[Congressional Record (Bound Edition), Volume 155 (2009), Part 17]
[House]
[Pages 23353-23360]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Iowa (Mr. King) is recognized for 
60 minutes.
  Mr. KING of Iowa. Mr. Speaker, I appreciate the privilege and honor 
of addressing you here on the floor of the House of Representatives. 
And I also appreciate the opportunity to listen to my good friend and 
colleague, Dr. Gingrey from Georgia. I think he's actually putting out 
a few more words per minute than he usually does. This is a passionate 
subject matter for him, and the bills that he's introduced and the 
foundation that he's laid, I think, is an excellent rebuttal to the 
statement that was made earlier in the 5 minutes by the gentlelady from 
California who said, Republicans, where is your plan on health care?
  Well, we have many, many plans on health care. And we have many, many 
ideas on how to address this. And they are consistent. They are 
consistent with human freedom and the instincts of humanity. They're 
consistent with the marketplace, consistent with the foundation of what 
has made this a great country. And on the other side of the aisle they 
seem to be consistent with managed economies and managed societies, the 
kind of societies that have always failed, the kind of societies that 
have drained away human ambition and put countries, entire 
nationalities in a position where, I believe it was Ronald Reagan that 
said, In the Soviet Union they pretend to pay people, and in the Soviet 
Union, people pretend to work.
  There's something about human nature that we understand over here on 
this side of the aisle, and we want the best out of all of us. And so 
I'd take us back to the broader structure of what has been delivered 
here on the House. There's really only one bill out here that has 
passed out of committees and is before the American people as the 
subject matter to be discussed, and that is, here in the House, H.R. 
3200. And I have, first, Mr. Speaker, a diagram of the previous bill 
that came out in 1993 and '94 that was known in many ways as 
HillaryCare. And so I have an observation here that I will post. This, 
Mr. Speaker, is the flow chart of HillaryCare. This is out of the 
archives of the New York Times. And it also is very close, if not 
identical to the flow chart that was on the wall of my office back in 
the early and mid-nineties, actually all the way through the nineties.
  This is the flow chart that was laid out when the previous attempt to 
take over health care, for the government to take over the American 
health care system, was made. Here, on this floor, a few feet behind 
where I stand now, at the time President Bill Clinton came to the 
floor, September 22, 1993, and he did the unprecedented thing. He asked 
to address a joint session in Congress to speak of a subject matter 
that wasn't about war. That was the unprecedented component of it. But 
it was about the Federal Government taking over 100 percent of the 
health insurance and health care delivery system in the United States 
of America. That is a huge reach, and it was something that mobilized 
the American people in opposition. There were good reports on President 
Clinton's speech immediately after he gave it, because he, like our 
current President, had an ability and retains that ability to be a 
compelling speaker and to move people

[[Page 23354]]

with the force of his words and not necessarily the force of ideas, but 
the tone and the force of the words themselves.
  So President Clinton, in the aftermath of that September 22, 1993, 
speech right here to this joint session of Congress, his numbers moved 
and it looked like he had perhaps broken the dam and there was going to 
be a National Health Care Act that would transform and take over the 
entire health insurance industry and the health care delivery system in 
the United States.

                              {time}  1630

  We know how that came out, Mr. Speaker. We look back on that 15 years 
ago, we know how it came out. And that was there was a push-back across 
the land. I don't know that we actually used that expression in those 
days. But I recall Harry and Louise and I recall Senator Phil Gramm, 
who, right down this hallway at the other end of the doors that you and 
I are facing, Mr. Speaker, at the other end of this Capitol Building, 
stood on the floor of the United States Senate and he said, This 
National Health Care Act will pass over my cold, dead, political body. 
That was Senator Phil Gramm. And a lot of people thought that his 
political body was going to be cold and dead and that we would have 
HillaryCare in America.
  It didn't take 15 years to find the results of that, Mr. Speaker, 
because the American people rejected the idea that the freedom that 
they had to purchase their own health insurance and the freedom that 
they had to make many of their own decisions with their doctor in the 
marketplace would be taken away, and it would be government run and 
government owned.
  This is the flowchart that described it better than anything else. I 
would submit as we look at these stacks of bills, an 1,100-page bill in 
H.R. 3200, the health care bill that has passed out of committee and is 
here waiting to come to the floor of the House, you can't understand 
the language; I don't care how good a lawyer you are if you have some 
diagrams. And you have to be able to look at the flowchart and track 
through the diagrams to find out what the language does, draw some 
pictures, so to speak. And even then I believe it is impossible for a 
single individual to analyze this legislation and be able to predict 
the pitfalls that are created by the vagaries in the language. There 
are many.
  But this was enough to scare the living daylights out of the American 
people and me. And in fact, Mr. Speaker, this flowchart was one of the 
significant components that drove me to take time away from my private 
business, the construction business that I started in 1975.
  And, Mr. Speaker, I seldom tell the story about that background, but 
I think for the sake of those who are listening--and we all want to 
evaluate the background of the people that are making recommendations 
for all 306 million Americans. For me, Mr. Speaker, I grew up in a 
lower-middle class family. My father was a law enforcement worker, a 
manager of the State police radio station, middle-level management. So 
he had pressure from the Governor on down and then he had some people 
who worked underneath him. Great reverence for the rule of law, a 
profound work ethic that something had to be going on all the time and 
you had to constantly be making progress.
  That was my background. No business background.
  But by 1975, Mr. Speaker, I had concluded that if I were going to 
control my destiny, it didn't pay for me to sit back and wait for the 
government to send me a check. The eagle wasn't going to fly for Steve 
King unless I did something to make the nest and get the eggs laid and 
hatch those eggs out. I had to take care of my own destiny.
  So one day in June of 1975, I decided that I didn't have a lot of 
alternatives, but one of those was to take a risk and a chance and 
start a business. And I decided it was the best alternative. And so by 
August of that year, I had borrowed a hundred percent and gone out and 
bought a bulldozer, and that was the business, it was the foundation of 
the business. I don't know how many hundred pounds of welding rods I 
burned on that machine and how much repair work I had to do just to put 
it out on the job for the first hour. By the way, it broke down again 
in the first half a day and back to the shop it went, and I had to tear 
it completely down, rebuild it again and try again.
  Many of us who have started businesses got knocked down over and over 
again, picked ourselves up again, and in the process of doing that were 
forced to learn the components of running a business. And anybody that 
started out with--I'll say for me it was a negative net worth in a 
highly capital-intensive business and had to meet payroll and meet the 
government regulations. And by the way, back then--I did a count. I had 
43 government agencies that regulated my business. I had to answer to 
43 government agencies, and if any one of them stepped in at any time 
and declared me to be out of compliance, they could either levy a fine 
or shut me down.
  Government was then the biggest fear that I had when I started the 
business. I wasn't worried so much about whether I could do the work or 
I could repair the machines or whether I could drive the truck. I 
wasn't even so worried about whether I could market the service that I 
had decided to provide. All of those things were going to take time and 
effort, and all of those skills had to be improved upon. But the one I 
was most concerned about was how do I possibly meet all of the 
government regulations that I don't even know.
  And there isn't any one single contact go-to point that any person 
who is starting a business to find out how many regulations you're 
going to have to meet, what will be the nature of that regulation. If 
you just stacked it all up, stacked up all of the paperwork and the 
regulations for 43 agencies that regulated me at that time, if I had 
known that, that would have been enough to scare me completely out of 
business before I ever went into business.
  I lay this background to tell you, Mr. Speaker, that I met payroll 
for over 28 years, over 1,400 consecutive weeks, and I paid myself 
last, if at all; and I paid my employees first and then I fed the kids. 
But we got through those years, and we had our ups and downs. And I 
would never categorize it as a magnificent success except that being a 
business owner, a founder and a manager had laid the groundwork for me 
to understand the components of the other businesses in the country and 
gave me the tools that I had the flexibility to raise my family in a 
fashion that I thought was far more constructive than it might have 
been if someone else were telling me when and where I was going to show 
up to work. And it also gave me a burning desire to try to clear some 
of the path for others that might want to do the same thing.
  So regulation has always been, I'll say in the last couple of 
generations anyway, the number one concern of business. What will 
government do not for us, but what will government do to us.
  So this was 1975 when I began. We had our ups and downs, Mr. Speaker. 
I had barely gotten a position that I was even there to be a target of 
the farm crisis in the 1980s. But I went through all of that, and many 
of us got hammered flat over and over again and got back up. And some 
of my neighbors didn't make it. And some of them, their spirit was 
destroyed even though they made it. Those were tough years.
  And the floods in 1993 and the other experiences along the way that I 
could chart on my financial statements, the ups and downs, all are 
triggered with some kind of an event.
  But the experience of dealing with government and the experience of 
having to be my own accountant, mechanic, truck driver, my own sales 
manager, my own human resources manager, my own equipment operator, 
sometimes my shovel operator, sometimes the wrench operator, sometimes 
just the person who is the superintendent that steers everybody else 
when things are working and it's all in tune, that's when you're the 
least busy. I went through all of that.
  I had to also deal with lawyers and insurance men and also, of 
course, our bankers. All of that laid a background

[[Page 23355]]

and I think a knowledge base that's been so very useful here in public 
life.
  But of all of the things that I mentioned, the one that's concerned 
me the most from the beginning, and the greatest impediment to people 
who might be entrepreneurs that want to establish and found a business, 
are government regulations. And this spider web of government 
regulations that were created by HillaryCare was enough to--didn't 
scare me out of business because it didn't pass over Senator Phil 
Gramm's cold, dead, political body, but it was enough to scare me 
towards politics, if not completely into politics. And I think it was 
enough to scare the living daylights out of the American people, and 
they killed HillaryCare.
  Now we have the modern era. Fast forward 15 years, Mr. Speaker. The 
previous chart, Mr. Speaker, was black and white. This is in full 
living technicolor. This is a 2009 version, the most recent version of 
a government takeover of the health care industry; and I mean, Mr. 
Speaker, the health insurance industry and the health care delivery 
industry in America. This 17\1/2\ percent of our Nation's economy and 
this flowchart with this full color is scarier yet.
  Now, I don't mean that it's actually scarier by functionality, 
because marginally it at least leaves the opportunity for health 
insurance companies to survive for a while. But, Mr. Speaker, it 
certainly sets the scene for the destruction of every private health 
insurance company in the United States and the elimination, 
potentially, of every health insurance policy in the United States. In 
fact, H.R. 3200 compels that every health insurance policy within 5 
years be approved by the health choices administration commissioner.
  This bill sets up a new health choices czar. It calls him a 
commissioner because Americans are full up to here with czars, but this 
is a health choice administration commissioner. I don't know that he's 
a czar; I don't know that he's a commissioner; I don't know if he's a 
commissar. So I have called him the Health choice administration's 
commi-czar-issioner. And he would be the person who heads up this 
commission through which every health insurance company here, the 
private insurers, everything in white on this are existing. Those in 
color are newly created agencies, departments, and functionalities.
  Thirteen hundred private health insurance companies. That sounds like 
a big number. Some of those companies have names for the different 
States that they operate in. But, Mr. Speaker, 1,300 health insurance 
companies here and the 100,000 potential, I'll say existing, policy 
variations here, the traditional health insurance plans, would all have 
to be qualified by this new commi-czar-issioner's board in order to 
provide through this period of 5 years to qualify, in order to provide 
the qualified health benefits plans.
  So every health insurance policy in America would have 5 years to be 
approved by the new health choices commi-czar-issioner. And the 
regulations would be written by them. So we have a piece of legislation 
that sets up a commission that would write new regulations, the 
commission to be named later, to write regulations that would be named 
later that would control the destiny of 1,300 health insurance 
companies and 100,000 health insurance policy varieties, options that 
the American people have.
  All of that would have to jump through the hoops to be created later 
after the legislation has passed by people to be appointed later, 
including the health choice administration commi-czar-issioner.
  So for the President to make the promise to the American people that 
if you like your health insurance policy and your doctor, don't worry, 
you get to keep it--if you noticed, he had to change the language when 
he stood here and gave his address to the joint session of Congress--I 
believe that was September 8. That's within a day, Mr. Speaker, and his 
language changed to actually be: ``Nothing in this bill will force you 
to give up your doctor or your health insurance policy.''
  Well, I don't know that that's true because something in this bill 
may force those companies out of business and may disqualify your 
health insurance policy, and it may discourage your doctor to the point 
where he decides that he wants to go drive a taxi cab like they do in 
Cuba. If you want to meet a doctor in Cuba, take a taxi. You'll get in 
the back seat of a 1954 Chevy with a five cylinder Russian diesel in 
it, and the guy behind the wheel might be a doctor. They have a lot of 
doctors in Cuba. It pays better to drive a taxi cab.
  So this reach that we have of taking the private insurance companies, 
1,300, and force their 100,000 policies to go through new regulations 
to be written--and we know there are going to be fewer than 100,000 
policies--so people will lose their policies.
  I hope the President, Mr. Speaker, turns on C-SPAN and understands 
what I'm saying. He can't say it any more, Mr. President. If anything 
more like this passes, people will lose their policies, and they're 
likely to lose their doctor.
  And you haven't told the Speaker of the House that she can't support 
something like this if she's going to be consistent with the intent of 
the language that she used herself.
  So, Mr. Speaker, I'll submit that this, the recharacterization, needs 
to revert back to the language of the bill. And we need to understand 
what happens when bureaucrats make decisions. And by the way, we 
sometimes just need to listen to the people on the other side of the 
aisle. They're for single-payer government takeover. A hundred or more 
of them have signed a letter saying they would vote against a health 
care bill if it didn't have a ``government option.'' Excuse me, that's 
not the right quote. The quote is a ``public option.''
  Mr. Speaker, a public option is a government option. It is a 
government takeover of the health care industry eventually. And, by the 
way, this is the purple circle of the 100,000--it won't be 100,000--but 
those that are left of the original 100,000 policies and the 1,300 
companies. This purple circle, the qualified health benefits plans, 
that will be the private sector that actually meets the regulations 
after 5 years.
  Fewer companies, fewer policies. We don't know how many, but we do 
know this: the government then would produce a public health plan. 
That's the second purple circle here. They would be under this health 
insurance exchange. So envision that as maybe an Internet site you 
would go to that had a series of bureaucrats behind there that would 
make recommendations, evaluate policies, and let you look at the 
government option versus the private sector option.

                              {time}  1645

  But this public health plan, this government option, has to be set up 
with Federal taxpayer dollars. You can't start an insurance company 
without capital. Where is it going to come from? The American 
taxpayers. And where does our money come from now after we have long 
past burned through the tax revenue for the 2009 fiscal year? It comes 
from the Chinese and the Saudis. And we are borrowing money from 
foreign countries. We are borrowing money to buy things from them, and 
now we would be borrowing money to start up a health insurance company. 
In any case, it would be national debt money, billions that would be 
the capital foundation to set up an insurance company so that there 
would be conceivably 1,301 health insurance companies. One more 
company.
  The President's view was, we need more competition in the health 
insurance industry. So, if 1,300 companies is not enough, set up a 
Federal company. That will be the difference. And we will borrow money 
and put billions into it. And now this enterprise, this Federal 
enterprise that is in direct competition with the private companies has 
to succeed.
  Well, if it can't sell policies, it can't succeed. So how does the 
government go about doing this? Well, they set the premiums low enough 
and the benefits competitive enough that they can get people to buy the 
policies, otherwise they are an irrelevant entity.

[[Page 23356]]

  So I guess you would say that's fine, except we need to understand 
this. The regulations that would be written for the government plan 
would be regulations that are written so the government plan can 
compete with all of these private plans, which means that the 
regulations would be written to favor the government plan. And the 
premiums the government would charge would be premiums that are 
designed to be competitive, and I'm going to say likely cheaper than 
can be offered in the private sector. And so the result of that will be 
that either we are going to have to subsidize the government plan 
health insurance company, or we are going to have to regulate these 
private sector businesses out of business.
  It's how government operates. We have several models that we can look 
at.
  The simplest and most stark of them all is the National Flood 
Insurance Program. If you want to know, Mr. Speaker, how health 
insurance will go if we have the government option, look at the 
National Flood Insurance Program. We had a government option on Federal 
flood insurance. In 1968, this Congress passed legislation that 
established the National Flood Insurance Program. We had property and 
casualty insurance companies in the private sector that sold flood 
insurance. But when the government got involved, they set new premiums 
and new regulations, and they still couldn't crack into the market well 
enough. And so then they passed a regulation that required that a real 
estate loan through a national bank had to include flood insurance. And 
when they put that mandate on the national banks, they required the 
flood insurance to be purchased--from where? The Federal Government. 
With premiums set by? The Federal Government.
  Today, it is impossible to buy flood insurance in America from anyone 
other than the National Flood Insurance Program because the Federal 
Government has squeezed out all of the competition, and the Federal 
Government owns the entire territory.
  We have today--I say ``we,'' the Federal Government has a monopoly on 
flood insurance. And their operation is pretty wobbly because they are 
$19.2 billion in the red. That's billion with a B, Mr. Speaker. The 
National Flood Insurance premiums don't reflect the risk. They've 
pushed out all the competition. They've lowered the premiums. And now 
what are we doing as a result? We are building more and more and 
developing more and more real estate in floodplains because the 
premiums for the flood insurance are cheaper than the risk. And so 
people can do that, and we create more risk accordingly.
  The markets, Mr. Speaker, can restrain and bring about rational 
decisions. Bureaucrats make mistakes over and over again. That's the 
Federal flood insurance. That's what will happen to this Federal health 
insurance if it should get passed.
  In addition, we have the school loan program. Twenty-five years ago, 
that was completely private. The private lending institutions set up 
the school loan program. But today, thanks to some very liberal Members 
of Congress, it looks like the steps have been taken that will, within 
a very short period of time, squeeze out what is left of the private 
school loan program, the school loan program, where I will predict that 
within 5 years from today, if there isn't a dramatic difference in the 
elections that are taking place in this country, there will be nothing 
but government student loans. There will no longer be any private 
student loans.
  This is a country that was built on free enterprise. We are a proud 
and independent people. We are slowly settling into dependence.
  We have handed over the private sector flood insurance. And by the 
way, in the State of Florida, they have State hurricane insurance now 
that owns that market, because they decided government could do it 
better than the private sector.
  Over and over again, we give up our freedoms and we forget about the 
underpinnings of American exceptionalism and the markets and personal 
responsibility. I heard the gentleman from Ohio say last night, I 
believe it was, that if you get sick, you may have to go into 
bankruptcy to pay your bills. He then asked the question, is that 
freedom? Well, yes, actually. This is a country that if you're going to 
have freedom, you have to be willing to take some risks. You have to 
have the freedom to succeed, and you have to have the freedom to fail.
  Now, I'm all about, and many of us are about reaching out to our 
neighbors and our friends, and we don't want people that have been 
responsible to have to pay a consequence because they happen to be very 
misfortunate. But by the same token, I don't want to take away the 
personal responsibility from the American people.
  I remember when Jimmy Carter was running for President. He said this 
profound thing. Well, for Jimmy Carter, this was a profound thing. He 
said, the people that work should live better than those that don't. 
Now I don't know whether he actually lived by that or set policy by 
that. But I remember when he said that because it caught my attention. 
This was maybe 1976 or so. The people that work should live better than 
those that don't. The people who step up and take responsibility should 
at least have a modicum of benefit for taking that responsibility.
  But the effort over on the Democrat side of the aisle seems to be 
take all the responsibility away from the people because I think they 
disrespect the ability, the work ethic, the character, the morality, 
the discipline, the education, the intellect and the core values that 
we have as American people.
  We can rise above anything. Mr. Speaker, we are not a regular people 
here in America. We're Americans. We're not just an extension of 
Europe. That was the base of our original population. We are far 
different from that. We are a people that are the recipients of all the 
best that came from Western civilization. But we have got also the 
cream of the crop from every donor civilization.
  The vitality that it must have taken and the dreams that it must have 
taken to be able to get on a ship and find a way to barter your way for 
passage or pay the passage to come across here. My great grandfather 
multiple times over came over here in 1757 from England. He served as 
an indentured servant in a livery stable and paid off his passage. He 
was the father of 17 kids, and their dreams were realized. And multiple 
generations arrived here that way. That's part of what is the core of 
who it is to be an American. It is not a normal, regular thing. We're 
not just an extension of Europe or any other country. We have a special 
vitality, because it has been hard to get here, and you had to have a 
dream to come here. The people that didn't have a dream stayed home in 
their own country. And some of them sat back and didn't work and didn't 
excel.
  Many came here for religious freedom. Many came here for economic 
freedom. And many more came here for religious and economic freedom. 
That beacon of the Statue of Liberty was in the minds of the American 
people and an inspiration for the world long before the statute was put 
up at Ellis Island. We are a unique people that have relied upon this 
freedom. Our vitality has been an inspiration for the world.
  We sit in the Congress and we begin to erode these freedoms one after 
another after another and trade them off for a dependency. If we take 
this false clarion call that somehow we can push the expenses for this, 
the debt for this, off on to the succeeding generations, what moral 
standard would anyone have to make a declaration to the little kids 
growing up in America and those children not born, that we, our 
generation, in our time, have somehow a right to put them in debt in 
the first place? And secondly, what right do we have to put them in 
debt because we want to give everybody in America not health care--not 
health care--because everybody in America has access to health care. 
The argument is we want to give everybody in America a health insurance 
policy created by the government.
  Think how this works. This single-payer national health care plan is 
the goal of the President of the United

[[Page 23357]]

States, the goal of the Speaker of the House and the goal of the 
leadership here. And I know that there is reference made to the 
chairman of the Judiciary Committee, Mr. Conyers. I went back and 
pulled a bill that he had introduced on health care in 1981. It's 
getting to be a while back now, 28 years ago. I know Mr. Gingrey 
referenced him in his earlier speech. But I read the bill. That bill I 
read. It was about 167 pages. It sets up a United States health 
services department, an agency.
  It says in there that every human being, every person, in the United 
States, legal and illegal, whatever their status might be, whatever 
their proclivities might be, has a right to quality, timely and 
respectful health care, a right to this in 1981. It's pretty 
astonishing to read that.
  Now you can have that concept, I guess, and that is the concept of 
the chairman. But to follow this thing along, he also declares that 
everybody has a right to this health care, legal and illegal, but in 
addition, all health care workers will be salaried employees. So he 
sets up a national company to manage all the health care in America, 
and no worker can be there working off a fee for service. The brilliant 
surgeons that are creating new ways to save lives and improve the 
quality of lives, and new surgical techniques and new equipment, they 
would all have to be paid at the end of the month just like the person 
who is, let me say, maintaining the building.
  It takes away the incentive. You have forgotten completely about the 
difference between being an American and being a regular dependent soul 
in a social democracy in Western Europe, for example.
  We have got to remember: We are Americans. We are a distinct group of 
people. That kind of idea of socialized medicine is anathema to 
freedom-loving, freedom-breathing people. If we bargain it away, it's 
never to be retained again, not in this generation, not in any other.
  I will conclude and go to the gentleman from Missouri.
  There's a lot at stake here. The future of America is at stake. And 
it is not just this national health care act. It is the socialized 
medicine that lies underneath it. It is the cap-and-trade which pushes 
our industry to India and China. It's the comprehensive amnesty policy 
that they are preparing to deliver. If any combination of these three 
should become law, they will try to ram the rest of them through. And 
that, Mr. Speaker, sounds to me like the end of American freedom.
  I will stand and fight it every step of the way, as will my friend 
from Missouri (Mr. Akin) to whome I will be very happy to yield 
whatever time he may consume.
  Mr. AKIN. It's my pleasure to join my good friend. And as you talk a 
little bit about freedom, you have spoken in somewhat general terms 
about the effects of the government taking over paying the doctors and 
what that would do. But I would like to get a little bit more into the 
details, because I think we have to remember the results of what that 
freedom has done in the area of medicine.
  The level of innovation that has occurred in medicine in a free 
society such as ours is just incredible. And it is America that drives 
all of these new developments of various drugs. It is America that is 
driving all of these things like laser surgery for eyes.
  We see examples now of something that was considered a very risky and 
strange procedure that wasn't covered by insurance company, called 
Lasik surgery for your eyes, which now is tremendously common. My wife 
had some 10 years ago, and her vision was terrible. It's much better 
than mine now because of the fact we had this innovation. We have 
innovation in terms of heart surgery and the way that we deal with 
that. My dad just had a seven-way heart bypass. That was something that 
wasn't available 30, 40 years ago. And he is surviving and doing well 
at 88 years old. There are so many different kinds of innovations, use 
of radiation which is now focused in a very, very tiny area to be able 
to destroy cancer, and different types of drugs and things. All of this 
innovation is the product of freedom, because as people take risks and 
try new ideas, new and better ways to do things are born.
  It struck me, my good friend from Iowa, that it was said that it 
wasn't until about the First World War that when you got sick and went 
to a doctor that you came out ahead. In other words, if you went to see 
a doctor before World War I, it was certainly after the Civil War, but 
if you got sick and went to see a doctor, at least 50 percent of the 
time you would leave the doctor worse than where you started. And that 
is, of course, kind of a grim situation to be very sick and have to see 
a doctor knowing you have got less than a 50 percent chance to do 
better than when you started.
  Mr. KING of Iowa. If the gentleman would yield, how would you compare 
those results to the results of dealing with the Pelosi Congress today?
  Mr. AKIN. I'm afraid that America is probably less healthy under the 
results of the Pelosi Congress. If you were to judge in economic terms, 
you would be talking in trillion-dollar measurements of less healthy. 
You would be talking about excessive spending and excessive government 
control.
  I think sometimes history is so close to us we fail to grasp the 
significance. Did you ever stop to think that the President of the 
United States fired the President of General Motors? That is an 
incredible intrusion that our forefathers would say, What? I can't 
believe that.
  And now we are talking about this isn't just a sort of semi-benign 
Lyndon Baines Johnson war on poverty. He figured out there were people 
that were hungry out there, so he decides to hand out some food stamps, 
which has turned out to be a very corrupt program.

                              {time}  1700

  So he decides to hand out some food stamps, which has turned out to 
be a very corrupt program, but he didn't try to have the government 
take over every supermarket and every farm in America.
  You've got 100 million people that have got good health insurance, 
good relations with their doctors and hospitals, getting good medical 
treatment, and for what he started saying, 30 million, and then your 
chart I see coming up is going to explain about how small this is.
  So we're going to basically have the government take over the entire 
system and mess everything up for 100 million people in order to try 
and help 15 million? I mean, just the common sense of this. And you're 
talking about the Pelosi Congress. I will tell you, the patient is a 
lot sicker than they were 6 months ago, my friend.
  Mr. KING of Iowa. Reclaiming my time and thanking the gentleman from 
Missouri, and I hope we can continue this dialogue. You've inspired me 
to go with this other chart. Some say 50 million uninsured. The highest 
number I generally hear is 44 million to 47 million, but this is the 47 
million uninsured chart.
  Now, the President has said there are two things that are very 
compelling that cause us to have to go down this path of a national 
health care plan. One is we spend too much money. We spend about 14.5 
percent of our GDP on health care. The average of the industrialized 
world is 9.5 percent.
  So we may spend too much. We could fix almost all that with tort 
reform and allowing people to buy insurance across State lines. The too 
much question, spending too money can be fairly easily resolved. The 
other component of this is too many uninsured.
  The gentleman from Missouri.
  Mr. AKIN. Now, who is it that should allow the Federal Government to 
tell American citizens whether they're spending their money in the 
right place? Isn't that kind of this Big Government top-down mindset 
that comes up with something as dumb as that?
  If you're sick, you're going to spend as much money as you need to 
try and get well. Who's to tell you you spent too much or too little? 
Even the very sniff of that speaks of this Big Government mindset.
  Mr. KING of Iowa. I'd suggest it's probably the predecessors to 
Merkel, Sarkozy, and Gordon Brown, or maybe even they, themselves. In 
fact, I heard

[[Page 23358]]

an actual dialogue with Chancellor Angela Merkel, We spend too much on 
health care. They have that look-over-our-shoulder tendency, as if 
global norms would be right. I remember one of those contributors to 
global norms would be the health care industry in Iraq. When we went in 
there in March of 2003, the average annual expenditure for health care 
per person in Iraq was fifty cents per year. So I suppose you could add 
that into the global average.
  We do spend a lot of money. We get great results. And I haven't heard 
the American people complaining all that much about their results, 
because they are great results. But if we want to take the cost down, 
then we take care of medical malpractice.
  I talked to an orthopedic surgeon--and my days blend together, but I 
believe it was yesterday--that out of his small little operation they 
spend more than a million dollars a year in premiums for malpractice 
and in unnecessary--unnecessary tests in order to avoid the litigation. 
Defensive medicine, over a million dollars a year out of what he 
considers to be a small practice; what I consider to be he's a great 
contributor to our society and to our civilization. That's multiplied 
across the country.
  When I hear numbers that come from representatives that are part of 
the health insurance underwriters in America and they tell me that 8.5 
percent of the overall health care costs are malpractice premiums, 
litigation, and defensive medicine, those three things in that 
category, and I multiply .085 times the gross receipts for the cost of 
health care, that comes to $203 billion a year unnecessarily spent 
because the trial lawyers have that corner of the market fixed, and 
there's no will on Harry Reid's side of this Capitol building or Nancy 
Pelosi's side of this Capitol building. In fact, there's a huge will to 
resist addressing malpractice and the reform of lawsuit abuse. That's 
the best and most important thing we could do.
  We evaluate these bills on the part of a 10-year plan; $203 billion a 
year. If we could fix it all, that's over $2 trillion. The President, 
in fixing the health care industry that he says costs too much money, 
only proposes to fix it by putting another $1.6 trillion into it. So we 
simply fix the malpractice and we have been able to fund all the other 
ideas which I don't agree with. That's a component of this. It needs to 
happen.
  And then we have the uninsured, Mr. Akin. I would like to raise the 
issue about the uninsured. These 47 million--now, this chart has got 
somebody else's software that did it, so I will tell you the numbers 
that I remember that I have vetted to be accurate.
  Starts out with 47 million uninsured. We need to fix this because 
there are too many uninsured in America. So what are they comprised of? 
All people who don't have affordable options? No is the answer, and 
here's what it's comprised of.
  These are the illegal aliens. This chart says 6 million. Mine said 
5.2 million. Then you have those that are here in the country legally 
that the law bars from benefits. That's the 5-year bar. It's a matter 
of solid Federal practice. They add up to 10 million--10.2 million, 
actually.
  Then you have those who earn more than $75,000 a year. That's about 9 
million people. And, presumably, they could write a check and buy 
themselves at least catastrophic insurance. They are not in a position 
where we need to tax somebody that makes less to take care of those 
people that are making more.
  Then you go on down the line. Those that are eligible for government 
programs; that number is actually 9.7 million. Most of that is people 
that qualify for Medicaid but don't bother to sign up. And then you 
have those that are eligible for employer insurance, roughly 6 million 
people, that either opt out or don't opt in to their employer-offered 
plan.
  So once you add up all of these people and you subtract these numbers 
that I believe are not the target of this dialogue and rhetoric or the 
bill, you end up with 12.1 million Americans that don't have affordable 
options. That's less than 4 percent of the population.
  This is what it looks like, Mr. Speaker. This is the entire 
population of the United States here, 306 million people, maybe 307 
million by now, and these are the categories that I have mentioned: 
illegals/immigrants; those with $75,000 a year; those that qualify for, 
generally, Medicaid; those under an employer's plan. But over here, 
this little sliver in red, those are the Americans without affordable 
options. Less than 4 percent; 12.1 million people.
  All of the rest of these people, not only are they insured, but 
they're happy with what we have.
  Mr. AKIN. So what we're doing, gentleman, is we're saying we're going 
to scrap the whole system, have the government take it over, because of 
that little 4 percent thing. I came from the engineering world, and 
there's one thing about solving a problem. There's another one to have 
a solution to just try to force your solution on something that doesn't 
make sense.
  It appears to me that the solution is we want the government to run 
everything. We want the government running health care, so we're going 
to force a government solution just because of that little red--that 
isn't even a decent piece of pie. You couldn't even gain any weight on 
that amount.
  Mr. KING of Iowa. A tiny little sliver. Even though 12.1 million 
people are a lot of people, they're still a small percentage of the 
American population. And to upset a hundred percent of the health 
insurance industry, perhaps destroy a hundred percent of the health 
insurance industry and change the delivery system for the best health 
care delivery system in the world, all of that--this is an excuse for a 
government takeover. It's not a reason.
  And if there's anything that my father taught me, he said, you know, 
Son, there's a difference between reasons and excuses. And I'm you're 
dad and I will tell you I know the difference. And I don't have to 
explain it to you. I will just label them as such.
  Well, this is an excuse, and I will label it as such. It's not a 
reason, not a reason to upset the entire industry, but an excuse 
because the people on this side of the aisle believe in Big Government. 
They don't believe in the American people, and they are sapping our 
vitality.
  Mr. AKIN. Gentleman, the truth of the matter is we're not standing 
here defending everything about the American health care system. 
There's things that need to be changed, and we've talked about those 
things. You have mentioned on the floor that tort reform has to be a 
big part of it because tort reform is just using up a whole lot of 
money that doesn't need to be spent, which could be spent on good 
medicine. So that's one item.
  But there's some other things that I think almost any American, if 
you heard about it, would say, Oh, yeah, that's right. For instance, 
there are some people in America who get to buy their health insurance 
using pretax dollars; whereas, small business men and self-insured 
people have to use the money they pay after they've paid taxes on the 
money.
  So that's not just justice. People are not equal before the law. We 
say we're a Nation of laws, but that's not a just solution. What we 
should do is that everybody should use the same equation. I think you 
and I would agree that we just pay for health insurance with pretax 
dollars. That would be making everybody consistent.
  There's a second thing that we could do. Another thing is the idea of 
a medical savings account. You could allow people with pretax dollars 
to set money aside. They could use that money to buy health insurance 
or to pay medical bills. And if they don't use it, they can keep it 
earning interest in an uninsured account. If they up and die, they can 
pass it on to their kids. That makes sense, too. That allows us to 
allow Americans having their own money, buying health care, and that 
equation starts to get people to shop for prices. So that's another 
good idea. And there are quite a number of other ones that we've 
proposed.
  You mentioned another one which makes a whole lot of sense. People 
say, Oh, well, you're trying to help the big insurance companies. No. 
What we

[[Page 23359]]

want is reasonable competition. And that idea of being able to shop for 
health insurance across State lines is a very effective and competitive 
mechanism, because if one State has got laws that allow the insurance 
to be purchased at a lower price, then why can't a citizen, 
particularly where we have a big metropolitan area that bridges two 
different areas, get their health insurance from places less expensive?
  So there's another idea that's been proposed. And there are other 
ones. I don't want to run too long on your time, gentlemen, but there 
are a number of things that we can do to make medicine better in our 
country.
  Let me tell you. You know who votes with their feet? You get some 
sheik in Bahrain or some other place or some other part of the world 
that's loaded with millions of dollars and they get sick, guess where 
they come to get their medical care? They come to the good old USA. 
That's because our medical system is not bad. It's producing very good 
results. It's just that there's a lot of cost shifting going on.
  Here's an idea, gentlemen. I just toss this out for you to think 
about it. Somebody summarized, if there is a problem with American 
health care, the problem is this: that is that one-third of Americans 
are paying nothing for it and the other two-thirds are paying for it, 
and that that cost shift is the problem, that one-third are paying 
nothing. And that's part of what's causing our cost shift problem.
  I'd yield.
  Mr. KING of Iowa. Reclaiming, I thank the gentleman from Missouri. 
Initially, I put this concept out here, Mr. Speaker, that the 
circumstances that are going on this way are that for a long time those 
that are in the income-earning and productive years of their lives have 
been paying for the health insurance, the health care of those that are 
retired. We've decided to do that. It's a matter of public policy. And 
I don't hear an objection on the part of the people that are paying 
their taxes on their payroll to support Medicare. In fact, I don't hear 
a complaint very much on the funding that goes into Medicaid at the 
lower-income side. And, generally, the younger people are beneficiaries 
of Medicaid.
  So you have on the low-income side Medicaid funded by the working, 
producing, tax-paying Americans, and on the senior citizen side you 
have Medicare funded by the working, producing, tax-paying citizens. 
But in the middle, those working, producing, tax-paying citizens today 
at least have the freedom to choose a policy of their choice, buy a 
policy of their choice or not buy a policy of their choice. And this 
bill, H.R. 3200, takes that away.
  And the subliminal message that I have not heard articulated that 
seems to be viscerally understood is that the people that are paying 
for Medicaid and Medicare out of their paycheck because they're going 
to work every day and managing and planning, now the government is 
saying, You no longer have the freedom to choose your own. You have to 
pay for everybody else's. You've been doing that a long time, but now 
we want to take away your right to buy your own health insurance 
policy. And that sticks in the craw of the American people because it 
diminishes freedom.
  Mr. AKIN. That strikes me a little bit as, first of all, you run over 
them with a car and then back over them to say you're sorry. I mean, 
you're getting them coming and going.
  First of all, they're doing what we would say is the right thing as a 
responsible citizen--having a job, buying health insurance, and trying 
to take care of their own bills--and now you're going to tax them for 
doing the very thing that you wanted them to do in the first place.
  There's a basic rule of economics, and that is what you tax, you get 
less of, and what you pay for, you get more of. The more people you pay 
for free medical care, you're going to get more and more people signed 
up for it. And the more you tax people who are working and paying for 
their own health care, you're going to get less of it. So why in the 
world would we want to adopt a policy like that?
  The interesting thing is, gentleman, this proposal, the Pelosi health 
care proposal, in spite of the fact that a lot of major media is 
pushing it and the President is pushing it and all kinds of people like 
that are pushing it, the American public is not buying this thing. And 
I was just kind of thinking in my mind, Who would be against this? Why 
is it that the polling data shows that this is not popular with the 
American public? And I'm thinking, well, it's almost like politics, in 
a way.

                              {time}  1715

  How many groups of people does this Pelosi plan antagonize? Well, 
let's see. First of all, if you're on Medicare, you're going to take 
$500 billion out of Medicare. Well, the people who are on Medicare are 
thinking, I don't want you to take $500 million out of the place where 
I'm getting my health. So the older people--who are pretty regular 
voters, by the way--they don't like this thing.
  Well, then you've got other people. Gentleman, you were a successful 
owner of a small business. Well, the small business guys are going to 
get soaked to have to pay for this plan, so they're not too enthused 
about it. Then you have some other people. They call themselves pro-
lifers. They don't like this plan very well either because there was an 
amendment offered in committee making it clear that we weren't going to 
use this government socialized money to pay for free abortions. That 
amendment was defeated in committee. It is very clear that this money 
is going to go for abortions, and that's why National Right to Life 
says, This is the biggest threat in the pro-life area since Roe v. 
Wade.
  So the pro-life people don't like this, small business people don't 
like it, older people don't like it. Then you have got the 100 million 
people that have their insurance, doctors that they like and a system 
that's giving them good health care, and basically you're creating 
something that's going to destroy that, and they're going to have to 
change to a government system within some number of years, so they're 
not liking this.
  After you start adding those people together, it starts to make sense 
why people don't like this. And particularly, most Americans at a 
fundamental level understand that good health care has to start with a 
patient-doctor relationship. It has to start with the doctor and the 
patient deciding what is the right health care alternative. We don't 
like it when some big insurance company sticks their nose in that 
relationship, and we like it a whole lot less when it's going to be a 
government bureaucrat.
  Mr. KING of Iowa. Reclaiming again, I completely agree. As I'm 
listening to the gentleman from Missouri, the engineer who sees things 
in black and white and finite formulas that work out or else they can 
be checked and balanced, a logical approach is, let me say, that's the 
engineering approach. As I'm listening to this, it's triggering in my 
memory some of the things about what it was like to start and run a 
business for 28 years and what the motivations are. Now my business, a 
construction business, seasonal business. I looked at it, and I look at 
it from this concept: I wanted to have people that I could rely on. I 
wanted it to be a career. So I set things up where we would keep people 
on all year long, even though it was a seasonal business. And when 
things freeze up in Iowa, and it gets cold, there is frost and the 
temperatures go down, we move people into the shop where we would 
rebuild our equipment.
  Sometimes we would take on some custom work, fixing somebody else's, 
but we kept them around. I kept people around 12 months out of the 
year. I want them to have a health care package. I want them to have a 
retirement plan. I want them to have a vacation plan. That's all fine 
when you pay the payroll, but when the government interferes--for 
example, the unemployment tax, and if they would offer unemployment 
benefits and sometimes they gave unemployment benefits to somebody that 
just didn't want to work. But it was sometimes impossible for me to 
fight it.
  So even though I had my reading at zero, if you're not willing to 
fight that,

[[Page 23360]]

many others would see it go up to 9 percent, and they'd pay the percent 
of their payroll to unemployment because government regulation had 
decided they knew better than the marketplace. As I said, the year-
round work part of this, keep people working year round. Well, the 
incentive is, if you're going to pay unemployment at the top rate 
anyway, you might as well lay people off rather than keep them working 
when you don't really need them. So instead, they become piecemeal 
workers rather than career employees.
  Then the Federal Government decided, you shall pay union scale, 
Davis-Bacon wage scale, and we'll decide what those categories are. Now 
you have people jockeying for a position, undermining the efficiencies, 
and the Federal Government looking over your shoulder, telling you how 
to run your business. All of that still has created inefficiencies by 
government regulation that bring about the illogical, irrational 
business decisions until you consider the government regulation. Then 
it becomes rational within those rules.
  To throw this health care thing on top of it, employers that have 
capitulated and decided they're going to use people as piecemeal 
workers rather than career employees because of too much regulation, 
they're going to also decide, I'm not going to pay this health 
insurance. I am just going to pay the premium. I'm going to add it on 
to the price of the work I'm doing, and it undermines the relationship 
between employers and employees. That's a component of all this.
  I wanted to throw out before our time ticks down, in what I believe 
is about 6 minutes, a little subtle segue, Mr. Akin. I think most of 
America should know what this little subtle segue is. This is a 
pervasive influence of the corrupt criminal enterprise ACORN. ACORN has 
developed since 1970, 39 years, to be this insidious operation of now, 
according to a Government Reform report issued by Mr. Issa of 
California on July 23, 361 affiliations, affiliations that have been 
engaged in shaking down lenders across this country in 120 cities.
  Put this in your mind, Mr. Speaker. This of Chicago, Chicago 
politics, Chicago hardball politics. The make-a-deal--this is 
shakedown. The head of ACORN who recruited President Obama and is proud 
of their relationship has bragged about going into lenders' offices and 
shoving the banker's desk over against the wall and surrounding him 
with ACORN people and intimidating that lender into making bad loans in 
bad neighborhoods.
  Mr. AKIN. You know, you talked about a lot of corrupt and illegal 
practices, gentleman. And when I think of ACORN, maybe as an engineer, 
I'm thinking cause and effect. ACORN is more closely associated with 
the central nerve center and hub of what created the housing crisis and 
the housing bubble in America. They're the ones that basically started 
all of these bad loans which Wall Street then lied about, saying that 
they were good loans, packaged them up and sold them all over the 
world, creating the current economic crisis. So if you want to look at 
the epicenter of what created, for many of us who lost 30, 40 percent 
of our life savings in this economic mess, you're looking at the symbol 
of that ACORN. I'm glad you've got a line through it because we don't 
owe them any favors.
  Mr. KING of Iowa. These are the people that are undermining American 
freedom more aggressively than any other. They're in many, many walks 
of life. Their influence is pervasive. They are at the core of the 
mortgage meltdown crisis. The intimidation factors, the shakedown in 
the cities of the lenders and at the same time the lobbying effort 
where they spent millions in this Congress to push to lower the 
underwriting standards on the secondary market of Freddie Mac and 
Fannie Mae. The chairman of the Finance Committee, Mr. Frank, has been 
engaged in lowering and fighting off the increased capitalization 
requirements of Freddie Mac and Fannie Mae, and that was lobbied by 
ACORN. If you look back through the financial crisis in the community 
level, it is ACORN at the core of that. The President of the United 
States has been at the beginning of this. His entire political career 
he has been part and parcel, tied to ACORN, and he has said so, and the 
videotape is available.
  Mr. AKIN. The interesting thing is, our judicial system should be 
punishing lawbreakers, and yet what we saw just a few weeks ago was a 
couple of courageous--I don't know if they were college students--some 
gal with some pretty legs going in with a hidden camera at ACORN and 
getting all of the financial information necessary and the legal 
information, how they could set up a house of ill repute, bring in 
underage illegals to work, to write them off as dependents so that the 
taxpayer is paying some of the tab so that this guy could run for 
Congress because he started this illegal brothel.
  This whole thing is on tape, and yet we've got the Justice Department 
and all of these institutions of law in America that should have been 
cracking down on this organization; instead, you've got a couple of 
courageous kids that are barely out of college, taking some videos and 
capturing the attention and building the rage of the American public. 
It is just mind-boggling that our government is so inefficient and so 
unable to stop this organization that passed out money like it was 
water down here in Washington, D.C.
  Mr. KING of Iowa. The crimes that they were promoting and supporting 
in those five major cities, Baltimore, Washington, D.C., Brooklyn, San 
Bernardino, California, and San Diego, California. All of that at an 
organization, and the President claims that he is not paying attention 
to this. I will submit, he knows who Joe Wilson is. He knew who 
Professor Gates was. He got involved in Officer Crowley's law 
enforcement up near Harvard, but he says he doesn't know what's going 
on in ACORN, even though I have seen the videotape of the President 
speaking to ACORN, telling them, We walk this walk together. ACORN was 
involved in promoting a whole series of crimes within these five 
cities, including: promotion of child prostitution; illegal 
immigration; violations of the Mann Act; helping to facilitate 
mortgages for a house of ill repute and telling them how to avoid 
taxes, report only 10 cents on the dollar and then qualify for the 
earned income tax credit, tapping money out of the taxpayer; and the 
child care tax credit for little children prostitutes.
  And were these mothers that were sitting behind the desk at ACORN 
when we saw the face of them? I heard children playing in the 
background. They're recruiting girls to be prostitutes while girls are 
being raised in the background. Those things happened, and there are 
some similarities in five cities across America. And that's not the 
full spectrum. The voter-registration fraud, the voter election fraud. 
Today in the State of Nevada, ACORN, as an entity, is under prosecution 
right now. The trial is going on right now about ACORN's fraudulent 
voter registrations, and Troy, New York, fraudulent votes--Mr. Speaker, 
this has got to stop.

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