[Congressional Record Volume 158, Number 111 (Tuesday, July 24, 2012)]
[House]
[Pages H5188-H5194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     AMERICAN JOBS AND HEALTH CARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 5, 2011, the gentleman from California (Mr. Garamendi) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. GARAMENDI. Mr. Speaker, thank you for the privilege. And thank 
you, to my colleagues in the Republican Doctors Caucus, for a most 
interesting but factually incorrect 45 minutes of debate here.
  We really were going to spend this evening talking about jobs and 
about the American Jobs Act and one of the great ``woulda, coulda, 
shoulda's'' of our time. But we're going to hold that for just a few 
moments, though, because there are a few things that really need to be 
discussed from the last half-hour.
  First of all, most of the discussion was about Medicaid. That's a 
national program in which the Federal Government pays about 50 
percent--it varies State to State, but roughly 50 percent of the cost 
of providing medical services to the poor, women, and children in the 
States.
  Now the debate was most interesting in that the argument was that 
there would be a lack of access and simultaneously an argument that 
there were no cost controls. Yet if you were listening to our esteemed 
colleagues, you would have heard them say, The doctors are not paid 
enough.
  I think if they're not paid enough, and the doctors want to get paid 
more in order to provide services, then the costs are going to go up. 
So the cost control argument here doesn't make a whole lot of sense. If 
you want to keep the costs down, you need to improve the effectiveness 
and efficiency of the system.
  Certainly certain services within the Medicaid and Medi-Cal, as we 
call it in California, are not paid sufficiently. Some other services 
are paid more than enough. So you need to balance that up over time. 
And all of these programs are run by the States. It's really the State 
that decides what the reimbursement rate is going to be. The Federal 
Government then matches the State's contribution.
  So the argument really didn't make a whole lot of sense. And even 
more so, in the Ryan Republican budget, which has passed this House 
twice now, there is a significant reduction in the educational services 
for doctors so that the money that we, all Americans, spend to educate 
doctors--particularly in that part of the program, both the basic 
education and then in the residency programs--the Ryan Republican 
budget significantly reduces the amount of money available for 
residency programs for family care practices, for the very basic 
programs that we all want to access.

                              {time}  2000

  For family care, for basic care, that money is reduced. You go, wait 
a minute, that doesn't make any sense. If you are down here on the 
floor arguing that there is an insufficient number of doctors and they 
are not paid enough, then don't argue at the same time that it is too 
expensive and there are not enough cost controls; and please don't 
argue that there are not enough doctors because, in fact, the 
Affordable Care Act expanded the number of residencies for very basic 
care, for the family practice programs. I'm not quite sure I understand 
what they are arguing.
  In addition to that, access across this Nation for millions and 
millions of people is provided in clinics. These are the

[[Page H5189]]

community clinics that a large population attend for their basic 
services, and most of those are the Medi-Cal or Medicaid population and 
the very poor that are not yet enrolled in what will be the expanded 
ObamaCares--the ObamaCares program.
  So what do the Republicans offer us?
  The Ryan Republican budget would cut by more than a third the support 
for the clinics, closing thousands of clinics across the Nation and in 
my State where people get access. So please do not come down here on 
the floor and argue for an hour or half an hour that access is being 
delayed when on the one hand you are cutting the money for access. 
That's what the Ryan Republican budget does. It cuts the money for 
access by reducing the residencies and reducing access to clinics by 
cutting by more than a third the money that is there to build up the 
clinics, the community clinics where people get care.
  I'm going to take a deep breath here because I don't want to get 
wound up too tight about this issue, and I want to ask my colleague 
from New York, Mr. Paul Tonko, to talk about the Medicare aspects of 
this.
  Mr. TONKO. Absolutely. We didn't hear too much about what would be 
lost in their cuts or repeal of the Affordable Care Act. Representative 
Garamendi, you are absolutely right, there is much that has been gained 
by the American population, health consumers across this Nation, with 
the efforts of the Affordable Care Act, to close the doughnut hole, to 
make prescription drugs more affordable for our pharmaceutical 
consumers out there, for seniors who require this medication, their 
prescription drugs to stay well or to stay alive. Far too many were 
balancing their household budget by reducing their intake of 
prescriptions advised by their medical community. That is immoral. It's 
unnecessary and has been addressed by the Affordable Care Act. So 5.3 
million seniors today are drawing $3.7 billion in benefits. That is 
something that could be taken away if the Republican majority in the 
House of Representatives had its way.
  Now, this is a wellness aspect. This is part of a formula that allows 
people to be cured, to be healed, to be allowed to live with a quality 
of life that then addresses their very needs. And so I think it's 
necessary to point out what would be taken away from the benefits 
already offered, and there are more to come. But as we know, they're 
staged. They are rolled into the operations of reform over the next 
several years. But suffice it to say, the screenings, the annual 
checkup, flu shots that are made available without cost, no copayment, 
no coinsurance, no deductible is required here. These are huge benefits 
to every age demographic that are offered through the Affordable Care 
Act.
  And so we heard about adding to the cost curve of health care. We 
have heard about repealing the Affordable Care Act. We have heard about 
taking away the benefits that have just recently arrived at the door 
steps of health consumers across this great Nation. And why would you 
want to play politics with the very fabric of quality of life of the 
people that we represent collectively by undoing progress? This is a 
recurring theme. They want to undo Social Security that has a 76-year-
old history. They want to voucher out Medicare that came to us in the 
mid-1960s that addressed the economic stability, the predictability of 
senior households and the quality of life in those households. Why 
would you want to take that progress away?
  It is heart wrenching to listen to some of this insensitive, callous 
dialogue on the House floor that really renders the public that we are 
here to serve without benefits that have just recently arrived through 
the success of the Affordable Care Act.
  Representative Garamendi, it is something that I think needs to be 
echoed out there from this House floor and shared with the constituents 
of this great Nation in a way that allows them to better understand 
what is part and parcel of the Affordable Care Act, a monumental piece 
of success. Is it perfect? No. We aimed for perfection, we struck with 
progress. But there is many, many a benefit that is part of the 
Affordable Care Act, and we are witnessing an all-out attempt by the 
Republican majority to turn that success into failure.
  Mr. GARAMENDI. Let me pick up on that, Mr. Tonko. You are quite 
correct, it is not just an attempt. There have been 33 votes on this 
floor by the Republican majority to either terminate completely or to 
eviscerate in part the Affordable Health Care Act. Now, what would be 
eviscerated?
  First of all, the Ryan Republican budget would terminate Medicare as 
we know it and give to every American who is not yet 55 years of age a 
coupon that basically says this coupon is worth 70 percent of the cost 
of insurance. Go get your insurance when you become 65 from a private 
insurance company. No longer would Medicare be available to all of 
those people who will eventually be 65. And for those people who are 55 
to 65, it makes it impossible for Medicare to go forward on a financial 
basis because it takes away the younger people.
  I heard something on the floor which I just said--wait a minute--some 
statistic that was tossed out here just a few moments ago that more 
people die on Medicare than die on regular insurance. Yes, Medicare is 
for the elderly. Medicare is for the elderly. Yes, they do get medical 
care but eventually they get old; and I will, too, be on Medicare, and 
I will die on Medicare. And I am so grateful to have Medicare available 
to me when I become 65 because I know that I have a solid insurance 
program. I know that I'll be covered, and I know that my younger 
brother and sister will be covered when they become 65. They will have 
quality care. And guess what, they will die on Medicare. Yup, that 
happens. You're on Medicare for the rest of your life. It may be for a 
year. It may be for 30 years. But for whatever, you've got a guaranteed 
benefit that is available to you.
  And what do you lose if the Ryan Republican budget and the effort to 
repeal Medicare is lost? Well, let's see. Nearly 13 million Americans 
will benefit from $1.1 billion in rebates from their private insurance 
companies that are presently overcharging them. Hmm. And 86 million 
Americans, including 54 million Americans on private policies and 32 
million Americans that are on Medicare, will lose their free preventive 
services.
  Now, you want to reduce the cost of health care, then you've got to 
make sure that people stay healthy as long as possible. And how do you 
do that? Blood pressure. You want to deal with blood pressure, okay, it 
is very cheap, if you get your medicine. But you have to find out about 
it, so you need that free checkup. Diabetes, stroke, all of those 
things can be delayed and often prevented if you know it's coming. So 
what are we talking, 32 million seniors will no longer have a free 
checkup, preventive services.
  In August, just a week from now, women will begin receiving free 
coverage for comprehensive women's preventive services--pap smears, 
breast cancer checkups. You want to repeal that? That's what the 
Republicans have voted 33 times to do--repeal the free checkups for 
women in America.
  105 million Americans will have a lifetime limit once again. Today, 
they do not have a limit.

                              {time}  2010

  So if you're 30 years old, you have a private insurance policy and 
you get cancer, you'll hit that lifetime limit immediately. Not under 
the ObamaCares program. In that program, there are no lifetime limits, 
and you will continue to receive the medical benefits.
  Mr. TONKO. Thank you, Representative Garamendi.
  One of the things you talked about with the influence or the focus on 
women's health care reminds me of the preexisting conditions that are 
precluded now as a rationale for denying insurance. And ``preexisting'' 
might mean, in youth, asthma; in our senior population, emphysema or 
cancer recovery or cancer struggle.
  But it can also mean in a gender-related bias--being a woman. That is 
used as a preexisting condition. Being a woman is a preexisting 
condition. So the benefits to women, as you outlined in the direct 
services, the screenings, the mammograms and the like, are a portion. 
The other portion is just being born a woman can deny you insurance.
  So, when you talk about the 30 cents on the dollar that the voucher 
would carry for the Medicare recipient, and

[[Page H5190]]

they're asked to go shop, this is saying that compared to today's 
standards, it's the senior digging much deeper into her pocket. It's 
the senior digging into another pocket to be able to afford his 
Medicare voucher portion. And that's unacceptable. That is playing to a 
special interest.
  That's what I believe the espoused virtue of this deny, this repeal, 
is about. It's about playing to special interests that don't want to be 
told that there's a transition here, that there's a new day in America 
for health care consumers, and that the heart has been poured into this 
to be more sensitive, to address a moral compass that this Nation has 
always uniquely embraced, that we are a compassionate society, that we 
are going to make a difference out there, and that we are solutions 
bound.
  That's what the Affordable Care Act was about: presenting a new 
approach to health care, providing more freedom and opportunity to our 
seniors and to our children.
  If you're 26 and under, you can stay on your parents' policy. These 
are the formulae for success that allow us to go forward with much more 
dignity, much more success, cost containment, affordability, and 
accessibility. These are the dynamics of reform.
  Why would you repeal something here other than to respond to special 
interests?
  Mr. GARAMENDI. Well, exactly so. For 8 years in the early nineties 
and then in 2000, I was the insurance commissioner in California. I 
wish I had this law because I could have held the insurance companies 
responsible.
  Now, my attitude about them is they always put profit before people. 
However, the Affordable Care Act has what we call the Patient's Bill of 
Rights, and this is the insurance discrimination that is eliminated by 
this law. And you spoke of a couple of these issues.
  Discrimination against a woman simply because they're a woman. They 
have an existing condition. They're a woman. They could get pregnant. 
So the insurance companies would not cover or they would charge more. 
Those days are over.
  Also, a young child, there are about 17 million children in America 
with preexisting conditions that can no longer be discriminated against 
by the insurance company. They have to be able to get insurance from an 
insurance company, 17 million children, one of whom is the son of my 
chief of staff, born with kidney failure. He had insurance the day he 
was born. He immediately lost insurance because he had kidney failure, 
and today, as soon as he leaves his parents' policy, which he's able to 
get now under the law because they cannot discriminate against 
children, he will be able to continue to get insurance. Under the old 
law, repeal the ObamaCares law and he will be denied insurance because 
there is an end to the Patient's Bill of Rights.
  The Patient's Bill of Rights guarantees that insurance discrimination 
is over.
  So what do they want here? What do the Republicans want from 
Americans? A big question.
  Apparently, they want more money for the doctors, and that's 
certainly necessary in some cases.
  Apparently, they say they want government out of health care. Does 
that mean end Medicare? Apparently, yes, because the Republicans have 
voted twice on this floor to end Medicare as we know it. You'll get a 
voucher. You will not have guaranteed coverage, and you will have to go 
out and shop for it yourself.
  Apparently, they don't want community clinics because they've already 
voted on this floor to cut about one-third of the community clinics in 
this Nation.
  Apparently, they talk about access, but at the same time they refuse 
to fund the residencies for family care, for the basic health care 
providers that we need in our hospitals and in our communities.
  And apparently, they want to eliminate the Patient's Bill of Rights.
  This is not a formula for America's health care.
  Now, we also heard on this floor a few minutes ago, a half hour, 45 
minutes ago, that the nonpartisan Congressional Budget Office said that 
because the Supreme Court eliminated the mandate that States have to 
provide more Medicaid coverage there would be fewer insured. True. 
That's true. Texas has refused to increase its Medicaid program. Well, 
that is Texas' decision, and I'm sure the Governor and legislature will 
have to address that.
  But the fact here is that the Medicaid coverage actually provides the 
opportunity for some 17 million Americans to get insurance that do not 
now have insurance. If we provide the clinics, if we provide the 
residencies for the doctors who would be able to care for them, they 
will have access.
  I can assure you that if we also do the preventative services, we 
will see a decline in the number of severe cases. People will not get 
so sick that they have to go to the emergency room. They'll get care 
early. And with the drugs that are necessary, they'll be able to avoid 
the very expensive illnesses. That's to all of our benefit. You 
mentioned vaccinations. These are all ways of reducing costs.
  So here we are, once again, debating something that is now the law, 
that is proven, proven to provide services to Americans, whether they 
are seniors or whether they are young, whether they are children. It 
works, and it's working for America today.
  Mr. TONKO. Well, if I might ask the gentleman from California if he 
would yield.
  I believe there's a whole lot of political posturing going on with 
the Medicaid decision by States. We are hearing a lot of talk about, 
well, we are not going to pay for that portion because, while it may be 
100 percent in the near future, it may go to 90 percent into the long-
distance future, and they don't want to pay anything for the new 
installments of the Medicaid plan.
  Well, today we are paying. It's not like it's against an absolute 
that costs nothing. If you have the poor uninsured, underinsured in any 
given State, there's indigent care. There is bad debt and charity that 
is addressed in ratepayer dollars for insurance coverage's sake because 
that is going to be incorporated into the overall actuarial plan, or 
you're paying it through taxpayer dollars and for a much more 
inefficient system.
  To have the poor, uninsured, and underinsured go to emergency rooms 
visiting a different doctor team every time they visit that emergency 
room, or perhaps a different emergency room, to not provide the stable, 
standardized care, acceptable notions of how to provide a predictable 
outcome, you're going to pay needlessly and wastefully. This is about 
networking people to a system that provides a stability, a standard 
that will enable them to have a clinic, have a contract that will cover 
them and make certain that all of us are strengthened by it.
  And guess what. The business community, we talk about 
competitiveness. We talk about a sharp competitive edge for America's 
business communities as they enter into the international sweepstakes 
on winning contracts. That translates into providing jobs and 
profitability for our business community. Well, part of their cost of 
doing business is to have health care for their workers. Many want the 
health care coverage for their workers but simply cannot afford it.
  So the exchange opportunities that are part of the package of the 
Affordable Care Act enables them to cut their cost. It's taking their 
experience, their actuarial experience of 10, 15, 20 workers in that 
small business and putting them in a pool of millions of workers.

                              {time}  2020

  That enables them to shave the peaks and enables them to take those 
catastrophic situations. One person in their plan of 10 impacted by 
catastrophic situations can cause their premiums as a company and the 
copayments of their workers to skyrocket. But if they're enabled to 
join this pooled effort, it provides for a better outcome for 
everybody.
  So there is wisdom and thoughtfulness poured into the reform elements 
of the Affordable Care Act. And it's done again with that American 
heart, that spirit, that sense of compassion for the worker, the 
sensitivity toward the employer, and putting together a package that 
has everyone responded to in a way that speaks to a long-overdue bit of 
success. The last industrialized nation, Representative Garamendi, to 
go toward a guaranteed health plan.

[[Page H5191]]

  So, long overdue. And now to taste success and have it pulled away 
from the American health care consumers of this great Nation is a very 
troubling notion.
  Mr. GARAMENDI. Well, Mr. Tonko, thank you very much.
  Next Monday, did you know, next Monday is the annual birthday of 
Medicare? Next Monday. It went into effect in 1965, and ever since, as 
you said earlier, Republicans have been trying to terminate it. They 
tried again this year, but the American public knows better. They know 
that they want to live long enough to get to Medicare because in 
Medicare they have a guaranteed benefit. They know that wherever you 
are in the United States, whether you are in Vermont or in California, 
you have the same quality policy that will cover most of what you need. 
If you want more, you can go out and buy that, that's called the 
Advantage program. And you get to choose your program.
  It's not a government takeover at all. In fact, it is a financing 
mechanism so that every senior in America can choose their own 
provider. They get to choose their provider. They can go wherever they 
want to go to get their medical services. And if they don't like their 
doctor, they can change.
  So the government is not saying where you can go. In fact, the 
government is financing the system so you can choose whatever provider 
you want to choose. It is a common policy across the Nation. It is 
efficient and it is effective, and the Republicans are trying to 
destroy it. We won't let that happen. Bottom line, we will not let that 
happen. And there are serious cost containments in the current Medicare 
program and in the Affordable Care Act.
  I'm just going to end with this, and then we really need to get to 
what we wanted to talk about, which were the job programs.
  The Congressional Budget Office today estimated that the Affordable 
Care Act, over the next 10 years, will reduce the deficit by $109 
billion. In the 20 years going out, because of the cost containment in 
this system, the Affordable Care Act will reduce the deficit by over $1 
trillion. Now, that's worth engaging. That's worth us doing. And 
simultaneously provide far better health care to Americans and far 
better access to health care wherever they may need it across this 
Nation. It's a good thing.
  When they want to stand up here and say ObamaCare, I'm going, you're 
right, Obama cares--cares deeply about the very health of every single 
American. That's why the Affordable Care Act is in place today, was 
found to be constitutional, does reduce the deficit, and does provide 
quality health care and choice of where you want to get your medical 
care.
  Mr. TONKO. My colleague from California just indicated that there 
would be a favorable deficit outcome because of the Affordable Care 
Act.
  Mr. GARAMENDI. Exactly.
  Mr. TONKO. Well, what else reduces the deficit? Putting people to 
work. Putting people to work, the American Jobs Act. Plain and simple: 
It's about addressing the deficit and providing for the dignity of work 
and the enhancement of services that strengthens the fabric of our 
communities, our States, our Nation. So, the American Jobs Act, 
according to experts, is a phenomenal plan.
  We've heard the Republicans say we have some 30 bills that are about 
growing the economy and producing jobs when, in fact, when put under 
the test, when reviewed by some very sound organizations out there and 
professional economists and analysts, they said it would do precious 
nothing. That it was not the formula. It's not what the doctor called 
for, if we can stay on that health-care related theme. But the American 
Jobs Act, well, listen to some of the experts.
  The chief economist at Moody's Analytics--who, by the way, Mark 
Zandi, was the former economic advisor for Senator John McCain--what 
does he theorize? That anywhere from 1.9 million to 2 million jobs 
would be the outcome of the American Jobs Act, something that not only 
produces the jobs, but would reduce the unemployment rate by at least 1 
percentage point. That's a major significant factor.
  What also happens is that, when you produce those 2 million jobs, 
you're addressing the GDP by at least 2 percentage points. Growth in 
the GDP, reduction in the unemployment, reducing the deficit, putting 
people to work, strengthening the economy, providing purchasing power 
at a time when businesses are saying the best thing you can do: Get us 
customers. A healthy economy, putting people into the work mode creates 
customers. It creates purchasing power. It creates a strength in the 
economy. Two million jobs.
  How can we walk away from a proposal? Oh, I know why: Because there 
were those who spoke before cameras reaching all of America saying 
anything this President offers, we won't do; our goal is to make him a 
one-term President. My friends, that is putting partisan politics--
petty, partisan politics ahead of the interests, the better interests 
of the American public.
  Where is that American spirit? Where is that sense of patriotism? 
Where is that sense of responsibility, of leadership in this House and 
in the U.S. Senate that needs to go forward with the American Jobs Act?
  Representative Garamendi, I know we've been joined by another 
colleague. It is just great to share this hour with you to talk about 
the progress we can taste that would lift every community in this great 
Nation.
  Mr. GARAMENDI. I was reading one of the Hill magazines--often called 
the Hill rags--and they said that the Speaker of this House starts off 
his weekly press conference by asking: Where are the jobs? Well, the 
jobs, Mr. Speaker, were proposed last September by President Obama--the 
American Jobs Act. Two million jobs minimum could have been created. 
This is one of the great woulda, coulda, shoulda's of our time. We 
could have had people back to work today, and in doing so reducing the 
deficit.
  There are so many different pieces of this. Mr. Speaker, the American 
Jobs Act are where the jobs are. You talked about a piece of it. I'm 
going to just pick up one more. This is one that speaks to the American 
homes, what's going on in the house where we live. Many of those homes 
are run down, they have problems with insulation, or they don't have 
any insulation at all. They leak energy. Well, the President proposed, 
as a piece of the American Jobs Act, that we could provide construction 
jobs, really, low-skilled construction jobs, in rehabilitating the 
American homes. This is not a new concept. This has been going on for 
some time. It's been used repeatedly to upgrade homes in the United 
States and simultaneously save energy and save dollars for the American 
public. One piece of it, construction jobs, could have been put in 
place.
  I'm going to pick up another one, and then I'm going to turn it back 
to you, Mr. Tonko. My daughter is a teacher, my son-in-law is a 
teacher. They've seen their class size just grow from 20, 22 to some 32 
people in the class. Now, this is a serious problem for the teacher, 
making it more difficult to provide the quality teaching that's 
necessary. My daughter is a great teacher, my son-in-law is too, but 
it's much more difficult. The class size has increased by a third.
  The American Jobs Act would have put 280,000 teachers back into the 
classroom. Now, if you happen to be a second-grader and you're not 
getting what you need to learn, then that's going to carry on through 
the remaining years of your schooling. And so 280,000 teachers could 
have been brought back into the classroom had the American Jobs Act 
passed.

                              {time}  2030

  Mr. Tonko.
  Mr. TONKO. Yes, they are both significant bits of legislation, so 
it's good to interlace the American Jobs Act and the Affordable Care 
Act.
  To the 280,000 teachers, I think it's very easy to state that the 
human infrastructure in our school systems across this Nation are a 
critical component to quality education, that personal relationship of 
students to teacher, the exercise of self-discovery--who am I, what are 
my gifts, what are my talents, what are my passions. That is exercised 
in the classroom. That is a spirit that prevails. It's a magic that 
happens in the classroom and that sense of self-discovery.
  Part of our goal here is not only to enable these students to 
understand who they are, to draw forth the soul of the individual; it's 
to provide the opportunity for our workforce of the future.

[[Page H5192]]

  That fourth-grader, hypothetically, that was impacted by class size 
or the lack of a teacher for certain subject areas, that's something 
that child will never gain again. What you lose in that given year is 
lost throughout the development. And it is important for us to make 
certain that every bit of opportunity, every bit of learning experience 
is granted our children so that they understand where they can best 
contribute to society, where their gifts can be utilized.
  And it's part of that development of the workforce of the future, the 
workforce of the present, training, retraining dollars, that are part 
of the American Jobs Act, absolutely a critical piece of the 
infrastructure.
  And the tens of thousands--this chart will say retain thousands of 
police officers and firefighters. We know it's tens of thousands across 
this Nation. An element of public safety, a quality-of-life component, 
making certain that our core communities have the given workforce of 
firefighters, of police officers that will enable us to respond to 
public safety measures.
  These are a core bit of principle, along with veterans that would be 
hired with benefits that are significant. That element was done under 
pressure, under scrutiny, under growing public sentiment. But think of 
what could happen if we did all of these and did even additional 
services with our veterans who are returning home and are in need of 
employment.
  These are the factors, these are the dynamics that are introduced 
through AJA, the American Jobs Act, that would allow for the deficit to 
be addressed and at the same time to have services responded to, 
essential services.
  We've talked about the belt-tightening, addressing waste and 
inefficiency and outmoded programs and fraud. And after we capture 
those savings from that exercise, it's important, I believe, to slide 
that into an investment zone so that the result is cut where you can, 
so as to invest where we must.
  The investment, absolutely critical. The investment in jobs, the 
investment in teachers, firefighters, public safety elements, our 
police officers, our veterans community, and items like an 
infrastructure bank bill, an infrastructure that we'll talk about in 
the remaining minutes of this Special Order.
  Mr. GARAMENDI. Well, let me just pick up a little more on the 
education. The most important investment any society will ever make is 
the education of their children and the re-education of their 
workforce.
  In the American Jobs Act there are the 280,000 teachers that would 
have been in the classroom this entire year. They're not there today 
because there's been no movement on this floor to even debate in 
committee, let alone take up a vote on this floor, the American Jobs 
Act.
  Also, many of the schools across America are run down. Their 
laboratories, their classrooms are antiquated. They don't have air 
conditioning, many, many other problems. The American Jobs Act provided 
money for 35,000 schools across the United States to be upgraded, to be 
rehabilitated so that 250,000 jobs would have been created right there.
  Before we go any further, I know you're all worried, oh, it's going 
to increase the deficit. The American Jobs Act would increase the 
deficit. No, it would not.
  Mr. Tonko, you spoke earlier about when people go to work, the 
economy gets going, money is circulated, taxes are paid.
  The other part of it is, the American Jobs Act was fully paid for by 
ending unnecessary tax subsidies to companies that don't need it, 
specifically the oil industry. The wealthiest industry in the world 
would lose its tax breaks that amount to over $16 billion, and that 
money would come back to pay for Americans going back to work.
  There are other things. The top end tax, at the very top end, the 
wealthiest 2 percent would see their taxes go back to where they were 
during the Clinton period. This is how the American Jobs Act was going 
to be paid for.
  Mr. Tonko.
  Mr. TONKO. I think it's interesting too because we're talking about 
the jobs created that impact the unemployment rate, that impact the 
reduction of the deficit.
  In contrast, the Ryan budget, which we've talked about many times, 
the Republican plan for this House, that's been adopted by Republicans 
that are in leadership and running for President, would, in contrast, 
according to the Economic Policy Institute, the cuts in services would 
result in a reduction of 1.3 million jobs in the first year and 2.8 
million jobs in the second year.
  Mr. GARAMENDI. Excuse me, 4.1 million jobs total.
  Mr. TONKO. So when you contrast that, that cut in jobs, the cuts that 
would be part of the Republican budget plan, adopted by this House, 
would grow the deficit because if we're arguing that employment reduces 
the deficit, unemployment, in contrast to the American Jobs Act, would 
drive up the deficit. It's going back to the failed policies of the 
past.
  We've fought two wars that were never put on budget. We offered 
trillions in tax cuts that we couldn't afford, and we avoided talking 
about paying for the war. Did we think there wasn't going to be a 
crash?
  Did we think that that behavior wouldn't come with a price?
  Of course it had to extract a price from the American society, and it 
was the loss of 8.2 million jobs; it was the loss of as many as 800,000 
jobs a month. It was about bringing America's economy to its knees and 
draining trillions of dollars from households that trusted that their 
investment with the private sector, with the financial industry was 
going to return them lucrative dividends.
  We saw the failure of those policies. Why would we go back down that 
road, which seems to be what the Republican plan, the Republican 
budget, is all about?
  Mr. GARAMENDI. Excuse me for interrupting, but if you look at the 
Ryan Republican budget, it would cut education and other services by 33 
percent. So instead of investing in our children, investing in re-
educating and helping our workforce learn new skills, they would cut it 
by 33 percent.
  In transportation, the Ryan Republican budget would cut 
transportation funding by 25 percent, even when we know that our 
infrastructure gets a D because of potholes, because the bridges are 
failing. So why would you cut the transportation budget by 25 percent?
  If you want to put Americans back to work, you don't do it that way.
  And you did talk about Moody Analytics already. It doesn't work.
  Now, I'm going to just pick up one more thing. I'm on the House Armed 
Services Committee, and we heard testimony last week from the CEO of 
Lockheed Martin, and the CEO of EADS, and also from two other 
witnesses. And they said this: you cut the budget for defense, and 
you're going to lay off 2 million people. That's part of the 
sequestration.
  So here you have the top CEOs of America's big huge companies saying 
don't cut the budget because you are going to lay Americans off. You're 
going to lose up to 2 million jobs.
  And yet for the last 2 years, our Republican friends have been trying 
to cut the budget. Not in defense, but in everything else, arguing that 
that will somehow create jobs.

                              {time}  2040

  However, testimony received last week from the CEOs of three large 
American corporations and one smaller corporation said categorically, 
If you cut the budget, we'll lay people off--creating unemployment.
  The American Jobs Act puts people back to work, and it is fully paid 
for.
  Mr. TONKO. Earlier, I think you had made mention of modernizing our 
schools and that part of the American Jobs Act includes the investment 
in the revitalizing of our schools, some 35,000 schools across this 
Nation. The statistics are there. People document, historically, what 
investments in refurbishing our schools have meant. For every $1 
billion of investment, we can grow some 9,000 to 10,000 jobs. That's 
the start of the story. So what we have here, the modernization of 
schools, would create some 250,000 jobs. As I said, that's just the 
start of the story.
  What happens after that?
  Maintenance costs and operating costs are reduced because you might 
have energy efficiency embraced in that restructuring. You'll have 
better, more efficient weather-type situations,

[[Page H5193]]

more comfortable situations for students in which to learn, which is 
important.
  Mr. GARAMENDI. Mr. Tonko, you might actually have bathrooms that 
work. You might actually have a place where kids would want to be. 
You'll have a school that has a decent paint job, air conditioning. 
Kids would want to be in that school. Yet we have schools across this 
Nation where you wouldn't want to be and I wouldn't want to be, and I 
certainly wouldn't want my kids in that classroom.
  Mr. TONKO. They're typical danger zones with ceilings falling and 
poorly upheld infrastructure.
  The jobs--the absolute jobs of a 250,000 count--would benefit, again, 
the economy. These operating costs are reduced, and they theorize that 
it could be in the neighborhood of $100,000 a year. Now, think of what 
you can do locally with that. That might mean two teachers, or it might 
mean 200 more computers, or it might mean 5,000 textbooks. It's a way 
to invest by balancing those savings with the investment in children--
in our future and our present--because our children represent our 
future and our present. It is a respect toward our children.
  These are, I think, in keeping with the old American spirit--the 
pioneer spirit--to enable us to dream bold dreams and to encourage our 
youngsters to pursue these career paths and to develop, again, the 
workforce of the new millennium, in which we are going to be asked to 
compete in a global marketplace where there are investments going on 
around the world. Now is not the time to cut our commitment to our 
children and to our society and our competitiveness as a business 
community. So it all comes together in a very structured sense, in a 
very comprehensive plan.
  Mr. GARAMENDI. Mr. Tonko, there is one additional piece to this 
puzzle, and that is that the Democrats have been putting forth for the 
last 2 years a project which we call Make It in America. This is the 
rebuilding of the American manufacturing sector. Twenty-five years ago, 
there were just under 20 million Americans employed in manufacturing. 
These were the middle class jobs. Now there are just over 11 million. 
We've seen the hollowing out--we've seen the outsourcing--of American 
manufacturing jobs.
  There were actually policies in place before the Democrats in 2010 
took control of this and ended tax breaks for American corporations 
that outsourced jobs. They actually were able to reduce their taxes by 
sending jobs overseas. We ended about $12 billion of those crazy, 
unnecessary, destructive tax breaks. Now the President has suggested 
that we put in place the remaining $4 billion. End those tax breaks, 
which is ending the rewarding of companies for outsourcing jobs. Turn 
it around and reward companies for in-sourcing, for bringing those jobs 
back home.
  I have a piece of legislation that we've been working on, and it's 
actually getting some legs and moving along. It's part of Make It in 
America. Our tax dollars have been used in the past to buy foreign-made 
solar systems, wind turbines, trains, buses, light rail vehicles. My 
legislation says, if it's our tax money, then, by golly, it's going to 
be spent on American-made equipment, bringing our tax dollars home so 
that we buy American, so that we Make It in America once again. When we 
Make It in America, America will make it.
  Mr. Tonko, I know that you are also into this with some pieces of 
legislation that you have, and maybe you'll want to talk about those. 
We can rebuild the American middle class by rebuilding America's 
manufacturing base. That's where you create wealth. Maybe it's in the 
food services. Maybe it's in the manufacturing of wine or in the 
manufacturing of food or automobiles or light rails or solar systems. 
We can do it, but we need to have in place smart government policies.
  I beg my Republican colleagues to take a look at this. Don't just 
assume it's a Democratic idea. Make this an American idea, a Democrat 
and Republican idea, to change our policies so that we can rebuild the 
American middle class by making things in America once again.
  Mr. TONKO. A couple of things come to mind legislatively.
  What about investing, as the AJA does, in community colleges--the 
campus of choice across this Nation? The associate degree is a very 
important, valuable bit of material to have in one's hand. We are going 
to rely heavily on those associate degrees, and community colleges need 
our assistance. They are also there as the operational center of 
training and retraining programs.
  What about investments in technology? investments in research? 
investments in alternative energy supplies that give us an opportunity 
to grow independent?
  Mr. GARAMENDI. Excuse me for interrupting.
  Before you came to the House of Representatives, that was your work 
in New York, wasn't it?
  Mr. TONKO. Absolutely.
  I was energy chair at the State assembly for the last 15 of my 25 
years in the legislature, but then went over as president and CEO with 
NYSERDA, the New York State Energy Research and Development Authority. 
We made it our goal to advance research, to make certain that we would 
incubate these ideas--these innovations, the cutting-edge technology--
that translate into jobs. Research equals jobs.
  I have advanced legislation that would slide subsidies that are given 
to the historically profit-rich in the tenure of capitalism--our goal 
here is to not feed the profit margin of our oil companies--over to 
cutting-edge technology, renewables, providing for consumer behavioral 
transitioning that enables us to grow American independence in the 
energy generation business.
  Why are we sending tens and hundreds of billions of dollars over to 
unfriendly nations to the United States for our dependency on fossil-
based fuels when, in fact, we can encourage renewables here and energy 
efficiency, utilizing that as our fuel of choice to make certain that 
we reduce demand that then reduces bills that then allows the 
competitiveness of our businesses to be all the sharper? Those are the 
sorts of things in which we want to invest, and it's the going forward 
from that point.
  How about our infrastructure bank bill that would leverage public and 
private monies and that would stretch our opportunities to respond to 
that deficient infrastructure of which you spoke? These are important 
measures. This is the sort of cutting-edge opportunity--the investment, 
the pioneer spirit again.
  We can learn from our American story. There have been those golden 
moments when we have hit bottom. There were those golden moments when 
we were tremendously challenged and when we rose to the occasion in 
tough times, primarily tough times, by responding with a tough agenda 
that said, look, true grit here will get us to the finish line--and it 
happened. It happened with Medicare. It happened with the Erie Canal, 
of which we often speak.
  Mr. GARAMENDI. Social Security.
  Mr. TONKO. Again, Social Security. You're absolutely right.
  The President lifted this Nation, and he made certain that all 
families would have at least a foundation upon which they could grow, 
upon which they could live in this society. It addressed the dignity 
factor, which has made us unique as an American society: caring about 
our fellow man, caring about the men and women of this great Nation in 
a way that created an American society, a sense of community--we the 
people--talking of us in a community sense, a neighborliness, 
neighborhoods and societies speaking in a compassionate way, caring 
about one another. That's when we're at our best.
  Mr. GARAMENDI. If we're going to really be caring about the American 
worker going back to work, we also need to be very cognizant of 
international competition.
  You spoke earlier about the need for our workforce to be competitive, 
which is the education process--K-12, vocational education, community 
colleges. They're exceedingly important. Also important is that there 
be fairness in the international trade situation, that we look not just 
for free trade but fair trade.
  One of the things that we really must address is the threat of 
China's unfair trade practices. The Chinese currency is undervalued; 
and as a result of that, they have a 20 to 25 percent advantage.

[[Page H5194]]

                              {time}  2050

  You eliminate that, and the American worker will be competitive.
  We have one of the pieces of legislation in the Make It In America 
package that the Democrats are putting forward which is forcing China 
to end its currency manipulation. When it ends its currency 
manipulation and allows the value of its currency to rise to 
appropriate parity, we will be able to be competitive. You can bet why 
the Chinese don't want to do it. They want that unfair trade advantage. 
That's one of the pieces of legislation that we put forward.
  When the Democrats controlled Congress a year and a half ago, we 
pushed a bill out of here that would force sanctions on China if they 
continued their currency manipulation. Since the Republicans have taken 
control of the House of Representatives, that legislation has died, has 
never even come up for a vote on the floor. It ought to come up for a 
vote. We need fair trade practices.
  We need to use our tax money to buy American-made equipment and 
supplies. We need to educate our workforces. These are investments in 
the American middle class. This is how we can restore the middle class 
of America. Health care is part of it also.
  You talked earlier about health care and the availability of health 
care for working men and women. We also need to make sure that those 
jobs are there.
  The American automobile industry is instructive on this count. It is 
instructive in that the U.S. Government and the leadership of President 
Obama actually allowed the American automotive industry to continue to 
even survive. Using the stimulus program, the President stepped forward 
and said, I will not allow the American automotive industry to die, and 
he put our tax money behind General Motors and Chrysler. Those 
companies are now thriving. And it's not just those companies. It is 
the thousands upon thousands of manufacturers across this Nation and 
others who supply all of the parts and all of the services. Think where 
we would be today if Congress had not given the President the power and 
if this President did not have the courage to take up saving the 
American automobile industry.
  Presidential politics come here. Mr. Romney says he would not have 
done it. Okay. President Obama did it, and the American automobile 
industry is strong and vibrant today, and the American middle class is 
back to work.
  Mr. Tonko, we must be about out of time.
  Mr. TONKO. Yes, we're down to our last 4 minutes.
  I always find these discussions to be interesting because there's all 
this rhetoric out there about 30 bills that have been advanced by the 
majority in the House and that it's the salvation that's going to 
produce jobs and get America working again.
  Major analysts have reviewed that legislative agenda and said it 
doesn't do what they contend it will do. It doesn't produce the 
results. We would love that to be the case, but it doesn't produce the 
result. They said that we are really in need of legislation that will 
advance jobs.
  Tonight, this discussion about providing the tools, putting 
additional tools into the kit that makes American industry competitive, 
speaks to our humble beginnings. So many people travel to these shores. 
Their journey was about the dream, a noble dream, an American Dream 
that they were going to make it here. That was our humble beginning, 
and we enabled people to experience the rags-to-riches scenario. We 
allowed for generations to continue to grow and prosper and build upon 
the success that preceded them.
  Today, sadly, our middle class is weakening household income-wise. 
The next generation may be the first to go backward. The President is 
trying to move us forward, with great resistance in this House to 
reject progressive policies.
  We say: Let's build upon the success of the past. Let's reach to 
those shining moments when we were challenged as a nation and produce 
the best outcomes. That can happen again here if we open up to what's 
best for America and not resort to petty partisan politics that want to 
deny a Presidency, that want to deny opposition that comes forward with 
constructive qualities to do it in a better way, to build the 
consensus.
  We need to move forward on behalf of the nobleness of the American 
Dream. With heart and soul poured into the efforts here in this House, 
we can achieve and grow that middle class, purchasing power enhanced 
for the middle class, opportunities for our middle class. A strong 
middle class means a strong America. Let's go forward.
  Representative Garamendi, thank you for leading us in this hour.
  Mr. GARAMENDI. Mr. Tonko, thank you very much for your passion on 
this issue, and thank you for your compassion for the American people. 
We can make it. We can make it in America. We need good and wise 
policies to do that. You can't do it by cutting, cutting, and cutting. 
You have to do it by investing, investing, investing.
  The American public understands. They really do understand that we're 
a great Nation. There is no greater nation in the world. We need the 
kind of policies that will put Americans back to work and keep them 
healthy.
  I want to thank those of you that are listening to this hour of 
discussion on health care and on jobs in America.
  Mr. Tonko, thank you very much, and, Mr. Speaker, I yield back the 
balance of our time.

                          ____________________