[Congressional Record Volume 170, Number 5 (Wednesday, January 10, 2024)]
[House]
[Pages H39-H44]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
POLICY SOLUTIONS TO THE BORDER CRISIS
The SPEAKER pro tempore (Mr. Bean of Florida). Under the Speaker's
announced policy of January 9, 2023, the gentleman from Utah (Mr.
Moore) is recognized for 60 minutes as the designee of the majority
leader.
General Leave
Mr. MOORE of Utah. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include extraneous material on the topic of this Special
Order.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Utah?
There was no objection.
Mr. MOORE of Utah. Mr. Speaker, before I yield time to my colleague
from Utah, I want to quickly highlight and reiterate the importance of
what we are doing here as the House GOP.
House Republicans, during the holiday break, took the time, over 60
of us, to go down to the border to be able to share what is truly going
on. We get to hear, hopefully, today a little bit more about this.
At no point in our Nation's history has the situation on the southern
border reached the levels of policy failure, humanitarian disaster, and
security threat that it has under the Biden administration.
Many of my House Republican colleagues witnessed firsthand the
tragedy at our border last week. It is out of control, and the Biden
administration has completely dropped the ball on this issue and
threatened the safety of every American community in the process. The
issue is, it is more simple than this.
To President Biden, the gig is up. You took office and thought: Let's
just reverse everything that the Trump administration had been doing.
Let's not necessarily evaluate whether it was successful, whether it
was the right policy. Let's just kind of use our executive pen to
reverse everything.
It is very simple to consider Migrant Protection Protocols, the
remain in Mexico policy, catch and release. These are simple policy
changes that would have an immediate positive impact.
Many of my colleagues were able to see this, to witness this, again,
firsthand this past week, and I look forward to hearing from
Representative Burgess Owens from the great State of Utah for more on
this issue.
Mr. Speaker, I yield to the gentleman from Utah (Mr. Owens).
Mr. OWENS. Mr. Speaker, I recently joined Speaker Johnson and more
than 60 colleagues to visit the southern border at Eagle Pass, Texas,
one of the busiest Border Patrol entry points. What I witnessed was
nothing short of an invasion, an invasion facilitated by the purposeful
policies of the Biden administration.
It was my second trip to the border since the spring of 2021, and
regrettably, the situation has only gotten worse.
Two years ago, I encountered a heart-wrenching tragedy of an
unaccompanied autistic 7-year-old child, a little girl who was
trafficked by the Mexican cartel. My guess is the Biden administration
is clueless as to the status of this vulnerable young lady. My guess
also is that she is now 1 of the over 100,000 unaccompanied children
who have been trafficked through the Biden administration's open border
and now lost. The 100,000 innocent children lost to our system
highlight the heartless administration that does not care about the
innocents.
The crisis doesn't end here. Over 100,000 Americans, primarily aged
between 19 and 48, have fallen victim to fentanyl, a deadly weapon
shipped from China to Mexico, processed, and then smuggled across our
borders. More Americans have lost their lives in a single year than the
two 20-year wars in Vietnam and Afghanistan combined.
As these Americans are being poisoned across our country--by the way,
this is across party lines. It doesn't matter what our race, creed, or
color might be. Take one, and we have lost another child.
As we are losing Americans, over 100,000, at this one port of entry,
Eagle Pass, they are making over $34 million per week through this
trafficking of fentanyl.
President Biden did not inherit this crisis at our southern border.
He purposely created it by rolling back the successful Trump policies
and then refusing to enforce U.S. immigration laws. In his first 100
days, he took 94 executive actions on immigration, resulting in 1.8
million illegal crossings since January 2021.
That is why I joined my House Republican colleagues to pass the
Secure the Border Act of 2023 7 months ago, which offers commonsense
solutions to the Biden border crisis. This legislation demands the
completion of the border wall, an end to catch and release, an increase
in Border Patrol agents, a halt to the flow of deadly fentanyl, and
protection of our innocent children from human traffickers. It places
the safety of the American people first, a sentiment shared by citizens
throughout our country who are tired of Washington's inaction. However,
the Senate Democrats refuse to bring it to the floor for a vote.
Mr. Speaker, I urge the Senate to immediately pass H.R. 2, send it to
the President's desk, and stand up for the safety, security, and sacred
laws of our great Nation.
Mr. MOORE of Utah. Mr. Speaker, I thank Representative Owens for his
firsthand look.
I spent time at the border--I believe it was in the late spring--and
the same situation continues on. The solutions are right in front of
us, and we just need the Biden administration to recognize that.
Mr. Speaker, I yield to the gentleman from California (Mr. LaMalfa).
Mr. LaMALFA. Mr. Speaker, I appreciate the time to be able to weigh
in on these issues in a little more relaxed manner here and spend some
time.
I want to talk a little bit about legislation we are working on here
known as S.J. Res. 38. In this case, it would ensure our taxpayer
dollars are used to buy American-made products, something that has had
bipartisan support, nonpartisan support, in the past around here.
Certainly, when we are talking about having something domestically
produced or buying it from a foreign competitor or ally, one thing we
shouldn't be doing is buying more and more things from China.
What is the sense of exporting so many of our dollars over to
somebody who is such an adversary in so many things on the world front,
with the funding of countries that are helping to sponsor terrorism and
the unrest they are helping fund in the Middle East? There are constant
threats to Taiwan and the other islands in the South
[[Page H40]]
China Sea that are possessions of Japan and others, constant aggression
on that. They sink many other smaller countries into huge debt by
dangling out loans they know they can't repay, and pretty soon, they
can take over the resources of that country.
As the United States of America, we can produce anything we want
here. We can produce it well, usually of the best quality, using the
best practices, by far, yet what are we doing? We are hamstringing our
own ability to strengthen our own economy with the energy we need to
produce in order to do that, with environmental policies that 50 years
ago were well intentioned but have been completely weaponized against
industries and farming, mining, and timber. The West burns each year
massively. In California and Utah, it is endless.
A lot of this currently comes from Biden administration policies, and
I jump back 3 years to 8 years to the Obama-era policies that have put
us in this spot.
Currently, President Biden wants to shoot down the waiver to
eliminate the buy in America requirements for, in this case, electric
vehicle chargers. That is what this bill, S.J. Res. 38, is about, which
would be purchased under the Infrastructure and Jobs Act, another
boondoggle itself.
If the money is going to be forced to be spent, and we have to buy
these electric chargers for electric cars, at least can we have them be
American produced, American made.
Don't get me mixed up with the electric car crowd. I don't think we
should be forcing that on anybody. At the same time, they are tearing
down the California power grid with the dams they are removing on the
Klamath River up in the north part of my district and one across the
border, and then threatening the Snake River farther up and one down in
Mendocino County.
It is just one thing after another, getting rid of hydroelectric
power and also the ability to store water and for the water to be
retained during flood control season and for some recreation--yes, even
water available to let out for fish when they need to. When they tear
these dams out, we lose that green, renewable, clean, CO2-
free power by these policies.
An addendum to that, CO2 is not a problem. It is only 0.04
percent of our atmosphere. The left wants to keep playing these games
like we are talking about here. They want to export jobs to China to
build these electric car chargers. They want to tear down the dams that
produce CO2-free, green, renewable power and try and build
even more batteries and more windmills that chop up the birds and only
run when there is a little bit of wind and the solar plants that only
run during the daytime when it is not a cloudy or rainy or snow-covered
day. It is amazing how dumb these ideas are.
In 2021, the Democrats included $7.5 billion of taxpayer money for
electric vehicle charging stations in their pie-in-the-sky idea that we
are going to electrify everything in the next few years. This is the
Infrastructure and Jobs Act.
I don't support the forced purchase and proliferation of electric
vehicles, but doggone it, if we are going to do this, we need to buy
American.
Why do we have to steamroll our own laws? Why is the administration
backstabbing our American manufacturers and sending billions over to
China and other Asian markets?
In the process, it also destroys our immigration laws and fosters
more chaos at the border when we have this continued policy by the
Biden administration of basically ignoring the border.
As mentioned earlier, 64 of my colleagues went to the border. I have
paid a couple of visits myself in Arizona and California and such. It
is indeed chaos. They are just walking right past you when you go visit
the border. Some of these are nice folks from Central America, families
and such. We keep putting out the magnet, the green light to come
across.
We have talked many times about the numbers coming across the border,
like 10,000 per day just in the month of December, 300,000 for a month.
The burden is being borne even by our Democrat-run cities, even they
are starting to cry uncle. We have the Governor of New Jersey saying we
need to check with these bus companies and see where they are all
coming from. No, you need to check over here at 1600 Pennsylvania
Avenue. That is where the policy is coming from. It isn't bus companies
from Texas or Florida or something. That is who you need to be talking
to because that is where the problem is.
Indeed, the administration is shifting from pushing our jobs overseas
to then having our jobs here filled by people who are coming here
illegally. It is the chaos they have had at the border coupled with
these other policies and fentanyl coming across the border.
Who knows what kind of terror cells are being built by people coming
across the border illegally and the gunrunning and everything else that
can happen? It has even resulted in the housing of illegal immigrants
in our National Park System, including a national park right there in
New York City, so people can't use it.
Now, you have seen the stories more and more recently that they are
going to be housing them in schools. Kids are getting kicked out of
schools in New York right now because they have a supposedly temporary
problem where they have to house them in the gym. The kids can go
online, back to Zoom learning, like during the height of COVID, which
was manipulated in my own home State of California, which took an extra
year to allow kids back into school.
{time} 1545
What a mess. Why are these people entrusted with power?
When you talk to the American public, this is all preventable. We
don't have to live like this, when we are talking energy, when we are
talking domestic production. No, we would rather export it, I guess,
and have kids in Africa mine the products in order to have your
electric car and electric gadgetry.
The National Park Police have testified that these encampments on our
National Park lands endanger the people that would normally enjoy and
use them. Also, in the wintertime, these areas can end up being a
floodplain, like the one in New York City, endangering the illegal
immigrants that are being attracted--until recently, when it seems
maybe the light is starting to turn around for the Governor of New York
and the mayor of New York City and such.
I don't know. I don't know.
Mr. Speaker, we have a porous border. We have a massive problem with
the encounters that we have at the border here that are overwhelming
our demoralized Border Patrol folks. How are they supposed to do their
job?
On my visit down to Arizona, they actually had, and still have today,
government-provided vans go over and just pick people up at the gaps in
the border and get them to the processing center sooner. We know that
85 percent of them are not going to be heard at their asylum trial any
time soon.
One thing after another is wrecking our economy, wrecking people's
confidence in government, and the ability just to conduct their own
lives. There is no reason we need to have such costly ways of doing
business with energy, with procuring food; everything else that is
happening under this Biden administration.
Mr. Speaker, just 3 years ago, things were looking pretty good on the
cost of fuel, cost of groceries, and employment until they used COVID
as a weapon to attack our economy at that time and tried to make it
look bad in order to win the 2020 election.
We have a lot of complex issues, but the solutions really aren't that
tough when you get down to it: enforce the border laws that we have.
We don't need comprehensive immigration reform. We already know what
we are supposed to do about the border. We just need to enforce the
laws that we have and have common sense applied to asylum.
At the same time, let's not exploit American jobs that we could be
doing if we have to produce these electric vehicle charging stations.
At least let Americans produce them instead of sending them to China.
Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman from California
for speaking very plainly and very simply. These solutions are right in
front of us.
Mr. Speaker, I yield to the gentleman from North Carolina (Mr.
Murphy).
Mr. MURPHY. Mr. Speaker, I rise today in opposition to the CMS'
proposed Medicare cut of 3.37 percent.
[[Page H41]]
Just to put this in perspective, when a physician sees a Medicare
patient, they do it because they care about patients. They do not do it
for money, because it doesn't make financial sense.
Let me give an example here.
You own a hardware store and you want to sell hammers. It costs you
$1 for each hammer. Say, the hammer is on Medicare, or you have to buy
the Medicare, and you have to sell it for 60 cents.
How long do you stay in business? It doesn't make sense.
So as we move time and time and time again, the number of physicians
who are able to take Medicare patients, out of the goodness of their
heart, is falling and falling. You actually lose money on Medicare or
Medicare patients that has to be taken up through cost shifting for
regular insurance.
When I ran a private practice, I stayed up many, many nights,
Saturday nights, searching for paper clips, making sure that I knew
where every penny went. I just had to make sure that my staff and the
bills got paid before I ever got paid.
My practice was heavily Medicare, so I did not take a salary many,
many times because the numbers did not work. In fact, adjusted for
overinflation for the last 20 years, Medicare physician fee schedules
have dropped 20 percent, and this is in light of the massive inflation
we have had over the last 2 years; even worse.
Mr. Speaker, what other profession expects to get a pay cut every
year?
This has to stop.
These are the people who are actually up in the middle of the night
taking care of your grandmother who has appendicitis, taking care of
your daughter, taking care of your child with a broken arm. They are
the ones doing this, and here we are rewarding them because they
basically have to take government pay patients by cutting and cutting
and cutting.
One of ObamaCare's directives was to starve private practices to
force physicians to work in hospitals or big conglomerations.
How did they do this? They cut their pay every year while hospitals,
although not as much so, got raises every year.
So what does this do? It pushes physicians out of private practice
because they can't pay the bills.
Mr. Speaker, I left my private practice when my partner said: We
can't do this anymore. We are going to be acquired by a hospital.
Mr. MURPHY: We can't provide the care to the patients that they need.
Why is it a bad model? Private-practice physicians are different
birds than employed physicians. It is just very simple. It is a well-
known fact in medicine. Those employed physicians tend to be less
efficient, cost more, and tend to work more on the clock.
Those who are in private practice put a taproot down in a community.
They have stayed there, and they are someone's doctor for 20, 30 years
or more. This is not happening now. They have made transitory medicine
the rule, not the exception.
The cuts that are going to the Medicare fee schedule absolutely need
to stop. This is why I introduced H.R. 6683, the Preserving Seniors'
Access to Physicians Act.
This legislation will stop this year's cuts while we work on a
permanent solution. This is not something that needs to happen year
after year after year where we are cutting and cutting the people who
actually take care of patients.
Mr. Speaker, I came to Congress to help work with my colleagues to
help fix Medicare. We are facing an absolute calamity with the shortage
of doctors, especially surgeons, in the next 3 to 5 years. Those who
are reaching retirement age, instead of working like most physicians
do, are finally throwing up their hands and saying, we are done.
Sadly enough, the ones coming out of medical school now--because of
some of the processes now were not working hard enough--are not nearly
coming out in the numbers and the efficiency to take the place of those
retiring.
Every day, we now add 10,000 new patients to the Medicare rolls. You
are expecting doctors to continue to take more and more Medicare,
earning less and less and less. They are going to go out of business or
have to go into employment, which we all know is a worse way of taking
care of patients.
Mr. Speaker, I ask my colleagues to support H.R. 6683 and help us try
to keep medicine back on track.
Thank you.
Mr. MOORE of Utah. Mr. Speaker, Dr. Murphy and I sit on the same
committee, Health in the Ways and Means Committee, and if his remarks
seem personal, it is because they are. He has had such a close
experience with this, and no one makes the point better that all of our
providers' costs continue to go up because of bad the monetary policy
that we have seen, particularly in the last few years. When we
constantly tell these providers, You are going to have to do more with
less, they have to make decisions, and this is ultimately the worst
possible thing for our patients.
The crowding-out effect that we have going on in our economy right
now, particularly with things related to government funding, there is
no situation where it is worse than this. The inability for us to get
after our true debt and deficit drivers will continue to crowd out, so
these types of cuts are forced on providers, and we have to be willing
and adult enough to be able to figure that out.
So thank you for that, Dr. Murphy.
Mr. Speaker, I yield to the gentleman from Indiana (Mr. Bucshon).
Mr. BUCSHON. Mr. Speaker, I thank the gentleman for yielding.
I am rising today to advocate for America's patients and their
physicians.
Over the past 3 years, doctors across the Nation have more than
stepped up to the challenges that they have encountered, COVID, often
risking their own health and safety to protect our communities. That
not only includes the physicians; that includes the nurses, the
technicians, and everyone in America's hospitals. However, when
Congress left town in December, we once again let down America's
doctors by allowing a 3.37 percent Medicare payment cut to hit January
1.
As a cardiothoracic surgeon for 15 years, I have seen firsthand the
consequences of cuts like these. What are the consequences? Access to
quality healthcare for rural America that I represent, underserved
urban America, the American people.
The payment cut to physicians will impede patients' access to care
while increasing the gap between physician expenses and reimbursement
rates.
I want to associate myself with Dr. Murphy's comments. Costs are
dramatically going up, and, if that continues, more and more of
America's physicians will not take Medicare. I didn't say Medicaid. I
said Medicare.
Given the existing shortage of physicians in the United States, the
combination of declining reimbursement and rapidly rising costs
threatens to drive more doctors out of the profession, particularly, as
I mentioned, in rural and underserved urban America.
It has led to a lot of consolidation, as Dr. Murphy mentioned--
physicians being consolidated into a large medical practice or employed
by large hospital systems.
Fortunately, we have a window of opportunity to right this wrong and
support the thousands of hardworking men and women serving millions of
Medicare beneficiaries. We must stop the bleeding and eliminate the
full 3.37 cut by January 19.
Congress must also implement a permanent solution that will halt the
downward spiral of physician reimbursement and provide much-needed and
deserved stability for America's doctors. Again, if we want access for
America's seniors to the Medicare program, we have to act. We have to
act soon.
Again, it is not just physicians out there not taking Medicaid. They
are not taking Medicare. I have elderly in-laws and an elderly mother.
They have experienced this.
In fact, we had a hearing in the Committee on Energy and Commerce a
couple of weeks ago. There was an economist there. He couched it in a
way that was positive. He said, Well, 60 percent of America's seniors
are not having trouble finding a primary care physician.
When it came around time for my questioning, I said, Well, I want to
rephrase that. Forty percent of America's seniors are struggling to
find a primary care doctor. That is a big number, folks. Forty percent
of America's seniors are struggling. Their physician retires. Their
physician moves.
[[Page H42]]
Trying to find a new primary care doctor is a big challenge. We cannot
let this continue--again, urban America and underserved areas, rural
America that I represent.
In 2023, for a more permanent solution, I introduced the bipartisan
Strengthening Medicare for Patients and Providers Act, which would tie
the annual physician fee schedule updates to inflationary measurements,
the Medicare Economic Index, or MEI. That is both fair and efficient.
It has been promoted. Almost every medical society in America thinks
this is a good idea.
I don't have the graph in front of me but let me just tell you what
it shows. Outpatient and inpatient hospital care gets an update based
on inflation every year. Providers do not. As Dr. Murphy outlined, it
has been at least a 20 percent cut just based on that in the most
recent history, and even more if you factor in the massive inflation--
which thankfully is down--that we had last year and the year before.
The current path toward further consolidation, physician burnout,
closure of medical practices must be corrected. If we don't correct
this, the problems I outlined are going to continue.
I urge congressional leadership to address this critical issue, and I
will continue to advance patient-centered solutions that empower
patients and support innovation to ensure that all Americans have
access to quality, affordable healthcare.
Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman, Dr. Bucshon,
for another incredible perspective on this looming issue that seems to
just be year over year over year, and we cannot continue to put our
medical providers in this situation.
Mr. Speaker, I yield to the gentleman from Tennessee (Mr. Rose).
Mr. ROSE. Mr. Speaker, I thank the gentleman from Utah, Vice Chairman
Moore, for yielding and for claiming this time this afternoon to
discuss these important issues facing our Nation.
Mr. Speaker, as the music note dropped in Nashville and Americans
rang in the new year on January 1, we woke up in the morning to
horrifying news. 302,000 illegal immigrant encounters had occurred at
our southern border, the most in any single month ever, in December
2023. To put this number into perspective, that is more than the entire
population of Knoxville, Tennessee, which is the third largest city in
my home State of Tennessee.
{time} 1600
Keep in mind, Mr. Speaker, that out of the 302,000 illegal immigrants
encountered at the southern border, none of these includes the illegal
immigrants who successfully evaded our Customs and Border Patrol
agents.
Nevertheless, Mr. Speaker, it is actually much worse. In fact, in
fiscal year 2023 which ended on September 30, so it doesn't include the
record-breaking month of December, Customs and Border Protection
reported 2.48 million illegal immigrant encounters, and there were over
1.1 million known got-aways. That includes 169 people who were stopped
trying to cross the border in fiscal year 2023 whose names appear on
the terrorist watch list, which is more than in fiscal years '17, '18,
'19, '20, '21, and '22 combined. Or to put it another way, the entire
Trump Presidency plus Biden's first 2 years.
Additionally, border officials seized 27,293 pounds of fentanyl in
fiscal year 2023. That is a whopping 464 percent increase from 2020
and, obviously, points out the failure of the White House and the
Department of Homeland Security to enforce our Nation's laws.
Their desire for open border policies is wreaking havoc on an entire
generation of young people in my home State and across our country who
are dying from fentanyl overdose at an alarming rate.
From halting border wall construction to ending the successful remain
in Mexico program implemented during the Trump administration to ending
title 42 powers that kept illegals out of the country, the White House
continues to send a message to the world that our borders are wide
open.
Thankfully, there is a solution that would make for a great new
year's resolution. The House Republicans passed H.R. 2, the Secure the
Border Act of 2023. It would end the catch-and-release policy, pay more
for Border Patrol agents, restart important border wall construction,
and strengthen and streamline the asylum process.
The bottom line is we must enforce the laws already on the books and
pass new ones that put an end to the skyrocketing illegal immigration
disrupting every corner of America, including my home State of
Tennessee. Unfortunately, until then, every town in President Biden's
America will be a border town.
Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman from Tennessee
for his remarks.
Mr. Speaker, I echo the gentleman's sentiments, and I will continue
to speak on it today. The solutions at the border are simple. We have
got actual data that can just be reimplemented and we can get rid of
the politics involved and just do something right by our Nation. We
look forward to an opportunity to leverage this moment to get this
border policy through. The things in H.R. 2 make absolute sense.
I am looking forward now to the remarks of my colleague from
Pennsylvania (Mr. Joyce).
Mr. JOYCE of Pennsylvania. Mr. Speaker, I thank the vice chairman for
yielding to me.
Mr. Speaker, last week, I joined the largest congressional delegation
in history to visit our southern border. What we saw is absolutely
alarming. It is alarming to me personally and will be alarming to every
American. We saw a Border Patrol station that has been under constant
siege for months. We saw a community in Eagle Pass dealing with the
strain of over 300,000 migrants crossing the border in the past 30
days. We saw an emboldened cartel that continues to smuggle drugs and
human trafficking into every community in America.
Speaking to Border Patrol agents and local sheriffs, it is clear that
President Biden's open border policies have led to this national
security crisis.
In the past 3 years, we have seen the number of attempted entries by
individuals on the terrorist watch list skyrocket to over 100 a year
with 1.5 million got-aways reported by the Border Patrol. That number
is surely larger. We have seen an increase in drug smuggling with
substances like fentanyl, methamphetamine, and heroin entering our
Nation at record levels.
Moreover, we have seen reports of public schools being used as
holding facilities for migrants instead of being used for American
students who are already suffering from historic learning losses after
the COVID pandemic.
All of this amounts to a pattern of failure brought on by the Biden
administration's refusal to address the border crisis head-on.
Half measures will not keep Americans safe. It is time for the Senate
to pass H.R. 2, the Secure the Border Act, and begin working in good
faith to protect our communities.
For far too long, my constituents have been poisoned by fentanyl
analogs that are created in China, made into pills in Mexico, and
brought into the United States through an open southern border.
It is time to enforce our laws. It is time to reinstate the remain in
Mexico policy. It is time to give Border Patrol agents the tools and
the resources that they need to protect our border and to protect the
sovereignty of our country. It is time to secure our Nation.
Mr. MOORE of Utah. Mr. Speaker, I thank Dr. Joyce for coming down
over the holiday break.
Mr. Speaker, I yield to the gentleman from Georgia (Mr. Carter).
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for
yielding, and I thank him for hosting this Special Order.
Mr. Speaker, I rise today to discuss CMS' Medicare physician fee
schedule which threatens seniors' access to healthcare, exacerbates
vertical consolidation within the market, and will further drive
patients toward higher cost sites of service.
Physician costs are growing, but their reimbursements are shrinking
yet again.
In America, we all want the same thing when it comes to healthcare.
Whether you are a Republican, a Democrat, an Independent, or whatever,
you want accessible, affordable, and quality healthcare. Everyone wants
that.
This is causing all three to suffer. Accessibility is decreasing.
More physicians and more physicians are no
[[Page H43]]
longer accepting Medicaid and are no longer accepting Medicare.
The issues are accessibility, affordability, driving patients to
higher cost sites, and, of course, quality.
Quality goes down when we lose quality physicians, and we are losing
them. They are getting out of the practices because they can't afford
to stay in the practices. In fact, Medicare doctor payments have been
cut by almost 10 percent over the last 4 years. This is simply
unsustainable.
Fortunately, we have a window of opportunity to right this wrong and
support the thousands of hardworking men and women serving millions of
Medicare beneficiaries. Over the holidays, I spoke with doctors in my
district who are preparing to make painful decisions including service
reductions and hiring freezes.
For patients, this means an inability to get even basic healthcare
services close to their homes or longer wait times as overwhelmed staff
race to keep up.
That is why I am working closely with my bipartisan colleagues on a
permanent solution, but we need to stop the full 3.37 percent cut and
ensure that physicians have the financial support necessary to care for
our seniors.
This is the United States of America. We have the greatest healthcare
system in the world, and we are ruining it.
Again, I don't care if you are a Republican, Democrat, Independent,
red, blue, or green. I don't care. We all want the same thing. We want
accessible, affordable, quality healthcare. This is ruining it. We have
got to compensate our physicians.
Mr. MOORE of Utah. Mr. Speaker, I thank the gentleman from Georgia
for his remarks emphasizing the need for good healthcare.
I hear this from several of my friends, family, and constituents back
home. I think one of the most alarming things that we are seeing right
now in the healthcare provider world is that--when I grew up, a lot of
my friends' parents were physicians. They would always encourage their
child to go into medical school and pursue a career that they loved so
much. This may just be an anecdote, but I am literally seeing that next
generation of current providers saying: Try something different.
Again, that may just be my experience. I don't think it is because I
have heard a lot of it from other colleagues of mine. We can't look
back at this time and say we didn't address this issue of not doing
right by our providers, by our rural healthcare and making sure that
they have what they need to be able to navigate the costs that are
continually increasing and being able to provide for their patients.
As Dr. Murphy also talked about, we have to have private practices
being able to stay nimble and focused on their specific community and
not just build big conglomerates. Small business is the backbone of our
Nation, and that needs to exist also in our healthcare market.
As I close here, let me just turn to the other topic that we talked
heavily about today which is the border. I spent some time at home the
last few weeks, and as I met with and had different forums back home
with constituents, I explained to them that one of the biggest problems
is the way that policy works in Washington, D.C.
It is in a very partisan and difficult circumstance back here. I
don't think anybody on either side of the aisle would disagree with me
that it becomes very difficult. When we factor in the Senate that
requires a 60-vote threshold--every bill needs to be bipartisan in the
Senate--that requirement isn't here in the majoritarian rule House, but
that is what we live with. Particularly when there is split government,
then we have difficult decisions and difficult things to navigate.
The point that I made to them was that with my Democratic colleagues,
we often can find the first three or four provisions of a particular
issue that we agree with, but then that is when it becomes difficult
because if Democrats want the fifth, the sixth, and the seventh item,
then they will say, no, we are not going to vote on any of the things
we agree on until we get some of these things we want, even though we
agree on the baseline.
We do it too. We have certain things that we want to make sure we get
so we are going to leverage that so we don't get the basics done.
I can't think of a scenario where this applies more than our border
crisis right now. I don't want to make this political. I remember a
little while ago when there were 34-odd migrants that suffocated in the
back of a truck. It was like a blip on the news feed. It was so quick.
It came out as a news cycle. That is the danger of what is going on
right now. We have empowered the cartel networks that we should be
united against. We have empowered the cartel networks to own the
border.
I heard a staggering statistic--I don't have the number in front of
me--on what we have calculated on how much money those cartels are
making on a weekly to monthly basis. It is terrifying because that
number is going directly into the drug trade.
The fentanyl crisis is one of the biggest impacts this has on our
community. I held this huge roundtable back in Utah with the
caretakers, law enforcement, and advocacy groups. It was a very
nonpartisan conversation, and it was so, so concerning on what was
going on.
This is what I want to tell the American people: We actually agree
that we should do a lot of the elements in H.R. 2. We should shore up
that protection and border security. However, then we need to make sure
we streamline the visa process, and we need to make sure we get a
stronger workforce here.
I am here to tell you, Mr. Speaker, we actually largely will agree on
that aspect of a comprehensive immigration reform.
{time} 1615
My biggest criticism of President Biden and his administration has
been that he immediately removed or reversed the Migrant Protection
Protocols, the remain in Mexico policy that the Trump-Pence
administration had done. ``Well, we are a new administration. We have
to reverse all those things.''
A lot of the energy things were done by executive order. It was also
this border policy. I think we are seeing now it is okay to have made a
mistake if you are willing to be the adult and say: ``Look, we actually
should reimplement some of this stuff.''
It is what the American people need. It is what the polling will tell
us. It is what we largely agree, that there are some basic things that
we can get done.
I think not telling the cartels: ``Hey, if you just get folks to the
border and get them across, they are going to get lost in the system.
You are going to be in there, and you are going to be fine.'' That is
what they are telling them. The immigrants who are coming here, it is
not the experience they are having because they get lost in the system
and then are forced to go into the drug trade or forced to be part of
the workforce of the Sinaloa cartel once they rush the product through
the borders however they get it, whether it is a port or nonport. I
don't care how it comes through.
Once that product gets here, then these individuals get leveraged to
do that because they have no other options because they were lied to by
the cartels.
If we can agree on some basic stuff, let's implement it. If we shore
up and get back to times that we saw in previous Presidencies, we can
then go and actually work on some of the other immigration policies
that also need reform.
I am committed to doing that, and I hope that we can address that. If
we leave the border with this type of policy that we have seen create a
beacon for these cartels, then we will not be able to accomplish
anything.
If it has to be done all in one bill, that is unrealistic because it
is just a bigger beacon. It is just more opportunity for the cartels to
try to get more people through, and it is nonsensical.
I hope for every opportunity to tell the Biden administration that
this is actually better for you politically. I hate to say it, but this
is what the American people need.
That is what my colleagues are trying to emphasize. That is why over
64 of my colleagues last week spent time down there. The same things
that I saw months ago when I visited Eagle Pass are continuing. They
are not getting better. There has to be policy change.
Mr. Speaker, I appreciate my colleagues for attending today's Special
[[Page H44]]
Order and sharing their thoughts on these very important issues, and I
yield back the balance of my time.
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