Floor Statements

I thank the gentleman for yielding.

Madam Chair, I rise in opposition to H.R. 3221. What we are doing here today is using our country's financial crisis as an excuse to eliminate an industry that has proven to be more popular and at least as well run, if not more so, than its government counterpart. I might add that my son just used this program for his own education.

A unified Democratic majority of the House, Senate and White House created the Direct Loan Program in 1993. Back then, many Republicans were skeptical that the Democrats' intention was to simply ``introduce competition and keep private lenders honest.'' In what is literally their first opportunity since then with a unified majority, they are proving Republicans' suspicions correct. The comparisons to our health care debate are obvious and too strong to ignore.

In the debate we are having on health care, our friends on the other side of the aisle are making the case that we need the government and private industry to compete to provide consumers the best choice. So it's astonishing that we're considering a bill that eliminates the Federal Family Education Loan program, which consumers are choosing by a nearly 3-1 margin over its government-run Direct Loan Program alternative. So much for competition.

What's worse is this legislation may increase the deficit even more. If we use CBO's generous assumptions, this bill will save $13 billion over the first 5 years, but only $7 billion over the next 10 years. That means in the second 5 years of the bill's scope, the bill will actually cost taxpayers $6 billion in new funding. This does not even begin to address what happens in the second 10 years when the spending doesn't have to be offset. It's just so disingenuous to pass more debt on to future generations while calling our actions

``fiscally responsible.'' That's only if the assumptions are correct. The CBO has estimated that, if the default rates run higher than their estimates, this bill could cost taxpayers $33 billion more in 10 years.

The spending would be less troubling if it weren't mandatory spending, which means it goes on autopilot and is never reviewed by Congress for effectiveness, and it never has to comply with annual budgets.

The most disappointing aspect of this whole debate is that there is an obvious bipartisan alternative that achieved 388 votes in the last Congress. The Ensuring Continued Access to Student Loan Act, which ensures that private lenders can make it through a tough credit crisis, should be what we're considering today instead of this partisan approach.

Since passing in the last Congress, we should all be commending Chairman Miller and members of the committee who were here last year for a job well done. Instead, the Democrats are, once again, trying to have the government take over private industry, which is providing a service the American people like.

Here is the bottom line in this debate: if you like multibillion dollar programs that have zero oversight from Congress and are on autopilot, vote for this bill. If you like to increase unemployment, you should vote for this bill. If you believe Washington bureaucrats will improve their performance and will find ways to become more efficient by eliminating their competition, you should definitely support this bill.

If you feel like we should be seeking common, bipartisan ground on the future of our children's education, please join me in voting ``no'' on this program and in voting ``yes'' on the Kline amendment.

Madam Speaker, I rise today to honor and congratulate the Higher Education Initiative by the City of Kingsport. The Higher Education Initiative worked to revitalize the economy in Kingsport by improving the overall education level of its labor force.

Madam Speaker, I am not the only one praising Kingsport for their initiative. Kingsport has been awarded the 2009 Innovations in American Government Awards by The Ash Institute for Democratic Governance and Innovation at the John F. Kennedy School of Government at Harvard University for its higher education initiatives.

To win this prestigious award, Kingsport had to compete against 600 other federal, state and local governments.

The Kingsport Center for Higher Education consists of five institutions: Carson-Newman College, King College, Lincoln Memorial University, Northeast State Community College, and the University of Tennessee. This unique partnership allows the Center to offer courses and programs ranging from associate to doctoral degrees.

Just recently, I moved my district congressional office to this impressive facility. As a member of the Education and Labor Committee, I support this great initiative and I thank Kingsport for their dedication to their local economy and their commitment to education.

Since Kingsport has taken the initiative towards promoting higher education nearly a decade ago, there has been a 23 percent increase in high school graduates, a 27.5 percent increase in those with Associate Degrees and a 19.2 increase in those with Bachelor's Degrees.

Education adds value and improves quality of life. I commend the City of Kingsport for their hard work and dedication that has truly made the city a better place.

Thank you, Dr. Cassidy. This evening members of the GOP Doctors Caucus want to talk to you about health care solutions. All of us are physicians who ran for Congress, in part, because we saw challenges in our health care system and wanted to be part of a debate on how to improve it. This is my first term. And when I first arrived I was energized by the opportunity to reform how the health insurance industry works and help make health care more affordable, which are probably the two biggest complaints about today's system.

I quickly realized, however, that the House Democratic majority had a radically different vision of how health care should be delivered. Rather than allowing patients and doctors to make health care decisions, House Democrats' plan is to have Washington bureaucrats decide what is and is not allowed based on its cost effectiveness.

Yes.

Well, the patient, Dr. Cassidy, is here and here. These are the patients over here. And this person right here, whoever this may be, will be one of the most powerful people in the U.S. This will be a health care commissioner who will decide what is adequate and not adequate insurance coverage. This bureaucrat right here will be very much in those health care decisions.

That's correct. And the solution should come the other way, from the grassroots up. Absolutely. In addition, they, the bureaucrats would create a system so complex that today's system would look like a walk in the park. And then to put the framework in place for government-run health care, the plan called for creation of a government-run insurance company, the so-called public option, which would, over time, bleed out the private insurance industry, because it would be mandated to pay rates less than the cost of care.

In my district, the First District of Tennessee, they call this socialized medicine, and they've sent me here with a very clear message to deliver. Please defeat this bill. People in my district want health care reform. They really, really do. I talk with people all the time who hate insurance companies, and in my time as a doctor, as you all have, I've often spent more time on the phone getting an insurance company to approve a procedure than I did actually doing the procedure. I also talk with people all the time who believe that reform is possible and that results in them getting the same care for less money. And I tell them it's possible, if we focus on rooting out waste in the system.

But even with this desire for reform, people in my district are clear that increasing Washington bureaucrats' roles in health care is not the direction they want our health care system moving in.

Yes.

That is correct. And one of the things, Dr. Cassidy, I think that's very important, that I've heard, and I've got some other comments in a minute. But I think it's very important when you hear about the cost of this health care plan. This plan's somewhere around $1 trillion over 10 years, which doesn't start paying any money out in the plan till 2013. So really, it's $1 trillion over 5\1/2\ years. Now, let me just explain why that is an extremely low number.

Will the gentleman yield?

Let me just tell you the folks out there, and we're going spend about the last half of this hour talking about the positive solutions and what we do agree on. But when I first came to D.C. and I heard of this public option I said, I've heard this before. And in Tennessee, in the early nineties we had managed care that was going to control the cost. We got a waiver from HHS and formed a program called TennCare, where we had about 8 different managed care organizations competing for your business. Now we have one.

In the 1993-1994 year, the State of Tennessee spent combined Federal, State revenue, $2.5 billion. Eleven years later, 10 to 11 years later, that had gone to over $8.5 billion. It had tripled and took up almost a third of the State's entire budget. We were complaining about 17 percent now. This took up almost a third and almost every new dollar that the State took in.

Well, actually, what happened, just to go over that a little bit, over that period of time, in Tennessee, it was a noble goal to cover as many of our people in our State as we could. But over a short period of time, 45 percent of the people who got on TennCare had private health insurance.

Our Governor is a Democrat, Governor Bredesen. As you all know and as everyone in this Hall knows, in a single-payer system, the way costs are controlled is by rationing care. Well, what we did in Tennessee was, about 200,000 people were removed from the rolls, and what did a significant number of those people do? They went back on their private health insurance.

There is another thing that, I think, you have to ask yourself. By tripling the amount of money you spend on health care, what kind of outcomes will there be? Ultimately, that is what you're really interested in.

What we ended up with in Tennessee was the highest per capita prescription drug use in the Nation, and number two, we were 47th in health outcomes.

I yield back.

Well, here, Dr. Cassidy--and then I'll turn it over to John--if you'll look at this--and it's so complicated that it's almost comical--the problem with it is that this is how your health care is going to be administered.

I do want to say for every physician in this room and in this Congress, both Democrat and Republican, and this is truly from the bottom of my heart, it has been a privilege to be a physician and to be able to provide care for people and to administer to them. I believe, and I think every Republican and Democrat believes, that health care decisions should be made between a family, a patient and the doctor.

Now, having said that, if you take a look at having to go through this, you're going to have a Benefits Advisory Committee--and I don't mean this funny, but when the Lord got tired, a committee built a moose, anything that ugly. Basically, this here is going to be deciding what's adequate here as administered by this down here. You'll have the Bureau of Health Information. We'll have comparative effectiveness outcomes.

I want to tell you the other thing. The people who really need to be fearful are senior citizens when you start looking at getting rid of Medicare Advantage and when you start talking about carving as much as $500 billion out. I don't think our seniors right now feel like too much is being spent if you'd talk to them and see what their supplementals cost. Well, do you know what that means when you spend less money? You're going to provide less care, and there's no plan in the world that can provide more and more care for a lot less money.

In our own practice, we had traditional health insurance, as most people did, 80/20 cost. As Dr. Fleming was saying, costs were continuing to go up, and about 3 years ago we introduced this plan for the physicians. There are 11 of us in the group, and all of us decided to go on this plan. And 2 years ago, we have a group that has 294 employees that elected to get their health insurance through our plan at the office: 294, 70 providers, doctors, and extenders. Eighty-four percent of those, of our people, our employees in our office, chose this plan because it put them in control of the dollars.

Let me explain to you how that is. If you believe in wellness and prevention--and the way our plan worked was you had a $5,000 deductible. That scares everybody to death. But our group put $4,200 per person in there.

Yes.

And guess what the empowered person does? At the end of the year, they've been healthy, they've taken care of themselves, they keep that money. But let's say they have an illness or a wreck or something happens to them. Anything above that deductible is paid 100 percent. So you have catastrophic coverage, but you're in control of the first dollars. And by doing that, again, I think as you pointed out in our Education and Labor meeting, that particular type of insurance protection is 30 percent lower than standard.

That is correct. And when you empower consumers, as I've said, how many of us have driven across four lanes of interstate to buy gas 3 cents a gallon cheaper? Americans are great shoppers, and they will look after it, as opposed to--when they're spending their own money, they are very careful with it, as opposed to the government up here which is not careful with their money.

Would you yield?

The Empowering Patients First Act that you just talked about does not contain, as Dr. Broun just described, these mandates, these taxes.

That's correct.

If the gentleman will yield, I have a letter that I received from a constituent which was given to me this past week; and I think it's worth passing on. It says:

``Dear Dr. Roe,

``My wife Missy and I are aware of the struggle you face on Capitol Hill over government-run health care. We wish to offer you our personal story of how the current system saved our son, Robby, to use as you see fit to put a human face on our side of this issue. Robby suffers from unbearable pain that began when he had a severe infection he contracted September 2007. It began one Saturday. He went to bed feeling a little off and woke up the next morning with a severe ear ache. Within 5 hours, his eardrum ruptured. In spite of several courses of antibiotics, this infection continued to spread into every cavity of Robby's head, and it began to attack his nervous system and his brain. The pain was torturous. Robby was admitted to the Knoxville Children's Hospital for over a week. The infection finally stopped with I.V. antibiotics, but the damage had been done. Robby lost the ability to walk. He also developed a motor vocal tick associated with constant shooting pain in his head. We researched Robby's symptoms and found doctors at Vanderbilt Children's Hospital in Nashville and Children's Hospital of Philadelphia where Robby was treated by the head of pediatric neurology. We were able to visit these doctors and receive treatment for our son only because our private health insurance gives us the flexibility to do so. In the last 18 months, Robby's been hospitalized six times, including most of this March. Pain medicine, including morphine, PCA, hydrocodone and Demerol gave no relief. He had to be sedated for over a week until the pain subsided. There is still no definitive diagnosis. In spite of this, Robby has had multiple exploratory procedures, MRI, CT, et cetera, and tried nearly 20 medications. We finally found the medicine that helped 4 months ago. This has eased his symptoms significantly. He is doing much better but is still not able to return to school. Throughout this ordeal, the medical system has been helpful, responsive, timely and accessible at all levels. We were always around to be a part of the decision-making process in our son's care from medicines and procedures to which doctors and hospitals treated him. We recently learned of another boy in our area who was about Robby's age that suffered from similar symptoms. He died. We believe competent, fast, flexible care that would be impossible under a government-controlled system saved Robby from this fate. Missy and I lived under a government health care system in the Army. I grew up in an Army family. I remember sitting for hours in the military emergency room with a broken arm.''

He goes on, ``and we had no recourse. You can't sue the government. We are not wealthy people. We make well below the median income and have had to pay thousands of dollars out of our own pocket to get Robby where he is now. It has been a struggle, but we would gladly pay any amount to ensure the timely care and freedom of choice needed to treat our son. It is true that under a government-controlled system we wouldn't have had these medical expenses. We believe they would have been funeral expenses. Please feel free to use our story. We would be glad to testify or do anything else you feel would be beneficial.''

This is Rob and Missy Mathis from Newport, Tennessee.

Mr. Speaker, I rise today to honor a great American who also happens to be a member of my staff.

Mr. Speaker, we all know the vital role our staff members play in our individual offices and in the U.S. Congress as a whole. My scheduler and office manager, Amber Aimar, was instrumental in getting me, a new Member, off the ground and running. I found out firsthand that success of the first few weeks has a huge impact on the months to follow. We succeeded, and it was due in large part to Amber.

Amber has been essential to me, but her contributions have reached far beyond the confines of my office. Numerous times constituents have called with an urgent problem; and, because of Amber, they have found a solution that saved the day.

She began her career working with my colleague and friend, Joe Wilson from South Carolina. Amber was just as instrumental in South Carolina's Second District, and I was very fortunate to get her into the Tennessee delegation.

Amber and her husband, Allen, and their son Alexander are moving to Ohio. This move will begin a new chapter in their lives. We wish them only the best and look forward to their future success.

Mr. Speaker, we will all miss them greatly.

Mr. Speaker, the Democratic leadership is reportedly trying to find a compromise on health care reform. The only problem is they're compromising with themselves rather than with Republicans. Democrats have been trying to blame their failure to find broad consensus on health care reform on Republicans, but this ignores the facts. The facts are three committees and the House Democratic leadership sat down and drafted a bill with no Republican input. These same Democratic leaders have then made changes to the bill based on concerns raised by other Democrats. Now, Democratic leaders are continuing their negotiation with a different group of Democrats in an attempt to secure 218 votes in their own caucus.

Since Republicans aren't invited to these negotiations, here's some free advice from the House floor: If you're having this much trouble getting the majority of your conference to support

your bill, then you're going to have an even bigger problem with the American people, particularly when they find out that this bill undercuts the President's promise to allow them to continue their health care if they like it.

Republicans have many ideas on how to reform health care and make insurance more affordable for small businesses and families and reduce costs across the system. Let's scrap this partisan plan and start over with what we all agree on and get health care right for the American people.

Madam Speaker, last night President Obama addressed the American public and urged Congress to pass health care reform. As a physician who has seen the shortcomings of our system, I am glad he strongly urges reform. I want to correct something he said about why Republicans oppose this plan and support other measures.

First, he said a public plan was needed to keep insurance companies honest. Republicans don't oppose insurance reform. We wholeheartedly embrace it. We oppose the public plan because it's a backhanded attempt at moving towards a government-run system where care is provided not because it's the best but because it costs the least or, worse, it's rationed.

Second, he said the wealthiest Americans should shoulder the burden for everyone's health care with a surtax. What he didn't say is that those same wealthy Americans are many of the same people we're relying on to create jobs and help reduce the staggering unemployment rate. You can't have it both ways. We can't dramatically increase taxes on the wealthiest Americans to some of the highest taxes in the world and then turn around and expect job creation.

We support ensuring patients can get the care they need from their physician, reforming the insurance industry, making health care more affordable through cost containment and tax credits. Let's get these ideas, sit down and hammer out a bipartisan compromise.

Madam Speaker, I rise today to pay tribute to a great landmark in Sevierville, Tennessee--Sims Barber Shop.

Often referred to as an unforgettable, Sims Barber Shop has been a landmark in the community and a family tradition since the 1930s.

Sims upholds a reputation for taking care of their customers and helping folks feel comfortable when they visit Sims Barber Shop.

To give you a little bit of history, Mr. Conley Sims started Sims Barber Shop on Bruce Street in Sevierville Tennessee in 1932.

In the 1960s, Mr. Conley Sims moved the shop directly across the street, who was later joined by his son Johnny Sims in the family business.

Mr. Conley Sims cut hair 6 and 7 days per week. Conley and Johnny cut hair together until 1992 when Conley retired.

Conley passed away two years later, but his legacy is kept alive today--at Sims Barber Shop in Sevierville.

Mr. Speaker, with the national unemployment rate nearing 10 percent and Tennessee's own unemployment rate at over 11 percent, people are outraged that not more is happening in Washington to help them find work. So far, this Congress has provided those who find themselves out of work extended benefits, but it insisted on taxing those benefits. Worse, the majority has not done enough to

stimulate the economy and to produce jobs, the best benefit of all, which is a job.

Despite all of the promises of a green job revolution and the millions of jobs that would be saved or created because of the economic stimulus package, the number of jobs since President Obama took office has gone off a cliff.

Republicans have called for an immediate end to the tax on unemployment benefits, which would surely help those who have been hurt by this recession. We have also called for tax relief for small businesses who can use that money to create jobs. These measures can improve our economy immediately.

American small businesses are the most innovative in the world and will pull us out of this recession if we allow them, but Democrats seem determined to prevent any recovery from occurring. In the past month, they moved to bludgeon our economy with a national energy tax and tax on small business to finance massive new health care entitlements.

Enough is enough. Create jobs.

Madam Speaker, I rise today to congratulate and thank Appalachian Christian Village for 55 years of excellence and care. As the first retirement community in Johnson City, I applaud all the amazing

things they've accomplished throughout these very special years.

Life at the communities of Appalachian Christian Village offers exceptional opportunities for new experiences, new friendships, and a new way of life.

Madam Speaker, this community has become one of the most favorable places to retire in the country in terms of the crime rate, cost-of- living, and access to excellent medical services, among other components.

I am so thankful to have this wonderful community in Washington County. Their presence is a tremendous contribution. I wish all of those at Appalachian Christian Village another successful 55 years.

I am proud to represent all at Appalachian Christian Village in Congress, and I will continue to protect the values of the constituency while I am in office.

I certainly don't want to take credit for putting that in.

What happened in Tennessee was we had a lot of uninsured in Tennessee, and it was a very noble goal of trying to cover as many people as we could. And we had a standard Medicare plan like most States do now. We got a Medicare waiver from HHS, the Department of Health and Human Services, to form a managed care plan for the State.

And what happened was, it was a plan that was very rich in benefits, much like you're seeing in this plan and that we heard discussed last hour. Provided a lot of benefits but not much access, we found out.

And what happened was, this plan, this public plan paid only about 60 percent. Now it pays less than, I found out the other day, less than 60 percent of the costs of actually providing the care. Medicare pays about 90 percent.

So businesses and individuals made a perfectly logical decision. They dropped their private coverage, and about 45 percent of the people who are

on TennCare had private health insurance coverage, but chose to drop it.

Well, that was fine until we got the bill in the State. What happened was the bills kept piling up until they consumed more of the State budget than education did.

Well, one of the things when I got to Congress here and I began to hear the plan, I said, Well, we tried that already in the State of Tennessee. This is nothing new. It failed. And can you say failed? It was a disaster.

And the Governor ran in 2002--our Democratic Governor--his platform was fixing TennCare. Fixing what 6, 8 years later was a mess in the State of Tennessee.

Now there are good parts of this plan, as we pointed out. Things we will agree on. And I do want to show the public one thing. I almost broke my printer in the office this afternoon. But this is the bill that came out this afternoon, just to give you an idea what we're going to talk about in the next couple of days.

It's 1,100 pages.

This is where the devil is in the details, right here.

Yes.

Mr. BROUN of GEORGIA. It's interesting. After our last series of votes I was walking into my office. As I went into the Cannon House Office Building, there was a Democrat engaged in this process.

Let me go over why it's important for the public and my patients and, as physicians, our patients to understand this. What we're concerned about is if this plan becomes a public option and that's the only option. And the way that occurs is, I've explained, when the cost of the public plan does not pay for the cost of the care, more costs are shifted to your private health insurers, meaning that they'll eventually drop the plan.

Now, having a single-payer system like Canada or England, is that necessarily bad? Well, I would argue that it is in America, and the reason is because it's going to limit choices.

And I know it was brought up just a moment ago by the gentleman from Arizona about costs, and I'm going to share with you--just a family practitioner in my own district the other day called me up and said, Bill, he said, I have had one lawsuit in my career. A very young woman had a serious problem, probably not preventable. He had a grade by the insurance companies of what a good doctor he was, in the top third, always. After this one lawsuit, and nowhere is medical malpractice mentioned here, his referral to specialists in 1 year went up 350 percent. His lab ordering went up 550 percent. This is not him saying this. This is a grade he got from the insurance companies. So there is the cost side that we were talking about earlier, and who knows, when you extrapolate that across the country, how much that must be.

Now, I got this letter right here this afternoon from CBO to Chairman Rangel, 14th of July, today. And in this, it says, Another significant feature of the insurance exchanges is that they will include a public plan that largely pays Medicare-based rates for medical goods and services. CBO estimates that the premiums for that plan would generally be lower than the premiums for private insurance. But on average, the public plan would be about 10 percent cheaper than the typical private plan offered in the exchanges, and therefore, they're saying right here in this document that that's what's going to happen.

The other thing about this I found interesting was this plan doesn't start until 2013. And what you're seeing here is only in the last 6 years, this $1.1 trillion plan. It actually is 150 billion per year is what it amounts to. It's not what they're currently saying it's going to be, a trillion over 10 years. It's really a trillion-plus over 6 years.

I yield back.

Will the gentleman yield for a second?

We have been over that previously.

But a couple of things I wanted to bring out.

This is from the CBO this afternoon that scored this bill that we're looking at here. It's 1,000-plus pages. After we have this monstrous government takeover in 10 years, we still have 17 million people uninsured. And, I mean, it's astonishing to me that we would look at a bill like this and still have almost half the people uninsured with the government then making health care decisions.

One of the things we were talking about, cancer a moment ago, and I think what we want to say is--and I think the gentleman from Arizona has hit it right on the head--you need to have patients in charge of health care decisions.

When I began my practice in the early 1970s and in the late 1960s when I was a medical student, 80 percent of children who went to St. Jude Children's Hospital died of their childhood cancer. Eighty percent died. Today over 80 percent live. It's really a phenomenal story to tell a parent. Almost all children with leukemia have lived now. It's unbelievable. And that's happened in the last 35 or 40 years.

When I began my medical practice almost half the women who came to me with breast cancer--and we saw too many of those--died within 5 years. Survival rates now are in the high 90s. It's astonishing. It's a wonderful story.

When the patient comes in, they're frightened, and you have already mentioned how scary that was when you are diagnosed with cancer. But to know that you are going to get through it, that's what this phenomenal health care system in America has produced.

And what is amazing to me is that we're going to have this bill that's a thousand-plus--well, that's the start of it. It will still leave that many people uninsured. And we have heard right here tonight a better way to do it, a much simpler way from the ground up.

And let me give you one other example. It's very simple. In my own medical practice back in Tennessee, we have 290-something people who get health insurance through our practice. We have two plans we offer them. One is just your standard Blue Cross plan, 80-20, we all are familiar with. The other is a health savings account, high deductible plan where you have the first $5,000 out of pocket. You pay for that. We put $4,200 away for that.

Everything above $5,000 is paid 100 percent. Eighty-four percent of the people in that practice, nurses, technicians, whatever, chose to manage their own health care dollars, not the insurance company but them. They will lose that ability with this particular plan, and I think that was a plan right now that I use and that people all over the country want to be in charge of their health care decisions, not the government.

I thank the gentleman for yielding. This is very

simply what's going to happen--what will occur in a government-run plan. First of all, I can assure you it's going to cost you two times what these estimates are. That's what happened in Tennessee with our TennCare plan.

Secondly, the way all of these plans work is they ultimately ration care. When you have a certain amount of dollars that you spend on health care and the demand is higher than the dollars to pay for it, you create waste.

Just an example. In Canada for a hip replacement it's 2 to 3 years to get your hip replaced. Bypass surgery is 117 days. Here in this country, George Washington University very near here, or Georgetown--it will be done very quickly.

So those are things that happen in a government-run plan. And who needs to be making health care decisions are families, patients, and their physicians. That's who should be making those decisions.

Yes.

No, this is an elective replacement.

One hundred-sixteen for me.

Mr. Speaker, on Friday, the Democrats on the House Ways and Means Committee announced their intention to finance a Washington takeover of health care by raising taxes. For those of you keeping score, the Democrats' economic plan has been to spend billions of new dollars on programs that generated no economic activity in a stimulus package, increase regular appropriations spending at a rate that is sure to increase inflation, implement a national

energy tax, and now, create a tax on those the Democrats call wealthy but who you and I call job creators and entrepreneurs. While I'm no economist, I'm pretty certain that no one in their right minds would call this a ``pro-growth'' agenda.

Remember earlier this year when Congress cracked down on abusive practices by credit card companies? Supporters argued this plan was needed because too many saw credit cards as a license to spend with little or no financial repercussions. Well, maybe we need a congressional ``credit card'' reform. While there are some in this Chamber who use the U.S. Treasury like a credit card with no limit, our children and grandchildren will be paying for this shortsightedness.

Let's start by rejecting this trillion-plus-dollar fiasco being billed as health care ``reform.''

I thank the gentleman for yielding.

Madam Speaker, I think when you are looking at health care, and I practiced medicine in the State of Tennessee for over 30 years in an OB/GYN practice, delivered a lot of babies. And I can tell you, having watched this very complex system, it's unfair to the American people. We are not talking about Democrats or Republicans. We are talking about the American people here who are going to be affected, all 300 million of us are.

And when we look at the issues out there that we are dealing with, first of all, there isn't any American that doesn't want to have quality, affordable health care for all of our citizens. I don't think any of us in this body, all 435 of us want that. It's how do we get there and how do we afford it when we do get there and not break the bank.

We have, if you read various publications, around 47 million people in America who are uninsured. And of that 47 people who are uninsured, approximately 10 million, these are estimates, but are approximately 10 million are illegal in this country.

Of the remaining 35 to 37 million, we have about 12 to 14 million who currently qualify for plans that are out there, SCHIP or Medicaid, but who are not on it. So we need to find out who these individuals are and make those assets available for them.

About 9 million people make over $75,000 a year and choose not to buy health insurance. Now, in my part of the world, in the First District of Tennessee, that's a lot of money, and I assume in a lot of places in Georgia and other places around this country that's a lot of money. We have about 8 million people who make between $50,000 and $70,000 a year who are uninsured. And certainly for those, if there are families, there are ways, very inexpensive ways to make sure affordable health care is available to them.

When I first heard--when I first came to D.C., I heard the argument of the President's plan, and it turns out, I don't think the President had a plan. But the plan that was coming out of the House of Representatives is that we are going to have private health insurance and we are going to have a competitive government-sponsored plan. And I said, What exactly is that supposed to do? And they told me, and I said, Wait a minute. 16 years ago, we did this plan in Tennessee. It was called TennCare. We got a waiver from Medicaid, HHS, to provide health care for as many citizens in the State as we could. And as you know, Tennessee is not a wealthy State. We have a much lower than average per capita income in the country. So it was a noble goal. And it was the government, the managed care plans, put a very rich plan together; in other words, it was very generous in benefits.

And what happened was almost 50 percent, 45-plus percent of the people who got on TennCare had private health insurance. And what we found, and for them it was fine. I mean, they had a plan that paid the coverage, paid to see a doctor. The problem with it was it didn't pay the cost. And when I started asking, digging into this plan, I said, How much of the cost of the providers--I am speaking of hospital outpatient surgery centers. What percent of cost does this plan pay? It paid 60 percent. Medicare, another government-run plan, pays about 90 percent of costs.

So what happened was you had costs shifted to the private insurers. And these private insurers--that would be the other businesses in Tennessee--their costs went up and up and up when they tried to buy health insurance. So more and more people were dumped into the plan because businesses couldn't afford it.

How did the State of Tennessee handle this?

Exactly. They made a perfectly logical decision. It was cheaper to go into the subsidized government plan than it was for businesses that were struggling to survive anyway.

And when you add this extra cost, they dropped that cost onto the public

plan. Well, what happened was the State couldn't even afford even paying 60 percent of the cost of the care. There were so many people on it, the health care part was getting more than all the education and the other things that the State was providing.

So our Governor, who is a Democrat in the State of Tennessee, and a Republican legislature, they had to cut the rolls. You only have two choices: You can either cut the rolls or you can ration care. So I predict to you, Dr. Broun and Madam Speaker, that when this public option comes out there, that it will be exactly like that. It will be a very generous plan subsidized by the taxpayers and supported by that. And businesses, especially small businesses first--the ones who provide most of the jobs in this country are small businesses, and you want to make it easier for them to provide the benefit, not more difficult-- they will drop that. And over time, this will morph into a single-payer system.

Now, some people, Madam Speaker, would say, Is that a bad idea or a good idea? I think some people would be happy with the single-payer system. I believe health care decisions should be made between patients, their families, and their doctors. And you don't need a bureaucrat, no pun intended, injecting himself into this very important decision, in health care decisions. That's what will happen.

In this plan in England, they have a comparative effectiveness, as you well know, called NICE. And what an acronym for NICE, and let me explain that to the viewers out there. What happens in a public system where it's funded by a single payer--for instance, the taxpayer, in England the government--a board or committee is put together by the government to evaluate the outcomes of certain treatments.

Well, they have, for instance, if they estimate in England that you are in your last 6 months of life--and a cancer, for instance, a cancer treatment, they might invest as much as $22,000 in you, about what a used Honda would be.

Well, I don't think the American people, I know the American people, I know the American people in my district, Madam Speaker, in your District, are not ready to let the government decide that your life and your family's life is worth that. So that is sort of, in a nutshell, where we were or are in Tennessee dealing with this.

There are a lot of other options out there. I think these mandates for, in this particular legislation which we haven't seen other than just a synopsis of it, we haven't seen the full legislation. And, of course, the devil is always in the details.

So I want to sit here and look at the American people and tell them that the Doctors Caucus, the conservatives in this House, I think both the Republicans and the Democrats, want to be sure that the patient and the doctor are making those very important health care decisions and not the Federal Government.

I do. When I began my medical practice, we had the same survival statistics that they did, 50 percent 30 years ago. In stage 1 disease now in America now it's as high as 98 percent 5-year survival. So when the patient comes to us, Dr. Broun and Madam Speaker, and they say, Dr. Roe, what are my chances of living? I am go going to look at that patient, I am going to look at her and say, It may be tough, you may have some down days, you probably will, but you are going to make it. You are going to be okay.

And we can provide that kind of hope in this country for our patients. I look at St. Jude's Children's Research Hospital in Memphis where I was a medical student, and when I first went there, 80 percent of children died of childhood leukemias and cancers. Today, over 80 percent live.

I had one of the greatest evenings this last Monday night of a young boy I had delivered 16 years ago, and 2\1/2\ years ago his mother called me and said, Dr. Roe, I am afraid my son has cancer. And we were there for that 16th birthday to celebrate. He is cancer free, and that is a wonderful, wonderful thing to celebrate. And my joy goes out to that family and that community. The whole community celebrated. And that's the kinds of things we have seen, I think, in America, with our health care system.

And I think back, Dr. Broun and Madam Speaker, when I began my medical practice, we had only five high blood pressure medicines. Three of them made you sicker than high blood pressure did. Today, over 50. Antibiotics, there was one type of cephalosporin antibiotic. Today, over 50.

We have all of the new robotic surgeries, laparoscopic surgeries that I was able to do and privileged to do in this Nation and provide everyone. I was at a business meeting not long ago, a year or so ago, and they said the health care system, certainly there are excesses, we need to do a better job of managing the system. They said, You need to run this like Southwest Airlines. I said--well, I was in Washington when I was told that. And I said, I will tell you what we will do. We will go over to Reagan National and we will pick a guy up who lives under the bridge there, a homeless person, and we will show up at Southwest Airlines. And I will go in my pocket, and I will pull my credit card out and I will say, here, I want to fly and the guy with me can fly, but the man that has no money can't.

And in America, if we all three get in there and go back to George Washington University's emergency room, day or night, 24 hours a day, 7 days a week, regardless of your ability to pay, in America we will take care of you. Now is that the best way to do it, and I would argue it is not. And that's what this debate should be about is how we better use those resources.

That is correct.

That is correct.

Yes. I know that only you can show up at an emergency at any time, but the only hospital that I have had patients denied care because of some bureaucratic snafu, they didn't qualify, was a government hospital, the VA. I have never had a patient refused care that I have taken care of if I said this patient has to be in the hospital. Our problem is not the quality of the care; it's figuring out a system to best pay for it. That's what we are dealing with here. And we are not going to wrap this up and be fair to the American people in 2 weeks.

It's too complicated. I was speaking with a friend of mine this Monday in Kingsport, Tennessee, Dr. Jerry Miller, and he and I were in a very detailed discussion about how complex when you're looking at home health care, oxygen infusion, devices, occupational therapy, physical therapy. All of that goes with increasing and improving the quality of your life. That's what we're dealing with, an incredibly complex system. And I don't believe that the government can best run this system. I think that the private sector is much more equipped to deal with new technologies.

I'll give you an example. I think if we were waiting on the government to develop a da Vinci robot, you wouldn't be having your da Vinci robotic surgery right now.

We see radical prostatectomies for prostate cancer that now are done in a couple of hours or less with very minimal blood loss. I mean, before radical prostatectomies, it was several hundred cc's of blood. Now it may be 75 or a 100 cc's. Minimal blood loss. Patients are leaving the hospital in a day or two and resuming normal activities incredibly fast.

Yes.

I would agree with that. I think the biggest problem you have when you don't have enough resources in the system to develop new medications and new technologies, new treatments, new pieces of equipment, there's no question that you freeze in time where you are.

I recall it wasn't a day that I would go to the operating room that I wouldn't see somebody back in the seventies getting operated on for an ulcer, bleeding ulcer. It's almost unheard of now because of medical treatments and other endoscopic treatment. You have almost eliminated that very invasive surgery. We certainly don't want this to slow down.

One of the things that I think we value in America--I know we do--is we value every human life. Every life has great value here. And that's one of the things that I've seen in my practice. Whether you are rich or you are poor, you are valuable to the American people and to the health care system. And we're going to take care of you.

Dr. Broun, Madam Speaker, one of the things that's an untold problem in the health care system is the availability of care--the accessibility of it, I should say. In the next 10 years, 50 percent of our registered nurses are able to retire. Fifty percent. We need a million more nurses by 2016. That's only 7 years from now.

So we need to be encouraging young people to go into these very needed specialties in medicine and as physicians. We're already behind the curve. In the next 10 years we will have more physicians retiring or dying than we're producing in this country. And the population is growing and the baby boomers are going to need more care. And guess what we're doing? We're living longer than we've ever lived in the history of the world.

So we have a multiprong problem. It's not just that; it's do we have access. Am I going to be able to find a nurse and a doctor to take care of me.

I yield to the gentleman.

Will the gentleman yield?

I think, Madam Speaker, what we need to do is look at the problem we're faced with. What are people concerned with? Well, affordability. Certainly, we've got to deal with this.

Number two is accessibility. We have talked about that somewhat. Thirdly, when we have a job, our health insurance is tied to our job. So we're concerned if I lose my employment, I lose my job.

Do you need an entire government takeover of medicine to address those issues? No, you don't. When you look at portability, that's certainly one thing that I think can be done with very minimal government involvement.

I will give you another quick example. Many of us have children. And today is a very poor work environment. So when you see young people come out of college or out of high school today, it's very difficult for them in this market to find a job.

But guess what happens to them when they graduate from East Tennessee State University or the University of Georgia, wherever, and there's no job available? They lose their health insurance coverage. Why not just leave them on their parents' plan until they're 25 years old? It wouldn't cost the government a nickel.

Do you know how many people that would cover, estimated, in this country? Seven million young people. And I know for all three of my children, when they got out of school, they all needed help with their health insurance coverage. I had to go out and buy a private health insurance plan, which was not tax deductible.

Another example I'll give you is myself. Last year, when I worked in my medical practice, I provided health benefits. That was one of the benefits we have for our employees and for me. I retired from my medical practice to run for Congress. The next day, my health premiums went up 33 percent because they were no longer deductible.

That's not expensive for the government to do. Simply allow individuals out there who want to purchase their own private health insurance plan--if you're a farmer or small business person, let them deduct that exactly like GE does, or any other large business

Yes.

Will the gentleman yield?

I would like to know the logic. I haven't had anyone yet since I've been in this body give me the logic of why a corporation with multiple assets is allowed to take a--let's say a small businessman. Let's take someone who is in a small landscaping business, who takes care of my yard--I should be mowing it myself--but who takes care of my yard.

Why shouldn't he be able to deduct as an individual employer--he's just got himself, is all he works for--why can't he deduct his health insurance just like General Motors does? I've never had anyone yet explain to me. You could help a tremendous number of people in this country if we did that simple thing.

I yield back.

Would the gentleman yield?

I would argue that would even do more than that, because it would do just the opposite of what the public plan will do. What it will do is, if you make that available where the uninsured can afford it to this tax break, it will make less people uninsured and therefore less cost-shifting to the people who already have health insurance.

I would argue it would do exactly the opposite. I bet you if we try, it will work immediately.

The challenge we have in a down economy, there's no question, is when people lose their job, they lose their health insurance. And it can't be COBRA. As you all know, Bill Gates can't afford COBRA, it's so expensive.

We have to have a plan that is affordable for people when they're unemployed. That's a real challenge, there's no question.

I yield back.

I am going to make an impassioned plea to the American people. A week ago we saw a cap-and-trade tax here that was brought before this House, not thoroughly vetted, a very, very important issue, and not read. Let me say this again--and I get angry when I think about this, something that affects every single American. Not one Congressman of the 219 that voted for that ever read the bill, and it will affect every American. I want to challenge this body right here and now not to bring a bill here in 2 weeks which no one has read, which affects the most precious decision, the care of you and your family and your children, and you haven't even read it. The American people need to know every dot and T in that bill before we have the audacity to pass that bill on to the U.S. Senate.

I yield back.

Just to amplify what you've said. Madam Speaker, years ago we had a test in our office, which we did about 10,000 of them a year. We contacted a local pathologist and said, We'd like to pay $10 for this test; and they said, Well it's $100,000 of income. We'll be glad to. Well, we couldn't do that because--guess what--it was $5 less than what Medicare paid. So we had to charge all of our patients $15 for this test. So that one little office, that one test ended up costing our patients another $50,000 in one medical practice in little old Johnson City, Tennessee. Now I've seen that already. You can amplify that across the country, and you can imagine the billions of dollars that are being wasted because of a lack of competition in the health care system.

I think the thing that I want the American people to understand is that for 30-something years I have had to look at patients, some who had health insurance and some who we had to try to figure out, How do we get this patient care? And that is certainly a patient we want to find out. We're the ones who go to the emergency room at 3 o'clock in the morning and treat a sick child or see a youngster who has a fractured arm or whatever. We're the ones who provide this and go out there along with the other health care providers. We want a way for that system to flourish as efficiently and as cost effectively as we can. And we can do this. We have solutions out there. The solution is not the government running your health care. That will be a problem. It will be a problem as far as innovation is concerned, as you've pointed out. It will be a problem as far as access is concerned. Access is already a major problem that we have to address.

I want to tell the American people--I want you to be engaged in this, learn about this. Call us. Tell us what you think. One of the last patients that I saw in my practice was a 60-something-year-old woman who worked, who didn't have health insurance. And quite frankly, that is a problem. She is 60 years old, just before Medicare. It's something that can be dealt with, though, without a complete takeover of the government health care system. The people had better pay attention. These next 2 weeks will be the most critical debate about health care that's occurred in the last 45 years.

I yield back.

Madam Speaker, I rise today to congratulate Sycamore Shoals State Historic Area on their play ``Liberty!'' being recognized by the Tennessee General Assembly as the official outdoor drama of the State of Tennessee.

``Liberty!'' has been performed annually during the month of July for 31 consecutive years. ``Liberty!'' tells the story of Tennessee's frontier beginnings by portraying the relationships between the American settlers and the native Cherokee Indians.

Hundreds of gifted local volunteers come together at the location where these historic events actually occurred and celebrate the lives of the people and depict important episodes that helped shape the heritage of this great state and country.

I want to congratulate and sincerely thank all of the volunteers that contribute their time and efforts to ``Liberty!'' for honoring our great state of Tennessee.

Mr. Chairman, I rise in support of the Paulsen amendment to give special consideration to SBIR funding for medical technology.

The underlying legislation prioritizes projects that are related to energy and infectious diseases, and there is no question that these are deserving areas. But I believe the Paulsen amendment adds an important priority category that is left out, medical technology. The fact is, because of our health care system, we lead the world in medical technology advances. It's a huge competitive edge we hold and one I do not want to lose.

As a physician, I was able to take advantage of this technology over the course of my career, and I can give numerous examples of how care was improved for my patients. Prioritizing SBIR funding for medical technology projects is one step to help us maintain our edge.

While this amendment will take steps toward creating a fertile environment for medical technology advances, it is important not to take two steps back by creating a government-run health care system.

A major problem with care that is managed by Washington bureaucrats instead of patients and doctors is that bureaucrats are focused on cost rather than advancing care, and they inevitably require the use of older, less expensive technology because of its comparative effectiveness.

If the health care system refuses to use new technology until older technology is proven ineffective, we eliminate much, if not all, of the incentive for new medical technology developments and rob future generations of the chance to find cures for cancer, Alzheimer's, Parkinson's, and diabetes, just to name a few.

I urge adoption of the Paulsen amendment, which to me is just common sense, and hope this Congress does all it can to keep the health care system that rewards medical research and development.