Floor Statements

Madam Speaker, throughout the health care reform debate, I focused on four tenets. We needed to improve affordability, access, quality and choice. I said when the bill passed that it did not fulfill those requirements.

It gives me no pleasure to show you where the actuary report for the Centers for Medicare and Medicaid Services agrees with me.

Affordability. ``By 2011 and 2012, the initial $5 billion in Federal funding for high risk pools will be exhausted, resulting in substantial premium increases to sustain the program.''

Access. The report projected that Medicare cuts would drive about 15 percent of hospitals and other institutional providers into the red, ``possibly jeopardizing access'' to care for seniors.

Quality. Some 18 million uninsured are estimated to go on Medicaid for their primary coverage, which will fail to provide meaningful access.

And finally, Choice. ``We estimate that in 2017, when the provisions will be fully phased in, enrollment in Medicare Advantage plans will be lower by about 50 percent.''

If you chose Medicare Advantage, half of you will be out of luck.

Mr. Speaker, inscribed on the Jefferson Memorial is a quotation from Thomas Jefferson that reads, in part: ``No man shall be compelled to frequent or support any religious worship or ministry or shall otherwise suffer on account of his religious opinions or belief, but all men shall be free to profess and by argument to maintain their opinions in matter of religion.''

There is nothing about the National Day of Prayer that compels anyone to support any religious worship or ministry. There are no ``prayer police.'' In fact, we who support the National Day of Prayer wish it were more successful, but in no way do we seek to impose it. Yet all men are free to maintain their religion through prayer and other means.

What threatens some people about a still small moment of silence for contemplation or a prayer to a higher being in whatever form? Nothing about the National Day of Prayer requires any person to do anything. So I ask those who are threatened by this, Where is the harm to them? The Founding Fathers gave us freedom of religion, not freedom from religion. The court decision declaring the day unconstitutional cannot stand.

Mr. Speaker, back in March a small foundation in Elk County, Pennsylvania gave its millionth dollar to a local organization and celebrated its 10th year of existence.

The Elk County Community Foundation has grown during its 10 years to encompass 68 permanent charitable funds. By managing these funds, the foundation improves the quality of life in Elk County and the surrounding area. The revenues earned by the various funds provide grants and scholarships to nonprofit organizations and to individuals.

On their anniversary, the foundation celebrated at the Central Hose Company in Ridgway, where the Ridgway Volunteer Fire Department recently received a grant to help with the purchase of new equipment for its tanker truck.

It is this type of generosity for which the foundation is known. Paula Fritz-Eddy, foundation executive director,

says that every fund has a story--from nursing to music to rewarding scholarship.

I would like to commend foundation president Judith Manno Stager and all associated with the foundation for their phenomenal work in helping both donors and recipients.

I wish them another productive 10 years of service.

Mr. Speaker, it has been a rare privilege this day to have the minister from my church, the Lighthouse Reformed Church in Howard, Pennsylvania, the Reverend Dr. Clyde Mighells, lead the prayer before the House of Representatives.

Dr. Mighells was born the son of a tent evangelist, and followed his father into the ministry when he was ordained by the Presbyterian Church, USA, in 1985. He then took his master's from Dubuque Theological Seminary and his doctorate at Newport University in 1996.

While performing the tasks of pastoral ministry, Dr. Mighells followed his father's example of using magic tricks as teaching tools. He found that magic tricks would pique the interest of his listeners and create a more receptive audience.

After 20 years serving churches across New York and Pennsylvania, in 2006 Dr. Mighells and his wife Sharon developed a performance ministry, taking the message of escaping drugs and the timely topic of anti- bullying into elementary, middle, and high schools. In 2009, they were featured at the International Fellowship of Christian Magicians.

We are lucky enough to have Pastor Mighells as our minister, and we don't mind sharing him with his continuing great ministry work in schools, churches, and with other groups.

Mr. Speaker, I draw your attention today to the DuBois Area Middle School and its outstanding level of excellence. It has been awarded, for the second time, the designation of the Pennsylvania Don Eichhorn Schools: Schools to Watch program.

The National Forum sponsors this program, and schools are chosen for the honor of achieving academic excellence based on the rigorous 37 criteria established by the National Forum to Accelerate Middle-Grades Reform. They must be academically excellent, developmentally responsive, and socially equitable.

The school is one of 15 in the State and only 200 nationally ever to be honored as a School to Watch. It is the first school in the State to receive a redesignation for 2010 to 2013, and it first achieved the honor in 2007.

The National Forum looks at these schools as part of the effort to identify and learn from high-performing middle schools, and to have the Schools to Watch serve as resources for other schools. There are 18 States participating in the program.

To achieve this award, high-performing schools establish norms, structures, and organizational arrangements to support and sustain their path towards excellence. They have a sense of purpose that drives every facet of practice and decisionmaking.

And I want to congratulate Principal Mike Newman and the teachers, students, personnel, and parents that are responsible for this fine school.

Mr. Speaker, under the new health care reform law, we find the Internal Revenue Service has been appointed as the health insurance police.

The Ways and Means Committee reports the following: IRS agents will have to verify that you have acceptable health care coverage, which has yet to be defined. That used to be your decision. Now, it's a decision to be made by an appointed Federal official. If they don't find your coverage acceptable or if you don't have coverage, the IRS can fine you up to $2,250, or 2 percent of your income.

One of the rubs is that the fine is much cheaper than buying health care coverage; and when you get sick, you can still buy coverage that will apply.

Now, if you can't pay the fine the IRS assesses, they have the power to confiscate your tax refund.

This new police force will require about $1 billion a year and more than 16,000 new Federal employees. But, of course, the new law did not include money to pay for this vast expansion of power for the IRS. It's just one more example of the Democrats' deficit spending.

Mr. Speaker, I rise in opposition to this flawed health care bill.

Mr. Speaker, the Democratic health care plan that will be forced upon the American people this weekend is, in reality, a jobs bill, a really bad jobs bill. What is the evidence that this is true?

This bill will result in the firing of 30,000 individuals from jobs who currently work in the private student loan industry. This bill will bankrupt rural and underserved urban hospitals, eliminating both jobs and access to quality care.

So where are the jobs, Mr. Speaker? This bill will create jobs. This includes 16,000 jobs at the IRS to service the health care police to determine if your health care plan meets the health care czar's demands.

This bill has already created a job for Senator Scott Brown, and I am confident, if this bill is forced on the American people, a surprising number of jobs will be created for new Republican Members of Congress in November.

Mr. Speaker, competition used to be viewed as a way to lower prices and improve services. A rental car company's slogan was, We're number two, so we try harder.

Competition apparently is no longer a virtue under this administration. The health care bill seeks to put health care for Americans in the hands of government bureaucrats, but it also seeks to put guaranteed student loans solely into the same government hands. Unlike the car company, I'm not sure the government can say that it ever tried harder, sought innovation, or went out of its way to help a student.

The Federal Family Education Loan program is administered primarily by private companies today, and under the proposed change, private lenders will be barred from making government-guaranteed loans. Some 30,000 employees across the Nation will lose their jobs. So much for worrying about the Nation's unemployment.

Choice and competition will die, but the Democrats say it will save money, about $87 billion, money they have already spent on Pell Grants and $9 billion diverted to pay for health care reform. Instead of that savings, look for poorer service, increased defaults, and higher administrative costs--like dealing with the IRS.

Well, I thank my good friend for yielding. I appreciate his references to songs. It's striking a tune with me tonight.

You know, you named a lot of States who are getting a lot of sweeteners. A lot of States are being paid off, bought out, you know, buyouts, it really comes down to corruption, I think. If we see this type of deal-making out in the private sector, you know, most people would wind up subpoenaed and in jail for this type of deal making.

There are three things that, you know, States like Pennsylvania--we don't have any of those sweeteners that I know of that have been, those deals have been made obviously. But I think there's a lot that we need to continue to look at in this bill and walk through it and find out, and not just this bill. I think part of what we have to look at--some time in months to come we're going to be dealing with an omnibus budget. And I have to say there's probably going to be some deals in there that folks who vote ``yes'' on this health care bill, we're going to be able to draw some lines and call--use the President's word from one of his joint sessions, and call folks out of deals that were made.

You know, there are three reasons that America needs to be alarmed. There are many reasons actually. But tonight I'm going to hit my remarks, first remarks on just three reasons of why this is not good for America. That's based on my experience, not 15

months in Congress, but 28 years working in health care, serving people who are facing life-changing disease and disability.

And frankly, my concerns tonight, I want to address just three basic areas: Cost, care, and corruption. And the cost? Well what's this going to cost us? Well, the President has said if you're in an individual plan, a nongroup plan, you can count on your premiums going up 10 to 13 percent. Well, I thought one of the ideas behind health care reform was to bring down the cost of health care for all Americans. But we're guaranteeing, the President has put his word on the line, that if you're in an individual plan, you can count on 10 to 13 percent increase in your premiums. And I think that's just to start with. Where it goes from there I don't think we really know.

We have costs in terms of cost to the States, the expanded roll is taking medical assistance to 133 percent of poverty. You know, States, there are States, many like Pennsylvania. Pennsylvania was the last State to settle its State budget this past year. And there were a lot of potholes, a lot of gaps in that budget, things that needed to be funded that they couldn't find resources to do. And now, the Federal Government's going to spend, reach into the Federal taxpayers, all Americans' pockets, and pay for expanded medical assistance rolls to start with. But guess what? That goes away within short order. And where are the States going to fill that gap? Because you expand that entitlement, it's not coming back, and it's going to create all kinds of problems for our States.

One of the costs I wanted to focus on because my good friend mentioned about my background as a manager within rural hospitals has to do with what does this do to rural hospitals? All hospitals. But I think the hospitals who will be hit first will be rural and urban underserved to begin. They'll feel the pain of this first. And one word, in short order, will be bankruptcy. Now let me explain why.

Today Medicare pays 80 to 90 cents for every dollar of costs. Medical assistance pays 40 to 60 cents for every dollar of cost. You know, the primary reason--there's a lot of reasons, actually, commercial health insurance is so expensive, including a lack of tort reform across the Nation. But I think the most pressing reason why it's so expensive is the Federal Government, the fact that the government creates these entitlements that they can't sustain, and then they're systematically underfunded. And so what do we do if have we have expanded medical assistance roles, if we have these, I know they're not calling it a public option but, frankly, if they're going to find for-profit and not-for-profit insurance companies and do this Federal nationwide negotiation with them to have them really compete with other insurance companies, well, I don't know anyone that competes with the Federal Government and wins.

And so the only way that they're really going to be able to provide premiums that will get the blessing of the health czar or whatever bureaucrat is now going to be overseeing our health insurance--today I found out somewhere that they're going to be hiring like 16,000 new IRS employees to determine whether our health insurance meets the criterion or not.

You know, the only way that they're going to get blessed is if the premiums cost less. The only way to have premiums cost less is to pay less, is to pay comparable to probably somewhere between Medicare and medical assistance rates. What that will do to all hospitals, but starting with rural and urban underserved, it will bankrupt those facilities.

You know, a hospital today, if it's healthy, if it's having a banner year, it's making a 1 to 3 percent margin. And out of that margin they're paying, hopefully they're giving some type of cost-of-living increase every year to keep the best and the brightest, because if somebody's going to use a scalpel on me, that's who I want, is the smartest person around. Or to invest in new lifesaving technology because we believe in innovation in this country. We are a country of innovators.

Now, you start cutting, taking those--and not all hospitals are making 1 to 3 percent margins. There are many hospitals across this country that are in the red and are not surviving now and are on life support. So we implement this Obamacare plan, and we're allowing them to bleed to death financially.

And if you want to impact access to quality care in a negative way, close rural hospitals. In my district, we have probably somewhere between 20 and 24 hospitals in my congressional district. You close any one of those and what you wind up with is a commute that makes a difference between life and death. And that's wrong. And that's just on the cost side.

And so I appreciate this opportunity tonight. I think it's very important that the American people continue to weigh in on this. This is not a done deal. We have the opportunity to stop this, to do what the American people are asking for, and that is to start over. And the more that we inform people about the problems in terms of the costs, the care, and the corruption with this proposal that the Democrats have, I think the safer the country will be. And I yield back.

I just wanted to follow up with a little feedback that goes well beyond this Chamber.

Certainly we know that if ObamaCare passes, we won't start to see the benefits in any way, and I happen to believe they're not benefits until 2013, 2014. Outside feedback. What's happening out in the country beyond this Capitol Hill?

There are three States that have already--Virginia, Idaho, and Utah have already passed laws to nullify ObamaCare's mandate that everyone purchase health insurance. Other States are following suit.

Arizona has a referendum on the ballot for November saying ``no'' to a mandate that every American should have to be required to purchase health insurance; ``no'' to the fact that an IRS agent can come evaluate whether you have or have not purchased that and then fine you or tax you.

Virginia's attorney general has already threatened legal action against the deeming process that is being used and touted and so discussed in this process.

Washington has no idea now how to deal with Medicare, Medicaid, and Social Security, and now we are creating a new entitlement that will accelerate, frankly, our path to ruin.

I want to share one quick feedback from a gentleman, a businessman. He and his dad have a business in Port Allegany, Pennsylvania. They make a product they are just so proud of. It helps with the car industry, and they do a great job, and they want to expand. They want to hire new individuals. They want to create prosperity. They want to grow. But, in fact, what has happened is that so much uncertainty has been created with this health care that they can't do that. They compete with China. They compete with South America. And now they can't compete because of this uncertainty.

Madam Speaker, from The Cincinnati Enquirer to The Washington Post, the editorials today tell the Democrats to stop this health care reform and start again. I agree because I've always based my work on health care on increasing access. This bill fails at increasing overall access. The Senate bill expands Medicaid to cover families earning up to 133 percent of poverty level. The Medicaid rolls will explode under this proposal. But what does that mean? Some 40 percent of family practice physicians currently do not accept Medicaid patients. This is expected to increase to 60 percent. Some 60 percent of specialists currently do not accept Medicaid patients. This is expected to skyrocket to 80 percent.

This bill expands Medicaid beyond its capacity to absorb patients, it cuts Medicare for seniors, and leaves malpractice tort reform untouched and skyrocketing costs in place. This bill has the potential to bankrupt rural hospitals that have a disproportionate share of the problems inherent in the bill. This adds up to less access and lower quality. That is not reform.

Madam Speaker, it was late in December 2009 when two high school football teams met on a snow-covered field in Hersheypark Stadium. They were there to determine who would walk away as the Pennsylvania Interscholastic Athletic Association AAAA champions. It was LaSalle College High School versus State College High School. LaSalle won 24-7. Touchdowns were made by Sam Feleccia, Jamal Abdur-Rahman, and Tim Wade. Going into the game, LaSalle had a winning record of 13 wins and only one loss. Feleccia's 55-yard run pushed the Explorers ahead 24-0 with 4 minutes left in the quarter, sealing the victory for the Catholic school in front of more than 3,000 LaSalle fans.

The LaSalle Explorers became the first-ever Philadelphia city team to win a PIAA football title. They went on to the honor of having six of their team players selected for the Pennsylvania sports writers' all- State football teams. LaSalle's coach, Drew Gordon, was selected as the Coach of the Year. Runner-up State College had three players chosen for All-State.

I want to extend my sincere congratulations to LaSalle College High School for their outstanding victory and the State College Little Lions for an outstanding season.

I thank my good friend from Iowa for hosting this Special Order tonight at a late hour, but it is important. It is important that we use every hour this week to stop what really is just a terrible attack upon the health care of this country.

When I came here 15 months ago, I came out of health care, 28 years working in nonprofit community health care, serving people that were facing life-changing disease and disability. I came here with a commitment that there were some things we could do to improve the system we have, and I have that same commitment today. But I came here with almost 30 years of experience, 30 years of pride in the health care system that we have, how we meet the needs of the people that have needs, and people with varying amounts of means as well.

There are many processes we have just in my congressional district. We have almost two-dozen rural hospitals. We also have other great facilities such as federally qualified medical centers that meet people's needs that frankly don't have a lot of means and don't have a lot of money to put towards health care, but they have access to quality health care.

And that is one of the things that disturbed me since this debate began, because the President and the Speaker have made this debate about access to health insurance. That is the wrong debate, absolutely the wrong debate. We should be talking about and should have been talking about from day one access to quality health care. That is what Americans want. That is what Republicans are committed to. Those are the proposals that we put forward back in July.

My good friend said a very important word when it comes to health care in this country and serving our citizens, and that is ``innovation.'' The United States of America is a country of innovation when it comes to health care. The system we have allows us to find procedures, treatments, medications, even just medical equipment, new innovations that frankly help those survival rates that you referred to, many of those that contributed to those higher survival rates for cancer in the United States of America, innovations in health and recovery that, once we help people survive, help people to rehabilitate, to recover, to get back to the things that they did in their lives, to be able to return to work and return to a productive life, which is what everybody strives to do.

My background actually was specifically rehabilitation, durable medical equipment, wonderful innovations that help people live and age with dignity, help people stay in their own home settings so that they don't have to go into any kind of an institutional setting. That innovation only comes from the health system that we have.

There are four principles I've led my life by as a health care professional and have guided me in this debate in 15 months, and that is that we need to do everything possible to, first of all, lower the cost of health care for every American. We need to strive to increase the access to quality health care for all. We need to improve on the quality and the innovation that we've enjoyed in this country, but we can do better. And the fourth principle for me is to strengthen that decisionmaking relationship between the patient and the physician, not allowing the government or a bureaucrat to insert themselves in that decisionmaking process.

Yet, as I look at what was the Pelosi health care bill and what I look at now as the Senate health care bill, I see, as I tear that apart, and not as a Republican, not as a partisan, but as someone who spent their lifetime dedicated to providing health care services and meeting the needs of people facing life-changing disease and disability, my evaluation, assessment is these bills make all four dimensions of health care worse.

They drive up costs. We can talk more on that as we go on this evening. It really will limit access. It will serve to decrease quality in the long run. And certainly it will kill innovation, which has been just one of the bright spots of this health care system in this country. Frankly, it provides a wedge--and that's a government or bureaucrat between the patient and physician in terms of decisionmaking.

I yield back.

Well, if the gentleman will yield, you have been here obviously serving the American people a lot more years than I have, but I have a question in this process. Obviously, we're supposed to--and I expect Friday night or Saturday we will see the Senate bill. It will be shoved at us, and we will be forced to take a vote on that. It will be a vote that we're supposed to take with a promise, under reconciliation, that all the very terribly flawed parts of this bill will be fixed under reconciliation.

My question is: Relying on your experience, what if reconciliation-- if we take this and my Democratic colleagues pass the Senate bill, which they don't like, but they do it under a false promise that it will be fixed in reconciliation, what happens if reconciliation never occurs?

Well, I believe that some of our colleagues across the aisle are probably looking to vote for this Senate bill that may even agree with us on abortion and how wrong that is to publicly fund, let alone to complete procedure under the promise--the promise it will be fixed through a reconciliation bill. And I just want to talk a little bit more about what the probability of that is.

We're going to be relying on the Senate to bring a bill to us, to pass a reconciliation bill to make these fixes that they're putting together, these sweeteners, these promises. Now, to the best of my knowledge right now, we've passed a number of bills in this Chamber in the past 15 months, and by my calculations, we've sent over 200 bills to the Senate that are just lingering in the Senate. They haven't taken action on them. So if there's 200 bills there already that they haven't taken action on, what is the probability, what is the chance that they'll actually do a reconciliation bill that would make these fixes?

I appreciate my good friend yielding.

I appreciate Dr. Burgess sharing those Wall Street Journal statistics. There was one just a few weeks prior, a CNN poll that showed that 79 percent of independents say start over. Stop the bill that is going on now. That is independents, 79 percent of them.

I was visiting a hospital earlier today, and I talked with everyone. As I talked with the staff, I went with the physicians, the nurses, the therapists, the secretaries; that was the same message they gave me. And these are folks that understand health care. They live it every day, long days in health care. And they said stop the madness, stop this bill, and start over.

And I talked with patients, I talked with family members, and I talked with just visitors. It was kind of interesting. They had no idea who I was. And I was riding in the elevator with a couple folks, and you can tell what is on their mind. They looked at me and they said, What are those people in Washington doing to our health care? They get it. The people at home get it. We need to stop and do the right things.

I just throw in here in terms of the unintended consequences here, one of my first principles was to decrease costs for all Americans. And you mentioned tort reform. Even the President has acknowledged for those folks who buy their insurance individually, non-group, you know, he has come out and said this is going to drive their premiums up 10 to 13 percent. Ten to 13 percent. That is exactly opposite of what we should be doing.

I appreciate you leading this tonight. I yield back.

Madam Speaker, the President just had a physical and is apparently very healthy. Among the tests he had was a virtual colonoscopy to screen for colorectal cancer. A virtual colonoscopy employs x ray technology that produces a three-dimensional image of the entire colorectal structure. However, it is much less invasive and does not require sedation that is often needed for a standard colonoscopy.

I bring this up because the Centers for Medicare & Medicaid Services have denied coverage of this procedure for seniors enrolled in Medicare. Colorectal cancer is the third most diagnosed cancer among men and women in the United States and the second leading cause of cancer death, despite having a 90 percent cure rate when detected early. Many insurers like Anthem Blue Cross-Blue Shield and CIGNA cover this virtual procedure but not Medicare.

The National Cancer Institute Colorectal Cancer Progress Review Group predicts that the minimal invasiveness and lower cost of this procedure could attract more people to be screened, with the possibility of saving 20,000 lives annually. The President has set an example. The American Cancer Society recommends it. Medicare should cover it as a provided procedure.

Well, first of all, I want to thank my good friend from Missouri for providing the leadership for this evening. It is just so important.

The American people, I have to tell you, I am very proud of the American people on this issue. During this past 15 months, I think they fulfilled the responsibility that our Founders intended. Our Founders have to be smiling right now, because the American people have woken up and are paying attention and engaging on this issue.

When it comes to health care, I think the large majority of Americans share the same perspective I do, and it is a perspective I developed as a health care professional. I started out as a therapist over 30 years ago, and for 28 years I was a health care manager, licensed as a nursing home administrator, worked in all areas of health care, in nonprofit community health care.

The four principles I have always led my professional life by have been the same four principles that have guided me in my role working for the people as a Member of Congress, and it is the same principles that I see the people agreeing with when it comes to health care. They want to improve our health care system, not throw it out, not create some government-run system.

My principles that I have always led my life by, and I think they are principles that are important in this debate, let's do what we can to make sure that we lower the cost of health care for all Americans. The bill that is coming at us at light speed from the Senate raises costs for most Americans. It doesn't address real cost reduction.

The second principle for me is increasing access, improving quality, and making sure that we strengthen that decisionmaking relationship between the physician and patient. We don't need the government or a bureaucrat making those decisions.

The bill that is coming at us, in particular I will just talk about one aspect. I started at that last principle of strengthening the decisionmaking relationship between the physician and the patient. This bill creates a health care czar, and this czar is going to have the ability to impose not just health care prices and controls, but that czar is going to dictate what kind of benefits we should get and not get. And just as my good friend from Texas was talking about, we will wind up paying for procedures, such as abortions, something that we would never use, that we certainly, based on my faith, would be very much in objection to.

So that type of imposition of a czar making decisions, inserting themselves between the patient and physician, is just absolutely wrong.

Mr. Akin, I want to come back to the chart you have there. It is a perfect capture of bureaucracy. Bureaucracy, one of the things that we talked about. We are all committed to lowering the health care costs for every single American. That is a principle that we all should be doing the right things towards. And there are solutions out there that we have worked on and introduced. The Putting Patients First Act is just one of them that would bring the cost of health care down for everyone.

But I want to talk about the consequences of that chart, of this Senate bill which is being shoved like a freight train through Congress and on the American people. Over a hundred different mandates, well over a hundred different new bureaucracies are being created in health care. I will just come back to one that was created, and the practical impact of that, under President Clinton: the Health Insurance Portability and Accountability Act, HIPAA.

Everyone wants privacy when it comes to health care. It is a very intimate subject. That is why we don't want a bureaucrat involved in our health care. The portability part, I have to say, if that worked back in the 1990s, we would all be better if we could take our insurance with us where we went. But it didn't; it failed. But what it did do is put a layer of bureaucracy in our health care system that has just piled tons and tons of layers and money, money that is required to be spent to implement and execute that bureaucracy.

And you know where that money comes from? It comes from direct care. That is money that goes into--and when they talk about waste in health care, government mandates are a tremendous waste. That is how I got involved in public policy, actually, out of frustration, because I saw what the Medicare regulations, many of them, were doing to add cost and decrease access to cost-effective health care.

Absolutely. And what we are talking about today goes well beyond Medicare. I thought Medicare and Medicaid were complex. This new proposal, this Senate bill that is being pushed at us, HIPAA, the impact of costs on health care just from HIPAA were significant. If you multiply that times a hundred new Federal mandates on health care, and you multiply that by 150 new bureaucracies within the health care system, the ultimate cost of what this will cost our country, our citizens, and our health is just devastating.