the extraordinary cooperative attitude and work not just of the leadership of the committee but the staff and also the members  today before i talk about the specific ease of the bills before us i want to comment on an oversight hearing that mr blown held in his subcommittee last week on the reform act as you well know and remember because you were such an integral part of that first time that we've reauthorized and i at that time thirteen years would now be fifteen years it was what i consider to be the milestone of my brief tenure as chairman of this very prestigious committee during that hearing last week dr so who's the current director of the united stated that the united form act is working in a letter that he sent to both you and to me he specifically stated and i quote kind of trouble that nobody can afford that's why we work so hard in the last congress to counter the tendency to politicize disease specific research we both believe that scientists not politicians and not advocates should figure out how to best maximize our limited resources for medical and scientific research you supported that goal then and you continue to support that goal today it's unfortunate but in inevitable that we continue to see a surge in disease specific funding proposals i understand that and so does everyone in this room today we all get elected as members trying to help people and we all feel the same pain when someone comes in with some terrible tale of woe about a specific disease that in their opinion is not being given the proper priority in the current current system so many of us myself included want to say yes i'll help what can i do we end up signing on the co sponsors of these many bills thanking at the time that sure it's a noble goal but probably nothing is going to happen if we continue to do that that leads us back to the bad old days when special interest muscle n scientific merit dictated where the research dollars go we make everything a priority that means in reality that nothing is a priority mr chairman i hope as we go through this market today and markets in the future that will remember the goal the reform act in the last congress goal that so far in this congress you and i both continue to support but that being said let's take a look at the eleven bills that we're going to mark up today sixty four sixty nine the or transplant act of two thousand and increases authorize funding for the r and transplant network this provides coordination between individuals in need of an organ transplant and donor organs made available from deceased donors support we support the increase of federal funding for this program which currently only represents seven percent of the operating costs senate seven hundred sixty the healthy start reauthorization act reauthorized the healthy star program this service provides special services to the needs of high risk pregnant women infants and mothers in geographically racially ethnically ethnically and linguistically diverse communities with exceptionally high rates of infant mortality this is an important program and we support its passage h r fifteen thirty two the comprehensive tuberculosis elimination act revises the national strategy to combat to tuberculosis at the c d c c d c provides leadership and assistance to domestic and international efforts to prevent contro and eliminate tuberculosis this bill will go a long way towards eradicating that  twenty nine ninety four the national pain care policy act enhanced his awareness of chronic pain with providers in the community chronic pain is an issue that many people suffer from this bill would create an inner agency coordinating committee to coordinate all efforts within h h s and other federal agencies related to paying research h r fifty to sixty five the paul wellstone muscular dystrophy dystrophy community assistance research and education amendment act that's a mouthful reauthorizes the existing c d c effort towards muscular dystrophy i'll just call that paul wellstone mr chairman and support of the bill's effort to  reauthorize and improve the existing muscular dystrophy registry the myth free families and community act reauthorize is a grant program which is administered by the substance abuse and mental health services administration this is a this is a needed piece of legislation and will go a long way towards helping combat that disease this bill updates the law by directing the agency to expand intensify and coordinate efforts to provide p p w family base treatment for methamphetamine addiction h r ten fourteen a heart disease education and analysis research and treatment or heart act for women provides help to those women who are struggling suffering from heart stroke or other cardiovascular disease h r sixty three fifty three the ryan hate online pharmacy consumer protection act prohibits the delivery distribution or dispensing of controlled substances over the current law allows plans to restrict or limit coverage of services and benefits so long as a action or limitation is applied to all similarly situated insured this bill provides that if a plan or insurer decides to restrict or limit coverage or benefits under the plan it must describe those restrictions and limitations to the persons prior to their enrollment in the plan that seems to me to make just plain common sense and finally h r seven fifty eight the breast cancer patient protection act allows patients who are seeking a msec to me or breast conserving surgery or lymph node dissection for the treatment of breast cancer to not less than a forty eight hour hospital stay provided that visitation finds that the length of stay is medically necessary furthermore the bill seeks to protect the insurer from losing their coverage when insurers finds that he or she did not disclose information on the insurance application about a treatment or condition unrelated to the treatment or condition for which the benefits are being sought to samit mr chairman is one which i brought to your attention and i'm very appreciative of you included in your manager's amendment i look forward to the  we appreciate that mr chairman these eleven bills have in most part almost total support of members not only of this committee but a majority of the house of representatives  they are an example of what can be done when we work across the aisles on a bipartisan basis mr chairman we look forward to a swift market today and passage of all eleven of these bills thank you for your leadership on these important legislative is deal as well as yourself and mr barton if you look at this list i mean i know there's not a lot of fanfare today but these really are important bills and it's to the testimony of the committee members who you know spend their time with their staffs and coming up with this legislation which is you know for the most part addressing some very important issues that the country faces so i always i know that we're doing everything by consensus today and that's certainly the way to do it but it doesn't in any way take away from the importance of this legislation and so i would urge obviously that that we move forward and we're going to try to get these bills as you said not only passed in the senate but signed by the president that's the whole point here is a gentleman from georgia  over the past several months members and staff from both sides of the aisle have engaged in a constructive debate which i believe ever resolve it in considerable improvements to many of the bills which will be considering today these piece of legislation aimed to address a wide variety of concerns regarding the public health of our nation as you know many of these bills support bolstered funding for the national institutes of health to aid in the development and treatment of diseases which americans across our nation battle each and every day while giving in greater flexibility to allow science to direct its research objectives in two thousand and six congress was able to pass legislation which empowers and i each to improve scientific research into these health issues and i'm pleased to see that these bills support this go and i'm not taking us in a step backwards to the ways great congressionally mandated research or deny which was the pattern of the past additionally will also consider several bills would seek to improve the ability of americans to access private health insurance benefits and to ensure that patients receive medically appropriate treatment based on decisions made between the patient and the provider not large insurance companies motivated by profit driven factors by requiring insurers to provide clear explanations of which items and services may be excluded from coverage we will be ensuring that patients are not presented with an unfortunate surprise in the face of the health care crisis this is a improvement but much more needs to be done i intend to offer an amendment to h r seven fifty eight the breast cancer patient protection act which seeks to correct an unfair situation affecting an increasing number of americans my amendment would work to protect thousands of self pay breast cancer patients and those with high deductible insurance policies from unfair health care pricing practices with over forty seven million uninsured individuals and an increasing number of patients electing to participate in alternative health care financing means and also with an increasing number of individuals who are seeing that they are mandated into policies with high front and adoptable this is a necessary step to ensure that all americans have the tools necessary to make better decisions about their health care again i'm encouraged by the bipartisan nature of the process that have moved these bills to this point and i believe that if we work together we can reach satisfactory compromises on these bills and others that we will deal with in the five co sponsors bipartisan the majority of the members of this full committee are co sponsors of the bill and i'm working with mr barton and i hope that we can  iron out the small differences that he sees right now there are one out of five adults that are suffering from arthritis in the country so this is a widespread and debilitating disorder  more than three hundred thousand children suffering from it this number is greater the number of children with juvenile diabetes unfortunately our country has a severe shortage of pediatric r s with only two hundred thirty nine of them nationwide and eleven states not having even one not even having one arizona wyoming montana south dakota north dakota south carolina i don't know arkansas maine vermont and alabama only has one and none in the district of columbia so mr barton let's get together today and see if we can't make this as part of the package that will be of bills that will be taken up next week because i believe that this is something that needs to be addressed for the people of our country as members i just want to add this as members we give loan reimbursements to staffers in our own offices so i think it's good enough for members of congress and our staff that it's good enough to do to produce the the doctors for our country who are going to care for these children so thank you for recognizing me and mr barton i look forward to working with you to clear out what concerns you and make this part of the package next week and with that yield back and thank you mr chairman for taking up the bills that are being taken up today i think they represent real achievement for this committee and most importantly for the people of our country gentleman from thank you mr chairman i'd like to thank you and also chairman barton for working with me over the past couple of years on legislation that aims to save our health care system money and more importantly save lives unfortunately not in legislation it's on our docket today and although there's many worthy bills here there's others it could have been put before us so would have saved a lot of lives lot of money as we've discussed many times the past i continue to remain committed to ensuring that hospitals report healthcare acquired infections the federal government and i'm concerned that many times they resist doing so this issue is too important be ignored and i'll continue to fight until we are all working to save lives as chairman dingell and ranking member barton my colleagues know i've been working and will continue to work on h r eleven seventy four the he hospitals act we cannot afford to lose another hundred thousand people from these infections we're not marking up this legislation today again i think both of your personal commitment to work on this issue and your insurance assurance that work together future to make public reporting infections a law since i began this effort back in the pennsylvania state legislature seeing the number of cases nationwide of possible infections rise the financial strain on the health care system continues to increase and most of serving we have seen hundreds of thousands of lives lost i'm gonna do states are eleven seventy four the healthy hospitals act as a jumping off point of this legislation off the reporting solutions tract infections i continue to work with hospitals the majority minority staff find a good policy and we've recently offered another version that would use the c d c and i want to thank take this opportunity think the hospice ocean of pennsylvania for endorsing this draft legislation and look forward to continue to work with them because that's what this is all about not villainize in hospitals but improving patient here and saving lives and rest assured for those who feel they don't want to report their infection rates they don't want patients to know the risk that they may face or in hospitals i'm going to continue to work until i find a solution and this problem is solved to date as of today for this year alone there have been one million two hundred fifty four thousand seven hundred ninety four cases there's been sixty two thousand one hundred five deaths and hospital court infections have cost our health care system thirty one billion three hundred sixty nine million eight hundred sixty three thousand and twenty three dollars how can we not be committed to this cause how can we let people continue to delay this legislation and most importantly how can we ignore the fact that come through when people pay attention to these rates they actually make incredible changes in my home state of pennsylvania has been shining example after example of hospitals that once they began to focus on these infection rates they have actually found some ways of making their infection rates go down to zero and save massive amounts of money in the process that when the pennsylvania state legislature signed their act into law they require this we found that hospitals were paying more attention for all their staff to wash hands sterilize equipment and follow approach infection control procedures when that is not done as it happens in many places around the country lives are lost we are facing some important changes next month when medicare an beginning of october one it will no longer pay for hospital acquired infections that's a good move my suggestion is in the future we not only say that ha the hospitals will no longer be reimbursed for infections but will no longer being reimbursed for any subsequent hospitalizations related to that infection we have to do something to get the attention of the health care industry to say this is intolerable particular because it can be prevented possibles in pennsylvania or in the business saving lives and i pleased that they have done so and have shown example there are other states as well that of they have shown this and other hospitals across the nation but i don't want to see is that some hospitals are taking these great steps to eliminate possible quite infections while others are not and that's why i believe universal standards of transparency themselves can look this up are important think of this again whether it's an airplane accident or a train accident is something occurs and there are some lives lost many federal agencies and hundreds of people swarmed the sites to see what happened what went wrong and that maybe a loss of perhaps twenty five or hundred lives here we're talking about one hundred thousands here we're talking about two hundred fifty today we ought to be able to do something to save this and i thank chairman barton and chairman dingell for working with us together to make sure that this committee fulfills its mission the health care area and works of saving lives and saving money and with that i thank you very much mr chairman in the interest of time and efficiency as submit my statement for the record let me just thank you let me just say mr chairman that the amendment renames the bill the stephanie tubbs jones organ transplant act of two thousand and eight in honor of our dear departed colleague who was that committed advocate of organ transplantation and was an organ and tissue donor herself upon her passing mr chairman she was able to continue to serve her constituents and the nation by donating her tissue and organs and this is really in memory of her the ranking member of the committee accurately summarized the bill which authorizes more money which is desperately needed by the public health service act with respect to making progress toward the goal of eliminating to regulus and for other with the chair notes the gentleman from texas mr green has a substitute and rather of an amendment in the nature of a substitute the clerk will report the amendment and then in the the this bill the comprehensive t v elimination act of two thousand and seven the house has already passed one international this would deal with our domestic and i could give the whole statement but since we have a vote on i'll be glad to try to answer questions via members have the amendment will specify authorization levels and better match six structure of the pain care policy act with the n h reform act as to avoid duplication or confusion i want to create graduate my colleague congressman mike rogers for his partnership on this we have ten minutes to get to the floor and given the fact it's got a little arthritis of his own we're going to take the time it'll take to get here the chair to note that members may have opening statements they'd like to inserted into the transcript notes without objection that will be done in a proper fashion the chair wants to say the members for their patience on this matter share notes it is fifteen minutes after the systems research and education amendments of two thousand and eight clerk court the bill h r five two six five a bill to amend the public health service act to provide for research with respect to various forms of mr chairman for holding this mock up today on so many good public health bills and i'm grateful that today we are marking up h r five to see five which is the paul de well stone muscular dystrophy community  education amendments of two thousand and eight today we have over one hundred twenty bipartisan co sponsors many of whom serve on our energy and commerce committee muscular dystrophy is a genetic disease which results in progressive degeneration of skeletal muscles and other organs notably the heart there are nine muscular dystrophy is affecting over three hundred thousand individuals in the us the most least lethal is duchenne muscular dystrophy which affects one in every thirty five hundred boys and there is no cure upright or two thousand one there were few resources directed towards research and development of therapies and care models for those afflicted with muscular dystrophy to address this issue the muscular dystrophy community assistance research and education amendments of two thousand and one was introduced congress overwhelmingly supported the legislation but unfortunately the authorization for this work expired back in two thousand and six that's why we're doing this today the law specified a number of provisions for expanding and intensifying research on muscular dystrophy these efforts included the establishment of six scientific centers of excellence the creation of a muscular dystrophy coordinating committee to  plans for supporting research education and muscular dystrophy and expansion by the centers for disease control and prevention into epidemic dimia logical activities regarding muscular dystrophy the reauthorization of the pole the will stone m d care amendments officially names the centers of excellence the poles the will stone muscular dystrophy cooperative research centers in honor of our former colleague the late and great senator wellstone in addition it ensures that data collection at c d c is updated regularly with it a requirement for regular reports to congress the bill also requires the agency for health care research and quality to work with appropriate medical or patient organizations to finalize an initial set of care considerations and for c d c to disseminate that information to targeted audience audiences i thank congressman burgess who is sponsoring this with me and once again i will be very very brief this is something that congresswoman cuban and i have worked on extensively i'm sorry she's not here today and we've worked with our prevention and treatment experts and i respect of states and on the national level and the provisions in this bill reflect what the professionals have told us of the greatest needs in their field it's an important first step to show that congress is committed to a comprehensive fight against methamphetamine epidemic that is not just limited combined that seven million was just three point eight million in two thousand and eighty percent increase in just six years in the abuse of prescription drugs a large number of individuals are taking these prescription drugs already internet through rogue internet pharmacies purchasing drugs online without a valid prescription can be simple a consumer just types in the name of the drug into a search engine quickly identifies a site selling the medication fills out a brief questionnaire and then clicks on the purchase the risk of self medicating however can include potential adverse reactions in appropriately prescribed medications dangerous drug interactions use of counterfeit products and the addiction to habit forming substances seven of these illegal sites failed to provide information about potential adverse side effects effectiveness of the drug and even where they are located in two thousand and four g a o report government accountability office study obtained sixty eight samples from eleven prescription drug for eleven for eleven different prescription drugs each from a different web site geo found that forty five online pharmacies provided a prescription based on their own medical questionnaire and had no prescription requirement mung the drugs geo obtained without a prescription were those with specially safe with special safety restrictions highly addictive narcotic painkillers the tragic case of ryan white whose mother has testified before congress is nationally known ryan died at the age of eighteen from an overdose of painkillers including vika and he ordered the internet without a legitimate prescription while he was a seventeen year old minor ryan height on line pharmacy consumer protection act would bear the sale would bar the sale or distribution of all controlled substances via the internet without a valid prescription in order for prescription to be valid must be issued by a practitioner who is licensed and whose conduct at least one person examination of the patient sixty three fifty three would also require our online pharmacies to clearly display on their websites a statement of compliance with u s laws and regulations this would allow consumers to clearly identify which pharmacies are safe and which are not legislation also creates a new federal cause of action that would allow a state attorney general to shut down a rogue site selling controlled substances in any state and increasing penalties for all illegal distributions of controlled substances classified as schedule three four and five substances this legislation is supported by the administration including the f d a the chain drug stores go daddy e bay federation of state medical boards and a fraternal order medical medical education and henchmen act of two thousand and seven were reports of title of the bill h r two five eight three a bill to amend title seven without objection a further reading of the bill concept that this committee i'm grateful to you and the ranking member for allowing this committee to address the growing problem we're going to have in the arena of the physician workforce many americans are growing older we have problems with reimbursement with our physicians and as a consequence our supply physicians is growing smaller and this is one of the areas where we should be putting some attention and some financing and this bill will least allow us to open the discussion for that and move a little bit in that direction and i really want to thank congress and matheson for working with me on this bill this bill will assist small hospitals that sort of rural or growing areas providing them with financial resources to establish a residency training program for high need medical specialties in medically underserved areas we need to increase the number of doctor we also need to make sure they practice where they are needed we should develop a residency but we need to develop residency training programs away from the urban centers in the areas where doctors are actually needed doctors are not terribly imaginative and we tend to practice where we train we don't move very far from from our training site we tend to get married locally we tend to stablish for referral patterns locally and hence we stay in the communities in which we train h r twenty five eighty three will help smaller in emerging communities to attract medical by placing medical residents he's there help attract physicians to the residency programs and thereby encourage those residents those doctors who graduate those residency programs to establish their practice in their area this bill establishes an interest free loan program for eligible hospitals to establish residency training programs and over the period of its authorisation should operate at little or no cost to the american taxpayer to qualify hospitals would need to have secured a preliminary accreditation by the american council on graduate medication or the ale way and have not had a residency training program in the past these loans would go to pay the salaries or benefits for residents salaries of faculties and any other cost directly attributable to the residency training program response to concerns raised during discussions on this bill and the energy and commerce committee staff member office staff have worked together in a bipartisan manner to address certain areas of concern as a result of these conversations negotiations the amendment offered today will modify the list of eligible specialties to focus on public health require the administrator to give preference for making loans to hospitals located in rural areas and clarify that the loan funds may only be used for direct cost associated with the residency training program and not the administrative costs of the hospital  additional establish certain penalties of the residency training program is terminated and stipulated that the cumulative annual dollar amount of loan may not exceed two hundred fifty thousand dollars also the men will revise the authorization period to five years and eight million dollars for fiscal y and ten and a five percent increase each year thereafter so i believe we have reached an acceptable compromise and again i want to thank mr matheson and his staff for working with with my staff so closely i know mr garner worked on the are ten fourteen the heart for women act on the docket for today this amendment makes changes that were carefully negotiated with both majority and minority staff as well as the stakeholders and i've been very proud to work with congresswoman barbara cuban from wyoming on legs on this legislation to improve the treatment of heart disease in women and we've been doing working on this since two thousand and six it's been nearly a year and a half since we held a hearing on h r ten fourteen and a whole lot of work since then has gone on to get this built to where it is today we now have two hundred thirty six bipartisan co sponsors including the majority of members on this committee i'm proud to say it has also been a priority of the congressional heart and stroke coalition and also the women's caucus both of which i'm proud to be co chair the cart for women act addresses the existing gaps in the way we approach cardiovascular disease in women as well as in minority populations r ten fourteen focuses on three components education research and a combination of diagnosis and treatment most people simply don't know that heart disease is the number one killer of women which is why an educational campaign is such a critical part of this bill both health care providers and the general public need to be better educated on the way heart disease manifests itself in women the second component of h r ten fourteen is diagnosis and treatment we need to make sure that women can be screened and diagnosed before they ever experience serious symptoms of heart disease since two thousand the c d c s wise woman program has been highly successful screening tool for reaching low income and at at risk  women we've it's been a pilot project and we've seen the number of sites increase to twenty states but with this bill we can expand that to more states and reach greater numbers of women early detection leads to early treatment and these are the keys to survival and i would add to cost containment finally h r ten fourteen addresses research by ensuring that the data collected on new drugs and devices is analyzed so that we can know how they work differently in patients of different se or ethnicity we know that the same treatments that work extremely well in certain populations may not be effective at all in others health care providers and patients need to have access to this information so they make the best decisions in determining their courses of care i want to thank the american heart association women heart and the society for women's health research for their role in preparing this legislation i would also like to thank virgil miller of the energy and commerce committee for his diligent work to bring this bill to where it and obviously i think work does for five minutes for that purpose and obviously want to thank you and the ranking member for allowing this bill to be considered today with our other public health bills in january two thousand and one the department of labor the i r s to the health care financing administration issued a ruling accordance with the health insurance portability and accountability act of one nine hundred ninety six that was designed to guard against discrimination in coverage of the group health market while addressing the issue of discrimination based upon participation in certain activities these rules allowed continued health plan nonpayment based on the source of injury this resulted in a situation where some people who paid their premiums and believe they would be covered by their plans were actually responsible for paying their own medical treatment because the exclusions were not clear or were very broad the lack of clear underlying these exclusions has created a situation for individuals who may ride motorcycles horses snowmobiles are part spate and other activities that could result in injury millions of americans enjoy these activities safely every year within the framework of state laws and utilizing proper safety precautions earlier this year congressman stupak and i introduced h r ten seventy six to restore fairness and equity to this situation in response to concerns raised during discussions on this bill house energy and commerce staff and my staff and the staff with of mr stupak have worked together in a bipartisan manner to address the areas of concern as a result of these conversations and negotiations we've now reintroduced our original encapsulate these principles h r sixty nine zero eight the health insurance source of injury clarification act would number one require that any limitations or restrictions on health plan benefits be explicit and clear number two that require that they be disclosed to the sponsor of the group health plan in advance of the point of sale to the good of the group health plan and number three require that the issuer of the health insurance coverage make available to participants and beneficiaries in an easily understandable manner a description of the limitations and restrictions upon their enrollment this legislation is supported by the american motorcyclist association the american council snowmobile association the horse council the motor american recreation coalition american trails and on and on it is i think a worthwhile amendment is that it is a at attempt to correct something that really was completely unintentional and an intentional and should have been corrected some time ago and i'm grateful to the committee for allowing its consideration i'm grateful to m from michigan bunch of us chairman i'll be brief but i'd like to strike the last word for five minutes this year with this legislation there's one simple thing it requires health insurance companies to be upfront and honest with their policyholders when they place limitations and restrictions on insurance benefits prior to the point of sale of the policy currently because of the way regulations were set up many americans were unaware their health insurance may not cover injuries resulting from certain recreational activities because their policy is unclear or very broad this lack of clarity has created a confusing situation for individuals that may ride motorcycles horses snowmobiles participate in other recreational activities while americans millions of americans enjoy these activities safely every year when the vigil is injured they often do not find out that their insurance they often find out their insurance will not cover their medical expenses and tell it's too late sixty nine zero eight would require that any limitations or restrictions on benefits be explicit and clear insurance companies would be required to make available to participants and beneficiaries in an easy understandable manner a description of the limitations and restrictions included in their insurance policy by passing the straightforward legislation we're protecting our constituents that may ride motorcycles horses snowmobiles or participate in other recreational activities from being caught by surprise when they thought their policy covered any possible injuries that may have to at any point the chair now recognizes my good friend the gentleman from texas mr barton for the purposes of reporting there of offering a member which the clerk will offered because of a situation that occurred in my congressional district recently a young woman who will remain anonymous had to  quit a job in which she had coverage under a group health insurance plan to go out of state to take care of her parents who were ill she took out a private insurance plan w a well recognized health insurance company went out of state to take care of her parents continue to pay the premiums her parents recovered she came back to texas went to work in  a business that didn't have group coverage so she maintained her private insurance on her own health she went for a routine examination and discovered she and her doctor that she had breast cancer when they tried to schedule the msec to me the insurance company instead of approving the procedure begin to ask all kinds of questions they finally poring through records that were years old found that several years before she had been treated for hypertension and for a brief period of time taking a blood pressure medicine or hypertension was no longer evident and she had stopped taking the medicine years before but in her application she failed to disclose that at some point in time she had been treated for hypertension when the insurance company found this out they cancelled a policy this is a woman who's had breast he has breast cancer and needs an immediate msec to me according to her doctor in desperation to see this woman call my covered under medicaid and went in for another examination and her doctor said not only did she have breast cancer but she might it might have metastasized into her stomach so when i found this out i called the president of the company and appeal to him to reinstitute this woman's insurance coverage to his credit he said he would personally look into it and the appeal that i made was if you find out that her in admitted and omission of this information about having hypertension in the past is not directly related to her breast cancer i ask that you reinstate this woman's insurance and he said that he would do that and to his credit he checked and discovered that what i had said was true the woman was said to me was true so he did reinstitute the coverage so what this amendment does if it passes the committee and passes the house and passes the senate and becomes law will never again will any person in this country have their insurance their personal insurance health insurance can canceled because of an inadvertent omission about a preexisting medical condition that is not directly related to the diagne this amendment does not preclude cancellation because of intentional fraud or misrepresentation it simply says that if something happened to you years before and you forget it because you've recovered from it to declare it on your application for a private insurance policy and discover later on that you have some life threatening disease like this woman has breast cancer the insurance company came on a technicality cancel your health insurance policy i think it is a worthy amendment the health insurance industry claims they don't oppose it although they have said they have some technical problems with it and they victims of price gouging at the hands of health care providers that seek to exploit people without health insurance coverage by charging them hundreds or thousands of percents more than they would charge insured patients with the exact same service not surprisingly an overwhelming ninety three percent of americans believe they have the right to know the price and quality information about their healthcare providers before making a help decision this being so in the absence of a comprehensive transparency memo like this to every disease as if it bill in the future as we move to protect these vulnerable patients from price gouging at the hands of some unscrupulous health care providers i want to clarify that i don't think all providers are doing this but it is critical that we have done a five those who engage in this pricing on fair pricing practice imagine a situation where you're traveling on vacation you need a room for the night would you stay in a hotel that refused to tell you anything about the room that you were going to stay in and refused to let you know how much the room was going to cost and only found out the price and when they send you a bill some six weeks later what if the hotel across for you had much nicer rooms at a less than half the cost would you like to know that as well but why should health care be any different if one hospital charges several thousand dollars more for the same procedure shouldn't the consumer have access to this information if you're paying for it out of your pocket and i think you want to know that and i that a recent visit to one of the largest hospitals in my district and administrators stated that one of their biggest concerns was that ninety percent of their self pay patients which are mainly patients who are without health insurance never paid for the services they received of course after listening to the following example i'm sure you would find this statistic is not really very surprising a close friend of one of my staffers who also works for a member of congress recently had to spend the night at a major university affiliated hospital here in d appendectomy because his insurance claim wasn't filed properly and he was treated as if he were a self paying patient he received a bill in the mail for a little over nineteen thousand dollars just for the room he stayed in for one night that's right nineteen thousand dollars just for the room not counting the appendectomy or other medical procedures after calling the hospital to explain the processing ery found that his insurance company was only built for twenty one hundred dollars for his room because they negotiated a right with the hospital if my friend had had had been uninsured or ease insurance plan would not have covered the room he would have been financially responsible for nearly twenty thousand dollars just for the hospital room for a one night stay and he wouldn't have known about it until he received the bill in the mail a few weeks later after he left the hospital knowing this it makes sense that about ninety percent of all self pay patients never play their hospital bills and that studies attribute nearly two million bankruptcies to medical bills each year if this hospital would be required to disclose the fact that it charges nearly twenty thousand dollars for a night in their hospital any self pay patient should be able to comparison shop and found a hospital or elder health care provider that would only charge him abraxane of this insanely over inflated calls it simply doesn't make any sense to charge people that can't afford health insurance or choose to play some or all of the procedures out of  pocket so much more for the exact same procedure and we need to stop allowing this to happen the uninsured and those with high deductible insurance policies deserve to know what prices they're going to pay and i believe that these patients have access to meaningful and understandable pricing and quality information providers would no longer be able to get away with this injustice as we see in many other areas empowering costume consumers increases the level of quality while driving down inefficiencies and waste it is my hope that we can do the same thing in the healthcare arena i would remind this committee that we held a hearing on transparency in this committee back in march of two thousand and six but we have not seen fit to act on it i think it is time for us to get serious mr deal's offering here is so vitally important we have transparency in many areas i mean it's odd to think that one can go online and compare prices of anything airline tickets and travel and rental cars just about any product imaginable except those that are most valuable to us and that's our own health it will be great when we have a day when one can look and compare quality measures for health care centers for  costs for transparency and on so many safety and quality measures and it really is essential when we look at those who whether they are insured or uninsured if you have someone who's paying out of their own pocket for them to have to get on the phone call or on the hospitals to find out if they can afford health care and hospitals say well we can tell your doctor say we can't tell you what we charge it's absolutely amazing to me and yet when we do look at some of these records i don't think anybody can make any sense out of some hospital bills where they may have massive rates there  and then when patients try and review their bill afterwards it's tough for them to find out if they were charged correctly or overcharged so to be able to find out for every patient but particularly those who are paying out their own pocket so that they can compare prices so they can compare that with quality and safety that's vitally important we're going to drive down health care costs it's something that we ought to insist and demand and i hope that some of this committee acts on thank you very much i yell back needs to be refined and perfected in is my understanding that the appropriate time in this market he's going to withdraw it having said that he brings to the table a very worthy concept and a very necessary reform when the committee becomes serious about reforming our health care system nothing can be more important than applying transparency to the process of pricing  i challenge any member of this committee to independently go and try to compare prices on procedures and be able to work with any kind of definition  certainty at all get reliable information about what certain procedures might cost if they were to electively pursue those procedures i cannot understand why the health care community or some in the health care community oppose the concept of mr deal's amendment and at the appropriate time i think that we will be able to agree on language not just for this  but in a much broader range that will help us in the health care reform activities that were going to be necessary at some point in a very near future for the committee to undertake so with a gentleman you i'd be happy to you i thank the gen yielding i had another personal incident to illustrate the importance of this with a former staffer within my own office the young man who just wanted to have a routine physical here in d c he would call offices and ask them how much is it going to charge me to do a routine physical and the answer was well who's paying for it what difference does it make who's paying for it as to how much a routine physical cost will the difference is that insurance companies paying for it is going to be substantially less than what you're willing to reach in your pocket and pay in cash for now that makes a mockery out of what we have heard from many indian surance in the health care delivery system that reasons for price inflation is the feeling out of paperwork for private insurance companies and filling out paperwork for government programs when somebody is willing to pay for it themselves there is no such paperwork so why would they be the ones that pay the very highest price for health care services there is something very suspicious about that kind of environment now i realize that this is an issue that there is a division of opinion about although i quite frankly have difficulty understanding why there would be and because i feel very strongly that the amendment that mr barton has attached to this bill is of great importance to the overall delivery of health care in this country i'm not going to insist on this amendment today and i don't because i understand that if i were to do so that probably the entire bill would be withdrawn from consideration of this committee but i challenge this committee to give serious thought to this issue because i don't think we can in good conscience talk about health care reform until we shed the light of day on the pricing and on the quality of care and the results from medical procedures that are taking place across this country the public deserves to know all of those things and i would hope that we could work in a bipartisan fashion to advance those issues they are critical to any significant reform of our health care system in this country and at this news was to make this observation members have been cooperative and decent in the handling of the business of the committee today we showed by going we can be bipartisan around this place and we member and also our good friend mr pope has worked very hard and the other members of the committee who have worked very hard i want to commend the staff on both sides performed a remarkable service to the committee we have twelve bills first of all without objection authorized to make the necessary technical corrections and problem of getting these bills on the floor with the log jam in the last the last hours days minutes which would urge my colleagues to speak to the leadership which they might have a concern