[Congressional Record Volume 155, Number 103 (Friday, July 10, 2009)]
[House]
[Pages H8000-H8006]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THE HEALTH CARE BILL'S PUBLIC OPTION WILL DENY THE AMERICAN PEOPLE
CHOICES
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 2009, the gentleman from Georgia (Mr. Broun) is recognized
for 60 minutes as the designee of the minority leader.
Mr. BROUN of Georgia. Mr. Speaker, I came to talk about the health
care problems here in America. I'm a medical doctor. I have practiced
medicine for three-and-a-half decades. I'm an old-time general
practitioner. I treat infants all the way to the elderly. My patients
are like family. They're like friends. They are friends. They are
family. And I'm very concerned about where we are going as a Nation.
Certainly health care in this country has become extremely expensive.
In fact, I myself, prior to being elected to Congress, being a small
businessman, could not afford a comprehensive health care insurance
policy. I had a catastrophic health care policy because that's all I
could afford. There are many small businessmen and women all across
this country that are in the same category that I was in. Now, since I
have been elected to Congress, I buy into the government health care
insurance program that all Federal employees can buy into.
We hear from our President that everybody in this country should have
a public option, an option that they can buy into. Last night my good
friend John Shadegg in a Special Order was talking about the draft of
the bill that Energy and Commerce is going to be looking at next week.
And during Mr. Shadegg's discussion last night on this floor, he said
that the public health care option is not an option at all. And, in
fact, the American people, if I could speak to them, Mr. Speaker, I
would ask them to look at what is being proposed and how quickly this
major policy change is being brought to the forefront.
Next week on Tuesday, the Energy and Commerce Committee is going to
start their process of looking at the health care reform bill. Tuesday
they are scheduled to have opening statements by the members of the
committee. Wednesday and Thursday they're going to have markup. And,
Mr. Speaker, I don't think the American public quite understands that
term. It's a term that we use, as you know, where the committee goes
through a bill line by line, issue by issue, section by section, and
amendments are offered, voted on, and are put in place in the final
product.
Well, the chairman of the Energy and Commerce Committee has decided
to not go through the regular order process of letting the Health
Subcommittee look at the bill. He wants the whole committee to do so.
Why? Well, it's reported that the reason that he wants to do that is
because he's concerned about the subcommittee's taking too much time
and maybe not even passing out this bill.
The majority, Mr. Speaker, it seems to me, is trying to force this
down the throats of the American people in a very expeditious manner.
Why would they want to do that? Well, I think the American people, if
they knew what was going on, Mr. Speaker, would understand that this
major policy change is being hastened through the legislative process
so that it can be put in place so that the American people don't have
the light of day shed upon this bill so that the American people can
say anything about it.
Over and over again, Mr. Speaker, in this House with these
appropriation bills, we have seen a change, an historical change, of
how regular order is carried out. Normally an appropriations bill is
brought to the floor with an open rule. Both sides agree on amendments
that are introduced. Both sides agree on time limits, and we can go
through a regular order. But the majority has declined to allow that to
happen. Even leadership, some of the leadership on the other side,
reportedly, would like to do so. But the Speaker and the chairman are
declining to allow that to happen.
So we're getting bill after bill presented to the floor that nobody
has had the opportunity to read. The public can't read it. The Members
of Congress can't read it.
We've had thousand-page bills, such as the nonstimulus bill that was
presented by the President and was introduced in the dead of night, and
we voted on it on this floor where no human being anywhere had had the
opportunity to read that bill. No one, Mr. Speaker, had the opportunity
to read that bill. It was 1,100 pages. Our leader, Mr. Boehner, had
that large stack of paper and dropped it on the floor. No one had the
opportunity to read that bill.
We don't have a health care bill. I have not seen it. No member of
the Energy and Commerce Committee has seen it on either side, Democrat
or Republican, because it has not been produced. Though Tuesday morning
they're going to start opening statements on that bill.
We here in Congress have not seen the bill. We here in Congress have
no way to evaluate the bill. We here in Congress have no way to
understand what the bill says in totality and how we can introduce
amendments to the bill to make it better. Democrats and Republicans
alike are being denied their opportunity to allow amendments to all
these appropriations bills and to a lot of the authorization bills,
such as the tax-and-cap bill, which is going to be a disaster
economically for America. This process is blatantly unfair. It's unfair
to Democrats. It's unfair to Republicans. But most of all, it's unfair
to the American people. The American people should demand better.
Our Speaker, when she came to office in the prior Congress, said
we're going to have a new era of openness and honesty, high ethics,
transparency. Nothing could be further from the truth. That's what went
on in the last Congress and is particularly going on in this Congress.
And we are having this health care reform bill being put together by
just a small handful of the committee leadership and the leadership of
this House, Democrats. The medical doctors, health care professionals,
at least on our side, aren't even being consulted. We have, I'm not
sure, 10 or 11 of us on our side. Not the first one of us has been
consulted about what my patients and all of our patients need in health
care reform.
We are being shut out of the process, and that's not fair to the
American people, Mr. Speaker. The American people should demand more.
They should demand openness. They should demand transparency.
We've had resolutions where we wanted to have at least 72 hours of
every bill being posted on the Internet
[[Page H8001]]
so that the American people could look at those bills. The American
people have been denied that opportunity by the leadership of this
House and of the U.S. Senate. It's not fair. It's not fair to the
American people.
We are having a major change in health care policy being shoved down
the throats of the American people, Mr. Speaker. The American people
need to rise up and say ``no'' to this cloaked-in-darkness process,
where members of the public across this country should be able to take
their reading glasses and put them on and read the bill, where Members
of Congress should be able to take their reading glasses and put them
on and look and see what's being proposed by the majority. The minority
is being totally shut out of this process.
Now, we do know some things that are in the bill. And the American
people need to understand what the ramifications of those things that
are in the bill that we know about are all about.
The first thing, we hear all the time by the majority, we heard it
during Special Orders, we've heard it during the 1 minutes this
morning, we hear it over and over again in all the debate and
discussion going around here in the House, about people need to have a
public option. Well, the American people need to understand, Mr.
Speaker, that that public option is going to deny them choices. It's
going to put a bureaucrat, a Washington bureaucrat, between them and
their doctor. And that Washington bureaucrat is going to make their
health care decisions for them about what tests they can have, what
medicines they can have, whether they can have surgery or not. And what
it's going to do is it's going to shift people, as Mr. Shadegg was
saying last night, over the next 5 years off their employer-based
health care insurance over to a single-party payer government
insurance.
We are told if people like their health insurance, fine, keep it. And
most American people will say, yes, that's right, I like my American
insurance policy that I have today. I don't like the insurance
companies. I don't like the costs. But I'm satisfied with my insurance.
But, Mr. Speaker, if I could speak to each individual in America
today, I'd warn them that, Mr. and Mrs. America, you're not going to be
able to keep your private insurance. You're going to be forced into a
government-run, socialistic medicine health care system where some
Washington bureaucrat is going to tell you whether you can go to the
hospital or not, whether you can get an MRI or not, whether you can
have the new treatments for cancer or hypertension or diabetes. It's
going to destroy the health care system that we know today.
We have the finest health care system in the world. That's the reason
people from Canada come to America to get their health care, even when
they could buy the private health care in their own country. But they
come to the United States. People in Great Britain come to the United
States. Even if they can afford to go through the private sector in the
United Kingdom, they come here because we have the finest health care
system in the world.
But, Mr. Speaker, if I could tell the people in America, if I was
allowed to through the rules of the House, I would tell them that that
health care system that you're enjoying today, the quality of health
care, the medications, the treatments, the tests, surgeries, and all of
the things that make us have the highest quality of health care in the
world, is going to be destroyed by this bill that's going to be started
through the legislative process next week.
{time} 1500
I have been joined in this hour by a physician colleague from
Tennessee, Dr. Roe, who has tremendous experience with TennCare in his
home State of Tennessee. I welcome him to join us today, and I ask the
doctor, I yield to the doctor to give us some insights about TennCare
and what it produced in Tennessee and about the cost and quality and
how things were affected there and whatever the gentleman wants to
inform the Speaker.
Dr. Roe, if you could speak to the American people. I know you would
like to speak to them, but you have to speak to the Speaker and me.
I yield to the gentleman from Tennessee.
Mr. ROE of Tennessee. I thank the gentleman for yielding.
Madam Speaker, I think when you are looking at health care, and I
practiced medicine in the State of Tennessee for over 30 years in an
OB/GYN practice, delivered a lot of babies. And I can tell you, having
watched this very complex system, it's unfair to the American people.
We are not talking about Democrats or Republicans. We are talking about
the American people here who are going to be affected, all 300 million
of us are.
And when we look at the issues out there that we are dealing with,
first of all, there isn't any American that doesn't want to have
quality, affordable health care for all of our citizens. I don't think
any of us in this body, all 435 of us want that. It's how do we get
there and how do we afford it when we do get there and not break the
bank.
We have, if you read various publications, around 47 million people
in America who are uninsured. And of that 47 people who are uninsured,
approximately 10 million, these are estimates, but are approximately 10
million are illegal in this country.
Of the remaining 35 to 37 million, we have about 12 to 14 million who
currently qualify for plans that are out there, SCHIP or Medicaid, but
who are not on it. So we need to find out who these individuals are and
make those assets available for them.
About 9 million people make over $75,000 a year and choose not to buy
health insurance. Now, in my part of the world, in the First District
of Tennessee, that's a lot of money, and I assume in a lot of places in
Georgia and other places around this country that's a lot of money. We
have about 8 million people who make between $50,000 and $70,000 a year
who are uninsured. And certainly for those, if there are families,
there are ways, very inexpensive ways to make sure affordable health
care is available to them.
When I first heard--when I first came to D.C., I heard the argument
of the President's plan, and it turns out, I don't think the President
had a plan. But the plan that was coming out of the House of
Representatives is that we are going to have private health insurance
and we are going to have a competitive government-sponsored plan. And I
said, What exactly is that supposed to do? And they told me, and I
said, Wait a minute. 16 years ago, we did this plan in Tennessee. It
was called TennCare. We got a waiver from Medicaid, HHS, to provide
health care for as many citizens in the State as we could. And as you
know, Tennessee is not a wealthy State. We have a much lower than
average per capita income in the country. So it was a noble goal. And
it was the government, the managed care plans, put a very rich plan
together; in other words, it was very generous in benefits.
And what happened was almost 50 percent, 45-plus percent of the
people who got on TennCare had private health insurance. And what we
found, and for them it was fine. I mean, they had a plan that paid the
coverage, paid to see a doctor. The problem with it was it didn't pay
the cost. And when I started asking, digging into this plan, I said,
How much of the cost of the providers--I am speaking of hospital
outpatient surgery centers. What percent of cost does this plan pay? It
paid 60 percent. Medicare, another government-run plan, pays about 90
percent of costs.
So what happened was you had costs shifted to the private insurers.
And these private insurers--that would be the other businesses in
Tennessee--their costs went up and up and up when they tried to buy
health insurance. So more and more people were dumped into the plan
because businesses couldn't afford it.
How did the State of Tennessee handle this?
Mr. BROUN of Georgia. I want to make that crystal clear. Businesses
could not afford to continue paying for the private insurance, and so
people went from private insurance, and they were being forced over to
the government plan; is that correct?
Mr. ROE of Tennessee. Exactly. They made a perfectly logical
decision. It was cheaper to go into the subsidized government plan than
it was for businesses that were struggling to survive anyway.
And when you add this extra cost, they dropped that cost onto the
public
[[Page H8002]]
plan. Well, what happened was the State couldn't even afford even
paying 60 percent of the cost of the care. There were so many people on
it, the health care part was getting more than all the education and
the other things that the State was providing.
So our Governor, who is a Democrat in the State of Tennessee, and a
Republican legislature, they had to cut the rolls. You only have two
choices: You can either cut the rolls or you can ration care. So I
predict to you, Dr. Broun and Madam Speaker, that when this public
option comes out there, that it will be exactly like that. It will be a
very generous plan subsidized by the taxpayers and supported by that.
And businesses, especially small businesses first--the ones who provide
most of the jobs in this country are small businesses, and you want to
make it easier for them to provide the benefit, not more difficult--
they will drop that. And over time, this will morph into a single-payer
system.
Now, some people, Madam Speaker, would say, Is that a bad idea or a
good idea? I think some people would be happy with the single-payer
system. I believe health care decisions should be made between
patients, their families, and their doctors. And you don't need a
bureaucrat, no pun intended, injecting himself into this very important
decision, in health care decisions. That's what will happen.
In this plan in England, they have a comparative effectiveness, as
you well know, called NICE. And what an acronym for NICE, and let me
explain that to the viewers out there. What happens in a public system
where it's funded by a single payer--for instance, the taxpayer, in
England the government--a board or committee is put together by the
government to evaluate the outcomes of certain treatments.
Well, they have, for instance, if they estimate in England that you
are in your last 6 months of life--and a cancer, for instance, a cancer
treatment, they might invest as much as $22,000 in you, about what a
used Honda would be.
Well, I don't think the American people, I know the American people,
I know the American people in my district, Madam Speaker, in your
District, are not ready to let the government decide that your life and
your family's life is worth that. So that is sort of, in a nutshell,
where we were or are in Tennessee dealing with this.
There are a lot of other options out there. I think these mandates
for, in this particular legislation which we haven't seen other than
just a synopsis of it, we haven't seen the full legislation. And, of
course, the devil is always in the details.
So I want to sit here and look at the American people and tell them
that the Doctors Caucus, the conservatives in this House, I think both
the Republicans and the Democrats, want to be sure that the patient and
the doctor are making those very important health care decisions and
not the Federal Government.
Mr. BROUN of Georgia. I wanted to bring out a point. I have got an
article here that came from Capitalism Magazine. The title of the
article is ``Health Care to Die for in Britain'' by Ralph Reiland, from
February 6, 2005. I just want to read a couple of points that Mr.
Reiland makes in this article.
He says, ``Among women with breast cancer, for example, there's a 46
percent chance of dying from it in Britain, versus a 25 percent chance
in the United States. `Britain has one of the worst survival rates in
the advanced world,' writes Bartholomew, `and America has the best.' ''
He is quoting an issue in the Spectator Magazine, the British
magazine, where James Bartholomew was talking about the British health
care system.
The point of that, and the American people, I hope, will understand
as we look at this, their single-payer system--now, in Great Britain,
if you are extremely wealthy, you have to be extremely wealthy, you can
buy private health insurance. And we have seen a lot of those people
who are extremely wealthy actually come to the United States for their
health care.
But unless you are extremely, extremely wealthy and you are in that
single-payer system--and that's where we are headed, in my belief, in
the United States--you have almost a half chance, and that's in a 5-
year survival rate in Great Britain, of dying, where actually it's less
than 25 percent today in America.
I think you have quoted some statistics on breast cancer. Do you have
those at hand that you could give?
Mr. ROE of Tennessee. I do. When I began my medical practice, we had
the same survival statistics that they did, 50 percent 30 years ago. In
stage 1 disease now in America now it's as high as 98 percent 5-year
survival. So when the patient comes to us, Dr. Broun and Madam Speaker,
and they say, Dr. Roe, what are my chances of living? I am go going to
look at that patient, I am going to look at her and say, It may be
tough, you may have some down days, you probably will, but you are
going to make it. You are going to be okay.
And we can provide that kind of hope in this country for our
patients. I look at St. Jude's Children's Research Hospital in Memphis
where I was a medical student, and when I first went there, 80 percent
of children died of childhood leukemias and cancers. Today, over 80
percent live.
I had one of the greatest evenings this last Monday night of a young
boy I had delivered 16 years ago, and 2\1/2\ years ago his mother
called me and said, Dr. Roe, I am afraid my son has cancer. And we were
there for that 16th birthday to celebrate. He is cancer free, and that
is a wonderful, wonderful thing to celebrate. And my joy goes out to
that family and that community. The whole community celebrated. And
that's the kinds of things we have seen, I think, in America, with our
health care system.
And I think back, Dr. Broun and Madam Speaker, when I began my
medical practice, we had only five high blood pressure medicines. Three
of them made you sicker than high blood pressure did. Today, over 50.
Antibiotics, there was one type of cephalosporin antibiotic. Today,
over 50.
We have all of the new robotic surgeries, laparoscopic surgeries that
I was able to do and privileged to do in this Nation and provide
everyone. I was at a business meeting not long ago, a year or so ago,
and they said the health care system, certainly there are excesses, we
need to do a better job of managing the system. They said, You need to
run this like Southwest Airlines. I said--well, I was in Washington
when I was told that. And I said, I will tell you what we will do. We
will go over to Reagan National and we will pick a guy up who lives
under the bridge there, a homeless person, and we will show up at
Southwest Airlines. And I will go in my pocket, and I will pull my
credit card out and I will say, here, I want to fly and the guy with me
can fly, but the man that has no money can't.
And in America, if we all three get in there and go back to George
Washington University's emergency room, day or night, 24 hours a day, 7
days a week, regardless of your ability to pay, in America we will take
care of you. Now is that the best way to do it, and I would argue it is
not. And that's what this debate should be about is how we better use
those resources.
Mr. BROUN of Georgia. Let's make this perfectly clear for Madam
Speaker and for the American public. You just made a statement that I
want to focus upon. You say somebody could go to the emergency room,
and it's really an emergency room in the United States, and they will
get health care provided to them; is that correct?
Mr. ROE of Tennessee. That is correct.
Mr. BROUN of Georgia. And there is a Federal law actually called
EMTALA, the Emergency Medical Treatment and Labor Act, that requires
emergency rooms to evaluate and essentially treat everybody who walks
in the door, whether they can pay or not, whether they are here legally
or not or any other way; is that correct?
Mr. ROE of Tennessee. That is correct.
Mr. BROUN of Georgia. And then the point I keep hearing, particularly
from those on the other side that want this socialized medicine
program, this Washington-based, Washington bureaucratic administered
health care system, that everybody needs access to health care.
But you just made a statement that the American people need to
understand, and, Madam Speaker, I hope that they will understand.
Everybody
[[Page H8003]]
in this country has access to health care by walking into an emergency
room.
And the question is, really, where people are going to get their
health care provided to them, who is going to pay for it and what cost.
Is that correct?
Mr. ROE of Tennessee. Yes. I know that only you can show up at an
emergency at any time, but the only hospital that I have had patients
denied care because of some bureaucratic snafu, they didn't qualify,
was a government hospital, the VA. I have never had a patient refused
care that I have taken care of if I said this patient has to be in the
hospital. Our problem is not the quality of the care; it's figuring out
a system to best pay for it. That's what we are dealing with here. And
we are not going to wrap this up and be fair to the American people in
2 weeks.
{time} 1515
It's too complicated. I was speaking with a friend of mine this
Monday in Kingsport, Tennessee, Dr. Jerry Miller, and he and I were in
a very detailed discussion about how complex when you're looking at
home health care, oxygen infusion, devices, occupational therapy,
physical therapy. All of that goes with increasing and improving the
quality of your life. That's what we're dealing with, an incredibly
complex system. And I don't believe that the government can best run
this system. I think that the private sector is much more equipped to
deal with new technologies.
I'll give you an example. I think if we were waiting on the
government to develop a da Vinci robot, you wouldn't be having your da
Vinci robotic surgery right now.
We see radical prostatectomies for prostate cancer that now are done
in a couple of hours or less with very minimal blood loss. I mean,
before radical prostatectomies, it was several hundred cc's of blood.
Now it may be 75 or a 100 cc's. Minimal blood loss. Patients are
leaving the hospital in a day or two and resuming normal activities
incredibly fast.
Mr. BROUN of Georgia. Would the gentleman yield?
Mr. ROE of Tennessee. Yes.
Mr. BROUN of Georgia. I want to interject here just a moment. With
the current technology we have on that radical prostatectomy, as we
call it in medicine--taking the prostate out, all the prostate out--in
the past, when we did it with the nonrobotic surgery, the chances of
that gentleman having to wear a condom catheter because they cannot
control the urine and they just have a constant leakage of urine out of
their bladder was very high compared to today.
Their chances, if they're a young man, of having impotence prior to
that--in other words, they cannot perform sexually--was a pretty good
chance that they were going to have problems with that. But with the
robotic surgery, the incidence of impotency, the incidence of
incontinence, which is where the urine leaks out, is very low.
It's because of that technology that the development of that
technology is going to come to a screeching halt, I believe. Would you
agree with that?
Mr. ROE of Tennessee. I would agree with that. I think the biggest
problem you have when you don't have enough resources in the system to
develop new medications and new technologies, new treatments, new
pieces of equipment, there's no question that you freeze in time where
you are.
I recall it wasn't a day that I would go to the operating room that I
wouldn't see somebody back in the seventies getting operated on for an
ulcer, bleeding ulcer. It's almost unheard of now because of medical
treatments and other endoscopic treatment. You have almost eliminated
that very invasive surgery. We certainly don't want this to slow down.
One of the things that I think we value in America--I know we do--is
we value every human life. Every life has great value here. And that's
one of the things that I've seen in my practice. Whether you are rich
or you are poor, you are valuable to the American people and to the
health care system. And we're going to take care of you.
Dr. Broun, Madam Speaker, one of the things that's an untold problem
in the health care system is the availability of care--the
accessibility of it, I should say. In the next 10 years, 50 percent of
our registered nurses are able to retire. Fifty percent. We need a
million more nurses by 2016. That's only 7 years from now.
So we need to be encouraging young people to go into these very
needed specialties in medicine and as physicians. We're already behind
the curve. In the next 10 years we will have more physicians retiring
or dying than we're producing in this country. And the population is
growing and the baby boomers are going to need more care. And guess
what we're doing? We're living longer than we've ever lived in the
history of the world.
So we have a multiprong problem. It's not just that; it's do we have
access. Am I going to be able to find a nurse and a doctor to take care
of me.
I yield to the gentleman.
Mr. BROUN of Georgia. Well, you're exactly right, Dr. Roe. We have a
critical shortage today of medical care personnel, nurses and doctors,
as you're saying. In fact, my alma mater, the Medical College of
Georgia in Augusta, is starting to develop some satellite campuses to
try to train more physicians in the State of Georgia.
In fact, one is going to be opening within the next 2 years in
Athens, Georgia, where the University of Georgia is, near where I live.
I live outside of Athens in Watkinsville.
But we still are going to be behind even with this new training. But
what I have seen, and I think Dr. Roe will probably corroborate this,
is that we have seen doctors stop taking Medicaid, stop taking Medicare
because of the poor reimbursement rates. And if we go to this
supposedly two systems of one private and one public, as has been
projected by the leadership and many people on the other side, what is
going to happen is that you're going to have, because of the very poor
reimbursements rates, you're going to have hospitals fail; you're going
to have doctors not take those patients on the public plan. So that in
itself is going to take choices away. Plus, you're going to have a
Washington bureaucrat telling the patient what medicines that they can
have.
You mentioned, Dr. Roe, just a moment ago about all the
cephalosporins, one of the powerful antibiotics. When you and I came
along--we were almost contemporaries in medical school, though you went
to Tennessee and I went to the Medical College of Georgia--we had
antibiotics that were very limited.
We have got bacteria today--in fact, a patient that's very close to
me personally has pseudomonas pneumonia. When I went to medical school,
that patient would have died within a matter of weeks. She now has a
PIC line. She's gotten IV antibiotics over and over again. That's not
going to be available to her in this new public-option plan, this
government-run plan, and she's just going to die. She's 85 years old.
And she's going to die. She's had this pneumonia for about 6 months
now. And she's still living. When I was in medical school, she would
have died within a matter of days.
Life is precious. Some would say, Well, she's 85 years of age; we
should just let her die. And that's exactly what's going on in Canada
and Great Britain today. They don't have the appreciation of life as we
do in our society, evidently.
Dr. Roe, a lot of people are going to die. This program, government
option that's being touted as being this panacea, the savior of
allowing people to have quality health care at an affordable price, is
going to kill people.
Mr. ROE of Tennessee. Will the gentleman yield?
Mr. BROUN of Georgia. Yes, sir.
Mr. ROE of Tennessee. I think, Madam Speaker, what we need to do is
look at the problem we're faced with. What are people concerned with?
Well, affordability. Certainly, we've got to deal with this.
Number two is accessibility. We have talked about that somewhat.
Thirdly, when we have a job, our health insurance is tied to our job.
So we're concerned if I lose my employment, I lose my job.
Do you need an entire government takeover of medicine to address
those issues? No, you don't. When you look at portability, that's
certainly one thing that I think can be done with very minimal
government involvement.
[[Page H8004]]
I will give you another quick example. Many of us have children. And
today is a very poor work environment. So when you see young people
come out of college or out of high school today, it's very difficult
for them in this market to find a job.
But guess what happens to them when they graduate from East Tennessee
State University or the University of Georgia, wherever, and there's no
job available? They lose their health insurance coverage. Why not just
leave them on their parents' plan until they're 25 years old? It
wouldn't cost the government a nickel.
Do you know how many people that would cover, estimated, in this
country? Seven million young people. And I know for all three of my
children, when they got out of school, they all needed help with their
health insurance coverage. I had to go out and buy a private health
insurance plan, which was not tax deductible.
Another example I'll give you is myself. Last year, when I worked in
my medical practice, I provided health benefits. That was one of the
benefits we have for our employees and for me. I retired from my
medical practice to run for Congress. The next day, my health premiums
went up 33 percent because they were no longer deductible.
That's not expensive for the government to do. Simply allow
individuals out there who want to purchase their own private health
insurance plan--if you're a farmer or small business person, let them
deduct that exactly like GE does, or any other large business
Mr. BROUN of Georgia. Will the gentleman yield?
Mr. ROE of Tennessee. Yes.
Mr. BROUN of Georgia. You made a great point there. The vast majority
of employees in this country are employees of small businesses. The
small businesses are having a hard time paying these high premiums. And
so if we could just have some tax changes to allow deductibility for
the individual or for the small business, which is not in law today--
it's only the large businesses that can deduct and not pay taxes on
that benefit to their employees or the employee not have to pay tax on
that benefit. It's only applicable to large businesses.
Most people who are employed, most of the uninsured in this country
who have a hard time affording it, most small businesses who have a
hard time affording to pay for health insurance for their employees are
in that situation because it's not deductible. And if we made some tax
changes to make it deductible for everybody for their health premium,
that in itself would take care of a lot of those people that you were
talking about earlier who are not insured today?
Mr. ROE of Tennessee. Will the gentleman yield?
Mr. BROUN of Georgia. Yes, sir.
Mr. ROE of Tennessee. I would like to know the logic. I haven't had
anyone yet since I've been in this body give me the logic of why a
corporation with multiple assets is allowed to take a--let's say a
small businessman. Let's take someone who is in a small landscaping
business, who takes care of my yard--I should be mowing it myself--but
who takes care of my yard.
Why shouldn't he be able to deduct as an individual employer--he's
just got himself, is all he works for--why can't he deduct his health
insurance just like General Motors does? I've never had anyone yet
explain to me. You could help a tremendous number of people in this
country if we did that simple thing.
I yield back.
Mr. BROUN of Georgia. Well, I thank the gentleman for yielding.
You're exactly right. I hear the majority Members over and over again,
many Members of the Democratic side talk about the Republican Party as
the Party of No, N-O, because we say ``no'' to this energy tax,
``no''--they're going to accuse us of being the Party of No on this
health care reform bill that they're going to shove down our throats--
down the American people's throats, this socialistic, Washington
government-based, Washington bureaucratic-run health care system.
They're going to accuse of us being the Party of No, N-O.
But I submit that the Republican Party is the Party of Know, K-N-O-W,
because just that one point, if we would make that one tax change, it
would pull into the insurance pool privately administered, no cost to
the taxpayer, no cost to our children and grandchildren. It would not
increase the deficit. Bring in that one thing of a tax policy change
and it would ensure on a private basis a lot of those people who are
uninsured today.
Mr. ROE of Tennessee. Would the gentleman yield?
Mr. BROUN of Georgia. Yes, sir.
Mr. ROE of Tennessee. I would argue that would even do more than
that, because it would do just the opposite of what the public plan
will do. What it will do is, if you make that available where the
uninsured can afford it to this tax break, it will make less people
uninsured and therefore less cost-shifting to the people who already
have health insurance.
I would argue it would do exactly the opposite. I bet you if we try,
it will work immediately.
The challenge we have in a down economy, there's no question, is when
people lose their job, they lose their health insurance. And it can't
be COBRA. As you all know, Bill Gates can't afford COBRA, it's so
expensive.
We have to have a plan that is affordable for people when they're
unemployed. That's a real challenge, there's no question.
I yield back.
Mr. BROUN of Georgia. I thank Dr. Roe for yielding back. In fact, I'm
developing a bill in my office right now that will give patients the
ownership of their health insurance, whether they buy it themselves or
whether it's paid for by their company. If the patient owns the health
insurance, that will stop that portability problem because the patient
owns it; and if they leave one job and go to another, they take the
insurance with them. That's what I'm talking about. We as Republicans
are the Party of Know because we know how to make insurance portable.
We have numerous Members over on our Republican side that are putting
together proposals that the American people will never see. Why?
Because the leadership of this House will not allow the American people
to see my bill or your bill, Mr. Shadegg's bill, Mr. Ryan's bill, the
Health Working Group of the Republican conference.
Bill after bill are being proposed to be introduced that will never
see the light of day. The American people won't see it, the Members of
this House won't see it, Members of Congress in either House won't see
those. Why? Because the leadership of this House is forcing in a
dictatorial manner their health care bill that's going to destroy the
quality of health care.
{time} 1530
Mr. ROE of Tennessee. I am going to make an impassioned plea to the
American people. A week ago we saw a cap-and-trade tax here that was
brought before this House, not thoroughly vetted, a very, very
important issue, and not read. Let me say this again--and I get angry
when I think about this, something that affects every single American.
Not one Congressman of the 219 that voted for that ever read the bill,
and it will affect every American. I want to challenge this body right
here and now not to bring a bill here in 2 weeks which no one has read,
which affects the most precious decision, the care of you and your
family and your children, and you haven't even read it. The American
people need to know every dot and T in that bill before we have the
audacity to pass that bill on to the U.S. Senate.
I yield back.
Mr. BROUN of Georgia. Dr. Roe, I agree with you wholeheartedly. The
American people need to demand that the bill be presented to the
American people so that they can understand how it's going to affect
them because it's going to affect every single person. There's a lot of
people who work for big companies that say, Well, I've got good
insurance through my employer, and I like it. Well, they need to
understand that they're not going to be able to keep it because in 5
years, whether they are in a big multinational corporation that's
paying for their health insurance today, they're going to be forced out
of that into their single-payer government program where that
Washington bureaucrat is going to be making their health care
decisions. That's the first thing. Secondly, it's going to be extremely
expensive for everybody. Government intrusion into
[[Page H8005]]
the health care system is what's driving up the cost. Dr. Roe and Madam
Speaker, let me give you a good example that happened in my own medical
practice of how government intrusion has affected the cost of insurance
and health care across the country, whether it's government-paid health
insurance, such as Medicare, Medicaid or SCHIP, or whether it's private
insurance.
I was practicing in a one-man office. I had three employees down in
Americus, Georgia, and I had a small automated lab in my office. If a
patient came in to see me, a doctor, and they had a red sore throat,
they might have white patches on their throat, they were running a
fever, coughing, and aching all over, maybe their nose is running,
maybe they're coughing up some stuff, I, as a physician, knew that they
may have a bacterial infection or they may have a viral infection or
they may even have allergies. An allergy can actually show those same
symptom complexes. I was taught in medical school not to abuse
antibiotics because the overprescription of antibiotics causes a whole
lot of problems for patients and causes a whole lot of increased cost.
Well, Congress passed a bill called CLIA, the Clinical Laboratory
Improvement Act, which basically shut down my small automated lab that
had quality control. I wanted to make sure that whenever I ran a test
that I had good, proper results. Well, Congress passed a bill, the
Clinical Laboratory Improvement Act, CLIA, that shut down my lab; and
if a patient came in with a red sore throat, coughing or aching all
over, I would do a CBC, a complete blood count, to find out if they had
a bacterial infection and, thus, needed antibiotics or had a viral
infection and did not need the expense or the exposure to those
antibiotics. I charged $12 for that CBC. CLIA shut down my lab. I had
to send patients over to the hospital. So they had to drive from an
office over there. It took an hour or two to do all the paperwork to
get into the hospital and have their blood drawn. Then they'd come back
to my office and sit and wait, frequently for several hours before I
got the results of the test back. But I was charging $12 for that test,
CBC. It took 5 minutes to do. It is a good quality control test, proper
results, $12, 5 minutes. The hospital charged $75, and it took 2 to 3
hours. You take that one test. It jumped from $12 to $75 for one test.
What does that do to costs for insurance across this country? It
markedly increases the cost of everybody's insurance and makes it less
affordable for everybody. HIPAA--let me bring another critter out. I
call CLIA and HIPAA and all these things critters. I tell my
constituents in the 10th Congressional District of Georgia that if they
see these congressionally creative critters, HIPAA, CLIA and all those
other acronyms, that they'd better hold onto their wallets because it's
going to take a big bite out of their wallets. Well, the Health
Insurance Portability and Accountability Act, HIPAA, was passed, and
it's cost the health care system billions of dollars and has not paid
for the first aspirin to treat the headaches it's created. It's totally
unneeded legislation. So government intrusion into the health care
system has created this mess of unaffordability, and the more
government intrusion we get into the health care system, the less
affordable it's going to be.
I will yield.
Mr. ROE of Tennessee. Just to amplify what you've said. Madam
Speaker, years ago we had a test in our office, which we did about
10,000 of them a year. We contacted a local pathologist and said, We'd
like to pay $10 for this test; and they said, Well it's $100,000 of
income. We'll be glad to. Well, we couldn't do that because--guess
what--it was $5 less than what Medicare paid. So we had to charge all
of our patients $15 for this test. So that one little office, that one
test ended up costing our patients another $50,000 in one medical
practice in little old Johnson City, Tennessee. Now I've seen that
already. You can amplify that across the country, and you can imagine
the billions of dollars that are being wasted because of a lack of
competition in the health care system.
=========================== NOTE ===========================
July 10, 2009 on Page H8005 the following appeared: Mr. BROUN of
Georgia. Just to amplify
The online version should be corrected to read: Mr. ROE of
Tennessee. Just to amplify
========================= END NOTE =========================
I yield back.
Mr. BROUN of Georgia. Well, I thank the gentleman for bringing that
test up. It's just a good example of how government intrusion in the
system creates higher costs for everybody, whether it's a privately
insured plan that a patient has or whether it is the government-insured
plan that the patient has, government involvement creates higher costs.
And we know, at least on our side, that we have some solutions. We can
literally lower the cost of health care if we change health care tax
policy and make it deductible for everybody, if we allowed the patients
to have some input into how health care decisions are made. In the plan
that I'm developing in our office, we have a plan that would make
patients be in charge, whether they're government insured or not. We
create a marked expansion of health savings accounts. We need to have
health savings accounts for Medicare patients where the Medicare
patients and the Medicaid patients control that health savings account.
It seems as if some in this body have decided it's a God-given right
for people to own health insurance. Maybe it is. I don't know. I don't
find it in the Constitution of the United States. And we haven't had
that until Medicare came along and then Medicaid, where government
intrusion in the health care system really has created this boondoggle
that we have today. But government intrusion already is rationing care
for my patients and yours. It's already causing problems for patients
to find providers that will accept their insurance. It's already
causing the high cost. It's already causing rationing of care. And to
go down this road that's going to create a bigger government intrusion,
which is going to destroy the quality of care, stop innovation, it's
going to stop all of these life-saving drugs and treatment modalities
that we see in the health care industry today, it's going to stop all
of that because of that cost effectiveness that the gentleman from
Tennessee was talking about.
I will yield.
Mr. ROE of Tennessee. I think the thing that I want the American
people to understand is that for 30-something years I have had to look
at patients, some who had health insurance and some who we had to try
to figure out, How do we get this patient care? And that is certainly a
patient we want to find out. We're the ones who go to the emergency
room at 3 o'clock in the morning and treat a sick child or see a
youngster who has a fractured arm or whatever. We're the ones who
provide this and go out there along with the other health care
providers. We want a way for that system to flourish as efficiently and
as cost effectively as we can. And we can do this. We have solutions
out there. The solution is not the government running your health care.
That will be a problem. It will be a problem as far as innovation is
concerned, as you've pointed out. It will be a problem as far as access
is concerned. Access is already a major problem that we have to
address.
I want to tell the American people--I want you to be engaged in this,
learn about this. Call us. Tell us what you think. One of the last
patients that I saw in my practice was a 60-something-year-old woman
who worked, who didn't have health insurance. And quite frankly, that
is a problem. She is 60 years old, just before Medicare. It's something
that can be dealt with, though, without a complete takeover of the
government health care system. The people had better pay attention.
These next 2 weeks will be the most critical debate about health care
that's occurred in the last 45 years.
I yield back.
Mr. BROUN of Georgia. I appreciate it. I want to ask the gentleman
this: During my three and a half decades-plus of practicing medicine, I
know in my own medical practice, and I know with colleagues that I've
been associated with in Georgia, which is where I practiced medicine,
that all of us have given away our services and not gotten paid. I
don't resent that. I don't regret that. It's just part of what I did as
a family doctor. Now under Federal law if I was accepting Medicare as a
preferred provider, if somebody were to come into my office to see me--
I did a full-time house call practice. I still practice medicine. I
still see patients when I go home today. So I am still practicing
medicine. I am actively practicing. But I don't take Medicare or
Medicaid. I just see those patients and treat them. If they pay me,
great. If they can't, that's great too. I don't
[[Page H8006]]
care. I went to medical school to serve people. I think you did the
same thing, Dr. Roe. But under current Federal law, if I were a
physician that was a preferred provider in the Medicare system, and I
had a young man, young woman who came into my office, was working,
trying to make ends meet, had a health care problem, and they just
could not afford to pay my bill, literally under the laws of this
country today if I told them, ``Don't worry about it. Don't worry about
it. I will treat you for free,'' as I've done to literally thousands of
patients, given away hundreds of thousands of dollars of my services
over my career practicing medicine. If I did that to one patient in the
Medicare system, if they knew about it, they could fine me for every
single Medicare claim I ever made, ask for all that money back, and can
put me in jail for seeing a patient for free. That's inane. It's
absolutely stupid. If we change how government insurance is provided
and get the Medicare, Medicaid, State Children's Health Insurance
Program, all the government insurers so that the patients own the
policy and the insurance is what it's supposed to be, to help those
people manage their finances, to help them manage their expenses for
their health care that they purchase, that they go see the doctor, go
to the hospital, if we could give them the ownership and give them
their rights to make those decisions, then doctors could see patients
for free, if they needed to be. Doctors could make those decisions;
patients could make those decisions; and that's what we want to do on
our side. But those philosophies are never, ever going to come to this
floor because the leadership won't allow it to happen. We can literally
lower--and I think by at least a third to half of what the costs are
today for medicines, health insurance, hospital bills, doctors' bills,
oxygen, wheelchairs, all those things--we can lower the cost of those
things if the Republicans' proposals could ever see the light of day
and be passed into law.
{time} 1545
I yield to the gentleman from Louisiana.
Mr. FLEMING. Madam Speaker, I think one of the things that Dr. Broun
brings out so eloquently is that it is a true privilege to do what we
have done, to practice medicine and try to heal the sick and take care
of those folks. That is what we want to do, to be able to continue to
provide those services where patients and doctors make those decisions,
not the government.
I yield back.
Mr. BROUN of Georgia. I thank the gentleman for yielding. We have
just a moment or two.
Madam Speaker, if I can speak to the American public today, what I
would say to the American people is that starting next week the
majority is going to force this health insurance reform down the
throats of the American people. It is going to adversely affect every
single American. The American people should stand up and say No, we
want transparency.
Madam Speaker, if I could speak to every individual across this
country, I would tell the American people to get on the phone, e-mail,
fax, or visit your Congressman, your U.S. Senator, and say, Let's slow
this process down. Let's get it right. Let's don't hasten in this
process of trying to force something down the throats of the American
people in the blackness of night where people can't see what's going
on. Let us see, as Americans, what you are proposing, so we can look at
the bill, so we can evaluate the bill, and so that everybody's voice
across this country can be heard.
The former U.S. Senator Everett Dirksen once said that when he feels
the heat, he sees the light.
The American people, Madam Speaker, need to put the heat on every
single Member of Congress in the U.S. House and the U.S. Senate by
calling, writing, faxing, e-mailing and visiting their offices and say
``no'' to this process of not allowing people to read the bill.
The American people need to demand that this health care policy be
looked at and be available for the American people to evaluate and not
be forced down their throats like it is being done today.
Not only that, Madam Speaker, I invite the American people to call
their family and friends and ask them to do the same thing. We have to
light a grass fire of grassroots support all across this country to
slow this process down. Demand transparency. Demand fairness. Demand
openness. We are not getting that today, Madam Speaker. We have to
demand it. The only way that is going to happen is if the American
people will stand up and say ``no'' and tell their Member of Congress,
particularly here in this House, between now and next Wednesday, they
need to tell their Congressman to stop this process, allow fairness and
allow transparency.
Let's have reform that makes sense. Republicans want that. Democrats
want to have reform. But we don't need to do something that is going to
break the system, destroy the quality of health care and be extremely
expensive for everybody. We need to say ``no.''
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