Madam Speaker, for the next hour, I am going to be joined by a number of my colleagues on the Republican side of the aisle, and most of them are members of the GOP Doctors Caucus, and we are going to spend time, Madam Speaker, talking…
Madam Speaker, for the next hour, I am going to be joined by a number of my colleagues on the Republican side of the aisle, and most of them are members of the GOP Doctors Caucus, and we are going to spend time, Madam Speaker, talking about health care reform. Certainly that is the number one thing that's on our plate as we go through these next 6 weeks leading up to the August recess. And, of course, as the President has outlined his desire to have a health reform bill on his desk for signature sometime in mid October of this year, whether or not that can be done remains to be seen. There are a lot of thoughts out there as to how to approach this, but we feel that it's very important as physician Members. I think there is something like 339 years of clinical experience combined in this GOP Doctors Caucus. About 15 of us are health care professionals who have actually practiced in the field, if you will, most of us involved just in clinical medicine, what I like to refer to, Madam Speaker, as meat-and- potatoes medicine. Not research at some high academic institutions but actually seeing patients every day in the office, in the operating room, in the delivery room. And so I think we have a perspective that we would like to share with Members on both sides of the aisle.
Earlier in the evening, Madam Speaker, we heard from the 30-Something Group on the Democratic majority side. They were very articulate, very well spoken, but I think very wrong in some of the ideas that they have in regard to a government default plan, and we will talk about this during the hour.
I have been joined by a couple of my colleagues, Dr. John Freeman, the doctor from Louisiana; and Dr. Paul Broun from Georgia.
I would like to yield time to my colleague from Louisiana at this point.
I want to apologize to the gentleman. I referred to him as Dr. John Freeman. Actually, it's Dr. John Fleming, a family practitioner from the great State of Louisiana. And it reminds me, the reason I did that, Madam Speaker, is because Dr. John Freeman was one of my classmates in medical school and also one of my co- residents in my OB/GYN training back in Georgia. I think Dr. John Freeman practiced his entire career in Boone, North Carolina; and I hope Dr. John, wherever he is, is doing well, if he happens to be tuning into C-SPAN tonight.
I wanted to say before yielding time to my colleague, Dr. Paul Broun, a fellow physician and family practitioner from the Athens and Augusta areas of Georgia, there was a letter sent from the National Coalition on Benefits within the last couple of days, addressed to the leadership of the House and Senate, House Speaker Nancy Pelosi, House Minority Leader John Boehner, Senate Majority Leader Harry Reid, and Senate Minority Leader Mitch McConnell, talking about the strong opposition to a public plan. I don't have time to stand here and read the names of all of these firms, but just to mention a few: Wal-Mart Stores, Xerox Corporation, Wellpoint Incorporated, Weyerhaeuser Company, National Restaurant Association, Bank of America, National Association of Health Underwriters, CIGNA Corporation, Chrysler LLC, Nike. I could go on and on. That's just maybe 5 percent of the number of companies that are a part of this National Coalition on Benefits that are so opposed to this idea of a public plan, which our colleagues, the 30-Something group, just an hour ago touted so strongly.
At this point, I would like to yield to my good friend and colleague from Georgia, Dr. Paul Broun.
Reclaiming my time, I thank the gentleman.
Before yielding to our colleague from Tennessee, Dr. Roe, a fellow OB-GYN physician, I just want to say to my colleagues on both sides of the aisle, Madam Speaker, that what we are about is trying to work in a cooperative way on both sides of the aisle and offer our expertise, to say to our colleagues, and there are some health care practitioners on the majority side as well, and we have reached out to them and made ourselves available, we want to be at the table.
Unfortunately, Madam Speaker, we are not at the table. We haven't been enjoined, if you will. But we still hope, we still have hope that that can occur, because we do have some ideas, I think some very good ideas, in regard to bringing down the cost of health care, making it more accessible, making it more portable, making it available to everybody, and that would include people who are currently considered high risk, maybe even considered uninsurable, or if they can get insurance it is because they can afford to pay three or four times the normal standard rate, which many, many cannot.
So we want to talk about some of those things tonight, and we will get back to that.
At this point I yield to my colleague from Tennessee, Representative Roe.
Well, I thank the gentleman. And before yielding back to Dr. Fleming, I wanted to say to my colleagues, Madam Speaker, that we are the party of a second opinion. And, of course, tonight we are talking about health care reform, but it could be an energy bill, a comprehensive, all-of-the-above approach to solving our energy problems and any other issue. But none really at this point in time is more important than solving this health care problem.
And the bottom line is to, again, to lower the cost of health care, to make it accessible to everyone within their financial reach. And there are so many things that we can do short of, Madam Speaker, turning this over to the Federal Government to run what may be like they run Amtrak or the post office or, indeed, the Medicare program. And I don't think that that's what people really want and expect. We can do better than that. And there are a number of issues in particular that we could talk about in detail if we had more than just an hour, Madam Speaker.
But clearly, this idea of electronic medical records, I think, is a way eventually to save money. I think the money that we put in the stimulus package, $19 billion to provide grants, I've got a piece of legislation that would help physicians purchase hardware and software and a maintenance program that's specialty specific, whether it was my specialty of OB/GYN or Dr. Fleming's specialty of family practice or a general surgery specialty program produced by a company in my district called Greenway where you have, as part of that electronic medical record program, you have algorithms set up of best practices that are developed not by a government bureaucrat, Madam Speaker, but by that very specialty group, those men and women, those leaders of that specialty society that want to do what is best and they want the best outcome at the lowest possible cost. They want to get paid a fair amount for their services, of course.
And, in fact, with an electronic medical records system, they're more likely, Madam Speaker, especially under the Medicare program where you have something called evaluation and management code and intensity of care that you bring, doctors, I think, tend to undercode because, Madam Speaker, they're petrified that some inspector general is going to come along and demand to see 10 charts out of their 10,000 and nitpick and find some few, two out of 10,000 where they overcoded, and first thing you know they're not participating in the Medicare program and maybe even they're facing a jail sentence.
So electronic medical records would--I don't know how much money, my colleagues, it would save, but I know that it would lead to a better practice of medicine based on best principles. We wouldn't need to have some comparative effectiveness institute, kind of like the Federal Reserve Board, telling doctors what they should do and not do, when it's time to operate, what medication to prescribe. We would have those best practices as part of an electronic medical records system. We could cut down on duplication of testing.
People could be in Timbuktu, and with that little card smaller than our voting card, they, Madam Speaker, they could take that card, even in a country where they don't speak the language, or maybe they come to the emergency department comatose and can't speak any language, you reach in their pocket, pull out that card, swipe it, just like we would our voting card, and there's the entire record. We know what they're allergic to. We know what medications they're on. We know their past medical history, and we give them the best and most effective, cost effective, safest medical care.
I'll be glad to yield to the gentleman.
Reclaiming my time, those stories are just all too familiar, and it's a shame that that time is wasted when it can be better spent with the patient.
I wanted to mention too, Madam Speaker, the issue of medical liability reform. Now, for a number of years--I've been here 7, this is my fourth term, and every year I have introduced medical liability or tort reform modeled after the system that was adopted back in the late seventies in California. The acronym for that bill is MICRA, but it has worked. It has stabilized the malpractice insurance premiums in that State. Yes, they've gone up somewhat because of inflation, but compared to other States that don't have that reform where there is a limitation on a claim, a judgment for pain and suffering, noneconomic, and where there is the elimination of this joint and several liability and there is collateral source disclosure--and I could go into some of the weeds of it.
But, obviously, we have not been able to pass that. When we Republicans had the majority in this House, we would pass it every year, Madam Speaker, in the House; but so many attorneys who are Members of the United States Senate would block that.
Well, why can't we come together again in a bipartisan way and say, look, we can agree that part of the cost of medicine, cost of health insurance is the fact that medical practitioners order so many unnecessary--and in some cases, Madam Speaker, harmful--tests, draw too much blood, get an MRI one day and a CAT scan the next day and a standard x ray the next day because they're trying to cover the possibility that someone would say, Why didn't you order this, or why didn't you order that?
Lord knows we've gotten to the point now where everybody who shows up in the emergency department anywhere across these great 50 States with a headache is going to get a $1,200 CAT scan instead of a blood pressure check and an aspirin and a ``come back to my office in the morning.''
So this is an area in which we could clearly come together in a bipartisan
way and hash out. Well, if the California version of tort reform is not acceptable, how about a medical tribunal, a group of independent people looking at the claim and saying whether or not it has merit?
There are so many things that we could do. And I've got a few more ideas, Madam Speaker, that I want to talk on, but I do want to refer back to Dr. Fleming and hear from him because I know he's got a lot of things he wants to share with us.
I yield to Dr. Fleming.
Reclaiming my time, I think that the gentleman has certainly hit the nail right on the head in regard to this, and we could go back to what we talked about earlier in regard to electronic medical records, which would be specialty specific--the information, of course, would be available for any provider who is seeing the patient.
But in regards to best practices, as the gentleman was talking about, and these algorithms, I mean, doctors, let's face it, they're busy. They're operating; they're delivering babies. They don't have time, nor can they afford every 4 months going to a continuing medical education course. A lot of times they have to do that online. And it is hard to keep up.
But with electronic medical records, this would help them keep up. It would absolutely help them order the right tests, give the best outcomes. And as Dr. Fleming pointed out, if they're in a single specialty group of eight surgeons and one in the group is not getting the information the others are getting, that information is available internally and externally. And you kind of police your own.
I want to give--I think he just asked for 1 minute--my good friend, Dana Rohrabacher, is going to be on the floor in the next hour. He asked for a minute, and I yield to him.
Well, reclaiming my time, and I thank the gentleman for his contribution in regard to that.
When you look at that number of 47 million who do not have health insurance, according to the Census Bureau, Madam Speaker, probably as many as 10 million of them are illegal immigrants. Now, they're not entitled, so to speak, to health insurance. That's not to say that you might not have a situation of extreme compassion if an illegal immigrant is admitted through one of our emergency departments and they are absolutely in the throws of a fatal illness, maybe it's a young, otherwise healthy person with congestive heart failure or congenital malformation that is resulting in an inability to sustain their blood pressure and they are on the verge of death, they would get the care in that hospital--in any hospital I think across the United States.
Yes. Of course not. They would get that care to save a life, of course we would. But the gentleman brings up a good point. And I did want to point out the segue into that number of 47 million.
It is estimated that maybe 18 million of those 47 million are making more than $50,000 a year, and many of them just choose, of their own volition--maybe they're 10 feet tall and bullet proof, 20-somethings, 30-somethings, have the Methuselah gene, they think, and don't spend much money on health care, and they just elect not to put the $200 a month payroll deduction or whatever it is. And maybe they have their own escrow account or their own health savings account. I think it's a bad decision, I think it's a bad bet, but a lot of people do that.
And you can't really force them, I don't think, unfortunately, in this Democratic plan, Madam Speaker. What the President is talking about is to have a mandate on the employer. If they are above a certain number of employees and if they don't provide health insurance for their employees, then they have to pay a tax or pay a percentage of their payroll into this connector; and individuals are absolutely required to sign up for health insurance, or if not, they have to pay a tax. I mean, that is not the American system. We want to encourage young healthy people to get health insurance.
And I want to make one point before I yield back to either one of my two colleagues. The insurance industry can help in a great way by looking at this. Let's say, take an example, a 22-year-old young man, newly married, newly employed, is not really convinced that paying for health insurance on a monthly basis is to his advantage, but he does it anyway. And he puts in whatever the cost is for a family premium and his portion of that payment month after month, year after year, with the same company maybe 15 or 20 years. During the course of that time, Madam Speaker, envision this, that individual develops high blood pressure, or maybe in addition to that high blood pressure develops type 2 diabetes--maybe the diabetes comes first, and then the high blood pressure--and then after that develops coronary artery disease. And then all of a sudden the company goes out of business and that individual is out of work, out of insurance, and desperately needs it. But because of these preexisting conditions, once COBRA runs out, how are they going to get health insurance? How are they going to afford-- struggling maybe to find a new job, but how are they going to be able to go out with no tax deductibility and purchase a health insurance plan that is three and four times the amount of a standard plan for everybody else?
What I would say, Madam Speaker, to the Association of Health Insurance Plans, why don't you grant those individuals credible coverage, just like we did in Medicare part D, the prescription drug benefit? If you have a credible insurance plan that covers prescription drugs, say, on a supplemental plan, and then you lose that after 4 or 5 years, then you shouldn't be penalized when you get into part D--and, indeed, the law says you won't be penalized. But why should the insurance company penalize these people who, in good faith, all those years have put that money, that premium--the insurance industry had it invested and had a good return on their investment--when these people all of a sudden are in a high-risk situation, I think they should get a community rating.
I would be very curious to know how my colleagues feel about that, and I will yield to Dr. Fleming.
I thank the gentleman, and I yield to the gentleman from Tennessee.
Reclaiming my time, we did talk about it this morning, and it was a Canadian testimony, was it not? And I yield back to you.
Well, reclaiming my time, and I think you're absolutely right, that the only way to solve the cost overruns, which would no doubt occur--and I do believe, as our friend from California suggested, that if the government was running the whole show, and eventually if we approve this government default plan, that's just a giant step, and it's just a baby step toward a single-payer system. And when you get into that situation, I can almost assure you, Madam Speaker, that under current leadership, you would have any and all, come one come all, just like they did in Tennessee. And Dr. Roe was describing the TennCare program and the problems they ran into.
And then the only way you could pay for it, as he points out, would be to start cutting reimbursement to the providers, to the health care providers, to the physicians, to those primary care docs that we so desperately need to be focusing and to be running our medical homes and to make sure that people are taking their medication, that there's an emphasis on wellness and keeping people healthy, keeping them out of the doctor's office, keeping them out of the emergency room, out of the hospital, and toward the end of life hopefully out of the nursing homes and in their own homes. That's why I think it's a mistake to even go in that direction of government-run health care.
I clearly feel, and I know my colleagues on the floor tonight agree with me, Madam Speaker, that the private marketplace works. And my two colleagues that are with me tonight weren't in the House back in 2003, but I know they were following the debate very carefully and very closely and maybe even felt that Medicare part D was something that we couldn't afford. Certainly it added cost, if you crunch the numbers statically, to the Medicare annual payments, Medicare part D did. But in the long run, in the long run, because of that program, if they can afford to take their medications for some of these diseases that I mentioned earlier, high blood pressure, high cholesterol, diabetes, and keep these things under control, then clearly what happens is you shift costs from part A, the hospital part of Medicare, and from part B, the doctor part, the surgeon part, the amputation part, the renal transplant part, and then also in part D keeping folks from having a massive stroke hopefully by controlling their blood pressure and you spend less on the skilled nursing home part. So I think that's a pretty good bargain and a pretty compassionate way of approaching things.
But our Democrat colleagues, Madam Speaker, who were in the minority at the time, stood up here and they symbolically, some of them, tore up their AARP cards because that senior organization had the audacity to support a Republican bill. And then, of course, they said, well, why can't we have a government default plan and why can't the government come in and set the price and say, okay, this is the price, this is the monthly premium for part D, the prescription drug part, and these free market thieves will not be able to run up the price? And they even suggested, Madam Speaker, that we set that monthly premium at $42 a month. Fortunately, my colleagues, that amendment was defeated. And when the premiums first came in from the prescription drug plans, the private plans competing with one another for this business, they came in at an average of $24 a month. Now, 3 years later, that has gone up a little bit because of inflation, but it's nowhere near $42 a month.
So if we don't learn from our history, we are going to repeat those same old mistakes. And it looks like the Democrats, with this idea of letting the government come in and run everything and saying that we can't trust the free market, I guess that's what they want to do with General Motors as well, and I'm very anxious to see how that one turns out.
I yield to the gentleman from Tennessee.
If the gentleman will allow me, as we get very close to that bewitching hour of 11 o'clock, my southern drawl had better get a little faster than a drawl. But my mom, Helen Gingrey, who lives in Aiken, South Carolina, in a retirement community, a great community, Kalmia Landing, my mom had her 91st birthday on February 8 of this year. Well, when she was 90, about 5 or 6 months ago, 6 or 8 months ago, she had a knee replacement. And Mom had gotten to the point, Madam Speaker, where she could barely walk, in constant pain, on the verge of falling and breaking her hip at any moment. And now she is enjoying life and enjoying being with her friends, and maybe she's going to live another 10 or 15 years. I don't know. She seems to have the Methuselah gene. But do you think in Canada or the U.K. or one of these countries where they ration care that she would have had an opportunity to have that knee replacement? The answer we all know, Madam Speaker, is absolutely not.
I would say in closing, the one thing I would like to see is the equal tax treatment of the health care benefit for individuals who have to go out and buy them in the market on their own. They don't get it from their employer. Why should they not get a tax advantage health care plan just like everybody else? And you know what, Madam Speaker? I have not heard the Democrats in the House, the Democrats in the Senate, or President Obama talk about that. And talk about fairness and wanting to be equitable, let's hear some more about that. We will talk about it in future Special Orders.
I want to thank my colleagues Dr. Roe, Dr. Fleming, and my good friend from California, Representative Dana Rohrabacher, for being with me during this hour.