Floor Statements

Madam Speaker, recently, two teams in my district won football State championships. In Class 2A, the Evangel Eagles, led by Coach John Bachman, Sr., defeated John Curtis High School.

David Dee Duron completed an 8-yard touchdown pass in the third quarter to Trey Taylor to give Evangel the lead. The Eagles won the game by a final score of 18-13. David Dee Duron finished the game completing 25 of 39 passes for 273 yards and two touchdowns, setting 2A title game records for most completions, attempts and yardage.

In Class 1A, the Haynesville Golden Tornados, coached by David Franklin, beat South Plaquemines to win the title. Late in the third quarter, B'Air McGee had a 21-yard touchdown to give Haynesville the lead, and then the Golden Tornado defense intercepted a pass with only 23 seconds left in the game to preserve the 19-12 win.

Congratulations to the coaches and players of both Evangel and Haynesville on this tremendous accomplishment.

Mr. Speaker, Democrats in the Senate are desperately looking for 60 votes for health care, so desperate that, in a new report released last week, the chief actuary of Medicare found the Reid-Pelosi bill would cause many physicians to stop treating seniors because of $465 billion in cuts to the Medicare program.

Unfortunately for Medicare beneficiaries, the CMS actuary also found that 20 percent of hospitals and nursing homes would go into the red within the next 10 years due to these cuts, seriously threatening the ability of seniors to rely on these institutions for their care.

As if that were not enough, the Reid bill would also cut payments to Medicare Advantage plans by roughly $120 billion, plans that 11 million seniors enjoy today. These cuts, according to the actuary, will result in 3.7 million seniors losing benefits under Medicare, causing many to pay more out of pocket each month for the drugs and services they lost. The.

Reid-Pelosi bill will make it harder for seniors to find treatment or afford care when they are sick.

Mr. Speaker, last month, I introduced H.R. 3789, the Amtrak Secure Transportation of Firearms Act of 2009. The bipartisan legislation will permit law-abiding gun owners to legally transport firearms on Amtrak trains--just as Americans have been able to do for years on our Nation's airlines.

Currently, sportsmen who choose to travel by rail for a hunting trip are left in an impossible situation because of Amtrak's prohibitions against checking unloaded firearms in the secure baggage car. Conversely, these same gun owners are legally allowed to check guns in their luggage on our Nation's airlines, of all places. Why the double standard? Should our federally subsidized passenger rail line have more restrictive regulations than air carriers?

The Amtrak Secure Transportation of Firearms Act would require Amtrak to enact regulations similar to those the U.S. airline industry uses to regulate the secure transport of firearms on airplanes. The requirements would apply for any year that Amtrak receives a federal subsidy.

I ask my colleagues here to support this bill.

Sure. I thank the gentleman, Dr. Cassidy, my colleague from Louisiana for doing a Special Order today, an opportunity to speak on that very subject. Yes. What you're referring to is a case in which my companies, my nonmedical companies, seeing health care premiums rising an average of 10 to 15 percent per year, we found that to be an unsustainable increase. And we began to analyze what are the choices, what are the options. Maybe we would pay less of the premiums, perhaps we would just stop insurance all together. We really weren't sure what we could do.

And then I recall something that at that time was a brand new concept, and that is a health savings account, where you lift the deductible of the policy to a higher level, saving a premium cost, but then, in turn, put the incremental increase that comes up to what the premium would be into a health savings account. So we began that about 6 years ago. We brought the deductible up to about $3,000. And employees would get as much as $50 a month put into their health savings accounts where they could purchase any health care service or item they needed, pretax.

In explaining this to my employees, however, as we gathered together, I wanted to make sure everyone was on the same page. I suggested to them that this was the way we probably would want to go, but I wanted to get the input as to what their concerns might be.

We had a lady who said, ``Well, you know, the problem with this is my inhalers. If I have to pay for them out of my pocket or my health savings account each month, it is going to cost me $100, maybe $150 a month. And true enough, this would come out of my health savings account, but I don't know that my health savings account would be able to withstand that.''

So I said to her, ``Well, let's think this through. Perhaps you should consider doing a smoking cessation program, stop smoking altogether. You could throw away all of your inhalers; you would save money on the cigarettes; you would save money on the money accumulating in your health savings account.''

Sure.

Basically, you're absolutely right, Dr. Cassidy. What we are really doing is saving her money and saving her life because there is no question there is direct correlation, an inverse correlation, between the use of tobacco and health. By the same context, if you stop smoking, then life span increases.

So we found in very real terms that it saved premium costs--both to the employer and to the patient--by instilling the health savings account and attaching behavior with costs. And even today, we received notice on our most recent new policy for the coming year. The increase was 3\1/2\ percent, which is really amazing when it comes to health insurance policies.

Yes.

This is a fast food business. It's a steep pyramid which means you have a wide base of entry-level employees and then middle management and then just a few high-income folks. Remember, the employer is putting the money into the health savings account. That doesn't mean that the patient or employee can't also put some money in, but the lion's share was put in by us. And now after 6 years or so, those who have taken good care of their health and not wasted the health care dollars now have saved as much as $15- to $20,000 in their family health savings account which is triple, if not quadruple, what the deductible is on their health policy.

Of course the premiums stay even. But what happens is the cash accumulates and it accumulates to the point where there is essentially no deductible, no copayment. Whatever health care needs you have, there is always plenty of money in the bank.

What's also interesting is for whatever reason you get out of that plan and went to something else--let's say you hit 65, you went to Medicare; let's say you just decided you didn't want to have insurance anymore, whatever reason--you still keep that money. It is still there for you for health care needs. And you can use it indefinitely no matter what other health plan you might be on.

Congressman Cassidy, I have looked at this for many years in terms of being a family physician figuring out how to get the best cost care to a patient delivered--and I am sure you have in your specialist role--but also as a business. And I have concluded over the years there are only two ways to control costs in a health care system: either you do as we just discussed, you have the doctor and the patient have a stake in the cost controls for themselves or at least particularly for the patient, in which case as a dividend; you have cost savings throughout the system; or you create a giant, highly bureaucratic system that engineers, micromanages life behaviors from top to bottom in which there is no connection between a patient and his or her behavior--or cost, for that matter--and for that system to be effective--because we see an exponential growth in consumer purchase behavior--and the infinite desire for value coming out of the system, whoever is putting the money in it, we as consumers always want to get as much out of a system as we can, especially when we are not putting anything into it.

When you have that scenario, then it puts an intense demand on the controlling entity which in this case is the Federal Government. It puts an intense pressure and burden to figure out ways of controlling costs, and there is only one way at that point to do it: that is long lines and rationing. That is the only way any system of that size has been able to control costs.

It would have a tremendous negative impact. First of all, if for whatever reason--let me back up a second.

This health care bill provides that whether it is a public option, a government-run insurance, or whether it's a private insurance plan, they all have to go through an exchange and meet certain minimum requirements and certifications. Every constituency out there is going to be knocking on our doors in Washington wanting their aroma therapies, their massage therapies, and everything else which is going to make the minimum requirements go up and, therefore, the cost.

I, as a small business owner, when I am having to decide about purchasing these required minimums and mandates, at some point I may say I can't afford it, in which case I will have to opt out of the health care plan but I will still have to pay an 8 percent of payroll tax or up to 8 percent payroll tax.

So even not covering my employees will lead to higher costs. And as soon as my costs go up, my profits go down, my ability to sustain business will fade, and the first thing I will have to do is lay people off or certainly not hire people.

If the gentleman would yield for one other point on that.

The taxes on the business doesn't stop there. With the Bush tax cuts expiring very soon, the marginal tax rates will go up from 35 to 39 percent and then this bill provides for another excise tax of over 5 percent. So marginal tax rates on small business owners will increase from 35 percent to 45 percent plus the 8 percent that we talked about, taxes that will occur on payroll even if the employer does not have or are able to purchase health care insurance.

So just an explosion of costs without any return on investment. And therefore, the business owner, in order to remain competitive, will have to reduce his workforce.

Yes.

Absolutely.

I want to add that apparently Puerto Rico and, I believe, Guam or Northern Mariana Islands had the 99th District, which I don't think they have but one district, but they are already up to 99th District with all of the jobs, the fake jobs, the artificial jobs that were created.

There is really, again, a two-tiered approach to increasing aspects to care. One is to do what this bill that just passed does, and that is to say we are going to cover as many people as we can and we will worry about costs later on. Another would be to attack cost first, create a more efficient system, such as we talked about a little earlier, and then organically you are able to cover more people because there is more money to go around.

So I really am concerned that we have started off in the wrong direction here. Of course, the Senate has some kind of bill, although we haven't seen the details of it from the majority leader, but I think it still attacks this whole problem in a sort of government takeover way.

If you look at the statistics, Mr. Speaker, what you find is that the American people oppose, and it depends on which poll you look at, but either by a slim margin or by a large margin, they oppose the government takeover of health care. The American people get it. Republicans in the House and in the Senate get it, so why can't the White House and the Democrats in Congress get that government has never proven to run anything well when it comes to a business-like, cost- effective, and efficient manner. So why are we going to take over one- sixth of the economy and do just that?

We covered the cost that is going to occur to small businesses and to individuals, perhaps those who opt out of insurance, having to pay 2.5 percent of their adjusted gross income or a $250,000 fine or 5 years in prison. But what about the States? You know, the States, Mr. Speaker, cannot have legal counterfeiting of money the way we in Congress do. They can't create a currency that doesn't exist. And all of a sudden we have a mandate by increasing Medicaid from 100 percent of poverty to 150 percent of poverty.

Yes, and that money is not going to come off the backs of our children and grandchildren as it does here in Washington. That is going to come directly out of taxpayer pockets. That is going to be roads that aren't going to be built, bridges that aren't going to be built, projects that aren't going to go forward, things that would stimulate job production. That is money sucked out of the economy.

And remember, as you expand Medicaid to higher and higher income levels, you are pulling people off of private insurance where premiums are being paid by employers and the families, to some extent. You are pulling them into Medicaid which is now 100 percent government paid for. And again, we are concentrating power in the government and cost on top of the taxpayer, really a terrible combination of things in an era where we are looking at pushing above a $12 trillion limit where our deficit spending has quadrupled within 1 year, where even the Chinese who lend us the money we live off, our credit card, if you will, have become terrified of our spending as well. I don't know where this ends, Mr. Speaker.

What we are talking about may sound theoretical, but we actually have a model by which, on a much more microscopic level--we actually have many, but one that I think is the best is Medicare itself. Medicare is a government-run health care program. Those who are served by it like it, but there is a good reason why they like it, because they get a lot more out of it than what they actually put into it. It is heavily subsidized in different ways. It is running out of money. I believe the estimate today is that it will be completely out of money in 8 years. The cost today, the annual cost of Medicare is exponentially greater, magnitudes greater than the estimates ever were in the past. It has always run much higher in cost than was ever predicted. And yet, we somehow think we are going to be able to take a much larger health care system controlled by a much larger governmental set of agencies, 111 new bureaucracies and mandates, and that what we couldn't do with a much smaller system that was a lot less complex, somehow we are going to miraculously do with a much bigger, more costly system. And even if it didn't, we don't have the money as it is. We are living on our future, our descendants, if you will. We are living off their dime at this point.

It is clear that all of these things--Medicare that exists today, running out of money; Social Security that exists today, running out of money; Medicaid already out of money and bankrupting States; jobs, killing jobs, and jobs are what keep our current health plans in place; $13 trillion in debt and rising--many, many dollars spent right here in this House that we have absolutely no way of paying for, and we see a confluence of events here, costs that are coming rapidly together that very quickly just the interest alone will begin to squeeze out all of the other services that we look to government to help us with, like common defense.

What are we going to do when we don't have the money to protect our country both internally and externally? What are we going to do when we don't have money for some of the programs that we use as kind of a safety net for Americans today who don't make enough to live off of, or used to be employed but became unemployed because of our spending? What are we going to do? We have to change direction.

I just spoke at a TEA party this weekend, and people are absolutely-- they are past angry. They are actually terrified at this point.

You mentioned, Dr. Cassidy, this summer, all of the town halls, and of course TEA parties have sprung up during that period of time. I think we have to look at that as sort of the canary in the mine shaft. That is the early warning sign that the citizenry out there is fed up with the irresponsible spending that we are doing here. It is time we begin to look at reinstating individual choice and individual freedom rather than the government controlling and micromanaging our individual lives and taking our own money away from us to give back to us in order to control us.

I thank the gentleman. I absolutely agree. And, again, it looks like, from what you've presented today, The New York Times, The Washington Post, and I read today from Reuters, and CMS just came out--all of these groups, very nonpartisan in many cases, and certainly no one can say that The New York Times is a Republican or even conservative publication--all of these groups, these publications, these boards, editors are coming out with great anxiety over the cost of this.

And you might say, well, why are they complaining after the fact? Well, remember that we debated for weeks on H.R. 3200, but we only had 1 day really to vote on H.R. 3962, which really doubled in size and doubled the number of bureaucracies virtually overnight. And I think now that all the celebration is over in the House, we may have a little hangover going forward.

Mr. Speaker, indeed, this is an historic day. We have a choice today between two bills; one which will have a government takeover of one-sixth of our economy, which will involve the Federal Government into the day-to-day lives of each and every American, or the Republican alternative, which actually goes to the central theme of the problems that we deal with today.

Not only that, senior citizens will be the most hurt by this government takeover of health care; $500 billion taken out of Medicare, and with not one scintilla of evidence as to where it's going to come from. It will come from access to care, of course. Furthermore, CBO says that part B will increase by $25 billion, and part D premiums by 20 percent.

I would say, in closing, God help us as the government takes over your day-to-day life.

It has been mentioned many times during this debate that the AMA and the AARP have endorsed this. However, the polls show that the majority of physicians oppose this. And the polls say that the majority of seniors oppose this bill, the Pelosi health care takeover.

Who is going to be hurt in this? Individuals will be required to pay 2.5 percent taxes or go to jail; 5.5 million of them will be unemployed. Businesses will be required to pay 8 percent payroll tax, and then an additional excise tax of 5.4 percent, bringing the marginal rate to 45 percent. States will have an increase in unfunded Medicaid mandate. Who is going to pay for that?

Mr. Speaker, seniors will see $500 billion, half a trillion dollars, removed from their access to care.

I urge my colleagues to vote ``no'' on Pelosi health care.

Mr. Speaker, health care reform should not be used as an opportunity to use Federal funds to pay for elective abortions. Health reform should be an opportunity to protect human life, not end it. House Speaker Nancy Pelosi is proposing a 2,032-page government takeover of health care that directs the new government-run plan to cover elective abortions. There is no getting around it. Under Speaker's Pelosi's government takeover of health care, Federal funds will be used to pay for abortions under the government-run plan and to subsidize individual plans that include abortion.

As an alternative to Speaker Pelosi's bill, House Republicans are offering a commonsense, responsible solution that would reduce health care costs and expand access while protecting the dignity of all human life. The Republican plan would codify the Hyde amendment and prohibit all authorized and appropriated Federal funds from being used to pay for abortions.

Under the Republican plan, any health plan that includes abortion coverage may not receive Federal funds. As a doctor with more than 30 years' experience, I will be voting ``no'' on the Pelosi health care bill that will destroy life instead of protect it.

Mr. Speaker, in July, I offered House Resolution 615, which urged my colleagues who vote for a government-run health care plan to lead by example and enroll themselves in the same public plan. The resolution has 96 Republican cosponsors and prompted almost 2 million Americans from across the country to contact my office in support of this.

Yesterday, I and several of my colleagues offered an amendment to the Pelosi health care bill that, if passed, will automatically enroll all Members of Congress and all Senators in this public option. This amendment is a direct response to the outcry of millions of Americans who have contacted me.

Members of Congress are exempt from this government takeover of health care, and I believe that if a law is good enough for the American people, then it should be good enough for the elected officials that represent them.

Tonight I will host a Webcast at 7 p.m. Eastern Standard Time, and I urge anyone watching to join me through my Web site, fleming.house.gov, to talk more about it.

Mr. Speaker, as a physician with over 30 years' experience, I cannot state strongly enough how devastating this Pelosi bill is going to be for American families, businesses, and seniors.

This 1,990-page bill has come in at a cost of $1.3 trillion by the nonpartisan Congressional Budget Office. It will create $700 billion in new taxes. It will cover over 6 million illegal immigrants, and as many as 5.5 million American workers can lose their jobs.

The government takeover of health care proposed in the Pelosi health care plan could cause as many as 114 million Americans to lose their current coverage.

This bill will also ring in a new level of Federal spending, creating levels of bureaucracy that will cost trillions of dollars in new Federal spending and will exacerbate the deficit and imperil the Nation's long-term fiscal solvency.

And finally, cuts to Medicare Advantage plans will result in higher premiums and dropped coverage for more than 10 million seniors.

In short, the Pelosi health care bill will raise taxes, provide less coverage for families and seniors, and cost millions of Americans their jobs.

I thank the gentleman, Congressman Gingrey, again, a physician colleague as well as a congressional colleague; of course Dr. Broun as well and others. We have done this a number of times. It's always enjoyable and important for the American people to see the physician perspective.

What I would actually like to do is to go over the fact that it's been said many times by Democrats here and everywhere that we are the party of

``no.'' We offer no solutions. And I have to remind people constantly that I ran on a pro-reform campaign to be elected to Congress last year. So it's very important to me as a physician to see true reform, not a government takeover of health care, but reform of what is really an excellent system. And we have had several plans that we are ready to offer, but now that we are getting to a point where there is actually going to be a Democrat plan on the floor perhaps this week or the next week that will be voted on, we're now ready to offer our substitute. And I wanted to contrast and compare for a moment how these two plans differ, and I will just hit the high points.

Number one, the Pelosi plan cuts Medicare by $500 billion. That's a half trillion dollars. It cuts it out. No explanation. No plan. No strategy. We have had Medicare for 45 years. No one knows how to reduce fraud, waste, and abuse any more than it has. In fact, we know that the larger the entity, the higher the fraud, waste, and abuse is. Our plan does not cut a dime out of Medicare.

The CBO estimates in PelosiCare that it will cut over $150 billion to Medicare Advantage, the private option of Medicare, which 25 percent of Americans, seniors, if you will, have chosen. It will take that program out completely. That will knock about 6 to 11 million seniors off of Medicare Advantage. And not only will they lose preventative health, the eyeware, and all the other benefits that go with it and the efficiencies and the preventative health, as I say, but they will be required to go out in the market and buy Medigap coverage; that's additional coverage. Our plan does not touch Medicare Advantage. It keeps it fully intact.

Here's a very interesting one: the CBO says that under PelosiCare that part B premiums will increase by $25 billion, and part D, the medication part, will increase by 20 percent. Again, ours does not increase those costs one iota.

Thank you. Yes, you're quite correct, many things that go beyond the standard Medicare. And Americans have learned that that is a good bill. It's private insurance using Medicare dollars. In fact, many of us would like to see us, instead of having more government running of health care, to actually have current government programs run in the private sector, where things can be done far more efficiently.

Also, there is a mandate, all employers, essentially all employers, will be imposed an 8 percent payroll tax under PelosiCare, absolutely. Under our plan, no mandate, no individual mandate, no employer mandate.

As pointed out, as many as 5.5 million jobs will be lost as a result of increased taxes, which will add to, of course, the overhead for average businesses.

Now, get this: currently businesses are at a marginal rate of 35 percent taxation. When the Bush tax cuts expire in the next year, that will jump to 39 percent. But added to it with the Pelosi health bill, there will be another surtax added of 5.4 percent, which will then take it up to 45 percent. So we're looking at a 10 percent increase in marginal tax rates. Now, tell me that that will not cause joblessness. There's no way around that.

Also employers will be required to pay at least 72.5 percent of the premiums. There will not be the flexibility that they have today to pay less if they can't afford more.

Will PelosiCare have medical malpractice reform? Not only will it not have it, but the so-called pilot studies that will be offered out there, a measly few million dollars to do that, the only States that can do that are States that do not have laws that restrict lawyer fees or awards or rewards--should I use the word ``rewards''--awards for damages. So that means that we can, of course, reform medical malpractice as long as we don't do anything to lawyers, which, of course, is the biggest interest group, I think, in this bill to begin with.

There are many things, Mr. Speaker, that are going to just blow the budget out. And I would say in summary that everyone, middle class and above, is going to be affected by this in a negative way.

And here's how they are going to be affected: they're either going to be paying higher insurance premiums, or they're going to be paying higher taxes or both. And the government will be deeply involved in every decision in life. Their lives will be managed by the Federal Government, micro-managed, if you will. And if you're a senior, you're going to have increasing difficulty in finding a provider, a hospital or a doctor. It's already true with Medicaid, the other government-run program, which, by the way, is going to increase to 25 percent of human beings in this country from where it is today.

And most people who are on Medicaid cannot find doctors as it is. Where are these doctors going to come from? Because you see, Mr. Speaker, the problem is, and again look at Cuba, look at North Korea, look at Canada, look at the United Kingdom, they all have universal coverage, but universal coverage doesn't mean you're going to get treated. Only one out of six people in Canada has a family physician. So the answer is always in these countries that are government-run systems, yes, you're not going to have to pay that; yes, it's fully covered; but you're just going to have to wait a couple of years to get it.

And some things that are common in the vernacular in Canada and the U.K. is, yes, you have cancer, but, no, we're not going to treat it, we're going to watch it. You will never hear a doctor say that in the

I thank the gentleman. To conclude my comments, I was comparing and contrasting the Pelosi bill with the Republican bill. The bottom line, Mr. Speaker, is there are only two ways you can control costs. There is the Nancy Pelosi way where you have an extremely large governmental system that disconnects the patient and the doctor from the cost and it leaves it to the government, it leaves it to a very, very distant decisionmaker in the Federal Government to make decisions about our personal lives and put in force things that affect us that we have no control over. That is one way to do it, and that is ultimately leading to rationing and long lines, like Canada and the U.K. do it.

The other way is a patient-centered perspective, which is the way the Republicans address it, and that is to leave the decisions between the doctor and the patient.

If you stop there, you are not going to control costs. The way you control costs is to engage both the doctor and the patient into the cost. That is not to say that the patient pays all of the costs or even most of the cost. It is just to say through a health savings account and perhaps other methods, the patient is aware what is being spent and there is a certain reward for making good decisions as a consumer. And in order to do that, you have to connect the patient with the cost in some way, and that is where health savings come in, and you have to have transparency and clarity, which we do not have today. And if we do that, then we make very savvy consumers out of patients, and we have the doctors and patients do buy into it. All of the right decisions can be made in the exam room, and you don't need this giant bureaucracy to do that and create long lines. To sum it up, care delayed is care denied.

With that, I thank you.

Mr. Speaker, this past weekend, my district in northwest Louisiana was hit with severe storms and tornadoes which left neighborhoods tattered, families without homes, and thousands threatened by levees that were threatening to break.

On Friday night, Bossier Parish officials had exhausted all options to save this levee when many citizens and especially the airmen of Barksdale Air Force Base mobilized to protect this community. Colonel Steven Basham assembled 140 airmen; and through their efforts, the levees were saved that night.

Over the days that followed, over 400 airmen worked around the clock to protect the levees, the homes and the families that surrounded it. Enlisteds, officers and even generals worked side by side in an effort to make sure that floodwaters did not destroy Bossier Parish.

I want to extend my sincere gratitude for their dedication and work during this natural disaster; and I want to say that the efforts of these airmen prove, once again, why the United States military is the greatest assemblage of outstanding men and women in the world.

I thank the gentleman, my colleague and good friend, Dr. Roe from the great State of Tennessee. I have visited there many times, the Smoky Mountains. Also, speaking of smoky, everything there is smoked, and it smells so delicious you want to eat bark off trees when you go through Tennessee. So it's a lovely State, and I always enjoy visiting it.

Like you, I grew up in a very middle class, working middle class environment. I had to work my way through

college. My mother became disabled when I was five, and then my father died just as I graduated from high school. I suddenly had the burden of helping out with the family, but also working my way through college and then ultimately medical school, which, with the help of the U.S. Navy, I was able to do that. I served 6 honorable years--some of the best years of my life, and my wife--in the Navy practicing medicine in such duty stations as Guam; Charleston, South Carolina; Oceanside, California; Camp Pendleton Marine Base.

It was, indeed, an honor to serve my country in that capacity as a physician. And then of course I've been in private practice since 1982, family medicine. I still see patients, I still provide care. I'm still dealing even day-to-day with some of the issues that all of us as physicians deal with.

Like you, in your many years of practice, I have carried a burden about what a wonderful contrast we have here. We have tremendous quality of care and delivery of care and the best of care and the best of technology, but yet some people do have access problems. There is no question about it; that needs to be solved.

I ran on a reform campaign, health care reform. I wanted reform, I came here to reform, but you know what I found when I got here is really anything but reform. What I'm seeing is a Congress that has taken a sudden left turn towards socialism to dismantle what is the best health care system in the world and remake it into the same image as Cuba, North Korea, Soviet Union, the U.K., Canada. Even some of the States like your own, Tennessee, who have experimented with socialized medicine and government takeover of medicine, have failed. I have actually asked, I have been to venues and asked, please, show me one example where government-run health care has ever been successful, and I have yet to find one single example of that.

So, like you, I am very interested in health care reform that is true reform, that is common sense, that makes the cost go down--bend the cost curve down, that's the common theme today. And there are so many ways that I'm sure we will get into as we go forward that we can do that. And I thank the gentleman for recognizing me.

Well, I quite agree, with you, Dr. Roe.

I would like at this moment--and I think it would be a fitting time for this--to quote an excerpt from The Wall Street Journal, today's edition, where there's an editorial, probably the best editorial I've ever read.

For those of you who are watching tonight, I would strongly recommend that you read a copy of, again, today's Wall Street Journal editorial. I'm going to read just an excerpt. Here is what it says. Again, these are financial experts who are writing this. This is probably the widest read newspaper in the country, period, even more than USA Today, and they're certainly the most intelligent and best-trained financial people.

It says: Speaker Pelosi has reportedly told fellow Democrats that she is prepared to lose seats in 2010 if that's what it takes to pass it.

This is obviously suggesting that there are a lot of people out there who don't like this, and she's bound and determined to have this as her legacy.

ObamaCare, as it says--I call it PelosiCare--and little wonder. The health bill she unwrapped last Thursday, which President Obama hailed as a critical milestone, may well be the worst piece of post-New Deal legislation ever introduced. In a rational political world, this 1,990- page runaway train would have been derailed months ago.

That's quite true. Not one single Republican at any point has supported this bill, and many Democrats have not supported it.

With spending and debt already at record peacetime levels, the bill creates a new and probably unrepealable middle class entitlement that is designed to expand over time.

Again, I emphasize ``unrepealable.'' Once this thing gets into law, like so many things, there is no way we can get rid of it. It will be with us forever.

Taxes will need to rise precipitously. Even as ObamaCare so dramatically expands the government control of health care, eventually all medicine will be rationed via politics.

So I think that's very critical. First of all, it's one party--and one party only--that wants to force this. Really, it's even less than that. Just the leadership of one party wants to force this takeover of one-sixth of the American economy forever and wants to put it under government control forever, controlling your life from day to day. For what gain? Dr. Roe just pointed out that we could easily cover the same number of additional people with much less cost and with much less effort.

What it does is it leads to rationing. It leads to long lines. I think, certainly, what has been said about justice is true about health care: health care delayed is health care denied.

Yes, I would be happy to.

One thing that I think can be said about this bill that's pretty obvious, and that is by virtue of a lot that you have said tonight, Dr. Roe, is that everyone will see costs go up. There is individual mandates, so even individuals who don't sign up for insurance will pay 2.5 percent taxes, which they don't have to pay. That's middle class, even lower socioeconomic class taxation.

There will be taxation on health savings accounts that does not exist today. Taxpayers will see their taxes increase. An employer will see their net tax go from 35 percent marginal rate today to 39 when the Bush tax cuts expire. Then another 5 percent above that, they will get to marginal rates of 45 percent, which most of those higher-income individuals in that range are small business owners, which means that they will have to reduce other benefits or reduce pay or reduce number of employees. That's all there flat is to it. There are only so many places you can cut.

I have. I have had a number of them say that. They have done the math. They cannot figure out where they are going to get the extra 5, 10, 15 percent. I mean, most businesses today operate on a margin of around 5 percent of gross income. Well, when you add overhead of another 15 percent, that means you are upside down by 10 percent. The bottom line is that everybody, not just the high-income people, everybody is going to be paying more in either taxes or premiums or both. Everybody is going to be getting less access to care. Yes, less access to care.

Again, just quickly going back to Canada, remember in Canada, care is free for everybody. It's universal, 100 percent. Well, only one out of six people have a family doctor in Canada. They actually have a lottery system. Yes, it's 100 percent universal. Unfortunately, you can't get in the system. They close hospitals down.

Even Cuba claims to have universal health care and medicine is free. The only problem is they've got no medicine. So what good is free when it isn't available? That is the direction that we are taking here if we go off this way.

Just to kind of summarize my comments on this, that is that every health care model in the world looks at two possibilities, two options to save money. One is to bring it down to the unit between the doctor and the patient and give them both a stake in what the total cost is, not necessarily pay completely out of pocket but at least pay a portion of it, and that's where health savings accounts make savvy consumers out of patients. Either that, in which they have a stake in controlling costs, or you have a giant bureaucracy such as in Canada and the UK, in which case you have to have long lines and rationing. It's one way or the other.

America, you are going to have to decide what you want. Today, we don't have the ideal thing. We need to improve the system we have. But if we go with the public option, which will lead to single payer, then we are going to go down the road of rationing and long lines. There is no doubt about that. And even Members of the other side of the aisle said that's where they want to be.

Mr. Speaker, as a doctor for over 30 years, I have become a pretty good judge of truth telling. We have heard Democratic leadership try to convince us that ObamaCare is going to pass, and with a ``robust'' public option.

It has become obvious there are not enough votes in Congress, and suddenly, the terms are changing. Within a few days, a whole new vernacular has emerged to describe the public option. This includes the opt-in and the opt-out option; the trigger--no offense to Roy Rogers' horse; the competitive option; and finally, the consumer option. Mr. Speaker, this is not a marketing problem; it is an idea problem.

To my Democrat colleagues, let me suggest a frequently spoken idiom: if you put lipstick on porcine, it is still porcine. Or if you prefer a Louisiana colloquialism: this dog won't hunt.

This bill will add 750 billion real dollars to the deficit, not to mention taxes and higher premiums on the middle class, all while covering relatively few more Americans. Fortunately, there are enough Democrats in both Houses who see past this sham and fear their voters more than their leadership, as they well should.

Mr. Speaker, as a family physician for over 30 years, I could have never imagined that the Democrats would come up with such a crazy idea as ObamaCare paid for on the backs of the American seniors.

As it stands today, $162 billion will be cut from Medicare Advantage, forcing seniors to buy Medigap insurance like that sold by AARP, one of the many special interest groups the President cut a sweetheart deal with behind closed doors. There is also another $350 billion that will be cut from the regular Medicare, which will directly remove access to medical care for this, the Nation's Greatest Generation.

In rural areas like much of my district in Louisiana, seniors will lose access to critical medical care as home health, doctors, and hospitals--they will all be closing their doors.

I call on Speaker Pelosi to stop this horrible attack on the health and welfare of our senior citizens now.

I thank the gentleman. And thank you, Dr. Gingrey, for having this hour. You have shown tremendous leadership over the last few months and even before that, of course, but particularly the last few months in being willing to control time for us to have these discussions. Of course, Dr. Cassidy, my colleague from Louisiana, has been deeply involved in this issue, and we have all worked together, I think, as a great team, the GOP Doctors Caucus.

I will get to that anecdote in just a moment. I think it is an important one. But let me stay with the subject just for a moment about the gimmickry, because I think that is essential to our discussion. I will develop it very carefully, but quickly, and also point out that this is an important part of the macroeconomics of health care that everyone must understand, and that is this: Currently Medicare and Medicaid, which are the current government-run health care systems, do not pay for the service that they are providing.

Let me repeat that: These programs, Medicare and Medicaid, do not pay, at least completely, for all of the services that are provided, because the government requires and forces doctors, if you will, hospitals and other organizations, to provide care for less than the 100 percent reimbursement. Physicians, nurses, hospitals, home health agencies and so forth actually have to settle for less.

So, how is it that we can stay in business, we in the health care industry, and get by on less? The answer is that the private insurance market, a much bigger market, subsidizes to the tune of about $1,700 to $2,400 per year per family. If it were not for that subsidy, it would collapse. Yet and still, Medicare is scheduled to run out of money by 2017.

Now, how long is 2017? This is 2009. That is about 8 years that we are going to run completely out of money. Nobody in Washington is advancing any solutions to that.

All right, where did the gimmickry begin? Remember that in the time period from about 1997 to 2003, Congress decided in its infinite wisdom that Medicare will be subject to a limitation on the budgetary increases from year-to-year. We call that the sustained growth rate, SGR for a lot of people. But because it was recognized even in the first year that such cuts would block access to health care by patients, it has never been enforced. So it has been a bookkeeping gimmickry that now has created an incremental difference of about $250 billion, and growing. And even the other day the Senate attempted to resolve this.

That is correct. It is just physicians only. It is actually part B, which is mainly physicians. It simply says if you guys can't keep your billing and your costs and everything down in totality, we will just cut across-the-board. Well, that is an impractical solution. It is gimmickry. It would never work. Now we have a $250 billion gap that is not being paid for. The Senate the other day tried to address that and failed to, because they knew it would be dumped on to the budget.

Let's advance, fast forward to this bill today. Right now this plan for approximately $500 billion that will be cut from Medicare, $160 billion or so of that would be a direct cut out of Medicare Advantage, which, as you know, is the more generous private system that is funded by Medicare dollars. If that happens, then those who are on Medicare Advantage, such as Humana Gold, will have to go back into the regular Medicare system and they will have to purchase Medigap insurance that they didn't have to purchase before. Again, seniors taking on the added burden.

On top of that is another $300 billion to $350 billion coming directly out of Medicare on the basis of some future savings, some future efficiencies that no one has been able to figure out.

So where are we today, Mr. Speaker? Basically $250 billion of doctor cuts, which have never been cut and will never be cut and are growing, that is going to end up in the budget at some point, another part of the deficit; another $350 billion which everybody in this room has known will never be paid for, but yet somehow it is being booked by the CBO as some savings. It is just continuous gimmickry. That is the only way this bill will ever be paid for, is gimmicks, which really means it is going to be taxpayers and premium holders.

Then to go back and kind of summarize, my point here is that, as Dr. Cassidy points out, the only way that this is going to be an efficient health care system in terms of cost is the decisionmaking has to be in the exam room between the doctor and the patient, and one of the best methods to do that was a plan started in 2003 or so, Health Savings Accounts.

All this does is allow the employer--and government could do this, too, for Medicare and Medicaid--to put money in the bank that can be used at the discretion of the patient to buy medications or whatever, and it's his money or her money to use efficiently.

Just an example of how it works, we implemented this with my own private health plan with my companies a few years ago, and instead of our rates going up an average of 15 percent per year, they're going up an average of 3 percent per year. I was giving this discussion to my employees one day, and one of my employees piped up and said, Well, look, if we go to this health savings account idea, that's going to mean that I'm going to have to pay out of my health savings account $100, $150 a month for inhalers.

I said, Well, let me suggest to you this: Why don't you stop smoking? You will save money from the tobacco. You will be able to stop your inhalers, and then you'll just be banking all this extra money, which will end up removing any deductible you're going to have in the future. She came back to me 3 months later and said, I stopped smoking. I no longer have to use inhalers, and I've got extra money every week.

I wanted to pull together some of these salient points that have to go with the gimmickry and how we're going in the wrong direction. Expanding government control is going to expand cost. Instead, we should be looking inwardly and bringing it down to the doctor-patient level where the decisions can really be made efficiently.

With that, I will yield back.

Would the gentleman yield for a moment?

That is a great point you make. What I would like to say is that something we have all observed as physicians is that while we all recognize collectively that, yeah, we should lose weight, we should exercise, and we shouldn't smoke, we, as human beings, tend to not address those issues until something comes up, until it affects us immediately in day-to-day life. The beauty of systems such as Safeway's is that they implement a financial impact, both positive and negative, that encourages healthy behavior before you ever get to a point where you go, You know what, I'm going to have to have heart stents or bypass surgery. Now I am going to make changes. Why not make the changes 5 years in advance? Then you don't have to go through that. Look at all the money you save and the health that you have as a result of that.

I yield back.