[Congressional Record (Bound Edition), Volume 155 (2009), Part 10]
[House]
[Pages 12814-12819]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   ADDRESSING THE HEALTH CARE CRISIS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Tennessee (Mr. Roe) is recognized 
for 60 minutes.
  Mr. ROE of Tennessee. Thank you, Mr. Speaker. We're here this evening 
to begin and continue a very important debate in American society. I 
think it's probably one of the most important social debates we've had 
in the last 40 years in this Nation since the debate on Medicare in 
1965.
  We're here tonight as a Physicians Caucus to discuss health care 
reform. My background, I spent 31 years practicing medicine in Johnson 
City, Tennessee, in the First Congressional District. As I've watched 
our health care

[[Page 12815]]

system change over the past 30 years, it really spurred me to run for 
Congress, to come here and be part of this great debate that will 
affect every American citizen.
  I recall when I made my decision to go to medical school, I wanted to 
be a family practitioner. Somewhere along the way, I discovered I had a 
great knack and a love of delivering babies. I have delivered almost 
5,000 of them, many of whom are now grown. One of the great advantages 
you have as an obstetrician when you run for Congress is that you can 
deliver your own voters. There is some advantage to that.
  We have a health care problem in America. Some call it a crisis. For 
some, it is. For others, it's cost. Certainly we know that there are 
great concerns about the cost of health care.
  In the next hour we're going to discuss how we're going to address 
this health care crisis. We can ensure that every American can get the 
care they need, protect individuals from costs that can bankrupt them 
and make health insurance portable so that you don't lose your coverage 
just because you change jobs or move from one State to another.
  We can also take the profits out of health care by reforming the 
health insurance industry to bring about a patient-centered approach to 
providing health care. Enacting a public plan will not bring about this 
type of change, and I'm going to go into that in some detail from the 
experiences we've had in the State of Tennessee with our Tennessee 
Medicaid system called TennCare.
  If you think you won't be affected by a public plan, consider this: A 
recent analysis of this plan by the respected independent firm Lewin 
Group estimated that 70 percent of individuals who have health care 
coverage through their employer would lose those benefits in favor of a 
public plan. Now this plan could very easily become a Medicaid-type 
plan.
  When supporters of a public plan say they want the public plan to 
compete with private plans, the facts show that what they're really 
saying is that they want Washington bureaucrats to take over the health 
care decision-making.
  I want to talk for a while or speak to you a little while about the 
principles that House Republicans have put forward to start the debate 
over how to bring about patient-centered health care.
  I want to mention a couple things before we start. Health care 
affects all of us, whether we're Democrats, Republicans, Independents, 
or whether we're totally apolitical. At some point in time in your 
life, you're going to have to make decisions about how I receive and 
get health care for myself or my family.
  We're going to start this evening by giving another opinion or 
another view of the health care plan and how it is to be administered 
and obtained. The principles that we're going to talk about for health 
care reform are, number one, make quality health care coverage 
affordable and accessible for every American regardless of preexisting 
conditions. In a country that spends 16 percent of its GDP, over $2 
trillion a year, on health care, I think there's no question that we 
can provide a basic health care plan for each American.
  Now what I mean by basic health care, it's not a plan where you can 
get hair transplants or face-lifts or all this. But if you are out 
there injured in an automobile wreck or have a heart attack or have a 
gallbladder that goes bad, you can get basic health coverage and care.
  I think this is something that all Americans believe in. I think we 
now have crossed that bridge and believe we can do that. I think the 
differences we're going to have in this great debate that we're going 
to have are, how are we going to accomplish this very noble task? In a 
few minutes I will go through how we tried this in Tennessee, and how 
it was not successful. But I think it can be.
  Most Americans also fear, I think rightly so, that a basic health 
problem--it may be leukemia or a cancer of some type--can bankrupt the 
family. Certainly we don't want a situation where a family, through no 
fault of their own, develops a disease process, and then you use up all 
the family resources you've saved in a lifetime to provide care for 
your family.
  The second principle we'll talk about is not a government-run health 
care plan. This eliminates coverage for more than 100 million people 
who receive insurance from an employer, and it restricts patient choice 
of doctors and treatments and results in the Federal Government 
takeover of health care.
  Let me sort of explain how this worked in Tennessee. In the early 
nineties and mid-nineties, the big debate in this country came along 
about controlling health care costs or managed care. We were going to 
control costs through deciding who and what care was appropriate and so 
on. Well, that didn't work. Health care costs have continued to 
escalate in spite of managed care, and managed care basically has moved 
the pay to providers over to the third-party payers.
  In Tennessee we had a very noble plan. We wanted to cover everyone in 
our State, and we're not a wealthy State, so it was a noble goal. Right 
now in the State of Tennessee we have TennCare, which is our Medicaid 
plan. We have the uninsured, we have Medicare, and then we also have 
the private health insurance coverage. About 60-plus percent of 
Americans are covered by private health insurance coverage.
  In Tennessee when we applied the TennCare solution, which was a 
managed care solution with multiple third-party payers at that time, 
the plan was not fully vetted and thought out well. One of the things 
I've said the entire time I've been here, Let's do this health care 
plan right. Let's not do it fast. I think one of the mistakes we made 
in Tennessee was going too rapidly with this plan.
  So we instituted this plan, and what we found out was that 45 percent 
of the people who applied for TennCare and were granted it had private 
health insurance coverage. Well, I went to the providers recently, 
hospitals and other providers, and I said, What percent of your costs 
does Medicaid or TennCare pay in your particular facility? And the 
resounding answer was, about 60 percent. So you have a significant 
percentage of people now who have given up their private health 
insurance and have gotten on the public plan, which only pays about 60 
percent of the provider costs. You also have the uninsured who pay some 
percentage of their own costs, and Medicare pays about 90 percent of 
the costs.
  So as you shifted more people from the private plans to the TennCare 
plan, you forced the private health insurers to charge more for their 
plan. That's what happened. What I can see happening in the public plan 
is exactly this. It's going to be described, we're going to have a plan 
that's competitive. It will be very rich in benefits. And what happened 
was, in Tennessee the actual TennCare plan was richer in benefits than 
I could afford to provide my own office staff and myself because of the 
costs.
  When you have politicians deciding what goes into a basic plan, it 
will become richer and richer and richer. What will happen in the 
public plan--and you'll hear the buzzwords. It will be competitive. If 
you like your own health insurance coverage, you can keep it. You don't 
have to give it up. Just keep what you have.
  Well, what will happen is this: Businesses will make a perfectly 
logical decision. What they will do is--and this is small business 
because in businesses in this country with over 200 employees, 99 
percent of those have health insurance coverage.
  So this is what will happen. You have the public option plan, the 
government-run bureaucratic plan that will have a lot of benefits, 
except it won't pay the cost of care. And when that happens, the cost 
of private insurance once again will be forced up, causing more and 
more and more businesses to do away with their private health insurance 
plans and put it on the public plan. And really over time--and I think 
a very short period of time--you will see the public plan, along with 
Medicaid and Medicare, become the only options available.

[[Page 12816]]

  Now why do we think that this is not a good idea? Well, we've looked 
at public plans, and I have studied these extensively in foreign 
countries. In England, Canada, Sweden, Norway, Germany, France, Italy, 
other major European industrialized nations.

                              {time}  1730

  And this is what you would find. The way costs are controlled are by 
rationing care. In other words, when you have used up all the public 
dollars that you have dedicated for health care, you have to create 
ways. An example is in Tennessee. What we did was we simply shrank the 
rolls. We realized if so many people got on the public plan, the 
TennCare plan, that the State no longer could afford to budget for it. 
Our health care costs were more than education in the State. So what 
the Governor did, along with the legislature, is just cut the number of 
people off the TennCare rolls.
  Well, for instance, in Canada, if you have a heart attack, your 
average time to go to the operating room is 117 days. They simply 
ration their care in Canada. And they have great physicians there. As a 
matter of fact, in the last decade, 11 percent of the Canadian 
physicians have moved to the United States. I have several very close 
friends who are Canadian physicians and colleagues. And they do a 
wonderful job. The president of the Canadian Medical Association once 
stated that a dog in Canada could get a hip operation within 1 week, 
and a patient there, it took between 2 and 3 years, simply because of 
lack of government funds to provide all of the benefits that the 
government had promised.
  So in this particular plan, the one thing that I want as a physician, 
that I have utilized for years, is that you want to maintain the 
patient-physician relationship. The one thing that is absolutely 
mandatory, in my mind, is that the decisionmaking between patient and 
physician is paramount. Doctors and patients should be making health 
care decisions. Some government bureaucrat should not be deciding 
whether you get your hip replaced or your aging parents get the care 
they need.
  I'm going to stop at this point in the principles, and there are lots 
to talk about tonight. And I see my colleague, Dr. Fleming from 
Louisiana, is here. And I would like to yield him as much time as he 
feels is necessary.
  Mr. FLEMING. Well, thanks to my colleague and the gentleman from 
Tennessee, Dr. Roe. Dr. Roe certainly has a lot to bring to the table 
being a physician for many years and also having quite a political 
background being mayor of a city and actually having balanced a budget 
and even having a surplus, something we don't see very often these 
days. And so I thank the gentleman for that.
  Yes, I wanted to make a few comments, as well, regarding this health 
care debate that is coming to a head here very soon. Patients are very 
simple in what they want from health care. Certainly they want choice. 
They want affordability. They want control. And they want good results. 
And I think that that is quite reasonable. And certainly on the other 
side of the aisle where there is a debate about a single-payer system, 
really a government-run system, I think that there is not any 
disagreement about the fact that we want everyone to have access to 
health care, and we want everyone to have access to good health care.
  I think where the debate begins to fall down is that in our opinion 
on this side of the aisle, we feel that a government-run system is not 
a well run system. It is an inefficient system. It is a wasteful 
system. We have many, many examples of why that is true. We don't have 
to even turn to health care. We can look at any system that has been 
run by government, and not just the United States Government. Cities 
and States all reveal considerable waste because it is the nature of 
the system itself. On the other hand, in the private system, there is 
the administrative ability to remove fraud, waste and abuse.
  I will give you an example. Today with Medicare and Medicaid, we 
recognize that there is fraud, waste and abuse. Everyone knows it. Many 
politicians get up and clamor that they will be able to remove it, but 
none has been able to do that. The reason is because of the nature of 
government itself. Government cannot remove fraud, waste and abuse. In 
order to attempt to do so, it has to build, first of all, a large 
bureaucracy. It has to catch the offenders. With that, there has to be 
prosecution of the offenders. And when you get down to it, you only 
find the very most egregious small percentage of those who are actually 
committing fraud, waste and abuse. So you get really a small tip of the 
iceberg. So much more is underneath that a government can never get to.
  On the other hand, if you look at a private business, private 
business has all sorts of ways of finding fraud, waste and abuse and 
removing it administratively. For instance, a physician who is 
practicing inefficient medicine in an organization, in a private 
organization, he can be reeducated, or she can be re-educated, or just 
simply removed entirely from employment. But government is unable to 
micromanage individual behavior. And every time we attempt, we simply 
run cost up. And I will give you another good example of that. If you 
look at the post office and compare it to FedEx or UPS, you will see 
these private companies run so efficiently and so profitably. And yet, 
of course, the post office does not run efficiently. There are long 
lines. And that is just one way to control cost, and then, of course, 
ultimately we have to pay higher rates.
  So I think that we really have to look at the endemic problems within 
a private system versus a public system when we see that really there 
are only two ways to control cost in a public system. And we are 
attempting one of them and have been doing so for the last 20 or 30 
years, and that is price controls, price controls on the providers, the 
hospitals and the doctors. And that would be a wonderful thing perhaps, 
at least for consumers, if it worked. But what goes up faster than 
health care every year? Nothing that I'm aware of. It is the one part 
of the economy where we have price controls, the only one, and yet it 
goes up faster than anything else.
  Well, what is the only other way we can control costs? That is 
rationing. And you say, well, we are not rationing care today. Look at 
Medicare and Medicaid, still a reasonably smaller percentage of the 
total health care system here, and it is able to provide good service 
to recipients, even though they are government-run programs, only 
because you have a much larger private system that is able to keep it 
supported. Now if we expand that to a large, government-run health care 
system, it is going to make up 17 percent of our entire economy. Where 
are we going to get the money to prop that system up? Where is it going 
to come from? And so what we are going to end up with is the same place 
where Canada, the U.K. and all the other countries that have gone to a 
single-payer, government-takeover-run system, and that is that there is 
going to have to be cuts. When we get up to a point where budgets have 
to be evaluated, we are going to have to make cuts. And when you make 
cuts, that equals rationing.
  Mr. ROE of Tennessee. Will the gentleman yield for a moment?
  Mr. FLEMING. Yes
  Mr. ROE of Tennessee. Here just a minute ago, we heard a debate on 
the floor about how we are going to have to redo Medicaid and Medicare. 
And we have a system already that has promised up to as much as a $70 
trillion promise that we have unfunded, a government system that we 
don't have the money to pay for now, and we are thinking about starting 
another one, another government system. And you mentioned rationing of 
care. It brings to me the thought of breast cancer.
  As a physician in our practice, we average seeing one newly diagnosed 
breast cancer per week. And when I began my practice over 30 years ago, 
half the women, approximately half the women, died in 5 years after 
being diagnosed with breast cancer. It was a terrible, and still is, a 
terrible diagnosis. And one of the great miracles of medicine is we 
haven't cured that disease, but we have improved the life expectancy 
for a woman diagnosed early to a

[[Page 12817]]

5-year survival rate of 98 percent. It is a wonderful story to tell. 
When a patient comes to my office, and she says, Dr. Roe, how am I 
going to do? I can say, look, you're going to have some tough times. 
It's going to be hard. This therapy is going to be difficult and tough. 
But you're going to make it. And you're going to live. And you're going 
to get through it. And I'm going to be through it with you.
  What has happened in England is that the best results they had ever 
was a 78 percent 5-year survival rate. And they quit doing routine 
screening mammograms in England. And the reason they quit doing that is 
because there is a false positive rate. That means the test says you 
have something wrong, you go and have a more sophisticated biopsy. It 
is called a ``wire-guided biopsy.'' It requires a radiologist. It is a 
fairly sophisticated, as you all know, procedure. But what happens is 
that that costs more than the screening mammogram. So now they just 
wait until you develop a lump that you can feel. And as most physicians 
know, that is about 2 centimeters or three-quarters of an inch.
  I don't think the American people are going to tolerate that for 
their families. I know I won't tolerate that for my family. I don't 
want a government decision based on the amount of money whether my wife 
or my daughter can have a mammogram. I yield back.
  Mr. FLEMING. I thank the gentleman from Tennessee, Dr. Roe, for his 
excellent comments.
  What you're pointing out is that rationing is not just about 
inconvenience, although there is a lot of inconvenience where someone 
has to wait 6 months to get a surgery, elective surgery or something 
like that. But it also means accepted death rates and accepted 
morbidity rates so that people go unable to work because they need a 
hip replacement or someone dies waiting for needed surgery for a 
disease disorder. They go delayed diagnosis for a tumor which is going 
to end up in much more cost down the line because it wasn't prevented 
or diagnosed earlier. So rationed care I think is unacceptable to the 
American mind. And I would just say that if we go towards a government-
run system, we have to be willing to accept the fact that we will have 
rationed care. I don't see any way around that.
  I do want to just sum up before I yield, and that is that I think 
that in evaluating the American psyche today when it comes to health 
care, we find that 83 percent of Americans like the health care the way 
it is. They like their insurance coverage. They like the doctor that 
they see. They are happy. The problem that we are talking about today 
is the 47 million uninsured. And who are these people? Well, statistics 
tell us that probably 10 million or so of those are illegal aliens. 
And, of course, that is a whole other debate. We need immigration 
reform. There is also probably half that number who are young adults 
who are healthy who elect not to get any health care insurance 
coverage. And so we have a real challenge before us to entice or to 
incentivize them to join, because if they join into the plan, we can 
work through preventive health care and early diagnostic care to 
prevent them from disease down the road, and also their dollars up 
front will help fund the last 10 million, which is the most critical 10 
million, and that is older adults who are not Medicare age who do not 
have affordable accessibility to health care coverage, and therein lies 
a problem. They are not the poor. They are not the elderly. And they 
are not people that work for corporations. They are small business 
owners and their employees, a critical 10 million population that are 
finding their ways into the emergency rooms late in their illness with 
outcomes poor, far more cost required. And of course we physicians and 
hospitals have a mandate to provide care to them regardless of their 
ability to pay, which is a noble American concept. But the problem is, 
that cost has to be passed on to others, taxpayers, those who are 
paying their insurance subscription rates. And I'm sure we, as 
Americans, are willing to do that to an extent. But if you take those 
same dollars and you allow these people to get insurance and early 
preventive care, have a medical home, a family doctor, those costs will 
collapse. They don't have to be the high-price, low-yield kind of care 
that they get through the emergency room.
  And lastly, I think it is important that we look at reforming health 
care laws where we can allow physicians and hospitals and other 
providers to come together to begin to work together and to compete to 
lower the overall cost of health care rather than having it being 
dictated from Washington, which as I pointed out, is really a very poor 
way to try to cut costs.
  And then finally, that we do away, remove from the lexicon, the idea 
and even the verbiage that says ``preexisting illness.'' There should 
never be that term used ever again.

                              {time}  1745

  In conclusion, I just want to emphasize the need to remove the term 
``preexisting illness'' from the lexicon and that we make it easy and 
affordable for all Americans to access the health care system; but as I 
say, I think we all tonight would agree that that is done much better 
through a private plan rather than through a government plan. I know 
that we hear some rhetoric about, well, let's have both a private plan 
and a public plan--and I'm sure that my colleagues tonight will expand 
on this--but if you have one plan that's controlled and subsidized by 
the government, whose responsibility it is to be sure that there's an 
even playing field in the competitive arena, we know that the public 
plan will always receive advantages and benefits, and the private plan 
will then atrophy. I think it's far better to work through the private 
arena and to let the government do what it does best, and that is to 
protect its citizens and to ensure an even playing field.
  With that, I yield back to my friend from Tennessee.
  Mr. ROE of Tennessee. Thank you, Dr. Fleming, and thank you for those 
great comments.
  For the public, we have had, for the last several weeks and months, a 
physician's caucus that has met now sometimes one and two times a week 
to discuss this ongoing health care debate. With us tonight here is one 
of the leaders in that caucus, Dr. Phil Gingrey, who happens to just 
have the same specialty as I do, and he has been very heavily involved 
in the health care debate over the past several years, so I will yield 
now to Dr. Phil Gingrey from Georgia.
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman for 
yielding. It's a pleasure to be on the floor with my colleagues, with 
my physician colleagues, who are part of the GOP Doctors Caucus. I 
think, among us, we have something like 335 years of clinical 
experience, so we do feel that we bring to the body, to this great 
House of Representatives, some useful information, some practical 
information, not highbrow, academic, research-based information. I 
think we're just talking about, for the most part, the meat and 
potatoes practice of medicine, different specialties.
  We just heard from our colleague from Louisiana, Dr. Fleming--a 
family practitioner for many years. Dr. Roe from Tennessee is a long-
term practitioner of obstetrics and gynecology, as am I, and we have a 
number of orthopedists in our GOP Doctors Caucus. So we bring a broad 
spectrum of experience.
  You know, as we look at this issue of health care reform, the main 
thing is the urgency that the Democrat majority has placed upon it to 
the extent that the Speaker, the majority leader, and the President 
want a health care reform bill by the time that we leave here for the 
traditional August recess. Here we are in mid-May, so we're talking 
about, maybe, 2\1/2\ months away. It's going to be awfully tough to do 
that. Although, Mr. Speaker and my colleagues, we have been doing a lot 
of work on both sides of the aisle. Unfortunately, it has not been done 
in a bipartisan way. Those of us in the minority, the Republican Party, 
have really not been privy to too many details about what is in the 
Democratic majority's plan for health care reform; but

[[Page 12818]]

we can read; we can watch television; we can listen, and we can pay 
attention. Indeed, there have been some trips over to the White House 
to commiserate with the new Commander in Chief, our President, about 
ideas.
  The former majority leader of the Senate and the almost Secretary of 
Health and Human Services--and I'm talking about Senator Tom Daschle--
wrote that book called ``Critical'' where he kind of outlines what he 
thinks the blueprint for health care reform should be. So we're getting 
little inklings.
  I'll tell you, Mr. Speaker, the main thing that we're opposed to, and 
I think that I speak for all of my colleagues, I know, in the 
Republican GOP Doctors Caucus but probably for most of my colleagues on 
this side of the aisle no matter what their profession. We do not want 
to overreact to a problem, to a problem of too many people not being 
able to afford health insurance, to an overall problem of the cost of 
health care and to those insurance policies, 150 million of them 
probably provided by employers. Many of these employers are small, mom-
and-pop companies, and they just can't afford it. They can't afford to 
continue to pay those premiums that are increasing by double-digit 
rates from year to year.
  So that's the problem, and we all understand that people don't have 
access because they can't afford it. In some instances, they don't have 
access because they have preexisting conditions, but we don't have to 
overreact. I don't know why it is that, in Congress, everything has to 
be a knee-jerk response where you just absolutely have to throw the 
whole kitchen sink at every problem. It may be because the media, in 
some instances, ginned it up almost to the point of hysteria. Then 
there are a lot of public opinion polls taken and a lot of push, and 
the next thing you know, you've spent $2 billion in preparing the 
country for swine flu and in producing a vaccine that probably will 
never be used, and if it is used, it will have the potential of doing a 
lot more harm than good.
  I don't want to say that we overreacted to Katrina. I don't think we 
did, but--gosh--we did buy a whole lot of trailers, sitting somewhere 
down there in Louisiana, that are soaked with formaldehyde because the 
construction was rushed.
  You know, in a lot of instances up here, we create, I think, more 
problems than we solve. There was an old adage, Mr. Speaker, in OB/
GYN--and I think Dr. Roe has probably heard this one, too, because he's 
also an OB/GYN practitioner. Most people want to say, ``Don't just sit 
there. Do something.'' How many times have we heard that expression up 
here? I mean, people will call and say, ``For goodness sakes, why don't 
you all do something? Don't just sit there. Do something even if it's 
wrong.''
  For Dr. Roe and I, our motto was ``Don't just do something. Sit 
there.'' I'm talking about late at night when you're waiting for a lady 
to have a baby, and if you just leave her alone, she'll have that baby, 
and all you'll have to do is catch it, and if you start meddling and 
trying to push things and rush things and overreact, you cause some 
problems, don't you, Dr. Roe?
  I yield to the gentleman.
  Mr. ROE of Tennessee. We used to say, ``Smoke a long cigar.''
  Mr. GINGREY of Georgia. ``Smoke a long cigar.'' That's right. A 
``covered wagon'' I think they called those things back when I was a 
kid.
  Mr. Speaker, that's what I want to bring to this discussion tonight. 
We need to be very careful not to overreact. We don't need a 
government-run program to solve this problem. We do have too many who 
are uninsured. There are various and sundry reasons why they don't have 
health insurance. Yes, some of them are not poor enough to be eligible 
for Medicaid, so they missed that safety net. They're not old enough to 
be eligible for Medicare, so they missed that safety net. They just 
have enough money, but they can't afford expensive health insurance. We 
can do things to help them without turning this great health care 
system that we have--lock, stock and barrel--over to the Federal 
Government.
  Right now, part of the reason for lack of access and affordability is 
that the private market and the physicians who practice in that venue 
have a tendency to do too much. Maybe they order too many tests. Maybe 
they order duplicate tests because they don't know that the doctor down 
the street or in the next county had done the very same test a month 
ago. There are no electronic medical records for at least 300,000 
doctors in this country, so we're a long way from having fully 
integrated electronic medical records where, every time that patient 
comes into your office or into the emergency room, you know exactly 
what they've had, what you should order and what you shouldn't order.
  So that's all part of the problem, but we can deal with this without 
having a government default program, because what happens is, in that 
instance, you're going to say, well, I'm going to solve this problem 
because the doctors and the hospitals are doing too much and are 
running up the cost, and so you turn it over to the Federal Government. 
What do they do? They do too little. They do too little. They begin to 
ration just like they do in other countries, like in the U.K. and like 
our great friends to the north and like other countries that have 
experienced that for many years. The only way they can pay for those 
systems is by rationing and by long queues. What happens? If they can 
afford to, a lot of those people come to this country for care. A lot 
of their doctors move to this country where they can practice medicine 
and can make a decent living.
  So I just wanted to touch on that. I will yield back to Dr. Roe, who 
is controlling the time.
  My friend from Georgia, Dr. Paul Broun, is on the floor. I know he'll 
want to talk and will want to bring some intelligence to this issue, 
but let's just say this as my closing remarks:
  I don't want to just do something even if it's wrong. I'm willing to 
sit there, to think and to hear from a lot of different folks who are 
experts on how we can best solve this problem, on how we can deal with 
this, whether they're the hospital associations, whether they're the 
insurance companies, whether they're the pharmaceutical companies or 
whether they're the doctors who've practiced for many, many years. I 
think we can come up with the answer, and I think we can do it a whole 
lot better.
  The final expression that I'll throw out there, Mr. Speaker, to you 
and my colleagues is the one that everybody has heard: ``Don't throw 
the baby out with the bathwater.'' We are on the verge of doing that. 
That would be a horrible thing for this country to take a great health 
care delivery system that needs some tweaking and that we can do in a 
bipartisan way without turning it over--lock, stock and barrel--to the 
Federal Government. They do a lousy job at running a lot of programs, 
and I certainly don't want them deciding what needs to be ordered and 
to come between the doctor and the patient in the exam room.
  With that, I'm going to yield back to Dr. Roe of Tennessee.
  Mr. ROE of Tennessee. Thank you, Dr. Gingrey. Thank you for those 
comments.
  I think one of the things that has concerned me the more I have 
watched this system and have watched this debate go on is, since I've 
been here, I've had one of the health care think tanks in my office 
about every week or so to discuss this issue, and it is incredibly 
complicated. That's why we cannot do it rapidly, because it is so 
complicated.
  I'll now recognize my colleague from Georgia, Dr. Paul Broun.
  Dr. Broun.
  Mr. BROUN of Georgia. I thank you, Dr. Roe, for yielding me some 
time.
  I want to make sure that the American people know what we're talking 
about. We on the Republican side are offering alternatives for the 
health care financing problems we have in America, and they are huge. 
People cannot afford to buy insurance. There are a number of people who 
are struggling just to have halfway decent health care insurance 
coverage, and that is a huge problem that we need to fix, and we need 
to do it as quickly as we can.

[[Page 12819]]

  I agree with Dr. Gingrey, my colleague from Georgia, that we can fix 
that system. We need to, and we need to do it as quickly as we possibly 
can. Yet what's being proposed from the other side of the aisle, from 
the Democrat side, is to set up a Washington-based health care system 
where health care decisions are going to be made by some bureaucrat 
here in Washington, D.C. That bureaucrat will tell your doctor how he 
can deliver your care--what care he can give you and when he can give 
it to you.
  What that's going to do is take away your choice. You may not have a 
choice of your doctor. You may not have a choice of what hospital you 
go to. You may not have a choice of whether you can even get some kind 
of procedure or a test or not. What it's going to do is it's going to 
delay your being able to get those tests and those procedures even if 
the Federal bureaucrat says that you may have them.
  We can't go down that road. It's going to destroy the quality of 
health care. It's going to destroy the health provisions that you're 
getting today as an American. I don't want that, and I'm sure you don't 
want that. I'm sure Dr. Roe doesn't want that. I'm sure no physician, 
at least on our side of the aisle, wants that kind of a health care 
system to deliver your health to you by some Washington bureaucrat. 
We've got to stop that, and it's up to the American people to do so.
  We're offering alternatives, many alternatives. I know one of our 
colleagues I talked to today is introducing a bill tomorrow that is 
going to be a health care reform bill. Our health care working group is 
developing a plan. I'm developing one in my office also that's 
independent of everything else, but we need to develop a solution that 
is patient-centered, not Washington-centered. We need to develop a plan 
that gives the American people the choice--the choice of their doctor, 
the choice of their hospital, the choice of whether they get a 
procedure or not. It should not be made by some Washington bureaucracy 
or bureaucrat or Federal bureaucrat anywhere, whether it is in 
Atlanta--in my own State--or in Knoxville or anyplace else.

                              {time}  1800

  We've got to develop a health care system that is patient-centered to 
give patients the choices that they deserve and they desperately need. 
We, as Republicans, are going to give you that opportunity. The 
opportunity is not going to be available from the other side of the 
aisle. They're developing a socialized medicine program, a Washington-
based health care system to give your health to you by some Washington 
bureaucrat, not by a doctor.
  And the American people need to know that very clearly, Dr. Roe, 
because they have a choice. Is it a choice between a Washington-based 
health care system, or is it a choice of a patient-centered health care 
system where those decisions are made in the doctor-patient 
relationship? And that is what we're offering.
  And I'm just encouraging the American citizens all over this country 
to write their Congressmen, write their Senators and demand a patient-
centered health care system. Demand that our alternatives are heard.
  Nancy Pelosi has blocked--she has been an obstructionist for every 
single alternative that we've offered whether it's for energy, whether 
it's for environmental issues, whether it's spending, whether it's 
straightening out this economic situation, as well as the health care 
solution. She has been an obstructionist. She's blocked every attempt 
we've made to deliver to the American people alternatives that make 
sense from an economic perspective as well as a market-based 
perspective.
  So we need to give our plans the light of day. And the American 
people are going to have to demand that, Dr. Roe. It's the only way 
it's going to happen. And I encourage people to contact their Members 
of Congress and demand that we slow this steamroll of socialism, as I'm 
calling it, this rolling over--the financial services industry is 
rolling over the car manufacturing; it's rolling over now the health 
delivery system. And we, as Americans, need to demand that all 
alternatives are heard, that we have the time to put something in place 
that makes sense to give patients the choice that they need.
  So I congratulate you for doing this. It's absolutely critical for 
the future of health care. If we continue down this road that the 
Democrats have taken, it's going to destroy the quality of health that 
we deliver as physicians to our patients, that you did as a 
practitioner for so many years and I have, also, for so many years. So 
I thank you so much.
  Mr. ROE of Tennessee. Dr. Broun, thank you for your comments.
  And just to summarize and sum up. I think our time is just about 
gone.
  This is just the beginning of this debate. It is a very important 
debate for the American people. We just got through a few of the 
principles tonight. We will continue those at another time.
  But I thank Dr. Broun for being here, and I thank the Speaker.
  I yield back the balance of my time.

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