Mr. Speaker, what we are going to do here for the next hour is talk about why we feel so strongly the need to repeal, and if not successful, to defund so many provisions of the Patient Protection and Affordable Care Act. But, Mr. Speaker,…
Mr. Speaker, what we are going to do here for the next hour is talk about why we feel so strongly the need to repeal, and if not successful, to defund so many provisions of the Patient Protection and Affordable Care Act.
But, Mr. Speaker, before I get started in the subject at hand, I do want to join my colleagues, particularly my colleagues on the Democratic side of the aisle, in remembering our colleague John Adler. I didn't realize that John had been sick. I didn't realize that John had had surgery. I didn't realize until just moments ago that our colleague from New Jersey had died. As I sat here listening to the New Jersey delegation on both sides of the aisle talk about John, it helped me understand a little bit better about him.
All I know about John is that he was a great guy and a really, really nice Member of this body and someone that I respected. I got to know him, Mr. Speaker, in the House gym at 6 o'clock in the morning usually. He would be working out, and I would be working out--I am 15 years older than John was--and we just struck up a good friendship. I truly will miss him, as well as my other colleagues, as they express their sympathy to his wife and his four sons. But truly a great Member.
It reminds me too, Mr. Speaker, that as we do our work, as we do our work with 1-minutes, and we do our work with 5-minute Special Orders, and now this leadership hour talking about a very important issue that our colleagues on the other side of the aisle for the most part, almost 100 percent of them feel very differently about this issue, we differ on a lot of things, and we will continue to do that. It has gone on forever.
But the point I would like to make, and I will conclude with this, is that there are 435 people in this House of Representatives. And sometimes we Republicans are in the majority and sometimes the Democrats are in the majority, and the worm turns, and nothing is forever.
But we have good, decent men and women serving here representing their districts and doing the work of the people. And God bless them. God bless each and every one of them. God bless a Member like John Adler, who died much too young, as my colleagues have said already.
But we want to always keep in mind that as we argue and debate and make points and feel very strongly about an issue, that doesn't mean we don't love one another. And we do. And I loved John Adler. He was a great Member of this body.
Mr. Speaker, again here we are, though, getting right back into the business at hand. And this is a hugely important week, a hugely important week as we try to come to some conclusion in regard to how much money we need to cut out of, not this fiscal year we are in right now, but the last fiscal year, which started--well, actually we are in the fiscal year, but it started on October 1 of 2010.
Here we are, what is it, the 4th of April, 2011, so half of the fiscal year has already expired and we have not funded the government except in this piecemeal fashion.
We didn't have a budget, we didn't have spending bills, and we put these little 2-week Band-Aids, 2, 3 weeks, a little bit of cutting, but from my perspective and from my side of the aisle and our leadership not nearly, nearly enough. And we are faced with this tremendous issue of trying to reach a compromise and an agreement to lower spending.
The American people certainly gave a mandate, I think, to 87 new Republicans and 9 new Democrats to come up here and quit all this spending. Let's not have $1.5 trillion deficits year after year after year. That's how you get to $14 trillion worth of debt, and that's what we are facing right now; and, indeed, in a month or so, we are going to be asked to even raise that debt ceiling statutorily to say, well, we will continue to borrow and kick the can down the road.
Obviously, Mr. Speaker, these are times that try men and women's souls, and we all feel very strongly about our position. But I know my leadership and Members on this side of the aisle, and I hope our Democrat colleagues, feel the same way. We hope and pray that we can do the people's work and cut this spending and get this country back on a sound fiscal footing so that as we go forward to the 2012 budget, which we will hear about tomorrow, that we will continue to work hard to finally balance this budget and get our country out of this significant debt.
Speaking of debt, Mr. Speaker, the reason I am here tonight, I represent the caucus on the Republican side of the aisle known as the House GOP Doctors Caucus. There are, I think, 21 of us now, doctors and nurses on this side of the aisle, with just years and years of clinical experience.
As an example, I spent 26 years practicing my specialty of obstetrics and gynecology. We have registered nurses that are part of the Doctors Caucus. We have specialists, general surgeons, cardiothoracic surgeons, family practitioners, gastroenterologists. I could go on and on, but some of them, hopefully, will be with me during this hour, will join me in a few minutes to talk a little bit more about our concerns, their concerns, Mr. Speaker, with the Patient Protection and Affordable Care Act of 2010.
This was a bill, a law, that was finally passed and signed by President Obama on March 23, 2010, after about a year and a half of debating the issue in both this Chamber and in the Senate Chamber; and when it finally came down to the reality that there weren't enough votes on the Senate side, it was passed by something called reconciliation which, to this day, I don't think the American people understand. But, Mr. Speaker, I will tell you this, what they do understand is they don't like it, they didn't like the process, and they don't like the policy.
Now, I have heard the President say, and I have heard the Democratic leadership in the 111th Congress, when this bill was passed, talk about how Congress and particularly the Democratic Members have been trying to pass a comprehensive massive health care reform law for almost 100 years. They talked about Franklin Delano Roosevelt, and they talked about John Fitzgerald Kennedy and they talked about, of course, President Bill Clinton and saying, you know, we finally got there, we finally did it, we finally accomplished what we were trying to do for almost 100 years.
Well, they missed the point, Mr. Speaker, because the reason why that type of legislation was not passed in 100 years is because the American people back then didn't want it anymore than they do today; and some 62 percent still say, very loudly and very clearly, in poll after poll after poll, we don't want the Federal Government taking over health care, one-sixth of our economy, lock, stock and barrel. We don't want that.
We want improvement in our health care; and no matter how good something might be, there is always room for improvement and, clearly, our health care system is too expensive. We agree with that. I think Members on both sides of the aisle can reach that conclusion pretty clearly.
So there is agreement to try to do everything we can to continue to provide the best health care in the world. It's not true when people say our health care system is like that of a Third World country. Nothing could be further from the truth. We have the greatest health care system in the world, and some of the doctors in the House GOP caucus will be with me tonight to talk about that.
You know the old expression, don't throw the baby out with the bath water, I think that's what we have tended to do here. We have enacted into law--on March 23 of last year, it's already had its 1-year anniversary a couple of weeks ago--we have done something that I think is not only opposed to what the American people want, you should never do that, but it's bad, it's bad medicine.
It's bad for consumers, it's bad for patients, it's certainly bad for corporate America. And it's absolutely bad for the taxpayer. It's a top-down sort of system where a bureaucracy comes between literally and figuratively a doctor and his or her patient. That's not a prescription for improving our health care system.
I have got a couple of posters here with me, and I wanted to reference these to my colleagues. In fact, I will have several more, but I am going to keep this one up on my far left, that one that shows the picture, I forget what his name is. Maybe one of my colleagues will remember.
Well, I remember Boss Hogg, but I was trying to remember what the actor's name is; I don't think he is still living. But I think most of my colleagues do remember Boss Hogg from that old series ``The Dukes of Hazzard.'' It was one of my favorites, kind of like poking fun at ourselves, really; sort of like Archie Bunker and ``All in the Family'' and things like that that those of us who have been around awhile can look back on and laugh and get a chuckle out of it.
But Boss Hogg sort of represents the boss, the bureaucracy, if you will, of the government, Big Government, running health care. Under old Boss Hogg's picture, there he is with that cigar in his hand: you can have whatever you like as long as the boss approves it.
And that's really the way it has turned out, what we talked about in the House. I think it was H.R., House of Representatives, bill No. 3200. It was Senate bill 3590 or H.R. 3590, a shell bill that came over from the Senate and finally was passed into law and became known as the Patient Protection and Affordable Care Act.
But that law has so much bureaucracy, and I will get into some of the numbers on that in regard to all of the new folks in the government that would control health care, but all under this giant government takeover, and Boss Hogg sort of represents that to me as a way of communicating with the public.
But in any regard, before I continue with some of the statistics on the bill, I see that I am joined by my colleague from Georgia, a fellow physician and a member of the House GOP Doctors Caucus, who is a family practice physician from the Athens area where the great University of Georgia is located. Dr. Paul Broun is actually a doctor who makes house calls, which is really unique and refreshing. He has been a welcome addition to not only our Georgia delegation but this body.
I yield to the gentleman from Athens and Augusta and my hometown, Dr. Paul Broun.
Mr. Speaker, I thank the gentleman for his contribution and for being with us this evening. I realize there are conflicting things going on on Capitol Hill this
evening, very important things. But I really appreciate Dr. Broun being with us.
We have also been joined by another member of the Doctors Caucus, that is our good friend and new Member, freshman Member from the great, great State of New York, where my daughter and son-in-law reside. Ann Marie Buerkle is a registered nurse, Mr. Speaker, by profession and certainly knows of what she speaks in regard to health care, representing the Angels of Mercy, if you will.
She is concerned, Mr. Speaker, about the health insurance industry and the complexity of such, and maybe even wants to discuss some ways that we could change and improve, certainly improvement is called for, and it doesn't have to be within a 2,400-page bill, as Dr. Broun was mentioning ObamaCare entails.
So at this time, I'm proud to yield to Representative Ann Marie Buerkle.
Mr. Speaker, I thank the gentlewoman from New York for sharing her thoughts. Certainly, I agree completely with her. She clearly knows of what she speaks.
This law, it is no longer a bill, it is now the law. Patient Protection Affordable Care Act, it has been the law for a little more than a year, as I said earlier. Of course, the Congressional Budget Office that estimates the cost of laws that we put into effect, they give us an estimate when it is in the bill form so Members can decide whether or not what we are about to do is something that is affordable. And the estimate of this law costing $900 billion, Mr. Speaker, the true cost over the next 20 years is probably in the neighborhood of $3 trillion, not $900 billion.
But I do want to just talk about that number and remind my colleagues
about the pay-for provision that the Democratic Party, the former majority party in the 111th Congress, had in place at the time this bill was passed. Everything had to be paid for, so you had to figure out a way to come up with the money.
In passing this bill and paying for it, Mr. Speaker, some $570 billion was taken out of the current Medicare program. The Medicare program, which serves something like 47 million of our seniors, 5 or 6 million of them are younger people who are on disability that are covered under Medicare. And we literally, to help pay for this new entitlement, this new entitlement which has very little to do with Medicare except that half of the money, half of the pay-for in this $900 billion was taken from a program, Medicare, servicing our disabled and our elderly, providing them health care, half of the money was taken out of that system. The actuaries and the Medicare trustees tell us that over the next 75 years, the unfunded liability, Mr. Speaker, of Medicare is something like $35 trillion, with a ``t,'' $35 trillion. And yet we took the money by cutting Medicare Advantage something like $120 billion. We cut money out of hospice. We cut money out of long- term care, skilled nursing homes.
We cut money out of home health care. We taxed everything that even looked like it had anything to do with health care: durable medical equipment, supplying oxygen for people who were and are continuing to struggle from chronic obstructive pulmonary disease. ``Emphysema'' is a term we use a lot, and I think most people would recognize that.
Finally, we came up and said, okay, we've paid for this; but at the same time, Mr. Speaker, we did absolutely nothing in regard to medical liability reform, something that probably if we enacted it--and if there were something in this bill, ObamaCare, as the President did promise that there would be--could save $200 billion a year, according to the RAND Corporation and other think tanks, from the overall cost of health care, which is one-sixth of our entire economy, of our gross domestic product in a year. That's how big this industry is. So there is essentially nothing in the bill about medical liability reform.
Why do I say that, Mr. Speaker?
My colleagues, I think you understand that it's not about the high insurance premiums that doctors have to pay on an annual basis so that they can practice and be protected from liability if something goes wrong. Obviously, they need that protection and those health insurance premiums for the high-risk specialties like the one that I enjoyed for 26 years, OB/GYN, and neurosurgery.
Mr. Speaker, think about that doctor at the Tucson Medical Center who was there in that emergency room when our colleague, Representative Gabrielle Giffords, was taken there literally near death. I think Dr. Rhee was his name, R-H-E-E. In fact, Dr. Rhee, I learned later, was a graduate of the great school that I went to, Georgia Tech, the Georgia Institute of Technology. Dr. Rhee spent his career in the military after completing medical school. He served his country for something like 22, 23 years, and he happened to be in that emergency room as head of the trauma center and had had all that specialty training and all those years of treating our wounded warriors in many conflicts--I'm sure in Afghanistan and Iraq.
If he had not been there for our colleague Gabrielle Giffords--God bless her--we would be talking about her today as we were talking earlier about John Adler, our former colleague from the great State of New Jersey who died today. But that doctor was there. He was there.
I fear, as I talk about this new health care law, there is hardly any provision in there that would provide for doctors, even for primary care physicians. There is some attempt, but when you take all the additional Medicaid-eligible patients, increasing the minimum eligibility at 138 percent of the Federal poverty level, you add just millions of additional patients to be seen and literally hundreds of billions of dollars of additional cost onto the backs of our States that have to have balanced budgets, unlike here in the Federal Government where we just keep borrowing money and where we're now up to $14 trillion worth of debt.
So we have a huge problem in regard to this law that the CBO says costs $900 billion over 10 years. I say--and this poster points it out--the true cost, which is the last bullet point with the red dot, is $2.2 trillion and counting; but as Ms. Pelosi said--and I quote her in the third bullet point here--``we have to pass the bill to find out what's in it.'' That was before the bill passed. Clearly, we are finding out now, unfortunately, what the true cost is.
Mr. Speaker, I want to yield additional time to my colleague from New York.
Mr. Speaker, the gentlewoman is absolutely right.
As I pointed out in that $500 billion-plus cut-out of the Medicare program to help pay for this new entitlement of the Patient Protection and Affordable Care Act, $120 billion of the $500 billion-plus was taken from the Medicare Advantage program. The Medicare Advantage program enrolls about 20 to 25 percent of our Medicare beneficiaries.
Why so many?
We are talking about, maybe, 11 million or 12 million who sign up and decide that, rather than the traditional fee-for-service and just pick a doctor out of the Yellow Pages who accepts Medicare, it's more like a health maintenance organization that emphasizes wellness, that emphasizes prevention, tests that are not typically covered under traditional fee-for-service Medicare, like colon cancer screening, breast cancer screening, mammograms for women, especially between the ages of 40 and 60, prostate cancer screening for men, annual physical examinations, follow-ups from a nurse practitioner within the doctor's office, maybe even on a monthly basis to make sure that the senior is taking the medication that was prescribed by the primary care doctor.
All of these things are included with Medicare Advantage. That's why it's called Medicare Advantage. It is an advantage with very little additional cost. In fact, people who are under those programs typically don't have to buy supplemental insurance to cover co-pays and deductibles and hospital care after they've exhausted their benefits. So that's why so many choose that.
Yet what we have done is we've stripped--we've gutted--that program so badly that, of those 12 million, it's estimated 7 million of them will lose that coverage under Medicare Advantage. They'll have to get it under the traditional Medicare, and they'll have to pay $130 a month extra for that supplemental whether they get it through a plan that's endorsed by the American Association of Retired Persons or through some health insurance company, but the average cost is going to be an additional $130 a month for those folks.
So as we talk about the cost, I do want to shift, Mr. Speaker, to the cost
to employers. In this next slide, where the title says, ``ObamaCare Hurts Workers, Increases Costs,'' the majority of employers anticipate health care reform will increase health costs. And most say they plan to pass the increases on to their employees--88 percent plan to do that--or reduce health benefits and programs, 74 percent.
This idea of setting up these exchanges throughout the 50 States and territories and that only 6 million people who have employer-provided health insurance can keep it, they won't need to be on the exchanges, Mr. Speaker, that is absolute poppycock. It's probably going to end up being about 130 million people who get their health care provided today by their employer will end up in those exchanges. And that's why I say this cost that was estimated by the CBO of $900 billion will be in the trillions, because when all of these people morph out of the employer- provided health care onto these exchanges, think how many of them will be eligible for a Federal subsidy to help them pay for that insurance. Because the law says, the so-called ``Affordable Care Act,'' that anybody with an income of less than 400 percent--not 100 percent, not 200 percent, not 300--400 percent of the Federal poverty level--which is getting close to $90,000 for a family of four--I think of my four children and their families of two and three and four, and I know what their incomes are--the Federal Government will be subsidizing so many people that the cost, the true cost will be astronomical, and it is something that we cannot afford. That's why our representative from New York and our other representative from Georgia spoke earlier about we can't do this, we can't afford to do this. We need to repeal this law. It is a bad law.
I've said before, Mr. Speaker, that in my humble opinion I think it's the worst law that has ever been passed in this Congress. There have been some folks on the other side of the aisle--well, not on the other side of the aisle, but the more liberal media who took me to task for saying that, but I truly believe it. I truly believe it's one of the worst laws that was ever passed. And we have made every effort to repeal it.
One of the first things we did in the 112th Congress was pass H.R. 2 to repeal ObamaCare. We sent it over to the Senate, and the Senate-- which is controlled by the Democratic majority and led by the Senator from Nevada, Harry Reid--just simply, I guess, put that in file 13, and H.R. 2 is sort of dead in the water over on the Senate side.
So what we are doing now, it is our obligation because of what the American people have told us: Over 60 percent of them a year after passage of the bill, despite the fact that Ms. Pelosi said, once we pass it and you find out what's in it, you'll like it. No, they don't. They don't like it. They don't like it one darn bit better, and they wanted us to repeal. We made every effort at repeal.
And now we're into Plan B, Mr. Speaker. Plan B, of course, is to try to defund especially the parts of the bill that are on automatic pilot, that we have no control over. And when I say ``we,'' I don't mean the new Republican majority in the House of Representatives; I mean every Member of Congress--100 Senators, 435 Members of the House, both sides of the aisle. For goodness sakes, we ought to have control over the spending.
This is not a poster. I don't have a poster on this one. But tomorrow, in the Energy and Commerce Committee, Mr. Speaker, the committee on which I am proud to serve, along with several of our other House GOP doctor members, we are going to have a markup on several bills to change this automatic pilot spending under ObamaCare and put it into the more typical discretionary spending where Members of Congress can say, do we want to spend that money? And if we do want to spend the money, how much do we want to spend? And that we have oversight and we can make sure every year that we look at the program, and if it's not working then defund it.
And these bills--and I'll just mention them real quickly--H.R. 1217, a bill to repeal the prevention and public health fund, $17.5 billion that the Secretary of Health and Human Services has control over, a fund of money that she can spend in any way she wants to. You think back to the ads that we saw with Andy Griffith as the pitchman on television last year about the great value of this new law and how it's going to strengthen and improve Medicare. How you do that by cutting $500 billion out of a program is beyond me. But that money, that $17.5 billion in this prevention and public health fund, can be spent indiscriminately by a decision made by whoever the Secretary of Health and Human Services might be. H.R. 1216, H.R. 1215, H.R. 1214 and H.R. 1213, in the aggregate, this is over $18 billion worth of spending that we Members of Congress have no control over. We're going to get control over it, though, and we're going to defund anywhere we feel that it is wasted, duplicative spending that the American people can ill afford.
I want to go ahead and point out a few other things that are on the slides, Mr. Speaker. I mentioned, of course, the $575 billion in cuts from the Medicare program. I mentioned the 7.4 million people who will lose that coverage under Medicare Advantage because of that $126 billion pay-for. I didn't mention, though, on this slide the third bullet point.
Many physicians may stop taking Medicare patients because reimbursements will be below the cost of providing the care. Now, is that Representative Phil Gingrey from the 11th of Georgia, is that a statement that I've made? Well, maybe I have made it. But I'm quoting the Actuary of Medicare, Richard Foster, who we had last week as a witness before the Energy and Commerce Committee talking about some of these things. This bears repeating, Mr. Speaker; ``Many physicians may stop taking Medicare patients because reimbursements will be below the cost of providing the care'' Richard Foster, Committee on Medicare and Medicaid Services, Chief Actuary.
Today, doctors are reimbursed under the Medicare program by a formula, an arcane, very difficult--you talk about calculus being difficult; understanding the sustainable growth rate formula to determine how doctors are reimbursed for providing their service, whether it's their brain power or their surgical skills, is beyond anybody's comprehension. And every year, for the last 6 or 7 years, when you apply that formula to the next year's reimbursement level, there is a cut from the last year's reimbursement--2 percent, 3 percent, 4 percent--to the point now, Mr. Speaker, what we have done, of course, we here in the Congress have mitigated those cuts and said we're not going to enact those cuts because these doctors will not be able to provide the care, just as Mr. Foster, the Actuary, said. And if we don't put a bandaid on these cuts and mitigate them, then the doctors will just drop out of the program. And I don't care how much you expand access and hand out more insurance cards, if there are no doctors there to see you, you're not going to have care. You do not have decent care--you don't have any care.
So in this bill, in this new law, not only is that formula still there, and the doctors are facing a 31-percent cut in their reimbursement if we don't mitigate it once again come December 31 of this year, not only is that on their backs, but in ObamaCare, there's this new provision called IPAB, this new bureaucracy--Independent Payment Advisory Board--that's going to actually cut the doctors even more. The Actuary is right: We're not going to have doctors providing the care.
And that's because we've taken money out of this program and put it into an entirely new entitlement program for the most part for young people. Some entitlement, when you force them to buy health insurance in many instances when they don't need it and they don't want it.
Mr. Speaker, I see we've been joined by the cochairman, along with myself, the cochairman of the House GOP Doctors Caucus, my classmate from the 108th Congress, the Member from Pennsylvania, my friend and colleague, Dr. Tim Murphy.
I yield to the gentleman from Pennsylvania.
I want to thank you, Dr. Murphy, and I appreciate you coming.
Mr. Speaker, I thank you for the time. I know our time is up.
I just refer to our last poster in conclusion: Repeal and Replace ObamaCare.