[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[House]
[Pages 26207-26208]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      HEALTH CARE AND TRANSPARENCY

  (Mr. BURGESS asked and was given permission to address the House for 
1 minute and to revise and extend his remarks.)
  Mr. BURGESS. Madam Speaker, on January 31, 2008, during the 
Democratic Presidential primary, President Obama said during the 
campaign, ``That's what I will do in bringing all parties together, not 
negotiating behind closed doors, but bringing all parties together, and 
broadcasting these negotiations on C-SPAN so that the American people 
can see what the choices are because part of what we have to do is 
enlist the American people in this process.''
  Not negotiating behind closed doors.
  It has now been over 5 months since the White House announced 
numerous deals with major stakeholders in the health care debate. 
Little to no details of these negotiations have been released by the 
White House. Despite the assertion of then-candidate Obama's promise to 
make all health care reform negotiations public, we have very few 
details on exactly what was agreed to in this highly publicized, yet 
guardedly secret, negotiations.
  How can the United States Congress be diligent in creating the policy 
before us without these crucial details surrounding these deals? We 
must learn what the negotiations mean for the millions of concerned 
Americans.

                                     House of Representatives,

                               Washington, DC, September 30, 2009.
     President Barack Obama,
     The White House,
     Washington, DC
       Dear Mr. President, I write you once again on the topic of 
     health care reform. As you know, Democrat leaders in the 
     House of Representatives are currently working to merge the 
     three committee bills. Meanwhile, the two Senate products are 
     waiting to be merged pending completion of the Senate Finance 
     Committee's mark-up.
       I have closely followed the health care debate for months, 
     making note of actions by all parties involved, including the 
     House, Senate, White House, advocate groups, and the health 
     care industry. These reforms have wide-reaching implications, 
     and you have stressed the importance of conducting business 
     in public so that the American people are aware and involved 
     in the process.

[[Page 26208]]

       In fact, during a Democratic Presidential primary debate on 
     January 31, 2008, you said: ``That's what I will do in 
     bringing all parties together, not negotiating behind closed 
     doors, but bringing all parties together, and broadcasting 
     those negotiations on C-SPAN so that the American people can 
     see what the choices are, because part of what we have to do 
     is enlist the American people in this process.''
       It has now been over four months since the White House 
     announced numerous deals with major stakeholders in the 
     health care debate to save upwards of $2 trillion in the 
     health care system. Little to no details regarding the 
     negotiations have been released, and recent actions and press 
     reports have reminded me of the importance of openness and 
     transparency throughout the legislative process.
       Roll Call reports today that negotiators working in the 
     House to merge the three committee bills plan to trim the 
     cost of the legislation by roughly $200 billion. I wonder 
     what programs or services are being cut, who will be 
     affected, and how these cuts are being decided.
       In the Senate Finance Committee's mark-up, Senator Bill 
     Nelson (D-Fl) introduced an amendment regarding drug prices 
     in Medicare and Medicaid. During the debate on the amendment, 
     Senator Tom Carper (D-Del), while arguing against the 
     amendment, said ``Whether you like PhRMA or not, we have a 
     deal,'' referring to the deal PhRMA cut with the White House 
     earlier this year.
       In addition, within the Senate Finance Committee plan is a 
     commission to slow the growth of Medicare spending, most 
     likely through changes to reimbursement policy. However, 
     hospitals would be exempt from this commission because, 
     according to CongressDaily, ``they already negotiated a cost 
     cutting agreement'' with the White House.
       Despite your promise to make all health care reform 
     negotiations in public, we still have very few details on 
     what exactly was agreed to during these highly publicized 
     negotiations. In fact, even the stakeholders involved have, 
     at times, seemed at odds with what was actually agreed to. 
     But the one thing we all know is that, through press 
     statements, many deals were made. Unfortunately, even where 
     brief descriptions of policy goals are available, details on 
     achieving these goals are absent, a point made by the 
     Congressional Budget Office (CBO).
       I am compelled to ask--how could Congress have done its due 
     diligence in creating the policy before us without crucial 
     details surrounding these deals? Were the votes we have seen 
     in the Senate Finance Committee as of late a direct result of 
     these backroom negotiations? Will CBO be able to actually 
     score any of these deals to apply those cost savings to 
     legislation? Were these negotiations in the best interests of 
     patients?
       Having little to no information, I cannot judge. However, 
     this begs even more questions. Is Congress enacting the best 
     policy reforms for Americans, or are certain changes being 
     made or not made because of the negotiations orchestrated by 
     the White House? Will smaller stakeholders suffer more from 
     our policy choices because of what larger groups may have 
     negotiated behind closed doors?
       Mr. President, I do not write this letter to chide you for 
     engaging in what I consider the most pressing debate before 
     Congress. I applaud you for your leadership in compelling 
     Congress to act. In order to fully understand the policy 
     choices before us, though, we need to know what took place 
     earlier this year during these meetings at the White House. 
     You have made it very clear that you value transparency and 
     have sought to make your Administration stand out in this 
     regard. As a member of the House Energy and Commerce 
     Committee's subcommittee on Oversight and Investigations, so 
     do I. The last thing I would want to see is a formal 
     investigation of these meetings.
       Thus, I formally request full disclosure by the White House 
     in the following areas regarding all meetings with health 
     care stakeholders occurring earlier this year on the topic of 
     securing an agreement on health reform legislation, efforts 
     to pay for any such legislation, and undertakings to bend the 
     out year cost curve:
       1. A list of all agreements entered into, in writing or in 
     principle, between any and all individuals associated with 
     the White House and any and all individuals, groups, 
     associations, companies or entities who are stakeholders in 
     health care reform, as well as the nature, sum and substance 
     of the agreements; and,
       2. The name of any and all individuals associated with the 
     White House who participated in the decision-making process 
     during these negotiations, and the names, dates and titles of 
     meetings they participated in regarding negotiations with the 
     aforementioned entities in question one; and,
       3. The names of any and all individuals, groups, 
     associations, companies or entities who requested a meeting 
     with the White House regarding health care reform who were 
     denied a meeting.
       In our efforts to improve access to health care services, 
     the American people expect us to act in their best interests, 
     rather than protecting business interests of those who are 
     interested in currying favor in Washington, DC. If these 
     health related stakeholders have made concessions to 
     Washington politicians without asking anything in exchange 
     for the patients they serve, Congress and, more importantly, 
     the American public deserve to know. Conversely, if they 
     sought out protections for industry-specific policies, we 
     need to know that as well.
       We must learn what these negotiations mean for the millions 
     of concerned Americans. How they will be better served, 
     including having affordable health coverage and access to the 
     providers they need? These negotiations may have produced 
     consensus on policy changes that are proper and needed, but 
     Congress will never know for sure that we are acting in our 
     constituents' best interests until all the facts are known.
       I look forward to the opportunity to speak with you at your 
     earliest convenience on this matter. Should your staff have 
     any questions about this request please contact me or my 
     Legislative Director J.P. Paluskiewicz at my Washington, D.C. 
     office.
           Sincerely,
                                         Michael C. Burgess, M.D.,
     Member of Congress.

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