142 EXTENSIONS OF REMARKS January 27, 1998 EXTENSIONS OF REMARKS IN HONOR OF ASTRONAUT JOE plan enrolls a person, they must soon do a The December 3, 1997 issue of JAMA, con­ FRANK EDWARDS, JR. health profile or work-up on that person. Medi­ tains an article, "Cost-effectiveness of the care and private insurance plans pay an HMO Clinical Practice Recommendations in the HON. BOB RILEY hundreds of dollars a month to "maintenance" · AHCPR Guideline for Smoking Ces­ OF ALABAMA an enrollee's health. But how can the HMO sation,"which states that" Tobacco use has IN THE HOUSE OF REPRES ENTATIVE S provide maintenance or preventative care been cited as the chief avoidable cause of Tuesday, January 27, 1998 (such as immunizations, mammograms, etc.), death in the United States, responsible for unless it sees the enrollee and establishes a more than 420,000 deaths annually, Despite Mr. RILEY. Mr. Speaker, I rise today to con­ health benchmark on the person? this, physicians and other practitioners fail to gratulate the extraordinary accomplishments of My legislation is designed to ensure that assess and counsel smokers consistently and one of Alabama's finest, Astronaut Joe Frank HMOs really do maintain people's health. By effectively." Again, an HMO would be the ideal Edwards, Jr., of Lineville, Alabama, who is pi­ scheduling an appointment and the collection setting to help a person stop smoking, but loting the space shuttle Endeavor, which took of basic health data, the HMO can truly begin they can't do it if they don't see the patient­ ott on January 22, 1998. to provide managed care health. It can deter­ and that's why we need H.R. 337. Graduating from Clay County's Lineville mine whether the person is a smoker, over­ As we start to pay HMOs thousands of dol­ High School in 1976, Joe went on to receive weight has high cholesterol, is diabetic, is fac­ lars a year for maintaining health, let's make a B.S. degree in Aerospace Engineering from ing glaucoma, etc. Once these benchmarks sure that they at least see the individual and the U.S. Naval Academy in 1980 and an M.S. have been established, the HMO can begin do something to earn these payments. If the in Aviation Systems from the University of the counseling or the other services needed to premise of managed care is correct, then H.R. Tennessee in 1994. As a Naval Aviator, Joe "maintain" or improve health-thus fulfilling 337's early profiling and subsequent coun­ has been honored with many medals, includ­ the promise of managed care. seling will save the HMOs money in the long ing the Distinguished Flying Cross, Air Medal, The November 5, 1997 issue of the Journal run by avoiding future expensive acute care Defense Meritorious Service Medal, Navy of American Medical Association (JAMA) con-. services. Commendation Medal, Navy Achievement tains an article, "The Relationship Between Medal. Joe has also received the Daedalian Patient Income and Physical discussion of Superior Airmanship Award in 1992, the Fight­ Health Behaviors," which states, "Although IN RECOGNITION OF THE ORANGE er Squadron 143 Fighter Pilot of the Year in unhealthy behaviors were common among all COUNTY SCHOOL OF THE CUL­ 1984 and 1985, the Fighter Squadron 142 income groups, physician discussion of health INARY ARTS Fighter Pilot of the Year in 1990, 1991 , and risk behaviors fell far short of the universal risk 1992, and the Carrier Airwing Seven Pilot of assessment and discussion recommended by HON. LORETTA SANCHEZ the Year in 1985, 1990, and 1991. the US Preventive Services Task Force. We In December 1994, Joe was selected as an OF CALIFORNIA conclude that the prevalence of physician dis­ IN THE HOUSE OF REPRESENTATIVES astronaut candidate by NASA. After com­ cussion of health risk behaviors needs to be pleting a year of training and evaluation, he improved." Tuesday, January 27, 1998 has qualified for assignment as a shuttle pilot. If physicians would do more to counsel their Ms. SANCHEZ. Mr. Speaker, I would like to During the STS-89 mission, Joe will be re­ patients especially the lower income, these in­ take this opportunity to recognize a remark­ sponsible for undocking from the eighth shuttle dividuals could receive adequate and inform­ able culinary school that was recently estab­ rendezvous with Russia's Mir Space Station ative health care advice. As the JAMA article lished in Orange County, CA, the Orange and piloting the flight around the space sta­ said, "Physicians also need to be more vigi­ County School of Culinary Arts. tion. The nine day shuttle mission objectives lant in properly identifying and counseling low­ The school is sponsored by the Regional include replacing astronaut Dr. David Wolf income patients at risk. Increasing the preva­ Occupation Program (ROP) of North Orange with Andy Thomas who will be the next U.S. lence of physician discussion of health risk be­ County. ROP is responsible for rehabilitating crew member on the Mir Space Station. More haviors could greatly affect productivity, quality and re-training underprivileged and unem­ than 7,000 pounds of experiments, supplies, of life, mortality, and health costs in the United ployed citizens and high school students to and hardware are scheduled to be transferred States. If the nation is truly interested in health compete and succeed in a competitive work between the two spacecraft. improvement, a multifaceted approach is re­ environment. Clay County, as well as all of Alabama, is quired to diminish the social gradients in The Orange County School of Culinary Arts very proud of Joe's exceptional hard work and health related to education, income, housing offers a wide variety of culinary classes that is commitment to space flight. I congratulate Joe and opportunity, including a more effective na­ as good, if not better, than that of the larger on this extraordinary honor and am proud to tional system for preventive services (Papani­ culinary institutes in America. While the cost of have him represent us on this important mis­ colaou tests, breast examinations, immuniza­ tuition at one of the big three Culinary Arts sion. tions) as well as improved discussion of health schools often exceeds $27,000 per year, a risk behaviors." course at the Orange County School of the FULFILLING THE PROMISE OF For instance in the case of smoking the Culinary Arts costs $40 per class, a $65 uni­ MANAGED CARE JAMA article states: "Our data indicate that form fee and the cost of the food that is pre­ 49% of all patients with whom behavioral dis­ pared and consumed. cussions occur attempt to cut down or quit There is currently a shortage of profes­ HON. FORTNEY PETE STARK smoking based on their physicians' advice and sionally trained chefs in the United States by OF CALIFORNIA 49% of those who report attempting to change 2 million. By the turn of the century, this num­ IN THE HOUSE OF REPRESENTATIVE S behavior no longer smoke. .increasing the ber is expected to increase dramatically with Tuesday , January 27, 1998 prevalence of physician discussion of smoking the expansion of the cruise industry and the Mr. STARK. Mr. Speaker, my bill H.R. 337 by 50% would result in a 6% decrease in the resort business throughout the United States. establishes consumer protections in managed prevalence of smoking. Based on mortality In Orange County alone, there are 8 positions care plans-just like many other bills currently and cost estimates of smoking, this reduction available for every qualified applicant, and ex­ pending before the Congress. in smoking could potentially result in 24,000 isting programs have not been filing the void . One unique feature in H.R. 337, however, is annual deaths delayed and a $3 billion annual The community has already flocked to the the requirement that when a managed care cost savings to our society." program. Almost 500 students have already e This " bullet" symbol id entifies statem e nts o r inser tions w hich are not sp ok en b y a Member of the Senate on the floor. Matter set in this typeface indicates words inserted or appended, rather than spoke n, by a Member of the H ou se o n the floor . January 27, 1998 EXTENSIONS OF REMARKS 143 enrolled when the student body was only pro­ stone in the history of York County and its gery, and can hospital procedure volume be jected to be 120 students. The courses range business community. Without their efforts, increased without decreasing the level of ap­ from beginner and advanced levels of prepa­ York County would not have achieved the propriateness? and 4) What is involved at a ration for a variety of foods, to restaurant man­ hospital operational level--can such a pro­ level of prosperity we enjoy today. I am gram be sustained over a period of time agement, nutrition, and sanitation. All courses pleased to associate myself with this important without draining financial resources and are instructed by chefs with an extensive train­ organization and join them as they celebrate dragging the organization down? ing in internationally-renown culinary acad­ their centennial. Preliminary results evaluating the Medi­ emies and working backgrounds from the fin­ care participating Heart Bypass Center Dem­ est resorts and cruise ships around the world. onstration project, I believe, strongly sup­ I would like to recognize the Orange County IMPROVING MEDICARE QUALITY­ port its immediate national expansion to ap­ School of Culinary Arts as a benchmark for SAVING MEDICARE LIVES: SUP­ propriately realign the incentives between other programs to follow. This program will not PORT FOR H.R.