Mr. Speaker, I thank the gentleman from Texas, my colleague; and as he pointed out, we're both in our prior life MDs and both in the same specialty, OB/GYN. I practiced a little bit longer than the gentleman from Texas, Dr. Burgess; but we…
Mr. Speaker, I thank the gentleman from Texas, my colleague; and as he pointed out, we're both in our prior life MDs and both in the same specialty, OB/GYN. I practiced a little bit longer than the gentleman from Texas, Dr. Burgess; but we certainly know of what we speak in regard to the stress and strain of everyday life, a work day in a physician practice across this country, whatever specialty it might be.
I was listening in my office just a few minutes ago, Mr. Speaker, to the gentleman from Texas, Dr. Burgess, as he talked about some of the things that we failed to do in the first session of this 110th Congress last year, 2007. He started off his discussion talking a little bit about that, the SCHIP program. I think most people, all of our colleagues of course, understand SCHIP is an acronym for State Children's Health Insurance Program, as Representative Burgess pointed out, enacted 10 years ago. It was a good, a good program. I think 1997, a 10-year authorization for this program, and it would expire. We wanted to see, of course, how it would work, was it going to be a good thing. So when you put sunsets on programs that makes sense, because sometimes ideas don't turn out so good. But this one really did.
And the basic concept, Mr. Speaker, as we all know, was to try to help parents have health insurance for their children when they were in a situation where their income was too much to qualify for safety-net programs, in particular the Medicaid program; they were making more than that minimum amount. But, yet, in no way were they coming close to having enough income, discretionary income to pay even their portion of a health insurance premium for their children if their employer happened to cover part of it. And, of course, many didn't.
So this program was a wildly successful program covering about 6 million children a year, Mr. Speaker, and spending about $5 billion a year in the process. And it was a Federal/State matching program, more generous on the part of the Federal Government, the taxpayers across this country, than the Medicaid program, which was more a 55/45 sharing. The SCHIP program was a better deal, if you will, for State governments. And it worked so well, of course, that there were 6 million children covered, I stated, and it was estimated that in some States that there were children that were falling through the safety net and not getting the coverage because States like my own of Georgia, and my own district, the 11th of Georgia, we were running out of money.
So I think clearly, as this program came to its expiration date this past year, everybody in this body, in this House and in the other body, in the Senate, I think all 435 Members realized we wanted to reauthorize this program and we needed to spend a little bit more money to make sure that those children that were eligible, needed the coverage, there would be enough money available for them.
Most people estimated that about 1 million additional children, 750,000 to 1 million children, we have some of them in the State of Georgia, needed that coverage. So President Bush in his wisdom said let's reauthorize this program and let's increase the spending by 20 percent, and I thought that was a pretty generous thing; that would cover these additional children.
But as Dr. Burgess pointed out, Mr. Speaker, the Democratic majority came to the floor with a bill that was not even vetted in committee, certainly no Member of the minority party had much chance at all to see this bill, that wanted to increase coverage to up to 10 million children. Now, we were covering 6 million, and they arbitrarily wanted to increase that coverage to 10 million. So that's an additional 4 million children, Mr. Speaker, when by anybody's estimate there were no more than 1 million that were in this range that warrant getting coverage.
So I honestly believe that the Democratic majority wanted to bring forward a piece of legislation that in no way could any fiscally responsible Member of this body vote in favor of. And it's hard to stand up here and say what people's motives are, but I think the gentleman from Texas alluded to it earlier. There are a lot of politics involved in this one, Mr. Speaker, and of course, here we are now, we ultimately we have an 18-month extension. But we need to come together. This is just a perfect example, in the health care arena in particular, where we can and should come together in a bipartisan way to do things for the benefit of the American people to provide better health care.
We like to tout that we have the greatest health care system in the world. Maybe we do. But sometimes I wonder, and clearly, I think there are things that we could do in a bipartisan way to improve it, and Dr. Burgess has mentioned it. He's talked about the payment formula, that flawed formula, in regard to paying our physicians, and so it's no surprise that not only are more and more of them unwilling to accept Medicare patients because they're not even being reimbursed enough to cover their expenses, there's no surprise to me when I picked up the Sunday newspaper, the Atlanta newspaper in my hometown of Marietta this past weekend, and there's this big full page ad where one of the chain drugstores is now opening up these clinics, manned and ``womanned'' by men and women who are not MD's, but they're nurse practitioners. They're very skilled. They're trained. They certainly are dedicated, and the fees for seeing them are anywhere from $60 to $75 for a 15- or 20-minute visit.
So what you're seeing is so much of medicine is not an MD providing the care. It's these situations like these drop-in clinics in chain drugstores. I don't think this is the way it should be,
and I think we can do things like enact tort reform to take some of the pressure off of the physicians so that there's not so much defensive medicine. And of course, that runs up the costs tremendously.
Tort reform is hugely important. Dr. Burgess and I, Mr. Speaker, have worked very hard in the 5 years into our 6 years as Members of this body trying to get that passed. We have been trying to get association health plans where people can come together in an industry and purchase health insurance across State lines, free of all these mandates of the individual States. Fifty different States have all these mandates on health insurance policies that drive up the premiums.
I thank Dr. Burgess for taking the time tonight on our first day back in this second session of the 110th to continue to talk about health care. This is clearly a passion of his. It's certainly a passion of mine, not just physician Members of this body, but a lot of very, very good, experienced Members who are concerned with this.
Before I yield the time back to my colleague and I continue hopefully during the remaining time tonight to engage in a colloquy with him on these issues, I think one of the most important things we could do and we could do it now is to enact electronic medical records, say a complete fully integrated system and incentivize doctors. We can do it through the tax code to give them an opportunity, particularly the small group practices, the primary care physicians so they can get electronic medical records. This would clearly save a lot of the money that Dr. Burgess was talking about. My friend has done some good work on that in his committee assignment on Energy and Commerce, Health Subcommittee, as well as the ranking member there, my colleague from Georgia, Representative Nathan Deal. We'll continue the discussion.
I also had an opportunity over that Labor Day weekend to go down on an angel flight to Baton Rouge and to try to help man, staff an emergency Red Cross clinic there. I think it was called the River Center, a huge clinic that had been set up. And as we began to see patients, I realized the enormity of this situation, as Dr. Burgess points out with his poster. One patient in particular was HIV positive and seven months pregnant and had not received any medication, retrovirus medication in 2 weeks, and this is the kind of thing that is life or death.
This situation in New Orleans really pointed it out. But suppose someone from this country is traveling in another country where they don't speak the language, and all of a sudden some catastrophic event occurs, a stroke, where the person cannot communicate. There's no way that the physicians, no matter how skilled they might be in the emergency room, and in the Ukraine they're not going to be able to take care of somebody from the United States that cannot communicate.
But with electronic medical records, it's just a matter of a swipe of a card, just like you do your American Express card where the radio frequency, identification system, secure, absolutely secure, privacy maintained, guaranteed, a system set up by our Federal Government where the standards are the same across the board. It, without question, would save a tremendous amount of money. The Rand Corporation estimates something like $175 to $200 billion a year out of that $1.6 trillion medical expenditures each year, $200 billion savings. But more important than the cost saving, of course, is the life savings aspect of it.
So I'm so glad the gentleman from Texas (Dr. Burgess) brought that up and showed that very, very telling poster.
If the gentleman will yield, I will point out that my 2 years of calculus at Georgia Tech, when I was getting that degree in chemistry, has not helped me one bit with figuring out this formula. So I appreciate the fact that the gentleman agrees it is an absolutely impossible, arcane system to ever figure out. And how they came up with it is Greek to me.
I yield back to the gentleman.
I thank Dr. Burgess for yielding.
Mr. Speaker, the issue of medical liability reform is something that we've been talking about for a long time in this House of Representatives and in the other body, and it's time that we do something about it. I remember back in 2004, during the Presidential debate between our current President Bush and the Democratic nominee, Senator Kerry, and on one particular debate they were talking about the cost of medical malpractice insurance. And Senator Kerry made the statement that, well, you know, if a doctor has to pay $40,000, $50,000 a year, some can afford it; that's just a very small amount in the big scheme of things. And I thought President Bush did such a great job of responding to that and he said, you know, Senator, I believe you missed the point. Yeah, some doctors can afford to pay $50,000, some can afford to pay $75,000 a year, depending on their specialty, for medical malpractice coverage; other doctors can't. But that is really not the point.
The point that causes the cost of medicine to go up so much is that all of these physicians practice in a defensive mode, and they order tests in many instances that are absolutely unnecessary, way too expensive, and, indeed, can be harmful to the patient.
You know, I would imagine today, Mr. Speaker, if you went to any emergency room in this country with a headache, you are not going to get out of there without a CT scan being performed. And that particular procedure, by the time it is done and the radiologist reads the film, you're talking about $500, $600, when it would be obvious to a clinician, a skilled clinician in physical diagnosis that this patient is suffering from a tension headache or maybe a migraine headache. So this is where that cost goes up so much.
I appreciate the gentleman giving me an opportunity to talk about it because the model for tort reform is what the State of California did back in 1978; the acronym is MICRA. But basically what we're talking about is to say that no patient who is injured by a physician practicing below the standard of care or a health care facility practicing below the standard of care that results in direct harm to the patient, they should have every opportunity for their day in court.
Dr. Burgess and I probably have seen situations where we are pulling for the plaintiff because we know what happened in the particular setting and maybe in our community. But the judgments for so-called pain and suffering that can be up into the millions of dollars, which are totally unrelated to the degree of injury, is inappropriate. And that's basically what was passed in California and it has worked. The State of Texas, my State of Georgia, the State of Florida, several States have done this; but the vast majority of States are in situations where you don't see any neurosurgeons covering the emergency room. You see very few OB/GYN doctors staying in practice beyond the age of 50. They're all either getting out of the practice completely or they're going over to just a GYN practice. So I thank my colleague for bringing this issue up.
And as I finish my remarks and yield back to the gentleman from Texas, I want to say, Mr. Speaker, that what happens so many times in what we do, we're constrained because of the cost. And we base cost on programs like Medicare part D, by this so-called static scoring that it cost too much money
when so often programs like that have the potential to, in the long run, save money, but would get no credit for it. So we don't do things that we should be doing. Just like, as we were talking about earlier in the evening on electronic medical records, yes, it would cost some money, Mr. Speaker; the Federal Government would have to spend some money. I think that the new Democratic leadership has made a mistake in enacting these PAYGO rules which make it impossible in some instances to do things like the physician payment fix that Dr. Burgess is talking about, the repeal of the alternative minimum tax, which clearly was a mistake, an oversight 35 years ago when it wasn't indexed for inflation.
And so now the Democratic leadership has put themselves in a position where we can't get things done because of those PAYGO rules when in the long run the program that we would enact would save money; it wouldn't cost money. So you would be paying for it doubly by cutting another program and raising taxes to pay for something that will eventually pay for itself. And, certainly, I think that's true with Medicare part D, and I absolutely believe it is true with the electronic medical records system that we need in this country, and I think it's true in regard to medical liability reform that Dr. Burgess is talking about. So I thank the gentleman for bringing that up, and I yield back.