[Congressional Record Volume 153, Number 110 (Wednesday, July 11, 2007)]
[House]
[Pages H7638-H7644]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 2145
THE OFFICIAL TRUTH SQUAD
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 18, 2007, the gentleman from Georgia (Mr. Price) is recognized
for 60 minutes as the designee of the minority leader.
Mr. PRICE of Georgia. Mr. Speaker, I want to thank the leadership for
allowing me to come to the floor of the House this evening and spend
another hour of The Official Truth Squad, a group of individuals who
come to the floor at least once a week, we try to, at least, to try to
shed a little light, a little correct view on the situations that occur
here in our Nation's Capital and especially here on the House floor.
This group grew out of some frustration by Members on the Republican
side of the aisle who felt that there was less light and less
truthfulness being spoken here on the floor of the House, and that so
often, because of the constrained rules on the floor of the House, we
and others were prevented from bringing those instances to light. So we
started what we call The Official Truth Squad, and the leadership has
been very kind in allowing us to shed that light, bring that truth to
the Members of the House and hopefully set the record straight so
often.
We have many favorite sayings. One of them that I enjoy most is one
from Senator Daniel Patrick Moynihan, who said that everyone is
entitled to their own opinion, but they are not entitle to their own
facts.
When you think about it, it's so very true here that if we were to
deal more in fact that we would have a much better debate, a much
better discussion, a discussion that would be much more appropriate for
the American people, and live up to the charge that we have all been
given, that is, to represent our constituents to the best ability that
we have.
But facts oftentimes don't hold the day here. But, hopefully, during
this hour we will be able to bring some light to some very interesting
matters that have been brought before the House and some that are yet
to come in the days and the weeks ahead.
It has been a curious time here in Washington since the beginning of
the year. It's a time of what I have called and dubbed Orwellian
democracy, Orwellian democracy, because so often what we see is the
party in charge, the majority party, says one thing and then does
something completely different. So it harkens back to the author,
George Orwell, and the double speak that he highlighted.
It's, sadly, distressing that the leadership on the other side of the
aisle seems to be all politics all the time. It's a shame, because we
both have just gotten back in town from a week of district work period,
and I know that you likely heard what I heard at home, and that is that
folks are frustrated and oftentimes disgusted with the kind of activity
that goes on here in Washington, the kind of lack of debate, the lack
of open and honest discussion. The all politics all the time is very
frustrating to my constituents, and, I suspect, to those of yours as
well.
Tomorrow is one of those days that will be a classic example of all
politics all the time. The majority party has seen fit to bring forth,
and you have heard a lot of folks talk about the issue this evening on
the other side of the aisle, but they have seen fit to bring forth
another resolution on the war in Iraq. It's curious that it comes
literally just hours after the Speaker of the House had an individual
stand up, who is known to folks far and wide across this Nation, and
say that she was going to challenge the Speaker in the next election.
So it appears that the timeliness of this resolution may be, again, all
politics all the time in response to an electoral challenge that may be
coming upon the Speaker of the House.
But the sad part about all of this, as it relates to the war in Iraq,
and we are going to talk about a number of issues tonight, but the sad
part about the resolution that's coming up tomorrow is that it is all
just politics. It's not anything about real policy debates for the
American people; it's not about real action. This Congress, this House
and the Senate, said relatively recently that we were going to allow
the reinforcements to run their course in Iraq, that we are going to
allow General David Petraeus, who is on the ground there, along with
credible fortitude and gallantry on the part of the American men and
women, that we were going to allow the increase in the reenforcements
of the American troops to run their course and see whether or not there
was progress being made.
[[Page H7639]]
Now, just a few short weeks after the number of individuals have
increased in Iraq, the majority party says, oh, no, we really didn't
mean that, we need a new bumper sticker, we need a new headline, so
they are going to bring a resolution on Iraq tomorrow. It is really a
shame and very sad, because it, again, doesn't add anything to the
debate, doesn't do anything other than highlight the politics of this
majority party and the fact that they are having extreme difficulty
getting any real accomplishments. So they bring another very
politically motivated resolution on the war in Iraq, Orwellian
democracy, saying one thing and doing another.
We have been told this is going to be the most open and honest
Congress, most open and honest Congress ever. Well, the facts of the
matter, the facts of the matter are that this is one of the most closed
and clandestine Congresses ever to grace the American public. It is
really a shame, again, really a shame, because issues aren't being
debated the way that they should. We will talk very specifically about
one of those issues tonight.
I want to highlight a couple areas where Orwellian democracy is
holding forth and living and surviving well with this new majority. As
you know well, this new majority came to power, and they said we are
going to cut spending, we are going to decrease spending; we are going
to be more responsible with spending hard-earned taxpayer money out
there.
What does this new majority do? They increase spending. They couldn't
wait to criticize all the spending that went on under the charge of the
Republican Party when we were in the majority. So what they said, in
essence, you spent so much, and it was so awful, that we are going to
spend more. That's what they have done. They have increased spending by
over $25 billion, $25 billion in the appropriations bills so far, and
we are barely halfway through, if that, of the appropriations bills.
I would suggest to the American people that it's time to put your
hands squarely on your wallet, because the true tax-and-spend majority
is back in charge, and it's of great concern, I know, to my
constituents and, I suspect, if you talk to yours as well.
When they adopted their budget, they adopted a budget that includes
the largest tax increase in the history of our Nation, nearly $400
billion tax increase. Again, not what they said they were going to do,
and not what they said they have done, as a matter of fact. That's why
it's Orwellian democracy, because they won't even fess up and own up to
the fact, the fact that they have passed a budget that includes the
largest tax increase in the history of our Nation.
Then they go on and they talk about fiscal responsibility. In fact,
many Members have posters outside their offices up here in Washington.
Some constituents may have come by the Halls of Congress and seen the
posters. The posters look wonderful. They talk about the need for
fiscal responsibility, and the amount of the debt, the amount of the
deficit. But, in fact, when given the opportunity to decrease the debt,
and to decrease the deficit, what happens is that they continually say
no. Orwellian democracy is alive and well.
Just today, just today we passed a bill that was the reauthorization
of the higher education act for our Nation. But it didn't just
reauthorize the act and provide more money for students of low-income,
and ``low'' means to be able to attend colleges and universities. No,
it didn't just do that. What it did in addition to that was to create
nine new entitlement programs, nine new entitlement programs.
Now, entitlement programs are really a misnomer. They are programs
that are on automatic pilot here. They are mandatory spending. They are
programs that get started, and they never, ever end, because they are
not able to be touched by the kind of discretionary spending that
Congress has more control over. They just spend on and on and on, year
after year.
Yes, this majority created nine new entitlement programs that will
spend upwards of $18 billion in just a few short years, a new $18
billion. So there are nine new entitlements, no reform, no reform
listed for the entitlement programs, which brings me to this issue of
mandatory spending growth that we have seen in our Nation.
It's comprised of all sorts of mandatory spending programs,
entitlement programs; but there are three that kind of highlight the
major problem that we have. Of the nine new ones that they passed
today, however, they may grow into being as important as these three,
but the three are Social Security, Medicare and Medicaid. Those three
programs, in and of themselves, comprise about 54 percent of our
Federal budget right now, about 54 percent of our Federal budget. Our
mandatory programs are mainly Social Security, Medicare and Medicaid.
The reason that's important is because these programs are mandatory,
because they are on kind of automatic pilot, the amount of money, hard-
earned American taxpayer money that comes to Washington that is spent
on those programs increases gradually every single year.
So what this chart here shows, these pie charts here show is that in
1995, those three programs comprised about 48.7 percent of the Federal
budget, about half of the Federal budget just 12 short years ago. Now,
as I mentioned, about 54, 55 percent of the Federal budget is comprised
of these mandatory, automatic-spending programs.
In a few short years, 2017, it will be about 62, 63 percent of the
Federal budget. That's important because one would think that if you
looked at that slope of increase in spending, slope of increase in
total spending of the mandatory programs, as it relates to the Federal
budget, in a relatively short period of time, it's true, as you know,
that those three programs will comprise the entire Federal budget, the
entire Federal budget, about 2030, 2035, somewhere in that range, which
is within the lifetime of most of us here in this Chamber and certainly
the vast majority of the citizens in our districts.
That's important because something has got to change. You can't have
these programs continue as they are without appropriate and responsible
reform.
So one would think that the party in charge would say, well, we have
got to look at these, and we have got to make certain that we reform
these programs, otherwise we are going to have all of the Federal money
going to these three programs.
When our party, my party, was in charge, what we attempted to do was
to appropriately reform these programs and work diligently to make that
happen.
So in 1997, with the Balanced Budget Act, we passed entitlement
reform. We decreased the slope of that line. Now, we didn't end it,
because of the difficulty in doing that, there are ways to do that, but
it's extremely difficult both politically and financially to do that.
But in the Balanced Budget Act of 1997, we increased by about $137
billion the entitlement mandatory spending over a period of time. In
fact, in the Deficit Reduction Act of 2 years ago, of 2005, it was
about $40 billion in reform, reform spending in those entitlement
programs. It makes it so that the hard-earned taxpayer money is more
responsibly spent, that it makes it so that we work diligently to
decrease the deficit and to decrease the debt.
One would again believe that looking at the previous charts, and
realizing that these programs are expanding exponentially, and that
they are very, very soon to comprise a much greater portion of the
Federal budget, one would say, well, the party in charge probably, when
they adopted a budget, they would bring about some appropriate reform
to mandatory programs. That's what I expected. It's what my
constituents expected.
Frankly, I think it's what the American people expected when they
went to the polls and voted last November. They expected a more bold
process for reform of automatic mandatory spending. Many of us on our
side of the aisle would have been in support of that.
But what happened? You see over on the far right of this chart, it
shows the amount of entitlement reform under this new leadership. Do
you remember Orwellian democracy, the talk about fiscal responsibility,
the talk about importance for entitlement reform, the talk about
reforming the Federal Government, making it run more efficiently?
[[Page H7640]]
Well, what happened is that the budget was adopted by this new
majority that had no entitlement reform, none. In fact, as I mentioned
earlier today, nine new entitlement programs adopted, put into place,
one could make an argument that that not ought to be zero, that ought
to be minus, that this new majority is going in the wrong direction.
When they talk about a new direction for America, there is a new
direction for America, but it's the wrong direction. It's the direction
of greater debt and greater deficit and greater fiscal
irresponsibility.
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That is not what the American people bargained for. I have no doubt
about it. Which brings us to the issue that I would like to spend a
fair amount of time on this evening.
There is a proposal coming forward later this month, within maybe
just a few short days, that will address the SCHIP program, the State
Children's Health Insurance program. This is a program that is near and
dear to my heart. Mr. Speaker, as you may remember, before I came to
Congress, I was a physician. I was an orthopedic surgeon. I spent over
20 years practicing orthopedic surgery in Atlanta. And one of the
things that drove me in to politics, to stand up and say, I would like
to serve my constituents in the public in this way, was a belief that
there were individuals both in my State capital and in Washington that
thought they had a better idea, about almost anything, but especially a
better idea about health care; that they thought that they could make
better decisions about health care than the people involved; that is,
patients.
So the SCHIP program, the State Children's Health Insurance Program,
is one of those that I think highlights one of the fundamental
differences, one of the fundamental flaws in this Orwellian Democratic
leadership, which is that they say one thing and then do something
completely different. Because what they will say is that they are
interested in reforming the system and bringing greater health care,
more health care for more children across our Nation, and, Mr. Speaker,
what they will do and what they will propose is in fact a program that
will move us one step closer, one step further down the road to a
nationalized health insurance program and also one step closer to a
program that will make it so that patients, parents, doctors are unable
to make health care decisions. It is not what the American people
bargained for, there is no doubt about it.
This new majority is obviously driven by the left in our Nation,
driven by, I think, a small minority of individuals who firmly believe,
again, that the government knows best; that the government knows best
how to make all sorts of decisions. But in this instance it is
personal. It is personal for every single American. Certainly it is
personal for the children in these programs; because what this program
is saying and what is being proposed is that the government, that
Washington knows better what kind of health care you need, and we make
better decisions. We, politicians, bureaucrats here in Washington, make
better decisions than individuals, than individuals, than children and
their parents together.
I think it is helpful that we are having this debate because I think
it provides that great contrast, that wonderful contrast between the
party of individual responsibility, and the party that believes that
patients and parents and their doctors ought to be able to make medical
decisions, and the party that believes that the government ought to be
making those decisions.
So I am looking forward to the debate. It is a difficult issue
because the consequences are so great and the consequences are so
personal to each and every American. I don't know anybody that believes
truly that the government can make better health care decisions for
themselves. I don't know anybody that believes the government can do
that. So I am looking forward to the debate as we move forward on the
SCHIP program, the State Children's Health Insurance Program.
I am going to talk a little bit more about that as we go on, but I am
pleased to be joined by my good friend from Tennessee, Congresswoman
Marsha Blackburn, who is a leader in so many areas, but especially in
the area of health care, and serves on the Energy and Commerce
Committee. I am so pleased to have you join us this evening and share
your concerns and your knowledge and information about the State
Children's Health Insurance Program.
Mrs. BLACKBURN. It is a pleasure to join you. And I appreciate the
opportunity to come and talk with our constituents about this program.
It is amazing to me as we are looking at this and looking at the
reauthorization of it and looking at what has been a very successful
program when it has worked as a block grant program, and then look at
the problems that would arise as it moves to being an entitlement
program. And this is something, though, that, unfortunately, it seems
to be more or less the method that the Democrat majority is using as
they move forward.
This is the ``Hold on to Your Wallet'' Congress, and they are
expanding programs. Today we have done the college cost of savings. It
sounds good, but, my goodness, nine new entitlement programs that they
have voted to establish today, nine. And it is not going to have an
effect with making certain that people have the ability to get into
college and then stay in college. You have got all these different
programs that appeal to special interest groups but not to the average
family that is sitting down at the table and taking out a pencil and a
piece of paper and saying, How do we make all of this fit?
I have just been amazed listening to the debate today as it pertained
to education. And, of course, we are seeing this as we are working
through our appropriations bills. They are spending more money. They
are spending above the President's request. They are proving Ronald
Reagan right at every turn. He has said, ``There is nothing so close to
eternal life on earth as a Federal Government program.'' And certainly
we see that. They are given the opportunity, and what are they doing?
They are starting new programs. They are starting the bureaucracy;
certainly not the kind of change that the American people thought that
they were going to get. And we see that as we look at the SCHIP
program.
Now, those of us who have watched health care and worked on health
care issues at both the State and the Federal level know the value of
having this program and having it work and States having the
flexibility that is there. But what we are seeing is the SCHIP program
being hijacked to help the liberal left move their agenda of socialized
medicine a little bit further toward the finish line. And when they
talk about Medicare for everybody, when they talk about expanding
Medicaid, and when they talk about moving SCHIP from a block grant to
an entitlement and then expanding the reach of that program, that is
what they are doing.
SCHIP is to be for children. We have States that are using it to pay
for adult health care. SCHIP was originally capped at $40 billion over
a 10-year period of time for block grants, for children's care. What
has happened, Congress has granted an additional $676 million in new
Federal spending for State bailouts through 2026. So, there again, we
hear accountability and we hear our constituents talk to us about
accountability and the importance of accountability, but what we see is
our colleagues on the left who will say, ``Well, if somebody gets in
trouble, let's pay for it. Let's pay for it. Let's let the Federal
Government pay for it.'' But the problem here is we forget, this is not
Congress's money. It is not the bureaucracy's money. It is not SCHIP's
money. It is not CMS's money. It is the hardworking family that goes to
work every day, that earns that money, that sends it to the Federal
Government. This is taxpayer money.
Mr. PRICE of Georgia. If the gentlelady will yield. I appreciate your
comments. And I appreciate especially concentrating in that last
statement about whose money this is, because so often we lose sight
here with the incredible number of zeroes that we deal with here in
Washington, billions and billions of dollars, truly. And all of those
dollars take hardworking Americans waking up every single day, making
certain that they have cared for themselves and their family, and
getting to work and being generous enough to entrust to us their
hardearned money, and it is incumbent upon us to spend that money
wisely. And the challenge that I see with every government program, but
especially
[[Page H7641]]
this State Children's Health Insurance Program; it is a noble cause. It
is a noble cause without a doubt. Who can object to providing health
care for needy children? So it is a noble cause, but it is a government
program that is clearly being morphed into something else. And I think
that is what you were alluding to.
Mrs. BLACKBURN. And I thank the gentleman for yielding. Today we have
6 million children that are covered in SCHIP. We also have 600,000
adults that are covered in SCHIP.
Mr. PRICE of Georgia. Let me get this straight. In the Children's
Health Insurance Program, there are hundreds of thousands of adults who
are being covered? How is that possible?
Mrs. BLACKBURN. I thank the gentleman for yielding. That is happening
because States are deciding that they are going to take the money and
then use it for some things other than the children. Maybe they don't
have enough children that fall below that poverty level or the 100,
200, 300 percent of poverty, wherever those levels may be for those
specific State programs, so you have part of that money being used for
adults.
Now, the problem that has come before us is SCHIP has to be
reauthorized before September 30th, and the funding will expire. Now,
this is a program we don't want to expire. We would like to see it
continue as it was originally set up to continue. We do not want it to
morph into other things and be a program that also covers adults, be a
program that covers those that are not falling into the category of
being needy children. We want to make certain that it remains a block
grant, that States are given flexibility, and that the money is used to
cover the children, the population for which it is intended. That is
how accountabilities should work with these programs.
Now, our colleagues across the aisle want to make it permanent. They
are not interested in addressing how the money is being spent or
whether a less costly, more efficient system could end up serving
children better and meeting the needs of those children in the
appropriate way.
One of the things that they are also wanting to do is to change the
income levels and include those that are at 400 percent of poverty. So
what we would have is families that are making $60,000 to $84,000 a
year would end up being eligible for SCHIP for their children. So what
we would have is the IRS looking at a family's tax return and saying,
``You are rich. You are going to pay the AMT.'' And then the SCHIP
program looking and saying, ``Well, you fall within the guidelines of
400 percent above poverty, and you qualify for this wonderful
entitlement called SCHIP.'' So that is the kind of frustration that we
see in the bureaucracy that causes frustration and a lot of questions
from our constituents and causes them to say, ``Wait a minute. How is
this money being used?''
Now, we also hear from our constituents that they don't want more of
this control centered with the bureaucrat. They want to be able to
preserve the doctor-patient relationship. They want to be able to make
choices for themselves. And they sure don't want socialized medicine
and government-run health care.
We have heard one of our colleagues say, do you really want the
bureaucracy that can't seem to straighten out Katrina, that can't seem
to handle homeland security, that can't seem to get their hands around
passports, to then manage health care from cradle to grave? And those
are the right questions for our constituents to ask. And as they bring
those questions forward, we say: And one of the ways that we need to
address this is through making certain that SCHIP stays as it was
intended to be, a block grant program that was put in place to assist
the States in providing health care for children at low-income levels,
those needy children.
And I yield to the gentleman from Georgia.
Mr. PRICE of Georgia. I thank the gentlelady again for that
perspective. And I just want to highlight something that you mentioned,
and that is that there are proposals here in the House and in Congress
to make this program mandatory, part of that entitlement mentality that
exists on the other side of the aisle, and to increase the eligibility
for this mandatory program up to 400 percent of the poverty level; you
mentioned that is about $82,000 for a family of four.
This chart demonstrates that the percent of children who would be
covered up to 200 percent, which is what has been the original
guidelines for the SCHIP program and what we believe ought to be
appropriate at this point, is 50 percent of the kids will be covered in
a Federal-State program.
{time} 2215
If you go up to 300 percent, then it gets to 77 percent of the
children. If you go up to 400 percent of the poverty level, you get
nearly 90 percent of children in a Federal health care program. And
that's what sheds light on the real issue here, the real issue being
who ought to be in charge of health care for our Nation's children and
for our Nation's families, and for individual people all across this
Nation. We believe it ought not be the Federal Government, I think that
that's fair to say. And the other side clearly believes that this is
the next step, to allow them to have the Federal Government control
health care. And I'm happy to yield.
Mrs. BLACKBURN. I thank the gentleman. And yes indeed. You know, one
of the things that one of my constituents is fond of saying when they
come to town hall meetings and gatherings is, Marsha, whatever the
government giveth, the government sure can take away. And we need to
keep our attention to as we talk about this health care. Do we really
want to put a bureaucrat behind a desk making a decision for the type
health care that our child is going to receive? Or do we want to make
certain that we, as parents, and as patients, with a physician, have
the opportunity to make those decisions about health care, and do we
want to make certain that we are moving toward a market-driven health
care system? Or do we want to move toward socialized medicine system?
And those are questions that the American people are certainly asking.
You know, one of the things, as we've looked at this, and you hear
the discussion about what it's going to cost, and generally, as with so
many programs that come from the left, they will say, oh, but it's only
going to cost this amount. And it's not going to be that much more
expensive to pick up those extra 45 percent of the children to move us
to 95 percent. It's not going to cost us that much. And it's going to
pay dividends in the long run.
Well, you know, the interesting thing about that is the way
government structures its budget. We're not looking at the 10-year, 20-
year, 30-year cost. We're looking at a 5-year snapshot. Many of our
States, when they construct their budgets, they're doing cost
accounting, which is a 1-year view into what is taking place.
And even at this, you know, CBO has scored this bill at $50 billion,
and we're finding out that the cost is more like a $108 billion to
cover the cost between adding an additional 1 to 2 million extra
children. And that doesn't even get into considering some of the income
requirements for recipients. And this is going to be an interesting
issue of debate.
And I yield to the gentleman.
Mr. PRICE of Georgia. I appreciate that because you triggered in my
mind something about cost-of-government programs. And I'm reminded of
the fact that when Medicaid itself was instituted in the mid-1960s that
there was a wonderful estimate that said that Medicaid, at the turn of
the century, when 2000 rolled around, would only cost about $8 billion.
In fact, it cost about $80 billion.
So the Federal Government is always off by a significant factor, and
so when you hear an estimate that this will only cost $108 billion, in
fact, we can say with relative certainty that that is a lesser amount
than it would actually cost, and it would be much greater burden on the
American taxpayer.
And I'm pleased to yield back.
Mrs. BLACKBURN. Yes. And one of the points that I would make in this
debate is that in fiscal year 2007 alone, SCHIP will cost the American
taxpayer $11.5 billion. Now, under the plan that the Democrat
leadership is pushing forward for expansion of this program, that cost
would increase fivefold. That would increase fivefold. This is what it
would cost turning it from a block grant with flexibility to the State
and moving it to an entitlement where you're going to put it on auto
pilot.
[[Page H7642]]
And people say, what are entitlements? What's the difference here?
When you're talking about Medicare, when you're talking about Medicaid,
when you're talking about some of our Social Service programs that are
entitlements that every year they just grow right along. There's not a
check and balance. You're not working on outcomes. You're not working
on making certain that you're achieving efficiencies. You've got it on
auto pilot.
Now we've established nine new today, nine new entitlement programs
in education. That is what the Democrat leadership wanted. It's not
what the American people wanted. That's what they wanted, entitlement
programs. And what we know is they would increase the cost fivefold on
this plan.
Another thing we need to keep in mind is that the SCHIP expansion
would generate a real shift away from private health insurance and that
private health insurance market for children. And for every 100
children who get public coverage as a result of SCHIP, there is a
corresponding reduction in private coverage of between 25 and 50
children. So you change the way that market is going to work. And it is
of concern to us. We know that this is something that will cause a lot
of questions.
We are very concerned with what we hear they are pushing to do to try
to make this palatable so that they can pull in votes to pass this
SCHIP program. We know that our physicians have a problem with the
payment system for Medicare reimbursement, and certainly, the gentleman
from Georgia, being a physician, understands this so very well. And
we've seen reductions in payments for Medicare payments to those
physicians. And so they're going to include this in the SCHIP bill.
Well, the Medicare payments don't have anything to do with the SCHIP
block grant. But in order to try to pull together those votes and pull
together something that they think the Republicans can't afford to
block, they're going to put that in there.
Now, if I were a practicing physician dealing with the SGR and with
Medicare reimbursement, I would be highly offended that I'm going to be
used as a bargaining chip in the Children's Health Care Insurance
Program.
Now, they're also going to look for ways to improve programs that
provide financial assistance to low income Medicare beneficiaries for
premiums, cost sharing and prescription drugs. So they're going to set
up a generational battle and say, well, we'll do this on SCHIP, but
we're going to take away some of the benefits from the Medicare part D
and the Medicare Advantage. So they're going to take away a little bit
from the seniors and then try to put that into the children's health
care.
Now, if I were a senior citizen, there again, if I liked my part D
and my Medicare Advantage, I wouldn't like the fact that they're going
to use me as a bargaining chip.
And then we find that they're going to provide a special focus on
addressing the health care needs of those living in rural areas. Well,
if I lived in a rural area, and if I had a community health center in
my area, and of course, in my seventh District of Tennessee, I have
plenty of rural areas and plenty of rural health centers. I wouldn't
like the fact that I'm going to be a bargaining chip.
And it is unfortunate that this seems to be the path that they are
going to choose to travel. Rather than addressing the issue straight
up, rather than addressing the needs of the States, rather than
addressing how do we best meet the needs of children, they're going to
pull all these different things and pull them into one bill and try to
make something they think that there are plenty of people that they
can't vote against it.
So I find that, indeed, unfortunate and something that, when we talk
about health care, preserving access to health care for all of our
constituents, it is, indeed, unfortunate that that bargaining chip-type
mentality, that let's make a deal with the hold on to your wallet
Congress, is the way they want to operate and do business.
And I yield to the gentleman from Georgia.
Mr. PRICE of Georgia. I thank you so much for you comments. And I
think the issues that you point out most recently there on the
bargaining chips really speaks to the cynicism with which this
leadership leads this Congress because it is, it's purchasing votes.
It's purchasing numbers of votes in order to pass a bill. And then to
have the, again, the all politics all the time, the bumper sticker
politics that goes on by this leadership. And it is, frankly, what the
American people are tired of. It's not what they voted for in
November. And they are clearly telling each other and telling any
individual who will ask that that has decreased their opinion of
Congress.
And I'm pleased to yield.
Mrs. BLACKBURN. You know, as you were saying that, I'm reminded of
what we in Tennessee went through in 1994 and 1995 as we saw the advent
of TenCare in our State, which was the test case for Hillary Clinton
health care. And we know what has happened in our State of Tennessee,
and the fact that TenCare now is consuming about two-thirds of our
State's budgets. It is a very, very difficult program.
And somebody always is going to pay. Somebody always has to pay the
bill. And what we are seeing with the American public is, they know
that it is the taxpayer that is going to pay; that there are not things
that are free. Someone pays for that, and they, the taxpayer, going to
work every day, American families holding American jobs, earning a pay
check that, unfortunately, the Federal Government has first right of
refusal on that pay check, they take their share before you get your
share. And it happens every single pay period.
And so many people are tired of it. They're tired of government not
being accountable, and they are tired of Congress having an insatiable
appetite for their hard-earned money. And it's what causes them to
contact us when they hear about how these appropriations bills are
being handled, when they hear about the increase in Federal programs,
when they hear about the increase in spending. And, yes, indeed, as
I've told my constituents this weekend, I'm not surprised that the
numbers for Congress are as low as they are. People wanted things done
differently. And this is not the kind of change they wanted. What
they're saying, this is exactly what we didn't want. It's exactly what
we didn't want.
I yield to the gentleman from Georgia.
Mr. PRICE of Georgia. I thank you so much. I appreciate your
perspective this evening so much on the program about which you know a
lot and your perspective from the committee, and especially your
perspective about representing constituents, real Americans, real
Americans who are working just as hard as they can to make ends meet
and being so very, very frustrated with a Federal Government and a
leadership now in Congress that appears absolutely more interested in
dividing and conquering, as opposed to putting in place appropriate
policies. So I appreciate your comments.
I just want to make a few more comments about the specifics of the
State Children's Health Insurance Program, because I think that there
are a number of issues that need to be pointed out as we move forward
with this debate. The current program, as we've talked about, was meant
to cover, was scheduled and meant to cover children up to 200 percent
of the poverty level. And as we've heard, many of the States covered to
a higher degree than that. Some 235, some 250, some went up to 350
percent of the poverty level. And although that is, I think, a move in
a direction that's not consistent, certainly with the intent of
Congress, it probably is a move away from where the American people
thought that program was going, without a doubt.
But, Mr. Speaker, it definitely is a move away from the intent when
you look at the programs and realize that even those States that went
up to 300 and 350 percent of the poverty level, some even up to 250
percent of the poverty level weren't even covering all of the children
under 200 percent of the poverty level. And they were covering adults.
{time} 2230
So it just was a flawed program.
And it is so often what happens here in Washington: Federal programs
are enacted. Noble cause is outlined. Wonderful banner headlines
provided. Great speeches given about how this will save this, that or
the other thing. And then the implementation is so terribly and
woefully flawed. And that has indeed happened in this case.
[[Page H7643]]
This reauthorization, as has been mentioned, is up because the
program is about to be 10 years old. It expires on September 30 of this
year. As a physician, I joined many of my colleagues before I came to
Congress and before I was in the State legislature early in the 1990s,
and many of us believed we were at a crossroads at that time as it
related to health care. There were many on the other side of the aisle,
on the Democrat side of the aisle, who believed that the government
ought to take over health care at that point in the early 1990s. And,
Mr. Speaker, as you will remember and as many folks will remember, if
they think back to that time, there was a huge battle and a lot of
expose about what the consequences of that would be. And thank goodness
we didn't march down that road.
But we are now back at that crossroads. We backed up. We went down
another road a little bit, and some of the direction was correct. Some
of the direction was putting us further toward government-run health
care. But we are now at that crossroads where we have a group of
individuals in charge in the United States House of Representatives
now, with a Democrat leadership, who believe that a Washington-
controlled bureaucratic health care model is what America wants.
I don't believe that is what America wants. It certainly isn't what
my constituents want. It wasn't what my patients wanted when I was
practicing medicine.
I think it is important, as we look at this program, the State
Children's Health Insurance Program, and as we look at the fact that it
is up for reauthorization, that we ought to ask some questions. What
have the consequences of the program been to date? Indeed, we have
covered a number of children who would not possibly have had health
insurance. One of the consequences of raising the Federal poverty level
eligibility for the Children's Health Insurance Program is that we
crowd out children who might otherwise be obtaining insurance through a
private plan where their mom or their dad work. But there are other
consequences, and some of those consequences are grave. One of them is,
I believe, an increased dependence on government for the provision of
health care. There is no doubt about that. I believe also that it
undermines parental responsibility. And there is no doubt that it
increases the burden on the hard-working American taxpayer.
I would like to touch on a few specifics on each of those. Increasing
dependency on government, where does that come from? Well, when you
look at the year 1998 and the percent of American children who were on
either Medicaid or the State Children's Health Insurance Program, in
1998 it was about 28 percent. Twenty-eight percent of American children
were enrolled in 1998 in either Medicaid or the State Children's Health
Insurance Program, SCHIP. In 2005, that number had jumped to 45 percent
or 6.2 million children. So it went in 1998 from 28 percent to 45
percent in 2005. So there is no doubt that there is an increased
dependency on the government for the provision of health care. Again, I
don't think that is what the American people had in mind.
State policies also have increased and encouraged the trend of adult
enrollees. A couple of examples which just boggle my mind, Mr. Speaker,
in Minnesota, for example, 87 percent of those enrolled in the State
Children's Health Insurance Program in 2005 were adults. Eighty-seven
percent were adults. That is not what Congress voted on in 1997. That
is not what the American people thought was going to be the program to
provide health insurance, health access, health care for the neediest
children in our Nation. In Wisconsin, the number was 66 percent. So, in
Wisconsin, 66 percent, and in Minnesota, 87 percent in 2005 were adults
on the Children's Health Insurance Program. That is not what this
program was to be about. And State officials, as we have mentioned,
didn't stick to the 200 percent. So in New Jersey, for example, the
amount went up to 350 percent of the poverty level. Mr. Speaker, that
is an income of about $72,000. Now, that may or may not seem to be a
lot of money to some folks, but the problem that we get in this
doublespeak in Washington, in this Orwellian democracy model that we
have by the leadership right now is that, as Congresswoman Blackburn
mentioned, on the one hand, $72,000 is deemed to be ``rich'' by the
other side of the aisle when it comes to the alternative minimum tax,
but $72,000 for a given State under this program is deemed to be needy
so that the State has to cover children in their health insurance
program. Clearly it is doublespeak. Clearly it is Orwellian democracy.
It has become increasingly clear that there are many Members of
Congress who believe that expansion into higher income levels for
families is exactly what they want because they at their core desire
government health insurance over private health insurance. They desire
a Washington-controlled bureaucratic model for the provision of health
care and medicine in our Nation. So it is clear that the program has
increased dependency on the government for the provision of health
care.
How about transferring family responsibilities, taking the place of
parents, transferring family responsibilities to the government? There
is no doubt that that has occurred and in a variety of ways. In many
cases, for example, the SCHIP program means that children's health
coverage will be totally separate than their parents. So they go to
different offices. They go to different office locations. There are
different office hours. There are different doctors that care for them,
different paperwork, all of which makes life more difficult. It makes
the Federal Government and the State government the determiners. It
makes them making the decisions for parents and for families.
I believe that the goal should be to help unite families, to help
unite their coverage under one private plan that they select, that they
own, not to spread the coverage out through a hodgepodge that increases
dependency on the government.
Some in Congress suggest that private coverage is unattainable for
lower-income families or working families. But the facts tell a
different story. Remember, Mr. Speaker, facts are stubborn things and
everyone is entitled to their own opinion, but they are not entitled to
their own facts? Well, the facts tell a different story. According to
the Congressional Budget Office, 50 percent of children whose families
earn between 100 and 200 percent of the Federal poverty level have
private health insurance coverage. Remember the other 50 percent
covered by this program, 50 percent are covered by private health
insurance. That number skyrocketed to 77 percent for those families
that earn 200 to 300 percent of the Federal poverty level. In fact, 60
percent of people covered by SCHIP expansions already had private
coverage available to them. Let me repeat that, Mr. Speaker, because
that is a startling statement. It is a startling fact, and it is
something that we ought to pay attention to. Sixty percent of the
people covered by SCHIP expansions were already covered by private
insurance before the program was instituted.
Mr. Speaker, what that means is that we are making decisions here in
Washington that are providing financial incentives for individuals and
businesses and people to move their health care coverage to government,
and when we do that, it is incumbent upon us to ask the question,
should we be doing that? What are the consequences of doing that? What
are the unintended consequences of doing that? In 2012, if we continue
down this road, 71 percent of the American children will be in a
government-run health care system.
Now, what does that mean? What are the consequences of that? As a
physician, I am here to tell you, Mr. Speaker, the consequences of that
are that more health care decisions are made by bureaucrats and are
made by individuals here in Washington than are made by doctors and
their patients and children's parents. That is what it means. It means
that more personal health care decisions move away from being made by
patients and their doctors. That is not what we ought to be about. That
is not increasing choice for individuals in the health care system.
That is not increasing freedom for individuals in the health care
system. That is creating a system that is Washington-controlled
bureaucratic health care, and I don't believe that that is what the
American people desire.
This program definitely has burdened the taxpayer. There is no doubt
about
[[Page H7644]]
that. You couldn't reach any other conclusion regardless of where you
come down on the program. As was mentioned, this will cost hundreds of
billions of dollars. And if it is made into an automatic or mandatory
or entitlement program, it will increase even greater than that.
Now, Mr. Speaker, I have just a few short minutes, but I do want to
touch on what we believe, what I believe we ought to do because there
are positive solutions. There are positive answers to how we ought to
move in a direction that provides patient-centered health care,
patient-centered health care, something that I believe is wanted by the
American people. It is something that I have termed American values and
American vision. And one of those American values and one of those
American visions is to have a health care system that is patient
centered, that allows patients and their doctors to make decisions, not
government officials. Not government officials. That is not where the
American people want us to be. So if we are going to have a Children's
Health Insurance Program, then we ought to live up to the premise for
which it was brought about, and that is to target it to low-income
families, low-income, uninsured families. And there is an easy way to
do that. There is an easy way to do that.
You can empower families to make health care decisions that directly
affect their own children. The way that you do that is through a robust
system of premium assistance. You can provide and allow parents to
utilize the SCHIP funds to be able to purchase private health care
coverage without government micromanagement. It is a system that
results, in essence, in a defined contribution program so that the
Federal Government would, when needed for low-income uninsured
children, provide assistance that would allow for the purchase of a
private health insurance policy so that the family owns the policy. And
when that happens, what that means is that it becomes patient-centered
because the individuals, the parents, will select the best program for
their child. And that is all that anybody is truly wanting. They want a
system that responds to the health care needs of their family and their
children; not a system where the Federal Government is making those
decisions.
It is easy to also provide for a program that would expand the
options for individuals and families beyond the narrow confines of the
SCHIP program. It is important that the perceived need is for a system
that provides appropriate health care, indeed, but the appropriate need
is for one that is responsive to patients.
I have a few other items that I just want to point out, Mr. Speaker,
before I close. And that is, again, that if we move toward the system
that is being proposed by the folks who are interested in Washington-
controlled bureaucratic health care, 71 percent of America's children
will be on Medicaid or SCHIP in the year 2012. Over the next 4 years,
if nothing has changed with this program and others, we will move from
$11,000 per year, per household, Federal money, $11,000 per household
to $13,000 per household spent on health care.
And there is a wonderful article that I would like to point out to my
colleagues, Mr. Speaker, that was published on June 28 by Robert Novak
called, ``Socialized Medicine for 'Kids.''' And I will include that in
the Record. I urge my colleagues to avail themselves of this article.
This talks about removing the ability of parents to make personal
health care decisions for their children.
Socialized Medicine for ``Kids''
(By Robert D. Novak)
Washington--There is no need to wait until a new president
is elected next year for the great national health care
debate. It is underway right now, disguised as a routine
extension of an immensely popular, non-controversial 10-year-
old program of providing coverage to poor children. In fact,
this proposal is the thin edge of the wedge to achieve the
longtime goal of government-supplied universal health
insurance and the suffocation of the private system.
The Senate Finance Committee was scheduled to mark up this
portentous legislation expanding the State Children's Health
Insurance Program (SCHIP) today [Thursday], but disagreement
over the size of the program and how to pay for it forced
postponement. Democratic Sen. Jay Rockefeller's version would
triple SCHIP's current five-year cost of $25 billion to a
level of $75 billion. That would grant federal largesse to
more than just poor ``kids'' (as politicians endearingly call
children). An estimated 71 percent of all American children
in families of four making as much as $82,000 a year would
become eligible, with states also continuing present coverage
of adults under SCHIP.
But where to find money to cover the massive cost? Senators
of both parties want to raise tobacco taxes, but that well is
not bottomless, as existing taxes have reduced cigarette
smoking. Instead, House Democrats want to take money from
private elements of Medicare instituted by the Bush
administration. The overall effect would make three out of
four American children accustomed to relying on government
care no matter what course their parents take. In sum, SCHIP
turns out to be socialized medicine for ``kids'' (and many
adults).
A principal sponsor of the $75 billion program is Sen.
Hillary Rodham Clinton, whose hand is detected in health care
struggles the past 15 years. After the Clinton
administration's sweeping ``Hillarycare'' failed in 1994 and
contributed to that year's Republican takeover of Congress,
the first lady miniaturized her goals by limiting coverage to
poor children. Republicans, led by Sen. Orrin Hatch in one of
his several collaborations with Sen. Edward M. Kennedy, had
lost their revolutionary zeal after the government shutdown
of 1995 and accepted SCHIP as a fallback position at a
beginning outlay of $4 billion a year. It was the bargaining
chip given President Bill Clinton in return for him signing
the Deficit Reduction Act of 1997.
SCHIP over the past decade has been a beloved ``kids''
program whose faults were overlooked, much like the Head
Start school program. The federal government has consistently
granted waivers to permit 14 states to cover adults under
SCHIP, which now cost $5 billion a year. Minnesota led the
way, with 92 percent of money spent under the program going
to adults.
The massive expansion was proposed by Sen. Clinton this
year, furthering her promise of ``step by step'' advancement
toward universal health care. Her proposal extends SCHIP to
families at 400 percent of poverty (or $82,000 annually).
Hatch after 10 years is back again supporting a Democratic
program along with Sen. Chuck Grassley, the Finance
Committee's ranking Republican. But they want a mere $55
billion (a $30 billion increase), compared with Rockefeller's
$75 billion, causing the postponement of today's markup.
The Democratic congressional majority now faces the
consequence of its ``paygo'' mandate to account for higher
spending. The Senate's preference for tobacco taxes runs into
present overall cigarette taxes of more than one dollar a
pack, lower legal cigarette purchases and reduced smoking
typified by a 19 percent decline in New York City. More
creative funding comes with Rep. Pete Stark's scheme in the
House Ways and Means Committee for slashing the popular
private Medicare program. That not only would fund an
expanded SCHIP but move toward government monopoly over all
health insurance.
An indirect but pervasive impact of Sen. Clinton's grand
design would be the impact in the same family of children who
are insured by the government while their parents are covered
privately. Would the children become accustomed to Washington
taking care of them? Would the adults drop private insurance?
The future is now for universal health care coverage, and
President George W. Bush may soon face the decision of
whether or not to veto it going into the election year.
Mr. Speaker, in closing, I just want to urge my colleagues to make
certain that we remember why we were elected. We were elected to
represent honestly and hopefully and responsibly our constituents,
especially in the area of health care, an area that I knew very well as
a physician and about which I became very frustrated because of
governmental intervention. We are responsible to make certain that we
set in place programs and policies that allow for the most personal
decisions of our lives and of our children's lives to be made by
individuals and their parents and their families, not by government.
So I urge my colleagues to make certain that as we move forward with
this debate and with this discussion that we act responsibly and allow
patients, their parents, and physicians to make health care decisions.
____________________