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Continuing Coverage of Tom Price Confirmation Hearing. Aired 1- 1:30p ET
Aired January 18, 2017 - 13:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PRICE: Senator, I believe that the metric ought to be the care that the patients are receiving...
WARREN: So, I take that as a no?
PRICE: I -- it's -- it's the wrong metric. We ought to be putting forth the resources...
WARREN: I -- I'm not asking you whether or not you think if you have a better metric. I'm asking you a question about dollars. Yes or no?
PRICE: What we ought to do is put forward the resources...
WARREN: ... really simple questions. And frankly, the millions of Americans who rely on Medicare and Medicaid today are not going to be very reassured by your notion that you have some metric other than the dollars that they need to provide these services.
You know, you might want to print out President-elect Trump's statement, "I am not going to cut Medicare or Medicaid," and post that above your desk in your new office because Americans will be watching to see if you follow through on that promise.
Now, I also would like to follow up on Senator Franken's question. I think there was something there that didn't quite get answered. As you know, Congressman, one -- the one goal of the Affordable Care Act was to push the healthcare industry to provide higher quality care at lower cost. And under the ACA, Medicare was recently allowed to change the way that it pays hospitals for hip and knee replacements to something called a bundle. And that means Medicare pays a set price for the care associated with hip and knee replacement and then the hospitals, not Congress, will decide the most effective implants, reduce second surgeries, better fight infections, how to spend their money to deliver better service at higher cost.
Now, I supported this change because the research shows that it really means you get better care at lower prices. But I know the policy is controversial because it affects how hospitals are paid, which in turn affects how much money the manufacturers of these hip and knee replacements can make. And one of the companies is the company raised by Mr. Franken -- Senator Franken, and that is Zimmer Biomet. They're one of the world's leading manufacturers of hips and knees and they make money if they can charge higher prices and sell more of their products.
The company knows this and so do the stock analysts. So on March 17, 2016, you purchased stock in Zimmer Biomet. Exactly six days after you bought the stock, on March 23, 2016, you introduced a bill in the House called the Hip Act that would require HHS secretary to suspend regulations affecting the payment for hip and knee replacements. Is that correct?
PRICE: I think the BPCI program to which I think you've referred I'm a strong supporter of because it keeps the decision making...
WARREN: I'm not asking you about why you support it. I'm just asking. Did you buy the stock and then did you introduce a bill that would be helpful to the company you just bought stock in?
PRICE: The -- the stock was bought by a direct -- by a broker who was making those decisions. I wasn't making those decisions.
WARREN: OK. So you said you weren't making those decisions. Let me just make sure that I understand. These are your stock trades, though. They are listed under your name. Right?
PRICE: They are made on my behalf, yes.
WARREN: OK. Was the stock purchased through an index fund?
PRICE: I don't believe so.
WARREN: Through a passively managed mutual fund?
PRICE: No, it's a broker...
WARREN: To an actively managed mutual fund?
PRICE: It's a brokered directed account.
WARREN: Through a blind trust? So let's just be clear. This is not just a stock broker, someone you pay to handle the paperwork. This is someone who buys stock at your direction. This is someone who buys and sells the stock you want them to buy and sell.
PRICE: Not true.
WARREN: So when you found out...
PRICE: That's not true, Senator.
WARREN: Well, because you decide not to tell them, wink, wink, nod, nod, and we're all just supposed to believe that?
PRICE: It -- it -- it's what members of this committee, it's the manner in which members of this committee...
PRICE: But it's -- it's important to appreciate that that's the case. WARREN: Then, I want to understand. When you found out that your broker had made this trade without your knowledge, did you reprimand her?
PRICE: What I did was comply...
WARREN: (inaudible) that she made it.
PRICE: What I did was comply...
WARREN: Did you fire her? Did you sell the stock?
PRICE: What I did was comply with the rules of the House in an ethical and legal and above board manner and in a transparent way.
WARREN: All right, let's just stipulate...
ALEXANDER: Time has expired, Senator Warren.
WARREN: I believe Senator Murkowski went over by two minutes. Did I misread the clock here?
ALEXANDER: By two minutes?
WARREN: I think that's what it was. And I just burned another 15 seconds.
ALEXANDER: Well, keep burning them and you'll be up to two minutes.
WARREN: OK. So your periodic transaction report notes that you were notified of this trade on April 4, 2016. Did you take additional actions after that date to advance your plan to help the company that you now own stock in?
PRICE: I'm offended by the insinuation, Senator.
WARREN: Well, lemme just read what you did. You may be offended, but here's what you did. Congressional records show that after you were personally notified of this trade, which you said you didn't know about in advance, that you added 23 out of your bills, 24 cosponsors.
That also, after you were notified of this stock transaction, you sent a letter to CNS calling on them to cease all current and future plan mandatory initiatives under the Center for Medicare & Medicaid Innovation. And just so there was no misunderstanding about who you were trying to help, you specifically mentioned...
ALEXANDER: Your two minutes are up, Senator Warren.
ALEXANDER: Thank you. Senator Warren. Who's next?
Senator Isakson, has three minutes.
ISAKSON: I wanted to reclaim my remaining three minutes by just making a point. I respect everybody on this committee tremendously. I respect the nominee.
But its very important for us to all (ph) understand under the disclosure rules that we have and the way it operates, any of us could make the mistakes that are being alleged.
I'm sure Senator Franken had no idea that he owned part of Philip Morris when he made the statement he made about tobacco companies. But he has a WisdomTree Equity Income Fund Investment, as disclosed in his disclosure which owns Philip Morris.
So it's entirely possible for any of us, to have somebody make an investment on our behalf and us not know where that money is invested because the very way it works. I don't say that to in any way, embarrass Mr. Franken.
But to make a point, that any one of us who had mutual funds or investment managers or people who do that, it's entirely possible for us not to know. And to try and imply that somebody's being obfuscating (ph) something or in other words, denying something that's a fact, is just not the fair thing to do and I just wanted to make that point.
PRICE (?): This is different than mutual funds.
ISAKSON: Its -- its in investment in Philip Morris.
PRICE (?): Right.
WARREN: And my question was about what do you...
ALEXANDER: Senator Warren, your time -- your -- your time has been generously.
No, I'm sorry, Senator Hassan?
HASSAN: I'm -- I'm happy to lead but I think Senator Cassidy was next. And he just came back in.
ALEXANDER: He did, but I was going back and forth. I'll be -- I'll be glad to -- do you...
HASSAN: Well, thank you...
ALEXANDER: ...that's generous of you, but.
HASSAN: All right, well then thank you.
And Congressman Price, thank you for being here this morning.
Mr. Chairman and Ranking Member Murray, thank you for the opportunity to participate.
As you and I discussed, Congressman, we share a concern for patients. My husband and I have two kids and our adult son, at times, has had up to 10 doctors and a couple of dozen medications.
So the Hassan family knows the strengths and the weaknesses of our healthcare system very, very well. And as governor, I was pleased to work with members of both parties to build on the example that Senator Young talked about in Indiana, to have a bipartisan New Hampshire specific Medicaid Expansion plan that's providing coverage now to over 50,000 hard working granted stators (ph).
And so I've seen the advantages of the Affordable Care Act and the flexibility that the Affordable Care Act gives states, right up close and work with the Republican legislature to -- to pass it. So its that context that I bring this series of questions.
First of all, as we talked about, opioid overdose deaths have been on the rise for several years and have hit New Hampshire particularly hard. We have about the second highest rate of drug overdose deaths in the country.
Under the Medicaid Expansion program that I just talked about, made possible only by the Affordable Care Act, thousands of New Hampshire citizens are getting the opportunity to get treatment for substance use disorder.
And I talked with one of them last week, a woman named Ashley (ph) who had had an addiction for almost a decade. Medicaid Expansion gets passed under the Affordable Care Act, she got treatment and she is now in recovery.
And after a year on Medicaid, which by the way we've done it in a particular way so that it's actually strengthened our insurance market in New Hampshire because more insurers came in as a result of the way we did Medicaid Expansion.
Anyway, she's not working and she's just switched over to private insurance because she's got employee -- employer provided insurance. So you have proposed repealing Medicaid Expansion in the budget that you proposed.
So yes or no, can you guarantee that you will make sure that Americans with substance use disorders who've gotten insurance through Medicaid Expansion, just like Ashley (ph) did, will not lose their health insurance?
PRICE: I think that, joined our conversations well and the -- and then subjects that we delved into, I think that it's absolutely imperative that we, as a nation, make certain that every single individual have access to the kind of mental health and the kind of substance abuse challenges that they have.
HASSAN: Well, so is that a guarantee that you -- that you will find funds to actually provide the treatment?
PRICE: It's a guarantee that I'm committed to making certain that we address that need which is so vital and important across this land.
HASSAN: So I'm just concerned that you're not going to be able to back up that guarantee if the Affordable Care Act is repealed, and I'm concerned about the impact that will have on states and people like Ashley who need the coverage.
I also just want to talk about whether you agree that people with health insurance should have some very basic essential coverage like check-ups at the doctor's office, do you think health insurance coverage should provide for that?
PRICE: I think that, as we mentioned, with choices for patients to be able to select the kind of coverage they want instead of someone else decides for them. It's so very important that we remember that at the center of all of these discussions is a patient and the patient knows best what he or she needs.
And that's the imperative that I would bring to you that I'm committed to making sure that patients have the choices available. And if they chose to select that kind of coverage then they ought - that ought to be available for them.
HASSAN: But if insurance companies don't offer it at all, like substance use disorders - so an essential benefit under the Affordable Care Act now requires private insurers to cover substance use -misuse treatment, they didn't use to do that.
They also have stopped covering a lot of things until the law requires them to. So yes or no the Empowering Patients First Act repeal - would repeal the requirements that insurance companies cover substance use disorders?
So do you think that's still a good thing?
PRICE: I think that what's a good thing, again, is to keep the patient at the center of all of this and make certain that we're providing the kinds of options and choices for patients so that they can address their clinical and medical needs.
HASSAN: But here's the thing, if insurance companies never offer it, they don't have the option. They can pay good premium dollars but it's just not offered. And the Affordable Care Act said to the insurance industry, here's some basic things you got to offer so that, when a patient needs care, the coverage is there and they can get the care.
And your answer and the Empower Patient Act would take that insurance away, it's not an option if insurance doesn't cover it.
PRICE: The good news for you is that as an administrator, if I'm privileged to serve in the capacity, that I follow the policies that are adopted by the congress of the United States and signed by the president.
And so we look forward to working with you to make certain that those kinds of things are covered and those patients receive the care that they (inaudible).
HASSAN: And with respect, there's been lots of opportunity to make certain that those things happen and until the Affordable Care Act was passed it never happened and people didn't the care they needed. And because of that, a lot of people, like the Ashley's of the world, weren't getting better, weren't getting treatment.
Providers don't exist to treat people if they can't figure out how they're going to get reimbursed. The most important thing that our treatment community said in New Hampshire was Medicaid expansion of the Affordable Care Act made it possible for them to stand up a higher volume of treatment.
So I look forward to working with you too but I'm concerned about your unwillingness to commit to making sure that insurance companies cover these essential benefits. I am almost out of time and we haven't even touched on the issue of women's health which is obviously of great concern. So let me just ask a couple of questions. Yes or no, do you think an employer should be able to fire a woman because she uses birth control?
PRICE: I don't believe so.
HASSAN: Well you voted in support of a resolution to disapprove the District of Columbia's non-discrimination law, the Reproductive Health Non-Discrimination Act, which protects women here in D.C. from being fired or penalized because of their reproductive health decisions.
So you're vote would have had the effect of allowing employers to fire a woman for using birth control or for other decisions she makes about her own body and reproductive health.
So how is that vote consistent with the answer you just gave me?
PRICE: Well, again, I think that it's - I think the question was about who's paying for that product. It's not --
HASSAN: No the question is whether an employer who let's say in a self-insured employer provided plan finds out that a female employee, who earned the benefit with her hard work, is using the benefit to provide birth control - to buy birth control, which the benefit provides, and then fires her because the employer disapproves of the use of birth control.
PRICE: I don't think that's the case.
HASSAN: You don't think that - would you like us to provide examples for you?
Price: Yes, I'd be happy to. HASSAN: So you would be willing to say that employers may not - you would support a law, a rule that employers may not discriminate against women for their reproductive health decisions.
PRICE: I don't think that employers ought to -- that employers have the opportunity right now to be able to let somebody go based upon their health status or the medications that they use.
HASSAN: So then why did you vote against the D.C. provision...
PRICE: I don't think that's what it did.
HASSAN: You don't think that that was your vote.
PRICE: I don't think that's what the bill did.
HASSAN: Thank you. We'll follow up on that. And again, I wish I had more time because I have about eight more questions. I'll submit them in writing. PRICE: Thank you.
ALEXANDER: Thank you, Senator Hassan.
CASSIDY: Thank you, Mr. Chair.
You all all seem worn out, but I've been galivanting with high school students. So I'm pretty energized.
ALEXANDER: Well, good.
CASSIDY: Let me say for the record that when John King (ph) came for an interview, I wanted to ask a second round and you wouldn't let me. I confirmed with staff. So I just -- I've been wanting to say that for two days now and I just want to say it. I was going to -- I've got another set of questions. You said, "shut up."
So anyway. Next...
ALEXANDER: It's nothing personal.
CASSIDY: Nothing personal.
For Price, how would HIPAA laws regard now a grandfather taking his grandson on house calls? You know what I'm saying? (inaudible) your grandfather would have busted, but that's another issue.
PRICE: Yeah, probably.
I love what you're saying about the patient-physician relationship. You and I have both worked in hospitals for the uninsured. I as a gastroenterologist liver doctor. And we've talked a lot about Obamacare and the wonderful things it's done.
But I keep on thinking of my patients at the hospital for the uninsured, with the $6,000 deductible.
PRICE: That's right.
CASSIDY: I mean, the patients you saw (inaudible), not those on Medicaid, but those who were working. They don't have $400 in their account.
PRICE: That's right.
CASSIDY: And they got a $6K deductible before they can be otherwise cared for. And just for the record, people don't believe me -- I put it on my Facebook page. A friend of mine from home, his renewal for his individual policy for he and his wife -- 60, 61 years old, no kids -- no health (inaudible) -- was $39,000 for a year, with a $6,000 deductible.
I put it on my Facebook page. No one believes this is like what a family pay for a mortgage and then some, and that was their yearly premium.
So I applaud you for looking for some alternative that's affordable. It may be working for New Hampshire, California, Massachusetts. God bless you. But for states like mine and yours and Arizona, people cannot afford $39,000 premiums.
(inaudible) more. Did the Empowering Patient Act repeal -- explicitly repeal the mental health parity laws?
PRICE: I don't believe so.
CASSIDY: I don't think so either. But just to Senator Hassan, mental health parity would still apply. And that does cover (inaudible). So there is those provisions -- that law still remains in effect.
Secondly, we've been talking about does it have to be a covered benefit. You're a big believer in health savings accounts. I gather a health savings account can be used to pay for doctor's visits?
CASSIDY: And for essential medical services and even colonoscopys if necessary?
CASSIDY: Yes. As a gastroenterologist, that comes to mind.
So to just also point that out. And when you speak about giving the patient power over her healthcare to allow her to choose, when we choose for her, we have a $39,000 premium. But when we allow her to choose, she has something which is affordable and she becomes a more activated informed consumer.
And there's a lot of academic literature to look at that. I applaud...
CASSIDY: We don't agree -- we don't agree with each other entirely, but substantially. And I applaud you for that.
Now, Franken always calls me a Luddite. Different issue. Because I am skeptical about -- he calls me many things, but a Luddite among them -- because I am skeptical about electronic health records and their negative impact on productivity. And again, he thinks I'm just some guy that didn't -- that calls a mouse a little furry thing, when most people (inaudible) a little (inaudible).
Now, I see that MD Anderson just laid off five percent of their staff. They're blaming it on financial losses related to decreased productivity, again directly attributable to the implementation of their (inaudible). Your department's going to be involved with meaningful use and such like that.
And I often find an orthopedic surgeon asking somebody about their smoking history is not really a good use of the orthopedic surgeon's time. Not that it isn't important, but nonetheless he's not the person who will implement the cessation program. It shall be their internist or -- you know what I'm saying.
CASSIDY: So what thoughts do you have? What can we do about this time and productivity (inaudible) that has become the electronic medical record and meaningful use, keeping that which is positive, but hopefully doing something better for the patient and for the physician?
PRICE: Yes, thanks, Senator. The electronic medical record and electronic health records are so important because they, from an innovative standpoint, allow the patient the opportunity to have their health history with them at all times and be able to allow whatever physician or other provider access to that.
We in the federal government I think have a role in that, but that role ought to be interoperability, to make certain that different systems can talk to each other so that it inures to the benefit of the patient. I've had more than one physician tell me that the final regulations and rules related to meaningful use were the final straw for them.
CASSIDY: And they quit. They retired.
PRICE: And they quit. And they quit. And they've got no more gray hair than you or I have. And when that happens, we lose incredible intellectual capital in our society that can care for people.
CASSIDY: Now, what can we do about that? What practical things can we do?
PRICE: I think the thing that's absolutely imperative is to find our what things ought to be determined and checked -- the metrics that are used, that they actually correlate with the quality of care that's being provided, as opposed to so many things that are required right now of the physician or the provider that make it so that they're wasting their time documenting these things so that it fits into some matrix somewhere, but it doesn't result in higher quality of care or outcomes for that patient.
So if we truly worked with those providing the care to say: What is it that we could ask you to measure that would really correlate with the outcome and the quality of care being provided? I suspect there's some very specific things that we could use.
CASSIDY: You know, it's interesting because you're emphasizing the patient-physician relationship. My wife is a retired breast cancer surgeon, and she used to say that really she counseled the husband as much as the wife, because the husband would be the one who was crying. But she would be the one telling them, looking them in the eye, "There's hope. This is not a death sentence. There is hope."
And I only imagine, if she were now in practice, typing up, "There is hope." It's a little bit of a different feel for the patient and her spouse.
PRICE: Yes, we've turned many physicians and other providers into data entry clerks. And it -- and it detracts, as you said, from their productivity, but it detracts greatly from their ability to provide quality care.
CASSIDY: Let me ask as well, one of our big challenges is how do we come up with expensive medicines that are only used by very few? How do we socialize that cost? Think of antibiotics. We just had some guerrilla -- some germ out there, bacteria that's apparently resistant to everything, but we can come up with gene therapy for a very few, very expensive to develop.
How do we pay for that? I just want your thoughts. I don't know if you have an answer, but I care deeply about those and so do you, with these rare diseases, but devastating, how do we care for them and socialize that cost?
PRICE: I talked earlier with Senator Hatch when -- during his time -- about rare diseases and about the Orphan Drug Act and the like that revolutionize the ability or the incentives for bringing to market drugs that address rare diseases. It's so incredibly important. And incentivization, from an FDA standpoint, is important -- incentivization to make certain that if individuals, companies are able to come up with things that cure diseases, that they are appropriately compensated for that.
CASSIDY: Now, in the area -- in the era of personalized medicine, where it might be (inaudible) of one or (inaudible) of a thousand. It's still very small, but the cure could be a million.
Anything specific about that?
PRICE: It's a -- we're entering a brave new world that is so exciting from a scientific standpoint to be able to provide this kind of personalized healthcare services to folks that will be able to cure things that we've never dreamed about curing. And the challenges of how we afford to make that available to our society are real. And I think we need to get the best minds together to figure out how to make that happen, and I look forward to working with you to do so.
CASSIDY: I will close by saying this, and I have a perspective my colleagues cannot, because I know orthopedic surgeons are the ones that are called at three in the morning when there's a car wreck and someone's so busted up there's no one else to fix them. But if they don't fix them, they die.
And so they kiss their wife goodbye. They climb out of bed. They drive to the hospital. They're up all night, and then they see their clinic schedule the next day. They make rounds in the evening. They get home at midnight and kiss their wife goodnight before they go to bed.
Price, you're the exact kind of person to have this job.
Thank you, and I yield back.
PRICE: Thank you, Senator.
ALEXANDER: Thank you, Senator Cassidy.
KAINE: Thank you to the committee leadership.
And thank you, Congressman Price...
PRICE: Thank you.
KAINE: ... for the visit the other day in the office.
An observation and a few questions. And forgive me. I was at another hearing, so I might be a little repetitive, but I'll try to move quickly.
My worry as a Virginian is your position about a whole range of programs that are basically about access and coverage, sort of the safety net that provides coverage to millions of people.
You've proposed turning Medicaid into a block grant program. That's exciting a lot of controversy in Virginia right now in our legislature with Democrats and Republicans. And you have repeatedly voted against the CHIP program for kids. At one point, calling it" socialized medicine." That's a combined Medicaid and CHIP about 800,000 Virginians.
You proposed a restructuring of Medicare that CBO found would increase out-of-pocket cost for seniors, that's about 1.3 million Virginians. You support to repeal of the affordable care act, there's about half million Virginians on the exchanges and hundreds of thousands of others that are otherwise benefited. You want to defund Planned Parenthood, tens of thousands of Virginians use Planned Parenthood as their primary healthcare provider.
These are the basic programs that provide health care coverage. For millions of Virginians, there's some overlap there, but it would be millions of our 8 million, and tens of millions of Americans, and many of them have very limited means. And so you're - there's a sort of consistency to your position in some ways across all these programs that I view as critical to the health safety net. I know that Senators Franken and Murray used the Hippocratic maxim (ph) first, do no harm and comments before I came, and I think - and I would hope you would agree that as we approach the discussion of the health care system access coverage cost quality, the president and congress should strive to do no harm. Would you agree with me?
KAINE: And we shouldn't harm people by reducing the number of people who have health coverage or reducing the quality of the insurance coverage they do have. That's what we should strive for, right?
PRICE: I think it's important to appreciate that there are challenges in these programs currently. One out of every three physicians who ought to be able to see Medicaid patients across this country, doesn't see Medicaid patients. If we're honest and sincere about addressing these problems, we ought to step back and say "why is that, what are we doing wrong?" one out of every eight physicians who is eligible to see seniors no longer sees Medicare patients. If you are a new Medicare patient trying to find a new physician that sees new Medicare patients, it is almost impossible anywhere in this country.
KAINE: I am all with you unfixing challenges and going forward, more coverage, more affordable.
PRICE: And that's what we're trying to do. That's what my proposals have tried to do.
KAINE: That is important. We shouldn't harm people by doing things that would increase their cost, correct?
PRICE: I think we need to drive down the cost for everybody.
KAINE: We shouldn't harm people by creating an anxiety for people about the most important thing in their lives, their health care and the healthcare of their families. We shouldn't be doing that in Congress, should we?
PRICE: One of my goals in this entire debate, and I appreciate you bringing this up, is to lower the about what we're about, because this - this -- this is real stuff for folks. These are their lives.
KAINE: Can we lower the temperature in Russia at the same time?
PRICE: I think we can move apace but lower the temperature and provide stability to folks out there. They need to -- people need to know that no rug is going to be pulled out from under them.
KAINE: I'll join you stability and I'll join on lower temperature. I don't think lowering the temperature inconsistent with rushing. In fact, my experience in going around Virginia is huge amounts of fear. And we shouldn't harm the American economy. Its - healthcare is the biggest sector in the American economy, 1/6 of it, by injecting uncertainty. We should -again, try to fix the problems that you've identified or those that I might identify and do them in a way that provides some stability and certainty. Shouldn't that be our goal?
PRICE: Certainty is incredibly important. I'm reminded of the fact that the congressional budget office has told us the ACA has actually decreased the workforce by the equivalent of 2 million FTE's. So there are challenges that we have throughout, and I hope that what we're able to do, is to work together to solve those challenges.
KAINE: Do you agree with the president-elect that the replacement for the affordable care act must ensure there is insurance for everybody?
PRICE: I have stated here and always that it's incredibly important that we have a system that allows for every single American have access to the kind of coverage that they desire.
KAINE: And he stated in this same interview a couple days ago that we should negotiate with pharmaceutical companies under Medicare part D to bring down prescription drug cost. Do you support that position of the president-elect?
PRICE: I think the cost of drugs is - is - is in many instances, a real challenge for folks and we need to do all that we can to make certain that we bring the cost down.
KAINE: Here's kind of an offbeat question, it's just a coincidence based on today. I was at a hearing with Nikki Haley - Governor Haley who was nominated to be U.N. ambassador, right before I came. She played a really significant role in moving her state away from use of the confederate battle flag in any official capacity.
When you remember the Georgia legislature, you fought hard to keep the confederate battle flag as part of the Georgia state flag and any sponsored resolutions to make April confederate history heritage month in Georgia and "urging schools to commemorate the time of southern independence," and I'd like to introduce that resolution for the record, Mr. Chair.
[13:30:00] I read the resolution with interest, because of the phrase "commemorating the time of southern independence."