[Congressional Record Volume 140, Number 108 (Monday, August 8, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 8, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
         SUBSTANCE AND PROCEDURE IN THE HEALTH AND CRIME BILLS

  The SPEAKER pro tempore (Ms. Schenk). Under the Speaker's announced 
policy of February 11, 1994, and June 10, 1994, the gentleman from 
Georgia [Mr. Gingrich] is recognized for 45 minutes as the designee of 
the minority leader.
  Mr. GINGRICH. Madam Speaker, I want to talk tonight about 
representative government and the health reform process and tie it into 
what I think is a growing problem in the Congress and a growing reason 
why so many people favor term limits and so many people are mad at the 
Congress.
  Madam Speaker, we are watching two bills move through the House and 
Senate right now, the crime bill and the health bill, and they both 
have problems, not just of substance, but of procedure, and I think the 
American people need to be aware of what is happening in Washington and 
of why it is important in understanding the decay of trust in American 
government and the decay of faith in our system of representation, and 
I think it strikes directly at the quality of the health bill that may 
be written this fall.

  Now health is an unusual issue because it affects life and death for 
every American and because it affects 14 percent of our total economy. 
There is no single issue that affects that scale of change. In fact, if 
you look at the defense budget, for example, the defense budget today 
is about one-fourth or less than one-fourth as important as the health 
issue in terms of economic terms. But health is even more important 
than the money involved, although that is massive. Health is important 
because it comes down to a question of:
  ``What control do you have over your life?''
  ``Will you be able to choose your doctor?''
  ``Will you have some control over the hospital you go to?''
  ``Or will the Government gradually take over control of your 
health?''
  ``Will you gradually go to rationing like they now have in Canada and 
in Britain?''
  ``Will you gradually find yourself in a situation where your taxes go 
up while your health services go down?''
  Madam Speaker, the longer people have had a chance to look at the 
Clinton administration's original plans, the more unpopular they have 
gotten. The more unpopular the original plans have gotten, the more the 
Democratic leadership has tried to write new bills, and there is a 
dance that we go through:'
  Somebody holds a press conference. They announce a new bill. It is 
reported favorably in the news media. Then somebody starts to read the 
bill. Then they begin to realize it is not very good. Then they realize 
it will raise taxes. Then they realize it creates a bigger bureaucracy. 
Then people begin to say, ``I don't like that one either,'' and then it 
is time for somebody to introduce a new bill.
  Now the two most recent examples of that are the Clinton-Gephardt 
bill here in the House and the Clinton-Mitchell bill in the Senate, 
and, when we look at those two bills, and they are very, very 
different, it is surprising this late in the year to see the Democratic 
leadership in the House moving toward a Medicare Part C directly 
Government provided health care system that might well have as much as 
half the country having their health care coming directly from the 
Government, and to see the Democratic leadership in the Senate moving 
toward a very different version that does not have as much government, 
but uses the Government to set up mandatory alliances and other 
controls--so they are dramatically different bills. They are not very 
compatible at all. They are each written, not to deal with health care, 
but to deal with the reality of the votes in the House and the reality 
of the votes in the Senate.
  Madam Speaker, it is very clear that, if the Clinton-Gephardt bill 
were introduced in the Senate, it could not pass. It is equally clear 
that, if the Clinton-Mitchell bill were introduced in the House, that 
probably the left wing of the Democratic Party over here would leave it 
because they are further to the left by a big margin than the Clinton-
Mitchell bill. So, it could not pass here.
  So, Madam Speaker, I say, ``If you're a voter, you might say to 
yourself, `Gee, if they are introducing one bill in the Senate and a 
different bill in the House, then what's my final health bill going to 
look like in September or early October? This is, after all, not very 
far away.'''
  The fact is, and it was indicated clearly by Senator Jay Rockefeller 
the other night on Mary Matalin's show on CNBC, it was hinted at by 
the President in his press conference last week, there is going to be a 
serious effort to write a totally different bill in the conference 
committee, so what will happen is, if the Clinton-Gephardt bill leaves 
the House, and the Clinton-Mitchell bill leaves the Senate, when they 
get to conference, then the people who are in charge of the Congress, 
the Democratic leaders, will set up a special conference committee made 
up only of people that they trust, willing to write a left wing bill 
that fits the Clinton plan, to report it back out at the last possible 
minute, to say to House and Senate Democrats, ``You have to pass this 
before the election. You can't go home with nothing passed.''

  Now, Madam Speaker, you may say why am I so suspicious. Well, let me 
turn just for a minute to the crime bill.
  Many people saw last week that the crime bill was completed in 
conference, but that is not really technically quite true. The fact is, 
as of tonight, no crime bill has been reported yet. The fact is that no 
Member, except maybe one or two of the senior Democrats, has seen the 
language of the crime bill. In fact, I have here some draft language 
which is all we have been able to get hold of, and it is very 
interesting. On pages 226 to 228 of this draft language it describes a 
brand new program to be set up by the Federal Government in the 
congressional district of one of the Democratic leaders. But at the 
very end it says, ``How much money will they get?'' And then there are 
blank lines with no numbers in them.
  Now this is all we have available as of today. Although supposedly 
the crime bill was finished last week, as of this afternoon the 
Republican leadership still cannot get the exact language. But, while 
no Member of Congress on the Republican side, and my guess is, except 
for one or two of the senior Democrats, none of the Democrats have seen 
it; there is a school in that Democratic leader's district which has 
already issued a press release. This was for immediate release Friday, 
July 29.
  That is right. On July 29 this college issued a press release 
thanking their Congressman, who is a Democratic leader, for giving them 
$10 million to spend on research and education. Now this is: ``The 
largest single designation of Federal funding'' in that university's 
history.''
  Now notice what is going on here. Here is a powerful Democrat writing 
into a bill a provision which no Member of Congress has yet seen to 
take care of one of his home town universities, and that university 
actually knows about it and releases a press release on it before the 
conference report is finished and before it is even brought to the 
House floor.
  But it gets better. I was told this afternoon by two Members that 
they have been approached by a member of the Democratic leadership who 
has said to them that they could rewrite part of the conference if that 
is what it took to get their vote on the rule. The way it works: ``You 
have to bring the conference back out, and, because it has some things 
in it that weren't there when it left the House, you have to pass what 
is called a rule before you can even get to the conference. It sets up 
in effect the rules of the game to bring the bill to the floor.''
  Right now, Madam Speaker, the Democratic leadership does not have the 
votes to bring the rule to the floor, so two Members were told here 
today that the conference is not quite finished, even though it is 
finished, and it is still open to be rewritten, and what will it take 
to get their vote, and in effect they are told they are going to have 
special access to write another part of the bill to fit their 
particular interests before the bill is even finished, even though we 
were told a week ago the bill is finished.
  Now one may say, ``What does that have to do with health care?''
  Well, in the Senate the Senate Finance Committee wrote a bill. We all 
watched them on July 2. And yet they did not write a bill. They wrote a 
set of proposals. And at the end of their proposals they passed it. But 
there was no bill written. And then, over the following 3\1/2\ weeks, 
the staff wrote the bill, and then some of the Senators found out that 
the bill the staff wrote was not the same as the bill the Senators 
voted for. But they were told, since all they voted for was an outline, 
that that was a tough break, this was now the bill.
  Now why is this important? I say to my colleagues, ``Well, guess 
what? When you, the American citizen, goes to court because you 
violated the law, and you're about to get fined, and Senator Mitchell 
has lots of fines in his bill, and you're about to be fined, you're not 
going to have the defense of saying, `Gee, this wasn't in the bill they 
agreed to; it was in the bill they wrote,' because the bill that 
finally gets written by the staff is the bill that can send you to 
jail, or the bill that can raise your taxes, or the bill that can cut 
off your kidney dialysis, or the bill that can eliminate your 
chemotherapy if you have cancer.''

                              {time}  1910

  What we have seen happening is a decay of the process, that over 
time, year by year, month after month, the system has just gotten worse 
and worse.
  Now, this is described in today's Roll Call in a column ``Whitewater 
Hearings Made Effective Case for Term Limitations'' by Charles Cook, 
who says:

       I'm not a big fan of term limitations, but after watching 
     the House Committee on Banking, Finance and Urban Affairs' 
     Whitewater hearings, I'm reconsidering my position.

  He went on to say,

       * * * the performance by Chairman Henry Gonzalez was an 
     embarrassment to the institution of Congress, and his 
     Democratic colleagues were only marginally better. No 
     Republican has ever made a better case for the problem with 
     one party staying in control of a legislative body than did 
     Gonalez and the Banking Committee Democrats.
       The arrogance of power exemplified by House Democrats in 
     the hearings was unlike anything I've ever seen in more than 
     two decades in Washington.

  Let me go repeat this one sentence by Charles Cook in Roll Call today 
because it so fits what I think you are going to see on the health 
bill. ``The arrogance of power exemplified by House Democrats in the 
hearings was unlike anything I've ever seen in more than two decades in 
Washington.''
  Cook goes on to say, ``* * * roughshod tactics that are commonplace 
in the House * * *.
  ``In the House, where Democrats seem to believe that they have 
control by some kind of divine right, committee ratios, staffing 
allotments, and closed rules are all evidence of this kind of 
behavior,''
  Now, why does the arrogance of power matter? It matters because when 
one party has been in charge for 40 years, as the Democrats have been, 
their leadership begins to think they can get away with anything, that 
they can do anything they want to, that it does not matter whether or 
not they break the rules or whether or not they, in fact, simply design 
for themselves the rule they want without any regard to what people 
think.
  I was really struck with this in looking at Health News Daily from 
August 5th. Again, I want to try to explain why these rules are so 
important.
  Imagine a baseball game where one team got seven strikes and you are 
out, and the other team got one strike and you are out. One team when 
it hit the ball out of the park, it was a home run, and the other, an 
automatic out. You begin to understand how the Democratic machine rigs 
the game here.
  We have a chance in the next few days to have a very serious series 
of votes on health care that will change the health care of all 
Americans. There will be a Republican alternative, which I am going to 
fight for and which we are very proud of that we have worked on for 
3\1/2\ years now. There will probably be a bipartisan bill, and there 
will be a Democratic alternative.
  There is a procedure called king-of-the-hill which says every vote 
can be a yes vote, but the last yes matters. So if you are the 
Democratic leadership, what you do is you set up the bills and you say 
to your Members, vote for anything you want to, but when you get to the 
last one, vote for ours.
  So the Clinton-Gephardt bill, if the Democratic machine has its way, 
will have the last vote.
  The Speaker was asked, apparently, in his August 4 press briefing, 
what about setting up a rule that would allow the bill gaining the most 
votes to prevail?
  Let me repeat this, because it is so American and makes so much sense 
to normal people that you have to understand how weird Washington has 
gotten and understand how out of touch with most of America the 
Democratic machine has gotten.
  Imagine the concept we are going to have four different bills 
offered, a single payer bill, a Republican bill, a bipartisan bill, and 
the Clinton-Gephardt bill. Imagine that one of them gets 240 votes, but 
it is not the Clinton-Gephardt. The Clinton-Gephardt bill gets 218 
votes, which is an exact majority.
  In most of America, if I showed you two ideas and said this one got 
240 and this one got 218, you would say, gee, I guess that means the 
240 won. Not if you are the Democratic machine and you can rig the 
rule. Because what you do is you set it up so the last item voted on 
wins. No matter how small its margin, and no mater how big the margin. 
If 300 Members voted for an earlier bill, they would still lose if they 
could get 218 to vote at the very end.
  Now, that sounds complicated, and you say why are we paying attention 
to it? Because all too often setting up the rules of the game determine 
who wins. You can rig the game. If I say let's play cards, and then I 
stack the deck, every American understands what just happened. You are 
not going to play a fair game, you are going to lose.
  What the Democratic machine is saying is that they want to set up the 
game so that their bill comes last, and no matter how few votes it 
gets, even if another bill gets 20 or 30 or 40 more votes, their bill 
would still win at the very end.
  They have another item, and, by the way, just so you know I am not 
exaggerating, this is a direct quote from Health News Daily, ``The 
House Speaker dismissed the possibility of crafting a rule for floor 
debate that would allow the bill gaining the most votes to prevail. 
Such a procedure would set a terrible precedent, he said.''
  Imagine the terrible precedent of allowing the bill with the most 
votes to win. Now, if that doesn't sound close to being at odds with 
everything every child and every first-grader in America starts to 
learn about how we govern America. Can you imagine trying to say that 
oh, no, you didn't win, you just got the most votes. It doesn't make 
any sense. Yet the Democratic machine cannot afford to come to the 
floor with a fair rule.
  But let me carry it a step forward further. There is a danger, and I 
have asked Mr. Moakley, the Democratic Rules chairman today, and he 
indicated he would not favor this, but there is a danger, I just want 
to warn my colleagues and the country, that we could have a system 
where the last day, next Friday, at the last minute, because the 
Clinton-Gephardt bill is losing, there would be an effort to come in 
and introduce a whole new amendment, maybe an entire substitute, as a 
so-called friendly amendment, with no Members having read it, no staff 
having looked at it, no experts having analyzed it, and, at the last 
second, change things.
  I hope in the next day to get a plain, flat commitment from the 
Speaker and majority leader that they would not consider that kind of a 
deal. But I am very worried that if they discover that an earlier bill 
could absolutely get a majority, and they were in danger of losing the 
Clinton-Gephardt bill, that they would offer something radically 
different.
  Now, you might be saying to yourself, why is there so much pressure? 
You have to understand, first of all, from the standpoint of the 
Democratic machine, the American people are too far to the right. The 
American people do not want the things the Democratic machine wants. 
And this is explained in a whole series of recent articles and 
editorials. Let me just quote a couple of them.
  George Will, in a column in the Washington Post yesterday, entitled 
``Political Woodstock''. The subhead was, ``Clinton's health care 
proposal now looks like an exercise in nostalgia.''
  He starts by saying, ``For President Clinton, life of late has been 
all Lent and no Easter, and last week echoes of events 30 and 25 years 
ago underscored his problems. The man who campaigned as the candidate 
of change seems uncomprehending of changes pertinent to governing. The 
man who pledged to make change our friend and not our enemy is finding 
that changes in public attitudes are unfriendly to his agenda.''
  He says the following, and this is George Will: ``In 1950, a median 
income family of four paid only about 2 percent of its income in 
Federal taxes, compared with about 25 percent today.'' Let me repeat 
this from George Will, because I think it begins to help people 
understand why many of us do not want the Federal Government to get 
bigger, and why we believe that government is already too big and 
already spends too much.
  ``In 1950 a median income family of our paid only about 2 percent of 
its income in Federal taxes, compared with about 25 percent today. 
Clinton's health care proposal reveals him to be oblivious to changes 
that have occurred in his lifetime concerning Government's prestige and 
burdensomeness, the former crashing, the latter soaring. For a 
perspective, considering in 1958, when Clinton was 12, a Gallup Poll 
showed that only 12 percent of Americans thought Congress was doing a 
poor job. Long before the Second World War, Americans were remarkably 
ready to concentrate power in new government agencies that Americans 
believed would wield power wisely for long-term planning. For example, 
regional problems produced such bold improvisations as the New York 
Port Authority in 1921, the Colorado River Compact in 1922, the 
Tennessee Valley Authority in 1933. Today, even if our solicitude for 
snail darters and spotted owls were compatible with such projects, our 
reduced confidence in government is not. This helps to explain the 
faith of Clinton's health proposal which his aides, recalling the 
Government friendly 1930's, have advertised as the Social Security of 
the 1990's. His proposal now looks like a political version of a 
Woodstock revival that no one wants, an exercise in nostalgia not 
widely felt, an attempt to revive a vanished and irrecoverable 
political past. Nostalgia is often a yearning for childhood, the years 
of fairy tales. ``The essence of a fairy tale,'' writes literary critic 
Cynthia Ozick, ``is that wishing does make it so. The wish achieves its 
own fulfillment through its very steadfastness of desire.''

                              {time}  1920

  Will's point is that proposing a giant government health program like 
Medicare part C, which is in the Clinton-Gephardt bill, is an exercise 
in a government that is gone. Boris Yeltsin is going to visit 
Washington on September 26 and September 27. Are we going to say to 
him, build a bigger government; hire more bureaucrats; create more 
taxes?
  No, we are going to say to him, decentralize. Shrink your government. 
Get rid of your bureaucrats. Open up your marketplace. Encourage 
incentives. Lower you tax rate.
  And it would be marvelous if we could get the very Democratic 
leadership that is going to preach all that to Boris Yeltsin to apply 
it here to America. Because the truth is, all over the world the 
information revolution is forcing us to shrink government, to recognize 
that we need to do more things in the private sector, to recognize that 
bureaucracies do not work and the government spends too much. Yet, the 
Clinton administration's passion for government is unending. It is a 
disaster.
  Let me quote a recent column by Charles Krauthammer:

       Vaccines for Children: Preview of Clinton Care.
       Months into the great health care debates, it remains 
     enveloped in a fog of unreality. Everyone has a preferred 
     plan complete with a finely-drawn schematic diagram and no 
     idea how it will turn out in real life.

  Let me repeat that. No idea how it will turn out in real life. 
Krauthammer's phrase is the perfect description of the 
Mitchell bill. There is no one in America, not Senator Kennedy, not the 
Kennedy staff which wrote the bill, not Senator Mitchell, not President 
Clinton, there is no one in America who has a clue what health care 
would look like under the Mitchell bill, because it has 17 new taxes 
and 25 new government agencies. We have some idea how America would 
look under the Clinton-Gephardt Medicare part C, because it would look 
like the Canadian plan, more rationing, higher taxes, bigger 
bureaucracy, less health care, but no one has a clue what the Mitchell 
plan would do.
  Krauthammer continues:

       Those opposing Clinton's nationalization plan like to say 
     that if you like how government runs the post office, you'll 
     love what they'll do to health care. But that is comparing 
     apples and oranges, say the plan's defenders. Okay, then 
     let's compare apples and apples. One Clinton health care 
     program has already been enacted: the Vaccines for Children 
     (VFC) initiative passed last year to guarantee universal 
     access to vaccination.
       Clinton identified the social problem: the scandalous 
     undervaccination of American children under 2 years of age. 
     He identified the principal cause: drug companies engaged in 
     ``unconscionable'' profiteering on vaccine prices. And he 
     identified the cure: government--which would abolish the 
     corrupted market, buy up all the vaccine and distribute it 
     free to every child in America.
       It was pointed out that because much of this free vaccine 
     would go to middle-class people who already pay for theirs, 
     this would be yet another unnecessary and expensive 
     government service. So Clinton compromised. The government 
     would buy a third of the national supply, package it, house 
     it and distribute it starting Oct. 1, 1994, to every child 
     who needs it.
       That was the promise. Even then, however, some were 
     skeptical. Sen. Nancy Kassebaum (R-Kan.) warned at the time 
     that the reason for our low immunization rates was not the 
     cost of vaccine but that ``too many parents do not know the 
     value of immunizations.'' Or, as one local physician put it, 
     ``Vaccines are available. The problem is the kids are not 
     available.''
       Proof of the proposition that the problem is not high cost 
     but neglectful parents is this fact: While barely more than 
     half of American 2-year-olds are fully immunized, 96 percent 
     of 5-year-olds are. Why? Because 5-year-olds cannot get into 
     kindergarten unless they are immunized. That seems to 
     concentrate the minds of the parents on the need for 
     vaccination.
       Moreover, poor people have the worst vaccination rates, and 
     for them vaccine is already free. Which is why Kassebaum last 
     year suggested a more modest program: With the president's 
     proposed $1 billion for federal purchase and distribution of 
     free vaccines, we could triple the number of community health 
     clinics, substantially increase the number of children 
     getting immunizations under Medicaid and boost Medicaid 
     payment rates to encourage private physicians to give the 
     shots to poor kids.
       Sensible, but of little appeal to Clintonian social 
     engineers, for whom health care, like other social problems, 
     is best handled by a revolutionary program that nationalizes 
     the issue and gives control to a benevolent federal 
     bureaucracy.
       And how has the federal bureaucracy done with this 
     microcosm of Clintoncare? The General Accounting Office, the 
     congressional investigative agency, last week issued a 
     progress report. It found the administration (1) way behind 
     in letting purchase contracts, (2) unprepared to evaluate 
     whether the system could efficiently process orders from the 
     70,000 doctors and clinics that will get the stuff, (3) 
     unprepared to adequately test whether its packaging and 
     delivery system would retain vaccine potency. (Vaccines 
     require very strict temperature control.)
       The plan has two basic problems, familiar to any student of 
     the Soviet five-year plan system: centralization and 
     bureaucratization. One-third of the country's vaccine supply 
     is to be sent to a single distribution point, a General 
     Services Administration (GSA) warehouse in New Jersey that 
     stores paper clips and flammable paint solvents among other 
     bric-a-brac. It is entrusted, notes Democratic Sen. Dale 
     Bumpers, to an agency that has never shipped a dose of 
     vaccine in its history and must now care for 30 percent of 
     the entire nation's supply.
       And centralization begets bureaucratization. Currently, 
     when a doctor needs more vaccine he contacts the manufacturer 
     to get it. Under the administration's ``disastrously flawed'' 
     plan, says Bumpers, the doctor will have to go through a long 
     series of transactions before the actual order is packaged 
     and sent out by GSA.
       As the British learned to their chagrin after World War II, 
     nationalization schemes suffer much in the passage from the 
     mind of the social engineer to the hands of the bureaucrat. 
     On paper, VFC looks good. Universal vaccination of toddlers, 
     like universal health care, sounds wonderful, energetic, 
     Rooseveltian. Who could be against it?
       Yet in practice things turn out differently. In conclusion, 
     says the GAO, our review indicates that it is unlikely that 
     [the government] can fully implement the VFC Program by 
     October 1, 1994, and raises questions about whether VFC, when 
     fully implemented, can be expected to substantially raise 
     vaccination rates. Translation from the polite: They can't do 
     it, and even if they can, it won't make a dime's worth of 
     difference.
       But as with most great government failures, who will know? 
     GAO notes that the VFC program neglects to collect baseline 
     data, so that evaluating its effectiveness will be difficult. 
     In the end we may be unable to determine its impact on 
     vaccination rates.
       Which means that VFC will live forever. Even if it achieves 
     nothing in reality, we won't know. And who is going to vote 
     to kill something called Vaccines for Children?

  What is Krauthammer getting at? He is getting at the fact that up 
until a year ago, when the Clintons decided they would get involved, 
that we vaccinated most children at an early age and that we made 
available for free, through the local system, to any child who is poor, 
a vaccine. But in New York City, where vaccines are free, only 62 
percent of the children get vaccinated, 38 percent do not show up, even 
though they are free. Even though it is free, 38 percent do not get 
vaccinated.
  Now where are we? We are now going to spend a billion dollars of the 
American people's money, set up a central warehouse in New Jersey under 
the government, which I will guarantee you will at some point have a 
major disaster with a vaccine which will go bad while it is in 
Government control. We are going to increase the total amount of 
paperwork so it is harder to get the vaccines and, for a billion 
dollars we will accomplish nothing except to run the risk of having bad 
vaccines for the children.
  It is in this context of government programs failing, of government 
being too big and spending too much, that we have to look at the 
Clinton plan again.
  I want to recommend to every American the article in Newsweek this 
week by Robert Samuelson, entitled ``Will Reform Bankrupt Us?'' The 
subhead, ``Health Care, 65 percent of Americans say Congress should 
start over. Newsweek's economics columnist argues that they are 
right.''
  Let me just read you part of Samuelson's article because it is so 
devastating and explains why the Clinton-Gephardt and Clinton-Mitchell 
bills are exactly wrong.
  Quoting from Robert J. Samuelson:

       President Clinton is right about the historic opportunity 
     and he blew it. Somewhere along the way the health care 
     debate took a decisive turn toward fantasy. The idea of 
     controlling spending got lost and in its place the President 
     and First Lady became the single-minded champions of 
     universal coverage. By any standard, the debate on health 
     care legislation that opens in Congress this week is 
     momentous, but not in the way the first family says.
       If Congress passes sweeping health reform, as they urge, we 
     will have compounded all our long-term budget and economic 
     problems by force feeding the monster of health care 
     spending.
       Our whole politics will be transformed. Government will 
     instantly create hundreds of billions of dollars of health 
     care entitlements by dictating to business what benefits they 
     must provide for people under 65.
       These would exist almost entirely outside the Federal 
     budget, and could be quietly expanded as new medical 
     ``needs'' arose. Once this happened, older Americans would 
     become even more resistant to cuts in their own government 
     health programs, mainly Medicare and Medicaid. In a single 
     stroke, we would have made it vastly harder to curb runaway 
     health spending.
       It is controlling this spending--and not creating 
     ``universal coverage''--that is the overriding national 
     health problem. We already spend a seventh of our national 
     income on health care; present trends would take that to a 
     fifth sometime early in the next century. The spending 
     depresses take-home pay, squeezes many government programs--
     for schools, police, parks, space program, the military--and 
     contributes heavily to persisting Federal budget deficits. 
     Since 1970, Medicare and Medicaid have increased from 5 
     percent to 17 percent of Federal spending. As the baby boom 
     ages, all these pressures will intensify. Someone 65 has more 
     than four times the health cost of someone 25. By 2030, one 
     in five Americans will be 65 or older, up from one in eight 
     today. Health costs could absorb more than half the existing 
     Federal tax base.
       We are slowly surrendering our economy to health care--for 
     surprisingly modest gains in our health--what we needed was a 
     debate that confronted those relentless pressures. `The cost 
     control imperative has been lost,' says John Inglehart, 
     editor of the respected journal Health Affairs. Someday there 
     may be frightful economic consequences. Business groups 
     already say the costs of government-dictated benefits will 
     destroy jobs. Those would mount if health spending climbs and 
     the costs are imposed on business by fiat or payroll taxes. 
     Europe's experience is sobering. Since 1974, its unemployment 
     has risen from 3 to 11 percent, and private job growth has 
     been meager. High payroll taxes and required welfare benefits 
     are major causes.

                              {time}  1930

  Let me stop here for a second. Samuelson's point is that the cost of 
welfare and the cost of health care in Europe has raised the 
unemployment rate from 3 percentage points to 11 since 1974. Younger 
Europeans are finding it very, very hard to find jobs. If you had a 
similar increase of 8 percentage points in the United States it would 
go from 6 to 14 percentage points of unemployment over the next decade.
  When you start talking about this Congress dumping on the country a 
brand new giant burden by congressional fiat, the Clinton-Gephardt 
Medicare C plan, or the Clinton-Mitchell mandated plan, either one is 
designed to increase and will have the effect of increasing 
unemployment.
  Let me go back to quoting from Samuelson:

       Against this backdrop, the health-care debate has been an 
     exercise in popular delusion--a point apparently appreciated 
     by much of the public. In a Newsweek poll, 65 percent of 
     respondents say Congress should start over again next year. 
     The whole discussion has implied (misleadingly) that more and 
     more health care could be had for everyone, at little or no 
     extra cost, if simply the `right' reform were enacted.

  In the Newsweek poll they asked the following question: Should health 
care reform legislation be passed this year, or should Congress take 
more time to examine the various proposals and start over next year? In 
the latest Newsweek poll, August 4 and 5, 31 percent, pass reform this 
year; 65 percent, start over next year. You will notice, this is not a 
poll that Republicans took, this is a poll that Newsweek magazine took.
  Let me outline where we are at now. If Samuelson says that the debate 
is wrong, if George Will says that the Clinton health plan is dead, if 
Krauthammer points out that the first Clinton effort to nationalize 
health in vaccines is a total failure, why are we then talking about, 
in 12 days, trying to ram through a health bill?
  The reason is simple: The Democratic leadership believes that if they 
do not pass something this summer, that they are going to lose so many 
seats this fall in the House and Senate that they will never get to 
government-controlled medicine, so they think this is their high-water 
mark.
  The country, having looked at the Clinton plan, having looked at the 
idea of government-controlled health care, having looked at Medicare 
part B, does not particularly want it. The country recognizes 
intuitively what The Heritage Foundation reports, which is that 35 
States and the District of Columbia would experience increases in 
business costs under the Gephardt bill.
  The losers under the Gephardt bill are concentrated almost entirely 
in the South and the West. The biggest losers among States would be 
Texas, down $8 billion, Florida, down $6.1 billion, and Georgia, down 
$3.5 billion, in the South, and California, down $5.6 billion, in the 
West.
  I urge my colleagues to get a copy of this new Heritage study, which 
used a computer simulation to look at the cost to business of higher 
insurance and higher taxes under the Gephardt plan. Some fascinating 
numbers. It is The Heritage Foundation's estimate that in Texas, the 
Gephardt plan will cost $1,209 more per employee per year. In Florida, 
it is $1,165 per employee. In Georgia, it is $1,227.
  Interestingly, in Arkansas and Tennessee, where you would think that 
President Clinton and Vice President Gore would have sensitivity, 
Arkansas, the average worker in Arkansas will lose $1,099, and in 
Tennessee the number is $1,035. Maybe Vice President Gore was slightly 
more sensitive than President Clinton.
  You go through State after State. California would lose 
$5,697,000,000 according to this analysis. I recommend to every one of 
my colleagues, look carefully at your State and look for the losses in 
your State, and you are going to be astonished. In Minnesota, $453 per 
worker. In a couple of other States, Arizona, $1,076 per worker; in 
South Carolina, $1,115 per worker; in Louisiana, $1,073 per worker; in 
North Carolina, $1,083 per worker.
  Again, I have an interest. I represent Georgia, $1,227 per worker, 
$3.5 billion in added costs. Guess what, you start taking out that kind 
of money, you are either going to lay people off and increase 
unemployment, you are going to cut salaries, you are going to do 
something, but it is not just made up by politicians in Washington 
waving a magic wand and saying ``Let's pass it.''
  The reason I wanted to come tonight and talk about all of this on the 
floor of the House is that I have been very, very worried about what I 
see as a very inappropriate process that seems to be evolving. I 
noticed the President last week in his press conference said that as 
long as they got something out of the House and Senate, they could 
write something different in the conference. I noticed, as I said 
earlier, that Senator Jay Rockefeller had made the comment that as long 
as they got something out of the House and Senate, they would write 
something different in the conference.
  I think there is something wrong when the Democratic leadership, 
after 40 years of control, has to rig the rules to try to pass 
something because they cannot afford a straight, fair, honest, up-or-
down vote; when they have to start talking about stacking the 
conference so they can rewrite the bill in conference, to try to ram it 
through. I think it is very important that we insist on a slow, steady 
process.
  I have recommended over and over again--and I want to repeat it 
tonight because it is the right thing to do--what we ought to do is 
file our bills by Wednesday, indicate next week any amendments we need, 
or frankly, indicate by this Thursday or Friday any amendments we need, 
in writing, so everybody can study it, and then go home for 3 weeks, 
let every expert in the country read the bills, let the news media read 
the bills, let it be out in the open, let people back home talk to us. 
That is the purpose of having the August break, is to go home to let 
the American people talk to their Senators and talk to their House 
Members and have enough time to analyze these bills.
  The Mitchell bill, I am told, is 1,400 pages. We do not know yet how 
big the Gephardt bill is because it has not come in. Now, 1,400 pages 
to be analyzed hastily is crazy. As I said earlier, the crime 
conference report has not even been written yet. It is still floating 
out there, apparently available for rewrite, to get a few extra votes.
  That is just wrong. It is the wrong process for representative 
government; it is the wrong process for the American people; and in the 
long run it is part of why people are so much for term limits and so 
mad at Congress.
  Let me go one step further. I think it would be totally inappropriate 
to have a surprise amendment to the Clinton-Gephardt bill at the last 
minute to try to buy 10 or 15 more votes. We think you ought to have a 
straight, honest effort to do the best we can this year.
  I will say one other thing in closing. I would rather pass a small 
reform that everybody agrees is good and not do any damage. This is the 
best health care system in the world. Eighty-five percent of the 
American people already have health insurance. People from all over the 
world, when they have a serious disease, come to America for the best 
experts in the world.
  I would hate to see us, in order to make the Democratic machine 
comfortable, ram through a bill nobody understood that just tore apart 
what has been the finest health care system in the world. I would much 
rather take a limited bill, the Michel-Lott bill, for example, which 
has malpractice reform.
  The Michel-Lott bill, which is the Republican alternative, has 
insurance coverage for people who are self-employed and who buy their 
own insurance, so they have the same tax deductibility as do big 
corporations. The Michel-Lott bill has a provision to manage Medicaid 
to lower the cost and to extend it to people who are working below the 
poverty level and are working overtime to get enough to bring it up to 
200 percent above the poverty level.

                              {time}  1940

  The Michel-Lott bill has insurance reforms so once you are insured, 
no precondition can ever allow you to lose your insurance; if you get 
temporarily unemployed you still do not lose your insurance; and if you 
change jobs, you are guaranteed the right to be insured without regard 
to preexisting conditions.
  We think it is possible to write a good, commonsense, middle-of-the-
road reform bill that does very little or no damage to the average 
American, does not require people to be fired or laid off, does not 
require any damage be done to the health care system; and we are not 
leaping out into some giant Government experiment, entrusting a 
bureaucracy to do more than it can in fact do.
  I think that people should be very cautious and they should learn 
some lessons from Charles Krauthammer's report on the child vaccine 
program. Government can only do so much. The Clinton-Gephardt Medicare 
part C would be the most dramatic expansion of Government that we have 
seen in health care up to this time. One estimate was that it would in 
fact expand the coverage to about half the country. I do not think we 
are ready to have the Government provide health care directly for half 
the country. I do not think that will work. I think it will be bad 
health care, and I think it means a loss of control over their lives 
and over their health, over their choice of doctor and over choice of 
hospital.
  Madam Speaker, I just wanted to come to the floor tonight to say, 
first of all, look carefully at both the Clinton-Gephardt and Clinton-
Mitchell bills because they both do a great deal of damage to the 
current system and they are both very dangerous expansions of 
Government. Second, let us try to agree to an honest, fair, open 
procedure. Third, the ideal would be, let us slow down a little bit. 
Let us make sure these bills get printed. Let us go home, let the 
American people speak, and then let us vote the first week of September 
after people have had time to see what is going to happen to their 
health care.

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