[Congressional Record Volume 156, Number 23 (Tuesday, February 23, 2010)]
[House]
[Pages H738-H744]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTH CARE REFORM
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 2009, the gentleman from Georgia (Mr. Broun) is recognized
for 60 minutes as the designee of the minority leader.
Mr. BROUN of Georgia. Thank you, Mr. Speaker.
I am a medical doctor. I have practiced medicine in Georgia for
almost four decades. As a medical doctor with all of that clinical
experience--I'm a family doc, a primary care provider.
I've examined the proposal that the White House put forward just 2
days ago. Frankly, I've got a diagnosis. I cannot give ObamaCare 2.0 a
clean bill of health. What I can diagnose for the American people,
though, is this:
It's going to make the American people sick--sick in their wallets
because it's going to cost more. Health care costs in this country are
going to skyrocket because of this ObamaCare proposal that the White
House recently put out.
As The Wall Street Journal just very aptly said in an editorial this
morning: The White House has accomplished a great thing. They took the
most onerous pieces of the House bill and the Senate bill and combined
them to make the current proposal of ObamaCare that the White House is
putting forward even worse than either of those bills.
The quality of health care in this country is going to go down. It's
going to go down because doctors and patients will no longer be able to
make health care decisions. It is going to be made by a Federal
bureaucrat here in Washington, D.C.--one that doesn't, in all
probability, have any medical training whatsoever.
As a health care provider, as a medical doctor today, I see Federal
bureaucrats who have no medical experience telling me and my colleagues
whether we can put a patient in the hospital or not, whether we can
give them a certain medication or not, how long they can stay in the
hospital, what kind of care we can give. So there is already control,
particularly with the Medicare patients of health care.
The problems that Medicare has today are going to be exacerbated, or
made worse, by what this administration is doing and by what the
leadership in this House and in the Senate are doing. It's not only
going to destroy the quality of health care, but it's going to destroy
the budgets of States, of local communities and, most especially, of
small business and of people who are working class Americans.
The reason it is going to do that is that the cost of health care is
going up. It's going to go up for everybody. It doesn't contain costs
at all. We've been told by the President that this--and in fact, they
claim on the White House Web site that this is going to help the
Federal deficit by $100 billion. Well, the reason for that is they are
going to markedly raise taxes--over half a trillion dollars in
increased taxes. Those taxes are going to be on everybody.
We hear from the President that he doesn't want to tax anybody but
the upper 5 percent of the population, 5 percent of the income, but
that's not factual. Everybody is going to be taxed because of the
mandates. We have been told over and over again that, if you like your
health insurance, you can keep it. Nothing can be further from the
truth.
Folks, Mr. Speaker, if you like your health insurance, you can't keep
it, because even this new ObamaCare 2.0, the second version, has so
many mandates and requirements on private health insurance that it
appears to me that what our administration is doing is they are putting
up a system that is going to force everybody onto the public exchange.
Well, the President told us a couple of months ago that he sees the
public option--or in the Senate, it's the public option lite. They call
it a public exchange. That is what is in the President's current
proposal. It's just the first step towards Federal bureaucrats'
controlling every health care decision in this country. Federal
bureaucrats are going to run the health care system for everybody.
The playing field has been laid, in this latest proposal by the
President, that it is going to put the squeeze on everybody in this
country, not only on the insurance companies--and I'm not a friend of
the health insurance companies. I fight them all the time as a health
care provider, as a medical doctor--but it's going to put the squeeze
on everybody to force them off of private insurance into a public
exchange or into a public option.
The President told us just a few months ago that his game plan, his
purpose of all this, is to try to force everybody into a government-
controlled health care system, and that's exactly the direction that he
is going.
{time} 2145
Now, frankly, I think this proposal of a bipartisan meeting on
Thursday, the 25th of February, is nothing but a ruse. It's nothing but
a dog and pony show either to try to make the Republican Party and
Republicans to be a party that has no ideas, which the Democrats over
and over claim, or to be an obstructionist party, that just want to be
the party of ``no.''
Mr. Speaker, the American public needs to understand the Republican
Party is the party of k-n-o-w. We are the party of ``know'' because we
know how to lower the cost of health care. We know how to lower the
cost of energy, to seek energy exploration here in America so that
we're less dependent upon energy sources from countries that hate us
and want to destroy us. We are the party of k-n-o-w, ``know,'' because
we know how to create jobs. And we do that through stimulating small
business, by giving them tax breaks to leave dollars in the hands of
small business men and women so that they can hire new employees, so
that
[[Page H739]]
they can expand their business, so that they can buy new inventory.
We're the party of k-n-o-w because we know how to give individuals
money in their pockets so they can be good consumers again.
Mr. Brady of, Texas in his 5-minute speech, talked about the folks
that he talked to just recently there in Texas, and these are small
business men and women that said that we need to get the fear out of
the system. We need to give assurance.
Mr. Speaker, I am here tonight as a medical doctor to try to give
some assurance to the American people that there are people here on the
Republican side that are fighting against this government takeover of
the health care system.
Mr. Speaker, the American people have spoken very loudly. A recent
poll showed that 70 percent of Americans either want us to scrap the
ObamaCare plans, the House plan and the Senate plan, and it would
include his new plan because it's the two plans put together, or do
nothing. Well, frankly, as a medical doctor, I don't want to do
nothing. I have introduced my own health care finance overhaul plan,
H.R. 3889, which is a comprehensive overhaul of the health care system.
It's a little over 100 pages. It would put patients in charge of health
care decisions, along with their doctors. And even Medicare patients.
It would stop this government control of health care dollars and would
put those decisions back in the hands of the patients and the families
where they should be. So Republicans are the party of k-n-o-w,
``know.'' We've tried real hard.
But the President has proposed this bipartisan summit. But a senior
White House official said Thursday the Democrat negotiators, talking
about this summit that is going to occur this Thursday, the Democratic
negotiators are resolving final differences in House and Senate health
bills. That's what we saw just this week in the Obama administration's
proposal that's on the White House Web site right now, 11 pages, no
bill, no legislative language. We do not have a bill. All we have are
bullet points and ideas that they have now resolved the differences and
have one bill that passed last year with virtually no Republican help.
Our leadership went over to the White House and said, We'll be glad
to come. We'll be glad to try to solve this problem for the American
people. Our leadership, our Republican leadership, has offered a hand
out to the White House and said to the White House, We want to find
some commonsense solutions. It's good for patients, good for small
business, good for America. We need to start all over again. Let's find
some areas of mutual agreement. Let's find where we can agree on
issues, where we can pass something to lower the cost of health care
for all Americans. Let's try to find some solutions to help those who
are struggling to pay their bills and can't buy health insurance by
making it more affordable. Let's find solutions to those who are
uninsurable because of preexisting conditions.
What was the answer from the White House? The White House's answer
was, No, we will not do that. You have to accept our plan. We're going
to start there. We will talk about our plan and we will see where we go
from there. We're not going to start over. We're not going to try to
find some common ground. You have to accept things that you do not
like. That was the answer from the White House.
Our leadership said, Well, at least do this: Let's take the ramrod
out. The ramrod has to do with the rule over on the Senate side that's
called ``budget reconciliation,'' and it's a way of trying to ram
things through the Senate.
The White House says, No, we won't do that. We're going to ram it
down the throats of the American people whether they like it or not,
and we will do it without your help. We will do it solely with
Democrats doing this. And we don't care what you say. We don't care
what you believe. We don't care what you bring to the table. We're not
going to consider your proposals. We're not going to consider anything
that you're offering. We're going to do it our way, like it or lump it.
That's what the White House told our leadership.
Is that what the American people want? I don't think so. I don't
think so at all. That's what the White House has said. Now, that was in
a private meeting.
They've suggested that we have this open bipartisan meeting
televised, and, frankly, I think it's just nothing but political
theater to try to force down the throats of the American people a
government takeover of health care so that government bureaucrats here
in Washington, D.C., make your health care decision if you're out there
in America; that's going to tell doctors, patients, and families
whether they can get care or not, whether they can have a medication
that may be even a lifesaving medication or not. And the cost is going
to go up. What's that going to do? Because the costs are going to go
up, it's going to hurt small business. It's going to hurt workers. It's
going to hurt the middle class. We're told one thing by the President,
but the President says one thing and does something else.
It's a sad day. It's really a sad day. It's a sad day for my
patients. It's a sad day for working men and women in America. It's a
sad day for those people who are struggling to make ends meet. It's a
sad day for those people who are on government assistance today. It's a
sad day for America because I think this dog and pony show, this
charade, this ruse that the White House has put together for Thursday
is nothing but something to try to pull the wool over Americans' eyes.
The good news is, though, America, I don't think, is going to buy it
because the American people get it.
The President recently said he's just not articulated well enough
about ObamaCare to allow the American people to understand how they
need this government takeover of the health care system. He didn't call
it a government takeover of the health care system. He said ``my
plans.'' ``My,'' ``I''--all his focus is on himself. But the American
people do get it. They understand very firmly that this is not what
they want. This is not the change that they thought they were getting.
This is not the hope and change that was promised.
I have been joined tonight by several of our Doctors Caucus members,
a couple freshmen and then a longstanding Member of the House that have
come tonight to talk to the American people, Mr. Speaker, through this
Special Order about ObamaCare to let people know that Republicans are
the party of ``know.''
To begin with, I would like to welcome and yield to a freshman,
another family doctor from the State of Louisiana, from Shreveport,
Louisiana, Dr. John Fleming.
Mr. FLEMING. I thank the gentleman from Georgia, Paul Broun, a fellow
family physician, a fellow conservative who has been a great
inspiration for me, a great Member, and under whose leadership many of
these issues have been very valuable to me.
Mr. Speaker, what I'm going to do is just touch very lightly, just
highlights, on where we started with this and where we are today and
certainly yield back for others to weigh in on this.
It's been slightly less than a year ago that we began to see a strong
movement towards the passage of health care reform in Congress. Quite
frankly, I ran on health care reform as a physician, and I'm sure Dr.
Broun sees many of the things that can be fixed in our system that are
problems. Having said that, we have the best health care system in the
world. How do I know this? Well, just one of many empiric facts is a
gentleman--I believe his name is Mr. Williams--who is Premier of
Newfoundland, who needed heart surgery, and the type of heart surgery
he needed was simply not available in Canada. So he came to the U.S. of
A., the good old U.S. of A., to have that heart surgery because that's
where the cutting edge is for health care. If you really need health
care, the best of health care, and you have the resources, the U.S. of
A. is the place to get it, but we need to be sure that good health care
is available to all.
Less than a year ago, there was launched, by both the House and the
Senate, efforts to pass health care reform, which really turned out to
be, in my view, nothing more than a government takeover of health care.
{time} 2200
Both bills are very similar. Both passed, of course, each House. The
one or two major differences would include the House bill has a
government option. The taxation is heavy in both.
[[Page H740]]
The financing is heavy in both, but very similar.
But, to cut to the chase, it cuts out a half-trillion dollars from
Medicare. It taxes people $800 billion, and it does not bend the cost
curve down. Even the CBO says that.
Now, we have a situation, despite the fact that all of us here who
are speaking tonight have been working very hard for many months, day
after day, night after night, attempting to drive a wooden stake in the
heart of this vampire, the government takeover of health care. And it
seems, even when it's dead, it seems to be rising again.
Now, you know, it started out with a slight approval rating in the
early days. I mean, who wouldn't be for health care reform? It sounds
like a wonderful idea. But as people began to learn about it, and
certainly when we got to the August recess where there were town hall
meetings, we saw situations where people became so angry they were
almost, I would say, out of control at times, very angry at many of
their representatives across the country who would dare want the
government to take over the most intimate part of our society, and that
is health care.
And so, little by little, and maybe not so little by little, but
perhaps even rapidly, we saw the approval rating of the government
takeover of health care drop. And today, 2 to 1 Americans are against
this. And those of us who were against it, it doesn't matter what party
you're in--it doesn't matter. I mean, the only thing bipartisan about
these bills we can actually say is that there are people on both sides
of the aisle who are against it. But the bottom line here is that
Americans do not want this.
I perceive us today, at this point in time, to be two touchdowns
ahead, and 2 minutes left in the fourth quarter. The debate is over
among the American people.
Yet and still, we have the President and Members of the House and the
Senate, Democrat Party, who still want to find a way to cram it
through. And one of the things they've come out with is just the
release, less than 24 hours ago perhaps, maybe a little more than 24
hours ago, of a compiled version of the two bills. And here is what we
have. The bill is most like the Senate bill, that is, the Obama 2.0
that Dr. Broun refers to is most like the Senate bill, but it increases
spending by $100 billion. It increases premiums that are already going
to increase by $2,100 per family per year. And it does something
unbelievable, unprecedented. It actually begins to tax, by a factor of
2.9 percent, unearned income. That's the capital gains tax, interest
income. These are all things that come to people who, in many cases,
have fixed incomes. And of course, yes, it is the people who make over
$200,000 a year.
But you know what? Where are we today with the AMT tax? It was never
indexed for inflation, and now we have middle class people paying it.
This is not indexed either, so sooner or later, middle class taxpayers
will be paying those taxes.
Mr. BROUN of Georgia. Will the gentleman yield a second?
Mr. FLEMING. Yeah, sure.
Mr. BROUN of Georgia. I want to point out something too so that we
understand. We keep hearing from the President, we want to tax the
rich. Most small businesses in this country file their income taxes
individually because they're sub S corporations, which means that their
income taxes are filed individually, as a person or as a couple. And
over half of those people that make over $200,000, which is in the
President's current proposal, are small businessmen and women, and it's
taxes on their business. So, by taxing folks making over $200,000 or
over $250,000, what it's going to do is it's going to take money out of
small businesses so that they can't expand, so that they cannot give
their employees the kind of salary that their employees deserve.
And I've talked to a lot of small businessmen and -women in Georgia
who are going to have to let people go. So this is going to cost a lot
of jobs. In fact, millions of jobs all over this country are going to
be lost because of this tax, so-called tax on the rich, because it's
really a small business tax. It's a tax on small business that's going
to cost millions of people their jobs in this country. They're going to
be out of work, and so we're going to have more joblessness in this
country if this monstrosity gets passed into law. I thank you. I yield
back.
Mr. FLEMING. Yes. I appreciate the gentleman, Dr. Broun. Absolutely,
that's the working capital for small businesses. You add to that that
there will be as much as an 8 percent payroll tax for businesses that
heretofore could not afford health care insurance, and they'll have to
pay the insurance without getting that. And then their employees, who
will not be able to afford to buy insurance, will be--instead of paying
$750 per person under the Senate version, it'll be $2,000. So we have
many things that are going to be job-killers out of this bill.
And last but not least, just when we thought all of those bad deals
that really got this thing in trouble to begin with were going away, we
find the Louisiana Purchase, the $300 million for Medicaid to
Louisiana, which--Louisiana needs money to offset a FMAP problem, no
doubt about it. But the problem is, if this bill goes to signature,
that $300 million will be swallowed by a billion dollars of additional
cost down the road that Medicaid is going to cost. So no real benefit
to the State of Louisiana.
The Yukon deal--Senator Dodd added $100 million for a hospital that
he liked for his State.
Gatorade--Ben Nelson secured extra benefits for Medicare Advantage
beneficiaries. The handout, the Montana, the North Dakota Senators
deal, Hawaii got a special exemption for higher Medicaid DSH, or
``Dish'' payments. On and on and on, there are all sorts of deals still
in this bill that have not been cut out.
And so I agree with the gentleman. As we go into this summit, health
care summit on Thursday, there's no doubt about it. The American people
need to understand that this is not about a true negotiation. The
Republicans have been locked out of negotiations. We've been locked out
of amendments.
Despite what I hear my Democrat colleagues say, we do not agree with
80 percent of this bill, not by any stretch of the imagination.
And so why now would we have this summit in front of the cameras? The
reason is, as I said, is because this bill is nearly dead. It's trying
to be revived, and now this is time for the Hail Mary. The President's
going to jump in there and try to revive this somehow at the last
minute.
And so I submit, Mr. Speaker, that it's time to kill this once and
for all. Let's go on to true health care reform, stand-alone bills,
starting with the low-hanging fruit, one at a time, attacking the
things that we know we can all agree on: Preexisting illnesses,
aggregating employees into large buying pools, purchase of insurance
across State lines, tort reform--these things are straightforward. We
could improve health care and lower the cost overnight by doing these
things. And then get back to the people's work, and that is creating
jobs for this country. I thank you and I yield back.
Mr. BROUN of Georgia. Thank you, Dr. Fleming. I appreciate it. Now
want to yield some time to another great member of our Doctors Caucus,
Dr. John Boozman from Arkansas. And Dr. Boozman, before you start, I
want to say that just to kind of tag on to what Dr. Fleming just said
about the Louisiana purchase. He's from Louisiana. But this new
proposal that President Obama has put forward is going to extend the
Louisiana Purchase to every State. Now, the governors are going to love
that, and the State legislatures are going to love that, because what
it's going to do is it's going to take some of the financial burden off
them for health care costs that are skyrocketing because of the Federal
Government. But what it's going to also do is it's going to put a heavy
burden on all the taxpayers in this country. So the taxpayers are going
to hate the Louisiana Purchase. And it's just a cost shifting,
basically, from a State level to a Federal level, and again, it's a
Federal takeover of the health care system, and to get the States, as
well as private insurance, out of the health care system, so--Louisiana
Purchase. So I appreciate Dr. Fleming bringing up the Louisiana
Purchase.
Dr. Boozman, I yield to you whatever time you may consume.
{time} 2210
Mr. BOOZMAN. Thank you very much.
[[Page H741]]
I agree. That sounds good in the sense of taking an additional role
by the Federal Government paying for these things. The problem is,
we've got a proposed budget by the administration of $3.8 trillion.
Almost half of that money is borrowed from people like Saudi Arabia,
China--people that don't like us very much. And the American public
knows it just doesn't work. These things sound good but at some point,
you have got to pay your bills, and we've got to start paying our
bills.
The President outlined his plan, and the reality is he's not hearing
the concerns of the American people. He is not hearing the concerns of
the people of Arkansas. What he is doing is he is telling us what
health care coverage we can have as opposed to what the American people
want.
The American people now in overwhelming majority have said, ``No.
This is not the bill we want.'' Right now, we're spending more than any
other country in the world by far with our health care system. The
proposal that we have will spend almost another trillion dollars and
yet costs will continue to rise.
So, again, instead of trying to do something in the free market way
to lower costs, what the bill actually does is basically say we're
going to do that by setting price controls. And price controls don't
work. What we're going to do is have rationing, and we will have
decreased quality of care.
Another real concern I've got is the abortion coverage. The Hyde
amendment has always said that we're not going to pay for abortions
with taxpayer funding, and yet this bill leaves that wide open.
The Medicare payroll tax. The administration is talking about putting
a 2.9 percent tax on non-wage income, and I don't think the American
public understands yet that that is in there or being talked about, the
ramifications about that. But when you start taxing dividends, when you
start taxing interest, capital gains, things like that, those are the
kinds of things that are creating jobs.
My frustration is instead of coming out with things that are job
creators in this economy, we continue to have these things thrust upon
us that are really job killers.
The group that he is not talking about--and we were discussing this
earlier, and I will yield to my colleague here--are the health care
providers.
Tomorrow, Thursday, there is going to be the meeting, and there is
probably 17, 18, 19, 20 Members of Congress that are health care
providers, and none of those are over there actually talking about
what's going on.
Mr. BROUN of Georgia. Let me reclaim my time here.
Let's say that again so we understand. The American people say,
``What? You're not including doctors who are taking care of patients?
How are you going to form a health care system?''
Dr. Boozman, please say that again very clearly so the Speaker and
anybody watching tonight can understand.
Mr. BOOZMAN. Again, and this is not a Republican or Democrat thing. I
am just saying health care providers amongst all of us. When you add
the experience up, the years of practice and things, you would think
that this is the group that you would call on first to get over and
give you good advice.
Mr. BROUN of Georgia. Reclaiming my time, I agree with you. In fact,
I introduced H.R. 3889, a comprehensive bill, a little over a hundred
pages, that totally would change health care financing in America and
it would give patients the power to make the decisions along with their
doctor.
I wrote the President. He said, If you have any ideas, my door is
always open. But I've been knocking on that door over and over again,
and it is slammed shut, locked, and I've been trying to open that door
that he said was open and it's not been opened.
I know other members on our side, Dr. Price from Georgia, another
physician, orthopedic surgeon, has introduced the Republican Study
Committee Bill, H.R. 3400. Dr. Price has offered to talk with the
administration. The door is locked. Bolted. Closed shut. Republicans Go
Away is the sign on the door. And we're not being included in this so-
called summit, bipartisan summit, on Thursday.
Why don't they want us there? Because we know about health care.
They're not interested in what we, as physicians, know. They're not
interested in our ideas. They're not interested in any Republican
ideas.
This is a ruse. It's a show. Nothing but a dog-and-pony show to try
to boost the President's approval ratings or try to make him look as if
he is reaching out a hand of bipartisanship trying to find solutions
for the American people. Actually, it's a fist that he is showing us,
and it's a closed fist. It's a closed, locked door, and it's nothing
but a show or a charade to try to look to be something different than
it is.
Thank you, Dr. Boozman.
We are also joined tonight with another colleague. Louisiana is
blessed by having three physician members of the Republican delegation
here. We heard from Dr. John Fleming just a moment ago. We have Dr.
Charley Boustany from Lafayette, Louisiana. Lafayette is one of my
favorite towns. I've got some great Cajun buddies that I duck-hunt with
down there. In fact, I talked to one today about he's coming to Georgia
and wants to go turkey hunting. Shelly Deshotels from Lafayette,
Louisiana is a good friend and a turkey hunting buddy. And Shelly
Deshotels told me today, ``Keep fighting.'' He doesn't want to see this
health care bill passed anyway.
We've got another physician, Dr. Bill Cassidy, who's joined us today.
Louisiana is like Georgia. We have three physicians from Georgia in
the Republican delegation, and we have three physicians from Louisiana
in their delegation.
I want to welcome and yield to Dr. Bill Cassidy for such time as he
may consume.
Mr. CASSIDY. Dr. Boustany will be at the summit meeting.
Mr. BROUN of Georgia. Oh, really? That is news. Hallelujah. Praise
the Lord.
Mr. CASSIDY. Clearly, I think we can all agree on what are the goals
of health care reform. We want access to quality care at an affordable
price. And it kind of gives us a nice way to judge each of these.
I am struck. Medicare is going bankrupt in 7 years. Medicaid is
bankrupting States, and we're about to create a third entitlement to
rescue the first two. And a third entitlement that is going to be based
upon the House bill and the Senate bill. The Congressional Budget
Office has said of both the House bill and Senate bill that they more
than double costs within 10 years.
So we're going to go from a status quo which may double costs in 10
years, to a reform which more than doubles costs in 10 years.
Folks ask me how do I like my first year in Washington, D.C. I say,
it's a crazy place. We pass a reform to control costs which is more
expensive than the status quo--and that is important because the
American people since August have been saying, Mr. Speaker, that we
need to control costs. They understand that you can give everyone
access, but soon our costs are out of control and access is gone. You
can give everybody the highest quality, but unless you control costs,
again you break the bank.
So the American people since August, and with the Senate election in
Massachusetts putting an exclamation mark behind the sentence, are
saying, Control costs.
Now as it turns out, the proposals before the President, the Senate
bill, again, according to Congressional Budget Office, more than
doubles costs in 10 years, and the President's proposal will be a
hundred billion dollars more expensive than that.
Now, the President is billing this as a tax cut to the American
people, but really it's a shell game. Some folks will have their taxes
simultaneously raised and their subsidies increased. Now, that's a
crazy thing, but on the other hand, if you're going to subsidize here,
you must tax there. And because some of the things being taxed are
insurance policies--insurance policies owned by union folks, for
example, who negotiated this through their wages--there will be a tax
on folks who most consider middle income.
What are the alternatives? You mentioned something earlier, Dr.
Broun. I said, man, you can tell the guy's a family physician. You
talked about empowering patients. I think the fundamental difference
between the Republican proposal and the Democratic proposal is that the
Democratic proposal
[[Page H742]]
is a top-down, control costs from Washington, D.C., type approach.
Mr. BROUN of Georgia. That doesn't control costs.
Mr. CASSIDY. Dr. Boozman just pointed out that the price controls
upon insurance policies is the ultimate in a top-down, bureaucratic,
doesn't matter what the market says, we're going to control your costs
from Washington. It never has worked.
On the other hand, the Republican approach is patient-centered. You
and I know as physicians--and I am still seeing patients. I see them
about once every 2 weeks in my practice. I work in a public hospital
treating the uninsured. If you involve the patient in her care, she
typically is healthier, she saves money, and the system saves money.
{time} 2220
Health savings accounts, Dr. Broun, I know you know this, but for the
audience, a patient will put, with pretax dollars, before you are taxed
on it, will fund a bank account, and that bank account is used to pay
for medical care.
As it turns out, with traditional insurance, say a family of four
puts up $12,000, and then a year later they put up another $12,000, and
then a year later they put up another $12,000. With a health savings
account, if you don't use the money, it rolls over to the next year.
And some families will continue to accumulate until the amount they
have to put in is zero because they have been so wise with how they
spend their money.
A good example of this, I am sorry Dr. Fleming left, because he talks
about how his medical practice went to HSAs for all the employees. And
he has an employee who was smoking. And she complained, because before
the insurance paid for inhalers--the smoking had given her asthma--and
now she had to pay for it out of her own pocket. So before she was
cost-insensitive, and now, because it is out of her bank account so to
speak, she is aware of it.
And Dr. Fleming said to her, Well, you know, if you stopped smoking,
you wouldn't need that inhaler.
And she goes, Really?
He goes, Yes.
She stopped smoking, her health is better, she no longer pays for
inhalers, and we are controlling costs overall. So by involving
somebody in her care, her health is better, the system saves money, and
she has more money in her pocket.
And, by the way, one last thing before I yield back, the Kaiser
Family Foundation has a study. They found that a family of four with a
health savings account, that that policy is 30 percent less expensive
than a traditional insurance policy for a family of four; that the
family with the health savings account and the catastrophic policy on
top, not only is that policy 30 percent cheaper, but they use
preventive services as frequently as a family with a traditional
insurance policy.
Now, if our goal is to give high quality care to all at an affordable
cost, well, what we just found out is with the HSA you lower the cost
by 30 percent. Okay. That is one of your goals. And they are using
preventive services as frequently. So they have access to quality care.
As it turns out, because it is lower cost, 27 percent of people in this
study who had a health savings account with a catastrophic policy were
previously uninsured. About 50 percent had a family income of $50,000
or less, and about 60 percent had a family income of $70,000 or less.
So again, by lowering costs 30 percent, people who were formerly
uninsured now have access to quality care. That is a patient-centered
approach, far different from the bureaucratic approach that is being
offered by the Senate and House bills. But from our experience as
practicing health care providers, I think we can say it is the right
approach.
I yield back.
Mr. BROUN of Georgia. Thank you, Dr. Cassidy.
One other thing that I want to add, too; not only is it less
expensive, people can afford to buy insurance where before they had not
been able to. They use more preventative services, but they take care
of themselves better. So they are healthier. Diabetics control their
blood sugar better. People who have high blood pressure control that
better. Folks with high cholesterol tend to get their cholesterol
lowered. They have less heart attacks, strokes. So they are healthier.
They live longer. They are more productive. They are happier. They feel
better, have more energy. So it actually promotes wellness.
If you really think about it, in the health care system today, we are
not taking care of healthy folks, for the most part. We take care of
sick people. That is what doctors do. That is what hospitals do, take
care of sick people. Some people say we have a sick care system. Well,
the system is sick because of the government.
Before I go back to Dr. Boozman, I want to tell a couple of stories
about my practice and how government intrusion in the health care
system has driven the cost of health care up for everybody. Back
several years ago, I was practicing medicine down in rural southwest
Georgia. Congress passed a bill called CLIA, the Clinical Laboratory
Improvement Act, and what this did is it shut down every single
doctor's lab in this country.
Prior to CLIA, I had a fully automated, quality controlled lab in my
office. And when patients came in to see me with a red, sore throat,
running a fever, coughing, runny nose, I would do a CBC, or complete
blood count, to see if they had bacterial infection and, thus, needed
antibiotics, needed that expense, needed the exposure to the
antibiotics and problems that may come from that, or whether they had a
viral infection that is not helped by antibiotics at all. They don't
need to spend that money. They don't need the exposure to the
antibiotics. Less chance of having anybody have allergic reactions,
less chance of developing the superinfections in this country.
I do that test, a CBC in my office, in 5 minutes. It costs $12. That
is what I charged. That is what I charged Medicare and Medicaid as well
as the patients. So this was a tool that I could use in my office,
fully quality controlled. But Congress, in its supposedly infinite
wisdom, in fact, Mr. Waxman, who is right in the middle of trying to
push forward this government control of health care, was the one who
pushed through CLIA--one of the ones.
After CLIA shut down my lab and every lab in doctors' offices across
the country, to do that same test I had to send my patients across the
way to the hospital. So they had to leave my office, go over there,
spend 2 to 3 hours doing what I could do in 5 minutes, $75 for one
test. Twelve dollars to $75. Five minutes to 2 to 3 hours for the
patient.
Now, what do you think that did to the cost of everybody's health
insurance in this country? What do you think it did to the cost that
Medicare has to pay for lab services? It rose the cost of health care
markedly all across this country. And that is with one government
intrusion, CLIA. We have hundreds.
Not long ago Congress passed HIPAA. HIPAA has cost the health care
industry billions of dollars. It is totally unneeded regulation. It has
cost the health care industry billions of dollars and has not paid for
the first aspirin to treat the headaches it has created. What does that
do to my insurance costs and the American people's insurance costs? It
drives it up markedly. Somebody has to pay that billions of dollars for
that one government regulation that was put in place by Congress and
the President signed into law. It has cost the health care industry. It
costs all of us a tremendous amount of money.
So it is government regulation, government intrusion in the health
care system that has raised the costs for me and for my patients. And
here we go with another government bill, another government takeover
that is going to put cost controls, that is going to put taxes out the
wazoo for everybody in this country. So it is going to cost everybody.
And I believe it is totally designed, to go back to what the President
said just a couple of months ago, that he wants to go to a government-
controlled, centrally run health care system, socialized medicine run
from Washington, D.C.
Before, Dr. Boozman, I go to you, I just want to point out a couple
things on this chart. What is in the new bill? It is just more of the
same. It is the worst of the House bill, worst of the Senate bill put
together. It is more of the same. It is a government takeover of health
care. There is no question about it. There are price controls, as
[[Page H743]]
Dr. Boozman was talking about. There are a lot of individual and
employer mandates.
So if you have health insurance and you like it today, it is going to
go away, because the Federal Government and the Federal bureaucracy in
Washington, D.C., is going to put mandates on your health insurance to
the point that it is going to go away.
{time} 2230
In fact, I believe it is geared up to try to put all health insurance
companies out of business so that there is only one health insurer in
America, and that is the U.S. Federal Government.
There is no medical liability reform. The President talked about he
wanted to have medical liability reform. It is not in any of the
Democrat bills, the House bill, the Senate bill, nor is it in ObamaCare
II. It still puts Washington bureaucrats in charge of defining what is
quality health care. In fact, in the stimulus bill, the nonstimulus
bill--the failed stimulus bill--the Democrats put in something that's
called--what was it called? I'm having a brain freeze here. It's called
an Effectiveness Research Council, or Comparative Effectiveness
Research is what it's called. What that is geared to do is physicians
look at the comparative effectiveness of different treatments, whether
if you have cancer, whether surgery, or chemotherapy, or radiation
therapy--or a combination of all three is better. That's what we do in
medicine.
The comparative effectiveness that the Democrats have put in place
actually is geared towards how to spend dollars. It is the comparative
effectiveness of spending $1 on a 40-year-old versus a 65- or 70-year-
old. And so the way the whole system is set up, it means that the
Medicare recipients are going to get thrown in the stick. Senior
citizens, under the comparative effectiveness, are not going to get the
care; they are going to be denied it by the Federal Government.
Cuts Medicare Advantage. It still raises taxes. There is over a half
of a trillion dollars of increase in taxes, and this is the only way
that they can even get it anywhere close to the kind of numbers that
the President promised. And he and his administration have used what I
call ``voodoo economics.'' The reason I call it voodoo economics is
because you have to be a dead man walking around with no soul to
believe the economic parameters of the economic issues that they've put
in place. But this Obamacare raises taxes and will raise taxes on
virtually everybody.
And it still gives the government-run plan a beachhead to eliminate
private insurance. And I think this is the bottom line. This is the
purpose that Henry Waxman and Charlie Rangel and Ted Kennedy and Nancy
Pelosi and George Miller and a lot of people have been pushing, the
government takeover. They're very open and frank about it, and I
congratulate them for being at least halfway honest. But the whole
purpose of the Pelosi bill in the House, the Reid bill in the Senate,
both ObamaCare and now the proposals that the President put forth
yesterday morning, is a government takeover of health care, to tell the
American people the kind of care that they can get.
Whether they can get it or not, it is going to take the
decisionmaking process out of the hands of patients and families, out
of the doctor's hands, and it is going to put it in--all those
decisions are going to be made by government bureaucrats here in
Washington, D.C.
So with that, I yield to Dr. Boozman.
Mr. BOOZMAN. Well, again, I would add that I was a health care
provider, but I was also a small business person in the sense that we
had about 85 employees that we had to meet payroll with. And always our
biggest cost of doing business, our biggest expense was health care
insurance for our employees. Every year the guys would come along and
they would say, well, your premium is going up 10, 15, 20 percent,
whatever it is. The major problem that we have going on right now is
increased cost. And as was discussed earlier by my colleague, you know,
things like health savings accounts, those are free market reforms. It
is a free market reform that lowers cost. Associated health plans,
allowing my barber with his two or three employees to team with maybe
thousands of barbers to get a much lower rate. And then lastly,
controlling the nuisance lawsuits. Those are free market reforms that
would lower costs, which we desperately need. The problem is--and
again, I don't know who the President is listening to--but those types
of things are not included in the bill that we see.
The only thing I would say though is, instead, there is no control of
cost, and what we have is in the fine-print wage and price controls
that they're just saying, well, we are going to dictate the cost. And
again, as my colleague said earlier, that just doesn't work. That has
been proven with several administrations in the past that it is going
to lead to rationing and decreased quality of care.
I yield to you.
Mr. CASSIDY. You know, it is interesting because we can see from the
Republican administration of Richard Nixon, the Democratic
administration of Jimmy Carter on oil and gas, that when you try to
artificially control price with regulation, it doesn't work. You have
to address the fundamentals.
So let me give an alternative between this top-down bureaucratic
means of control and a patient-centered approach. I was speaking about
HSAs and patient-centered approaches with a constituent, and he says,
you know, doc, I take a pill for my ulcer. Now, I have an HSA. My
physician wrote a prescription and I said, physician, I know from
experience that this pill is going to cost me $159--he didn't say $160,
he said $159. He said, I have an HSA, I pay for this out of pocket, can
you do me something different? And the physician said, oh, you have an
HSA? Tore it up and wrote a prescription for generic and it cost him
$20. The system just saved $139.
I have another patient who called me--I am a liver specialist--called
me up, and she says, Dr. Cassidy, I have a bad heart. My doctor over
here said I needed this test because of my bad liver, not my heart, but
rather my liver. And I said, from a liver perspective, you don't need
it. She said, well, I will pay for it if I need it, I have an HSA, but
I will pay for it if I need it. I said, no, ma'am, you do not need it.
The system saved $1,000. Because she had an HSA, she was motivated, she
was motivated to find out how much it cost and then to see if she
really needed it.
Mr. BOOZMAN. Will the gentleman yield?
Mr. CASSIDY. I will.
Mr. BOOZMAN. Under these plans, the generic is not covered in the
HSA; is that not correct? Can you comment on that?
Mr. CASSIDY. That is correct. It is kind of a crazy thing where if an
HSA is used for a generic price on an over-the-counter drug, which is
what we are describing here----
Mr. BOOZMAN. Which lowers cost.
Mr. CASSIDY. Which lowers cost, it's not available for an over-the-
counter medicine. And so that $20 prescription is actually over-the-
counter medicine, and we're talking about ulcer medicine. So in this
way, the patient reacts so as to take care of her health and to lower
her cost. And in millions of those interactions across the Nation, not
from Washington, D.C., but rather from the exam rooms themselves is how
the system saves costs.
You recall, Dr. Broun and Mr. Speaker, how we spoke of the HSAs being
30 percent cheaper. Well, that's why they're 30 percent cheaper because
patients are incentivized to control their cost.
One last thing I will say. When you ask a crowded room who is most
responsible for each person's health, we all know that it is that
person in particular. So what the Health Savings Account does, the
patient-centered approach does, it says that the patient is most
responsible for his or her care, and in so doing, we trust that the
patient, with her physician, will make the right decisions. And the
story of Health Savings Accounts is that that is true, that is a well
placed trust.
Mr. BROUN of Georgia. Well, I will reclaim my time, and I thank you,
Dr. Cassidy.
In fact, my health care overhaul bill, H.R. 3889, expands health
savings accounts, creates Medicare health savings accounts. So it puts
Medicare patients in charge of their own dollars, and they own those
dollars. And those dollars, if they're not expended, would roll into
their estates so that their heirs would get them.
[[Page H744]]
We pay our Medicare taxes to the Federal Government, and we should
get it back. I am an original intent constitutionalist, and I
understand that some people would say, well, Dr. Broun, an HSA is not
constitutional under Medicare, but we've got to fix Medicare. And it is
a bridge to help Medicare patients start controlling their own costs
and controlling their own money and controlling their own health care
decisions. That is exactly what my bill, H.R. 3889, would do.
But I wanted to go back to this summit just in the last few minutes
that we have. Actually, the mainstream media has written some articles
that just came out today, and I wanted to read a couple of things from
the mainstream media. The President has talked about he wants to reach
out in a bipartisan way. The Wall Street Journal wrote today, Democrats
have decided to give the voters what they don't want anyway. A San
Francisco Examiner editorial said, Republicans publicly wondered if
Obama's proposal represented a refreshing new attempt by the Chief
Executive to display genuine bipartisanship and whether they should
trust him to come to the summit with a truly open mind. And that is
what we had hoped.
Going on with what they said: We now know the answer to both
questions is a resounding ``no.''
The Washington Post said, President Obama's opening bid on health
reform is not designed to entice Republicans to join the game.
And as we said earlier, I don't believe the President wants
Republicans to join the game, he doesn't want the Governors to join the
game. He doesn't want anyone to join the game because he has set the
game rules himself, tilted towards just what he wants and what nobody
else wants. It is just the leadership meeting in secret behind closed
doors, with no input actually from our Democratic colleagues nor our
Republican colleagues, nor Governors, nor health care providers,
anybody except just the leadership has brought forth ObamaCare II.
And even in his hometown newspaper, The Chicago Tribune--not known to
be a conservative newspaper--said this: Obama wants Republicans to
approach the summit in a spirit of compromise. Too bad he's not leading
by example.
So, Mr. Speaker, we've spent an hour with my colleagues talking about
health care. Republicans are the party of k-n-o-w, know. We can lower
the cost of health care. We can empower patients and doctors to make
the decisions and start health care reform, health care financing
reform, that makes sense economically, that will cover those that are
uninsured, that will cover those who have preexisting conditions that
can't get insurance today. We can do those things if the President and
the leadership of this House and the leadership of the Senate would
just listen to some of the proposals that we have put forward. Doctors
have not been enjoined in this process. The American people have not
been in this process. And the American people need to say no to
ObamaCare.
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