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   Frankly, we have the complete opposite picture from what we wanted to bring to the floor of the House. First of all, about a year ago, doctors at the AMA convention indicated they wanted

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   Frankly, I think we have a responsibility to put this bill forward. But the Committee on Rules, the Republican Committee on Rules knew what they were doing when they added the Coburn amendment and the Cox amendment to prevent something the bill doesn't do anyhow--force a physician to join a union. That is not in the Bill--plain and simple. The Supreme Court just 48 hours ago just indicated to this Congress that the right to an abortion is the law of this Nation however the Coburn brings up unnecessary anti-choice provisions. Why we have this legislation in this way in order to undermine the very good bill offered by the gentleman from California (Mr. CAMPBELL), of which I am a cosponsor, I do not know.

   Mr. Speaker, I support the ranking member's proposal that we defeat the previous question and allow a redrafting of this rule to eliminate the Cox amendment and to offer the Greenwood amendment, to get on with the business that health care providers need to serve the people of America's health needs.

   Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Texas (Mr. PAUL).

   (Mr. PAUL asked and was given permission to revise and extend his remarks.)

   Mr. PAUL. Mr. Speaker, I rise in strong support of the rule. It is an imperfect rule, but this bill needs to be brought to the floor.

   H.R. 1304 is the only bill that I have seen in the last 3 years, probably in the last 30 years, that would move us in a proper direction for health care in this country. For 30 years now we have moved in the direction, not toward socialized medicine, we do not have socialized medicine, we have a mess. We have a monster we created called ``medical management.'' But we have moved toward corporate medicine.

   Who are the greatest opponents of H.R. 1304? The HMOs and the insurance companies.

   All we are asking for here is a little bit of return of freedom to the physician, that is, for the right of the physician to freedom of contract, to associate. We are giving no special powers, no special privileges. Trying to balance just to a small degree the artificial power given to the corporations who now run medicine, who mismanage medicine, who destroyed the doctor -patient relationship.

   Mr. Speaker, this has given me a small bit of hope. I am thankful the leadership was willing to bring this bill to the floor tonight. We should go through, get the rule passed, and vote on this. This is the only thing that has offered any hope to preserve and to restore the doctor -patient relationship.

   We need this desperately. We do not need to support the special corporate interests who get the money. The patient does not get the care. The doctors are unhappy. The hospitals are unhappy. And who lobbies against this? Corporate interests. This is total destruction of the doctor -patient relationship.

   All we want to ask for is the freedom to associate and the freedom to contract. If they do not want to become a union, doctors do not have to. They had the power to become unions in the 19th century, but under ethical conditions they did not. Nobody tells doctors that they have to, if we remove this obstacle.

   Mr. HALL of Ohio. Mr. Speaker, I yield 2 1/2 minutes to the gentleman from New York (Mr. NADLER).

   Mr. NADLER. Mr. Speaker, this bill is one of the most essential pieces of legislation I have seen in the last several years, and I commend the gentleman from California (Mr. CAMPBELL) for the work he has done to bring it to the floor, and I condemn the underhanded actions of the Republican leadership of this House in allowing poison pill amendments to put those of us who think this bill essential in a quandary in supporting it.

   Mr. Speaker, I will talk more during the general debate about why this bill is essential, but the gentleman from Texas (Mr. PAUL) hit it on the head. An HMO comes into town, signs up the employers, controls all the health care, controls all the patients, and says to the doctors: sign on the bottom line. Take it or leave it.

   If they do not want to have to treat 20 patients an hour, 5 minutes apiece, if they think it requires more time to give them decent treatment, too bad. They do not have to sign up with us; we will get plenty of doctors who will not have such scruples.

   The bill authored by the gentleman from California will enable the doctors to get together and say: no, we need time to talk to our patients and we need time to do proper services.

   Mr. Speaker, this is profoundly in the interests of the patients of the United States. This is easily as important as the Patients' Bill of Rights in destroying the tyranny the HMOs have taken over the doctors and patients in this country.

   But then we have the Coburn amendment made in order as a poison pill with one purpose and one purpose only. Nothing to do with abortion. That is the fig leaf. The real purpose of this amendment is to get people to vote against the rule and vote against the bill who otherwise would vote for it.

   The real purpose of this amendment is to get people who would vote against the insurance interests and for patients' rights, which is what this bill is about, to put them in a quandary so they cannot do it.

   Mr. Speaker, I urge that Members vote against the previous question so that we can rewrite the rule. If the previous question motion is passed, I will reluctantly vote for the rule and hope that we can then defeat the Coburn amendment. Because this bill is as important a bill as any bill we have seen on this floor; and we should not allow a leadership that does not dare get up and say its real purpose, that we are beholden to the insurance companies and we do not want to serve the patients of the United States, we want doctors to be slaves to the insurance companies, so let us hide behind the fig leaf of an extraneous issue. We should not hide behind that issue.

   Mr. GOSS. Mr. Speaker, I yield myself such time as I may consume only to point out to the gentleman that the real purpose of me being here is to pass this rule, and I appreciate his help.

   Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Ohio (Mr. BOEHNER), the chairman of the Subcommittee on Employer-Employee Relations of the Committee on Education and the Workforce.

   Mr. BOEHNER. Mr. Speaker, I thank the gentleman from Florida (Mr. GOSS) for yielding me this time.

   Mr. Speaker, we all know this is a very difficult bill. I congratulate my colleagues on the Committee on Rules for doing the best they could with a difficult situation. But I say to you, Mr. Speaker, you can put lipstick on a pig, but it is still a pig.

   We have problems in our health care system, and I think all of us know it. There are ways to address these problems, such as the Patients' Bill of Rights that we are working on in conference today. There are other things that we can do. But this, I would argue, will destroy our health care system.

   What protection are we giving our Nation's patients when we take away their health insurance because of increasing costs? What other group of Americans have we ever exempted from our antitrust laws that were created over 100 years ago to stop the big steel trusts, to stop the big oil trusts? We put those antitrust laws in place to prevent consumers from being harmed.

   What we are doing here is we are exempting one group of Americans in our health care system, one group of Americans to go out and to negotiate on whose behalf? Come on, they will be negotiating on their own behalf. That is why the Congressional Budget Office and others have talked about the tremendous increase in cost that will result if this bill is passed.

[Time: 21:45]

   So, Mr. Speaker, let us quit kidding ourselves. This is a bad solution to a problem that does exist. There are better solutions. Let us defeat the rule, send this bill back to committee and go home and visit with our constituents over the next week.

   Mr. HALL of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman from New York (Mrs. MALONEY).

   Mrs. MALONEY of New York. Mr. Speaker, I thank the gentleman from Ohio for yielding.

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   Mr. Speaker, I rise reluctantly in support of the rule. I regret that the amendment of the gentleman from Pennsylvania (Mr. GREENWOOD) was not placed in order. He should have the right to bring his amendment to the floor and have it fully debated.

   I am very much opposed to the Coburn amendment. The Coburn amendment is a transparent and deceptive attempt to politicize the debate on the underlying bill. The Coburn amendment is not just an anti-choice amendment, which I believe would be defeated in this House, would be definitely defeated in the Senate, and vetoed by the President, it is unconstitutional according to the court decision yesterday. But its real role in this debate is to bring down the rule so that this body does not have a chance to debate and vote for and hopefully pass the very thoughtful Quality Health Care Coalition Act of the gentleman from California (Mr. CAMPBELL).

   The bill of the gentleman from California (Mr. CAMPBELL) deserves to be debated on this floor; therefore, I support this resolution. The bill is a very creative attempt to empower doctors to make medical decisions for their patients.

   This bill has been before this Congress for 3 years. It has over 220 cosponsors. There have been hearings on it, markups. The committee voted favorably by a vote of 26 to 2. Time and time again, this leadership has brought bills before this body on which there have been no hearings, no committee, and no amendments allowed.

   This time, the gentleman from Oklahoma (Mr. COBURN) and this body have played by the rules, and we deserve a vote on his bill before this House.

   My colleagues do not have to support the bill. If they do not like the bill, then do not vote for it. But to be fair to our colleague, let us pass this rule and allow a vote on his bill.

   If we do not vote for this bill, this rule, it will not get to the floor for a vote. Patients, doctors, and the health care system are depending on it. Let us bring the Campbell bill to the floor and fully debate it fairly.

   Mr. GOSS. Mr. Speaker, I yield 1 minute to the distinguished gentleman from Montana (Mr. HILL).

   Mr. HILL of Montana. Mr. Speaker, I thank the gentleman for the time; and as a cosponsor of the bill, I stand here in support of the bill and support of the rule. We need to pass this rule tonight because it is the only way that we are going to get a chance to vote on this bill.

   Now, this is surely a controversial issue. Should doctors be able to bargain collectively on an equal footing with the insurance companies. I happen to think they should.

   An earlier Speaker said we have never exempted anybody else from anti-trust laws. But the truth of the matter is we did. When we passed McCarran-Ferguson, we gave special provisions to the insurance industry that they use today.

   Now, we have been debating HMO reform for over 2 years. Everybody says doctors, not bureaucrats, doctors, not adjusters, but doctors ought to be making medical decisions that impact their patients. Well, tonight, here is my colleagues' chance to empower doctors to be making those kind of medical decisions. But the only way we are going to do this is to pass this rule.

   Now, if my colleagues oppose the amendments, defeat the amendments. Let the House work its will. But let us pass this rule, let us give the bill a chance, and let us support the rule and support the bill.

   Mr. HALL of Ohio. Mr. Speaker, how much time do I have remaining?

   The SPEAKER pro tempore (Mr. SHIMKUS). The gentleman from Ohio (Mr. HALL) has 6 minutes remaining. The gentleman from Florida (Mr. GOSS) has 9 minutes remaining.

   Mr. GOSS. Mr. Speaker, I am totally ambivalent about the rotation here. We are prepared to go.

   Mr. HALL of Ohio. That would be fine, Mr. Speaker.

   Mr. GOSS. Mr. Speaker, I am pleased to yield 2 minutes to the gentleman from Florida (Mr. WELDON), a distinguished doctor .

   Mr. WELDON of Florida. Mr. Speaker, I thank the gentleman from Florida for yielding to me, and I rise in support of the rule and support of the underlying piece of legislation.

   I, too, am an original cosponsor of this bill. In the general debate, I hope to be able to elaborate further on my experience in this particular arena. I do have some real experience, and it is underlying my strong support for the bill.

   But one thing I want to just amplify on, and the gentleman from Montana (Mr. HILL) really covered this very nicely, but he was very, very pressed for time, there are some people going around saying this is going to unfairly tip the playing field, this Campbell legislation.

   Mr. Speaker, the field is not level. The gentleman from Montana just explained that to us. This Congress passed legislation that tilts the negotiations and strengthens the hand, I think, excessively of insurance companies. This legislation I believe is going to take a situation that is like this and level it out.

   Regarding the issue of the amendment of the gentleman from Oklahoma (Mr. COBURN), I happen to personally feel that the gentleman from Oklahoma is very well intentioned, and his concerns, I think, are legitimate. I happen to personally believe his concerns are most likely not necessary, but the language in his amendment I find to be acceptable. I intend on supporting his amendment.

   I would encourage all of my colleagues on both sides of the aisle to support the rule. We have amendments allowed under the rule that would allow people on both sides of this issue to cast their vote in good faith and then ultimately get the final product up for a vote.

   Support the rule and, of course, support the underlying bill.

   Mr. HALL of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania (Mr. HOEFFEL).

   Mr. HOEFFEL. Mr. Speaker, I thank the gentleman from Ohio for yielding me this time.

   Mr. Speaker, I rise in strong support of the Campbell bill and, accordingly, in strong support of motion to defeat the previous question by the gentleman from Michigan (Mr. CONYERS).

   The gentleman from Michigan (Mr. CONYERS) would allow us to avoid this outrageously rigged rule that is designed certainly to scuttle the Campbell bill. The Campbell bill is desperately needed. We have a situation where doctors are put into a very unfair situation, unable to negotiate on a level playing field with the large HMOs and managed care companies.

   The Campbell bill will stop the arbitrary, unfair, one-sided contracts that the managed care companies are offering to doctors.

   I listened intently to the gentleman from Iowa (Mr. GANSKE) a few minutes ago. He got one fact wrong. He said that the largest managed care company in Philadelphia is controlling 50 percent of the market. They are actually controlling 62 percent of the market, growing every day. That large managed care company recently offered orthopedic surgeons in the Philadelphia area a 40 percent pay cut. That kind of arbitrary activity is unacceptable.

   The Campbell bill will allow collective bargaining and allow doctors a level playing field, not just to improve their fee agreements, but to avoid the kinds of changes in their medical practices that managed care companies often demand.

   They want to impose gag rules on doctors so they cannot discuss their treatment options. They want to discourage appropriate referrals. Companies want frequently to block appropriate tests and delay care. They want to grant financial rewards to doctors for not giving care.

   Those things must be stopped. They can be stopped through appropriate negotiations. But first we must pass the Conyers motion to defeat the previous question.

   Mr. Speaker, I urge a yes vote on that motion.

   Mr. GOSS. Mr. Speaker, I yield 2 minutes to the distinguished gentleman from Pennsylvania (Mr. GREENWOOD).

   Mr. GREENWOOD. Mr. Speaker, I thank the gentleman for yielding me this time.

   Mr. Speaker, I am very conflicted by the vote on this rule.

   As has been referenced, I took to the Committee on Rules last night an amendment to amend the amendment of the gentleman from Oklahoma (Mr. COBURN) because I have a difference of

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   The Committee on Rules denied me the opportunity to bring my amendment to the floor this evening, and I do not like that. My normal inclination when the Committee on Rules denies me one of the few amendments that I take to the Committee on Rules is to oppose the rule. That was my inclination.

   However, the gentleman from California (Mr. CAMPBELL) has been made a promise, and that promise is that his bill would be debated on the floor. I think he deserves it. He worked hard to have his day, his night on the floor, and I think he is deserving of that.

   More importantly, there are thousands and thousands of physicians across this country who have felt frustrated by the present situation and whether we agree with their position or not, whether we agree with the position of the gentleman from California (Mr. CAMPBELL) or not, they went to the United States Congress, and they said, ``Please debate this issue. We think it is deserving of the greatest deliberative body on earth. Please take our issue to the Congress and have a debate.'' If this rule is defeated, imagine all of those physicians all over the country saying the Congress does not work.

   We are frustrated. We get a bill. We get over 220 cosponsors on the bill; and for something to do with abortion, we are not even allowed to have our issue debated after all of these years.

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