complications arise from amputations. they can force a veteran to return repeatedly to the veterans' administration for medical care. or what begins as a migraine may turn out to be a traumatic brain injury requiring a battering of time consumer tests. even those veterans that live near a veteran's facility find it difficult balancing their medical requirements with other demands on their time and, of course, many veterans live far away and must travel a long distance like a veteran in texas who must drive back and forth to the v.a. office in temple in what may take four or five hours. but this is not the only long road that some veterans confront. this legislation is the result of problems texas veterans brought to my attention. they said wounded veterans should not be fired after they exhaust their sick and vacation leave to receive care for injuries that a v.a. doctor says they need, that they incurred while defending our country. i agree, and they said there ought to be a law supporting our veterans, and i felt confid

she has a foot infection that has gotten so bad she has to have it amputated. that for her is a life changing event. her life is never going to be the same. she's never going to be the same person, same mother. she'll have to deal with the disability for the rest of her life just because she didn't have the money or the coverage to get some simple antibiotics that would have treated that foot infection. that doesn't make sense in the richest country in the world, but think about it from the cost perspective. i don't know how much that surgery cost, but it's in the thousands of dollars i'm sure. she didn't have the money to pay for it. maybe she got billed for it. but probably more than likely it got just sort of sucked into the unreimbursable costs by that hospital, picked up essentially by the taxpayers in subsidy for that hospital or by those people that had insurance by higher insurance rates to help the hospital compensate for people like that woman who didn't have care. we paid for that surgery. but we paid for a surgery that didn't need to happen. there's

he assisted with amputations, he helped with bed pans and sat with probably hundreds of young men as they died, wrote thousands of letters to bereeved parents. these are civil war hospitals all in washington, d.c. many of them were terrible houses. i was very moved by that and i began to work on it at the time when the iraq war was really going bad. i was very worried about the soldiers at walter reed. the guys who were coming back and i was -- i felt like there was more and more i wanted to learn what whitman had done. not that i discovered it but i stumbled on the fact that he had a brother who was an ordinary soldier who had written probably hundreds of letters to walt and to their mother in brooklyn and walt was a very, very faithful correspondent. wrote to this brother many hundreds of letters. so there was a body of correspondence. and it opened the door into the family that was a great and exciting discovery for me. so i suddenly felt that although whitman has been written about, there was -- there was this great potential story about this family, this family enduring the war

money to treat somebody said they don't get diabetes rather than paying a reimbursement for an amputation of part of a leg that is normally the result of diabetes? that is the type of change and positive health outcomes that will benefit -- that will greatly benefit consumers of medical care and make the system cheaper for everybody. thanks, guys. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> earlier today, president obama made remarks on the energy bill scheduled for debate tomorrow in the house. it would cap greenhouse gas emissions emission credits. this is about five minutes. >> >> good afternoon. right now, the house of representatives is moving towards a vote of historic proportions on a piece of legislation that will open the door to a new, clean energy economy. for more than three decades, we have talked about our dependence on foreign oil. we have seen that dependence grow. we have seen our reliance on fossil fuels jeopardize our national security. we have seen its pollute the air we breathe and in danger of ou

she was writing to her son who was a nurse dealing with amputations and walt would write her mother, i have to tell you about a soldier i saw yesterday, i cared for him his wound already has gained three he will die. he is beautiful like a god. i combed his hair, i watched him and could barely hold back the tears i am so sad. she would write back and talk about much din is $0.32 a pound and then there be a paragraph saying walt, you can write me about the soldiers, understand that you love them and it is a fascination, there is nothing wrong with that. i a understand she would encourage him and hearing that from his mother really would book him up. she would do the same thing with george you would write to her very, very frankly about what he was going through in the war. the mother, i had no idea i would come upon her and read her letters which have been ignored by many may's dollars not only ignored but it irrigated. so i feel the subject chosen the. >> you said you wrote the history of ida b. wells before you wrote the biography is that typical? how do generally do you come upon a

and as a consequence, we don't pay $30,000 for a foot amputation. all right? so there are all sorts of -- [applause] >> -- all sorts of ways that i think that we want to improve care. and that helps us manage risk. now, people are still going to get sick. and going to still be really catastrophic costs. and there have been a lot of ideas floated around in congress or the ways that we can help to underwrite some of the catastrophic care that takes place. so that would help lower premiums. i'm open to a whole range of these ideas. and one of the things -- one of the approaches that i've tried to take is to not just put down my plan and say it's my way or the highway. first of all, one of the things it turns out is congress doesn't really like you to just tell them exactly what to do. [laughter] >> i think keegan can testify to. that so it's always better to be in a collaborative mode. and to listen. but the part of the reason it's not just the politics of it, it's also because these are genuinely complicated issues. and nobody has all the right answer so what we

so there are all sorts of ways -- for a foot amputation. there are all sorts of ways to improve footca health care, andt helps us manage risk. people will still get sick, and there will still be catastrophic costs. there have been a lot of ideas floating around in congress for ways that we can help to underwrite some of the catastrophic care that takes place that would help lower premiums. i am open to a whole range of these ideas. one of the approaches i have tried to take is to not just put down my plan and say it is my way or the highway. first of all, one of the things it turns out is that congress does not like for you to just tell them exactly what to do. steve kagan can testify to that. it is always better to be in a collaborative mode and to listen. part of the reason, it is not just the politics of it. these are genuinely complicated issues. nobody has all the right answers. what we have to do is find the 80% step that everybody agrees on, things like electronic medical records that can eliminate errors and hospitals. right now, nu

as a consequence, we do not pay $30,000 for a foot amputation. there are all sorts of ways that i think we want to improve care and that helps us manage risk. now, people are still going to get sick and there are still going to be really catastrophic costs. there have been a lot of ideas floating around in congress on the ways that we can help to underwrite some of the catastrophic care that takes place so it would help lower premiums. i am open to a whole range of these ideas. one of the approaches that i have tried to take is to not just put down my plan and say it is my way or the highway. first of all, one of the things it turns out is congress really doesn't like for you to tell them that. steve can testify to that. it is always better to be in a collaborative mode and to listen. it is not just the politics of it, it is also because these are genuine the complicated issues. nobody has all the right answers. will we have to do is find the 8% of stuff that everyone agrees on like electronic medical records that can eliminate errors in hospital

costs a lot less and has far better outcomes if you put off carom to when you have to have your leg amputated. the messages about the positive aspects. wellness is definitely a positive step we can take. when the more powerful messages to emerge is the idea that your insurance company should not be able to deny treatment because your 65 years ago where a child has asthma or your of a certain age. i think hitting those refrains when your messaging to the public and talking about a, it is sending the resonates and people understand both from it making sense without it getting into the number of dollars that goes to chronic care management and could, and just highlighting the potential in terms of the wellness and cost savings. >> that is an example of the sort of approach we should have. it is not just about this condition, not just about mental health, but when you link it to diabetes, certain people are expanded greatly in giving people something, it is quicker to understand the idea. they did not -- do not think everyone knows when you say chronic care that everyone knows what's that mean --

she was writing to reyerson, who was this nurse dealing with amputations.alt wood reichert, mother i have to tell you about a soldier i saw yesterday. his wind is already being grannis and i know he is going to die. he is beautiful like a god. i watched him, i combed his hair. i can barely hold back the tears i am so sad about this. she would write back, she would talk about mountain is 32 cents a pound, and then there would be a paragraph saying, you can write me about the soldiers. i understand that you love them and it becomes a fascination. there is nothing wrong with that. i understand. she would not say i know what you are going through but she would encourage him and hearing that from his mother really bucked him up. she would do the same thing with george the would write to her very frankly about what he was going through and the war. so, this mother, i had no idea i would come upon her and that i would lead-- read her letters which have been ignored by many, many scholars. not only ignored but irrigated. in a way i felt that family, the subject sho

costs a lot less and has a far better outcomes and if you put out here until you have to have a leg amputated so i think the messages about the positive aspects of prevention and wellness is common sense we intend to reinforce and that. in terms of the coverage one of the more powerful messages to emerge through recent things is your insurance company should be able to deny treatment because you're sick five years ago or your child has asthma and so i think hitting does your friends when messaging to the public is something that resonates and people understand both from this makes sense without having taken into the number of dollars that goes to health care management and highlighting the potential both in terms of unwellness and out comes as well as prostrating. >> is an example of the approach to have which is it is not just about this condition that the swing to diabetes and expanding greatly and giving people does m.r. publicly discuss and quicker to understand the idea don't think everyone knows and is a chronic care and understanding and the more it sounds like on care management syste

there's many amputations of the civilians and a lot of trauma to the populace. and in some ways he was protected a little bit by the fact that he was the only person willing to take care of lassa fever because there's big walls around the lassa ward and even rebels were too scared to go close to that. so from there, we're going to read a little bit. the first passage is about my essentially first day at the lassa ward. and just a way of explanation, at the lassa ward was dr. conte who was the only doctor there. and then there were three nurses, amy was the head charge nurse. then we had zuri and bryan were two of the other nurses. it's the nurses that are actually running all the things. so -- so my first day at the lassa ward, which was in july of 2003. blood soaked sheets covered the unmoving bodies as the wales pierced the walls. the boy had died that morning just before i arrived. his boded spout fluid out of every orifice and former iv site. the child had drowned as the liquid quickly filled his lungs. the guard did not allow the boy's family to enter. thei

there's one woman who testified -- who had an amputation of one arm from combat. when she showed up at the doctor's office, he just assumed it was lost from something else like cancer. he didn't even think this could be a combat-related injury. we can go on and on. but we need to change the culture and change the behavior and change the resources available. that's what this bill by ms. herseth sandlin starts to do. there are about 1.8 million women veterans today to, or 7% of the nearly 24 million veterans we serve. assuming that the current enrollments remain the same, the number of female veterans who use the v.a. system will double in the next five years, making female veterans one of the fastest growing subgroups of veterans. in this environment of changing demographics, h.r. 1211 has the potential to improve health care services for women veterans. i urge my colleagues to support the legislation and reserve the balance of my time. the speaker pro tempore: the gentleman reserves. the gentleman from arkansas. mr. boozman: thank you, mr. speaker. i yield myself

who have diets do not have to wait until they are really sick and have to have arms, legs or feet amputated but take care early on. the purchasing pools that we will create under health care reform, if people have a preexisting condition, they don't get, excluded, they can participate, as well. we are going to be covering more people for pharmaceuticals, doing a better job of making sure people who will benefit from a particular pharmaceutical, whether large monthly cularge orsmall, with w. we are going to do a better job of coordinating care and providing medical homes for people as we go failure. and we're going to take examples like -- a neighboring state of senator feingold, over in minnesota, they have mayo clinic and they figured out how to provide better health care, better outcome, lower cost, than most other places in this country. they took their model, they went down to florida where costs are very high for health care and they took the mayo model in florida and ended up with better outcomes, lower costs, than florida compared to the other folks doing business in florida, providi

preventive care at a much earlier stage helps but also what helps to prevent hostile stations and amputations is to make sure that those suffering from diabetes actually are on an appropriate regime. . . have proven to be very effective and my guess is your area is likely to be, unfortunately, rising high on the list of an area that's likely to be one of the -- i think there are 133 communitieses that will have additional resources to focus on this effort. >> thank you, madam secretary and i yield back my time. >> thank you. mr. walden? >> thank you, mr. chairman. madam secretary thanks for being here today and the work that you're doing. i have some questions. like many of my colleagues i'm just starting to look through discussion draft that's out and i know that you've undoubtedly played a role in working with some members of the committee on the. so if you can help me with some of these things. is it true under the bill an employer could be subject to 8% tax even if they offer a worker an employer-sponsored health care policy? >> yes, i think that's accurate that there are some ways, if it

from part a, the hospital part of medicare and from part b, the doctor part, the surgeon part, the amputation part, the renal transplant part. and then also in part d, keeping folks from having a massive stroke hopefully by controlling their blood pressure and you spend less on the skilled nursing home part. so i think that's a pretty good bargain and a pretty compassionate way of a -- approaching things. but our democratic colleagues stood up here and said, well -- some of them tore up their aarp cards because that senior organization had the audacity to support a republican bill. and then of course they said, well why can't we have a government default plan and why can't the government come in and set the price and say, ok, you know, this is the price, this is the monthly premium for part b, the prescription drug part. and these me-market thieves will not be able to run up the price. and they even suggested that we set the monthly premium at $42 a month. fortunately, my colleagues, that amendment was defeated. and when the premium first came in from the prescription drug plans, the private