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[CAPTIONING MADE POSSIBLE BY THE
NATIONAL CAPTIONING INSTITUTE,
INC., IN COOPERATION WITH THE
REPRESENTATIVES.
UNITED STATES HOUSE OF
ANY USE OF THE CLOSED-CAPTIONED
COVERAGE OF THE HOUSE
PROCEEDINGS FOR POLITICAL OR
COMMERCIAL PURPOSES IS EXPRESSLY
PROHIBITED BY THE U.S. HOUSE OF
REPRESENTATIVES.]
ON THIS
VOTE THE YEAS ARE 233.
THE NAYS ARE 179.
THE PREVIOUS QUESTION IS
ORDERED.
THE QUESTION IS ON ADOPTION OF
THE RESOLUTION.
SO MANY AS ARE IN FAVOR SAY AYE.
THOSE OPPOSED, NO.
IN THE OPINION OF THE CHAIR, THE
AYES HAVE IT.
THE GENTLEMAN FROM
MASSACHUSETTS.
ON THAT I ASK A
RECORDED VOTE.
A
RECORDED VOTE IS REQUESTED.
THOSE FAVORING A RECORDED VOTE
WILL RISE.
A SUFFICIENT NUMBER HAVING
ARISEN, A RECORDED VOTE IS
ORDERED.
MEMBERS WILL RECORD THEIR VOTES
BY ELECTRONIC DEVICE.
THIS IS A FIVE-MINUTE VOTE.
[CAPTIONING MADE POSSIBLE BY THE
NATIONAL CAPTIONING INSTITUTE,
INC., IN COOPERATION WITH THE
REPRESENTATIVES.
UNITED STATES HOUSE OF
ANY USE OF THE CLOSED-CAPTIONED
COVERAGE OF THE HOUSE
PROCEEDINGS FOR POLITICAL OR
COMMERCIAL PURPOSES IS EXPRESSLY
PROHIBITED BY THE U.S. HOUSE OF
REPRESENTATIVES.]
ON THIS
VOTE THE YEAS ARE 238.
THE NAYS ARE 181.
THE RESOLUTION IS ADOPTED.
WITHOUT OBJECTION, THE MOTION TO
RECONSIDER IS LAID UPON THE
TABLE.
FOR
WHAT PURPOSE DOES THE GENTLEMAN
FROM KENTUCKY RISE?
THE HOUSE WILL BE IN ORDER.
FOR WHAT PURPOSE DOES THE
GENTLEMAN FROM KENTUCKY RISE?
MR. SPEAKER, I ASK UNANIMOUS
CONSENT THAT ALL MEMBERS MAY
HAVE FIVE LEGISLATIVE DAYS TO
REVISE AND EXTEND THEIR REMARKS
ON THE LEGISLATION AND TO INSERT
EXTRANEOUS MATERIAL ON THE BILL.
WITHOUT
OBJECTION, SO ORDERED.
MR. -- PURSUANT TO HOUSE
RESOLUTION 269 AND RULE 18, THE
CHAIR DECLARES THE HOUSE IN THE
COMMITTEE OF THE WHOLE HOUSE ON
THE STATE OF THE UNION FOR
CONSIDERATION OF H.R. 1216.
THE CHAIR APPOINTS THE GENTLEMAN
FROM TEXAS, MR. POE, TO PRESIDE
OVER THE COMMITTEE OF THE WHOLE.
THE HOUSE IS IN THE
COMMITTEE OF THE WHOLE HOUSE ON
THE STATE OF THE UNION FOR
CONSIDERATION OF H.R. 1216,
TITLE.
WHICH THE CLERK WILL REPORT BY
A BILL TO AMEND THE
PUBLIC HEALTH SERVICE ACT TO
CONVERT FUNDING FOR GRADUATE
MEDICAL EDUCATION AND QUALIFIED
TEACHING HEALTH CENTERS FROM
DIRECT APPROPRIATIONS TO AN
AUTHORIZATION OF APPROPRIATIONS.
PURSUANT TO THE RULE,
THE BILL IS CONSIDERED AS READ
THE FIRST TIME.
THE GENTLEMAN FROM KENTUCKY, MR.
GUTHRIE, AND THE GENTLEMAN FROM
TEXAS, MR. GREEN, WILL EACH
CONTROL 30 MINUTES.
THE CHAIR RECOGNIZES THE
GENTLEMAN FROM KENTUCKY.
THANK YOU, MR.
CHAIRMAN.
I YIELD MYSELF SUCH TIME AS I
MAY CONSUME.
THE GENTLEMAN IS
RECOGNIZED.
I RISE TODAY IN
SUPPORT OF H.R. 1216, THE HEALTH
CARE BILL THAT SPENT OVER $1
TRILLION LAST YEAR AND EMPOWERED
FEDERAL BUREAUCRATS MORE THAN IT
DID THE AMERICAN PEOPLE.
AS A MEMBER OF THE ENERGY AND
COMMERCE COMMITTEE, I HAVE BEEN
WORKING ON LEGISLATION THAT
TAKES STEPS --
THE GENTLEMAN WILL
SUSPEND.
THE HOUSE WILL COME TO ORDER.
THE GENTLEMAN FROM KENTUCKY IS
RECOGNIZED.
THANK YOU, MR.
CHAIRMAN.
TAKE STEPS TO PEAL BACK A FEW OF
THE MANY MANDATORY PROGRAMS
INSTITUTED IN THE HEALTH CARE
LAW AND LIMIT THE FEDERAL
GOVERNMENT'S UNPRECEDENTED
POWER.
SECTION 5508 OF THE HEALTH CARE
LAW, AUTHORIZES THE HEALTH AND
TO WORK
TEACHING HEALTH CENTERS AND
APPROPRIATES $230 MILLION FROM
2011 TO 2015.
H.R. 1216 AMENDS THE PUBLIC
HEALTH SERVICE ACT TO CONVERT
FUNDING FOR GRADUATE MEDICAL
EDUCATION AND QUALIFIED TEACHING
HEALTH CENTERS FROM DIRECT
APPROPRIATIONS TO AN
AUTHORIZATION OF APPROPRIATIONS.
THIS BILL IS NOT ABOUT THE
MERITS OF GRADUATE MEDICAL
EDUCATION OR TEACHING HEALTH
CENTERS, EVERYONE AGREES THERE
ARE STRONG NEEDS FOR MORE
PRIMARY CARE PHYSICIANS IN OUR
HEALTH SYSTEM.
BUT PICKING AND CHOOSING ONE
PROGRAM OVER ANOTHER TO RECEIVE
AUTOMATIC FUNDING IS
IRRESPONSIBLE.
MAKING THESE PROGRAMS MANDATORY
SPENDING IS UNFAIR TO ALL OF THE
OTHER HEALTH CARE PROGRAMS THAT
HAVE TO BE -- COMPETE EVERY YEAR
TO CONTINUE TO RECEIVE FUNDS.
FOR EXAMPLE, AS H.H.S. SECRETARY
SAID DURING HER TESTIMONY BEFORE
THE HOUSE ENERGY AND COMMERCE
COMMITTEE EARLIER THIS YEAR, THE
PRESIDENT'S F.Y. 2012 BUDGET
ELIMINATES GRADUATE MEDICAL
EDUCATION FOR CHILDREN'S
HOSPITALS.
WHILE CHILDREN'S HOSPITALS MUST
GO THROUGH THE REGULAR
APPROPRIATIONS PROCESS TO FIGHT
FOR FUNDING, TEACHING HEALTH
CENTERS WILL RECEIVE AN
AUTOMATIC APPROPRIATION.
WE ARE A $14.3 TRILLION IN DEBT
AND OUR DEFICIT FOR THIS YEAR
WILL APPROACH $1.5 TRILLION.
CONGRESS IS MAKING DIFFICULT
DECISION ABOUTS WHICH PROGRAMS
.
TO FUND AND WHICH TO REDUCE.
WE MUST PRIORITIZE AND I FIND
IT UNFAIR THAT SOME PROGRAMS
ARE UNSHIELDED AND DO NOT HAVE
TO HAVE MERIT TO CONTINUE THEIR
FUNDING.
I URGE MY COLLEAGUES TO VOTE
YES AND RESERVE THE BALANCE OF
MY TIME.
THE GENTLEMAN
RESERVES.
THE HOUSE WILL COME TO ORDER.
THE COMMITTEE WILL COME TO
ORDER.
THE COMMITTEE WILL COME TO
ORDER.
THE GENTLEMAN FROM TEXAS IS
RECOGNIZED.
THANK YOU, MR.
SPEAKER.
I YIELD BACK THE BALANCE OF MY
TIME.
WITHOUT OBJECTION.
I RISE NOT IN
SUPPORT OF H.R. 1216.
THE AFFORDABLE CARE ACT
AUTHORIZED A FIVE-YEAR PROGRAM
TO SUPPORT A CREDITED PRIMARY
CARE RESIDENCY TRAINING
OPERATED BY COMMUNITY-BASED
ENTITIES INCLUDING
COMMUNITY-BASED HEALTH CENTERS.
THIS TRAINING TAKES BASE IN
SETTINGS SUCH AS COMMUNITY
HEALTH CENTERS.
RESEARCH SHOWS THAT C.H.C.
TRAINED PHYSICIANS, FOR
EXAMPLE, ARE TWICE AS LIKELY AS
THEIR NONC.H.C. COUNTERPARTS TO
WORK IN UNDERSERVED AREAS.
IT MAKES SURE THAT TRAINING
TAKES PLACE, WHICH IS MANDATORY
FUNDING FOR PROGRAMS HELP DO.
IT WILL HELP STRENGTHEN THE
PRIMARY CARE WORK FORCE IN
UNDERSERVED AREAS, SPECIFICALLY
THOSE THAT ARE HARD TO RUSS
TAINT WORK.
IT INCLUDES PEED AT RICKS,
GYNECOLOGY, PSYCHIATRY,
GERIATRICS.
IT'S HYPOCRITICAL FOR I OR THE
REPUBLICAN COLLEAGUES TO TAKE
AWAY THIS FUNDING.
THEY CONTINUE TO ARGUE THERE IS
NOT ENOUGH PHYSICIANS TO
PROVIDE CARE TO PEOPLE WHO NEED
THEM IN PRIMARY CARE SERVICES.
THIS PROGRAM IS DESIGNED TO
HELP ADDRESS THIS VERY PROGRAM,
BUT THEY KEEP TRYING TO HAVE IT
BOTH WAYS IN THE HEALTH REFORM
DEBATE.
THIS IS JUST ANOTHER EXAMPLE.
TODAY, THE MAJORITY IS GOING TO
SAY THEY HAVE AN OBLIGATION TO
SHARE THIS PROGRAM IS SUBJECT
TO APPROPRIATIONS PROCESS.
DUE TO THE NEED FOR
TRANSPARENCY IN OUR SPENDING
PROCESS AND CURRENT BUDGET
PROCESS.
LET ME REMIND THE MAJORITY WE
ARE NOT THE ONLY PARTY WHO'S
DIRECTED MANDATORY FUNDING FOR
PROGRAMS.
THE MAJORITY MUST HAVE
SUPPORTED AUTOPILOT SPENDING AS
REPRESENTATIVE FOXX DESCRIBED
IT, THE TEACHING HEALTH PROGRAM
WHEN THEY PASSED A
MODERNIZATION ACT OF 2003 WHICH
REQUIRED MANDATORY FUNDING FOR
TRANSITIONAL PROGRAMS.
I SUPPOSE AT THAT TIME THE
MAJORITY CERTAINLY FELT THEY
KNEW BETTER THAN THE
APPROPRIATORS THAT THE M.M.A.
WAS A WORTHY PROGRAM AND
DESERVED MANDATORY PROGRAM.
EVEN THOUGH THEY PASSED IT
UNDER THE COVER OF -- WITH A
LOT OF ARM TWISTING.
I CAN'T UNDERSTAND THE
OPPOSITION, PARTICULARLY FROM
MY REPUBLICAN COLLEAGUES, THEY
HAVE REPEATEDLY AND
INACCURATELY COMPLAINED WE DO
NOT DO ENOUGH TO PROHOTE HEALTH
WORK EXPANSIONS AND NOW THEY
ARE GOING TO CUT ARE THE HEALTH
WORK EXPANSION.
IT WILL MAKE IT CHALLENGING FOR
THESE 11 PROGRAMS THAT HAVE
ALREADY MADE THE DECISION TO
PARTICIPATE IN CONSULTATION
WITH KEY STAKEHOLDERS LIKE
TEACHING HOSPITALS AND THEIR
BOARDS AND BASED ON THAT
CONTINUING FUNDING WILL BE
AVAILABLE.
TO MOVE THIS TO DISCRETIONARY
FUNDING WILL DETER OTHERS TO
EXPAND RESIDENCY TRAINING SINCE
FUNDING OVER THE NEXT FEW YEARS
COULD BE SUBJECT TO THE ANNUAL
APPROPRIATIONS FIGHT.
THIS WILL BE A ANOTHER
POLITICAL STUNT BY THE
REPUBLICAN TO DEFUND HEALTH
REFORM.
THIS IS PLAYING GAMES TO I CAN
-- SEVERAL WEEKS AGO THEY
COULDN'T STOP TALKING ABOUT
MEDICAID, WILL BE GREATLY
IMPROVE WITH THE RYAN BUDGET
BECAUSE IT PROVIDES STATES WITH
BLOCK GRANTS UNDER THEIR
MEDICARE PROGRAM.
HOW GREAT WOULD IT BE TO GIVE
SENIORS VOUCHERS TO PURCHASE
HEALTH INSURANCE?
AND THIS WEEK WE'RE BUSY TAKING
AWAY FUNDS TO MAKE SURE WE
TRAIN PHYSICIANS TO MAKE SURE
THAT ALL AMERICANS HAVE ACCESS
TO AFFORDABLE CARE.
ONCE AGAIN, THE REPUBLICAN
MAJORITY IS WRONG IN THIS.
I RESERVE THE BALANCE OF MY
TIME.
THE GENTLEMAN
RESERVES THE BALANCE OF HIS
TIME.
THE GENTLEMAN FROM KENTUCKY.
I YIELD TWO
MINUTES TO THE GENTLEMAN FROM
PENNSYLVANIA, THE CHAIRMAN OF
THE SUBCOMMITTEE.
THE GENTLEMAN FROM
PENNSYLVANIA IS RECOGNIZED FOR
TWO MINUTES.
I'D LIKE TO THANK
THE GENTLEMAN FROM KENTUCKY FOR
HIS LEADERSHIP ON THIS ISSUE.
IT AUTHORIZES THE SECRETARY TO
AWARD GRANTS TO TEACHING HEALTH
CENTERS TO ESTABLISH NEWLY
ACCREDITED OR EXPANDED PRIMARY
CARE RESIDENCY PROGRAMS.
THE NEW HEALTH CARE LAW, HI
PACKA, PROVIDES A MANDATORY
APPROPRIATION OF $230 MILLION
FOR THIS PURPOSE FOR THE PERIOD
FROM F.Y. 2011 THROUGH F.Y.
2015.
YOU MAY RECALL THAT IN THE
PRESIDENT'S FISCAL YEAR 2012
BUDGET HE ELIMINATED FUNDING
FOR TRAINING AT CHILDREN'S
HOSPITALS.
BECAUSE OF THIS I AND THE
RANKING MEMBER OF THE HEALTH
SUBCOMMITTEE, THE GENTLEMAN
FROM NEW JERSEY, MR. PALLONE,
HAVE INTRODUCED H.R. 1852, A
BILL TO RE-AUTHORIZE THE
CHILDREN'S HOSPITALS GRADUATE
MEDICAL EDUCATION PROGRAM FOR
AN ADDITIONAL FIVE YEARS AT THE
CURRENT FUNDING LEVELS.
WHILE THE ADMINISTRATION
COULDN'T FIND MONEY IN ITS
BUDGET FOR TRAINING AT
CHILDREN'S HOSPITALS, HIPACCA
HAD AN ADDITIONAL $230 MILLION
FOR OTHER HEALTH CENTERS
WITHOUT ANY INPUT OR APPROVAL
REQUIRED BY CONGRESS.
IF IT DID THIS WITH A NUMBER OF
FUNDS, APPROPRIATIONS.
THE BILL BEFORE US TODAY, H.R.
1216, SIMPLY CONVERTS THE
MANDATORY APPROPRIATIONS TO AN
AUTHORIZATION SUBJECT TO ANNUAL
APPROPRIATIONS PROCESS.
JUST LIKE THE CHILDREN'S
HOSPITAL G.M.E. PROGRAM, MAKING
IT DISCRETIONARY.
PASSAGE OF THE BILL WOULD ALSO
SAVE $215 MILLION OVER FIVE
YEARS.
I URGE SUPPORT OF THE BILL AND
I YIELD BACK THE BALANCE OF MY
TIME.
THE GENTLEMAN FROM
PENNSYLVANIA YIELDS BACK HIS
TIME.
RESERVES.
THE GENTLEMAN FROM KENTUCKY
RECOGNIZED.
THE GENTLEMAN FROM TEXAS IS
MR. SPEAKER, I YIELD
TWO MINUTES TO MY COLLEAGUE
FROM THE ENERGY AND COMMERCE
COMMITTEE, CONGRESSWOMAN CAPPS.
THE GENTLEWOMAN FROM
IS RECOGNIZED FOR TWO MINUTES.
THANK YOU, MR.
SPEAKER.
I THANK MY COLLEAGUE FOR
OPPOSITION TO THIS RECKLESS
YIELDING, AND I RISE IN STRONG
BILL.
I CANNOT COUNT THE NUMBER OF
TIMES MEMBERS ON BOTH SIDES OF
THIS AISLE HAVE DECRIED
SHORTAGES IN THE PRIMARY CARE
WORK FORCE OF OUR COMMUNITIES
AND WORKING OFTEN IN BIPARTISAN
MANNER TO DEVELOP WAYS TO
INCREASE THE PRIMARY CARE
RANKS.
AND YET TODAY, THE NEXT VICTIM
IN THE REPUBLICAN OBSESSION
WITH REPEALING THE AFFORDABLE
CARE ACT IS A PROGRAM THAT
DOESN'T DEAL WITH THESE
SHORTAGES.
IT INCREASES OUR PRIMARY CARE
PHYSICIAN RANKS AND TRAINS THEM
WITH SPECIAL EXPERTISE IN
SERVING THE COMMUNITY.
THE BILL BEFORE US WOULD DEFUND
THIS PROGRAM, TAKING MANY
QUALIFIED AMERICANS OUT OF THE
PRIMARY CARE WORK FORCE BEFORE
THEY EVEN HAVE AN OPPORTUNITY
TO JOIN IT.
MOREOVER, CUTTING THESE
TRAINING PROGRAMS WOULD AFFECT
ALREADY EXISTING JOBS AT THE 11
COMMUNITY-BASED ENTITIES THAT
HAVE ALREADY EXTENDED THEIR
PROGRAMS TO TRAIN THESE NEW
DOCTORS.
TAKE I WAY THIS FUNDING WOULD
FORCE POSSIBLE LAYOFFS AND
WOULD HAVE A CHILLING EFFECT ON
OTHER SITES DEVELOPING THIS
TYPE OF PROGRAM.
YES, IT IS PAID FOR UNDER
MANDATORY FUNDING BUT THAT'S
NOT UNHEARD OF OR EVEN UNUSUAL.
THE GRADUATE MEDICAL EDUCATION
PROGRAM WHICH HAS HAD MEASURED
SUCCESS IN STRENGTHENING OUR
HEALTH CARE WORK FORCE IS A
MANDATORY SPENDING PROGRAM.
THE PROGRAM THE REPUBLICANS ARE
TRYING TO CUT TODAY IS SIMPLY A
COMPLEMENT TO THIS G.M.E.
PROGRAM.
FOCUSED ON COMMUNITY-BASED CARE
AND PREVENTION.
THE CHOICE ON H.R. 1216 IS
CLEAR.
IF YOU BELIEVE WE DO NOTE HAVE
A JOBS -- NOT HAVE A JOBS
PROBLEM AND WE'LL HAVE ALL THE
DOCTORS WE NEED, THEN GO AHEAD
AND VOTE FOR THIS BILL.
IF YOU THINK WE NEED TO CREATE
JOBS AND WE NEED MORE PRIMARY
CARE PROVIDERS, YOU MUST VOTE
AGAINST H.R. 1216 AND PROTECT
THIS VERY IMPORTANT PROGRAM.
WE CAN'T HAVE IT BOTH WAYS.
I URGE A NO VOTE AND I YIELD
BACK.
THE GENTLEWOMAN FROM
CALIFORNIA YIELDS BACK.
THE GENTLEMAN FROM TEXAS
RESERVES.
RECOGNIZED.
THE GENTLEMAN FROM KENTUCKY IS
I YIELD FOUR
MINUTES TO MY FRIEND FROM
TENNESSEE, REPRESENTATIVE
BLACKBURN.
THE GENTLEWOMAN FROM
FOUR MINUTES.
TENNESSEE IS RECOGNIZED FOR
AND I THANK THE
CHAIRMAN FOR THE TIME.
I THANK THE GENTLEMAN FROM
KENTUCKY FOR HIS LEADERSHIP ON
THIS BILL.
YOU KNOW, MR. CHAIRMAN, IT'S SO
INTERESTING TO ME, WE HAD A 2,7
HUNDRED-PAGE HEALTH CARE BILL
THAT BASICALLY WAS A GOVERNMENT
TAKEOVER OF HEALTH CARE.
WHAT WE HAVE HEARD FROM SO MANY
PEOPLE IN THIS COUNTRY IS GOSH,
I WISH SOMEBODY WOULD HAVE READ
THAT BILL BEFORE THEY PASSED IT
AND THE FORMER SPEAKER SAID WE
NEED TO PASS THE BILL AND THEN
WE CAN READ IT AND FIND OUT
WHAT'S IN IT.
ONE OF THE THINGS THAT MANY OF
THE PEOPLE DID NOT LIKE THAT
WAS IN THAT BILL WAS WAS MANY
OF THE MANDATORY PROVISIONS PUT
IN PLACE, PROGRAMS THAT HAD
BEEN ON THE BOOKS FOR YEARS
THAT ALL OF A SUDDEN BECAME
MANDATORY.
AND THE CONFUSING THING, MR.
CHAIRMAN, IS THERE DIDN'T SEEM
TO BE ANY CONSISTENCY.
AS THE SUBCOMMITTEE CHAIRMAN
WHO SPOKE BEFORE ME HAD SAID,
MR. PITTS HAD SAID, YOU KNOW,
YOU DON'T TEND TO -- CHILDREN'S
HOSPITALS IN THE SAME WAY, YOU
DON'T TEND TO NURSES IN THE
SAME WAY.
THERE IS THIS DISCRETIONARY FOR
TEACHING HOSPITALS, A TOTAL OF
$230 MILLION MILLION, OVER $40
MILLION A YEAR.
NOW, IT DOESN'T MATTER IF YOU
NEED THE MONEY OR NOT, IT
DOESN'T MATTER WHERE YOU'RE
GOING TO USE IT OR NOT.
THE MONEY IS GOING TO BE
APPROPRIATED.
IT'S PUT ON AUTOPILOT.
DOESN'T MATTER WHAT WE SAY IS
GOING TO HAPPEN WITH THE
GOVERNMENT IF WE NEED ARE
REDUCE IT.
THEY'RE GOING TO GET THAT
MONEY.
THAT'S WHY THIS BILL IS SO
IMPORTANT.
YOU'LL NOTICE, MR. CHAIRMAN,
THAT 2,700-PAGE BILL, WE'RE
ABLE TO DELETE $230 MILLION OF
THAT APPROPRIATION, MANDATORY
APPROPRIATION WITH THE BILL
THAT BASICALLY IS ABOUT TWO
PAGES LONG.
AND WHAT WE DO IN THIS TWO
PAGES IS RESPONSIBLY ADDRESS
WHAT THE AMERICAN PEOPLE WANT
TO SUES US ADDRESS.
THEY KNOW THAT THE FEDERAL
MANDATES ARE COSTING PRIVATE
SECTOR JOBS.
THEY KNOW THAT THE FEDERAL
GOVERNMENT COMING IN AND TAKING
OVER HEALTH CARE IS CAUSING
PRIVATE SECTOR HEALTH CARE
JOBS.
INDEED, WE HAVE STUDY AFTER
STUDY THAT IS SAYING WE HAVE
ALREADY LOST OVER A MILLION
JOBS.
IT SEEMS LIKE EVERY TIME WE
TURN AROUND, WHETHER IT IS OUR
HEALTH CARE DELIVERY SYSTEM,
WHETHER IT IS OUR HOSPITALS,
WHETHER IT IS OUR PHYSICIANS'
OFFICES, WE'RE HEARING ABOUT
THE LOSS OF JOBS TO HEALTH CARE
PROVIDERS AND IN THE HEALTH
CARE SECTOR BECAUSE OF THE
PASSAGE OF OBAMACARE, AS MANY
PEOPLE IN OUR COUNTRY REFER TO
THE BILL.
ONE OF THE REASONS WE HAVE TO
GO ABOUT REPEALING THESE SLUSH
FUNDS, MR. CHAIRMAN, IS BECAUSE
WE SIMPLY CAN'T AFFORD THIS.
EVERY SECOND OF EVERY DAY,
EVERY SINGLE SECOND OF EVERY
$40,000.
SINGLE DAY WE ARE BORROWING
WE ARE BORE -- BROING 41 CENTS
OF EVERY -- BORROWING 41 CENTS
OF EVERY DOLLAR WE SPEND.
THIS GOVERNMENT IS SO
OVERSPENT.
WE ARE SPENDING MONEY WE DON'T
HAVE FOR PROGRAMS THAT OUR
CONSTITUENTS DON'T WANT, AND
INSTEAD OF ELIMINATING WHAT WE
ARE SAYING IS, LOOK, LET'S
ELIMINATE A MANDATORY PROGRAM
AND TURN IT BACK TO WHAT IT WAS
FOR YEARS, DISCRETIONARY, SO
THAT MEMBERS OF THIS BODY BRING
THEIR DISCRETION TO BEAR ON THE
ISSUES OF THE DAY AND BRING THE
OPINIONS OF THEIR CONSTITUENTS
TO BEAR ON HOW THIS CHAMBER
SPENDS THE TAXPAYERS' MONEY.
MR. CHAIRMAN, IT IS NOT FEDERAL
IT IS THE TAXPAYERS' MONEY.
MONEY.
THIS GOVERNMENT IS JORE SPENT.
WE CANNOT AFFORD -- THIS
GOVERNMENT IS OVERSPENT.
WE CANNOT AFFORD THESE FEDERAL
MANDATES.
WITH THAT I YIELD BACK MY TIME.
THE GENTLEWOMAN'S
TIME HAS EXPIRED.
THE GENTLEMAN FROM KENTUCKY
RESERVES.
RECOGNIZED.
THE GENTLEMAN FROM TEXAS IS
I GLADLY YIELD TO
THE RANKING MEMBER OF THE FULL
ENERGY AND COMMERCE COMMITTEE,
CONGRESSMAN WAXMAN.
MR. CHAIRMAN.
THE GENTLEMAN WILL
SUSPEND.
HOW MUCH TIME DO YOU YIELD?
THREE MINUTES.
THE GENTLEMAN IS
RECOGNIZED FOR THREE MINUTES.
MR. CHAIRMAN, THERE
WAS SO MUCH MISINFORMATION
GIVEN OUT BY THE PREVIOUS
SPEAKER THAT IT'S HARD TO KNOW
WHERE TO START.
THE REPUBLICANS HAVE SAID THEY
DON'T LIKE THE AFFORDABLE CARE
ACT, BUT WHAT DO THEY HAVE TO
REPLACE IT WITH?
THEY SAY THEY'RE GOING TO
REPEAL IT AND REPLACE IT.
WHAT ARE THEY GOING TO DO ABOUT
THE UNINSURED IN THIS COUNTRY,
ABOUT THE HIGH COST OF HEALTH
CARE, ABOUT THE PEOPLE WHO
CAN'T EVEN BUY INSURANCE EVEN
IF THEY HAVE THE MONEY BECAUSE
THEY HAVE PRE-EXISTING MEDICAL
CONDITIONS?
WE HAVE NO PROPOSAL FROM THE
REPUBLICANS EXCEPT IN THEIR
BUDGET THEY WANTED TO TAKE
MEDICARE AWAY FROM FUTURE
SENIORS BY MAKING IT A BLOCK
GRANT, AND THEY WANTED TO CUT
THE MEDICAID PROGRAM WHICH CUTS
A BIG HOLE IN THE SAFETY NET
FOR THE POOR TO GET THEIR
HEALTH CARE NEEDS WHICH MEANS
PEOPLE IN NURSING HOMES WOULD
BE DUMPED OUT OF THOSE NURSING
HOMES.
BUT THE BILL BEFORE US NOW IS
TO STOP THE PROGRAM THAT WOULD
TRAIN PRIMARY CARE PHYSICIANS.
DOES ANYBODY DISAGREE THAT THE
NOTION THAT WE NEED MORE
PRIMARY CARE PHYSICIANS?
EVIDENTLY THE REPUBLICANS DO
BECAUSE AS WE HEARD FROM THE
LAST SPEAKER SHE WANTS TO MAKE
IT AN APPROPRIATED PROGRAM, NOT
A MANDATORY SPENDING PROGRAM.
WELL, SPENDING IN MEDICARE AND
MEDICAID SINCE 1965.
TRAINING PHYSICIANS SHOULD BE
ASSURED WITH FUNDING WE CAN
RELY ON.
WE CAN'T TRAIN A DOCTOR IN JUST
ONE YEAR.
DOCTORS NEED A NUMBER OF YEARS.
THEY'RE GOING TO BE ASSURED OF
THEIR CONTINUATION IN MEDICAL
SCHOOLS.
THAT'S WHY WE'VE HAD ASSURED
FUNDING THROUGH MEDICARE AND ME
CADE AND IN THE AFFORDABLE CARE
ACT, THE PURPOSE WAS TO TRAIN
PHYSICIANS FOR PRIMARY CARE IN
COMMUNITY SETTINGS.
THAT'S WHAT THE REPUBLICANS
WANT TO REPEAL AND IF THEY CAN
AFFORD IT FROM ONE YEAR TO THE
NEXT, THEY'LL PUT IN FUNDS, BUT
IF THEY CAN'T BECAUSE THEY WANT
TO GIVE MORE TAX BREAKS TO THE
WEALTHY, WE WON'T BE ABLE TO
AFFORD IT.
WITH ALL THE COSTS TO GO TO
MEDICAL SCHOOL, WE OUGHT TO
ASSURE SPENDING FOR PRIMARY
CARE DOCTORS.
I YOU REMEMBER MY COLLEAGUES TO
OPPOSE THIS BILL.
IT'S INCOMPREHENSIBLE TO ME WHY
IT'S ANOTHER EFFORT THE
WE HAVE IT ON THE HOUSE FLOOR.
REPUBLICANS HAVE BEEN PUTTING
UP TO CHIP AWAY AT HEALTH CARE
REFORL.
THEY WANT TO REPEAL IT, THEY
WANT TO CHIP AWAY AT IT, THEY
WANT TO KNOW, ARE THEY GOING
GOING TO LEAVE AMERICANS ON
THEIR OWN WITHOUT THE ABILITY
TO BUY HEALTH INSURANCE?
ARE THEY GOING TO TELL THE
ELDERLY ON THEIR OWN?
THE GENTLEMAN'S TIME
HAS EXPIRED.
THE GENTLEMAN FROM TEXAS
RESERVES, THE GENTLEMAN FROM
KENTUCKY IS RECOGNIZED.
I YIELD MYSELF SUCH TIME AS
I MAY CONSUME.
THE GENTLEMAN IS
RECOGNIZED.
THERE WERE A
NUMBER OF AMENDMENTS VOTE ON,
BLOCK GRANTS, SEVERAL GOVERNORS
HAVE COME TO WASHINGTON AND
TALKED ABOUT BLOCK GRANTING
MEDICAID TO GIVE THEM THE
OPPORTUNITY TO NOT JUST DEAL
WITH MEDICAID IN THEIR STATE
BUS WITH THE OTHER PARTS OF
THEIR BUDGET.
IN KENTUCKY, I USED TO BE A
MEMBER OF THE STATE
LEGISLATURE, AS MEDICAID HAS
CONTINUED TO CONSUME MORE OF
THE STATE'S BUDGET, IT'S HARDER
TO FUND HIGHER EDUCATION,
TUITION COSTS GOING UP BECAUSE
OF THE PIE OF MEDICAID GOING
FORWARD.
WE PASSED MEDICAL LIABILITY
REFORM WHICH SAVES THE COUNTRY
$54 BILLION.
WE'RE GOING TO HAVE A BILL
TOMORROW TO PURCHASE HEALTH
INSURANCE ACROSS STATE LINES TO
MAKE HEALTH INSURANCE MORE
AFFORDABLE INSTEAD OF MORE
EXPENSIVE ON THOSE WHO SPEND
MONEY OUT OF THEIR OWN POCKET.
ONE THING ABOUT RELYING ON
FUNDING FOR ONE YEAR, WE DO
APPROPRIATIONS FOR EVERYTHING
FROM DEFENSE TO OTHER THINGS ON
AN ANNUAL BASIS AND I WILL TELL
YOU, THERE ARE NOT PEOPLE
TURNING DOWN FEDERAL MONEY
BECAUSE YOU'RE ONLY
APPROPRIATING IT FOR ONE YEAR
AND WE DON'T WANT TO COMMIT TO
A LONG-TERM PROGRAM.
IF YOU BUY THAT ARGUMENT, LOOK
AT WHAT'S IN THE BILL.
ALL WE'RE SAYING IS WE WANT THE
TEACHING HEALTH CENTERS TO BE
TREATED EQUALLY TO OTHER PARTS
OF THE BILL.
THE ARGUMENT IS, IF YOU DON'T
HAVE THE PAM, YOU WON'T HAVE
PEOPLE PARTICIPATING, IT MEANS
THAT PEDIATRIC EDUCATION AND
TRAINING, NURSE RETENTION, 5309
SECTION, FAMILY NURSE
PRACTITIONER TRAINING, EP
DEEMOLOGY, LABORATORY CAPACITY
GRANTS, RESEARCH AND TREATMENT
FOR PAIN CARE MANAGEMENT,
TOMORROW'S PEDIATRIC HEALTH
CARE WORK FORCE, THE ARGUMENT
THAT, OBVIOUSLY THE ARGUMENT
THAT WAS MADE WAS IF WE DON'T
HAVE THE TEACHING HELL CENTERS
OEN AN AUTOMATIC FIVE-YEAR
APPROPRIATION, PEOPLE AREN'T
FWING TO PARTICIPATE IN THE PAM
AND THAT HAS TO APPLY TO THEE
DIRECTLY.
I GUARANTEE YOU, I'D BE WILLING
TO SAY THAT PEOPLE WILL BE
APPLYING FOR THESE PROGRAMS AS
THIS MOVES FORWARD.
I RESERVE MY TIME.
NO FURTHER SPEAKERS.
I RESERVE MY TIME.
THE GENTLEMAN FROM
KENTUCKY RESERVES.
THE GENTLEMAN FROM TEXAS IS
RECOGNIZED.
I YIELD TWO MINUTES TO A
CLASSMATE AND VICE CHAIR OF OUR
DEMOCRATIC CAUCUS.
THE GENTLEMAN IS
RECOGNIZED FOR TWO MINUTES.
TO PUT EVERYTHING IN
PERSPECTIVE, WE'RE TOLD THAT
TODAY WE CAN FORESEE A SHORTAGE
OF SOME 40,000 PRIMARY CARE
PHYSICIANS IN THIS COUNTRY IN
LESS THAN 10 YEARS.
WITHIN ANOTHER FIVE YEARS THAT
SHORTAGE WILL GROW TO ABOUT
42,000 TO 46,000 PRIMARY CARE
PHYSICIANS.
GRAMMING WATT
MEDICAL EDUCATION FUNDS, DOES
SOMETHING VERY SIMPLE.
IT SAYS TO SOME OF THESE
CLINICS, SOME OF THESE HEALTH
CARE POVIDERS THAT IF YOU
GUARANTEE YOU'LL MAKE GRADUATE
MEDICAL TRAINING AVAILABLE TO
OUR FUTURE DRRKS WE WILL
GUARANTEE THERE WILL BE MONEY
BEHIND THAT TRAINING SO THAT
WILL BE A CONSISTENCY SO THAT
MEDICAL STUDENT CAN FINISH
TRAINING.
WE JUST HEARD THAT THIS MONEY
THAT'S AVAILABLE TO THESE
HEALTH CARE PROVIDERS, THESE
CLINICS, SHOULD NO LONGER BE
GUARANTEED SO THE QUESTION YOU
HAVE TO ASK, IF YOU WANT TO
BECOME A PHYSICIAN AND YOU'RE
GOING TO MEDICAL TRAINING AN
CERTAINLY THE QUESTION YOU HAVE
TO ASK IF YOU'RE ONE OF THESE
CLINICS THROUGHOUT THE ENTIRE
COUNTRY WHERE YOU WANT TO TRAIN
SOMEBODY TO A FAMILY MEDICAL
TRRKS AN -- A PEDIATRICIAN, AN
ON STE SE TRIGS/GYNECOLOGIST,
SOMEONE WHO SPECIALIZES IN
JERNTOLOGY.
YOU HAVE TO ASK YOURSELF, IF I
WANT TO TRAIN SOMEONE BUT DON'T
HAVE THE FUNDS, HOW CAN I
GUARANTEE I'LL BE THERE TO PAY
FOR THE EDUCATION TO PAY THEM
BE DOING?
FOR THE WORK THEY'RE GOING TO
YOU CAN'T.
THAT'S WHY G.M.E. IS SO
IMPORTANT.
WE WERE JUST TOLD THIS IS A
SLUSH FUND POT OF MONEY.
FURTHEST THING FROM THE TRUTH.
WE'RE TOLD THAT THE -- THE REAL
TRUTH WHEN WE HEARD A SPEAKER
ON THE REPUBLICAN SAY, WE'RE
GOING TO DELETE THIS MONEY.
THAT'S WHAT'S GOING TO HAPPEN.
IF YOU DON'T GUARANTEE IT, IT'S
GONE.
WE HAVE TO MAKE SURE WE CAN
TRAIN THE NEXT GENERATION OF
MEDICAL LEADERS AND I URGE MY
COLLEAGUES TO VOTE AGAINST THIS
LEGISLATION.
THE GENTLEMAN'S TIME
HAS EXPIRED.
RESERVES.
THE GENTLEMAN FROM TEXAS
THE GENTLEMAN FROM KENTUCKY IS
RECOGNIZED.
I YIELD MYSELF ONE
MINUTE.