[Congressional Record (Bound Edition), Volume 155 (2009), Part 13]
[House]
[Pages 17321-17328]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Texas (Mr. Burgess) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. BURGESS. I thank the Speaker. I also want to thank the minority 
leader and the leadership on the minority side for providing this hour 
for us to talk in some detail about health care and what is pending 
before this Congress over the next 3 weeks.
  Mr. Speaker, it is ironic that as we sit here on the literal eve of 
the markup of this bill in the Committees of Energy and Commerce, Ways 
and Means, and Education and the Workforce, all beginning next week 
when we return from our districts, as we sit here on the eve of that 
markup, there is no House bill. And it makes it very, very difficult. 
We're told, if you have amendments, let's get them all together because 
we want to have a good look at them before we start the markup. How do 
you amend a bill that you haven't seen yet? Well, that's the task 
that's before many of us on the committee and that's where we have been 
placing our efforts during this past week, but it is a task made much 
more difficult.
  Mr. Speaker, I will just tell you, as someone who was involved in the 
campaigns last fall, I was a surrogate for Senator McCain. It meant 
that I went all over the country debating health care with surrogates 
for President Obama. It seemed a virtual lock that there would be a 
presidential directive for a health care bill that would come shortly 
after the election, and certainly by Inauguration Day. In fact, Senator 
Baucus convened a great group over at the Library of Congress at the 
end of last October and produced a white paper that for all the world 
looked like a blueprint for a plan for a health care bill.
  Election Day came and went, President Obama won, no health care bill. 
We had the holidays, Christmas, New Years, no health care bill. The 
Inauguration, all the festivities that took over Washington, but no 
health care bill. And here we are, the week after the July 4 recess, 
still waiting for that bill. What happened to the promises on the 
campaign trail last fall? Were they really that ephemeral that they 
could not be condensed into legislative language and produced for the 
House floor? Well, that's where we find ourselves.
  Now, in March of this year, the President did convene a group of us 
down at the White House. He spoke very eloquently. He said the words 
you've already heard spoken on the floor of this House tonight, If you 
like what you have, you can keep it. Let me emphasize that, he repeated 
it, If you like what you have, you can keep it. And of course he says 
if you like what you have you can keep it because polls show anywhere 
between 60 to 80 percent of Americans like what they have and want to 
keep it; 160 million Americans receive their health care through 
employer-sponsored insurance, another 10-15 million through individual 
insurance policies, and they like what they have and they want to keep 
it. In fact, their greatest fear is that something will happen to their 
employment or their ability to make those premium payments, and they 
will lose what they have because they like what they have and they want 
to keep it.

                              {time}  2100

  But the second thing the President said was, The only thing I will 
not accept out of this Congress is the status quo. But wait a minute. 
If you like what you have, you can keep it would imply if you like what 
you have, you can keep it. How do you do that? How do you keep what you 
have and not accept the status quo? And therein is the quandary that 
has been presented to the other side, and that is what has taken the 
incredible length of time.
  Now, coupled with that are the beginnings of some bills began to leak 
out of the Senate side at the end of June. We got into the issue of 
cost and coverage. And the initial reports that came out of the Senate 
Committee on Health, Education, Labor, and Pensions was a price tag of 
$1 trillion. That wasn't the whole bill because we hadn't quite figured 
out all the Medicaid parts, but $1 trillion for the opening salvo, and 
it would cover about a third of the reported uninsured. Well, that's 
not a great bargain. That's not great value for your dollar.
  The Senate Finance Committee came up with another bill. Another score 
was given to that bill, and the cost was over $1.5 trillion. And they 
immediately went back and started to rework the bill to bring that 
price down to at least $1 trillion. That appears to be now the new 
high-water mark for health care legislation.
  The House bill, as scored through the Committee on Ways and Means 
just this week, also scored at $1.5 trillion. No word, no word on the 
number of people that would be covered. If you like what you have, you 
can keep it right up until the time we tell you that you can't. And 
that apparently is the game plan, is the mission statement for the 
health care bill that will be brought to us from the Democratic 
majority.
  Mr. Speaker, I'm joined by a number of other people who wish to speak 
on this very important topic, and I do want to give everyone the 
appropriate amount of time.
  Just one housekeeping detail, the Congressional Doctors Caucus had an 
open forum during this past week down at George Washington University. 
Different from the White House infomercial on health care, this was an 
open forum. It was open to anyone who could come in and question 
Members of Congress who also happened to be physicians. It turned out 
all of us who were Republicans who showed up, but they could come and 
question the Republican House physicians on the issues related to what 
is going on with changes in the health care system. And we had a very 
lively hour and 45 minutes, a number of questions that were delivered 
by the staff and faculty there at George Washington and a number of 
questions that just came from the audience. But it was a lively hour.
  The event was Webcast live at the time that it was carried out, and 
that Webcast has been archived and is available on the Congressional 
Health Care Caucus Web site. That's www.healthcaucus.org. Go to the 
appropriate tab for archived events, and the George Washington health 
care event has been archived on that Web site.
  Well, again, we are joined by many Members of Congress. People are 
eager to speak about this. Goodness knows we're not going to get a 
chance to have a legislative hearing in our committee. But let us begin 
this evening, and we are going to hear from one of the doctors who was 
there at the forum at George Washington, an orthopedist from the great 
State of Georgia, a member of G-7, Dr. Tom Price. 
  Mr. PRICE of Georgia. Thank you so much, Dr. Burgess, for your 
leadership on this issue and so many others. And I want to thank you 
for your participation we had at the event at George Washington 
University and really the wonderful perspective that you bring as a 
physician to the table.
  In my previous life, I was an orthopedic surgeon. I spent 20-plus 
years practicing orthopedic surgery in the Atlanta area.
  As we move forward with health care reform, it's clear that something 
is coming. And I get asked by folks: What kinds of things don't we 
want? What kinds of things can they do to us that would be bad? And I 
would suggest, Dr. Burgess and colleagues, three things that would be a 
death knell for quality health care in the United States.

[[Page 17322]]

  The first is ceding the definition of quality to the Federal 
Government. If we say as a society that we are going to allow the 
bureaucrats, nonmedical individuals, to decide what quality health care 
is, as has been proposed by the President through his Comparative 
Effectiveness Research Council and others with the list of programs 
that you've heard Mr. Shadegg describe just a moment ago, then that 
would be a death knell for American medicine. Quality truly is only 
known by compassionate, caring physicians and patients and their 
families who know what is best for them because there is no way that 
the government can define what's best for each and every individual.
  The second death knell for quality health care I believe to be any 
mandate, any individual or employer mandate. If individuals are 
required to purchase health insurance, that's a death knell. If 
employers are required to provide health insurance, that's a death 
knell. Why? Well, it's a mandate, which is a bad idea. But more 
importantly, when we here in Washington mandate something, what we do 
is define what we are mandating, and in this instance we would demand 
what qualified as health insurance or health coverage.
  Dr. Burgess, you well know that this Congress would define something 
that doesn't include all sorts of robust things already out there in 
the marketplace like health savings accounts, medical savings accounts, 
high-deductible catastrophic plans, some cafeteria plans. They wouldn't 
only be unavailable, they'd be illegal. This Congress would make them 
illegal. So the notion that if you like what you have, you can keep it 
is just folly. It's power fiction.
  And the final death knell to the quality of American health care I 
believe to be any government-run program, any government takeover of 
any portion of our health care system beyond where it already is, the 
public option as it's described, which is a euphemism for a government 
takeover. And why is that? Well, I would ask my friends on the other 
side of the aisle, and really folks across this land, to think about 
your health care principles. What are your health care principles? What 
do you believe ought to be foremost in any bill that we produce? I've 
got six of them. They're accessibility, we ought to have accessibility 
to the health care system for all Americans; affordability, it ought to 
be affordable. It ought not to have the costs rise more than they 
should; quality, we need to have the highest quality of health care; 
responsiveness and innovation, we need a system that's responsive and 
innovative; and then choices, we need choices.
  Those are my six: Accessibility, affordability, quality, 
responsiveness, innovation, and choices. I would suggest to my 
colleagues that none of those, in fact, I would suggest that none of 
the principles that any American could come up with, are improved by 
the intervention of the Federal Government. None of them are improved 
by more government control. None of them are improved by an 
administration that believes that a health czar is what we need as 
opposed to the highest quality of medicine.
  There are wonderful solutions, and I know we will be talking about 
them this evening.
  I want to commend my colleague from Texas, Dr. Burgess, for his 
leadership on this issue and can only hope that as we move forward, we 
are allowed to have an open and a vibrant discussion so that the 
Congress of the United States can have the benefit of the wonderful 
experience of people on both sides of the aisle as we move forward to 
solve this remarkable challenge in the area of health care.
  Mr. SHADEGG. I commend the gentleman from Arizona for his comments 
about mandates, and I couldn't agree more. But I thought maybe it would 
be useful for the audience to illustrate the kind of poster child for 
mandates that the other side often recites and talks about, and that's 
mandatory auto insurance.
  The gentleman pointed out that individual mandates tend not to work, 
and, indeed, the individual mandates in the health care plan in 
Massachusetts are not working. People are refusing to go along with 
those. People are choosing to be fined instead of complying with the 
government mandate to buy health care. But as the gentleman knows, most 
of the States, as a matter of fact, 48 out of the 50 States, mandate 
auto insurance.
  I wonder if you and I could have a little discussion about how well 
mandatory auto insurance works, because that's the reason we're told, 
well, if mandatory auto insurance works, why not mandatory health 
insurance?
  Mr. PRICE of Georgia. I appreciate my friend from Arizona's comparing 
it to auto insurance because that's what you oftentimes hear. You hear 
folks say, well, we require folks to have automobile insurance, why 
shouldn't we require them to have health insurance? And you allude to 
the fact that mandatory automobile insurance doesn't result in 
everybody having automobile insurance.
  Mr. SHADEGG. It actually doesn't work.
  Mr. PRICE of Georgia. It doesn't work. That's why you don't do it for 
health insurance.
  But more importantly, if one mandated health coverage, then we, 
again, cede the definition of what that coverage would be to the 
Federal Government. And ceding the definition of what automobile 
insurance is is one thing; ceding the definition of quality health 
care, something so personal to each and every one of us and our 
families, I would suggest is a step in the wrong direction.
  Mr. SHADEGG. I agree with the gentleman completely. But we don't 
mandate a single auto insurance policy for the entire country in auto 
insurance. We let the 50 States define what constitutes auto insurance 
in their State.
  But let's talk about how mandatory auto insurance actually works. I 
don't know if the gentleman knows it, but 48 States have mandatory auto 
insurance. So if you own and drive a car, you are compelled by law to 
buy liability insurance. Two States don't: Wisconsin and New Hampshire. 
Guess what? The percentage of people in those two States who are 
uninsured is lower than the average percentage in the States where it's 
mandatory. That's right. In the 48 States where the government says you 
must have auto insurance, fewer or a lower percentage are actually 
insured than in the two States where they don't have mandatory auto 
insurance. I think that proves mandatory auto insurance doesn't work.
  But what I really love when the other side cites the beauty of 
mandatory auto insurance is of the 48 States that mandate that you 
cannot drive a car in that State without auto insurance, 22 of those 
States mandate that you must also buy uninsured motorist coverage.
  Wait a minute. Let me see if I understand this. We have told all the 
people you must buy, as a matter of law, auto insurance, but in 22 of 
the States where they've done that, they are so confident that many 
people will break that law that they mandate also, the government 
putting a gun at your head, uninsured motorist coverage. Now, if 
everybody was going to comply with the first law and buy auto 
insurance, why in God's name would you need the second law? And the 
answer is mandates don't work. In at least those 22 States, the 
legislatures have openly acknowledged that mandatory auto insurance 
doesn't work, so we're going to require mandatory uninsured motorist 
coverage.
  Mr. PRICE of Georgia. You said that 48 States mandate auto insurance, 
two States don't, but the two States that don't have a higher level of 
insured motorists?
  Mr. SHADEGG. A higher level of insured and a lower level of 
uninsured.
  Mr. PRICE of Georgia. So the moral of the story is?
  Mr. SHADEGG. Mandates don't work.
  Mr. PRICE of Georgia. Mandates don't work.
  Mr. BURGESS. Reclaiming my time briefly, for a mandate to work, there 
has to be a broad recognition that the mandate exists and there has to 
be a broad understanding of the penalty involved, and the penalty 
administered must be significant.
  If we look at the number of the rate of insured in this country, it's 
about 85

[[Page 17323]]

percent of people voluntarily carrying health insurance and 15 percent 
do not. Well, where is a model for that broad recognition that there is 
a requirement that you do something and a very swift and severe penalty 
if you don't?
  Certainly the IRS fits that bill. Everyone knows in this country you 
must pay your income taxes, that you must file on time or face a swift 
and sure penalty. And I'm not even entirely sure what the penalties 
are, but I do know I don't ever want to experience those penalties. And 
what do we see with compliance rates with the IRS in this country? We 
see 85 percent comply and 15 percent do not. In other words, it is 
unchanged from the voluntary compliance that we have under health 
insurance.
  Mandates are an anathema in a free society. Rather than trying to 
create the mandates and requiring people to do something that they are 
disinclined to do, what if we tried to build programs that would 
attract people just as we did with the part D part of Medicare where 
Dr. McClellan, to his credit, created the protected classes of drugs, 
created the programs that people actually wanted, and what do we have 
now? We have 92 percent of seniors with credible drug coverage, 
satisfaction rates in excess of 90 percent. So that's a success story 
from a government program that actually worked because the emphasis was 
put on delivering value to the customer, value to the patient in this 
case, value to the Medicare recipient in this case, rather than just 
simply you do what we tell you to do because we can. We are a free 
society, after all.
  Mr. SHADEGG. Will my colleague from Texas yield?
  Mr. BURGESS. I would be happy to yield.
  Mr. SHADEGG. Briefly, we serve on the Commerce Committee. We're going 
to get to have a markup next week on this bill, but we will not have 
ever had a hearing on the bill. And as we pointed out earlier, there is 
no bill yet. But in the discussion draft that has been released, there 
is stunning information. It's one thing to talk about the stuff in the 
bill that's goofy; it's something else to talk about stuff in the bill 
that's outright absurd.

                              {time}  2115

  The gentleman talked about penalties. There is a provision in the 
bill that is outright absurd, and it goes to the point the gentleman 
just raised. The bill not only has a mandate that individuals must buy 
care, it has a mandate that employers must provide care. Okay. Maybe 
that's a good rule. But guess what--here's the absurdity. If you, as an 
employer in America, comply with that law, and you buy health insurance 
for every single one of your employees, and one of your employees says, 
``You know what, I don't want your insurance. I decline it,'' you, the 
employer, must pay a penalty of 8 percent of that employee's salary 
because the employee chose to turn down the coverage. So you are 
penalized not for failing to offer the care. You are penalized because 
the employee said they didn't want it. What if the employee didn't want 
it because they preferred their spouse's coverage? That's the story in 
the Shadegg family. For years my wife worked for the school district in 
Arizona. She was offered health care coverage. She declined it because 
she took it under my coverage. There's no point in buying two policies. 
Apparently under this bill, were she to decline it in the future, the 
Federal Government, that pays my health insurance, would have to pay a 
fine--of course they wouldn't apply the penalties to the government--of 
8 percent of her salary because she turned down the care. You've got to 
be kidding me. You can't come up with stuff that goofy, but they did.
  Mr. BURGESS. That is a very valid point brought up by the gentleman.
  I want to now go to our other doctor from Georgia, a fellow 
obstetrician, Dr. Gingrey, who was actually the leader in bringing the 
Doctors Caucus together for that rather spirited and insightful 
afternoon down at George Washington earlier this week. I will yield him 
the floor for whatever time he will consume.
  Mr. GINGREY of Georgia. Mr. Speaker, I thank my colleague for 
organizing the hour tonight and for bringing this important issue 
before the Members of this body and the American people. Of course, as 
my colleagues have said, next week in the Energy and Commerce 
Committee, the Ways and Means Committee, the Education and Labor 
Committee of this House, markups are going to begin on this bill. So we 
are at the dividing point where people need to understand what this is 
all about. And as my colleague from Texas said, yes, we have formed a 
Doctors Caucus on the Republican side. We asked the Members of the 
Democratic side who are also health care providers to join that group. 
They declined. But we have a group of about 14, including a number of 
doctors who are on the floor tonight participating in this special 
hour, with over 330 years of clinical health care experience and has 
any one of that group--and in that group, I think we're talking about 
10 or 11 physicians. We're talking about an optometrist, a clinical 
psychologist and three dentists. And not one of those Members, Mr. 
Speaker, has been asked to participate in the drafting and crafting of 
legislation that would improve the health care system that we have in 
this country.
  And when I talk about improvement, I mean exactly that, Mr. Speaker. 
We do not need to destroy a good system. We need to make it better, and 
we can do that. That's why the District of Columbia Medical Society at 
George Washington Hospital this week invited this group of physicians, 
this group of health care providers to come and be on a panel and to 
answer questions from their doctors, from employees of the hospital, 
from nurses, from people from all walks of life, really, to let's talk 
about this issue and give an opportunity for another town hall meeting. 
President Obama had one with ABC or NBC, one of the major networks, 
coming from the White House, but it was totally one-sided. So as my 
colleagues have said, we can fix this system. We can do it. We don't 
need to throw the baby out with the bath water, as the old expression 
goes. We feel that if there are 10 million people in this country who 
cannot afford health insurance or are denied it because of a pre-
existing condition, that's too many.
  There are a number of things that we can do, and I will just briefly 
mention a couple. Clearly we can agree with our colleagues on the other 
side of the aisle with regard to the efficacy and money-saving aspects 
of electronic medical records. I would hope that our colleagues on the 
other side of the aisle could agree with us that meaningful tort 
reforms, where doctors weren't constantly having to order just tons of 
unnecessary tests, and hospitals doing the same thing, knowing that 
they're unnecessary and maybe downright harmful to the patient. But 
with this fear, this constant fear of frivolous lawsuits facing them, 
all this extra money is spent for naught. So these are just a couple of 
things that we can do. Certainly the insurance industry, the health 
insurance industry needs to reform. There are a number of things that 
they could do, and hopefully later in the hour we can get back to that. 
But I think the most important thing for our colleagues and the 
American people to understand is that we do have the best health care 
system in the world, and we have the capability of coming together in a 
bipartisan way. My colleagues who have already spoken have plans, have 
bills that they've worked on for years. But do they get to see the 
light of day? Absolutely not. The President and this majority is so 
focused on this public plan. One of my colleagues is going to speak in 
a few minutes; and he is going to talk about, Well, since that public 
option is so darn good, then maybe President Obama, Mrs. Obama and 
those two precious children ought to be on that public option plan 
rather than a Blue Cross/Blue Shield or some other Federal Employees 
Health Benefits plan. If it's good enough for the general public, it 
ought to be good enough for Members of Congress. I may be stealing 
somebody else's thunder. At this point I will yield back to my 
colleague from Texas, as he continues to control this time.

[[Page 17324]]


  Mr. BURGESS. I thank the gentleman for his insight. I thank him for 
the passion that he has brought to this. I wonder if, just very 
briefly, I could go back to the gentleman from Arizona on the issue 
that he brought up in an earlier speech he gave on the House floor 
which wasn't part of this hour. I want to be certain that we have it 
for the DVD that's prepared, Mr. Speaker, if we were to prepare a DVD 
of this transaction.
  But you have talked about an advisory panel or an advisory board. 
Health care czar is a term we've heard, commissioner or commissar of 
health care, putting someone in there to make a decision for us. I 
wonder if you would briefly expound upon that again so we could have 
that as part of the Congressional Record of this discussion.
  Mr. SHADEGG. I would be happy to. I thank the gentleman for yielding.
  I have worked on health care reform since I got here in 1995. It is a 
passion that I have. I believe we can do better than the current 
system, and I applaud the President for calling for health care reform. 
I personally believe the current system is damaged by the fact that 
it's controlled by third parties. Your employer picks your plan, and 
your plan picks your doctor. What I heard the President say and what I 
heard, quite frankly, the current Secretary of State, Mrs. Clinton, say 
when she was a candidate was, ``If you like what you have, you can keep 
it.'' You know, I think if most Americans hear that, they're going to 
be fairly comfortable because many of us are worried really about two 
things: We're worried about the cost escalating too quickly, and we're 
worried about the uninsured. But as I said earlier, some 83 percent of 
Americans are satisfied with their care. Guess what--that promise ``If 
you like what you have, you can keep it,'' by the current President and 
by Democrats in this Congress, is simply untrue if you read the 
discussion draft that's out there. It is blatantly, patently, clearly, 
unquestionably untrue. Here's why: As the gentleman from Texas points 
out, the legislation creates the Health Benefits Advisory Committee. As 
my colleague from Georgia pointed out, what that committee is going to 
do is it's going to define what constitutes health insurance in 
America. It's going to set the standard for every single health care 
policy sold in America. We are going to have literally a one-size-fits-
all mandate or dictate from this Health Benefits Advisory Committee. 
They're going to say, ``That's a policy, and it qualifies.'' ``That's 
not a policy, and it doesn't qualify.'' There is no chance that the 
rules they issue will, in fact, allow the policies sold all the way 
across America today to all of the employers who provide health care to 
actually fit into their new rules. So as a practical matter, virtually 
every American--I suggest indeed every American in the span of 5 
years--will lose the health care plan they have. So if the statement, 
``If you like what you have, you can keep it'' turns out not to be true 
because, as my colleague Mr. Price from Georgia pointed out, we're 
going to have a board that constitutes a policy, no policy currently 
sold by employers will fit what that board dictates. Therefore, in 5 
years they will no longer be able to give you that plan. You might lose 
your health care plan the first year, but you will certainly lose your 
health care plan and not be able to keep what you have in 5 years 
because the law says, In 5 years every plan must fit the dictates of 
that new advisory board. So if you like what you have--as I said today 
earlier, and I say it again--if you like what you have, be prepared to 
lose it because you are going to lose it.
  I thank the gentleman.
  Mr. BURGESS. I thank the gentleman for his quick summation of that.
  We've also been joined this evening, very fortunately, by the ranking 
Republican on the Committee on Energy and Commerce, one of the true 
leaders on our side on this issue who as I started this hour, I said, 
Here we are on the literal eve of the markup of this bill without a 
bill; and apparently the ranking member has some new information about 
when we might expect that bill and what we might find contained 
therein.
  So I'll yield such time as he may consume to the ranking member of 
the committee, Mr. Barton from Texas.
  Mr. BARTON of Texas. I thank the gentleman from Texas. I want to 
apologize to Dr. Fleming for coming ahead of him.
  I was watching the debate in my office, catching up with some 
paperwork. I was very impressed that Congressman Shadegg has apparently 
read the draft--or his staff has--so we have at least one Member. And 
I'm sure Dr. Price, Dr. Gingrey, Dr. Fleming, Mr. Gohmert and Dr. Broun 
have also read it. But I am the senior Republican on the committee of 
primary jurisdiction, the Energy and Commerce Committee; and as such, I 
communicate with the chairman of that committee, Congressman Waxman of 
California, and my chief of staff with his chief of staff. As you all 
know, we had scheduled opening statements next Monday. We were going to 
start the markup on Tuesday. At least until today we were led to 
believe that it would be a full and fair open markup. Well, we just got 
word about 30 minutes ago that apparently, as Congressman Shadegg has 
said, there is still no bill. As we are here on a Thursday evening, 
there is no bill to mark up. There is not going to be a bill tomorrow, 
apparently. There may be a bill over the weekend. There may be a bill 
on Monday, but there may not be. We had asked that there be a hearing 
once the CBO, the Congressional Budget Office, scores whatever it is 
they are going to mark up, that we have a day of hearings, which is 
normal procedure. Well, apparently we're not going to get a hearing. 
We're going to get a closed-door briefing, and we're going to start 
opening statements on Tuesday of next week. Then we're going to start 
the markup. Assuming that there is a bill to mark up, we'll have a 
markup that begins on Wednesday, and they will conclude it by next 
Friday. So I just want the country and Members of Congress and those 
who are in their offices, like I was, listening to the debate to 
understand, the health care industry, which is 15 percent or 20 percent 
of our GDP, in which the preliminary scores on the draft and the bill 
in the Senate is somewhere between $1 and $2 trillion over 10 years, 
which is somewhere between $100 billion and $200 billion per year, 
which is 2 percent of GDP. A bill that's going to add 2 percent of GDP, 
which is not yet written, if we're really, really lucky next week, we 
may get 2 days of markup in the committee of primary jurisdiction.
  Now I want to put that in context. I've been in this body 25 years. I 
have seen major bills that were not half as important as this bill have 
weeks of hearings on the legislation once the legislation was out and 
weeks or months of markup.

                              {time}  2130

  Former chairman of the committee, John Dingell, in the Clean Air Act 
in the 1990s marked that bill up in committee. He worked on it for 
several Congresses, but the final work product he marked up over I want 
to say a 6-month period.
  It is arrogance beyond explanation not just to the minority Members 
of this body, to the moderates and conservatives on the majority side, 
but to the American people that we can attempt to move a bill that 
affects 20 to 25 percent of our GDP, which adds 2 percent of our GDP 
cost per year for the next 10 years, not even have that out so that it 
can be studied today. When they get around to introducing it sometime 
next week, they are going to start marking it up on Wednesday and 
report it out on Friday.
  Now the reason I came over to ask time to speak is because right now 
I am in a debate with the administrator at the EPA, Administrator 
Jackson, in which back in April, they issued an endangerment finding on 
CO2 saying that CO2 is a harm to public health. 
It is a dangerous element, and therefore it has to be regulated to 
protect the public health. We have e-mails that show a reputable senior 
Ph.D., a doctor, a researcher within the EPA, prepared a report, as 
required by law, that stated that the science that they had based the 
endangerment findings on

[[Page 17325]]

was faulty and out of date, and in all probability there really wasn't 
a danger. That report was not made a part of the official record. The 
e-mail says it wasn't because his direct supervisor says that the 
decision has been made at levels above you. We are going to go forward 
with this regardless of what the facts are.
  So here we have on climate change and cap-and-trade the facts be 
darned, we are going forward. And now we are coming to the next big 
issue in the Obama administration, and they are saying, the public be 
darned, we don't want anybody to know what is in the bill. We are going 
to make the majority vote for it no matter what. And we are going to do 
it in 2 days.
  Now most of you here are medically trained. You went to medical 
school for years. You had an intern program for several years. Most of 
you practiced in private practice for decades. You have got experience. 
You had your patients that trusted you because you were open and 
transparent and you had experience behind you.
  The majority that is running this body doesn't have enough trust in 
the population to tell them what is in their bill a week or two ahead 
of time so we can study it, prepare amendments, and have an open and 
fair markup process.
  I think that is outrageous. We don't know what is in the bill. Mr. 
Shadegg has done a pretty good job of going through the draft. And he 
knows that the draft is scary enough that we ought to have a long, fair 
markup on it. Most of that stuff will probably be in the final bill. 
But we don't know. So the reason I came over, Congressman Burgess, was 
to encourage you and all the other Members that are participating in 
this Special Order and the people that are watching it. They need to 
get on the phone tomorrow. We want openness. We want transparency. We 
want time to see what the bill is. We want to post it on official Web 
sites so that the public can understand it. We want to give Members on 
both sides of the aisle the opportunity to draft amendments. And we 
want a markup process in the committees of jurisdiction that those 
amendments can be made, they can be debated, and they can be voted on 
in public. And maybe, just maybe, the work product that comes from that 
will be worthy of being reported to the floor.
  But one thing I'm certain of, the bill that we don't have that has 
been drafted in secret is not worthy of becoming public law. I can say 
that sight unseen.
  In the Revolutionary War, ``one if by land, two if by sea, the 
British are coming,'' rationed health care is coming. No-doctor-choice 
is coming. Private insurance is going away if we let this--I'm trying 
to think of a polite way to describe what is about to happen. But it is 
a travesty of the process. It is a policy that will do much more harm 
than good to health care in America.
  Mr. BURGESS. We had, of course, a meeting of our committee this 
afternoon where we talked about amendments. We thought we had 3 or 4 
days, which, in fact, seemed pitifully short in that context. I know 
our office had submitted 50 amendments. I think I saw a list of almost 
200 amendments that was being discussed.
  There is no way in the 10 to 12 hours that will be available to us to 
debate that bill to allow Members on our side, let alone if any Members 
on the majority have ideas about how the bill might be improved. It is 
a virtual guarantee that only a very limited number of voices are going 
to be heard, if any, to try to improve that bill in the time that we 
have allotted to us.
  I will yield back to the ranking member.
  Mr. BARTON of Texas. I plan on talking to Chairman Waxman immediately 
in the morning and saying at a minimum we need a day to look at the 
bill once it is out. We need several days to prepare amendments. And 
then we need at least 1 week or 2 weeks to do markup. It is not just 
the minority Members, but there are a number of Members on the majority 
side that have substantive concerns and substantive amendments.
  This Congress can do good work. But it can't do good work in the dark 
with a handful of Members making deals in the back room and then 
forcing the majority to almost automatically rubber-stamp that product.
  What you're doing here is excellent work. I commend you and the other 
Members. But I strongly, strongly encourage people that if they believe 
in an open and fair process, we need to figure out a way to get this 
bill out there in public and give us enough time to study it before we 
go forward and try to mark it up.
  Mr. GOHMERT. Do you think there is any chance that something as 
ridiculous as amendments being filed in the middle of the night might 
happen? Do you think it is possible around here?
  Mr. BARTON of Texas. Apparently, if they do what they have been doing 
in the past, we won't get the product that is going to be marked up 
until Chairman Waxman introduces a manager's amendment in the nature of 
a substitute sometime Wednesday afternoon.
  Mr. GOHMERT. Or 3:09 a.m. perhaps?
  Mr. BARTON of Texas. He has to put something in play to actually 
start the markup. But if the past is a predictor of the future, 
whatever he puts in play will not be what is going to be marked up. It 
will just be a placeholder.
  Mr. BROUN of Georgia. I congratulate the gentleman for suggesting the 
American people contact their Members of Congress. I just want to say I 
just explained to the American people when we as Members of Congress 
say I associate myself with those comments, that means I agree 
wholeheartedly. And I do associate myself with those comments.
  I want to remind the American people that former U.S. Senator Dirksen 
one time said that when he feels the heat, he sees the light. The 
American people need to put heat on the Members of Congress in the 
House and the Senate because the Senate has a bill too that is 
disastrous. It will do just the things that Mr. Shadegg was talking 
about. In our shop we have looked at those proposals over there on the 
Senate side, and it is going to be disastrous if that bill as we see it 
thus far is passed.
  The only way we are going to stop it is for the American people to 
get on the telephone, to call their Members of Congress, call their 
U.S. House of Representatives as well as their U.S. Senators and say 
``no.'' We as Republicans have been accused of being the Party of No, 
n-o. Frankly, we are the Party of Know, k-n-o-w. We know how to fix 
this problem. We know how to lower the cost of health care. We know how 
to give patients choice and give them ownership of their health care 
plan. We know how to fix this problem. We know that government 
intrusion into health care decisions and the health care decision-
making process and reimbursement and all the reasons it is so high and 
unaffordable today.
  I just wanted to associate myself with the comments that you made and 
encourage the American people to get on the telephone, to get on their 
e-mail, to get on their fax machines, to call their neighbors and their 
friends all over this country and encourage their neighbors, friends 
and family to contact their Members of Congress. Let's shut the 
telephone system down tomorrow, across this Nation, people calling, 
faxing and e-mailing to say ``no'' to this travesty, ``no'' to this 
piece of garbage. I will be outright and say it. You were looking for a 
nice word. But it is garbage. And it is going to destroy the quality of 
health care.
  I am a medical doctor. I practiced medicine for 38 years. And this is 
going to place a government bureaucrat between the doctor and the 
patient. It is going to be extremely expensive. The quality is going to 
go down. Innovation is going to be for naught, and it is going to go 
away. People are not going to like this, and we need to have it in an 
open process.
  Mr. BARTON of Texas. The comment ought to be ``show us the bill.''
  Mr. BURGESS. Let me reclaim the time briefly. I appreciate the 
ranking member taking the time out of his evening and spending some 
time with us. There are a number of Web sites where people can go and 
sign online petitions. Americasolutions.com has a petition, galen.org 
has a petition, another group called Let Freedom Ring

[[Page 17326]]

actually has a downloadable responsible health care pledge where you 
ask your Member of Congress or Senator to have at least read the bill 
in its entirety and have the bill available for 72 hours on a Web site 
so the public can view this bill prior to a vote being taken in the 
House of Representatives.
  He has been very patient. He is a new Member. And he is probably more 
patient than I deserve him to be, but Dr. Fleming is from my 
neighboring State of Louisiana. He is one of two new Louisiana doctors 
who have joined the Republican Caucus. I want to thank him for his time 
tonight. He has a very interesting proposition that he wanted to share 
with us.
  So I yield whatever time he may consume, bearing in mind we have 15 
minutes left of the hour.
  Mr. FLEMING. Well, I thank the gentleman, and I will be quick here 
because I do have something very important. I want to draw the camera's 
attention to this placard and particularly the Web site outlined below, 
fleming.house.gov regarding House Resolution 615 that really gets to 
the meat of the matter. And again this is another effort to appeal to 
the grass-roots.
  Over the past few weeks, Members of Congress and the American people 
have come to know the details of the proposed health care plan advanced 
by the administration and the Democrats. Call it whatever you like, but 
at the end of the day, the proposal is still a government-run health 
care system.
  Now with its health care plan, the administration and the liberal 
leadership of this Congress are guaranteeing this democracy is on the 
solid path towards socialism. As a physician, I am amazed at the number 
of bureaucrats in this House who are quick to claim a government-run 
health care plan is the reform this country needs.
  So I come before this body to announce a resolution that I just 
mentioned, House Resolution 615, saying very simply that any Members of 
Congress who votes for legislation creating a government-run health 
care plan should lead by example and enroll themselves and their family 
in the same public plan.
  Again, to repeat that, very simply, any Members of Congress who vote 
for this legislation, that is one that includes a single-payer or 
government-run health care plan, should be willing to commit to enroll 
themselves in that. You see, it is very interesting how Congress tends 
to carve itself out and create sort of a lead state in many things, and 
this is one good example. The plans that we see thus far, which we 
don't know the details of, of course, suggest to us that for the next 5 
years the Congressmembers will be still on the Federal health plan 
exchange and not be part of the single-payer system.
  In closing, I just want to suggest that to those who are viewing this 
evening and along the lines of Dr. Broun and Dr. Gingrey, is yes, 
please call. Call your Representatives. Call your friends. Let 
everybody know we need to defeat this single-payer system. And the way 
to do it is to hold our Congressmen accountable for what they do. If it 
is good for you, it should be good for them as well.

                              {time}  2145

  Mr. BURGESS. I yield to the gentleman from Georgia, Dr. Gingrey.
  Mr. GINGREY of Georgia. I realize we are running short on time, but I 
just wanted to comment on the gentleman from Louisiana, Dr. Fleming's 
resolution. Mr. Speaker, it would be akin to a member of a public 
school board, let's say in your own community or in my community. In 
fact, I was on a public school board, and do you think I would have had 
the audacity to have my children enrolled in a private school while I 
served on the local public school board? Absolutely not. All four of my 
children went to that public school. It wasn't a perfect school, but it 
was my job to make it perfect, as perfect as I could.
  And so for this Democratic majority, and this President, I would take 
it a step further than what Dr. Fleming said. I would say to the 
President, and to Mrs. Obama and to the children, you know, Sign up for 
this public health plan, because you are purporting it to be the best 
thing since sliced bread, better than any private, Blue Cross/Blue 
Shield, WellPoint, whatever is out there in the private market.
  This is a wonderful hour, and I thank the gentleman from Louisiana 
for bringing up this commonsense point.
  Mr. BURGESS. I also would thank the gentleman from Louisiana. I would 
also point out that in the last Congress I introduced a bill that would 
remove Members of Congress from the Federal employee health benefit 
plan and give them a $3,000 voucher to go out into the individual 
market and purchase insurance, figuring that if we became uninsured it 
would make us more creative about seeking solutions for people who seek 
this problem.
  I did not get any cosponsors. I did offer it to then-Senator Obama 
through his surrogates at several points, but I never got any takers.
  I also prepared an amendment, when we do get our bill in committee, 
and I have hesitated on this, because I don't want my more conservative 
friends getting angry at me for expanding an entitlement, but I have 
prepared an amendment that would make Medicaid available to every 
Member of Congress. In fact, to make Congress a mandatory population to 
be covered under Medicaid, so that again we could experience for 
ourselves firsthand the frustration that patients find when they go to 
find a Medicaid provider, because in many States, my home State of 
Texas, Medicare reimburses poorly, Medicaid reimburses abysmally. And 
it's very, very difficult to find a provider on Medicaid. But I think 
the gentleman is on the right track, and I thank them for bringing that 
to us this evening.
  I would like to take a few minutes. We have two doctors from Georgia, 
two from Louisiana. I was only able to attract one doctor from Texas, 
which is me, but I do have a Texas judge. I yield to him if he has a 
few comments to make on the subject of the evening.
  Mr. GOHMERT. I wanted to thank my friend, Dr. Burgess, and to be 
among such wonderful physicians. And I have been listening, a trained 
judge, I got to listen a great deal. And I heard so much wisdom from my 
friend Dr. Price, Dr. Fleming, Dr. Gingrey, Dr. Broun and Dr. Burgess 
over the last 4\1/2\ years I have been here, and I have come to know 
their hearts and know their heart is for the good of America.
  When we hear about transparency, and we look at what's been 
happening, look at the Federal Reserve. My goodness, what's going on? 
And you look at the auto task force and what they have done with that, 
and now they are going to do that with health care? It's the doctors 
that save our lives. It's the health care that will save lives.
  Well, that's what it used to be.
  And so then we hear, and I don't know if, Mr. Speaker, if the 
American public knows what former Chairman Barton was saying, but 
manager's amendments have been filed after committees have done their 
work, and what little work was done.
  And the manager's amendment just completely replaces all the work 
that was done, and it's put in at the last minute. And then we have 
amendments, as we did on crap-and-trade, that were filed at 3:09 and 
then supersedes everything and then right up here at the Speaker's 
desk. There was not a complete copy, as that was made clear.
  And I have been listening to these things, and I appreciate so much 
the work of all of these people trying to come together with a plan. 
And I have been trying to get alleged counsel to put together a 
compilation of these ideas in a bill, but they will not. They have not 
so far. Former Chairman Barton has submitted this request, and I hope 
we have a bill so America can know about what's out there.
  But I think Dr. Fleming has a great point. Congress ought to be part 
of anything we make anybody else comply with. And that's why how about 
a system where instead of Medicare, Medicaid and SCHIP, we just put 
money in a health savings account that the patient controls and get out 
of what Mr. Shadegg was pointing out, all this bureaucracy, all these 
insurance companies coming between the patient and the doctor, and then 
have catastrophic care to cover everything

[[Page 17327]]

above the health savings account amount where the patient and the 
doctor decide on treatment. These are things we could do. These are 
things that will be good for America. These are things that all of us, 
we have talked about, we would be willing to do ourselves. That's what 
we ought to do for America.
  And I am broken-hearted for what this body is going to cram down into 
the lives of people. And if they think they didn't like some of the 
things that were dictated from Washington, wait till Washington gets to 
control your life, because I am guaranteeing you, when the government 
takes over health care, they have every right to tell you what to do, 
what to eat, how to live. They will have a right to monitor your credit 
card receipts. Oops, you had too many Twinkies you bought last month.
  I mean, that stuff is coming once the government controls your health 
care. It controls your life.
  Mr. BURGESS. I thank the gentleman from Texas for his valuable 
insight. It brings up a valid point, Mr. Speaker, and the American 
people are going to be asked to undergo significant change in the way 
they receive their health care.
  Yes, it may be change they voted for in November. Yes, it may be 
change they can believe in, but I don't know that it's necessarily 
going to be change they like.
  So I do, Mr. Speaker, if I could, I know I must address my comments 
to the Chair and not to the public at large, but, Mr. Speaker, if I 
could address the public at large, I would tell them they need to be 
very, very skeptical of what this body is doing, typically in the 
middle of the night, without much scrutiny and without much study of 
these bills and processes as they go through.
  The individual Members of Congress do need to hear from their 
constituents on this issue. It's too important, too important for the 
American people to remain silent. There are Web sites out there where 
there are petitions that may be signed, AmericanSolutions.com, 
galen.org are two that I know have petitions up. This one that I was 
recently made aware of, Let Freedom Ring, which has a responsible 
health care pledge that they have posted online.
  These are very worthwhile efforts that the American people can 
undertake and make certain that their representatives know how they 
want it to be, how they want to be represented.
  And it is, I think, people got the message on cap-and-trade but they 
got the message a little late. We may, in fact, have been able to turn 
that vote had we been able to have one additional half day of debate on 
that topic.
  Let me now turn to the doctor from Georgia, who we heard from briefly 
earlier. He may have some wrap-up comments that he wants to offer the 
body.
  Mr. BROUN of Georgia. American people need to understand what is in 
this bill, as little as we know about it. There are some things that we 
do know about it. Our friend, John Shadegg, just talked about that, the 
untruth of your being able to keep the health care policy that you 
currently have, is absolutely in this bill. People are not going to be 
able to keep their health care policy. We know that.
  We also know, without a question, that there is going to be a 
Washington bureaucrat put between the doctor and the patient. So a 
Washington bureaucrat is going to be making your health care decisions, 
is my message to the American people, Mr. Speaker. It's going to make 
your health care decisions for you, Mr. Speaker.
  You doctor is not just going to be able to make those decisions. You 
are not going to be able to make those decisions. Your family is not 
going to be able to make those decisions. And the decisions are going 
to be rationed. In other words, some Federal bureaucrat, some 
Washington bureaucrat is going to tell the patient what tests that they 
can have, what medicines they can have, what surgeries they can have, 
what X-rays they can have and what they can't have.
  And there are going to be more can't-haves than can-haves, because 
this is going to be extremely expensive.
  We know this that's in this bill: Right now, today, when people have 
insurance provided by their employer, that is a tax-free benefit. We 
already know that this Democratic bill is going to put taxes on your 
health insurance, and you're going to have to pay those. So what you're 
getting now, Mr. Speaker, the American people, at no tax consequences 
to you, you're going to have to pay taxes on it.
  We know this, too--that Mr. Obama said a few weeks ago that he had to 
push through this, what I call cap-and-tax bill, the cap-and-trade 
bill, that it wasn't about the environment, because he said himself 
that he needed those taxes to pay for his health insurance program, 
this single-party payer program that we're going to; some Washington, 
bureaucratic-directed health care system. He needs those taxes to pay 
for it. So people's taxes are going to go up. Business taxes are going 
to go up. We're going to have these energy taxes, which is going to 
increase the cost of all goods and services--gasoline, heating oil, 
natural gas, food, medicine, everything is going to go up because of 
the energy tax that's over in the Senate. And I hope the American 
people will call and tell their Senators ``no'' to that, too.
  It's critical at this late hour, which should be a very, very early 
hour but it's a late hour because the majority is going to force down 
the throat of the American people this health care plan that's going to 
be disastrous and take their choices away, increase their taxes. It's 
going to destroy our economy, and it's going to destroy the quality of 
health care. I hope they'll call, fax, e-mail their Members of Congress 
and say no, let's put everything out in the open so that we can know 
what it is and so that alternative systems can be looked at.
  I thank the gentleman for yielding.
  Mr. BURGESS. I thank the doctor for coming down and participating. It 
may be late on the East coast but it's early on the West Coast, and he 
has a perfect point to make--that your voices must be heard. Again, the 
Webcast of the Doctors Caucus meeting over at George Washington earlier 
this week. The open forum that was held on health care, The Web site 
www.healthcaucus.org has an archive of that.
  Additionally, there are many, many interviews with other thought 
leaders and headline-makers in health care that have been accumulated 
on this site in the last 6 months. I do encourage, Mr. Speaker, people 
to consider going. Americansolutions.com has a petition, galen.org has 
a petition; and there is the Let Freedom Ring group that is available 
on your search engine that also has a petition. I would encourage 
people to weigh in with that.
  Don't discount calling the Speaker's office. You can find that at 
www.speaker.gov, hit the ``Contact Us'' button and find the number to 
call into the Speaker's office to weigh in on this important issue. And 
finally your calls and faxes, Mr. Speaker, that constituents will make 
to their individual Member's office are going to be extremely important 
in this endeavor. I hear all the time from people back home, What can 
we do to help you? Now is the time. You need to make your voices heard 
on this very important issue. Whichever side you may reside, wherever 
your feelings lie on this, you need to make your feelings known to your 
Member of Congress. The time for that action is now. The markup starts 
next week. We will vote this out of the House of Representatives by the 
end of the month. Don't ask me why we have that arbitrary, condensed 
timeline, but that's what we've been given by the Speaker of the House.
  So now is the time to make your voices heard on this very, very 
important matter. As the ranking member of the committee said, this is 
the ``one-if-by-land, two-if-by-sea'' moment. The American people need 
to make their voices heard on this very critical matter, which will 
affect not only their future, their children's future and their 
grandchildren's future.
  Thank you, Mr. Speaker, for the time.

[[Page 17328]]



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