Floor Statements

Madam Speaker, on rollcall No. 889, 890, and 891, I was unavoidably detained.

Had I been present I would have voted ``yea'' on rollcall No. 889, ``yea'' on rollcall No. 890; and ``aye'' on rollcall No. 891.

Mr. Speaker, as we are about to deal with this health care bill before Congress, many of us have still attempted to try to improve the bill. I offered three amendments to the Rules Committee last night, and they were rejected. One of them was to say: before we cut $500 billion out of Medicare, maybe we ought to fix it first.

There is a great deal of savings that could come from Medicare if we used scientific, evidence-based medicine to help improve chronic care conditions and deal with many other programs. That was rejected. Instead, we will cut the money from Medicare.

Another amendment I offered makes sure that if the Senate should move forward with their provision of allowing States to opt out, the States should also be able to opt out of paying the health care taxes. In other words, we should have no taxation without hospitalization. Instead, my fear is that high taxes will remain in the bill to the point where it is going to cost our economy more jobs and cost our small businesses more.

There still is much to do in this bill, and it is not yet ready. I still hope there is time in the coming weeks to improve these bills and work on real health care reform.

Our President said, ``Our health care is too costly,'' and I agree. Yet before us in Washington are bills that tax wheelchairs, heart monitors, pacemakers and your insurance. These taxes make a family's health insurance cost $4,000 more. The President said that defensive medicine may be contributing to unnecessary costs, and I agree with the

President. But the House bill coming up will block tort reform. As a candidate, the President said that we shouldn't underestimate the amount of money that can be saved in the current health care system. I agree. But these bills will cut Medicare by $500 billion and eliminate disease management programs and other programs that could save money.

This bill doesn't fix our health care system. It finances it. It is not too late to reform Medicare, reform Medicaid, reform health care, cut the waste and improve quality. Let people buy across State lines. Let them join groups. Make insurance personal, portable and permanent. Millions are asking us to fix health care, but they want us to do it right. Millions of Americans can't all be wrong.

Madam Speaker, on rollcall Nos. 826, 827, 829, 830, and 831, I was unavoidably detained.

Had I been present I would have voted ``yea'' on rollcall No. 826; ``aye'' on rollcall No. 827; ``aye'' on rollcall No. 829; ``yea'' on rollcall No. 830; and ``yea'' on rollcall No. 831.

Mr. Speaker, the President said our health care is too costly. I agree. But the Democrat plan doesn't reform or eliminate the $1 trillion in waste, so you will pay more--not just your children or your grandchildren, but you. How? Their plan has a wheelchair tax, a hospital bed tax, asthma device tax, artificial hip tax. Diabetes supplies, medicines, home oxygen equipment, all taxed. Have a heart attack? There's taxes on heart monitors, heart valves and pacemakers. How about health insurance? They tax you if you have it and tax you if you don't. Employer paid insurance? They tax them if they will and they tax them if they won't. States can opt out of the government-run plan, but you still have to pay the taxes. It's taxation without hospitalization.

Let's reform Medicare, reform Medicaid, reform health care, cut the waste, improve quality, let people buy across State lines, join groups, make insurance personal, portable, permanent. Millions of Americans are begging us to fix the problems, not finance them. Millions of Americans can't all be wrong.

Thank you, Doctor. I appreciate that.

You know, the big question becomes: Are we going to reduce the cost of health care or are we going to increase it?

During the President's inaugural address, he said our health care is too costly. I could not agree more, and that has been our passion to reduce health care costs, and I still want to work with the President and with my friends on the other side of the aisle to make that work, but there are a couple of questions here.

If you're on Medicare, if you're sick or if you have health insurance under the plans being proposed, you may pay more. Let's review that really quickly.

First of all, with $500 billion cut from Medicare, there will be less to hospitals, less to skilled nursing facilities, $5 billion cut from inpatient rehab facilities, $56 billion cut from home health care, and fewer payments to doctors for drug programs, for part D and for Medicare Advantage, which has a lot of preventative services.

Those are a lot of cuts. When you're taking away preventative services and when you're taking away money from the programs that we know save money, such as disease management--and that's important-- they're going to end up with higher costs.

The second thing is, in taxing the sick, the proposal that's being kicked around the Senate now is increased taxes on all of these medical devices: heart monitors, heart valve rotators, pacemakers, artificial hearts--I hope you don't have a heart attack, because it will cost you more--defibrillators, hearing aids, hospital beds, nebulizers, artificial hips. There are a number of things. There are wheelchairs and ventilators. All will be taxed, including the insurance plans because it comes down to this:

With the insurance taxes, you get taxed if you do have it and taxed if you don't. If the employers offer insurance, they may tax employers if they do offer it and tax them if they won't.

Finally, there are issues with States. If States have an opt-out provision where they do not have to have as a provision in their State where they will have this health insurance plan run by the Federal Government, they may still pay the taxes, and that becomes taxation without hospitalization.

Look, there's a lot we can do to fix this system. There's a lot we can do to reform Medicare. There are so many problems with the Medicare system, not just the fraud and abuse. I believe Congress will work on that, but it's just how things are run there, and we need a more effective and efficient system to make changes in how we operate with Medicare.

Why does it take months to get a power wheelchair for someone? Why do you need such expensive procedures to get a crutch? Why do we have so many things that cost so much money? It's because they're done ineffectively and inefficiently.

Let's change that. Let's make Medicare and Medicaid work better for people. If we're going to do anything so that the Federal Government can run it better, shouldn't we start off by making the government run it better? Let's cut the waste. Let's improve the quality. Let people cross State lines, as so many of my colleagues have said. In a survey in my district, 70 percent of people said that they wanted that.

Let people join groups and have the purchasing power of the group. Let's make insurance permanent because millions of Americans are begging Congress to work together with both sides of the aisle to fix the problems. That's what we should be doing. Millions of Americans can't all be wrong. Let's not dismiss Americans as being frivolous with all of that.

With that, Dr. Gingrey, I yield back to you for the remainder of our time here. Let's continue to work together as a Congress and as a Nation to fix this problem, not just to finance the problems.

Madam Speaker, health care costs are not high because people have health insurance. They are high because we have $800 billion of waste in the system. Now our friends in the Senate are proposing to increase taxes on health insurance.

When workers such as ironworkers and steelworkers and communication workers and the IBEW negotiate their pay package, they work to make sure that their health care plan is covered. Too often now they find that they don't take a raise because their health insurance is going up in cost. They worked to have lower copays, lower deductibles, to have vision, dental, mental health services, among others.

But now we are talking about taxing these plans. What we need to do is figure out ways we can actually lower health care costs instead of discouraging people from having health insurance.

After all, isn't this what we are supposed to be trying to do? The communication workers alone are being told that these new proposals may cost their workers about a thousand dollars more per year in taxes.

This is the wrong approach. It's not good health care. As someone who has practiced in the health care field, I am telling you, it's bad medicine.

I appreciate the gentleman yielding.

There are a couple items on that, that are important to know. When people talk about the low overhead cost for administration for Medicare, that is because they don't count the things that go with the Department of Health, CMS, and all of the administrative costs that physicians have to have, because what they do is, they pay doctors and hospitals less, as has been pointed out, and have many times a loss on this.

If I could elaborate on this, this is important, because as the majority is looking at removing $500 billion from Medicare, you can cannot slash a program by that much without having devastating effects.

It reminds me of the old days in medicine, I wasn't around at the time, when they thought they could treat patients by bleeding them. They said you won't miss a pint or two of blood. It does affect the patient.

In this case, let's keep this in mind: Health care is not expensive because people have insurance, and yet they want to tax insurance. It is expensive because it is filled with waste and inefficiency and misdirected government mandates. When the government comes by and gives doctors pages and pages of paperwork and says you can do this but you can't do that, it is a concern.

Let me give you an example of that. Ninety-five percent of Medicare goes to pay for chronic illness, but because Congress says you can't really manage chronic illness, it is a massive amount of waste. What can doctors pay for? Individual tests, individual procedures. But we know that disease management saves money. With a diabetic patient, heart disease, pulmonary disease, very complex cases which often times require multiple specialists to go to, multiple medications, but as the President himself said, and I remember having this conversation at the White House as well, we will not pay a penny to have a nurse or physician's office call that patient, check their blood glucose levels, check their oxygen levels, see how they are doing, but we will pay tens of thousands of dollars to amputate their feet for a severe diabetic. That is part of the problem we face with Medicare.

Here are a few more. Not only do we not pay for disease management, Medicare Advantage does. Medicare Advantage pays to have someone belong to some sort of an organization where they will get in physical shape. It pays for vision and dental. But now the talk is, let's cut Medicare Advantage because it costs too much and let's somehow do these other things.

It doesn't make sense. This is not evidence-based medicine. Evidence- based medicine says for patients who have a lot of complications, you treat those patients, you work with those complications. And yet what is happening here, the way this Senate bill goes, and I was just looking at this, is, it says let's slash Medicare Advantage so seniors do not have this.

Keep this in mind: Only 1 in 10 Medicare beneficiaries are traditional fee for service, because fee for service doesn't limit out- of-pocket expenses and provides many of the supplement benefits that Medicare Advantage does. That is where, when people says it rewards overuse, it is because that is the only thing sometimes it will pay for.

We need to focus on how we can actually reduce health care costs. The sad thing about this is that by reducing fees this much for Medicare Advantage, by refusing to pay the very thing that we acknowledge that science and medicine is telling us is going to work, instead what it is going to be is pay doctors less, pay hospitals less, put more burden on the patients, gut $500 billion, and somehow miraculously out of the sky will come a more efficient health care system. It is just the opposite, I submit to you. Just the opposite.

Mr. Speaker, as we discuss the issue of health care, one thing that's brought up often is, Why not let the government run health care? After all, we already have Medicaid, Medicaid, TRICARE and the VA.

Here is a true story: a gentleman in his eighties needs a motorized wheelchair, so he gets a medical exam. A few dozen pages of paperwork are filled out, and 3 or 4 months go by, waiting for the wheelchair to arrive. Unfortunately, during that time, the medical exam expired after 60 days and has to be repeated. Again, more billing, a couple dozen pages of that, and he gets his $25,000 wheelchair. Unfortunately, by that time, he is in hospice care and can barely use it. And here is the other tragedy: it goes into storage. It can't be used. It cannot be returned, and it's a big waste of money in many ways.

It's not atypical for issues with Medicare and Medicaid. They, quite frankly, will pay for this sort of expense but will not pay for the care it takes to prevent these sorts of problems. Before we take on more health care and $1 trillion more spending, shouldn't we fix those things we are already responsible for? I think that would save a lot of money, make a lot of sense, and save a lot of lives.

Madam Speaker, on rollcall No. 733 had I been present, I would have voted ``no.''

Mr. Speaker, over the past several years we repeatedly hear politicians during debate using increasingly harsh words. Verbal attacks are rewarded with sound bites on the evening news and a bump in polling numbers, public profile, and fund- raising. Then like Pavlov's dog, we salivate at the next opportunity for a verbal attack. But to what end?

If there is anywhere that decorum in debate has a place, it is in the Chamber of the House of Representatives, with respectful discourse. When we focus only on the anger, we lose legitimacy as thoughtful legislators. We are tasked with maintaining a standard of cooperation and civility rather than insult and hostility. Both sides, both parties, all of us, must focus on changing for the better and set the example for our country, for the public, and for our people.

During this session of Congress alone, over a dozen resolutions have been brought up to attack, embarrass, and deride Members of Congress. In the meantime our Nation is faced with unemployment in record numbers, an ailing stock market, a health care crisis, growing debt, and two wars. That is the work of Congress. That is what the American people want us to address. Anything less is unacceptable. Period.

Let's all stop the name-calling and shouting. We've got work to do.

Madam Speaker, on rollcall No. 685 I was unavoidably detained.

Madam Speaker, on rollcall No. 283, 284, 285, 286, and 287 I was unavoidably detained.

Had I been present I would have voted ``nay'' on rollcall No. 283; ``nay'' on rollcall No. 284; ``nay'' on rollcall No. 285; ``aye'' on rollcall No. 286; and ``aye'' on rollcall No. 287.

Mr. Speaker, last night the President spoke about health care. And despite what some may portray as big rifts, there is much room for agreement. And so I urge we work on these health care principles to get this job done. Everyone should have the choice to purchase in groups, the choice to purchase across the Nation competitively, the choice to have your plan portable and permanent across jobs, and the choice to purchase a basic plan that covers emergency and hospital care.

The President used the analogy of buying car insurance. But let's keep in mind that with auto insurance, you can buy a very basic liability plan and add to it if you choose. Keep health insurance very basic, and you can keep it very affordable. But there should be no choice to cut coverage because a person is sick or was sick at one time, and there should be no choice to have plans and hospitals that tolerate waste, fraud and inefficiency. This includes stopping hospital-based infections.

With these changes, we can make health care more affordable. With these changes we can supplement payments for lower cost, high-quality health insurance for those who cannot afford it, and that does not have to include the government running an insurance company. There's lots of room for agreement. Let's solve this problem for America. That's good medicine.

Mr. Chair, on rollcall No. 662 I was unavoidably

detained. Had I been present, I would have voted ``no.''