[Congressional Record Volume 168, Number 119 (Tuesday, July 19, 2022)]
[House]
[Pages H6869-H6875]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
HEALTHCARE SPENDING DRIVES OUR DEBT
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 4, 2021, the gentleman from Arizona (Mr. Schweikert) is
recognized for 60 minutes as the designee of the minority leader.
Mr. SCHWEIKERT. Mr. Speaker, I have been coming behind this mike
every week when we are here, sometimes for half an hour or an hour, and
I have been basically taking the bark off our brothers and sisters on
the left because of my belief that so much of the policy here hurts
people.
I have shown over and over the working poor are getting poorer, the
poor are getting poorer, the middle class--I mean, last week, I had
charts here that showed that, in my Phoenix-Scottsdale area, we have
the highest inflation in the continental United States. You get to work
a month-and-a-half for free just because of the change in our inflation
index. Even when you plug in any salary growth we have had in our
marketplace, you are functionally donating over a month of labor that
you get no purchasing power for, no compensation. That is inflation.
I have tried in those previous speeches to turn to my brothers and
sisters in the majority, the Democrat side, and say: Hey, here are some
things we could do policy-wise to take on inflation. Inflation is not
just a monetary issue; it is also things we can do on policy, the
fiscal side.
I thought I would go to crazy town for a moment and show some things
that are optimistic. The fact of the matter is that a lot of them
aren't necessarily right or left. They are just technology adoption.
We have to stop doing the dumb--sorry, I think it is a break in
decorum if I curse on the floor, so you can just fill in the blank
there--but the virtue signaling, like we just did a half hour ago on
the floor. It is theater.
I understand the polling numbers are miserable for my brothers and
sisters on the left, so they are going to throw out every virtue
signaling vote, whether it is actually legal or mechanically sensible
or even has any place in reality. So let's go to what is really going
on and some things that would be good that we could do together.
First off, we need to understand the scale of how much trouble we are
in. This slide is almost a year old, but the
[[Page H6870]]
fact of the matter is that we are in a world right now where your
government is an insurance company with an army. It is a way to think
about it. We are an insurance company with an army.
Then you start to understand, over the next 30 years, Medicare and
Social Security are 100 percent of future debt. That future debt, from
last year's CBO number, is $112 trillion in today's value. If you add
in inflation, our calculations are now blowing through $120 trillion of
borrowed money.
Now, the fact of the matter is, almost every model says we can never
get there; we blow up long before that. But you have to understand,
mandatory--that is Social Security and Medicare and other things that
we have made that are formula. Over here is the defense, and over here
are other domestic programs. Only about 13--actually, I think this
coming year it may be less of everything we spend is really--it is FBI.
It is environment. It is research. It is this tiny sliver down here.
The reality is, what is driving that mandatory monster that is
consuming everything? It is Medicare. About three-quarters of all the
spending, about three-quarters of all the debt that is coming, is
Medicare. The vast majority of Medicare comes out of the general fund.
It is healthcare costs.
The brain trust around here--we will do things like the ACA,
ObamaCare, the Republican alternative, Medicare for All. They are all
financing bills. We play games around here. It is about who gets
subsidized, who has to pay.
A number of the boards that I am going to show today are about
healthcare disruption to change not who pays but what we pay.
There is a reason you don't go back to Blockbuster video anymore.
There was a technology revolution where you no longer go wait in line
at the local strip mall, get a little silver disc, and take it home.
Half the time, three-quarters of the time, you couldn't get the silver
disc you wanted because somebody else already had it.
Today, you go home and hit a button, and you have dozens of streaming
services. That is a technology disruption. If Blockbuster video had
hired enough lobbyists, this place would have slowed down the internet
to make sure Netflix couldn't exist.
You need to think about what goes on here. Let's start to walk
through and understand how much trouble we really are in.
This board is a year or 2 old. You start to add in. When you do
Social Security and healthcare entitlements, it is this line. The rest
of the budget is actually in decline or flat. Defense is down here. You
can wipe out every dime of defense, and you can't keep up with the
growth of the debt being caused by Social Security and Medicare.
That is not Republican or Democrat. We got old as a society. Does
anyone ever hear about baby boomers? This place basically didn't figure
out baby boomers existed until the last couple of years.
It is demographics, and it is happening all over the industrialized
world. When you look at our numbers--and we are working on this right
now in our office--of what has happened the last couple of years, sort
of the post-COVID baby bust--remember, last year was the lowest
fertility rate in U.S. history. The math is getting really ugly.
I am the ranking Republican over Social Security, and we had the
Social Security actuary report come out a couple of weeks ago, saying:
Hey, we added a whole year. We now have 11, 12 years before Social
Security runs out of cash, and we just live on the revenues.
But they missed inflation. They also screwed up, I believe, on the
fertility rates, population growth.
Let's start to walk through it. If healthcare costs are the primary
driver of U.S. sovereign debt, what can you and I do? What could this
place do? Some of this stuff will not work, but, damn it, we need to
try.
We do enough virtue signaling here where we say pretty words, and
then we walk off the floor and say: Well, that is never going to
actually happen, but, damn it, it is a great campaign ad.
Maybe it is time we start to try to do some of the things that are
really difficult.
Some basic math--first, come down to this line. Thirty-three percent
of all healthcare spending is associated with diabetes. That is type 2
and some type 1, but mostly type 2, 33 percent of all healthcare
spending and 31 percent of all Medicare spending. Why wouldn't you
absolutely fixate?
Look, we won't call it Operation Warp Speed because that had
something to do with Donald Trump, and the left despises him, so give
it any damn name you want.
But come on, people. If I came to you and said 33 percent of all of
our healthcare spending and 31 percent of all Medicare spending is
diabetes and Medicare is the primary driver of U.S. sovereign debt,
can't we hold hands together and jump and say we are going to throw
everything we have at this because we know there has been a
breakthrough?
Now, it is only like a half dozen people who have been cured of type
1 diabetes, and we don't have any long-term data on it, but it is
optimism.
First, I want to go over my frustration. You will see this as a
policy split on the way the brains around here work differently between
my brothers and sisters on the left and those of us on the right.
A few weeks ago, this place committed to give, I think it was $36
billion--might be 38--but I think I remember $36 billion of cash
subsidies to Big Pharma, which they were railing against, saying they
are charging too much for insulin.
{time} 1900
And the way we are going to stop these crazy insulin prices is, we
are going to give a bunch of cash to the very people we think are
charging too much.
Does anyone see the absurdity?
Instead of creating, Hey, we are going to incentivize competition. We
are going to put more people in the marketplace. We are going to make
the systems work--no, because the left is addicted to handing out cash.
Well, it turns out at the same time they are doing that, not too far
from here, in Virginia, there is functionally a co-op that had been put
together years ago that is in construction right now that is going to
bring a number of generic insulins to market at less than the new
subsidized price.
And the fact of the matter is, what the Democrats did a few weeks ago
in trying to subsidize Big Pharma's insulin production, may have blown
up some of the economics and the financing behind this.
Why wouldn't we have said, for a fraction of the money--say we are
going to set aside some money. We are going to help these folks get
their permitting, their reviews. We are going to actually put FDA
reviewers on site as they are building so that the day the clean rooms
are up and ready, it can be in production.
Add competition, not subsidies. And it exists.
And think about this: They are talking about $55 for a whole box; $30
per vial. That is cheaper than the legislation we passed a few weeks
ago where we are handing out, what, $36 billion in subsidies to Big
Pharma.
You see the craziness around here. The virtue signaling was more
important than actually something that made people's lives better, and
actually added optionality and competition.
And this isn't a Republican or Democrat, this is a solution. But I
guess there is a hell of a lot more power--maybe better fundraising
opportunities--when you are handing $36 billion to the very people you
rail against and then--wink wink, nod nod--here is the cash. This place
has actually become perverse.
So back to where I was going. I have talked about this over and over
because it is one of my personal fixations. The discussion of an end to
insulin, where there has actually been--and we saw the first academic
article on this last December, and we try to track it, functionally,
every week, we try to follow what is going on.
One of the trials that is actually in the FDA phase is on hold right
now as they are doing some safety efficacy. But the fact of the matter
is, we have a half-dozen Americans, who through a stem cell and now the
newest ladle is they are taking it and apparently tagging it with a
CRISPR mechanism, so the body doesn't see it as foreign. The elegance
of that is that means that this mechanism works.
[[Page H6871]]
You can do a production line of these insulin-producing cells--the
islet cells. I always get made fun of because I mispronounce that. But
the ability to get someone's body to produce insulin again, why isn't
there just excitement around here?
Remember, 33 percent of all healthcare spending is associated with
diabetes. If there is a potential, just a potential, we can cure our
brothers and sisters--and yes, it is going to cause all sorts of
difficult decisions around here when you start dealing with type 2. I
represent the population with the second highest per capita population
of diabetes in the Nation. My Tribal communities, Salt River Pima-
Maricopa, amazing community; smart, well run. And genetically, they are
number two and their sister Tribe is number one, they are a population
that has diabetes.
Next year, we are going to be doing the farm bill. Within that there
will be nutrition support. One of the ways this place has always passed
the farm subsidy bills and nutrition support is they merge them
together.
How about if I came to you and said, Let's just have a really
uncomfortable conversation instead of the EBT card--which is sort of
the modern-day food stamp. If you have someone who wants to sign up for
the program, saying to them, We are going to try to cure your body and
get your body to make insulin again, but you have to do the nutrition
program with us. And that may be 2 years of a food box showing up three
times a day at your house, where it is microwavable; Lyft can drop it
off.
But what is more elegant? From a society standpoint, what is kinder
is, Here is an EBT card, go to Jack in the Box--I love the onion
rings--and you can use the EBT card at Jack in the Box.
Is that really making society healthy? Better? Because we have also
been doing some experiments in the Joint Economic Committee, just
trying to do math. And starting to realize health--the fact that you
have a household member who has severe diabetes that may be heading to
get a foot cut off is a component in income inequality. I thought that
was the holy grail to my brothers and sisters on the left. Let's try to
make our brothers and sisters healthier.
And the fact of the matter is, if there is something going on out
there in the literature, why wouldn't we take some of the dollars we
spend here, the things we put into pure theater, and say--this science
is already in phase 1. Whether it be through tax incentives, whether it
be through other types of incentives, how do we get this into the
field? And then we, as a body, have to have really difficult
discussions because you're not going to give someone stem cells to get
their pancreas to start producing insulin again if they are still
morbidly obese.
I mean, this is a big boy conversation--a big person conversation,
knowing we are not allowed to use gender identity anymore.
But what is merciful? What would be great for the budget? What would
be great for society? What would be great for productivity?
Because at the end of the speech, my hook is going to be inflation is
killing our country. It is blowing up the future of young people. It is
eating the savings of older people.
How do you get productivity back in the society? It is actually
disruptions. It turns out if you can disrupt things like this, you have
this virtuous circle. And how many times does this body even talk about
doing big things that are actually really good for everyone.
And if it is true, you would think the majority here, who basically
controls all the power, one of the first things they would have done is
invited the researchers who had gotten together with CRISPR and the
stem cell and brought them in here and said, Let's have a conversation.
How real is this? How far is it?
What resources, what incentives, what things could we do in the
capital stack to get money to invest in it?
What could we do as a body?
Because if this is really 33 percent of all healthcare spending is
associated with diabetes. Could you imagine? Even if it was a fraction
of that population of our brothers and sisters, we are removed from the
suffering.
I have pitched over and over and over to people with power in this
body saying, Invite the researchers here. We need to understand this.
And instead, over and over, my brothers and sisters on the left seem to
say, no. We care more. We are going to build more diabetes clinics. We
are going to build more community-based clinics.
And I am saying the disruption is the solution. Cure the damn
disease. It is going to be hard. There will be things that will go
wrong. There will be people who will call us names because we are
trying to say, Well, we need to do the nutrition, and maybe some
exercises, as we get ready to make this investment in you. But it is
the moral thing to do for our society, and also economically really
smart.
Let alone, also think of the economic expansion we get when we live
in a society where we have so many of our brothers and sisters who
can't participate in the economy because parts of their lives are
miserable, their health issues. The cure is the solution. Patching
people up is--it may be great virtue signaling but it is not that
merciful.
So that is sort of the theme. I am going to walk through these
boards.
Now, let's go through other things we could do as a society to
disrupt.
So how many times have we all been here on the floor and we hear
about the Build Back Better? Yes, we can spend more money and that
would be good for inflation. And you sit there and scratch your head
and say, My elementary school economics teacher was wrong. But they are
working on it in the Senate.
We are being told there is a pared back version coming. In that pared
back version, would you believe there is a provision that you can't
automate the ports in California? Huh?
You have to back up and think about this. So I have a White House--
and some of my brothers and sisters here on the left, inflation isn't
their fault. It is not the incredible amounts of spending; the
trillions of dollars being handed out to people without any requirement
for them to participate in the society or the economy. It is not their
fault. It is supply chains. And one of the first things they really
want to do is a piece of legislation that would restrict automating the
ports. Huh?
There is a worker shortage. There is a technology shortage. We have
ships parked, but the longshoremen write checks to Democrats so they
will slow down--you can't have it both ways.
So the fact of the matter is, the language is there. I have had a
number of people look at me and say, Oh, that can't be. No? That
slipped in, and it is still over there in the Senate draft. This is
absurd.
I will argue the disruption is the cure. So it is not only automating
the ports, it is the second half.
There are some brilliant articles out there with some technology now
that say that the rail spurs in the Port of Long Beach, the Port of Los
Angeles--some of the others--and these are some former space engineers
that have designed this--you take the container, you park it on the
electric rail car, and you tell it where to go. And it just goes
automatically to the spur, to drop it off, this and that.
Functionally, you go from an automated port to an automated travel
delivery system. That is forward thinking. That is policy that is rule
set that popped that productivity, popped the problems in the supply
chain. Ta-da. You did something positive, and when you do that, you
also take on inflation.
And instead, this body is trying to stop the very disruptions that
would make our lives better. They are pandering to a group that writes
them a check.
But it exists. I mean, there are fun articles about these automated
freight train cars. And they are electric. You just, boom, put the
container on it and tell it where to go.
Look, we have a demographic crisis. We have trouble with workers. We
have all these things. The disruption is the solution. Do you see any
attempt around here? Instead, we have debates here where we sound like
it is still the 1990s.
So one of the other battles here is energy prices. And I have had an
ongoing, reasonably friendly discussion with a Democrat who's from back
East, who is a friend--and I will call him a friend: Oh, we have to
stop hydrocarbon. Oh, natural gas isn't this clean. Oh, David, you
don't understand.
[[Page H6872]]
Yes, natural gas when properly burned for energy, those things may be
40 to 50 percent cleaner than other fuel sources, but you have methane
leakage.
Okay, I'll do that with you.
And we know the methane math on the latest calc is like 8.79 to 1 in
its greenhouse effect if you do the math. But it also has--as we know,
the new math has a much shorter half-life. That's why so many of the
global warming models from a year or two ago are actually wrong because
we are now recalculating methane.
But it turns out that some experiments have been going on the last
two years of, functionally, a solution for capturing methane,
particularly in oil and gas and pipelines. And I am going to be a
little silly here because it is a dirt-cheap solution. It is clay. I
think it's a copper-oxidized clay. It's like a sponge for methane.
Maybe it works, maybe it doesn't. But there are a couple good
academic papers saying, Hey, you do realize we could functionally take
kitty litter, pack it into wellheads, pack it into the pipe fittings,
pack it into the other things, and it is a methane sponge.
Why wouldn't we take a run at this? Instead, the Malthusians around
here that basically run this place, say, No, we are going to restrict
ourselves because, oh, God, we can't have access to this.
No, the solution is in the disruption. I am just excited about this
one because it is super cheap. It is not some of the grandiose, build a
new regulatory body, build an inspection, build these huge tankers that
sit on top of the wellheads and capture the methane. Turns out it could
be functionally copper-oxidized kitty litter.
Does anyone around here read?
So I have had a proposal here, and for anyone who is bored out of
their mind, go to Schweikert environmental crowdsourcing. There is a
YouTube video I put together a couple years ago that basically said,
look, we all walk around with these super computers in our pocket. What
if I came to you tomorrow and said, Instead of the regulatory model we
use right now to protect air quality and you can use those for water
and other things, where functionally you fill out pieces of paper, you
take them to your local regulatory body--your EPA, county air quality,
whatever you have in your area--and they stick it in a file cabinet.
And everyone knows that file cabinets full of pieces of paper make
the air quality better, right? No, it's documentation so one day
someone can sue you.
{time} 1915
What would happen if I came to you and said they exist today and they
are not expensive. If you had a couple thousand people in your
marketplace, a few thousand--something like Maricopa County, which is
huge--had a little attachment on their phone and it does air quality
samples?
You crowd source the problem. You no longer need people filling out
pieces of paper for their permitting because if someone screws up, you
catch them immediately. The elegance of this is the clowns that may be
painting cars in their backyard behind your house, they are never
getting a permit, they are never getting caught unless you had a crowd
source model where the UPS driver, the soccer mom, everyone else is
walking around with a little thing attached to their phone or a
Bluetooth on their car or attached on the side.
The beauty of these things--they do PM10, they do volatile organics.
There is even one out there, a little panel, that actually does
radioactive, which there was a discussion of putting those on UPS vans.
The solutions are out there. Think of how different the world would
be. I want to open up a motorcycle paint shop. I have to go get an
engineer to stamp my air quality permit. I have to go get the
scrubbers. I have to do this, do this, do this, do this.
What if the solution is, hey, here are the things you have to do. You
don't need a permit because the moment you screw up, we catch you that
same day. It is a living. Do any of you use Waze when you go driving?
It is a living crowd source model. These ideas exist out there.
In Detroit where they had the water issue. There is a little ring out
there that is like $39. If you put it under the sink, you would have
caught it. You could have crowd-sourced the information and not gone
through multibillion dollars of misery. The unwillingness of this place
to understand what century we are in. If someone gets bored, take a
look at that YouTube video, it sort of explains the concept.
For those of us in the West, this is a crazy one but it's worth
thinking about. Maybe it works, maybe it doesn't. Desalinization. You
know we know there is a number of desalinization plants along the coast
of California. There are even some discussions of some in Mexico and
other places and around the world, but there is always an issue of the
brine. You have got to really spread the brine out, so you don't create
intense areas.
Now, there are some researchers out there that are going, hey, that
brine--did you know, there may be all sorts of really neat stuff in
that. There may be rare earths. As the desalinization plant is mining
potable water, we could be mining the brine for rare earths.
I am just begging the people around here--think--think a little more
creatively because this place is absolutely dystopian anymore, and
there are solutions out there. Is this Republican or Democrat?
I am sure someone will make a contribution to one side or the other
and then immediately the other side will say, oh, that is a Republican
idea. The fact of the matter is it is worth at least understanding.
It turns out, I have an absolute fascination with carbon capture.
There is actually a tax credit in those things that I am the lead
author on that is out there in law and other things. The break-
throughs--it turns out we are getting really good at this.
There is ambient where they are actually pulling in the air. There is
point source. There is a power generation outside of Houston called an
Allam cycle where they actually blow up the natural gas, and they don't
heat up steam to throw the turbine, they use the actual gas from the
burn. It has no smokestack; they capture every bit of it.
We are actually getting really good. And all over the world there are
researchers spending time on this. There was even an amazing paper
about 2 years ago, MIT came up with a nanotube electric-charged plate
that goes on, off, on, off, but it actually crashed the cost of
capturing--and they were doing it ambient. They were just blowing air
across it, and it crashed the energy to do carbon capture.
Okay. So my brothers and sisters on the left say they are the ones
that care about the environment. Okay. But we are the ones actually
doing the policy that is practical that works, that we don't actually
put ourselves back in the stone age, and options to grab the carbon.
There are multiple versions of this. This is actually--there is an
actual facility, and I think this one may actually be in Canada--and,
yes, it has Gates Foundation money and others. This is an active
ambient capture. It apparently does amazing things. This technology is
only a couple years old, and it is already out of date.
The technology is moving so fast. This isn't pie in the sky. This
isn't theoretical--they exist. What could we do policy-wise other than
me doing the 45 on the tax code to try to say, hey, we are going to
give you a tax credit for carbon you have captured if you sequester it
or put it in concrete or other things.
Are there things we could do?
This becomes a moment where those of us who believe the use of
hydrocarbons is basically keeping a society prosperous. My brothers and
sisters on the left that want to eliminate hydrocarbons--maybe there is
a technology solution that brings us together. It is worth
understanding and working on.
How many detailed hearings have we seen here where we brought in the
engineers?
Not the talking heads, not the lobbyists. Not another idiot doing
virtue signaling for us, but the actual engineers. You know, those
types where you have to have a conversation where you own a calculator.
This stuff exists.
There are other revolutions happening around us that are incredible
opportunities--very scary, very wonderful. We are going to do the farm
bill next year. I grabbed this article almost 2 years ago and we have
been tracking it, and they have had some success. I
[[Page H6873]]
am going to geek out for a couple seconds. I will try to do this as
quickly and lightly as I can.
Do you all remember your high school biology class--C4 plants, C3
plants. These plants actually need a carbon molecule to grow because
they turned it into a sugar. But the dear Lord--there is actually this
weird little glitch where sometimes the plant grabs an oxygen molecule,
and it goes: Oh, I don't need this. And it spends its energy purging
the oxygen molecule and going back trying to get a carbon.
What would happen if researchers--through a little synthetic
biology--could tweak it so every time it grabbed the carbon?
Some of the researchers think for some plants that could be a 40--
now, on some of the other articles I am reading it is down, in some
others plants it might be in the 20s, 25, 28, there is a 30. Think
about it.
If I had a crop that could grow 40 percent more efficiently--40
percent less land, 40 percent less fertilizer, 40 percent less water.
The disruption to the world--you basically just fed the world for the
next century.
Worldwide agriculture functionally produces 2.2 times more global
greenhouse gases--I guess is the term the left uses--than every car on
Earth--2.2 times more. So if I had a 40 percent improvement, just this
synthetic biology on plants would be equal to removing every car off
the face of the Earth.
Now, we all know the math is going to turn out that way--yes, there
will be lots of people who resist it because they are scared of
technology. Why wouldn't we have this part of our conversation if we
care about--those of us that live in drought-prone areas--care about
the environment and care about feeding the world.
This is the future. What is the chance anything like this will be
part of the farm bill next year?
Pretty much zero because it is a disruption of technology, and this
place basically has become a protection racket. We protect incumbents.
Not incumbent Members of Congress, incumbent business models, incumbent
associations, incumbent bureaucracies. We don't ask them to leap into
the future. This is the future.
This one I use on occasion, it is fairly snarky, but I think it makes
a point. How many care about plastic in the ocean? Oh, the hands go up.
Here in D.C. I don't think we are allowed to use plastic straws because
everyone knows D.C. plastic straws were critical to ocean-wide plastic
except there is almost no plastic from North America in the ocean.
It turns out that 90 percent of the plastic in the ocean comes from
10 rivers--8 in Asia, 2 in Africa. Ninety percent of the plastic in the
ocean comes from 10 rivers, 8 in Asia and 2 in Africa.
If you actually cared about plastic in the ocean, would you be
writing your checks--or in this case, your credit card--to groups that
go out and say, we are going to go out and capture plastic. Great. Or
wouldn't we adjust some of our technical foreign aid, our response in
environmental aid? Saying, we are going to go to those 10 rivers, 8 in
Asia and 2 in Africa, and we are going to do something like we are
going to create a value for the plastic. All of a sudden, I have an
economic solution. Instead of dumping it into the river, we are going
to collect it.
See, this is an actual solution. The problem is the solution takes
away the virtue signaling. This place lives on telling great stories
demonstrating you care. It doesn't give a darn about actual solutions.
Ninety percent of the ocean plastic comes from 10 rivers. Go to those
rivers and let's deal with it.
Another thought experiment--and now I am going to do a lot more on
healthcare. I accept a number of these will not work. I accept a number
of these will make some people angry because it blows up their business
model. Remember, money, power, vanity, but most of the time D.C. is
about the money.
What is the single most powerful thing this place could do tomorrow?
If I said between now and the end of the year, I want to have a
disruption in the cost of healthcare. But, David, that is only a few
months. D.C. is not capable of actually setting off a revolution in a
few months to do something powerful for the price of healthcare.
What if I came to you tomorrow and said: The models say--the research
says--and this one we have known for years and years and years and
years--16 percent of all healthcare spending is actually people not
taking their medicine--not taking it properly or not taking it at all.
If you have hypertension and you don't take the calcium inhibitor.
You have high cholesterol; you don't take your statin. It turns out you
stroke out; you have a heart attack; you cost the system a fortune. You
stay on your meds--actually, they are cheap, they are safe, they are
very effective. We have decades and decades of history on their
effectiveness; you stay healthy.
It turns out you could actually just say for certain types of health
pharmaceuticals, put the 99 cent pill cap on it that beeps at you when
you didn't open it today. If you want to do the fancy one--this slide's
a little year or two old--there is the fancy one where the pill cap
actually talks to your phone and the phone tells you you didn't take
it.
Mr. Speaker, 16 percent of U.S. healthcare costs--it would be $570
billion a year--so over a half a trillion dollars a year. What would
happen if tomorrow this place got together, and said: Hey, for some of
our populations that we know are likely to miss taking their pills, or
grandma is having some cognitive issues, or someone is just busy in
their life, let's spend the 99 cents on the pill bottle, give them the
thing that beeps when it is not open.
If that actually helped even a fraction--maybe it is not 16 percent,
but what if we were able to do half of that? We are talking hundreds of
billions of dollars. Is this Republican or Democrat?
It smacks us in the face. There is just no constituency here lobbying
or writing us checks for this.
The solution is in the disruption. The disruption is part of the
technology.
{time} 1930
Before I do this slide, I need to tell a story and see if I can put
this in perspective.
Mr. Speaker, there is a reason I seem to just annoy the hell out of
so many folks here because this is a challenge to how we think. A few
years ago, I was reading one of my crazy blogs. It is a material
science blog, oddly enough. A professor, I think it was Duke, I may
have the university wrong, she had been working on this breath biopsy
where you could put breath across it, and it could designate if you
have this category of flu. The model basically said that once we know
that category, then we can bounce off your medical records on your
phone, and it can just automatically work your antivirals. It has been
worked on and worked on.
Think of this, Mr. Speaker. It is a flu kazoo. You blow into it, and
it can designate, and the latest models and experiments now are picking
up dead cancer proteins. When a cancer cell dies, it throws off a DNA
strip. Some of the sensors are getting so good they can actually
identify them.
What is the problem with something like a breath biopsy? I wish I had
some brothers and sisters here in the body to yell at me. What is the
problem with it? You blow into it, it bangs up your medical records,
and it orders your antivirals.
What is the problem with it? It is illegal. I am allowing an
algorithm to prescribe. The Social Security Act says I will see a
doctor, not an algorithm. Now, the fact of the matter is wink, wink,
nod, nod, if you have something with a diabetic pump, they already have
an algorithm that is prescribing, and they have been doing it for
years. This is not new. If you had it certified by the FDA--and there
are algorithms certified by the FDA--why wouldn't we make them
reimbursable?
Why wouldn't we do some simple conceptual ideas that you could have
technology in your home medicine cabinet that you lick, you spit, you
urinate, or you blow into--whatever it is--and you can monitor your
health? That technology exists today.
One of the reasons the capital stack won't invest in it is it is
functionally illegal, and they are basically betting that the lobbyist
armies will keep it illegal here because--I have to be honest--it will
change the foot traffic in many of our medical facilities. It will also
save society from the debt implosion that is being driven by future
healthcare costs.
So, you have to decide: Are you going to save us? Are we going to
protect the world from disruption?
[[Page H6874]]
It is back to my Blockbuster example. Should Congress have stopped
Netflix or streaming and protected the renting of the little silver
disks? That is, functionally, what we do in healthcare.
There is technology out there coming. The newest version is of folks
with the Apple watches. The reality is if I can know your O2, your
temperature, your pulse rates, then the algorithm may say: Hey, you
might have a problem here.
What happens with the new versions that are stunningly accurate? We
have math for a number of these that are more accurate than a human.
Yes, it is scary. Disruption always is. If we don't have a disruption
in the cost of healthcare, then there is a technical economic term: We
are screwed.
There are lots of these at-home biopsy-type tests. You have all seen
the one because it had some great pop culture last year of an iPhone
app where you could zoom in on a mole, and the algorithm behind it was
stunningly accurate: Yes, you need to get that thing cut off because
that is skin cancer.
Why aren't we promoting things here?
Mr. Speaker, I have been at war since I got here on telehealth. I had
a piece of legislation over and over, and I could never get a hearing
on it for telemedicine, telehealth, until the pandemic hit. Then, they
functionally took our language--I was actually doing this with a couple
of my Democrat colleagues. They took our telehealth expansion language
and put it into law for the pandemic. Mr. Speaker, do you know that the
expansion of telehealth goes away the day the pandemic is declared
over?
The argument used to be: Well, David, you don't understand. Seniors
aren't going to figure out how to hit the button and use FaceTime to
talk to their doctor. Seniors aren't going to figure out how to put
something on their wrist or on their chest or blow into it. You don't
understand.
It turns out they were wrong.
I am looking forward to this body deciding: Are you going to be with
the lobbyists or the expansion of access to healthcare through
telehealth? Because this goes away when the pandemic is declared over.
Here is another example. It is just another breath biopsy. These
things exist. They have put them together. What is fascinating is this
slide is about a year or so old, and it keeps going and going. They are
working now on a number where it is a breath biopsy to detect different
types of cancers.
Why doesn't this place find joy and embrace the solutions?
Mr. Speaker, you start to understand that, outside the folks that
politicized messenger RNA and didn't understand the mechanisms and all
those things--but we are getting so close to treating so many diseases,
whether it be my fascination with the stem cell being able to set off
insulin production again, to the fact--I am going to show a number of
slides here where an incredible number of the cancers, particularly
soft cell, we can set off your body to fight them now using messenger
RNA. We are getting right on the cusp.
If I came to you right now, Mr. Speaker, and said: Hey, malaria,
certain cancers, HIV, influenza, heart disease--the heart disease one
is fascinating, teaching your body through a messenger RNA how to build
certain protein stacks to help rebuild heart damage. It is here.
How much discussion do you have in this body? How many experts have
we brought in saying that technology is the cure if healthcare is what
is chewing us alive? Do we do another bill on who is going to get
subsidized and who has to pay? Do we do another group saying: Oh, there
is a group out there we are not taxing enough. We need their cash to
throw into Medicare because we all know the crisis that is happening on
Medicare financing.
Why is this place incapable of having a conversation about crashing
the price of healthcare?
I am going to go through a number of these because I collect these. I
spend 10 hours a week on an airplane, and I get bored easily. I read a
lot of things. I keep coming across these.
This one is really interesting. It is immunotherapy for brain cancer.
Now, it is not the solid tumor, but they think they have had amazing
success on this. This was one of those we didn't think we could do
anything with, and it looks like there is an immunotherapy for brain
cancer.
Here is one. I have not read the details on this because I just saw
this on my flight, I think, a couple of days ago. A drug cures 100
percent of colorectal cancer patients in a small initial trial.
Maybe it works, maybe it doesn't. But this is what we need to be
fixating on. Instead, what we are going to do here is watch the bill
that comes from the Senate, where they are going to blow up the capital
stack for the very research that finances these sorts of things.
A couple more, just for the fun of it. Biotech--and I think this one
is already out in phase one, in multiple phase ones; I don't know if it
has reached phase two--malaria. You do understand, Mr. Speaker, for
much of the world, malaria is just a brutal, vicious disease. I saw
some data a couple of months ago. They were only about 30 percent
effective. Believe it or not, that is actually terrific because if they
have hit 30 percent effective, we can through adjustments and through
other factors. Could you imagine the amount of misery you could end in
the world? They could get a 50 percent effective vaccine for malaria.
Instead, we will do certain types of foreign aid. Instead, it turns
out one of the most powerful things we could do for the world is our
intellectual property, fixing what we incentivize, and it is not
handouts of cash. It is to fix the regulatory model here, fix the
capital stacks, fix the tax incentive, and you do amazing things for
the world.
I did a presentation on sickle cell anemia last year, and I got a
little over the top on getting a little technical. I used to have about
a dozen slides on this one. But it turns out we think we know how to do
a certain type of gene editing with a couple of other optionalities for
sickle cell anemia, and this one is out there in trials.
Isn't that a moral thing to do? The fact of the matter is, do you try
to help people maintain their misery? Or when you actually see data
that says there is a path, do you pursue the cure?
My argument here is the cure is better for us as a society
financially, productivity-wise. Just from a purely ethical and moral
standpoint, removing someone's misery is a pretty neat thing to do.
This is a heart disease one. I just found it fascinating that through
a functioning CAR T, which is the derivative of the mRNA, you are
setting off your body. In this case, instead of it going after a
disease, it is actually repairing damage. I think this one is coming
out of the Boston area. There is a reason that these folks have Nobel
Prizes.
When you start to understand these infectious diseases, herpes,
diabetes, the other things, we are on the cusp of having cures, and the
misery that I believe the last 16 months of really bad policy here have
brought to this country, the damage inflation is doing, the damage that
is going on at the border of my State, the homelessness, the fentanyl,
imagine, Mr. Speaker, if this place would set aside some of the virtue
signaling legislation--oh, this is going to get the other side in the
next legislation; oh, that just writes a great ad--and you brought in
the engineers and experts in the different areas that we all claim to
pretend we know something about and say: Here is what the future looks
like, and if we get it right, the future is amazing.
A little while ago, Mr. Speaker, you saw a little girl behind me. I
have a 6-year-old. Two weeks ago, out of nowhere, my phone rang, and
the birth mother of my little girl had a little boy. Now, my wife and I
have a little boy. I have a 3-week-old.
It is my primary reason for running again. I have to find a way to
beat this body into submission to understand there are good things out
there, but it doesn't work into our current political construct. It
doesn't work in the way this place raises political money or keeps
certain friends. The cures are disruptive, and disruption is the
future.
Disruption makes society healthier, better, wealthier, and more
productive. That productivity solves the inflation problem, and it
solves so many other things.
How do we move this body to stop being terrified of its own shadow
and saying, screw it, we are going to do what is right, not necessarily
what is easy or political?
[[Page H6875]]
Mr. Speaker, I yield back the balance of my time.
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