[Congressional Record (Bound Edition), Volume 155 (2009), Part 17]
[House]
[Pages 23027-23034]
[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, it's a pleasure to be able to join you and my 
colleagues today and those who are in the gallery to talk about 
something that has been the talk of the town now for a number of months 
and is an intensely personal and important subject to all of us, and 
that is the health care of the bodies that we have to live inside.
  A great deal has been said and a great deal more needs to be said in 
clarifying exactly where we are on this issue because of its tremendous 
importance, its importance to us in an economic sense as a Nation, its 
importance to us as close to 20 percent of our entire gross domestic 
product, but also, as I said, because of the importance that each of us 
have to live inside our own bodies and are much attached to our health 
care system.
  Now, one of the great concerns about what's being proposed is is that 
the government will not immediately but indirectly and inevitably take 
over health care. Just as we saw earlier this year, the president of 
General Motors is being fired by the President of the United States. 
That's a unique situation. Usually we separate our private industry 
from the Federal Government, and what is being proposed here is, over 
time, the government takeover of one-fifth or so of our economy; that 
is, health care.
  Now, when the government does too much, we have come over time to 
recognize certain consequences. First of all, it becomes very expensive 
because the government, with its $500 hammers, is not the most 
efficient. In fact, you could sometimes talk about a health care system 
with the efficiency of the post office and the compassion of the IRS.
  The inefficient allocation of resources is legendary, particularly in 
other countries that have had the government try to run the health care 
system. The quality is degraded, and we will talk about those in hard 
statistics, particularly with people who have, for instance, cancer. We 
will take a look at what the cancer survival rates are in some of the 
European countries that have socialized medicine as opposed to the 
American medical system that we have in this country today.
  And then, of course, to me, perhaps one of the more frightening 
things is bureaucratic rationing. That is, decisions not by a doctor 
and the patient, but decisions made by some bureaucrat that gets in the 
way.
  Now, the first thing that the people have commented sometimes is, if 
health care is expensive now, just wait until it's free. That seems to 
be the experience for, particularly, people of Canada and other 
Nations.
  We have heard that this is a system that's being proposed by our 
President that's going to be simple, that it's going to save money. In 
fact, he said if it were going to cost us one dime more, then he 
wouldn't even support it. And yet we take a look at the simplicity of 
the organization--this is the Democrats' bill. It's an organization 
chart

[[Page 23028]]

for the Democrats' bill. It's complicated. This is trying to put a 
1,000-page bill onto one poster, which obviously it is going to look a 
little bit complicated. But you have here a tremendous maze of 
interlocking organizations and groups trying to replace a fifth of the 
U.S. economy. Obviously, it's going to be somewhat complicated. The 
question is, in this maze, can the patient find their way to their 
doctor. That is a good question.
  Well, what are we talking about in terms of costs here? Is there some 
way that we could try to decipher when the President tells us this 
isn't going to cost us much, in fact, the efficiency is going to be 
such that we can do this whole thing without spending any more money, 
what sort of a way can we get a handle on that?
  Well, one of the things we have already is Medicaid and Medicare and 
Social Security. Those, of course, are the three huge entitlement 
programs that have been running for some period of time, and we have 
here cost projections as to the rate of increase in the expenses for 
Medicare and Medicaid. And when you take a look at these over time, 
what you realize is that if nothing is changed in Medicare or Medicaid, 
Social Security, that the U.S. Government at a certain point out here, 
at 2052, for instance, that there will be nothing else in the Federal 
budget. They will absorb the entire Federal budget.
  We have a certain tax rate that we're running, and what we found in 
terms of tax policy is you can raise people's taxes but it doesn't 
raise the amount of money the government is pulling in. You can raise 
taxes so much it stalls the economy and you end up taking the same 
thing in in taxes as you did when your tax rate was lower.
  So this is kind of our historic tax rate, and when you project that 
out, you realize that Medicare and Medicaid, at least a big portion of 
this blue chart, is going to gobble up all of the Federal revenues. 
That means we won't spend any money, not just on food stamps or 
welfare, not just on art, not just on sort of ancillary things, but 
there will be no money for defense or anything else with the way that 
these programs are going.
  So the President, when he says this is going to be very efficient, 
it's going to save a whole lot of money, and you say, well, what do we 
have as an example of that sort of government efficiency, you've got 
Medicare and Medicaid. Those are not very comforting examples as to 
what's going to happen to our GDP.
  In fact, the President's made a lot of promises. He complained, as he 
came in to give his talk here about 3 weeks ago on health care, that he 
had inherited a $1 trillion deficit. In fact, he had not. It was about 
a $250 billion deficit, which is bad, shouldn't have inherited that, 
and yet what we have here proposed in the last 6 months, you can see 
the level of spending at $3.6 trillion that we've spent in 6 months on 
all of these--here's the Wall Street bailout. That's $250 billion. That 
was started in the previous administration, but half of it was spent by 
our current President.
  Then you've got the economic stimulus. I would call it the porkulous 
bill, didn't have much to do with stimulus at all. There goes $787 
billion more. And then you have got SCHIP and then the appropriations. 
You've got an IMF.
  This cap-and-tax, the House has passed this one. This is the biggest 
tax increase in the history of our country. The President made the 
promise that if you're making less than $250,000, don't worry, we're 
not going to tax you, except a little detail. Anytime you flip your 
light switch, you are going to get taxed, with this $846 billion which 
is, of course, the biggest tax hike in our history. And then, of 
course, the government health care that's being proposed, it even 
dwarfs that.
  So we're talking about a pattern in history of a tremendous rate of 
spending. In fact, if you were to take a look at all of the deficits 
from George Washington to George Bush, that comes out about five-
something trillion. We're looking at $8 trillion for this 
administration.
  So we have a promise that this isn't going to cost very much. We 
don't have very much historical data to give us any sense that this is 
going to be a financially responsible package.
  Now, one of the things that goes to the heart of health care, and I 
think probably if a bunch of just plain old Americans were going to 
stand around and say, you know, let's talk about what are you going to 
do to health care, one of the things you'd say, well, one thing we know 
for sure is that we want to make sure that the relationship between the 
doctor and the patient is left alone. We don't like this deal where the 
insurance company comes in and gets between the doctor and the patient, 
and so one of the things we want is to leave that sacrosanct. If you 
like your doctor or health care provider, you can keep them. If you 
like your health care plan, you can keep that, too. This is what the 
President told us in July. He's repeated it. Is that true, though?
  He's also said it's not going to cost anything. He also said you're 
not going to be taxed anything if you make less than $250,000. So what 
is the truth of this statement? Can you really keep what you currently 
have, because this is a very important question because 100 million 
Americans have health care policies and relations with doctors that 
they like just fine right now. And we've probably got, when you sort 
through it, about 15 million people who are not insured. And so the 
question is: Are we going to basically take apart entirely and try to 
rebuild the system for 100 million people in order to deal with a 
problem 15 million? That's the question.
  So here's the promise that comes from the President, but is that 
really true? Well, here's MIT health care economist Gruber. He says, 
with or without reform, that won't be true.

                              {time}  1630

  His point is that the government is not going to force you to give up 
what you have. But that's not to say that other circumstances won't 
make that happen. In fact, what's going to happen, and that's what this 
MIT professor was going to talk about, is that when the government 
jumps in to this entire equation and starts to have a government 
option, what it tends to do is crowd out the private provider. So over 
a period of time, your employer is going to say, I'd rather pay the 
fine and just dump your health insurance on the government; and more 
and more people do that until, guess what, there is only the government 
left, the single provider.
  Now, you can say, well, do you have any evidence that that's going to 
go on? Well, we did. It was a week before last, we just voted in a way 
to make the student loans in America--almost all of them are all going 
to be provided now through the government. Originally, the government 
came in just to help the student loan process. But now what's happened 
over a period of time, the government can easily forgive a student that 
doesn't pay their loans, whereas the private companies can't.
  So the government has an advantage because they keep soaking the 
taxpayer. And so the question then is, that's what this is, that 
Jonathan is saying here, what his point is, that what's going to happen 
inevitably is that we're going to end up with a government-driven 
system and, therefore, you will not be able to keep your insurance or 
your health care provider.
  And so what is being said is not, in fact, true. Along the same 
lines, and of particular importance, is this entire question about 
whether we are going to allow government agents or bureaucrats or 
people working for the government to make health care decisions. Is the 
government going to jump into the middle of the doctor/patient 
relationship? Well, that's not the kind of amendment that's allowed on 
this House floor. The Democrat Party does not allow us to make 
amendments that we might like to make. It has to go through Rules 
Committee. They control the Rules Committee, and if they have an 
amendment that would be embarrassing or they don't want, they just say 
you can't have it in the rules to offer that amendment.
  But in committees, we do offer amendments. This is an amendment that 
was offered by Dr. Gingrey. Dr.

[[Page 23029]]

Gingrey is a good doctor from Georgia, been a medical doctor a long 
time, now joining us here in Congress. And he said a very simple 
sentence: nothing in this section shall be construed to allow any 
Federal employee or political appointee to dictate how a medical 
provider practices medicine. In other words, this amendment would 
guarantee the doctor/patient relationship. It would say that that 
doctor/patient relationship is not going to be interfered with by some 
government bureaucrat. Well, how did this amendment fare in Nancy 
Pelosi's committee that was putting together the House health care 
bill? Well, here's how it came out. The Republicans, 23 Republicans 
voted ``yes.'' We want to keep that doctor/patient relationship 
sacrosanct, and none of them were against it. If you take a look at the 
Democrats, however, 32 Democrats voted against this, which, if you say 
you're against this, then it suggests that you're going to be in favor 
of letting bureaucrats control costs. And only one Democrat voted for 
it.
  So what happened? Well, this amendment failed. When this amendment 
failed, it, again, raises a serious question whether what the President 
says is really true, Are you going to be able to keep your doctor? Are 
you going to be able to keep your health insurance? Will you get your 
health insurance through the same place you get it now, or is it all 
going to be provided by some government? Now, I have had either the 
fortune or misfortune of being in public office for a number of years. 
And one of the experiences that those of us who are public servants 
have is we get phone calls. We get phone calls from our constituents 
and they say, hey, Congressman Akin, I've got a problem with this, that 
and the other government agency. Can you help out? Or I've had really a 
hard time with this, this, and this. Can't you do something about this? 
And so we, in a sense, then go to bat for our constituents with 
different either State or Federal agencies.
  I recall one of my earliest experiences as a State rep, and there was 
a bad intersection where there had been some accidents in my district, 
and we needed to get a left-turn arrow put in at a traffic light. I 
would bet that I made over 100 phone calls over a 2- or 3-year period 
to the highway department in our area trying to talk them into putting 
one lousy left-turn arrow into a traffic light signal. There was 
already a lane painted for the left turn, so all they had to do was to 
change the traffic light. It took me several years to talk the highway 
department into putting one silly left-turn arrow in.
  Now, can you imagine what goes on if we're Members of Congress and we 
get phone calls saying, the government that you represent has told my 
wife that she can't get that heart bypass. They've told my mother that 
she can't get that heart bypass. They've given her a bottle of aspirin 
and told her to go home and wait to die. Is that the sort of thing that 
we want to deal with with the bureaucrats getting in the way of health 
care decisions? I don't think so. This amendment should not have 
failed. If the American public knew that this amendment were being 
offered, they would have called their Congressman and said, don't you 
mess with the relationship between me and my doctor, or between our 
family and our doctor. That's what's at stake.
  Now, from my point of view, this becomes personal. I was elected to 
Congress in the year 2000, came here in 2001 to serve. And one of the 
things I found out about this Congress is the fact that there are some 
Navy doctors in this building in a clinic. So sometimes if somebody's 
walking around in the summer and they have a stroke or this or that, 
they've got an ambulance, then the first place they go is to the little 
clinic right here in the Capitol Building. It's almost like a little 
mini-city for a certain number of blocks. There are some medical 
professionals that are there. And those medical professionals also 
offer physicals, your yearly physical. So I had not had a physical 
because I had been in the State of Missouri in the Missouri 
legislature, and basically, what happened there was my insurance had a 
health care provider that there was no way you could go see your 
primary care doctor, and so the insurance company was getting between 
me and some potential doctor that I could never even figure out who the 
doctor was. They said my primary care physician is so and so. You call 
them and you could never see them. So I walked into the clinic 
downstairs in this building feeling bullet-proof, about 52 or 53 years 
old, and they told me my health was great except for one little detail. 
Congressman Akin, you have cancer. Now that's the sort of word that 
gets your attention when somebody tells you that you've got cancer. And 
so it was that because I was here and I had access to health care, I 
was able to get the cancer treated.
  But if you take a look, when it talks about cancer, let's talk about 
the survival rates between men and women in the United States. In men 
it's 62 percent, 66 percent in women in the U.S. Take a look at where 
it is with socialized medicine in the United Kingdom: 44 percent. For 
women it's not 66, but it's 52. So in other words, your chances of 
survival in America are a whole, whole lot better with our free 
enterprise system. So all of this talk about how bad American health 
care is, boy, that's a lot of hooey. We still have a very, very good 
health care system; and to try to destroy what 100 million people enjoy 
just to try and take care of 15, that doesn't seem to make sense.
  I have been joined by my good colleague. Did you want to join us on 
the health care discussion? Please jump in. I yield.
  Mr. McCLINTOCK. I thank the gentleman for yielding. Mr. Speaker, I 
wanted to address a matter of the health care debate that was brought 
up by none less than the President of the United States in this very 
Chamber just several weeks ago where he assured us that it was not 
going to add a penny to the deficit. I don't think we can fully 
appreciate the magnitude of the health care debate without also 
recognizing the magnitude of the Nation's deficit, and I'd have to call 
into question the accuracy of the President's assurances to this House 
several weeks ago.
  I brought along a chart. This represents, both as a percentage of GDP 
as well as total dollars, our deficit over the past 40 years, from 1970 
to 2010. As you can see, we've not done a very good job of managing our 
Nation's finances, except for 4 years during the Clinton 
administration. I might add, there was a Republican Congress, but give 
credit where credit's due. Bill Clinton produced 4 years of surplus 
budgets. We then go into the Bush years which was the most fiscally 
irresponsible that we've seen in peace time. The last budget deficit 
taking nearly 3 percent of the gross domestic product of our country.
  Mr. AKIN. So let's just go along. So you're saying the worst we had 
up through Bush was 3 percent of GDP.
  Mr. McCLINTOCK. That's this bar and this point right here.
  Mr. AKIN. Right.
  Mr. McCLINTOCK. Now, this red line, that red line is this year's 
budget deficit ending today, September 30. That's the full fiscal year 
deficit. You can see it's on a magnitude completely unprecedented in 
the history of our Nation.
  Mr. AKIN. That number is incredible to me. Let me just try and put 
that in context, what you're saying. When the President started his 
speech on health care in this Chamber, he complained about inheriting a 
$1 trillion deficit or something, when it was I guess, 250 billion, so 
he magnified----
  Mr. McCLINTOCK. Well, actually, fiscal 2008 was about $450 billion.
  Mr. AKIN. He said it was $1 trillion.
  Mr. McCLINTOCK. Bush added another 700 billion with the bailout which 
of course Obama supported. So he can't just blame Bush for that. He 
supported that bailout, adding another 700 billion. The point is today 
this year's budget deficit exceeds $1.6 trillion and that is absolutely 
catastrophic. We all know that if you live beyond your means today, of 
necessity, you're going to have to live below your means tomorrow and 
that's the tomorrow that we're creating for our country.
  Mr. AKIN. So just to reclaim my time a minute, what you're saying, 
gentleman, is we've got a big financial

[[Page 23030]]

problem with this promise that this health care system isn't going to 
cost anything.
  Mr. McCLINTOCK. Exactly right. I mean, as we know----
  Mr. AKIN. And you're saying that red line that you showed, was that 
about three times more deficit than what he had inherited from 
President Bush?
  Mr. McCLINTOCK. Actually nearly four times more than last year's 
deficit.
  Mr. AKIN. So the President that stood here and told us he had 
inherited a deficit didn't mention the fact that he had four times more 
that he'd spent in 6 months or 8 months than the deficit that he 
inherited.
  Mr. McCLINTOCK. He has dramatically increased that deficit beyond 
anything that we've seen in the peacetime history of our Nation.
  Mr. AKIN. Anything in the peacetime history, so that'd be a 
combination of all of these things. Did you count the biggest tax hike 
in history, the cap-and-tax?
  Mr. McCLINTOCK. We're just looking right now at what we've spent in 
fiscal 2008 and what we expect to spend by the end of midnight tonight. 
That's a nearly fourfold increase in a single year.
  Mr. AKIN. And that's not even including the biggest tax hike in the 
history of our country passed by the House that means every time you 
flip your light switch on you're going to pay taxes on that.
  Mr. McCLINTOCK. This is on the spending side, not on the tax side. In 
fact, the deficit is the difference between what we spend and what we 
take in. That's what we're talking about with the deficit. And that's 
four times larger than it was last year. And as I said, that is being 
taken out of the future economic prosperity of our country. That's 
being taken from our kids.
  Now we have before us the health care measure which is nearly $1 
trillion more. But we are told, don't worry, that won't add a dime to 
the deficit. Well, pardon my skepticism but----
  Mr. AKIN. A trillion dollars won't add a dime to the deficit? That is 
a stretch.
  Mr. McCLINTOCK. This is the same President who recently announced 
that he'd underestimated the current deficit projection by $2 trillion. 
But he assures us this isn't going to add anything more, we're going to 
pay for it. Well, my problem with that is we've got plenty of 
experience with government health plans, both in this country and 
abroad. They've produced very consistent results. They've produced 
massive cost overruns, followed by an absolutely brutal rationing of 
care. Now, the point I wanted to make in coming down to the floor today 
is that when this health bill was considered by the House Committee on 
Labor and Education, I offered a simple amendment to take the President 
at his word, to take the Democrats at their word that this is not going 
to add to the deficit. So the amendment simply said that we're going to 
suspend the cost components of the bill if the Congressional Budget 
Office determines that it will be adding to the deficit.
  Mr. AKIN. So you basically just took the President's words and just 
put an amendment to say, okay, we're going to hold your feet to the 
fire. You said it's not going to add one dime to the deficit so we're 
going to put an amendment on the bill----
  Mr. McCLINTOCK. We've been assured from the outset that this was not 
going to add to this catastrophic deficit. So when H.R. 3200 was taken 
up before the House Committee on Labor and Education, that's exactly 
the amendment that I offered. If the Congressional Budget Office says 
this is adding to the deficit, we'll suspend the cost provisions of the 
bill. Well, perhaps not surprising to you or to those who follow this 
carefully, but I think surprising to a lot of folks who believed the 
President, that amendment was defeated on a straight party-line vote.

                              {time}  1645

  Mr. AKIN. Let me just highlight what you said then.
  What you're saying was the President said this is not going to add a 
dime to the deficit or that he wouldn't support it.
  Mr. McCLINTOCK. Yet just a few months before that on a straight 
party-line vote, his supporters in this House defeated an amendment 
that would have protected the Treasury against this measure adding to 
our deficit.
  Mr. AKIN. And that was your amendment then?
  Mr. McCLINTOCK. It was.
  Mr. AKIN. Congressman McClintock from California simply taking what 
the President said, offering it as an amendment, and in a straight 
party-line vote, it was defeated.
  Does that leave you with any comfort that we're not going to add a 
dime to the deficit?
  Mr. McCLINTOCK. No, it leaves me with a great deal of confidence that 
the supporters of this bill don't believe that claim. And that's the 
point I came down here to make. If the President's supporters actually 
believed this bill would not add to the deficit, they should have had 
no problem with the amendment. Obviously, they don't have that 
confidence.
  Mr. AKIN. They don't believe that's going to happen.
  How are they going to pay for this whole thing, anyway? The 
Congressional Budget Office says it's a trillion-dollar bill for this 
basically having the government take over all of this health care, and, 
of course, that's just for openers.
  Mr. McCLINTOCK. Well, we know what H.R. 3200 says. About a half a 
trillion dollars is going to be from raising the taxes of the very 
wealthy individuals who earn over $250,000 a year. Well, we get paid 
pretty well by the taxpayers for our jobs, but that doesn't affect us. 
It doesn't affect most people. What a relief, right? Until you scratch 
the surface and you realize that more than half of those taxpayers 
aren't very wealthy and they aren't even individuals. They are small 
businesses filing as subchapter S corporations that are barely holding 
on by their fingernails right now. Those are the people who will be 
bearing that.
  Mr. AKIN. So now we're going to increase your taxes, right? Is that 
what you're saying? We're going to increase the tax on small business, 
is that right, what we're doing?
  Mr. McCLINTOCK. If H.R. 3200 is passed, that's precisely what it 
proposes.
  Mr. AKIN. Let's take a look at the logic of that.
  If we increase taxes on small business, they have less money to 
invest. Small businesses create 80 percent, or 79 percent of the new 
jobs in our country. We've got unemployment now, not at 8 but 9-
something percent. And so what we're going to do is we're going to tax 
small businesses, which is going to make it even harder for them to put 
in new pieces of equipment or new processes to hire new people, so 
we're going to kill jobs even more by going to this socialized 
medicine.
  Mr. McCLINTOCK. Not necessarily. It will still be very easy to build 
a successful small business in America. All you'll have to do is start 
with a successful large business.
  Mr. AKIN. I guess that doesn't help us do much in terms of the 
unemployment. So a piece of it is going to be we're going to tax small 
business.
  My understanding is, though, that some of this is going to come out 
of the hide of people that are on Medicare.
  Mr. McCLINTOCK. No doubt of that. We've seen the proposals. And the 
attack particularly on Medicare Advantage.
  Mr. AKIN. My understanding that was $500 billion--isn't that close to 
half of that trillion--is going to come out of Medicare.
  Mr. McCLINTOCK. That's what the authors are proposing.
  Mr. AKIN. I am kind of scratching my head because every year we've 
got a problem that Medicare, they keep trying to automatically ratchet 
down how much we're spending on it, and then they don't pay the doctors 
anything, and the doctors are not going to take anybody in Medicare 
anymore. So we quick-quick do a patch.
  I know you have really been keeping an eye on the numbers here, and 
we very much appreciate your leadership. The people of California did a 
good job of sending you here.
  But how in the world--you're a good numbers man--how in the world are 
we

[[Page 23031]]

going to cut $500 billion out of Medicare and not expect to feel that 
somehow?
  Mr. McCLINTOCK. The fact is ultimately I think the supporters of the 
bill realize that their numbers don't add up. That's why they have 
opposed every attempt to actually enforce the fiscal integrity of this 
measure by amendment. The question I think all of us should be asking 
right now is if the authors of this plan have no faith in its fiscal 
integrity, why should the rest of us?
  Mr. AKIN. That is really a good question.
  And the thing that's disturbing for my good friend from California, 
the thing that's disturbing is that you're not the only guy that's 
offered amendments in committee on this bill.
  Mr. McCLINTOCK. Quite right.
  Mr. AKIN. The amendment that I just mentioned a moment ago--which I 
think to me, it's personally scary--and this is a medical doctor, and 
what he's saying in this bill is nothing in this section shall be 
construed to allow any Federal employee or political appointee--that is 
a bureaucrat--no bureaucrat can dictate how you and the doctor, how 
that medicine is going to be delivered.
  In other words, the doctor and the patient make the decisions. And 
again, just like your amendment, this thing goes down in flames on a 
straight party-line vote.
  How can you stand there and vote that you want bureaucrats to ration 
health care? I don't understand it. But I do understand why Americans 
would be strenuously opposed to this.
  Mr. McCLINTOCK. While we're on the subject of amendments that have 
already been offered to H.R. 3200, there are two others we ought to 
mention. One, making it very clear that illegal aliens will not be 
entitled to care under this plan. That was voted down on a straight 
party-line vote. So obviously the intent of the authors of the bill is 
something quite a bit different than the President assured us was the 
intent on the floor several weeks ago.
  Mr. AKIN. Just to reclaim my time for a minute, this is the 
President. I've got the actual flip of his quote on that subject:
  ``There are also those who claim that our reform effort will insure 
illegal immigrants. This, too, is false. The reforms I'm proposing 
would not apply to those who are here illegally.''
  Now, that's pretty plain what the President said, but is it true?
  Mr. McCLINTOCK. Yet an amendment that made that clear was voted down 
on a straight party-line vote in committee.
  Another amendment that was offered, as you know, was to require 
Members of Congress to take the public option.
  Mr. AKIN. Well, there's a poison pill.
  Mr. McCLINTOCK. And interestingly enough, that amendment was killed 
on a straight party-line vote in the Ways and Means Committee.
  Mr. AKIN. Here is actually the text of this amendment. This is the 
Heller amendment, one of our colleagues. Bright fellow. He offers this 
amendment in committee: In order to utilize the public health insurance 
option, an individual must have his or her eligibility determined and 
approved under the income and eligibility verification system--that's 
this--and the systemic alien verification for entitlements, SAVE 
programs, under section 11.
  In other words, what they're saying is if you want to get this free 
health care from the government--which is going to be very expensive 
for your free health care--you've got to prove you're here legally.
  Now, this amendment also was offered in committee. Republicans gave 
it 15 ``yes'' votes and zero ``noes,'' no one voted against it, and yet 
the Democrats had 26 people saying, No, we don't want this in the bill. 
That means, in other words, that there is no enforcement mechanism for 
these illegals, that they're just going to come in and we're supposed 
to pick up the tab for all of these other people.
  In fact, it was interesting to note that this very question was sent 
to the Congressional Research, which is a nonpartisan group, and they 
point the same thing out. The President is just flat wrong.
  It says here, under 3200--that's Speaker Pelosi's bill--health 
insurance exchange would begin operation in 2013 and would offer 
private plans alongside a public option. Does not contain any 
restrictions on noncitizens, whether legally or illegally present.
  This is just a bunch of researchers who read the bill. Which is, of 
course, when you've got a thousand-page bill and all of this--but 
that's what they came up with.
  You've given us a number of examples: One, it's not going to add a 
dime to the deficit. We know that's not true because you offered the 
amendment. And then the other one is that you get to keep your doctor 
and you get to keep your insurance. And then there's this thing that 
it's not going to fund illegals.
  I can see why the American public would be upset because they're 
getting very conflicted information.
  Mr. McCLINTOCK. You mentioned the researchers reading the bill. The 
big problem for supporters of this government takeover of our health 
care system is very simple: the American people are reading the bill 
and are realizing the impact that it will have on their lives and are 
now rejecting it by a substantial margin.
  Mr. AKIN. That raises another question, that the American public has 
a chance to read the bill. Because what's being proposed by those of us 
who are Republicans is that we want to make sure that there are 72 
hours for people to be able to read something before they pop it up for 
a vote.
  You and I sat here on this floor, and we find out that 300 pages of 
amendments were passed at 3 o'clock in the morning, and the next day 
we're supposed to vote on a thousand-page bill with 300 pages of 
amendments. And the usual policy is there's a copy of the bill here in 
this Chamber. Well, there wasn't any copy of the bill, on that cap-and-
tax bill. They were still busy trying to collate the amendments when 
they were taking the vote.
  And the American public thinks, hey, maybe it's a good idea if you 
guys read the bills before you pass them. We have a proposal to allow 
for 72 hours so people could read the bill.
  Mr. McCLINTOCK. I come from the California legislature, and I thought 
that was a process that had deteriorated. But the California 
legislature in its constitution requires that a bill be in print for 30 
days before any action; even a committee changing a punctuation mark. 
Thirty days.
  Mr. AKIN. I thought California was the land of the fruits and the 
nuts. All of us in Missouri, we kind of worry about California out 
there. And yet you are so much more sober than the way this institution 
is.
  Mr. McCLINTOCK. California still has a few last vestiges of sobriety 
in its process, that being one of them. A proposal that a bill should 
be in print 72 hours before final passage doesn't sound so radical.
  Mr. AKIN. Doesn't sound radical to me at all. I don't think our 
constituents, gentleman, would think that's radical that we would have 
72 hours at least to look over some proposal before we're going to be 
voting on it.
  And yet what we saw in that huge bill--I guess it was 1,300 pages 
when you put the 300 with the thousand--the biggest tax increase in 
history. Snap, bam, we passed it right out of the House here.
  Mr. McCLINTOCK. And don't forget the so-called stimulus bill.
  Mr. AKIN. Oh, that was a piece of work.
  Mr. McCLINTOCK. $787 billion, more than three-quarters of a trillion 
dollars, the biggest spending bill in the history of this country, 
introduced at 11 o'clock at night and taken up for debate at 10 o'clock 
the next morning.
  Mr. AKIN. And did that have some ACORN funding in it?
  Mr. McCLINTOCK. And if you want to know why it is that the Federal 
Government would end up sending out 4,000 stimulus checks to 
incarcerated felons at various penitentiaries, there's your answer.

[[Page 23032]]


  Mr. AKIN. That was another piece of efficiency and government at 
work, especially when you do things in the midnight hour and try to 
hide things under the basket that way.
  Mr. McCLINTOCK. As you know, there's a lot of concern among the 
Members of Congress, particularly on this side of the aisle, that the 
intention of the majority is to suddenly emerge with a new health care 
bill in the same manner that we saw the stimulus jammed through. That's 
why we're seeing so much resistance among Democratic Party leaders to 
the discharge petition that requires the bill be in print for 72 hours 
and bring it to the House floor for a vote.
  Why would they be resisting?
  Mr. AKIN. Just think a minute. Let's say that you were the Speaker, 
Speaker Pelosi, and you had a bill that was going to do these things: 
one, it's going to take $500 billion from Medicare. So that doesn't 
mean that your older people in America are going to be too happy with 
it. Two, it's quite clear that it will provide abortions over time, 
free abortions for people using taxpayers' money. That doesn't make the 
pro-life community too happy.
  So they've got the older people on Medicare, you've got the pro-life 
people upset. Then if you're a small business person--small business 
employs about 80 percent of the people in America--they're going to get 
a huge tax increase to help pay for this government takeover. Well, the 
small business people aren't going to be too happy with it.
  Let's see what else you've got.
  You've got a hundred million people who have insurance policies, and 
those insurance policies, they're pleased with because they have a good 
relationship with their doctor. So they're getting good health care 
currently. And that whole system is going to be completely rewritten. 
They've been promised they can keep what they have, but they're not 
going to be able to. So they're not going to be very happy either.
  When you start putting all of those things together, you're going to 
have illegal immigrants being able to get free health care on the back 
of the U.S. taxpayer, you start putting that all together and you're 
Speaker Pelosi, that's a hard bill to pass. So you've got to do 
something tricky to get that thing through.
  Mr. McCLINTOCK. Justice Brandeis long ago told us that sunlight is 
the best of disinfectants, sunlight on this bill that the majority 
seems so frightened of. And that's why it's so important to get that 72 
hours' notice, not just for the Members of Congress who are being asked 
to vote on it but for the people of the United States who are being 
asked to live under it ought to have some chance to know what bills are 
being proposed and being adopted by this Congress in their name that 
directly affects the quality of their lives and their families' lives.
  Mr. AKIN. I was just talking a little bit earlier. Did you serve in 
the California House as well?
  Mr. McCLINTOCK. Yes.
  Mr. AKIN. I'm sure that you've gotten phone calls from your 
constituents and they're saying, Hey, Congressman, I'm having trouble 
with this, that, or the other part of the Federal Government, I'm 
trying to get my passport or this or that. And you or your office goes 
to bat for those people trying to talk to different Federal agencies to 
help them with their problem.
  Now, I'm just trying to picture in my mind. Let's say that the 
Democrats jam this thing down everybody's throats. Can you picture 
getting a call from somebody from your district and they say, The 
bureaucrat that you're in charge of in that Federal Government just 
told my mom she couldn't have a heart bypass.
  How are you going to deal with a constituent like that?
  Mr. McCLINTOCK. That's a story that we hear all the time out of those 
nations that have allowed their governments to take over their health 
care system. There's an article I believe in the Wall Street Journal 
today telling the story of a Canadian from Calgary who had a hip 
problem. It was going to be more than a year before they would allow 
her the surgery. Of course they're not allowed to have private 
insurance in Canada. As the bumper sticker says, The government hates 
competition.

                              {time}  1700

  She traveled to Montana and paid $50,000 out of her own pocket so 
that she could get that hip surgery done in a timely manner.
  Mr. AKIN. I think The Wall Street Journal had another guy--I 
remember, because he was in his late fifties--and the Canadian system 
said, Sorry; you're too old. You can't get a hip replacement. Well, I'm 
62 and my hip has been giving me trouble. I'm probably going to have to 
get a hip replacement. I fell on some ice when I was jogging 10 years 
ago. They basically tell me, Take some aspirin and suck it in, buddy, 
because you're not allowed to have that.
  Mr. McCLINTOCK. You may remember the story of the Calgary mother a 
few years ago. It was a big story at the time. I think she had 
identical quintuplets. The odds of that are something like one in a 
zillion.
  Mr. AKIN. Winning the lottery.
  Mr. McCLINTOCK. So a great deal of publicity. What didn't get a lot 
of publicity was the fact that that Calgary mother had her baby in 
Great Falls, Montana.
  Mr. AKIN. Are those all U.S. citizens now?
  Mr. McCLINTOCK. By the way, she wasn't just visiting Montana. She had 
to be rushed more than 300 miles south to an American hospital to have 
those babies, just as the woman with the hip surgery, also from 
Calgary, had to travel to Montana to have her hip surgery done. And the 
question occurs: If we allow the same thing to happen to the American 
health care system, where are we going to go for necessary surgery when 
all of us end up on a waiting list?
  We all know that a common hallmark of the bureaucracy is long waiting 
lines, whether it's at the DMV or the post office. Long waiting lines 
at the DMV and the post office are inconvenient and they're annoying, 
but a 6-month waiting list for needed heart surgery can be downright 
fatal.
  Mr. AKIN. Well, Congressman McClintock, you just brought up a little 
bit of a tender subject for me. Just about 6 or maybe it was 8 weeks 
ago, my father, who's 88, in the State of Missouri, went to a new heart 
doctor. His new heart doctor took a look at the medicines his previous 
doctor had prescribed and said, What did the doctor do for your heart? 
My dad said, Well, I don't know what you mean. He just gave me these 
medicines.
  So you can see this troubled look in his new doctor. The new doctor 
says, Well, you need to come in tomorrow, and we're going to give you a 
chemical stress test. I don't know how exactly that works, but it's 
like a stress test of being on a treadmill, except it's for older 
people. They do it chemically, somehow.
  He didn't go very far and the doctor said, Stop, that's good enough. 
He said, You need to come in the beginning of next week for this heart 
catheterization, or whatever it is. So he comes in and they put him out 
and they take a camera and go up through his leg and look at his heart.
  He wakes up--and they said they might put some stents in or 
something--and they said, Well, we didn't do anything. And I was at the 
meeting with the doctor. The doctor said, Your heart is in too bad a 
shape to put in stents. You need open heart surgery.
  This is, mind you, about a week and a half elapsed, or so. So I'm at 
the meeting on Monday and he says, Here's the numbers. First of all, if 
you have open heart surgery at 88 years old, because it should have 
been done earlier, you've got about a 10 percent chance of a major 
complication. But if you don't get it this next year, you've got a 50 
percent chance of a major heart attack. So you take a look at the 
numbers and you go, Okay, he explained it so I understand it.
  So the doctor said, Well, you can come in tomorrow or Thursday. It's 
Monday. My father goes in Tuesday, has a seven-way heart bypass and by 
Saturday he's back home again, and he's doing well now.

[[Page 23033]]

  Now people want to say that the American health care system is 
broken, but I would suggest that that being done in less than 3 weeks, 
a seven-way heart bypass and the technology involved in that, that's 
the kind of thing that you're never going to see with a government-run 
health care system.
  Mr. McCLINTOCK. Fortunately, there is a better alternative. It can be 
summed up in a word: Freedom. We have the ability through the tax 
system to provide a refundable, prepaid tax credit; a health voucher, 
if you will, on a sliding income scale that would bring within the 
reach of every American family a basic health plan that they could 
choose according to their own needs; that they could own, regardless of 
who their employer is; and that they could change if it failed to suit 
their needs.
  Mr. AKIN. So the government wouldn't have to run the whole thing at 
all.
  Mr. McCLINTOCK. Correct. It would be the individual owning their own 
policy.
  Mr. AKIN. That's something about freedom, isn't it?
  Mr. McCLINTOCK. You can tell a nonresponsive insurance company, 
You're fired--I'll take my business elsewhere. You know, in all the 
years I've held public office, I've never had anybody write a letter to 
me and say, My grocery store stopped carrying Wheaties this month, and 
you need to pass a law to force them to do so.
  Why don't I get those letters? Because it's a lot easier to take your 
business to the next supermarket that does have what you want at a 
price that's competitive
  Mr. AKIN. That's called freedom, isn't it?
  Mr. McCLINTOCK. The problem is, today in this country, unless you're 
self-employed, chances are you don't own your own health plan. Your 
employer owns it or the government owns it. And you don't control it 
and can't tell a nonresponsive health plan or a nonresponsive company, 
You're fired, because you don't own the plan to begin with.
  If we can use the tax system to bring within the means of every 
family that basic health plan that they will own, they will then have 
the same power over their health plan, over their health insurance 
company, that they have right now over their grocery store--to take 
their business elsewhere if it fails to meet their needs.
  Mr. AKIN. Gentleman, what you're talking about is you're talking 
about one of a whole series of different Republican proposals of what 
can be done to health care. Our position in being very critical of 
socialized medicine is not to say that there aren't things that are 
constructive or positive that should be done with our current health 
care system. In fact, a lot of the problems in our health care system 
were put there because we already have the government with its big nose 
in about half of it.
  But there are some things that can be done. As you say, one of the 
things is you own your own health care policy. People sometimes use the 
word ``portability.'' That is, if you own it, you can take it with you 
as you go from job to job. It also means if you're insured, you're not 
going to get uninsurable because you already have the health care plan.
  Mr. McCLINTOCK. And if you have that voucher that brings within your 
reach that basic health plan and then have the freedom to shop around 
for that plan that best meets your needs, you are in a controlling 
position that will protect you against nonresponsive insurers, 
nonresponsive health plans.
  But that's going to require a couple of other things, which is also 
included in Republican legislation. One of those things is the freedom 
to shop across State lines for that plan that might give you better 
services at a lower cost. I know in California we don't have that 
freedom. We don't require Californians only to shop at California 
retailers or only to bank at California banks.
  Mr. AKIN. You just don't buy your groceries in California. You can go 
across State lines to buy groceries.
  Mr. McCLINTOCK. Exactly. We don't allow the freedom of Californians--
and this is true of most States--to go across State lines to buy a 
better health plan.
  Mr. AKIN. That makes a whole lot of sense, doesn't it?
  Mr. McCLINTOCK. Of course it does.
  Mr. AKIN. And the way that works is that of course you've got 
different States that have their own requirements for health care, but 
if a plan meets the requirements of a given State, and that company 
wants to sell their health plan to someone over a State line, now 
you've got a chance for shoppers to get a better price on their 
product. And it tends to break up the monopolies that an insurance 
company can generate in a particular State market.
  I picture, gentleman, that that's going to be particularly effective 
where you've got basically large metropolitan areas that span several 
States. You can go back and forth and kind of shop for what's better 
for you. Is that your impression?
  Mr. McCLINTOCK. Exactly right. You remember what Will and Ariel 
Durant wrote. This was before the government took over our automobile 
manufacturers. They asked the question, What makes Ford a great car? 
Chevrolet. Competition.
  We restrict competition in the health care field. And that's one of 
the reasons why people have such restrictions on their choices.
  Another of the restrictions on their choices, of course, are the 
endless number of mandates that are imposed by State governments and 
the Federal Government. Every one of those mandates require you to pay 
for coverage you might not want, you might not need, but you're being 
forced to pay for.
  Mr. AKIN. Or you might not able to afford.
  Mr. McCLINTOCK. I tell you another thing that needs addressing--and 
that's where this debate is so healthy; there are things that have to 
be changed--and that's the question of preexisting conditions.
  I had a fellow come to me a few years ago. He had left his job and 
therefore lost his insurance. So he was now trying to get insurance as 
a private individual. He couldn't find it anywhere. Why? Preexisting 
condition. He had bursitis.
  He says, Look, I don't care about the bursitis. I'll take care of 
that myself. I'm concerned about a catastrophic disease or a 
catastrophic illness. Just write me a policy for all of that and I'll 
take care of the bursitis myself.
  The response was, We'd love to write you such a policy, but we can't.
  Mr. AKIN. Why would that be, gentleman?
  Mr. McCLINTOCK. It's against the law.
  Mr. AKIN. Against the law federally?
  Mr. McCLINTOCK. In California. I actually introduced legislation in 
the California legislature that would allow health plans to provide 
coverage and write out that preexisting condition. Also, by the way, 
legislation to allow Californians to shop across State lines. Both of 
those were killed on straight party-line votes in the California 
legislature, and now we're watching the same reforms being defeated 
here by the Democrats in this Congress.
  Mr. AKIN. It's interesting that we seem to--as a political party 
system, the Democrats seem to be wedded to trying to copy what did not 
work well in the United Kingdom or in Canada. You can take a look at 
these cancer statistics and other measures of quality and they're 
really bad.
  If you look overall at cancer in the United Kingdom, you're looking 
at a 50 percent survival rate. Whereas in America, the numbers are so 
much higher. So why do we want to repeat something that doesn't work? 
Why do we want to mess up something that 100 million Americans have got 
a good system going, and we want to just turn it over to the 
government?
  It's almost like we've got these blinders on. Regardless, we know the 
government should do it all. And so half the Democrats want to go that 
way, the other half are kind of dragging their feet--and I'm thankful 
for them.
  Mr. McCLINTOCK. But Americans know better. There's a certain degree

[[Page 23034]]

of skepticism that the same government that pays $400 for a hammer and 
$600 for a toilet seat and is currently running a $1.6 trillion annual 
deficit is somehow going to keep our health care costs down. There's a 
great deal of skepticism that the same government that runs FEMA is 
going to somehow bring efficiency to our doctors' offices. And there is 
a great deal of skepticism that the same government that runs the IRS 
is going to bring compassion and understanding to our insurance 
companies.
  Mr. AKIN. You know, that's the thing that I find hard, the amount of 
faith that's required, when you take a look at the performance of 
government agencies, to turn our physical bodies over to those 
government agencies to take care of us. It's kind of a hard thing to 
swallow.
  As you say, the compassion of the IRS, the efficiency of the post 
office. FEMA, we've seen that--legendary. But we've got other ones. 
You've got the Department of Energy.
  Do you know why the Department of Energy was created? To make sure we 
weren't dependent on foreign oil. Aren't you glad that we've got all 
those employees making sure we're not dependent on foreign oil?
  And then you've got the CIA; the cloak and dagger stuff. Well, that 
would be great, but they're the ones that gave us a report in Gulf War 
I that the Iraqis were 10 years away from making a bomb, a nuclear 
device. When we got in there, they were about a year to a year and a 
half away from making it in Gulf War I. So we go to Gulf War II, they 
tell us, Oh, within a year, year and a half, they'll have a bomb. We 
get in there, and they weren't doing anything.
  And we want to trust our health care to these agencies? It's one 
thing if it's the post office or something, a letter gets missed. What 
happens--that's what I'm asking you my friend--what happens when we get 
the call and somebody says, Congressman McClintock, they're not letting 
my mom get the heart bypass, and I don't have any other alternative. 
How are we going to deal with that? How can we explain that?
  Mr. McCLINTOCK. We've seen it time and again, every single time, 
whether it's in Britain or Canada or in places like Tennessee and 
Massachusetts that have tried the same thing. Very consistent results. 
Every time. Massive cost overruns that must be then followed by a 
brutal rationing of care.
  Mr. AKIN. That's the other thing that's interesting. America, such a 
great country, and we have these fifty States. And the States, to some 
degree, were like little laboratories. People could try stuff in the 
States and see how it worked. And then, if it worked really well, 
perhaps you might want to bring it to the Federal level. But why would 
we want to repeat the failed experiment of Massachusetts and Tennessee?

                              {time}  1715

  Mr. McCLINTOCK. I just want to thank you, Congressman, for organizing 
this discussion today and for including me in on it. I know you have 
some remarks to conclude with, so I will yield back.
  Mr. AKIN. I very much appreciate your taking some time to join with 
us. This is such an important discussion. Your experience in California 
with the great amendments that you offered both in California but now, 
I understand, in committee are making it clear that the promise, we are 
not going to spend one dime of deficit, and yet it gets defeated on a 
straight party-line vote. It took some courage to offer that amendment, 
but at least it defined where we are in this entire situation. And I'm 
very thankful that you came out and joined with us today on a very 
important discussion.
  The talk is that sometime in the next couple of weeks, this whole 
thing may come down to a vote. Once again, I go back to my own personal 
experience with having been a survivor of cancer, coming into this very 
building, having medical doctors tell me, Congressman Akin, you are fit 
as a fiddle except for the fact you have cancer. That's a sobering kind 
of thing. So what had happened to me was the insurance companies had 
discouraged my getting a physical. I should have. If I had been smart, 
I would have forced myself to get a physical and line up and wait for 
it all, but I didn't do it until I got here in Congress.
  Well, here's what happens, one step worse than an insurance company 
getting between you and your doctor, and that's when the Federal 
Government gets in between and starts to ration and dictate what's 
going to happen. We have this experience in the United Kingdom with 
what happens in cancer there, and in Italy and Spain. Then you take a 
look at the U.S. results, and in spite of the complaints about American 
health care, if you're some well-to-do sheik from Bahrain and you have 
got unlimited billions of dollars or millions of dollars to spend and 
you're sick, guess where you come. You come to the good old USA for our 
health care because we still have a lot of good things going on with 
the level of services we provide.
  There are changes that need to be made, but the change doesn't need 
to be socialized medicine. It doesn't need to be a government system 
which will crowd out all of the privates. It doesn't need to be a 
system which is going to create an incentive for private companies to 
dump their employees on the government. It doesn't need to be a system 
which is going to take $500 billion of Medicare funds away from people 
who are on Medicare. It doesn't need to be a system that basically 
guarantees that illegals can get health care at the public trough. It 
doesn't need to be a system that says that we're going to use Federal 
money to provide free abortions for anybody who wants those. And it 
doesn't need to be, above all, a system that is driven by bureaucrats 
getting between the patient and the doctor. Those are things that we 
don't need in America.
  Americans, in spite of the fact that a great preponderance of media 
have not been giving all the facts and pointing out that these 
quotations are not true, in spite of that fact, Americans across the 
board, whether they're liberal or conservative or whatever, they're 
saying, Please, don't take our one-fifth of the economy and completely 
redesign it to fit 15 million people who may not have insurance when 
100 million people are comfortable with what they have.
  We need some reforms. We need some changes, and there are some very 
good things we can do. We haven't even mentioned tort reform, the high 
cost of defensive medicine. That's one thing that's needed to be fixed 
for a long time. That will drive health care costs down. We haven't 
even mentioned here today the fact that people that work for big 
companies or the government get to buy their health insurance with 
pretax dollars; whereas, a small business or self-employed person has 
to pay for their health insurance with after-tax dollars. That is not 
just. It should not stand. We should not tolerate this.
  There are changes we need to make, but socialized medicine is 
certainly not one of them. All you need is a little common sense to 
look at the foreign countries or the two States in America that tried 
this Pelosi-type plan and you will see that this is not the direction 
we need to go.

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