[Congressional Record (Bound Edition), Volume 155 (2009), Part 15]
[House]
[Pages 19746-19753]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Missouri (Mr. Akin) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. AKIN. Mr. Speaker, I appreciate your recognizing us on a very 
interesting and important topic, something that I believe that anybody 
who pays much attention to what is happening in Washington, D.C., is 
quite aware of. That is the subject of health care, something that 
impacts every single American in our country, affects our budget, and 
affects our family members, and is something of great interest.
  I would like to start tonight by just backing up, though, about 4 
weeks or so to this very Chamber that we are meeting in, that we are 
talking in today. It was here, during a day that we were debating a 
bill that was called cap-and-tax, and it was the largest tax increase 
in the history of our country.
  Now, what happened right before that was of interest because at 3 
o'clock in the morning a 300-page amendment was passed to an 1,100-page 
bill. And as we were debating this bill on the floor, because of the 
speed with which the Democrats moved we didn't even have a copy of the 
bill on the floor. You are supposed to have a copy at least so in case 
somebody wants to check a fine point, they could read it.
  Of course no one had read the 1,100-page bill. And certainly what was 
happening right behind me at the dais, we had good staff people 
hurriedly trying to put those 300 pages of amendments in the 1,100-page 
bill, and we are debating a bill and there's no copy on the floor. And 
the thing was passed without, as I recall it, a single Republican 
voting for it, and Democrats all voted for it.
  Now, the public doesn't like it when we pass bills that we don't know 
what's in them or haven't read them, and we've been embarrassed a 
number of times this year by that same process. Why do you pass a bill 
that people haven't had a chance to read or don't know what happened in 
the dark of night, or the amendments?
  Mr. HOEKSTRA. If the gentleman will yield?
  Mr. AKIN. I do yield to my very good friend from Michigan. Please 
jump in.
  Mr. HOEKSTRA. I thank my colleague for yielding. But I think the 
issue that we see in front, that you've highlighted with the cap-and-
trade bill, actually begins much earlier in the new Congress and the 
new administration. It was only the second day of the new 
administration when the President indicated that we are going to close 
Gitmo, we are going to close Guantanamo. He announced a whole series of 
task forces that were going to evaluate and present a plan as to how 
this was going to happen.
  The first thing is, you don't set a deadline without a plan. And the 
President is now finding out that perhaps he got out in front of 
himself because a couple of the task forces were supposed to report 
within the last couple of weeks, and they've missed their deadlines. 
And the reason they've missed their deadlines is that they started 
looking at closing Guantanamo--an objective that President Bush had 
before him--it's like, whoa, this is more difficult than what we 
thought, and we may not be able to do it. So we had an objective 
without a plan. And I'm not sure what's going to happen here, but we 
may get to the same point where we get to January of 2010, and we won't 
be able to accomplish it.
  Then you go again, before cap-and-trade, $787 billion in a stimulus 
plan that was rushed through the House, rushed through the Senate, made 
its way to the President's desk, and he signed it. And here we are now, 
what, 4 months----
  Mr. AKIN. And just reclaiming my time for a minute, that was the 
stimulus plan, as I recall--was that the one that had the special 
bonuses for insurance executives and it was a finger-pointing deal as 
to who put this in in the dark of night?
  Mr. HOEKSTRA. It is. And we're trying to find out exactly who put it 
in. But it was $787 billion, and I think the promise was something 
like, this is going to ensure that the unemployment rate will not 
exceed 8 or 8.5 percent on a national basis. We are now at 9.5 percent; 
in Michigan we're at 15.2 percent. The money is going out a lot slower 
than what people anticipated. It's going to a lot of questionable 
projects that we are now starting to find out where this money is 
going. It's $787 billion on the backs of our kids and our grandkids. We 
now, last month----
  Mr. AKIN. This is exactly the same bill, just to put this in 
perspective, this is a bill that if we didn't pass it, we might see 
unemployment at 8 percent, right? Is that the same bill?
  Mr. HOEKSTRA. That's right. It's the same bill.
  Mr. AKIN. Now unemployment is whatever it is, 9 something.
  Mr. HOEKSTRA. 9.5 percent. And I believe next week we will see a new 
number, and it will probably be somewhat higher.
  But we've seen higher unemployment numbers than what was promised 
under this bill. We see people questioning whether the bill is working 
or not. It's being spent out slower than what people expected it to be 
spent out. And last month, at the end of June, think about it, we have, 
for the first time, exceeded $1 trillion for a deficit for 1 year.
  And then we hurry through and we do cap-and-trade, which, again, you 
can argue about the bill, but it was passed. And it wasn't passed in 
the middle of the night--although 350 pages of it were inserted in the 
middle of the night. And now we are in this mad rush to pass health 
care. And every day we're hearing about there is going to be this new 
markup or that new markup. And this affects 16 to 18 percent of the 
U.S. economy, and it is going to be done without a full hearing.
  Mr. AKIN. Just reclaiming my time, what you're saying is pretty 
incredible. What you're saying is a bill that we've been working on for 
some number of

[[Page 19747]]

weeks that is going to put the government in charge of all of health 
care in America, basically the government is going to be taking over, 
what is it, just under 20 percent of the U.S. economy----
  Mr. SCALISE. Would the gentleman yield?
  Mr. AKIN. I do yield to my friend from Louisiana.
  Mr. SCALISE. And I appreciate my friend from Missouri yielding.
  Of course when President Obama brought that stimulus bill and he said 
that this would stave off the unemployment rate that was approaching 8 
percent--of course now at 9.5, approaching 10 percent--added $800 
billion to our national debt, a real offshoot of that stimulus bill 
since the President passed his stimulus bill, 2 million more Americans 
have lost their jobs. And so we see more people unemployed, in large 
part because of this big-government approach like the stimulus bill, 
then that cap-and-trade energy tax that they brought, and now we see 
this health care bill.
  I'm on the Energy and Commerce Committee. We were supposed to have 
another meeting tonight to take up amendments to this proposal by 
President Obama and Speaker Pelosi to have a government takeover of 
health care--a devastating approach to really addressing the problems 
that we can address in a very specific way instead of this government 
takeover. But now they're short on votes, and they're definitely having 
problems getting the votes, which is, I think, in large part because 
Americans across the country have started to see some of the details of 
this bill, and they realize how bad of an approach it is.
  Just the other day when they canceled the vote on the House floor 
that was supposed to occur this week, you saw the stock market actually 
take off. So American families out there who have retirement accounts 
and pension funds actually saw an increase, not because of the policies 
of this administration working, but because Americans finally saw that 
some of this Big Government approach, this government takeover of 
health care, actually is in trouble, and that's what really got the 
economy back going again. So I think you can see their approach is 
actually hurting the economy instead of helping the economy.
  And so I yield back to my friend from Missouri.
  Mr. AKIN. Reclaiming my time, in summary, then, we've just been 
taking a look at the last 6 months--and it has been a scary 6 months--
but we've seen a pattern. We've seen a pattern of rushing to spend a 
tremendous amount of money, or rushing to tax the taxpayers a whole 
lot, without letting people be aware of what's in the bills. And we've 
had a pattern of a lot of fiscal mistakes.

                              {time}  1830

  We have a pattern of an unprecedented level of spending and taxation. 
But there is also the pattern of doing it in the dark of night, and 
that's what I wanted to get to on this health care thing.
  What I would like to do is let's talk a little bit about whom do you 
want to keep in the dark on this? Who would naturally be opposed to a 
government takeover of health care? That's where I would like to go, 
because I think a lot of people are interested. Well, hey, if I were a 
congressman or how would I want my congressman to vote or what's my 
position on this? Well, there are a lot of groups of people that are be 
going to be affected very seriously by this government takeover of 
health care, and I think that's what we need to talk about.
  I yield to my good friend from Michigan.
  Mr. HOEKSTRA. I would put forth the premise that maybe we should just 
set health care aside for a period of time and take a look at this $800 
billion that we have put on the backs of our kids. I mean, if we have 
committed to spending $800 billion to stimulate the economy and it's 
not working----
  Mr. AKIN. Unemployment is still going up
  Mr. HOEKSTRA. Unemployment is still going up. Maybe Congress ought to 
stay in session, and rather than taking a look at another massive 
program that we're not sure whether it's going to work or not--I am not 
saying health care reform is not important. It's essential. It's vital 
that we do it, but--
  Mr. AKIN. How you do it is important.
  Mr. HOEKSTRA. How we do it is important. But let's step back. Maybe 
Congress ought to stay in session for the month of August, and rather 
than doing another half-baked idea, let's take a look at this stimulus 
program worth another $800 billion----
  Mr. AKIN. Fix the other four or five half-baked ideas we've already 
started.
  Mr. HOEKSTRA. And finish the half-baked ideas that we have started.
  Too often we think here in Washington that if we pass the bill, we 
have solved the problem. In the business community, if you get the 
agreement from the board of directors and say, okay, Pete, you've got 
the approval to move ahead with this new product launch. We are going 
to invest $2 million to build this product to do the marketing 
campaign, and you just kind of walk away from it and say, well, I guess 
I have that one done. No. What the board of directors would ask you is, 
by the way, we are investing $3 million, $4 million, $5 million on 
this. We want an update every quarter. As a matter of fact----
  Mr. AKIN. So we passed the stimulus bill. The purpose is to make sure 
that we don't have unemployment and that we've got plenty of jobs. And 
here we are, whatever it is 4, 5 months later, and the board of 
directors, which is the public, is saying we're at 9 percent 
unemployment, which is a conservative number, and rising, and you guys 
just spent whatever it was, almost $800 billion, to make sure this 
doesn't happen.
  Mr. HOEKSTRA. You spent $800 billion of our money, the public's 
money, to deliver a result of 8 percent unemployment or less. You're 
clearly missing the targets. Maybe you ought to go back and reevaluate, 
and reevaluate the $800 billion rather than talking about a second 
stimulus package which is going to spend even more money.
  Mr. AKIN. The funny thing is that these are not Republican targets. 
These are not our targets. This is the President's target. He's saying 
8 percent if you don't give me the stimulus. He gets the stimulus bill 
and now it's 9.
  I yield to my friend from Louisiana.
  Mr. SCALISE. Back in Louisiana there's something called the ``rule of 
holes.'' And what the rule of holes says is if you find yourself in a 
hole, the first thing you do is you stop digging. And here they are. 
They brought this bill, the stimulus bill, $800 billion of debt for our 
children and grandchildren that's actually led to increased 
unemployment. Clearly their approach didn't work, as many of us 
predicted it wouldn't. You would think the first thing they would do is 
say, okay, yes, that was something that they did wrong. Maybe we should 
go look at some of these Republicans who put alternative ideas on the 
table and suggested and maybe we'll look at their ideas. And instead 
they talk about spending even more money. In fact, the Vice President 
just 2 weeks ago said that they need to keep spending even more money 
to keep from going bankrupt, as if anybody can make any sense out of 
that. But then they filed this bill to propose a government takeover of 
our health care system.
  And I want to show you right here, this is a depiction of the actual 
organizational chart of their proposal.
  Mr. AKIN. That actually looks like a structure that will----
  Mr. SCALISE. If you look at this, I think--and, clearly, we have 
reforms that we need to make in our health care system. Commonsense 
ideas like allowing portability so if somebody leaves a job, they can 
take their health care with them, or removing the discrimination 
against preexisting conditions. I don't think it's fair that if 
somebody gets cancer that they can literally be discriminated against 
in their health plan. We addressed that in our proposals. 
Unfortunately, what they proposed is this new system where they have 
dozens of new bureaucracies.
  Mr. AKIN. I hate to interrupt, but I've got this chart up here and 
you've got that chart up there, and the two charts aren't the same. 
Even though I

[[Page 19748]]

don't like reading complicated charts, it's obvious to me there's a red 
box on your chart that isn't on my chart. This is my understanding of 
the Democrat proposal for health care, to take over 20 percent of the 
economy. And this is very much of a simplified chart of what is being 
proposed. When the government takes something over, they have got an 
awful lot of different things to connect. And yet your chart has got 
this big red box on it. I would like you to explain where that thing 
came from.
  Mr. SCALISE. I think the gentleman from Missouri makes a very 
important point. We put this chart together based on their bill, the 
bill that President Obama, Speaker Pelosi, and many of the other 
liberals who are running Congress put this bill together, proposed a 
government takeover of heath care. They create all these new dozens of 
bureaucracies.
  I think the most important relationship in health care is that 
relationship between the patient and the doctor. And look at what their 
bill does to create dozens of new Federal bureaucratic agencies that 
come in between the doctor and the patient.
  So when we put this chart together to actually show what their bill 
does, the Speaker censored this document, literally said we can't send 
this out to the public.
  Now, I'm holding this up because I have the ability because we're 
here on the floor, but I, by the rule of the Speaker, can't even send 
this to my constituents back home. People want to know what their bill 
does, and they're trying to censor that information from being shown to 
the public. But the public is figuring it out anyway, and they see 
dozens of new bureaucrats. A health care czar that can ration care.
  Mr. AKIN. Reclaiming my time, what you're saying goes to a little bit 
more even than the health care debate. We are talking about the right 
to free speech. What you just said, as a Member of the U.S. Congress 
from the State of Louisiana, if you'd like to communicate to your 
constituents a flowchart of the bill that the Democrats proposed, they 
will not allow you to do that, and if you were to send that to them, 
they would make you pay for the thing personally. Is that what you're 
saying?
  Mr. SCALISE. That's exactly what I'm saying. I represent about 
650,000 people in Southeast Louisiana, people who are starting to look 
at the details of this bill, and they don't like what they see because 
what they see is government bureaucrats in Washington telling them 
which doctor they can see or even if they can get a medical procedure 
and the ability by this new health care czar that you can't even see 
because it's censored by the Speaker to ration care----
  Mr. AKIN. Reclaiming my time, you're getting at the very heart of 
what I want to talk about today, and that is there's a reason to censor 
something, because you don't want somebody to know something. There is 
somebody who is not going to like this bill, and you just told us one 
of the groups.
  Mr. HOEKSTRA. Will the gentleman yield?
  Mr. AKIN. I would like to yield to my friend, who is actually the top 
guy in the Intelligence Committee. We need to pay attention to him, my 
good friend Congressman Hoekstra.
  Mr. HOEKSTRA. I think one of the things that we need to be a little 
careful about, we keep talking about ``the bill.'' And being a member 
of the Energy and Commerce Committee, you know very well that the bill 
that you have today may be very different than the bill you will see 
tomorrow if you mark it up because there are all these negotiations 
going on behind closed doors, very limited groups, that by the time you 
start working on this bill tomorrow, it may be a very, very different 
bill than what you think it is today.
  So not only is it this bureaucracy, but it is something that is very 
much in flux, out of the public eye, and you may have to vote on that 
bill coming out of committee, which is going to be probably very 
different than what you're looking at right now, by what, maybe Friday?
  Mr. SCALISE. I sit on the committee, and yet I'm not even privy to 
these discussions, these secretive backroom discussions that are going 
on. This is coming from the administration that said they would be the 
most transparent in history.
  In fact, on this health care bill just 2 weeks ago, we had a hearing 
with the head of the Congressional Budget Office talking about the cost 
of the bill. This is a bill in its current form that adds over 240 
billion more dollars to our national debt, and we're concerned about 
the cost. We had the head of the Congressional Budget Office come to 
our committee to talk about the cost.
  Mr. AKIN. I need to reclaim my time again. You're going awfully fast 
for us.
  The first thing you said was if you don't like government bureaucracy 
and you don't want a government bureaucrat between you and your doctor, 
then you probably don't like this flowchart. You want something a 
little simpler where it's you and your doctor making the health care 
decisions.
  You also said if you're worried about fiscal responsibility, you're 
not going to like this bill, too. That's another group, because you're 
worried about the government spending. This thing here, even when they 
try to use every gimmick in the book, it's over a trillion dollars more 
spending. So if you're worried about that, you don't like it.
  I would like to recognize my friend from California. You've been 
dealing with this chart, and if you could share it, because you've 
gotten into the details.
  What are we trying to hide here?
  Mr. DANIEL E. LUNGREN of California. I don't know.
  I appreciate the gentleman's using my chart up here because we have 
tried to work this out with the majority. In the past on the Franking 
Commission, we have attempted to allow Members to be involved in 
vigorous and full debate but not put out what would be considered 
campaign material. And all of a sudden, the goalposts have been moved 
on us.
  Now, this may not be of interest to the average citizen except for 
this fact: What we have presented is what we believe to be a reasonable 
interpretation of the bill as we know it now.
  Now, I do know that there was mentioned just a moment ago by the 
gentleman from Michigan, before he left, that we're talking about ``the 
bill,'' and that can be a bit of a moving target. In fact, I just left 
my office and there was a group of reporters hanging around outside my 
office, not for me, but for a meeting, they said, of the Progressive 
Democrats. They used to be called liberals. They are now Progressives, 
who are concerned about what the Blue Dogs are asking for on the 
Democratic side, and so maybe there will be some changes from what 
we've seen.
  But this is an accurate portrayal from our standpoint of the 
bureaucratic morass that will result from the grand outlines of the 
bill as articulated by the President and as presented by the Democratic 
leadership in the House of Representatives.
  And so they objected to this diagram and basically censored it, as we 
said, because, first of all, they said we called it the House Democrat 
plan. First of all, they said it wasn't true, and now we have shown 
that it is a reasonable interpretation of the facts. Secondly, they 
said there wasn't enough attribution there, and we suggested that it 
very clearly states that this is developed by the Republicans. Then 
they said, well, wait a second. You say it's the Democratic health plan 
but not all Democrats support the health plan. So if they would give us 
the list of those Democrats they have not yet been able to corral to 
support it, we'd be happy to talk to those individuals.
  Mr. AKIN. Reclaiming my time, you've used a couple of terms that I 
think some people might not be as familiar with. You talked about a 
thing called the Franking Commission.
  Mr. DANIEL E. LUNGREN of California. Yes.
  Mr. AKIN. The Franking Commission is a group of Republicans and 
Democrats that meet together, and when you're going to send a piece of 
mail to your district or do something using government money to do the 
printing

[[Page 19749]]

and mailing, it's an agreement that what's going to be there is going 
to be at least reasonably accurate. It's not a political piece and 
you're not slamming, but you're trying to simply communicate some 
information.
  Mr. DANIEL E. LUNGREN of California. Yes. We've done things in the 
past by limiting the number of references you can make to yourself. 
There are only so many times you can mention your name or say ``I,'' 
and that's so----
  Mr. AKIN. Reclaiming my time, the idea is to have kind of a fair 
standard so people can communicate with their constituents. We think of 
it as the First Amendment, just speaking to your constituents.
  Mr. DANIEL E. LUNGREN of California. Of course, I have only been here 
15 years, but in my 15 years, spread over 30, I have not seen this 
happen before.
  Mr. AKIN. Where something was censored.
  Mr. DANIEL E. LUNGREN of California. Well, it's censored. And when 
you compare it with those things that we have approved on the 
Democratic side, we had the controversy over President Bush's 
recommendations to try to, as he saw it, save Social Security and make 
some recommendations for it. They very strongly criticized the 
President's package in terms that I would disagree with, but we on the 
Republican side on the Franking Commission did not say you cannot say 
that because we don't like the way you said it. When they talked about 
the prescription pharmacy section of Medicare, the new section that 
came in, we approved of news letters that went out on the Democratic 
side that criticized the President's plan and said it didn't do what 
was needed to do for seniors. They called it the Republican majority 
plan. And yet they object to our calling this the Democratic plan.
  You know, I have said when I first came to Congress, there was 
something raging at that time called the cold war, and it just reminded 
me of something in the cold war. There is a word we don't see in the 
lexicon anymore. So I went and looked it up and tried to make sure 
people understand what it is. It's called ``samizdat,'' s-a-m-i-z-d-a-
t. And samizdat is defined as a system in the USSR and countries within 
its orbit by which government-suppressed literature was clandestinely 
printed and distributed.
  Now, what does that mean? That means those who were known as 
refuseniks at that time, those who were in disfavor, to say the least, 
with the government were not allowed to publish anything that could be 
handed out, whether it was charged for or not. So the freedom 
underground, if you will, went and had their own printing and they 
would clandestinely put these things out so that they could get their 
message of free speech.

                              {time}  1845

  So my suggestion is that maybe we re-title our particular--and call 
it American Samisdat. We're the freedom fighters here, trying to 
express what we believe to be a reasonably intelligent analysis of a 
bill that's presented to us, which is going to affect 18 percent of the 
economy of the United States, which is going to, if it is enacted, 
forever, at least for our lifetimes, cement the relationship you will 
have with your doctor and the relationship that government will have in 
that. And our argument has been that that chart precisely shows the 
interference of the government which will exist between you and your 
doctor with some 50-plus organizations, agencies, task forces, czars, 
bodies of different types.
  Mr. AKIN. We've been joined, as you note this evening, by my good 
friend, Congressman Bishop, and I'd like to recognize him and let you 
jump in here in just a minute.
  Mr. DANIEL E. LUNGREN of California. But he has no charts.
  Mr. AKIN. Well, but he maybe has a couple of ideas about your charts, 
gentleman. I yield.
  Mr. BISHOP of Utah. This is one of the few times I am here without 
charts, and I feel totally naked on the floor. I apologize for that. 
But I also appreciate the chart that was here and any effort that you 
can get to maybe publicize that because it speaks to the problem that 
we have if, indeed, this kind of expansion of the government takes 
place.
  That chart is the reason why the Federal code of our laws cover 35 
volumes, one-sixth of which is about the Federal regulations and 
bureaucracy, but the Federal regulations is a 200-volume document, and 
why it has grown from John F. Kennedy's time of 15,000 words to 77,000 
words; why Kennedy was able to appoint within 2 months about 300 
officials that ran the bureaucracy.
  For George W. Bush, it took him almost a year because he had to do 
3,300 officials appointed, having been subjected to advice and consent 
from the Senate. We are expanding this thing enormously. And in this 
particular project, because my committee, unfortunately, spent 20 hours 
going through the organizational part, most of the questions that our 
side had of how this plan worked was, we will have to work that out. 
Somehow, the new commissioner will solve that problem.
  Let me just give you one example, and you can play with this one. In 
this plan is supposedly a position of a new national ombudsman whose 
job is to meet with individuals to help them work through their health 
options. However, the law says that this ombudsman must speak in a 
linguistically appropriate manner. Now, my problem was, what is a 
linguistically appropriate manner? It's not defined anywhere in the 
pages that are in that bill. It's someone's poetic idea of being 
politically correct. But when you don't have definitions, it opens us 
up to lawsuits galore. And, once again if we, as Congress, don't take 
the time and the ability to solve these problems and answer these 
questions, some bureaucrat, in this case the commissioner, is going to 
be able to make more and more regulations. And that's why the 
bureaucracy is sometimes called the unelected faceless people in 
Washington because there is no interface between people and the 
bureaucracy.
  Mr. AKIN. And, gentleman, just reclaiming my time, what you've just 
said to us is, again, when we take a look at why do you want to keep 
this thing secret, why would you want to censor it, why would you want 
to tell us we couldn't send a flow chart out, part of the reason is 
because when the American public sees things like that there are going 
to be people who get worried about it. They're going to vote ``no,'' 
particularly every single one of us that some day is going to get sick 
and we're going to want a doctor to help us, and I'm not sure that we 
really want to have somebody going in between in the Government, some 
part of this organization, second guessing the doctor the way the 
insurance companies do too much in our own day.
  So if you really like your doctor/patient relationship, then this 
thing is bad news. That's why they're wanting to censor it. Do you 
believe that's right, gentleman?
  Mr. BISHOP of Utah. I believe it's so. But I will tell the gentleman 
from Missouri that at least when they are interfering with your doctor, 
they will do it in a linguistically appropriate way.
  Mr. AKIN. A linguistically appropriate way.
  Mr. BISHOP of Utah. That gives me confidence.
  Mr. AKIN. In other words, if you're like I am, an old geezer at 62 
years of age, and you need a new hip the way I do, they're going to 
say, we're putting you out to pasture; take a few pain pills. But 
they're going to say that in a really nice way, though, at least. So I 
hope it's linguistically appropriate, but my hip's still going to be 
sore anyway.
  Mr. DANIEL E. LUNGREN of California. Would the gentleman yield for 
just one moment? I just wanted to make one reference. I talked about 
the Cold War a minute ago. It also reminds me what Ronald Reagan said 
when he was negotiating with the Soviet Union and they asked for trust. 
And his response was trust, but verify. And what we're here to do is to 
be the verifiers for the American people. We're being asked to trust 
the bureaucracy to deliver medical care without interference. We're 
here to verify whether that is or is not true. And to deny us the 
opportunity to provide, in a very easily understood way, the 
information

[[Page 19750]]

that undergirds this tremendous bureaucratic morass is unworthy of this 
place.
  We ought to be able to debate it vigorously, and the American people 
ought to expect that we are looking out for them, rather than for some 
formless bureaucracy that's going to take on dimensions that we can 
only imagine today.
  Mr. AKIN. We've been joined this evening on the floor by a couple of 
very distinguished Congressmen, a couple of my very good friends, the 
gentleman from Texas and also the gentleman from Indiana. I'm going to 
recognize the gentleman from Texas who seems like he's got really 
something he's got to say. And I'll go right back over to my good 
friend, Congressman Pence from Indiana, highly respected on the floor, 
for your perspective on this.
  Mr. GOHMERT. I appreciate the gentleman yielding, because in the 
discussion about what's linguistically appropriate, and the discussion 
about how political, supposedly, it is, how politically inappropriate 
to have a chart that lists all the levels of bureaucracy that the new 
bill is going to propose and how they think it may be a bit too 
political to say that it's government-run health care.
  Mr. AKIN. Just reclaiming, gentleman, what you just said, I think, is 
another censored phrase, government-run health care. We're not allowed 
to say that. And our constituents say, why don't you say something 
more? And they're telling us if we print ``government-run'' health 
care, then we can't, then we have to pay for the mailing out of our own 
pocket. Isn't that weird?
  Mr. GOHMERT. That's what they're saying. But I just went and printed 
this off Speaker Pelosi's own Web site, and I apparently need help with 
what's linguistically appropriate. This is on the official Speaker's 
Web site under the title, ``Honest Leadership and Open Government.'' 
The first sentence is, the culture of corruption practiced under the 
Republican-controlled Congress was an affront to the idea of a 
representative democracy, and its consequences were devastating.
  Now, I have a little trouble, and I'm glad I'm here with such bright 
minds, including our wonderful chairman of our conference. But how is 
it a little bit too political to use government resources to say the 
words government-run health care, but it is entirely appropriate for 
the Speaker of the House to say the culture of corruption practiced 
under the Republican-controlled Congress was an affront to the idea of 
representative democracy, and its consequences?
  But that's not all. Led by the House Democrats on the other hand, and 
apparently this is not considered political, this statement, House 
Democrats have acted to make this Congress the most honest and open 
Congress in history. Well, besides being factually wrong, that's----
  Mr. AKIN. But you've got to be up at 3:00 in the morning to hear 
what's going on in committee.
  Mr. GOHMERT. Yeah. Let me just read another statement. With honest 
leadership and open government, America's leaders can, once again, 
focus on the needs of the American people. So that's as political, it 
seems to me, as could be.
  Mr. AKIN. Reclaiming my time, you're talking about honest leadership 
and they're saying, as they take a look at this incredible flow chart, 
they're saying that if you've got a good relationship with your 
insurance company and your doctor and you like what you have, you can 
keep what you have. And yet listed in the bill is specific language 
that says you can't. That doesn't seem to me like they're following 
what the Web site says.
  I'd like to recognize our conference chairman. Maybe you could get us 
out of this morass, gentleman, because we're a little confused between 
the politically appropriate language which seems to be okay for 
Democrats but not for Republicans to call this a Democrat health plan. 
But I yield to my good friend from Indiana.
  Mr. PENCE. First, let me commend the gentleman from Missouri (Mr. 
Akin) for his yeoman's work in bringing these important discussions to 
the floor of the House of Representatives. Judging from YouTube, it 
appears people in Missouri are pretty interested in the subject of 
health care reform. And not surprisingly, in the ``Show Me State'' 
there seems to be a fair amount of skepticism out there about it. I'd 
like to speak to this whole business of government takeover, but I 
won't take more than just a couple of minutes of the gentleman's time.
  First, let me say emphatically to anyone that might be looking in, 
Mr. Speaker, House Republicans support health care reform. We've been 
calling for health savings accounts to be greatly expanded to small 
businesses around this country for years. We've been calling for 
association health plans that would allow people to pool together 
resources around the country, the way Federal employees do to purchase 
private health insurance.
  We've been talking about trying to end the age of defensive medicine 
by allowing for the adoption of medical malpractice reform in this 
country. All these kinds of changes, we believe, would reduce the cost 
of health insurance, reduce the cost of health care in this country in 
the long term. What the Democrat plan, even as it's being modified at 
this very hour, continues to include is a government-run insurance plan 
that would lead to a government takeover of our health care economy, 
paid for with nearly $1 trillion in tax increases.
  Now, I saw the President of the United States today on the television 
giving a speech expressing, with a rather uncharacteristic passion, his 
frustration with two things, and I wanted to speak to those in the few 
minutes that I have. First, the President said no one wants to have a 
government takeover of health care. Well, I don't doubt the President 
doesn't want it to happen, but there's something about bureaucracy that 
when, it is unleashed in certain ways, it takes over areas of our 
economy. It's an unbroken truth of the history of governments around 
the world that unchecked, unlimited government expands.
  And whatever the President's intention, the reality is that should 
this government create a government-run insurance option to so-called 
compete with the private sector, that government option would compete 
with the private sector the way an alligator competes with a duck. It 
would consume it. And most Americans know that. Now, the other thing 
the President had a problem with--
  Mr. AKIN. Just reclaiming my time a moment, what you just said is 
mirrored--just a week or so ago we had about 1,100 pages of the bill. I 
started reading it and it said the commissioner shall, we go to another 
page, the commissioner shall, and we had page after page, the 
commissioner shall do this, the commissioner shall do that. It may not 
be his intention to have the government run it all.
  He could have called it the czar. We had some discussion whether it's 
a commissioner or a czar or a commissar. We weren't sure what. But 
anyway it was one after the other pages. That's what the bill says. And 
just to your point. Sorry to interrupt. I yield back.
  Mr. PENCE. Well, I thank the gentleman for yielding. But let me say, 
the other point the President expressed was that some of us, and some 
independent organizations were trying to scare the American people by 
suggesting that if the government introduces a government-run insurance 
option, that you'll lose your health insurance. But the Lewin Group, 
which has been praised by Republicans and Democrats over the years, 
actually estimated 114 million Americans would likely lose their health 
insurance if the Democrat health care plan and the administration's 
plan were actually to be adopted.
  But why is that? Now, to be perfectly fair, the President did make 
the point today at the podium that nothing in this plan will make 
people give up their private insurance. And I want to grant that point, 
Mr. Speaker, for anyone that might be looking in. That's not really the 
point, though.
  What the administration and some of our colleagues fail to understand 
is that as soon as Uncle Sam offers health insurance, a government 
health insurance for every American employee for

[[Page 19751]]

free, there's almost no employer in America who's not going to sit 
their employees down during this worst recession in 25 years and say 
something like, look, I love you; we appreciate your being here, but 
we're trying to keep the lights on and the doors open at this business, 
so you know what? We're going to cancel the health insurance that we 
have through this company, and we're going to send you down to Uncle 
Sam to apply for it.

                              {time}  1900

  That's why the Lewin Group, which is an independent organization, and 
common sense should tell the American people, if the government 
introduces an insurance program to compete with the private sector, 
tens of millions of Americans will lose the health insurance they have.
  So, whether it's the intention that we have a government takeover, 
the fact is, if we insist, as the Democrats in Congress and the 
administration are, on a government option, even with the tweaks 
they're putting around the edges, it will result in a government 
takeover, because tens of millions of Americans will be relegated to 
that new government program.
  That's why I really believe that we have to oppose this program, that 
we have to scrap this government takeover with its $1 trillion tax 
increase and that we have to start over and come around to those 
bipartisan solutions that Republicans are prepared to work on today.
  I yield.
  Mr. AKIN. I really appreciate the gentleman's points that have been 
made here, explaining the fact that one of the people who is not going 
to like this is somebody who has an insurance policy that he likes, 
because when the government offers something for free, one can bet that 
what's going to happen is that the insurance policy is going to go 
away.
  Now, it isn't as though the ideas that are being advocated in this 
bill are particularly new. They've been tried in other places. Here is 
one. Massachusetts tried. Basically, everybody has to have insurance, 
and the government is offering health care. What was the end result? I 
mean we don't have to reinvent the wheel. We see that what happened 
was, first of all, Massachusetts took a huge hit financially, and 
health care access is down because patients have to wait 70 days to see 
a doctor in Boston.
  So, first of all, it is the typical red tape in government. You've 
got to wait in a line, but what's more, it costs a whole lot of money 
to wait in line because now your health care costs in Massachusetts are 
133 percent more than what the average is. So it's not like we haven't 
tried this before. It has been tried; yet we're going to want to try 
and do the exact same thing.
  It has been tried in other places. It was tried over here in Europe. 
We can take a look at that. What happens with cancer? I happen to be a 
cancer survivor. I'm not a wizard doctor; I'm not even a wizard 
economist, but I know a little bit about cancer because I survived it.
  I see my good friend from California. If you'd like to jump in here, 
we'd be delighted to yield you time.
  Mr. DANIEL E. LUNGREN of California. Yes.
  I would like to just follow up on what Mr. Pence said, which is, if 
you are concerned that there is the possibility that a public option 
will lead to a government takeover, you need look no further than at 
what happened with the student loan program.
  The student loan program has a government option, but what is 
happening now with this Congress and with this President? We are 
eliminating the private option, and we're going totally to the public 
option, which now becomes a public monopoly.
  Mr. AKIN. Can you get a private student loan now or is it that, 
basically, you can't get them anymore?
  Mr. DANIEL E. LUNGREN of California. The way we are phasing them out, 
you will not be able to get those. They will be, basically, the Federal 
student loan programs.
  Mr. AKIN. So it's like Henry Ford and his car. You can get any color 
you want as long as it's black.
  So the only kind of student loan you're going to get is a government 
student loan because we've basically chased the private sector out.
  Mr. DANIEL E. LUNGREN of California. Well, we do have a Member on the 
other side of the aisle, a distinguished Member on the other side of 
the aisle, who in a townhall meeting admitted that this is going to 
lead inevitably to a public takeover of health care, and he said, yes, 
that is a good thing.
  Mr. AKIN. A lot of them are quite happy with the idea of socialized 
health care. They acknowledge that.
  Mr. DANIEL E. LUNGREN of California. You can't use that word.
  Mr. AKIN. I'm not allowed to say ``socialized''? Socialized. 
Socialized. Socialized.
  Mr. DANIEL E. LUNGREN of California. You can't say it in print.
  Mr. AKIN. Oh.
  Mr. DANIEL E. LUNGREN of California. We're not allowed to say that. 
We're not allowed to say it on our particular chart of the Democratic 
health plan. We've been told that that is not allowed if we're going to 
print it and send it out to our constituents.
  The last thing I would just say is this: Look, I happen to be the son 
of a doctor. My dad was my hero growing up. I used to go on house calls 
with him. I'd make rounds with him. I thought I was going to be a 
doctor until, as I like to say, God sent me a strong message during my 
sophomore year at Notre Dame called ``organic chemistry.''
  Mr. AKIN. Organic chemistry. As an engineer, I feel your pain, my 
friend.
  Mr. DANIEL E. LUNGREN of California. But I never lost the sense of 
service that my dad had as a doctor. From my observation of the way he 
practiced medicine, he taught me that the doctor-patient relationship 
was paramount. I heard him many times on the phone, arguing on behalf 
of a patient with somebody who was employed by the insurance company. I 
heard him arguing with hospitals. I heard him arguing with nurses if he 
didn't think they were doing a great job. I heard him praise the nurses 
when they did a great job for his patients. I heard him praise the 
hospital.
  His whole focus was on his patients. He was not only his patients' 
greatest diagnostician, and not only the greatest doctor they could 
have, but he was their greatest advocate. That's what I don't want to 
lose in this or in any other plan.
  Mr. AKIN. I think you just put your heart right on what this debate 
is about.
  Mr. DANIEL E. LUNGREN of California. I don't want the government to 
be my advocate. I want my doctor to be my advocate. I want my family to 
be my advocate. Listen to what the President said in that interview on 
television when asked about the 100-year-old woman.
  Mr. AKIN. Go through that again.
  Mr. DANIEL E. LUNGREN of California. The 100-year-old woman, who was 
an extraordinary person with great verve in her life, who also had 
tremendous health, needed a pacemaker. Her doctor thought she should 
have it because he knew her. He called a specialist who would actually 
do the implantation of the pacemaker, but he was skeptical. He said he 
wasn't going to do it on a 100-year-old lady.
  He said, Just meet her. Examine her.
  He examined her, and his position was changed. She received it at 
100. She is now a very active 105-year-old.
  It was presented to the President, and it was said, Mr. President, 
will my 100-year-old mother still be able to have a pacemaker?
  The President gave a long, long convoluted answer. At the end, he 
said this: It may mean that, instead of some sort of surgical 
procedure, we will give your mother painkillers, pain pills.
  Mr. AKIN. What we're really talking about--and this isn't politically 
correct. I guess I've never learned that very well. We're talking about 
government-rationed health care, aren't we?
  Mr. DANIEL E. LUNGREN of California. Here is the deal. If you're 
concerned about cost, you can do it in one of two ways to limit cost: 
competition or rationing.

[[Page 19752]]

  Now, competition has some premises involved in it. One of them is 
that we need greater transparency. There's no doubt about it. We need 
to know what it costs with certain doctors or charges. We need to know, 
when we go in the hospital, what the infection rates are. It's those 
sorts of things. Competition from doctors and competition from medical 
health care providers and from insurance companies will give us 
tremendous options so that we can make the decision, and that tends to 
keep costs down.
  In a government system, when you have a monopoly, there is only one 
way you keep costs down. It is called rationing. If you don't believe 
it, look at England; look at Canada; look at France; look at all of 
those other systems.
  Mr. AKIN. Reclaiming my time, gentlemen, that's what I'd like to do 
because I have a chart here.
  I would also like to recognize my good friend from Texas, Congressman 
Gohmert, who is noted, actually, for being, in spite of his humble 
demeanor, really an expert when it comes to knowing how to phrase 
things in a tactful and direct kind of way.
  Mr. GOHMERT. Well, I appreciate the gentleman for yielding.
  I'm still perplexed. Since Republicans are not allowed to comment on 
anything that's a governmental resource, and so I am wondering, if we 
phrase in any mail-out or on any Web site, if we say that the Democrat-
controlled Congress is taking the Nation in the wrong direction and 
that too many Americans are paying a heavy price for those wrong 
choices, including paying record costs for health care, I'm wondering 
if that would be something that would also be found objectionable for 
its being a little too political.
  I'll yield to find out what you think.
  Mr. AKIN. It seems like the basic principle should be to respect your 
other colleagues and, at the same time, to also tell the truth. It 
sounded like what you said would be my idea of what the truth is, but 
then I may not pass the political correctness test.
  Let's take a look at this.
  Mr. GOHMERT. If the gentleman would yield, let me just say that 
that's on the Speaker's Web site in the reverse, meaning the 
Republicans took the Nation in the wrong direction, and too many 
Americans are paying a heavy price.
  So, anyway, it sounds like, if Republicans said that about Democrats, 
as my friend says, it's probably true, and it would be politically 
inappropriate under the Franking determination, but it's okay if the 
Speaker does it, apparently.
  Mr. AKIN. I'd like to take a look, though.
  You were just talking about there being different ways to control 
costs. One of them is, when the government does it, they ration health 
care or they make various decisions to keep costs down. Here is the 
result of a comparison. These are 5-year survival rates for all 
different kinds of cancers.
  This is the European Union average. They all have socialized 
medicine. I guess they do call it ``socialized medicine.'' Here is the 
U.S. system, which at least is, largely, more of a free enterprise 
system. It's the beige.
  Now, if you'll take a look at these different kinds of cancers, one 
of the things that you'll notice is that the survival rates are a whole 
lot better in the U.S. than they are with these socialized systems, and 
I don't think that that's a coincidence. It's just a fact that free 
enterprise works a lot better than socialism does.
  The particular cancer I had here was called ``prostate cancer.'' Let 
me see if I can see where it is. Here is ``prostate'' down here. You've 
got the survival rate in the United States at 90-something percent. 
Back over in Europe, it's only at 78 percent. I'll tell you, if I were 
to have prostate cancer, which I had, I'd want to be treated in 
America. That's what I'd want.
  Mr. DANIEL E. LUNGREN of California. Will the gentleman yield for 
just a moment.
  Mr. AKIN. We know that, for the British, for the European Union--in 
England--this is a 50 percent number.
  Now, if I were sick, you could talk to me all you want about the 
government's giving me free health care, but it wouldn't do me any good 
if I were dead. This shows you what happens when we go to a government-
run system.
  I would be happy to yield to my friend.
  Mr. DANIEL E. LUNGREN of California. This points out vividly the 
difference between a system where competition exists and where a 
monopoly by government exists. Where a monopoly by government exists, 
inevitably to attempt to try and control costs, you have to impose 
rationing. That's why you have these variations of survival rates among 
cancer patients, because they are not getting the care in those other 
countries that we get here, and they're not getting the care in a 
timely fashion.
  Mr. AKIN. Timeliness. You know, in cancer, they always say, if you 
can diagnose it early, your probability of success goes up. As for that 
timely thing, you know, I think the socialized medical system says, 
We'll give you a free C-section, ma'am, as long as you're willing to 
wait 12 months.
  Mr. DANIEL E. LUNGREN of California. Well, I happen to be someone who 
had a hip replacement about a year and a half ago. Under the rules that 
prevail in at least one of those countries, I would not have been able 
to have it because I'm not 65 years of age. Had I needed it when I was 
80, I would have been too old to get it. They have defined by age the 
category of people who can receive that operation. It's not just a 
limitation on time, on how long it's going to be.
  The point is, if you look at our younger generation today and look at 
how active they are in certain sports, with repetitive actions 
affecting their joints, we are going to have younger people being in 
need of the replacement of joints--of knees and hips. That runs 
precisely contrary to what you see as being available in these other 
countries. That's why this debate is so important.
  If, in fact, as we believe, the plan presented by the majority would 
inevitably lead to government-run health care, these are the 
consequences. That's why we ought to be able to debate that. They can 
argue with us and say, No, it's not government-run. We can argue how we 
believe it is, but at least we ought to be allowed to have that debate 
so that people can see what the consequences of our actions here in the 
House are on them and on their personal lives.
  Mr. AKIN. I yield.
  Mr. GOHMERT. Thank you for yielding.
  I wanted to have time to ask my friend from California: Do I sense 
there is a concern that, if someone with the Federal bureaucracy had 
seen you move athletically before the hip replacement, they would have 
said giving you a hip would have been wasted?
  Mr. DANIEL E. LUNGREN of California. Only a Texas Aggie would ask 
that question, and I will take that as a rhetorical question that needs 
no response.
  Mr. AKIN. Well, gentlemen, I would call your attention to another 
colleague of ours, Congressman Rogers, from Michigan.
  He told the story the other day of when he was, I believe, 18 or 19 
years old and had bladder cancer. Now, his doctor didn't know that, of 
course. He had some blood in the urine. He went to his doctor, who had 
known him and who had known his family for some period of time. The 
statistical probability of his having bladder cancer at that age was 
almost nothing. Yet, because he had that relationship with his doctor, 
she didn't let it go.
  It was just like your father wouldn't, my friend.
  She didn't let that thing go. There was something about her intuitive 
sense of knowing there was a problem there. They checked it out, and 
found out that he had bladder cancer. He's a Congressman now. This was 
some 40 years ago.

                              {time}  1915

  But you know when you have these statistics saying it just fits in 
this category, he held up a calculator and he

[[Page 19753]]

said, There's nothing in this government calculator that knows anything 
about health care. All it is is some government agent running 
statistics.
  There was a guy from Canada that I just read about, and he was 
younger than you are. He was in his fifties, and the Canadians said, 
You can't have a hip replacement. You're too old. So of course he used 
the option. He came to America and got it--the free enterprise system.
  My good friend from Texas.
  Mr. GOHMERT. And I do appreciate you yielding. And obviously I was 
being facetious and perhaps rhetorical for my friend from California 
because the point is no government bureaucrat should ever be able to 
look at any American and say, I don't think you ought to get this 
treatment. I don't think you ought to get this surgery. That is the 
last thing you want is the government intervening.
  And what has really gotten outrageous and got my attention is when we 
got the latest numbers we could for 2007 and the total amount of 
Medicare and Medicaid tax dollars spent and you divide it by the number 
of households in America, it's about $9,200, over $9,200 per household. 
You look at what President Obama is proposing. CBO says it will be 
between $1 trillion and $2 trillion, $1 trillion to $1.6 trillion? You 
divide just a very conservative amount of that by 117 million 
households that are estimated right now in America by Census, and you 
have $10,000 more per household for every household in America they 
have to come up with to pay for this plan on top of the $9,200 in 
Federal tax dollars they are paying now.
  Mr. AKIN. Let's do this again. Every single household in America is 
going to get hit with an additional $10,000 per household to make this 
transition to a socialized medical system that produces this kind of 
result? Is that what you're saying?
  Mr. GOHMERT. That's on top of the $9,200 average per household in 
America right now. Around $19,000 per household.
  Mr. AKIN. Here's something that I think is kind of amazing. Take a 
look at this statement. This was an amendment that was offered to the 
Democrats' health plan: Nothing in this section shall be construed to 
allow any Federal employee or political appointee to dictate how a 
medical provider practices medicine.
  Now, I would say I think that's something that a lot of my 
constituents would say I don't want some bureaucrat telling some doctor 
what he can and can't do to take care of me. Take a look at the vote 
when this was done in committee. This was an amendment that was 
proposed by Dr. Gingrey. He spent his life going to medical school and 
taking care of patients. And look at the votes. Republicans, 23 votes 
saying we don't want to put a bureaucrat between you and your doctor, 
and zero voted against this, of the Republicans. Of the Democrats, only 
one Democrat voted for this amendment and 32 of them voted against 
that.
  Now, I think a lot of people on Main Street America think why can't 
we just get along as Republicans and Democrats and just solve problems. 
But this is a very fundamental difference between the two parties, 
isn't it? This is what we've been talking about. Do we really want a 
Federal bureaucrat? And what they just voted to say was we think that 
in order to control costs, you're going to have to let some government 
bureaucrat make those decisions and tell a doctor and a patient that 
they can't get the care.
  Mr. DANIEL E. LUNGREN of California. This makes about as much sense 
as the Vice President's recent statement that in order to avoid 
bankruptcy, we have to spend more Federal money.
  Mr. AKIN. That's not intuitively obvious, in order to avoid 
bankruptcy, we've gotta spent more money.
  Mr. DANIEL E. LUNGREN of California. And the President is basically 
telling us, by entering the Federal Government in the largest way in 
the history of the United States into medical care, it is going to cost 
less and provide more accessibility.
  And I think that is--well, what I'm finding from my town hall 
meetings, my teletown halls, my discussion with people back home, 
they're not buying it because they know it just doesn't seem to make 
sense. Just as the gentleman has pointed out on this amendment, if in 
fact they're not going to put anything between you and your doctor, why 
would they reject an amendment that says just that?
  Mr. AKIN. With only one exception of one Democrat, a straight party-
line vote saying we want to put Federal employees between your doctor 
and you as a patient.
  This is pretty serious stuff. This is very serious stuff to me. 
Because as I said, when I came to Congress, I had a poor health care 
plan. I came to Congress and found out there were some Navy doctors in 
this building, and those Navy doctors gave me a physical. I felt 
bulletproof and everything at 52. I found out that I was bulletproof 
and doing great except one little detail: I had cancer. And the fact 
that they discovered that and were able to get treatment without some 
bureaucrat taking that away from me, that's why I'm alive today.
  I can understand why people are going to be very, very cautious 
entering some government-run plan that produces results for people, 
something like what the European Union is doing.
  I yield to my good friend from Texas.
  Mr. GOHMERT. Our time has expired, and I appreciate being a part of 
this. This is too serious to let the bureaucrats control people's 
lives.
  Mr. AKIN. I thank you very much. I thank my many good friends who've 
joined us here for this discussion. I think many understand it's a very 
serious issue. It's better to go slow and get it right and don't mess 
it up as we have some of the things that have been passed at 3 o'clock 
in the morning.

                          ____________________