOMAS

Mr. THOMAS. Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and to include extraneous material on H. Con. Res. 196.

Mr. THOMAS

Mr. THOMAS. Madam Speaker, I yield myself such time as I may consume. Madam Speaker, I am moving this resolution for the gentleman from Michigan (Mr. Ehlers) who represents the area of Grand Rapids, which was the area that Gerald R. Ford represented as a Member of the House of Representatives and as its minority leader. I think it is entirely appropriate that the Presidential Congressional Gold Medal be awarded to President and Mrs. Ford. Congressman Ford wound up President Ford in one of the most unique series of events in the history of the United States. Congressman Ford was appointed Vice President of the United States according to the 25th Amendment, and then Vice President Ford became President Ford upon the resignation of President Nixon. I will soon conclude my time and the gentleman from Michigan (Mr. Kildee) will have an opportunity to talk about this particular representative from Michigan. I have known President Ford for some time. I knew him briefly before he became President, and I have known him for some time after he became President. He is one of those individuals of which we have many on the floor of the House who are professionals. That is, they go about the business of representing their constituents in a professional fashion. That is one of the reasons Jerry Ford rose to be minority leader and why when there was a need to fill the vice presidential slot in a time of national trouble that they turned to Jerry Ford and that, in one of the saddest periods I believe that, notwithstanding his being appointed to the two highest offices in the land, he conducted himself and his presidency in exemplar fashion, and that he should have been rewarded, in the humble opinion of this gentleman from California, the presidency through the electoral process. That was not to be. But the people of the United States owe President Ford a great debt of gratitude on the way in which he conducted himself as an appointed Vice President and as an appointed President. It is entirely appropriate that, in the rotunda on October 27, President Ford and Mrs. Ford will receive the Congressional Gold Medal. Madam Speaker, I reserve the balance of my time.

Mr. THOMAS. Madam Speaker, I move to suspend the rules and agree to the concurrent resolution (H. Con. Res. 196) permitting the use of the rotunda of the Capitol for the presentation of the Congressional Gold Medal to President and Mrs. Gerald R. Ford.

Mr. THOMAS. Madam Speaker, on that I demand the yeas and nays.

Mr. THOMAS. Madam Speaker, I have no other requests for time, and I yield back the balance of my time.

Mr. THOMAS

Mr. THOMAS. Mr. Chairman, while we are talking about evolution, let us talk about the fact that there are a number of unions that support the Norwood-Dingell bill. And why in the world would the American Medical Association align itself with unions? Perhaps my colleagues were asleep when the American Medical Association decided to adopt collective bargaining. The arguments that we have heard, no matter how strongly or forcefully presented about the fact that the coalition bill tramples State law, are simply wrong. Let us not try to rely on each other. Let us go to the independent, professional attorneys that we have relied on since Congress created itself, the Congressional Research Service. Those lawyers, totally objective, analyzing the coalition bill said this: ``This provision would not interfere with, but would support, a recent holding in a Federal district court decision upholding the ordinary care provision of the Texas law.'' Now, my friend is a lot of things, but the gentleman from Georgia (Mr. Norwood) is not an attorney. The Congressional Research Service says the coalition bill supports State law. Now, if we want to meet a trial lawyer, follow an ambulance. If we want to know who is supporting this measure, take a look at their list of supporters. On the coalition bill we will find that virtually medical association for medical association they match. But we cannot stay with them when the unions endorse their provision and the trial lawyers support their provision. Why? Because people whose lives are on the line, in terms of their economic survival, say this: ``The Chamber of Commerce strongly opposes any proposal which permits jury trial lawsuits for unlimited punitive and compensatory damages.'' Do we believe the trial lawyers? No. Who will butter their bread? Take a look at the list of supporters of the coalition. We do not have the trial lawyers. Take a look at Norwood-Dingell. The trial lawyers and the doctors are together. Now, talk about evolution. Not only are they going to be following an ambulance, but they are going to be in the ambulance. This is exactly the wrong approach to take when employers still have the ability to say, yes, I will provide health insurance; or, no, I am not going to run the risk of unlimited punitive and compensatory damages. That is the risk that will be run if Norwood-Dingell becomes law. And I can assure my colleagues that employers will say, at some point, it is not worth the risk. Do not feed trial lawyers.

Mr. THOMAS

Mr. THOMAS. That vaccine is for America's children?

Mr. THOMAS. So on one hand, it is rhetoric about corporations; and on the other hand, it is vaccine for the America's children.

Mr. THOMAS. Mr. Speaker, I understood that there would be a denial of a vaccine if this measure is voted down.

Mr. THOMAS. Mr. Speaker, will the gentleman yield?

Mr. THOMAS

Mr. THOMAS. Mr. Chairman, I move that the Committee do now rise.

Mr. THOMAS. Mr. Chairman, I yield myself the balance of my time. Mr. Chairman, I would tell my friend from Maryland, he cannot have it both ways. When we were debating the rule, there was plea after plea from the other side of the aisle, do not vote for the rule because they would not let us have an eleventh hour amendment to our bill, and yet they say that they have had their bill without making changes. They cannot have it both ways. Either they pleaded for an eleventh hour amendment, they did not get it and they voted against the rule, or they have a position they have held for some time. We can read off hundreds of medical associations. They have endorsed the Coburn-Shadegg bill, just as they have endorsed the other. I can say, we fall by the wayside when we reach about 200 endorsements. The reason we do not reach the level of 300, that the gentleman from Maryland cited, is because we do not have the labor unions and the trial lawyers. The trial lawyers are endorsing their bill. Why? Because their bill will allow trial lawyers, without medical doctors proving harm, to go to the courtroom and have open-ended penalties imposed by juries. Frankly, we do not think those extra 100 endorsements are the kind of endorsements Americans think should be made in today's health care structure. Our bill makes sure that medical doctors make the decision, and when the plan is wrong, one can sue. What I find most egregious is the fact that employers struggling to provide health care to their employees if Norwood-Dingell becomes law, will have to examine the exposure to those same trial lawyers and juries and decide if the risk is worth it. It is a sad statement to make, but I believe a factual one; if Norwood-Dingell becomes law, there will be fewer people covered. On the other hand, if the Goss- Coburn-Shadegg-Greenwood-Thomas bill becomes law, we will have an ordered process, internal and external, reviewed by medical doctors, and if the plan is wrong, they have to provide the coverage. If there has been medical harm, they can go to court, and they can, yes, those now famous phrases, sue their HMO, but it is done in an orderly fashion, and guess what? The trial lawyers do not endorse our proposal. Why? Because it is not open ended, and it is not left up to a jury to determine injury. If we are going to advance medical coverage in this country, it is clear one of the things we have to do is to allow patients to get what they rightfully deserve, and, if harmed, to get proper adjudication. But what we do not need is open-ended trial juries with trial lawyers endorsing the process. They proudly announce they have the trial lawyers on their side. We proudly announce we do not, and that, I think, is the bottom line.

Mr. THOMAS. Mr. Chairman, I yield 30 seconds to the gentleman from Oklahoma (Mr. Coburn), one of the central participants in this debate.

Mr. THOMAS. Mr. Chairman, I yield myself 3\1/2\ minutes. Mr. Chairman, there was a colloquy just a short time ago on the exigency question. I had said sometime earlier that it was possible to abort the system under Norwood-Dingell and go to jail if they claim that they have been harmed. And it could be denial of medicine for one day, denial of a procedure for one day. That was the point that the gentlewoman from Connecticut was talking about, that although there are numbers stated in the bill, there are ways to short-circuit those numbers and, notwithstanding the internal and external appeal language, go to court. What was read from the Goss-Coburn-Shadegg provision claiming to be loaded with exigencies is under the section that deals with the emergency 48-hour provision. The 14-day time frame is the ordinary one in which they are required to exhaust the internal and the external. And then based upon the medical exigency, they have a 48-hour capability. In other words, instead of writing all of the medical conditions that would trigger the 48 hours, they use the phrase ``medical exigency.'' The English word was the same. The location and the usage was entirely different. I will tell my colleagues, that has been the basis for a number of challenges in this debate. Just because a word is there does not mean anything. As most people know, it is the context, the location, and how that word is used. Let me also point out that although the Clinton administration is pleading for us to move this kind of legislation, and we are talking about in the coalition bill a fast and fixed 14 days in ordinary situations on the internal appeal, 14 days on ordinary situations in the external appeal, and in both situations, depending upon the medical exigencies, 48 hours. The Clinton administration, with a stroke of a pen, could change the appeals procedure in Medicare. Do my colleagues know what the appeals procedure in Medicare is today? For Part A on a fair hearing, it is 52 days. And if they want to appeal that decision, on average, it is 310 days. Why are they not making the kinds of changes in Medicare law that they are arguing ought to be imposed on the private sector? Now, if my colleagues think that is bad, in the Part B appeals provision, currently it is 524 days. It seems to me a fixed 14 days and in serious conditions 48 hours with medical doctors reviewing the appeal, not the rush to judgment, not the claim of harm, not the ability to go to court and let a jury decide whether or not they are harmed, but it seems to me some folks ought to go back and with a stroke of the pen make the changes in Medicare that they are claiming are so necessary to be imposed on the private sector.

Mr. THOMAS. Mr. Chairman, I yield 2 minutes to the gentlewoman from Illinois (Mrs. Biggert). (Mrs. BIGGERT asked and was given permission to revise and extend her remarks.)

Mr. THOMAS. Mr. Chairman, I yield myself 2 minutes. Mr. Chairman, notwithstanding that statement, there is a phrase ``discretionary authority.'' My colleagues can qualify it. They can argue that is what it means. It is not defined. I guess the most ironic aspect, though, of this discussion is the constant argument that doctors are no longer making decisions, that we have got to put doctors back in the decision-making key positions. I hope somebody finds that ironic that, in the Norwood-Dingell bill, the question of whether or not someone has been physically harmed is not determined by a medical doctor. It is determined by a jury. Under the coalition plan, both on the internal review by medical doctors and the external review by medical doctors, that decision is made. In Norwood-Dingell, there is a hole one can drive a medical malpractice case through because one alleges harm and one goes to court. A jury determines something that they have been constantly pleading ought to be in the hands of a doctor. By the way, was not it desirable for doctors to have medical malpractice? Where is it in the bill? Ironically enough, the argument that they are doing this for doctors does not contain the thing that the doctors have always said they wanted so they would not have to practice defensive medicine, so they would not have to overutilize to protect themselves. Something as simple as medical malpractice, which is present in a number of States, is not available in this bill. Mr. Chairman, it is my pleasure to yield 7\1/2\ minutes to the gentlewoman from Connecticut (Mrs. Johnson), a member of the Subcommittee on Health of the Committee on Ways and Means, someone who has worked long and hard on these issues, has examined them, not only from someone who deals with this issue in the Congress of the United States, but who is very familiar with it from her close relationship in the medical community.

Mr. THOMAS. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I am sure that by now people trying to follow this debate are thoroughly confused. When we look at the plans, there are significant portions of the various bills that are identical. The reason for that is that in 1997, when we worked together to produce the most significant change in the Medicare system since the beginning of Medicare, the gentleman from Maryland (Mr. Cardin) and others joined together with me to produce a bill which we thought was responsible in the area of emergency rooms, gag rules, and most of what is in, in a specified fashion, all through the bills. Obviously that is not what is at issue tonight and tomorrow. It is the question of who can sue whom, when and how. If my colleagues look at that and examine the various bills in that regard, what we hear over and over again in an attempt to defend Norwood-Dingell and its reasonableness or appropriateness dealing with employers is ``unless,'' ``if,'' ``and,'' ``but.'' What we have is hedging. Because, frankly, at the end of the day, employers, through no fault of their own, can be liable under Norwood-Dingell. When employers are faced with potential liability on something which is an option to begin with, which has continued to increase in cost to the employer, there will be some employers who say I have had enough. In contrast to that, if my colleagues will look at the Goss-Coburn- Shadegg-Greenwood-Thomas substitute, we can say this: employers cannot be held liable if they provide health care coverage, in selecting a plan, in selecting a third-party administrator, in determining coverage or increasing or reducing coverage, intervening on behalf of an employee, or declining to intervene on behalf of an employee. When we look at what is available in terms of remedies, one of the things that concerns people is the open-endedness of the ability to sue. When we compare, for example, the Norwood-Dingell bill, it basically says that someone has a right to sue for something that is denied to them under a health plan. One also has the right to sue for something that is not under the health plan. Now, how in the world, when it is entirely possible that a benefit request that is requested for external review does not have to be under contract, and a court can grant a benefit that is not under contract, that creates an open-ended opportunity. In contrast, the position that the gentleman from Oklahoma (Mr. Coburn) and the gentleman from Arizona (Mr. Shadegg) have been willing to modify with the gentleman from Florida (Mr. Goss), the gentleman from Pennsylvania (Mr. Greenwood), and myself says that what is adjudicated is in the contract. More importantly, if the plan follows the contract, internal review, and external review, the plan is not liable. That cannot be said about the Norwood-Dingell plan. If, in fact, there is an ability to bring a charge, no matter how remote, no matter how qualified, it is not the number of cases that are critical. It is the case that says it is not under the plan, and one followed all the rules, but one can still be sued. No matter how qualified that position is, it is absolutely true that, under the Norwood-Dingell plan, no matter how remote, that can occur. When an employer looks at that potential exposed liability, there will be, and if one does it, that is too many, a number of employers who will say that exposure, no matter how limited, is too much. That is one of the real key differences that we should be discussing, how much exposure, how much protection, how many safeguards are reasonable and appropriate. On that ground, I think my colleagues will find that Norwood-Dingell is too open ended, too exposed, too much relying on third parties able to impose themselves and make decisions that are different than were contained between the two parties who originally wrote the contract. That contract in opposition to the coalition bill is, I think, protected on a far, far higher level. The gentleman from Georgia (Mr. Norwood) has been standing in the well; and if the gentleman from Maryland (Mr. Cardin) wishes to yield him time, I would be more than willing to respond to him. Mr. Chairman, I reserve the balance of my time.

Mr. THOMAS. Mr. Chairman, I would ask the gentleman from Maryland to proceed.

Mr. THOMAS

Mr. THOMAS. Mr. Speaker, to briefly explain what occurred on the machinery, this is not unprecedented. On May 4, 1988, the same situation occurred. As one might guess, it is a human error. There was a Member who had a card, and we all know that these new cards are much better than the old laminated ones but they do go bad. When that Member's name was adjusted on the visual screen, it was placed first, out of order alphabetically, and so when the votes were recorded they skipped one. They did not match up. I want to assure every Member that the computer is far more sophisticated than that. These lights are for visual purposes only. The machine records the vote according to a unique identifier number. Regardless of where a Member might be placed alphabetically the unique number from the card records the vote. However, I want to compliment the gentleman from Michigan (Mr. Dingell), who is one of the few Members around here who remembers this is the way we used to do business on an ordinary basis, about a quarter of a century it was done under this system, the other half with lights. The votes were recorded accurately, but given the concern over the visual reference it was entirely appropriate to go through this procedure. It was a revisiting of a previous existence of the Congress. Our hope is that the human errors are now minimized, but the actual vote that is recorded, notwithstanding the visual display, was recorded accurately by the machine.