Floor Statements

Mr. Speaker, last week, Governor Bobby Jindal announced that Louisiana, along with 16 other States, would not participate in the government takeover of health care's temporary high risk pools. I commend Governor Jindal on this decision and for having the foresight not to put Louisiana on the hook for yet another tax-increasing, job- killing, unfunded mandate, and subjecting our citizens to more Federal inefficiency and bureaucracy.

While I have always supported the concept of high risk pools, this effort will thrust the burden onto the backs of Louisiana taxpayers, eventually saddling them with another federally mandated program they can ill afford. Louisianans have made it clear that they are sick and tired of carrying the water for an ever-expanding Federal Government. I commend our Governor for doing the right thing for our State and our country.

Mr. Speaker, last week, I introduced H.R. 5126, the Helping Save Americans' Health Care Choices Act.

This important legislation restores the popular Health Savings Accounts and Flexible Spending Accounts, which are diminished through taxation and restrictions under ObamaCare.

Millions of Americans rely on HSAs to cover deductibles, insurance copayments, over-the-counter medications, and a plethora of other medical expenses. Furthermore, it is an excellent tool to cut health care costs while ObamaCare, itself, provides no such tools. I find it extremely ironic that the name of the current law, the Patient Protection and Affordable Care Act, betrays the fact that it drives up costs for patients and for their employers.

If you truly support health care affordability, I ask all of you to support H.R. 5126, which restores this valuable tool that saves costs.

Mr. Speaker, the DOD's recently released Military Power Report on Iran should be a wake-up call for the President and the leadership here in Congress. While I am glad the Pentagon undertook this assessment, I and most Americans didn't need a report to confirm the Iranian threat is real and credible.

Iran's extremist regime poses a significant danger to the United States and our allies, particularly Israel. Also, because of our failure to implement tough sanctions against Iran, many nations will feel the need to develop nukes, while we are reducing our stockpile and failing to modernize our nuclear inventory.

In addition, we have halted the production of F-22s, allowed a window of vulnerability in missile defense, and have delayed development of the NextGen bomber. I hope the Democrat majority and the President do not shortchange the DOD again this year on key investments in ballistic missile defense, the NextGen bomber, and other vital initiatives to protect our homeland and our allies well into the future.

Mr. Speaker, the government takeover of health care just celebrated its 1-month birthday, and we are already seeing the disastrous effect it will have on our Nation's economy.

Since the beginning of this debate, U.S. employers have warned that this bill would destroy American jobs and harm our fragile economy. Over the past few weeks, we've seen the real-life impact these job- killing tax hikes and health care costs are having on American employers. From AT&T to Caterpillar to Lockheed Martin, we have seen billions of dollars in losses to American companies which will result in further job losses, higher prices, and less choice for the American consumer. And to add insult to injury, actuaries at CMS working under Secretary Sebelius now confirm what most Americans already knew: health care costs will skyrocket as a result of this bill.

The long-term effects of this bill are still not fully fleshed out, will be devastating to this country's economy, and are not worth the time and effort that we have put into it. Let's move forward to repeal this law.

Mr. Speaker, as millions of Americans, and the people in my State of Louisiana, file their income taxes today, they are reminded how they labor under a tax scheme that discourages hard work, investment and savings.

Federal, State and local taxes claim almost 27 percent of the average American's income. This means the average taxpayer worked until April 9 this year just to make enough money to pay their taxes. Meanwhile, our budget deficit this year is a record $1.5 trillion, three times the highest Bush deficit.

This tax increase equates to more than $2,100 for every person in the United States and explodes the President's pledge not to raise taxes on Americans earning less than $200,000.

And now we hear that the administration is considering a value added tax which taxes goods and services at every point in the process.

Mr. Speaker, when it comes to taxes and our budget, let me suggest that Americans are not undertaxed; Washington is overspending. It is time for Congress to cut taxes across the board and stop the wasteful spending programs.

Mr. Speaker, I rise today to commend MedCamps for 23 years of outstanding service in the State of Louisiana.

Founded in 1987, MedCamps of Louisiana provides a summer camp experience to children with physical and mental disabilities such as spina bifida, cerebral palsy, autism, and epilepsy. Each week, free of charge, children come from across Louisiana to participate in a week- long, fun-filled camping experience at Camp Alabama in my district. Children participate in activities such as fishing, arts, crafts, nature hikes, canoeing, and many others. As a family physician for over 30 years, I know firsthand the important role that organizations such as MedCamps play in the lives of children with disabilities.

I congratulate MedCamps on their outstanding service to our State and wish them all the best as they continue to serve the children of Louisiana.

Mr. Speaker, I rise today to commend Louisiana State Representative Patrick Williams, who is currently making his annual 226-mile walk from Shreveport, Louisiana, to the State capitol in Baton Rouge to raise awareness for autism and childhood obesity.

Autism is a common and serious developmental disability in the United States, with one in 150 children likely to have some form of this disability.

Representative Williams is also bringing attention to a serious factor affecting childhood obesity, nutrition in the home, especially among poor families.

As a family physician for over 30 years, I support Representative Williams' efforts and look forward to working with him to address these important issues. I congratulate him on raising awareness for these two important issues and join my constituents in thanking him for his service to the great State of Louisiana.

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

Madam Speaker, let me get to the point here. In this bill we have the other side says there's $500 billion that's going to be taken out of Medicare without one word of explanation how they're going to do it. They're going to take it to extend the life of Medicare. And they're going to count it to subsidize private insurance. Totally dishonest.

Now I have here a memo from the Democratic Caucus, and just to quote in talking about this giddy CBO score that's supposed to show savings: Do not allow yourself to get into a discussion of details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered. Do not give them ground by debating details. For example, the March 11 letter has some estimates of discretionary cost not accounted in the total. Again, instead focus only on the deficit reduction and number of Americans covered.

Finally, with regard to SGR, we know that that was carved out of this bill, $250 billion, so let's add that to the trillion that's not being accounted for, and I quote: ``Most health staff are already aware that our health proposal does not contain a `doc fix' . . . The inclusion of a full SGR repeal would undermine reform's budget neutrality. So, again, do not allow yourself . . . to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered.

`` . . . Leadership and the White House are working with the AMA to rally physicians' support for a full SGR repeal.''

So now we understand why the AMA is supporting this.

Mr. Speaker, I am going to be starting this hour on behalf of my colleagues from the GOP Doctors Caucus. Congressmen and Drs. Murphy and Gingrey are our two cochairmen. We make up a group of 10 M.D.s and 4 other professional health care workers, including a dentist, a psychologist, an optometrist. We have been meeting on a very regular basis throughout this debate. Perhaps this weekend we will have a culmination of quite a debate. And what a debate it has been all year.

As I tell folks often, I ran in my election in 2008, my first election, on health care reform. I am a physician, a family physician of 30 years. I have enjoyed the practice of medicine. I still practice medicine when I go back to my district. And for this 30-year period I have learned a lot about the economics of health care, things that are so important. I have been through all phases. In the early days of Medicare, when we didn't have a lot of the restrictions and restraints that we have today; during the HMO days, where we had capitated care and the so-called gatekeeper; during the days when the CLIA laws came out that more or less outlawed laboratories for doctors' offices; of course the SGR days, sustained growth rate that we have been dealing with for the last 10 years. I have seen it all, and so have my colleagues. In fact, among us we have over 400 years of clinical experience. I would include our two physicians from the Senate in that group.

What I want to talk about this evening is a little bit of background, and also we will kind of get into where we are with the latest situation. One of the observations that I made early in my practice was that oftentimes economics actually controlled the decision-making more than the actual health care itself.

I will give you a good example. I had a patient who required monthly blood tests to check his clotting factor because he was on anticlotting drugs because of chronic deep venous thrombosis. And I could not for the life of me get him to get those blood tests on a regular basis, not because he was afraid of needles, but simply he didn't want to pay the price. However, once we were brought under an HMO, health maintenance organization, and all of a sudden he didn't have nearly the out-of- pocket expenses that he would have had, not only did he want to have the blood tests, but he wanted to have many other tests as well, things far beyond anything that I could conceive would be a benefit to him. So for him it was a value issue. Since he wasn't paying and somebody else was paying, well, let's utilize as much as we can so I get my money's worth for what I am getting.

One of the things I like to tell people when I speak to groups is think of health care consumption like a credit card. If I were to give you a credit card that has a limit of $10,000 on it and I said to you, buy whatever you need, but nothing that you just want. I often ask the crowd, ``What would you buy?'' And of course people come back with, well, I would buy probably a new shotgun to go hunting, or camo, or perhaps some physical fitness equipment, or a treadmill, something of that nature. Things that maybe I am not willing to pay out of pocket for, but if it's your money, then I'm willing to pay it.

This, Mr. Speaker, is really the core of the problem when it comes to cost. There are two areas of our economy in which cost has gone up more rapidly than inflation. One is education and the other is health care. And it just happens that those are the two areas in which a third party, in the case of education it is the government who pays for that, and in the case of health care it is both government and private insurance that pays the main balance of the bills.

So from that I have observed that if ever we are going to deal with increasing coverage, which is really what this is all about, how do we increase coverage, in order to do that we are going to have to find a way to lower the cost. I have agreement among all of my colleagues on the Republican side to just that. In order to have more coverage, we have got to lower the cost. And we have to do it fundamentally.

This bill that is before us that we may vote on within the next 3 days, it has a lot of things in it. It has 3,000 pages, it has over a hundred mandates and boards. It has three specific boards of unelected bureaucrats who make decisions about what doctors are going to be paid, what is going to be in your insurance policy, many things about your life that you would otherwise have control of. But the one thing it does not do, Mr. Speaker, is it does not address cost.

And so I can say to you that fundamentally if we are going to at some point in time address cost in health care, there is one of two ways: either we look at it on the doctor-patient level, where the doctor and the patient, who make the majority of decisions that impact cost, we either give them incentives and we also give them some responsibility, some accountability for cost, in which case if that cost is lowered as a result of accountability for them, then it lowers it for the entire system. That has been proven to work time after time.

For instance, as soon as health care insurance began to cover more and more out-of-pocket expenses, we began to see over the years the cost of insurance going up far faster than the inflation rate. In recent years, we have come up with a tool to counteract that,

and that is health savings accounts. I instituted that with my small businesses, which are apart from my medical practice, approximately 6 years ago. And it was considered to be sort of revolutionary. And there was a little angst among employees, what is this going to be like? Because our deductible is going to go up. But I committed to them that the incremental increase in what the policy costs would be, I am going to put it in their tax-free account which they can use for any health care purchase they like.

Despite their reticence at first, they quickly came on because what they found is that now instead of being free utilizers of health care and running costs up because it's a use-it-or-lose-it proposition, now they have money in the bank; and if they make good, wise, savvy consumer decisions, they can choose generic drugs instead of brand name and save hundreds of dollars. They can shop around costs for certain procedures, certain doctors. It works very effectively. In fact, I would love to see that in health care reform at some point. It is not contained in this bill.

We could even do that for Medicare and for Medicaid, put money in the bank on their behalf. Not out of pocket, mind you, but it is the insurance money or the Medicare money that goes in there to be spent on their behalf. Because if they are saving money for themselves, they are saving it for the system at large.

What we are going to see here with this bill if it comes to law is just the opposite. Nothing to commit the doctor and the patient into controlling cost. In fact, in many ways it lowers the out-of-pocket expenses to a point where the patient behavior, the consumer behavior is unaffected by cost. And yet the consumer and the doctor are making those choices.

Now, there will be, of course, layers and layers and layers of bureaucrats who will be controlling from Washington how things are paid. No question about it. And they will be attempting to control people's lives, what they eat, how they eat, what they weigh, whether they smoke or whatever. But unfortunately, there is no way that Washington, D.C. can micromanage human behavior. Attempts will be made with this bill, there is no question about it, but it will not work.

So then there will have to be plan B. How will we save money? And what we found in every case, whether it is Tennessee, which attempted this some years ago, Massachusetts, which has attempted this much more recently, Canada, the United Kingdom, most Western European countries, Australia, every one of them, this is what has happened. The plan works nicely at first. People get less out-of-pocket cost. They can go to the doctor they want. Everything works beautifully. But then all of a sudden the costs begin to explode and they go far beyond anything that has been predicted or budgeted.

And then what happens? Somewhere costs have to be controlled. And how do they do that? They do that through rationing and long lines. Every single case. Just the other day TennCare cut its Medicaid visits from unlimited down to eight visits a year. That is exactly the way it happens every time. Massachusetts, they are way over what their budget is. And as a result of that, they have come to a point now where they are actually reaching out to the Federal Government to control that.

So just to kind of conclude this discussion about cost itself, either you start with lowering costs by using commonsense methodologies of the free market, with transparency and with turning the patient into a savvy consumer who has all the choices before him or her and can make the best choices for quality and for cost, therefore improving the quality and lowering the cost, or you can go to a top-down, government- run, government takeover system in which a Federal bureaucrat will be walking with you every step of the way.

I have been joined here tonight by one of my colleagues, again as I alluded to a little earlier, Congressman Dr. Phil Gingrey from Georgia, a cochair of the GOP Doctors Caucus. In fact, it was his leadership that led us here tonight for one of many doctor caucus discussions and debates. He ran a little bit late because he had a tele-town hall back to his district. But he has now joined us.

So I am going to yield to the gentleman, the obstetrician of many years from Georgia.

I thank the gentleman. Great comments.

And my experience, Dr. Gingrey, is the same as yours. The teletown halls that I have done on this subject in the last 6 months started out that 85 percent of my constituents were against this. Now it's up to 92 percent. Unbelievable.

Let me just touch again on economics, and then I'm going to pitch this back. We have been joined by Congressman Broun also from Georgia.

But first let me mention, let us talk about Medicare just for a moment.

We hear the other side of the aisle continuing to complain that you're seeing this catastrophic increase in insurance rates, private insurance, and it has been going on for years. And, yes, it has been. It has been faster than inflation. No question about it. But if you look within that, what you find is that because Medicare pays well below break-even for a physician or a hospital and Medicaid pays even half of that, that you have tremendous cost shifting. So you have to raise something; something is going to have to go up to offset the costs that are not being paid.

So, Mr. Speaker, in light of all of that, what we have in this bill is we're going to have a dramatic increase in Medicare and especially in Medicaid which is going to make those rates go up, that is, private insurance, even faster.

But let's look for a moment at what are the economics of Medicare in this bill.

This bill, at least the version we think we are talking about this evening, because we have not even seen the final draft of it and yet we are soon to vote on it, where does it raise revenue? It raises revenue first by taking a half trillion dollars out of Medicare. Speaker Pelosi today said--the way she was asked, How do you do that? And her answer was very simple: You get rid of fraud, waste, and abuse. We've had this program for 40 years and nobody has been able to figure out how to get any dollars out of fraud, waste, and abuse, much less a half a trillion dollars. So I don't believe that is going to happen.

Number two, the $500 billion that we're talking about is earmarked to extend the life of Medicare which is going to run out of money in 2017. That is really 7 years from now. But it's also going to be used to help subsidize private insurance.

The CBO wrote a letter last week saying, You're counting the same half trillion dollars twice, and to get it, you've got to take it out of something you can't take it out of. So really we're tripling down on the same money, which gives us an error of $1 trillion.

So the economics, Mr. Speaker, of this are crazy. They're smoke and mirrors. They don't add up, and there are many other parts of this that we can get into as we go forward. But that is the fundamental problem, as I talked before. Utilization is going to skyrocket, which is not even measured for by the CBO. And then you've got the same dollars counted not once, not twice, but three times.

So with that, I would like to welcome Dr. Broun, also a physician, a fellow family physician from the great State of Georgia, and I yield to the gentleman

I thank the gentleman. I thank both gentlemen from Georgia for your comments and, again, your many years of experience as physicians.

I would like to change the topic slightly, and that is to talk about process for a moment. Now, what I would really describe, this situation is one in which, as this debate continued, Mr. Speaker, as this debate continued through the year, it began to lose momentum almost immediately. We began to see the polls. At first, it was 50/50. Half America wanted this health care reform but didn't know much about it, the other half really didn't want it.

As this debate has gone on and on and on and the news gets out, the acceptance of this has dropped. In fact,

today it is at its lowest point that it's been. I think we are up to now 55 percent of Americans are against it and down in the 30s are actually for it. In fact, a CNN poll--and I'm sure that CNN wouldn't be considered as an extreme right-wing media outlet--shows that--they asked a question a little different way. What should we do with this bill? Seventy-five percent of Americans said either scrap it altogether and forget about it or start over again. And that's exactly where we are. We would like to start over again and pass commonsense reforms without the government takeover of health care.

Well, anyway, as this thing has been losing steam, it has caused more and more difficulty for the other side of the aisle to get things passed, vote after vote. And we saw that there was such a reaction across the country that our good friend, Scott Brown, was elected to, believe it or not, Senator Kennedy's seat, something that no one could have imagined this time a year ago. And while he is an excellent candidate, something else had to be in play there, and we know what it is, and that is health care. Also, through the process to get it through the Senate, even with the 60 votes that already were there, it took special deals. I will just name them real quickly.

The Louisiana purchase; $300 million to go to my State of Louisiana, which would seem ostensibly to be a good thing, but by signing this bill, the President would actually cause costs that would be far greater than the $300 million that we would receive. So the net result is money lost, not money gained.

The Nebraska kickback, which everyone has hated. And, in fact, what it is going to do is probably it will pass in this reconciliation, if it is passed, will actually extend the same benefit to all States which is going to drive up taxes and cost.

A $10 million earmark for a Connecticut hospital for Chris Dodd, our Senator, and certainly Gator aid, where every State will lose its Medicare Advantage except for the State of Florida.

But if that wasn't enough, Mr. Speaker, now that we're in the House, we've got another situation. We're talking about reconciliation; that is, instead of sending it to the Senate in the final form and have it passed and get past the cloture rules over there, they want to slide it in under reconciliation, a mere 51 votes. But all of that being as bad as it is, now we're talking about the Slaughter solution.

And I will pitch back to my friend, Dr. Broun, for his comments.

Those are all great. I appreciate your adding some of the things I left out. This list is getting so long of all the special deals. And the way that the Democrats are attempting to bypass the Constitution is just really unbelievable, and it's making Americans awfully mad. The emails I'm getting are really showing me either people are extremely mad or extremely terrified.

Now I would like to turn to the other gentleman from Georgia, Dr. Gingrey, and see, do you have other comments about the process?

And by the way, I must say that the President, Nancy Pelosi, and even Harry Reid say the process doesn't count, that the American people don't care about the process, only the finished product. Well, that tells me that the ends justify the means, and I just don't agree with that.

What say you, sir?

Reclaiming my time. And then one other deal that just slipped in on the House side is the North Dakota deal. There are carve- outs there.

So the sweet deals have not stopped even though the Senate bill is complete. I understand that there have been in fact ambassadorships, like an ambassadorship to NATO has been offered for a ``yes'' vote. We have Members of Congress being carted around in Air Force One and certainly asked out to dinner and all sorts of things like that.

Look, this is one-sixth of the economy. This is the future of our Nation for a century. Are we so lack of character that we are willing to sell our souls for just about nothing? I yield to the gentleman from Georgia.

Reclaiming my time. I am sure that my other colleague from Georgia has a few choice comments as well.

Reclaiming my time. In the last few moments that we have in our discussion, which I think has been a great discussion, and once again I thank the gentlemen for joining me this evening.

You know, we are in the final hours of this, it would appear. And we don't know if it is going to pass or not. I suspect that if the votes were there, we would be voting on it today. So I do think that the American people still have an opportunity to reach out to those who have not committed, and even those who have.

You know, we don't have even one single Republican that has voted for any of this except for one, and even he is not going to vote for it this time.

So this is not a bipartisan bill except to the extent of its opposition. We have the Republicans, we have a good group of Democrats, and also particularly pro-life Democrats, and the American people. But, unfortunately, we have a big enough group, a large enough group, if you will, of Democrats who feel through their arrogance they can still trump the American people and those others.

And, you know, when you are talking about monumental legislation, Mr. Speaker, we are not talking about a small little bill that maybe it is a financial bill and maybe there are some little deals that have to be made in the back so that we can pull a couple more votes. We are talking about a fundamental bill, perhaps the most important that has been voted on in more than 40 years that affects every American in the most intimate way. Yet we are in the situation with this where we are still up to sleazy deals. Anyway we can get it done, even if you hate the bill, get it done. We can fix it later. That is the craziest thing I have ever heard of.

And I would be happy to yield to the gentleman, Dr. Broun.

And if you would yield back for one moment. This will be the biggest increase in abortions since Roe v. Wade. And I yield back.

We have got only 1 or 2 minutes remaining, and I am going to turn the remainder of this over to Dr. Gingrey.

I thank you gentlemen for joining me this evening. I thank our audience. This has been again another productive discussion about health care. I ask that everyone going forward in the next 3 days pray for us. And I yield to the gentleman.

I thank the gentleman, and once again the Chamber this evening is filled with gentlemen that I admire and I'm learning from here in my first term in Congress. I certainly thank each one of you for your leadership.

I just want to hit one thing before we get back to the topic of the Constitution, which is so important, and the process. I listened some to the hour before last, the women. There was a women's leadership hour on the other side of the aisle. Attractive women, nice ladies. We see them every day. We work with them. We happen to have a different worldview. And much of what they talked about was the human element, how this affects human beings. How this affects folks. Individual situations where someone loses their insurance and they run into problems and so forth.

And I want to get back to that just for a moment. And here's why. We, the three physicians that are here, and our friend, Mr. King, we've all seen situations--health care problems, situations where people develop cancer, heart disease, what have you. And we want the best. We want health care reform. In fact, I campaigned on health care reform, but of course I had no idea that health care reform could in any way be a takeover of the health care system, but simply using a scalpel to fix the problems.

But let me talk about, again, the human issue, and that is, let me remind my friends that coverage does not mean access. Coverage does not mean access to care. And I'll give you an extreme example. Look at Cuba today. In Cuba, 100 percent coverage. Care is free. The problem is you can't get care. They have one colonoscope for the whole country. Yeah, antibiotics are free. If you get pneumonia, you're still not getting any antibiotics. The same is true in North Korea. The same is true with the Soviet Union. Socialized, centralized economies do not work. They create spot shortages and sometimes extreme shortages.

So let's look at Western European countries and Canada. What do we see there? Again, government-run health care. We talked in the previous hour about the fact that there's two ways to control cost: either do it by investing the patient and the doctor into it or have the government sort of control it. But the only way the government can actually save money is to create long lines and rationing.

So if you look at Canada, we had both doctors and patients come and testify before us several months ago. I think some of the Members here were there. And what we heard was really, I think, spine-tingling. We heard the situation of a young mother who developed a spinal condition which left her wearing adult diapers. And there was a permanent treatment for her problem, a surgical treatment. Unfortunately, she had to wait years to get it. When she asked them, Why can't I have this surgery? I'm a young mother, I have a husband, and yet I have to wear diapers because I'm fully incontinent. The answer to her by her doctor was, You haven't suffered enough. You haven't suffered enough.

Yes, health care is free in Canada, but you have to wait as much as 2\1/2\ years to get an MRI scan, and then you have to wait in line to get whatever it is. And it's not unusual for doctors in Canada to say, Yes, you have cancer, Mrs. Smith. We'll watch it. You will not hear a doctor in the United States tell you, You have cancer, and we'll watch it. The doctor may say it's untreatable, but he's not going to watch it if he thinks that there's any chance at all that there's either a cure or at least palliative care.

Then finally we look at--let's go up a couple thousand feet and look overall. Two of the most important cancers in this country--prostate cancer and breast cancer. One in six women get breast cancer, and something like 60 percent of men over age 90 get prostate cancer. And look at the death rates. They're not comparable. The survival rates in the United States of America are far above those in Canada and the U.K. for two reasons. Number one, in the case of breast cancer, the government says it cannot afford mammograms, which are saving lives in the United States, and they cannot afford the more expensive and innovative chemotherapeutic drugs which are saving lives.

So I just wanted to bring this down to the human element because we're talking about process, as we should, and we're talking about the economics, as we should, and we know they don't work. But I hear what these ladies are saying, that there is suffering out there. But again, bankrupting our health care system is not going to save lives or to free people from pain.

Mr. Speaker, over months of debate over the government takeover of health care, a growing list of terms created by the Democrats have been added to the American lexicon, terms such as ``Cornhusker kickback,'' ``Louisiana purchase,'' ``Gator aid,'' the ``doc fix,'' ``reconciliation,'' ``nuclear option,'' ``taxpayer-funded abortions,'' and now worst of all, ``deeming a bill passed,'' ``self- executing'' and the ``Slaughter solution.''

The Democrat House members carp that the American people don't care about the process. After speaking to thousands of Americans about this--not only do they absolutely hate this bill 3 to 1 and feel it will damage America forever, they feel the Democrat Party's arrogance of power is unprecedented in American history.

Mr. Speaker, process does matter, especially when Members of Congress and a President get themselves elected to power on the promise of transparency and ethics, and then stoop to a system of bribes and creative parliamentarian procedures to ram through a government takeover of one-sixth of the economy, health care, merely to advance their ideology of incremental socialism, which is strongly opposed by the American people.

Well, I thank my friend from Missouri. You're absolutely right. But you know what's interesting? Everywhere I go, there are a lot of people around Capitol Hill today. I bump into people that I know, people who are just average, everyday people, and it's amazing how much they are keeping up with this even though it is getting boring. They know about this. This is not something that they're not tuned into, and that's for sure.

What's interesting, the way I have a mental picture about this, is that this bill way back months ago was being pushed like a locomotive up a hill. And as it got closer and closer to the top, more and more problems began to come out. It weighted it down. Finally as the bill, both in the Senate and now in the House, is getting close to the top, it's lost so much momentum because of the sleazy deals, the Louisiana purchase, the Cornhusker kickback, the carve-out for Medicare Advantage in Florida. These things are turning the American people off, and it's really taking a lot of momentum out of the process. And on top of that is the shenanigans, the fakery, if you will, the smoke and mirrors way of financing it which is, again, $500 billion taken out of Medicare, although no one will actually explain how we can do without $500 billion from Medicare. Then that money is used to extend the life of Medicare, which is going to run out of money in 8 years. It's also used to subsidize the middle class entitlement of private insurance. So it's really the same money counted three times. One is taking it out of something we know good and well you can't do without collapsing the system. Two, extending the system. And then three, paying for other entitlements, and then adding the same amount again, another $500 billion in taxes. The American people are not buying this.

Well, I will remind the gentleman that currently physicians and hospitals are being paid 80 cents on the dollar, and the mystery that seems to be out there and very few people are addressing is--and you hear the other side talking about the rapid rise of private insurance costs. Well, one of the main reasons for that is to offset the shortfall in the Medicare payments to doctors and hospitals. So private insurance is having to make up the difference.

That is correct.

That is absolutely correct. And that is not considering Medicaid, which pays more like 30 cents on the dollar, which under this bill will increase by 30 percent. The number of people covered, that is.

It will cut access off to them for health care, and I can prove it.

Yes.

Well, if doctors and hospitals are under-reimbursed further--they're at their limit today. If the cuts go even further--and of course $500 billion is draconian by any stretch of the imagination; that's as much as the entire annual budget for Medicare. If you cut it that much, then doctors will have to opt out of Medicare altogether, and the senior citizens won't have doctors to go to.

Absolutely.

Absolutely. And again, it was only a month or so ago that the Mayo Clinic--I believe their branch in Arizona--announced that they were taking no further Medicare patients. And that's under the current pay system.

Yes.

Well, I thank the gentleman. I've practiced medicine for over 30 years and still have a clinic and see patients from time to time. You know, insurance companies are a bee in my bonnet too. You hear the other side of the aisle talking about how insurance companies are the bad people. They're to blame for all of these problems. Well, I can tell you, insurance companies have been a headache for me, but insurance companies are not the problem here. They are not the problem. And if you don't like the bureaucracy of an insurance company, which you point out very adroitly, you're a customer, and you can always change who provides that service. When you get into this, not only is it 10 times worse than any insurance company and far more powerful, but you can't change. There is only one provider. Now you might say, Well, there will be a number of insurance companies within the exchange, but these insurance companies will essentially become utilities who will simply take the administrative cost for profit and basically do the work of the Federal Government.

Yeah, absolutely. Tennessee had something called TennCare. It I think is a similar model to what Massachusetts has today and somewhat similar to what we're looking at here. And what Tennessee found is the thing that's really a reality that we all need to understand. And that is that if somebody else is paying the bills, then you're going to have an explosion of cost. When I'm in town hall meetings, this is the way I like to put it. I say, I have a credit card here, and of course it's a virtual credit card. It has a $10,000 limit on it. I'm going to give you this credit card, and you can take it to Wal-Mart or Home Depot or anyplace you want, but only buy the things you need. Nothing that you want; only what you need.

And, you know, my question is, what do you need? And of course, the answer always comes back, well, I need a new shotgun because hunting season is coming up and I need some more camo, and I need, need, need. I need all kinds of things that I wouldn't pay out-of-pocket for myself; but if somebody else is paying for it, I'm willing to do it.

So if you take that and apply it to this, and what I've witnessed over 30 years, when it comes to HMOs, capitated models, traditional insurance, no co-pays, high co-pays, what we find is that the more somebody else, a third party or insurance or government, is paying the bills, the more consumption occurs. And I'm talking about excessive consumption, far beyond anything that's actually needed.

And then if I could just add to that, addend that, is in theory, well, that's nice; you can have whatever you want whenever you want it. The problem is that taxpayers ultimately end up paying for this, and at some point you run out of taxpayers. You end up with budget limitations. And so every country that's tried this gets back to the same thing. And the only way to control cost, when you have a third payer, a government or whatever, paying the bills, is to set some rate- limiting steps, and that's basically going to be waiting lines and, of course, rationing.

And what I like to tell people is, look at Cuba. Cuba has universal health care. It's free. The problem is, it's not available. They have one colonoscope in the whole country. And you may need antibiotics, and it may be free; unfortunately, they don't have any antibiotics.

Let me address that.

We were talking a moment ago about the fact there are two ways to save money in health care. One is to have the patient become a savvy consumer and make choices for himself or herself in combination with his or her doctor.

Free enterprise. That is right. Free choice. The other is to have total government control. And then you are going to have to have long lines and rationing.

Now, in the countries that have the latter, that is the long lines and rationing, and these are well-developed countries like Canada to our north, the United Kingdom, the difference in death rates from common cancers, breast cancer and prostate cancer, are unbelievable. We are getting extremely high cure rates, well over 90 percent here in the United States.

Let's take breast cancer. Breast cancer affects one in six women. Let me say parenthetically, the other side over there talks about women's rights and all the things we need to do for women, but yet this, if we follow this pathway, we're going to have a lot more women dying of things like breast cancer because here is why. You look at the U.K., the United Kingdom, they don't pay for mammograms. And also the better chemotherapeutic drugs that can cure the more difficult cases of breast cancer, they don't pay for them. Why? It costs too much. It doesn't fit into the budget.

Exactly.

Unelected bureaucrats.

And if you multiply that times the number of women who get cancer, you are talking hundreds of thousands of women just in that range there.

That is absolutely right. Furthermore, just as way of an example, we actually had people from Canada and from the United Kingdom, both patients and doctors, who came to testify before us. And they told us really crazy things that we would never accept in the United States under our system. One is if someone gets cancer, oftentimes they are told, we're going to watch it. We're going to watch cancer. That's crazy. Why would you watch cancer? You've got to treat it. But in their country, in Canada, in some places it is 2\1/2\ years just to get an MRI scan. Then you get in the waiting line to actually get surgery or treatment.

Yes. Absolutely.

And just one last thing. The way they define emergency surgery in Canada is any surgery that doesn't at this moment save your life. What does that mean? Someone who needs bypass surgery, who has a 99 percent lesion in their artery, unless they are dying that moment, if they get bypass surgery, that is elective surgery. And we saw a recent example where a premier from Newfoundland literally came across the border to get his heart surgery because he chose the United States of America to get his care as opposed to his own homeland.

We know people come from around the world. If they have the resources to get care here, they know where the best care in the world is. We've got problems, but these are solvable problems that we can use a scalpel to fix rather than taking a wrecking ball to the entire system and rebuilding it in a socialist view.

I think it bears noting that this bill defies common sense. We just talked about the fact that you take a half a trillion dollars out of Medicare, which is already struggling, and no one has ever explained in this year-long debate how in the world they are going to do that except to say fraud, waste, and abuse. But if we had the tools to do that better today, why aren't we already doing it? That is number one.

The other thing is the idea that suddenly you can cover 30 million more Americans using the same resources. Nobody buys that.

And finally, another way to say this is that there is going to be an increase of taxes on 25 percent more Americans; they are going to pay more taxes to cover 7 percent more Americans. The Americans are not buying that.

The statistics show that the number one issue for Americans today is jobs, without question. And that health care reform, while it is important to you and me and all of the Republicans and everyone in the House, for that matter, it's only, like, number five or even lower than that on the list. Americans see that the imperative right now is to get jobs back, and we're using a job-killing bill. How in the world are you going to get private insurance if you don't have a job to begin with?

A recent poll by CNN--and certainly I don't think anybody could ever claim that CNN is a hard-right institution--says that 75 percent of Americans feel that we should either scrap this bill completely, throw it away and forget about it, or scrap it and start over again.

So the American people, as you say, three to one, don't like this bill, and they don't want to see it or hear of it again.

Madam Speaker, of this massive almost 3,000-page bill, there is not one thing that lowers cost; not one. A recent Heritage Foundation article focused on the fact that the health care system is fraught with perverse economic incentives that generate artificially high and rapidly increasing spending. This system does nothing to incentivize the doctor, the patient or the insurance company, let alone the Federal Government, to spend the health care dollars efficiently. However, I'm not suggesting that patients have to bear higher out-of- pocket costs. By this, the doctor and the patient must be reengaged, however, with the cost of their care. And how can we do that?

One amendment that we have tried to get into this bill a number of times and has failed is a robust system of health savings accounts for all. This way, we get to have our cake and eat it too. By that I mean that a portion of

the insurance premiums should be put into a special medical spending account for those on all government and private insurance programs who would, in turn, be able to use tax-free funds for discretionary health care purchases. This would be the first step in turning patients into savvy health care consumers. As they save money for themselves, they will save it for the health care system at large, thus bending the cost curve downward.

Madam Speaker, I would like to congratulate and honor a young student from my district who has achieved national recognition for exemplary volunteer service in his community. Charlton Boyd of Shreveport is today being named one of the top two youth volunteers in Louisiana for 2010, in the 15th annual Prudential Spirit of Community Awards. This is an extraordinary honor; more than 21,000 young people across the country were considered for state-level recognition in this year's program.

Mr. Charlton Boyd of Shreveport is being recognized for being one of the top two youth volunteers for 2010 by The Prudential Spirit of Community Awards, a nationwide program honoring young people for outstanding acts of volunteerism. The awards program, now in its 15th year, is conducted by Prudential Financial in partnership with the National Association of Secondary School Principals, NASSP.

In light of numerous statistics that indicate Americans today are less involved in their communities than they once were, it's vital that we encourage and support the kind of selfless contribution this young citizen has made. People of all ages need to think more about how we, as individual citizens, can work together at the local level to ensure the health and vitality of our towns and neighborhoods. Young volunteers like Mr. Charlton Boyd are inspiring examples to all of us, and are among our brightest hopes for a better tomorrow.

The program that brought this young role model to our attention--The Prudential Spirit of Community Awards--was created by Prudential Financial in partnership with the National Association of Secondary School Principals in 1995 to impress upon all youth volunteers that their contributions will inspire other young people to follow their example. Over the past 15 years, the program has become the nation's largest youth recognition effort based solely on community service, and has honored nearly 100,000 young volunteers at the local, state and national level.

Mr. Charlton Boyd should be extremely proud to have been singled out from the thousands of dedicated volunteers who participated in this year's program. I heartily applaud Mr. Charlton Boyd for his initiative in seeking to make his community a better place to live, and for the positive impact he has had on the lives of others. He has demonstrated a level of commitment and accomplishment that is truly extraordinary in today's world, and deserves our sincere admiration and respect. His actions show that young Americans can--and do--play important roles in our communities, and that America's community spirit continues to hold tremendous promise for the future.