[Congressional Record Volume 155, Number 171 (Wednesday, November 18, 2009)]
[House]
[Pages H13126-H13133]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         GROWING THE GOVERNMENT

  The SPEAKER pro tempore (Ms. Kosmas). Under the Speaker's announced 
policy of January 6, 2009, the gentleman from Missouri (Mr. Akin) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. AKIN. Thank you, Madam Chair.
  It's a pleasure to join you this evening and to join my friends as we 
take a look once more at a debate which has stirred the imaginations 
and minds of Americans and has perhaps even tried the patience of many 
Americans now for many months, but something that is not complete, it's 
not done, and that is the question of health care.
  One of the things that I want to do is to recognize the speakers from 
the previous hour, as they were talking in glowing terms about free 
enterprise and about the possibilities of what America can do in the 
future and about setting bold new objectives and all. All of that 
sounded pretty good. I agreed with all of it. Except the only trouble 
is what we've really been doing for the last 10 months, which is the 
government's taking everything over. So it's a vision, but it's not a 
bold vision.
  I don't know of any nation that really set any great records or 
achievements in a positive sense by the government taking over more and 
more things. In fact, most nations, when the government takes over more 
and more things, they do more and more mischief and damage. Indeed, we 
have many nations that are government-run that have given us the worst 
tyrannies in history. For instance, the history of communism, a 
phenomenon of the last century. The communist nations of the world 
killed more of their own populations than all of the wars in history. 
So the idea of expanding government at a rapid and radical pace and 
sort of saying that this is free enterprise is amusing.
  There was also a comment made that all of this unemployment was, 
implied that that happened a long time ago. It was somebody else's 
fault. The only thing I remember was that just a few months ago we had 
a stimulus bill. It was a guarantee. They said we're supposed to pass 
the stimulus bill. I called it the porkulus bill. If we didn't pass the 
stimulus bill, by golly, unemployment could get all the way to 8 
percent. So you have got to jump on and spend $787 billion by expanding 
Medicare and giving money to community organizing organizations like 
ACORN because this is really important stimulus money. So we passed, 
not with my vote and not with one Republican vote,

[[Page H13127]]

the stimulus bill. That was to make sure that we didn't have this 
problem of unemployment. Well, now it's 10.2, and that stimulus bill 
doesn't seem to have worked.
  Now, you don't have to be a rocket scientist to know it wouldn't 
work. All you had to do was look back at the Great Depression. Look at 
Henry Morgenthau. He was a guy that marched right along with Little 
Lord Keynes, saying, Hey, if we're going to stimulate the government, 
we're going to stimulate the economy by having the government spend 
tons of money. Well, Henry Morgenthau comes to the Congress, to the 
Ways and Means Committee in 1939, and he said, Well, we tried the 
stimulus idea. Friends, it didn't work. We have got unemployment as bad 
as ever, and we're in a tremendous amount of debt to boot. Now, we 
aren't going to learn from that. We're going to march on with this bold 
new vision of the government spending money like mad, and they justify 
it in the name of free enterprise. I find that amazing.
  We have another example of this bold new spending initiative, and 
that is what happens in the area of health care when the government 
tries to take over one-sixth of our economy.
  I am joined by my very good friend, Congresswoman Foxx, who has 
agreed to come here in spite of an extremely busy schedule this 
evening, a young lady that adds tremendous vigor to the Republican 
Caucus. And anybody gets out of line, you've got the grandmother to 
deal with. So everybody knows you've got to line up.
  Congresswoman Foxx, we've just heard a vision of tremendous free 
enterprise, new materials, all sorts of things, and we're marching 
boldly because we don't want to stay in the staid ways of the past. But 
the solution seems to be more government spending, more government 
takeover of things. Can you think of any civilization that you can 
think of that became great because the government grew and took over 
everything?
  Ms. FOXX. No, I can't. And I want to thank the gentleman from 
Missouri for taking on this Special Order tonight and for bringing up 
issues that are very, very important to the American people and doing 
it on such a consistent basis. You've done a terrific job.
  I think, as I heard today in a meeting--I'm not sure if you were in 
that meeting when somebody pointed out--when the Communist Chinese 
start lecturing us on having too large a deficit, something is out of 
kilter in the world. And we know that in the last few days the 
President's been in China, and they have been lecturing us about this 
issue.
  Mr. AKIN. Just reclaiming my time, there is something that's almost 
funny about that. It shouldn't be funny. It should be sad, I suppose, 
that the Communist Chinese are lecturing us about the government 
spending too much money and taking too many things over. It's, of 
course, because they own a whole lot of American treasuries, and they 
don't want to see us mess the whole system up. So here we have the 
Communist Chinese talking to us about excessive big government. I mean, 
this has been a year of amazing things, hasn't it?
  We saw the government fire the president of General Motors. Just on 
the face of it, that's kind of a weird thing to see. We've got czars 
now in charge of all kinds of areas of government, people that have 
never been approved by the Senate. They're unconstitutional, and 
they're setting the prices of American executives, how much they're 
paid. So we've got the government doing that. Now they want to take 
over a sixth of the economy in this health care situation, and they're 
not thinking of this as any kind of problem at all.
  But Congresswoman Foxx, you know, when the government does too much, 
we see these kinds of typical symptoms: bureaucratic rationing, 
inferior quality, inefficient allocation, excessive expense. We've seen 
that in department after department of Federal Government when they 
grow and try to do too much. It has led to the quip, ``If you think 
health care is expensive now, just wait until it's free.''
  Ms. FOXX. Would the gentleman yield?
  Mr. AKIN. I do yield.
  Ms. FOXX. You mentioned a minute ago about the fact that this has 
been a year of very unusual things to have happen. I learned just 
recently that there is a poll that was done, and we know people are 
polling in this country all the time. But a poll was done that said 
that two-thirds of Americans believe it is more likely that we'll 
discover life in outer space than that the Democrats' health plan will 
be deficit-neutral.
  Now, I think that's a good sign for our country. It's a good sign 
that people are paying attention to what is happening in this country 
and what is happening in this House and in the Senate, the fact that 
two-thirds of our citizens don't believe the line that's being fed to 
them that this health care bill is deficit-neutral.
  That deficit, as you say, is causing tremendous harm, not just 
because the Chinese are nervous about it, but from the money it's 
taking out of the private sector and the problems it's causing small 
businesses. I know you want to talk a little bit about that tonight, 
and I hope that you will. I'm not going to be able to stay with you for 
the whole hour because I have the great pleasure of going over to be 
with Senator Jesse Helms' family who are in town for the unveiling of 
his portrait tonight, but I want to stay with you for a few minutes. I 
can just imagine Senator Helms watching us from heaven thinking, ``Oh, 
I wish I were there to be in this fight.'' The Senate right now is 
behind closed doors, behind closed doors despite all the promises of 
transparency, working on a bill that's going to create havoc. But the 
American public has awakened, and it knows this is not right.
  Mr. AKIN. You just tickled my imagination. So we're saying that two-
thirds of Americans in this poll said that they think there is more 
chance to discover life in outer space than there is that this health 
care bill is going to be budget-neutral. That gets to the very top 
excessive expense.
  Let's just talk about the big picture of what's going on. You 
remember just a year or so ago, we heard that President Bush spent too 
much money. Do you remember hearing that? The Democrats said it all the 
time, and some Republicans said it a fair amount, too. So let's take a 
look at President Bush's worst year in deficit spending.

                              {time}  1745

  His worst year was 2008--and the Democrats controlled Congress--and 
his worst spending was about $450 billion, which was too much deficit 
spending but was 450.
  Now this year, the bold new vision says we are going to do things 
differently. And so what is our deficit spending now? Well, it's $1.4 
trillion. So we've tripled the deficit this year, and we are kind of 
wondering, Gosh, gee, I wonder why we have got problems with 
unemployment.
  You know, one of the things that the Democrats, at a minimum, should 
do is they ought to learn from other Democrats even if they won't 
listen to Republicans. I can understand they don't want to listen to 
Republicans because we say things that are uncomfortable truths that 
they want to ignore such as laws of supply and demand and gravity and 
other miscellaneous things.
  But they could listen to JFK. He was met with a recession, and what 
he figured out was he wanted more jobs. He thought, Gosh, gee, where 
did the jobs come from? Oh, small businesses, where most of the jobs 
are. If you look at America, 80 percent of the jobs are in small 
businesses, that is 500 or fewer employees.
  So he says, How are we going to get these small businesses to hire 
people? Well, maybe let's back off on taxes, give them some more room, 
some money to work with. Then they will add wings on the buildings, new 
machines, new ideas, innovation. We have heard a lot about innovation. 
Innovation doesn't come from the Federal Government, taking everybody's 
money. JFK understood that. So he backed off on taxes, and the small 
businesses started producing jobs, and we pulled out of the recession.
  Now, Ronald Reagan understood that. He did the same thing, and we 
pulled out of a recession because we allowed small businesses to create 
jobs. And Bush, II, did that with dividends, capital gains, death tax. 
He allowed the small businessman--instead of taxing him into the dirt, 
he gets them going.

[[Page H13128]]

  What we're seeing under the Pelosi plan, this is a repeat of FDR. 
We're going to turn a recession into a depression because they haven't 
learned even from the Democrats, which is such as Henry Morgenthau or 
JFK.
  Ms. FOXX. Will the gentleman yield?
  Mr. AKIN. I yield.
  Ms. FOXX. I have quoted Morgenthau many, many times saying we've 
spent, we've spent, we've spent, and we can't do anything about the 
unemployment rate. And I think we need to keep repeating that quote. 
And I know you have it, and it's a little more eloquent than what I 
have summarized here.
  But I wanted to go back for a moment when you started out talking 
about our colleagues who were here earlier on the floor talking small 
businesses and about small government. You know, we hear that talk from 
our colleagues across the aisle all the time; and it reminds me of the 
North Carolina motto, which I've occasionally used on the floor when I 
have heard those kinds of speeches being made. The North Carolina motto 
is ``To be, rather than to seem.''
  Unfortunately, our colleagues talk a good line, but when it comes 
down to doing what needs to be done, they want to seem rather than to 
be. So they try to tell their folks at home--they act like they're 
conservatives. They act like they're going to be good people with the 
purse, that they're protecting people. Then they come up here and they 
vote to spend money. Day after day after day we see all of these bills 
coming up authorizing expenditures, spending money. And as you said, we 
have the largest deficit right now that we have had, than we had with 
our first 43 Presidents. And it is really dragging down our economy.
  You know, my daughter runs our nursery and landscaping business, a 
business my husband and I started a long time ago; and I can remember 
going to my husband at times and saying, You know, I'd like to do this 
in the garden shop and spiff it up a little bit. And he would say to 
me, Well, how much is that going to help our bottom line? Is it going 
to bring in more money? And I would sometimes say, No, it will just 
make things look better. He would say, If it isn't going to bring in 
more money, then we shouldn't be doing it.
  That is the decision small business people have to make every day of 
their lives. Some of them lay awake at night worrying how am I going to 
pay my bills, how am I going to make my payroll. They personally 
sacrifice to take care of their employees. I know. We've been there. 
And yet we have people up here who've never worked a day in their life, 
a real job. They have been in Congress for 50, 40, 30 years, and they 
have no concept of how hard it is to run a business and how dedicated 
small business people are.
  Mr. AKIN. They seem to understand one thing, which is what Ronald 
Reagan always said: taxing and spending.
  Let's take a look at what we've got here. We're talking about just 
this year. Here's $350 billion for the Wall Street bailout. Here's 
another $787 billion. That's the one that's supposed to make sure we 
don't have unemployment, right?
  Ms. FOXX. Will the gentleman yield?
  Mr. AKIN. I yield.
  Ms. FOXX. If I remember right, the promise was if that passes, 
unemployment will not go above 8 percent; is that correct?
  Mr. AKIN. Yeah.
  Ms. FOXX. What is our unemployment right now?
  Mr. AKIN. Last time I checked it was 10.2, and you know those were 
conservative numbers because it doesn't include somebody being 
unemployed more than a year. They take their name off the list. It 
doesn't mean they got the job.
  Ms. FOXX. I have heard from many economists that the actual 
unemployment rate is probably 17 to 20 percent because of the folks you 
mentioned, those who've given up looking for jobs, those who have gone 
to work part time. So it was not supposed to go above 8 percent.
  This really has damaged the credibility, I think, of both this 
Congress and this administration because all these promises have been 
made and none of them have been kept.
  Mr. AKIN. The implication is that the unemployment that we're having 
trouble with was really Bush's fault. Everything that doesn't work 
right, well, it was Bush's fault. Bush, when he came in--I was here; I 
came in the same year he did--and we had a problem with a sagging 
economy. We were going into a recession, and he dealt with it the same 
way that JFK had done it and Ronald Reagan had done it, and that is he 
got off the back of the small businessman because he knew he had to let 
that guy have some breathing room to get those jobs going. We're doing 
the exact opposite, which is what Henry Morgenthau did, and we're going 
to turn a recession into a depression if we're not careful.
  And when this thing passed, this stimulus bill, we stood here on the 
floor--and I think you were with me, young lady--and we said it's not 
going to work. I don't mean to be an ``I told you so.'' You don't have 
to be an ``I told you so.'' All of history is screaming that this is 
not the way to solve this problem.
  And now we hear, well, because we have unemployment, it must be the 
Republicans' fault somehow when we're 40 seats in the minority.
  Ms. FOXX. Will the gentleman yield?
  Mr. AKIN. Yeah.
  Ms. FOXX. My recollection is every single Republican voted against 
the stimulus package in the House.
  Mr. AKIN. That's correct.
  We've been joined, as you know, by my very good friend, Congressman 
Bishop from Utah, a gentleman that is so commonsense and so 
straightforward in explaining himself. He has already made a great 
reputation here, and I would like to yield time to my good friend.
  Mr. BISHOP of Utah. You're very kind, Mr. Akin. I wish I believed 
what you said about me.
  You know, I was intrigued by the original chart that you had up there 
when government does too much. Sometimes we tend to overlook that.
  I have always contended that the issue of health care we saw was 
foretold by our Founding Fathers over 200 years ago when they 
instituted a system of federalism, because they knew back in that time 
even though there were only 13 States in the original country--actually 
11 when we started, eventually 13--that the Federal Government would 
always be too big to take--to do anything other than a one-size-fits-
all approach. And that if indeed you wanted to have justice, take in 
the circumstances, creativity or perhaps a program if it failed, it 
didn't destroy an entire country. You had to have it done by State and 
local government. That is the value of it.
  Mr. AKIN. It's called federalism, as I recall.
  Mr. BISHOP of Utah. You know, they didn't limit the power of the 
Federal Government just for the fun of it. There was a reason and a 
purpose to it.
  One of our great Justices on the Supreme Court once said, The 
Constitution protects us from our own best intentions. It divides power 
precisely so that we will resist the temptation to concentrate power in 
one location as an expedient solution to the crisis of the day.
  Now, he was not writing, obviously, about the health care bill that 
passed this House, but it applies. And what we did was simply lose 
sight of the structure the Founding Fathers put in place to create 
balance and creativity and empowerment of individuals.
  I'd like to talk simply about one of the things the States are doing, 
specifically in my State, because my State recognizes we have a unique 
demographic.
  Mr. AKIN. What you were talking about I think at one point it was 
viewed that States were, in a way, kind of a laboratory of creativity. 
So you have got now with 50 different States, if some State wants to 
get a little bit out in the land of fruits and nuts, and California 
wants to spend a whole lot of money and do things one way, there is 
some flexibility to do that. But that doesn't mean that Missouri or 
Utah has to do it the same way.
  And certainly in the area of health care we've seen that. We've seen 
a couple of States try some innovative ideas in health care. One was 
Massachusetts, and one was Tennessee. And both fell flat on their faces 
because they did the same thing that is being done here.
  I don't want to get ahead of you.
  Mr. BISHOP of Utah. That is part of the issue.
  Massachusetts has a program that is expensive. They appear to like 
it, but

[[Page H13129]]

it's very expensive. It would not work in Utah. Our program would not 
fly back in Boston.
  Utah has unique demographics. We're a very young State. We have a lot 
of kids, whereas most small businesses, 42 percent of the Nation, 
provide insurance. In Utah it's only 32 percent. That's a unique 
demographic challenge that we have to face.
  What would happen, though, if we simply go along with the PelosiCare 
that we passed is that every one of the small businesses in Utah rather 
than getting help to solve the problem would be hit with a 5 percent 
tax that would attack 5,500 small businesses already nickled and dimed. 
What they really want is for us to get off their backs with mandates 
and out of their pockets with taxes so they can solve problems.
  So what the State legislature in Utah provided is a way of solving 
those problems by recognizing that small business has a great concern 
once they get into health care because they don't know what their costs 
will be over the period of time, and it's very marginal.
  So what they have tried to do is come up with a concept which 
empowers individuals to choose. Small businesses now can give a pot of 
money they would be giving to an employee as a defined contribution, 
they could then go and buy the health care service that they want.
  Mr. AKIN. That idea sounds like freedom. I am really liking this 
already.
  Go ahead.
  Mr. BISHOP of Utah. It's dangerous, isn't it? It's almost scary as we 
think about it.
  But the goal is to have a clear, transparent index in which all of 
the options that are legal in the State of Utah--and right now there 
are 66 options from which people can choose. They are easily adaptable, 
easily accessible, easily understandable. If you change jobs, you're 
still in the insurance. So there's a portability.
  Mr. AKIN. So you have portability?
  Mr. BISHOP of Utah. Costs are stabilized for the business; employers 
now have options from which to choose. And this is only in the first 
year. It has had a phenomenal response, and we are just beginning.
  If the Federal Government were then to try and help that out by doing 
simple things like allowing--removing barriers for cross-state 
purchases, doing tort reforms which would bring down the costs, the 
number of people who are truly uninsurable because of preexisting 
conditions can be shrunk to an area that is possible for States to 
easily handle and maybe even the Federal Government could give grants 
to that.
  Mr. AKIN. Can I ask you about what you've got, because that's really 
an exciting concept.
  First of all, what you're saying is that a small business has some 
employees, they want to treat their employees right but they also have 
to make the small business make money so they can say, Look, we're 
going to put aside this amount of money for each of our employees to 
help them with health care, but we're going to allow those employees to 
have some choices as to what they buy.
  So, for instance, let's just say that I am a husband. I've got a job 
in small business. I have a wife. And it turns out we know that we're 
never going to have any children. So I don't really need to get the 
coverage for childbirth or something that maybe somebody else does. So 
I could find a policy that would suit, that would be more tailor-made 
to our family and therefore could get better coverage in some other 
areas possibly.
  So you have a way to fine-tune something that meets your particular 
situation.
  Mr. BISHOP of Utah. And by controlling your own money with your own 
choices.
  When I go into a grocery store to pick up cereal, there's an entire 
wall of choices. I pick the kind I like. You would go in with me and 
you'd go over and pick another one. Why isn't the role of government to 
allow people to have choices?
  I have one of my fellow teachers who was upset because in his plan 
the district only allowed him two options. If you actually go to a 
single-payer system by the Federal Government, you get one.
  The State of Utah is saying there are 66 options, which is a 
comparative advantage of that. It also means one of the situations that 
we have in large business provides insurance for its workers. The owner 
or the manager picks what company it is and everybody has to follow 
along. In this program, the large business already providing insurance 
could do the same thing by providing the amount of money to an 
individual who could then go on the State index and pick what he or she 
wants to do.

                              {time}  1800

  Here is the kicker: this is a great idea.
  Mr. AKIN. Of course this Pelosi bill is going to absolutely torpedo 
everything that you are talking about, isn't it?
  Mr. BISHOP of Utah. You just took the words out of my mouth because 
that is the kicker. States have the ability of becoming creative. They 
are, as you were earlier quoting Louis Brandeis, becoming laboratories 
of democracy. They have the idea of making a system that meets the 
demographic needs of that particular State. What we should be doing is 
encouraging that kind of creativity, encouraging those kinds of 
options. But you are exactly right, with the bill that we passed the 
other week, that stops that concept dead in its tracks.
  Mr. AKIN. First of all, the Pelosi bill has all of these mandates in 
it, and let's just talk about this mandate. This one here is the 
mandate for, let me get it on the chart, this is the mandate for 
employers. First of all, employers have to offer a qualified health 
care plan to all full and part-time employees. What do you think that 
``qualified health care plan'' means?
  Mr. BISHOP of Utah. We may be comfortable today with what is defined 
as qualified. Unfortunately, and this is what the Supreme Court Justice 
was saying, the Constitution protects us from our own instincts of 
doing this, that by creating a commission that in the future will tell 
what the private sector will do when it is in competition with the 
Federal Government. What may be qualified in the future is not 
necessarily what is qualified today.
  As you stated very convincingly earlier, if you have a specific need, 
what is your need may not be what some distant bureaucrat in Washington 
determines to be qualified. And, in fact, one of the biggest problems 
we have when people talk about health care, no one has ever really 
defined what health care actually is. Is cosmetic surgery part of it? 
Is mental health part of it? Nursing homes, are they part of it? What 
is the goal or purpose of it? We have yet to do that. See, that is what 
we are allowing a bureaucrat in the future to do as opposed to what 
some of the States wish to do in allowing citizens, employees, to have 
options and choices so they have control over their own lives.
  Mr. AKIN. There will be a number of our colleagues who may be 
watching, and other Americans who are hearing this discussion. Which 
would you prefer to have? The option that you are offering, which is 
what Utah is doing--your employer gives you some money, you can go out 
and use that money to buy something. You can buy one of, what was it, 
66 different policies, and try and find something that really fits the 
need of you and your family. That is one alternative.
  This is the old Henry Ford alternative: you can have any color car 
you want as long as it is black. This is the government plan: employers 
must offer a qualified plan. Who says what qualified is? The Federal 
Government says what qualified is.
  How does it work? First of all, the employer has to pay somewhere 
between 65 and 72 percent of the cost of the plan. Now we have already 
defined this because the government knows what the employer should 
provide. It shouldn't be 50, it shouldn't be 80; it has got to be this.
  Or if you don't do that, you have to pay a tax of 8 percent of the 
payroll costs. Here is how this works. You have 20 employees. One 
employee decides he wants something else. That means just one out of 20 
doesn't take your plan that the business offered, and now the business 
gets hit with 8 percent, regardless if the other 19 employees were 
happy with it. So now they are going to get whacked with this 8 percent 
tax off of payroll, so you are hammering small business, which makes it 
less efficient

[[Page H13130]]

and forces everybody into, guess what, Henry Ford's one color, black. 
You've got a qualified health care plan. Which qualified health care 
plan? The one by the Federal Government.
  You have a choice of one, one, or one. The insurance companies, what 
are they going to write? The qualified plan. Because if you don't write 
the qualified plan, what happens is, you get fined by the Federal 
Government, because you had a nice health plan that fits some people's 
needs that you thought was a good deal, and you are going to get fined 
instead. That is mandate. That is not freedom.
  Mr. BISHOP of Utah. If I can add one thing here, because I notice 
that we have been joined by two other colleagues who have given their 
entire professional career in this area. They know what they are 
talking about. I would add our Founding Fathers, sitting over there 
with their knee britches and their powdered wigs, knew exactly what we 
needed today because their highest goal was to provide individual 
liberty for the citizens so that people could make choices for 
themselves. They realized it is not the role of government to tell 
people what is best for them. That is a risk-aversive system of nanny 
government where we tell people what to do because we know what is 
best, and it is cheaper as we see it.
  Our goal should be to provide people with choices and options that 
ennoble their souls and allow them to control their own destinies. The 
only way of doing that is allowing States to move forward on their own, 
as Utah is trying to do, and not be stopped by this Pelosi care bill 
which will stop the States' progress and all of the innovations that 
are taking place out there.
  Some time we have to realize that you don't solve problems by putting 
a lot of experts in a room in Washington, D.C. There is a font of 
knowledge out there that is waiting to blossom and provide new 
solutions. Our salvation as a Nation is to go back to the Constitution 
and believe in federalism. That is how we move forward.
  Mr. AKIN. Well, I very much appreciate the gentleman from Utah. 
Congressman Bishop, you are just an inspiration, and that really is a 
breath of fresh air flowing through this Chamber, the idea of freedom 
and the idea of limited government and the idea that we will allow 
States to solve their own problems instead of the Federal Government, 
the one-size-fits-all Pelosi plan. And it also takes the pressure off 
of intense levels of Federal spending that are bankrupting our Nation. 
We talked about earlier--can you believe that the communist Chinese 
were telling us that our government is spending too much money and 
getting too big? That is a wrong day in American history. It is 
something else.
  I am joined by Dr. Gingrey from Georgia, who has some great charts. 
They look more interesting than mine, so I yield to Dr. Gingrey.
  Mr. GINGREY of Georgia. Thank you, Mr. Akin. Referring to the 
gentleman from Utah (Mr. Bishop), the historian, what he was talking 
about, I carry this with me in my pocket all the time, and I am sure 
many of my colleagues do, a pocket Constitution. This is the 
inconvenient truth, and this is exactly what my colleague was just 
talking about.
  You go in the back and look up in the glossary or the index and try 
to find anything about health care, it is not in there. It is not in 
there. My colleague, Mr. Speaker, referred to some of the posters that 
I have with me. I do want to point those out to Members on both sides 
of the aisle, because I think in many instances a picture is worth a 
thousand words. In this instance these posters are worth a thousand 
words.
  Focusing in on the first one, Mr. Speaker, it shows the ship of state 
and the captain of the ship. That would be the administration, that 
would be the President of the United States, and that ship is the 
economy. Down here at the bottom of the poster it shows a trailer as we 
see on television news a lot of times: Alert, bulletin: 10.2 percent 
unemployment, and then the caption, ``Good news, I'm almost done 
reorganizing the medicine cabinet'' as the ship of state is sinking.

  Mr. Speaker, it is a point that I have made over and over and over 
again. When the President sat right where you are, or stood right in 
front of where you are and spoke to the Nation before a Joint Session 
of Congress and said our number one priority is to reform our health 
care system. One-fifth of our economy, colleagues, I believe we are 
talking about, and yet we have spent $787 billion on an economic 
bailout when our unemployment rate was 8 percent, now 10.2 percent, and 
I think we have lost, and correct me if I'm wrong, Mr. Speaker and my 
colleagues, the loss of jobs since February of 2009 when we passed this 
so-called economic stimulus, which was supposed to stem the 
unemployment at 8 percent, it is now 10.2, and we have 16 million 
people out of work, an additional 3.5 million since February of this 
year. Why is that not our number one priority instead of reorganizing 
the medicine cabinet?
  I have some other posters that I want to refer to as well, but I want 
to yield back to the gentleman controlling the time because there are 
other Members who would like to speak. Hopefully you will have an 
opportunity to come back to me.
  Mr. AKIN. I appreciate that, and I look forward to doing that. I 
thought you were going to bring some sort of gory medical pictures 
here.
  Mr. GINGREY of Georgia. If the gentleman would yield, I definitely do 
have some of those that I will bring up.
  Mr. AKIN. We also have my good friend, G.T., joining us. I think it 
is good to have different people from different States to have a part 
in this discussion. We haven't had too much of a part because all of 
the doors have been closed and we have been on the outside, but we have 
a few ideas.
  One thing we know how to do is to reduce the cost of health care; and 
we also know that one size fits all doesn't sound like freedom. Mr. 
Thompson, I would like to yield to you at this time.
  Mr. THOMPSON of Pennsylvania. I thank my good friend from Missouri.
  I came here in January, and I came here knowing that I had a pretty 
good handle on health care. I worked in health care for almost 30 
years. I actually think we have a pretty good health care system, but 
it can be improved. And much of the improvements that I saw was getting 
government out of the way. The frustrations I had as a health care 
professional, as a health care manager, as a therapist, as a nursing 
home administrator, is when the government was creating problems, 
preventing access to cost-effective care, increasing costs because of 
these arbitrary ways that it gets involved.
  To me, I think, as my good friend Mr. Bishop talked about, it is 
about the wisdom that our Founders had, and it is about free market.
  You look at all the Republican proposals we have; they are free 
market proposals. It is not about inserting more government; it is 
getting government out of the way. And it is about the arbitrary rules 
that we have on where we can buy our health insurance from. The 
government tells us we can only buy within the confines of our own 
State, and it is about the government telling us we can't group 
together and form association health plans, that we have to endure 
medical liability. That becomes legislated and codified into our lives 
and adds just hundreds of billions of dollars of waste onto the health 
care system.
  I am just so proud of the proposals that Republicans have put 
forward. I don't know how many in total we have, but between 35 and 40, 
I believe.
  Mr. AKIN. I heard there are over 50 different bills at this point. 
Some are a combination of different ideas and put together in different 
ways.
  You know, you used to be an administrator and you had to deal with 
red tape and bureaucracy. What we have just done is we have got a 1,990 
page bill. It passed with less than 72 hours for the public to review 
it. It creates 118 new boards, bureaucracies, commissions and programs, 
and it is full of new mandates. And it contains the word ``shall'' 
3,425 times. This is what it looks like. And that doesn't even have all 
of those 118 new boards on it. This is just a simplified version of it. 
Now, does that look like something to you that gives you much choices? 
And second of all, talk about overhead, talk about redtape.
  You know, we were thinking about, and I see my colleague has come out 
here with some great sort of cartoons and things, and we were thinking 
about turning this into a cartoon. We were going to put patients over 
here and

[[Page H13131]]

doctors over here, and turn it into a place mat, and we are going to 
have lines like a maze, and the trick is, before your dinner is cold, 
to try to get the patient to the doctor. We were going to set the maze 
up so there wasn't any way to get there, because that is really what 
this tells you.
  If you really want good, efficient health care, this thing here is in 
your way. That's the reason why a great majority of Americans don't 
believe that the Federal Government can take this thing over and manage 
it efficiently and effectively without the costs going through the roof 
and also without degrading health care, because the trouble is no other 
country has ever been able to do this.
  I yield to the gentleman.
  Mr. THOMPSON of Pennsylvania. Let me reflect on my experiences as 
someone who was a manager of health care services in a rural hospital, 
skilled nursing, rehabilitation service--across the board, on what this 
means. Because you talked about increased costs to the taxpayers of 
this country.
  I have to tell you, what I see there is a nightmare in terms of costs 
for hospitals and for providers. Hospitals alone, when you look at over 
1,990 pages of new text, and that is just the bill. The regulations to 
be promulgated as a result of over 2,000 pages of law will be--it will 
just take a forest to be able to print those regulations. Those 
regulations all need to be administered.
  Here is my prediction: For those hospitals that are not bankrupt in 
the near future, they are going to have to add tremendous employees to 
deal with that bureaucracy. Those employees' only job will be to 
interact with all those agencies, not health care, not people providing 
direct care. They will have to lay off people who provide direct care 
to be able to afford what will be required to administer those 
regulations, to make those regulations work within a hospital. That is 
not good health care.

                              {time}  1815

  Mr. AKIN. That's overhead.
  Mr. THOMPSON of Pennsylvania. That's overhead. That's the complete 
opposite of access to quality care. That's preventing access.
  Mr. AKIN. I would like to go to my friend Dr. Gingrey. He's got 
another very heavy medical concept for us. I can tell. He's got it all 
cued up here.
  Mr. GINGREY of Georgia. I thank the gentleman for yielding back to 
me. In fact, I would ask him to put the previous poster back up, the 
one that showed all those additional bureaucracies that are created by 
H.R. 3962. In fact, that poster was created when it was H.R. 3200 and, 
as the gentleman from Missouri said, a thousand pages, now 2,000 pages. 
But he said something about, Madam Speaker, putting that in cartoon 
form. Well, I've got the cartoon for my colleagues, and here it is.
  When you put a gown on that chart, this is what it looks like: a 
bloated, bloated patient called the House health bill. And this is a 
cartoon actually from the San Diego Union Tribune a few days ago. And, 
my colleagues, look at the poor patient, and, of course, I don't know 
if you can see up at the top corner, ``nip/tuck.'' And these two 
Senators are standing over here. I guess that may be the majority 
leader of the Senate, Harry Reid, and possibly the chairman of the 
Senate Finance Committee or the chairman of the Senate Health Committee 
standing next to Majority Leader Reid, and the caption is, ``Hey, this 
might take a while'' to nip/tuck this bloated 2,000-page bureaucracy 
that's depicted by my colleague Representative Akin.
  It just shows you in a cartoon form, but unfortunately it's not 
funny, is it? It's not funny, my colleagues and Madam Speaker. This is 
serious business. And I hope and pray that the Senate will be the 
saucer that cools the drink of the hot cup that has come over from the 
House, because Lord help this country if we don't do a whole lot of 
nipping and tucking if not downright eliminating this bill, H.R. 3962.
  Mr. AKIN. I appreciate your keeping it in a sort of a big picture 
form as to what we're talking about on cost.
  Mr. GINGREY of Georgia. No pun intended, of course, about the 
cartoon.
  Mr. AKIN. But the cost supposedly by the Congressional Budget Office 
was that this was going to cost a trillion dollars, so your figure over 
there was overweight in costing a trillion dollars. The trouble with 
this estimate is it's wrong because the Congressional Budget Office 
took some assumptions when they built it because they were told we've 
got to keep this thing under a trillion dollars.
  The problem is, first of all, the Democrat Governor of the State of 
Tennessee, who has already tried this lovely idea, has taken a look at 
this and called it the ``monster of unfunded mandates.'' What that 
means is that that trillion dollars was trimmed one way, was to dump a 
bunch of the costs down to the various States, aside from the fact that 
it destroys everything that the State of Utah has set up, which is 
actually kind of an innovative idea. It destroys that because it says 
every single health insurance plan has to follow what the Federal 
Government says. So now they're going to define what health insurance 
is and that's all there is, one definition. And anybody else that 
doesn't follow that definition, you know what the bill says. You're 
going to get fined if you're offered health insurance that doesn't fit 
with what the government guidelines say. So this trillion dollars is 
wrong.
  The other thing they did was they took the trillion dollars and they 
took the time to calculate this in such a way that the revenue was 
coming in but the real expenses of the program hadn't hit their peak 
yet. So they cheated on the two different time scales as to when the 
money was coming in versus when the costs were going to come. So, in 
fact, the trillion as the Senate has calculated it is closer to $2 
trillion, which is $2 trillion we don't have.
  I think the gentlewoman Congresswoman Foxx said that there was a 
survey done that said that Americans believe there is more probability 
that we're going to discover aliens in outer space than the fact that 
this thing is ever going to be anything other than a big budget-busting 
deficit, driving deficit spending. And, you know, there is a pretty 
good reason why Americans have that common sense, because we've tried 
these things before. The Federal Government has tried Medicare and 
Medicaid, and we see their costs are going out of control, and we're 
told, Trust us. Medicare and Medicaid are going out of control, so 
we're going to take the whole system over and run it by the government 
and it's not going to go out of control.
  I yield to my good friend from Pennsylvania.
  Mr. THOMPSON of Pennsylvania. I appreciate that, Mr. Akin.
  To that point on Medicare, because of the baby boomer generation, 
utilization is going up. Those costs are climbing. But just this past 
week we heard from the Centers for Medicare and Medicaid Services. They 
released their 31-page actuarial report on the Pelosi health care plan 
on what would this do to Medicare. You know what? You're going to have 
to make that poster a little larger because what the Centers for 
Medicare and Medicaid Services--which is the Medicare agency, and 
they're nonpartisan. That's not a partisan report. It comes from the 
people who actually run the Medicare and Medicaid systems in the 
country. As they looked at this bill when they scored it, they said 
that this would increase costs to the Medicare program over the next 10 
years by $289 billion. So I'm afraid we're going to have to budget for 
a little larger poster, because with the Pelosi health care bill, it's 
going to take quite a steep climb beyond where Medicare is already on--
--
  Mr. AKIN. So you're saying that the cost of Medicare is going to go 
up with this program.
  Mr. THOMPSON of Pennsylvania. Absolutely, $289 billion is what the 
Medicare agency----
  Mr. AKIN. Now, wait a minute. My understanding was that what we were 
cutting was 400 or $500 billion out of Medicare in order to pay for 
that trillion. How then is the cost of Medicare going to go up if we're 
cutting $500 billion? How do the mathematics work?
  Mr. THOMPSON of Pennsylvania. You know what? I have asked that 
question many times since I came here in January, how does the math 
work in this Chamber, because it doesn't add up.
  Mr. GINGREY of Georgia. If the gentleman from Missouri would yield.

[[Page H13132]]

  Mr. AKIN. I yield to my good friend Dr. Gingrey.
  Mr. GINGREY of Georgia. On this issue, as the gentleman from 
Pennsylvania just said, the actuaries of CMS, Medicare and Medicaid 
Services, just said exactly what he said, that over a 10-year period of 
time, the amount of Medicare expenditures are going to go up by 
something like $289 billion.
  Look, colleagues, Madam Speaker, we are going to face something on 
this floor tomorrow, something called ``doc fix.'' I think the bill 
number is H.R. 3961. And I want to use my reference to my last chart to 
bring this home to our colleagues that this is nothing but a Trojan 
horse. Here's the Trojan horse with this 3961. I know, my colleagues 
and Madam Speaker, it's hard to see this, but it says ``Democrat doc 
fix,'' but what's inside that Trojan horse, of course, is the $500 
billion cut to the Medicare program that the gentleman from 
Pennsylvania was just talking about. And also it says H.R. 3200. We now 
know with the Pelosi health reform act, as H.R. 3962, the poor horse is 
back because it's gone from a thousand pages to 2,000 pages. But that's 
what's inside this Trojan horse.

  Make no mistake about it, my colleagues. Members back home and, yes, 
your physician constituents, your physician constituents are going to 
recognize this Trojan horse because they were promised in this massive 
bill, H.R. 3962, that there would be this permanent ``doc fix'' in 
there. But the leadership and the President got together and said, oh, 
no, that's going to make the cost go over $900 billion, and I promised 
not one dime more than $900 billion. So let's pull the doctor fix out 
and then we'll bring it forward as a stand-alone bill. But guess what, 
colleagues? It's not paid for. And the gentleman from Pennsylvania, I 
know that he knows this. That adds another $250 billion to the deficit.
  Don't vote for this Trojan horse tomorrow, 3961.
  Mr. AKIN. Reclaiming my time, you were speaking clearly except there 
was one word I didn't quite catch. I thought you said, was it ``doc 
fix'' or was it ``doc tricks''?
  Mr. GINGREY of Georgia. I said ``doc fix,'' Madam Speaker. But I 
probably misspoke. I think the gentleman from Missouri is absolutely on 
target. Doc trick. Amen.
  Mr. AKIN. So it's a trick to make it seem like everything is going to 
go right with Medicare, but, in fact, it's not. In other words, the 
idea was it was going to fix the formula in Medicare so that the 
doctors wouldn't keep having their salaries cut a certain--what was it, 
5 percent a year or something like that?
  Mr. GINGREY of Georgia. If my colleague would yield, and I'll yield 
right back to him because I know we've got another Member that wants to 
speak.
  Mr. AKIN. I yield.
  Mr. GINGREY of Georgia. It is a doc trick. And what it does is it 
does not solve the problem. It just substitutes one bad formula for 
another. And I think, unfortunately, our doctors, if this thing passes, 
are going to wake up and find out that they are now working for the 
Federal Government and they're making far less on Medicare 
reimbursement than they are today.
  Mr. AKIN. My friend is a medical doctor, and you're planning to vote 
``no'' on the bill.
  Mr. GINGREY of Georgia. In fact, the gentleman is right. I wish there 
was a ``heck no'' button, but I don't think there is. But I will be a 
definite ``no.''
  Mr. AKIN. Thank you very much, Dr. Gingrey. Thank you for joining us, 
and I appreciate your at least trying to put somewhat of a humorous 
face on a very, very serious situation.
  We're joined by a very good friend of mine from Louisiana. I hope you 
would join us here on our discussion we've got going here tonight.
  I yield to the gentleman.
  Mr. SCALISE. I thank the gentleman from Missouri.
  You're talking about these tricks, and, of course, the American 
people are saying Halloween's over, we're tired of all these tricks. In 
fact, for most American people right now, the only treat they get is 
when Congress adjourns and during those times when Congress isn't 
trying to pass all of these policies that literally are adding millions 
and billions of new taxes on the backs of American families, adding 
billions of debt onto the backs of our children and grandchildren, and 
running millions of jobs out of our country. All of this happening 
under Speaker Pelosi's leadership. The public's had enough of the 
tricks, and like I said, that's the only treat they want.
  But one trick that they just found out about the other day, this goes 
back to the stimulus bill, something that we talked about a long time 
ago. We opposed that pork-laden bill, that bill that massively grows 
the size of government, over $787 billion of money we don't have. But 
the White House promised the American people there would be a full 
accounting of the money. And now we find out, in fact, that people just 
in the last few days went to the White House's own Web site that was 
set up to track the spending in the supposed job creation, which they 
initially said it was going to create all these jobs and then they 
changed the wording and said there will be jobs created or saved, and 
there's no definition of a job saved. I guess every job that's out 
there they can try to claim they've saved. But then what we've seen is 
we've only had millions more jobs lost since that massive spending bill 
that grew the size of government.
  But now talk about another trick on the American people, just Monday 
night when they would go to the Web site that the White House had set 
up, and maybe this was good news for States like yours, mine. In 
Louisiana, we found out, according to the White House's Web site, we 
had 15 congressional districts.
  Mr. AKIN. How many was that, gentleman?
  Mr. SCALISE. Fifteen, according to the White House. In fact, 
Louisiana's Eighth Congressional District, according to the White 
House's own Web site, created more jobs than the First Congressional 
District that I represent. That all sounds really good until you 
realize Louisiana doesn't have 15 congressional districts. Louisiana 
only has seven congressional districts.
  So we did a little bit of research, and some people did some calling 
around on their own and they actually called the White House. And they 
said, Can you explain to us, you said there would be all this 
transparency. You said there would be accountability. How is it, how is 
it that somebody can go to the White House Web site and pull up in 
Louisiana Congressional District 26 or Congressional District 45? And 
the response from the White House was, ``Who knows, man, who really 
knows.''
  That was Ed Pound, who is the spokesperson for the White House's 
recovery.gov Web site. The best he could come up with was ``who 
knows.'' And then he further went on to say, ``We're not certifying the 
accuracy of the information.'' That's the White House's spokesperson on 
the stimulus bill actually saying that they're not going to certify the 
information after they said they would be so transparent.
  So when the American people say what happened to $787 billion of 
money that was borrowed from our children and grandchildren, money we 
don't have, money that surely hasn't done anything to create jobs 
because it was going to cap unemployment at 8 percent and now we've got 
unemployment at 10.2 percent, and then you go to the White House, what 
about that accounting that the American people deserve to know where 
their money is being spent, and the best the White House can say is, 
``Who knows, man, who really knows,'' well, the American people have 
had enough.
  Mr. AKIN. Reclaiming my time, I would like to take a look at your 
chart here. You were boggling on my poor brain here. You're the 
Congressman from District One, and they're saying there are 40 some 
congressional districts in Louisiana, which is real news to me. I 
suppose that was news to you, too. And you finally get ahold of the 
White House, and they spent millions of dollars to create this Web site 
to track down where we spent the $787 billion, which was guaranteed or 
supposed to keep us under 8 percent unemployment, and we get some guy 
that says, ``Who knows, man, who really knows.'' It's like Woodstock 
lives on.

                              {time}  1830

  And we've spent billions of dollars to get that kind of answer?
  Mr. SCALISE. Right.
  And what the American people are really asking is, where are the jobs 
and where is the accountability? And when the White House actually goes 
out and

[[Page H13133]]

made these statements back months ago and they told the American people 
that that stimulus bill needed to be passed, we said back then it was a 
mistake, we shouldn't do it because it wouldn't create jobs. We 
proposed alternatives.
  Mr. AKIN. Gentleman, you were here on the floor when we talked about 
this. We said, Look, all of the mathematics, all the common sense says 
this is wasting a lot of money that we don't have. We said, It's not 
going to create jobs. It didn't for Henry Morgenthau when he turned the 
recession into the Great Depression. We said, The reason it's not is 
because jobs come from businesses, particularly small businesses. 
You're hammering the small businesses. At least learn from the 
Democrats, learn from FDR, learn from Henry Morgenthau.
  Instead, we've got this half-baked Web site telling us that there's 
40 some congressional districts. I mean, you'd think they would at 
least check how many congressional districts there are in a State.
  Mr. SCALISE. If this was just a mistake limited to Louisiana, maybe 
you could understand their excuses. But, of course, this was all across 
the country. I talked to a colleague of mine from Arizona where they 
claim there was a 99th District from Arizona.
  But one final word on that. President Obama himself just yesterday 
said, and I'll quote another quote from the President: ``If we keep on 
adding to the debt, people could lose confidence in the U.S. economy in 
a way that could actually lead to a double dip recession.''
  Now, of course, those words ring true to us. They would really ring 
true to the American people if it weren't for the fact that this is the 
same President that passed a budget just a few months ago out of 
Congress that doubles the national debt in the next 5 years. And yet 
here he is quoted just yesterday saying, If we keep on adding to the 
debt, people could lose confidence in the U.S. economy in a way that 
could actually lead to a double dip recession.
  Now, I would agree with that. The only problem is, the President 
needs to start living up to the comments that he's actually making and 
pull back his bill that doubles the national debt and actually work 
with us to balance the budget, which is what we've said from the 
beginning needs to happen, not only to create stability in our economy, 
but actually to go out and start creating jobs as opposed to his 
policies that are running millions of jobs out of our country.
  Mr. AKIN. Do you really think that we're going to balance the budget 
with a socialized medicine bill that they've said is going to be a 
trillion? Do you know what the budget estimate on Medicare was when it 
was passed? The Congressional Budget Office, they tried to estimate it. 
They were off by a factor of seven times. This thing is clearly over 2 
trillion when you do honest math with it. If that's off by a factor of 
seven, that's $14 trillion. No wonder the Chinese were giving us a 
lecture telling us we've got the government spending too much money. 
They've got some American Treasury bills. It's not like they don't mind 
big government, but they just don't want to see us ruin their 
treasuries.
  I've got my good friend from New Jersey here, Congressman Garrett. 
Please join us.
  Mr. GARRETT of New Jersey. I appreciate the opportunity to join you, 
and I commend the gentleman for leading tonight and also for those very 
interesting quotes from the White House with regard to the Web sites 
that are out there.
  I think the American public are asking some very basic questions--
Where is the transparency? Where is the accountability? Where are the 
jobs?--on all this legislation that's coming through. And when they see 
this, when they see Web sites that you just pointed out talking about 
congressional Web sites that don't even exist, when they see about job 
creation that doesn't even exist.
  You probably recall that the majority leader was on this floor back 
in the early part of this year when he was exclaiming that we had to 
vote for a seven or $800 billion stimulus bill and you had to vote for 
it today. Why? Because it would make or create 3 million new jobs, not 
next year but this year. And, of course, we now know what the facts 
are. What are the facts? Instead of making or saving 3 million new 
jobs--and I never did quite get an explanation of what is saving a 
job--but making or saving 3 million jobs, we, of course, have lost 
upwards of 3 or 4 million jobs, just the inverse of that, just the 
opposite of that.
  So the people are asking, where is the honesty in that aspect of 
things? Where is the accountability with the job creation? They're also 
asking about, and you're talking about all the money that we're 
spending, the trillion dollars with regard to the health care 
legislation and the like. Actually, I think the number was a little bit 
larger than what you were saying as far as the discrepancy with the 
projections with regard to Medicare which was created back in the mid 
sixties. They said by 1990, that program would cost around 10 or $11 
billion. It actually cost $112 billion, so it was off by a factor of 
10.
  Mr. AKIN. So seven--I was being too generous.
  Mr. GARRETT of New Jersey. You were being too generous.
  Mr. AKIN. So if you take the 10 factor, how much congressional 
budget--I mean, they're making assumptions trying to guess what 
something is going to be years into the future. But if you take that 
10, if you put the unfunded mandates from the States and you put in the 
fact that they skewed the time schedule to try to keep it under a 
trillion, say, they're over 2 trillion, that's $20 trillion?
  Mr. GARRETT of New Jersey. Those numbers are just so mind boggling 
you can't get your arms around it. But you know what you can get your 
mind around is something that's happening to everybody right now, and 
that is, I'm getting phone calls to my office with regard to the swine 
flu situation that's going across this country, and they're saying, We 
can't get the swine flu vaccine. This is something that's supposed to 
be administered by this administration, that they promised would be out 
there for everybody who needed it, and in my counties, my district, you 
can't go to a doctor or a county clinic or to a county hospital and get 
that. But you know who is getting it? People who work at the Federal 
Reserve in New York, people who work for some of the largest financial 
institutions in this country. And the people who absolutely need it are 
not getting it. The people who are in jail down at Guantanamo are 
getting it as well. I just use that as a real life example of the 
administration running a program for health care and not getting the 
job done.
  I yield back to the gentleman as the time comes to an end.
  Mr. AKIN. Looks like we're just starting to have fun and the clock 
has already run out. I just want to thank all of my gentleman friends 
here. Congressman Garrett, thank you so much for joining us. Hearing 
from the east coast, that's very refreshing. From down in the South, 
from Louisiana, Congressman Scalise. And also G.T., all that health 
care experience that you bring here to the floor managing, we 
appreciate that.

  Thank you. Have a great evening.

                          ____________________