[Congressional Record Volume 155, Number 125 (Tuesday, September 8, 2009)]
[House]
[Pages H9328-H9332]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Texas (Mr. Burgess) is recognized 
for the remaining time until midnight.
  Mr. BURGESS. I thank the Speaker for the recognition. I almost feel 
like now that I have got equal time for a reply from the last 45-minute 
segment, I would remind my friends on the majority that they are in the 
majority. This is the House of Representatives of the United States. 
Any bill can pass on the floor of this House with 218 votes. As I 
recall the last numbers, we have 177 Members on the Republican side, 
you have 258 members on the Democratic side. That means you can pass 
pretty much whatever you want whenever you want as long as you keep 
only 40 Members of your party from straying, and you can only lose 40 
Members from your side and you can pass whatever you want.
  Now we read some articles in the paper today where there are 23 
Democrats who say no way are they voting for this health care bill 
after they have been through the summer that they have had. Okay, you 
still have a comfortable margin of 20 votes to pass whatever bill you 
want. So, please, don't set this up as a straw man Republican versus 
Democratic argument. The Republican Party in the House of 
Representatives in this Congress cannot stop you from passing anything 
that you want to pass. We do not have the numbers. We do not have the 
organization. Some might argue we don't have the leadership to block 
anything that you want to pass.
  So your argument is an internal argument. It is Democrat versus 
Democrat. Bring the bill to the floor of the House that you want to 
bring. Bring it to the Rules Committee. You certainly have done it 
plenty of times. Bring it to the floor of the House. We will have our 
obligatory 2 hours of debate. We will have the vote, win the vote, and 
send it over to the Senate. You have 60 votes on the Senate side. This 
should not be a challenge for you. Send it down to the White House. You 
have a President who will sign virtually anything you send down to him.
  This is not an argument that you are having with Republicans. This is 
an argument you are having internally within your own caucus. And why 
are you having that argument internally within your own caucus? Because 
you have not sold this proposal to the American people. And you felt 
that acutely during the August recess.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The gentleman is reminded to address his 
remarks to the Chair and not to others in the second person.
  Mr. BURGESS. Absolutely. I will refer to the Chair.
  Madam Speaker, this is because the other side did not make the sale 
to the American people. They did not engage the American people from 
the bottom up, from the grass-roots up, which is the way you have to do 
tough legislative proposals, transformative legislative proposals. You 
don't start at the top and work down. That's the Soviet style of doing 
things, Madam Speaker. This is America. We go from the grass-roots up.
  Our friends on the Democratic side chose not to do it that way. 
Instead, they would rather vilify Republicans because, after all, 
that's what helps them raise money and win votes. And after all, isn't 
it all about just winning votes and maintaining your majority? You're 
not really held to account by the American people as to whether or not 
you pass your agenda or not, apparently, if we are to believe the poll 
numbers.
  But, Madam Speaker, I do not believe this can be done from the top 
down. I do believe this has to come from the grass-roots up. We saw a 
Member of Congress, a Democrat in one of the midwestern States, 
plaintively ask her audience on YouTube during the month of August 
during one of the August town halls, don't you trust me? And the 
response she got back from her audience was, well, apparently not. The 
audience didn't trust her.
  All across this country, Members of Congress have heard the voices of 
August. The question is, the real question for this House is, was 
anyone listening to those voices as they were speaking to us?
  Right now, this Congress has historic low credibility ratings. We 
have some of the lowest credibility ratings in the

[[Page H9329]]

last 26 years. Two years ago, 2\1/2\ years ago, when the Senate tried 
to pass massive immigration reform, they found because of the very low 
credibility levels that they had that no one trusted the United States 
Senate to pass this type of immigration reform. As a consequence, 
despite the backing of two very powerful Senators, one on the 
Republican side and one on the Democratic side, despite that very 
powerful backing, they were unable to pass sweeping immigration reform 
in 2007. The American people recoiled in horror when they saw what was 
happening, flooded the Senate switchboard, shut down the Senate 
servers, and the Senate got the message and very quickly went on to 
other things that might occupy their time for the rest of that summer.
  Well, this summer has been no different. Switchboards have been shut 
down. Servers have been overwhelmed. The American people have weighed 
in on this issue, and it is overwhelmingly opposed to what the Speaker 
of the House has pushed through the three committees here on the House 
side.
  Now, if we do not have the credibility to do a sweeping proposal, a 
sweeping legislative proposal such as has been before us, to 
essentially allow the government to claim one-seventh of the Nation's 
economy, if we don't have the credibility to do that, should we just do 
nothing? Or should we, in fact, try to achieve some deliverables for 
the American people? I think every one of us heard that the American 
people are interested in us effecting some reforms. We heard some of 
them mentioned just in the last hour on the Democratic side. There are 
things on which we do agree. There are things on which we can work. And 
there are deliverables we can accomplish for the American people.
  But the fact of the matter is the American people do not trust us, do 
not trust us to undertake this type of sweeping reform and transform 
the way health care is delivered in this country such that many people 
may not even recognize it.
  Now, I do take some exception to some of the comments that I heard in 
the last hour. I was a physician. For 25 years, I practiced medicine. 
There are plenty of times I got up in the middle of the night, and I 
knew that delivery I was going to do or that operation I was going to 
perform was something for which I would never be compensated. That's 
just part of the job. American physicians, men and women, show up all 
hours of the day and night to render this type of care, and they don't 
ask where the payment is coming from.
  People get taken care of in this country in a timely and respectful 
manner, and it happens every day of the week. And quite honestly, I am 
very tired of hearing the type of rhetoric we just heard on this House 
floor where America's physicians are seemingly indifferent to the 
plights of people who happen to be ill and uninsured. Patients are 
taken care of all the time across this country in clinics, in hospitals 
and in emergency rooms by caring physicians, caring nurses and caring 
hospital staff without regard for that patient's ability to pay. It 
happens every day of the week.
  It is so frustrating to hear people talk about the only way to pay 
for health care in this country is either through a private insurance 
or a government program. There is plenty of care that is just donated 
by the generosity of America's physicians, America's nurses and 
America's hospitals.
  In fact, the only thing standing in the way of this sweeping health 
care reform that the President is going to come talk to us about 
tomorrow night is, again, an internal conflict on the Democratic side. 
If we had done this bill in July, as had been proposed, if, in fact, we 
had voted on this bill on July 31, which was what the chairman of the 
three committees desired, which is what the President at the White 
House desired, had we voted on this bill by the 31st of July, we would 
have gone home to face our town halls; but it would have been a 
different equation because the bill would have already been passed and 
would be off to the Senate. But we didn't do that.
  A funny thing happened on the way to ramming this thing through, and 
many Members on the Democratic side began to hear from their 
constituents and began to hear that this was not perhaps such a good 
idea after all.
  Do bear in mind, Madam Speaker, 218 votes are what are required to 
pass any bill out of the floor of this House under a rule. The Rules 
Committee is the Speaker's Committee. The Speaker has a 9-4 advantage 
in that committee. The Speaker could get any rule pushed through the 
Rules Committee that she wishes. She could bring any bill to the floor 
that she wishes. We have seen it time and time and time again; 218 
votes are what is required.

                              {time}  2320

  Do not tell me, do not continue to perpetuate the fantasy that 
somehow 177 Republicans are able to prevent this bill from coming to 
the floor. And again, I would reiterate, you have the magic 60 votes in 
the Senate. You don't need reconciliation; you don't need a fancy 
procedural maneuver, you have the votes, 60 votes in the Senate, to 
pass whatever you care to pass. And of course you have a President who 
has already committed to signing this bill.
  One of the things that I heard a lot back home was a concern about 
the cost. And this is something that is going to continue to come up 
and continue to be problematic for anyone who wants to undertake a bill 
that is as sweeping as the one that we had before our committees last 
month. The bill itself had very little in the way of cost containment 
contained within the bill. Oh, sure, there were some physician cuts--we 
always rely on those--there were some cuts to home health care, there 
were some cuts to our radiologists and imaging, but in general there 
was very little in the way of cost containment in the bill.
  Now, we do hear a lot of talk and there is a lot of rhetoric on the 
issue of preventive care. Preventive care, preventive medicine, you 
bet, I'm for that. The cost savings from preventive care, though, are 
much less certain and the timeline to achieving those cost savings is 
also uncertain. In fact, the Congressional Budget Office in its report 
to our committee in July delineated the very low rate of return on 
those savings and the fact that it might be years before those cost 
containments were achieved. That doesn't mean that it's not worthwhile, 
it doesn't mean that it's not worth doing, but to go to the American 
people with the statement that we're going to do all of these things 
and we're going to be able to pay for all this additional care by not 
cutting anyone's services, but because we're going to do things better, 
faster, cheaper, smarter just, in fact, does not square with the facts 
and the American people have seen through that.
  Now, many of the studies have shown that in fact in the early years, 
by increasing the preventive regimen, the cost may in fact increase. 
And you would expect this to be the case because there is going to be 
more spent on the infrastructure necessary, more spent on the clinics, 
the exam rooms, professional personnel, nurse practitioners, 
paramedics, the physician extenders that are going to be necessary to 
see the increased numbers of patients who will be coming through those 
clinics as we increase the throughput through those clinics. So it is 
going to cost more money up front. I think there is broad recognition 
of that.
  Now, we did hear some concern about the Medicare part D program. I 
would just simply remind people that Medicare part D, when it was 
passed in this House of Representatives back in 2003, Medicare part D 
was a prevention-based strategy. It only made sense, if you were going 
to cover the doctor's expense, if you were going to cover the 
hospitalization as was covered under Medicare's part A and B at the 
time and you did not allow for the coverage of a prescription drug 
benefit, that it was going to be much harder to deliver on the promise 
of preventative care without the medicines available to prevent the 
illnesses that you wish to prevent. It seemed relatively simple and 
straight forward in 2003, it seems relatively simple and 
straightforward now.
  I think this Congress, I think the people who have written this bill 
would have done well to look at some of the things from the Medicare 
part D program that actually have worked very well. And true enough, 
there were some problems with Medicare part D as it was passed. There 
were some problems with implementation, I don't think

[[Page H9330]]

anyone would deny that. But the fact of the matter is that under the 
Medicare part D program, remember, there was no mandate. There was 
never a mandate that said a senior had to take a certain type of 
prescription drug coverage. Different levels of coverage were available 
to every senior. Every senior was encouraged to have some type of 
credible coverage for prescription drugs. There was a cut-off date 
beyond which there would be an increased cost for buying into the 
insurance program if someone did not enroll during the open enrollment 
period, but it did not come to us under the mantle of a mandate.
  There was no requirement that every senior buy coverage. There was 
simply the recommendation that every senior have credible coverage 
under the plan. In fact, there were some benefits for people if they 
went ahead and established that credible coverage by a certain cut-off 
date. And what that meant was that the companies that were involved in 
providing the coverage then were competitive on the basis of trying to 
create programs that people actually wanted rather than saying we know 
you've got to buy this, so we're just going to put one or two programs 
out there and you can pick or choose from one or two and take it or 
leave it. Dr. McClellan, Mark McClellan, who at the time was head of 
Medicare and Medicaid Services, said there were going to be six 
protected classes of drugs within the program. Within each of those six 
classes there have to be at least two different choices. And with those 
relatively simple parameters, the companies were allowed to go out and 
construct programs and go out there and compete in the marketplace.
  Now, we were told early on when we talked about this type of change 
in the Medicare part D program that in fact you will never get 
companies showing up to provide these products; you would have to 
mandate something, otherwise people just simply won't have any program 
at all from which to choose. But Dr. McClellan stuck to plan, and as a 
consequence, in some States we have well over 40 different plans that 
were there making available different types of Medicare part D 
coverage. In fact, we were criticized a year into the plan that there 
were too many choices, people couldn't possibly decide what to buy 
because there was too much choice out there. Well, in fact, it was a 
good problem to have. And as a consequence, now we have the Medicare 
part D program where the coverage rate is in excess of 90 percent, the 
satisfaction rate is in excessive 90 percent.
  And it rivals any insurance program with a mandatory or coverage 
mandate, whether it be an individual or employer mandate. By creating 
the type of program that people actually want, that is actually useful, 
that actually matters to them in their lives, we have been able to 
provide more coverage to more people at lower costs than anyone thought 
possible back in 2003 when the legislation was passed.
  Now, we heard very many compelling anecdotes in the past 45 minutes 
about people with difficult problems in tough medical situations. And 
no one would argue that those are not compelling stories. I would just 
remind people that are studying this issue that the bill that we had 
before us that came out of the three committees, the bill that will 
likely come to the floor sometime this month, while it does provide for 
a public option and it does provide for a public option for coverage, 
those methods of coverage do not become generally available to the 
general population until 2013, 3 years after the enactment of the bill. 
So those are not going to be immediate benefits that are going to be 
accessible by any of the tough situations that you've heard described 
here in the last hour. In fact, those programs are going to lag 
significantly behind the start-up time of that bill.
  Well, what can we expect in January when the bill starts if the bill 
is passed and signed as is planned? What can we count on in January? 
Well, you can count on the taxes occurring. Those certainly will. The 
taxes will begin January 1 of 2010. An 8 percent payroll tax on small 
business in this country. An 8 percent payroll tax may will be the 
largest single employment tax that has ever been passed in this 
country.

  This may be the largest single job-killing event to occur in this 
young century. This is something that we need to be very, very careful 
about as we go about enacting this legislation because we are in the 
midst of a recession. We are hopeful that the recession is ending, but 
one of the difficult things about ending a recession, as we found in my 
early years here in 2003 and 2004, that as a recession ends, job growth 
does not necessarily follow immediately. What is the major engine of 
job growth in this country? Well, it's small business. So if we don't 
do anything to encourage small business and in fact we go so far as to 
hurt small business, it will be very, very difficult to grow those jobs 
that are actually going to be what ultimately lifts us out of this 
recession.
  None of us likes to look forward to a jobless recovery, and yet that 
seems to be what's in the cards for us right now. This is a very 
serious situation and something to which this Congress should best 
place some heed because the absence of job growth in this economy will 
lead to that double dip or W-shaped recession that many economists talk 
about.
  I did have several meetings with small business owners in my 
district. I conducted forums with small business owners just to hear 
their concerns about what Congress was doing. And yes, we heard some on 
the energy bill that was passed earlier this year and how that would be 
a job killing piece of legislation, but a lot of concern over what is 
happening in health care. And even more to the point, there is so much 
uncertainty out there in the country right now. No one knows what we're 
going to do, Madam Speaker. Are we going to pass this bill? Are we 
going to put an 8 percent payroll tax on top of the taxes that small 
businesses already pay?

                              {time}  2330

  Many employers with whom I spoke told me, Yeah, the recession may be 
ending. We see some signs. Things seem to be easing up a little bit.
  Well, are you going to expand your business? Are you going to be 
adding jobs? Are you going to be bringing back some of those jobs that 
you outsourced or laid off?
  Well, I'm not so sure about that because the environment out there is 
kind of unsettled right now. We don't know what you're going to do with 
this health care bill. We don't know what you're going to do with that 
energy bill. As a consequence, we're going to put our expansion plans 
on hold for right now.
  I heard this over and over and over again.
  Now, to be sure, every business that I talked to was, perhaps, 
talking about adding one or two or three jobs, and they put those plans 
on hold, but when small businesses across the country are putting on 
hold plans of adding one, two or three jobs, spread over the entire 
country and over the entire economy, that's a significant number of 
jobs that are right now being held in limbo because, again, employers 
are not certain about what Congress is going to do next.
  Well, I think one of the things that came through loud and clear for 
me in listening to my constituents during the month of August was that 
Congress fundamentally lacks the trust of the American people to do 
something this large, and it is very, very difficult to do this in a 
top-down centralized fashion. We really do need to recruit, to 
encourage and to educate the American people as to what we are trying 
to do and as to where the value for them is in it on what we are trying 
to do rather than to just simply superimpose this large government 
program on the American people.
  You've heard it over and over again: Have you read the bill? Who can 
read the bill? It's too big. It's too complex. No one can understand 
it.
  This is a valid complaint, and it's reflective of the fact that this 
legislation is large, that it is sweeping and that people do not trust 
the Congress to make those kinds of changes on a portion of their lives 
that is that important to them. People do not trust the Congress to be 
able to do the right thing.
  We've heard over and over again from our constituents: Hey, if this 
is not even good enough for Members of Congress, why should we sign up 
for it? Why should we accept what you won't even take yourselves?
  Now, to be sure, during the debates in the committees, there were a 
number

[[Page H9331]]

of amendments that were offered. Some suggested that whatever the 
public option is and whatever it turns out to be should be the type of 
insurance that Members of Congress and that members of the 
administration and their staffs are required to take. That is, if it is 
good enough for the American people, it ought to be good enough for the 
governing class as well. I don't disagree with that. That amendment was 
knocked out on a technicality in our committee, and we never had the 
chance to vote for it. That ruling was appealed, and the appeal of the 
motion of the Chair was upheld on a party-line vote. So, essentially, 
every Democrat said, Hey, we don't want this coverage for ourselves. 
Every Republican said that we should at least have the debate, that we 
should at least hear the amendment and that we should hear from both 
sides on this issue, but we weren't allowed to do it. It was shut down 
in committee on a party-line vote.
  I had an amendment that would have made Medicaid available to every 
Member of Congress. Congress could be a mandatory population under 
Medicaid, so every Member of Congress would be covered under the 
Medicaid system, and every Member of Congress would then understand 
what it is like to try to find a physician--doctor--for themselves or 
for a family member in the Medicaid system. It can be very difficult to 
do that. Why is that? Because reimbursement rates under Medicaid are so 
low that members of the medical profession simply cannot afford to take 
large numbers of Medicaid patients into their practices for fear that 
they won't be able to cover their overhead and for fear that they will 
not be able to keep their practices open.
  Again, on a technicality, this was prevented from a vote, and it just 
underscores the hubris of the United States Congress when it will 
consider doing things to the American people, those things it would 
never consider doing to Members of Congress. People see that and they 
resent that. They can feel that it is not right that a Member of 
Congress would vote on a type of bill that would require Americans to 
take a certain type of insurance when that Member of Congress would 
have no intention of taking that insurance himself.
  We heard it in some of the townhalls that were conducted by the White 
House: Is this insurance something that will be good enough for members 
in the White House and for members of their staffs?
  No, not necessarily. We want something good for members of the White 
House.
  It is exactly that type of hubris that has gotten people so upset. We 
could deal with that. We could deal with that by requiring that any 
public option or that even Medicaid is something that is not just made 
available but required of Members of Congress, but we won't have that 
discussion. We won't have that debate. It somehow seems to be demeaning 
or beneath us to have that debate, but certainly that's a problem we 
could fix and that we could fix pronto.
  There was nothing in this bill that dealt with liability reform. As a 
physician, I will tell you that that is one of the single largest 
issues that faces physicians in this country. It is the constant threat 
of medical litigation, the expense of medical liability insurance and 
the cost of defensive medicine that drives the cost of the practice of 
medicine literally through the roof.
  A study back in 1996 by Dr. McClellan from Stanford University at 
that time estimated a cost of nearly $30 billion for two diagnoses in 
the Medicare system because of defensive medicine. Well, that was in 
dollars of 12 or 13 years ago. Imagine what those dollars have grown to 
today in our current liability climate.
  This is something that the American people understand needs to be 
fixed, and they simply do not understand why Congress will not at least 
consider entertaining the debate. What they see is that this is 
something that is being blocked by special interests and that this is 
something that is being blocked by a certain lobbyist group that is 
being prevented from even being discussed in a congressional committee. 
The American people look at that and say, Well, that's not right. We 
cannot possibly believe anything else that's in that bill, because we 
don't trust you to have a rational discussion about this.
  I dare say, if liability reform and fairness in the physician 
compensation system had been on the table at the very beginning, you 
might well have had some Republicans on board for this bill right from 
the start.
  What I do know is that you never tried. Never did any of the 
committee chairmen, Madam Speaker, and never did the President or the 
White House seriously try to achieve any type of bipartisan balance in 
this bill. It simply was of no interest to them because--and I'll go 
back to my early remarks about the arithmetic in the House--they can 
lose 40 votes in the House and still pass a bill. They have 60 votes in 
the Senate. They can cut off debate at any time and pass a bill and 
send it down to the White House and get it signed into law.

  We heard over and over again in our townhalls this summer about the 
problems with preexisting conditions and about the problems with 
insurance recision. We're talking about insurance reform. That is 
something that we could accomplish. Yes, there are some thorny issues 
to be addressed, but it's certainly no more difficult than anything 
else we've taken on. We could have solved that problem. We could have 
debated that problem. We could have voted on that problem before we 
went home for the August recess, and we could have shown the American 
people that, in fact, we were serious about taking care of a very 
serious problem that affects 8 to 10 million people in this country, a 
problem that prevents them from getting the health care coverage they 
would like to have.
  Yes, there are going to be some difficult arguments to have over 
rating bans. Yes, there are going to be some difficult arguments as to 
whether or not there is a premium cap or whether or not there is a 
premium to be paid for someone's not having had insurance before 
someone got a tough diagnosis. We can have those arguments. There 
perhaps could be new moneys made available in State and Federal 
subsidies for people who can't afford the cost of a State high-risk 
pool. Nevertheless, we could have those debates. We could have those 
arguments. We could look at those figures and decide what a correct 
number would be. Again, that is something that is easily within our 
level of achievement, and this House could have done it before we went 
home for August, but for some reason, we chose not to.
  On the issue of portability, we could have dealt with that before we 
went home for the August recess. One of the biggest problems that 
people are having right now is job loss because of the recession. Yes, 
if someone loses his job and he has employer-sponsored insurance, it 
becomes tough to continue that insurance. Under COBRA, employer-
sponsored insurance has to be offered for the next 18 months, but it's 
extremely expensive. For someone who has just lost his job, to be able 
to cover his portion and the employer's portion and an administrative 
fee becomes terribly difficult, but we could have dealt with that. The 
fact of the matter is we chose not to. We chose to go home for the 
August recess with our work being undone, and the American people saw 
right through that. That's why they were so frustrated with us in the 
month of August.
  Now, we heard on one of the Sunday shows this weekend that the 
President's main adviser said, In some States, why, there is no 
competition. There's only one insurer.
  Well, how do you deal with that if there is only one insurer in some 
States? Do you really make the situation measurably better by adding a 
second insurer? Well, maybe. If it's a government-run program, then 
maybe that's a good thing. Maybe it's a bad thing. Maybe you run out 
the one insurer who was there already, and you're back to one insurer 
which is now the public option. There are 1,300 different insurance 
companies out there. If we would simply relax some of the restrictions 
against selling across State lines, we could open those markets up, not 
to one other insurer, not to ten other insurers, but to hundreds of 
other insurers.

                              {time}  2340

  That's real competition in the marketplace. The same type of 
competition you see today for car insurance

[[Page H9332]]

and for life insurance and with the power of the Internet, those costs 
have come down significantly for those two products. We could have 
achieved the same type of success in the health insurance market if we 
were just clever enough to have the discussion and begin to negotiate 
how we would go about putting the protections in place so that people 
weren't taken advantage of in that situation, and that's well within 
our power to do that, Madam Speaker.
  I again come back to the concept that Members of Congress were not 
willing to take the very insurance that they were requiring the 
American people to take. When you talk about hubris, that's one of the 
things I heard over and over again. The bill is too big; nobody knows 
what's in it. You haven't even read the darn thing and why won't; if 
it's so darn good, why won't a Member of Congress sign up for it?
  We heard those same comments over and over and over again. And what 
did they tell us? It's a big bill. People are frightened of Congress' 
ability to actually deliver on a bill like this or ability to deliver 
on a promise like this. And if it is so darn good, then why aren't you 
willing to step up and take it yourself?
  And that really distills the arguments that we heard during the month 
of August. Now, unfortunately, coupled with all of this--and we heard 
some of the comments in the last hour when the Democrats had the 
floor--you heard the comment made, Madam Speaker, that it's the right-
wing talk radio crowd that's causing the objections to this health care 
bill, otherwise it would be done.
  I submit to you the right-wing talk radio crowd is my crowd. They 
talk to Republicans. But it's only 177 Republicans in the House of 
Representatives. You have got 258 Democrats. The right-wing talk radio 
crowd doesn't talk to the 258 Democrats, and you can still lose 39 
Democrats and pass almost any bill that you want out of the House.
  So, please, it is not a Republican that is preventing you from doing 
this. Recognize what's happening here. It is the fact that you have not 
sold this bill to the American people. That's what's preventing this 
from being done.
  Now, the other unfortunate thing this summer was the Speaker of the 
House took it upon herself and the majority leader took it upon himself 
to write a joint op-ed piece for USA Today where they vilified the 
American people. Well, you know, if you are trying to build a grass-
roots consensus for what you are trying to do, for something as big as 
transforming the delivery of health care in this country, is it really 
a smart idea to vilify the very people whom you are trying to recruit 
to help you to do this project? I don't think so.
  I mean, that's Politics 101. That's one of the first tenets. You 
don't, you don't, you don't irritate the very people that you are going 
to be asking to help you pass a bill of this magnitude.
  I do believe it is possible, that it is reasonable for us to get down 
and work on some of these things that I have outlined tonight. I 
suspect there are others out there that people on both sides of the 
aisle might like to see. These are just mine that came up during my 
town halls.
  I would like to see us have some serious discussions on this. I think 
the American people really do want to see this done in a bipartisan 
fashion.
  Now, tomorrow night we are going to have a big speech here in the 
House. The President will come down; all of our friends from the Senate 
will be here. We may well have members of the Cabinet here as well to 
hear what the President is going to say.
  Will there be something new brought up tomorrow night? I don't know. 
Will we simply see, hear a rehash of the same things? Will we hear 
criticisms of Republicans for not working with Democrats on this issue? 
We might.
  I would just simply again offer that we don't have the numbers to 
stop anything; and when I made overtures to the other side early this 
year, in fact, even during the transition period before the President 
was sworn in on inauguration day, completely rebuffed by the chairman 
of my committee, by the President's transition team. No one seemed 
interested in any Republican input at that point.
  We have got the votes, we won the election, we can do it all and so 
we shall.
  Well, it's August. It was a hot month; things got a little heated at 
home. And now that we are back here in the fall working on this, 
perhaps it is time to rethink this.
  I saw it on one of the Web sites the other day: maybe it's time for 
the President to hit the reset button. Maybe that's not a bad idea. 
This is a big, big change in the way things are being handled in 
America in regards to health care.
  The benefits in this bill don't go into effect for 3 years' time. 
There is no rush to do this thing this month. There is time for us to 
get this right.
  And, you know, like the old saying goes, if you don't have time to do 
it right when are you going to find time to do it over? Or as one of my 
surgery professors used to tell me years ago, this is so important, 
let's go slowly. We don't have time to be in a hurry.
  Well, I think those are words that might serve us well as we continue 
to work on this legislation.
  We are going to hear from the President tomorrow night. I, for one, 
am looking forward to what he is going to say. I would welcome the fact 
that perhaps we can all get back together and work on some of these 
things. My concept would be on let's keep it a little bit simpler so 
that we do build some trust back with the American people.
  Certainly the President enjoys a much higher popularity figure, much 
higher poll numbers than any of us in the United States House of 
Representatives have. But, on the other hand, that popularity is waning 
as well.
  I think it's important that the American people see that we can work 
together on this, that we can produce deliverables for the country. And 
I, for one, would be happy to get on with that work.
  With that, Madam Speaker, I am going to yield back the balance of my 
time.

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