[Congressional Record Volume 153, Number 118 (Monday, July 23, 2007)]
[House]
[Pages H8284-H8290]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        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. Madam Speaker, I want to thank my leadership on 
the Republican side of the aisle for allowing me to address the House 
this evening. It is always an honor to come before the House of 
Representatives and to discuss issues of importance to this Chamber, to 
this Capitol and to the Nation.
  This is a truncated version of the Official Truth Squad because of 
the hour of the evening. The Official Truth Squad is a group of 
individuals who come to the floor of the House and try to shed a little 
light, try to shed a little truth, if you will, on the deliberations 
going on here in our Nation's Capital and hopefully bring a perspective 
that will allow Members of the House and this Chamber and men and women 
across our Nation to be able to gain a little greater perspective on 
exactly what is going on here in Washington as we struggle with the 
challenges that we have facing the issues that we have in our Nation 
that demand so much of our attention and demand, frankly, a greater 
level of cooperation than is frequently seen here in Washington.
  It is one of the things that I strive, along with my colleagues, try 
to bring about, and that is a greater sense of urgency to solve the 
challenges that we have, and to address honestly and openly and 
truthfully the issues we have before us.
  We have one special quote that I like to quote that I think kind of 
puts it all into perspective, especially when you are talking about 
issues that are so complex in Washington. It comes from Senator Daniel 
Patrick Moynihan. He used to say everybody is entitled to their own 
opinion, but they are not entitled to their own facts.
  So often here in Washington, people want their opinions to be facts. 
It is one of the items or issues that the Official Truth Squad attempts 
to address, and that is trying to talk about facts, trying to bring 
facts to the table as it relates to any particular issue.
  Tonight we are going to talk about at least one issue that is in 
great need of facts. Madam Speaker, we are in appropriation season. 
During this period of time, the House works on its multiple 
appropriations bills and tries to determine exactly how we as a Nation 
ought to set priorities from an appropriations or a spending 
standpoint, what level of spending ought to go into the various 
programs of the Federal Government. And so often, and we just heard it 
this evening, many people come to the floor and they say, if we just 
had more money, if we just had more money for this program or that 
program, that would solve the problem.
  And so often it is not money that is needed for programs, especially 
out across our Nation, because what is needed most often is to free up 
the wonderful enthusiasm of the American people and the wonderful 
ingenuity of the American people. What happens is along with the money 
that comes from Washington comes rules and regulations and strings and 
stipulations, and makes it that those individuals who are trying as 
hard as they can to make ends meet and improve their communities and 
make certain that they are providing for their families, so often what 
Washington does is ties their hands behind their back and makes it so 
they are not able to realize the kinds of dreams that they would 
otherwise be able to realize.
  We cite often the Golden Rule. You know what that is. Most folks know 
what that is, but the Golden Rule of Washington is not what most people 
across this Nation know. The Golden Rule across this Nation is to do 
unto others as you would have them do unto you. But the Golden Rule 
here in Washington is he who has the gold makes the rules. That is 
especially true during appropriation season because we put all kinds of 
strings attached to the money that the Federal Government spends.
  We often forget, as I am fond of reminding my friends here in the 
House, of whose money it is, because it is not government's money, it 
is the people's money. It is hard-earned American taxpayer money.
  We have had individuals come even to this well and say, ``Keep your 
hands off my money.'' My money. It is phenomenal when you hear that, 
when I go home to the Sixth Congressional District in Georgia, and my 
constituents ask incredibly insightful questions about that kind of 
mindset that exists here in Washington. ``How can politicians believe 
it is their money?'' This is so important as we are in this 
appropriation season and as we determine exactly how to spend that 
hard-earned taxpayer money, and we ought to do it more responsibly, I 
would suggest, Madam Speaker.
  I want to talk tonight about an issue that is near and dear to my 
heart, and to the heart and well-being of every single American, and 
that is the issue of health care. Before I came to this body, I was a 
practicing physician. I was an orthopedic surgeon and practiced for 
over 20 years in the Atlanta area.

  One of the things that drove me into politics or had me stand up and 
volunteer to get into politics was the recognition and the appreciation 
that year after year after year would go by as I tried the best I could 
to care for my patients and worked with my colleagues to provide the 
best and highest quality of health care we could provide, and year 
after year, and month after month, and day after day each of us 
appreciated that there were more individuals in our State capital and 
in this Capital right here who were making decisions about health care 
that affected very directly what I could do for and with my patients 
than anybody I ever met in medical school and anybody I met in 
residency and training as I was training to become an orthopedic 
surgeon. That was true for every specialty that I talked to, every 
single colleague.
  If you talk to your doctor, Madam Speaker, or if the Members of 
Congress would speak to their physicians and to their neighbors, they 
would appreciate readily that there are so many rules and regulations 
that are coming from Washington and from State capitals around this 
Nation that tie the hands, that make it more difficult, not easier, 
more difficult for physicians and other health care providers to be 
able to take care of patients. And that's wrong. That is wrong because 
what it means is we have a lesser quality of health care system than we 
would otherwise have if the government weren't involved in the way that 
it is.
  And there are all sorts of programs that you can talk about that 
would lend truth and credibility to that statement, but I want to talk 
about one specifically this evening that is going to get a lot of 
discussion, Madam Speaker, here over the next week or two and maybe 
number of months as we move forward in Washington, and that is the 
program known as SCHIP, or the State Children's Health Insurance 
Program.
  That is a program that was begun 10 years ago. It was part of the 
Balanced Budget Act of 1997. It was a program that had wonderful goals. 
The goals were, specifically, there was a recognition that low-income 
individuals who weren't eligible for Medicaid, they made too much money 
to be eligible for Medicaid, but they didn't make enough money to be 
able to afford health insurance for their families, those individuals 
ought to be able to have some sort of assistance provided by States and 
the Federal Government in a complex formula that would allow those 
families to be able to have health insurance for their children. So 
hence the name State Children's Health Insurance Program. And it was a 
laudable goal, without any doubt. And it was passed by a significant 
majority, and the goal was to increase the enrollment of children who 
were below 200 percent of the poverty level. That is what was selected 
as the limit at the time.
  Over the last 10 years what happened, however, is a distortion, a 
significant

[[Page H8285]]

distortion, of the program so that it covered not just children up to 
200 percent of the poverty level, but in some States covered up to 350 
percent of the poverty level, and it covered not just children. The 
State Health Insurance Program covered hundreds of thousands of adults. 
So like other government programs, it grew.
  Government programs in the area of health don't just grow, as I 
started this conversation talking about, they insert themselves in 
terms of rules and regulations into the process and make it extremely 
difficult for those who are charged with the administration of the 
program, charged with caring for patients in this instance, to be able 
to care appropriately for them.
  So what we saw between 1998 when the State Children's Health 
Insurance Program was instituted and became effective, at that time 
there were about 28 percent of the children of this Nation on some sort 
of government-run health care. In 2005, that number had grown to 45 
percent. It is a little more than that right now, but about 45 percent.
  The proposal that will be on the floor of the House or certainly in 
Committee of the House is to move it so that in a relatively short 
period of time, another 5 years, we will have 70 to 75 percent of 
children on government-run health care.
  We will talk a little bit more about the consequences of that and why 
many of us believe that is the wrong direction to head, because most of 
us, most people, most Americans, I believe, are not interested in 
having a Washington-controlled, bureaucratic medical model be the one 
that is making those kinds of personal health care decisions for 
themselves and their families, and especially for their children.
  That is what we are going to talk a little bit about tonight. I am so 
pleased to be joined by one of my good friends and colleagues, the 
gentleman from New Jersey (Mr. Garrett), who has great insights into 
both fiscal responsibility issues and issues where government tends to 
intervene in ways that most of us would desire that it not. I am happy 
to have the gentleman join us this evening, and I yield to the 
gentleman.
  Mr. GARRETT of New Jersey. I thank the gentleman from Georgia for 
coming to the floor this late hour, although on the west coast it is 
just early evening, and so we welcome all those who partake in these 
forums that we have that are educational to not only the American 
public, but also to our colleagues who may be in their chambers 
learning a little about SCHIP as we go along.
  I was listening to your opening comments, and you were right on point 
on this one, as you are always right. I have great respect for your 
ability to have a strong grasp of the situation on a whole slew of 
topics. I sort of focus on certain areas like the U.N., which is one of 
my pet peeves, or financial services, or education and No Child Left 
Behind. But I know whether on the floor or at home, I can watch and be 
assured that you are covering thoroughly a topic of importance to the 
American people. And SCHIP is one of those topics.
  You were just beginning to address the issue of the number of 
children that will be on SCHIP and the direction that the government is 
going in this area. Your chart makes the point abundantly clear.
  Red is usually a warning sign to people. When the red flashers go off 
or the red lights flash, you know something is amiss, and I guess you 
chose the appropriate coloration of your charts that something is 
amiss.
  We see back in 1998, less than a decade ago, a little over a quarter 
of the kids in this country were under a government-run plan, and now 
we are looking to see almost three-quarters of the children in this 
country under a government-run plan.

                              {time}  2300

  That is fine. That would be fine if you thought that the U.S. 
government, if Washington is in the best position to take care of and 
administer the health of our children.
  But you know, you don't have to listen to The Official Truth Squad 
here on the floor each week to know that things are oftentimes amiss 
when it comes to the efficiency and the accountability of the Federal 
Government.
  Heck, just look a couple of years ago when the whole issue of Katrina 
was coming on, there was railing from both sides of the aisle, 
rightfully so, when we realized that the Federal Government couldn't 
get into an area where it had an obligation to, and that is, to help 
out people in a tragic situation, whether it's home settings or others 
or in a health situation.
  Likewise, I think I recall there was railing again against the 
Federal Government when, again, in an area that the Federal Government 
does have a distinct responsibility, and that is taking care of our 
veterans and our men and women who are in the military or returning 
back from the military to the facility just down the road a piece from 
here, and there was a question as to the conditions of those medical 
facilities and whether we're giving those brave men and women all the 
facilities and care and comfort and proper medical care that they 
deserve.
  Yet, when we know that all those problems exist, there are some, 
especially from the other side of the aisle in this House and certainly 
on the other side of the aisle in the Senate, who would say that the 
solution to the health dilemma in this country is not by turning it 
back to a patient-doctor relationship, but instead of turning it to a 
Federal Government/doctor-patient relationship. So we are going in the 
wrong direction with regard to that.
  I'd like to come back to that in a moment or two, but at this point I 
yield back to gentleman if he would like to speak.
  Mr. PRICE of Georgia. I appreciate your comments in pointing out a 
number of different areas where the government has been intimately 
involved in health care issues specifically and ones where most 
individuals across this Nation I believe, Madam Speaker, have questions 
about the advisability of governmental involvement and the 
effectiveness of governmental involvement.
  We're pleased to be joined by another good friend, the gentleman from 
Wisconsin, who has been chair and now is ranking member of the Budget 
Committee, an individual who has great perspective on both fiscal 
responsibility and the issue of health care as a member of the Ways and 
Means Committee. We are pleased to have Mr. Ryan join us this evening 
and I'm happy to yield to him.
  Mr. RYAN of Wisconsin. I thank the gentleman for yielding, and I 
thank the gentleman for his leadership on health care issue, not only 
the fact that you're practicing physician, but also your leadership 
here in Congress, and the gentleman from New Jersey as well.
  I just listened to this conversation you're having in my office, and 
I wanted to come down and just add maybe a few facts. I missed part of 
your debate as I walked over here.
  But we're looking at all these various SCHIP bills to renew this 
program, and we looked at what the other body is doing over in the 
Senate. They propose a new $35 billion expansion of the program, but 
what we find in their legislation is that, not only do they provide a 
$35 billion expansion, they provide another $35 billion expansion after 
that in 5 years. Then to contort their budgets to make it all work, 
they actually say that we will cut off 4.5 million children off of 
SCHIP insurance to make their numbers work, meaning they have a budget 
gimmick.
  The budget gimmick is, they're going to put as much money into this 
program as possible, but to fit in their contorted budget window, they 
will just assume that in about 9 years everybody's knocked off of 
health insurance.
  Both you and I know that that's not going to happen, but what we have 
over here in this body is an even larger SCHIP expansion, a $50 billion 
SCHIP expansion which translates into $100 billion SCHIP expansion if 
their full 10-year ambitions are realized.
  And what does that mean? What they're talking about is having all 
families at 400 percent of poverty, a family of four earning $80,000, 
being on government health care. What they're talking about is the 
largest expansion of Washington-controlled bureaucratic health care we 
have seen in decades, and this expansion of Washington-controlled 
bureaucratic health care is not the recipe for America.

[[Page H8286]]

  All of us know from the fact that we represent Americans that the 
cost to health care and the cost of health insurance is an enormous 
crisis in America today. Finding good quality, affordable health care 
is a big problem.
  And so what the majority is doing is, rather than attacking the root 
cause of health care inflation, rather than looking at what is 
producing these high costs, they're simply saying we will just pay for 
more of that from the government. They simply want to take more control 
in Washington and go down the same path, the same path where, today, we 
spend two-and-a-half times per person on health care of any other 
industrialized world; yet, today, we have 46 million people who have no 
health insurance.
  We have a system today where all the fiscal experts in Washington and 
across America from the left and the right are telling us health care's 
unsustainable, the entitlements in this country are bankrupting 
America, that our children and grandchildren simply won't be able to 
pay for the government of tomorrow because of the cost of health care 
today and the trajectory it's on.
  We believe in a different philosophy, a different alternative. We 
believe we can have affordable, accessible health care that is patient-
centered, that is patient-driven and patient-controlled health care.
  And so that is why we have a very different vision of this 
Washington-controlled bureaucratic health care, where the patient and 
his or her doctor are making the decisions in health care, where we 
actually go at the root cause of health care inflation and attack those 
causes so that people get affordable health care at a good price and 
good quality, and that the patients are the ones who are the drivers of 
the system.
  Today, under the third party payment system we have today, either an 
HMO bureaucrat or a government bureaucrat's making the decisions, and 
we as consumers really don't care what things cost because someone else 
is paying the bills. We can't shop around based on quality and price 
because we don't know what quality and price is or we're told who and 
where we've got to go to by our closed network. That's a system that's 
unsustainable. That's a system that we have today, but this is the 
system that the majority wants to not only expand, but they want to 
turn more of it over to Washington, more of it over to government 
bureaucrats making our health care decisions which will cost us even 
more money, $50 billion to be specific, in this bill that's going 
through the Ways and Means Committee and Commerce Committee this week.
  But the key here is that we have 16 percent of the GDP, 16 percent of 
the economic output of this country is dedicated to just health care. 
The Democrats want that to grow and grow and grow. What's ironic about 
this is the other 84 percent of health care doesn't work like the 16 
percent of GDP that health care consumes, because the other 84 percent 
of our economy operates on the basic free market premise of 
competition, competition on price, competition on quality. If you don't 
do a good job, you don't get more business. If you're not price 
competitive, people aren't going to buy your product.
  Unfortunately, that is not how health care works today, and those are 
the reforms that we want to inject into health care so that people can 
get affordable, accessible health insurance coverage, health care that 
is very high quality and that doesn't grow at 6, 10, 20, 18 percent of 
price increases every single year.
  So we have two different philosophies, two different visions of where 
we want to go to with health care. We very much believe in putting the 
patient at the center of the equation, giving the patient and their 
physician control over the health care system so health care providers, 
rather than oligopolistic pricing, rather than just raising prices on 
everybody, will compete again for our business on price and quality.
  What the majority wants to do is continue this system, where 
providers continue to raise prices over and over and over, third 
parties make the decision whether it's a bureaucrat at an insurance 
company or a bureaucrat in Washington, and they simply want to raise 
more taxes to pay for more of this.
  In this particular bill, they want to cut Medicare patients. They 
want to raise taxes on low-income individuals in order to pay for this 
unprecedented expansion of Washington-controlled bureaucratic health 
care. To me, that's not the right way to go. It's not the right 
priorities, and what it will do will be to get more difficult for small 
businesses, individuals, families and even large businesses to be able 
to afford health insurance.
  That's not the path to take. That's the way that's going to bankrupt 
this country. That's going to raise our taxes and that's going to take 
health care decisions away from individuals and families.
  That's the approach that we want to go, and I just am pleased to see 
that my colleague from Georgia and New Jersey have joined in this 
debate on the floor because it's a very important debate. I would argue 
that the cost and affordability and accessibility of health care is the 
largest domestic crisis facing America today, and it's high time we do 
something about this.
  I just want to thank the gentleman for including me in this debate.
  Mr. PRICE of Georgia. I thank the gentleman for his comments and 
really succinct presentation of the issue of health care and the 
philosophical difference between the two parties, philosophical 
difference between the majority party and our party at this point.
  The majority party believes that Washington-controlled bureaucratic 
medicine, bureaucratic health care is exactly what the country needs, 
and we don't believe that. We believe firmly in patient-centered health 
care and patient-centered decisions as it relates to health care.
  So I thank you very much, and you point out as clearly as anybody 
could ever do the philosophy on that side of the aisle, once again, 
that is, if we just give it more money, give it more money, it will 
somehow miraculously improve.
  You know as well as anybody as the ranking member on the Budget 
Committee that when the estimates are a certain amount, it's never that 
amount. So if $50 billion is the estimate for the first 5 years and 
$100 billion for the 10-year period of time, it will never remain at 
that level. When folks across America hear that kind of comment, they 
just better say I better hold on to my wallet.
  I'm pleased to yield to you once again if you have any other 
comments.
  Mr. RYAN of Wisconsin. All I would say is I think most Americans 
realize, if you're spending someone else's money, you are not going to 
be judicious with that money like you are with your own, and that is 
what we do here in government.
  And in health care, by asking Washington to spend our taxpayer 
dollars, they are not spending it like it's their own money. Think of 
what's happening in health care. In health care, they're spending 
someone else's money, our money, and they're spending it in a very 
irrational way, and it's giving us high health care costs. That is the 
basis of this third party payment system.
  And so by simply saying we're going to raise taxes to spend more 
money in Washington on health care in a system that takes control of 
health care out of the hands of the patient, him- or herself, is just 
wrong.
  I can't think of a more intimate and personal decision you experience 
in your life than making a decision over your own health care. Yet, 
they want more bureaucrats to make that decision than individuals. They 
want Washington to control this system. They want HMO bureaucrats to 
control this system and not the patient and their doctor.
  That is the real core of the issue here, who you trust. Do you trust 
Washington with your money to make personal decisions for you or do you 
trust individuals to make them for themselves?
  I would argue, and I think the evidence is clear, that when 
individuals make the decisions for themselves, when they're spending 
their own money, when they're talking to their doctor and making 
decisions on their own treatments, with affordable insurance, that the 
system's going to be far better, people are going to be much more 
satisfied, and we're going to save a lot more money and we'll have 
healthier outcomes.

[[Page H8287]]

  So it's a real difference in philosophy, and where we see competition 
working, prices go down and quality goes up, even in health care.
  I will just give one final conclusion. I used to have really bad 
eyes. I had 8.5 in this eye and 8.0 in this eye, which means you have 
really bad eyes, about 2800 vision. In the year 2000 after years and 
years of wearing contacts, I decided I'm going to get this LASIK 
surgery, and that LASIK surgery cost me $2,000 an eye for a total of 
$4,000 out-of-pocket discretionary spending in elective surgery. They 
used this Excimer Laser at the time, and it went very well. I can see 
your charts extremely well. I can even see the detail on your tie. 
You're standing about 20 feet away me, and the LASIK worked well.
  Well, what is LASIK procedure now in the year 2007 where it was in 
the year 2000? It costs $800 an eye at the same place, and they've 
revolutionized this procedure, revolutionized this Excimer Laser they 
use four times over. So the procedure is much better in quality, it's 
much better in recovery, and it costs $800 an eye instead of $2,000 an 
eye. $1,600 instead of $4,000 seven years ago. Better quality, lower 
price, because of competition.
  So, even in health care, with complicated things like eye surgery, 
you can see where competition is allowed to work, is allowed to 
flourish, that good results can occur, and that is the way out of this. 
That is the way forward, and that is the lesson that we need to learn 
as we go through this, instead of raising taxes on Americans and having 
more Washington-controlled bureaucratic health care, which has given us 
this double digit inflation on health care.
  And with that, I'd be happy to just yield back to the gentleman, and 
I thank him for including me this time debate.
  Mr. PRICE of Georgia. Thank you ever so much for your comments and, 
once again, succinctly pointing out the rationale for why it doesn't 
make sense for Washington to be controlling health care.
  And sometimes I get the question as a physician, what does it mean 
specifically? What kind of issues would the government insert 
themselves into? If I think back on personal experience that I have, 
there are a number of issues where Washington and governments insert 
themselves into health care. The reason that it sometimes isn't easy to 
see is because patients don't often see it.

                              {time}  2315

  I worked for a period of time in a veterans hospital in Atlanta, and 
every quarter there were a certain number of joint replacements that 
were allowed to be done at the hospital. When we got to the end of that 
number, even though it wasn't the end of the quarter, there were more 
patients that needed joint replacements, we couldn't do them. We 
weren't able to do them because the resources weren't there to be able 
to fund them.
  Now, the patients that didn't get their joint replacement in May or 
June because they were rescheduled to July didn't know that the reason 
they didn't get their joint replacement in May or June wasn't because 
there wasn't anybody to do it, or there weren't any prostheses to 
implant, or the nurses weren't there, or the operating rooms weren't 
functioning, no. They didn't know that the reason they weren't getting 
it is because the Federal Government wouldn't pay for it. That was the 
reason.
  So, the government inserts itself in so many ways into the practice 
of medicine. Medicaid programs are a classic example. Medicaid programs 
across this Nation, which are government-run health care for lower-
income individuals, the vast majority of States have formularies for 
drug prescription plans in Medicaid, which means that the government is 
deciding which drugs are available for folks at the lower end of the 
economic spectrum. That's wrong. That's simply wrong.
  Now, there is a way to solve that without the heavy hammer of the 
government, because when the heavy hammer of the government comes in, 
what happens is that they just put more restrictions on, or they make a 
change, and for 2 months it's the right change to make.
  But government isn't nimble, it isn't flexible, it can't change 
easily. Even if it made the right decision at one point in relatively 
short order, it would be the wrong decision, because science moves on, 
medicine moves on, health care moves on. There is no way the government 
can catch up, which is why the importance of having patient-centered 
decisions, patients and their families making decisions in concert with 
the consultation with the physician, is so incredibly important.
  I yield to my good friend from New Jersey (Mr. Garrett).
  Mr. GARRETT of New Jersey. The last point you make as far as the area 
of intrusiveness of the Federal Government and how they are sometimes 
basically out of step with what is appropriate between the normal 
doctor-patient relationship, maybe that's because the Federal 
Government and all governments in general always lag behind the private 
sector, whatever field you might consider, as far as innovation and 
moving ahead and new areas.
  I mean, think about it. You can go to the store tonight and buy any 
item that you possibly want, whip out your credit card and slip it 
through a machine. Within seconds that transaction is created, and they 
know your credit rating and whether you have money in that bank account 
to pay for that item. It's all done just in the blink of an eye.
  Go to your local town hall or go to the IRS or go to anybody else 
like that and see whether they are up to date with that technology, and 
you will find out they are not. Those are okay, because that's not a 
life-and-death situation. But you, as a physician, know that when it 
comes to a life-and-death situation, or we all know, that we want our 
children and our spouses to be able to have the most up-to-date, the 
most innovative, the most advanced technology available to them.
  I think that is going to be found on the marketplace of ideas that is 
in the general marketplace, as opposed to the convoluted, Byzantine 
system that we call this, the Federal Government.
  Mr. Ryan just stated that what the Federal Government is attempting 
to do here, with the expansion of this program, as we come to the floor 
tonight, we mark approximately the sixth month of control of the 
Federal Government under Democrat leadership. As we mark this sixth 
month, we have seen the largest expansion in taxes, the largest tax 
increase in U.S. history. I guess, as we discussed here on the floor 
tonight about the Democrat plan for the expansion of the SCHIP program, 
we see the largest expansion intrusion into the family and personal 
life by the health system, by the expansion of the SCHIP system.
  The point I just wanted to make, though, is take a look at how the 
system has worked so far with respect to the system, the distribution 
of money to the States. If you go back to I guess it was 1968 or 1969, 
the first couple of years under the Nixon administration, and he came 
up with a program of distributing money to the States that was called 
revenue sharing. That was a new idea at the time, and after a time we 
realized it didn't really work exactly the way Nixon intended it to do. 
In fact, he tried to do it in certain areas like education and was 
never able to get it into legislation. Yet the same sort of idea here, 
in the original version and the version that will be coming out in the 
Senate as well.
  In a similar situation that we can all relate to, say you have four 
kids in your family, and you are going to give them all $40 to spend 
each week. So you give each one of your children $10 each. So here, 
Child One, Two, Three, Four, presumably you have better names than that 
for them, here is $10 each. You each get to spend it on anything you 
want during the course of this week. But, mind you, when the weekend 
comes, if you don't spend it, if one of the other ones here happens to 
go over their budget, and you didn't spend it all, what we are going to 
do is redistribute those funds to the other child there.
  What do you think that your kids are going to do? I would imagine 
that each one of them is probably going to go out as soon as they 
possibly can, spend that full $10, and maybe even spend $11 just hoping 
that there will be some money left over from their siblings there to 
spend it.
  Well, children, not to make the comparison here to the States, but 
the States here are a lot like children in

[[Page H8288]]

this situation. This system was set up with $40 billion initially 
spread out to all the States. It was done, you might say, as fair as 
the Federal Government goes, as far as how many children may be in the 
program versus how many children are under other programs. But what 
happened immediately after that, when they told the States, now, look, 
if you don't spend your money, we are going to take your leftover money 
and send it to the other States? Well, initially, in the first couple 
of years, a number of States did not spend all their money. In 2001, 
only 12 States exhausted their entire allotment. However, once they saw 
how that all came down, in 2006, 40 States used all available funds. In 
that same period of time, unused State funds dropped from $2 billion to 
only $170 million.
  So, finally, in this past appropriations, we had to step in, because 
there was too few States not spending all their money, too many States 
spending it. So we had to come up with spending of an additional $393 
million that was recently appropriated to address the 2007 shortfall. 
That just goes to show you one of the inherent problems in the system 
and the way it has been administrated in the past and, I believe, will 
continue under this system as well.
  Mr. PRICE of Georgia. I thank the gentleman for pointing out the 
shortfall of Federal Government rules, because they can't ever catch 
up.
  My State, Georgia, was one of those States that spent too much. It 
spent too much, we would argue, in Georgia, because we were too 
efficient at signing up children in the program.
  Because the formula wasn't flexible, wasn't nimble enough, couldn't 
accommodate for a State that overperformed, if you will, then it wasn't 
able to be able to get the match that it was promised. Whether or not 
that should have happened in the first place is a different question. 
But the fundamental challenge that we see in all of this is that the 
Federal Government can't respond, and it can't respond in so many 
different ways.
  But what we see with this chart here that my colleagues know very, 
very well, and that is that there are all sorts of children out there 
right now across our Nation that are covered by private insurance. What 
happens when the Federal Government and the States get involved and 
they say, let's put this carrot in front of you; let's entice you to 
come and join government-run health care? What happens?
  The fact of the matter is that there is a crowd-out phenomenon, that 
individual families who currently have private insurance, either they 
or their employer looks at the program and they say, well, we could 
save that money by having you enroll your children in government-run 
health care.
  Mr. RYAN of Wisconsin. So what the gentleman is saying is because you 
have so many families and children with private health insurance, with 
this new expansion, taxpayers will be replacing that private health 
insurance and paying for families who already have health insurance?
  Mr. PRICE of Georgia. That's exactly right. That's what we saw with 
the previous program. It happens every time when you have a government 
program that potentially can supplant the private program.
  In 1998, 28 percent of the children in our Nation were covered by 
some sort of government-run health insurance. In 2005, 45 percent. This 
is a combination of SCHIP and Medicaid.
  Now, the problem is that when you look at the number of children that 
are covered by private health insurance in our Nation, up to 200 
percent, 50 percent of them are already covered by private health 
insurance. If you go up to 300 percent, which is what the Senate 
proposes, 70 percent of the children in America whose families have 
incomes less than 300 percent have some form of private health 
insurance.
  Mr. RYAN of Wisconsin. At 400 percent?
  Mr. PRICE of Georgia. At 400 percent it's nearly 90 percent.
  Mr. RYAN of Wisconsin. So in the bill that's coming to the House 
which takes SCHIP to have government, Washington-controlled, 
bureaucratic health care, for all children at 400 percent poverty, 
those families, 89 percent of those family already have health 
insurance. We are talking about having the government step in, raising 
taxes on taxpayers, and having the government take over the provision 
of health care for a group of families, 89 percent of whom right now 
have private health insurance?
  Mr. PRICE of Georgia. That's exactly right. That is the crux of the 
matter. If everything else were equal in the system, if it were to 
allow for the same kind of ability for patients and families and 
doctors to make decisions, that might be one thing. But as we have 
talked about, and as everybody across this Nation knows, that's not the 
case.
  When you have government get involved in the provision of health 
care, government is going to make decisions about where you can be 
treated, who can treat you and what kind of treatment you can have. 
That's where the personal health care decisions go away from the 
individual. I don't believe, and I know you don't believe, that that's 
what the American people want. It's up to you.
  Mr. RYAN of Wisconsin. So just to expand on this point a little bit 
further, we have here a situation where 89 percent of the children in 
these families are already covered by private health insurance that 
their parents had purchased, that their parents and employers probably 
had provided them. So what we are proposing here in this bill is that 
we raise taxes on the American taxpayers, and that we pay for 
government-controlled health care to replace that health insurance that 
they already have.
  Mr. PRICE of Georgia. Yes.
  Mr. RYAN of Wisconsin. So we are going to pay for a system that we 
already have coverage of so that we can raise taxes and have the 
government control their health care system. That is a system, that is 
a sense of priorities that just doesn't square with the American people 
that I know. That is not what people in Wisconsin sent me to Congress 
to do.
  I don't believe the American people, if they really know the truth 
and the facts surrounding this issue, want to see their taxes raised so 
that Washington controls the health care for all of these families, for 
all of these children, especially when they already have health care 
provided to them.
  I think people understand that if we truly have uninsured poor 
children, that they ought to get health insurance. I think there is no 
disagreement here about making sure that uninsured low-income children 
receive health insurance.
  But talking about providing government-controlled health care to 
families that already have health insurance and raising taxes to do 
that, that just doesn't jive with the priorities of the American people 
and the American taxpayer, in my opinion.
  Mr. PRICE of Georgia. No, it doesn't make any sense at all. It lays 
bare the true motive and the true philosophy, which, on the other side 
of the aisle, at least the true leadership who are pushing this 
legislation, their belief is that government knows better how to spend 
people's money than the people themselves. This stretches all the way 
into the area of health care, which, as you mentioned, are very 
personal, personal, health care decisions.
  Mr. GARRETT of New Jersey. I know that the gentleman from Wisconsin 
would be able to elaborate on this in much more detail, but in the best 
case scenario, would that the Federal Government be awash with cash 
right now, and would that we had no mandatory spending problem going on 
in the Federal Government right now, maybe some people would want to 
sit down right now and say, how can we spend our extra dollars around 
the country?
  But as the gentleman can elaborate in much detail, and we have seen 
in the Budget Committee for the first months of this year, testimony 
after testimony after testimony, expert after expert after expert from 
all spectrums of authority, we are now in that situation where we find 
ourselves with the Federal Government and mandatory spending going out 
of control. There are legitimate groups within that that the American 
public would agree with, or those that we should be targeting, to make 
sure that they do.
  The aged, the poor, the infirm, who desperately need medical care and 
are not able to cover it by themselves and are not fortunate enough to 
be able to work any longer, and who are not working now and covered by 
an employer plan, and did not unfortunately

[[Page H8289]]

work for a company that provides for a company-sponsored plan after 
their termination at work, those are the people that the American 
public would ask that's where our focus would be.
  But do we find ourselves in our situation right now where we can say 
that we have all the other mandatory spending under control that we can 
address this now?
  Mr. RYAN of Wisconsin. All three entitlement programs that are in 
place today, Medicare, Medicaid Social Security, all go bankrupt in 
about 10 years. It's because we are doubling the amount of retirees in 
this country at a time where we were only increasing those taxpayers 
into the program by 17 percent.
  So we are seeing a 100 percent increase of the consumers of those 
three entitlements, while only experiencing a 17 percent increase of 
the taxpayers in these entitlements. That's why these three programs 
are going bankrupt. That's why these three programs will consume 100 
percent of our budget by about 2030. By about the year 2040, when my 
kids are my age, they will have to pay twice the level of taxes we pay 
today just to keep today's Federal Government going at that time.

                              {time}  2330

  We have run this Federal Government remarkably constant at about 18 
percent of GDP. We have had to tax the U.S. economy at about 18 percent 
of the output of the economy just to run the Federal Government for 
about the last 40 years. And what we are on the trajectory today 
because of the aging of America and way the entitlement programs are 
designed and the baby boomers retiring, my children will have to pay 40 
percent of GDP just to keep today's Federal Government going when they 
are at my age group. You can't have a strong growing economy, a high 
standard of living.
  So what we are in the middle of doing here, we are deciding whether 
or not we are going to sever that American legacy to our children and 
grandchildren. And the American legacy that I was taught by my parents 
was that you leave the country better off for the next generation than 
when you received it. You leave a standard of living better off for 
your children and grandchildren than that which you received from your 
parents. We are at risk of severing that legacy for our children and 
grandchildren if we are going to confound them to a system to where 
they will literally have to pay twice the amount of taxes to just the 
Federal Government than we do today.
  At a time when we are in tough competition and globalization with 
China and India, it is impossible to pretend that we are going to be 
able to enjoy this kind of standard of living if we are requiring our 
kids and our grandkids to pay double the amount of taxes they pay today 
to Washington when they are in our age bracket. It will just be 
fundamentally irresponsible if this is the future we would confine them 
to, yet that is exactly the trajectory we are on today.
  Mr. PRICE of Georgia. You are absolutely right. And to give some 
credibility to that from a pie chart standpoint, these are the 
mandatory spending programs, and all of what you said happens unless we 
act. Unless we act as a Congress, all of these things happen.
  In 1995, those three programs were this yellow portion, about percent 
48.7 percent of Federal spending. In 2005, about 53.4 percent. In 
relatively short order, 2017, 62.2 percent. And, as you mentioned, in 
2030 the yellow portion of that will be the entire pie.
  Mr. RYAN of Wisconsin. And if the gentleman will yield, so the blue 
portion, which is what we call discretionary, that is national defense, 
the Department of Education, the Department of Commerce, the Department 
of Energy, Transportation, roads, bridges, the Pentagon, all of those 
things are the blue portion. There won't be any money left for those, 
Will there?
  Mr. PRICE of Georgia. You are absolutely right. And that is why you 
mentioned the significant increase in taxes that would be required, and 
that is if we don't do anything. That is why it is so imperative that 
we act, which is why it was so astounding to me that this new majority 
that came in with this ``new direction'' that they were going to take 
us on for our Nation. You know what happened when they had the 
opportunity to bring about some entitlement reform.
  What happened with the bill that they passed this year in their 
budget was no entitlement reform, in spite of the fact that we worked 
as diligently as we could back in 1997 with the Balanced Budget Act, 
about $130 billion of entitlement reform, and fought like the dickens, 
as you remember, in 2005 with the Deficit Reduction Act to get about 
$40 billion in entitlement reform.
  But this new majority comes in with the previous chart that we saw, 
increases in Social Security spending, increases in Medicare spending, 
increases in Medicaid spending, the prospect of another $100 billion 
entitlement with the SCHIP program if they have their way, and no 
reform. Can you imagine what that is going to do to our economy?
  Mr. GARRETT of New Jersey. If the gentleman would yield, And lest 
anyone following this get confused when we talk about the tax 
increases, the gentleman from Wisconsin set it out and you followed up 
with quite some detail, as far as the tax increase necessary in order 
to pay for those entitlement expansions over time. That would be in 
addition to what we have already seen has occurred during this first 6 
months in office.
  In other words, we have already seen the largest tax increase in U.S. 
history. And the current tax increase means that 115 million taxpayers 
are going to see a $1,716 increase in their tax bill in just a couple 
years; 84 million women would see their taxes go up by $1,970; 42 
million families with children, which is what we are down here talking 
on the floor about right now, those children, trying to be sure they 
have health insurance. Those 42 million families with children will see 
an increase of over $2,000 in their taxes already this year because of 
what the Democrats have done. And what you are speaking of is going to 
be in addition to and on top of that.
  In trying to just throw some numbers to the percentages that you were 
throwing out there before as far as this expansion of children that 
will come under this program now, those children who may be just living 
across the street from us who their dads or moms work for a company 
right now that provides them insurance, all of a sudden those companies 
don't provide it anymore because now the government, we are going to 
pay for it.
  Or those children who have parents who have retiree benefits and are 
getting insurance for them now, they will no longer have to get it from 
their retirement pension programs; the government, meaning taxpayers, 
will pay for it.
  The CBO just came out with some numbers on this, and real numbers 
means that for the first, just the expansion of the program as far as 
additional dollars means 600,000 new children who used to yesterday 
have coverage under the private sector will now look to the taxpayer to 
pay for it; and another 600,000 children yesterday who had insurance, 
whether through pensions or their parents' employers, will now look to 
the Federal taxpayers. So 1.2 million children. Now, that is under the 
House version. That number, I haven't gotten a CBO estimate yet, would 
be even greater under the Senate version as far as children expanded 
into this program who are already covered.

  Mr. PRICE of Georgia. I appreciate your pointing out the issue of 
taxes, because there has also been work that has laid out the tax 
increase for the average citizen in every State across this Nation. And 
in Georgia, that average increase is $2,700 average tax increase when 
those tax increases go into effect if they are not changed. They were 
included in this budget that included no entitlement reform. In 
Wisconsin, the average number was $2,964. And New Jersey is a big 
winner, average increase $3,779.
  Mr. GARRETT of New Jersey. We are number one in a number of things, 
in the number of taxes that we pay and the number of taxes that the 
Democrats are going to make us pay in the future as well.
  Mr. PRICE of Georgia. I want to thank you all for joining us tonight. 
I do want to close on a positive note, and that is that there is an 
alternative. And the alternative, as we talk about, is patient-centered 
health care. And patient-centered health care, as you know, puts the 
opportunity and the

[[Page H8290]]

right and the privilege and the responsibility for decisionmaking among 
patients and their doctors, among families and their doctors. And the 
way to do that is to structure a tax system that allows individuals, 
incentivizes individuals to purchase health insurance, through whether 
it is tax deductions or tax credits, or advanceable refundable tax 
credits, through high-risk pools, through risk pools that allow people 
to pool together, making certain that individuals have the same kind of 
tax treatment for the purchase of health insurance as employers do now, 
as businesses do now, all sorts of wonderful ways to bring about the 
opportunity for folks to purchase health insurance.
  So it is not whether or not you have the current system or whether 
you march down the road to more Washington-controlled bureaucratic 
medicine. There is another way. And I know my good friend from 
Wisconsin has worked on this extensively on Ways and Means, and I would 
be pleased to hear your comments.
  Mr. RYAN of Wisconsin. I just think that we have a different vision, 
and that vision is that we believe we can provide a system that gives 
us universal access to affordable health insurance for all Americans, 
where they and their physicians are the nucleus of the medical system. 
What the majority is offering is a bankrupting entitlement system, 
massive tax increases unprecedented, in addition to the largest tax 
increase in American history that they have already passed here on the 
floor this year, and more Washington-controlled bureaucratic health 
care, where bureaucrats, either HMO bureaucrats or government 
bureaucrats make the decisions in health care rather than patients and 
their physicians. We can come up with a system that is patient 
centered, where every American has access to affordable health 
insurance, where we have universal access to affordable health 
insurance throughout America. Or that person who has a risky health 
care profile, may be overweight and has diabetes, has a history of 
cancer in the family, we can come up with a system where that person, 
too, can get affordable health insurance and get access to it without 
having the government run the entire system, without have to go through 
a government or an HMO bureaucrat to make decisions on how you get your 
care. You ought to be able to go to your doctor and come up with a good 
treatment plan that works for you, and that is where the decisions 
ought to be made.
  And more important to that, all the health care providers, the 
hospitals, the physicians, all those who are in charge of providing 
care in the health care system will compete against each other for the 
consumers and the patients' business. That is the vision we see, where 
everybody has access to affordable health care and it is a patient-
centered system, not a government-driven, government-run, 
bureaucratically controlled system. And I just thank the gentleman from 
Georgia and the gentleman from New Jersey for taking this time to 
address this incredibly important issue.
  Mr. PRICE of Georgia. I appreciate the gentleman's comments from 
Wisconsin. And this is what we believe, patient-centered health care, 
and we going to work on putting some limbs and leaves on the tree of 
this over the next number of weeks and number of months, and make 
certain that the American people understand, Madam Speaker, that there 
is an alternative and it is a positive alternative. Because we live in 
a wondrous and a grand Nation, and a Nation where when individuals are 
allowed to encourage their own visions and their own dreams and their 
own entrepreneurship and their own work, that they can decide what is 
best for themselves, not government.
  Nobody across this Nation I believe is truly interested in having 
Washington-controlled bureaucratic medicine, yet that is the road that 
we are about to march down if this new majority has their way. Our 
alternative is patient-centered, patient-centered health care and 
allows individuals to make decisions with their families and with their 
physicians and with their health care providers.
  I look forward to working with colleagues on both sides of the aisle 
to make certain that as we move forward on this issue, that we move 
forward in a way that ensures that those decisions, those very personal 
decisions are able to be made in a very personal way without the 
government limiting care, without the government determining where you 
can be seen and who can see you and what kind of treatment you would 
receive.
  Madam Speaker, on that positive note and looking forward to patient-
centered health care across this Nation, I want to once again thank the 
leadership for allowing us to spend this time on the floor.
  I yield back the balance of my time.

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