[Congressional Record Volume 166, Number 8 (Tuesday, January 14, 2020)]
[House]
[Pages H225-H229]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       TALKING DEBT AND DEFICITS

  The SPEAKER pro tempore (Ms. Porter). Under the Speaker's announced 
policy of January 3, 2019, the gentleman from Arizona (Mr. Schweikert) 
is recognized for 60 minutes as the designee of the minority leader.
  Mr. SCHWEIKERT. Madam Speaker, to our stenographer, if I start 
talking too fast, just give me that horrible look because my staff was 
telling me last week that I was sounding like a machine gun.
  Madam Speaker, this is something I try to do at least half an hour 
every week. It is basically to have a little bit of honesty about math 
and a little optimism about what policy can do to make things work.
  Once again, I have a couple of my old slides here. I am sorry that I 
haven't been able to update them because there are some new numbers, 
but it is a really simple concept. Let's walk through it.
  How many times do you hear Members from both the right and the left 
get on television and talk about things? Why does no one talk about the 
debt and deficits? I can tell you why we don't talk about the debt and 
deficits, because to tell the truth of what is driving the debt and 
deficits is really uncomfortable.
  We are going to try to do a little bit of that math honesty because 
it is demographics. It turns out, demographics are not Republican or 
Democratic. It is just math.
  We continue to exist in this pretend world, saying: Well, if we would 
tax rich people more, if we get rid of waste and fraud--none of those.
  I have brought these charts here before. There are fractions of 
fractions of variance.
  Why is it so hard for us to tell the truth? Why is it so hard for us 
to own calculators? We basically are a math-free zone.
  This slide is a few months old, and I am sorry about that because 
there is optimism on the tax cuts in the revenues. As you all know, 
last fiscal year, we broke over 4 percent revenue growth in a time with 
lower rates, which none of us modeled. The economy is doing really well 
there.

                              {time}  1415

  Demands on social services have fallen fairly dramatically because of 
the incredibly robust labor environment. Discretionary spending, turns 
out the caps that that line is about, the benefits we were getting from 
the caps, when we did the budgetary deal functionally in September and 
October, we blew up the caps. So this line is bigger; this line is 
smaller.
  But the punch line here is really, really simple: 90 percent of 
rising debt deficits between 2019, so last fiscal year, and 2029--90 
percent Social Security and Medicare.
  Now, those are earned entitlements. We have a societal obligation to 
keep our promises. But it is mostly Medicare. So we can't have an 
honest conversation here about debt unless you are willing to actually 
have an honest conversation about medical costs, healthcare costs.
  We are going to pull some slides here that I am just incredibly 
optimistic that we could actually have a revolution in healthcare 
costs, but the only way that happens is this place has to grow up 
intellectually and join this century of technology and opportunities 
because, once again, let's go back a decade.
  The ACA, ObamaCare, what was it really? It was a financing mechanism.

[[Page H226]]

It was who got subsidized and who had to pay.
  What did we, as Republicans, do? I still think ours was much better. 
It wasn't who got subsidized and who had to pay; it was who had to pay 
and who got subsidized.
  We basically debate about healthcare financing. We do not have honest 
conversations about how to crash the price, because it is a really 
uncomfortable conversation because the things that would crash the 
price often actually make us have to have very uncomfortable 
conversations with our constituencies.
  The different groups that are wandering the hallways right across the 
street right now lobbying us for this or that, they believe in their 
causes. They are wonderful people. But there is a disruption of 
technology.
  So let's sort of walk through the math once again so we understand 
that we could have this amazing future if we could just focus on the 
facts.
  This is a slide I have been showing almost for a year. If you and I 
remove Social Security and Medicare out of the 30-year projection, we 
have $23 trillion in the bank. If we pull Social Security and 
Medicare--and this chart is not inflation adjusted, so you could remove 
about a third of it if you want to do constant dollars and you will see 
the difference of what is actual spending and then the financing costs, 
the interest on those. But if you pull Social Security and Medicare 
back into that number, we are $103 trillion in debt.
  So think about that difference: 23 cash positive, $103 trillion in 
debt.
  For those of you who care about your Medicare, you care about Social 
Security, you actually want these to exist, we must be honest about the 
math, because if we don't get our act together, we are going to get 
squeezed and there are no more dollars.
  It is math. It is not Republican math; it is not Democratic math; it 
is demographics.
  We have 73 million of us who are baby boomers. We are about halfway 
through retirement. That is what is driving the future debt.
  So the next time you hear someone walk behind a microphone and say, 
``I am very concerned about the excess spending; I am very concerned 
about debt and deficits,'' if their next sentence isn't, ``And I am 
going to work on a revolution to change the costs of healthcare and the 
things we provide,'' they are not being honest about how we save this 
society or how we save this country.
  So, one more time, just to get our heads around the scale of the 
problem, and then we are going to actually talk about solutions.
  This is a 2024 chart, so it is only what? Now, that is 3 fiscal years 
from now.
  Nondefense, this is discretionary. This is what we get to vote on. 
This is defense. Everything you see in a blue shade there is on 
autopilot.
  Do you notice something? The vast majority of spending is on 
autopilot. We don't vote on it. We don't do policy on it, and it is 
consuming everything.
  So get our heads around something. Just the growth, just the growth 
of Social Security, Medicare, and the healthcare entitlements, over the 
next 5 years, just the growth portion equals one of these wedges. It 
functionally equals the entire Defense Department spending.
  So, if you are someone who walks in the door and says, ``Well, we 
spend too much money on defense; get rid of it,'' do you realize you 
just took care of only 5 years of the growth? What do you want to do 
with everything else? Over 10 years, it equals all the discretionary 
spending.
  Once again, it is demographics.
  Why is this place so uncomfortable to talk about that? Because it 
violates the pitches we go home and tell our voters. But it is math and 
it is honest, and if we keep avoiding the subject, the future becomes 
incredibly ugly. If we take it on, there is a path where things work.
  So every week I come behind this microphone and I say, here is where 
the problem is, but here are solutions. And the very last slide is the 
one we do all the time, where we believe we have a formula where you 
grow the economy very aggressively. You do things from tax policy to 
immigration policy to trade policy that maximize economic velocity, and 
you are seeing some of that right now.
  If I had come to this room a couple of years ago and said we are 
going to live in a time where we have more jobs than available workers, 
where the bottom 10 percent, the working poor in our society, have had 
the fastest growing wages in modern times, basically double what the 
mean is--it is working.
  We should be, actually, as Republicans and Democrats, trying to 
figure out what is working, particularly for those quartiles--and I 
hate that term--those quartiles in our population that we were writing 
off a couple of years ago: You don't have a high school degree, you 
don't have skills, we are writing you off. You are part of the 
permanent underclass.

  That was brutal. It was arrogant. It was vicious. It was wrong.
  We know, right now, over the last couple of years, the movement of 
wages for those very people we were writing off 3 years ago, it is 
working.
  How do we keep that going?
  If you love and care about people, we need to keep this going, 
because, in my lifetime, there has never been a period of this type of 
economic growth and stability. Let's keep it going.
  But let's not pretend that our future isn't buried in debt. Once 
again, if we take a look at it, it is substantially the growth of 
Medicare.
  I intend that this Congress is going to keep its promises, but, 
mathematically, we are not going to keep our promises unless we 
actually deal with the reality.
  So when we have come in here, we have tried to show that there is a 
path, but beyond the economic growth issues.
  We have labor force participation. You can't grow the economy unless 
our brothers and sisters are working, and those are folks who are both 
older, but we still have a problem with millennial men.
  We had a miracle begin a year ago, December, where millennial females 
started entering the labor force in droves. The math right now says 
there are more females in the labor market than there are males.
  Those are good things, because when we did tax reform, the joint tax 
folks, you know, the 50 of them who are all freaky smart, said your two 
problems of continuing the economic expansion will be capital stock--
and I know I am getting a little geeky, and I am sorry--but capital 
stock, available capital for lending, for borrowing, for the growth, 
and people, available labor.
  It turns out they were completely wrong on the capital stock. We have 
had hundreds and hundreds of billions of dollars more in what we call 
repatriation come back into the country than we had originally modeled. 
People are saving much more of their tax savings from tax reform than 
we ever modeled.
  So the United States now is flush with cash. This is working over 
here. We have great capital stock, and you see it in our interest 
rates.
  Our biggest fragility right now for continued economic expansion is 
actually labor participation. Now, there are miracles there.
  Sure, because we are all really geeky, we all ran and looked at the 
U-6 unemployment numbers last Friday--not the top line, not where we 
stayed at 3.5, but the actual, what we used to talk about for years, 
``What is the real unemployment?'' and you saw now we are in the sixes. 
We broke below 7 percent of real unemployment.
  These are the folks who had become and we wrote off as discouraged 
workers, not participating; their skill sets are outdated. All of a 
sudden, they are entering the labor force.
  We need public policy that continues to encourage that. How do you do 
that? How do you take someone who says, ``I am older, but I am still a 
skilled worker; yeah, I might need an employer that is willing to make 
some accommodations for me,'' how do we create policies that 
incentivize that?
  For our millennial males, how do we create policies that incentivize 
them? Because if we don't have that labor participation, we can't grow 
the economy.
  The other things that also get uncomfortable, and we are going to 
talk about those today, is: How do you have a disruption, a disruption 
in the cost of healthcare?
  I want to argue and I am going to make you an argument that we are 
living on the cusp of miracles.

[[Page H227]]

  On one hand, we have technology. Many of you are carrying it in your 
pocket. That cell phone, that supercomputer, and the new sensors and 
other things, the ability to stay healthy, the ability to know when you 
have a problem.
  Then, on the other side, the miracle cures, the single-shot cure for 
hemophilia that will be here this year, the experiment that is going on 
that cures sickle cell anemia. We are in the time of miracles.
  Why this side is so important on my little upside-down bell curve is 
5 percent of our population is the majority of our healthcare spending. 
It is our brothers and sisters who have chronic conditions.
  What happens if we could get our act together and, through a series 
of financing and policy and licensing, these new biologic drugs, these 
new small-molecule drugs, these new things we are learning, get them to 
market and we are curing people who are part of that 5 percent of 
chronic conditions? Even if we can cure parts of their struggles, it is 
wonderful for society, and it is also really good for the cost of 
healthcare.
  So we are going to touch base on just some things that I find fun, 
because it is part of the--and I know I overuse this term--thought 
experiment of what is coming.
  So we now have almost complete miracles of technology. This is 
something that was just shown last week at the Consumer Electronics 
Show. This is a defibrillator you can carry in your purse. You can 
almost carry it in your pocket. It is just handheld.
  This type of technology, as you now know, with the new types of 
pacemakers, the new abilities to help someone manage everything from 
hypertension to arrhythmia to now actually being able to restart a 
heart, this is at the Consumer Electronics Show.
  We need to think about these types of disruptions.
  Here is one. It turns out, if you were to take a look at how many 
Americans will lose their life to heart disease, to a heart attack, we 
now have the ability to monitor, with just almost a single pod like 
this in your home, just a single patch you put on, talking to your 
phone. These concepts crash the price of that disease if we could get 
them adopted.
  It means we, as policymakers, have to figure out everything from the 
elegance of the licensing mechanisms--which the FDA does get some 
credit. They have been trying to create some kind of a third rail.

  If you wear one of the Apple watches, you realize parts of that are 
coming on a new third rail of: Is it technology? Is it a health device?
  These things are coming, and we are building models now that show 
they can help crash the price of keeping people healthy.
  One of the slides I did not bring today but we have talked to the 
professor, the thing that looks like a big kazoo. I am sorry. This is 
the best way we have to describe it.
  You blow into it, and it instantly knows if you have the flu, 
instantly can bounce off your medical records if you are carrying them 
on your phone and instantly can order your antivirals.
  So this could be in your medicine cabinet at home. You blow into it. 
They think the future version will be able to pick up bacterial 
infections, and the one a couple of years in the future will pick up as 
many as 20 different cancer proteins.
  And it is a kazoo. You blow into it. We call it a flu kazoo in our 
office. People laugh at me for that, but they remember it.
  Do you know that technology is illegal?
  Think about that. The thing you would blow into that instantly knows 
you have the flu, that instantly can ping your medical records, knows 
that you are not allergic or are allergic to this particular antiviral, 
orders that antiviral and that Lyft or Uber or somehow gets it to your 
door an hour later, that process right now is illegal under many of our 
State laws under the way we reimburse under the Social Security Act 
because an algorithm is writing the prescription.
  Should Congress, a few years ago, have slowed down the internet to 
protect Blockbuster video from Netflix?
  You have got to understand, we have these disruptions in our society; 
we live with them all the time; but we sometimes need to step back and 
say: Okay. I like going home and hitting a button on my television and 
seeing all those movies instead of going and getting the little silver 
disc.

                              {time}  1430

  Apparently, Blockbuster Video didn't have armies of lobbyists walking 
up and down the hallways here in Washington, D.C. trying to protect 
their portion of the business model.
  The technology is here that could crash the price of healthcare. Is 
that Republican or Democrat? I am going to argue it is just necessary. 
We do not have a choice. Do you remember the earlier boards? They were 
about if we don't have a revolution in healthcare costs.
  So part of that same thought experiment, over that next 30 years you 
saw the majority of the debt and deficits are driven by Medicare. 
Thirty percent of that spending is just diabetes. What happens if--and 
I accept diabetes I and II are incredibly complex, there are autoimmune 
issues, there are lifestyle issues, it is complex, but just as part of 
the thought experiment--the single biggest impact you could have on 
future deficit spending is a cure for diabetes. Does that help sort of 
put it into perspective?
  Let's actually walk through a couple of these. It turns out, remember 
how I said I think it is sort of an upside-down cure? On this side is 
the use of technology to keep us healthy to be able to manage our 
health issues, if you need a pharmaceutical get it quickly, get it 
through use of technology; over here is the curative.
  It turns out we are now coming across some studies that are talking 
about some of the new gene therapies that are crazy expensive, except 
the model is because of the cures they are producing, it will save 
billions of dollars in the future because you are cured. The miracles 
are coming.
  Have you seen what we are able to do now in what we call CAR T? That 
is where we find out the type of cancer you have, we see what types of 
proteins it is producing, what T cells would properly attack it, and we 
set your body's immune system to attack. Some of the companies that are 
producing this technology actually give you a guarantee that if it 
doesn't work, you don't pay.
  We just had a breakthrough a couple weeks ago, it turns out that we 
may be able to not only grow these in a petri dish, but we may be able 
to grow parts of those first immune responses to these types of 
diseases in an agnostic fashion before it is customized to you, so the 
price is about to crash. What is the value of curing your cancer 
instead of trying to find a way where you live with it for decades?
  This place needs to think through the benefits of: How do we finance 
the cures? And this is where it gets a little political. I am sorry I 
am going to hurt some people's feelings, but there is a bill that has 
moved through this House called H.R. 3. It was a drug pricing bill. If 
you will be honest and sit and read it in detail, it is basically the 
keep Big Pharma protected bill because what it does is it wipes out all 
the small biologic, small molecule companies that are the disrupters.
  These are the ones, you know, the product clearance is really simple. 
The drug that cures hemophilia is here. It is going to be like a 
million-and-a-half bucks a shot, but in many parts of the country 
hemophilia A may be a half a million dollars a year for the clotting 
factor and everything that goes with that. A million-and-a-half dollars 
a shot is a great investment. You are back in the money after 3 or 4 
years. Our discussion should be financing that and getting those rolled 
out into society really fast.
  But if H.R. 3 had existed when they were starting to research that 
drug, that drug would not be here. In a perverse way, the incentives 
are, without that drug, the ways of pharma and the infrastructure 
around that disease, they don't have a disruption. They are not put out 
of business by a cure.
  H.R. 3, I know some of my brothers and sisters on the Democratic 
side, we have worked on it, we have talked about it, they mean well. 
There are actually some good things in the bill. But the basic 
reference pricing mechanisms that come with it, importing the European 
model, which in Great Britain a

[[Page H228]]

year of healthy life is worth, I think $38,000. So if the drug costs 
more than $38,000, even though it gives you a year of healthy life, 
they don't buy it. And that is what this bill does, it imports that 
pricing mechanism into our market.
  It is absurd because we should be looking at both pricing mechanisms 
that crash the price where we can, but cure. How do we cure our 
brothers and sisters who are part of that 5 percent who have chronic 
conditions that are the drivers?
  We just passed a bill through this body that basically protects Big 
Pharma's current monopolies and wipes out the disrupters that were 
going to take their market share. They did it with glee because I think 
the hatred of Big Pharma blinded from understanding who actually won 
and who gets to just change their business model a little bit and stay 
protected and who you just wiped out, because that would wipe out those 
miracles that are coming.
  I know that is partisan, and I don't mean to hurt anyone's feelings, 
but it is the math of the legislation. So these are important.
  Another thought, if you want to have a real disruption that you could 
do before the end of this year, half the pharmaceuticals that will be 
picked up today at pharmacies will not be used or will not be used 
properly. Our model says it is a half a trillion dollars a year from 
not using your pharmaceuticals properly. The person that doesn't take 
their hypertension pills and ends up having an aneurism, the person 
over here that takes too many, or the person over here gets confused. 
Half a trillion dollars a year for noncompliance with pharmaceutical 
regimes, and half the pharmaceuticals that will be picked up today will 
not be used or will not be used properly.
  The thought experiment is really simple. Go look in your own medicine 
cabinet. Take a look, and what is sitting in there? What is the value 
of what is sitting in there? Let's be honest. Almost all of us, if we 
go, yes, I probably do have hundreds of dollars of value sitting there. 
Let's just go after one small portion, the efficacy, the person who, if 
they really take their hypertension pill every morning, and there is a 
miracle, we think there might be a one- or two-shot-a-year system about 
to come that may actually intervene instead of having to take the daily 
pill--but I don't mean to take us down that side.

  How about a pill bottle that pings you and says, Hey, Bob, you didn't 
take your hypertension pill this morning. Don't forget, this is really 
important. It turns out, just that $20 piece of technology would save 
billions of dollars of healthcare costs and stop many tragedies in our 
families.
  I have actually brought the board here that is actually for seniors 
that looks a little bit like a dome that drops the pills into a little 
cup and then notifies you, because some people have regimes where they 
need to take this one in the morning, this one during lunch, these 
three before going to bed to stay stable. And how many of us have ever 
had that moment saying, Now did I take it? Did I remember? This 
technology exists. We need to think about making those as part of our 
formulary, so we are reimbursed. Because it turns out in those cases it 
is not the price of the pharmaceutical, it is our efficacy of how we 
take them. Half a trillion dollars a year, because we don't stay on our 
regimes of our pharmaceutical prescriptions properly.
  If you wanted to have a disruption in healthcare costs tomorrow, make 
high-value pharmaceuticals, put them in a double blister pack, put them 
in a cartridge so they stay sterile, and make them returnable. Use 
technology like this so we take our pharmaceuticals as we are supposed 
to. Make it so it could also talk to family members or even the 
physicians' assistants to call in and say, Betty, we are getting a 
notice that you haven't been opening your pill bottle. The technology 
is here. Why do we fight it?
  Here is also a level of disruption that was being shown at the 
consumer electronics show, but I need to put this a little more in 
context.
  In the Phoenix area we have an experiment going on. I am blessed, I 
represent, I truly believe, the greatest congressional district you 
could ever imagine. I have north Phoenix and Scottsdale, and I have a 
lot of freaky-smart people in our community and moving into our 
community. And there is this one business, a couple autonomous 
automobile engineers got together and said, Hey, we have made a lot of 
money, we want to take on the biggest issue in our society, which is 
the cost of healthcare. Let's try an experiment. Let's see if we can 
create autonomous healthcare clinics.
  Think of this, you walk into a Safeway grocery store--it is a little 
unfortunate, they are in former Theranos spots, but you all get that 
joke--but you walk in the door, you pick up the iPad, you sign in. You 
take a picture of your driver's license, a picture of your insurance 
card. You walk into a booth alone. The instructions pop up on the 
screen. You put your arm in this, you hold this up, you follow an 
avatar, you shine this in your mouth, your nose, your ears, you do 
this, you look into this, and it turns out the algorithm is stunningly 
accurate. And I believe they have had a couple of their algorithms now 
certified by the FDA. And there are a dozen clinics now or they have a 
dozen clinics in a dozen grocery stores.
  Are we willing to make that technology legal? Because at the end they 
have to bring a doctor on the screen to meet the laws. Well, what would 
happen if that autonomous--what they call in some of the literature, 
they now refer to them as sensor clinics or sensor healthcare, but we 
need to think about this. This is here. It is coming very fast.
  It turns out at the electronics show last week they were showing one 
that is a micro size that you could have in your medicine cabinet that 
does many of those very same types of tests and the algorithm 
apparently is freaky accurate and can do all sorts of diagnostics. Are 
we ready for this?
  Last year I came and showed a box--that actually is sort of what 
Theranos had promised, but it actually now exists--it is from an 
Israeli company, it is certified in the EU, that does all sorts of 
blood tests. The technology now exists. It is not being offered here 
because it is too hard to hit our market at this point.
  Go back to the beginning slides. The debt and deficit are 
functionally being driven by our demographics. The cost of those 
demographics is our healthcare. Are we going to continue to have the 
absurd debate around here of financing options, which may have effects? 
There are parts of it that are good, but they don't have a disruption. 
Are we going to find a way to promote, legalize the next-generation 
technology that can crash the price of healthcare and make us healthier 
and cure many of the diseases that crush our brothers and sisters?
  So back again--the slide we either start with or end with--we believe 
to take on the debt-ridden future and keep us from breaking through 
that 95 percent debt-to-GDP it is not a single solution. Today we just 
did healthcare technology disruption. But it is everything. It turns 
out it is economic policies that grow because if we don't grow the 
math, you can't get anywhere.
  Population stability, how do we incentivize family formations? How do 
you build an immigration system that is much more talent-based, 
because--let's be brutally honest--since 1971, the United States has 
been below replacement rate in our birth rates. The last few years we 
have actually had fairly stable economic times, the last 2 years, great 
economic times, and our birth rates are still falling.
  There is a paper I have in my office that says, in about 8, 9, 10 
years, two workers, one retiree. The math doesn't work. So what do you 
do to encourage family formation? For some Republicans we are going to 
have to really step up and think about that.
  But also for immigration, you need to move to a talent-based system. 
The elegance of that is you don't care about someone's religion, their 
race, who they cuddle with, or where they come from. But what you do 
care about is what they bring to our society to maximize economic 
expansion. In many ways it is a much more honest and elegant system 
than this carve-out system that we have today.

  Changing the way or creating benefits incentives within the benefits 
of Social Security and Medicare to stay in the labor force or to come 
back into the labor force or become a part-time entrepreneur, we need 
to fix the way we tax certain benefits, the way we

[[Page H229]]

crush people if they are still saving when they are older. We need to 
deal with the reality of how much longer baby boomers are going to be 
living. And we have got to get our labor force participation numbers 
up. It turns out all these things tie together. You can't do one 
without doing the others to get the economic benefits of it.
  And that is what terrifies me about our place here: Are we capable of 
doing complex policy, when over here I am doing immigration issues, and 
over here I am doing tax reform issues, and over here I am doing trade 
issues, and over here I am doing healthcare technology issues; and 
understanding they are all sympathetic to each other, they all tie 
together to create the economic philosophy and the changes in our cost 
structure together? When what we have here is a place where we fight 
over the naming of a post office.
  I understand we are living in a time of political rage, and that is 
how so many people raise money, how they hold office.

                              {time}  1445

  I have a 4-year-old daughter. I am 57 with a 4-year-old daughter. My 
wife, the same.
  You know I am pathologically optimistic, but I am optimistic because 
I get to get behind this microphone and advocate for what I believe is 
an actual path that saves us from a debt-ridden future.
  I have been doing this now for a year, saying here is the problem, 
but also offering the steps of a solution.
  I will go back to my office now, and the phones won't ring. There 
won't be any text messages or emails from even fellow Members, let 
alone the world, saying: Hey, David, can you tell me about this 
technology? Can you tell me about this? How do we help?
  If we don't have that revolution, I am terrified.
  Madam Speaker, I yield to the gentleman from Texas (Mr. Roy) for the 
purposes of a colloquy.
  Mr. ROY. Madam Speaker, I thank the gentleman from Arizona for 
highlighting a number of different issues, starting, of course, with 
spending and talking about the future that we are going to deal with 
from a fiscal standpoint in our country, particularly the extent to 
which Medicare and our entitlement situation is going to drive that, 
but, importantly, getting to the point of disruption, technology, and 
the ways that we can totally transform healthcare in a way that will 
both fix our fiscal situation as well as provide the best healthcare in 
the world.
  As the gentleman from Arizona (Mr. Schweikert) knows, I am a cancer 
survivor. I am a father, as well, of a 10-year-old and an 8-year-old.
  Mr. SCHWEIKERT. Madam Speaker, I wish he would tell that story more.
  Mr. ROY. Madam Speaker, I do, and I try to talk about it. There are 
others of us in this body who have gone through that sort of thing.
  This is what is so critically important, what we are talking about: 
We have the ability at our fingertips to transform our healthcare 
system and to save our country from the depths of $23 trillion, $24 
trillion, $30 trillion, $40 trillion of debt. This is where we are 
headed if we don't go down this road.
  I know there is a bipartisan thirst for this, but we have to stop 
having our leadership in two corners, with shirts and skins squabbling 
instead of focusing on these kinds of roll-your-sleeves-up solutions.
  The question I would ask my friend from Arizona is, what does he see 
as the obstacles to what we are talking about here, in terms of the 
current situation with insurance oligopolies and the government 
bureaucracies that get in the way of innovation, technology, and direct 
primary care and going to the doctors of your choice, and being able to 
get that kind of innovation?
  Mr. SCHWEIKERT. Madam Speaker, look, in some ways, telling the truth 
is like soaking yourself in kerosene and running around with a lighter.
  Congress has functionally become a protection racket. The armies in 
our hallways, both with Democrats and Republicans, say, ``We like this 
technology, but,'' and the ``but'' always happens to be, ``you are 
going to blow up my business model.''
  How do we as policymakers stop having the arrogance of thinking we 
know what the future is and, instead, design the rules, reimbursements, 
licensing, and mechanisms that all go with that so the best technology 
is constantly winning and today's winner, it turns out, gets crushed 
tomorrow because a better one comes along?
  Today the way we do it is we build walls of protection that say, 
``This is good. Yeah, there is something incredibly good over here, 
but.''
  That is why I use that Blockbuster video example. We all sort of 
accepted that, hey, we used to go get the little silver disk and shove 
it in the machine. The creepy guy would give us movie recommendations. 
He was creepy, but his movie recommendations were really good.
  Today, we go home and hit a button. We just lived through that, and 
the world didn't come to an end.
  When it comes to healthcare technology particularly--and I do a 
similar presentation on environmental technology. There is stunning 
stuff that could revolutionize those issues. If you are concerned with 
global warming or greenhouse gases, the technology is here, yet we 
don't talk about it because we know what we know. The problem is, much 
of what I and others know is a decade out of date.
  Mr. ROY. Madam Speaker, I would ask the gentleman, does he agree with 
me that when we are talking about this kind of disruption, that this is 
not a partisan problem, that this is a problem of this body not sitting 
down and rolling up its sleeves to try to address using innovation and 
finding how to break through and not getting into the trap of this town 
where the power brokers make all the decisions and the lobbyists are 
driving a lot of what we are doing so powerful insurance companies or 
powerful government entities are making decisions for you instead of 
you and your doctor, and technology and innovation?
  Mr. SCHWEIKERT. Madam Speaker, we have to be a little careful because 
I find there are certain insurance companies that are ready to offer a 
technology, sensor-based healthcare, but it is illegal.
  There are hospitals I have worked with that desperately want to do an 
outreach in the community, where they are using data and algorithms to 
keep people healthy and to know when there is an issue coming.
  It is not only us as Members of Congress and what we know and don't 
know, and the arrogance of how we often do pieces of legislation where 
we don't future-proof it to use it, and also the incentives that are 
built in to surviving election, raising money, everything there, I will 
also argue our bureaucracies have become calcified.
  The bureaucracies now have become incredible barriers when they say: 
``Well, we don't see that in the rules; therefore, you can't do it. 
Yes, it would help society. Yes, it would make us healthier. Yes, it 
would.''
  Mr. ROY. Madam Speaker, by that, government and private sector 
bureaucracies, and State and Federal.
  Mr. SCHWEIKERT. Exactly, Madam Speaker. States are going to be a real 
issue, and then different lobbying organizations and different 
constituencies.

  Guess what? We don't have a choice. The single biggest threat to our 
Nation is the massive wave of debt that is here.
  One of our charts, in just a decade or two, we are running $2\1/2\ 
trillion, almost approaching $3 trillion, deficits. It is almost all 
solely driven by our demographics. We have gotten older.
  Mr. ROY. Madam Speaker, I would just like to thank the gentleman. I 
appreciate his time and his dedication to this. Let's do this again.
  Mr. SCHWEIKERT. Madam Speaker, I enjoyed it.
  Madam Speaker, there is a path. Will we step up and understand that 
the path turns out to be complicated? We are going to make some of our 
constituencies just elated with the opportunity to change. We are also 
going to terrify some of our constituencies.
  There is a way to get there, and believe it or not, it is technology. 
It is not Republican technology. It is not Democratic technology. It 
turns out it is math, and the math will always win.
  Madam Speaker, I yield back the balance of my time.

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