[Congressional Record Volume 152, Number 28 (Tuesday, March 7, 2006)]
[House]
[Pages H608-H612]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  THE STATE OF HEALTH CARE: REPUBLICAN EFFORTS FOR HEALTH CARE REFORM

  The SPEAKER pro tempore (Mr. Dent). Under the Speaker's announced 
policy of January 4, 2005, the gentleman from Georgia (Mr. Gingrey) 
will control the remainder of the hour.
  Mr. GINGREY. Dr. Murphy, thank you so much for bringing that 
expertise in regard to health IT and health care quality. In fact, I 
wanted to point out, Mr. Speaker, and my colleagues one of the posters 
in regard to this.
  The Rand study that Dr. Murphy mentioned, a potential savings of $162 
billion annually by going to that system, and also at least 90,000 
lives, and possibly more. I wanted to close out that portion before I 
call on some of my other colleagues to discuss other pertinent issues.
  We do have legislation introduced from the Republican Conference to 
incentivize physicians, particularly small group physicians through our 
Tax Code, in the 179 section of the Code, to let them rapidly 
depreciate indeed up to $250,000. We do this for businessmen and women 
currently up to $100,000, but it is so critically important, this cost 
savings that I point out, that we want to make sure these physicians 
can afford to do this, because we need every one of them to participate 
in health IT.
  At this point, the next issue that we wanted to talk about, and the 
gentlewoman from Florida, my colleague, and classmate, Ms. Ginny Brown-
Waite, a member of Financial Services, Homeland Security, Veterans' 
Affairs, a Member of the Health Care Public Affairs Team, as most of us 
are; in addition to that she leads the Women's Issue Team of the 
Republican Caucus. She wears many hats.
  But tonight the gentlewoman is going to talk about long-term care. 
And I hope she will include a little bit about the issue of health 
savings accounts and how they can be rolled into that. I think the 
President may have mentioned that a little bit.
  At this point I gladly yield to my colleague from Florida (Ms. Ginny 
Brown-Waite).
  Ms. GINNY BROWN-WAITE of Florida. Mr. Speaker, I appreciate the fact 
that Mr. Gingrey is holding these to help inform people of exactly what 
Congress is doing on the issue of health care. I am sure when every 
Member here goes back into their district, people ask them about health 
care.
  In my district, of course, the issue is always not only just health 
care for seniors, but also veterans. And Dr. Murphy was absolutely 
correct that the VA was the first entity to begin computerizing their 
records, which is the reason why a veteran can go from New York at a VA 
facility down to one in Florida, and virtually with a few key strokes, 
they pull up his or her record. That is a good way to make sure that we 
have continuity of care.
  In Florida, of course, we have many, many nursing homes. People move 
to Florida, and as they age in Florida, the nursing home industry is a 
very, very vital part of our economy. When I was a State senator, I 
worked long and hard on nursing home issues. We did nursing home 
reform.
  And one of the reasons that we did nursing home reform was because we 
wanted to increase the staffing and make sure that nursing homes 
provided the kind of quality care that we all want for our seniors who 
are in nursing homes. But, you know, one of the issues clearly is the 
cost not just for those living in a nursing home, but also for younger 
families who have got to care for older parents or loved ones, very 
often termed the sandwich generation.
  You know, long-term care costs can be very, very stifling. And I 
agree about having them be able to roll into a medical savings account. 
It is certainly a very important component of what we are trying to do 
long term.

  You know, you do not fix health care forever. The need for health 
care reform continues as technology improves, as we all age, and also 
as we take into consideration all of the new pharmaceutical products 
that are out there that prevent people from going into hospitals, and, 
many times, nursing homes.
  You know, that sandwich generation I was just speaking about, they 
are the ones who are very often helping to care for their parents. You 
know, nursing home costs can be upwards of $60,000 if a person does not 
have insurance. And home health care costs can sometimes reach $20,000 
a year.
  When we look at the demographics, those who are 85 years of age or 
older are the most likely candidates for long-term care service. But 
age is not the only indicator. Actually people of any age with limited 
self-care or mobility issues are candidates as well.
  For the average person over age 50, home health care can cost over 
$5,800 a year. Even families who have long-term care insurance are 
facing hefty costs. Kind of base plan premiums run between $564 a year 
for a 50-year-old, for example, to $5,300 a year for someone who is 79.
  When families can no longer cover these costs, Medicaid has to pick 
up the tab for those who do not have long-term care insurance. And when 
we look at the spending in Medicaid, one-third

[[Page H609]]

nationwide of all Medicaid spending goes toward long-term care.
  Moreover, two-thirds of these funds are used for institutional care, 
even though consumers prefer to remain in their own homes and 
communities. I am sure, Dr. Gingrey, that in your State as well as in 
my State, that they have applied for waivers, kind of all efforts 
possible to keep people in their own homes.
  People prefer to be in their own homes, but there are times when they 
do need to be in long-term care. One of the bills that I recently 
introduced that I know many of my colleagues are on, is the Qualified 
Long-Term Care Fairness Act. We want to encourage people to participate 
in long-term care insurance.
  This bill provides the same tax deduction available to those who 
itemize as those who do not. Currently only people who itemize on their 
income tax can take off the cost of long-term care insurance. This was 
obviously overlooked when they passed the bill, in that they only allow 
people who itemize.
  We want to make sure that this tax deduction may be used for long-
term care insurance premiums, activities of daily living, diagnostic, 
preventative or rehabilitation services, and certainly other services 
prescribed by a licensed health care practitioner.
  My bill also, by the way, covers home health care expenses. By taking 
out a policy, it really and truly helps the family so very much. We 
want to make sure that this additional tax deduction can be claimed by 
people who take that extra care to be sure that if they need nursing 
home care that they have the insurance to cover it.
  You know, Mr. Speaker, in 2001, spending for long-term care services 
for persons of all ages represented 12.2 percent of all personal health 
care spending. This was almost $152 billion of $1.24 trillion spent for 
health care.
  Congress should encourage all Americans to purchase long-term care 
insurance. And certainly this is but one way that we can encourage our 
constituents to spend that money for a long-term care policy.
  If I may take a moment just of personal privilege to tell a story 
about a very dear gentleman that everyone thought he was my dad; he was 
not. He had three daughters and he cared about those daughters.
  Because he lived in the same community that I did, and because we 
were very close, people just thought that Arne was my father. Well, let 
me tell you, Arne was a very, very thoughtful father, because he took 
out long-term care insurance.
  He developed Alzheimer's, and needed to be in a long-term care 
facility. His wife had passed on and the progression was very, very 
fast. Arne passed away last year, but I can just tell the Members in 
the Chamber tonight and those who may be watching in the audience, that 
Arne's children truly appreciated the fact that he took out that long-
term care insurance. Because that way, the insurance paid for all of 
the time that he had to spend in the nursing home. And he was able to 
preserve his life's savings to leave to his children, which is really 
what he wanted. And he also wanted to make sure that he was not a 
burden on the taxpayers.
  I would ask as many people as possible to consider that kind of 
insurance to make sure that they are cared for and that their children 
or whoever they want to leave the rest of their savings to, that they 
are also provided for. I think it is an excellent way to do it.
  Mr. GINGREY. If the gentlewoman would yield for a second. This is 
such an important item, long-term care, and the anecdotal case that you 
just presented to us is touching and very personal, but very real and 
very practical, as you point out.
  And we are going to talk a little bit later about, and I point out on 
this chart, health savings accounts; but I think the gentlewoman would 
agree that the opportunity to utilize money out of a health savings 
account to purchase at some point, maybe not when you are 35 years old 
and you just had the plan and you are building it up for a couple of 
years, but as you mentioned, I think you said in your fifties, it 
probably is certainly time to start saying not only do I pay for an 
annual physical, and maybe a mammogram or colonoscopy out of my health 
savings account, but maybe I need to look very closely at purchasing 
long-term care insurance to protect my assets, Mr. Speaker, so that 
they are not all used up, as I or anybody else who suffers from some 
debilitating illness that lasts for a long time, in a nursing home, 
they have no insurance, they have exhausted all of their assets.
  Mr. Speaker, I commend the gentlewoman from Florida, too, in thinking 
outside of the box. I think that is part of why we as Members of the 
Republican Conference as a health care team, want to bring to our 
colleagues on a regular basis that we are thinking of ways to get the 
job done.
  We are not just sitting back and accepting the same old, same old. 
And your bill, and I was not aware of the specifics of it, but that 
allowance for someone who does not itemize to actually get a deduction 
for the purchase of long-term care insurance I think is a great idea.
  I commend the gentlewoman for that.
  Ms. GINNY BROWN-WAITE of Florida. Mr. Speaker, I commend the 
gentleman. And certainly the use of any funds from a health savings 
account for this purpose accomplishes the same thing. It gives people a 
tax incentive to save, to also save and preserve their assets for the 
future.
  And, you know, I recently, this past weekend, ran into a young man 
who was all of 55 years old. He was injured, and spent some time in a 
rehab center. And, you know, he said to himself, you know, he did not 
have insurance. When he told me the cost of that rehabilitation, it was 
astronomical.
  So, you know, we all want to believe that we are going to be as 
healthy tomorrow as we are today. But, that is not always the case. And 
I remember when I reviewed the policy with Arne, because I was a little 
skeptical, he was 75 when he first started looking at it, and I was 
amazed what it did cover and how reasonable the cost was. And, you 
know, I looked on every line, looking for a loophole. And it ended up 
being something that I did recommend to him, never realizing that a few 
years later he would need to have this.
  So I commend the gentleman for promoting the health savings accounts 
and any other way that we can help seniors to better prepare for their 
future.

                              {time}  2045

  Mr. GINGREY. Mr. Speaker, I thank the gentlewoman for bringing us 
this information on long-term care.
  At this time, we have an opportunity to hear another issue discussed 
by my colleague on the Rules Committee, the gentlewoman from West 
Virginia, Representative Shelly Moore Capito. And Representative Capito 
is going to talk tonight about something that, and she knows the 
numbers, she has been here a little longer than I have in regard to how 
many times we have addressed this issue of tort reform, of trying to 
level the playing field. Not take away anybody's rights to a redress of 
grievances if somebody has injured them by practicing medicine below 
the standard of care. That could be the provider of the care, it could 
be the physician, or the hospital.
  In any regard, at this point I would like to turn the program over to 
Representative Capito and have her talk to us about the issue of 
medical liability reform.
  Mrs. CAPITO. I thank my colleague from the Rules Committee, not only 
for talking about issues that are important to us but his service on 
the Rules Committee as well. And also the fact that we are taking this 
time to talk about an issue that is probably the most-talked about 
issue in my district and that is health care in a general sense, but in 
a broader sense health care for our future.
  I come from the State of West Virginia, and I think this is a great 
topic for somebody from West Virginia to speak on. We have passed out 
of the House medical liability reform I think in excess of seven times 
and I have lost count. I do not know exactly. But I would like to talk 
a little bit about what happened in the State of West Virginia and how 
that legislature there and the Governor there joined together to answer 
a desperate cry from a lot of West Virginians.
  In the summer of, I think it was, 2002, the only trauma center in the 
largest metropolitan area of our State, CAMC

[[Page H610]]

Trauma Center, closed because they were unable to staff the trauma 
center because people of the specialty and the hospital were having 
difficulty meeting the high cost of medical liability insurance. They 
could not get it. That traumatized our area. We live in a rural State; 
but this area, Charleston, was the magnet for all of southern West 
Virginia and eastern and western sides to come in case of a high-level 
trauma.
  During this time, a young boy of 4 or 5 years old got a penny stuck 
in his throat, and he lived about 10 minutes away from the trauma 
center, but the trauma center was not there. It was not open. So his 
parents, along with their physician, had to take him to Cincinnati, 
Ohio, to have this extracted from his windpipe. It had a happy ending. 
He was fine, but if they had not had to take that amount of time to go 
to Cincinnati to have the work performed, I do not know what would have 
happened to this young boy.
  Throughout 2002, I met more constituents who were telling me that 
their doctors, even though they were not old retirement-age doctors, 
middle age, in their fifties, in the peak of their profession, were 
moving. They were moving to other States. They were retiring out of the 
practice of medicine and into administration because they absolutely 
could not afford to continue practice. We were losing our specialty 
physicians. I know there is a problem nationwide with neurosurgeons, 
certainly orthopedists, OB-GYNs are one of the highest problem areas, 
and it was just cascading across our State.
  We are known in our State as being one of the best places for trial 
lawyers to set up shop. We are very, what do I want to say, generous 
and we have a very good litigious society.
  Mr. GINGREY. We like to use the expression in those situations: ``it 
is easier to sue your doctor than it is to see your doctor.''
  Mrs. CAPITO. Right and we were reaching that point in West Virginia. 
We had our doctors leaving.
  Another thing, I spent Sunday night with a group of physicians here 
in Washington, D.C., and one of the things they told me repeatedly, no 
matter what State they were practicing in, is that more and more they 
have got to practice defensive medicine. Are you going to do the MRI, 
Doctor?
  And even though they do not think it is called for, it is not 
medically necessary, they go ahead and do it because if they do not do 
it, there is that small fraction of a chance that something might have 
shown up or that they could come back and be sued because they did not 
proceed with a procedure that they did not feel was medically 
necessary.
  And what happens when you practice defensive medicine? The cost goes 
up and up and up. And this was happening in West Virginia. Again, our 
large medical centers, we could not recruit our doctors. We would have 
residencies throughout our State and as soon as the physicians were 
trained, educated, and ready to practice, they would leave the State. 
And this was really very difficult because the word was out across the 
Nation: West Virginia, if you want to practice medicine, do not go to 
West Virginia.
  So we had all of this coupled with just the out-of-control lawyer 
compensation that this breeds, this medical liability breeds.
  So we had this kind of situation in West Virginia and what happened? 
It was not the doctors. It was not the hospitals. It was not the health 
professionals. It was the everyday citizen in West Virginia coming to 
policy-makers, coming to their State legislators, coming to their 
Governor, coming to their Congresspeople and saying, you have got to do 
something. You have got to pass something. And by golly, in the State 
of West Virginia they have passed one of the leading, cutting-edge 
medical liability bills that exists now in any States in the Union.
  And what has happened? Confidence is back in the health professions, 
more specialties are being recruited into our State. And just today I 
had a young man in my office who was just finishing his residency at 
Lexington, Kentucky. He said, I am coming home to West Virginia because 
that is where I want to raise my family and practice medicine.
  So medical liability does work. It does go to providing higher-
quality care, refreshing your physician and health profession supply. 
It does go to bringing about an era of confidence that good-quality 
health care is going to be there for you. And so I would say in terms 
of, I know Dr. Gingrey has introduced the HEALTH Act again, and we are 
hoping that we will pass it out of the House of Representatives again, 
we will do that because we know it is important. But more and more what 
is happening in West Virginia is happening in other States across the 
Nation. And they are hearing from their everyday citizens, their folks 
who want to see their doctor when they want to see them, the doctor 
they have seen their whole life. And this is an extremely important 
issue to have before the American public.
  The problem has been we have passed it here, and we have not heard 
anything more about it. It had faded out there across the Hall. I think 
the stronger the voices are at the local level, just like they were in 
West Virginia where we did not think it could ever be done, the 
stronger those voices are, the more optimism we can have, we can meet 
the demands of a good and solid medical liability reform bill.
  I want to join with my colleagues here on the Health Affairs Team who 
think it is something we need to talk about quite a bit.

  If I could take just 2 more minutes here to talk about another health 
issue that is extremely important to me, and that is the prescription 
drug bill for seniors. It is something I worked on, and it is probably 
the number one issue as I have moved across the State over the last 5 
years.
  I was sitting in a dinner the other night after reading all the 
political rhetoric about the prescription drug bill and how it does not 
serve people, and actually one of my colleagues from the other side of 
the aisle in my own State called it a national disaster. I sat down 
next to a gentleman. He said, I want to talk to you about the 
prescription drug bill. I almost thought I had to put a helmet on to 
hear what he had to say. I said, What is that? He said, I am going to 
save $4,000 this year. Thank you, Congresswoman, for passing that. 
Thank you for providing that first-time availability of a prescription 
drug bill through Medicare.
  I want those who are watching to know this is an extremely 
revolutionary bill and an availability of a prescription drug bill for 
our seniors.
  Doctor, I would like to yield back my time to you. I appreciate your 
efforts in this area, and I join with you in seeing that we get that 
medical liability reform bill passed once again.
  Mr. GINGREY. Thank you. As you point out, it could be seven times. We 
had passed it just last year, and I guess we will have to do it again 
this year maybe for the eighth time.
  I just have got a little poster here, Mr. Speaker, that I want to 
call my colleagues' attention to here. The gentlewoman from West 
Virginia talked about it a little bit in regard to these issues of the 
need for tort reform, the cost factor, Federal outlays for health care 
on the rise. Yes, indeed. Nearly one-third of all Federal spending goes 
towards health care. And that is what she is talking about.
  A lot of this spending is defensive medicine. It is unnecessary. She 
is talking about the trauma center in West Virginia that had to close 
because they could not get coverage. They could not get the 
neurosurgeon to take the liability or a thoracic surgeon to see that 
youngster with the penny lodged in his windpipe.
  These are the issues; and, yes, everybody that comes into the 
emergency room anywhere in the country with a headache, doctors know 
physical diagnosis and ability to examine by looking in the eyes and 
checking the blood pressure. But they are not sending that patient home 
with a couple of aspirins and careful instructions to call the next 
day. They get a CAT scan and the most expensive one that is coming 
along for that particular year.
  She did such a great job. Finally, in her last two minutes and I am 
so glad that she did that in regard to the Medicare Prescription Drug 
Act, part D. We have heard all of these naysayers. I am sure they were 
out there in 1965 when we had the optional Medicare part B which 98 
percent of seniors are paying upwards of $90 a month to be part of 
because it is a good program. This is a good program.

[[Page H611]]

  I thank Representative Shelly Moore Capito for giving us some 
information, personal anecdotal statistics from West Virginia. It is 
absolutely true.
  At this point it is a pleasure to have as part of our team tonight, 
and actually my co-chair of the Policy Committee, the Republican Policy 
Committee on HealthCare Reform, another physician, a freshman who does 
not seem like a freshman because of his knowledge and skill and 
ability. I am talking about the gentleman, Dr. Charles Boustany, 
cardio-thoracic surgeon from Lake Charles, Louisiana.
  Before I yield him most of the remaining time in this special hour, I 
want to thank him for the work that he did on the gulf coast during not 
only Hurricane Katrina but Rita that hit his area, his district, and 
devastated over 125 miles of that great part of our country and what he 
has tried to do in regard to going forward to work on issues, like 
making sure in a catastrophe like that in the future that we would have 
a data bank of physicians by specialty so that we would be much more 
organized and could respond like he did, personally, in an efficient 
fashion.
  So at this point it is indeed a pleasure to call on the gentleman 
from Louisiana, Representative Boustany. He will talk a little bit 
about competition in health care and some of the hallmarks for reform.
  Mr. BOUSTANY. I thank my friend and colleague from Georgia for 
yielding time to me. Also, I thank him for putting on this program this 
evening. It is very important that we inform the American public about 
these issues in health care.
  It is undeniable that the United States has the finest health care 
system in the world, and I have seen it firsthand as a cardio-thoracic 
surgeon. I have had the great privilege of saving many lives in the 
practice of cardio-thoracic surgery. At the same time, I also learned 
firsthand about the difficulties that families go through and the high 
cost of health care incurred by families and small businesses.
  Particularly, when my son was involved in a terrible car accident 
that required months of hospital care and the stress it put on my 
family and the financial pressure really awakened me to many of the 
problems that we have in our health care system. So I come here with 
strong determination to try to do something to help American families 
with the ever-rising cost and burden of providing health care.
  Health care costs have doubled between 1993 and 2004, growing to 
nearly $1.9 trillion and representing 16 percent of the United States 
gross domestic product. When you look at health care, we have to make 
sure that it is affordable, it is available and accessible because I 
commonly say, I often say back at home, All health care is local. What 
good is health care if you cannot access it and get it where it is 
affordable where you live? That is where you need it. It does not do 
you any good if it is available in New York or Boston if you cannot get 
it at home in Lafayette, Louisiana.
  So with this unsustainable rise in cost, we have got to do something 
to bring the cost down and make it more affordable and available. 
Competition is the key.
  I think there are three words that really describe the principles for 
health care reform: information, choice, and control.

                              {time}  2100

  First of all, with regard to information, we need a free flow of 
information about prices, about cost to families, about cost of 
hospital care, cost when you go to see the doctor, the cost you incur 
when you go.
  We also need a free flow of information about quality and outcomes, 
because if we have this flow of information, and information technology 
was mentioned earlier this evening, information technology is a 
critical part in providing this kind of information to the consumer and 
to ultimately the patient, to the family.
  I often say what good is it if you do not have this information. If I 
go to the store to buy soft drinks or sodas for my family, I can go 
down the aisle, and there is a wide range of products, different 
quality, different flavors, different prices, and I make an informed 
decision. But in health care, we cannot do that. So we need 
information.
  Choices, that is the other one. If we had a wide range of choices in 
health care, wide range of insurance products, then we could create 
this competition that will bring the cost down. It is one of the things 
we hope to see in the Medicare prescription Part D program, where we 
create competition to drive the cost of pharmaceuticals down for our 
seniors in these plans.
  Another way of providing choice is certainly the health savings 
accounts that were mentioned earlier, associated health plans which is 
something we passed in the House. And there is also a bill that I am a 
proud cosponsor of; this is a bill by Representative Shadegg, H.R. 
2355, the Health Care Choice Act of 2005, which will allow people to 
shop for insurance products, health care insurance, across State lines, 
again creating more competition and hopefully bringing the cost down.
  The final piece of this is control. We do not have portability and 
control. I want to put health care destiny back in the control of 
families and individuals because I believe by doing so we create true 
portability in health care, and if we do this, then we will solve a lot 
of the problems. We will free up our businesses, let them do what they 
do best, by providing work and wages and so forth, but let us let 
families have that portability in health care.
  Those are the keys to health care reform. It is important to 
recognize, if you look at our health care system, 45 percent of all 
health care spending is in the form of Medicare and Medicaid and other 
Federal programs. Fifty-five percent of it is in the so-called private 
sector, and yet what we have is a price control system where everything 
is set by basically paying at the Medicare rates, which creates some 
degree of rationing in health care. Yet, on the other side of the coin, 
when you look at what is happening to providers, providers are having 
to deal with the free ranging, inflated cost of supplies, 
pharmaceuticals, surgical equipment, and this has created major 
distortions in our health care system. This also needs to be addressed.

  So, again, if we can create competition by using those three 
principles I mentioned, then I believe we can truly start to bring the 
costs down in health care and make it more affordable, available and 
accessible for American families.
  I thank my colleague from Georgia for yielding to me, and I 
appreciate this opportunity to comment on health care.
  Mr. GINGREY. I thank Mr. Boustany so much for being with us this 
evening and for pointing out the rising cost of health care and what we 
need to do about it. I particularly appreciate what you said about 
transparency.
  In the final few minutes, I am going to talk a little bit about the 
health savings accounts that the President has promoted and increased 
the amount of money that can be put aside, very much like an IRA, but 
this would be an IRA for health care. Because you are absolutely right; 
we use the expression, and maybe it is really apropos for health care, 
skinning the game. They are going to be better consumers. People do a 
great job shopping for an automobile or an appliance or new flat-screen 
television set, and they may go to eight different stores, discount big 
box stores, trying to save an extra fifty bucks on a plasma TV. And 
people do that, and I do not blame them. We can do that in health care, 
too.
  I think Mr. Boustany is absolutely right. There will be a day when we 
do have electronic medical records throughout the system. Secretary 
Leavitt is totally committed to this, and Dr. Brailer, as our good 
friend Mr. Murphy said at the outset of the hour, but will also need to 
be done as everybody is interconnected, every medical office, every 
clinic, whether it is the size of Mayo or Rochester or whatever, or 
maybe just a two-doctor shop, everybody's information about their 
patients is interconnected so that we know what their needs are and 
also the information that physicians, their pricing information, what 
does an OB/GYN typically charge for a routine hysterectomy or delivery 
or cesarean section; what does a vascular surgeon charge for the 
procedures that they do. We call those endarterectomies, put in a graft 
to go around a blocked vessel. What does a general surgeon charge to

[[Page H612]]

take out a gallbladder through laparoscopic, or appendix or thyroid? 
There are more than one good doctor in each community. I do not know 
about cardiothoracic surgeons. They are in short supply, but there are 
lots of us OB/GYNs and general surgeons that do a good job.
  People will one day in the near future, because of what we are doing, 
the efforts of this Republican majority and this President, who is 
totally committed to making sure that we continue to have the best 
health care system in the world, we will see the day that in a secure 
environment, people can look on a Web site and know exactly what the 
differences are and shop economically for not the cheapest health care 
but the best-priced health care and good health care.
  We talked a little bit at the outset of the health savings account 
issue. I think that this is a wonderful opportunity. I wanted to show 
maybe one last poster in regard to that, because we hear a lot of 
criticism sometimes here on the floor of this Chamber, and sometimes 
out in the halls and maybe indeed sometimes back home in our districts, 
say, oh, you know, the health savings account, they are just, here 
again, something for the rich, and you Republicans only care about the 
people that have lots of money. Well, look, Mr. Speaker, at this health 
savings account, not just for the healthy and wealthy.
  Seventy-three percent of those who have established, and there are 
about 3 million now and we predict within the next couple of years 10 
million, and it is growing rapidly, 73 percent have families with 
children. Fifty-seven percent of these holding health savings accounts 
are over age 40; 35 percent are from households with four or more 
people; 40 percent are high school graduates or have technical school 
training as the highest level of education. Also, I might say 
parenthetically, some of these folks are the most successful because 
they are hardworking and work by the sweat of their brow; 40 percent 
did not indicate any prior coverage.
  So this is something for everything, and for those who do not want 
that, the President has talked about refundable tax credits to purchase 
health insurance for an individual. When I say refundable tax credits, 
I mean somebody that, because they are a lower economic earner and they 
do not typically pay taxes, they do not get any advantage from a 
deduction. So we actually give them money. A refundable tax credit 
means you give them money for the sole purpose of purchasing health 
insurance. These are some of the things that we wanted to talk about.
  The gentleman from Louisiana, I would be glad to yield to him for a 
comment.
  Mr. BOUSTANY. Mr. Speaker, I thank the gentleman for yielding. I also 
point out another feature of health savings accounts and it is 
something very important to think about; and that is, as we get a large 
part of our generation to sign on to these health savings accounts, as 
our generation moves up into the Medicare years, that money will accrue 
and could be used for health care costs incurred at that time. It will 
help take some of the burden off the Medicare system in the future 
potentially. So it is a good, good feature as we look at these. Again, 
it helps the individual, it helps the family to control their own 
health care destiny.
  So I just wanted to point that out, in addition to these very good 
facts that you pointed out as well.
  Mr. GINGREY. Mr. Speaker, I thank the gentleman, and just in the 
closing minutes, I would say that also it is important for people to 
know that while people maintain these health savings accounts and add 
to them each year, they enjoy the miracle of compound interest as these 
accounts grow. They can only be spent on health care, but typical 
insurance does not cover dental care or a lot of eye care. It certainly 
will not pay for a hearing aid, no cosmetic surgery. It does not help 
women who have infertility problems who need assisted reproductive 
technology so they can achieve the wonderful joy of childbirth and 
raising a child or children. All of those things can be paid for out of 
these health savings accounts.
  We talked about purchasing long-term health care insurance, and when 
a person turns 65, they can actually use some of this money for other 
things.
  Well, that wraps it up. I see my time is drawing to a conclusion. I 
think the Speaker has tapped that gavel a little bit, and I do not want 
to cut into my good friend's, the gentleman from Georgia on the 
Democratic side, and his special hour. So at that we will conclude.

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