[Congressional Record Volume 168, Number 25 (Tuesday, February 8, 2022)]
[House]
[Pages H1067-H1069]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      ECONOMICS OF CURING DISEASE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 4, 2021, the Chair recognizes the gentleman from Arizona (Mr. 
Schweikert) for 30 minutes.
  Mr. SCHWEIKERT. Mr. Speaker, last week, I got behind this microphone, 
and we were actually trying to show something that was a bit 
optimistic. But like everyone else on our side, the frustration we are 
going through on so many of the Democrat policies that I don't think 
were meant to be mean-spirited or so dystopian in the damage they 
cause, particularly to the working poor, which is one of my fixations--
sometimes, the economics is the economics, sometimes virtue signaling 
over the unintended consequences.
  I want to go over something and try to explain why I think this is 
such a big deal for both those on the left and those of us on the 
right. There is actually a window of optimism, but it is going to take 
a policy pivot.
  Last week, I got up here and talked about--remember, I gave a couple 
of presentations last December, a major success in curing type 1 
diabetes. Now, it was really only one use case where they were able to 
take T cells and convert them into insulin-producing cells. In that 
particular one, the individual would need some immunosuppressants 
because of the body's reaction to it.
  Now, we have an organization that is doing some of the same 
technology with T cells, turning them into insulin-producing cells but 
with CRISPR as a partner. They are doing a tiny tweak. The model says 
the body won't recognize it as a foreign cell, and you won't need 
immunosuppressant drugs for the rest of your life.
  Conceptually, why is this such a big, big, big deal to have a cure 
for type 1? If you dig through the literature, it says that, at least 
for people with type 2, we might have a way to get their body--
actually, we do have a way--dear Lord, let the technology be true and 
actually coming forward--to help individuals in type 2, their bodies to 
produce insulin again.
  Then, we have some other big policy things we would have to do here. 
We would have to have an honest conversation of how we do nutrition 
support. We would have to have an honest conversation of what we do in 
the farm bill, what we encourage Americans to grow, instead of just 
sort of the commodity crops.
  North America used to grow 3,500 different types of grains. Maybe you 
design a farm system that allows both regional and uniqueness for 
different arid climates and others, sort of a cacophony, or whatever 
the proper word there would be, for optionality because there is a food 
security issue when you only grow certain crops.
  God forbid you have like what is happening in parts of Europe, where 
olive trees have a type of fungus. Olive trees that are hundreds and 
hundreds of years old are dying. We make ourselves much more fragile in 
food security.
  I sort of say that because I actually see an elegant solution coming 
here if we could change the way we view public policy. It is often this 
right-left paradigm of the left's version of wanting to be 
compassionate. They are going to build more clinics for those in urban 
areas and Tribal communities and even certain world populations that 
have just stunning percentages of type 2 diabetes and the misery that 
comes with that. Put up more clinics. My argument is: Screw that. Let's 
cure it.
  If we are seeing technology that may lead us to a cure, put the 
resources forward that create the disruption because curing a misery is 
so much more wonderful than helping people being able to maintain and 
live within their misery.
  Oh, by the way, for those of us who are absolutely fixated that the 
debt is going to destroy this Republic, it makes a hell of a lot of 
difference. Let's walk through some of the math of why I wish we were 
having this level of optimism that the technology disruptions we have 
now of knowing how to cure so many diseases actually may be the path 
that we start to take on the crushing debt that is coming.
  This is important. This is year-old data from CBO. It is a year out 
of date. The numbers today are much worse. In 29 years, $112 trillion 
of publicly borrowed debt in today's dollars; the vast majority of it 
is Medicare, Social Security. The rest of the budget is in balance.
  Why this is so important is the political class, particularly here in 
Washington, we have lied for decades to our constituents.
  The left will say: Oh, rich people don't pay enough. We spend too 
much money on defense.
  Republicans say: Oh, we have to get rid of foreign aid, waste, and 
fraud.
  Maybe those are true, but they are not the driver of the debt. The 
debt is demographics. We are getting old as a society. You are going to 
see some slides later on that really will kick you in the head on these 
numbers. That $112 trillion of publicly borrowed debt as projected by 
CBO last year--and this is a number that says there are no more 
pandemics and no more recessions.
  How many of you want to have a secure retirement? How many of you 
give a darn about your kids? Well, think about one little factoid here. 
You just saw that Medicare was the primary driver of U.S. sovereign 
debt. What was it? $77 to $78 trillion of borrowing over the next 29 
years? Thirty-one percent of Medicare is just diabetes. Now, you are 
seeing the tie.
  If I come to you and say: I hope it works, but considering the 
numbers and the benefit of if it does work, why aren't we, at least the 
left and the right, saying let's end people's misery? Oh, by the way, 
by doing that, one of the greatest effects we can have on society is 
actually curing these diseases that make us poorer, sicker, and 
actually are the primary drivers of our debt.

[[Page H1068]]

  


                              {time}  1930

  Mr. Speaker, 31 percent of Medicare spending is just related to 
diabetes--33 percent of all healthcare costs. So, remember, Mr. 
Speaker, the problem with this place is ObamaCare, the ACA, and the 
Republican alternatives were finance bills. They weren't about what we 
spend, they were who got subsidized. That is the math. The Democrats' 
bill had three tiers, the Republican had four tiers, but it was who was 
cross-subsidizing whom and then how much was coming out of the general 
fund to subsidize those groups. They were spending subsidization bills. 
They had nothing to do with what we spend.
  My argument is if we would embrace the technology, push it forward--
and we have changed a bunch of laws to legalize the very technology 
that will disrupt healthcare costs--then we save Medicare. But we also 
end a hell of a lot of misery in our society.
  And is that Republican or Democrat?
  I am sure at some point someone will contribute to one side or the 
other and we will turn it into partisan, right?
  But at least between now and then it is technology.
  And, once again, I fixate on this also: 5 percent of our brothers and 
sisters who have multiple chronic conditions are the majority of our 
healthcare spending.
  If you say you care about healthcare, Mr. Speaker, is it 
nationalizing health care?
  Well, once again, nationalizing health care, the Medicare for All, 
doesn't remove any costs. It just collectivizes how you can ration.
  If you want to reduce costs, cure people, and end the misery, once 
again, 5 percent of our brothers and sisters are the majority of our 
healthcare spending.
  You already see what is going on right now, Mr. Speaker, with some of 
the messenger RNA, some of the new stem cell therapies, the number of 
diseases we are curing. We now have a cure for hemophilia. We are about 
to have trials for sickle cell. You already see in so many diseases we 
are taking on, so many of the blood cancers today, we can cure. But the 
10,000-pound gorilla is diabetes.
  Maybe it is a little bit utopianism, but we have seen a perfect 
example of this.
  Do you remember this body just a decade or so ago, Mr. Speaker?
  We were having a real stressor. We were having to have conversations 
with State Medicaid systems on how we were going to pay for all these 
liver transplants for those people who may have had too good a time in 
the seventies. Remember, we had hundreds of thousands of individuals in 
the United States that we thought were having failing livers from 
hepatitis C. Liver transplant clinics were being funded and organized 
all over the country, and then, suddenly--I think the first drug out 
was Sovaldi--we figured out how to cure it. And the drug was 
outrageously expensive, it was something like $88,000, but it was a 
fraction of the cost of a liver transplant and then someone spending 
the rest of their life on anti-rejection drugs.
  And then another drug came to market with a slightly different 
technology. The price crashed and saved a fortune and ended lots of 
future misery.
  We lived in the last decade an example of what I am talking about.
  But I beg of my friends on the Democrat side: Think about your 
legislation like H.R. 3. We know H.R. 3 functionally makes Big Pharma 
bigger because it incentivizes them to take their current portfolio of 
pharmaceuticals, make little tweaks, and keep them. But the capital 
staff for the small biotechs that are disruptive is crushed. There are 
good articles out there, and there are good economic papers that make 
it very clear.
  If the Democrats get their way, it is great politics. It is 
absolutely brilliant politics. Talk about drug prices, how outraged we 
are. We are outraged.
  But, Mr. Speaker, are we outraged to the point that you are going to 
kill the next generation because they don't get the next pharmaceutical 
that is curative?
  We need to think maybe more with a calculator like economists, maybe 
economists with a soul and a heart rather than: Hey, this is brilliant 
for the next election cycle.
  Back again, think about the body, the place we work in. We go home, 
we campaign, and we say all the wonderful things we are going to do. 
But the fact of the matter is, this last fiscal year, 77 percent of all 
the spending here was on autopilot. It is what we call mandatory.
  Ten percent was defense. Thirteen percent was everything else. We act 
as if we are here doing something when if you put defense and say we 
are just going to keep the baseline where it is at and the 77 percent 
is mandatory--Social Security and Medicare, you fall under a certain 
income, you are part of a certain ethnic or tribal group or you hit a 
certain age--it is automatic. It is formulaic.
  This is all we get to focus on. This is what all the theater here is 
about. And one of the reasons I think the theater has gotten so 
hyperbolic is we know this is what wipes us out, and not one person 
here has actually voted on this. It has been, except for the last 
handful of votes the Democrats moved forward, we were adding, like we 
just did today, in a piece of legislation that actually added to 
mandatory spending because it is easy. It makes you look like a hero. 
Hey, all we protected is there.
  But we don't have the resources to pay for it.
  To give you an idea, Mr. Speaker, of how crappy the last fiscal year 
was and how much we borrowed, these slides are all out of date now. The 
numbers are much worse. One of the reasons I grabbed this one is, take 
a look here. This was 2030. We are going to hit $30 trillion of 
borrowing. Well, we hit that last week.
  Think about what we have done. And there was a time here a couple of 
decades ago the discussion was: Well, are you willing to do entitlement 
reform?
  Take that off the table. I know it is great political rhetoric, but 
it is too late. The vast majority of baby boomers are already in their 
retirement age. We missed the window. The window was a quarter century 
ago if we were going to do entitlement reform.

  Other than the things we have come here and talked about, the massive 
subsidies that we give actually to really, really, really rich people, 
when it is their third home on Martha's Vineyard and we give them 
subsidized flood insurance, or the Democrats' Build Back Better bill 
which if you would be making $400,000 or $800,000 a year and you were 
going to get--what is it, $125,000 in tax credits if you bought the 
right electric vehicle, the right solar panel. At some point we need to 
have an honest conversation. We calculated over the next 10 years there 
are $1.4 trillion of subsidies for really rich people.
  So instead of the constant rhetoric of let's tax rich people more and 
make them pay their fair share, maybe we should just stop subsidizing 
them because the subsidies create distortions.
  So back to the thing we don't do here called math, the 2050 number, 
we were saying we were going to be at 195 percent of GDP. That number, 
the best calculation as of today is 15 points higher than that. We will 
be well over 200. And that is a baseline, not another pandemic, not 
another war, and not another major recession.
  Then we start to deal with our newest reality, and I should have 
grabbed the slide, but you see part of it here. There is a model put 
out by CBO that says that if interest rates over the time of that 29-
year period, if the baseline borrowing costs of the United States was 2 
points higher in that 25 year, then every dime--every dime--of tax 
receipts will go just to pay interest. We have made ourselves that 
fragile, that if the cost of borrowing money goes up by 2 points on 
U.S. sovereign debts over the baseline, then every dime in the future 
just goes solely to cover the interest costs.
  We have lost our minds. And yet, think of the crazy stuff we debate 
here. It is as if we are desperate to debate the shiny objects, the 
stupid, little indignation of the day, and at the same time we are 
borrowing $47,000 every second--$47,000 every second.
  That is why I keep coming behind these mikes saying that it doesn't 
have to be this sort of dystopian, crushing future. I need the majority 
to think differently, and I need my minority over here to think 
differently. Because here are some of the drivers, and this is really 
uncomfortable. I have been booed in front of audiences when I have 
given this presentation, but the math is the math, and the math always 
wins.

[[Page H1069]]

We can virtue signal, we can tell anecdotal stories, and we can talk 
about how compassionate we are. But at some point, the math will win.
  This is important because I am going to show you the sister slide to 
this in a couple of moments, and you need to get your heads around 
this. The money you put in taxes, into Social Security, and the money 
you are going to get out of Social Security are pretty close to each 
other. You actually get a little bit more out. It is a fairly even 
deal. But that chart you were seeing, Mr. Speaker, is substantially 
driven by this. So the average couple--and this is someone who is 
retiring right about now--has put in about $161,000 into Medicare, and 
they are getting $522,000 out. And those are adjusted dollars. So, 
ceteris paribus, whatever the fancy term is, that gap there is the 
primary driver of U.S. sovereign debt.
  So, Mr. Speaker, what happens when you talk to millennials?
  We all have in our offices over here kids born in 1985, and they just 
think they are never going to see any of this. These are actual surveys 
where they already see themselves in enough financial pain, and they 
are worried. Then they have people like me get behind the microphone 
and show them the slides and basically say: If we don't do something 
about this, your retirement--and this is a technical economic term--you 
are screwed. We need to start using language like that around here 
because somehow the fancy language doesn't seem to sink into the thick 
skulls here.
  Do you care about this generation?
  These 25-year-olds we have in our offices who are freaky smart, they 
are working their hearts out, and they look at the numbers saying, Oh, 
my God, when they start getting near their retirement age, the United 
States will have a couple hundred percent of debt to GDP, and if 
interest rates are up, if interest rates are up--I didn't bring the 
slide--there is one model that says that 2 percent higher baseline 
borrowing costs, we go from that 210 percent debt to GDP in 29 years to 
about 300, 320 percent because of the multiplying effect because we 
never pay anything off.
  The model as it is as of today says that millennial, that person born 
in 1985, they are going to put $236,000 into Medicare. And if we don't 
do something to disrupt the cost of healthcare, then they are going to 
take out over $1.2 million, and this makes the curve steepen. When you 
see the CBO curve, you wonder why it starts to steepen. It is this 
delta there.
  There is a hope. There is a path, but it needs to be everything. I 
have my healthcare disruptions, but I have also come here and talked 
about how you can change the immigration system to maximize economic 
growth and not crush the working poor. When we open up the borders--we 
have brought the papers here--we crush the working poor because we 
flood the country with people with similar skill sets.
  Mr. Speaker, in the last year and a half, we are what, 1.7 million 
behind in legal immigration. The kid who just got the Ph.D. from 
Arizona State University and we are sending him home. You have seen the 
healthcare. If you care about the environment, the concept of radically 
changing the way we look at regulation using crowdsourcing and data 
instead of the 1938 model of stick paper in file cabinets, a Tax Code 
that maximizes economic growth.
  Are we willing to have really disruptive conversations, or should we 
go to a border adjustability model, so you don't have a tax arbitrage 
for around the world to move products to the United States instead of 
making them here?

                              {time}  1945

  There are ways, and the trick is, the model says you have got to do 
all of it almost at the same time. And this place can barely agree on 
what time of day it is. Then we have seen policies around here that 
when so many of our brothers and sisters who are older, are basically 
saying it is the rational decision: I am leaving the labor force.
  One of the other parts of that growth model is everyone is needed. 
Every American is needed. We need your talents. We need your labor, 
particularly if you are older. Would this place be willing to provide 
certain incentives? So you are 65, you don't need to retire. But we are 
going to fix parts of the way we tax your benefits to incentivize you 
to stay in the labor force.
  There are ideas that work that basically make the future something 
optimistic. My wife and I joke about this, and I have said it behind 
this microphone a bunch of times. We are both 59 years old and I have a 
6-year-old daughter. You know you are pathologically optimistic when 
you are 59 years old and you have a 6-year-old daughter. But darn it, 
doesn't she have the right, doesn't the kid that is growing up in a 
neighborhood of poverty have the right, doesn't the person who is older 
have the right to have a decent retirement?
  Don't we have the right to be in a nation of optimism where we told 
the truth about the math and our demographics, and then we provided an 
optimistic vision that gets us there instead of the crazy stuff that 
has been posed this last 12 months that we keep showing economists 
after economists--and these are not conservative economists. Many of 
them are from liberal groups saying: You do realize that Build Back 
Better by the end of the decade make people poorer?
  But it was great politics. Stop the crazy. Buy a calculator, and then 
if we do it by math, I think you could actually see this body work 
together because an optimistic vision can be ours if we just fixate on 
the disruptions that make the future great.
  Mr. Speaker, I yield back the balance of my time.

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