[Congressional Record Volume 155, Number 134 (Tuesday, September 22, 2009)]
[House]
[Pages H9796-H9802]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       INCREASE SOURCES OF ENERGY

  The SPEAKER pro tempore (Mr. Kratovil). Under the Speaker's announced 
policy of January 6, 2009, the gentleman from Georgia (Mr. Price) is 
recognized for 60 minutes.
  Mr. PRICE of Georgia. Mr. Speaker, what a glorious evening it is to 
come to the floor to remind my colleagues about a little fact and about 
a little truth. I have heard so many things over the last 15 or 30 
minutes, Mr. Speaker, I am not quite certain where to begin.
  But I guess I would begin by imploring my colleagues on the other 
side of the aisle to talk to the Speaker. Goodness gracious, talk to 
the Speaker. When they talk about expand drilling, oh, they could talk 
to the President as well, expand drilling. You betcha, Mr. Speaker, you 
betcha that that's what we want to do is expand drilling.
  When they talk about clean coal technology and advancing clean coal 
technology, you betcha, Mr. Speaker. The problem is, the Speaker of the 
House and the President of the United States don't support it. That's 
the problem.
  I would encourage them to talk to their own leadership because the 
principles and the policies that they have just espoused over the last 
15 to 30 minutes are as strong as we have on our side of the aisle, the 
Republican side of the aisle, espoused over the last number of years. I 
would encourage them to talk to their leadership. I would point out, 
Mr. Speaker, that one of the things that was said is absolutely 
correct, and these aren't Democrat problems and these aren't Republican 
problems. They are American problems.
  To that end, I want to talk about what America has been concerned 
about. Mr. Speaker, if you think about what happened in August in this 
Nation, all across this Nation, it was a remarkable outpouring, a 
remarkable outpouring of concern, yes, and of fear, yes, and of anger 
about the direction in which the American people see their Nation 
headed.
  What they said, I believe, in town hall after town hall and meeting 
after meeting after meeting was, Washington, you are not listening. You 
are just not listening. We thought that we were electing change in 
November of 2008, and, in fact, we have elected change as a Nation.

                              {time}  2220

  The problem is the change that's being instituted by my friends on 
the other side of the aisle and the Speaker and the President are not 
the change that the American people wanted. That's the problem.
  So they come out to these meetings and they come out to talk to their 
Representatives, if even they will meet with them. So many of my 
friends on the other side of the aisle refused to hold town hall 
meetings. But they come out to these meetings and they say, Please, 
please listen to us. Listen to what we're telling you. Your policies 
are killing us. They're killing us from an economic standpoint, too 
many taxes. You're spending our children and our grandchildren's money. 
You just can't do that. We can't do that at home. You can't do that at 
the Federal level.
  And so what they want are solutions. And my friend on the other side 
of the aisle earlier talked about solutions. And I'm going to talk a 
lot--a lot--about solutions this evening, because even this evening my 
two grand colleagues from Ohio reiterated this fabrication, this 
falsehood. Oh, yes, Mr. Speaker, something that isn't absolutely the 
truth when they say that Republicans have no solutions; they don't 
bring any solutions to the table.
  Well, we're going to talk about tonight a couple of solutions just in 
the area of energy and health policy. And if you, Mr. Speaker, would 
like to go look at our solutions, they're on our Web site. I'm 
privileged to chair the Republican Study Committee, the largest caucus 
in the House of Representatives, that puts solutions on the table for 
every single American challenge that we face, solutions that embrace 
fundamental American principles that are optimistic and forward 
thinking and upbeat and realize that the reason we're the greatest 
Nation in the history of the world is because we have followed 
fundamental American principles.
  So you can Google Republican Study Committee or go to RSC.price.
house.gov--RSC.price.house.gov--and look at our solutions. Look at our 
solutions for an economy that we've seen a nonstimulus bill that is 
driving more individuals into unemployment, that is losing 4 million 
jobs just in this year alone.
  Look at our solutions, which is the contrast to a budget that was 
passed by this House of Representatives that spends money that we don't 
have, borrowed from the Chinese Government; money that makes us $1 
trillion in debt year after year after year after year. And the 
American people are fed up with it, Mr. Speaker.
  Look at our solutions that say that the way to be able to utilize 
American resources responsibly so that we solve the energy challenges 
that we have, there's a way to do that that makes it so that the 
government isn't put in charge and also so that we aren't taxing the 
American people to death.
  Mr. Speaker, look at the solutions at RSC.price.house.gov for the 
health care

[[Page H9797]]

challenges that we face that we will be talking about a little more 
this evening.
  I want to start with the health care issues because one of the things 
that drove me into public service after 20 years of practicing 
medicine--Mr. Speaker, I took care of folks who had broken bones and 
battered bodies as an orthopedic surgeon for over 20 years. I took care 
of them the best way I knew how and the best training that I was able 
to avail myself of, and I took care of them in a way that oftentimes 
led me to believe that the State government and the Federal Government 
were impacting the ability of myself and my staff in an adverse way--in 
an adverse way, not a positive way--in an adverse way to be able to 
care for those patients.
  So my friends on the other side of the aisle, the presentation that 
we just saw, Mr. Speaker, the gentleman had six Ps. I only caught five 
of them. But they were: People, portability, preexisting conditions, 
physicians, and prevention.
  Mr. Speaker, I would suggest that none of those--none of those 
challenges that the gentleman from Ohio described--none of them are 
improved by the intervention of the Federal Government. Not one. Not 
one.
  So when I talk about principles in the area of health care, which is 
what I think we need to be talking about here in the United States 
House of Representatives and the Congress of the United States and by 
the President, we ought to be talking about principles of health care 
so that we create a system that is responsive to patients. That's the 
goal. Correct, Mr. Speaker? Responsive to patients.
  When we talk about principles, most of us have the top three. Most 
Americans have the top three principles. They're affordability. You 
ought to be able to afford the system that we create. Accessibility. 
You ought to be able to get into the system if you're a patient. And 
quality. You want the highest quality of care in the world, which is in 
fact what we have right now.
  I add three more principles to those: affordability, accessibility 
and quality. I add three. One is responsiveness. You have got to be 
able to have a system that's responding to people, which is so often 
not the case in other nations where they have systems that are taken 
over by the government.
  The second is innovation. We are a Nation that has allowed for the 
greatest amount of innovation in the world--in the world--in the area 
of health care. That has resulted in the highest quality of care for 
all of our citizens, for every single American. So we want a system 
that creates and incentivizes innovation.
  Third and finally, choices. The American people want choices when it 
comes to health care. They want to be able to choose their doctor; they 
want to be able to choose where they're treated. They want to able to 
choose when they're treated and how they're treated. And that ought to 
be their right. That ought to be their right.
  So principles of health care--affordability, accessibility, quality, 
responsiveness, innovation, choices. Those six principles, Mr. Speaker. 
And you may have some others, the people listening may have some 
others.
  I would suggest to you, Mr. Speaker, that those six principles, and 
the ones that were outlined by my friend from Ohio just a little bit 
earlier this evening, that none of those principles are improved by the 
intervention of the Federal Government. Think about it. Accessibility 
to the system. The Federal Government runs basically four specific 
medical programs: Medicare, Medicaid, the VA Health Service, and the 
Indian Health Service.
  Accessibility. All of those systems have some kind of rationing of 
care. You don't have to take my word for it. Talk to anybody who works 
in those systems. When I worked in the VA Medical Center in Atlanta, we 
would get to a point every single quarter when they would say, I'm 
sorry, you can't perform any more total joint surgeries this quarter. 
And it wasn't because we'd run out of total joints; it wasn't because 
we'd run out of prostheses. It wasn't because we'd run out of patients 
for whom the indication was to provide them with a total joint.
  No, Mr. Speaker, it was because we had run out of money. And that's 
because when you get a government-run system, what happens is that the 
decisions are controlled by money; they're not controlled by patients 
and by quality. Accessibility is limited in every one of those.
  For example, the Mayo Clinic, one of the finest health care providers 
in the Nation, in Jacksonville, Florida, is limiting the number of 
Medicare patients that it sees. Limiting the number of Medicare 
patients that it sees. Why? Not because they forgot how to take care of 
seniors. No, it's because the system is broken and flawed.
  That's what happens with a government system, is that it limits 
accessibility. When veterans in our veterans health care system call up 
for an appointment, are they given the appointment in the way that 
happens in a personal or a private setting? No, because accessibility 
is limited in a government health care system, not just in the United 
States, but in every other system in the world that is run by the 
government. It's limited. Accessibility is limited.
  So affordability is compromised; accessibility is compromised. 
Quality is compromised because of those first two. Responsiveness and 
innovation, certainly not consistent with anything that the Federal 
Government does with responsiveness and innovation. No, we know that 
responsiveness is in the private personal sector. We know that 
innovation is in the private personal sector, not in the governmental 
sector. Certainly, the government tries to catch up. And sometimes it 
does with relative efficiency. But it doesn't do so initially because 
there's nothing, nothing in the Federal Government that demands that 
you have responsiveness and innovation.
  And then the final principle of choices. The Federal Government and 
choices are inconsistent with each other because the Federal Government 
defines what individuals ought to do, defines what individuals must do, 
and determines basically what is available to people. And if it's 
available in something that doesn't mean anything to folks by and 
large, it doesn't really make a whole lot of difference.
  But in the area of health care, in the area of medicine, in the area 
of personal decisions that make it so that you are able to care for you 
and your family in the most personal and effective way, the government 
has no place in those decisions.

                              {time}  2230

  The government has no place in those decisions, Mr. Speaker, none. 
And they ought not. So our friends on the other side of the aisle say, 
Oh, no, the government is the only entity that can provide the balance 
to this equation. Mr. Speaker, you know that the balance in this 
equation in the area of health care means that individuals will not 
receive the kind of care that they desire, not receive the kind of care 
that they and their families choose for themselves. They'll receive the 
kind of care that the government chooses for them, but they won't 
receive the kind of care that they and their families desire.
  In the fall of 2009, nothing could be more important here in 
Washington and here in the United States Congress as we try to talk 
productively about this issue that is of such incredible importance to 
the American people. One of the greatest concerns that I have is that 
at least half, and maybe more--at least half of the Members of Congress 
have been shut out of this debate. I mentioned that I'm privileged to 
Chair the Republican Study Committee, the largest caucus in the House 
of Representatives. We have attempted to solicit and take the President 
at his word when he said, If you have an idea, if you'd like to discuss 
the issues that we have before us in the area of health care, come on 
down to the White House. My door's open. Right, Mr. Speaker? That's 
what he said. My door's open. Come on down, and we'll go over the bill 
line by line.
  Well, Mr. Speaker, this may come as a surprise to some folks, but we, 
the Republican Study Committee, have been asking for a meeting with the 
President of the United States since the week he was sworn into office. 
And the response every single week has been, Well, thank you very much. 
This is an incredibly important issue. There are nine Members of our 
conference who are physicians, like I am, who have significant passion 
about the

[[Page H9798]]

issue of health care and the reason that we ought not put the 
government in charge. Our friends on the other side of the aisle say 
cavalierly, Well, you just ought to let the government compete for 
this.
  The fact of the matter is, Mr. Speaker, if the government competes 
for it, it drives over 100 million individuals, over 100 million 
Americans from personal, private health insurance that they choose, 
that they select for themselves and their families. It drives them, it 
shoves them, it forces them into the government program. Mr. Speaker, 
that's not what you want, or at least that's not what you say you want. 
That's not what my colleagues on the other side of the aisle say they 
want, by and large. But that's the system that we're going to have if, 
in fact, the Speaker of the House and the President have their way.
  So we've got some incredibly important issues to discuss here in the 
United States House of Representatives. I'm joined this evening by a 
great friend and colleague, the gentlelady from North Carolina (Ms. 
Foxx) who has been front and center on the health care issue and on the 
energy issue. I know that she has been frustrated by much of the 
information we have heard this evening, especially in the area of 
energy policy, because we have been fighting tooth-and-nail to make 
certain that we could put forward an all-of-the-above energy strategy. 
My friends on the other side of the aisle earlier this evening talked 
about the lack of solutions that we have. So I'm pleased to yield to my 
friend from North Carolina, Virginia Foxx, for her comments on energy 
or whatever else she would like to chat about this evening.
  Ms. FOXX. Well, I thank you, Dr. Price, for beginning this hour and 
bringing an extraordinarily comprehensive and cogent discussion to the 
health care issue. I did hear more of our colleagues who were here in 
the previous hour talking about energy than health care. But I did hear 
them say if we were to adopt the health care proposals--and I assume 
that they mean H.R. 3200--that that would bring long-term economic 
growth to this country. And I thought that I must be living in either 
Never-Never Land or Wonderland or someplace other than in the United 
States of America and serving in the United States Congress, because 
having the government take over health care in this country is a 
formula, in my opinion, for harming economic growth in this country, 
not creating economic growth. I think that the American people have 
caught on to that.
  I want to say that the thing that kept running through my mind as I 
was listening to them--and let me say here that many folks wonder why 
we often are here speaking to an empty Chamber. But we're usually in 
our offices, listening to what's going on in the Chamber, along with 
about 800,000 other people in the country. So we do listen to each 
other, and sometimes it is very frustrating to hear what's being said, 
because I believe, in many cases, the American people are being misled 
by the comments that are being said. We don't expect to see long-term 
economic growth from health care. One of the best things, I think, that 
has happened this entire summer is that the American people have been 
paying closer attention to what's being proposed in the Congress.

  H.R. 3200 has been looked at by the public, and they understand that 
what we have been saying about the bill is more accurate than what our 
colleagues have been saying about the bill. I have read the bill. I 
know you have read the bill, and I want to encourage more and more 
Americans to read it because I don't think that the time has passed for 
our considering that bill. I think that, or something similar to it, is 
going to be dealt with on the floor of the House.
  But what I wish is that more Americans had paid closer attention to 
the bill that our colleagues call cap-and-trade, and which we call cap-
and-tax, because I think if the American people had paid as much 
attention to that as they have to the health care bill, they would have 
been up in arms earlier this year. Most of them don't realize that, 
again, what our colleagues were saying is just the opposite of what 
they do in legislation.
  Last summer we were here talking about the problems with energy. Gas 
prices were skyrocketing. And as you pointed out, we stood for an all-
of-the-above energy policy in this country. We want to be able to use 
the resources that are available to us in this country. I believe the 
Good Lord gave us the resources in this country to take care of our 
energy needs. But our colleagues on the other side of the aisle--and 
let's say it--the Democrats are in control of this Congress. It's very 
important that people understand that our colleagues who were speaking 
a while ago were speaking of the folks in charge who are of their 
party. They make it seem like they're not in control, that they can't 
make the things happen that they're talking about. But they are in 
control. Every day they make us more and more dependent on that foreign 
oil that they say they don't want us to be dependent on.
  We have seen here how they have shut down accessibility to shale and 
oil and the Outer Continental Shelf. Over and over and over again, they 
stymie every opportunity that we have to increase the sources of energy 
in this country.
  Mr. PRICE of Georgia. Will the gentlelady yield?
  Ms. FOXX. Absolutely.
  Mr. PRICE of Georgia. I appreciate those comments because I was 
stunned as I was sitting here, listening to the gentleman from Ohio 
say--and I wrote it down just because I was so astounded--say that we 
ought to increase our use of ``coal, nuclear and oil shale.'' He said 
that, and in fact, that is exactly the opposite thing that his party 
has done; isn't that the truth?
  Ms. FOXX. It is absolutely the truth. In fact, in the cap-and-trade 
bill, that they call it--we call it cap-and-tax--what it will do is it 
will make us more dependent. It stops the use of coal in this country. 
We have much more coal resources available to us than Saudi Arabia has 
oil resources, and we know that. But they seem to hate coal and want to 
do everything that they possibly can to diminish the use of it.
  There are no plans for creating nuclear energy, increased nuclear 
energy. Yet we know if we're going to maintain our standard of living 
in this country, we need to be building in the next 30 years 30 to 50 
nuclear power plants. We also know that since World War II, France has 
gotten 85 percent of their electricity from nuclear power, and they 
have never had one tiny problem as a result of that. But the radical 
environmentalists in this country seem determined to create blackouts 
in this country. They don't want coal. They don't want us to drill for 
oil. They don't want nuclear. They're even protesting now putting in 
solar panels out in the Mojave Desert. They don't want wind farms.
  Solar and wind are not the solutions to our energy needs, and we know 
that. President Obama said he would double the use of alternative 
energies, meaning wind and solar, and yet President Bush did that in 
the last 18 months of his administration. We went from 1.5 percent to 3 
percent. Well, President Bush did that in 18 months. President Obama 
has said that he would double it during his first term. Well, going 
from 3 percent to 6 percent, given how the technology is growing, isn't 
a very big leap.

                              {time}  2240

  But we also know that we can only absorb in our current electric grid 
only 10 percent of solar and wind. Beyond 10 percent we put our 
wonderful system of energy in great jeopardy because we simply don't 
have the grid to handle it, and we can handle up to 10 percent, as I 
understand it from listening to the experts. But even that, for us to 
absorb 10 percent of wind and solar, which are undependable, and that's 
the main reason we can't absorb more than 10 percent, would take $3 
trillion to redo our grid. They never say anything about that cost. And 
to be able to put in cap-and-tax would be enormously expensive to the 
average American consumer. We know that it's probably going to increase 
energy costs between $1,700 and $3,000 for the average American family. 
They never mention that when they're talking about what they want to do 
in terms of alternative energy.
  I think it's very important, again, that we call the attention of the 
American people to that bill. I'm sorry I forgot to write down the 
number of the bill, but if people, again, would pay

[[Page H9799]]

some attention to that bill and read it, as they have H.R. 3200, I 
think they'd find that we are telling the truth about it and that 
rather than expanding domestic energy sources, it's going to contract 
domestic energy sources because of all the rules and regulations and 
the costs of them. I think it's a cruel hoax being put out to the 
American people along with what they have been saying about health care 
also.
  I want to switch back to that subject because you are an expert in 
both of these areas, but you're really such an expert in the health 
care area. I want to take it down, though, to, I think, a conversation 
that everybody can understand.
  When I was growing up in western North Carolina in the 1950s, my 
family was extraordinarily poor. I mean dirt poor, as we used to say. 
And yet we could afford health care. I had chronic asthma and allergies 
and often had to get health care treatment, and my family could pay for 
that. The costs were very low. And I began to think a few years ago, 
now, what has happened since I was a child living out in the country, a 
very rural area, the poorest county in North Carolina, and yet we had a 
small hospital, we had doctors there who would treat us, and we could 
pay cash and meet our obligations? What has happened since that time in 
the mid 1960s Medicare was created, Medicaid was created? Government 
policies encouraged companies to provide health insurance for their 
employees because they could tax deduct it but individuals could not. 
So the rules changed dramatically.
  I know also that we have wonderful technology. We have many, many 
more specialists in our country, and our health care has gotten better 
and better in this country. And I get really furious when I hear these 
statistics from our colleagues that want to say that we are 35th in the 
level of health care that we provide. Well, why is it that everybody 
comes to our country to get health care and why is it that our average 
lifespan is now 80 years old and people are living such vibrant lives 
right up almost until death, most people are? It's because we have 
created government-run health care in Medicare and Medicaid and in the 
other areas that you talked about and third-party payer. We have taken 
away the sense of responsibility from Americans for how much things 
cost. And everybody thinks, well, if insurance is going to pay for it, 
it's not costing me anything. I'll utilize it to the full.
  But I make the analogy we all have to buy car insurance because as we 
drive our cars, there is the chance we will harm someone else, so we 
all have to have liability insurance. But our car insurance does not 
pay to change our oil or put new tires on the car, and yet we have come 
to accept that.
  The same thing with homeowner's insurance. We buy homeowner's 
insurance because it's the practical thing to do. But if our roof gets 
a leak in it, we don't turn that in to the insurance company. We fix 
the roof because we know if we don't fix the roof, pretty soon the 
ceiling is going to be leaking, then the floor is going to be damaged.
  So we assume that responsibility for our cars and our homes, and yet 
over the years, this insidious growth of government and third-party 
payer through insurance have taken away the sense of responsibility 
that we have for taking care of our own bodies and taking care of our 
own health. And the more we involve the government, the worse it's 
going to be. We don't need government-run health care in this country. 
We need to follow the principles that you outlined, and I think you did 
a beautiful job.
  The other thing I want to say is we keep hearing that Republicans 
have no alternatives. Our alternatives fit exactly the principles that 
you outlined, and I just want to mention a couple of bills here.
  H.R. 2520, the Patient's Choice Act by Mr. Ryan from Wisconsin. The 
Patient's Choice Act would transform health care in America by 
strengthening the relationship between the patient and the doctor by 
using the forces of choice and competition rather than rationing and 
restrictions. It seeks to ensure universal affordable health care for 
all Americans.

  And then there's the bill that you introduced, which you, I don't 
think, have spoken of, but it's H.R. 3400, and we want to make sure 
people understand the difference: The Empowering Patients First Act to 
increase patients' control over their health care decisions by offering 
more choices and the highest quality available.
  We have comprehensive bills out there that do what needs to be done, 
but the Speaker refuses to pay attention to those, as you said, and the 
President refuses to pay attention to them. They are determined to 
control every aspect of our lives, and taking over health care gives 
them the wonderful opportunity to do that.
  I want to thank you again for leading this hour tonight and getting 
us on the right track on these issues.
  Mr. PRICE of Georgia. Thank you ever so much, my dear friend from 
North Carolina, Ms. Foxx, who outlines very specific and clear and 
cogent discussion points in the area both of energy policy and in 
health care policy.
  I think one of the important takeaways that I would offer in the area 
of energy policy is that we have been talking about and desirous of 
what we call an all-of-the-above energy solution that our friends on 
the other side talk about but, in fact, they have never voted for or 
introduced policy legislation that would accomplish that. And by ``all 
of the above,'' we mean sincerely that America has been blessed with 
incredible resources, remarkable resources, and that we ought to be 
able to utilize them in a very environmentally responsible and sound 
way.
  What does that mean? That means that offshore from the United States, 
there are resources that we can utilize. Onshore there are oil 
resources that we ought to be able to utilize: oil shale technology 
that allows us to gain the fossil fuels from oil shale; shale out west, 
to be able to use that and supply the American people with appropriate 
resources in the area of oil; clean coal technology, which my friend 
from North Carolina discussed and our friends on the other side talk 
about but, in fact, they vote against every time it comes up; and then 
nuclear technology.
  We ought to be able to use increasing nuclear resources to be able to 
provide energy for the American people. And we ought to be able to do 
so not just because it's the right thing to do for our Nation, not just 
because it's available to us and the good Lord has blessed us with this 
remarkable knowledge and expertise and resource base, but because in so 
doing, we make it so that we're not helping people across the world who 
don't like us. There are people that we are supporting to a huge 
degree, the Government of Venezuela, which is headed by an individual 
that has absolute animosity for the United States. There are 
governments in the Middle East that we are sending literally hundreds 
of billions of dollars to that are not fond of the United States or our 
government or our people.

                              {time}  2250

  We ought not be utilizing American resources, American tax money, 
American labor, and ingenuity to fund folks who don't care for us. That 
is just wrong. If it were the only option available, that would be one 
thing, but it is not. There are wonderful resources that we have, but 
we are blocked by the Democrats in charge and the majority party. And 
that is wrong.
  The President has said over and over again that he doesn't believe 
that we ought to utilize our resources in this way. As the gentlelady 
from North Carolina says, he wants to double wind and solar energy. 
That is fine. That is great. But it will be ultimately 6 to 8 percent 
of the energy utilization of this Nation. That is not going to get us 
over the hurdle. It is not going to get us where we need to be.
  So on the one hand, we need to conserve more. Absolutely. We need to 
utilize American resources for Americans. That is a responsible thing 
to do. That is a common sense thing to do. One would think if one was 
elected to the United States House of Representatives or the Senate 
that one would have that as a responsible feature of their policy, to 
utilize American resources for Americans. And we ought to be able to 
incentivize the creation of the new form of energy without the 
government picking winners and losers. That is a responsible energy 
policy. That is an all-of-the-above energy policy. That is an energy 
policy that we have been clamoring for for years, literally, and

[[Page H9800]]

have been blocked at every single turn by our friends on the other side 
of the aisle in their beholden nature to folks who would not allow us 
to use American resources.
  I want to talk a little more about the issue of health care because 
it is driving the entire debate here in Washington today.
  I have talked about principles in health care: accessibility, 
affordability, quality, responsiveness, innovation, and choices, and 
that none of those principles are improved by the intervention of the 
Federal Government.
  I don't think there is a single American who sincerely believes that 
they are improved by more imposition of rules from Washington. So if 
you believe that, if we believe that, then the President would have us 
believe there are only two alternatives, that it is either the 
government in charge or it is the insurance companies in charge.
  Well, Mr. Speaker, that is a false choice. That is a false premise. 
In fact, it is not just the government in charge or the insurance 
companies in charge; in fact there is a better way. There is the right 
way. There is the correct way, and that is to put patients and their 
families in charge.
  How do you do that, to put patients and their families in charge so 
that accessibility, affordability, quality, responsiveness, innovation, 
and choices are all improved? In fact, all of the principles in health 
care are improved if the patients are in charge. In fact, the system 
moves in the direction that it ought to move, and the direction that 
our health care system ought to move isn't the direction I, as a 
physician or Member of Congress believe it ought to move; it isn't the 
direction that you believe it ought to move; it isn't the direction in 
which our collective intelligence here in the House believes it ought 
to move. The direction that it ought to move in is the direction that 
patients want it to move. The only way to do that is to allow patients 
to control the system.
  Mr. Speaker, the bill that will do that is H.R. 3400. You can go to 
the Web site for the Republican Study Committee, rsc.price.house.gov. 
Look it up. It is right there. There is a side-by-side with H.R. 3200, 
which is Speaker Pelosi and the Democrats in charge here in the House, 
their monstrosity, a 1,000-plus-page bill. Or there is a responsible 
way to do it, H.R. 3400.
  Now what does H.R. 3400 do? Well, it does five big things very 
specifically, in addition to a lot of other things, but five big 
things.
  One is that it gets Americans insured. It is imperative that we make 
certain that those individuals who are unable or appear to have the 
lack of resources to be able to finance health coverage for themselves 
or their family have the wherewithal to do that. How do you do that as 
a good conservative? Well, you make it so for every single American it 
makes financial sense to be insured. Americans are bright people. They 
are making financial decisions right now not to be insured. So we 
devise a system, create the rules of a system that will respond to 
patients that will make it so each and every American citizen sits down 
at the end of the day and when they are doing their budget, they 
realize that it makes more sense for them financially to be insured 
than not.
  You do that through a series of tax deductions, tax credits, 
refundable tax credits, advanceable refundable tax credits, tax equity 
for the purchase of insurance so that individuals are able to purchase 
insurance with pretax dollars, just like businesses, instead of post-
tax dollars. So you get folks insured.

  Secondly, you have to solve the challenges of the health insurance 
system right now. There are wonderful things about our health care 
system, but there also some things that are flawed. Those flawed things 
we ought to solve, and they are relatively easy to solve.
  For example, the two main issues, portability, you ought not lose 
your insurance if you change your job or you lose your job. It ought 
not be the case. Preexisting injury or illness. If you happen to have a 
diagnosis that results in a major calamitous event for you or your 
family from a medical standpoint, or you have an injury that results in 
a major expenditure, you ought not be priced out of the market. You 
ought not lose your insurance. That is wrong.
  So how do you solve that? Well, you make it so that individuals own 
and control their insurance policy so they can take it with them if 
they lose their job or they change their job. In addition to that, you 
make it so Americans can pool together with millions of other people 
for the purchase of insurance. So you get the purchasing power of 
millions even if you are one individual or a small group or small 
business or small employer in that market to purchase health insurance. 
So you solve those challenges. You get people insured, and you solve 
the insurance challenge.
  Third is to make absolute certain that it is patients and their 
families and doctors who are making medical decisions. Not government 
bureaucrats, not insurance bureaucrats, not anybody else.
  Medical decisions are some of the most personal decisions we ever 
make in our lives for ourselves and for our family. We ought to have 
the right, we do have the right, but we ought to be able to exercise 
the right of making those decisions ourselves.
  It is a sad commentary, Mr. Speaker, right now in America that in 
order to get that accomplished you have to write that into law. That is 
a sad commentary, but it is where we find ourselves right now. So H.R. 
3400 says that, that nobody else in the Federal Government or the 
insurance industry will be able to make decisions as it relates to the 
provision of medical services and care for individuals or members of 
their family.
  Fourth, we solve the issue of lawsuit abuse. Lawsuit abuse, the 
lottery mentality that we have created in our society that makes it so 
that individuals believe if they just hit the right note, if they just 
are able to find the right cause of action against a physician or 
hospital, they might make millions. That results in the practice of 
defensive medicine. And the practice of defensive medicine are those 
tests and examinations that your doctor performs or orders in order to 
make certain, make absolute certain to as much scientific certainty as 
one can that the diagnosis or procedure he or she proposes for a 
patient and then carries out is backed up by all of the knowledge and 
evidence that is available to them so that if they find themselves in a 
court of law at some point they can look at the judge and jury and say 
look, I did every one of these things to make certain what I proposed 
to do and what I did was appropriate for this patient. And the judge 
and the jury nod their head and say, yes, he or she did.
  It doesn't make any difference whether the first two of those things 
were what was necessary to perform the diagnosis or cure the patient, 
the next 15 or 16 were redundant; but that is the practice of defensive 
medicine. Hundreds of billions of dollars each year, and it is not 
necessarily that it harms the patient, because it doesn't; but it makes 
it so that the system spends so much more money than it has to in order 
to provide the care that it currently provides because of the lawsuit 
abuse that we have.
  Mr. Speaker, so we can have everybody insured. We can solve the 
insurance challenges. We can make certain that medical decisions are 
made in their rightful place, that is, between patients and families 
and doctors; and we can solve the whole issue of lawsuit abuse.
  And the fifth item in H.R. 3400 is that we can do all of those things 
that would solve 99 percent-plus of the challenges that we face in 
health care, all of those things we can solve without raising taxes one 
penny. Not one penny.

                              {time}  2300

  So, Mr. Speaker, when we look at 3400 and when we compare it to the 
bill that has been passed through three committees here in the House of 
Representatives by the Democrats in charge, a $1.3 trillion 
monstrosity, a 1,000-plus-page monstrosity that results in an $800 
billion tax increase and a $500 billion slash to Medicare programs--
when you look at that, that's why the American people are confounded, 
they're confused. They don't understand what's going on because they 
know that that's not the solution. They know that the majority party--
the Democrats in charge, the Democrats in power--are taking us down a 
path that is not consistent with what they believe.

[[Page H9801]]

  They cry out, clamor, and have said over August and earlier this 
month, Why aren't you listening to us? Why aren't you listening to us?
  So that is why the opportunity that we have in this Chamber and in 
the Senate, right down the hall here in the Capitol, to solve the 
challenges that we face in positive ways that make fundamental American 
principles come to the table is so wonderful. We've got a great 
opportunity. In fact, we're ignoring that right now because of the 
leadership that we have--because of the lack of leadership from this 
Speaker and from this Congress to allow to be put in place the positive 
solutions that are available to us as a Nation.
  My friend from North Carolina is kind enough to stick around and to 
remain here for these discussions. I'm happy to yield to her.
  Ms. FOXX. Well, I thought that it might be useful to throw out a few 
other statistics tonight. I haven't had a chance to read this entire 
article, but the Weekly Standard, September 21, has an interesting 
article in it by Fred Barnes, entitled ``An Unnecessary Operation.'' It 
has some very interesting statistics in it, some of which we have 
talked about before. I think it's important to point out, he says here 
in this article, that 89 percent of Americans, in a June 2008 ABC News-
USA Today-Kaiser Family Foundation survey, said they were satisfied 
with their health care.
  Most Americans think that we're trying to do too much in our 
government. One area that they're very happy with is their health care, 
and I think that it's important that we point that out.
  As you say, there are things that do need to be done. There is no 
question. Republicans understand we need to make modifications in 
people's accessibility to health care, in its portability--those 
principles that you laid out earlier. We want to do that, and we have 
ways to do that, as you say, without it costing a dime to the American 
people. That's what we should be focusing on. With 89 percent of 
Americans being satisfied with their health care, let us make minor 
adjustments to the health care system.
  Let me point out some other statistics that, I think, are very, very 
important. These go against those people who decry what an awful health 
care system we have in this country, which really infuriates me 
because, again, we know that people are coming here--thousands of them. 
In here, I think they say 400,000 people a year come from other 
countries to get medical care. Let's talk a little bit about those.
  The two very major innovations in health care are the MRI and the CT. 
The statistics on this are absolutely astounding in terms of the 
numbers of machines. The United States has 27 MRI machines per million 
Americans. Canada and Britain have 6 per million. We have 27. The 
United States has 34 CT scanners per million. Canada has 12 per 
million. Britain has 8 per million.
  Now, we know just on the face of it, with that many fewer machines, 
it's going to take a lot longer to have access to those machines. Right 
now, American patients pay out-of-pocket expenses of 12.6 percent. It's 
much higher in other countries, including the countries that have 
government-run health care.
  Then we can talk a little bit about mortality. I mean, again, you've 
laid out the arguments for why we should make the kinds of changes 
you've recommended and that Republicans have recommended, but let's 
talk a little bit about survival rates:
  For all cancer, 66.3 percent of American men and 63.9 percent of 
American women survive. In Europe, it's only 47.3 percent of men and 
55.8 percent of women who survive after 5 years. These are 
statistically significant numbers. Let's talk about breast cancer. 
There is a 90.1 percent survival rate for Americans and a 79 percent 
survival rate for Europeans. I mean, not only do we have the least 
expensive health care in this country and the most available health 
care in this country, but we also have much, much greater survival 
rates in this country.
  Why do we want to mess up that system by implementing what Speaker 
Pelosi and President Obama have recommended? That is simply going to go 
against the Hippocratic oath.

  I was thinking about that earlier. I know physicians say, above all 
else, they should do no harm. You know, I really think that that needs 
to be added to our oath when we come here and swear our allegiance to 
the Constitution. I think it's entirely appropriate for us to do that, 
but I really think we should add something like the Hippocratic oath, 
which says to do no harm, because what the Democrats want to do, who 
are in charge of this government right now--of the Congress as well as 
of the executive branch--is to actually bring harm to the American 
people. They will be violating all of those principles which you laid 
out earlier, and we're going to be reducing life spans and survival 
rates if we go to a government-run plan. It's unnecessary except that 
it is part of the philosophy of the liberal Left.
  Their idea is that the government knows best. For those of us who are 
conservatives and who are mostly Republicans, our idea is that it's not 
the government that knows best. We should leave people as free as 
possible, and we should operate as we have for over 200 years in our 
society and in our country, which is with a capitalistic operation. We 
have a Judeo-Christian bedrock. Our rule of law and our capitalistic 
system have allowed us to have the most successful society that has 
ever existed in the world.
  Yet these folks want the government to take over. They want the 
government to run automobile companies and to become banks for student 
loans. Everything should be run by the government, in their minds, 
while we say let's perfect the situations that we have. We can 
certainly improve what we do in almost every area, and we should focus 
on those things instead of turning upside down and reversing the things 
that we do well.
  So I want to thank you very much for leading this hour and for 
focusing on these two issues, energy and health care, which are so 
important to Americans, and for helping to set straight some of the 
things that our colleagues said, particularly in the previous hour, but 
they're things which they say almost every day. Let's call them to task 
on those issues.
  Thank you, Dr. Price, Congressman Price, for the leadership you've 
given to the RSC and particularly to this issue of health care.
  Mr. PRICE of Georgia. Thank you so much, my friend from North 
Carolina, Congresswoman Foxx, for your wonderful expertise and 
comments.
  You alluded to significant misinformation on this issue, and there is 
a lot of misinformation out there. It's no wonder that the American 
people find themselves somewhat confused.
  One of the problems that I have found is that one of the greatest 
purveyors of misinformation happens to be the President of the United 
States, himself. Again, you don't have to just believe me. I have a 
letter from the American Academy of Orthopaedic Surgeons, responding to 
President Obama's remarks about amputations, remarks which some of you 
may recall. The President has insisted on saying that physicians make 
financial decisions, and that's why they do things in treating 
patients, which is abhorrent to members of the medical profession. The 
oath that they take, as you said, Ms. Foxx, is, first, to do no harm.

                              {time}  2310

  The President, as you recall, Mr. Speaker, said sometime about 6 to 8 
weeks ago that we have a system that doesn't allow or doesn't 
incentivize the treatment of a diabetic limb disease and then rewards 
by providing 30 or 40 or $50,000 in compensation for surgeons to take 
off a limb, amputate a limb.
  Mr. Speaker, I was struck by that, because when I first heard it I 
was astounded. In fact, what it showed me was that the President has no 
clue about what it means to take care of patients and the incentives 
that go into caring for patients, not a clue.
  I was so heartened when I read a letter from Dr. Joseph D. Zuckerman, 
who is the president of the American Academy of Orthopaedic Surgeons, 
that I would submit for the Record, dated August 13, 2009, in which he 
said to the President:
  ``Dear Mr. President:
  ``On behalf of the American Academy of Orthopaedic Surgeons (AAOS), I 
am writing to express our profound disappointment with your recent 
comments regarding the value of surgery and blurring the realities of 
physician reimbursements. The AAOS represents

[[Page H9802]]

more than 17,000 U.S. board-certified orthopaedic surgeons who provide 
essential services to patients every day. As you yourself have said, 
`Where we do disagree, let's disagree over things that are real, not 
these wild misrepresentations that bear no resemblance to anything 
that's actually been proposed.' In that spirit, we would like to bring 
some clarity to your comments and underscore the value that orthopaedic 
surgeons bring to Americans every day of every year.
  ``First, surgeons are not reimbursed by Medicare, nor by any provider 
for that matter, for foot amputations at rates anywhere close to 
$50,000, $40,000 or even $30,000. Medicare reimbursements to physicians 
for foot amputations range from approximately $700 to $1,200, which 
includes the follow-up care the surgeon provides the patient [for] up 
to 90 days after the operation. Moreover, orthopaedic surgeons are 
actively involved in the preventive care that you mentioned. We are a 
specialty that focuses on limb preservation whenever possible and when 
it is in the best interests of the patient. Our approach to amputation 
follows the same careful, thoughtful approach, always with the 
patient's best interest as the primary focus.
  ``It is also a mischaracterization to suggest that physicians are 
reimbursed `immediately.' The AAOS itself, along with numerous other 
organizations, has testified in congressional hearings investigating 
the delays in reimbursement by Medicare and other payers that create 
additional administrative burdens making it more difficult to provide 
access to care for patients.
  ``As you continue to pursue your health care reform agenda, we 
implore you to disengage from hyperbole,'' and it goes on.

                      [From AAOS Now, Sept. 2009]

                                                  August 13, 2009.

              AAOS Responds to Obama's Amputation Remarks

     President Barack Obama,
     The White House,
     Washington, DC.
       Dear Mr. President: On behalf of the American Academy of 
     Orthopaedic Surgeons (AAOS), I am writing to express our 
     profound disappointment with your recent comments regarding 
     the value of surgery and blurring the realities of physician 
     reimbursements. The AAOS represents more than 17,000 U.S. 
     board-certified orthopaedic surgeons who provide essential 
     services to patients every day. As you yourself have said, 
     ``Where we do disagree, let's disagree over things that are 
     real, not these wild misrepresentations that bear no 
     resemblance to anything that's actually been proposed.'' In 
     that spirit, we would like to bring some clarity to your 
     comments and underscore the value that orthopaedic surgeons 
     bring to Americans every day of every year.
       First, surgeons are not reimbursed by Medicare, nor by any 
     provider for that matter, for foot amputations at rates 
     anywhere close to $50,000, $40,000, or even $30,000. Medicare 
     reimbursements to physicians for foot amputations range from 
     approximately $700 to $1,200, which includes the follow-up 
     care the surgeon provides to the patient [for] up to 90 days 
     after the operation. Moreover, orthopaedic surgeons are 
     actively involved in the preventive care you mention. We are 
     a specialty that focuses on limb preservation whenever 
     possible and when it is in the best interests of the patient. 
     Our approach to amputation follows the same careful, 
     thoughtful approach, always with the patient's best interest 
     as the primary focus.
       It is also a mischaracterization to suggest that physicians 
     are reimbursed ``immediately.'' The AAOS itself, along with 
     numerous other organizations, has testified in Congressional 
     hearings investigating the delays in reimbursement by 
     Medicare and other payers that create additional 
     administrative burdens making it more difficult to provide 
     access to care for patients.
       As you continue to pursue your health care reform agenda, 
     we implore you to disengage from hyperbole and acknowledge 
     that health care delivery can only be improved by recognizing 
     that health care is a system in which orthopaedic surgeons 
     play a crucial role. With $849 billion of our national 
     economy impacted by musculoskeletal conditions, orthopaedic 
     surgeons provide care that improves lives and puts peoplg 
     back to work. Pediatric orthopaedic surgeons provide life-
     altering care to our nation's children and play an invaluable 
     role in ensuring Medicaid patients have access to needed 
     services. Military and civilian orthopaedic surgeons provide 
     care to our service women and men, which preserves limbs and 
     has improved survival rates over past conflicts. Orthopaedic 
     trauma surgeons perform limb- and life-saving procedures and 
     help to ensure that our communities have the medical services 
     that we all deserve. Total hip and knee replacement surgeries 
     are now two of the most successful operations in medicine 
     through a predictable reduction in pain, restoration of 
     function, and return of patients to both work and activities 
     of daily living. And we are working every day to ensure that 
     medicine provides Americans with disabilities the quality of 
     life to which they are entitled.
       The AAOS is committed to improving the American health care 
     delivery system and increasing health care coverage. The most 
     expedient way to accomplish your goal is to ensure that the 
     debate is based in fact and reflects the value of the 
     services that all physicians, including orthopaedic surgeons, 
     provide. We request a meeting with you and your staff at your 
     earliest convenience to discuss these important issues.
           Sincerely,

                                      Joseph D. Zuckerman, MD,

                                       President, American Academy
                                          of Orthopaedic Surgeons.

  Mr. Speaker, it is remarkable that the leader of this Nation 
continues to suggest, as do our friends on the other side of the aisle 
and the majority party, that the quality of health care that's provided 
in this Nation is not of the highest quality in the world. In fact, it 
is.
  If you look at disease-specific criteria, whether it's cancer or 
heart disease or diabetes or trauma or virtually any disease you can 
think of, Americans have the highest quality of care related to that 
specific diagnosis than anywhere in the world. It's why my friend from 
North Carolina said that when people are injured or have a disease from 
somewhere else in the world, they come, they flock to the United States 
by the hundreds of thousands to get care. And in this whole discussion 
about health care, to denigrate the care that's provided by 
compassionate and caring physicians and other providers around this 
Nation does a disservice to the debate and it makes it so that we are 
not talking about real things, about real things that affect real 
people.
  So I implore the President, I call on the President, I call on the 
Speaker, I call on my friends on the other side of the aisle to know of 
which you speak when you are talking about health care, to make certain 
that when you are talking about issues that relate to accessibility for 
patients and affordability for patients and quality of care and 
responsiveness of a system and innovation in a system and choices that 
patients must have in order to gain the highest quality of care and the 
care that's most appropriate for them and their families.
  Because, Mr. Speaker, as you may know, and as I hope the President 
now recognizes, that a given diagnosis in one patient doesn't 
necessarily mean that the same diagnosis in another patient is followed 
up with the same treatment, because no two people are the same. It's 
what this whole debate ignores. No two American citizens, no two 
individuals in this world, given the same diagnosis, regardless of that 
diagnosis, are absolutely the same, and the treatment that those 
individuals ought to receive ought to be determined by patients, those 
patients, and their families and caring and compassionate physicians.
  This notion by the Secretary of Health and Human Services, by the 
President of the United States, by the Speaker of this House and by 
members of the majority party that somehow you could come up with some 
algorithm that if you just answer the questions correctly and march 
through the maze that the American people will be better served, Mr. 
Speaker, you know that's not true and I know that's not true.
  When we come to this House, when we come to the United States Senate 
and we recognize that there are challenges that we face in the health 
care arena, we ought to come together as Americans and solve this 
challenge in a way that respects those principles of health care and 
respects the fundamental American principles that have allowed us to 
become the greatest nation in the history of mankind.
  I look forward to that debate. I look forward to that discussion, and 
I look forward to being able to vote and have all Members of this body 
vote on a bill that will reform our health care system in a positive 
and productive way.

                          ____________________