Congressional Record, Volume 156 Issue 3 (Wednesday, January 13, 2010)

[Congressional Record Volume 156, Number 3 (Wednesday, January 13, 2010)]
[House]
[Pages H124-H131]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

HEALTH CARE

The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 2009, the gentleman from Texas (Mr. Neugebauer) is
recognized for 60 minutes as the designee of the minority leader.
Mr. NEUGEBAUER. Mr. Speaker, we are clearly in a technical revolution
in our country. People now have more information available to them than
literally at any other time in probably the history of our country.
They know more about what is going on in their government than they
ever have before. I think that is one of the reasons we are seeing
people all across America rise up and start to make such bold
statements and attending these TEA parties and attending these Members
that are having meetings in their districts, and they are coming in
record numbers.
Back this August, I had an opportunity to have a number of town hall
meetings in my district, and thousands of people came to voice their
opposition to what they think is happening to

[[Page H125]]

their country, and particularly in opposition to this health care bill.
Every morning, Americans wake up and follow with deep interest public
policy issues that we are sent here to solve, and many people watch C-
SPAN. I know that when I am back in the district, many people will say,
Congressman, I saw you on C-SPAN.
In fact, recently I had a conversation with one of my constituents
who lives over in Muleshoe, Texas. She was calling to express her great
concern about what is going on to her country, these huge deficits,
trillions of dollars of spending money that we don't have, the
government taking over the health care, and she was concerned about
what is going on. What I learned, as she spoke more and more, she knew
a lot about the issues that are facing our country, and she said she
picked up a lot of that by watching C-SPAN.
A lot of the viewers that call in to C-SPAN on a daily basis, they'll
voice their disappointment or concerns about what is going on in their
country, and they'll say, And thank God for C-SPAN.
C-SPAN is kind of the watchdog, the eyes and ears, the vehicle that
enables millions of Americans to see what we are up to here in
Washington, D.C. Every day, people can view Congress raising their
taxes, decreasing their freedoms, forcing business owners to pay more
fines. All of this, thanks to C-SPAN, it is here for millions of
Americans to see. Except, that is not going to be the case for health
care reform in our country.
Mr. Speaker, it is no secret that the majority plans to negotiate the
final thousand-page health care bill without C-SPAN cameras present.
President Obama promised when he was running for President that he
was going to change Washington. He vowed, at least eight times, that
the American people would get to see the negotiations of the health
care bill on C-SPAN.
Speaker Pelosi promised that the Democratic-led Congress would be the
most transparent Congress in history. She went on to say that the work
on the health care bill will be displayed transparently, while
simultaneously, unapologetically, denying C-SPAN cameras access to
capture the ongoing negotiations.
In fact, those negotiations have been going on somewhere in this
building. None of us, very few of us know where, and very few people
are in the room making decisions that are going to impact the American
people, not for this generation, but generations to come. All of this
talk about transparency and openness, yet nobody knows who is actually
in the room and actually what is happening.
But we do know what happened when they went into the room, for
example, in the Senate and other places: Deals were cut. And I think
one of the problems that this majority has and this White House has is
they have got a health care bill that is so unpopular that they have to
meet in secret to talk about it so that they can cut deals so they can
get enough votes to pass it.
Wouldn't it be nice if the American people could experience some of
that transparency that the Speaker and the President of the United
States promised the American people, that they could be able to see the
negotiations.
I had the opportunity to experience what is positive about having
these negotiations in a public setting when we did the farm bill a
couple of years ago. We sat down at a table. We had Republicans and we
had Democrats. The cameras were on. The discussions were frank, they
were honest, they were open, and in the end, democracy took its place
and a bill was crafted and it was passed by the House and the Senate.
I don't understand why we can't have that same transparency and
openness when we are talking about people's health care. Probably one
of the most important things to many Americans is the ability for them
to have some control over their health care. We have now a bill that is
talking about taking over the government and government taking over the
health care of our country, yet we are negotiating and debating this
bill in the darkness of some room somewhere in the Capitol, and who
knows where.

Let's turn the lights on to this debate. Let's turn the lights on in
that room. Let's turn the lights on so that the American people can see
what is going on as these decisions are being made about their health
care. It is too important.
Now, the Democrats are going to say, Yeah, but when the Republicans
were in charge, that is the way they did things. Well, that sounds like
kind of a schoolyard taunting contest. But the fact is, that is not the
truth.
I want you to remember these dates: July 15, 2003, September 9, 2003,
November 20, 2003. And you say, Well, what happened then? One of the
good things about C-SPAN is they have a great library of American
policy and democracy in action. In fact, it is probably one of the most
extensive ones in the world, and people can come and research and see
actually what did happen on the floor of the House on a particular day.
And what happened on that day was that Members of Congress met to
resolve their differences between the House and the Senate version of
the Medicare reform legislation that provided medical prescription drug
benefits for Medicare recipients. A very important piece of
legislation, one that was not without some controversy. The House
passed a version, the Senate passed a version, and then, in the light
of day, these two versions were negotiated on these days. The American
people got to see the discussions that went on and got to see this bill
being crafted that eventually became law.
If the Democrats weren't engaging in these backroom deal-making
deals, I think they wouldn't mind the lights being turned on. But the
problem is that they are cutting deals. And the reason they are having
to cut deals is because they are trying to pass a piece of legislation
that the American people don't embrace.
Many of us agree that health care needs to be reformed. And my
colleagues on my side of the aisle, Republicans, conservatives, have
been offering some commonsense ideas that could reform the current
system without turning over health care to the government, without
limiting patients' rights, and bringing more transparency and making
health care more affordable and available and accessible to the
American people.
If the President and the Speaker and the congressional leaders are
serious about this new era of openness and transparency, then why, Mr.
Speaker, why, Mr. President, why aren't the lights on and why aren't
the cameras in the rooms so that the American people can see what is
going on in their country? I believe they deserve to know.
This is a very important issue to the American people, and I hope
that the Speaker and the President of the United States will keep their
word and allow the lights to be turned on for this important issue.
It is now my pleasure to recognize the gentleman from Pennsylvania
(Mr. Thompson).
Mr. THOMPSON of Pennsylvania. I thank my good friend from Texas for
leading this very important Special Order tonight and for yielding.
Transparency and accountability is such an important part of what we
need in government. And what I have seen since my election a little
over a year ago and when I came to Congress in January of 2009, and
especially on every issue, we should have that type of transparency
that we are talking about today. In particular, today we are talking
about health care.
There are probably few issues that we can deal with as a country and
that we can debate and discuss as intimate to our lives as health care.
It touches our lives in so many different ways. Plus, it is such a
significant part of our economy. The issue of health care is just
central to the American people. And for the type of debate--and I use
that actually cautiously, that word ``debate,'' because there really
hasn't been allowed an avenue of debate.
I thought when I came to Congress I had a responsibility to represent
the people that I now work for. When I worked in health care, and I did
that for 28 years, I only had one boss. It changed from time to time.
Today, I feel a responsibility that I work for 660,000 really smart
people, and that is the citizens that live and work in the Fifth
Congressional District of Pennsylvania. I came here with a
responsibility to represent their needs in the Federal Government, in
Congress, in this Chamber, and yet from day one

[[Page H126]]

have been locked out of some of the most important debates that we
could be having, that surrounding health care.

{time} 1745

Now I came with some expertise--almost 30 years of serving
individuals facing life-changing disease and disability. I happen to
believe we have a pretty good health care system, but that we could
improve upon it. That the four dimensions of health care that I've
dedicated my life as a health care professional working on were
increasing access, decreasing costs, improving quality, and
strengthening that decisionmaking relationship between the patient and
the physician--not having a bureaucrat or the government coming between
the two.
I looked forward to that debate. I was pleased when President Obama
said that we're going to work on health care. When he said that, I took
him at his word. I thought that meant I would be invited to the table.
And that is not the case. That has not happened. I actually happen to
serve on one of the committees of jurisdiction, the House Education and
Labor Committee. The only time I had a chance to even look at that bill
was when I was asked to mark it up. When you do bill markup, the bill
has been written. That's where you come in and you make the final
substantiative changes and you offer amendments. And we did that as
members of the Republican Caucus and the House Education and Labor, as
did Ways and Means, as did Energy and Commerce. We made amendments in
the twelfth hour of that bill's proposal. It had already been written.
It had been written behind closed doors. It really was a backroom deal.
And all of our amendments were rejected. What minute input we had was
rejected.
As I reflect back and I remember 2008, that Presidential campaign
year, and well over a half a dozen, eight or nine times, who was then
candidate, now President Obama, saying--and it was his idea. He was
going to have C-SPAN broadcast the health care negotiations. We were
going to provide that type of transparency. Eight or nine times. The
documentation is out there. I have watched the video replayed in the
national media over the past number of weeks. Yet, despite that, that's
not what has happened.
Today, what passed out of the House and passed out of the Senate were
written in the Democratic leadership Chambers, both the House and
Senate, respectively. Today, we're not even having--not following due
process and having a conference committee. This is done over the
telephone today, I guess. That means that Members of Congress, I guess,
will be telecommuting. Next, we won't need to come to Washington
because it looks like it's not a democracy or a constitutional
Republic. Maybe it's a dictatorship. Just a handful of chosen leaders
at the top dictate what is probably the most important piece of
legislation that we could deal with in terms of health care.
Now I'm real proud to have signed on, as my colleagues have, a
sunshine resolution by Congressman Buchanan from Florida that calls for
transparency. I believe there's 151 signatures, cosponsors. It's
bipartisan on that bill. It's calling for full transparency when it
comes to health care. As of today, we've started working on a discharge
petition--a measure that we find is not used very often on this floor.
Unfortunately, it does not appear that Madam Speaker is going to bring
Mr. Buchanan's bill to the floor to allow the Members of Congress to
have an up-or-down vote on whether we want transparency or the American
people deserve transparency. I certainly believe they do.
So this discharge petition is a new tool. If we're able to garner 218
signatures, it forces that issue to the floor, of transparency. So I
certainly encourage all of my colleagues. I'm very confident that we've
got unanimous support on this side of the aisle, and we certainly
encourage all my colleagues on the other side of the aisle to sign that
discharge petition. The American people deserve to have at least an up-
or-down vote on transparency when it comes to an issue that is as
significant as health care.
Now I do believe that we're probably going to see some type of health
care bill that will be back in this Chamber. I suspect, unfortunately,
that may happen by the State of the Union address. I happen to believe
the President's looking for something like that to speak about as a
topic. Unfortunately, imposing that type of an artificial timeframe to
continue to compress and to force this through--the American people
deserve better. They deserve full debate and full time scheduled for
developing this legislation.
I happen to have significant concerns as a health care professional
with almost 30 years of experience, tremendous concern, as I look at
this bill. I look at cost. The idea behind health care reform was to
bring down the cost of health care. What is being proposed in either
the House or Senate version doesn't do that. It drives cost up for the
average American. One estimate I saw was at least a $300 increase in
health insurance premiums per individual, $2,100 per family. That's for
the average American, driving those costs up. If you happen to be an
individual who sacrificed on salary because you wanted more health care
benefits from your employer, well, those more than likely will qualify
as a Cadillac health care plan. You're going to get taxed 40 percent.
Forty percent is what that health care bill is going to be increased. I
don't know many employers that can afford to absorb all that.
That's also going to fall back on the true economic engines of this
country, which is our small businesses, but also it's going to fall
back on employees, individual workers, to make up--to pay that bill.
Mr. NEUGEBAUER. Would the gentleman yield?
Mr. THOMPSON of Pennsylvania. I certainly will.
Mr. NEUGEBAUER. The interesting thing, again, about this not being
done in the daylight is now we're hearing that the unions have gone
over and sat down and cut a deal that if the Cadillac insurance plan
was negotiated by labor contract, they're going to be exempted. So the
question is that that burden then is going to be transferred more and
more and more to families that didn't have a health care plan
negotiated by a union. Again, that's the reason, I think, as the
gentleman stated, we need to be doing this in the light of day, because
the American people need to see what is going on here. And, quite
honestly, what is going on isn't necessarily in everybody's best
interest.

I yield back to the gentleman.
Mr. THOMPSON of Pennsylvania. I thank the gentleman for that. It
strikes me that perhaps we need to bring in a facilitator, given the
spirit of the Democratic leaders, and perhaps we could see if Monty
Hall--I don't know if he's still alive or not; if he is, perhaps the
old game show host from ``Let's Make a Deal''--because that seems to
be, as I follow this, and obviously it's what's reported in the media
and what the Democratic Caucus reports, there's a lot of dealmaking,
whether it's a hospital I believe in Connecticut, one hospital being
purchased, helped to secure votes; whether it's Nebraska getting an
exemption on any future medical assistance increase. Even the
Democratic Governor of Tennessee, I love what he called that. I've
never met the man, but I have a lot of respect for how candid he is. He
called that ``the mother of all unfunded mandates,'' what it does with
medical assistance.
I know in Pennsylvania our medical assistance bill, over 10 years,
medical assistance is expected to go up, under these Democratic
leadership health care bills, $2.4 billion. We were in a financial
meltdown as a State this past year. We went 6 months without a budget
because those folks who were serving in the State legislature, the
Governor, they couldn't balance the books. They couldn't get the
revenue to match expenses. And now we've got this unfunded mandate
coming out of $2.4 billion for the Keystone State. Now that was before,
I think, the Nebraska sweetheart deal was made. So I'd be curious to
know what portion of paying for Nebraska do the Pennsylvania taxpayers
have to make up, because every other taxpayer in America is going to
have to make up for the sweetheart deals that are made.
I thank the gentleman, and I'll yield back at this point.
Mr. NEUGEBAUER. Well, I thank the gentleman. One of the things the
gentleman brought up, I think the American taxpayers didn't get the
benefit, as someone who, I think you said,

[[Page H127]]

someone with over 30 years as a health care professional and, as you
know, in the Congress we have, particularly on our side, we have a
number of physicians that have worked in health care, have dealt with
Medicaid and dealt with Medicare, have seen the private payment system,
all of the existing systems, and bring a huge amount of knowledge to
this process, but unfortunately the American people didn't get the
benefit from their knowledge, your knowledge. And, quite honestly, it's
a shame.
As you said, you have 660,000 customers. Every Member of Congress has
about 660,000 people that are looking to them to come up here and have
serious discussion, serious debate, and work on things that are good
for the American people. It's not good for the American people when
very few people sit down and make a decision about something that's
going to impact not only my 660,000 people, but yours and the other
gentleman from Ohio. This is serious policy.
It's now my pleasure to recognize the gentleman from Ohio, Mr. Latta.
Mr. LATTA. Well, I thank the gentleman for yielding. I really
appreciate him hosting this Special Order late this afternoon. I think
it's very, very important that the American people absolutely know
what's going on here. As we all were home over the Christmas holidays,
I know that I had a lot of events that I had to attend. I don't care if
I spoke at a Chamber of Commerce or a Rotary, you name it, people were
very, very concerned with what's going on in this Chamber. They're
worried about a lot of things. They're worried about the health care
that's been passed by this House, they're worried about jobs, they're
worried about the cap-and-tax legislation, they're worried about the
EPA and other mandates that are being forced down their throats. But I
think it's important probably to start off talking about the health
care a little bit here.
I don't think there's anybody in this Chamber, there's not one person
in this country that would say that we shouldn't do something about
having some meaningful debate on health care in this country. But when
we're looking at it, what we've seen happening is we've seen, as has
been mentioned by my colleagues from Texas and also from Pennsylvania,
it's been a one-way street. And the American people don't care for
that. They want an open debate, and they want to make sure that they
know what's going on.
But as we're talking about this health care, I think it's important
that we also hear what the people back home are saying. When I'm home--
I represent the largest manufacturing district in the State of Ohio. I
also represent the largest agricultural district in the State of Ohio.
In 2008, I represented the ninth-largest manufacturing district in
Congress. Because of what's happening in this economy, I've dropped to
15. And I don't even want to know when the next numbers come out to
find out where the Fifth Congressional District is located in that long
list.

But when I go out and go to the different factories and go to the
small businesses, and I really want know what is going on, that's the
best way I can gauge what is going on in the economy. When I'm out
there--one visit to one factory in particular sticks with me. A
gentleman came up to me who was a press operator. He came up and said,
I really don't understand what you guys are doing in Washington. And he
said, You know, you all talk about health care. If I can't put a roof
over my family's head, if I can't put food on that table, why do I care
about health care right now? I worry about jobs, and I worry about my
job.
And I think that that's something that has been lost in this. I know
one of our colleagues from the Senate recently said that maybe in the
past year that the Congress here should be really concentrating on not
health care but on job creation. Because let's just talk about these
jobs and what's happening out there, not just from that individual that
works on that factory floor, but just an individual like everybody you
know that might work in a factory across this country.
But also I remember walking and being in one of my small business
owner stores in the district, and after I was in the store and I bought
some things, I was walking out and he said, Can I talk to you for a
little bit? We stood out, and it was pretty darn cold that afternoon,
but we stood outside for a good long period of time. He said, Let me
tell you something. If you all pass this health care legislation, I'm
out of business. He said, There's no way. He said, Even though your
bill was over 1,000 pages long, and I know that the Senate bill is
going to be several thousand pages--a couple thousand pages long--he
said, What I've been able to get out of it and figure out in the
newspaper, I won't be able to stay in business. He said, Look around
here. Look at the people running the cash register, stocking the store
in here. They're all going to be without a job. And it's going to be
one more store on Main Street USA that's going to be vacant. And we
can't have that happen.
I think that what we need to do in this body is really go out and
talk to these individuals. I have advocated what we need to do is
instead of trying to do a few hearings down here--and I don't think we
had enough hearings when we talked about health care and during this
debate--I think what we should have done is taken these hearings across
America. And we wouldn't have done anything but help the American
people to, first of all, have their say in what is going on, and two,
that the Members of this body would be able to hear it directly from
the American people.

{time} 1800

I know when I served in the Ohio Legislature for 11 years--you know,
when you're representing the State of Ohio, it's not that large of a
State, and many times we would have all of our hearings in Columbus.
But many times, we would take our hearings out across what we called
the four quadrants of the State and hold hearings in different areas.
And that's so that people can actually come nearby to where they live.
They didn't have to drive down to the State capitol.
I think that's what we should have done with this whole debate on
health care. Let's bring these hearings to the American people, and let
them have their say. That is where we are going to find out what they
are going to have to say about this. That is where we are going to find
these things out.
When you're talking about jobs killers--you know, with the model that
was being advocated by Ms. Romer, we could lose up to 5 million jobs in
this country. The National Federation of Independent Businesses, just
from the employer mandate on small businesses across this country,
they're estimating 1.6 million jobs could be lost. That's on top of the
millions of jobs that we've lost since the beginning of this recession
and also the almost 3 million jobs since the beginning of last year
that have been lost just from the beginning of this administration.
We can't afford to lose more jobs in this country, because where are
these people going to go? It's not that hard to remember back to 1982.
In 1982, during that very tough recession that we can all remember,
President Carter, during his administration from 1977 up to 1981,
during the campaign when he was elected, had created what he called the
misery index. And that misery index took the unemployment rate, the
inflation rate, and the interest rate. It was toward the end of his
administration. You know, we saw in this country 21.5 percent interest
rates. We saw unemployment rates in double digits, and we saw the
inflation at double digits.
Well, where we are today, when we look at having over 10 percent
unemployment in this country, and we're talking about losing millions
more jobs because of this bill, we can't afford it. When you're talking
to the small businesses and small factory owners out there about what's
in this piece of legislation besides all these mandates--but just talk
about the taxes.
This was prepared by an analysis done by the Committee on House Ways
and Means from Ranking Member Dave Camp. Since the increases in 2009,
just in general, the net taxes that were passed by this House were
$1.71 trillion. And just the estimate on this health care bill alone,
they're looking at over $732.5 billion. That's billion dollars.
And who's going to pay for this? When they're looking at that 5.4
percent surtax placed on a lot of the small businesses that are the
ones that create jobs out there and on certain individuals at a certain
higher level, when

[[Page H128]]

you're looking at $460.5 billion in taxes, when you're looking at these
employer mandates at $135 billion, and you go right down the line, this
is what's going to kill incentive in this country. This is what's going
to kill the entrepreneur.
This is what is going to kill people who will say, Why even get up in
the morning and try to go out and create jobs? Because one of the
things that is lost here in Washington and in these Halls of Congress
is that this body does not create jobs. This body spends the wealth of
this country.
You know, the American people are really out there, and they
understand it. When you look at this, it was mentioned a little bit
earlier about what is happening with the increases, when you're talking
on the Senate side about a 40 percent tax on those individuals out
there with a quote-unquote Cadillac plan. Well, a lot of people say,
Oh, Cadillac, they must be rich individuals. Well, I'll tell you what,
in the State of Ohio, we have a lot of auto plants, and when you're
looking at these auto plants, a lot of these folks are the auto workers
who are going to end up paying 40 percent on an individual premium or
will spend $8,500 on their health care plan, a family plan at $23,000.
When you put these together, it's like, how are they going to pay for
this as a small family?
When you take all these costs that are being associated under this
piece of legislation, it's unfathomable. When we talk about
unfathomable, I did read the health care bill. I sat down one weekend.
I think it was 1,028 pages. I read it, tabbed it, underlined it so I
could really get a good understanding. You are looking at a couple
thousand pages on the Senate side.
But I think what is missing in this whole debate is, you know, here
is what someone gave me not too long ago, the Constitution of the
United States. But you know, as that little commercial on TV says: But
wait, there's more. In this little book that's in about 10-point type,
there's the Constitution, the Convention, the Congressional
Resolutions, all of the amendments, the Virginia Bill of Rights, the
Declaration of Independence, the Massachusetts Bill of Rights, the
Articles of Confederation, the Virginia Statute of Religious Liberty,
the Annapolis Convention, the Virginia Randolph Plan, the New Jersey or
Patterson Plan, the Hamilton Plan and The Great Compromise, right
there. That is America in a nutshell.
How is it that we end up today putting out thousands of pages that
people can't comprehend, but America, our government, and how we were
founded is right there. Put it in your pocket, and read it at any time.
And I think that's what the American people are very concerned about,
and I appreciate the gentleman for yielding.
Mr. NEUGEBAUER. Well, I thank the gentleman for pointing out the
taxes that are in this bill. I think the bad news is that they're going
to have to be higher tax because they are disguising, as you know, what
this bill actually costs. Now the stated cost that the Speaker of the
House says is this bill costs $891 billion. But if you add the mandated
cost of the employer-mandating tax, it's another $135 billion. And if
you add the cost of individual mandate tax for individuals that are
going to be penalized under this plan, it's another $33 billion. So the
total cost, the CBO score is $1.06 billion.

You don't hear the Speaker or the leadership or the President talking
about this number. Now the other piece is that in the House bill, there
is no provision for what is being called the ``doc fix.'' Today we have
reimbursement levels that are being projected to be reduced by a
substantial level, which is going to cause more and more doctors not to
see Medicare and Medicaid patients. So this leadership team has
promised and made a deal with the docs that they will bring a separate
bill. They don't want to bring it in this one because, why? It cost
$209 billion. So now instead of $1.06, you have got a nearly a $1.2
trillion bill.
Now the other piece is that Medicaid is being transferred to--part of
this cost is going to be Medicaid which is going to be transferred to
States, unless you're from Nebraska. What is the cost of that? That's
$34 billion. Now here is the real sleeper. I hope that the American
people are watching C-SPAN and the like because the lights are on here,
and the lights are on this chart. And guess what, this little bill
collects taxes that the gentleman was talking about for 10 years, but
it only has expenses for 7 years.
Now think about all of the businesses and families all across America
that if you could collect 10 years' worth of salary but you only had to
pay 7 years' worth of expenses, that's like the first 3 years you don't
have to make your house payment, you don't have to buy your gasoline,
you don't have to make your car payment. You just get your paycheck.
Nothing taken out of it, no Social Security, no withholding. What a
great deal that would be. Well, that's the way this bill has been put
together in order to disguise the real cost of this.
So once the 3-year period passes, then on an annualized basis, this
bill costs another $727 billion more than what is being represented to
the American people. So what does that total? $2.1 trillion. So a bill
that this leadership says is $891 billion--it's not $891 billion. It's
$2.1 trillion. And at a time in which, as the gentleman was talking
about, small businesses are struggling to keep their doors open--in my
district--and I think the gentleman's district as well--small
businesses play a huge part in creating jobs. Who is going to pay this
$2.1 trillion? Because the taxes that they're talking about collecting
only pay for a bill that costs $891 billion, but this bill costs $2.1
trillion.
Now here's the other thing that people have looked at: this bill
mandates, as both of my friends know, mandates that every American have
health insurance. And in fact, if you don't, there is a penalty for it.
So one of the things, people say that if the government is requiring to
you do something to pay for health care or to have health care, and
there is a penalty for doing it, it becomes a tax or a cost. Some
people who have kind of calculated what that means for the economy, GDP
and overall, said maybe that's a $4 trillion number. So possibly what
we are looking at, if we shed light on this bill, as we should, that
really the impact of this is that it's a $6 trillion piece of
legislation.
Now I don't know about you, but I think the American people think
that whether it's $2 trillion or $6 trillion or even $891 billion that
we should have had more debate than we did on this bill. As my
colleagues will remember on the day that we passed this bill, very
little debate was--I think one amendment--there was one amendment to a
$2 trillion--to a $6 trillion bill was allowed.
These are the kinds of things that cause me to say, Mr. President, we
have to hit the pause button here because we're talking about something
that impacts families all across America. We have some numbers here
that are big. We are now spending money that we don't have. Every
dollar that the government spends, they have to go out and borrow
nearly 40 cents of that from people, like in China and Japan; and it is
not a sustainable thing. Yet now we're talking about more taxes and I
think potentially bigger deficits because we've not had good
discussions on this bill.
Now I will yield some additional time to the gentleman from
Pennsylvania to reflect on these important issues again.
Mr. THOMPSON of Pennsylvania. Well, I thank my good friend for
yielding. I just want to come back. You hit on such an incredible point
about the individual mandate to purchase health insurance. Now I
wouldn't consider myself in any way a constitutional scholar. I'm just
an American and a citizen. But my good friend here has a copy of the
Constitution. And as I've read in the version of the Constitution that
I carry around, which is about 28 pages, I think that was put together
by some really smart people a long time ago that has withstood the test
of time. And really our Constitution has become a model for other
countries and emerging countries to base their governing principles on.
But to the best of my knowledge, I can't recall that there is anything
in that Constitution that provides a basis for Congress mandating that
every individual American in this country purchase health insurance.

I will yield to the gentleman with the pocket Constitution there to
just see what his thoughts are on that.
Mr. LATTA. I thank the gentleman for yielding. I think you would be
very

[[Page H129]]

hard pressed to find it. I know that when I went out in my district--I
know that Members going across their districts, across this country
have found the same questions being asked, Where does it say that?
Especially a question, as the gentleman from Texas has mentioned, that
under this bill that was passed by the House that there was a $2.5
percent, quote-unquote, fine on individuals, plus that individual
mandate that you have to have it or civil or criminal penalties could
be imposed.
How can we do that? You know, it's unfathomable that this would be
able to withstand a challenge in court that an individual would be
forced to have to do this. Again, I think if you just read this little
document, you are going to be very hard pressed to find it. If I could
just mention--and also what the gentleman from Texas was talking
about--what it's going to do to the States. In the Columbus Dispatch,
there was an article that broke it down for the State of Ohio. We are
running about an $850 million deficit. And unlike this body, we have to
balance our books. It is constitutional that we have to make sure that
we're in balance. So Ohio is out of balance by about $850 million, but
there was also a story by the Columbus Dispatch, in their calculation,
that this bill would impose a Medicaid debt upon the State which would
increase that deficit by another $900 million.
I think that this is what people need to find out. This is not just
going to affect small businesses or large businesses or individuals.
This is going to affect your State government, your local government,
if they can even function. Because all of a sudden, these mandates are
going to come down from Washington, and good luck.
I thank the gentleman for yielding.
Mr. THOMPSON of Pennsylvania. I appreciate that. In terms of cost,
much of my professional life was involved in serving older adults. A
particular section that I find very appalling of what I see in both the
Democratic House bill and the Democratic Senate bill is what is
authorized in terms of increasing the cost of individual insurance
premiums for older adults. Older adults rely on Medicare. I will talk a
little bit on Medicare in just a second. But they purchase supplemental
insurance to fill in the gap, to make sure that they don't exhaust
their life savings that they've accumulated over time. They've earned
those. They've put those aside so that they can enjoy those retirement
years and be able to do the things that they've always hoped and
dreamed about doing. So supplemental insurance serves an important
purpose there.
Well, within the House bill, it authorizes, it allows, it codifies
that insurance premiums for older adults are allowed to double. In the
Senate bill, it does one step better than that; it allows supplemental
insurance costs, individual insurance costs for older adults to triple,
and that's a crime.

{time} 1815

I want to take the next step. I have talked about the four dimensions
of health care. Now I want to talk about accessibility. If we are doing
health care reform correctly, we are increasing accessibility. I don't
think we are. We are making health care less accessible. Part of that
is through Medicare cuts, half a trillion dollars in Medicare cuts.
There are a lot of physicians today that do not accept medical
assistance patients or Medicare patients today, and it is all
economics. Medical assistance pays 40 to 60 cents for every dollar of
cost, and Medicare pays right now 80 to 90 cents for every dollar of
cost.
Just recently one of the facilities that President Obama lifted up as
a bright, shining example of what we can do for health care reform, the
Mayo Clinic, their operations in Arizona decided and announced that
they were no longer taking Medicare payment, which meant if you are an
older adult and you are going to a facility that doesn't accept
Medicare, you will have to pay out of pocket. You have to have some
other provisions.
So these cuts we have piled on top with Medicare just adds insult to
injury. My diagnosis for either the House or the Senate, the Democratic
bills are fewer doctors and fewer hospitals. Most doctors in
Pennsylvania, the average doctor is over 50 years of age in
Pennsylvania. Right now they are looking at significant cuts under
these bills in terms of reimbursement. They are not paying their costs
now.
I would predict, and as I meet with physicians around my State, many
are preparing to retire because it is better to get out now rather than
burning through their life savings. With that, we will result in less
accessible health care services. Hospitals are only making 1 to 3
percent margin today. With Medicare cuts, they will be in the negative
column. You can't run a business, whether it is a hospital or any other
business, and have more expenses than you do revenue and stay in
business for very long. Hospitals close, that is less accessible health
care. So this bill not only drives up costs, it makes health care much
less accessible.
Once again, I want to thank the gentleman for leading this Special
Order tonight. I am going to yield at this time to the gentleman from
Ohio (Mr. Jordan).
Mr. JORDAN of Ohio. I thank the gentleman for yielding. I thank both
him and the gentlemen from Texas and Ohio for this Special Order hour
on behalf of the Republican Study Committee.
I notice the chart in the well of the Chamber is talking about the
real cost of the health care legislation and what it means over time:
$2.1 trillion. I think when you look at that number and couple it with
some of the things that we have seen happen in the last year--in fact,
I gave a speech last week back home in the Fourth Congressional
District of Ohio where I talked about this, and I started the speech
with the question, Who would have imagined? Who would have thought? Who
would have thought that we would run a $1.4 trillion deficit last year,
the largest in American history? Who would have thought that we would
have a $12 trillion national debt, moving to $13 trillion in the very
near future, slated to go on the Obama budget spending schedule to $20
trillion over the next 10 years? Who would have thought within 2 years
the interest payments on that debt would be over a billion dollars a
day? We are talking some serious, serious financial concern.
And what do we have being pushed by the leadership in this Congress?
A health care bill that is going to add $2.1 trillion to those already
unbelievable numbers. Every single American, every man, woman, and
child today, to pay off the debt we currently have, it is $39,000 that
they have to pay. It is unbelievable. You think about one of the things
that makes America great, that makes us the greatest Nation in history,
is the simple concept that parents make sacrifices for their kids so
that when they grow up they can have life better than we did. They in
turn do it for their children, and each generation in this country has
done it for the next.
But now what we have in America, unfortunately, is this focus on
living and spending for the now, living and spending for the moment and
sending the bill to our kids. Unfortunately, this health care bill
represents all that is bad about Washington, not only on the spending
side, but as my colleagues have pointed out, in a whole host of other
areas as well.
I would just say in just a general sense, and I will make this last
point and then I will yield back to the gentleman from Texas. I would
just say this bill represents what Americans hate about Washington.
This health care bill is big taxes, big spending, big Washington, big
bureaucracy, Federal Government telling families and small business
owners and individual Americans how they are now going to get their
health care, telling Americans that you will now have bureaucrats
between you and your family and your doctor. It represents everything
that Americans don't like about this place. Unfortunately, it seems
like the leadership in this Congress is bound and determined to move
forward with that.
One thing I know about Americans, Mr. Neugebauer, is that we hate
being told what to do. It is part of the American DNA. They see this
health care bill as telling them how they are going to get their health
care, and they don't like it. The old line that we have in Ohio, and
probably have in Texas, too, is that for most Americans when they are
traveling down the highway and they see the sign that says 55, for most
Americans that is not the limit, that is the challenge. That is how we
look at things. We hate this idea of being told

[[Page H130]]

how we are going to do things. That is why we are Americans. And the
idea that now the central government, the Federal Government, is going
to tell us how we are going to get our health care, and it is going to
cost us $2.1 trillion in addition to all of the debt we currently have,
is what really offends Americans.
So I appreciate the gentleman from Texas taking the time tonight to
lead this hour, and I yield back to the gentleman.
Mr. NEUGEBAUER. I thank the gentleman, and the gentleman brings up a
very important point. On top of this being a very expensive bill and
the fact that we are going to be spending money that we actually don't
have, when I look at this chart, I think about my new grandson, Miles,
and I think about my two grandsons, Nathan and Noah, and I think about
what kind of legacy, what kind of future are we leaving these young
people, the next generation, that by 2012 we are talking about a $16.7
trillion debt in this country. And as the gentleman said, by 2020 we
are talking about $20 trillion.

When I was back in the district, and maybe you all have used this
analogy, but for people to get their arms around what is a trillion, if
you counted to a trillion, it would take you 19,000 years to count to a
trillion. We are talking some serious money here. So I thank the
gentleman for bringing up those important points.
This is all intertwined. We are talking about jobs and the impact of
health care on patients' rights and also small businesses, but we are
really talking about the impact on an entire Nation of, one, turning
health care over to the government; and, secondly, continuing down this
road of borrowing and spending money that we don't have and charging it
to future generations.
I know each Member here on the floor tonight has this voting card,
and right now it is a credit card and it has a huge credit limit on it.
What I think many in the Chamber with me tonight want to do is turn
this into a debit card where we are spending money that we actually
have instead of borrowing from our children and grandchildren.
Mr. JORDAN of Ohio. The gentleman is right on target with his
comments.
I just remind the Speaker, last spring the Republican Study Committee
offered a balanced budget, something families and small business owners
have to do every year and something local governments have to do.
Unfortunately, the Federal Government never has to do that. RSC brought
forth a balanced budget, and we plan to do the same thing this year
because we understand that we cannot continue what that chart shows,
not only for present-day America, but as the gentleman points out,
because of what it means for our kids and grandkids. So we will bring
that balanced budget back. It does the right things. It keeps in place
those good tax cuts that were put in place in 2001 and 2003, protects
Social Security, protects Medicare and national defense during this
time we find ourselves in, and cuts spending, which we have to do. We
have to make those tough decisions and do the right thing.
Mr. NEUGEBAUER. I thank the gentleman, and I yield to the other
gentleman from Ohio (Mr. Latta).
Mr. LATTA. I thank the gentleman for yielding.
Just talking about these numbers, how are we going to pay for this?
We are looking at 21, 22, $23 trillion in the outyears here. The
question is how are we going to pay for this. We owe $3 trillion to
foreign governments, over $800 billion owed to the Chinese alone, our
largest creditor. Down the road when the Chinese and the Italians, all
these governments are now saying, Wait a minute, America, you have got
to do something about your spending. You have got to get this under
control. They are worried about something. They are worried about
getting paid back, and they don't want to see this debt that we owe
them become cheap money, and so they are getting concerned about this.
But if you just go back to 1981, 1982, if we go to those years when
the Federal Government was out there borrowing heavily, we had 21\1/2\
percent interest rates in this country. I was just starting to practice
law back then, and we had to write land contracts if a person wanted to
sell a house. You couldn't go to the bank and get a loan because there
was no money. The seller would meet with the buyer and they would say,
In 3 years time, you are going to pay me so much interest and
principal. And hopefully at the end of that time there would be a
balloon payment to try this pay this thing off if they could get a
loan.
But when we are looking at these numbers, it is going to be
unfathomable how we are going to pay this off, because the Federal
Government is going to have to go out there and borrow every penny that
is out there and somehow do this. But then when you look and talk to
these private enterprises out there, the small businesses, they are
having a hard time getting credit today, and we are not in that
situation. It is bad, but it is not going to be anything like this that
you show in your chart.
Mr. NEUGEBAUER. The other gentleman from Ohio brought up a point
about the current interest payment that is approaching a billion
dollars at the most historically low rate time in the history of our
country. The gentleman reminded all of us there was a time in our
country, and I was in business when we were paying 15, 16, 17 percent
for money. It was hard to get, and once you got it, you had to have a
really good idea to make it. So you begin to think about what happens
to our interest payments if we--let's just say we doubled the interest
rates that the Treasury is doing right now. That begins to double the
payment. So now instead of $1 billion, it is $2 billion. What that
begins to do is, as we put together our budget, there is less and less
money for discretionary spending because the first thing you have to do
is make your mortgage payment, and we are mortgaging the future of our
country. So these are important issues and I appreciate the gentleman
bringing that point up.

I think the other thing that kind of concerns a lot of people is the
point that the gentleman made about our creditors. What if China, for
example, who is our largest creditor, and as the gentleman points out,
they have said, We are not quite sure what our appetite in the future
is for continuing to loan America money to just spend and borrow
without some kind of discipline, and that is something that we have to
look at.
I have another chart, and I would like to make one quick point and
then go back to see if any folks have departing comments.
One thing that the American people are also pretty tired of is all of
these bureaucracies. I know when I went around in August, and I think a
lot of my colleagues did, too, we brought this chart around to show the
American people. This is a diagram of the House version of this bill.
You can see all of these new bureaucracies and all of these new
agencies, and somehow this is going to simplify health care for
Americans? This is going to make it better for Americans?
What we do know is hidden in this is a czar that is given very broad
powers that is going to be able to determine what kind of policy you
and I get to have. That concerns me that the Federal Government is
going to be picking and choosing the kinds of coverages that are going
to be offered to the American people instead of the American people
being able to pick and choose the things that they think are coverages
that they need.
So I think when you look at the cost, when you look at the complexity
of this, it is no wonder the American people are asking the Speaker of
the House and they are asking the President to keep their promise about
transparency here because they are very concerned about this.
I yield to the gentleman from Pennsylvania. I think he probably
showed this chart to his folks back home, too. What was their reaction?
Mr. THOMPSON of Pennsylvania. They were appalled. And it has grown as
these bills have been further proposed and developed in the back rooms
among the Democratic leadership. The current set of new bureaucracies
is somewhere around 130 new bureaucracies that have been created to
dictate to that part of our lives called health care.
I will just give you one example. In addition to just the imposing of
the Federal Government among our personal lives and our personal
decisions with health care, what it does to the cost of health care.
Under the former

[[Page H131]]

Clinton administration, we wrote out HIPAA, Health Insurance
Portability and Accountability Act, and certainly no one can be opposed
to maintaining privacy as it relates to health care. And portability,
we would be much further along if that would have taken care of
portability, if it was the right solution for taking your insurance
with you when you change employers. I happen to think that type of
portability is a positive thing.

{time} 1830

But the fact is that is what HIPAA did. And that was just one new
bureaucracy that was created under HIPAA. The cost of providing health
care because of HIPAA, I am sure that we could find many health care
hospitals that will say, health care systems that actually probably
laid off direct caregivers because they had to hire people to push
papers, they had to hire people to be compliance people to be able to
comply with all this massive new bureaucracy and the new regulations
that were as a result of HIPAA.
Now, you take HIPAA, multiply that times at least 130, I forget the
last count, my colleagues may have a better count of the new health
care bureaucracies under the Pelosi or the Reid health care plans, but
you just take the experience of HIPAA, the overhead costs of providing
health care, multiply that times at least 130, that is a devastating
effect on the providers of health care throughout this country.
Mr. NEUGEBAUER. I thank the gentleman. And I think he makes a great
point. And I think one of the things that is the center of all of this
is, you know, the administration is talking about jobs. I thought it
was interesting today that they are going to quit tracking jobs tied to
the stimulus plan because you know what, the stimulus plan hadn't been
creating any jobs. This health care plan is going to stimulate, it is
going to stimulate a bunch of new hires in Washington, D.C., and not
across the heartland of America, because they are going to have to put
people in place here to fill all these positions. And they are going to
be shuffling paper, and they are going to be asking hospitals and
doctors and health care providers to jump through all of these hoops so
that they can justify their jobs.
I think the American people want to create jobs out there in States
like Ohio and Texas. So, you know, the job creation, unfortunately, is
moving in the wrong direction if you are creating jobs in Washington,
D.C. we need to be creating jobs in the heartland of America.
I want to yield some additional time to my friend from Ohio.
Mr. LATTA. I appreciate the gentleman for yielding. I would be remiss
if I didn't bring this up. As I mentioned a little earlier, I represent
the largest agricultural district in the State of Ohio, along with
manufacturing. When we are talking about all these numbers about what
could occur with all this massive debt that we are going to be
accumulating, what is that going to do to the farmers out there? How
are they going to get their crops out? How are they going to be able to
buy land? How are they going to be able to buy machinery?
The last thing that we want to be in this country, not only do we not
want to be a debtor Nation, but we don't want to become dependent on
the rest of the world for our food. Because once we lose that ability
to grow our own food, to supply it for ourselves, we are done. And if
the American people think the times are tough now when we are worried
about where we get our energy or who is going to be buying our debt,
you throw food into that mix, and that will be pretty much the end. I
think that is why you take all these things together and why this
debate is so important. And that is why I think really that we should
have had this debate going on across the United States. I appreciate
the gentleman for yielding.
Mr. NEUGEBAUER. I would now like to yield some time to another one of
our colleagues who has joined us here, the gentleman from Louisiana
(Mr. Scalise).
Mr. SCALISE. I want to thank the gentleman from Texas for yielding
and for hosting this hour, because it is so important right now. As the
American people are watching what is going on here in Washington, most
people are saying they don't want a government takeover of health care.
They want us to be focusing on creating jobs, which we should be doing,
but instead you have got these meetings going on behind closed doors by
Speaker Pelosi and her liberal lieutenants to try to have this
government takeover of health care being forced down the people's
throats.
The President said multiple times during the campaign that he would
insist that these meetings be held in public, they be on C-SPAN so the
American people could see it. And yet the President has totally gone
back on his word. These meetings are behind closed doors. You know,
ironically the President goes out publicly and he bashes big insurance
companies, and then he goes behind closed doors and he cuts special
sweetheart deals with insurance companies. He goes behind closed doors
and first says Republicans don't have a plan, and yet when we submit
our plan to him, he refuses to meet with us. He throws us out of the
room.
The American people are tired of this. Because we should be doing the
things that we have proposed to reduce the cost of health care. But
instead, you have got these back room sweetheart deals, you have got
these closed door meetings instead of the public transparency that we
were promised.
And it is very unfortunate, because we are talking about one-sixth of
our economy. We are talking about a government takeover bill that would
literally throw millions of Americans off their health care. So I
appreciate what you are doing.
Mr. NEUGEBAUER. I thank the gentleman. And I thank my colleagues for
entering into this very important discussion so that the American
people can have a little light shined on a very important issue.

____________________