The past few days have been challenging for all of us as Central New Jersey has endured Hurricane Sandy and taken the first steps toward recovery.  Although we still have hard work ahead, our country stands ready to help:  the Federal Emergency Management Agency (FEMA) has declared eight counties in New Jersey, including Middlesex and Monmouth counties, to be major natural disaster areas.  If you live in these counties, you are now eligible to apply for federal disaster assistance.

I know that many residents of other New Jersey counties have also suffered great losses.  Yesterday, I spoke to the Secretary of Homeland Security, Janet Napolitano, and to the FEMA director, Craig Fugate, to ask that they move as quickly as possible to add further counties to the disaster declaration.  I also have written the president to make the same request, and I will let you know as soon as any expanded disaster declaration is made.

In the meantime, no matter where you live, it is critical that you document your losses and any expenses incurred in your recovery – including, for instance, the costs to pump water out of your basement, to replace your water heater, or to stay in temporary housing.  Take pictures of any damaged belongings, and keep all of your receipts.  Although documenting your losses does not guarantee your eligibility for disaster relief, the documentation may be required by FEMA or your homeowner’s insurance company.

If you live in a county covered by the initial disaster declaration and have suffered uninsured losses, I encourage you to apply for disaster assistance as soon as possible – even if you are not sure you are eligible.

The first step in the disaster relief process is to register with FEMA.  You may register online at www.disasterassistance.gov or by calling 1-800-621-FEMA (3362) or TTY/TDD 1-800-462-7585.

In most cases, federal agencies do a good job of ensuring that people receive the money that they are owed.  But sometimes, people find that they have fallen through the cracks or simply haven’t received fair treatment from their government.  Many come to me for help, thousands this year.

I help people from many backgrounds – from people who are living below the poverty line to those of comfortable means, including many seniors, veterans, soldiers, and new citizens.

They have a wide range of problems, from Social Security or veterans’ benefits that have been wrongly denied, to IRS penalties that have been inaccurately assessed, and more.

I do my best to help.  Not every result is a positive one, but I am pleased to report that, as of this week, I have helped secure more than $1,000,000 for Central New Jersey residents this year.

Among the constituents I’ve helped:

• A South River resident, a victim of identity theft, could not receive his tax refund because a hold had been placed on his IRS account.  After my inquiry, he received a check for $3,627.
   
• A West Windsor resident’s deceased husband, a 100% disabled veteran who died from service-related injuries, had applied for disability benefits that were never awarded.  With my help, she received a total of $116,105 in retroactive benefits, burial benefits, and other payments.
   
• A Manalapan resident was denied an insurance payment for the costs of ambulance travel to an emergency room.  After I reached out to his insurer, he was reimbursed $924.

In addition to assistance that produces direct financial benefits, I also work to help constituents who have encountered non-financial problems with federal agencies, such as delays in passport or visa applications, difficulty in recovering lost discharge papers or military medals, and much more.

If you have encountered problems in your dealings with any federal agency, please contact me by visiting http://holt.house.gov/contact or calling 1-87-RUSH-HOLT (1-877-874-4658).  I will do my best to help you get answers.

(West Windsor, NJ) – U.S. Rep. Rush Holt (NJ-12) today announced that, as of this week, he has helped to secure more than $1 million in 2012 through his one-on-one advocacy for residents of central New Jersey.

The current total of $1,092,286 includes veterans’ and Social Security benefits that Holt helped to secure, inaccurately assessed IRS penalties that Holt helped to overturn, and health insurance claims that Holt helped to ensure were paid.

“In most cases, federal agencies do a good job of ensuring that people receive the money they are owed,” Holt said.  “But sometimes, people find that they have fallen through the cracks or simply haven’t received fair treatment from their government.  I help people from many backgrounds – from people of comfortable means to those who are living below the poverty line, including many seniors, veterans, soldiers, and new citizens.  Many feel that they have nowhere else to turn, and I do my best to help.”

We must not lose sight of the fact that Medicare is ultimately about people:  the grandfather who can barely afford his heart medication, or the widow who finds her savings wiped out after she is diagnosed with breast cancer.

Democratic staff on the U.S. House Committee on Energy and Commerce recently dived into the consequences of the 2013 Republican “Ryan” budget on individuals.  According to the Committee’s report, the budget would:

• Increase prescription drug costs for 11,000 Central New Jersey seniors, forcing them to pay an extra $101 million for drugs over the next decade.
   
• Eliminate new zero-copay preventive care benefits for 103,000 Central New Jersey Medicare beneficiaries.
   
• Threaten affordable housing programs that provide rental support for 5,100 Central New Jersey senior households.
   
• Put at risk the nursing home care for 2,300 Central New Jersey residents whose expenses are paid by Medicaid.

These are just the consequences of the budgets for seniors.  Many others in Central New Jersey would face other consequences:  cuts in federal investments in infrastructure, education, research and development, Food Stamps, and more.  Yet even as it slashes these crucial programs, the Ryan plan provides such enormous tax breaks, mostly to the wealthy, that it would fail to balance our budget until 2040.

The budget is a moral document, as you may remember me saying.  The Ryan plan is written down in black and white and approved by almost all Republicans and opposed by almost all Democrats in the House.

Last month, the Institute of Medicine released a new report that drew a startling conclusion:  in 2009, about 30 percent of U.S. health care spending, roughly $750 billion, was wasted on unnecessary services, excessive administrative fees, fraud, and other costs that did not improve anyone’s health.

The Institute’s report makes clear that, although good data exist on how to spend health care dollars more effectively, these data are often not being used to train better doctors in medical schools or to educate providers in the field.  The report also identifies specific reforms – including the better coordination of patient care, the speedier adoption of best practices, and a revamped payment system that rewards doctors for the quality rather than the quantity of services delivered – that can help bring down costs. 

But we take too narrow a view if we consider wasteful health care spending to be merely a financial problem.  Unnecessary medical care is not just expensive; it also is painful, discomforting, inconvenient, and potentially even dangerous.  If a father’s untreated high blood pressure leads to an unnecessary heart attack, then yes, his ER visit will cost money – but the greater tragedy is that his life has been placed needlessly at risk.  If a grandmother must return to the hospital because she was sent home prematurely, then yes, her readmittance will cost money – but even worse, she will endure needless suffering.

In the worst cases, ineffective care can even result in unnecessary deaths.  The Institute estimates that 75,000 people die each year due to wasteful or inappropriate care.  Health reform seeks to address these tragedies in several ways, including the creation of Accountable Care Organizations that tie provider payments to measures of patient outcomes.  But more must be done.

The Institute’s recommendations shed light on ways that we can save money by building a more efficient medical system.  But just as importantly, they point us toward a more effective medical system, one that does a better job at keeping Americans alive, healthy, and happy.

The following article appeared as a commentary in the journal Nature.

Before I was elected to the US Congress in 1998, I taught and researched topics such as solar spectroscopy and plasma physics. This background inspired some of my constituents to make bumper stickers that read: “My congressman IS a rocket scientist!” The residents of central New Jersey seemed to be calling for more science, or at least more scientific thinking, in Congress.

I agree. Scientists, engineers and technologists are not necessarily smarter or wiser than others, but we have many habitual practices of mind that would be valuable in the sluggish legislative process. ‘Scientific thinkers’ — and to be clear, not all such thinkers are professional scientists — have a deep appreciation for evidence. They have a realistic understanding of technology’s promises and pitfalls. They work comfortably with estimates and data. They use statistical reasoning. They are more alert to the mental tricks that they, like all humans, play on themselves. Most importantly, they understand that the path towards good solutions is paved with uncertainty, trial and error; that conclusions should be tentative; and that alternative views should be entertained.

Recently, the journalist Fred Bernstein wrote an opinion piece in the New York Times arguing that members of Congress should not provide direct service to their constituents.  He argued that constituent services helps only individuals and does not fix the system, that legislators’ requests to federal agencies will be taken as threats of removing appropriations, and that members of Congress should stick to a narrow conception of legislative work. 

My staff and I, who spend much if not most of our time dealing with the individual questions and problems that people bring to me, were troubled by this.  In our diverse, complicated country, some people are unfairly neglected or unaware of the services or rights that are due them. People fall between the cracks. Our ingenious representative government is intended to deal with that problem by enabling their elected representatives – members of Congress – to work directly with federal agencies on their behalf.

Being a representative means much more than simply legislating in some abstract sense removed from the people of, by, and for whom the government exists. It means being the person who connects each American with his or her government.  It means trying to insure that each person finds the liberty, the equality, the opportunity, and the fairness that are our goals.  In short, it means helping people.

Medicaid matters.  Many people know about its proven record of improving the health of low-income children and families – but many don’t know that two-thirds of Medicaid’s funding is devoted to supporting people with disabilities and to seniors.  Medicaid is part of the safety net that nearly every American relies on.

Ever since Medicaid was created in 1965, the federal government has paid much of the program’s cost.  In exchange, it has required states to follow guidelines on who should be eligible for the program and which benefits should be covered.

The House-passed Ryan budget, which I’ve discussed before, would tear up this agreement. It would essentially write states a check and, for the first time, allow them to set their own rules for how the money should be used.  According to the Kaiser Commission on Medicaid and the Uninsured, this could lead up to 27 million Americans to lose access to health coverage.

A better approach is outlined in the health reform law, which enables states to cover more people through Medicaid.  Expanding Medicaid would help millions of low-income Americans, including adults without children, gain access to health insurance for the first time.  It also would give more Americans access to doctors and preventive care, which would help improve health outcomes and lower costs.

The good news is that expanding Medicaid makes financial sense for New Jersey.  In fact, we would receive an estimated $22 billion in new federal Medicaid funds over eight years.  Earlier this month I sent Governor Christie a letter urging him to expand Medicaid in New Jersey.  I hope that Governor Christie does what is right and puts the people of New Jersey above politics. 

At this time last year, tens of thousands of families in our community were struggling to recover from the rains and floods of Hurricane Irene and Tropical Storm Lee.  What strikes me now, looking back, is the storm’s arbitrary fury.  I saw how some households escaped damage while others, just a few hundred feet away, suffered devastating floods.

How could anyone prepare for such a haphazard misfortune?  We do it together.

The federal government pumped $21 million in disaster relief funding into Central New Jersey last year, helping our friends and neighbors put their lives back together.  The government also helps communities invest in flood prevention, and at the National Weather Service, government scientists save countless lives by predicting each storm’s path and intensity.

I am grateful that, in modern America, few would say to those in a hurricane’s path, “Government won’t help you.  You’re on your own.”

Why, then, would so many in Congress abandon Americans when other disasters strike – when a father is laid off from work because of a financial crisis he didn’t cause, or when a mother is denied health insurance because of a cancer she could never have predicted?

(Washington, DC) – U.S. Rep. Rush Holt (NJ-12) today issued the following statement upon the House’s passage of a four year extension of the FISA Amendments Act, which will allow continued, industrial-scale surveillance of American’s communications by the National Security Agency:

“This bill is just as bad now as it was when it became law almost four years ago.  The measure continues the suspension of the 4th Amendment, allowing the government to electronically collect and search the communications of Americans without a warrant. This ‘fishing expedition’ approach to surveillance has not improved our security, and only eviscerated our liberties.

“As Senators Wyden and Udall have discovered, this blanket surveillance authority has been abused by our government, just as such blanket surveillance was abused in the Johnson and Nixon eras. I sincerely hope that Senator Wyden will not lift his hold on this legislation unless it is rewritten. Our surveillance laws should strictly adhere to a 4th Amendment standard—warrants should only be issued by a judge based on genuine probable cause. 

“This is not simply a civil liberties nicety; it is a matter of getting better public safety by holding collectors and law enforcement to high standards.  Our Founders understood why such protections are essential to protect the rights of the people, and to promote better, not worse, protection of the people. We ignore their wisdom at our peril.”

BILL WOULD PROVIDE MATCHING GRANTS TO PRESERVE HISTORIC SITES ACROSS THE COUNTRY, INCLUDING MANY IN NEW JERSEY

(Washington, D.C.) – The U.S. House of Representatives yesterday passed the American Battlefield Protection Program Amendments Act (H.R. 2489), a bipartisan bill authored by U.S. Rep. Rush Holt (NJ-12) that would provide competitive matching grants to preserve battlefields from the Revolutionary War, the War of 1812, and the Civil War.

The legislation will now be sent to the U.S. Senate for further consideration, where a companion bill has been introduced by U.S. Sen. Charles Schumer (NY).

“Sprawl and commercial development are threatening the historic sites where our nation was forged and shaped,” Holt said.  “Each time a historic battlefield is replaced with a parking lot, a chapter of American history is obscured, and future generations lose an important window onto their heritage.  This bill would provide matching funds that would leverage private efforts to preserve our nation’s past.”

Over the weekend, Neil Armstrong, the first man to walk on the Moon, passed away.

Although the Apollo project resulted in Neil Armstrong walking on the Moon, its purpose was never to send Neil Armstrong, the person, to the Moon.  Its aim instead was to use a lunar landing to establish America’s presence in space, to demonstrate America’s industrial might, and to spur new technologies and new innovations.  To be sure, Project Apollo could never have succeeded without a Neil Armstrong; he clearly had “the right stuff,” with nerves of steel and a powerful mind that could keep many systems and activities in perspective simultaneously.  But neither could Neil Armstrong have walked on the Moon without a Project Apollo.

We underappreciate Armstrong if we think of him only as a brilliant engineer or a talented pilot or a bold voyager, although he was all of these things.  He was a new kind of hero, because Project Apollo was more about us than about him.  Tonight is a full moon, a good time to remember what we as a nation can accomplish together.

Armstrong’s family released a brief and moving statement after his death.  They said, in part: “For those who may ask what they can do to honor Neil, we have a simple request. Honor his example of service, accomplishment, and modesty, and the next time you walk outside on a clear night and see the Moon smiling down at you, think of Neil Armstrong and give him a wink.”

(West Windsor, NJ) – U.S. Rep. Rush Holt (NJ-12) today announced that, as of this week, he has helped to secure more than $1 million in 2012 through his one-on-one advocacy for residents of central New Jersey.

The current total of $1,092,286 includes veterans’ and Social Security benefits that Holt helped to secure, inaccurately assessed IRS penalties that Holt helped to overturn, and health insurance claims that Holt helped to ensure were paid.

“In most cases, federal agencies do a good job of ensuring that people receive the money they are owed,” Holt said.  “But sometimes, people find that they have fallen through the cracks or simply haven’t received fair treatment from their government.  I help people from many backgrounds – from people of comfortable means to those who are living below the poverty line, including many seniors, veterans, soldiers, and new citizens.  Many feel that they have nowhere else to turn, and I do my best to help.”

(Washington, DC) – U.S. Rep. Rush Holt (NJ-12) today issued the following statement upon the House’s passage of a four year extension of the FISA Amendments Act, which will allow continued, industrial-scale surveillance of American’s communications by the National Security Agency:

“This bill is just as bad now as it was when it became law almost four years ago.  The measure continues the suspension of the 4th Amendment, allowing the government to electronically collect and search the communications of Americans without a warrant. This ‘fishing expedition’ approach to surveillance has not improved our security, and only eviscerated our liberties.

“As Senators Wyden and Udall have discovered, this blanket surveillance authority has been abused by our government, just as such blanket surveillance was abused in the Johnson and Nixon eras. I sincerely hope that Senator Wyden will not lift his hold on this legislation unless it is rewritten. Our surveillance laws should strictly adhere to a 4th Amendment standard—warrants should only be issued by a judge based on genuine probable cause. 

“This is not simply a civil liberties nicety; it is a matter of getting better public safety by holding collectors and law enforcement to high standards.  Our Founders understood why such protections are essential to protect the rights of the people, and to promote better, not worse, protection of the people. We ignore their wisdom at our peril.”

BILL WOULD PROVIDE MATCHING GRANTS TO PRESERVE HISTORIC SITES ACROSS THE COUNTRY, INCLUDING MANY IN NEW JERSEY

(Washington, D.C.) – The U.S. House of Representatives yesterday passed the American Battlefield Protection Program Amendments Act (H.R. 2489), a bipartisan bill authored by U.S. Rep. Rush Holt (NJ-12) that would provide competitive matching grants to preserve battlefields from the Revolutionary War, the War of 1812, and the Civil War.

The legislation will now be sent to the U.S. Senate for further consideration, where a companion bill has been introduced by U.S. Sen. Charles Schumer (NY).

“Sprawl and commercial development are threatening the historic sites where our nation was forged and shaped,” Holt said.  “Each time a historic battlefield is replaced with a parking lot, a chapter of American history is obscured, and future generations lose an important window onto their heritage.  This bill would provide matching funds that would leverage private efforts to preserve our nation’s past.”

(West Windsor, NJ) – U.S. Rep. Rush Holt (NJ-12) today announced the names of the students who have served as interns in his congressional office in the summer of 2012.
 
“It has been a pleasure to welcome these outstanding interns to my staff,” Holt said.  “As a former educator, I am deeply impressed by their intelligence, willingness to learn, and commitment to public service.  They have served the people of central New Jersey with distinction.”

Congressional interns are selected on a competitive basis and contribute in a variety of ways to Holt’s service to central New Jersey, including aiding in legislative research, attending congressional hearings, conducting community outreach, and helping with office administrative duties.  Interns in the summer session served from June through August 2012.  High school and college students who are interested in interning in future sessions are encouraged to visit http://holt.house.gov/ to learn more.

(Washington, D.C.) – Yesterday and today, U.S. Rep. Rush Holt (NJ-12) continued to lead efforts to block legislation that, if enacted, would endanger New Jersey’s beaches by accelerating offshore drilling without updating safety and environmental reviews. 

As the House considered the so-called “Congressional Replacement of Offshore Drilling Plan”, HR 6082, Holt offered amendments to prevent drilling off the coast of New Jersey, to ensure adequate environmental review of proposed drilling, and to end royalty free drilling the Gulf of Mexico. This was the 11th drilling bill to be brought to the House floor in the last 18 months to benefit Big Oil at the expense of worker safety, public health, and environmental degradation.

“The Big Five oil companies made a record profit of $137 billion in 2011. In the first quarter of this year they continued to capitalize on the pain Americans are feeling at the pump, raking in $368 million in profits per day,” said Rep. Holt.  “An oil spill off of the U.S. East Coast would endanger over 200,000 jobs and $12 billion associated with New Jersey’s fishing and tourism industries – and that is not even counting the indirect effects as this money flows through our local economies.”

Mr. Chair, I rise in opposition to the TRAIN Act. This misguided legislation would undermine the Environmental Protection Agency's ability to enforce the Clean Air Act and significantly limit the federal government's ability to ensure that the air we breathe is safe and pollution-free.

Mr. Speaker, nearly two-thirds of Americans say that job creation should be Washington's top priority. But no one here needs an opinion poll to learn that. I am sure all my colleagues are hearing what I hear by mail, fax, e-mail, Twitter, phone calls, Facebook, and passersby on the street. Everyone is saying, ``Congress, get on with it! Make jobs! Get America to work! Get my husband, my cousin, my daughter to work.'' And, yet again, the Republican majority in the House is playing political games--wasting time debating a senseless resolution when we could, and should, be doing the work that the American people sent us here to do: creating jobs and revitalizing our economy.

Mr. Speaker, I rise in opposition to the outsourcers' bill of rights.

This bill would be devastating to workers across this country and kick off a new race to the bottom. The outsourcers' bill of rights is a naked attempt to directly interfere in a pending Labor Relations Board case. Now, there is much to be said about workers' rights and the importance of protecting them; but in the short time I have, let me just say a little bit about what this means for the American economy.

Mr. Chair, I rise today in support of the Empowering Parents through Quality Charter Schools Act, H.R. 2218, which is a bipartisan bill to reform and strengthen the charter school program.

I recently gave the graduation speech at the Princeton Charter School, a high quality charter that opened its doors more than a decade ago and was recognized as a blue ribbon school by the U.S. Department of Education in 2004. And I was pleased to see the success there. But I urged them to make sure they are well-integrated in the public school system in their community.

Madam Chair, I rise in reluctant support of this bill.

This bill is, by the conventional standards of the House, an appropriate vehicle for meeting many of the routine needs of the Intelligence Community. However, it completely fails to undertake the kind of probing, large-scale reassessment of the structure, mission, and purpose of our intelligence enterprise in a post-bin Laden era. I regret that Congress has not shown the stomach for the kind of thorough, comprehensive, and brave review of intelligence activities that was undertaken by the Church Committee in the 1970's. Given the events of the last decade, such a review is both long overdue and very badly needed. Despite my strong reservations about what this bill does not but should do, I will support this bill.

The past few days have been challenging for all of us as Central New Jersey has endured Hurricane Sandy and taken the first steps toward recovery.  Although we still have hard work ahead, our country stands ready to help:  the Federal Emergency Management Agency (FEMA) has declared eight counties in New Jersey, including Middlesex and Monmouth counties, to be major natural disaster areas.  If you live in these counties, you are now eligible to apply for federal disaster assistance.

I know that many residents of other New Jersey counties have also suffered great losses.  Yesterday, I spoke to the Secretary of Homeland Security, Janet Napolitano, and to the FEMA director, Craig Fugate, to ask that they move as quickly as possible to add further counties to the disaster declaration.  I also have written the president to make the same request, and I will let you know as soon as any expanded disaster declaration is made.

In the meantime, no matter where you live, it is critical that you document your losses and any expenses incurred in your recovery – including, for instance, the costs to pump water out of your basement, to replace your water heater, or to stay in temporary housing.  Take pictures of any damaged belongings, and keep all of your receipts.  Although documenting your losses does not guarantee your eligibility for disaster relief, the documentation may be required by FEMA or your homeowner’s insurance company.

If you live in a county covered by the initial disaster declaration and have suffered uninsured losses, I encourage you to apply for disaster assistance as soon as possible – even if you are not sure you are eligible.

The first step in the disaster relief process is to register with FEMA.  You may register online at www.disasterassistance.gov or by calling 1-800-621-FEMA (3362) or TTY/TDD 1-800-462-7585.

In most cases, federal agencies do a good job of ensuring that people receive the money that they are owed.  But sometimes, people find that they have fallen through the cracks or simply haven’t received fair treatment from their government.  Many come to me for help, thousands this year.

I help people from many backgrounds – from people who are living below the poverty line to those of comfortable means, including many seniors, veterans, soldiers, and new citizens.

They have a wide range of problems, from Social Security or veterans’ benefits that have been wrongly denied, to IRS penalties that have been inaccurately assessed, and more.

I do my best to help.  Not every result is a positive one, but I am pleased to report that, as of this week, I have helped secure more than $1,000,000 for Central New Jersey residents this year.

Among the constituents I’ve helped:

• A South River resident, a victim of identity theft, could not receive his tax refund because a hold had been placed on his IRS account.  After my inquiry, he received a check for $3,627.
   
• A West Windsor resident’s deceased husband, a 100% disabled veteran who died from service-related injuries, had applied for disability benefits that were never awarded.  With my help, she received a total of $116,105 in retroactive benefits, burial benefits, and other payments.
   
• A Manalapan resident was denied an insurance payment for the costs of ambulance travel to an emergency room.  After I reached out to his insurer, he was reimbursed $924.

In addition to assistance that produces direct financial benefits, I also work to help constituents who have encountered non-financial problems with federal agencies, such as delays in passport or visa applications, difficulty in recovering lost discharge papers or military medals, and much more.

If you have encountered problems in your dealings with any federal agency, please contact me by visiting http://holt.house.gov/contact or calling 1-87-RUSH-HOLT (1-877-874-4658).  I will do my best to help you get answers.

We must not lose sight of the fact that Medicare is ultimately about people:  the grandfather who can barely afford his heart medication, or the widow who finds her savings wiped out after she is diagnosed with breast cancer.

Democratic staff on the U.S. House Committee on Energy and Commerce recently dived into the consequences of the 2013 Republican “Ryan” budget on individuals.  According to the Committee’s report, the budget would:

• Increase prescription drug costs for 11,000 Central New Jersey seniors, forcing them to pay an extra $101 million for drugs over the next decade.
   
• Eliminate new zero-copay preventive care benefits for 103,000 Central New Jersey Medicare beneficiaries.
   
• Threaten affordable housing programs that provide rental support for 5,100 Central New Jersey senior households.
   
• Put at risk the nursing home care for 2,300 Central New Jersey residents whose expenses are paid by Medicaid.

These are just the consequences of the budgets for seniors.  Many others in Central New Jersey would face other consequences:  cuts in federal investments in infrastructure, education, research and development, Food Stamps, and more.  Yet even as it slashes these crucial programs, the Ryan plan provides such enormous tax breaks, mostly to the wealthy, that it would fail to balance our budget until 2040.

The budget is a moral document, as you may remember me saying.  The Ryan plan is written down in black and white and approved by almost all Republicans and opposed by almost all Democrats in the House.

Last month, the Institute of Medicine released a new report that drew a startling conclusion:  in 2009, about 30 percent of U.S. health care spending, roughly $750 billion, was wasted on unnecessary services, excessive administrative fees, fraud, and other costs that did not improve anyone’s health.

The Institute’s report makes clear that, although good data exist on how to spend health care dollars more effectively, these data are often not being used to train better doctors in medical schools or to educate providers in the field.  The report also identifies specific reforms – including the better coordination of patient care, the speedier adoption of best practices, and a revamped payment system that rewards doctors for the quality rather than the quantity of services delivered – that can help bring down costs. 

But we take too narrow a view if we consider wasteful health care spending to be merely a financial problem.  Unnecessary medical care is not just expensive; it also is painful, discomforting, inconvenient, and potentially even dangerous.  If a father’s untreated high blood pressure leads to an unnecessary heart attack, then yes, his ER visit will cost money – but the greater tragedy is that his life has been placed needlessly at risk.  If a grandmother must return to the hospital because she was sent home prematurely, then yes, her readmittance will cost money – but even worse, she will endure needless suffering.

In the worst cases, ineffective care can even result in unnecessary deaths.  The Institute estimates that 75,000 people die each year due to wasteful or inappropriate care.  Health reform seeks to address these tragedies in several ways, including the creation of Accountable Care Organizations that tie provider payments to measures of patient outcomes.  But more must be done.

The Institute’s recommendations shed light on ways that we can save money by building a more efficient medical system.  But just as importantly, they point us toward a more effective medical system, one that does a better job at keeping Americans alive, healthy, and happy.

Recently, the journalist Fred Bernstein wrote an opinion piece in the New York Times arguing that members of Congress should not provide direct service to their constituents.  He argued that constituent services helps only individuals and does not fix the system, that legislators’ requests to federal agencies will be taken as threats of removing appropriations, and that members of Congress should stick to a narrow conception of legislative work. 

My staff and I, who spend much if not most of our time dealing with the individual questions and problems that people bring to me, were troubled by this.  In our diverse, complicated country, some people are unfairly neglected or unaware of the services or rights that are due them. People fall between the cracks. Our ingenious representative government is intended to deal with that problem by enabling their elected representatives – members of Congress – to work directly with federal agencies on their behalf.

Being a representative means much more than simply legislating in some abstract sense removed from the people of, by, and for whom the government exists. It means being the person who connects each American with his or her government.  It means trying to insure that each person finds the liberty, the equality, the opportunity, and the fairness that are our goals.  In short, it means helping people.

Medicaid matters.  Many people know about its proven record of improving the health of low-income children and families – but many don’t know that two-thirds of Medicaid’s funding is devoted to supporting people with disabilities and to seniors.  Medicaid is part of the safety net that nearly every American relies on.

Ever since Medicaid was created in 1965, the federal government has paid much of the program’s cost.  In exchange, it has required states to follow guidelines on who should be eligible for the program and which benefits should be covered.

The House-passed Ryan budget, which I’ve discussed before, would tear up this agreement. It would essentially write states a check and, for the first time, allow them to set their own rules for how the money should be used.  According to the Kaiser Commission on Medicaid and the Uninsured, this could lead up to 27 million Americans to lose access to health coverage.

A better approach is outlined in the health reform law, which enables states to cover more people through Medicaid.  Expanding Medicaid would help millions of low-income Americans, including adults without children, gain access to health insurance for the first time.  It also would give more Americans access to doctors and preventive care, which would help improve health outcomes and lower costs.

The good news is that expanding Medicaid makes financial sense for New Jersey.  In fact, we would receive an estimated $22 billion in new federal Medicaid funds over eight years.  Earlier this month I sent Governor Christie a letter urging him to expand Medicaid in New Jersey.  I hope that Governor Christie does what is right and puts the people of New Jersey above politics. 

At this time last year, tens of thousands of families in our community were struggling to recover from the rains and floods of Hurricane Irene and Tropical Storm Lee.  What strikes me now, looking back, is the storm’s arbitrary fury.  I saw how some households escaped damage while others, just a few hundred feet away, suffered devastating floods.

How could anyone prepare for such a haphazard misfortune?  We do it together.

The federal government pumped $21 million in disaster relief funding into Central New Jersey last year, helping our friends and neighbors put their lives back together.  The government also helps communities invest in flood prevention, and at the National Weather Service, government scientists save countless lives by predicting each storm’s path and intensity.

I am grateful that, in modern America, few would say to those in a hurricane’s path, “Government won’t help you.  You’re on your own.”

Why, then, would so many in Congress abandon Americans when other disasters strike – when a father is laid off from work because of a financial crisis he didn’t cause, or when a mother is denied health insurance because of a cancer she could never have predicted?

Over the weekend, Neil Armstrong, the first man to walk on the Moon, passed away.

Although the Apollo project resulted in Neil Armstrong walking on the Moon, its purpose was never to send Neil Armstrong, the person, to the Moon.  Its aim instead was to use a lunar landing to establish America’s presence in space, to demonstrate America’s industrial might, and to spur new technologies and new innovations.  To be sure, Project Apollo could never have succeeded without a Neil Armstrong; he clearly had “the right stuff,” with nerves of steel and a powerful mind that could keep many systems and activities in perspective simultaneously.  But neither could Neil Armstrong have walked on the Moon without a Project Apollo.

We underappreciate Armstrong if we think of him only as a brilliant engineer or a talented pilot or a bold voyager, although he was all of these things.  He was a new kind of hero, because Project Apollo was more about us than about him.  Tonight is a full moon, a good time to remember what we as a nation can accomplish together.

Armstrong’s family released a brief and moving statement after his death.  They said, in part: “For those who may ask what they can do to honor Neil, we have a simple request. Honor his example of service, accomplishment, and modesty, and the next time you walk outside on a clear night and see the Moon smiling down at you, think of Neil Armstrong and give him a wink.”

In 1935, being old generally meant being poor.  Yet today, only one in ten American seniors lives in poverty.  Indeed, seniors today are less likely than Americans in any other age group to live in poverty.

What is responsible for this turnaround?  The answer, of course, is Social Security, which marked its 77th anniversary last week.  In its nearly eight decades of existence, Social Security has lifted tens of millions of Americans out of poverty – including about 13 million today.  Social Security also assists many with disabilities and many children who survive the loss of a parent, as I did.

Although you would not know it from the hyperbole in Washington today, Social Security has never missed a payment and remains in pretty good financial shape. According to the two independent trustees overseeing the Social Security and Medicare programs, without any changes at all, the Social Security program can pay all benefits through at least 2036.  Even after that, it could still pay out about 77 percent of scheduled benefits.  

This modest long-term shortfall in Social Security is a good reason to take steps to shore up the program.  Yet those who would use these challenges as an excuse to privatize Social Security, as Rep. Paul Ryan and others have proposed in recent years, are simply fear-mongering in hopes of advancing their impractical ideology.  Worse still, they are threatening the guarantee that is at Social Security’s heart.

As President Franklin D. Roosevelt said shortly after Social Security was created, “None of the sums of money paid out to individuals in assistance or in insurance will spell anything approaching abundance. But they will furnish that minimum necessity to keep a foothold; and that is the kind of protection Americans want.”

What if, when you were 18 years old, a federal agent rounded you up from the streets and demanded that you defend your standing as a member of American society?  What would you say?

Maybe you would say that you were working hard to gain an education:  that you had graduated from high school and were working toward college.  Maybe you would say that you had enlisted in the Army and were ready to defend your nation.  Maybe you would say that you were peaceful and law-abiding – that you had never committed any serious crime.

What if, despite all of your arguments, the United States government threatened to expel you from the country?

That is the situation that, for many years, millions of people throughout the United States have faced.  They are the so-called “childhood arrivals”:  immigrants who were brought to this country as children, who have since grown into productive and valued members of our society.  Whatever your feelings on America’s immigration policies, surely you can agree that these immigrants represent our lowest deportation priorities.

In June, President Obama took a stride toward making our immigration system more rational, fair, and economically beneficial.  He announced that his administration would refocus its enforcement efforts on preventing illegal border crossings and on deporting violent criminals while, at the same time, deferring action against certain childhood arrivals.

Earlier this week, U.S. Citizenship and Immigration Services announced the guidelines for the program.  In general, individuals are eligible for two years of deferred action, subject to renewal, if they are under the age of 31, came to the U.S. before they turned 16, have not committed any serious crime, and have either graduated from high school or been honorably discharged from the Coast Guard or Armed Forces.

More details, including application instructions, are now available on the USCIS Childhood Arrivals website.  If you have questions about or difficulty with the application process, please let me know.  You can reach me at 1-87-RUSH-HOLT (1-877-874-4658) or at holt.house.gov/contact.