[Congressional Record Volume 166, Number 135 (Thursday, July 30, 2020)]
[House]
[Pages H4185-H4187]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  2145
                   COVID-19 MEDICAL INNOVATION IDEAS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2019, the Chair recognizes the gentleman from Arizona (Mr. 
Schweikert) until 10 p.m.
  Mr. SCHWEIKERT. Madam Speaker, we know we are in an election year. We 
know passions are running high. We know we have an environment where 
our country is incredibly hurting right now.
  If you saw the unemployment numbers this morning, the GDP numbers, 
how vibrant the economy was last quarter, you can almost have your 
heart ache. We have millions and millions and millions and millions of 
our brothers and sisters outside these walls who are hurting. And I 
guess for many of us in the minority, there is that frustration of ``we 
care, but we want something that actually works.''
  And so one of my reasons for taking some time tonight is I wanted to 
do one or two things.
  Originally, I was going to bring in all this data of what we have 
learned about who gets sick and who doesn't get sick, and those things. 
And I realized, maybe that is not what we should do. So I was going to 
do just a couple data points and then actually talk about pieces of 
legislation that should be easy for us, that actually would help our 
brothers and sisters out there in dealing with the coronavirus, in 
dealing with the economic devastation it has brought to us, and 
providing some of the basic mechanisms. None of them are panaceas, but 
it is good policy.
  Let me start with one thing, just so we have this: If we look at our 
fellow Americans that we have lost since the pandemic--family members, 
mothers and fathers, grandmas and grandpas who passed away--45 percent 
of them were actually in a nursing home or hospice-type care and their 
death certificates make it clear that there was COVID as part of it.
  So if you actually had that as a data point, I am hoping we can sort 
of think through who are the most vulnerable in our society, and do we 
continue to sell, tell, share the message that if you are in some of 
these vulnerable groups, if you are in the nursing home, it is risky. 
There is a concentration where resources should go and what we can do.
  And that is an interesting baseline for those who actually have great 
interest in the numbers. For myself in Maricopa County, Arizona, our 
nursing home fatality rate is at 39 percent of the fatalities. There 
are other places where it is over 50 percent. Using that actually is a 
benchmark. If the national number is 45 percent of the fatalities from 
COVID come from nursing homes and those types of facilities, if you are 
above that, you really need to think about how you are treating that 
population, how you are working with that care delivery network. If you 
are below it, maybe you have a sense you are going in the right 
direction.
  But these are the types of things we need to be sharing with people 
around the country, to understand that if you are 25 years old, the 
chance of you losing your life--and we don't want anyone getting sick--
but you are well under 1 percent.
  And this is something called--I do a lot of presentations here on the 
floor, and I didn't bring all the charts because I just didn't want to 
overwhelm the conversation--allocation of resources.
  If your community, when you pull up your ZIP Code map--and in 
Arizona, we are doing a really good job of using this heat map, where 
you can see where we are having outbreaks--how do we actually share? 
Because we have provided resources--maybe we need to provide more 
technology or other things--but if you see on the heat map that this 
neighborhood, this part of your community is having an outbreak, why 
don't we have outreach into that community? Why don't we have people 
knocking on the doors saying, Do you have a mask? Do you understand all 
the little rules? Do you understand the Sunday barbecue in the backyard 
with everyone in the neighborhood probably isn't a brilliant idea?
  I really want us to communicate the idea where the devastation is but 
also, how do we be proactive? How do we get out there? Instead of doing 
some of the craziness of everything shuts down, whether you are in 
communities where we can't find efficacy of transmissions to where we 
see some pretty tough numbers. So that is actually one of the things we 
have been trying to communicate to the professionals in Arizona, is 
sort of, how do we reach out to where we see the problems?
  In Arizona recently, we had the Federal Government provide testing in 
some of the hardest hit areas, and we hoped actually some of those 
numbers helped. There are other economic numbers that are really tough 
because some of it is getting on the cusp of being partisan. And I am 
going to beg for my brothers and sisters on the left, and those of us 
on the right, to back away from it and actually sort of think it 
through.
  We actually have built a number of charts, and we are trying to build 
more data of what is actually going to happen if schools aren't able to 
find a safe way to open up.
  Do you actually know what happens to long-term incomes of females in 
the country? These are things people don't necessarily think about, but 
we can show you--we are working on it because we are trying to make 
sure we are getting our math right--that by not having the daycare 
facilities and our schools open, it turns out the moms and dads--but, 
particularly the moms that work--that may now have lost several months 
of being in the workplace, it actually has an effect on

[[Page H4186]]

their entire future working careers, income potential, if not their 
Social Security and other things.
  We need to understand the totality of the decisions we are making. 
And this was just a chart I grabbed because I thought the information 
was interesting, but the compound effects of when we are not able to 
come up with a safe method to open up our schools, you actually start 
to see that for, particularly moms, it looks like by the numbers they 
lose about half their working time. But we can even find another set of 
numbers that 19 percent of those who are actually healthcare workers 
can't be there providing those services.
  We don't seem to stop and take a step backwards. And on one hand, we 
are talking about how desperately we need healthcare workers and 
facilities in places that are having a tough time. Oh, by the way, we 
are not going to come up with a safe way for education, for daycare to 
open up. You do realize that actually just reduced your healthcare 
workers by 19 percent?
  We haven't been taking a step backwards and thinking about this 
holistically. And that is why I am going to walk through a couple of 
the pieces of legislation we have introduced in the last couple of 
weeks. We are trying to come up with ways to try to help. In the 
future, we are going to talk more about this on the effects on the 
children.
  I have a little girl that is about to turn 5. She passed her test to 
get early enrollment into kindergarten. When I go home, you can just 
see almost how desperate she is to be with other little kids. I mean, 
she loves mommy and daddy, but, apparently, we don't play the same way 
as other 4-and-a-half-year-olds, five-year-olds. What would be the 
long-term effect in her ability to socialize?
  What is the effect? We came across--and we haven't been able to vet 
it yet, so I am going to say it, but understand, we haven't vetted the 
numbers--of high-school age kids that will pass away from the 
coronavirus compared to the increase of high-school aged suicides. And 
not being able to have services, not being able to have counseling, not 
be able to have social relationships. And I know these are sometimes 
really uncomfortable numbers to, one, get accurate, but even talk 
about.
  We have got to find a way to understand decisions we are making over 
here. Are we ultimately doing more damage to the people in our country? 
And this is more than the economy. It is people's mental health, their 
economic future, their future earnings power, and just societal 
cohesion.
  Let's actually talk about some things I think that are both 
optimistic and opportunities. One of the things that happened when we 
started to do some of the emergency legislation on the pandemic, for 
some of the staff that have been here, you know, there are a handful of 
us who have been pounding the doors around here for years about 
expanding telemedicine.
  Oddly enough--I know this sounds crazy right now--but telemedicine in 
the past has been a controversial subject here because it disrupts some 
of the medical delivery business model. We have lots of lobbyists in 
Washington, D.C., that really don't like telemedicine because it is 
another avenue of competition. But we did it. We took a piece of 
legislation that Mr. Thompson and I had passed, grabbed some of the 
language, and that is actually the law right now--except for one catch: 
When the pandemic is declared over, that expanded authorization of 
telemedicine goes away. But we are getting a living test right now.
  What is fascinating is, if you and I go back to 2019, only about 11 
percent of healthcare consumers--you and I--11 percent in 2019--use 
telemedicine. In the last few months, we are actually seeing it around 
46 percent of folks that need some type of medical advice or doctor 
visit are actually using telemedicine. We have just proven it works.
  And there is actually some amazing data coming in about the ability 
to make it very cost-effective, and the ability to find out the 
satisfaction levels. Turns out that people are more satisfied with many 
of their telemedicine visits than when they go visit the doctor's 
office. And it turns out, also, that the actual face-time with that 
medical professional actually is longer in telemedicine than when you 
have actually gone to the doctor's office.
  So we need to understand these things, because when we get beyond 
this pandemic, will we understand that telemedicine isn't scary. We 
need to find a way to extend it, make it permanent, and actually expand 
what the definition is. Look, we have some great data that is coming in 
that this is working. This is one of the things we did, bipartisan, on 
something that we couldn't get done for years. It is happening right 
now.
  So we have introduced a piece of legislation that will just make it 
so when the pandemic is declared over, telemedicine isn't ended in its 
new reimbursements, in its efficacy, in its availability.
  Now, I want to go further. I actually believe the future of 
telemedicine is more than just picking up your phone and talking to a 
medical professional or face-time. I also think it is the body sensors 
you can put on that produce data from your body, that the algorithm can 
be calculating, that finds if there is something wrong, the medical 
professional can call you.
  So we are going to try to see if we can expand that definition to 
even the technology out there, because this is one of our arguments 
that we have been making here, that as Republicans and Democrats, we 
have been having the wrong debate about healthcare. We keep debating on 
who should pay, who should get subsidized, and we are not having enough 
of the debate on technology. What are the things we can do that would 
actually change the price? Changing the price is what makes healthcare 
much more available, not a constant debate on who should end up paying 
and who should be subsidizing.
  This piece of legislation has been dropped, and I am very grateful. 
Thank you for those who are helping us cosponsor it. We want to see 
more.
  Another thing we are having that discussion of:
  How do you start to open up society?
  How do you open up your community?
  How do you open up the little businesses in your neighborhood?
  Many of them need to be able to put up that plastic shield. They are 
going to need to be able to buy protective equipment or ways to 
sterilize those things.
  We have come up with a tax credit idea for those businesses. It is 50 
percent of their cost, particularly for testing. If you want to test 
your employees, a tax credit--but it is not the tax credit that at the 
end of the year, next year you might get some money. We do it as a tax 
credit off your payroll.

  And the benefit of that is certain businesses, every couple weeks, 
every month, they are turning in their FICA, you know, their payroll 
tax, they can get the credit right there. So the cash flow is available 
to go pay for testing, pay for things that make their businesses safe. 
So as they start to invite their teams, their employees back, it is a 
way to make sure they are staying safe.
  The other one--and this is a big deal, and this one I think actually 
both Republicans and Democrats will embrace--and we are going to geek 
out just a tiny bit.
  When the ACA passed--most folks know it as ObamaCare--one of the 
mechanisms in there was the ability to deduct your medical expenses was 
going to go up over time to 10 percent of your adjusted gross income. 
And for a lot of seniors, that was going to be pretty tough. When we 
did tax reform, we actually extended the 7\1/2\ percent of your 
adjusted gross income when you hit that level the next dollar you could 
start to deduct off your taxes for a couple of years.
  But the fact of the matter is, it is scheduled to go up to 10 percent 
of your adjusted gross income, your medical expenses, before you can 
start to deduct them.
  In a time like this, in a time when we all talk about healthcare and 
the financial stresses and impacts that puts on our family, let's do 
this: For the next 2 years, let's make it 5 percent. So if you had 
medical expenses that you are paying for, you hit the 5 percent, you 
can actually take it. And after that, we will keep it at the 7\1/2\ 
percent.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SCHWEIKERT. Madam Speaker, we will come back next week and do

[[Page H4187]]

the Invest Act, and I yield back the balance of my time.

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