is on. >> el paso is not. el paso is one of our strongest supporters of the high-speed rail, not that they expect to see the 900 miles from houston to el paso built as a high-speed rail. it's the line from el paso to albuquerque to denver that you talk about, and they see that as a real possibility and they see the proof in the system on the t-bone that the houston to dallas would be the next debt to provide the capacity to move forward and build the el paso route to albuquerque and onto other points in the west. >> one of the things that's been fascinating in new mexico, governor richardson stepped up and did commuter rail, and there were a lot of doubts. an earlier governor had talked about doing it and was ridiculed by the press, but he stepped up and did it. and on time, on schedule. and ended up, it's been going about nine months now. it's past the 2 millionth passenger. and in a very short period of time. and one of you, i think it was mr. skancke mentioned reliable, you used the term reliable ridership

t-bone -- >> el paso isn't, but el paso is one of the strongest supporters of high speed rail, not that they expect to see the line to houston, but the line from el paso to albuquerque to denver, and they see the proof in the system on t-bone, this would be the next step to provide the capacity to build the el paso route to albuquerque and on to other points in the west. >> the -- one of the things that's been fascinating in new mexico, governor richardson stepped up and did commuter rail and there were a lot of doubts, an earlier governor talked about doing it, was ridiculed by the press but he stepped up and did it, on time, on schedule, ended up, it's been going about nine months now, it's past the 2 millionth passenger and in a very short period of time. one of you, i think it was mr. skancke mentioned reliable -- you used the term reliable ridership and predictions. i don't think anybody would have predicted in new mexico, now granted this is the same period where we hit $4 gasoline and we're a terribly rural state and people are known to travel 120, 150 miles a day to work. just t

t-bone -- >> el paso isn't, but el paso is one of the strongest supporters of high speed rail, not thathey expect to see the line to houston, but the line from el paso to albuquerque to denver, and they see the proof in the system on t-bone, this would be the next step to provide the capacity to build the el paso route to albuquerque and on to other points in the west. >> the -- one of the things that's been fascinating in new mexico, governor richardson stepped up and did commuter rail and there were a lot of doubts, an earlier governor talked about doing it, was

first, we cannot perpetuate a system in which, as you saw from mcallen purses el paso, we spend twice as much in some areas as others and don't seem to get anything in return. addressing that is going to be difficult, you cannot write down a full list of proposals today that will address it in any kind of definitive way. but we conceptually know based on the work that has been done here at the institute of health and elsewhere, the things that are most auspicious, we are trying to do as much of that as possible and perhaps just as importantly, put in place a change in the process so we can keep up overtime with an e evolving health care market. separate and apart from that, but the health reform that will be adopted at some point this year, working with senator ba h bacchus and others, medicaid savings and additional revenue, we have put on the table $635 billion and scored savings. the president indicated last week that we will be putting $200,000,000,000,000 more on the table in the near future. you can easily do the math to see that your quickly getting into the range of the sorts

not because people in mcallen, texas, are sicker than they are in el paso, not because they are getting better care or getting better outcomes. it's simply because they are using more treatments. treatments that in some cases they don't really need. treatments that in some cases can actually do people harmed by raising the risks of infection or medical error. and the problem is this pattern is repeating itself across america. one dartmouth study shows that you are less likely, -- you are no less likely to die from a heart attack and other ailments in a higher spending area than in a lower spending area. there are two main reasons for this. the first is a system of incentives where the more tests and services are provided, the more money we pay. and a lot of people in this room know what i'm talking about. it's a model that rewards the quantity of care rather than the quality of care. that pushes you, the doctor, to see more and more patients, even if you can't spend much time with each. and gives you every incentive to order that extra mri or ekg, even if it's not necessary. it's a mode

not because this area of texas is sicker than in el paso. not because they are getting better care or better outcomes, it is simply because they are using more treatment. treatment that in some cases they do not really need. treatments that in some cases can actually do people harm by raising the risk of infection or medical error. the problem is that this pattern is repeating itself across america. one part of the study shows you are no less likely to die from a heart attack and other ailments than a higher spending area than in a lower spending area. this. the first is a system of incentives where more tests and services are provided and the more money we pay. a lot of people in this room know what i am talking about. it is a model that rewards the quantity of care rather than the quality of care. that pushes you, the doctor, to see more and more patients, even if you cannot spend much time with each. it gives you every incentive to order an extra mri or a cagey, even if it is not necessary. -- ekg even if it is not necessary. it changes y

"the new yorker" which stated which is shocking of the cost of care and make dollars in taxes and el paso 30 miles down the road it was $50,000 per person under federal medicaid and el paso was $7,500 per person in. so quite remarkable. if we don't address that type of issue then the question is why is that? because of malpractice insurance, over testing, kinds of medicine but i think we should talk about that. >> if you read that article is a culture of the excess with respect to the provision of care. i have been thinking if the way this willow go in this once in a generation time where congress gets it right with respect to the broad aspect of reform that have been discussed, and then the time created for those implementation activities it to take place, that becomes the critical time for those of us were mental-health advocates come and knock on wood, but we will have reform and parity will be included, but we think. so to keep a fresh eye on reform but that creates a playing field for change. then it seems the message of wellness and prevention becomes, in a sense come a sweet spot f

, texas and he found mcallen texas the costs were about double what they are in el paso. i think there are a number of things that we can do. i think there's some things that this bill would do that would help change those disparities. i think the promotion of comparative effectiveness research is very important in getting that proliferated as substantially as possible not precluding a doctor from, you know, making a clinical decision but at least providing guidance to the physician and to the patient, i think that's very important. so i think there are some things that can be done which i think will reduce this wasteful spending that occurs in too many places. one last thing, and that is -- >> it's going to be your last thing. >> the chairman wanted to us gavel us down here. we'll have to cut you off there. >> i don't know if he wanted to jump in on your question. he looked like he wanted to jump in on your response. >> the microphone. >> just very briefly. with respect to the cost of care and i think we really need to focus in on that, there's so many things that commun

not because people in mcallen are sicker than they are in el paso. not because they're getting better care or getting better outcomes. it's simply because they're using more treatments. treatments that in some cases they don't really need. treatments that in some cases can actually do people harm by raising the risk of infection or medical error. and the problem is this pattern is repeating itself across america. one dartmouth study shows that you're less likely -- you're no less likely to die from a heart attack and other ailments in a higher spending area than in a lower spending area.

i don't know if you've seen el paso school system. for 12 years they had an exercise program in it. 6 their drug usage is down about 30%, their dropout rate is down about 25% rate. their graduation rate is way up. their grades are way up, their testing is way up and their college attendance is way up. through -- and it can all be directly attributed to a mandatory you will kper stiez if you go -- exercise if you go to these schools. so the neurosciences are starting to figure out if you exercise a child, they learn about 20% to 30% more because you have just flushed their brain with oxygen and the nutrients that create new neurons and synapses. >> great. >> so we're build building a walking path. if you don't teach someone to do it, it's not a good -- it's a stimulus, but it doesn't accomplish the goal. i'm wanting to put brakes on that money to see if we put the money somewhere else. what i should have been offering is an amendment to eliminate this money and go the other direction. >> i was looking the other day. don't hold me exact

for half of that time, i was border patrol sector chief, first in mcallen, texas, then in el paso, texas. as the only member of congress with a background in border enforcement, i'm keenly aware of the invaluable work these brave men and women perform for our country each and every day. we have a lot to thank them for. in these times of heightened security, the u.s. border patrol and those agents are not only vital in helping to protect our country from terror threats and illegal entry of drug, but they also apehend and deter human smugglers and bring them to justice. oftentimes, these agents are the first people to respond in humanitarian situations in the desert by providing first aid, food, water, and shelter to people who have goten in trouble because of the heat and the distance that they're forced to travel in remote areas. border patrol agents perform countless rescues every year and provide critical training to law enforcement both at home and abroad. mr. speaker, the u.s. border patrol is vital to our homeland security -- 30 seconds? ms. sanchez: i yield the gentleman 30 seconds

i used to play light my fire in el paso back to back with a bridge over troubled waters. i could be in my car and across the golden gate bridge by the time that play finished. >> rob: you also need to take a bathroom break and play a long song. >> johnny: two minute records went to five minute and six minutes. here we have a 2-2 ballgame. phillips at 1st base. >> rob: did you ever meet grateful dead? >> johnny: sure. garcia. >> rob: deadhead. me and my wife. that's when i knew i loved her. >> johnny: nix goes down swinging. >> rob: here's macdougal challenging him. nice pitch there. >> johnny: talking about getting the job done. the bullpen is really, the last 16 ballgames, 2.7 era for this bullpen. down from 6.65 the first 40 games of the year. macdougal delivers to hernandez having to play 1st these days. >> rob: you want to time his home plate. >> johnny: phillips at 1st. 1-2 ballgame. hernandez, 1-0. macdougal for the stretch. >> rob: beautiful. 95 miles per hour heat. that helps. >> johnny: started outside and came right back across the corner of the plate. >> rob: w

my colleagues to swing by sweet water, texas, it's on i-20, it's an easy drive from fort worth or el paso, 300 miles either direction, to see this museum and get a player of for what these women en-- flavor for what these women endured during training. it was in a pretty rough part of texas and you'd be impressed with what they did and what they accomplished. additionally i would like to thank air force major nicole who worked tirelessly to secure this tribute for the service of these women. the major was a thunderbird pilot, the thunderbirds are the -- two more minutes. ms. ros-lehtinen: i yield an additional two minutes to the gentleman from. the speaker pro tempore: the gentleman is recognized for an additional two minutes. mr. conaway: thank you, madam chairman. the thunderbirds are the elite performance team for the air force and nicole was a member of that team in the early 1990's. as a test pilot from err -- from her letter, as a test pilot, no one understands this legacy better than her. as she explained in her letter to me, i'm convinced that every opportunity i've been afforded

look at el paso schools.ey put an exercise program in there that has dropped bmis, dropped the dropout rates, raised education, decreased drug use, and increased graduation rates. just through exercise because the new neuroscience today says that you learn 20% more if you've been exercising before you go into class. but we ought to incorporate all of that, all of the incentives to help us do what we want to do. but we haven't taken the time to listen. we've said, we've got to be on this schedule. so my appeal to you is, i honor you for your desire. you have the same desires i do. how we get there is very different. i would remind you of the three tenets of medicine. listen. they'll tell us what's wrong. if it's been done, don't do it again. and, for god's sakes, don't do any harm. thank you, mr. chairman. >> thank you very, very p much, senator. >> thank you very much, mr. chair. it is a real honor to be here in this marble hall addressing the question of affordable, accessible health care for every single am

you mentioned el paso, he had vermont. i don't know if they're working or not. maybe they are. but let's get the experts out there and see if they really are working and if they are, then let's promote those and evaluate those. we evaluate everything in this bill. that's another reason we do annual appropriations so we can look at these things and evaluate them. third on this idea that we're -- we've got to put everything in one agency, that's why we set up this public council. because all the different departments, we're trying to get everybody involved in prevention and wellness across the spectrum from department of agriculture to the department of treasury and everybody else. that's why we set up a public council so that all of these departments are thinking about this. so we do -- so that's why we have annualappropriations. that's why we have evaluations so we can get the metrics. i agree with you. i think we ought to put more in public education. i think we should. hopefully we can begin to put more money out there. but again, the cdpc, the centers for disease and prevent

are senior corporal normal smith of the dallas police department, officer see czar arreola of the el paso department, lieutenant alexander of the corpus christi police department, sergeant randy white, harvey of the lubbock sheriff's department and now we add the name of henry canales of the houston police department to that hallowed role of honor. all americans should recognize the profound debt of gratitude we owe our law enforcement officers and the gratitude we owe their families. into he is officers put themselves into harm's way to guard our safety because they care about our communities and the people they serve. they are the ones standing between us and the bad guys every single day. so tonight we bid farewell with humble gratitude to senior officer henry canal he is and to his wife and his children we say, may the lord bless you and keep you, may his face shine upon you and be gracious to you, may he lift up his countenance upon you and give you peace. and that's just the way it is. and i want to thank the gentleman from idaho and the chairman for yielding time and with that i yi

and they could cause them to go to the terrorist side and send them to el paso. and then in a year, that will be the evil gitmo. and then they will end up in a county jail. until they are back home on the terrorist battlefield, they will recruit based upon that holding facility. it's a ridiculous argument saying you have to close guantanamo because it becomes a recruiting tool for leffion worth. mr. king: the reputation of gitmo is something created by the liberal news media and moveon.org people. chancesr that criticism is untrue. people were waterboarded at gitmo, not true. but the public believes it did. if there is a rumor out there, if you want to call this an urban legend that exists about something, do we go and eradicate it because there is a rumor? i don't understand what the criticism was of gitmo was. they had to go somewhere. it's a humane thing to do. no, waterboarding didn't take place at guantanamo bay, but evil people reside down there. and they aren't innocent people that randomly were picked up. these are not goat hearders, but evil people whose

critically ill medicare patients received almost 50% more specialist visits in mcallen, texas, than in el paso, and were more likely to see so 10 or more specialists, why? there's a different approach to care and that is providing more care, providing more surgical procedures, etc., doing more tests, that were not necessarily warranted. you have another area like where the mayo clinic is up in rochester, minnesota, where that dominates the scene. they have fan as itically high levels of this. but it's medicare spending is in the lowest 15% of the country. $6,000 per enrollee in 2006 which is $8,000 less than for mcallen, texas. i bring that up to say that in u.s. it is part of what you're describing, access -- patients need access to these tests but we also need to make sure that physicians and nurses and all medical specialists are getting the information they need to make sure that quality is what we're driving here. and you're dealing with just issues of insurance or just issues of defensive medicine, you're not necessarily driving quality but you're driving more test. i yield back. mr. kir

for medicare patient treatment in that town in texas was $15,000 a year while the average cost in el paso -- and chicago, i might add -- was right at $10,000 a year. why did it cost 50% more to treat a medicare patient in mcallen, texas. he sat down with doctors because he knew what to ask and the first answer was "defensive medicine," because the lawyers will sue us. and another say, wait, that is not true. texas has the toughest medical malpractice law in america limiting pain and suffering recovery to $250,000 and this doctor went on to say and said nobody is suing us around here. it is not about defensive medicine. if it is, it is a tiny part of it. many of the doctors in the community -- and hospitals -- are ordering more procedures than are needed. if you are a patient, or the parent of a patient you are not going to question it when a doctor says, i think we need an m.r.i -- are you going to say, doctor, are you sure we need an m.r.i.? you trust his judgment and that judgment can be very expensive. because the trkts in that town are motivated by more procedures, more billing, more