Congressional Record, Volume 157 Issue 47 (Monday, April 4, 2011)

[Congressional Record Volume 157, Number 47 (Monday, April 4, 2011)]
[House]
[Pages H2277-H2283]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

GOP DOCTORS CAUCUS

The SPEAKER pro tempore (Mr. Gibbs). Under the Speaker's announced

[[Page H2278]]

policy of January 5, 2011, the gentleman from Georgia (Mr. Gingrey) is
recognized for 60 minutes as the designee of the majority leader.
Mr. GINGREY of Georgia. Mr. Speaker, what we are going to do here for
the next hour is talk about why we feel so strongly the need to repeal,
and if not successful, to defund so many provisions of the Patient
Protection and Affordable Care Act.
But, Mr. Speaker, before I get started in the subject at hand, I do
want to join my colleagues, particularly my colleagues on the
Democratic side of the aisle, in remembering our colleague John Adler.
I didn't realize that John had been sick. I didn't realize that John
had had surgery. I didn't realize until just moments ago that our
colleague from New Jersey had died. As I sat here listening to the New
Jersey delegation on both sides of the aisle talk about John, it helped
me understand a little bit better about him.
All I know about John is that he was a great guy and a really, really
nice Member of this body and someone that I respected. I got to know
him, Mr. Speaker, in the House gym at 6 o'clock in the morning usually.
He would be working out, and I would be working out--I am 15 years
older than John was--and we just struck up a good friendship. I truly
will miss him, as well as my other colleagues, as they express their
sympathy to his wife and his four sons. But truly a great Member.
It reminds me too, Mr. Speaker, that as we do our work, as we do our
work with 1-minutes, and we do our work with 5-minute Special Orders,
and now this leadership hour talking about a very important issue that
our colleagues on the other side of the aisle for the most part, almost
100 percent of them feel very differently about this issue, we differ
on a lot of things, and we will continue to do that. It has gone on
forever.
But the point I would like to make, and I will conclude with this, is
that there are 435 people in this House of Representatives. And
sometimes we Republicans are in the majority and sometimes the
Democrats are in the majority, and the worm turns, and nothing is
forever.
But we have good, decent men and women serving here representing
their districts and doing the work of the people. And God bless them.
God bless each and every one of them. God bless a Member like John
Adler, who died much too young, as my colleagues have said already.
But we want to always keep in mind that as we argue and debate and
make points and feel very strongly about an issue, that doesn't mean we
don't love one another. And we do. And I loved John Adler. He was a
great Member of this body.
Mr. Speaker, again here we are, though, getting right back into the
business at hand. And this is a hugely important week, a hugely
important week as we try to come to some conclusion in regard to how
much money we need to cut out of, not this fiscal year we are in right
now, but the last fiscal year, which started--well, actually we are in
the fiscal year, but it started on October 1 of 2010.

{time} 1920

Here we are, what is it, the 4th of April, 2011, so half of the
fiscal year has already expired and we have not funded the government
except in this piecemeal fashion.
We didn't have a budget, we didn't have spending bills, and we put
these little 2-week Band-Aids, 2, 3 weeks, a little bit of cutting, but
from my perspective and from my side of the aisle and our leadership
not nearly, nearly enough. And we are faced with this tremendous issue
of trying to reach a compromise and an agreement to lower spending.
The American people certainly gave a mandate, I think, to 87 new
Republicans and 9 new Democrats to come up here and quit all this
spending. Let's not have $1.5 trillion deficits year after year after
year. That's how you get to $14 trillion worth of debt, and that's what
we are facing right now; and, indeed, in a month or so, we are going to
be asked to even raise that debt ceiling statutorily to say, well, we
will continue to borrow and kick the can down the road.
Obviously, Mr. Speaker, these are times that try men and women's
souls, and we all feel very strongly about our position. But I know my
leadership and Members on this side of the aisle, and I hope our
Democrat colleagues, feel the same way. We hope and pray that we can do
the people's work and cut this spending and get this country back on a
sound fiscal footing so that as we go forward to the 2012 budget, which
we will hear about tomorrow, that we will continue to work hard to
finally balance this budget and get our country out of this significant
debt.
Speaking of debt, Mr. Speaker, the reason I am here tonight, I
represent the caucus on the Republican side of the aisle known as the
House GOP Doctors Caucus. There are, I think, 21 of us now, doctors and
nurses on this side of the aisle, with just years and years of clinical
experience.
As an example, I spent 26 years practicing my specialty of obstetrics
and gynecology. We have registered nurses that are part of the Doctors
Caucus. We have specialists, general surgeons, cardiothoracic surgeons,
family practitioners, gastroenterologists. I could go on and on, but
some of them, hopefully, will be with me during this hour, will join me
in a few minutes to talk a little bit more about our concerns, their
concerns, Mr. Speaker, with the Patient Protection and Affordable Care
Act of 2010.
This was a bill, a law, that was finally passed and signed by
President Obama on March 23, 2010, after about a year and a half of
debating the issue in both this Chamber and in the Senate Chamber; and
when it finally came down to the reality that there weren't enough
votes on the Senate side, it was passed by something called
reconciliation which, to this day, I don't think the American people
understand. But, Mr. Speaker, I will tell you this, what they do
understand is they don't like it, they didn't like the process, and
they don't like the policy.
Now, I have heard the President say, and I have heard the Democratic
leadership in the 111th Congress, when this bill was passed, talk about
how Congress and particularly the Democratic Members have been trying
to pass a comprehensive massive health care reform law for almost 100
years. They talked about Franklin Delano Roosevelt, and they talked
about John Fitzgerald Kennedy and they talked about, of course,
President Bill Clinton and saying, you know, we finally got there, we
finally did it, we finally accomplished what we were trying to do for
almost 100 years.
Well, they missed the point, Mr. Speaker, because the reason why that
type of legislation was not passed in 100 years is because the American
people back then didn't want it anymore than they do today; and some 62
percent still say, very loudly and very clearly, in poll after poll
after poll, we don't want the Federal Government taking over health
care, one-sixth of our economy, lock, stock and barrel. We don't want
that.
We want improvement in our health care; and no matter how good
something might be, there is always room for improvement and, clearly,
our health care system is too expensive. We agree with that. I think
Members on both sides of the aisle can reach that conclusion pretty
clearly.
So there is agreement to try to do everything we can to continue to
provide the best health care in the world. It's not true when people
say our health care system is like that of a Third World country.
Nothing could be further from the truth. We have the greatest health
care system in the world, and some of the doctors in the House GOP
caucus will be with me tonight to talk about that.
You know the old expression, don't throw the baby out with the bath
water, I think that's what we have tended to do here. We have enacted
into law--on March 23 of last year, it's already had its 1-year
anniversary a couple of weeks ago--we have done something that I think
is not only opposed to what the American people want, you should never
do that, but it's bad, it's bad medicine.

It's bad for consumers, it's bad for patients, it's certainly bad for
corporate America. And it's absolutely bad for the taxpayer. It's a
top-down sort of system where a bureaucracy comes between literally and
figuratively a doctor and his or her patient. That's not a prescription
for improving our health care system.

[[Page H2279]]

I have got a couple of posters here with me, and I wanted to
reference these to my colleagues. In fact, I will have several more,
but I am going to keep this one up on my far left, that one that shows
the picture, I forget what his name is. Maybe one of my colleagues will
remember.
Mr. BROUN of Georgia. Boss Hogg.
Mr. GINGREY of Georgia. Well, I remember Boss Hogg, but I was trying
to remember what the actor's name is; I don't think he is still living.
But I think most of my colleagues do remember Boss Hogg from that old
series ``The Dukes of Hazzard.'' It was one of my favorites, kind of
like poking fun at ourselves, really; sort of like Archie Bunker and
``All in the Family'' and things like that that those of us who have
been around awhile can look back on and laugh and get a chuckle out of
it.
But Boss Hogg sort of represents the boss, the bureaucracy, if you
will, of the government, Big Government, running health care. Under old
Boss Hogg's picture, there he is with that cigar in his hand: you can
have whatever you like as long as the boss approves it.
And that's really the way it has turned out, what we talked about in
the House. I think it was H.R., House of Representatives, bill No.
3200. It was Senate bill 3590 or H.R. 3590, a shell bill that came over
from the Senate and finally was passed into law and became known as the
Patient Protection and Affordable Care Act.
But that law has so much bureaucracy, and I will get into some of the
numbers on that in regard to all of the new folks in the government
that would control health care, but all under this giant government
takeover, and Boss Hogg sort of represents that to me as a way of
communicating with the public.
But in any regard, before I continue with some of the statistics on
the bill, I see that I am joined by my colleague from Georgia, a fellow
physician and a member of the House GOP Doctors Caucus, who is a family
practice physician from the Athens area where the great University of
Georgia is located. Dr. Paul Broun is actually a doctor who makes house
calls, which is really unique and refreshing. He has been a welcome
addition to not only our Georgia delegation but this body.
I yield to the gentleman from Athens and Augusta and my hometown, Dr.
Paul Broun.
Mr. BROUN of Georgia. Thank you, Dr. Gingrey.
Dr. Gingrey, I have taken a history and physical of ObamaCare. I have
looked at all the laboratory results, I have looked at all the X-ray
results, and I have got a diagnosis:
ObamaCare is a destroyer. It's going to destroy jobs in America. In
fact, already, it has destroyed jobs. I have got a lady in my district
that right now today has eight people in her employment. She
desperately wants to expand her business, she would like to hire at
least one or two people for her small business, but she is not going to
do it because of the onerous effect of ObamaCare on her business.

{time} 1930

So it is destroying at least one or two jobs in that one lady's
business. I have got another businessman in my district that wants to
make a $31 million expansion of his business. He has the cash in the
bank. He doesn't even have to borrow it with all the regulations and
all the problems that we are facing with the financial problems that
the Dodd-Frank bill has placed on banks as well as small businesses. He
wants to make a $31 million expansion of his business. But he is not
going to do it because of ObamaCare and because of the increased taxes
and also the increased burden that this is going to place on him. That
is killing hundreds of jobs just in two businesses within my district.
So it's going to destroy jobs.
But it's also going to destroy budgets. It expands Medicaid. In fact,
the State of Georgia has a balanced budget amendment to our State
constitution, and our general assembly is just going through the
process of trying to balance its budget with a $2 billion shortfall
because of the downturn of the economy, the downturn of the economy
that was created basically because of policy that was put in place by
Democrats. Barney Frank was a big part of that, too.
But ObamaCare expands Medicaid markedly. In fact, the State of
Georgia is going to have to add at least about half again as many
people to the Medicaid rolls in Georgia, and the State budget is going
to have to pick that up, and it's going to destroy the State of
Georgia's budget. It's going to destroy every State budget in this
country. And it's going to destroy our budget. It's certainly not
affordable.
In fact, we see this administration has already, I think it is 1,168
waivers that they've already given to unions and businesses and
different entities just because of the onerous financial effects it's
going to cost all those people.
And it's going to destroy family budgets. I had a lady tell me about
her 26-year-old son recently, that his insurance doubled from last year
to this because of ObamaCare. He is paying for his insurance himself.
He's self-employed. And he can't afford it.
So it's going to destroy budgets. It's going to destroy family
budgets, it's going to destroy State budgets, and it's going to destroy
the Federal budget. Not only is it going to destroy jobs and destroy
budgets, but it's also going to destroy the quality of health care. In
fact, Dr. Gingrey, we were told, and I'm sure you're going to bring
this up, the American people were told by the President, if you like
your insurance you can keep it. Nothing could be further from the
truth. The American people need to understand it. The American people
need to understand ObamaCare was designed to force everybody out of
their private insurance into a single-payer, socialized health care
system that the President himself said that he wanted just before
ObamaCare was passed into law.
So my diagnosis is that it's a destroyer. It's going to destroy jobs,
it's going to destroy budgets, and it's going to destroy the quality of
health care. And also we need to have a plan of action. So I made the
assessment, so we need to have a plan of action, and our plan of
action, Dr. Gingrey, is--and the American people need to understand
this--it's absolutely critical that we repeal ObamaCare and replace
that law with something that makes sense, that truly lowers the cost of
health care.
There have been numerous Republican bills introduced here in this
Congress, in the last Congress, that would lower the cost of health
care. I introduced two that would repeal ObamaCare and would replace it
with something else. One is a comprehensive bill. I call it the Patient
Option Act. It's 106 pages, not almost 3,000. And then I introduced
another act that Democrat after Democrat colleagues told me, Paul, this
makes sense, more so than ObamaCare. It's a good first step. The
American people want us to do it in a step-by-step process. It would
allow purchases for individuals and businesses across State lines. It
would allow anybody in this country to buy insurance through an
association. They would have multiple insurance products at a much
lower cost. It would stimulate the States to set up high-risk pools.
Several States have already done that. Mississippi, I talked to
Governor Haley Barbour about his plan. Their high-risk pool that they
have in Mississippi has been very successful. Colorado has done the
same thing I understand.
And the fourth thing that it would do is it would allow everybody to
deduct 100 percent of their health care costs off their income taxes.
That would change the dynamics of health care. So, Dr. Gingrey, I have
done that physical examination and history, history and physical, my
subjective, objective assessment, and the plan. The plan is, we must,
absolutely must, repeal ObamaCare and replace it with something else, a
market-based system that literally lowers the cost of health care and
keeps all decisions in the doctor-patient relationship.

ObamaCare does none of those. It's not affordable for the government
nor individuals nor businesses. It's certainly not going to preserve
the quality of care, because it is a destroyer. So I have made that
diagnosis, Dr. Gingrey, and I would yield back to you for our further
discussion.
Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman for his
contribution and for being with us this evening. I realize there are
conflicting things going on on Capitol Hill this

[[Page H2280]]

evening, very important things. But I really appreciate Dr. Broun being
with us.
We have also been joined by another member of the Doctors Caucus,
that is our good friend and new Member, freshman Member from the great,
great State of New York, where my daughter and son-in-law reside. Ann
Marie Buerkle is a registered nurse, Mr. Speaker, by profession and
certainly knows of what she speaks in regard to health care,
representing the Angels of Mercy, if you will.
She is concerned, Mr. Speaker, about the health insurance industry
and the complexity of such, and maybe even wants to discuss some ways
that we could change and improve, certainly improvement is called for,
and it doesn't have to be within a 2,400-page bill, as Dr. Broun was
mentioning ObamaCare entails.
So at this time, I'm proud to yield to Representative Ann Marie
Buerkle.

{time} 1940

Ms. BUERKLE. Mr. Speaker, it is good to be here. I thank the
distinguished gentleman, my colleague from Georgia. I am very honored
to be here to speak about health care in the United States of America.
As was said, I am a registered nurse. I have been a registered nurse
since 1972, a time in our Nation's health history where the physician
and the patient had a relationship, and the government had not injected
itself into that relationship. And then after awhile, I went into law.
And for the last 13 years, Mr. Speaker, I have been a health care
attorney for a large teaching hospital in upstate New York, for the
last 13 years.
What we did in that hospital and in my role as an assistant attorney
general, we look at money, money that was owed to the State of New
York. So I had a very up close and personal look at the complexity of
health care in our country today.
I contend that this bill, this piece of legislation that does
anything but reform health care, will only increase the complexity of
health care in this country. It will only make it more complicated. It
will once again put the government right in the middle of the patient-
physician relationship. I contend that is not what the United States of
America is about. We need to let the free market play here in our
health care system.
I have spoken in my district to many, many people. I have done all
kinds of talks, but there is nothing more up close and personal and of
great concern to me than the health care system in our country. It is
an issue that affects every American in one way, shape or form. This
health care bill does not improve the health care system in this
country.
I came to Washington with a wide range of goals as a freshman, as my
colleague has mentioned, but nothing more important to me than
repealing this health care bill; this 2,000-plus-page bill that does
anything but reform health care. It adds to the complexity of an
already complex system. It puts the government in places where it
shouldn't be, and it doesn't protect that patient-physician
relationship.
Last week when I was in the district, I had my very first health care
advisory council meeting. I spoke with a group of physicians, a group
of health care providers, hospital administrators, and we had a
conversation. I said to them: What are your concerns as health care
providers? You are on the front line. What can we do down in Washington
on health care to make the delivery system better and more affordable?
They looked at me, and interestingly enough, all of the people on the
front lines came up with different solutions because, as you can
imagine, doctors and health care providers are good at diagnosing. The
question is now about the solution. What are we going to do for health
care in this country?
We are here tonight to say this bill is the wrong bill for this
country, but we are not willing to leave it go at that. We understand
that true health care reform will include medical malpractice reform.
We need tort reform in this country. We need to increase the use of
health savings accounts. We need to make insurance portable so when a
person loses their job, they don't necessarily lose their health care
coverage. We need to allow for the purchase of health care across State
lines. We need to put the patient back in the center of health care.
And I contend that this health care bill does not do that.
So as we sat around, I said to my group of health care advisors, I
said to them, What is it that concerns you most regarding health care
in this country? The first thing was our health care, this health care
bill that was just passed. And when you get into why does it concern
you, because it adds so many layers of bureaucracy and regulations to
an already ladened bureaucracy, already an industry and system that is
ladened with regulations. If you talk to a hospital or a physician, the
regulations and the impediments they have to access that patient for
health care are incredible.
So the concern with this bill is it adds so many more layers. It
takes this health care bill, and one of the biggest problems with this
health care bill is that it takes a piece of legislation and it hands
it off to the regulators. Then, with the regulators, they are left to
interpret and to deal with and come up with regulations that affect our
health care providers.
Beyond that, they recognize the need for tort reform. We need medical
malpractice liability reform. If we are going to talk about reducing
the cost of health care, we must consider that. And then they talked
about the increased regulations on the health care profession.
What we all agreed upon in that meeting was that the health care in
this country, it is a good health care system. We have good health
care. The quality of health care is not the issue. The issue is the
system of health care. And this bill that was passed in 2010 does
nothing to make that health care system better. It only complicates it.
It only ladens it with more regulations and once again puts the
government back in between the physician and the patient relationship.

I thank my colleague who has an esteemed history of being a medical
provider in the health care industry. He understands these issues. He
understands what good health care is and what a good health care system
would look like. And so I commend him and thank him for this
opportunity to speak.
I think what we need to do in Washington is to repeal this health
care bill. We need to put our heads together collectively and talk to
the professionals, talk to the health care providers, talk to the
patients, and get together and come up with a systemic plan that will
reduce the cost of health care, help to improve access to health care,
and not affect the quality of the wonderful health care that the United
States of America offers.
In my years in the attorney general's office representing a large
teaching hospital, I know how many people wanted to come to this
country for health care--I know people from Canada and from Europe--
because they knew they had access to good, quality care. They knew they
wouldn't have a 6- or 9-month wait. I think with this system, if we
allow it to go on, this health care bill, we will see those 6- and 9-
month waits while patients are waiting for the government to make a
decision about their health care access.
So we need to repeal this bill. We need to enact true health care
reform so we can improve access, we can reduce the cost of health care,
and we can maintain the fine quality of health care in this system.
I thank my colleague.
Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentlewoman from New
York for sharing her thoughts. Certainly, I agree completely with her.
She clearly knows of what she speaks.
This law, it is no longer a bill, it is now the law. Patient
Protection Affordable Care Act, it has been the law for a little more
than a year, as I said earlier. Of course, the Congressional Budget
Office that estimates the cost of laws that we put into effect, they
give us an estimate when it is in the bill form so Members can decide
whether or not what we are about to do is something that is affordable.
And the estimate of this law costing $900 billion, Mr. Speaker, the
true cost over the next 20 years is probably in the neighborhood of $3
trillion, not $900 billion.
But I do want to just talk about that number and remind my colleagues

[[Page H2281]]

about the pay-for provision that the Democratic Party, the former
majority party in the 111th Congress, had in place at the time this
bill was passed. Everything had to be paid for, so you had to figure
out a way to come up with the money.
In passing this bill and paying for it, Mr. Speaker, some $570
billion was taken out of the current Medicare program. The Medicare
program, which serves something like 47 million of our seniors, 5 or 6
million of them are younger people who are on disability that are
covered under Medicare. And we literally, to help pay for this new
entitlement, this new entitlement which has very little to do with
Medicare except that half of the money, half of the pay-for in this
$900 billion was taken from a program, Medicare, servicing our disabled
and our elderly, providing them health care, half of the money was
taken out of that system. The actuaries and the Medicare trustees tell
us that over the next 75 years, the unfunded liability, Mr. Speaker, of
Medicare is something like $35 trillion, with a ``t,'' $35 trillion.
And yet we took the money by cutting Medicare Advantage something like
$120 billion. We cut money out of hospice. We cut money out of long-
term care, skilled nursing homes.

{time} 1950

We cut money out of home health care. We taxed everything that even
looked like it had anything to do with health care: durable medical
equipment, supplying oxygen for people who were and are continuing to
struggle from chronic obstructive pulmonary disease. ``Emphysema'' is a
term we use a lot, and I think most people would recognize that.
Finally, we came up and said, okay, we've paid for this; but at the
same time, Mr. Speaker, we did absolutely nothing in regard to medical
liability reform, something that probably if we enacted it--and if
there were something in this bill, ObamaCare, as the President did
promise that there would be--could save $200 billion a year, according
to the RAND Corporation and other think tanks, from the overall cost of
health care, which is one-sixth of our entire economy, of our gross
domestic product in a year. That's how big this industry is. So there
is essentially nothing in the bill about medical liability reform.
Why do I say that, Mr. Speaker?
My colleagues, I think you understand that it's not about the high
insurance premiums that doctors have to pay on an annual basis so that
they can practice and be protected from liability if something goes
wrong. Obviously, they need that protection and those health insurance
premiums for the high-risk specialties like the one that I enjoyed for
26 years, OB/GYN, and neurosurgery.
Mr. Speaker, think about that doctor at the Tucson Medical Center who
was there in that emergency room when our colleague, Representative
Gabrielle Giffords, was taken there literally near death. I think Dr.
Rhee was his name, R-H-E-E. In fact, Dr. Rhee, I learned later, was a
graduate of the great school that I went to, Georgia Tech, the Georgia
Institute of Technology. Dr. Rhee spent his career in the military
after completing medical school. He served his country for something
like 22, 23 years, and he happened to be in that emergency room as head
of the trauma center and had had all that specialty training and all
those years of treating our wounded warriors in many conflicts--I'm
sure in Afghanistan and Iraq.
If he had not been there for our colleague Gabrielle Giffords--God
bless her--we would be talking about her today as we were talking
earlier about John Adler, our former colleague from the great State of
New Jersey who died today. But that doctor was there. He was there.
I fear, as I talk about this new health care law, there is hardly any
provision in there that would provide for doctors, even for primary
care physicians. There is some attempt, but when you take all the
additional Medicaid-eligible patients, increasing the minimum
eligibility at 138 percent of the Federal poverty level, you add just
millions of additional patients to be seen and literally hundreds of
billions of dollars of additional cost onto the backs of our States
that have to have balanced budgets, unlike here in the Federal
Government where we just keep borrowing money and where we're now up to
$14 trillion worth of debt.
So we have a huge problem in regard to this law that the CBO says
costs $900 billion over 10 years. I say--and this poster points it
out--the true cost, which is the last bullet point with the red dot, is
$2.2 trillion and counting; but as Ms. Pelosi said--and I quote her in
the third bullet point here--``we have to pass the bill to find out
what's in it.'' That was before the bill passed. Clearly, we are
finding out now, unfortunately, what the true cost is.
Mr. Speaker, I want to yield additional time to my colleague from New
York.
Ms. BUERKLE. Thank you.
Mr. Speaker, my colleague just brought up the cost of this health
care bill. I think it's interesting to talk about and insert what I
have heard from the health care community throughout the course of this
discussion.
For many hospitals which have a high level of indigent patients,
there is what is called a disproportionate share of money that is paid
to those hospitals to help them offset the cost of treating folks who
are on Medicaid and who are not able to afford their own health care
coverage. This health care bill removes the disproportionate share. It
phases out that payment to hospitals so that they can afford to treat
indigent patients who cannot afford health care. I think that's a very
significant piece of this bill--of this law--that was not discussed nor
how it will impact and how it will hurt hospitals.
I think, beyond that, we need to talk about seniors and the choices
that this health care bill takes away from seniors--again, that wasn't
discussed--which are the Medicare Advantage programs and all of the
disadvantages that this bill will cause to seniors. We need to keep our
health care system intact so those who need the system, such as the
seniors, have access to good health care and so their coverage is not
hurt. This bill does hurt the senior coverage.

Mr. GINGREY of Georgia. Mr. Speaker, the gentlewoman is absolutely
right.
As I pointed out in that $500 billion-plus cut-out of the Medicare
program to help pay for this new entitlement of the Patient Protection
and Affordable Care Act, $120 billion of the $500 billion-plus was
taken from the Medicare Advantage program. The Medicare Advantage
program enrolls about 20 to 25 percent of our Medicare beneficiaries.
Why so many?
We are talking about, maybe, 11 million or 12 million who sign up and
decide that, rather than the traditional fee-for-service and just pick
a doctor out of the Yellow Pages who accepts Medicare, it's more like a
health maintenance organization that emphasizes wellness, that
emphasizes prevention, tests that are not typically covered under
traditional fee-for-service Medicare, like colon cancer screening,
breast cancer screening, mammograms for women, especially between the
ages of 40 and 60, prostate cancer screening for men, annual physical
examinations, follow-ups from a nurse practitioner within the doctor's
office, maybe even on a monthly basis to make sure that the senior is
taking the medication that was prescribed by the primary care doctor.
All of these things are included with Medicare Advantage. That's why
it's called Medicare Advantage. It is an advantage with very little
additional cost. In fact, people who are under those programs typically
don't have to buy supplemental insurance to cover co-pays and
deductibles and hospital care after they've exhausted their benefits.
So that's why so many choose that.
Yet what we have done is we've stripped--we've gutted--that program
so badly that, of those 12 million, it's estimated 7 million of them
will lose that coverage under Medicare Advantage. They'll have to get
it under the traditional Medicare, and they'll have to pay $130 a month
extra for that supplemental whether they get it through a plan that's
endorsed by the American Association of Retired Persons or through some
health insurance company, but the average cost is going to be an
additional $130 a month for those folks.

{time} 2000

So as we talk about the cost, I do want to shift, Mr. Speaker, to the
cost

[[Page H2282]]

to employers. In this next slide, where the title says, ``ObamaCare
Hurts Workers, Increases Costs,'' the majority of employers anticipate
health care reform will increase health costs. And most say they plan
to pass the increases on to their employees--88 percent plan to do
that--or reduce health benefits and programs, 74 percent.
This idea of setting up these exchanges throughout the 50 States and
territories and that only 6 million people who have employer-provided
health insurance can keep it, they won't need to be on the exchanges,
Mr. Speaker, that is absolute poppycock. It's probably going to end up
being about 130 million people who get their health care provided today
by their employer will end up in those exchanges. And that's why I say
this cost that was estimated by the CBO of $900 billion will be in the
trillions, because when all of these people morph out of the employer-
provided health care onto these exchanges, think how many of them will
be eligible for a Federal subsidy to help them pay for that insurance.
Because the law says, the so-called ``Affordable Care Act,'' that
anybody with an income of less than 400 percent--not 100 percent, not
200 percent, not 300--400 percent of the Federal poverty level--which
is getting close to $90,000 for a family of four--I think of my four
children and their families of two and three and four, and I know what
their incomes are--the Federal Government will be subsidizing so many
people that the cost, the true cost will be astronomical, and it is
something that we cannot afford. That's why our representative from New
York and our other representative from Georgia spoke earlier about we
can't do this, we can't afford to do this. We need to repeal this law.
It is a bad law.
I've said before, Mr. Speaker, that in my humble opinion I think it's
the worst law that has ever been passed in this Congress. There have
been some folks on the other side of the aisle--well, not on the other
side of the aisle, but the more liberal media who took me to task for
saying that, but I truly believe it. I truly believe it's one of the
worst laws that was ever passed. And we have made every effort to
repeal it.
One of the first things we did in the 112th Congress was pass H.R. 2
to repeal ObamaCare. We sent it over to the Senate, and the Senate--
which is controlled by the Democratic majority and led by the Senator
from Nevada, Harry Reid--just simply, I guess, put that in file 13, and
H.R. 2 is sort of dead in the water over on the Senate side.
So what we are doing now, it is our obligation because of what the
American people have told us: Over 60 percent of them a year after
passage of the bill, despite the fact that Ms. Pelosi said, once we
pass it and you find out what's in it, you'll like it. No, they don't.
They don't like it. They don't like it one darn bit better, and they
wanted us to repeal. We made every effort at repeal.
And now we're into Plan B, Mr. Speaker. Plan B, of course, is to try
to defund especially the parts of the bill that are on automatic pilot,
that we have no control over. And when I say ``we,'' I don't mean the
new Republican majority in the House of Representatives; I mean every
Member of Congress--100 Senators, 435 Members of the House, both sides
of the aisle. For goodness sakes, we ought to have control over the
spending.
This is not a poster. I don't have a poster on this one. But
tomorrow, in the Energy and Commerce Committee, Mr. Speaker, the
committee on which I am proud to serve, along with several of our other
House GOP doctor members, we are going to have a markup on several
bills to change this automatic pilot spending under ObamaCare and put
it into the more typical discretionary spending where Members of
Congress can say, do we want to spend that money? And if we do want to
spend the money, how much do we want to spend? And that we have
oversight and we can make sure every year that we look at the program,
and if it's not working then defund it.
And these bills--and I'll just mention them real quickly--H.R. 1217,
a bill to repeal the prevention and public health fund, $17.5 billion
that the Secretary of Health and Human Services has control over, a
fund of money that she can spend in any way she wants to. You think
back to the ads that we saw with Andy Griffith as the pitchman on
television last year about the great value of this new law and how it's
going to strengthen and improve Medicare. How you do that by cutting
$500 billion out of a program is beyond me. But that money, that $17.5
billion in this prevention and public health fund, can be spent
indiscriminately by a decision made by whoever the Secretary of Health
and Human Services might be. H.R. 1216, H.R. 1215, H.R. 1214 and H.R.
1213, in the aggregate, this is over $18 billion worth of spending that
we Members of Congress have no control over. We're going to get control
over it, though, and we're going to defund anywhere we feel that it is
wasted, duplicative spending that the American people can ill afford.

I want to go ahead and point out a few other things that are on the
slides, Mr. Speaker. I mentioned, of course, the $575 billion in cuts
from the Medicare program. I mentioned the 7.4 million people who will
lose that coverage under Medicare Advantage because of that $126
billion pay-for. I didn't mention, though, on this slide the third
bullet point.
Many physicians may stop taking Medicare patients because
reimbursements will be below the cost of providing the care. Now, is
that Representative Phil Gingrey from the 11th of Georgia, is that a
statement that I've made? Well, maybe I have made it. But I'm quoting
the Actuary of Medicare, Richard Foster, who we had last week as a
witness before the Energy and Commerce Committee talking about some of
these things. This bears repeating, Mr. Speaker; ``Many physicians may
stop taking Medicare patients because reimbursements will be below the
cost of providing the care'' Richard Foster, Committee on Medicare and
Medicaid Services, Chief Actuary.
Today, doctors are reimbursed under the Medicare program by a
formula, an arcane, very difficult--you talk about calculus being
difficult; understanding the sustainable growth rate formula to
determine how doctors are reimbursed for providing their service,
whether it's their brain power or their surgical skills, is beyond
anybody's comprehension. And every year, for the last 6 or 7 years,
when you apply that formula to the next year's reimbursement level,
there is a cut from the last year's reimbursement--2 percent, 3
percent, 4 percent--to the point now, Mr. Speaker, what we have done,
of course, we here in the Congress have mitigated those cuts and said
we're not going to enact those cuts because these doctors will not be
able to provide the care, just as Mr. Foster, the Actuary, said. And if
we don't put a bandaid on these cuts and mitigate them, then the
doctors will just drop out of the program. And I don't care how much
you expand access and hand out more insurance cards, if there are no
doctors there to see you, you're not going to have care. You do not
have decent care--you don't have any care.

{time} 2010

So in this bill, in this new law, not only is that formula still
there, and the doctors are facing a 31-percent cut in their
reimbursement if we don't mitigate it once again come December 31 of
this year, not only is that on their backs, but in ObamaCare, there's
this new provision called IPAB, this new bureaucracy--Independent
Payment Advisory Board--that's going to actually cut the doctors even
more. The Actuary is right: We're not going to have doctors providing
the care.
And that's because we've taken money out of this program and put it
into an entirely new entitlement program for the most part for young
people. Some entitlement, when you force them to buy health insurance
in many instances when they don't need it and they don't want it.
Mr. Speaker, I see we've been joined by the cochairman, along with
myself, the cochairman of the House GOP Doctors Caucus, my classmate
from the 108th Congress, the Member from Pennsylvania, my friend and
colleague, Dr. Tim Murphy.
I yield to the gentleman from Pennsylvania.
Mr. MURPHY of Pennsylvania. I thank you for yielding, Dr. Gingrey.
You know, all of us in the Doctors Caucus are people who have treated
patients, and we know full well the value of quality health care. We
also know what happens when bureaucracy gets

[[Page H2283]]

between the patient and the doctor, and you find yourself spending as
much time worried about paperwork and forms and what the government is
going to do than sometimes your dealing with your patient. That's not
good health care. And that certainly isn't good health care reform.
All of us who are health care professionals know that the treatment
should not be more harmful than the illness itself. And what happens
with the health care bill that was passed, when you look at some of the
parts of this and realize what it does to the patient, to taxes, to
employers, to hospitals, to community health centers, to the cost of
drugs, you have to conclude that we did not fix the problem; we
financed the problem and it is growing and growing. And that's not the
right direction.
Let me give you a couple of examples.
This bill, this act, actually creates about 1,900-plus new duties and
responsibilities for the Secretary of Health. It has a hundred or more
boards, panels, and commissions of people that we don't yet know who
they are to write regulations that we don't yet know what they are.
We also know that despite the words about the goal, the actual means
to get there and what happens isn't what is purported to be doing.
Let's look at, for example, we keep hearing about 35 million
Americans will be covered. And yet, we also hear from various
consulting firms that it won't be 9 million Americans that will lose
their health insurance, it may be tens of millions of people who will
lose their private insurance. So covering 35 million but perhaps the
same or double that losing their insurance doesn't get us to where we
need to be.
We also heard that health care costs were going to go down. I had
someone from HHS from Philadelphia come to my office and they told me
with a smile that wasn't it great that health care costs were only
going up 2 or 3 percent. I asked this person if they bothered to talk
to some of the employers in the State of Pennsylvania, because a lot of
them told me their health care costs are going up 20 and 30 and 40
percent. I asked if they'd talked to some of the families whose
children were covered on plans before that exclusively cover children
to find out that those plans were not going to cover children any more
because of the way the government decided to design those.
Our goal should be to treat. Our goal should be to help. Our goal
should not be to stop at just rhetoric and say, ``We have good
intentions, and therefore we have good outcomes.'' But good intentions
don't make good outcomes.
Where we could be spending money is on some real reforms. One of the
issues that we've been united on has been to help community health
centers. One community health center in Pittsburgh that I visited with,
the Squirrel Hill Health Center, treats about 700,000 individuals
through more than 2.3 million visits annually. These community health
centers in Pennsylvania, there are 45 in 67 counties--60 percent urban
and 40 percent rural. Their patient base is 68 percent Medicaid,
uninsured, and 93 percent of patients of incomes at or below the 200
percent of the Federal poverty level.
What is interesting is how much lower in costs those clinics
throughout Pennsylvania, quite frankly throughout the Nation, could
provide high-quality health care.
But what we've created is a couple of burdens. I found it interesting
as part of the health care bill that one of the things we passed was an
amendment that Congressman Gene Green, a Democrat from Texas, and I had
authored to allow doctors to volunteer at community health centers. If
Dr. Gingrey wanted to go to a community health center and volunteer,
and if I wanted to and any of the other ones, we couldn't do it. And
the reason being that those community health centers say, ``We can't
afford to have you volunteer.'' Because in order to volunteer, they'd
have to pay the medical malpractice costs instead of having them in the
Federal Torts Claims Act--employees of those clinics can do that--and
that adds to their costs. In the meantime, those clinics are short 10,
15, 20 percent of what they need in providers.
They are a tried and true method of bringing people together, people
from a wide range of disciplines: OBGYNs, family practitioners,
dentists, podiatrists, social workers, psychologists, to work. That's
one of the many things we could be doing. But along those lines, there
are a great many things that we can be doing.
Mr. GINGREY of Georgia. I want to thank you, Dr. Murphy, and I
appreciate you coming.
Mr. Speaker, I thank you for the time. I know our time is up.

I just refer to our last poster in conclusion: Repeal and Replace
ObamaCare.

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