Floor Statements

Mr. Speaker, what we are doing today is sort of a continuation of the theme that since the beginning of this Congress we have been walking through. So let's put this sort of in context.

This is probably our fourth or fifth time to come to the floor and do part of this theme. The first time we did this we took almost an hour and we actually sort of walked through what is happening in our society, when you actually do the math of the massive unfunded liabilities in Medicare; the issues with the fact that in 9 years, 50 percent of the noninterest spending of this government in 9 years will be to those 65 and over.

So it is important to understand what is happening to us demographically. Much of that difficulty that is coming toward us is about healthcare costs.

One of my passions has been trying to get an understanding of this. There are a number of things we can do to actually deal with the fact that we are getting older as a society. We are seeing what is happening on our birth rates. The fact of the matter is, those of us who are baby boomers--there are 74 million of us--and in 9 years, all of the baby boomers will be functionally 65 and older.

It is a demographic bubble moving through our society, and there are benefits that we as a society have been promised. So what do you do? How do you make sure you have a vibrant enough economy to keep our promises? How do you make sure we have a vibrant enough economy not to crush the young in their opportunities?

We have been laying out five little legs. We will call them our proposals, everything from an immigration system that is talent based so you maximize economic vitality; policies, such as tax, regulatory, trade, that maximize economic growth; policies that are all up and down, whether it be our programs within the social safety net, or just incentives within Social Security, and Medicare; other programs to stay in the workforce or enter the workforce because labor force participation is crucial.

We had a good number last month where we broke over 63 percent labor force participation. I know this sounds a little geeky, but it is crucial.

The fifth one--and we will come back to the fourth--the fifth one is looking at our retirement entitlements and how we design them to incentivize everything from being a good consumer to staying in the labor market longer. But the fourth one that we keep talking about over and over and over again is technology.

Once again, I put up this slide right here just to understand the scale. In a decade, you and your partner, if you have jobs, there will be two people working for every one person in retirement in 10 years: two workers, one retiree. And understand Medicare and Social Security are functioning right now as pay-as-you-go programs because we are using today's income to pay today's retirees.

The next slide is just to emphasize the scale of the unfunded liability. When you look at this slide, you will see up on the top that this is the 30-year projection. It is not adjusted for inflation. So if you want to adjust it for inflation, you can remove a third of the value. But, functionally, over the next 30 years, you have an $84 trillion unfunded liability when you add in the cost of the programs and the interest related, $84 trillion over the next 30 years.

But if you take a really close look, almost all of that comes from Social Security and Medicare. The rest of the budget has about a $16 trillion on the positive side, so you have got an $84 trillion shortfall. So what do you do as far as solutions?

Well, we are going to show some slides of some creative ideas. Remember, we are working on that. We have five piers. Right now we are going to talk about our technology pier. Just, once again, to sort of get your head around these numbers, from 2008 to 2028, the calculation is 91 percent of the increased spending of this Federal Government will be interest, Social Security, and healthcare benefits.

Your government is functionally an insurance company with an Army. So how do you have a revolution in healthcare costs? We have lots of proposals around here, and if you listen to them--and we have got to be brutally honest--think about the ACA, many know it as ObamaCare, or some of our alternatives; we are often having a debate of who gets to pay. Those don't have a revolutionary--they don't have a disruptive nature in the cost of healthcare services. We are just moving around saying: we want more government subsidies. No, we want more nongovernmental private-sector competition, but we are often moving around who gets to pay.

Our argument is we are in the middle of a technology revolution. How many of you have a watch that helps you manage your blood pressure? How many of you have seen the patch that helps you manage your blood oxygen? There are a number of these sorts of things--we call them digiceuticals--that are coming onto the market. We as a body need to drag technology into this debate so technology brings us a disruption in the cost.

I say this over and over and over, but it is a good visual. When was the last time you went to Blockbuster video? Didn't it feel like almost overnight from going down and getting the little silver disk and getting a movie recommendation to now you go home and hit a button? We are living in a society that is having an amazing technological revolution.

What happens when this supercomputer in your pocket is functionally your primary-care physician? It turns out that that technology is here today, but we as a body need to talk more about who gets to pay and more about lowering the price of healthcare.

I will argue that the elegance of dragging this technology, removing the barriers, removing our inequities in the compensation for using this healthcare IT is we will be healthier. We will deal with our issues much faster, particularly for those of us who have very busy lives, instead of waiting for that appointment.

So I want to just show some of the revolution that is already out there. These things are already out there in our society.

This next slide shows a handheld ultrasound. It is basically the size of your phone. You plug it into your Bluetooth, or you plug it into whatever, iPhone--at least I think this one is an iPhone in this picture--and it is a handheld ultrasound.

What happened to the days when you used to have to go to a medical clinic that had the specialty equipment? You would sit there and find out that you had a bone chip in your heel. Now, you are at your office, your nurse's office, your company's office. You can actually buy this as an individual. You can actually see, and we are reading articles that are saying very soon you won't actually look at the picture. You will use this handheld ultrasound and the algorithm will actually tell you what it is seeing. This is a revolution.

Right now, I think you can buy one of these on Amazon for under $2,000. Conceptually something that used to be a large piece of equipment is in the palm of your hand. That is a revolution.

We are about to have a series of discussions about drug pricing. Drug pricing is a huge component of what we do to have a revolution in the cost of healthcare.

Here is a quick thought experiment. What if I came to you and said: 50 percent of the pharmaceutical prescriptions that will be written this year will not be properly used or used at all. So just as a thought experiment, half the pharmaceutical prescriptions written this year just won't be used at all, or will be misused.

Well, right there--it is absurd to say if we would fix this problem we would have a 50 percent reduction in the need to pay for pharmaceuticals, but it could be a huge impact. This has less to do with fighting over the formularies, the mechanisms over here. Will we have enough money for healthcare research? This is just about proper utilization.

So what would happen if I would come to you right now and say: I have a relative who has some dementia issues or did you take your hypertension medicine this morning? Turns out, we can actually put on a bottle cap that actually would talk to your phone saying: Hey, you did not take your pill today. Hey, you did not take your pill in the time prescribed that you are supposed to take it.

Something like this, as simple as this, is a technology solution to an issue where we know we have lots and lots of seniors that don't take their medicines on time or in the proper fashion.

We even have more complicated ones that are in the same vein. What if you are someone who has multiple pills that you take? This one was particularly designed for seniors with some memory issues combined.

This is a dispensary that was just shown at the Consumer Electronics Show in Las Vegas 3 weeks ago. At a certain time, it notifies you and drops the prescribed combination of pills into a little cup for you. It is a technology solution for drug utilization where we know that 50 percent of pharmaceuticals are not being properly used.

Mr. Speaker, I beg of us as a body, we need to get out of our rhetoric sounding like it is the late 1990s. There is a technology revolution around us. Let's drag that creative thought, creative design into our debate and say, this is more than the continuing debate of who pays, who doesn't pay. It is: we need a revolution in how we stay healthy.

Is this Republican or Democrat? I am making the argument it is technology. Now, as we joke in our office, eventually, we will figure out that one party will take a side so we can fuss at each other. But at least right now, the discussion of dragging technology into our own personal healthcare is not partisan. It is a solution. Let's go on to the next slide.

About 2 years ago I had a situation where I was cooking. It was a Sunday evening. I love to cook, and I almost chopped off my pinky. So I am at the emergency room in Scottsdale, Arizona, and I am bleeding like crazy.

The wonderful person who is on the intake side in the emergency room, as I am bleeding down my arm, is saying: David, do we have your medical records? Are you allergic to anything?

And I am going: I am bleeding. Well, the absurdity is my medical records were in the office that was closed because it was a Sunday evening. I should have my medical records with me and you should have your medical records with you. It is not that hard. It turns out others agree. This technology is out there.

Now, I had the blessing of being the co-chair of the Congressional Blockchain Caucus. I actually believe there is a really elegant way of using an encrypted, what we call, blockchain, a distributive ledger, with levels of permission. So it is more than just my medical records, because, as we are going to show in a couple more slides, this is actually just the beginning.

If I can carry my medical records with me on this, why can't I have that wearable that helps me manage my diabetes, also doing 24 hours, 7 days a week data; the thing that actually helps me deal with my heart arrhythmia, 7 days a week, 24 hours every day. That type of algorithmic data is also attached to my medical files; instead of thinking that my medical professional is going to find out I have an issue in that 15 minutes I am in their office.

This is more than a medical record concept. If I am able to have digiceuticals--wearables--that will help me manage my healthcare and help me manage my chronic condition, will I be healthier?

Mr. Speaker, it is like the contact lens that actually helps manage your blood glucose talking to your pump, so you don't crash if you are diabetic, it helps maintain you. You already see some of that technology on a number of people's shoulders today where it is actually Bluetoothing into the pump.

The revolution is already around us using these technologies. We, as a

body, need to have a very honest conversation of how do we remove barriers--and we will need our friends at the State and local level to also remove some of their regulatory barriers--to allow the adoption of these types of technologies.

The thought experiment goes a little further. In the Scottsdale area--I think we now have five or six, maybe seven of them up--there are functionally autonomous healthcare clinics. It is a crazy thought. You walk in, you sign up on an iPad, and you take a picture of your insurance card. You go into a booth, and the avatar on the screen talks to you and says: Can you shine this in your nose? Can you turn it right, turn it left? It will show you.

This avatar bends the device, and then says, put it in your ear, turn it, and down your throat, turn it, turn it. It is autonomous. Think about the cost savings.

The algorithm does a calculation and says: we are actually calculating you have the flu.

It turns out that algorithm is remarkably accurate.

Now, in today's world, at the very end of the consult, a doctor comes on to the screen and talks to you. A doctor can choose to hit the button and accept that algorithm.

But, conceptually, think about that. What if that type of technology wasn't just sitting in an autonomous healthcare clinic, but was at your school nurses' office, your office?

How about if it got small enough, compact enough, and inexpensive enough so it was at your home?

How many of us have had the occasion where we have the cold or the flu, we suffer with it for a couple days, and then we start saying: Can I go to the urgent care center? Maybe I can get an appointment with my doctor.

By the time you show up at your doctor's appointment, Mr. Speaker, you are actually already on the mend.

I have a picture on my phone of something that looks like a large kazoo, and here is the final part. You blow into this, Mr. Speaker, and it is able to tell you if you have a viral infection--the flu--or a bacterial infection like a cold.

What would happen if that large kazoo you could have sitting at home, you blow into it, it says that you have the flu, we are ordering your antivirals, and they are going to be delivered--let's say by a drone or an autonomous vehicle, if we are going to be really techno-utopian--and it is delivered to your home a couple of hours later.

How much healthier did our society get? The fact you didn't go to work and infect everyone; that you were able to deal with this almost immediately; that the time between actually getting your pharmaceutical to actually manage this infection and the moment you were feeling sick it is now hours.

How much cost did you just save out of the medical system?

So I need us all to be creative here and think this issue through. If 50 percent--actually more than 50 percent of our healthcare cost is 5 percent of our brothers and sisters with chronic conditions; we already know these types of technologies are helping us manage individuals' needs and issues who have chronic conditions.

We saw the pill bottles to make sure that--is there a way that the 50 percent of pharmaceuticals that are not being properly used or used at all are being properly managed? Our ability to manage our data is going to be coming from all these healthcare devices.

So my thesis is very, very simple. As we have the arguments about drug prices and as we have the arguments about healthcare costs, we need to have the discussion of it is time for a technology revolution, and we need to drag that technology solution into the debate in how we regulate, how we incentivize, and how we compensate.

Because, Mr. Speaker, I will make you the argument: this is the moment that--if you remember, the first couple slides were the healthcare costs that we have committed to as a society that functionally consume almost every incremental dollar of our future. What would our future look like if we were able to bend that cost curve because we actually found and embraced the technology disruption that is on our doorstep?

Wouldn't this be a much more elegant debate and a much more optimistic conversation?

That is what I have for today. But we are going to do the next phase of this next week and the week after that to sort of walk through these pillars of, there is a path where we can make this work.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I am going to try to do a couple of things tonight, and some of this is actually to answer some correspondence we had into our office when we did part of our, we will call it, unified theory presentation a couple weeks ago on what we see happening.

I have two key points I really want to try to drill home tonight. I am going to say them over and over, and I am going to use a number of different slides to talk about them.

Mr. Speaker, one is, it is obvious. You see what is happening in our mandatory spending, but that mandatory spending is substantially driven by our demographics. We are getting older as a society, and we need to just deal with that. That is not Republican or Democratic; it is basically math.

Those of us from the baby boom--there are 74 million of us--the peak of the baby boom, I believe, right now, is about 63 years old. A lot of the reforms should have happened a decade ago. Now it is almost too late.

So how do we deal with the fact of the matter? We are going to see a number of slides of what is about to happen in our mandatory spending curve and what that means to the financial impact of our debt and our economic growth in our society, because much of the debate you will see behind these microphones, I believe, is actually missing the point.

We joke in our office that D.C. is substantially a math-free zone. We are going to try to actually do some math.

The reason we put up this slide is very, very simple: just to visualize it. It is about a year old.

This new CBO report update came out today. We are grinding through it. We have a couple slides here from that.

But just to visualize, this is 1965, and that is 2018.

Mr. Speaker, do you see the red area on the 2018? That is to give you a sense that we don't vote on that. That is on autopilot. The blue area is actually the defense spending; that is about 15 percent. The green is basically everything else.

So remember, 70 to 75 percent of all of the spending around here is on autopilot. I am going to show you, Mr. Speaker, in a number of these slides how much of that is actually really based on our demographics.

This slide is very powerful--and I am going to bend it just a bit to try to understand.

Now, this is done by the Manhattan Institute. It was done about a year ago. So we are going to try to get the numbers updated.

Now, this is not adjusted for inflation. So when it says what is causing an $84 trillion deficit, functionally, over the next 29, 30 years, you can take off about one-third if you want to do the inflation adjustment in your head.

But when you look at it, the point is up here. You see the first bar; that is Social Security. The middle bar there is Medicare, and the third bar is everything else.

Mr. Speaker, you will notice everything else over the 30 years is actually positive in its impact on revenues, but Social Security and Medicare are the

vast, functionally, almost all of that $84 trillion of debt.

It is demographics, it is math, and we need to deal with it, because as a society and as a government, we have an obligation to keep our promises. These are earned benefits. But how do we do it?

We are going to talk about how we keep our promises in the last part of these slides.

But, once again, I am trying to make the point that the scale of the problem, if you have a political person, an academician--anyone--and they are talking about the future of this country, if they are not talking about what is happening to us demographically and our entitlement promises, then they are not telling you the truth, Mr. Speaker, because this is going to drive all policy around it.

Now, I will have lots of conversations with folks back home in Arizona--which is just beautiful; I think it was 74 degrees today in Scottsdale--and I will get: Well, I paid into the program.

And you did, and we have a social contract with you on those benefits, but we do need to understand some of the actual math.

This is sort of the average person who will be moving into retirement over this decade. For Social Security, you will have paid in about $540,000 in Social Security taxes. You are going to get about $616,000 back out.

Those two are fairly in balance, even though all that money that went to the trust fund then is loaned to the Federal Government, and then the Federal Government--actually, Treasury--puts special T-notes. The last time I checked, they were paying like 3 percent, so they had a reasonable rate of return.

But the one that causes most of the deficit over the next decade, two decades, three decades, you look at Medicare. The average person will have paid about $140,000 in Medicare taxes. They are going to get $422,000. So 140 in, 422 out.

When you see that number, it is an understanding that we need to do the things that would bring price disruption to the delivery of those health services. If not, think of this: 74 million baby boomers--74 million baby boomers--and, on average, we will have put in $140,000 in Medicare taxes, and we are going to get $400-some thousand in benefits back out. The math is just devastating for our economic future.

This is a brand-new slide. This is in today's CBO report. The reason I had this one printed is to understand, in 9 years, according to today's CBO report--9 years--50 percent of all Federal spending, not counting interest, just 50 percent of all Federal spending, will be to seniors.

Just understand what that means. I believe, in the early 1970s, for every dollar that went to seniors, $4 to $5 went to our children. It has, obviously, more than doubled in the other direction.

It is just demographics. We are getting older. Birth rates have substantially collapsed in the country.

But this is in today's CBO report, just to get our heads around it. The dark brown you see on top, that is those who are 65 and older. What is more of a rust color, those are 20 to 64, just to give you an idea of the population differences. Yet, the brown part, in 9 years, is 50 percent of all Federal spending. We need to understand that it is demographics.

Another slide, just to sort of make the point here, if you were to go from 2008 to 2028, take those years, 91 percent--91 percent--of the increased spending of the Federal Government is, functionally, interest, Social Security, and the healthcare--we will call it healthcare entitlements, healthcare delivery. That can be Social Security. It can be Medicare. It could be Indian Health Service.

Think of that. Ninety-one percent of all the spending growth from 2008 to 2028, over those 20 years: Social Security, interest, healthcare entitlements. Ninety-one percent. It gives you a sense of where the spending is.

Yet, we will have hours and hours of debate on this floor over this coming year on trivial issues, because this is really difficult. This is hard. No one really wants to talk about it because the math is difficult. There are lots of zeroes.

The elements of it mean some very difficult things for someone like me who believes one of the greatest issues of our time is retirement security. Yet, 91 percent of the increased spending from this Federal Government over that 20-year period: Social Security, interest, healthcare entitlements.

Now, this is a brand-new slide. We are going to, over the next couple weeks, come back and do some more analysis on the CBO report today, the Congressional Budget Office report, and what it is telling us.

This is a little awkward. We have never printed one this direction. I hope it works. This is directly from today's information, the budgetary policy release.

See those lines? The only reason I put that up is to understand, whether it be what you all think of as the Social Security trust fund, the Social Security disability trust fund, or the Medicare trust fund, you will notice, in the next couple years, all of them go below zero.

We need to understand the impacts, that demographics spending promises have now caught up with us, and we are emptying out those trust funds.

This one is a good one. If you are like I am--and I know I am blessed to have some folks who correspond with me after we do these presentations. They have a fixation on: Well, what is the spending as a percentage of the size of the economy?

In many ways, when you have someone throw out a debt number, the number that is most important to most economists, actually, is: How much is that dollar amount as a percentage of the size of the economy? That is why there is this fixation for many of us here that we have to grow the size of this economy, because that is how we can digest the amounts of debt that are, demographically, about to come to us.

Do you see this number out here, that 15.1? Understand that is, functionally, 9 budget years from now. That is saying, 15.1--and this is from, I believe, today's CBO report. It is saying, in 9 years, 15.1 percent of the entire economy will be Federal Government mandatory spending and 5 percent will be discretionary. Remember, discretionary is things like the military, parks, healthcare research.

All those things will be 5 percent, and 3 percent of the entire economy's value will be what we are spending just to cover interest. Add those together, and you start to understand: In 9 years, Federal spending, we are over 23 percent of the entire GDP.

What should blow off this page to you: In 9 years, over 15 percent of the entire Nation's economy is just covering the mandatory spending here. That is under today's policies.

Now, in the next couple weeks, we will do more of this, and I am going to find a way to print some boards that become more digestible, because I will get calls that will say: Well, David, just do this. Lift the caps on Social Security.

Well, let's look at some of those numbers. If we come over here and start to say to eliminate FICA caps from the 15 percent payroll tax, so just lift the caps, you have to understand that it covers 0.78 percent of the 6-plus percent of GDP shortfall.

These are all the pop solutions that I hear often from my friends on the left. You start to add them up, and they cover only fractions of the avalanche of debt and spending that are coming at us.

We will do some more breakdowns on these over the next couple weeks, just to understand where the real math is, because we have a classic problem around here. Our rhetoric doesn't actually fit our calculators.

Let's walk through some of the other things that are going on. I have repeatedly come behind this microphone and talked about something we in our office refer to as the unified theory. I believe there are, functionally, five things out there we have to do to sustain the future and survive, those of us who are baby boomers, and our earned promises, our entitlements.

The first one we talk about is: What are you going to do to maximize economic growth? What are you going to do to keep people in the labor force?

This one here that I put up, this is a chart of what we call labor force participation.

We were all joyful when we found out in December that we crossed over 63

percent participation. But, remember, it was only like a decade ago that we were close to 67 percent of our population participating in the labor force, working.

There is a great article today, if you have a chance to look at it, in the Wall Street Journal, talking about, in this incredibly robust job market we have today, where we have, functionally, hundreds of thousands--millions, if you actually do the average out--of positions looking for workers, that we are starting to see something that is really good for society. Those who have had a rough time are moving into the labor force. Those who have designations of having handicaps, maybe on Social Security disability, others, are moving into the labor force.

I am fixated on this particular slide because we have to do better. I ask every policymaker, whether you are on the left or the right, to think about how we design these programs that are meant to be our safety net. How do we design them to encourage work, to encourage that participation in the labor force? We have to have that on this end, if we are going to have the resources on the other end to keep our promises.

We are going to go through all five things that I believe, optimistically, can get us there.

This one I put up just because it is from Arizona. A bit of trivia: You saw the numbers a few months ago talking about the collapse, functionally, in U.S. birthrates, you know, down to 1.67. Do you know what State had the largest fall of birthrates? It was actually my home State of Arizona.

You start to see this and understand the scale we are at. We are substantially below replacement rate right now.

When you see this slide, you immediately should start thinking about what we can do as incentives in our society for family formation with children, but also what are the levers within immigration that would help us move to certain types of population stability.

Before we go to the next slide--let's hold off on that one--let's walk through sort of an optimistic vision of what we can do. It is big; it is complicated; and it is going to require a lot of us to explain really difficult things to constituencies that have heard politicians for decades now saying: Well, if we just take care of waste and fraud.

You understand, there are problems out there. It needs to be fixed. I believe there are technology solutions to stop the waste and fraud. It is a fraction of a percent of what is actually happening out there.

So let's walk through our five.

We have to grow our economy. That is why we did tax reform. That is why we also now have to fix our trade situation. That also is why we have to continue the proper types of education in our society.

There is a series of things you do as a society to maximize economic expansion, because we are talking more than just this year, next year, the next decade. We really need to have a window that goes out at least 30 years.

Remember our baby boom population of 74 million with the peak being 63 years old? We need to be thinking at least 30 years out of what we do to maximize economic expansion over that time.

A lot of it is going to be tax, regulatory, education, trade, those types of things that we have the levers on that can maximize that expansion.

The next thing we were just talking about is labor force participation. Let's fixate on that.

As we start to go through these, what do you also do within the incentives?

You are 65. You are healthy. What could we do as incentives within Medicare, Social Security, certain of our tax rules, to encourage someone to stay in the labor force?

If you have an interest in this, read some of the articles about things Japan has been doing to try to create some labor force participation stability, even though their population is aging out very, very quickly.

The next slide I want to go to is one of my favorites, just conceptually. That is, much of the explosion in the costs, you see, is in the Medicare area. The debates that happen on this floor about healthcare, if you take a step backward and can strip your mind a little bit from being a Democrat or a Republican, you do understand that much of the debate around here is not about what changes the cost, but it is about who gets to pay.

The ACA created a world where we are saying: Okay. We are going to create all these government subsidies; we will move it this way.

But it didn't remove any costs. Then we will actually do things that are saying: Well, we believe this will actually get more participation in the marketplace, and that will actually create actuarial stability.

But, ultimately, if you actually take a step backwards and think about, in society, what do any of these do to actually remove costs? And I want to argue there is a technology disruption revolution about to hit in healthcare.

The poster next to me actually is a handheld ultrasound. Think about an ultrasound that is the size of your phone. You take it, you actually plug it into your phone, and you have an ultrasound; something that, just a few years ago, was really expensive, you can have in your pocket.

It is under a couple of thousand dollars, and, apparently, the prices are crashing because there are now multiple competitors in this technology because of the development of new types of sensors. Think about a world where it is much more than you are wearing a smartwatch that helps you with your heart arrhythmia, but think about something where you can blow into it, and it tells you if you have the flu and automatically could order your antivirals. Well, it turns out that is actually in testing right now.

How many of you went to Blockbuster video last weekend? Of course not. There was a technology revolution--feels like it happened overnight--where we used to go stand in line, get a little box with a little disc in it, get movie recommendations from the person behind the counter. Today, we go home, we hit a button, and it is HBO Go, it is Netflix, Hulu, whatever you ultimately watch. We were quite willing to accept that technology in our homes almost overnight.

I am going to continue to ask Congress, the regulators, the people in our society, think about what we could do to disrupt the costs of the delivery of healthcare, and I will argue with you that it is technology. There is an experiment going on in Arizona right now where I think they are up to five little clinics that are substantially autonomous. It is a powerful thought experiment.

You will hear people; Members of Congress talk about telemedicine. I will argue with you, some of the research we have been doing out of our office, telemedicine now is already out of date. There is now algorithmic, where it can read these sensors that you wear on your body. It can actually read with the thing you blow into, and the algorithm is amazingly accurate.

Would that concept help us in our issues in rural healthcare, but also in our ability to have the cost collapse that technology potentially brings? And I know it is uncomfortable because we are used to the system we have, but we can't afford the system we have. You have seen it in the chart. You see what is coming at us.

Then the last thing of the five is we are going to have to have an honest conversation about the way Medicare, the way Social Security, the way many of these programs are designed. Do we need to look out into the future and build a shock absorber into them that has to do with life expectancy? What would happen tomorrow if we were blessed to have a cure to Alzheimer's and life expectancy suddenly--what is the term? Like a punctuated equilibrium, we had a sudden pop of a few years in life expectancy, what would that mean to actuarial tables?

Do we need to start designing in shock absorbers policy-wise today, the incentives to actually stay and work so we have the labor force participation, but, also, can we build some spiffs, some incentives?

So if you start to look at everything from fixating on the growing of the economy, fixating on participation in the labor force, fixating on the adoption of technology as a price disrupter, and then the actual structure we use on the delivery of entitlements, and we understand the scale and how fast this is coming at us, I will argue with you, it is something we need to do almost immediately.

My goal is, over the next few months, every week, every other week to come behind this podium, and we are going to start to get more granular in how the policies would work and what drives them.

So my point, once again, is understanding it is mandatory spending. It is substantially, remember, 91 percent, delivered by our demographics, and demographics isn't political. It is just what we are as a society. So what do we do?

Last bit, because I skipped it, and I want to come back to it. Immigration; designing an immigration system that substantially promotes a talent-based model. Why? If everything we do policy-wise has a fixation on economic expansion, on economic growth, so we actually have the resources to keep our promise as a society, you actually have to think about, even immigration, and a model within that both looks at population stability--because you saw what was happening to our birth rates--but a talent-based system so you get the maximum multiplier effect of economic growth.

When we do the math in our office, we see a way to stabilize the debt. It doesn't go away. It keeps growing, but the economy grows so that percentage of debt to GDP actually keeps us so our interest rates don't explode off the charts because no one will take the risk on our debt, but think of the number of policy decisions I am asking this body to make.

There is a path. It is going to be hard. We are going to have to explain a lot of very difficult mechanics of why we need to do what we are going to do, but it is the path that saves our country.

I have a 3-year-old little girl, best little girl ever. I want her to have the same opportunities I have had. And the way our demographics pile up our debt over the next 30 years, she won't have the same opportunities I have had, and that just isn't fair. That is not fair to anyone. We have got to find a way to keep our promises and have the next couple of generations also have the same opportunities.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, this is one of those opportunities, now that we have the new session of Congress up and running, to come up here and sort of walk through some of the math and the reality.

And, look, it is always fascinating when we hear, you know, the discussion of, well, there is $5 billion for security and the barriers, but I just want

to say to everyone, before we sort of go into the presentation of the actual math of what is going on in our society, you do realize the total amount that is being discussed as the plus-up for the border security is less than we borrow in 2 days. It is less than 2 days of borrowing.

I mean, we live in this world of absurdity where the politics actually have outstripped sort of the reality and the math.

And, look, I accept that there is part of our society that so desperately doesn't want the White House to ever get any of its priorities, they will burn the place down, but come on.

Being from a border State, you know, come and see the fentanyl, the heroin, the human exploitation that is happening not only across the country, but particularly for those of us that are from border States.

But that isn't why I had reserved tonight's time. I actually want to make sure that once we get beyond this partial shutdown and we maybe get back to the business of governing, we actually start to have some understanding of the reality of what our society is up against.

In the first chart I have brought I am going to try to make an argument that our greatest difficulty we have as a society, as a country, is actually demographics. This is something we often don't talk about, because it is not something we really can do a lot about, but the reality of it is, as a society, we are getting older very fast.

There was an article just last week saying we are growing older the fastest in 80 years. You have seen the crash in our birth rates. I mean, you do realize that our birth rates are nowhere near what we call replacement rates as a society. We are down to, what is it? What do they say? 1.76 births, when you need to be up around 2.1 just for population stability.

What does that actually mean? Well, we are going to walk through a number of these boards and start to understand what that fiscal impact means if you want to keep our society's promises on things such as Social Security, Medicare, and how we deal with it.

I actually want to give sort of an optimistic idea. We believe we have sort of a five-point idea, but it is going to require my brothers and sisters on the left, my friends on the right, and people in between to pull out their calculators and think.

The fact of the matter is I often feel like I work in a math-free zone.

Just a bit of trivia. In 11 years, you and your partner, so two people, will be supporting one retiree. In 11 years, two workers for every one person in retirement. Think about that.

No matter what you think about politics and who pays and who doesn't pay, just think about that structurally as a society: two workers for every one person in retirement, and that happens in 11 years.

It is hard to talk about because, let's face it, we are Members of Congress. We often like talking about the shiny object, the thing that when we walk out these doors, the reporter is going to stick the microphone in our face, and it is going to be the shiny object of the day instead of the structural reality of what threatens our Republic.

The first slide here, all I want to be absorbed is this is 1965, a long time ago, 50-some years.

Do you see the red? That is what we call mandatory spending. Those are things that are on autopilot.

The most elegant way I think to describe that is that you have Social Security and Medicare. Those are earned entitlements. You worked a certain number of quarters; you paid in; and you get those benefits.

There are other entitlements that fall under this. If you are part of a certain Tribal population, we have a treaty obligation. Or if you fall under a certain income, you get these benefits. But they are mandatory. They are built into the base. We don't vote on them. They are on autopilot.

In last year's budget, actually, well over 70 percent of all the spending was on autopilot. It is what, ultimately, is consuming the budget.

We are going to do a couple of these slides, just to try to get our heads around this. Let's swap to the next one. This is just to sort of help the breakout.

My understanding is that in this coming budget year--you need to think about this--defense spending in the 2019 cycle will basically be the same as Medicare.

How many of us, when we go home to talk to our constituents, somehow think defense is two-thirds, a third of the budget? Basically, as you start to look at the charts here, you will actually see--and these are the 2018 numbers.

As you walk through, you see the blue. We will call that the sea foam blue. That is Social Security. That is 24 percent of all our spending.

If you come over here, national defense is this rust. That is 15.

Last year, Medicare was actually a little over 14-point-something. This year, Medicare and defense are almost the same.

With our demographics--remember the baby boom, 74 million of our brothers and sisters who were born in that 18-year period who are baby boomers--the peak of the baby boom right now is about 62, 63 years old. They are just starting to move into the years where they will receive those earned benefits.

Then you come over here to Medicaid and other income programs, net interest--remember, interest is a mandatory. You have to pay it to protect the sanctity and full faith and credit of U.S. debt. You start to realize, the amount that we, as Members of Congress, actually get to work on starts being about a quarter of all the spending.

It is not driven, really, by current policy. These are previous policies. It is driven by our demographics. We are getting older very fast.

This is the slide that is the most devastating to get your head around. Yes, I have not adjusted this for inflation, so these are stagnant dollars. When you use a 30-year time window, you can deduct about a third. Eventually, I will get this slide up, and I will do the interest deduction.

But think of this: Over the next 30 years--2018 to 2048, a 30-year window--what is causing an $84 trillion budget deficit? It is substantially interest, the shortfalls in Social Security, and the shortfalls in Medicare. The rest of the budget has about a $16 trillion surplus in what we calculated as revenues to spending.

That is really important to get our heads around. It is fascinating that, when you show these numbers, I will get people who will protest the math. It is not Republican math; it is not Democratic math; it is just math.

The reality of it is that we have these massive, unfunded liabilities that are basically in two programs, Social Security and Medicare, and we have a moral obligation to keep our promises as a society.

So how do we get there?

The next one, I am just going to put this one up so it helps reemphasize the way this works. Think of this: From 2008 to 2028--so that 20-year window--91 percent of the increased spending in this body comes from three things: interest, the growth in Social Security, and the growth in spending in healthcare entitlements.

When you see my kind come behind these microphones, and we speak as eloquently as we can, unless we are telling the truth about the demographics, we are actually not telling the truth of what is really going on. I know it is hard. It is math with lots and lots of zeroes. But this is the reality. When you look at the charts, things like defense, nondefense discretionary, even some of what we call the other entitlements, they are substantially flat over that 20-year period.

We are getting older very fast as a society, and our birth rates as a society have collapsed. We don't have enough children right now, over the last decade, to even be at replacement rates. We are basically following the trend of the rest of the industrialized world.

You have to think that through. What does that mean for our ability to promise Americans, as they move into their senior years, that retirement security? That, I think, both Republicans and Democrats all agree we must have, but, yet, then we do everything we can to avoid the actual math.

The next slide I want to go to is to, once again, reemphasize the reality of what is happening in our society population-wise. For this next chart, I am using Arizona, because that is my home. But guess which State appears

to have the biggest fall in birth rates? Arizona.

Now, please be merciful on me. I am going to try to explain something with a lack of sort of elegant language. I have had multiple conversations with a couple of folks who make their living just fixated on demographic numbers, and they, partially, are giddy about this for one thing in society. They sort of come back and say: Look, in previous demographic modeling, we thought parts of our Hispanic populations, parts of our LDS populations, and parts of others were going to continue to have very high birth rates, and that was going to provide some population stability.

But the fact of the matter is the melting pot, apparently, is actually working in our society. In our country, the melting pot is working. One of the ways that demographers refer to it is say: Look, we are all not having children like each other. The likelihood you will have a similar education, live in the same neighborhood, and now also not have children like each other, you see it in the math.

So, on one hand, yes, the melting pot is working. That is great for our country. We are Americans. We are a diverse lot, but we are Americans.

Now we need to deal with the social entitlement problem. That is, in 11 years, if I have two workers for every one person that is retired, and my birth rates are continuing to fall, how do you make the math work? How do you keep your promises?

Remember my first quip when first coming up to the podium: We are having this dispute over an additional $5 billion of border security and the effects that has on humanitarian aid. But the absurdity is that it is less than 2 days of borrowing right now, and almost all that borrowing is driven by--you saw it on the previous slide--our allocation to cover our interest costs, Social Security, and the healthcare entitlements, where almost all the spending growth is.

This is a reality, but it is fascinating. The beginning of this is 2000. In 2000, we were basically about 3.1 in birth rates. Fertility rates have collapsed. When you actually start to do the mean nationwide, we are now down to--what is it?--1.67.

We need to actually couple that in with the massive unfunded liabilities we have and start to understand that the greatest threat to our country right now is massive entitlement promises and the lack of resources to cover them.

I have done it before, and I am going to do this about every week. I am going to bring in different boards. I have a series of boards that show almost every idea that gets quipped out of: ``Well, we will raise tax rates to this, or we will do this.'' None of them come anywhere close to actually covering the scale of our obligations.

Right now, I want to do one or two things that I actually believe are optimistic. I am going to give you sort of a five-point idea. This is something I have been talking about in Arizona and partially around the country and other places. I need us to think about, okay, this is the math reality. We have these massive unfunded liabilities that are basically driven by two programs and our interest obligations. How do we fix it?

Let's actually walk through a list and understand it. I call this the unified theory because we have to do all of them. We have to do all of them at the same time, and we have to fixate on the growth aspects they all bring.

The first one I want to talk about is immigration. As we go through, partially, the political theater, as this body has been doing with regard to immigration, let's actually take a step backward and say: What immigration policy maximizes economic growth for the country so that growth helps us pay our promises, so people will receive their Social Security and Medicare?

We will have to move to a talent-based immigration system, because, as the rest of the world has done, whether it be New Zealand, Great Britain, Canada, or Australia, the rest of the world has basically moved to a talent-based system because they figured out it maximizes economic growth.

In our case, hopefully, we would move to a substantially talent-based system. You still are going to have compassion. There will still be types of visas for our brothers and sisters around the world that meet our standards of compassion. But with that, I believe, you also are going to have to put in math shock absorbers that deal with the fact that we are going through a cycle right now with birth rates falling. Would you adjust certain portions of that talent-based immigration population to deal with something we call population stability for the future?

Remember, this is about maximizing economic growth, so we can keep our promises as a society.

The slide I have next to me is sort of as we deal with the next couple issues. So I believe a major reform in the immigration system can maximize economic expansion.

The next thing is a fixation on growth. When we did tax reform, as we get together and start to realize this supercomputer we carry in our pocket, oddly enough, could be the greatest regulator in our society because it can crowd source information. I have done presentations on this in the past.

Instead of building bureaucratic models, where we make people fill out lots of pieces of paper and shove them in file cabinets, how about moving to a modern system?

As a simple example, how many of you use Waze as a way you drove to your office, or to work, or to pick up the kids? That is a crowd source model that gives you information.

It turns out that same concept can actually be a way to regulate air quality and know that we are safe without building a bureaucratic model. It can be so many things.

We need to fixate on what maximizes economic growth in our society, and that is Tax Code; that is regulatory code; that is removing barriers, removing the barriers at the State, local, and Federal level that encourage risk-taking entrepreneurship, the things that create the economic disruptions, so we grow.

The third thing, and that is what that chart is about, we call it labor force participation. We got the report last week that was actually in some ways wonderful and in some ways it is heartbreaking.

We are giddy that we broke 63 percent labor force participation. We hit 63.1. I can show you a stack of articles from the last decade from really smart economists, mostly on the left side. They said we are never going to get back to 63 percent labor force participation because we are getting older as a society, we have so many worn-out workers, or whatever the current pop cultural term is.

Well, we broke through 63.1 last month in December. But understand, it was only a decade ago we were pushing around 67 percent labor force participation. What does that mean? It means we have substantial portions of our population who, for lots of reasons, whether it be drugs, whether it be certain educational aspects, whether it be societal expectations, are not in the labor force.

I have actually done it before, and we will do it again over the next couple of months. I will do some charts where it is actually a really interesting sort of barbell-type curve where we have lots of young people--mostly males--who are not in the workforce, and then older parts of our population who are choosing maybe the rational thing, to retire.

How do you build a society that encourages a person to stay or to enter the workforce? So as we have debates around here where the left wants to talk about certain types of income assistance, we in the right will talk about: How do you take that and make it a reward to work?

We need more of our population to work. If we could go right now from that 63 percent labor force participation and get back to that 67 that we were at just a decade ago, it is amazing how it helps.

So the third thing I am going to give you is we need to have everything, whether it be from the discussion of SNAP--food stamps--to incentives in Social Security and Medicare, to encourage someone to stay in the workforce longer, to a young person in their student loans to actually enter the workforce and begin that process.

Every program we as a government, as a society, participate in, we should maximize the incentive to work because we need it if we are going to keep our promises.

Remember, this is a loop. Everything here we talk about is, if we are going to keep our promises on Social Security and Medicare, we have got to have the economic expansion that provides the resources.

The next one I am going to give you is the one that I am most optimistic about. And let's put that board up. But this one is a little harder to talk about, so I will beg you to bear with me.

When we have had debates around here on the ACA--some people know it as ObamaCare--or our Republican alternative, or this healthcare debate, I need everyone intellectually to strip away our partisanship and take a step backwards. Almost all of the debates have been about who gets to pay.

The ACA just shifted lots and lots of the spending onto the government. Some of our alternatives were actually trying to spread the cost out more across the private payer populations. But we have done almost nothing to disrupt the cost curve.

So part of the thought experiment I want us all to engage in is: How many of us went to Blockbuster Video last weekend? I know it is a little starky, but think about it. Didn't it feel like almost overnight you no longer stood in line at the local retail strip center at Blockbuster Video to get the little silver disk that you were going to take home and shove into your Blu-ray player? You would now go home and you hit a button and you get Netflix, or HBO Go, or Hulu, or whatever you are watching.

That is what we call a disruption. Almost overnight, society figured out, hey, this is cheaper, faster, better.

How do we take that sort of concept of disruption and make it part of healthcare? How do you say, instead of playing this game that we have played over and over of just trying to move around who gets to pay, we are going to engage technology in such a fashion that we disrupt the cost curve of healthcare delivery?

The fact of the matter is there is so much technology rolling out, this is about to become your primary care physician.

How many of you have seen the articles of something that looks like a kazoo, a large kazoo that you blow into and it tells you if you have the flu virus. The article from last week, something a little bigger, a cone over your nose and mouth, you blow into it and it tells you if you have a bacteria.

There is the Apple Watch that will help you manage your arrhythmia. There is all of this technology rolling out. There are things, I am told, right now at the Consumer Electronics Show, a couple of hundred items being shown at this moment that are all technology--we like to refer to them as digiceuticals in our office--that will disrupt the cost of healthcare if we can break down the regulatory legal barriers, whether it be on how we pay for them or the fact that many of them provide a level of autonomous healthcare. Our system as it is regulated and compensated today does not, was not designed for a level of autonomous.

We have a company in Scottsdale that now has four or five locations up. I guess they used to be Theranos booths. I think they are at Safeways, if I am allowed to say such a thing.

You go in and you functionally fill out your information in an iPad. You go into a private booth. There is an avatar on the screen. You grab the scope--and forgive me, I am not a medical person--and you shove it down your throat, in your ear, in your nose. It tells you how to move it. It tells you what they need.

You put your hand on something. It can do a pulse and the temperatures and other things. And an algorithm does the calculations. Apparently, the algorithm is amazingly accurate.

What would happen if that type of healthcare became available to all of us? We crash the price. We dramatically change the availability. And, yes, these things are scary because it is a disruption of technology into our economy, but we don't have a choice.

You saw the charts before. The greatest fragility in our society is promises we have made that we have no money. And almost every solution gets us nowhere close to the types of resources needed. We must have a disruption in the cost of delivery.

And part of the thought experiment, it has been a year or two, but we have seen things like the contact lens that can calculate your blood glucose, that talks to your insulin pump.

Because we do know that more than half of our healthcare costs in this country are for the 5 percent of our brothers and sisters who have chronic conditions, what happens when those digiceuticals help manage those chronic conditions to prevent the crashing?

How about the pill bottle that makes sure that--we know that 50 percent of pharmaceuticals are not used properly. The solution becomes a technology one when all of a sudden your phone rings. The beeper goes off. You haven't taken your hypertension medicine that morning.

We desperately need this body to start to understand this. And is that Republican or Democratic? It is technology. Now, I am sure, eventually, we will break down and it will become a Republican issue or a Democratic issue, whether it be because which lobbyists go where, but for right now, it is just a solution.

The last one I will give you of my five is when we do all of this progrowth, this ability to crash the cost of delivery of healthcare, we are going to then have to have a really honest conversation of what we must do, particularly in Medicare, to modernize the design, deal with the reality that life expectancies for those who make it into retirement are going up.

Many of us will spend a third of our life in retirement. Do we need to change the incentives within those individual programs on how we take our benefits? How we manage those costs? How we participate in them?

We have some really interesting ideas: Would you make adjustments for folks who may have the ability to carry previous healthcare options with them?

But I truly believe we need to do all five of these, and we need to do them almost immediately because every day we wait, another 10,300 of our brothers and sisters, Americans, reach 65 and start to move into their benefits. And every day we wait, we avoid the reality of math.

I guess there are a couple of smart people out there who many years ago said: Tell me your demographics and I will tell you your destiny.

I have just told you our demographics. I have just shared with you the scale that is off the charts on the promises we have made and our lack of resources, and I believe I have actually begun to give an approach of a unified theory of how we make it work and how we make it through, functionally, our 74 million baby boomers who are moving into retirement and how we move through that population bubble so someone like my 3-year-old daughter also has the economic opportunities that I have had.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I move that the House do now adjourn.

The motion was agreed to; accordingly (at 7 o'clock and 10 minutes p.m.), the House adjourned until tomorrow, Friday, January 11, 2019, at 9 a.m.

Madam Speaker, I rise today to honor the memory of Mr. Jesse Hernandez, a close member of our Phoenix community, devoted to his family and spiritual fellowship, and a long-time political activist in Arizona. Jesse not only served as a member of my district staff, serving as Director of Outreach, but he also devoted himself to the Arizona Latino Republican Association, where he served as Chairman and Executive Director. His hard work and commitment to his community truly helped make a difference in the lives of his fellow Arizonans. He served his country proudly in the United States Marine Corps, and we are forever grateful for his sacrifice and service to our nation.

Jesse had great love for his family and always supported everyone in their personal journeys to grow and learn. He was a role model and inspiration to his family: Margaret, James, Jessica, and Elvia, as well as his grandchildren. To all who knew Jesse, we shall continue to cherish the memories of his wit, laughter, love of family, friends and faith, and his commitment to the Republican Party.

Jesse served unselfishly for the betterment of others. May we continue to honor his memory through our passion and service to our communities.

Mr. Speaker, I rise today to honor the memory of Mrs. Leona Johnston, a passionate educator, traveler, and dedicated political activist in Arizona. Leona devoted 30-plus years of her professional life teaching disadvantaged students in South Bend, Indiana, before retiring to Fountain Hills, Arizona, where she was deeply involved in local political activism in her community and throughout our state. She was a member of the Fountain Hills Republican Club, and the club named her ``Republican of the Year 2005''. She was also highly involved with the Arizona Federation of Republican Women, the Paradise Republican Women Club, the National Federation of Republican Women, the Arizona Republican Party, and Dodie Londen.

To all who knew Leona, may we continue to cherish the memories of her wit, laughter, story-telling, love of family and friends, and commitment to the Republican Party.

Leona served as a role model for political activism to better local communities. May we continue to honor her memory through our passion and service to our communities.

Mr. Speaker, before comments, this was my first term on the Ways and Means Committee. I will tell you that, both on the Democratic side and the Republican side, is a group of very special Members, having been on other committees, even in moments like this, where we see the world very differently. Everyone is freaky smart, incredibly respectful, and if they could see what goes on in the back where we actually get along, it is a very special committee. But the fact of the matter is we sort of see the world very differently.

Have you ever had that moment where you were walking up to the podium and you were going to read something? I was going to originally read the comments from a number of Members, particularly on the other side, who were incredibly critical of the fact that many of these tax cuts expired and now they are complaining that we are extending them. We do have this sort of body where we race to whatever the current argument is. But that would actually be a little hard to do, right after saying such nice things about everyone. So let's actually have a couple of comments on the reality of what we see in the math.

Do you remember when the tax bill passed, the math was that we needed a 0.4 percent growth in GDP over 10 years and the tax reform paid for itself? How are we doing so far?

We have had, now, multiple revisions upward. Something is working out there in our society when you see more jobs than workers; when you see, in my community, the populations that have had a really rough decade with the growth recession of the last decade, they have jobs. There are good things happening.

You would think there would be almost this joy on both the left and the right when you see job training in our Arizona prisons. We actually brought one of the three-time convicted felons to testify in the Ways and Means Committee. It is so hard for this body to actually give a little and say: Look at the great societal things that are happening right now.

Also, we have the backup on the math. If we do not have substantial economic growth this decade and next, we can't keep our societal promises.

I would like to argue, when we get beyond this, we have the conversation of: What does tax reform do for future economic expansion? Again, yes, we are going to have to talk about a lot of difficult things to keep that economic expansion, but the baseline math--and I know we are only 8, 9 months into the data--it is working. Could we at least have a little sound of joy for what is working?

Mr. Speaker, I thank Mr. Hill for yielding. And to the gentlewoman from Arizona, I thank her for doing this every year.

This is one of those moments where you are walking toward the microphone because we just got out of votes in Ways and Means, and you are sort of discussing in your head whether you ultimately tell the personal story. I have two I want to share.

My reason for doing this is, if someone is watching, we have someone in our life, and you are having self-destructive thoughts, please, please reach out, get the help, and understand the devastation that happens and the pain that happens when someone takes their life.

My two stories. When I very first got elected in the Phoenix- Scottsdale area, one of the very first constituent meetings I had was with a mom. Her son had been part of the Phoenix VA. She always felt that the prescriptions he was given put him into an emotional spiral.

They kept trying to get him mental health services. They felt all that he was receiving was more prescriptions and a future date for mental health services. And he took his life.

That mother, the pain, the tears, the crushing blow, what the loss of her son's life meant to that family.

I believe now, a few years later, the Phoenix VA is better. They have learned a lot, they understand how to be almost a quick reaction force in helping an individual. But we need to make sure these things never happen again.

Now for the personal one that I have never told in public.

I was born in an unwed mothers' home in L.A. I was adopted. It turns out the gentleman who adopted me had multiple sclerosis. But he was a veteran, and he was receiving his medical treatments from VA.

This is a long, long time ago, but this is about the pain that comes when a veteran takes his or her life.

Because of the pharmaceuticals he was given, the lack of emotional counseling, and the failure to properly diagnose his disease, he put himself in a car in a garage, turned on the motor, and took his life. That was my dad.

Some time later, my mother remarried Mr. Schweikert. I got readopted, and I was blessed to grow up in a wonderful household that had brought me to Arizona.

Many years later when I was a young adult, my mom sat me down and told me the story. You could tell there was still that burning hole in her heart of finding her husband, my dad, dead in that car, having taken his own life, believing it was the failure of the very services he was receiving from the VA.

Now it is decades later, and I believe we have learned a lot. This body has tried as hard as it can to get their heads around: Are we allowing too many pharmaceuticals to be prescribed? Are we not providing emotional services? Do we need to put resources into having that communal get-together, the quick reaction force?

I believe it is getting better.

But understand the pain that Mom shared with me when I was first elected about the loss of her son. Even these many, many years later, it is still part of our family's legacy of that pain. If this body can do anything, if we can find ways to make that pain come to an end, then we will have done something very honorable and very powerful.

Mr. Speaker, I thank Mr. Hill for yielding to me.

Mr. Speaker, I thank Mr. Hill for doing this Special Order.

Mr. Speaker, I am going to give you, actually, a slightly different recollection, because I am one of those who, over the years, since almost 1982, had time around John McCain.

I want to start with the fact that I have had the pleasure of having John McCain step in when I was running for office and endorse me and help me and do things. And I have had the pleasure of having John McCain step into one of my races to oppose me and work against me.

It was always a really interesting experience, because one of the reasons I have never held hostility, and, actually, always really appreciated him, it is something that rarely happens around this body. Someone fusses at you and a couple of hours later calls you and says: Hey, I thought about that. We need to talk it through. I think there is a way we can fix it. Hey, I didn't mean that.

To have a U.S. Senator sometimes being frustrated with what you were doing, and then a couple of hours later call you and say: Hey, I am sorry. I was probably a little aggressive on that. I understand. Have you thought about doing it this way?

This place never says sorry. This place never sort of has that type of passion. And you heard over and over in the memorials in Phoenix and here at the Capitol discussions of people who were very close with Senator McCain, this sort of discussion of how human he was, how passionate he was.

I want to make the argument of someone who knew Senator McCain most of his life and interacted with him in and out throughout that life. It is that humanity, that ability to at one moment put a finger in my chest and fuss at me, and an hour later call me and say: David, how can I help you? I want to help you get something done. Can I help you get this done if you do it this way?

That humanity, that passion, is something that desperately is missing around here. We have all become so careful in everything we say and everything we do, because there is always the next moment we are going to get beaten up by someone out in the community, or the press, or those things.

Imagine this body if we all were like Senator McCain, where you just sort of let your passion fly. If you went a little too far, you said you were sorry. If it was something worth fighting for, you stood up and you engaged in it. And then, a few minutes later, you went out and had a hamburger with the very people you were debating.

Some of that is really missing around here, because we are so far in our camps. I am not sure the public completely understands the power, whether it be on the Democratic side or the Republican side, of when the cameras go off, when the reporters aren't around, when we are walking through the hallways, when we are in the elevator. There is this great humanity around here.

I think that humanity was exemplified by my former senior Senator, John McCain.

Mr. Speaker, I offer a privileged resolution (H. Res. 1047) resolved, that the House has heard with profound sorrow of the death of the Honorable John Sidney McCain, III, a Senator from the State of Arizona, and ask for its immediate consideration.

Mr. Speaker, I rise today to celebrate the life of Lois Fitch who passed away on July 23, 2018. Throughout all of my life, I have known Lois as someone who dedicated herself to helping young people find ways to become more meaningfully engaged in their community. Through her work leading the Teenage Republicans, Lois helped so many individuals find their place in the civics of working to improve our town, state, country, and America's place in the world. Lois epitomized a leader. She was kind and gracious to all. She was encouraging and supportive in helping others find their passions. She was the reason I decided to run for elective office. And, she has inspired me and so many others to serve on all levels of government. This past Sunday I had a chance to visit with Lois in the hospital. As I shared with her then, I will share here in the United States Congress--``Lois, you changed me for the better, and I will forever be grateful for your courage and service.'' May the flag of the United States Capitol fly in full tribute to her.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of H.R. 519, which would provide tax- exempt mutual irrigation companies with more flexibility in respect to funding their operations, maintenance, and improvement of their water infrastructure, especially in drought-stricken areas.

Tax-exempt mutual ditch or irrigation companies are important to rural communities and to agriculture. These companies allow farmers, ranchers, and others, including water users and even some urban water users, to collaborate and pool resources to install and maintain vital infrastructure for the delivery of water.

To maintain their tax-exempt status, however, mutual ditch or irrigation companies must satisfy Tax Code requirements that the bulk of their income, which is used to fund operations and capital improvements, must be from the shareholders of these irrigation and water delivery districts.

H.R. 519 allows these companies to receive other sources of income and still maintain their tax-exempt status. The bill provides that, for the income from other sources to receive this preferential tax treatment, it generally must be used for operations and maintenance to ensure that these funds will be reinvested in irrigation infrastructure systems.

This bill would provide mutual irrigation companies with more flexibility with respect to funding their operations and maintaining improvements to their water infrastructure, especially in the drought- stricken areas, and it will facilitate more efficient water allocation in support of these rural economies.

This bill also clarifies that governance matters in regard to these mutual ditch or irrigation companies may be arranged as permitted under the State laws.

This bill supports local economies, promotes more efficient use of water, helps farmers and ranchers in many arid areas, and actually is just much fairer in how these resources are maintained and the ability to maintain these districts under the understanding of the current Tax Code.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, just sort of a quick commentary.

I want to thank the gentleman from California for his input, his observations. He has been incredibly constructive and paid a lot of attention to protecting his constituents. Those of us from arid areas, we care a lot about this.

Mr. Speaker, I yield 4 minutes to the gentleman from Colorado (Mr. Buck).

Mr. Speaker, I have no other speakers, and I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume for a very quick closing.

In a previous life, I was the treasurer of Maricopa County. We had 3,300 taxing districts in this county. A substantial number of those taxing districts were actually just these, irrigation and water delivery. Many of them were in the rural parts of my county, but a lot of them, you would be surprised, were actually in the suburban and even some in downtown Phoenix.

I have actually had a conversation with a couple of them, one asking if they had an excess water allocation that year, could they actually sell it to the local pond, the little conservation reserve in our riverbed, and those things; and if they did so, if that amount of money exceeded 15 percent of their revenues, would they blow up their tax status.

In this case, this legislation would prevent that, but they still have to use that money to constantly improve their infrastructure, therefore, I believe, being more water economical.

So this is a good thing for our communities, particularly rural, particularly the uniqueness of those of us in the desert Southwest.

Mr. Speaker, I urge my colleagues to vote ``yes,'' and I yield back the balance of my time.

Mr. Speaker, I will do this really quickly.

Being from Arizona, where I have, functionally, 23 Tribes, 21 or 22 reservations, it is surprising how often this becomes a subject and trying to understand how big and complex many of our Tribal communities are. We think our lives are sometimes complex. Imagine having to operate in the world of multiple layers, where you have to deal with State and local, Federal, and then Tribal politics, issues, and those things.

I was visiting some of my friends on a Tribal community called Ak- Chin. It was interesting. One of the gentleman there basically said: I am on council. I can't participate in Social Security. But before I was on council, I managed one of the Tribal operations, and there I could participate in Social Security.

I know this is sort of a glitch, but this is one of those honorable things where we step up and we create some optionality. Within that optionality, I think we respect Tribal sovereignty, and we are just doing the right thing here.

Mr. Speaker, this week I bid farewell to my longtime Chief of Staff, Oliver Schwab, who served with great heart and commitment in this body for nearly a decade.

Since Oliver's announcement on Monday that he would be transitioning his role to pursue new opportunities, I have been moved by hundreds of people who have come up to me to share just how much Oliver's friendship has meant to them. As a mentor, Oliver has been devoted to helping others discover qualities and confidences that they did not always know they possessed. As a mentee, Oliver has sought guidance and perspective with the kind of dedication to lifelong learning that only the finest of others can bestow.

Oliver is the best that I have ever seen at helping others work through their needs. Anyone who knows Oliver can attest to his passion for history, love for our country, and work to restore civility to our politics.

Oliver began serving as my Chief of Staff in January 2011 after managing my successful 2010 election to the U.S. House of Representatives. Since that time, Oliver has guided an

inspired management approach, building one of the best teams on Capitol Hill. Just this year, the Congressional Management Foundation recognized Oliver's efforts by naming our office a finalist for the first-ever Democracy Award highlighting excellence in workplace culture. Oliver's academic focus on behavioral science, talent management, and decision theory has made him one of the most effective practitioners of leadership.

I will always be grateful for the manner in which Oliver directed strategy and operations to help me achieve two seats on the U.S. House Financial Services Committee followed by a seat on the U.S. House Ways and Means Committee. Additionally, Oliver masterfully directed a member services initiative that enabled me to secure a cardinal seat on the U.S. House Republican Steering Committee.

I thank Oliver for the talented hard work and devotion that he has given me, the people of Arizona, and the United States Congress. I am going to miss having him by my side, but I know there are great things in store for him next. Oliver and Ana will always have my support and friendship.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days to revise and extend their remarks and include extraneous materials on the topic of this Special Order.

Mr. Speaker, this is actually one of those sort of joyful moments that we finally get a chance to come up here, and we don't very often get to do that.

We are going to have a discussion of what is happening in our economy, in our society for both our friends on the left and those of us on the right, the love of people, and the fact that they have opportunity.

When you look at the unemployment statistics, when you actually take a look at how many of our brothers and sisters are moving back into the workforce, the income, and the closing of income inequality, there are wonderful things happening out there.

The neat thing tonight, we are going to bring a number of Members from different parts of the country, particularly in the West, and we are going to talk about what they are seeing happening in their region. We are going to talk also about a little bit of the data and a handful of fairly interesting things that I am actually excited about.

So, first, I yield to the gentleman from Montana (Mr. Gianforte) and give him an opportunity to talk about what is happening in his State.

Mr. Speaker, as we walk through these, there are fun little tidbits to understand.

Math is complicated and tax revenues--the fact of the matter is we are only where we are at in the year, so we are not completely done with the fiscal year. But we pulled up, a little while ago, the status from the amount of revenues up until April.

So in the 2017 fiscal year, at that April time, we had taken in $456 billion in revenues. Revenues come from lots of different sources, but substantially they are from the economic activity in our Nation, the income tax, corporate tax, payroll taxes, and other things. So it was 456 last year. This year it is $510 billion.

So understand that. It is not a complete fiscal year, but as our friend from Montana was just saying, there was such hyperbolic language from some of our friends on the other side that the world was going to come to an end, the fact of the matter is that revenues are blowing the doors off from where we thought they would be. This is a wonderful thing.

To tell one of the other stories, I will invite the gentleman from Colorado (Mr. Tipton) to tell us what is happening in Colorado.

Madam Speaker, I yield to the gentleman from Colorado (Mr. Tipton).

Madam Speaker, I have a quick thought experiment for everyone.

If I had come to you a year ago and said that the United States would be at 3.8 percent unemployment, you would have laughed at me. If I had come to you and said that African American unemployment would be the lowest in

modern times, Hispanic unemployment would be tied with some of the lowest numbers in modern times, that you would be seeing data of felons being recruited out of prison for work because there is such a labor shortage, and when one of the greatest difficulties we have in our society right now in the labor force is not enough workers and too many jobs, why isn't there this sound of joy from every American that this was the dream so many of us had of where we would be?

So, as we go through our regions, I was going to invite Mr. Curtis of Utah to come up and tell us what is happening in that beautiful State because I have actually seen some stories of the Salt Lake area and other parts of Utah just doing amazingly well right now.

Madam Speaker, I yield to the gentleman from Utah (Mr. Curtis).

Madam Speaker, there is actually some really fun and wonderful things we are seeing out there in the data. As we were also talking about the unemployment numbers, what has also been amazing is, if you look at home prices, if you actually look at savings rates, and if you actually look at a lot of the data that we care about as a society, it is important that we actually embrace and understand we are in what we would refer to as a Goldilocks economy.

Madam Speaker, if I had come to, like our previous thought experiment a year ago, and said we would be in this sort of world where the inflation numbers are within the calculation of the Fed targets, where we have more jobs than workers, when we are actually seeing incomes really beginning to rise, when we are actually seeing some first signs of data saying for the first time in decades that income inequality is actually shrinking because there are so many more of our brothers and sisters in the labor force with rising incomes, this would actually be really exciting.

I will make the challenge to every Member in Congress: How do we not screw it up? How do we keep that engine going forward?

Madam Speaker, I yield to the gentlewoman from Arizona (Mrs. Lesko). She has the district right alongside me and she will basically tell the story of what she sees happening on the west side of Maricopa County.

Madam Speaker, I thank Representative Lesko. I am so used to calling her Debbie, having known each other for so long.

What is also amusing here is, the next person I'm going to introduce, I have actually known most of my life, which is sort of terrifying. The three of us are from Arizona. I think we actually have a wonderful story to talk about what is happening in the Southwest, but particularly our State.

The fact of the matter is, with the tax reform, some of the regulatory changes, some of the wonderful things in the economy, Arizona is blessed. Right now, our State is doing very well.

Madam Speaker, I yield to the gentleman from Arizona (Mr. Biggs) to tell us a bit about what is happening in the Southeast Valley.

Madam Speaker, I will have a little bit of a colloquy or a little bit of a conversation with the gentleman.

For those of us in Arizona, the gentleman has seen the data that came out about 2 weeks ago that turns out that Arizona is actually having what would be the fastest acceleration of income growth in the entire Nation. Some of that is because we were hit pretty hard in 2008. A lot of it is because our State legislature, our Governor, have engaged in very pro-economic expanded qualities.

Madam Speaker, I yield to the gentleman to tell everyone what he did before taking this job.

Madam Speaker, the gentleman was there during some of the brutal years of the previous decade. The gentleman may remember the struggles of trying to keep the wheels on of how do you cover healthcare, education, and so many of the other needs that are in the State.

Actually, we have a rough situation. We own so little of our land that I have seen some data where we are the most urbanized State in the country because we functionally live in two major metroplexes. That is where most of our population is. And to have a State now, where we are seeing some revenue forecasts and every month it looks like they are having to raise that forecast because of the economic vitality in our State and most of the States around the country.

So I think there is often this misnomer of we talk about Federal tax reform. And I hold up a chart, it says: Last year at this time, we had $456 billion in revenue and this year we are at this time $510 billion. So a substantial increase.

But I think we failed to talk about what is happening in our community, in our city, our county, and our State revenues, which are also benefiting from this cascade of economic expansion.

Madam Speaker, I yield to the gentleman from Arizona.

Madam Speaker, we just finished a visit to the McKesson facility that is on the Salt River Pima-Maricopa Indian Community, and they are talking about several hundred additional positions.

As we sort of talk about this, we actually had a really neat experience about a month ago. The Arizona correctional system has sort of a pilot program that has been up and running for about a year.

So picture this. We are in the Ways and Means room, we are holding a hearing. And sitting on the table before us is the woman who is a friend of ours who is the Central Arizona Homebuilders representative and over here is a gentleman with a very large electrical contracting company. The person sitting in the middle there with tattoos and those sorts of things is, I think, a three-time convicted felon who actually now is making $22 an hour and telling the story of how he had a substance abuse problem and had multiple times fallen back into that lifestyle. This time, he actually said: I am going to give this a try.

They set up job training in the prison solely funded by the businesses, because they actually need electricians and carpenters and other things. They did the job training in the prison with a deal that if they finish this program, we will guarantee you a job. It doesn't mean they guarantee they are going to keep you, because you still have got to show up, you have to demonstrate productivity.

But think about a world where the economy is so vibrant that businesses are actually going and reaching into our prison communities and doing job training and actually offering employment.

I guess my heartbreak is I thought there would be this sense of joy around

here in Washington that we have actually passed a level that so many economists just a couple of years ago said we could never reach, this level of economic vitality, where we are actually seeing felons being able to be pulled into society's workforce.

We see programs like that in our State that are being creative, because we need those carpenters; we need those plumbers; we need those electricians. He started, I guess, at like $13 an hour. Within a year, he was up to $22, because he was productive, and he showed up to work on time.

He had one of the greatest quotes of all time. He says: I am working so many hours, I haven't had a chance to relapse.

It turns out maybe there is something to that saying about idle hands.

I am one of the people who have to actually admit to this, that, often, as Republicans, we sound like accountants on steroids. We are looking at the numbers. We want to do policy by facts and not feelings, because when you do things by feelings, you end up, ultimately, hurting people. When you do it by facts, you actually build something that is sustainable.

This is one of the moments where a lot of the economic theories we have talked about, if you would lighten and go to a more rational regulatory model, if you would design a Tax Code that got rid of these incentives to move your profits overseas and pull your expenses into the United States and go to a territorial system where you had the vitality, where capital would flow in, where you actually gave businesses the incentive to actually buy much more efficient capital equipment--because the way you pay people more is we have to get more productive as a society.

Yes, some of the barriers we were worried about were: Will folks get this tax benefit and spend it all? Now we have seen some data, which is different than how CBO modeled it. People are paying off debt and other things, so the capital stock in our country is going up.

There are just really good things. Right now, we have a labor shortage, and you can see something amazing.

Take a look at things like Social Security Disability. A year ago, it had only like a year before the trust fund was empty. Now we are seeing some things that it may be 5, 7, 8 years now, just substantially because we did change some rules, and we tightened up.

We also have so many more people paying in and working, and many of our brothers and sisters in the country making a decision saying: ``I could pursue a disability claim, or I could go into the workforce.'' They are going into the workforce.

So there are all these tells out there right now. The gentleman sees it in his community. I am blessed to see it in my community.

How do we keep it going? Because, it turns out, the economic vitality is a powerful thing for families, their ability to save for their retirement, for their kids' education, for being able to pay off, let's face it, a certain amount of debt that built up over a pretty rough decade, particularly being a State like ours with so many people who are coming to it for opportunity.

As the gentleman talks to small businesses, and I talk to small businesses and even big businesses, we have this conversation: How do we keep it going, and how do we keep it going for as long as possible?

Those are the policies we are chasing.

This is one of my favorite stories. About 6 weeks ago, maybe 2 months ago, I believe it was Starbucks that gave the bonus, and I am in my favorite Starbucks. As the gentleman knows, I have a coffee problem and openly admit it. If anyone wants to start a 12-step program, we are holding the meetings at a coffee shop.

I walk in. I am not someone you typically would be jumping up and down to see, you know, a fairly conservative Republican Congressman. She looks at me and goes: ``Dude, thank you.''

She had just gotten, I guess, a bonus check from her employer, and she actually understood what it meant monetarily to her. It was one of the neatest conversations I had with this young woman as I am ordering my coffee about how excited she was to have the money and what it meant to her to pay off some bills and just how things were going.

That is when it starts to click. That is when it is more than just sitting behind tables with stacks of binders and spreadsheets and analytical reports and feedback loops of what the tax reform is going to do and growing the size of the economy, when it gets down to those individual lives.

Look, I often walk around with this app. It is from the Atlanta Federal Reserve. Madam Speaker, if I had come to you even months ago and said: ``The Atlanta Federal Reserve has the calculation for this quarter, at this moment, at a 4.6 percent GDP growth,'' you would have worried about my mental health. It turns out, that is actually what the number is.

The odds are that it doesn't stay there, and it is going to go through cycles, but that number is stunning. The bias has been, actually, over 4 in the last handful of data points. I know I am back to speaking like an accountant on steroids, but the fact of the matter is that we have some pretty rough things coming toward us as a society. We are getting older very fast. We have tremendous unfunded liabilities in Medicare. We have issues on Social Security.

We will find a way to keep our promises to those folks who have paid into those programs. Turns out, making the math work is a lot easier if you have a society, an economy, that has actually been able to hold economic growth rather than one that has been in the troughs as we were for the previous decade.

How do we sort of tell that story to folks who may be on the left or those who are just trying to raise their families or those of us who our constituents are paying attention? This really is that moment where the rising tide raises boats and opportunity for everyone.

Madam Speaker, I remember when the gentleman first got here, and we were going over those models. They were like 1.8, 1.9, and that was our future. Let's face it, we have blown that off the rails.

In that same vein, it was only a couple of years ago, actually behind these same mikes, that a discussion was had of the sort of concept of people being trapped, trapped in their house because they were underwater, trapped in their job because they didn't have mobility and options.

For a State like Arizona, the fact of the matter is that your ability to sell your home and get a job in another State because you are choosing to move to the Southwest is important to our growth. You could actually see that in the migration statistics around the country of how many people, because of the thin employment market, job opportunities, were underwater in their homes.

As the job opportunities and our real estate values and the stability of the economy have come back, all of a sudden, you are seeing people have this thing called choice, options, the ability to move around the country, pursue their dreams, pursue those careers, change jobs.

I think, actually, that is what the American Dream is supposed to look like. If you have a dream of living in a certain part of the country or pursuing a certain career, you get to do it. You get to do it because the economy is working.

Madam Speaker, as we started to talk early on, if you really do love and care for people, take a look at what is happening to the income and employment statistics of so many groups that have been disaffected in our population for the last decade. They had a really rough decade, and they are coming back, their opportunity, their ability to save for their retirement, their future, and their kids.

There should be a sense of joy. There should be, actually, sort of a uniform discussion between the right and the left of how we keep it going, because it is not only things I fixate on, of being able to have revenues or being able to cover our unfunded liabilities and our entitlements, but also that ability to have a society that is healthier, that actually the income gaps shrink because there is mobility and growth.

Populations that so many of the so-called smart people, the economists, had almost written off as the marginally employable--which is, if you take a step sideways, it is just really cruel. Those people are finding a way to come back into the economic part of our society.

I know when the gentleman was in the State legislature, he had worked on a job training program, and now we are actually seeing some really interesting data in Arizona where the employers themselves are saying: We are so desperate for employees, we will do the job training. We will take someone who is not even from our field, and we will train them.

It turns out that has been incredibly successful, because you are actually trained not in a job training program over here and then you get trained again for the actual job you have taken, but now you are being trained for that rhythm.

I know there has been just tremendous employment growth in the southeast valley. I think it is a type of high-tech CNC machine shop that some friends own in the gentleman's district, and they are talking about even taking in very young people and training them right there on site.

Madam Speaker, I ask Congressman Biggs: Those of us who see these numbers, how do we find a way to humanize that discussion? We want to talk about economic vitality and these things, but there is almost this cruelty of you are going to remain unemployed, you are going to remain underemployed, you are going to remain undercompensated, you are not educated well enough to come into the mainstream.

We have demonstrated in the last several months that that doesn't have to be the America we live in, that we are seeing individuals who were substantially marginalized in our society finding employment and finding opportunity and finding that economic vitality and growth.

We are looking for a way to humanize the story that, it turns out, a robust economy actually is really good for families, for individuals, for your future, for just the individual psyche. And maybe there is an artist out there of language who can help us find an elegant way to say this story.

Madam Speaker, I yield to the gentleman from Arizona.

Madam Speaker, it is a powerful story.

Madam Speaker, I think he is his constituent.

Madam Speaker, I know I kept him longer than I promised to, but I never get the chance to talk.

Madam Speaker, I have appreciated this block of time. I appreciate your patience with us, particularly talking about Arizona, but it is-- you know, we love our State, and we are very, very proud of how far it has come. We are proud of the fact that we are leading much of the Nation in growth--in population growth, economic growth, income growth--and it is, in many ways, our moral goal around here to keep this vitality up for every American.

Whether you live in a red State, blue State, whatever you pursue, you should have the ability and the opportunity to pursue that. We want to make the powerful argument that where we have gotten this country to economically right now is pretty darn amazing.

Now, can we do even more? Our goal is we are going to even make it better.

Madam Speaker, I yield back the balance of my time.