[Congressional Record (Bound Edition), Volume 156 (2010), Part 1]
[House]
[Pages 137-144]
[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 Texas (Mr. Neugebauer) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. NEUGEBAUER. Mr. Speaker, we are clearly in a technical revolution 
in our country. People now have more information available to them than 
literally at any other time in probably the history of our country. 
They know more about what is going on in their government than they 
ever have before. I think that is one of the reasons we are seeing 
people all across America rise up and start to make such bold 
statements and attending these TEA parties and attending these Members 
that are having meetings in their districts, and they are coming in 
record numbers.
  Back this August, I had an opportunity to have a number of town hall 
meetings in my district, and thousands of people came to voice their 
opposition to what they think is happening to their country, and 
particularly in opposition to this health care bill.
  Every morning, Americans wake up and follow with deep interest public 
policy issues that we are sent here to solve, and many people watch C-
SPAN. I know that when I am back in the district, many people will say, 
Congressman, I saw you on C-SPAN.
  In fact, recently I had a conversation with one of my constituents 
who lives over in Muleshoe, Texas. She was calling to express her great 
concern about what is going on to her country, these huge deficits, 
trillions of dollars of spending money that we don't have, the 
government taking over the health care, and she was concerned about 
what is going on. What I learned, as she spoke more and more, she knew 
a lot about the issues that are facing our country, and she said she 
picked up a lot of that by watching C-SPAN.
  A lot of the viewers that call in to C-SPAN on a daily basis, they'll 
voice their disappointment or concerns about what is going on in their 
country, and they'll say, And thank God for C-SPAN.
  C-SPAN is kind of the watchdog, the eyes and ears, the vehicle that 
enables millions of Americans to see what we are up to here in 
Washington, D.C. Every day, people can view Congress raising their 
taxes, decreasing their freedoms, forcing business owners to pay more 
fines. All of this, thanks to C-SPAN, it is here for millions of 
Americans to see. Except, that is not going to be the case for health 
care reform in our country.
  Mr. Speaker, it is no secret that the majority plans to negotiate the 
final thousand-page health care bill without C-SPAN cameras present.
  President Obama promised when he was running for President that he 
was going to change Washington. He vowed, at least eight times, that 
the American people would get to see the negotiations of the health 
care bill on C-SPAN.
  Speaker Pelosi promised that the Democratic-led Congress would be the 
most transparent Congress in history. She went on to say that the work 
on the health care bill will be displayed transparently, while 
simultaneously, unapologetically, denying C-SPAN cameras access to 
capture the ongoing negotiations.
  In fact, those negotiations have been going on somewhere in this 
building. None of us, very few of us know where, and very few people 
are in the room making decisions that are going to impact the American 
people, not for this generation, but generations to come. All of this 
talk about transparency and openness, yet nobody knows who is actually 
in the room and actually what is happening.
  But we do know what happened when they went into the room, for 
example, in the Senate and other places: Deals were cut. And I think 
one of the problems that this majority has and this White House has is 
they have got a health care bill that is so unpopular that they have to 
meet in secret to talk about it so that they can cut deals so they can 
get enough votes to pass it.
  Wouldn't it be nice if the American people could experience some of 
that transparency that the Speaker and the President of the United 
States promised the American people, that they could be able to see the 
negotiations.
  I had the opportunity to experience what is positive about having 
these negotiations in a public setting when we did the farm bill a 
couple of years ago. We sat down at a table. We had Republicans and we 
had Democrats. The cameras were on. The discussions were frank, they 
were honest, they were open, and in the end, democracy took its place 
and a bill was crafted and it was passed by the House and the Senate.
  I don't understand why we can't have that same transparency and 
openness when we are talking about people's health care. Probably one 
of the most important things to many Americans is the ability for them 
to have some control over their health care. We have now a bill that is 
talking about taking over the government and government taking over the 
health care of our country, yet we are negotiating and debating this 
bill in the darkness of some room somewhere in the Capitol, and who 
knows where.
  Let's turn the lights on to this debate. Let's turn the lights on in 
that room. Let's turn the lights on so that the American people can see 
what is going on as these decisions are being made about their health 
care. It is too important.
  Now, the Democrats are going to say, Yeah, but when the Republicans 
were in charge, that is the way they did things. Well, that sounds like 
kind of a schoolyard taunting contest. But the fact is, that is not the 
truth.
  I want you to remember these dates: July 15, 2003, September 9, 2003, 
November 20, 2003. And you say, Well, what happened then? One of the 
good things about C-SPAN is they have a great library of American 
policy and democracy in action. In fact, it is probably

[[Page 138]]

one of the most extensive ones in the world, and people can come and 
research and see actually what did happen on the floor of the House on 
a particular day.
  And what happened on that day was that Members of Congress met to 
resolve their differences between the House and the Senate version of 
the Medicare reform legislation that provided medical prescription drug 
benefits for Medicare recipients. A very important piece of 
legislation, one that was not without some controversy. The House 
passed a version, the Senate passed a version, and then, in the light 
of day, these two versions were negotiated on these days. The American 
people got to see the discussions that went on and got to see this bill 
being crafted that eventually became law.
  If the Democrats weren't engaging in these backroom deal-making 
deals, I think they wouldn't mind the lights being turned on. But the 
problem is that they are cutting deals. And the reason they are having 
to cut deals is because they are trying to pass a piece of legislation 
that the American people don't embrace.
  Many of us agree that health care needs to be reformed. And my 
colleagues on my side of the aisle, Republicans, conservatives, have 
been offering some commonsense ideas that could reform the current 
system without turning over health care to the government, without 
limiting patients' rights, and bringing more transparency and making 
health care more affordable and available and accessible to the 
American people.
  If the President and the Speaker and the congressional leaders are 
serious about this new era of openness and transparency, then why, Mr. 
Speaker, why, Mr. President, why aren't the lights on and why aren't 
the cameras in the rooms so that the American people can see what is 
going on in their country? I believe they deserve to know.
  This is a very important issue to the American people, and I hope 
that the Speaker and the President of the United States will keep their 
word and allow the lights to be turned on for this important issue.
  It is now my pleasure to recognize the gentleman from Pennsylvania 
(Mr. Thompson).
  Mr. THOMPSON of Pennsylvania. I thank my good friend from Texas for 
leading this very important Special Order tonight and for yielding.
  Transparency and accountability is such an important part of what we 
need in government. And what I have seen since my election a little 
over a year ago and when I came to Congress in January of 2009, and 
especially on every issue, we should have that type of transparency 
that we are talking about today. In particular, today we are talking 
about health care.
  There are probably few issues that we can deal with as a country and 
that we can debate and discuss as intimate to our lives as health care. 
It touches our lives in so many different ways. Plus, it is such a 
significant part of our economy. The issue of health care is just 
central to the American people. And for the type of debate--and I use 
that actually cautiously, that word ``debate,'' because there really 
hasn't been allowed an avenue of debate.
  I thought when I came to Congress I had a responsibility to represent 
the people that I now work for. When I worked in health care, and I did 
that for 28 years, I only had one boss. It changed from time to time. 
Today, I feel a responsibility that I work for 660,000 really smart 
people, and that is the citizens that live and work in the Fifth 
Congressional District of Pennsylvania. I came here with a 
responsibility to represent their needs in the Federal Government, in 
Congress, in this Chamber, and yet from day one have been locked out of 
some of the most important debates that we could be having, that 
surrounding health care.

                              {time}  1745

  Now I came with some expertise--almost 30 years of serving 
individuals facing life-changing disease and disability. I happen to 
believe we have a pretty good health care system, but that we could 
improve upon it. That the four dimensions of health care that I've 
dedicated my life as a health care professional working on were 
increasing access, decreasing costs, improving quality, and 
strengthening that decisionmaking relationship between the patient and 
the physician--not having a bureaucrat or the government coming between 
the two.
  I looked forward to that debate. I was pleased when President Obama 
said that we're going to work on health care. When he said that, I took 
him at his word. I thought that meant I would be invited to the table. 
And that is not the case. That has not happened. I actually happen to 
serve on one of the committees of jurisdiction, the House Education and 
Labor Committee. The only time I had a chance to even look at that bill 
was when I was asked to mark it up. When you do bill markup, the bill 
has been written. That's where you come in and you make the final 
substantiative changes and you offer amendments. And we did that as 
members of the Republican Caucus and the House Education and Labor, as 
did Ways and Means, as did Energy and Commerce. We made amendments in 
the twelfth hour of that bill's proposal. It had already been written. 
It had been written behind closed doors. It really was a backroom deal. 
And all of our amendments were rejected. What minute input we had was 
rejected.
  As I reflect back and I remember 2008, that Presidential campaign 
year, and well over a half a dozen, eight or nine times, who was then 
candidate, now President Obama, saying--and it was his idea. He was 
going to have C-SPAN broadcast the health care negotiations. We were 
going to provide that type of transparency. Eight or nine times. The 
documentation is out there. I have watched the video replayed in the 
national media over the past number of weeks. Yet, despite that, that's 
not what has happened.
  Today, what passed out of the House and passed out of the Senate were 
written in the Democratic leadership Chambers, both the House and 
Senate, respectively. Today, we're not even having--not following due 
process and having a conference committee. This is done over the 
telephone today, I guess. That means that Members of Congress, I guess, 
will be telecommuting. Next, we won't need to come to Washington 
because it looks like it's not a democracy or a constitutional 
Republic. Maybe it's a dictatorship. Just a handful of chosen leaders 
at the top dictate what is probably the most important piece of 
legislation that we could deal with in terms of health care.
  Now I'm real proud to have signed on, as my colleagues have, a 
sunshine resolution by Congressman Buchanan from Florida that calls for 
transparency. I believe there's 151 signatures, cosponsors. It's 
bipartisan on that bill. It's calling for full transparency when it 
comes to health care. As of today, we've started working on a discharge 
petition--a measure that we find is not used very often on this floor. 
Unfortunately, it does not appear that Madam Speaker is going to bring 
Mr. Buchanan's bill to the floor to allow the Members of Congress to 
have an up-or-down vote on whether we want transparency or the American 
people deserve transparency. I certainly believe they do.
  So this discharge petition is a new tool. If we're able to garner 218 
signatures, it forces that issue to the floor, of transparency. So I 
certainly encourage all of my colleagues. I'm very confident that we've 
got unanimous support on this side of the aisle, and we certainly 
encourage all my colleagues on the other side of the aisle to sign that 
discharge petition. The American people deserve to have at least an up-
or-down vote on transparency when it comes to an issue that is as 
significant as health care.
  Now I do believe that we're probably going to see some type of health 
care bill that will be back in this Chamber. I suspect, unfortunately, 
that may happen by the State of the Union address. I happen to believe 
the President's looking for something like that to speak about as a 
topic. Unfortunately, imposing that type of an artificial timeframe to 
continue to compress and to force this through--the American people 
deserve better. They deserve full

[[Page 139]]

debate and full time scheduled for developing this legislation.
  I happen to have significant concerns as a health care professional 
with almost 30 years of experience, tremendous concern, as I look at 
this bill. I look at cost. The idea behind health care reform was to 
bring down the cost of health care. What is being proposed in either 
the House or Senate version doesn't do that. It drives cost up for the 
average American. One estimate I saw was at least a $300 increase in 
health insurance premiums per individual, $2,100 per family. That's for 
the average American, driving those costs up. If you happen to be an 
individual who sacrificed on salary because you wanted more health care 
benefits from your employer, well, those more than likely will qualify 
as a Cadillac health care plan. You're going to get taxed 40 percent. 
Forty percent is what that health care bill is going to be increased. I 
don't know many employers that can afford to absorb all that.
  That's also going to fall back on the true economic engines of this 
country, which is our small businesses, but also it's going to fall 
back on employees, individual workers, to make up--to pay that bill.
  Mr. NEUGEBAUER. Would the gentleman yield?
  Mr. THOMPSON of Pennsylvania. I certainly will.
  Mr. NEUGEBAUER. The interesting thing, again, about this not being 
done in the daylight is now we're hearing that the unions have gone 
over and sat down and cut a deal that if the Cadillac insurance plan 
was negotiated by labor contract, they're going to be exempted. So the 
question is that that burden then is going to be transferred more and 
more and more to families that didn't have a health care plan 
negotiated by a union. Again, that's the reason, I think, as the 
gentleman stated, we need to be doing this in the light of day, because 
the American people need to see what is going on here. And, quite 
honestly, what is going on isn't necessarily in everybody's best 
interest.
  I yield back to the gentleman.
  Mr. THOMPSON of Pennsylvania. I thank the gentleman for that. It 
strikes me that perhaps we need to bring in a facilitator, given the 
spirit of the Democratic leaders, and perhaps we could see if Monty 
Hall--I don't know if he's still alive or not; if he is, perhaps the 
old game show host from ``Let's Make a Deal''--because that seems to 
be, as I follow this, and obviously it's what's reported in the media 
and what the Democratic Caucus reports, there's a lot of dealmaking, 
whether it's a hospital I believe in Connecticut, one hospital being 
purchased, helped to secure votes; whether it's Nebraska getting an 
exemption on any future medical assistance increase. Even the 
Democratic Governor of Tennessee, I love what he called that. I've 
never met the man, but I have a lot of respect for how candid he is. He 
called that ``the mother of all unfunded mandates,'' what it does with 
medical assistance.
  I know in Pennsylvania our medical assistance bill, over 10 years, 
medical assistance is expected to go up, under these Democratic 
leadership health care bills, $2.4 billion. We were in a financial 
meltdown as a State this past year. We went 6 months without a budget 
because those folks who were serving in the State legislature, the 
Governor, they couldn't balance the books. They couldn't get the 
revenue to match expenses. And now we've got this unfunded mandate 
coming out of $2.4 billion for the Keystone State. Now that was before, 
I think, the Nebraska sweetheart deal was made. So I'd be curious to 
know what portion of paying for Nebraska do the Pennsylvania taxpayers 
have to make up, because every other taxpayer in America is going to 
have to make up for the sweetheart deals that are made.
  I thank the gentleman, and I'll yield back at this point.
  Mr. NEUGEBAUER. Well, I thank the gentleman. One of the things the 
gentleman brought up, I think the American taxpayers didn't get the 
benefit, as someone who, I think you said, someone with over 30 years 
as a health care professional and, as you know, in the Congress we 
have, particularly on our side, we have a number of physicians that 
have worked in health care, have dealt with Medicaid and dealt with 
Medicare, have seen the private payment system, all of the existing 
systems, and bring a huge amount of knowledge to this process, but 
unfortunately the American people didn't get the benefit from their 
knowledge, your knowledge. And, quite honestly, it's a shame.
  As you said, you have 660,000 customers. Every Member of Congress has 
about 660,000 people that are looking to them to come up here and have 
serious discussion, serious debate, and work on things that are good 
for the American people. It's not good for the American people when 
very few people sit down and make a decision about something that's 
going to impact not only my 660,000 people, but yours and the other 
gentleman from Ohio. This is serious policy.
  It's now my pleasure to recognize the gentleman from Ohio, Mr. Latta.
  Mr. LATTA. Well, I thank the gentleman for yielding. I really 
appreciate him hosting this Special Order late this afternoon. I think 
it's very, very important that the American people absolutely know 
what's going on here. As we all were home over the Christmas holidays, 
I know that I had a lot of events that I had to attend. I don't care if 
I spoke at a Chamber of Commerce or a Rotary, you name it, people were 
very, very concerned with what's going on in this Chamber. They're 
worried about a lot of things. They're worried about the health care 
that's been passed by this House, they're worried about jobs, they're 
worried about the cap-and-tax legislation, they're worried about the 
EPA and other mandates that are being forced down their throats. But I 
think it's important probably to start off talking about the health 
care a little bit here.
  I don't think there's anybody in this Chamber, there's not one person 
in this country that would say that we shouldn't do something about 
having some meaningful debate on health care in this country. But when 
we're looking at it, what we've seen happening is we've seen, as has 
been mentioned by my colleagues from Texas and also from Pennsylvania, 
it's been a one-way street. And the American people don't care for 
that. They want an open debate, and they want to make sure that they 
know what's going on.
  But as we're talking about this health care, I think it's important 
that we also hear what the people back home are saying. When I'm home--
I represent the largest manufacturing district in the State of Ohio. I 
also represent the largest agricultural district in the State of Ohio. 
In 2008, I represented the ninth-largest manufacturing district in 
Congress. Because of what's happening in this economy, I've dropped to 
15. And I don't even want to know when the next numbers come out to 
find out where the Fifth Congressional District is located in that long 
list.
  But when I go out and go to the different factories and go to the 
small businesses, and I really want know what is going on, that's the 
best way I can gauge what is going on in the economy. When I'm out 
there--one visit to one factory in particular sticks with me. A 
gentleman came up to me who was a press operator. He came up and said, 
I really don't understand what you guys are doing in Washington. And he 
said, You know, you all talk about health care. If I can't put a roof 
over my family's head, if I can't put food on that table, why do I care 
about health care right now? I worry about jobs, and I worry about my 
job.
  And I think that that's something that has been lost in this. I know 
one of our colleagues from the Senate recently said that maybe in the 
past year that the Congress here should be really concentrating on not 
health care but on job creation. Because let's just talk about these 
jobs and what's happening out there, not just from that individual that 
works on that factory floor, but just an individual like everybody you 
know that might work in a factory across this country.
  But also I remember walking and being in one of my small business 
owner stores in the district, and after I

[[Page 140]]

was in the store and I bought some things, I was walking out and he 
said, Can I talk to you for a little bit? We stood out, and it was 
pretty darn cold that afternoon, but we stood outside for a good long 
period of time. He said, Let me tell you something. If you all pass 
this health care legislation, I'm out of business. He said, There's no 
way. He said, Even though your bill was over 1,000 pages long, and I 
know that the Senate bill is going to be several thousand pages--a 
couple thousand pages long--he said, What I've been able to get out of 
it and figure out in the newspaper, I won't be able to stay in 
business. He said, Look around here. Look at the people running the 
cash register, stocking the store in here. They're all going to be 
without a job. And it's going to be one more store on Main Street USA 
that's going to be vacant. And we can't have that happen.
  I think that what we need to do in this body is really go out and 
talk to these individuals. I have advocated what we need to do is 
instead of trying to do a few hearings down here--and I don't think we 
had enough hearings when we talked about health care and during this 
debate--I think what we should have done is taken these hearings across 
America. And we wouldn't have done anything but help the American 
people to, first of all, have their say in what is going on, and two, 
that the Members of this body would be able to hear it directly from 
the American people.

                              {time}  1800

  I know when I served in the Ohio Legislature for 11 years--you know, 
when you're representing the State of Ohio, it's not that large of a 
State, and many times we would have all of our hearings in Columbus. 
But many times, we would take our hearings out across what we called 
the four quadrants of the State and hold hearings in different areas. 
And that's so that people can actually come nearby to where they live. 
They didn't have to drive down to the State capitol.
  I think that's what we should have done with this whole debate on 
health care. Let's bring these hearings to the American people, and let 
them have their say. That is where we are going to find out what they 
are going to have to say about this. That is where we are going to find 
these things out.
  When you're talking about jobs killers--you know, with the model that 
was being advocated by Ms. Romer, we could lose up to 5 million jobs in 
this country. The National Federation of Independent Businesses, just 
from the employer mandate on small businesses across this country, 
they're estimating 1.6 million jobs could be lost. That's on top of the 
millions of jobs that we've lost since the beginning of this recession 
and also the almost 3 million jobs since the beginning of last year 
that have been lost just from the beginning of this administration.
  We can't afford to lose more jobs in this country, because where are 
these people going to go? It's not that hard to remember back to 1982. 
In 1982, during that very tough recession that we can all remember, 
President Carter, during his administration from 1977 up to 1981, 
during the campaign when he was elected, had created what he called the 
misery index. And that misery index took the unemployment rate, the 
inflation rate, and the interest rate. It was toward the end of his 
administration. You know, we saw in this country 21.5 percent interest 
rates. We saw unemployment rates in double digits, and we saw the 
inflation at double digits.
  Well, where we are today, when we look at having over 10 percent 
unemployment in this country, and we're talking about losing millions 
more jobs because of this bill, we can't afford it. When you're talking 
to the small businesses and small factory owners out there about what's 
in this piece of legislation besides all these mandates--but just talk 
about the taxes.
  This was prepared by an analysis done by the Committee on House Ways 
and Means from Ranking Member Dave Camp. Since the increases in 2009, 
just in general, the net taxes that were passed by this House were 
$1.71 trillion. And just the estimate on this health care bill alone, 
they're looking at over $732.5 billion. That's billion dollars.
  And who's going to pay for this? When they're looking at that 5.4 
percent surtax placed on a lot of the small businesses that are the 
ones that create jobs out there and on certain individuals at a certain 
higher level, when you're looking at $460.5 billion in taxes, when 
you're looking at these employer mandates at $135 billion, and you go 
right down the line, this is what's going to kill incentive in this 
country. This is what's going to kill the entrepreneur.
  This is what is going to kill people who will say, Why even get up in 
the morning and try to go out and create jobs? Because one of the 
things that is lost here in Washington and in these Halls of Congress 
is that this body does not create jobs. This body spends the wealth of 
this country.
  You know, the American people are really out there, and they 
understand it. When you look at this, it was mentioned a little bit 
earlier about what is happening with the increases, when you're talking 
on the Senate side about a 40 percent tax on those individuals out 
there with a quote-unquote Cadillac plan. Well, a lot of people say, 
Oh, Cadillac, they must be rich individuals. Well, I'll tell you what, 
in the State of Ohio, we have a lot of auto plants, and when you're 
looking at these auto plants, a lot of these folks are the auto workers 
who are going to end up paying 40 percent on an individual premium or 
will spend $8,500 on their health care plan, a family plan at $23,000. 
When you put these together, it's like, how are they going to pay for 
this as a small family?
  When you take all these costs that are being associated under this 
piece of legislation, it's unfathomable. When we talk about 
unfathomable, I did read the health care bill. I sat down one weekend. 
I think it was 1,028 pages. I read it, tabbed it, underlined it so I 
could really get a good understanding. You are looking at a couple 
thousand pages on the Senate side.
  But I think what is missing in this whole debate is, you know, here 
is what someone gave me not too long ago, the Constitution of the 
United States. But you know, as that little commercial on TV says: But 
wait, there's more. In this little book that's in about 10-point type, 
there's the Constitution, the Convention, the Congressional 
Resolutions, all of the amendments, the Virginia Bill of Rights, the 
Declaration of Independence, the Massachusetts Bill of Rights, the 
Articles of Confederation, the Virginia Statute of Religious Liberty, 
the Annapolis Convention, the Virginia Randolph Plan, the New Jersey or 
Patterson Plan, the Hamilton Plan and The Great Compromise, right 
there. That is America in a nutshell.
  How is it that we end up today putting out thousands of pages that 
people can't comprehend, but America, our government, and how we were 
founded is right there. Put it in your pocket, and read it at any time. 
And I think that's what the American people are very concerned about, 
and I appreciate the gentleman for yielding.
  Mr. NEUGEBAUER. Well, I thank the gentleman for pointing out the 
taxes that are in this bill. I think the bad news is that they're going 
to have to be higher tax because they are disguising, as you know, what 
this bill actually costs. Now the stated cost that the Speaker of the 
House says is this bill costs $891 billion. But if you add the mandated 
cost of the employer-mandating tax, it's another $135 billion. And if 
you add the cost of individual mandate tax for individuals that are 
going to be penalized under this plan, it's another $33 billion. So the 
total cost, the CBO score is $1.06 billion.
  You don't hear the Speaker or the leadership or the President talking 
about this number. Now the other piece is that in the House bill, there 
is no provision for what is being called the ``doc fix.'' Today we have 
reimbursement levels that are being projected to be reduced by a 
substantial level, which is going to cause more and more doctors not to 
see Medicare and Medicaid patients. So this leadership team has 
promised and made a deal with the docs that they will bring a separate 
bill. They don't want to bring it in this one because, why? It cost 
$209 billion.

[[Page 141]]

So now instead of $1.06, you have got a nearly a $1.2 trillion bill.
  Now the other piece is that Medicaid is being transferred to--part of 
this cost is going to be Medicaid which is going to be transferred to 
States, unless you're from Nebraska. What is the cost of that? That's 
$34 billion. Now here is the real sleeper. I hope that the American 
people are watching C-SPAN and the like because the lights are on here, 
and the lights are on this chart. And guess what, this little bill 
collects taxes that the gentleman was talking about for 10 years, but 
it only has expenses for 7 years.
  Now think about all of the businesses and families all across America 
that if you could collect 10 years' worth of salary but you only had to 
pay 7 years' worth of expenses, that's like the first 3 years you don't 
have to make your house payment, you don't have to buy your gasoline, 
you don't have to make your car payment. You just get your paycheck. 
Nothing taken out of it, no Social Security, no withholding. What a 
great deal that would be. Well, that's the way this bill has been put 
together in order to disguise the real cost of this.
  So once the 3-year period passes, then on an annualized basis, this 
bill costs another $727 billion more than what is being represented to 
the American people. So what does that total? $2.1 trillion. So a bill 
that this leadership says is $891 billion--it's not $891 billion. It's 
$2.1 trillion. And at a time in which, as the gentleman was talking 
about, small businesses are struggling to keep their doors open--in my 
district--and I think the gentleman's district as well--small 
businesses play a huge part in creating jobs. Who is going to pay this 
$2.1 trillion? Because the taxes that they're talking about collecting 
only pay for a bill that costs $891 billion, but this bill costs $2.1 
trillion.
  Now here's the other thing that people have looked at: this bill 
mandates, as both of my friends know, mandates that every American have 
health insurance. And in fact, if you don't, there is a penalty for it. 
So one of the things, people say that if the government is requiring to 
you do something to pay for health care or to have health care, and 
there is a penalty for doing it, it becomes a tax or a cost. Some 
people who have kind of calculated what that means for the economy, GDP 
and overall, said maybe that's a $4 trillion number. So possibly what 
we are looking at, if we shed light on this bill, as we should, that 
really the impact of this is that it's a $6 trillion piece of 
legislation.
  Now I don't know about you, but I think the American people think 
that whether it's $2 trillion or $6 trillion or even $891 billion that 
we should have had more debate than we did on this bill. As my 
colleagues will remember on the day that we passed this bill, very 
little debate was--I think one amendment--there was one amendment to a 
$2 trillion--to a $6 trillion bill was allowed.
  These are the kinds of things that cause me to say, Mr. President, we 
have to hit the pause button here because we're talking about something 
that impacts families all across America. We have some numbers here 
that are big. We are now spending money that we don't have. Every 
dollar that the government spends, they have to go out and borrow 
nearly 40 cents of that from people, like in China and Japan; and it is 
not a sustainable thing. Yet now we're talking about more taxes and I 
think potentially bigger deficits because we've not had good 
discussions on this bill.
  Now I will yield some additional time to the gentleman from 
Pennsylvania to reflect on these important issues again.
  Mr. THOMPSON of Pennsylvania. Well, I thank my good friend for 
yielding. I just want to come back. You hit on such an incredible point 
about the individual mandate to purchase health insurance. Now I 
wouldn't consider myself in any way a constitutional scholar. I'm just 
an American and a citizen. But my good friend here has a copy of the 
Constitution. And as I've read in the version of the Constitution that 
I carry around, which is about 28 pages, I think that was put together 
by some really smart people a long time ago that has withstood the test 
of time. And really our Constitution has become a model for other 
countries and emerging countries to base their governing principles on. 
But to the best of my knowledge, I can't recall that there is anything 
in that Constitution that provides a basis for Congress mandating that 
every individual American in this country purchase health insurance.
  I will yield to the gentleman with the pocket Constitution there to 
just see what his thoughts are on that.
  Mr. LATTA. I thank the gentleman for yielding. I think you would be 
very hard pressed to find it. I know that when I went out in my 
district--I know that Members going across their districts, across this 
country have found the same questions being asked, Where does it say 
that? Especially a question, as the gentleman from Texas has mentioned, 
that under this bill that was passed by the House that there was a $2.5 
percent, quote-unquote, fine on individuals, plus that individual 
mandate that you have to have it or civil or criminal penalties could 
be imposed.
  How can we do that? You know, it's unfathomable that this would be 
able to withstand a challenge in court that an individual would be 
forced to have to do this. Again, I think if you just read this little 
document, you are going to be very hard pressed to find it. If I could 
just mention--and also what the gentleman from Texas was talking 
about--what it's going to do to the States. In the Columbus Dispatch, 
there was an article that broke it down for the State of Ohio. We are 
running about an $850 million deficit. And unlike this body, we have to 
balance our books. It is constitutional that we have to make sure that 
we're in balance. So Ohio is out of balance by about $850 million, but 
there was also a story by the Columbus Dispatch, in their calculation, 
that this bill would impose a Medicaid debt upon the State which would 
increase that deficit by another $900 million.
  I think that this is what people need to find out. This is not just 
going to affect small businesses or large businesses or individuals. 
This is going to affect your State government, your local government, 
if they can even function. Because all of a sudden, these mandates are 
going to come down from Washington, and good luck.
  I thank the gentleman for yielding.
  Mr. THOMPSON of Pennsylvania. I appreciate that. In terms of cost, 
much of my professional life was involved in serving older adults. A 
particular section that I find very appalling of what I see in both the 
Democratic House bill and the Democratic Senate bill is what is 
authorized in terms of increasing the cost of individual insurance 
premiums for older adults. Older adults rely on Medicare. I will talk a 
little bit on Medicare in just a second. But they purchase supplemental 
insurance to fill in the gap, to make sure that they don't exhaust 
their life savings that they've accumulated over time. They've earned 
those. They've put those aside so that they can enjoy those retirement 
years and be able to do the things that they've always hoped and 
dreamed about doing. So supplemental insurance serves an important 
purpose there.
  Well, within the House bill, it authorizes, it allows, it codifies 
that insurance premiums for older adults are allowed to double. In the 
Senate bill, it does one step better than that; it allows supplemental 
insurance costs, individual insurance costs for older adults to triple, 
and that's a crime.

                              {time}  1815

  I want to take the next step. I have talked about the four dimensions 
of health care. Now I want to talk about accessibility. If we are doing 
health care reform correctly, we are increasing accessibility. I don't 
think we are. We are making health care less accessible. Part of that 
is through Medicare cuts, half a trillion dollars in Medicare cuts. 
There are a lot of physicians today that do not accept medical 
assistance patients or Medicare patients today, and it is all 
economics. Medical assistance pays 40 to 60 cents for every dollar of 
cost, and Medicare pays right now 80 to 90 cents for every dollar of 
cost.

[[Page 142]]

  Just recently one of the facilities that President Obama lifted up as 
a bright, shining example of what we can do for health care reform, the 
Mayo Clinic, their operations in Arizona decided and announced that 
they were no longer taking Medicare payment, which meant if you are an 
older adult and you are going to a facility that doesn't accept 
Medicare, you will have to pay out of pocket. You have to have some 
other provisions.
  So these cuts we have piled on top with Medicare just adds insult to 
injury. My diagnosis for either the House or the Senate, the Democratic 
bills are fewer doctors and fewer hospitals. Most doctors in 
Pennsylvania, the average doctor is over 50 years of age in 
Pennsylvania. Right now they are looking at significant cuts under 
these bills in terms of reimbursement. They are not paying their costs 
now.
  I would predict, and as I meet with physicians around my State, many 
are preparing to retire because it is better to get out now rather than 
burning through their life savings. With that, we will result in less 
accessible health care services. Hospitals are only making 1 to 3 
percent margin today. With Medicare cuts, they will be in the negative 
column. You can't run a business, whether it is a hospital or any other 
business, and have more expenses than you do revenue and stay in 
business for very long. Hospitals close, that is less accessible health 
care. So this bill not only drives up costs, it makes health care much 
less accessible.
  Once again, I want to thank the gentleman for leading this Special 
Order tonight. I am going to yield at this time to the gentleman from 
Ohio (Mr. Jordan).
  Mr. JORDAN of Ohio. I thank the gentleman for yielding. I thank both 
him and the gentlemen from Texas and Ohio for this Special Order hour 
on behalf of the Republican Study Committee.
  I notice the chart in the well of the Chamber is talking about the 
real cost of the health care legislation and what it means over time: 
$2.1 trillion. I think when you look at that number and couple it with 
some of the things that we have seen happen in the last year--in fact, 
I gave a speech last week back home in the Fourth Congressional 
District of Ohio where I talked about this, and I started the speech 
with the question, Who would have imagined? Who would have thought? Who 
would have thought that we would run a $1.4 trillion deficit last year, 
the largest in American history? Who would have thought that we would 
have a $12 trillion national debt, moving to $13 trillion in the very 
near future, slated to go on the Obama budget spending schedule to $20 
trillion over the next 10 years? Who would have thought within 2 years 
the interest payments on that debt would be over a billion dollars a 
day? We are talking some serious, serious financial concern.
  And what do we have being pushed by the leadership in this Congress? 
A health care bill that is going to add $2.1 trillion to those already 
unbelievable numbers. Every single American, every man, woman, and 
child today, to pay off the debt we currently have, it is $39,000 that 
they have to pay. It is unbelievable. You think about one of the things 
that makes America great, that makes us the greatest Nation in history, 
is the simple concept that parents make sacrifices for their kids so 
that when they grow up they can have life better than we did. They in 
turn do it for their children, and each generation in this country has 
done it for the next.
  But now what we have in America, unfortunately, is this focus on 
living and spending for the now, living and spending for the moment and 
sending the bill to our kids. Unfortunately, this health care bill 
represents all that is bad about Washington, not only on the spending 
side, but as my colleagues have pointed out, in a whole host of other 
areas as well.
  I would just say in just a general sense, and I will make this last 
point and then I will yield back to the gentleman from Texas. I would 
just say this bill represents what Americans hate about Washington. 
This health care bill is big taxes, big spending, big Washington, big 
bureaucracy, Federal Government telling families and small business 
owners and individual Americans how they are now going to get their 
health care, telling Americans that you will now have bureaucrats 
between you and your family and your doctor. It represents everything 
that Americans don't like about this place. Unfortunately, it seems 
like the leadership in this Congress is bound and determined to move 
forward with that.
  One thing I know about Americans, Mr. Neugebauer, is that we hate 
being told what to do. It is part of the American DNA. They see this 
health care bill as telling them how they are going to get their health 
care, and they don't like it. The old line that we have in Ohio, and 
probably have in Texas, too, is that for most Americans when they are 
traveling down the highway and they see the sign that says 55, for most 
Americans that is not the limit, that is the challenge. That is how we 
look at things. We hate this idea of being told how we are going to do 
things. That is why we are Americans. And the idea that now the central 
government, the Federal Government, is going to tell us how we are 
going to get our health care, and it is going to cost us $2.1 trillion 
in addition to all of the debt we currently have, is what really 
offends Americans.
  So I appreciate the gentleman from Texas taking the time tonight to 
lead this hour, and I yield back to the gentleman.
  Mr. NEUGEBAUER. I thank the gentleman, and the gentleman brings up a 
very important point. On top of this being a very expensive bill and 
the fact that we are going to be spending money that we actually don't 
have, when I look at this chart, I think about my new grandson, Miles, 
and I think about my two grandsons, Nathan and Noah, and I think about 
what kind of legacy, what kind of future are we leaving these young 
people, the next generation, that by 2012 we are talking about a $16.7 
trillion debt in this country. And as the gentleman said, by 2020 we 
are talking about $20 trillion.
  When I was back in the district, and maybe you all have used this 
analogy, but for people to get their arms around what is a trillion, if 
you counted to a trillion, it would take you 19,000 years to count to a 
trillion. We are talking some serious money here. So I thank the 
gentleman for bringing up those important points.
  This is all intertwined. We are talking about jobs and the impact of 
health care on patients' rights and also small businesses, but we are 
really talking about the impact on an entire Nation of, one, turning 
health care over to the government; and, secondly, continuing down this 
road of borrowing and spending money that we don't have and charging it 
to future generations.
  I know each Member here on the floor tonight has this voting card, 
and right now it is a credit card and it has a huge credit limit on it. 
What I think many in the Chamber with me tonight want to do is turn 
this into a debit card where we are spending money that we actually 
have instead of borrowing from our children and grandchildren.
  Mr. JORDAN of Ohio. The gentleman is right on target with his 
comments.
  I just remind the Speaker, last spring the Republican Study Committee 
offered a balanced budget, something families and small business owners 
have to do every year and something local governments have to do. 
Unfortunately, the Federal Government never has to do that. RSC brought 
forth a balanced budget, and we plan to do the same thing this year 
because we understand that we cannot continue what that chart shows, 
not only for present-day America, but as the gentleman points out, 
because of what it means for our kids and grandkids. So we will bring 
that balanced budget back. It does the right things. It keeps in place 
those good tax cuts that were put in place in 2001 and 2003, protects 
Social Security, protects Medicare and national defense during this 
time we find ourselves in, and cuts spending, which we have to do. We 
have to make those tough decisions and do the right thing.
  Mr. NEUGEBAUER. I thank the gentleman, and I yield to the other 
gentleman from Ohio (Mr. Latta).
  Mr. LATTA. I thank the gentleman for yielding.

[[Page 143]]

  Just talking about these numbers, how are we going to pay for this? 
We are looking at 21, 22, $23 trillion in the outyears here. The 
question is how are we going to pay for this. We owe $3 trillion to 
foreign governments, over $800 billion owed to the Chinese alone, our 
largest creditor. Down the road when the Chinese and the Italians, all 
these governments are now saying, Wait a minute, America, you have got 
to do something about your spending. You have got to get this under 
control. They are worried about something. They are worried about 
getting paid back, and they don't want to see this debt that we owe 
them become cheap money, and so they are getting concerned about this.
  But if you just go back to 1981, 1982, if we go to those years when 
the Federal Government was out there borrowing heavily, we had 21\1/2\ 
percent interest rates in this country. I was just starting to practice 
law back then, and we had to write land contracts if a person wanted to 
sell a house. You couldn't go to the bank and get a loan because there 
was no money. The seller would meet with the buyer and they would say, 
In 3 years time, you are going to pay me so much interest and 
principal. And hopefully at the end of that time there would be a 
balloon payment to try this pay this thing off if they could get a 
loan.
  But when we are looking at these numbers, it is going to be 
unfathomable how we are going to pay this off, because the Federal 
Government is going to have to go out there and borrow every penny that 
is out there and somehow do this. But then when you look and talk to 
these private enterprises out there, the small businesses, they are 
having a hard time getting credit today, and we are not in that 
situation. It is bad, but it is not going to be anything like this that 
you show in your chart.
  Mr. NEUGEBAUER. The other gentleman from Ohio brought up a point 
about the current interest payment that is approaching a billion 
dollars at the most historically low rate time in the history of our 
country. The gentleman reminded all of us there was a time in our 
country, and I was in business when we were paying 15, 16, 17 percent 
for money. It was hard to get, and once you got it, you had to have a 
really good idea to make it. So you begin to think about what happens 
to our interest payments if we--let's just say we doubled the interest 
rates that the Treasury is doing right now. That begins to double the 
payment. So now instead of $1 billion, it is $2 billion. What that 
begins to do is, as we put together our budget, there is less and less 
money for discretionary spending because the first thing you have to do 
is make your mortgage payment, and we are mortgaging the future of our 
country. So these are important issues and I appreciate the gentleman 
bringing that point up.
  I think the other thing that kind of concerns a lot of people is the 
point that the gentleman made about our creditors. What if China, for 
example, who is our largest creditor, and as the gentleman points out, 
they have said, We are not quite sure what our appetite in the future 
is for continuing to loan America money to just spend and borrow 
without some kind of discipline, and that is something that we have to 
look at.
  I have another chart, and I would like to make one quick point and 
then go back to see if any folks have departing comments.
  One thing that the American people are also pretty tired of is all of 
these bureaucracies. I know when I went around in August, and I think a 
lot of my colleagues did, too, we brought this chart around to show the 
American people. This is a diagram of the House version of this bill. 
You can see all of these new bureaucracies and all of these new 
agencies, and somehow this is going to simplify health care for 
Americans? This is going to make it better for Americans?
  What we do know is hidden in this is a czar that is given very broad 
powers that is going to be able to determine what kind of policy you 
and I get to have. That concerns me that the Federal Government is 
going to be picking and choosing the kinds of coverages that are going 
to be offered to the American people instead of the American people 
being able to pick and choose the things that they think are coverages 
that they need.
  So I think when you look at the cost, when you look at the complexity 
of this, it is no wonder the American people are asking the Speaker of 
the House and they are asking the President to keep their promise about 
transparency here because they are very concerned about this.
  I yield to the gentleman from Pennsylvania. I think he probably 
showed this chart to his folks back home, too. What was their reaction?
  Mr. THOMPSON of Pennsylvania. They were appalled. And it has grown as 
these bills have been further proposed and developed in the back rooms 
among the Democratic leadership. The current set of new bureaucracies 
is somewhere around 130 new bureaucracies that have been created to 
dictate to that part of our lives called health care.
  I will just give you one example. In addition to just the imposing of 
the Federal Government among our personal lives and our personal 
decisions with health care, what it does to the cost of health care. 
Under the former Clinton administration, we wrote out HIPAA, Health 
Insurance Portability and Accountability Act, and certainly no one can 
be opposed to maintaining privacy as it relates to health care. And 
portability, we would be much further along if that would have taken 
care of portability, if it was the right solution for taking your 
insurance with you when you change employers. I happen to think that 
type of portability is a positive thing.

                              {time}  1830

  But the fact is that is what HIPAA did. And that was just one new 
bureaucracy that was created under HIPAA. The cost of providing health 
care because of HIPAA, I am sure that we could find many health care 
hospitals that will say, health care systems that actually probably 
laid off direct caregivers because they had to hire people to push 
papers, they had to hire people to be compliance people to be able to 
comply with all this massive new bureaucracy and the new regulations 
that were as a result of HIPAA.
  Now, you take HIPAA, multiply that times at least 130, I forget the 
last count, my colleagues may have a better count of the new health 
care bureaucracies under the Pelosi or the Reid health care plans, but 
you just take the experience of HIPAA, the overhead costs of providing 
health care, multiply that times at least 130, that is a devastating 
effect on the providers of health care throughout this country.
  Mr. NEUGEBAUER. I thank the gentleman. And I think he makes a great 
point. And I think one of the things that is the center of all of this 
is, you know, the administration is talking about jobs. I thought it 
was interesting today that they are going to quit tracking jobs tied to 
the stimulus plan because you know what, the stimulus plan hadn't been 
creating any jobs. This health care plan is going to stimulate, it is 
going to stimulate a bunch of new hires in Washington, D.C., and not 
across the heartland of America, because they are going to have to put 
people in place here to fill all these positions. And they are going to 
be shuffling paper, and they are going to be asking hospitals and 
doctors and health care providers to jump through all of these hoops so 
that they can justify their jobs.
  I think the American people want to create jobs out there in States 
like Ohio and Texas. So, you know, the job creation, unfortunately, is 
moving in the wrong direction if you are creating jobs in Washington, 
D.C. we need to be creating jobs in the heartland of America.
  I want to yield some additional time to my friend from Ohio.
  Mr. LATTA. I appreciate the gentleman for yielding. I would be remiss 
if I didn't bring this up. As I mentioned a little earlier, I represent 
the largest agricultural district in the State of Ohio, along with 
manufacturing. When we are talking about all these numbers

[[Page 144]]

about what could occur with all this massive debt that we are going to 
be accumulating, what is that going to do to the farmers out there? How 
are they going to get their crops out? How are they going to be able to 
buy land? How are they going to be able to buy machinery?
  The last thing that we want to be in this country, not only do we not 
want to be a debtor Nation, but we don't want to become dependent on 
the rest of the world for our food. Because once we lose that ability 
to grow our own food, to supply it for ourselves, we are done. And if 
the American people think the times are tough now when we are worried 
about where we get our energy or who is going to be buying our debt, 
you throw food into that mix, and that will be pretty much the end. I 
think that is why you take all these things together and why this 
debate is so important. And that is why I think really that we should 
have had this debate going on across the United States. I appreciate 
the gentleman for yielding.
  Mr. NEUGEBAUER. I would now like to yield some time to another one of 
our colleagues who has joined us here, the gentleman from Louisiana 
(Mr. Scalise).
  Mr. SCALISE. I want to thank the gentleman from Texas for yielding 
and for hosting this hour, because it is so important right now. As the 
American people are watching what is going on here in Washington, most 
people are saying they don't want a government takeover of health care. 
They want us to be focusing on creating jobs, which we should be doing, 
but instead you have got these meetings going on behind closed doors by 
Speaker Pelosi and her liberal lieutenants to try to have this 
government takeover of health care being forced down the people's 
throats.
  The President said multiple times during the campaign that he would 
insist that these meetings be held in public, they be on C-SPAN so the 
American people could see it. And yet the President has totally gone 
back on his word. These meetings are behind closed doors. You know, 
ironically the President goes out publicly and he bashes big insurance 
companies, and then he goes behind closed doors and he cuts special 
sweetheart deals with insurance companies. He goes behind closed doors 
and first says Republicans don't have a plan, and yet when we submit 
our plan to him, he refuses to meet with us. He throws us out of the 
room.
  The American people are tired of this. Because we should be doing the 
things that we have proposed to reduce the cost of health care. But 
instead, you have got these back room sweetheart deals, you have got 
these closed door meetings instead of the public transparency that we 
were promised.
  And it is very unfortunate, because we are talking about one-sixth of 
our economy. We are talking about a government takeover bill that would 
literally throw millions of Americans off their health care. So I 
appreciate what you are doing.
  Mr. NEUGEBAUER. I thank the gentleman. And I thank my colleagues for 
entering into this very important discussion so that the American 
people can have a little light shined on a very important issue.

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