[Congressional Record (Bound Edition), Volume 156 (2010), Part 13]
[House]
[Pages 19101-19107]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           GOP DOCTORS CAUCUS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Georgia (Mr. Gingrey) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. GINGREY of Georgia. Mr. Speaker, thank you for your patience as 
we tried to get our act together here this evening, not realizing of 
course that here it is almost Christmastime, that our pages have all 
gone home. It reminds me of what a great, great job these young men and 
women do for the Members in so many ways, not the least of which is of 
course helping during these Special Order hours. But, Mr. Speaker, 
thank you for your patience.
  I want to of course thank my leadership on the Republican side for 
allowing me and my colleagues in the House GOP Doctors Caucus to lead 
this Special Order for the next hour. And we are going to do that, Mr. 
Speaker, on health care and on the recently passed--I say ``recently''; 
10 months ago, March of this year--the passage of ObamaCare, now, I 
know, formally referred to as the Patient Protection and Affordable 
Care Act.
  But this is a piece of legislation, Mr. Speaker, that the American 
people, at the 60 percent plurality level, opposed and have remained 
here 10 months later, as certainly was seen in the results of the 
election on November 2. The American people felt that this was 
something that was forced upon them against their wishes, although they 
had a 2-year period of time to let not just our Democratic majority and 
President Obama, but every Member of Congress in both the House and the 
Senate understand not only that they were opposed to this bill but why 
they were opposed to it.
  And, in fact, during this campaign, our Republican Party made a 
pledge to America on many things, not the least of which, of course, 
was to repeal this bill, this 2,400-page monstrosity that has done 
hardly any of the things that President Obama had hoped, wished, 
promised that it would effect. So we said to the American people, you 
give us an opportunity, you give us an opportunity to elect, to choose, 
to have John Boehner as the next Speaker of the House and give the 
Republicans an opportunity to lead, that we will repeal this bill.
  So, Mr. Speaker, this evening I am very proud, as the cochairman with 
my colleague from Pennsylvania, Dr. Tim Murphy, to chair the House GOP 
Doctors Caucus. There are about 11 current active members. That 
includes medical doctors, psychologists, dentists, people that were 
involved in health care before they came to this body as a profession. 
And I am telling you, I think most of our colleagues know, Mr. Speaker, 
that the number of years of clinical experience among this group is 
something like 350 years. Several of us have got a little gray hair 
around the temples.
  But I think we have served a great purpose for our colleagues on both 
sides of the aisle to make sure that everyone understands from a health 
care perspective what this bill has done, the harmful effect that it's 
had--harmful effect on individuals, harmful effect on the practice and 
profession of medicine, harmful effect on companies across this 
country. We will talk about that tonight, the burden that is placed on 
small business men and women trying to abide by these provisions of 
ObamaCare. Last but not least, of course, Mr. Speaker, the harmful 
effects that it's had on the entire Nation in regard to our economy, 
the lack of recovery, the joblessness rate.
  The unemployment numbers came out just this past November, 9.8 
percent, creeping a little higher, not getting better, despite a 
trillion dollar stimulus package, which hasn't saved jobs. But this 
bill, and the reason we were so opposed to its passage even 2 years ago 
when it was first introduced in the Energy and Commerce Committee in 
the House, was Members on our side of the aisle understood very clearly 
that the number one priority for this country was to put people back to 
work, to jump-start this economy. And yet we spent literally 2 years, 
these first 2 years of President Obama's administration, on passing--
trying to pass an energy bill. Thank God, Mr. Speaker, in my 
perspective, it did not pass, the so-called ominous cap-and-trade, 
which would have increased the energy costs for every family in this 
country approximately $3,000 a year. Thank goodness this bill, after 
passing in the House, became bogged down in the Senate. And hopefully, 
it will remain there quietly dying.
  But unfortunately, ObamaCare did pass, and the economy is no better. 
We just got our priorities a little bit backwards. But I am pleased to 
say that a couple of our colleagues in the GOP Doctors Caucus, House 
GOP Doctors Caucus are with me tonight to discuss this issue: 
Congressman John Fleming, a family doctor from Shreveport, Louisiana, 
and Congressman Paul Broun, my colleague from Georgia, also a family 
practice doctor. I will call on them. I am going to defer to them as 
much time as they want to take, Mr. Speaker.
  We will basically have a colloquy and talk about some of these issues 
tonight in regard to ObamaCare and what we Republicans, the new 
Republican majority in the next Congress, the 112th Congress, have 
pledged to the American people that we will do. Our pledge was to 
repeal this bill. And first and foremost, we are going to make every 
effort to be faithful to our pledge and to try to repeal this bill. 
Understanding, of course, and I think the American people do understand 
this, that President Obama is the President, and he will be President 
for the next 2 years. The Democrats do have a continuing majority in 
the United States Senate, and they will have for the next 2 years.
  So while we feel very confident that we can lead the charge, the 
House GOP Doctors Caucus lead the effort of repeal in this body, the 
House of Representatives, we will succeed in doing that and fulfill our 
pledge to America and make

[[Page 19102]]

every effort to do the same thing in the Senate, although we know that 
we don't have the votes. But maybe we can persuade some of our 
Democratic colleagues, especially some of those that are up for 
reelection in 2012, Mr. Speaker, to understand finally, at long last, 
what the American people said on November 2.

                              {time}  1940

  Then, of course, the hurdle of getting a bill passed, a repeal bill 
passed, by President Obama. He has the veto pen, there is no question 
about that.
  But, you know, hope springs eternal. I think the negotiations with 
the Republican leaders a couple of days ago in regard to keeping the 
tax rates the same for every American taxpayer for the next 2 years 
sheds a little light on maybe the President's attitude of working with 
the heretofore minority and soon-to-be majority in the House and kind 
of moderate his stance on some of these things. Because, as the 
President himself said, Mr. Speaker, elections have consequences. And 
this election on November 2 certainly would tell President Obama that 
people do not like this bill and they want it repealed.
  So maybe he won't veto. But in the likely event that either we are 
not able to get the bill of repeal passed through the Senate, or if we 
do, that President Obama, indeed, would use his veto pen, then, of 
course, the options that we have are a couple that I want to talk 
about. I know my colleagues will get into that as well.
  But there are so many provisions in this bill that we will have the 
opportunity in this House to defund, to absolutely pull the plug on 
some of this spending so that this bill will not go forward. And, 
again, in the meantime, there are a number of parts of the bill that we 
will have individual pieces of legislation that will strip that away. 
And these are the things, Mr. Speaker, that we will be talking about 
tonight.
  I would like, at this time, to call on my colleague from Louisiana, 
Representative John Fleming.
  Mr. FLEMING. Well, I thank the gentleman, Dr. Gingrey, and, of 
course, Dr. Paul Broun, my other colleague who is here tonight, both 
gentlemen from Georgia. I want to thank you both and state my 
appreciation for your leadership and for holding these Special Orders.
  You know, we did a ton of these Special Orders back here in the 
health care debate, and I've got a feeling we are going to be doing a 
bunch more. Because, in my opinion, my humble opinion--I am just ending 
my first term up here--but I have a feeling that the health care debate 
has just begun, that this thing is far from over.
  As a preface to my discussion about health care, I want to point out 
and remind everyone, certainly, Mr. Speaker, the fact that we are in 
desperate need of reviving our economy, 9.8 percent unemployment.
  And as I travel around the country, and particularly in my district, 
there are three main reasons for that given to me by employers. ``Why 
aren't you hiring people?'' and this is what they tell me.
  Number one, our tax situation is so uncertain, we don't know what to 
expect, and hopefully soon we are going to put certainty back into our 
tax policy by not raising taxes a single dime on any individual in this 
country.
  Number two, they tell me that banks are just not lending money. There 
are many reasons for that. We are not going to get into that tonight, 
but the bottom line is credit is not available to businesses.
  Then, finally, and I think most importantly, is the ObamaCare. 
ObamaCare has thrown such a monkey wrench into the machinery of the 
economy of this country, creating such uncertainty and difficulty of 
planning, that employers are just frozen with fear. We know that as 
soon as it was passed, immediately, companies began to come out and 
talk about how it was going to immediately eat into their earnings. We 
get continuous reports of how the premiums are going to go up for the 
employees as well as the employers, all things that were guaranteed to 
us by the President would not happen.
  But I will just give you a quick story. I spoke to a gentleman who 
owns a small company in my district. The name of it is Explo, and they 
have a very unique kind of business. What they do is they have the 
responsibility to take that explosive charge that's normally used in a 
cannon that has, for some reason, grown too old and no longer useable, 
they actually recycle that. They tear it down and they take the various 
parts. And, of course, it is an explosive, so they do have some risk in 
all of this. They have a 5-year contract to dismantle thousands, tens 
of thousands, hundreds of thousands of these explosive charges that 
actually propel the shell from the cannon to go to its destination.
  And he said, you know, I have got a good contract. I don't have a big 
margin, but I do have a margin that I can make profit. But he said, You 
know what? With ObamaCare, that margin is totally wiped out. If I stay 
in business, I am likely to go out of the business and go bankrupt.
  So just that uncertainty, just that one little factor can make the 
difference in a company from maybe $100,000, $200,000 a year profit to 
losing $200,000 or $300,000, which a small business owner can do maybe 
1 year, maybe 2 years. Maybe he can borrow money to get by.
  But this is the reality that faces Americans around the country, 
700,000 small businesses, when you enter this unknown about ObamaCare, 
and it just simply freezes the businessman. So I can say FDR, President 
Roosevelt, had it right when talking about the Great Depression that 
the only thing we have to fear is fear itself.
  Right now, small businesses, businesses across the land are in 
desperate fear. They are afraid to make those valuable investments 
because they just don't know what next week, next month, next year is 
going to be like. I would say that the largest cause of this is health 
care, the health care reform.
  So just to kind of reiterate that again, Mr. Speaker, we have three 
things that businesses identify as roadblocks to success and to hiring. 
One is lack of credit, number 2 is uncertainty about taxation, and 
health care reform. We are about to tackle the taxes. I think the banks 
are going to be turning the credit around. So that one thing we have 
ahead of us is ObamaCare, which is, I think, a big stumbling block to 
recovery.
  I join with my colleagues this evening calling for a repeal to 
ObamaCare and a return to commonsense reform methods, which we will do 
with piecemeal legislation one step at a time, incremental reform, 
testing and listening to the American people, to what they want, rather 
than forcing it down the throats of those who have to pay for this 
thing.
  Mr. GINGREY of Georgia. Dr. Fleming, thank you for being with us this 
evening.
  Before I defer to my colleague from Georgia, Dr. Paul Broun, I just 
wanted to mention something, Mr. Speaker, that Congressman Fleming just 
said in regard to the taxes, the tax situation that we have and 
hopefully the compromise, obviously, the compromise worked out between 
President Obama, his administration, and the Republican leadership in 
the House and the Senate. All of that has to be approved, Mr. Speaker, 
as you know, by the entire Senate and by this entire House before it 
becomes law. I hope that we will be able to do that before we leave 
here for any kind of a break, even a Christmas break.
  But as part of that compromise, there is to be this cut in the 
payroll tax for a full year to literally cut the employee portion of 
the Social Security payroll tax from 6.2 percent down to 4.2 percent. I 
think, Mr. Speaker, that's a good thing, just as keeping the tax rates 
that currently exist, and have for almost the last 10 years, to keep 
them all in place, not to raise any, especially not on the job 
creators, the small business men and women, the so-called rich.
  But the ironic thing about this, my colleagues, is in this bill, 
Patient Protection and Affordable Care Act, ObamaCare, it called for 
raising the payroll tax, for raising the payroll tax

[[Page 19103]]

on Medicare for anybody that makes above a certain dollar amount of 
income, by 3.7 percent. That is going into effect right now, by 3.7 
percent, to increase the payroll tax.

                              {time}  1950

  And that's why, Mr. Speaker, we're here on the floor tonight as 
representative of our leadership to try to point out some of these 
things and say, gosh, you know, that really makes no sense at all to 
say that we need to cut payroll taxes and we're going to do it on 
Social Security for the next year for everybody. No matter what their 
income might be, we're going to cut it by a third, in fact.
  And then on this bill to raise the Medicare taxation 3.7 percent, it 
doesn't make a lot of sense--as a lot of things about this bill don't 
make a lot of sense.
  Before I call on Dr. Broun again, I want my colleagues to look at the 
easel to my left, to your right, on the number one priority, as I 
mentioned at the outset, our Republican priority and our Pledge to 
America is to repeal and replace ObamaCare.
  Now, on this second slide, and I talked a little bit about that--and 
we'll get into that as the hour progresses--but priority number two, in 
the event that we're not able to repeal because we just don't have the 
votes or that President Obama uses bad judgment and vetoes our repeal 
bill, we're going to have the opportunity--and Dr. Broun will talk 
about this--to defund certain provisions in this bill.
  And with that, I'll yield to my colleague from Athens, Georgia, and 
my great friend, Dr. Paul Broun.
  Mr. BROUN of Georgia. I greatly appreciate you yielding, and I 
appreciate you doing this tonight so that we can inform the American 
public about how bad this bill is and what the Republicans are going to 
try to do in this next Congress.
  We heard all during the discussion on ObamaCare as well as through 
the last two Congresses since I've been here--I'm finishing up my 
second term--that Republicans are the party of ``no.'' We are the party 
of k-n-o-w because we know how to lower the costs of health care. And 
we can do it in a bipartisan manner.
  And in fact, during the discussions about ObamaCare, I challenged 
individual Democrats to introduce a bill, that I would give them the 
legislative language, all they had to do was write their name in a 
blank, introduce it, and it would be a Democratic bill. They could call 
it ObamaCare. And I was told by Democrats over and over again that this 
makes a whole lot more sense, Paul, what you're proposing here than 
this ObamaCare bill that we dealt with here in the House, the Pelosi 
original bill, and the one we finally passed that came from the Senate.
  And in fact, two colleagues on our side, Republicans John Shadegg 
from Arizona and Congressman Charlie Dent from Pennsylvania, and I 
wrote an op-ed that was published in The Washington Times newspaper 
challenging Democrats to introduce the bill. And it would do four 
things, commonsense solutions, that I told the Democrats individually 
if they would introduce the bill, it could be their bill, a Democratic 
bill; they could take credit for it. I'm concerned about policy, not 
whose name's on the bill. And they could take credit for it.
  Mr. GINGREY of Georgia. If the gentleman will yield?
  Mr. BROUN of Georgia. Yes, I will.
  Mr. GINGREY of Georgia. If you would call attention to that poster 
because I think that our colleagues need to focus in on that.
  Mr. BROUN of Georgia. Absolutely. In fact, I was going to do that. I 
appreciate my colleague, Dr. Gingrey, for reminding me.
  I have a poster here with these four commonsense solutions. And 
actually I introduced the bill when my Democratic colleagues wouldn't 
take up my offer to introduce it after ObamaCare was actually passed 
into law.
  I introduced the bill that does actually five things. It repeals 
ObamaCare and puts in place these four commonsense solutions. It's not 
a comprehensive bill because it doesn't really deal with Medicare and 
the problems that we have with that or Medicaid, and we'll mention that 
in a minute or two.
  But the four things are to allow all individuals to deduct 100 
percent of their health care costs--including the cost of the 
insurance--off the income taxes. This in itself would change the 
dynamics of health care for everybody in this country. In fact, this 
eventually would take care of the problems that we as physicians have 
with managed care because it would put patients in control of their 
health care decisions but allow everybody to deduct all their health 
care costs.
  Second thing it would do is it would strengthen and expand new 
avenues for affordable health care for sick Americans through high-risk 
pools that are set up on a Statewide basis. There are several States 
like Colorado that have already done this very successfully. Multiple 
States have already done so. We would stimulate that.
  The third thing it would do, as the chart right here says, it would 
expand choice and competition by allowing consumers to shop for health 
care insurance across State lines. Now, I'm an original intent 
Constitutionalist. The Commerce Clause is one of the clauses that's 
been perverted so much to allow the great expansion of the size and 
scope of government. The Commerce Clause is actually supposed to expand 
commerce, not to control it. And it is to allow people to shop for all 
goods and services across State lines.
  So by the original intent of the Commerce Clause, we're just doing 
exactly the opposite. And when States lock up the insurance pools just 
within their State borders, they're actually doing an unconstitutional 
control of commerce.
  And the fourth thing: Just create association pools so anybody in 
this country could join a huge pool. And this would allow people to buy 
insurance at a much lower cost than they have today. And it would 
actually allow people who not only cannot afford to buy health 
insurance but those people who have preexisting conditions to be in 
association pools so that they actually could buy health insurance at 
an affordable rate.
  And these four commonsense solutions have been introduced--I 
introduced the bill--to repeal ObamaCare and to do these four things. 
And I'll be introducing this same bill in the next Congress.
  The bottom line is the Republicans are the party of k-n-o-w. We know 
how to lower the costs of health care. We, as physicians, have been 
dealing with all of these problems like our patients--particularly us, 
like Dr. Fleming and I in family medicine, we deal with the insurance 
company. We try to find our patients good, quality care at the lowest 
price, which includes trying to find them insurance, medicines, all 
health care products at the lowest prices--it's what we do as family 
doctors. And it's something I've been dealing with for almost four 
decades of practicing medicine. And it's something that the American 
people desperately need.
  ObamaCare is going to--the experts tell us--is going to put 5\1/2\ 
million people out of work.
  Dr. Fleming talked about the uncertainty it creates in employers. I 
hear that all the time. I've got a small businessman that wants to do a 
$31 million expansion of his business in my district, but he's scared 
to and he's not going to because, Dr. Fleming--he doesn't have the 
problem with the banks because he has $31 million in the bank right 
now, cash money. So he doesn't have to go to the bank to get the money. 
But he's scared of those taxes. He's scared of the energy tax, 
particularly. That scares the willies out of small businessmen and 
women in my district. He's very frightened about ObamaCare.
  So we must repeal ObamaCare and replace it with some commonsense 
solutions.
  Mr. GINGREY of Georgia. Reclaiming my time just for a second from Dr. 
Broun.
  Dr. Broun, if you don't mind holding that poster up again because I 
wanted to enter, Mr. Speaker, into a colloquy with the gentleman, my 
colleague from Georgia.

[[Page 19104]]

  In the four points on his poster, addressing that first one, allowing 
individuals to deduct 100 percent of health care expenses, including 
the expense to purchase health insurance--whether it's first dollar 
sickness coverage or long-term care, which people, when they get our 
age, need to start thinking about.
  But under current law, and I want my colleagues to correct me if I'm 
wrong on this, but I think under current law, an individual in filing 
their tax return if they itemize their deductions, they can only deduct 
health care expenses that are more than 7.5 percent of their adjusted 
gross income. And hardly anybody reaches that threshold.
  And I think what Dr. Broun, Mr. Speaker, is suggesting in regard to 
this change in the IRS Code--of course this would have to come through 
the House Ways and Means Committee--but what a novel and a great idea 
that he and Mr. Shadegg and Mr. Dent have proposed during this 
Congress.

                              {time}  2000

  I am refreshed to know that Dr. Broun will introduce this bill in the 
112th Congress, but the point he was making is not only that bullet 
point, Mr. Speaker, but on his poster, the three others with regard to 
purchasing health insurance across State lines for an individual, for a 
group of individuals sometimes referred to as an association, to be 
able to avoid, Mr. Speaker, the mandates that so many States have 
passed in regard to what a health insurance policy has to cover.
  Every time you add a little mandate, a little test here, a little 
test there, then the cost of the cheapest health insurance in the 
individual State goes up. So that is why this idea of someone who needs 
a policy in Georgia being able to go online and see what is offered in 
Louisiana, as an example, is a great idea.
  What Dr. Broun was saying, we had some ideas. We are the party of K-
N-O-W, he likes to say, not the party of N-O; and President Obama knows 
that. And the Democratic majority knew that, knows that. And they 
ignored it; and as a result, they are soon to become, at least in this 
body, the Democratic minority.
  I yield to Dr. Broun for other comments before I call on Dr. Fleming.
  Mr. BROUN of Georgia. Thank you, Dr. Gingrey for yielding.
  In fact, this first bullet about 100 percent deductibility will solve 
the problem with portability. Right now, 85 percent of America gets 
their health insurance through their employer. It is because employers 
can deduct the cost of their health insurance that they provide to 
their employees as a regular business expense, and the employee can get 
that money as a nontaxable benefit. But if we make it 100 percent 
deductible for everybody, then the employer can give that money in 
increased wages to the employee. It is still a deductible amount. It 
won't cost the employer any more money out of their bottom line, but 
they can give it to the employee, and then the employee can take those 
dollars and instead of having to be saddled with whatever insurance 
policy that the employer provides for them, the employee can go buy the 
insurance wherever they want with whatever kind of coverage that they 
want.
  In fact, Dr. Gingrey brought up something about the mandates that the 
States have put on. My friend, Neal Boortz, who has a radio program 
that is syndicated all over this country, keeps talking about him and 
his wife, who are beyond the age of having any babies, have to buy 
maternity coverage. There are insurance policies that mandate that 
people have to pay for sex change operations or hair transplants and a 
whole lot of other things. Everybody in that pool has to pay, whether 
they want a sex change operation or hair transplant or maternity 
benefits, and that drives the cost up for everybody. The across-State-
lines purchasing and the association pools will help stop that.
  We have managed care today because the employers want to have some 
finite amount of money for their own budgeting process so they know 
what they are dealing with in their business so they go and buy managed 
care policies for their employees so they have some finite number, and 
it is not just a blank check.
  That makes sense from a business perspective, but it doesn't make 
sense for a lot of the employees who want to be able to choose their 
doctor and they want to be able to go to the hospital that they desire. 
They don't want to be dictated to about what kind of coverage that they 
can have. And the first point where everybody has 100 percent 
deductibility of all expenses will take care of the portability 
problems. It will empower the patient and the doctor to be able to make 
the best decisions for their patient. Those things are just commonsense 
solutions.
  Mr. GINGREY of Georgia. Dr. Broun, thank you. Your four commonsense 
solutions are great. Keep that poster handy, we may want to refer back 
to that.
  We are going to get into the subject of Republican priority No. 3, 
and that is on my poster to my left, attack key components of ObamaCare 
until the bill can be repealed. So in the next 15-20 minutes or so, we 
will be talking about some of these key components of ObamaCare that we 
can legislatively attack.
  I am going to yield to the gentleman from Louisiana (Mr. Fleming) to 
begin that discussion or any other comments that he wants to make 
before we get into that.
  Mr. FLEMING. I did want to enter in a couple of ideas before we move 
right into that.
  You know, Mr. Speaker, the other side of the aisle oftentimes says to 
us: well, now, you Republicans, you want to repeal ObamaCare. You mean 
to say you want to stop what is in it in terms of increasing insurance 
coverage up to age 26? Do you mean to say that you want to bring back 
preexisting conditions that would prevent some from getting health care 
coverage because of chronic disease? Do you mean that you don't want to 
see insurance expanded? Well, of course not. We don't want to see those 
things return. That is to say we don't want to see once again that kids 
up to age 26 for some reason can't get insurance covered by their 
parents. Of course we don't want to see that. And certainly we don't 
want to bring back preexisting illnesses to somehow block people from 
getting care. Those are all things that both sides of the aisle can 
agree on.
  The problem is that the structure of ObamaCare that is so steeped in 
bureaucracy and so costly and so, I guess, handcuffing if you will of 
health care in general, health care decisions made by doctors, by the 
patients themselves, that is so difficult that what you are really 
getting is a situation where you are throwing the baby out with the 
bath water. The few benefits that are in ObamaCare are certainly way 
outweighed by all of the problems.
  So of course we would love, after repealing ObamaCare, to bring back 
some of the things that we on this floor may have unanimous agreement 
on, and that is never again would we see preexisting conditions that 
would block people from getting health care coverage.
  Mr. GINGREY of Georgia. With regard to the last comment that the 
gentleman made with regard to preexisting conditions, and Dr. Broun 
referenced it on his four commonsense solutions, in regard to those 
high-risk pools that the States can create, can set up, can say to 
health insurance companies, whether it is the Blues or Aetna or Cigna 
or smaller companies, there are literally 3,000 health insurance 
companies across the country offering policies, not these big, huge 
mega-companies, but to say to the ones that are doing business in your 
State, to have to abide by a requirement of a State insurance 
commissioner or a Governor of a State, like our Governor-elect in 
Georgia, Nathan Deal, who spent 18 years in this body and left here as 
chairman of the Health Subcommittee on Energy and Commerce, these 
Governors know. We will get into a little bit of their concern about 
the Medicaid expansion in a few minutes, but they know.
  Like Representative Fleming was saying, these high-risk pools can be 
set up in States, and we won't spend $6 billion of the taxpayers' money 
doing it.

[[Page 19105]]

And that won't even be enough with the Federal bureaucracy trying to 
run these high-risk pools.
  I appreciate that, and I yield back to the gentleman. If you want to 
engage in a colloquy with Dr. Broun, certainly he may want to ask you 
about that as well.
  Mr. FLEMING. I thank the gentleman.
  Yes, indeed, the bottom line, what we are saying here is that we can 
achieve all of these laudable goals without the complex bureaucracy of 
ObamaCare. We can expand health care to many more millions of people 
without creating an individual mandate and an employer mandate.

                              {time}  2010

  Certainly, there are far more efficient ways, as Congressman Broun 
points out, that we can provide coverage to people who may have 
preexisting illnesses, ways that are already in place in many States--
excellent programs. I would like to inject just two more possible 
solutions to this and then segue again into the dismantling of 
ObamaCare that you, the other gentleman from Georgia, referred to.
  No. 1: Health Savings Accounts.
  HSAs grew by 25 percent in 2009 to a total of 10 million Americans. 
Americans love health savings accounts. They are working. We 
implemented it in my own companies back home 6 years ago, and it has 
totally flattened out our premiums. The problem with it is that 
ObamaCare begins to tax it as much as 10 to 20 percent.
  Believe it or not, today, of course, pre-ObamaCare, you can go and 
buy aspirin or any type of over-the-counter medication--cold 
medication--you want, and you can pay for it with your health savings 
account. However, beginning in January, in order to do that, you've got 
to get a prescription from a doctor for a nonprescription drug.
  Now, how is that going to play in our offices back home when we have 
hundreds and maybe thousands of citizens and patients calling, saying, 
I need a prescription for Tylenol so I can get it on my health savings 
account? So you can see just how ridiculous that is going to be. People 
are not going to be willing to come in and certainly pay for a doctor's 
visit just to get a prescription for Tylenol. So that is No. 1.
  I introduced H.R. 5126, the Helping Save Americans' Health Care 
Choices Act, which would restore flexible savings accounts and health 
savings accounts. I'd love to see us follow through on that.
  The second point: the gentleman, Congressman Gingrey, Dr. Gingrey, 
and I worked on H.R. 5690--and the gentleman showed great leadership on 
that--which is the Meaningful End to Defensive Medicine and Aimless 
Lawsuits Act of 2010.
  Once again, President Obama promised us that he would reform medical 
malpractice in ObamaCare; and, of course, that was left on the cutting 
room floor. Once again, real solutions are being ignored in favor of 
bureaucracy and mandates.
  So, with that, I'll segue back.
  Mr. GINGREY of Georgia. If the gentleman will segue back to me, I'll 
yield additional time to Dr. Broun.
  I just wanted to comment, Mr. Speaker, on Representative Fleming's 
last remark in regard to the medical liability reform that he and I 
have worked very hard on. In fact, this is my fourth term; and every 
year that I've been here--even before Dr. Fleming and Dr. Broun joined 
us and joined the House GOP Doctors Caucus--I have introduced medical 
liability reform legislation, sometimes referred to as ``tort reform.''
  I won't go into the details of it; but, basically, it is a fair and 
balanced approach for people who are hurt by practice below the 
standard of care, whether it's by the physician, the hospital or by 
anybody associated or affiliated with their care, who would certainly 
have to answer for that. These people would have an opportunity to have 
their redress of grievances. So, when we say ``tort reform,'' we don't 
mean taking away anybody's individual rights.
  I will tell my colleague that the incoming chairman of the Judiciary 
Committee in the House, Representative Lamar Smith, has already 
informed me that he will be having hearings on our legislation, 
Representative Fleming, and on other pieces of legislation regarding 
this type of reform that the CBO says very conservatively would save 
$54 billion over 10 years. The RAND Corporation says it would save more 
than that on an annual basis. So I did want to let my colleague know 
that hope is on the way, and we will continue to work hard on either 
our legislation or on anybody's legislation.
  Maybe, Mr. Speaker, one of our colleagues who is on the Democratic 
side of the aisle would like to work with us in a bipartisan way. Maybe 
they've got an even better idea in regard to that.
  I would like to yield back to the gentleman from Georgia (Dr. Broun).
  Mr. BROUN of Georgia. Thank you, Dr. Gingrey.
  Let's go ahead and jump into some of the key components and some of 
the things that we can do. What I would like to focus on is your No. 3 
bullet point on your chart there: Medicaid expansion.
  The Medicaid expansion of ObamaCare is going to break the budgets of 
States, which are already suffering, because it is going to drastically 
increase the people in this country who are going to qualify for 
Medicaid.
  Again, the Republican Party is the party of ``know,'' K-N-O-W, 
because we know how to deal with this in a better manner.
  In fact, as the gentleman from Georgia, Dr. Gingrey, knows, I've been 
trying to get on the Energy and Commerce Committee. One thing that I 
will do--and I know that there are others who are on the committee 
today who will--is push for dealing with Medicaid in a block grant to 
the States. Let's just send the Medicaid money, with no strings 
attached, to the States. Let the States, which is what our Founding 
Fathers believed to be the best laboratory of public policy, figure out 
the best way to deal with people who desperately need Medicaid or State 
Child Health Insurance Programs. Let's send those back to the States, 
as they should be. Even under the Constitution, those functions should 
be dealt with by the States, not by the Federal Government. Let's let 
the States have the money so that they can deal with this and find the 
best solution instead of our generating all the policy, the regulations 
and all the things that drive up the cost. The Medicaid expansion that 
ObamaCare has put in place is literally going to break the bank in 
State, after State, after State.
  Mr. GINGREY of Georgia. Mr. Speaker, I have put up an additional 
poster that I want to call my colleagues' attention to in regard to 
this very important point that Dr. Broun is discussing.
  So far, 34 States and the District of Columbia have had to cut 
funding for K-12 education, which is 5 years old--kindergarten--through 
the 12th grade. Mr. Speaker, we all know that education has always been 
near and dear to the hearts of our Democratic colleagues. It is near 
and dear to the hearts of, hopefully, all of us on both sides of the 
aisle; but it has been a signature issue for the current majority 
Democratic Party. In doing something like this, in putting a Medicaid 
expansion mandate on the States, all of which have a constitutional 
requirement to balance their budgets, they can't just print money. 
Treasury Secretary Geithner and chairman of the Federal Reserve 
Bernanke want us to come up with another $600 billion worth of money. 
They can't do that. They have to balance their budgets.
  So, if they have to expand Medicaid because of this requirement that 
Dr. Broun and Dr. Fleming are talking about, what do they do? They cut 
money for public defenders, first responders or education. It's just so 
counterproductive and counterintuitive. Thirty-four States already, 
plus the District of Columbia, have had to cut that funding.
  I yield back to my colleague.
  Mr. BROUN of Georgia. Well, you're exactly right, Dr. Gingrey. Thanks 
for bringing that up.
  With ObamaCare, the States are going to have to cut more. In fact, we

[[Page 19106]]

already see first responders--fire departments, police departments--
being cut in their funding. In State after State, there are educational 
funding cuts across the board. In our own home State of Georgia, they 
have had to markedly cut the educational budget because of all of these 
mandates that are put on them by the Federal Government and because of 
the requirement by the State constitutionally to have a balanced 
budget.
  I introduced a balanced budget amendment to the Constitution here in 
Congress; and, hopefully, we are going to do that, too. It has been 
part of our pledge to America, and I will continue to fight for a 
balanced budget. I think the Federal Government also needs to live 
within its own means.
  Just on the Medicaid expansion, we should just do block grants back 
to the States and let them be the laboratory of public policy, as our 
Founding Fathers talked about and believed in very firmly--and I 
believe in those same things--for Medicaid as well as for SCHIP. In 
Georgia, we call it PeachCare. If we send those dollars back to the 
States, don't tie any strings to them and let the States utilize those 
funds in whatever way best suits their State budgets and their State 
needs, we will be a whole lot better off. The States will be better 
off. The Federal Government will be better off. The taxpayers will be 
better off. The Medicaid recipients will be better off. We will 
actually be able to cover more patients.
  So, back again, the Republican Party is the party of K-N-O-W.

                              {time}  2020

  We know how to solve these problems and we're going to try to do that 
the next time.
  I yield back.
  Mr. GINGREY of Georgia. I thank my colleague.
  Mr. Speaker, reclaiming my time--in fact, I will yield back to Dr. 
Fleming because I would, on this poster, again, that's here for my 
colleagues to peruse, this first item, the individual mandate--Mr. 
Speaker, there are probably 12 different line items, bullet points on 
these next two posters. We may not have time to get to all of them 
tonight, but we will continue this in another hour. But I want to hear 
what my colleagues have to say about individual mandate, employer 
mandate. Dr. Broun has already talked about the Medicaid expansion, but 
the cuts in Medicare? So I will yield to my colleague from Louisiana.
  Mr. FLEMING. Thank you. I appreciate you throwing number four to me, 
because that's the one that I think gets my gall the most, quite 
frankly.
  Mr. Speaker, you realize that in ObamaCare half a trillion dollars is 
taken from Medicare. And this is not just window dressing; this is real 
cuts that are occurring actually as we speak, are actually being 
scheduled, starting with psychiatric care, including care for assisted 
living, home health care. Virtually nothing is being touched.
  And that so-called half a trillion of savings that's being taken out 
of Medicare is being used to do two things: Number one, to tack on the 
end of Medicare because it's running out of money in 6 years, to extend 
the life. And I still, after a year, cannot get an explanation on how 
you take the money out of something and add it back in and make it last 
longer. I know I could try that budget at home and it would never work. 
Secondly, the same money is being counted again in this bookkeeping 
scam that will subsidize the middle class, lower-income class in terms 
of their private health care. So this is just more gimmicks, more 
Washington gimmicks that is going to hurt a lot of people.
  Mr. GINGREY of Georgia. If the gentleman will yield to me just for a 
second.
  Mr. FLEMING. Yes, sir.
  Mr. GINGREY of Georgia. Mr. Speaker, I just wanted to--and I know the 
gentleman from Louisiana and the gentleman from Georgia know this--to 
remind my colleagues, that cut to Medicare that Dr. Fleming is talking 
about, Mr. Speaker, is $528 billion over 10 years. It's about a 10 to 
12 percent a year cut annualized, and it includes cutting Medicare 
Advantage $160 billion. It includes hospital cuts, cuts to hospice--
that organization that takes care of people that are dying of cancer--
cuts to nursing homes, home health cuts.
  But again, it's kind of embarrassing almost to see these television 
ads, Mr. Speaker, about Medicare, or get some flier, some glossy flier 
in the mail--those of us who are on Medicare--touting the benefits that 
ObamaCare has brought to the program and how it's going to make it so 
much better, and yet it cuts $528 billion out of the program.
  I agree with the gentleman from Louisiana, and I yield back to him.
  Mr. FLEMING. I thank the gentleman.
  But even before we get to those cuts, it's already steeply increasing 
the premiums of average, everyday citizens. There is no way that you 
can cover an additional 32 million Americans--I mean, this is an 
empirical fact: There is no way you can increase the coverage, add to 
the coverage of 32 million Americans, and raise, through special 
interests, all the additional bells and whistles into those plans and 
not see the costs go up. And why in the world the American people could 
ever get hoodwinked into believing that I don't know. And I don't think 
they did, which is, frankly, why they want, by a vote of 60 percent in 
the polls, they want us to crush ObamaCare and replace it with 
something that is common sense, free-market based, that leaves the 
decisionmaking up to the patient, and that is efficient rather than, 
again, some government-controlled program.
  We know that, also, finally--just kind of a final comment because I 
know we're getting close to the end, but increased coverage does not 
mean increased access to care. We know this. There are countries around 
the world--our neighbor to the north, Canada, has 100 percent coverage 
but they do not have 100 percent access to care. They have to wait 
often well past the time frame in which it takes to actually adequately 
treat a condition; therefore, no access. So what good is coverage when 
you don't have access? And we're going in that direction.
  So I suggest, Mr. Speaker, that we repeal ObamaCare and replace it 
with something that will properly match the efficiencies of the system, 
allow it to be patient driven, and that people get timely care at an 
affordable cost.
  Mr. GINGREY of Georgia. Mr. Speaker, reclaiming my time, and I thank 
the gentleman from Louisiana.
  And my colleague from Georgia may want some last few seconds of 
comments, and I yield to him.
  Mr. BROUN of Georgia. Thank you, Dr. Gingrey.
  I just wanted to mention the employer mandate. An employer is 
mandated to provide coverage for their employees. They have a lot of 
mandates. And those employer mandates are going to mean that people are 
going to lose their jobs.
  Dr. Fleming and I talked a little bit ago about how employers are 
scared. I've got a lady who runs a small business. She has eight 
employees. She desperately needs to hire another one or two, but 
because of the employer mandates of ObamaCare, she's not going to hire 
anybody. She's just going to try to struggle along herself and is not 
going to expand her business. She could hire two new people, and the 
employer mandate is going to prevent these two people who need jobs 
today from going to work for this small business.
  I already mentioned the guy who wants to do a $31 million expansion. 
He's not going to do that, not going to hire the 100 or so new 
employees that he would hire because he's afraid of ObamaCare and the 
employer mandates.
  One other thing--and then I will yield back to Dr. Gingrey--is that, 
to kind of go along with these cuts to Medicare, in the stimulus bill a 
lot of Americans don't realize that they put in something called 
``comparative effectiveness research.'' In medicine, we compare the 
effectiveness of one treatment versus another. Breast cancer, is it 
just taking a tumor out? Is it giving chemotherapy? Is it radiation 
therapy?

[[Page 19107]]

Is it a combination of all this? That's not what this is all about. 
It's to compare the effectiveness of spending a dollar. And it's age 
related, which means that those people on Medicare, comparative 
effectiveness is just going to mean that they're just not going to get 
the care.
  And I yield back.
  Mr. GINGREY of Georgia. If the gentleman will yield back to me for 
maybe a concluding remark.
  And yes, the gentleman, Mr. Speaker, has brought up the ``R'' word, 
``rationing,'' and that's exactly what we're talking about with regard 
to all of these bureaus and boards and agencies, I don't know, 
something like 40--I wish I had brought that chart with me--but 
comparative effectiveness is research, is Medicare, payment board--this 
new board, IPAB. These things are going to lead to rationing. And the 
folks, Mr. Speaker, that we are most concerned about are our precious 
senior citizens, our parents, our grandparents, who are the ones that 
we fear, because of this legislation, are going to get pushed under the 
bus.
  Mr. Speaker, thank you very much. And as I predicted, we wouldn't get 
to all the bullet points that we wanted to discuss, but this colloquy, 
this Special Order is to be continued.
  And I yield back.

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