[Congressional Record Volume 170, Number 89 (Wednesday, May 22, 2024)]
[House]
[Pages H3478-H3481]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             THE BENEFITS OF MORALITY AND REALLY GOOD MATH

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 9, 2023, the Chair recognizes the gentleman from Arizona (Mr. 
Schweikert) for 30 minutes.
  Mr. SCHWEIKERT. Mr. Speaker, I say to my friend from Texas, your 
intro was actually brilliant because we are going to try to do 
something this evening that is going to make a whole bunch of people 
really cranky.
  Mr. Speaker, let's see if I can frame this in a way that I don't 
sound too much like a jerk. Week after week after week after week, I 
have come to the floor here and walked people through saying, the blue 
here, that portion we get to vote on and that every dime a Member of 
Congress votes on is on borrowed money.
  This is all borrowed, plus actually a portion of your Medicare, if 
you look at the math, is actually borrowed. Gross interest is going to 
be $1.2 trillion, making interest the second biggest expense in this 
government.
  One of the arguments I deal with over and over is trying to find 
moral, effective ways that we can save ourselves; that you could 
actually impact this remarkable amount of debt where we are hovering 
around borrowing about $100,000 a second.
  Every second of every day, we are just a little below that. Then the 
really uncomfortable is when you walk through the data, it is interest 
and healthcare. I am not a doctor; I am good at math.
  The dear Lord gave me one thing, I am good at math, but I thought I 
would try something new and exciting. How about if I brought, A, my 
friend who just happens to be benefited with a medical school 
education. That is why we will call him Dr. Harris and talk about if 
healthcare is the primary driver of U.S. sovereign debt, why not engage 
in the morality of a society that is healthier, that could be more 
vibrant?

[[Page H3479]]

  I have come here, and we have talked about diabetes being 33 percent 
of all U.S. healthcare, being 30 percent of Medicare spending, the 
cascade of conditions that come from obesity in America and the 
morality of loving our brothers and sisters and having a healthier 
society.
  My economists right now, we are working on our reply to the 
President's budget. We are vetting all the math, and we are 
highlighting things. We are still about 2 more weeks from our 
publication. We estimate that obesity will result in anywhere between 
$8.2 and $9.1 trillion in excess medical expenditures over the next 
decade.
  Maybe the most powerful thing you and I could do for U.S. sovereign 
debt and burying your retirement and our children and our great-
grandchildren and our great-great-grandchildren in piles of debt would 
be to actually work on policies to make us a healthier society.
  You get the benefits of the morality and really good math. I just 
happen to have a medical doctor who is a Member of Congress who is on 
the Appropriations Committee who has an expertise that I don't have and 
can talk about things that I can't say, but understand, we mean this 
from a portion of optimism.
  There is a path here, but we have to do something that is brutally 
uncomfortable for us: We have to tell the truth.
  Mr. Speaker, I yield to the gentleman from Maryland (Mr. Harris).
  Is that a fair set up?
  Mr. HARRIS. Mr. Speaker, I thank the gentleman from Arizona for 
yielding me some time today.
  Mr. Speaker, to those who see the gentleman virtually every week come 
up here and talk about the economics of the United States and our debt 
problems and things like that, today, we will take a little different 
view because we are going to talk about something that doesn't just 
have to do with economics; it has to do with providing a healthier 
America. An America where, yes, we would save money if we were 
healthier, but the other benefits are so tremendous.
  We are not doing this just because we want to save money; we are 
doing this because we think this is actually the right approach for 
Americans. If you look at the cost of healthcare, about 70 percent is 
to take care of chronic diseases and the big chronic diseases are 
hypertension, diabetes, and obesity. They are the big chronic diseases.
  Cancer is not a chronic disease. It is an acute disease. It is the 
chronic diseases that are costing literally hundreds of billions of 
dollars to the United States.
  Today, we are going to focus on obesity. Now, hopefully in the 
future, we will focus on diabetes, maybe on hypertension. The reason 
why it is so important to start with these three is that the amount of 
spending, as the gentleman indicates, is tremendous.
  I am going to pull some data from this study from the Milken 
Institute. It is called America's obesity crisis. It is from 2018, so 
5\1/2\ years ago, October 2018, but it is subtitled, ``The Health and 
Economic Cost of Excess Weight.'' The health and economic costs because 
they are both costs.
  Again, it is not just dollars and cents. They count, but the fact of 
life is just not as good for someone who has a chronic disease, so 
let's do something to prevent it.
  However, the first thing you have to do is say, what is the history 
of obesity in the United States?
  Look, I have been on this Earth 67 years. I will tell you that it has 
been noticeable that more Americans are obese or overweight. It is true 
throughout the world, but let's concentrate on America.
  These are medical definitions. If you are higher than the normal 
range of weight, you are overweight, if you are slightly higher; then 
you are obese if you are higher than that; and then severe obesity or 
morbidly obese, as well.
  Using these definitions, the same definitions in 1962, 3.4 percent of 
adults were considered obese. Again, it is not overweight; it is obese. 
If it is more than overweight; it is obese.
  From 1962 to 2000, 30.5 percent. In 2016, 39.8 percent. Mr. Speaker, 
8 years ago, it was 39.8 percent. The latest data the CDC has which is 
from 2017 to 2020, 41.9 percent. Mr. Speaker, 41.9 percent of Americans 
classified as obese.
  Now, why is that classification important?
  By the way, the demographic breakdown is very interesting because 
what we ought to be doing is, we ought to be looking at the 
demographics and paying attention to where it exists in the population: 
49.9 percent of Black adults are obese, 45.6 percent of Hispanic 
adults, 41.4 percent of White adults, 16.1 percent of Asian adults.

                              {time}  2000

  It actually is overrepresented in the Black and Hispanic communities, 
but why is that important? By the way, that is adults.
  The striking thing is for children in the last year that we have 
data: 16.1 percent overweight; 19.3 percent obese, one in five children 
are considered obese; one in 16, 6.1 percent, severe obesity in 
children. Again, that severe obesity in children number is actually 
higher at 6.1 percent than the entire adult population back in 1962.
  It begs the question of why it is so important that we identify 
obesity. It is because I think a lot of people don't understand the 
broad range of diseases, including expensive healthcare diseases, in 
which the risk of that disease is higher if you are obese. It is not 
everybody who is obese who has these problems, but if you are obese, 
you are statistically more likely to have these problems.
  I want to read the list so you understand why this is such a large 
economic problem. Alzheimer's and vascular dementia, most people don't 
realize obesity is a risk factor for that. We worry a lot about that 
because the cost of Alzheimer's in America and the treatment, again, is 
measured in the hundreds of billions of dollars. Other diseases include 
asthma and COPD; breast cancer--we know that cancers are; chronic back 
pain; colorectal cancer; congestive heart failure--again, a large 
consumer of healthcare dollars; coronary artery disease; diabetes, of 
course. Again, diabetes and obesity kind of go hand-in-hand, but only 
20 percent of the cost of obesity, again, the approximately $1.7 
trillion annual cost back in 2016, only 20 percent of that can be 
attributed to the coexistence of diabetes and obesity. Again, diabetes 
has to be handled by itself, but obesity is a risk factor for that.
  Dyslipidemia, so people with high cholesterol and lipids; end-stage 
renal disease; endometrial cancer; esophageal adenocarcinoma; 
gallbladder cancer; gallbladder disease; gastric adenocarcinoma, so 
stomach cancer; hypertension; liver cancer; osteoarthritis; ovarian 
cancer; pancreatic cancer; prostate cancer; renal cancer; and stroke--
all of these have a higher incidence in someone with obesity.
  Scientifically, we say that if we can reduce obesity, we will reduce 
the incidence of all these diseases and the costs associated with them. 
The costs associated with them attributable to obesity are over $1.5 
trillion a year, both direct costs, the cost to actually treat someone, 
and the indirect costs, the cost of decreased productivity and 
decreased contribution to the GDP and the economy by someone who is 
ill, all these indirect and direct costs. These numbers are just 
staggering.
  Mr. SCHWEIKERT. Yet, I promise you, tomorrow, we will have things on 
our phone attacking us for telling the truth.
  Mr. Speaker, I am going to argue our willingness to come here and 
tell the truth--I love people. I want them to flourish.
  Doctor, we are about to have our fifth year of prime-age males where 
their life expectancy is shorter. You were actually walking me through 
some of the math earlier.
  Does anyone care?
  The concentration I see of the lack of family formation, 
productivity, the ability to participate in society, the healthcare 
costs--what would happen if we had a society where we were not afraid 
to talk about the stigma?
  We are saying there are policies. I have the stacks of charts and 
these things, but there are policies we can engage in to make a 
difference.
  This is on topic and uncomfortable, but one of the things I come here 
and talk about over and over--let's just use this chart down here. 
Medicare is singularly the primary driver of our debt. It is healthcare 
costs. It is an earned benefit. You paid your 40 quarters for Social 
Security, but the average couple

[[Page H3480]]

will have paid in $227,000 in FICA taxes, the portion that goes toward 
Medicare, but they get back $725,000. That differential right there is 
the primary driver of U.S. sovereign debt.
  Do you do what some of the folks around here want to do, my 
Democratic colleagues, where they want to basically say Medicare for 
All? We are going to ration it. It is going to be government 
everything. The doctors you have are going to be government employees, 
that sort of model. Or should we actually take on something much more 
moral, much more creative, and much more, I would argue, doable?
  Let's look at the government policies we engage in where we subsidize 
people's misery. Could we turn some of the very programs we have to 
make them more moral and help make our society healthier?
  Doctor, I know that has been one of your fixations. You have been in 
front of committees over and over, talking about things we could do, 
everything from agricultural legislation, nutrition legislation--the 
things I do in Ways and Means, trying to finance access to therapies to 
make people healthier.
  Mr. HARRIS. Sure. I chair the Agriculture, Rural Development, Food 
and Drug Administration, and Related Agencies Subcommittee of the 
Appropriations Committee, and we are in charge of funding the 
Supplemental Nutrition Assistance Program, the SNAP program.
  If you were paying attention about an hour ago, an hour and a half 
ago, to the folks from the other side of the aisle, all they wanted to 
do was push more money into the Supplemental Nutrition Assistance 
Program.
  The second word there, by the way, is ``nutrition.'' If you go back 
to the original founding, the program was founded to provide nutrition. 
In the early days of the program, there was a significant number of 
people in the country who actually did not receive enough calories. 
Literally, they didn't receive enough calories. At that time, the 
emphasis was to get food of all kinds to these folks so that they are 
not calorie starved.
  Again, I talked about the trend in obesity, and what we see is that 
something is happening. We have programs like the Supplemental 
Nutrition Assistance Program where the last time they looked at it was 
in 2016--it might have been earlier than that--where 10 percent of the 
funds went to sugary soda. Remember, this is a $122 billion a year 
program of taxpayer dollars. We ask taxpayers to pony up or to borrow 
$122 billion to put into the Supplemental Nutrition Assistance Program. 
Ten percent is on sugary soda, $12 billion, our best estimate, is spent 
on something that we now know--maybe 40 or 50 years ago when the 
obesity rate was 6 percent or 3-plus percent, we didn't know that.

  We do know now what contributes to obesity. We do know that insulin 
resistance, the presence of sugars and processed foods in the diet, 
directly cause obesity. Of course, diabetes, which again we will get to 
in the future, and probably also hypertension to some extent, are all 
interrelated diseases. We actually know that that is bad.
  I have proposed taking out nonnutritious--it is about 20 percent. It 
is 10 percent sugary soda beverages and another 10 percent salty 
snacks, ultra-processed food. Again, it raises your insulin levels. It 
does all the bad things that ultimately lead to an increased amount of 
fatty tissue and obesity.
  Let's just say that we will allow States to restrict that in a 
program and take that money and spend it on fruits and vegetables or 
something. That sounds like a pretty novel idea. That sounds like a 
pretty good idea based on the scientific evidence.
  The pushback has been tremendous, mainly from the other side of the 
aisle, which is: No, all we need to do is spend more money on this 
program.
  I would suggest to the gentleman from Arizona that we have enough 
proof that what we have been doing hasn't been working. In fact, it has 
been making the problem worse because the data on people who receive 
Supplemental Nutrition Assistance Program shows they are more obese and 
more overweight.
  Mr. SCHWEIKERT. And sicker.
  Mr. HARRIS. Of course, they are sicker because we know these diseases 
relate to it. The studies were done against individuals who had the 
same socioeconomic status, same income, but were not getting SNAP 
benefits.
  Mr. SCHWEIKERT. Doctor, the morality argument I really want us to 
make is the way we have designed these programs, as they were 
originally designed decades and decades and decades ago, we now 
understand, we are financing people's misery instead of financing the 
opportunity to be healthier, to be part of society, to actually live 
longer.
  It is uncomfortable, but we have to have a moment of honesty. I don't 
understand the left's fixation on basically using borrowed money to 
finance misery.
  Mr. HARRIS. I agree. This is not just about economics. It is using 
borrowed money to actually cause the need for more borrowed money in 
the future.
  Mr. SCHWEIKERT. Yes. On the economic side, we call it knock-off 
effects, second-degree, third-degree effects. In some ways, they are 
not even that. They are just the principal effects.
  Mr. HARRIS. It is direct. Again, even if this were economically 
neutral--but it is not--one would make the argument that the right 
thing to do for people is to give them a better, healthier life.
  Mr. SCHWEIKERT. Yes.
  Mr. HARRIS. In the hearing today, we had someone suggest that all we 
need to do is do public service announcements, that we will just do 
education.
  Mr. SCHWEIKERT. And?
  Mr. HARRIS. One of the experts said, quite accurately, that when you 
deal with an addiction--and we won't get into that today, but by the 
way, just so everybody understands, it is now pretty clear from brain 
chemistry that sugar--and when we say sugar, mostly it is fructose 
because the other sugar is cane sugar, which is sucrose, a combination 
of fructose and glucose. Fructose, basically, we understand that it is 
actually physically addictive in the brain because it results through 
the modifier of MGO, a chemical called MGO, which binds to receptors in 
the brain. It actually releases dopamine.
  Mr. SCHWEIKERT. Yes. Would this explain my ice cream problem?
  Mr. HARRIS. It could. Every single addictive issue in front of us 
involves--whether it is an addiction like opioid addiction, an 
addiction like sugar addiction, an addiction like gambling, or your 
cell phones and the fact that our youth now spend 7 hours a day on 
their cell phones, on the internet and playing games and things, it is 
because this is designed to release dopamine in the brain.
  We understand it is the exact same mechanism, and it is up to us. 
People say to educate. Our government shouldn't be involved in this. 
Wait a minute, we are talking about regulating the industry for 
children with regard to apps, regulating the opioid industry because it 
is addictive, dealing with gambling because it is addictive. Why 
wouldn't we talk about a food addiction that leads to misery and huge 
economic costs?
  Mr. SCHWEIKERT. Doctor, look, my personal philosophy, I am probably a 
little bit more libertarian here. Have what you want, but understand, 
A, should government finance things that make our population less 
healthy, and, as a matter of fact, make much of the population very 
sick? The reality of it is when the majority of healthcare partially is 
financed in some fashion through government, we have an interest. In 
some ways, it sickens me, but that is the reality we have to sort of 
mechanically deal with.
  The statistics, the data, are just crashing on us since the pandemic, 
the curve of our brothers and sisters who are getting sicker and 
sicker. Now, I am dealing with some of the data we are looking at of 
those moving into their retirement benefits being also much sicker and 
trying to figure out how we finance that. We are financing it with 
partially borrowed money.
  It is honestly a good economics and moral argument. Maybe we should 
change the way we do nutrition assistance in America. Maybe we should 
change even down to some of the agricultural policy of adding more 
variety. I have given presentations on the concentration of certain 
crops and the whole way commodity pricing works, and the black swan 
theory of that level of concentration, God forbid something ever 
happened to one of the crops, but

[[Page H3481]]

it all ties together. It is a unified theory. If I care about 
healthcare spending--and, understand, ObamaCare was a financing bill. 
It was about who got subsidized and who had to pay. Our Republican 
alternative was a financing bill.

                              {time}  2015

  We are right now doing the hardest thing in Congress. We are actually 
talking about what we pay for. Could we actually reduce healthcare 
spending by having a healthier country, a healthier population? That 
would actually be much more egalitarian with prosperity.
  Mr. HARRIS. There is no question that that is true. The fact is that 
we can send a strong economic signal through our ability to modify what 
is available under food programs, not only direct payments but also the 
fact that, over the past 50 years, we have kind of funneled all the 
production, as you said, into only a handful of major crops.
  In my district, for instance, they used to grow tomatoes. It used to 
be one of the tomato capitals of the country. I didn't even know this, 
but it is not anymore. It is just soybeans and corn, partly because we 
have a big poultry industry, but the variety of crops has just 
disappeared.
  Again, everything comes together. Everything points in the same 
direction. We must address the obesity crisis. We know what causes it.
  We actually have a pretty good idea of how to solve it, how to get 
there, but we have to decide that that is something we are going to do. 
I think the average American understands it. I think they do.
  Mr. SCHWEIKERT. It is fascinating when I am home in Arizona, the 
number of folks I walk up to who will almost pull me aside and say: I 
can't believe you were willing to talk about that. You told the truth.
  It is almost like they weren't ready to have those of us from the 
political class do something that is uncomfortable.
  The math is the math. If you take a look at mortality statistics, is 
it moral to have a society, particularly working, prime-age males--I 
mean, you were actually quoting some of the statistics in our previous 
conversation. They are dying younger and younger.
  What we have done to younger people in the country, what we are doing 
to seniors, we can fix this. We just have to be willing to do some 
difficult policy here--it is not difficult policy.
  There are some experiments out there--and you and I have not talked 
about this before, so we are winging it--where it was the food box and 
saying that we are going to deliver to our brothers and sisters who 
need nutrition support a box. There was a problem. Sometimes, the 
fruits and those things were thrown away, so they experimented with 
other ways to deliver it.
  It was in a microwave pouch, and it turned out that it was working. 
They were making people healthier, and then that pilot program 
disappeared.
  We are talking billions and billions of dollars, which means there 
will be armies of lobbyists in the hallway here tomorrow really cranky 
about what we talked about.
  Can we make the argument that we should do the right thing? Is this 
Republican or Democrat? It should be just the right thing.
  Mr. HARRIS. That is right. You bring up a good point.
  The first thing you start with is say that we don't have to change--
let's do a few pilot programs. Let's get some data. Otherwise, it is 
incredibly difficult to see whether some of these ideas work to change 
the way people buy and their habits. Obviously, it will take a 
generation for the obesity that already exists to plateau.
  Mr. SCHWEIKERT. I am more optimistic than you.
  Mr. HARRIS. I mean, with Ozempic and Wegovy, maybe it is quicker, but 
these are not the solution. The solution is not to become obese and 
then take a drug to reduce the obesity. It is not to become obese in 
the first place, but your point is critical.
  Right now, a 3-year-old has a lower life expectancy than a 60-year-
old had at the same age. That is because our adults are getting these 
chronic diseases at an increasing rate. That 3-year-old, if we don't 
change the trajectory, will have much less of a chance to live to the 
same age as their grandfather did or their father did.
  We cannot accept that in America. We are actually in a situation 
where our children have a lower life expectancy than us.
  This is the opposite of everything anybody does anything for. As a 
father, you want to do everything for your children so they have it 
better than you.
  We are kind of intentionally, because we are intentional in how we 
spend dollars, forcing our children to a lower, shorter life expectancy 
than we have. Shame on us if we don't fix this.
  Mr. SCHWEIKERT. We are already crushing the next generation, the next 
three generations. My wife is my age, and I have an 8-year-old and a 
23-month-old.
  Mathematically, my 23-month-old, when he is 20 years old, U.S. taxes 
will have to be double what they are today to maintain baseline 
services.
  This is what we are doing to our society. We are coming behind these 
microphones, and we have done the economic presentations. We can do the 
Democrats' tax scheme. You get about 1.5 percent of GDP if you were 
able to tax maximize everything.
  For those of us who want to cut things, we get about a point of 
discretionary nondefense. That is $300 billion there if we could cut 
that much, so 2.5 percent.
  This fiscal year so far, we were expecting to borrow about 5, 5.5 
percent of GDP. We are closer to 9. Does anyone see a math problem 
there?
  If this is the political rhetoric, that they want to raise taxes and 
we want to cut, and you only get this much, maybe we need to promote 
policies that disrupt the cost of government and the cost of 
healthcare.
  A couple of weeks ago, I gave a series of presentations here on using 
technology, using AI, those things, to make government much smaller. We 
can do things like this. There are paths.
  Mr. Speaker pro tempore, are we up against time?
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. SCHWEIKERT. Mr. Speaker, I thank Dr. Harris for joining me, and I 
yield back.

                          ____________________