[Congressional Record Volume 140, Number 98 (Monday, July 25, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 25, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                           HEALTH CARE REFORM

  Mr. BUYER. Madam Speaker, it was a real pleasure for me to be here 
and listen to my colleagues from the other side of the aisle try to 
convince America about universal access universal coverage for health 
care.

                              {time}  2010

  I think those who are listening and paying attention, they firmly 
believe in the sincerity of their heart that government is the solution 
to what ails you. I say they just do not understand that that is at 
times what ails the American people, is so much government intrusion 
into our daily lives and that of our family.
  There are some who look out a window into a parking lot, and when 
they look out into that parking lot they think that every person in 
America ought to have the same kind of car. When I look out into the 
parking lot, I believe that everyone should have the same opportunity 
to get whatever car they want, to achieve whatever level they seek.
  There are many of us here that will vote on a lot of different 
issues. Whether it is health care or welfare reform, somehow we have to 
have a real good set of principles when you move into this Congress. I 
analyze it like this. I say, Does it promote individual liberty and 
protect it? Does it enhance economic opportunity? Does it promote 
personal responsibility? Does it promote high standards? Does it 
protect American citizens at home and abroad?
  Members can even apply that to health care. I salute my colleague, 
the gentleman from South Carolina [Mr. Derrick], who just said a few 
moments ago, ``Let us not fool the American people.'' I agree with 
that.
  What I am prepared to do here tonight for you, the American people, 
is to talk about not only the politics of health care, the pragmatism 
of health care, and the plans of health care. The only way I can do 
that is that I have prepared a chart, a road map of my thoughts. I am 
going to explain this, because it helps explain the actual debate that 
is going on right now about health care.
  Madam Speaker, right here along this section, this is where we 
presently are in America. This is the present hybrid health care system 
that we have in America. The reason I call it a hybrid system that we 
have is because we have Medicaid, Medicare, the VA, the Veterans' 
Administration hospitals and clinics, and we have the military health 
care delivery system. We really, technically, have a hybrid health care 
system.
  In the hybrid system that we have, we have come along and said the 
present system that promotes the greatest quality health care system in 
the world, and the system that also preserves the greatest choice of an 
individual, of doctor or facility or alternative methods of treatment, 
is at 85 percent. Right now we are right here, right here at this 
square, at 85 percent.
  So we, because of our compassion and sincerity for the uninsured and 
underinsured, we seek to do better. We also recognize that there are 
growing costs, and we try to seek cost containment.
  How do we want to do that? Do we want to move forward this way, or do 
we want to take this direction? Let me explain.
  Madam Speaker, here at the 95 percent, or actually I should write 94 
percent, there is a system that is referred to in Washington here a lot 
called the Hawaiian health care system. It has 94 percent coverage. It 
is a universal coverage system. It has been in effect for 20 years and 
has only been able to achieve 94 percent.
  Think about this for a moment. If we are presently at 85 percent and 
the A model universal coverage health care right now is the Hawaiian 
system, and it is exempt, it is exempt from whatever plan is going to 
be passed here, so they must like the 94 percent, now think about this. 
Utilize common sense.
  When you were in school and you got a 85 or an 87 on a test, how did 
you feel? You probably felt pretty good. You did not say, ``Oh, my 
gosh, my 87, 85, is a failure. I have to go out and get an all new 
method of learning.'' No, you did not say that.
  If you want to get to 94, you work harder at what you are presently 
doing. You don't go out and say, ``I need to get a brain transplant to 
move to 94 percent.''
  What we seek to do is increase the access, maintain the quality, and 
have cost containment. How do we do that? We do it by working on what 
is wrong with the present system and not moving to brain transplant.
  Let us think about what is really happening out there. It is 
wonderful to get up and talk to America and say, ``I'm going to be the 
protector of the middle class. I'm going to deliver to you less. It is 
not going to cost you.'' Incredible. The American people did not wake 
up yesterday. It almost reminds me of a knock-knock joke:
  ``Knock, knock.''
  ``Who is there?''
  ``The Government.''
  ``The Government who?''
  ``I am the Government and I am here to save you.''
  Come on. The American people are much smarter than that.
  So if we are paused right here, this is where we are, at 85 percent, 
there are those of us that believe and support incremental reforms to 
the present system, to open up the access, to permit greater risk 
pooling out there.
  We also recognize, when I say open up the access, I am referring to 
allow small businesses, whether it is local chambers or associations, 
to create greater risk pools so there is greater integration in the 
health care economy, both vertically and horizontally.
  As we do that, Madam Speaker, we also, as we are paused right here, 
there are those here in the Congress that say, ``You know what we need 
to do is, we should have incremental reforms to a single-payer 
system.'' They are not saying that, they are not going to say that, 
because they want to fool the American people. You see, the real goal 
is a single-payer plan, a Canadian-style universal coverage system for 
America, but they are not going to say it. They are not going to say 
it.
  The ones that I respect in this body are those who come out and say, 
``I believe in a Canadian-style health care system for America.'' I 
respect them because they come right out and look you in the eye and 
say, ``That is my sincere belief.''
  The ones in America that you should be scared of and frightened of 
are the ones that finesse it. They finesse it by saying, ``Well, we are 
just going to have some triggers, we are going to help out the small 
business sector, we are going to help out the middle class, we are 
going to protect you, we are going to look out for you.''
  Let me explain what this is. We are right here. They are 
sophisticated. They, meaning the liberal side of the Democrat Party, is 
sophisticated enough that they cannot make a hard left turn and take 
America directly to a single-payer plan. They cannot move from here to 
a single-payer plan. America will say ``no'' and reject it.
  What is their answer? Their answer is substantive incremental reforms 
to a single-payer system, so they want to move from here and take 
America this direction. That is the debate that is going on right now.
  The President is going to say, ``I might loosen up a little bit.'' 
Vice President Gore yesterday said, ``We might relax. Maybe 10 years 
out may be acceptable, it may not be acceptable. We will have to look 
at it.''
  What are they really talking about? They are talking about how to 
move America to a single-payer plan without telling you, without 
telling you. So what they seek to do here, Madam Speaker, is move 
America from the 85 percent and go this direction. They want to turn 
left and take America this direction.
  Now, this time period could last anywhere from 7 to 10 years, time 
enough to pull America into a malaise. Then when they get out here in 
the year 2000, 2002, they turn around and say, ``Those of you who, like 
Congressman Buyer, back in 1994 said we need incremental reforms from 
the present system,'' they will say, ``See, Steve, you were wrong. We 
tried but we could not make it.''
  Think about this. They tried? What they are going to do is, in the 
reforms they are going to rewrite up there in the back room, that we 
may or may not get a chance to see before we are voting on it--which is 
an incredible thought, they control the process. When they control the 
process, they can then control the substance and predetermine the 
outcome of legislation. Get it? I got it.
  So what they are going to do is set unrealistic expectations in 
different sectors of the health care economy that cannot be achieved. 
That is why they are saying out here 95 percent.
  We have Hawaii that has been doing it for 20 years, and which they 
are exempting, and they cannot even reach 95 percent. So the goal, the 
goal is, by the liberal side of this body, is to move America to a 
Canadian-style health care system, but they are not going to say it. 
They are not going to say it because they are scared to death. They are 
scared to death that you will not send them back to this body, and 
their job, to them, is so important.

                              {time}  2020

  What is it they are going to try to do? They are going to try and 
fool the American people.
  I agree with my colleague, the gentleman from South Carolina, let us 
not fool the American people. There are those of us that firmly believe 
that we do not need a brain transplant when it comes to health care. 
What it is we support are incremental reforms to the present health 
care system that increases the access and permits greater risk pooling 
to occur. We seek tort reform, medical malpractice reform, 100-percent 
deductibility of insurance premiums, the list goes on and on.
  There are many things that we can do to the present system without 
sacrificing the quality, without diluting the quality, without 
restricting the freedom of choice of doctors and facilities and 
alternative methods of treatment, let alone of its impact upon jobs and 
small businesses.
  If we want to talk about the protector of the middle class, it will 
be the conservatives who are the protectors of the middle class.
  Madam Speaker, I would like to yield to a gentleman from the Seventh 
District of Michigan. He represents eight counties just above Indiana. 
It is the southern tier, the farmland counties of Michigan, in Battle 
Creek, there with Kellogg's and Post.
  I yield to the gentleman from Michigan, Nick Smith.
  Mr. SMITH of Michigan. Madam Speaker, I thank the gentleman from 
Indiana for yielding.
  The gentleman sort of perked my interest when he mentioned jobs 
because I chaired a health care task force forum in Jackson, MI, at 
Foote Hospital a couple of weeks ago. Joining me were Representative 
Dennis Hastert of Illinois and Representative Pete Hoekstra, my 
colleague from Michigan. That is what we were doing.
  We were asking: ``How is this going to affect you as a small business 
and how is it going to affect those jobs in your business if you cannot 
pass on that health care reform?''
  Madam Speaker, they gave us an earful. We had 16 witnesses that 
testified and they were unanimous in their testimony that if this 
liberal plan of Government takeover of health care passes, it is going 
to hurt business, but what it is going to do to the American people is 
hurt jobs. It is critical, it seems to me, that Congress listen to 
these businesses and that the American people start talking to their 
neighbors in their towns and villages and cities.
  ``What will this do if this is forced on your business? Is it going 
to make a difference in jobs?''
  Madam Speaker, some of the things that people testified at this 
health care forum, businessmen and businesswomen, were very concerned 
whether they could absorb this additional cost. It seems to me that the 
lure of some people suggesting, ``Look, let us lower the cost of health 
care, do it our way. Go to universal coverage, go to a single payer 
system,'' we need to be very careful that we do not get sucked into a 
new socialistic program of health care by the suggestion that we are 
going to save money. We already know how to reduce the cost of health 
care. The Democrats know how, the Republicans know how. In fact, we 
have joined together in many of these bills to deal with tax reform and 
pooling and tort reform and cutting down the overzealous regulations.
  At this hearing a couple of weeks ago, Noelle Clark of Hasselbring-
Clark, Inc. of Lansing said:

       My point is this: Many small businesses do not provide 
     health insurance because they simply can't afford it. Just 
     because it's forced on us doesn't mean the money will be 
     there.

  Sharon Roy, an accountant from Onsted, testified that many of the 40 
to 50 small business accounts, that they were not going to be able to 
afford an additional Government mandate. She said that if you force on 
us this up to 7.9-percent payroll,

       It's going to mean jobs. They don't have the profits to cut 
     and they cannot pass costs through to consumers. Who are they 
     going to pass it on to? They're going to price many of these 
     small businesses right out of the market because they cannot 
     compete with the big chain outfits. So you're going to force 
     some out of business and definitely a lot of layoffs.

  Jim Ahearn, a pipeline oil salesman of Jackson said that of his 
business, the best he could calculate it, would be charged an 
additional $55,000 and he could not pass that on in his business with 
increased prices. So it meant several things.
  He said, probably getting rid of people and not buying the additional 
trucks that they need.
  Charlie Owens of Michigan's branch of the National Federation of 
Independent Businesses [NFIB] came up with the calculation that it was 
going to cost our State, Michigan, alone 32,604 jobs and it is going to 
affect another 817,000. We asked that witness what he meant by 
``affect,'' and he said that it is going to mean that we reduce their 
paychecks. If we are forced to provide health insurance, we cannot pass 
it on in increased costs. It is going to have to come out of their pay. 
So instead of them having the choice of what health care system they 
buy, we are going to mandate the health care system and will have to 
reduce their pay to comply with the Federal Government.
  Richard Todoroff had a good statement, of Todoroff's Restaurant in 
Jackson. He said, ``This is pure socialism. I see the United States of 
America getting what the U.S.S.R. got rid of.''
  He also stated:

       ``I do not need government to tell me how to operate my 
     business, and, damn it, that's what they're doing. Every time 
     you turn around there is another mandate. If this health care 
     plan passes, this will be the final nail in the coffin.''

  Virginia Atayan of a car dealership in Charlotte summed it up when 
she said that Government mandates of this magnitude would take away the 
incentives that entrepreneurs have to invest and work hard to be 
successful.
  She said:

       I've already paid the OSHA prices, paid to get safety 
     features in place. I've paid for Work Comp., I've paid for 
     Unemployment Comp., I've paid all these high taxes. I've done 
     all these things. It takes work time on my part to figure out 
     how to keep this Government happy. Now to place these 
     additional burdens is going to drive us out of business, or 
     we're going to have to increase the price of our product, in 
     this case automobiles, to the consumer.

  Madam Speaker, I think we have got to be careful not to fool 
ourselves that there is some secret way to reduce the price of health 
care in this country. I think we have got to be careful not to fool 
ourselves that when liberals say, let us start a new expansive 
socialistic program in this country, a new entitlement, that somehow we 
are going to magically provide greater health care for a lower price.
  I am excited about moving ahead. I am excited about the possibility 
of Democrats and Republicans joining together to do some of the things 
that we know can reduce the price of health care in this country.
  Mr. BUYER. Madam Speaker, I would like to thank the gentleman from 
Michigan [Mr. Smith] and ask him to stick around here for a little bit 
if he can.
  I yield to the gentleman of the 22d District of Texas, a district 
that spreads in all directions, at Allen's Landing on Buffalo Bayou and 
home to Johnson Space Center in Houston, TX, Mr. Tom DeLay.
  Mr. DeLAY. I appreciate the gentleman yielding to me.
  It is also the home of Albo Pest Control, a wonderful small business 
that I own. It is through the ownership of that small business that 
brings me to the understanding of what this administration is trying to 
do and what this Democrat-controlled House and Senate is also trying to 
do to small business people.
  Let me say from the outset that Albo Pest Control provides a very 
good health care group plan for their employees. But I have got to say 
that is amazing to me, and I understand what President Clinton is 
trying to do. What he is trying to do is to bring universal coverage to 
every American and to in some way control the cost of health care. The 
problem is they have no clue about what free enterprise is, how it 
works, what the effect of Government mandates are on small businesses 
and how they affect jobs and our overall competitiveness in this world.
  I could give a very real example. I built my company from scratch. I 
built the company up and had more and more employees come on board. 
They were great employees, and for many reasons, but not the least of 
which I wanted to be very generous to my employees because they were 
doing a great job for me, and for themselves, I bought a health care 
plan that was 100 percent coverage for my employees. None of my 
employees at that time, and there were some nine of them, none of my 
employees at that time were over the age of 35, so you can imagine. 
They were in very good health, their wives were in very good health, 
their children were in very good health. They really did not need a 
health care group policy that covered them 100 percent. But I bought 
it, anyway.
  I immediately found out in just a little over a year, that was the 
dumbest thing that I could have done to me and to them. Because they 
would go to the emergency room to get a Band-Aid. If they had a cold, 
they would go to the doctor because they were not paying the bill.

                              {time}  2030

  Immediately, as it follows anywhere else when you do these kinds of 
things, immediately the cost of my health care started rising, and I 
could not understand why. As I checked into these costs, I found out 
that these 35-year-old and below families were using the doctor for 
things that most people do not use the doctor for. Why? Because they 
were not paying the bill.
  What is the answer to the Clinton plan and this universal coverage 
plan and mandated plan, single payer plan? They want to take a failed 
system and expand it and make it even worse.
  I think Medicare has a lot of problems that can be corrected if we 
bring consumer choice and market pressures to bear. Medicaid is a 
disaster. It is going to cost, if we do not do something to reform 
Medicaid, it is going to drive costs through the roof. Why? Because the 
people who are receiving the care are not paying the Medicaid cost, not 
paying the bill, and that drives up the cost, because you overuse the 
service.
  The same thing happens to every small business person in this country 
if you take a single payer plan and expect it to hold down the costs 
and expect it to be reformed.
  Mr. BUYER. Will the gentleman yield on that point?
  Mr. DeLAY. I yield to the gentleman from Indiana.
  Mr. BUYER. The gentleman mentioned a couple of failed systems, 
Medicaid and Medicare. Does the gentleman realize that under the Great 
Society when it began back in the early 1960's, in 1965 Medicare Part A 
was predicted to cost $8.8 billion by the year 1990, but the actual 
cost today is $71 billion.
  Mr. DeLAY. The gentleman makes my case absolutely. The case history 
shows that if you do not provide into the mix making the choice of what 
kind of health care they want, and what kind of health care they need, 
and bring costs in the market system to bear on that and all of the 
pressure and intricacies of our system included in that, you are doomed 
to failure. That is what we are facing. This administration and the 
Democrat leadership of this House and Senate do not understand what 
this economy is all about and what the ultimate result is going to be, 
at least in Texas.
  The American Legislative Exchange Council projected that job loss in 
Texas alone would be 68,300 jobs. Of course, this does not account for 
all of the wage reductions that the gentleman from Michigan was 
mentioning earlier. CONSAD Research Corp. estimates that almost 1\1/2\ 
million workers will face reduced wages, hours, and benefits.
  It is really interesting that some people are trying to disguise 
employer mandates in the form of these hard and soft triggers. No 
matter what you call it, when you implement employer mandates, that 
means job loss and lower wages.
  I would like to quote the ranking Republican member on the Small 
Business Committee, who may have already been quoted. Jan Meyers from 
Kansas said it very well when she said:

       It defies logic to suggest that we would eliminate 
     someone's job to provide them with health insurance coverage. 
     The uninsured become the unemployed. What kind of tradeoff is 
     that?

  That is what the Republicans are all about in insisting on a market-
based plan. We have a plan. It is market-based. It understands what the 
problems are and brings a market-based solution to them.
  I appreciate the gentleman from Indiana taking this special order.
  Mr. BUYER. I appreciate the gentleman's leadership here on the 
Republican side that he has shown on health care. I am really pleased 
to hear the gentleman talk about personal and individual responsibility 
here on the House floor. It is amazing when you use the words morality 
or personal responsibility in Washington, people look at you as it you 
are not supposed to say those things of kinds. It is incredible. So I 
salute you for sticking to traditional values which we are trying to 
instill in this country.
  Another thing you mentioned was the effects in the small business 
sector. The gentleman could not be more correct or on point.
  When the gentleman talked about family orientation, there is a strong 
district in Arkansas that has 16 counties in the northwest corner of 
that State, in the Ozarks, the great rounded green mountains that the 
sun shines in would seem like forever in those mountains with 
traditional-minded people, very family-oriented, and they are 
represented by a true statesman, Tim Hutchinson. And I yield to the 
gentleman from Arkansas.
  Mr. HUTCHINSON. Madam Speaker, I thank the gentleman for yielding. 
May I say it is the home of some of great entrepreneurs in America and 
some of the great companies that are going to be hit very, very hard by 
the mandates that we have been discussing this evening.
  I want to commend the gentleman from Indiana for organizing this 
special order. It was interesting to be able to hear Members from the 
other side of the aisle discuss health care prior to our special order, 
and I heard a familiar refrain over and over again during that hour. 
They said there is something worse than doing nothing. And I very much 
want to join in doing something. I think we can do something. I think 
we can accomplish meaningful and substantive health care reform that 
will help control costs, that will expand coverage to more people, that 
will maintain quality, maintain choice in our health care system.
  But I agree with them, there is something worse than doing nothing. 
What would be worse than doing nothing would be to turn the best 
quality health care system in this world over to the Government to run, 
a Government to run, a government that has never demonstrated its 
capacity to run anything efficiently or compassionately.
  I was in this Chamber January 25, 1994, this year, when the President 
said, ``Hear me clearly. If the legislation you send me does not 
guarantee every American private health insurance that can never be 
taken away, I will take this pen,'' and he showed us the pen, ``veto 
that legislation, and we'll come right back here and start over 
again.'' That is what he said January 25.
  Last week he said, ``You can't physically cover 100 percent. It's 
impossible. Nobody can do that.'' That's what he said to the National 
Governors Association.
  So we see the weaving and the bobbing, the defining and the 
redefining. We hear of the triggers, the hard triggers, the soft 
triggers, the mandates, the global budgets, the price controls. I 
suggest that that is the language of a fatal cure for the health care 
system of the United States.
  Last week supporters of a Clinton style health care bill embarked on 
a campaign-like bus tour designed to drum up support for Government-run 
health care. The buscapade, as it has been called is a public relations 
gimmick financed by special interests. Organizers are asking various 
special interests, labor unions, businesses, other groups to finance 
the venture by paying $20,000 for each bus, and requiring sponsors to 
promise that they are going to support, in advance, whatever bill comes 
out of the House and Senate from the Democrat leadership, bills that 
have not yet been drafted. So prospective sponsors do not even know the 
details of the legislation that they are endorsing and promising to 
support.
  That is the tragedy that we may well face, a bill the first 2 weeks 
of August that the American people have never even had an opportunity 
to read or study and in fact that many Members of this institution of 
Congress will not have had an opportunity to study either because 
congressional committees that have been able to pass health care plans 
developed markedly different kinds of bills. The leadership will now 
meld those in, bring those into one bill, and at the last moment we 
will be presented with that legislation. The American people ought to 
have at least 30 days to read and study that legislation. Congress 
ought to have time to study that legislation. Hearings ought to be held 
on the specific bill that is brought before this body before it is 
endorsed.
  We have heard a lot about employer mandates this evening. I would 
like in the few minutes that I have left to speak to two or three other 
issues that are very important when we talk about Government-run health 
care. I want to talk about rationing. I want to talk about the abortion 
coverage inclusion in the health care bill, and I want to mention its 
impact on families because the Members on the other side of the aisle 
kept talking about the middle class, what will Government-run health 
care really do to the middle class.
  First of all, price controls, global budgets, Medicare reductions 
will inevitably, ultimately result in rationing of health care in our 
country. The administration is suggesting that we cut $124 billion out 
of the Medicare system. This is on top of a $56 billion cut in Medicare 
which occurred in 1993. Therefore, just for starters we are looking at 
a cut of $180 billion or 14 percent of total Medicare expenditures for 
the multiyear scoring window.

                              {time}  2040

  And then in the so-called Health Security Act, section 4114, it 
limits payments to physicians of high-cost hospital staffs. This 
provision would have the effect of withholding 50 percent of payments 
from physicians who treat severely ill elderly patients who need 
intensive treatments. This provision appears to be an explicit 
rationing provision for Medicare beneficiaries who are severely ill.
  But regardless of what is done on Medicare, a global budget, and that 
is the concept that we are only going to spend a certain number of 
dollars on health care, will ultimately have to result in rationing of 
health care.
  Price controls will have the same effect. Price controls will 
diminish the quality of care. One of the ways a producer responds to a 
price fixed below the true value of his product is to reduce the value 
of the product correspondingly until it equals the new lower price. 
That is what will happen in health care with price controls.
  Doctors will spend less time seeing patients. Hospitals will either 
cut back on staff or cut back on expensive lifesaving technology. 
Either way, the result for consumers will be a diminished quality of 
care. In some instances, patients will die who otherwise would have 
lived.
  This happens now in England where the newspapers are full of stories 
of people dying while waiting in line for rationed medical procedures 
readily available in the United States. In Canada, which has fewer 
high-tech imaging machines in the whole country than can be found in a 
typical large American city, pets can receive CAT scans after regular 
business hours but people cannot.
  Given the British and Canadian examples, it seems plausible to think 
that deaths will occur as a consequence of medical price controls and 
global budgets if we adopt them.
  I want to give a very personal example of how this could impact 
people in the United States. My mom about a year ago, over a year ago, 
had triple bypass surgery. She was over 80 years of age at the time. 
She was having severe angina attacks several times a day.
  We took her and tests were run. The physicians said she had severe 
blockage, that a heart attack, perhaps a fatal heart attack, was 
imminent. He was concerned whether or not surgery could even be 
performed quickly enough to save her life.
  My mom had always said she did not want extraordinary means to save 
her when she got older, and I was frankly concerned whether a person of 
that age could take a triple bypass surgery. I asked the doctor, I 
said, ``At her age, can she handle a major surgery like that?'' The 
doctor said, ``Well, she is otherwise healthy, and because she is 
otherwise healthy, it may take a little bit longer because of her age 
to recuperate, but she should do fine.'' I was wondering how Mom would 
react.
  They brought her in at that point, and they told her that she had to 
have surgery and had to have it quickly. I was amazed at her response. 
She said, ``Do it.''
  Because I think God has put within the soul of every human being an 
instinctive desire to live, and she wanted to live, and she knew that 
was the only way she could live.
  They had to rush her into surgery before the following Monday, 
because the angina attacks had become so frequent they were afraid they 
would never get her in before the heart attack hit. She want through 
the surgery, and to make a long story short, she made a remarkable 
recovery. It has been a new lease on life. I do not know how many years 
my Mom has, but I do not know how you put a price tag on those years. 
She went back and became president of her Sunday school class. She made 
a trip to Oklahoma City, and she went to Branson, MO. She started a new 
class in her home. She has had a new lease on life.
  This is what the surgeon told me before we brought my mom in to talk 
about choices. He said, ``Mr. Hutchinson,'' and they always want to 
lobby you when they know you are in Congress, but he said, ``I want you 
to know if your Mom lived in Great Britain that she could not get this 
surgery because of her age. Because of her age, they simply would not 
allow the surgery to be performed if she lived in Great Britain.'' And 
then he said, ``If she lived in Canada, she would be put on a waiting 
list, and in your Mom's case, she would die waiting.''
  Now, ladies and gentleman, my colleagues, I know that there are very 
difficult choices that must be made in how we expend health care 
dollars towards senior citizens, but I believe, and I think the 
American people believe, that those decisions ought to be made by the 
family, by the patient, and by the doctor and not by some bureaucrat in 
Washington, not by the Government, and that is what happens when you 
ration health care, and that is what will happen under a Government 
health care system.

  Mr. BUYER. It is interesting you brought up Great Britain and the 
notion. There was a question asked of Virginia Bottomley, Great 
Britain's Secretary for Health. The question was:

       Question. The notion that many Britons wait an excessively 
     long time for treatment is often used by critics of national 
     health care in the United States to illustrate the 
     imperfections of a British-style national system. Are the 
     long waiters a ``fatal flaw'' in Britain's system?
       Answer. The number of people waiting is not important 
     provided they are treated within a reasonable time. It is the 
     time people wait that matters not the total number waiting. 
     Half of all admissions to hospitals are immediate. Of those 
     admitted from waiting lists, half are admitted within five 
     weeks, nearly 75 percent within three months and 98 percent 
     within a year.

  Mr. HUTCHINSON. And that in defense of the British system? I think 
again the gentleman makes the case very well that in fact if you are 
among those who have to wait, it could mean your life.
  Let me touch very quickly upon a couple of other points. One is the 
inclusion of abortion services, because every health care bill that has 
come out of the major committees with the exception of the Committee on 
Veterans' Affairs, has included abortion services, and the Committee on 
Armed Services, but the major committees of jurisdiction, Ways and 
Means, Education and Labor, Energy and Commerce did not produce a bill, 
but these brought forth health care bills that include abortion 
services.
  I think it is very ironic that our President has endorsed this 
concept when, in the State of Arkansas and during his 12 years as 
Governor of the State of Arkansas, he so eloquently made the case that 
regardless of your position on abortion, you ought not be required to 
violate your conscience by subsidizing that practice for others through 
taxes or through health care premiums mandated by the Government.
  That is the issue. Our country is very much divided on the abortion 
issue, but we are not much divided on the issue whether you have to be 
forced to pay for somebody else's abortion.
  Mr. DeLAY. If the gentleman will yield, I had an experience just 
Saturday. I was in Minnesota up in the northern parts of Minnesota, 
actually, yesterday, Sunday, and I ran into a farmer who was very 
upset. He called me aside and said, ``You are a Congressman from 
Texas?'' I said, ``Yes.'' He says, ``Well, I welcome you here, but I am 
very concerned that the President of the United States is going to 
require me to fund abortions in this country.'' He says, ``I am pro-
life, but for me to fund abortions in this country is against my 
religion, and it will force me to do something I do not want to do.'' 
He says, ``I am a very devout Catholic, and in the Catholic Church,'' 
but I am not a Catholic, but this is the farmer talking, ``In the 
Catholic Church, if you help someone procure an abortion, you are 
supposed to be immediately excommunicated,'' and he feels very deeply 
about this, and he says, ``I will be forced to not pay my taxes if this 
is passed, and I could go to prison.'' He was very upset about this 
particular provision that the Clintons just seem to accept willy-nilly 
without even understanding the impact of their actions.
  Mr. HUTCHINSON. I appreciate that very eloquent example, because 
inclusion of abortion services will require millions of Americans just 
like the one that you spoke of, conscientious Americans who have deep 
convictions in this area, and it will make them really participate in 
an act they find morally objectionable, and I think it is a tragedy 
that such a thing would be included.
  Mr. BUYER. I noticed that the Senate Finance Committee had passed 
what they call a conscience clause, and to try to take the place of 
those out there in America who are uncomfortable with having to provide 
abortions, but really you have to play this out here even much further.
  If you have a Catholic hospital out there that says, ``We do not want 
abortions at our Catholic hospital, we do not believe in abortions,'' 
but they as a hospital and as an institution will be required to 
provide abortions in this minimum-benefit package for their employees, 
so the conscience can only go so far, because the Government will step 
in and say, ``I do not care how you feel. We know what is best for you, 
America.''
  Mr. HUTCHINSON. I appreciate that example, and you are so right. I 
could give many examples.
  For instance, a person who works in the VA health system, who has a 
moral, sincere objection to the practice of abortion, who may have 
spent a lifetime serving our veterans in the veterans' health care 
system, under the Clinton health care plan would be required to 
participate in the practice of abortion in that VA hospital, and I tell 
you that that would be replayed over and over again.
  We could give many other examples. Let me just say this: This plan is 
not only going to ration health care, it is not only going to require 
Americans to violate their conscience, but it is going to hit middle-
class families, and our colleagues spoke so much about the middle 
class, but according to the Lewin-V.H.I. study, almost 50 percent of 
American households are going to pay more under the Clinton health 
care, the Government-run health care system, and 61 percent of those 
families are going to pay over $500 a year more, and that is the middle 
class. They are going to be impacted negatively. They are going to pay 
more, and those who do not pay more may actually end up with less 
coverage than they have under their current plans.

                              {time}  2050

  I believe that Government health care is Government-assisted suicide 
for the best quality health care system in the world.
  Mr. BUYER. I thank the gentleman for his contributions, a statement 
well-said.
  I now yield to my good colleague, the gentleman from the State of 
Illinois, from the 15th District of Illinois. He and I share some 
contiguous counties along the border with Illinois in that good 
farmland called Brookston Home.
  Mr. EWING. I thank the gentleman for yielding to me.
  Madam Speaker, we certainly do share a common heritage along the 
Illinois-Indiana line.
  Madam Speaker, I think we probably learn a lot from the people we 
represent. I was really moved by Congressman Hutchinson's comments 
about his mother. All of us who have older members in our families 
realize how important this is, very personal, how important it is to us 
as well as to all of our constituents.
  I think you may know that I travel home almost every weekend, as 
other Members, as the gentleman from Indiana does, and I visit with our 
constituents. I would hope that every Member on the other side of the 
aisle would take a little time to go home and listen and visit on the 
very personal basis with members or people they represent about the 
health care issue.
  I think it is great when I go home to go into the restaurants and sit 
around the round table and talk to the farmers and business people and 
just-retired individuals. They are asking me some questions.
  They are saying to me, ``Are you going to have a recess? I see in the 
paper here, on the television, they may cancel the recess and stay in 
Washington and do the health care bill.'' My response to them is, ``The 
recess does not matter. When we come home, we are going to work 
anyway.''
  But we can stay in Washington and work. But the thing I do not want 
to do is stay in Washington until the leadership on the Democrat side 
of the House and the Democrat leadership in the Senate come together 
with a little plan and then drop it here on these tables maybe 24 
hours, if that much, before they expect us to vote on it; and have it 
bulldozed through, using the recess as a reason to do that, to force a 
vote, because what we do here will last maybe for years. Its effects 
may go on and on.
  So I think that question is easily answered. We should go home in the 
recess and listen to our constituents. If there is a plan from this 
side of the aisle, as vacant as it is tonight, we need to take that 
plan home and, as one of our colleagues said earlier, we should have 
hearings, we should have discussion. The American people should know 
what is in that plan.
  Then I was asked the question: ``Do you think that Congress can pass 
a plan before the election?'' My response to that is: ``We would be 
better not to pass a plan than to pass a bad plan.''
  Well, they said, ``Are the Republicans, do they have any proposals?'' 
Then I named a few. I named also some bipartisan proposals that many of 
us may be on. I named proposals that we on this side of the aisle have 
put forth. Yes, we have proposals.
  Compromise comes, I believe, when both sides address the issues that 
you can agree upon.
  Mr. SMITH of Michigan. I would like to mention the House Republican 
proposal now has 141 cosponsors. It is more than any other plan, 
including the President's plan. That is 80 percent of the House 
Republicans ready to move forward. Republicans are saying let us move 
ahead, let us do something. But the concentration is to improve 
accessibility, to improve portability, and to reduce cost of health 
care. We can do it. Both sides of the aisle know how to do it. I say 
let us not be blackmailed by a President that says either we go to 
socialized medicine or we do nothing.
  Mr. EWING. I think the gentleman is absolutely right. There is the 
Rowland-Bilirakis bill, a Democrat-sponsored and a Republican-
sponsored, bipartisan. There is much good in that plan that we should 
be debating and talking about.
  If there is one thing I want to say, if I bring anything to this 
debate tonight, which I think is very well planned, it is that the 
American people deserve a chance to see what we are going to pass on 
their behalf, if we pass anything.
  They have and should have an opportunity to visit with us, their 
elected Representatives, about it. Today there was one final thing that 
came down today from the courts. It is very important in this regard. 
Today in Federal court, Judge Royce Lamberth ordered that case against 
Hillary Rodham Clinton and the White House health care task force must 
go to trial. A great victory for the American people. This is a victory 
because this is going to allow the American people to know who are the 
donors, who are the people sponsoring the First Lady's health care 
plan.

  Before, you know, that was all kept secret from the American people. 
``They don't have any right to know who the special interests are 
behind the First Lady's health care plan.''
  All health care bills will now be written by the Democratic 
leadership on Capitol Hill, and are based on the Clinton plan. We have 
a right to know who is sponsoring it, who is footing the bill, who are 
the main players.
  I think it is a great victory for the American people.
  With that I say let us all dedicate ourselves to working to be sure 
the American people do know what is in the health care plan. Again I 
congratulate you for this effort today.
  Mr. BUYER. Reclaiming my time, I thank the gentleman for his 
contribution. I think we have had an excellent discussion tonight about 
what happens when the Government takes over health care. When we talk 
about a global budget, a global budget is a set amount spent on health 
care for America. That includes our advanced medical technologies, 
which means that when you dull the competitive edge of the advanced 
medical technologies, it has an impact upon the American family that 
will be detrimental.
  The gentleman from Arkansas [Mr. Hutchinson] was very close when he 
started to talk about quality-of-life issues, when he was talking about 
the rationing of care, and the impact of a Government-run system has on 
the quality of health care.
  Madam Speaker, I have 16 hospitals in my congressional district in 
Indiana. I have toured 15 of those hospitals. I have also toured Riley 
Hospital in Indianapolis, IN. Riley Hospital is a magnificent 
children's hospital. It is the only place in the world where I have 
ever been where I have seen more children who are ailing, who are 
dying, who are burned, who are crippled, who are diseased, who are very 
sick. But there is an incredible sense and feeling of hope inside that 
children's hospital, probably similar to other children's hospitals in 
America. Why is it these children have so much hope? Why is it the 
parents and the grandparents and the families and the friends also have 
that sensation and feeling of hope that you find in the children's 
hospital? It is because we understand the cutting edge of our advanced 
medical technologies and what they can do, the miracles and cures that 
we can deliver today. Why we would ever want to dull that is beyond me.
  I found myself standing inside the neonatal ward with Dean Daly. He 
is the dean of the medical university. We were surrounded by 50 infant 
babies. That is what I call them, infant babies. The doctor calls them 
neonates. That is the first time in my life I have ever seen a human 
being whose weight was measured in grams.
  The baby was a little more than 4 months old. There were many of 
them.
  I turned to the dean and I said, ``Dean, close your eyes. Now put 
yourself in Canada. Now open your eyes. Would we see this? Would we see 
it?'' I looked down at the end and I saw a family, and I know that they 
could not have afforded the medical treatment. I asked the dean, I 
said, ``Dean, what does this cost?'' And he said, ``It is costing 
approximately $1,500 a day on Medicaid.''
  Now let us be very raw here for a moment. This is not what is not 
being talked about in the health care debate, or the quality-of-life 
and value-of-life issues.
  Now, think about this for a moment. Let us be raw. Here in America we 
say that a mother, if she chooses, she can either give life or take 
life.

                              {time}  2100

  If she chooses life, we, as a society, will expend up to $1,500 a 
day, or more, until that child reaches a viable state where that baby 
can be brought home with mom and dad.
  Now let us go to the other end of life's spectrum, to senior 
citizens. We, as a society, again place such a value on life that, when 
we say that that senior citizen, if they choose, or it does not have to 
be a senior citizen, it can be anybody in our society above the age of 
18, if they say, ``I don't want to be hooked up on life support 
system,'' they can choose what we call death with dignity, execute a 
living will. But if they elect to be hooked up to a life support 
system, we, as a society, will pay for that. That is what we do today. 
Those decisions are made by our families.
  I say, ``America, if you want the Government to take those decisions 
from you and away from your family, and allow the Government and a 
system of accountants and lawyers to make those decisions for you, then 
just tell us. Just say to the United States Congress, `We want the 
Government to take over the health care system. We want everybody in 
America to have the same type of health care.' Just tell us.''
  I do not think America is prepared for that.
  I yield to the gentleman from Michigan.
  Mr. SMITH of Michigan. Madam Speaker, I think it is a point that we 
need to say over and over again to the American people: ``What sector 
of Government that you know does an outstanding and an excellent job of 
performing that particular duty?''
  Mrs. Clinton and the President have suggested that, if we pass their 
plan, it is going to take 50,000 new Government employees to run this 
system, and Government really has not done that good a job on so many 
things we have been doing. As the rest of the world goes away from a 
strong centralized Government controlling the lives and taking away our 
freedoms, here we are going and telling, suggesting, that we take over 
17 percent of the private sector economy, and we have Government take 
over health care when they really do not have a proven track record of 
doing many other things very well.
  What it is is a transfer of wealth. It is a transfer of wealth like 
we talked about, from small business to big business. It is a transfer 
of wealth from the young to the old. As Government gets in trouble, if 
they take over this system, they will continue to tax the young people 
to pay for the people that need greater health care costs at their 
older age with some kind of an elusive promise such as we are now doing 
in Social Security that says, ``Look, when you get old, we'll somehow 
tax those that are left working enough to pay for your Social Security 
and, in this case, your health care.''
  I plead with those people in America to not let this go by, to study 
the details, to consider the consequences, because the Government 
taking over health care in America is going to put middle class America 
dependent upon Government, and Government, as they go about trying to 
save money, they are going to pass all kinds of mandates and dictates 
on how we can run our personal lives.
  Mr. BUYER. Madam Speaker, I thank the gentleman from Michigan [Mr. 
Smith].
  We can even take this to the personal level. It is easy to stand here 
and talk about what it is going to do to quality. Let me share with my 
colleagues and America that I was deeply moved at a visit of a young 
family farmer from my district. I think that all of us here that sit in 
this body seek to be responsible and responsive to the people that 
elected us to this body. I do not question the sincerity of those who 
believe that Government is the answer. I do not question their 
sincerity because they firmly believe that. I think they are wrong, but 
I do not question their sincerity.
  I will never forget going to the home of a young farmer. This 
gentleman fell from the inside of a silo to the bottom, and I visited 
his house. He is now paralyzed from the neck down. He was there at the 
kitchen table in a wheel chair, and he can only now move forward or 
backward, right to left, by a straw that goes into his mouth by either 
sucking or blowing.
  Now he is one of the most courageous individuals I have met. His 
young son was bouncing a balloon off the wall up in the ceiling and 
bouncing it toward his father with no understanding why dad this time 
does not bounce the balloon back to him.
  My colleagues, this young farmer only had one message for this 
Congressman who sat at his table in his home. His request to me was: 
``Please do not let the Government take over health care because I 
understand that it will dull the advance of medical technologies,'' 
because he said his hope was that he might heal one day which rests in 
our advanced medical technologies. He understands that. He, of anyone, 
understands that.

  Let me comment on some other people in Indiana.
  On the issues that were discussed here tonight, whether it was 
abortion, or increasing taxes for health care, I recently had sent out 
a questionnaire back in Indiana. It was very interesting. I have now 
received over 5,000 responses in Indiana.
  The first question was: ``Do you favor increased taxes to pay for 
federally mandated universal health care?''
  Overwhelmingly, of the 5,000, only 498 said yes; 4,479 said no to 
increased taxes.
  The second question: ``Should abortions be included as part of an 
overall health care coverage for all Americans?''
  Of the 5,000 responses, Madam Speaker, 625 said yes; 4,370 said no to 
abortions in health care.
  On the issues of the impact on the small business sector that the 
gentleman from Texas [Mr. DeLay] and the gentleman from Michigan [Mr. 
Smith] spoke about here tonight, let me share with my colleagues some 
comments from a health care questionnaire from Indiana. One is an 
individual, a small business person, from Williamsport, IN. They say:

       We are a family owned business. It would be a financial 
     hardship, and I would have to evaluate whether or not I can 
     stay in business if the government would force me to pay for 
     health care. A small company such as ours doesn't net very 
     much, but we provide jobs which helps the local economy. 
     Unexpected expenses could be major problems for us. If the 
     government determines the cost of business such as ours, the 
     amount is apt to be unrealistic. I don't believe they know 
     what small really is.

  Another small business in Demotte, IN. This small businessman writes:

       We are a family owned feed business employing 14 people 
     that is celebrating 40 years of business this year. Our dad 
     taught us to manage funds carefully and grow in the free 
     enterprise system. Frankly it scares me to see the government 
     getting involved in health care reform because the costs 
     always exceed the benefits. Our government just cannot 
     operate as sufficiently as the private sector. Having said 
     that, we feel it would be best to let the market adjust to 
     health care as it is already doing.

  I partly agree with the gentleman. I think there are things we can do 
right now, but not let the Government take over the health care system.
  Another gentleman writes from Kokomo, IN:

       Any employer mandate or mandate to force me into cover 
     health insurance costs for my employees will result in nine 
     unemployed people. If the government is so concerned about 
     their needs, then they can take care of them. There are nine 
     employees, seven wives and seven children.

  I mean the list goes on, and on, and on. I think what is important 
though is in this health care debate, and what is real is that there 
are many different plans out there.
  But what is pragmatic, my colleagues, is that I do not control the 
process here in the Congress. The process inside the Congress is not 
controlled by conservative Democrats either. It is controlled by the 
liberal side of the Democrat Party and their goal as a single payer 
plan for America, and they want it. They want it. It was Senator Jay 
Rockefeller who said that we are going to pass health care reform 
whether the American people want it or not. That is his quote.
  Now, Madam Speaker, when they say, ``National health care reform,'' 
what they mean is government controls of health care. When 
conservatives say, ``National health care reform,'' we are talking 
about incremental reforms to the present system to provide access. That 
is what we want to do, and the American people deserve no less than to 
have the opportunity to review a health care plan, not a plan that is 
drafted in the back rooms of this Congress. So, if a plan is drafted in 
the back rooms, demand an opportunity to see it, and that is what we 
will do.

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