[Congressional Record Volume 155, Number 103 (Friday, July 10, 2009)]
[Pages H8000-H8006]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


  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 
  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 
  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 
  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 

[[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 
  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. 

[[Page H8003]]

in this country has access to health care by walking into an emergency 
  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 
  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 
  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 
  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 
  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.''