November 18, 2003 CONGRESSIONAL RECORD — HOUSE H11493 Crowism, social injustice, segregation, and those present have voted in the affirm- care Prescription Drug Bill to provide discrimination. However, our strong faith and ative. a much needed payment update to phy- belief in the promise of America has enabled Mr. LEWIS of . Mr. Speaker, sicians for the next 2 years. us to persevere in the face of adversity. on that I demand the yeas and nays. I represent Las Vegas, which is home In all areas of life, have The yeas and nays were ordered. to the fastest growing seniors popu- made an important contribution. In music, from The SPEAKER pro tempore. Pursu- lation in the . In my com- jazz to hip-hop, African Americans continue to ant to clause 8 of rule XX and the munity, we are facing a health care cri- have a strong influence upon our nation’s mu- Chair’s prior announcement, further sis. The rapid growth of southern Ne- sical heritage. From Langston Hughes and proceedings on this motion will be vada has put a strain on the health Richard Wright, to Maya Angelou and Toni postponed. care system, and many doctors face a Morrison, African Americans have enriched f tough choice when it comes to treating Medicare patients because reimburse- this country’s literary heritage. We have ex- GENERAL LEAVE celled in film, sports, and business and con- ments are not keeping up with the tinue to sow into the life of this nation. Mr. NEY. Mr. Speaker, I ask unani- costs of practicing medicine. In addi- African American scientists, inventors, edu- mous consent that all Members may tion to staffing costs and utilities and cators, and physicians, such as Dr. Charles have 5 legislative days within which to rent, malpractice insurance for doctors Drew and Dr. Ben Carson to name a few, revise and extend their remarks and in- in my community has skyrocketed have and continue to enrich the daily lives of clude extraneous material on H.R. 3491. anywhere from 150 to 400 percent. all Americans—from developing blood trans- The SPEAKER pro tempore. Is there We rely on our doctors to treat more fusion and blood bank procedures to learning objection to the request of the gen- than 150,000 seniors under the local the path of the mind to perform delicate brain tleman from Ohio? Medicare system; but with the cost of surgery. Inventors, such as Garrett Morris and There was no objection. doing business so high and the demands Granville T. Woods to name just a few, have f for their services at a premium, in developed everything from the stoplight and MOTION TO INSTRUCT CONFEREES many instances our doctors cannot af- gas mask to critical railway switching tech- ON H.R. 1, MEDICARE PRESCRIP- ford to see new Medicare patients. We nology. TION DRUG AND MODERNIZA- used to talk about the quality of Additionally, we have proudly served our na- TION ACT OF 2003 health care, but the situation is becom- tion with distinction in every war—from the ing so bad that we are no longer talk- Ms. BERKLEY. Mr. Speaker, I offer a Revolutionary War to today in Operation Iraqi ing about the level of treatment the motion to instruct. Freedom. The struggle for freedom, equality, patient receives, but whether or not The SPEAKER pro tempore. The and civil rights has always been a struggle for they will receive any treatment at all. Clerk will report the motion. My community is struggling to at- the full realization of true democracy in Amer- The Clerk read as follows: ica. Our legacy is firmly ingrained in the very tract enough medical professionals to Ms. BERKLEY moves that the managers on fabric of this democracy. However, in spite of address the health care needs of our the part of the House at the conference on ever-expanding population. But how our triumphs and accomplishments, there the disagreeing votes of the two Houses on does not exist a national museum located in the Senate amendment to the bill H.R. 1 be can we expect more doctors to see more Washington D.C. on or near the National Mall instructed as follows: Medicare patients if we continue to cut dedicated to the documentation of African (1) To reject the provisions of subtitle C of payments to doctors under Medicare? If American history. This bill creates such a mu- title II of the House bill. we do not act soon, there will be an- seum. (2) To reject the provisions of section 231 of other 4.5 percent reduction in reim- the Senate amendment. bursements to physicians who are The National Museum of African American (3) Within the scope of conference, to in- History and Culture would properly collect, crease payments for physician services by an treating those who depend on their preserve, exhibit, and honor, on a national amount equal to the amount of savings at- physicians’ care the most, our seniors. level, the period of slavery, Reconstruction, tributable to the rejection of the aforemen- If we allow this to happen, the result the Harlem Renaissance, and other periods tioned provisions. will be a loss of $17 million in pay- associated with African American life, art, his- (4) To insist upon section 601 of the House ments to physicians in my State of Ne- tory, and culture. Not only will this national re- bill. vada alone. The time is long past due pository of the Black experience in America be Ms. BERKLEY (during the reading). that we increase these payments which viewed by millions of tourists who flock to the Mr. Speaker, I ask unanimous consent have limited medical providers from nation’s capital each year, but will be acces- that the motion to instruct be consid- expanding the number of patients re- sible to students and scholars alike. It will also ered as read and printed in the RECORD. ceiving care. I have heard from doctors demonstrate to our youth that they can take The SPEAKER pro tempore. Is there in Las Vegas who say they want to pride in their rich cultural heritage. objection to the request of the gentle- treat Medicare patients, but they are Mr. Speaker, I urge my colleagues to lend woman from Nevada? being forced to choose between taking their support to this important piece of legisla- There was no objection. on new Medicare patients or keeping tion. I would just like to take this opportunity The SPEAKER pro tempore. Pursu- the lights on in their offices and their to thank my distinguished colleague, Rep- ant to clause 7 of rule XXII, the gentle- practices solvent. resentative JOHN LEWIS, for his tireless dedica- woman from Nevada (Ms. BERKLEY) and According to the AMA, since 1991 the tion and leadership. Mr. LEWIS has committed the gentlewoman from New Mexico cost of practicing medicine has gone up more than 10 years of his life to the vision of (Mrs. WILSON) each will control 30 min- by more than 33 percent, but payments a national monument celebrating the legacy of utes. have grown less than 10 percent. For African Americans on the national mall. We The Chair recognizes the gentle- years doctors have provided important are now on the verge of making that dream a woman from Nevada (Ms. BERKLEY). tests for seniors for cholesterol, depres- reality. Please support this bipartisan bill. GENERAL LEAVE sion, blood pressure, vision, and hear- I also extend my sincere appreciation to Ms. BERKLEY. Mr. Speaker, I ask ing impairment without any reim- Representatives JACK KINGSTON and ROGER unanimous consent that all Members bursements from Medicare. WICKER, and Senators SAM BROWNBACK and may have 5 legislative days within Medicare reimbursements for pri- CHRISTOPHER DODD for their leadership. which to revise and extend their re- mary care are inadequate, and in Janu- Mr. NEY. Mr. Speaker, I yield back marks and include extraneous material ary they will be too low for many doc- the balance of my time. on this motion to instruct. tors to continue to serve Medicare pa- The SPEAKER pro tempore (Mr. The SPEAKER pro tempore. Is there tients. Just last year, doctors’ pay- PEARCE). The question is on the motion objection to the request of the gentle- ments were cut by 5.4 percent; and if offered by the gentleman from Ohio woman from Nevada? we allow them to be cut once again, (Mr. NEY) that the House suspend the There was no objection. this will be the fifth reduction since rules and pass the bill, H.R. 3491. Ms. BERKLEY. Mr. Speaker, I yield 1991 and would place doctors’ reim- The question was taken. myself such time as I may consume. bursements 8 percent below 2001 levels. The SPEAKER pro tempore. In the Mr. Speaker, I rise to offer a motion It does not make any sense to be cut- opinion of the Chair, two-thirds of to instruct the conferees on the Medi- ting payments to doctors when the

VerDate jul 14 2003 02:32 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00099 Fmt 7634 Sfmt 0634 E:\CR\FM\A18NO7.178 H18PT2 H11494 CONGRESSIONAL RECORD — HOUSE November 18, 2003 costs of practicing medicine are on the my colleague from Nevada has offered is available and on sound financial rise. it, because the conference committee footing for generations to come. Our doctors simply cannot afford to on the Medicare bill has already agreed Mr. Speaker, Medicare spends $247 take any more cuts. Already one-quar- that we are not going to have the pro- billion a year as it stands. The gentle- ter of the family physicians across the visions in there that she is worried woman that offered the motion to in- Nation are saying they can not accept about that we are going to adjust the struct is from Nevada and, of course, any new Medicare patients. Who knows physician payments. Nevada has had a serious problem with how many more will choose to do the In fact, the American Medical Asso- liability in recent years. In fact, a same in January when they are told ciation has written to us asking us to study by Kessler in 1996 showed that their reimbursements have been strongly oppose the Berkley motion to with two diagnostic codes, $50 billion a slashed once again? instruct and urges the conference to year could be saved in Medicare if we As a Nation we must provide our doc- pass the pending Medicare conference did not have to bear the costs of defen- tors with the means to treat and pro- report. So, in fact, I think the problem sive medicine in this country. That $50 vide health care to our citizens. This that the gentlewoman has addressed or billion would more than fund the $40 motion would instruct the conferees to has identified here has already been ad- billion a year with which we are seek- protect the language in the House dressed in the conference report to the ing to add a prescription drug benefit. version of the Prescription Drug Bill satisfaction of physicians nationwide. The House-passed Medicare bill does that would reverse the cut to our phy- Perhaps to explain this a little bit not ever require that Medicare bene- sicians while providing a 1.5 percent in- more fully we will turn to a physician. ficiaries leave traditional Medicare. I crease in payments for the next 2 Mr. Speaker, I yield 3 minutes to the might add that we will have a new out- years. To fund the increase in pay- gentleman from (Mr. BURGESS), patient drug prescription drug benefit ments to our doctors, this motion who is an OB-GYN and he has worked available to beneficiaries. Anyone who strikes funding for privatization provi- very hard on issues related to health says otherwise either does not under- sions in the Prescription Drug Bill. care. stand the legislation or does not care The Centers for Medicare and Med- Mr. BURGESS. Mr. Speaker, I thank to talk about the facts. icaid Services estimated that under a the gentlewoman from New Mexico This is an irrelevant motion intro- privatized Medicare, premiums would (Mrs. WILSON) for yielding me time. duced only to score political points. I skyrocket for the seniors who choose Mr. Speaker, I confess to being a lit- urge Members to recognize it for what to stay in traditional Medicare. I am tle bit mystified as to why we are here it is and to vote against the motion. concerned that by increasing the pre- tonight with a motion to instruct con- Ms. BERKLEY. Mr. Speaker, I yield miums of traditional Medicare, many ferees when the conference report ap- 10 minutes to the gentleman from Ohio patients would be forced into HMOs pears to have been decided; but I am (Mr. BROWN). and other private plans. This 1.5 per- just a simple country doctor, and I do Mr. BROWN of Ohio. Mr. Speaker, I cent increase will give doctors nation- not always understand the ways of thank the gentlewoman from Nevada wide enough to continue to treat sen- Congress. (Ms. BERKLEY) for her leadership on iors on Medicare, and it will give Con- But the motion to instruct as I un- health care issues and for her advocacy gress time to develop and permanently derstand it would strip out important on behalf of seniors, especially in Ne- fix this flawed system that short- competitive provisions in the Medicare vada, and around the country. changes doctors and continues to re- conference report and redirect funds al- strict the ability of seniors to access legedly towards reimbursement of phy- Mr. Speaker, I normally when speak- health care services. sicians. The conference committee has ing on the House floor do not quote I ask my colleagues to work with me reportedly included a provision that from a television show, but I would to fix the Medicare physician reim- will provide physicians with positive like to start this evening with several bursements formula which currently updates in 2004 and 2005. That is not a of my colleagues. The gentlewoman threatens to destabilize the Medicare permanent solution. It does provide from Ohio (Mrs. CAPPS), the gentleman program. Seniors rely on their doctors Congress with the time it needs to from Rhode Island (Mr. KENNEDY) and and the medicines they need to stay make long-term substantive changes to maybe some others, maybe the gen- healthy. Seniors have waited too long the Medicare physician payment for- tleman from New Jersey (Mr. PALLONE) for a prescription drug benefit in Medi- mula. It will also ensure that Medicare and the gentleman from Massachusetts care and relief from high prescription beneficiaries continue to access high- (Mr. DELAHUNT) are going to speak on drug costs. We must work together for quality health care. this too. a drug benefit that prevents seniors That is why the American Medical I am quoting from Al Hunt on ‘‘Cap- from risking their health by cutting Association, the American Osteopathic ital Gang.’’ If you have seen that show, pills in half or having to choose be- Association, and the Alliance of Spe- those people watching, you know he tween paying for medicine and paying cialty Medicine all strongly support does something called the ‘‘Outrage of for their rent, their electricity or even the House Medicare bill. the Week.’’ He says: ‘‘Now for the out- the purchase of their food. I am aware the supporters of the mo- rages of the week. The American Asso- For 4 decades this Nation promised tion are attempting to portray this as ciation of Retired Persons, the largest that Medicare would provide health a choice between HMOs or doctors; and lobby for the elderly, is on the verge of care for all seniors. It is a program this is false and the authors know it is selling out many seniors on the Medi- that ensures these hardworking older false. However, do not take my word care bill.’’ This is a commentator say- Americans who have paid taxes and for it. Listen to what the AMA has to ing this, not me. ‘‘The legislation as it have paid into the system will have say about this motion: ‘‘Simply at- now stands would deny 4 million retir- health care coverage. tempting to transfer dollars from pa- ees coverage they currently get, would I urge my colleagues to vote for this tients to physicians through some am- give sweeping new powers to HMOs motion to allow our constituents to biguous, unspecified mechanism, as is over the traditional one for Medicare,’’ continue to choose what doctors they intended under the motion to instruct, basically a $12 billion pay-off to the in- see, what hospitals they are treated in, would not change the flawed Medicare surance companies, ‘‘and would gut a and to continue to access the highest payment formula and thus would not measure approved by both Houses to quality of care. ensure long-term access for Medicare facilitate importation of cheaper pre- Mr. Speaker, I reserve the balance of patients.’’ scription drugs from Canada,’’ from my time. As mentioned before, the House bill countries that charge two and three Mrs. WILSON of New Mexico. Mr. increased reimbursements for physi- and four times what the drug compa- Speaker, I yield myself such time as I cians and is supported by the physician nies do in this country. may consume. community. It also provides seniors ‘‘The AARP Washington lobbyists ap- Mr. Speaker, it is a little bit hard for with more choices under Medicare and parently care more about their own in- me to understand why we are going to attempts to make some long-term fluence than what they can do for vote on this motion to instruct or why competitive reforms so that Medicare struggling seniors.’’

VerDate jul 14 2003 00:37 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00100 Fmt 7634 Sfmt 0634 E:\CR\FM\K18NO7.201 H18PT2 November 18, 2003 CONGRESSIONAL RECORD — HOUSE H11495 Mr. Speaker, we should not be sur- ace to ’s book on how to As this discussion goes on, I cannot prised by this. Let me share some com- privatize Medicare, the same Newt get out of my mind the faces of the ments, some articles written about Gingrich that said: If I have my way, seniors in my district, several meetings AARP which most of us in Washington Medicare’s going to wither on the vine. over the past several weeks that I have know is one of the largest insurance The same Newt Gingrich that said had with them, seniors who signed up companies in the country. that. for Medicare+Choice, that partnership In Newsday 3 years ago, ‘‘Critics say Mr. Novelli writes, ‘‘Newt’s ideas,’’ between the private sector, the HMOs, AARP, which formally unveiled its new and they are on a first-name basis obvi- the insurance companies and Medicare, headquarters building in downtown ously as much time as they spent to- a volunteer program, voluntary pro- Washington last month, has softened gether trying to dismantle Medicare, gram that they signed up for to help its earlier militancy because it is pre- ‘‘Newt’s ideas are influencing how we pay their prescription medications. In occupied with its profit-making enter- at AARP are thinking about our na- my congressional district which is, a prise, including $100 million in earnings tional role in health promotion and lot of parts of it are rural, one after an- from the sale of insurance.’’ disease prevention and in our advo- other of these HMOs after raising their cating for system change.’’ If only his b 2200 premiums, after raising their copays, 40 million members knew that he was have left. In parts of my district, there The Denver Post wrote not too long in league with Newt Gingrich to try to ago, ‘‘AARP receives more than $100 is no choice for seniors but straight privatize Medicare; that he, Mr. Medicare or medigap programs, and in million in revenue from health insur- Novelli, was in league with the drug in- ers.’’ other areas, there is one program just dustry which will gain $150 billion, bil- hanging on by a thread. Newsday wrote, ‘‘Critics suggest that lion with a B, that is twice what we are AARP’s substantial profits from the So the high cap program, the part of spending in Iraq, $150 billion to the Medicare that provides a voluntary sales of insurance policies, drug com- drug industry and a $12 billion insur- pany advertising,’’—no surprise there counseling service, had gathered sen- ance payout to the insurance compa- iors together to explain to them why either considering they sold out to the nies. That is like 1,000 times more than drug industry on this one,—‘‘drug com- they got this letter from the HMOs Halliburton is still paying DICK CHE- pany advertising in its magazines, and saying that they were going to with- NEY, the Vice President of the United draw from the area, not serve them any investment schemes conflict with its States. interests on behalf of seniors. AARP longer, confuse seniors in their These things are pretty incredible, eighties, many of them with health President William Novelli acknowl- Mr. Speaker, when we think about the edged complaints from members that conditions. They were frightened. They money that AARP is going to make were frustrated, and they do not want AARP has been too timid in the polit- from this bill. They are going to get in this legislation. They know very well ical battles to defend Medicare and So- line behind the drug companies and the what happens when we begin the proc- cial Security. He conceded that AARP insurance companies with their hand ess, which this bill most certainly will has pulled its punches since right-wing out. groups and Members of Congress criti- Mrs. CAPPS. Mr. Speaker, will the do, to take us into privatizing of Medi- cized it.’’ gentleman yield? care, exactly what the former speaker, Capital News Service wrote, ‘‘AARP’s Mr. BROWN of Ohio. I yield to the Mr. Gingrich, had in mind when he be- pharmacy service,’’—its connection to gentlewoman from California. came Speaker of the House in the last the drug industry, think about that,— Mrs. CAPPS. Mr. Speaker, I thank decade. ‘‘is part of its insurance sales operation my friend the gentleman from Ohio This bill, the House bill and the Sen- which generated $101 million in rev- (Mr. BROWN) for yielding to me. ate bill which are now being rec- enue last year, 17 percent of the organi- I want, first of all, to acknowledge onciled, are trying to impose an un- zation’s total budget.’’ No wonder they this motion to instruct conferees and tried and really unnecessary privatiza- are there for this bill that enhances the thank my colleague from Nevada. It is tion scheme. Medicare works. The profits of the drug industry, $150 billion very appropriate that this motion be piece that needs to be modernized is it enhances their profits and gives a $12 submitted at this time as we are aware the prescription benefit. Privatizing billion blank check to the HMOs in this that the conferees on the Medicare Medicare will, contrary to what some- country. modernization bill are meeting, but one from the other side of the aisle Milwaukee Journal says, ‘‘AARP re- some news has been trickling out, even said, will not give seniors that backup, ceives millions of dollars from though to my knowledge there are because it will force and by bribing the UnitedHealthcare, a national health in- Members only on one side of the aisle HMOs, by putting money up front to surance firm based in Minnesota.’’ attending that conference report from the HMOs, which this motion to in- Now, Mr. Speaker, in the last minute the House of Representatives, and so it struct seeks to remove, by bribing the or two before yielding to my friends, I is just bits and pieces of news that HMOs to come into an area, the folks want to mention that Mr. Novelli, who come. who are left with Medicare, straight is the head of AARP, who did the nego- I am thankful that my colleague Medicare will be the older and the sick- tiations, these tough-minded negotia- from Ohio mentioned the fact that er seniors, because those HMOs will tions with the drug companies and the AARP has endorsed this legislation raise their rates. They will raise their insurance companies, Mr. Novelli wrote which we really have not seen yet, but premiums, they will cherry pick, and the preface to Newt Gingrich’s book on they must know some things about it, only the sick seniors, the old seniors how to reform Medicare. and I just want to say to my colleague who have the highest costs will be left Newt Gingrich is the guy that first that I sent Mr. Novelli a letter today with straight Medicare. That is not a thing after Medicare passed in 1965, resigning my membership, withdrawing choice and that is going to happen. It only 12 Republicans voted for it. Bob my membership from AARP. I remem- will be happening before the end of this Dole voted no. Donald Rumsfeld voted ber so clearly members from the orga- decade if this bill is passed and goes no. Strom Thurmond voted no. All nization from the Washington office into effect. kinds of Republicans voted no. In those coming to my office to tell me in very This is something our seniors know days, Republicans did not like Medi- strong language this summer about the very well, and the seniors who have care. They say they do now, but then four principles that they were high contacted my office today in response Newt Gingrich, when the Republicans bound must be in a prescription medi- to my removing myself from AARP are finally took control of the House in cation bill, a Medicare modernization thankful that we are speaking up be- 1995, the first thing Newt Gingrich did bill, including defined benefits, includ- cause they know that this is something was cut $250 billion from Medicare to ing no means testing, including other that will not benefit them. do what? Guess. To pay for a tax cut standards, all of which are fast dis- Mrs. WILSON of New Mexico. Mr. for the richest people in the country. appearing from the legislation as it is Speaker, I yield myself such time as I Same old story. being prepared to bring to the floor for may consume. Mr. Novelli has decided he is buying a conference vote before we adjourn I think all of us agree that Medicare in. The head of AARP writes the pref- here. is one of the most successful health

VerDate jul 14 2003 00:37 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00101 Fmt 7634 Sfmt 0634 E:\CR\FM\K18NO7.203 H18PT2 H11496 CONGRESSIONAL RECORD — HOUSE November 18, 2003 care programs in the history of this urge her to reconsider her opposition going to have to figure out a way to country, and I think all of us have a to medical liability reform legislation make a profit. How do you make a right to be proud of what we are about such as H.R. 5, the HEALTH Act, the profit with risk insurance when you to accomplish here because we have tort reform bill, a bill that was strong- have someone as high risk as a senior been elected to make a difference. All ly supported by both the AMA and the citizen? Well, if you are smart about of us come here to make a difference Nevada Medical Association. The other your insurance practices, you try to on things that matter to the people body has not acted yet, so the gentle- avoid the risk. That is the whole na- that we serve, and a large number of woman will have yet another chance to ture of insurance, to avoid risk. national organizations, including the truly support physician providers. I hope I am not telling anyone any- AARP and the American Medical Asso- Mr. Speaker, I strongly support the thing new, but that is the nature of in- ciation, the hospital association, have bipartisan Medicare conference agree- surance. So you avoid risk, and that all endorsed what we are about to ac- ment, and we will soon consider this on means avoid the sickest seniors. Avoid complish. the House floor. This motion to in- the seniors who will cost the most. And I am very pleased to welcome this struct no longer serves any purpose. In- there will be no argument from the evening the other doctor from the deed, the provisions related to Medi- other side on this because it flies in the State of Georgia (Mr. GINGREY) to ex- care competition that the gentle- face of the for-profit nature of the HMO plain further what this bill is going to woman references in her motion are companies that they are about to turn do for Americans. not even part of the final conference our Medicare system over to. 1 So you avoid all the seniors that are Mr. Speaker, I yield 3 ⁄2 minutes to committee agreement. the gentleman from Georgia (Mr. I urge my colleagues to join me in re- costing you, you take the seniors that GINGREY). jecting this motion to instruct and do not require much health care and Mr. GINGREY. Mr. Speaker, I thank supporting the final Medicare con- you want to sign them up. And then the gentlewoman from New Mexico for ference agreement. what do you do? What happens to all yielding time to me. Ms. BERKLEY. Mr. Speaker, I yield 5 those seniors that are not signed up? Mr. Speaker, there they go again. minutes to the gentleman from Rhode Oh, you propose to leave them in the traditional Medicare program, but will They do not like the message so they Island (Mr. KENNEDY). start trashing, trashing the messenger, Mr. KENNEDY of Rhode Island. Mr. increase the premiums of part B on the and in this case, the messenger just Speaker, I want to thank the gentle- traditional Medicare program to cover happens to be 35 million seniors who woman from Nevada for offering this the increased cost that the Medicare are members of the AARP. Excuse me, motion, and I reject those who would program will incur. And the Repub- 35 million less one. The gentlewoman call it political. licans put a provision in the Medicare from California just told us that she re- Yes, believe it or not, we are in a po- program saying that if it should exceed signed. litical body, and yes, believe it or not, certain cost guidelines, then we will have to come back to Congress to fig- This is a solution, Mr. Speaker, in we live in a democracy where we are ure out what to do. desperate need of a problem. The mo- Representatives of the people, and we Well, guess what is going to happen tion to instruct conferees, like so many represent those folks the best we can. that the minority has offered before, then? At that point you will say, well, The gentlewoman from Nevada is doing we are going to have to dismantle serves no useful purpose in this debate. her job in highlighting the fact that They are simply political tools used in Medicare because, guess what, it just is the Republican conference report on not working. Well, you are setting it a desperate attempt to divert attention the Medicare bill is a sham. away from the fact that the Republican up not to work. You are underfunding If this was about prescription drug it. And if my colleagues do not believe House will in a matter of days deliver, coverage, we would have it all done. anything I am saying, just understand it will deliver on its commitment to There is no disagreement from anyone this. Who is in favor of this bill? The providing seniors with access to mean- about the fact that prescription drug pharmaceutical industry. Why are they ingful, affordable and comprehensive coverage ought to be passed. We are in favor of this bill? Because it does prescription drug coverage. talking about $400 of prescription drug not do what needs to be done to take Mr. Speaker, I support properly reim- coverage for seniors. It would be done on the pharmaceutical industry and bursing physicians. The House bill did tonight. We could have it on the Presi- say you need to give in this matter. that and so does the bipartisan Medi- dent’s desk. There would not be one Thirty percent profit rates for the care conference agreement which is person against it other than those who pharmaceutical industries are too why it is supported by a number of are dead set against any kind of Medi- much when our seniors are barely able medical societies, including the Amer- care improvement whatsoever. to make it buying the prescription ican Medical Association. The problem the gentlewoman has drugs they need and affording them the Listen to what they say: ‘‘The Amer- accurately identified is that this pre- health and other things they might ican Medical Association strongly sup- mium support plan that is essentially need in terms of housing and food and ports passage of the Medicare prescrip- part of their reform is untenable. It is the like. The pharmaceutical compa- tion drug conference report, which cur- untenable because the nature of senior nies like the Republican bill. rently includes historic and critical citizens, their high risk of needing Who else likes the Republican bill? provisions for improving choice and ac- health care, is such that, guess what, Guess what, the insurance companies cess for Medicare seniors and disabled we needed the Medicare program be- like the Republican bill. And as the patients. In addition,’’ Mr. Speaker, cause when we relied on the private gentleman from Texas (Mr. DELAY) has ‘‘in addition, the conference report sector, the private sector was not said before, and the gentleman from would halt 2 years of impending Medi- there. California (Mr. THOMAS), the chairman care payment cuts to physicians and b 2215 of the committee, and so we do not other health professionals and replace misunderstand their intentions, be- them with payment increases of at That is why we have the Medicare cause they said it very clearly, and least 1.5 percent per year. Because the program, for those who do not under- here is the chairman of the committee: Medicare conference report includes stand what we are talking about to- ‘‘To those who say that the House bill these critical provisions for improving night. We have the Medicare program ends Medicare as we know it, our an- choice and access, the AMA strongly because when left to the private sector, swer is: we certainly hope so.’’ opposes the Berkley motion to instruct they did not cover seniors because they Well, my friends, if senior citizens and urges Congress to pass the pending were too high risk. are comfortable with the fact that the Medicare conference report before they So what do the Republicans propose? future of Medicare is in the hands of adjourn.’’ They propose going back to the days those who believe in the private sector, If the gentlewoman from Nevada is before we passed Medicare, where we then so be it. serious about wanting to help our Na- left the seniors’ health care to private Mrs. WILSON of New Mexico. Mr. tion’s providers, our physician pro- insurers. Now, what are private insur- Speaker, I yield myself such time as I viders, and I trust that she is, I would ers going to do? Guess what, they are may consume.

VerDate jul 14 2003 00:37 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00102 Fmt 7634 Sfmt 0634 E:\CR\FM\K18NO7.206 H18PT2 November 18, 2003 CONGRESSIONAL RECORD — HOUSE H11497 Sometimes I feel here like we are parents, she has a growing list of ail- Mr. PALLONE. Mr. Speaker, I have a looking through the looking glass, like ments. Some of them are serious; some great deal of respect for the gentle- in the Alice in Wonderland book. of them are just annoying. But pre- woman from New Mexico, and also the Sometimes things people say do not scription drugs have allowed her to live gentleman from Georgia, but I have to make any sense to me at all. I do not a relatively healthy life in her senior say I feel like I am listening to Alice in understand how can people say we have years. Wonderland when I listen to what the underfunded, when we are just about to Last year, she paid $1,700 for the two of them are saying about this add $400 billion in new benefits to whole year just in copayments for her Medicare conference report that we are Medicare. medicine. She is on a fixed income. Her about to vote on in a few days. When Medicare was started back in husband, Robert, also has medical bills; The gentlewoman said that Medicare 1965, medicine was only 1 percent of the and he gets Social Security. He has a is very successful, and she pointed out cost of health care. We did not have the small pension. All together they earn that we are adding $400 billion to the miracle medicines that we have today. about $16,000 a year. Well, when you program. But I would ask a very simple Cancer, the diagnosis of cancer in 1965, pay the groceries and the light bill and question: If it is so successful, why do was a death sentence. Today, people the heating bill, the checking account we not just add it as a drug benefit and survive it because of medicine. And yet gets a little short by the end of the give the seniors the $400 billion for we have a system under Medicare that month. And that happened recently. their prescription drugs? will pay for a diabetic to go into the Mrs. Griego ran out of money in the That is what the Democrats pro- hospital and have their foot amputated checking account 7 days before the posed. We said, right now you have but will not pay $29.95 a month for the next check came in. She also ran out of part B where you pay so much, I think Glucophage to control blood sugar. Lovexil, which is a medicine she takes it is about $50 a month for your doc- That is why so many seniors in New for her thyroid problem. The phar- tor’s care, a $100 deductible, 80 percent Mexico have opted for something called macist told her if she did not buy her of the cost paid for by the Federal Gov- Medicare+Choice, because that is the medicine in the next 7 days, she would ernment, and 20 percent copay. That is only thing in Medicare that has given get a little groggy and tired in the what the Democrats proposed. We said, them something of a prescription drug meantime. And that is what happened. do the same thing with prescription benefit. Now, this is my card as a Mem- But Mrs. Griego could not get her pills drugs: have the seniors pay $25 for a ber of Congress. I am actually a mem- until she had her check. premium, a $100 deductible, 80 percent ber of an HMO, like a whole lot of New In New Mexico, 52 percent of seniors of the cost paid for by the Federal Gov- Mexicans. It is very common in New are low income, including Bertha and ernment, 20 percent copay up to a cer- Mexico. Forty percent of seniors in Robert. When we pass this legislation, tain amount, and then it becomes cata- New Mexico take advantage of these and we get this program in place, Ber- strophic. But that is not what the Re- kinds of plans because it has given tha and Robert will not have to wait publicans did. for the next Social Security check to them some choice and some options, The reason that the gentlewoman come in to buy their medicine. And when Medicare has not given them that from Las Vegas is proposing this mo- that is why this matters. That is why choice before. tion is because she does not want to What we are adding to Medicare this we have a responsibility to do what we give money to the HMOs. She does not week is a guaranteed benefit not just can with what we have from where we want to force seniors to have to go to for people who are fortunate enough to are and start making a difference for an HMO to get their prescription drugs. live in Albuquerque, New Mexico, but the problems that affect the people we She says, let us give this money in this care so much about. for everybody else who has not had case to the doctors or let us give it to Mr. Speaker, I reserve the balance of that opportunity: a guaranteed benefit the seniors in some way so they benefit my time. under Medicare to add prescription Ms. BERKLEY. Mr. Speaker, I yield from it. I totally agree with the gentlewoman drugs. That reduces the cost of medi- 30 seconds to the gentleman from that we need to provide prescription cine for everybody, and that gives peo- Rhode Island (Mr. KENNEDY). ple choices and options. Mr. KENNEDY of Rhode Island. Mr. drug coverage and preventive care for I think people want choices. If you Speaker, I thank the gentlewoman for seniors, but then why are the Repub- are in Santa Rosa, New Mexico, maybe yielding me this time, just a couple of licans giving away money to the you want to get your prescription seconds to respond to the gentlewoman HMOs? Why are they forcing seniors to drugs by mail order. My family, we like from New Mexico. go to an HMO to get their prescription to get it at the pharmacy, at the Jour- The fact of her being so passionate drug coverage? Sure, if someone wants nal Center at Loveless, just because about seniors I do not question whatso- to join an HMO, like in my State, some that is convenient for us; but seniors ever, but if she was truly interested in people do get their drug coverage, I should have those choices. helping those low-income people, then have no problem with that; and I know The other thing I think is important how come her votes and those of her the gentlewoman does not. But this to seniors is that this is voluntary. If colleagues repeatedly have cut the forces the seniors into the HMO. My there is a senior, and I know a lot of very programs on behalf of the people colleagues are saying they have to join veterans who are already covered by that she says she is trying to help? In- an HMO in order to get the prescrip- the VA or folks who have earned their stead, her party votes to cut taxes for tion drug coverage. And that is not health benefits through employment the richest 1 percent of our population, fair. That is not choice. That is not and they have great retiree plans, they those with incomes over $350,000, by voluntary. do not have to sign up for this if they nearly $2 trillion. And two-thirds of Now, the gentleman from Georgia, do not want to. But for those who do that goes to the wealthiest 1 percent. said, well, we are providing with this not have that coverage now, they will And I might add that when they are Medicare agreement meaningful, af- have the opportunity to get prescrip- done with this Medicare bill, they are fordable, and comprehensive coverage. tion drugs through Medicare. going to give all the money they cut; That is simply not the case. First of Now, why does all this matter? I they are going to add to special inter- all, seniors are being forced into an mean, we talk here about deductibles est money for those with HMOs and HMO. The Republicans are privatizing and donuts and all these kind of things; those with pharmaceutical interests. Medicare in the long run. But think but I had somebody call my office re- And do not take my word for it; just about this benefit that you are giving cently, her name is Bertha Griego, and look at the Wall Street Journal. The the senior citizens. First of all, we do she is a wonderful lady who is 74 years HMOs and the pharmaceutical compa- not even know what the premium is, so old. She has lived all her life in New nies are jumping up and down thanking it may not be affordable at all. There is Mexico, and she talks with affection the gentlewoman from New Mexico for no set premium. We know that the de- about the 1929 Model T her dad had giving them a gift. ductible is $275, not $100, like it is for driving around the dirt roads of New Ms. BERKLEY. Mr. Speaker, I yield 3 part B. And then there is, in fact, as Mexico. She is a wonderful lady. And minutes to the gentleman from New the gentlewoman mentioned, this huge like most of our parents and grand- Jersey (Mr. PALLONE). donut hole when you do not get any

VerDate jul 14 2003 00:37 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00103 Fmt 7634 Sfmt 0634 E:\CR\FM\K18NO7.209 H18PT2 H11498 CONGRESSIONAL RECORD — HOUSE November 18, 2003 coverage at all. So the seniors in the signed and our constituents hear of it, Sometimes we get the kind of luke- long run are going to be paying more we get calls back saying oh, I am re- warm endorsement around here that out, in my opinion, than they are going signing, too. I want to tell Members Members just pull a sentence or two of. to get back. when the seniors in this country catch This is not one of them. This is un- Now, yes, this is a voluntary pro- on to what the other side of the aisle qualified support from an organization gram. But what good is it if nobody are doing to them, they are going to that is not known for supporting Re- sees fit to sign up for it because they want to resign. publican provisions in bills, frankly. will be forced into an HMO or they will Mrs. WILSON of New Mexico. Mr. And I think we got to this point be- have to pay so much money out of Speaker, I yield myself such time as I cause we put aside partisanship and pocket that they do not get a meaning- may consume. politics and focused on making a dif- ful, affordable, or comprehensive ben- Mr. Speaker, I am not old enough to ference for the people that we came efit the way the gentleman from Geor- join AARP, but since they have become here to serve. gia described? None of that is the case such a big part of this debate, I want to I think we have a right to be proud of here. read what they have said. It is not an what this body and this Congress as a Finally, why can we not have real unqualified endorsement. I have never whole is about to achieve this week. I competition? Let us have the Medicare seen the perfect bill yet in this job, but welcome and commend the AARP for administrator negotiate price reduc- it is a pretty good bill. I think the setting aside its traditional focus on tion. That is not in this bill either. AARP came to that conclusion. I would sometimes which party Members are in b 2230 like to enter their statement into the and focusing on policy and not on RECORD, but maybe reading some parts politics. Mrs. WILSON of New Mexico. Mr. will explain where they are coming AARP ENDORSES MEDICARE PRESCRIPTION Speaker, I yield myself such time as I from. It is dated November 17, 2003, may consume. DRUG BILL AARP endorses Medicare prescription AARP today announced its strong endorse- Mr. Speaker, this bill does not force drug bill, and this is directly from anybody to join an HMO, but seniors ment of the prescription drug bill offered by them. the conference committee and will work vig- have the right to choose to get their ‘‘AARP today announced its strong orously for its passage. medicine from managed care if they endorsement of the prescription drug AARP believes that millions of older want to. Or if they want to, they can bill offered by the conference com- Americans and their families will be helped choose a stand-alone prescription drug mittee and will work vigorously for its by this legislation. Though far from perfect, plan or they can have it integrated passage. the bill represents a historic breakthrough with a fee-for-service plan that works ‘‘AARP believes that millions of and important milestone in the nation’s commitment to strengthen and expand for them. older Americans and their families will People choose different ways to get health security for its citizens at a time be helped by this legislation. Though when it is sorely needed. their health care. My family has made far from perfect, the bill represents an The bill will provide prescription drug cov- our choice, and we are comfortable historic breakthrough, an important erage at little cost to those who need it with why we make those choices for a milestone in the Nation’s commitment most: people with low incomes, including lot of reasons, but we should have to strengthen and expand health secu- those who depend on Social Security for all enough variety in this new system so rity for its citizens at a time when it is or most of their income. It will provide sub- we do not have a one-size-fits-all sys- sorely needed. stantial relief for those with very high drug tem, and that seniors have the right to ‘‘The bill will provide prescription costs, and will provide modest relief for mil- choose, whether it is a stand-alone pre- lions more. It also provides a substantial in- drug coverage at little cost to those crease in protections for retiree benefits and scription drug program, a mail order who need it most: People with low in- maintains fairness by upholding the health program, added to fee-for-service, or comes, including those who depend on benefit protections of the Age Discrimina- rolled into a managed care plan, if that Social Security for all or most of their tion and Employment Act. is what citizens want, that is what we income. It will provide substantial re- AARP is pleased by the improvements have tried to do. lief for those with very high drug costs, made to the conference report in recent I have to say, in the end, this pro- and will provide modest relief for mil- days. A new structure called ‘‘premium sup- gram is being supported by a pretty lions more. It also provides a substan- port’’ which required competition between broad array of organizations who see it tial increase in protections for retiree traditional Medicare and private plans was downsized to a limited test starting in 2010, for what it is, a very good step towards benefits and maintains fairness by up- which has significant protections for those providing prescription drugs to seniors holding the health benefit protections in traditional Medicare. The government in this country. of the Age Discrimination and Employ- will provide coverage in areas where private Mr. Speaker, I reserve the balance of ment Act. plans fail to offer coverage. The integrity of my time. ‘‘AARP is pleased by the improve- Medicare will be protected. Ms. BERKLEY. Mr. Speaker, I yield 1 ments made to the conference report in An unprecedented $88 billion will encour- minute to the gentlewoman from Cali- recent days. A new structure called age employers to maintain existing health fornia (Ms. WOOLSEY). ‘‘premium support’’ which required retiree benefits. The legislation will help Ms. WOOLSEY. Mr. Speaker, I thank competition between traditional Medi- speed generic drugs to market and add im- the gentlewoman for yielding me this portant new preventive and chronic care care and private plans was downsized management services. Finally, this legisla- time. to a limited test starting in 2010, which tion protects poor seniors from future soar- Mr. Speaker, I would like the gen- has significant protections for those in ing prescription drug costs. tleman from Georgia to know he is traditional Medicare. The government AARP is launching a national grassroots, going to have to continue doing the will provide coverage in areas where advertising and information campaign this math and subtraction because the gen- private plans fail to offer coverage. The week to explain the legislation and urge bi- tlewoman from California (Mrs. CAPPS) integrity of Medicare will be protected. partisan support for its passage. is not alone in resigning her member- ‘‘An unprecedented $88 billion will Mr. Speaker, I reserve the balance of ship today. I resigned mine, and I also encourage employers to maintain ex- my time. circulated a letter here on the House isting health retiree benefits. The leg- Ms. BERKLEY. Mr. Speaker, I yield floor, and within 30 minutes I had over islation will help speed generic drugs myself such time as I may consume. 50 Members sign a letter to Mr. Novelli to market and add important new pre- I am absolutely astounded by the saying they were resigning their mem- ventive and chronic care management continued nonsensical talk about bi- bership because of his change in his po- services. Finally, this legislation pro- partisanship when the Democrats were sitions with AARP determining that it tects poor seniors from future soaring not even allowed in the room when the is more important to protect their in- prescription drug costs. decisions were made, when consumer surance industry and their own insur- ‘‘AARP is launching a national grass- groups were excluded, when there was ance company than protecting the roots, advertising and information absolutely no interaction of bipartisan- membership of AARP. campaign this week to explain the leg- ship on this bill, and I dare say that we I want Members to know each time islation and urge bipartisan support for have not even seen the legislation yet one of us announces that we have re- its passage.’’ in its completed form because it has

VerDate jul 14 2003 00:37 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00104 Fmt 7634 Sfmt 0634 E:\CR\FM\K18NO7.210 H18PT2 November 18, 2003 CONGRESSIONAL RECORD — HOUSE H11499 yet to come from the House leadership son and the way they do that is the is Ella May Naser. She is older than so all of us can review this. So this bi- same way we are going to see under Medicare. She is about to be 98 years partisan discussion is nonsense. these new plans because it is kind of old, and she is still sharp as a tack. She Mr. Speaker, I yield 2 minutes to the like when Americans go down to is on her own now, but in August of gentleman from Oregon (Mr. DEFAZIO) Costco or Price Club, when buying in every year she has to change her to enlighten all of us. bulk, consumers are going to get a bet- health care plan from one Mr. DEFAZIO. Mr. Speaker, the gen- ter price. Medicare+Choice system to another be- tlewoman from New Mexico (Mrs. WIL- Mr. DEFAZIO. Mr. Speaker, will the cause she only gets about $685 a month, SON) mentioned the VA. I assume she is gentlewoman yield? and at some point the prescription aware as a veteran that the VA nego- Mrs. WILSON of New Mexico. I yield drug benefit runs out in her plans. She tiates on behalf of all of America’s vet- to the gentleman from Oregon. has one medicine to control her high erans, and they have negotiated prices Mr. DEFAZIO. Mr. Speaker, I would blood pressure, another to prevent de- and the extortionate cost of pharma- ask the gentlewoman just to clarify, is generative bone disease, and another ceuticals of about 60 percent. That is the VA part of the government and are one for glaucoma. She has family that how we can afford to give them very in- we prohibiting the rest of the govern- helps her sort all of these things out expensive medications with a very ment from negotiating on behalf of and try to make sure that her plans small copayment. seniors? cover what she needs because they Those are similar to the reductions Mrs. WILSON of New Mexico. Mr. know she will stop taking her medicine in Canada, about 50–60 percent, but the Speaker, reclaiming my time, I would if she does not have the money to pay Republicans have prohibited in this be happy to answer the gentleman’s for it. legislation that the government should question in my own way here. This plan will help people like her. negotiate on behalf of the 40 million The VA does negotiate low prices be- That is why we are doing this. That is people in Medicare any reduction in cause they have the leverage of having why we have to set aside the little dif- the price of pharmaceuticals at the be- a lot of people who use the medicine. ferences in order to accomplish the big hest of the pharmaceutical industry. That is the same concept we are apply- things that people send us here to do. This bill also prohibits the importation ing here, that there are large groups of Mr. Speaker, I yield back the balance of drugs from Canada. They say, no, it people who can get a better price and of my time. does not do that, we are going to give get lower costs because they do it to- Ms. BERKLEY. Mr. Speaker, I yield the authority of the Secretary of HHS gether. There is a group rate, just like 45 seconds to the gentleman from Mas- to reimport the drugs, but guess what we do if we go into Denny’s with a sachusetts (Mr. DELAHUNT). he has already said, he will not do it large party, diners get a group rate and Mr. DELAHUNT. Mr. Speaker, I because they are not safe. But, in fact, a lower cost. think it is important that we note as a arguably drugs, U.S. manufactured, The estimates are that the cost of matter of record that where the gentle- FDA-approved drugs are safer when medicine will go down between 15–25 woman from New Mexico (Mrs. WILSON) they come back from Canada because percent, and we do not say that there indicated there were two Democrats their supply chain is left corrupt in has to be a Medicaid price. The compa- that were present at the conference, Canada because it is controlled by the nies can negotiate a low price, as low and the gentlewoman I understand government and because they nego- as they can get, and we give them le- served on that conference. The gentle- tiate 50–60 percent reductions in the verage to do so. I think that is the way woman is aware that the gentleman price. to go. And I think that guaranteed ben- from New York (Mr. RANGEL), the gen- The gentlewoman talks about com- efit is the way to go in this program. tleman from Michigan (Mr. DINGELL), petition. Guess what, the insurance in- Mr. Speaker, in closing, we are about and the gentleman from Arkansas (Mr. dustry who the gentlewoman wants to this week to pass historic legislation BERRY) were appointed by the leader- subsidize with $20 billion is exempt that has been a long time in coming. ship to serve in that conference and from antitrust law. They can throw out This House has passed Medicare pre- were denied access. any senior at any time. We may get a scription drug bills twice before, but 1-year plan from a company, but it is this is the first time that the Senate b 2245 like every other form of insurance in has also passed something and we can There was no input from the Demo- America today, file one claim, next meet together in the middle. Contrary cratic Party in this House into this year you are back in the Medicare fee- to the protestations by some of my col- particular conference. for-service plan where the premiums leagues, there actually were Democrats Ms. BERKLEY. Mr. Speaker, I yield have gone up because the industry has in the room, Senator BAUCUS and Sen- myself the balance of my time. cherry picked people out until they ator BREAUX have both signed onto this I have always believed in providing a need the service. They will give them a approach, and without their support, prescription medication benefit under service grudgingly until the end of year we would not be passing this bill. I the Medicare system. It makes no until they can cut them off. think that is important. sense to me that we have a Medicare The people in my district know I think it is important to set some of system that allows seniors to see a doc- HMOs, they know them really well. those partisan things aside and try to tor, the doctor prescribes the least ex- The HMOs pulled out. They said we are get things done, recognizing that it is pensive, most cost-effective way of not making enough money in southern not perfect, but we are getting some- dealing with illness, which is prescrip- Oregon, we are pulling out of southern thing done for the people who need it. tion medication. Many of the seniors in Oregon, and they did. Now, there are no It is voluntary. It gives people choices. my district and throughout the United options. So we are going to put people It gives the most help to those who are States cannot afford the prescription back into the plans and the graces of low income and those who have high medication that the doctor prescribes. the private insurance industry, after medicine costs because they are very Being a doctor’s wife and having a giving them a $20 billion subsidy with- sick. For the first time in Medicare, we stepdaughter who is a third-year med- out subjecting them to antitrust law are going to really focus on chronic ical student, I do not need to be lec- and exempting them from any negotia- disease management so that we im- tured by the other side of how the ef- tion by the government to reduce the prove the quality of life of seniors in fect of these Medicare reimbursements price of pharmaceuticals. This is a addition to extending the length of life. are affecting doctors because I know giveaway to the pharmaceutical indus- The biggest problem in Medicare firsthand and personal what it is doing. try, plain and simple. today is that not enough seniors can I know that the doctors are suffering Mrs. WILSON of New Mexico. Mr. afford life-saving medicine. We need to and that there is a real crisis in health Speaker, I yield myself such time as I add this prescription drug benefit to care and that our doctors need to be may consume. Medicare. appropriately reimbursed for the Medi- Mr. Speaker, it is true the VA does I told Members about a lady in my care patients that they see. negotiate very hard to get low costs for district and there is another one I met But what I am opposed to is veterans in their system; and the rea- who is a great grandmother. Her name privatizing the Medicare system, and

VerDate jul 14 2003 00:37 Nov 20, 2003 Jkt 029060 PO 00000 Frm 00105 Fmt 7634 Sfmt 0634 E:\CR\FM\K18NO7.212 H18PT2 H11500 CONGRESSIONAL RECORD — HOUSE November 18, 2003 that is what this legislation does. NEDY) and the gentleman from Ohio ship that it fosters. For many seniors, Make no mistake about it, this legisla- (Mr. REGULA) each will control 30 min- not only at the home is delivered a tion, rather than being a prescription utes. meal but a face with that meal, a per- drug plan, rather than being a Medi- The Chair recognizes the gentleman son, someone who can offer companion- care reimbursement plan for doctors, from Rhode Island (Mr. KENNEDY). ship and friendship and know what is what this is is the first step in Mr. KENNEDY of Rhode Island. Mr. going on in the home when they arrive privatizing Medicare, and that would Speaker, I yield myself such time as I and deliver the meal. The value of be a disaster for our seniors. may consume. these meals pays itself back in both I urge my colleagues to vote for this Today I rise to offer a motion to in- the importance of good nutrition and motion. My motion addresses the con- struct the House conferees on the 2004 also through the companionship and cern of the doctors across the country Labor, HHS and Education appropria- care that these meal volunteers pro- and ensures that Medicare patients can tions bill to insist on the highest level vide. have access to their doctors by pro- of funding possible for nutrition pro- We talk in Congress about how an viding these doctors with a 1.5 percent grams for seniors, programs such as ounce of prevention is worth a pound of increase in physician payments over Meals on Wheels and congregated meal cure. That is nowhere more true than the next 2 years. I ask my colleagues to sites. the Meals on Wheels and the con- protect our citizens and not have them As I rise this evening, I want to gregated meal site programs. In the investing in risky and untested privat- thank the gentleman from Ohio (Mr. congregated meal site programs, sen- ization schemes and to put the nec- REGULA) and the gentleman from Wis- iors get together at the senior centers essary funding in the prescription drug consin (Mr. OBEY), who are both leaders to join in lunch; but in the process of bill to fairly reimburse our doctors who on the Labor-HHS-Education sub- doing that, they are exposed to an administer the necessary care to Medi- committee and who both know how im- array of social services that may also care patients. Instead of putting the portant these programs are. I want to be of assistance to them. Unfortu- Medicare system in jeopardy, we thank them for their hard work year in nately, as many of us know in our Na- should protect our constituents’ access and year out to protect these programs tion, one in 10 seniors lives in poverty. to care. This motion fixes this problem so vital to our senior citizens. At the same time, there is expected to for another 2 years, but I implore my This week we are debating controver- be a 30 percent increase in the number colleagues that in the future we must sial legislation, as Members have just of Americans eligible for the Older work together to address a permanent no doubt heard, on the floor about the Americans Act now that the baby fix for the formula. future of the Medicare system and the boom generation is becoming the sen- ior boom generation. Already in my I urge my colleagues to support our importance of providing a drug benefit State of Rhode Island, 14.5 percent of doctors and their patients and vote without forcing seniors into HMOs. But our population is 65 or older. We need ‘‘yes’’ on this motion to instruct. the importance of that debate will be to be ready for this population as it re- Mr. Speaker, I yield back the balance left to another time. Tonight we are in tires. We need to be ready for them as of my time. agreement when it comes to the impor- tance of senior nutrition programs, and we take care of the seniors of today. The SPEAKER pro tempore (Mr. Finally, Mr. Speaker, before I turn it ROGERS of Alabama). Without objec- this truly is a bipartisan issue. I know that most Members of this over to my colleagues, let me say, I tion, the previous question is ordered have met Edna Bateman in one of my on the motion to instruct. Chamber have often visited their senior centers and know, having spoken to tours on a senior meal site. Edna Bate- There was no objection. man is from East Providence, Rhode Is- The SPEAKER pro tempore. The them, how important it is that they re- ceive these congregated meals. To- land, and she knows what a difference question is on the motion to instruct it has made to her in her life not only offered by the gentlewoman from Ne- night, this is an opportunity to put our money where our mouth is, and it is an to get that hot meal but also to have vada (Ms. BERKLEY). that companionship, that visitor every The question was taken; and the actual opportunity to encourage our conferees to spend the money on senior day that she is looking forward to see- Speaker pro tempore announced that ing, who she wakes up every morning the ayes appeared to have it. nutrition. Even in spite of the fact that we have tight budgets, we cannot give looking forward to talking to, who she Ms. BERKLEY. Mr. Speaker, on that unlocks her door and leaves it open so I demand the yeas and nays. senior citizens short shrift. As I said, Members know about these that she looks forward to hearing that The yeas and nays were ordered. Meals on Wheels volunteer coming to The SPEAKER pro tempore. Pursu- programs, but I do not know how many of them truly appreciate their mag- her door. ant to clause 8 of rule XX, further pro- That is why I rise tonight to make nitude and reach. I would encourage ceedings on this motion will be post- sure more people like Edna Bateman those colleagues of mine who have not poned. get the services like this Meals on been out on a Meals on Wheels visit to Wheels program. I want to pay tribute f go out with a volunteer and visit the to her and the many others who receive people for whom these programs help MOTION TO INSTRUCT CONFEREES this program. Tonight I know we all make a difference. Nearly 2 million ON H.R. 2660, DEPARTMENTS OF rise in support of those folks. LABOR, HEALTH AND HUMAN people receive meals through the con- Mr. Speaker, I reserve the balance of SERVICES, AND EDUCATION, AND gregated meal site program and 1 mil- my time. RELATED AGENCIES APPROPRIA- lion through the Meals on Wheels pro- Mr. REGULA. Mr. Speaker, I yield TIONS ACT, 2004 gram. This adds up to a total of 250 myself such time as I may consume. Mr. KENNEDY of Rhode Island. Mr. million actual meals served. That is a (Mr. REGULA asked and was given Speaker, I offer a motion to instruct. compelling statistic that reflects the permission to revise and extend his re- The SPEAKER pro tempore. The nature of these programs. marks.) My father, Senator EDWARD KEN- Clerk will report the motion. Mr. REGULA. Mr. Speaker, the gen- NEDY, was the author of the legislation The Clerk read as follows: tleman from Rhode Island has de- that made the seniors’ nutrition pro- scribed many of the values of this pro- Mr. KENNEDY of Rhode Island moves that grams part of the Older Americans Act. the managers on the part of the House at the gram. He is a very valued member of conference on the disagreeing votes of the I am proud that my father, Senator ED- our subcommittee. As he well knows, two Houses on the bill, H.R. 2660, be in- WARD KENNEDY, was responsible for the we have done all we could for this pro- structed to insist on the highest funding lev- founding of Meals on Wheels. What he gram within the constraints of the els possible for nutrition programs for our and others of his colleagues have recog- Budget Act. It is a great program. I nation’s seniors as authorized by the Older nized over 30 years is that Meals on think one of the benefits that probably Americans Act. Wheels is an important program not was not mentioned is it gives a lot of The SPEAKER pro tempore. Pursu- only for the nutrition that it brings people in communities a sense of par- ant to clause 7 of rule XXII, the gen- but also because of the companionship ticipation because these meals are de- tleman from Rhode Island (Mr. KEN- and the neighbor-to-neighbor relation- livered by volunteers in most cases if

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