[Congressional Record (Bound Edition), Volume 155 (2009), Part 15]
[House]
[Pages 20455-20462]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         HEALTH CARE IN AMERICA

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Iowa (Mr. King) is recognized for 
60 minutes.
  Mr. KING of Iowa. Mr. Speaker, I appreciate the privilege to be 
recognized here on the floor of the United States House of 
Representatives. And having had an opportunity to listen to some of the 
dialogue that went on previously, I'm glad that I have a chance to 
raise these issues.
  On the front of everybody's mind in this country is the situation of 
our health care and our health insurance for 306 million people in the 
United States. And I would point out that if we look at the size of 
this economy and the size of this population, it is a huge endeavor to 
think that we would take 17.5 percent of the American economy, 17.5 
percent of our gross domestic product and switch it over to a 
government-run plan, and do so in almost the blink of a legislative 
eye, and do so without the full deliberation of the floor of the House 
of Representatives or without the American people having an opportunity 
to weigh in.
  I am glad that this process has been slowed down--however great the 
price has been--so that there is an opportunity now for some of the 
legislation that has been more closely refined, shall we say, in its 
1,100 or so-page form to be available to the public, a public that has 
more access to this information that is going on in the House than ever 
before because of being able to access this information now by the 
Internet. And all of us in this Congress have Web sites, and I would 
think there is at least one link on every Member of Congress' Web site 
that will help you access this information on where we are with bills 
that are being deliberated here in this Congress.
  And as I look at where we are today and what's out there, I'm very 
interested in the entire month of August and I'm very interested in the 
first week of September. Those are the times when the American people 
will have had a chance to read the bill, talk to the people within 
their profession or whatever their interest group is that have read the 
bill, weigh their ideas, do this across the backyard fence and do this 
at the coffee table at work, and be able to give us the benefit of the 
wisdom of the American people to weigh in on all the components that 
have been created here that are promised to come at us and perhaps have 
a vote on a final passage; not here, not any longer this week or next 
week or in the month of August, but perhaps in the first or second week 
in September, and

[[Page 20456]]

something that--this will decide the fate, if it's passed, of the 
health care system of the United States, I believe, at least as far as 
we can look into the future. And it is a national health care plan. It 
is a government-run health care plan. It is a model that transforms the 
entire health care system in the United States.
  Today we have more than 1,300 private health insurance companies 
competing for premium dollars, And they do so by providing the best 
value for the dollar and marketing that best value for the dollar and 
trying to adjust those policies to meet the demands of the American 
people. Over 1,300 private health insurance companies, and among them 
they offer, in the aggregate, perhaps as many as 100,000 different 
health insurance options. And the President of the United States has 
said he just wants to offer one more option, 100,001 policies now for 
everybody in America to choose from if this bill should pass.
  And this extra government option that he would offer, as if there 
wasn't enough competition out there among the 1,300 health insurance 
companies and the roughly 100,000 policies that are there, how can 
anyone presume that one more policy that would just compete with the 
other policies out there would result in anything other than one one-
hundredth more options for the people of the United States?
  I would submit that there is a lot more afoot here, Mr. Speaker, 
there is a lot more afoot here. The people that are advocating for this 
public option, the people that are advocating that the Federal 
Government should run their own health insurance policy in order to 
compete against the private sector are the people who sometimes they 
will leak it into the media, sometimes they will shout it out in a 
private meeting, but in their soul they want a single-payer, 
government-run, socialized medicine, one-option government plan for 
everybody. And they want to run every private health insurance company 
out of business and take the 100,000 options that the American people 
have with them. That is their agenda.
  And I can put together a string of quotes from the very liberal 
Members of this Congress that find themselves in powerful positions in 
this Congress, gavels in hand, that are determined to take away the 
private health insurance options and turn it into one government plan.
  Even the President of the United States believes in that, however 
much lip service he has paid to the idea of telling the American 
people, well, if you like your health insurance that you have today, 
then you get to keep it. That's one thing that I cannot accept that the 
President believes when he says it. He is a very smart man. He's got to 
understand that if it says in the bill--and it does, section 102 of the 
bill--that every private health insurance policy has to be rewritten in 
the first 5 years of the passage of the legislation that's proposed, 
that means the American people's individual policies will all change 
within 5 years and they will have to accommodate themselves to the new 
qualifications that will be written by a health insurance czar to be 
appointed by the President later, and regulations that are not in the 
bill, but regulations that would grant that health insurance czar the 
power and the authority to set the standard.
  So he might rule that every health insurance policy in America has to 
pay for abortion. He might rule that everyone has to pay for mental 
health. He might rule that everyone has to pay for all pharmaceuticals, 
or maybe only generic pharmaceuticals.

                              {time}  1700

  Whatever he may decide, he'll be looking at the costs of the premium, 
the percentages of copayments, and the regulations will be written so 
that the public option, which is so carefully defined and that language 
that's determined to be defended by the Democrats in this Congress--so 
that the public option can compete with all of these 1,300 private 
health insurance companies that have competed in the marketplace for 
years and found their niche in the market and done it the American way.
  Now, if somebody thinks that there's too much money in the health 
insurance business, why don't they get in that business and provide 
that health insurance and lower the premiums and cut down on the 
administrative overhead and take some money and take some profit out of 
it?
  That's how this works in the free market system. If there's something 
out there in the marketplace that has too much profit in it, you don't 
need government to come in and do it for you. You need to take a look 
and determine is it a monopoly? If it's a monopoly, then Teddy 
Roosevelt rides again. Let's bring him in and let's bust the trust. But 
if you have 1,3000 health insurance companies and 100,000 health 
insurance policies, you don't have anything that looks at all like a 
monopoly. You see something that looks like the maximum amount, or 
nearly the maximum amount, anyway, of competition in the marketplace.
  So that argument is specious, the idea that we need to create one 
more company, unless it is the intent of the proponents to create 
socialized medicine--one size fits all, take away the American people's 
individual policies and give them a government policy or a facsimile of 
a government policy that would be their former private health insurance 
company that has had to adapt to the new rules written by government 
and offer a qualified plan.
  Now, why am I suspicious of this? I am more than suspicious. I'm 
convinced that this is the initiative: to wipe out all private health 
insurance and force everybody into a public policy and a public plan. 
One of the reasons is because there has been such an indignation about 
those of us who have said that this is a government-run health care 
plan that they're proposing.
  They have tried to censor us here in the United States. They have 
actually effectively to a degree censored Members of Congress who 
wanted to simply mail out the flow chart, the schematic, if you will, 
of what this proposed health insurance plan or this health care policy 
looks like.
  And I would take the people in this country back, Mr. Speaker, to 
this little chart right here. This is a chart that hung on my office 
for probably a decade starting in 1993, when Hillary Clinton came to 
town and became the secret master of the reform of the health care and 
the government takeover of health care in the United States. A lot of 
people remember, as I do, those were intense times. I was watching my 
freedom being marketed away day by day in secret meetings. I don't know 
if they actually kept minutes, but I know they weren't available to the 
public. I know the press wasn't allowed in the room. The public wasn't 
allowed in the room. There weren't Members of Congress representing 
their constituents. There were people like Ira Magaziner and others who 
were handpicked by Bill and Hillary Clinton to devise a plan.
  And the idea of this was, put these smart people in a room, have them 
devise a plan, don't let anybody weigh in on that, no kibitzers on this 
plan, because if that happens, then the American people would start to 
grumble, and if they start to grumble, they might start to talk out 
loud, and if they talk out loud, they might start to yell, and if they 
start to yell, they might come to town and tell us that they don't want 
to have a government-run health plan in the United States, that they 
don't want to have their private plans taken over.
  Well, that's what they finally did. They finally said they are not 
going to tolerate it, and the American people scared enough Members of 
Congress and enough United States Senators that they were going to lose 
their seat if they supported this monstrosity that this monstrosity 
finally was pulled down. This was a time when United States Senator 
Phil Gramm said that this health care policy will be over his cold, 
dead political body if they pass something like this. He stood there. 
He meant it. They held their ground. People in this House held their 
ground. And people like Dick Armey held their ground. In fact, Dick 
Armey was instrumental in helping to form this chart, this black and 
white chart that is the schematic that shows all the

[[Page 20457]]

government agencies that are created by the old plan back in 1993, 
which I will at least give Bill Clinton credit for. He wrote a bill. He 
presented a bill to Congress, and he asked Congress to pass the Hillary 
plan. And, of course, Congress liked their job. They didn't pass the 
Hillary plan.
  And when I call it a ``schematic,'' I don't know that one might think 
today that that's pejorative, but in here they actually do call their 
own plan a ``scheme.'' Someplace in this chart it addresses at least 
some of the components in it as a ``scheme.'' Well, I call it a 
``schematic'' or maybe more appropriately a ``scheme-attic,'' Mr. 
Speaker.
  But it has here an ombudsman who is supposed to broker the deals 
between government because people can't get through government 
bureaucracy; so you create an ombudsman. Well, we have to change the 
name of that because now people know what an ombudsman is. We have the 
HMO provider plan that doesn't show up in the other chart that I can 
see. HMOs have slid down in their popularity.
  Here we have the global budget. In 1993 a global budget for a health 
care plan. All of these squares and boxes are created as new 
affiliations with the exception of the executive office of the 
President. A few others, but generally speaking, this scheme, and they 
call it a ``scheme,'' does scare the American people.
  Now, Mr. Speaker, I would point out that as scary as this chart 
looks, we have another chart here that is far more scary. This is the 
color-coded, modern-day, software-driven, packaged-up plan that is a 
very accurate facsimile of what actually is taking place in the 
Democrat bill here in the House of Representatives. This is 31 new 
agencies, and there are subagencies and other responsibilities that are 
behind it.
  But just to look at the chart, Mr. Speaker, one can look at all these 
white boxes here. If they're not colored, if they're white and they 
have black letters in them, they're existing government agencies. These 
are already hoops that people have to jump through. And then when you 
look at the colored boxes, the orange and yellow and the green and the 
blue and the purple, those are all new agencies. These are all new 
hoops for the American people to jump through. These are untried. They 
are untested.
  When you create new government agencies, you run a little beta test 
because you don't know how it's going to act, how it's going to 
function, and you don't know how people are going to react. All you can 
do is guess how people will react. And you don't know if you can 
actually manage this.
  But I will suggest this: We don't do that good a job of managing the 
health care that we pay for out of this Federal Government today. Right 
now the Federal Government is paying 80 percent of what the cost is to 
deliver Medicare services. And if I look at my State, where we have a 
high percentage of Medicare patients because we have a very high 
percentage of senior citizens, then the percentage of that Medicare 
that they're providing is less than 80 percent, and one of the reasons 
is because we have some of the highest-quality care. In the State of 
Iowa, if people go there, Mr. Speaker, they can expect that they will 
receive quality care in the top five of all of the States in the 
country year after year after year. And with that high-quality care, 
Iowa sits at the lowest Medicare reimbursement rate.
  So we're looking at this and wondering if it is the majority's, and 
that means the Democrats' and that means the President's idea, that we 
are going to fund the cost of this $1 trillion to $2 trillion health 
care ``scheme-attic'' that we have here, and we're going to fund it, in 
part, by reducing the funding that is going to Medicare by roughly $500 
billion when Medicare funding that is already inadequate at best pays 
80 percent of the costs, and they're going to cut these costs and fees 
going into the States to come up with enough money to pay for this?
  So what it means is, Mr. Speaker, is this: If you take $500 billion 
out of Medicare in order to fund a national health care plan, that 
means you're taking it right out of the health care for the senior 
citizens in the United States of America across the board. The health 
care access for senior citizens will be diminished. The services will 
be diminished. Presumably the quality will be diminished because the 
doctors and nurses and providers will have to spend less time per 
patient, accelerate their time with them, and that means less quality 
care. And it means fewer services to our seniors.
  So this $500 billion, a half-trillion dollars, taken out of Medicare, 
right out of the Medicare services, the health care services for our 
senior citizens, in order to find a way to do a pay-for for a $1 
trillion to $2 trillion National Health Care Act. And President Obama 
has said we're going to pay for all of this. We're going to find a way 
to pay for it. Well, that's the problem that Charlie Rangel has run 
into in the Ways and Means Committee. But it looks like some of it 
comes out of not the pockets of our senior citizens that are accessing 
their health care; it comes out of services to them.
  And the arguments I've heard were behind closed doors, the derogatory 
comments that have been made about doctors and nurses and providers and 
the allegations made, for example, by the President of the United 
States that we have doctors that are removing tonsils because it pays 
rather than because they need to be removed. I think that needs to be 
documented and it needs to be quantified. And, yes, there are people in 
every industry that don't meet the highest standards. But to paint the 
whole industry with anecdotes like that without any data to back it up 
just further clouds this debate and makes it harder for us to make 
progress.
  This chart, by the way, this chart that we have called government-run 
health care, we have called this--well, it is. It's the organizational 
chart of the House Democrats' health plan, and this ``scheme-attic'' 
that has 31 new agencies, I would just direct, Mr. Speaker, your 
attention and the public's attention down to these boxes right here on 
the bottom:
  This white box here that says ``traditional health insurance plans,'' 
that's where the 1,300 companies are. That's where the 100,000 policies 
are, in this square box right here; 1,300 companies, 100,000 policies 
in traditional health insurance plans. According to the bill, section 
105, all of these plans, every single health insurance plan in America, 
would have to run through--they would be here in this white box. They 
couldn't function after 5 years unless they met the qualified health 
benefits plans here in this purple circle right here. In order to be 
qualified, they would have to meet the new government standards that 
are not yet written. These new government standards would be written by 
the Health Choices Administration right here.
  Health Choices Administration would be run by the HCA, Health Choices 
Administration, Commissioner. Now, he's a commissioner, or she, because 
America is up to here with czars. We have 32 czars. We do have more 
czars than the Romanovs, and they're less accountable than the 
Romanovs. They're not held up to any kind of confirmation. They're not 
answerable to Congress. I don't know that we have subpoena power to 
even bring them before Congress to ask them what they did when they 
were managing the car industry, for example. We know we had a Car Czar 
that had never made a car nor sold one. I presume he'd driven one, 
probably never fixed one.
  But he was running the car business in America and on the phone 
sometimes multiple times a day with President Obama's appointed CEO of 
General Motors. The Car Czar wasn't doing too well. He got replaced. 
Now we have a new Car Czar, and that new Car Czar says, well, the 
Federal Government would like divest themselves eventually of General 
Motors and perhaps the Chrysler stock, but there's no definitive plan, 
just kind of a general goal. Well, it looks to me like the general goal 
has been to nationalize huge industries in America rather than divest 
the Federal Government from those and let the free market prevail.
  So if this bill passes, we will end up with a health insurance czar. 
He will be

[[Page 20458]]

running the Health Choices Administration, and he will be called the 
Commissioner of the Health Choices Administration, but he'll be the 
czar. Commissioner. I don't call him commissar. Maybe I'll call him 
``commi-czar-issioner,'' but he will be calling the shots for all of 
these 1,300 health insurance companies that exist today and writing the 
regulations so that they could become qualified health benefits plans 
coming out of there. So 100,000 qualified health benefits plans from 
1,300 companies would have to qualify under new standards written by 
the new ``commi-czar-issioner'' of the Health Choices Administration.
  Now, if you had a few million dollars invested in a health insurance 
company, Mr. Speaker, would you really be interested in investing more 
money in that company on the odds that that new ``commi-czar-issioner'' 
would write some regulation that lets you stay in business, when the 
people that are writing this regulation want to take you out of 
business and they say so, people like the chairman of the Financial 
Services Committee, Barney Frank, who on tape says that he believes 
there has to be a public option? The public option is this purple 
circle right here, the public health plan. Chairman Frank believes 
there has to be a public option.

                              {time}  1715

  This is because that public option is the path to a single-payer 
plan. A single-payer plan is code word for socialized medicine, one-
size-fits-all, the government runs it all, and every one of these plans 
here that were in the private sector will all be swallowed up, they 
will all be squeezed out, and eventually this purple circle becomes the 
whole and everything else is swallowed up and diminished.
  I think this happens if this bill happens, because it is the goal of 
the liberals in this Congress to end private health insurance and 
eventually end private health care and eventually have every doctor 
working for the government or else for a government pre-fixed price, 
and the nurses and the clinics doing the same thing. They might be 
billing fee-for-service or fee-for-patient, but they won't be running 
their own clinic; they won't be working competitively anymore.
  When I look around the world, I will give you examples of why I 
believe this. The oldest example is Germany. Now, Germany has had its 
ups and downs over the last century, but the last century and a decade, 
about that far back, they passed their first national health care plan. 
That was back before we had modern medicine and certainly didn't have 
anything that looks like modern medicine today.
  But the German plan was passed under Otto von Bismarck. And as I read 
history, he did so in order to consolidate a political base in order to 
expand his political power. But it got established then.
  Of course, there will be Germans that will defend their policy. And 
it probably has helped and it has no doubt helped millions of them, and 
other millions have stood in line and they probably at this point don't 
have a concept of what it is like to have the freedom we have to go out 
and purchase a policy or be an employer to negotiate and select from 
the policies we want and do the best we can working with our employees 
and being an agent for our employees to put the best packages together, 
or for individuals to purchase individual policies.
  In Germany it works this way: you can buy a private plan there. They 
are pretty proud of being able to have private plans in Germany, even 
after more than a century of socialized medicine. But today it is this, 
Mr. Speaker: ninety percent of the plans in Germany are the public 
option. Ninety percent. And the 10 percent are the private options.
  Now, the private options, they only exist as the company is 
functioning and selling health insurance in Germany in order to cater 
to those people who are reasonably well off, those that believe they 
can get a little bit better quality of care, even though they have to 
pay a premium for that better quality care, because they don't want to 
be in the government line. They want to try to find a way to take care 
of their care and health means too much to them to let the government 
run it.
  That is the bottom line in Germany. Ninety percent on the pubic 
option, 10 percent on the private option, mostly self-employed and 
independently wealthy people. Not regular common people, very rare, not 
people that are generally working for someone else for a wage, not 
punching the time clock, not paid a salary so much. It is self-employed 
people and often independently wealthy people that carry their private 
health insurance in Germany. That is about 10 percent. Ninety percent 
the public plan, 90 percent socialized medicine. That is Germany.
  The United Kingdom passed their National Health Care Act in 1948. 
There they were recovering from the Second World War. They were a 
nation that was nearly broke. Nobody had any money, their industrial 
base had been destroyed by the bombing from Germany, and they had used 
all of their resources to save their country.
  God bless them, they were a great ally and it is a great thing for 
the world that the Allied Powers were successful in World War II and we 
turned back the level of tyranny that was threatening to swamp the 
world.
  But Great Britain was broke post-World War II, and they were looking 
for anything that provided them security, and they believed that they 
could manage health care in Great Britain if they just took it over and 
they could do better in government.
  If we remember, this nation was in peril in World War II, and we grew 
government in a great big way. There was a threat to take over the 
steel industry in that era as well. We managed to provide private 
sector industry that turned out bombers and battleships and the things 
that we needed to be successful in that war.
  But if our industry had been destroyed, if the spirit of the people 
had been hammered as hard as it was on a percentage of its population 
as it was in Great Britain, we might have been looking for security. We 
might have decided that we needed to do something with government to 
supplant what was being so efficiently provided in the private sector.
  For whatever the reason, Great Britain passed their National Health 
Care Act in 1948. And I read, Mr. Speaker, through a whole stack of 
Collier's magazines from that era, and each of them featured the 
socialized medicine that was being implemented in the United Kingdom at 
that time. And they showed pictures of long lines at the doctors' 
offices, lines that went outside the clinic, and they interviewed 
doctors and showed doctors that were haggard and frazzled and tired, 
and they lamented that they could not do that doctor-patient 
relationship in the fashion that they had before, that they had to 
limit the time per patient and they had to move from room to room and 
they had set up more rooms so they could get the patients in the room 
and get them ready for exams so they could walk in, do the exam, order 
what was to happen and go on to the next one.
  And doctors that are hurried like that make mistakes. So does any 
human being. But a human being should not be treated like they are on 
an assembly line. That was already what was taking place in the United 
Kingdom in 1948.
  The stories that are in those Collier's magazines from that era are 
the same stories that we hear in the modern version of socialized 
medicine that exists in the United Kingdom today. They are not a lot 
different than the stories you read and hear about in other countries 
in the European Union, including Germany.
  For example, I ran into an immigrant from Germany, actually it was in 
a Menards Store some months ago, and he told me that he had a hip 
replacement done. It had gotten very bad and he could hardly walk, and 
he had to wait, and he waited a long, long time in line. Finally he 
decided that he would try to get himself in more than one line so that 
he had the best chance of getting it over with so he could get on with 
his life. And so he got in a line, and the shortest line that he could 
get into was the line in Italy.

[[Page 20459]]

  So he queued himself into the line for a hip replacement in Italy, 
and some months later he was able to go to Italy to have the surgery to 
replace the hip. And now, good surgery, good job, he is healthy, moving 
around and enjoying life.
  But to have to go to another country to have the surgery done, it 
begs the question. It must be a lot of what it is like to be a 
Canadian, to go to another country to get your surgery done. And 
thinking of the Canadians and those kinds of surgery, I could give an 
example on that.
  We had a presentation done that was a little over a week ago by a 
doctor from Michigan, and this was at the Policy Committee on a 
Thursday night, a week ago last Thursday, if I recall.
  He has practiced medicine in Canada and in the United States. In one 
of his earlier forays into providing medicine and services in Canada, 
he was working in the emergency room and a patient came in, a younger 
man, who had torn up his knee playing sports. He had a torn meniscus, a 
torn ACL, an anterior cruciate ligament, and his knee was a mess. This 
doctor in this emergency room in Canada examined the knee and said, You 
need surgery and you need it right away. I will schedule you for 
surgery in the morning.
  Apparently the doctor wasn't familiar with the standards of 
qualifying for reconstructive surgery care, and he found out after he 
made that promise to the patient that he had to first get him scheduled 
for the specialist who approved the surgery. So he did his best to get 
that patient covered, because the patient was in a lot of pain. They 
had to put him in a knee brace. He was on crutches. And they scheduled 
him finally to be examined by the specialist who approves for the 
surgery, and he was examined 6 months later.
  He was not operated on the next day, not operated on 6 months later, 
but on crutches and with a knee brace on, unable to work, 6 months 
later examined by the surgeon, the specialist, who approved the 
surgery. The surgery was approved. Well, that was an obvious thing to 
the doctor who looked at him the first night, and 6 months later they 
did the surgery.
  Now, Mr. Speaker, I have to go back and reiterate, because it sounds 
implausible. A young man with the knee torn up, a torn meniscus, a torn 
ACL. He needed surgery the next day. In the United States of America he 
would have had surgery the next day. Instead, the exam to approve his 
surgery, which is required in Canada, took place 6 months after the 
injury, and the surgery itself took place 6 months after the exam.
  Almost a year to the day the surgery took place to reconstruct the 
knee. And we know what happens. He lost more than a year's work because 
the rehab was another couple of months, and that leg will atrophy 
because you are not using it, and all of that loss of quality of life, 
the things he could have been doing, his entire lost productivity gone, 
because bureaucracy is calling the shots, not the doctors, in Canada.
  Now, that sounds like anecdote. Well, it is a real live human being 
case, and I am confident that I could trace that back and name the 
individual, and I am confident I am likely to get that individual to 
come here and try to talk to the thicker skulls that exist on this side 
of the aisle.
  But suffice it to say that here is the data that supports this 
individual that some might allege is an anecdote. And it is this: the 
average waiting time for hip surgery to replace a hip in Canada, the 
average waiting time is 196 days. Once you are approved for surgery, 
you wait in the line, in the queue, 196 days. A lot of people with bad 
hips are on crutches--196 days.
  If you are waiting for a knee replacement, Mr. Speaker, you wait for 
340 days on average in Canada. Outrageous delays, loss of human 
productivity. And there isn't anybody's chart that calculates the loss 
to the GDP, the gross domestic product of Canada, lost work time, the 
loss to their economy, because people who would otherwise be productive 
are hobbling around on crutches or sitting in a wheelchair because they 
can't get the services until that delay is over.
  Mr. Speaker, that is what goes on in Canada.
  Furthermore, there are companies in Canada that when they offer their 
employment, they set it up as part of the employment package that the 
worker has an opportunity to come to the United States if he needs 
reconstructive surgery.
  If, let's say, for example, it is heart surgery that would be 
necessary, it is written into the policies. In some of the policies in 
Canada, if you have a good job and you have a good benefits package, 
they will have it set up so they will package it up. Say you need 
bypass surgery, they can put you on a plane, fly you to Houston for 
heart surgery, and give you the heart surgery, get you back on the 
wellness side of this thing, get a little rehab, and then send you back 
home again and set that all up, and it is turnkey. It is turnkey 
provided there because they know that people can't wait in line in 
Canada. Everybody is not going to be alive at the end of their waiting 
period.
  But in the United States, it is a different story. We get people in 
immediately. We bring them in immediately because it is lifesaving. In 
Canada they make provisions to get out of the country and come to the 
United States.
  There are companies that are set up in Canada for the very purpose of 
packaging up health care access into the United States. And so let's 
presume this, and this is not a documented story, but let's just 
presume it this way.
  Let's say you live in Toronto and you need hip surgery and you don't 
want to wait the 196 days. You want it done. You want to get on with 
your life. So let's just say travel agency companies are a natural to 
tie up together with health care providing companies, people that know 
things about health care.
  You might be able to go into a company in Canada and contract to come 
down to, let's say, the Mayo Clinic at Rochester, Minnesota, and they 
will turnkey that. They will say, we have got you an airplane ticket. 
Here is the hotel you go to. Here is the shuttle bus, the 
transportation from the airport to the hotel. You will up show up at 
the clinic tomorrow morning or on the morning following your flight. 
You will be examined that morning. If it is what I think it is, you 
will go right into surgery the same day or the next day.
  They will give you the rehab that you need, take care of you to get 
you back out to the airport, fly you back home to Toronto. All of that 
for, write one check, hand over your debit card or your credit card, 
and have access to the best health, reconstructive surgery in the 
world, right down here in the United States of America.
  Why is that? Do the people on the other side that propose this scary 
schematic, this color-coded, it will be quotas. There will be 31 new 
agencies, do they think that the best health care in the world that 
brings people from not just Canada, but all over the world to access 
this best health care, do they think that it just kind of randomly 
spawned itself out of American society? Or do they think that there is 
real reasons that we have the best health care system in the world? I 
think there are reasons for that.
  One is health care is important to us and the American people are 
willing to pay for high-quality health care because our health is the 
most important thing that we can protect with the capital that we have 
in this country.

                              {time}  1730

  We're a country that's comparatively very, very wealthy. We've 
demonstrated our commitment to health care by committing a lot of our 
wealth to health care. We should not begrudge the people that are 
making our lives longer and more enjoyable for making a profit at it. 
We should not begrudge them for that. If we think they're making too 
much money, we should get in the business, compete against them, gather 
in some of that profit, and then lower our prices. Competition lowers 
prices. That, we know. Adam Smith wrote about that in 1776 in Wealth of 
Nations; and it's been true well before he recognized it; and it's been 
true

[[Page 20460]]

every day since; and it always will be true.
  This schematic, by the way, that is here is not something that the 
Democrats in this Congress want to see out in the public eye. It's 
something that they want to censor, in fact. Here's the model of what 
they have done. This chart shows 31 agencies. It shows how every 
American who has a health insurance policy will have to watch as that 
policy submits to the new regulations that are written by the health 
insurance czar and qualify under new rules that will be written by that 
Health Choices Administration commissioner. They will watch every 
policy change in America or else watch the qualifications be adapted to 
a few policies in America that the Federal Government wants to allow to 
compete. People understand this chart.
  But here's what's going on over the head of the Franking Commission, 
I believe. It's been prohibited for Members of Congress to send this 
chart out in our mail to the American people, Mr. Speaker. I don't 
think there's ever any comparable job of censoring Members of Congress 
than what's going on here. They have decided this chart can't go out in 
the mail, paid for under the franking privilege that any other chart 
can go out. We saw mail go out under President Obama's stimulus plan 
that advocated in a partisan way for how the stimulus plan was going to 
solve our economic problem. Democrats in this Congress used the 
franking privilege to try to convince the American people that the 
stimulus plan was the only way to go, and it's clear to everybody in 
America today that the stimulus plan has failed, with the exception of 
the gentlelady from Texas who I heard a little bit ago say that it had 
succeeded, and it had created jobs. She hasn't shown me where they are 
yet. So I will reserve my judgment on the accuracy of that statement 
until I actually see some jobs created by the stimulus plan.
  Mr. Speaker, my point is, in a partisan fashion, Democrats in this 
Congress used the franking privilege to put the virtual stamps on their 
mail to tell the American people that the stimulus plan was necessary 
or the economy was going to collapse. That went on. This chart is not 
pie-in-the-sky threats that scare people. This chart is just stomp-down 
accurate, and it has withstood the test of the criticism of even the 
Democratic staff in the Ways and Means Committee, the Energy and 
Commerce Committee and the Joint Committee on Taxation. They've tried 
to blow holes in it, and yes, there's a little tweak there, but it's 
not substantive. It's simply specious to make that single little point, 
and it doesn't change the score of this bill.
  Bottom line--31 new agencies, other obligations that are behind these 
squares, added to all of these white boxes that are existing programs 
or agencies, it creates all these hoops that the American people would 
have to jump through, and Democrats don't want this chart shown to the 
American people. So I thought, Okay, if they don't want us to show this 
chart, there must be a lot of truth here that they surely don't want to 
have to face, and they surely don't want to see the American people 
come to their town hall meetings and fill up that room and ask them how 
they're going to defend swallowing up 17.5 percent of America's gross 
domestic product, our health care, and turning it into government run.
  Have we done that good a job with Fannie Mae and Freddie Mac? Have we 
done that good a job running General Motors and Chrysler? Have we done 
that good a job with anything the government is doing other than, let's 
just say, our military, for example, who's done a great and fantastic 
and noble job and has achieved victory in Iraq? Does anybody have 
confidence that the Federal Government can run health care better than 
the American people, working with their private health insurance 
companies, negotiating for their own policies? I say not, Mr. Speaker. 
I think the American people understand what this is. I think they 
understand that when something is censored, it's not profane. Democrats 
want to fund the National Endowment for the Arts, which is funding 
millions of dollars to produce profanity in America. They're not 
offended by all of the profanity that goes out from the National 
Endowment for the Arts. They're offended by the truth about their bill 
about health care; and so they censor it because they have the majority 
here in this Congress, and they decide which staff people get a 
paycheck and which ones don't, in some cases. They also have the 
benefit of the President, I believe; and there are people in this 
Capitol building and in this complex of offices around who are more 
interested in pleasing the President, I think, than they are in 
preserving the fundamental integrity of the franking privilege or 
objective debate. This is objective debate.
  Here are some of the subject matters that the Democrats don't want us 
to use when we describe this national health care plan. Mr. Speaker, 
these are all objectionable phrases, the seven dirty words or phrases 
you're not supposed to use to describe the leading Democratic health 
care proposal. It says, ``you can't use,'' but I'm going to use them. 
These are the words that, in part, brought about the censorship of this 
color flow chart of the 31 new agencies that swallow up people's 
private health care in America. We can't call it a government-run plan. 
They want to amend that. They have another word for that. I think it is 
the public option, rather than the government-run plan. It is a 
government-run plan. I will submit, Mr. Speaker, that you could walk 
down the streets of America, and you could ask those good, well-
educated, commonsense people that I have the privilege to represent in 
western Iowa and in many places across this country, and go to them a 
month ago and say, Explain to me with regard to health insurance what 
is a public option. I can only imagine what kind of answers we would 
get if we asked people what that meant. But I will suggest that most of 
those answers would not have been accurate. They would not have said, 
Oh, a public option. Let me see. That's what President Obama wants to 
make sure everybody has. That would be government-run health care. If 
they were going to describe what a public option is, a regular man or a 
woman on the street with common sense couldn't describe what a public 
option was, if they understood what it was, without describing it as, 
Oh, government-run health insurance. They would have to describe it as 
government-run or they couldn't even describe it at all. This phrase is 
far more descriptive and honest than public option. Public option is 
Orwellian gobbledygook for the eventual Federal Government monopoly on 
health insurance. We just say government-run. The President wants us to 
say public option. They want to censor government-run. I say, I'm going 
to say it over and over again. It's government-run. Don't say single 
payer. A single-payer system means socialized medicine. So we can't say 
single payer. How do you describe that? Ask a commonsense person on the 
street, What is a single payer for a health insurance public option? 
Well, let's see. They would have to say, A single payer is when only 
one entity pays for all of the health care that an individual might 
receive. So let me describe how that works. Mr. Speaker, let's use that 
hip replacement because that's an easy thing to describe. Somebody went 
into the clinic and said, I'm in terrible pain here. I don't think I 
can hobble along any longer. What can you do, Doc? A doctor would do 
that examination. He would likely do an x-ray. He would evaluate the x-
ray. If he was satisfied that he knew what was there, he might 
prescribe that there be reconstructive surgery done that would put a 
new hip joint in that individual, put him through some rehabilitation 
and hand him a cane that could be handed away later on and get him back 
out to the square dance. All of those things are going to take place. 
There would be billing that would come from the clinic, billing that 
would come for the service of the surgery, billing for the 
anesthesiologist, the operating room, the hospital bed, the gauze, the 
Tylenol, and whatever else there might be. Who would pay for all of 
that? Well, it might be the patient today, and it

[[Page 20461]]

might be Medicare, and it might be a private health insurance company. 
But when they say single payer, that's code for--the only entity that 
ever pays for it all--I shouldn't actually say that because there are 
private individuals that will pay for it all out of their pocket. So 
the entity they're talking about is the Federal Government paying for 
all of the health care services. That is socialized medicine. That's 
taxpayer-funded government doing it all single payer. But if you're not 
versed in the vernacular of the Orwellian gobbledygook, when they use 
the term single payer, you might think something entirely different. I 
don't think a normal person on the street can describe what a single 
payer means. We say single payer. Democrats think it's pejorative, that 
it is biased against the single-payer plan, for example. So using the 
terms that describe what they want to do is pejorative, and they are, 
presumably, forbidden, and it shouldn't show up on a color chart. We 
shouldn't send it out and can't send it out on our frank mail, 
otherwise they will bill us back for the costs out of our own pockets. 
We can't say socialized medicine. I already slipped into that in 
describing single payer. Socialized medicine does describe what they're 
talking about, maybe not in the first phase because they won't do like 
Canada eventually did and outlaw the health insurance policies of 
everyone in America. If you apply the Canadian plan today, the 
Canadians outlawed private health insurance. They did so incrementally 
in the provinces over the years, and then they did so in a Federal 
fashion. I would have to guess, but I think the year was 1964 when that 
happened. It may have been after that. So Canadians have socialized 
medicine. They have single payer. They have government-run.
  We know what's going on up there, don't we? There is a 196-day wait 
for a hip, 340-day wait for a knee. They have government-run, single-
payer socialized medicine. They just don't have ObamaCare. You can't 
say ObamaCare because that aligns the President with a policy that is 
becoming ever more unpopular. We use shorthand around here to describe 
things, and this is why the American version of the English language 
has been such an effective language to communicate because it's fluid, 
and it picks up new meanings, and it conveys those meanings. I think 
that we can paint the picture of this society and this culture very 
effectively because our language adapts, it flows, and it moves. This 
is one of those words in our language that--back in 1993, everybody 
knew what HillaryCare was. HillaryCare was the black-and-white 
schematic that we had then. No one wondered. It wasn't pejorative then. 
This chart got mailed out by franking mail, by Members of Congress in 
'93. It was devastating to those that wanted socialized medicine. We 
just simply called it HillaryCare, and this chart was in the minds of 
millions of Americans as they went in and filled the offices of their 
Members of Congress and said, I don't want that. And I don't want this 
thing to be run over the top of Senator Phil Gramm's cold, dead, 
political body either. I don't know who has put a stake out there in 
the United States Senate that's taken that kind of stand, that's gotten 
that much press out of it. But I hope they're there, and I hope they're 
strong, and I encourage them to speak up.
  This was HillaryCare in 1993. We are not supposed to declare this to 
be ObamaCare in 2009 because this has been censored by the Democrats in 
this Congress who think that these terms that are on this chart are 
pejorative. Pejorative terms, government-run. What about a government-
run United States Marine Corps? That makes me feel good. I like 
government-run Air Force. I like government-run Navy. I like 
government-run Army. We cover those four branches. Government does some 
things good. Government-run is not pejorative. But it tells you what is 
going on if they are going to run health care. Single payer--hmm. 
Single payer does tell you that government will be calling all the 
shots because of the golden rule. Whoever has the gold makes the rules. 
The government will have all the gold, and they will write all the 
rules for everybody's health insurance policy in the United States of 
America. That's in the flow chart that's behind here that's been 
censored. And if it's single payer, it is socialized medicine. To 
declare it to be ObamaCare, it is pretty accurate. I haven't heard 
whether the President disagrees with the liberals in this Congress or 
the liberals in the United States Senate. I have heard the President 
talk about all kinds of socialized medicine programs. All he has said 
that defends the private market is if you like your policy, you get to 
keep it. That is simply not true, Mr. Speaker. When you look at the 
chart, when you look at the language, and you understand that every 
single policy would have to qualify under rules yet to be written by 
President Obama's appointee, the health insurance, czar-issioner.

                              {time}  1745

  Would we get rationed care? Indeed. We're only paying 80 percent of 
the Medicare today of what it costs to deliver it.
  They propose to take $500 billion out of the Medicare funds that are 
streaming there now. How are they going to do that? They're going to 
have to cut down on services, cut down on surgeries for seniors, cut 
down on access to health care in order to come up with the $500 
billion. All of that spells rationed care.
  Care has been rationed in every Nation that has a single-payer, 
socialized medicine, government-run plan. We can't believe it's 
anything else. It will be rationed care. ObamaCare will be rationed 
care. We're on a path, if we pass this, to single-payer, socialized 
medicine, because there will be government-mandated care for everybody, 
whether you can hang on to your private plan or whether you can't.
  Government-mandated care is another term that we're not supposed to 
use because they think it's pejorative, but this chart, the color-coded 
chart of the 31 new agencies schematic is full of all kinds of 
government mandates. That's what they are. They're mandates, Mr. 
Speaker, almost all of them. You're not even supposed to say keep your 
change care. Well, I don't know that you get to keep your change. I 
don't use that phrase very much, but it's one of the things that 
they've raised as objectionable.
  So in the end, in real summation of this issue of the national health 
care plan that is almost completely crafted here in the House of 
Representatives and probably poised to go before this House on a vote 
sometime after Labor Day, presuming that there are enough Members of 
Congress still standing after the public shows up at their town hall 
meetings, at their offices, at their house, wherever they might be able 
to encounter their Member of Congress or their staff, presuming that 
there are enough Members of Congress still willing to walk this path, 
we're likely to see a vote here on the floor, and the result will be 
all of these things that we're not supposed to say now.
  If it passes, it will be a government-run, single-payer, socialized 
medicine, ObamaCare, rationed care, government-mandated care. If not 
the first day, it will be over time when everybody's health insurance 
has to requalify and be run through the qualifications that will be 
drafted by the new health insurance czar, the commissioner, the 
comiczarissioner of health insurance in America. That's where we are, 
Mr. Speaker.
  And so I will quote Congressman John Shadegg who articulated this as 
well as anyone in this Congress when he said, if you like your health 
insurance that you have today, get ready to lose it. That's what will 
happen. The American people understand that it is their freedom, that 
their discretion is at risk, and there are people who want to create a 
complete nanny state, who have privatized--excuse me--who have 
nationalized eight huge entities here and moved us on a leftward lurch 
off the abyss into socialism in the private sector; three huge 
investment banks, AIG, Fannie Mae, Freddie Mac, General Motors, 
Chrysler, all now under the control of the White House. And this White 
House now wants to take over all the health care in America, 
eventually. And we understand that was President Obama's original 
policy. He

[[Page 20462]]

has just moved to try to set up health insurance in such a way that he 
can promise you you get to keep it.
  And I promise you that it will not look like anything you have today 
if the government's going to write new regulations that it has to 
qualify for. And I will submit that Republicans have good solutions to 
this. I'll submit also that what we're trying to fix here is this. 
Here's where I agree, Mr. Speaker.
  I believe that we have a very, very difficult economic situation to 
work our way out of. I believe that it may be as serious as anything 
that we have seen since the Great Depression, but I'm not certain of 
that because I lived through the eighties during the farm crisis and 
the other, the housing crisis that we had and the banking crisis that 
we had during that period of time. We lost 3,000 banks in the eighties. 
Those were tough times. I want to measure this after it's over and look 
back before I would commit that this is the worst time since the Great 
Depression. But it's not a very good time. It's a bad time.
  And we have our challenges ahead of us, and we have to fix this 
economy. With that, I agree with the President. But the President says 
that health care in America is broken. I don't agree. I don't believe 
it is broken. I believe that we can improve it, and we should. But the 
President declares that we can't fix the economy without first fixing 
health care.
  Now, if health care--and that encompasses health insurance and the 
health care that's provided through our clinics and our hospitals and 
the whole breadth of the health care that we have. If health care is 
broken, there must be a service out there that's not adequate compared 
to some other country in the world.
  I'll submit health care is not broken. We have the best health care 
in the world. It costs too much money. I'll agree with the President on 
that. About 14\1/2\ percent of our GDP, and some of the costs that you 
see in the rest of the industrialized world are around 9\1/2\ percent 
of GDP. They ration health care. They have socialized medicine. They 
don't have the research and development that we have. We have the best 
in the world.
  We lead the world in development of pharmaceutical and surgery 
techniques, and we lead the world in survival after cancer diagnosis. 
And we also lead the world, I believe, in the diagnosis of cancer 
itself. All of those things are at risk today. But if we have to, 
according to the President, change 100 percent of the health care 
system that we have in order to declare we have fixed it so we can 
declare we're fixing the economy, I will submit that that statement 
cannot be valid. It cannot be defended or sustained in open public 
debate or any kind of analysis because they want to spend $1 trillion 
to $2 trillion.
  Now, if we're spending too much money on health care in America, and 
we are, why do we need to dump another $1 trillion to $2 trillion into 
it to fix it? If we're going to fix it, we should be able to fix it and 
save money, not fix it and dump trillions of dollars into it and raise 
taxes and cut funding that goes into Medicare and deny health care 
services to our seniors, all of that wrapped up in the name of fixing 
something that's not broken, just changing and transforming America.
  We socialized three large investment banks, AIG, Fannie Mae, Freddie 
Mac, General Motors and Chrysler. They're nationalized today. This is 
about the nationalization of the best health care system in the world, 
and 17\1/2\ percent of it, and taking away the freedom of the American 
people to go out and purchase a health insurance policy that they 
choose.
  I want to expand the health savings accounts and I want to provide 
100 percent deductibility for everybody's health insurance premium. And 
I want to reduce the medical malpractice liability that's out there by 
capping the liability claims so people get whole again but trial 
lawyers don't get rich. We can do all of those things and more, 
besides.
  And by the way, there's only 4 percent of America that are 
chronically uninsured, 4 percent, 10 to 12 million people, depending on 
whose study you look at. That's 4 percent. And we would upset 100 
percent of the health care system in order to fix an expensive health 
insurance program only if you compare to other countries that don't 
have the quality that we have. I think that would be a colossal 
mistake, and we could never get back from that colossal mistake because 
it creates 306 million people that would be dependent upon the 
government-run, single-payer, socialized medicine, ObamaCare, rationed 
care, government-mandate care. And I reject it. I hope the American 
people do.

                          ____________________