[Congressional Record (Bound Edition), Volume 156 (2010), Part 2]
[House]
[Pages 1680-1686]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Georgia (Mr. Broun) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. BROUN of Georgia. Thank you, Mr. Speaker.
  I am a medical doctor. I have practiced medicine in Georgia for 
almost four decades. As a medical doctor with all of that clinical 
experience--I'm a family doc, a primary care provider.
  I've examined the proposal that the White House put forward just 2 
days ago. Frankly, I've got a diagnosis. I cannot give ObamaCare 2.0 a 
clean bill of health. What I can diagnose for the American people, 
though, is this:
  It's going to make the American people sick--sick in their wallets 
because it's going to cost more. Health care costs in this country are 
going to skyrocket because of this ObamaCare proposal that the White 
House recently put out.
  As The Wall Street Journal just very aptly said in an editorial this 
morning: The White House has accomplished a great thing. They took the 
most onerous pieces of the House bill and the Senate bill and combined 
them to make the current proposal of ObamaCare that the White House is 
putting forward even worse than either of those bills.
  The quality of health care in this country is going to go down. It's 
going to go down because doctors and patients will no longer be able to 
make health care decisions. It is going to be made by a Federal 
bureaucrat here in Washington, D.C.--one that doesn't, in all 
probability, have any medical training whatsoever.
  As a health care provider, as a medical doctor today, I see Federal 
bureaucrats who have no medical experience telling me and my colleagues 
whether we can put a patient in the hospital or not, whether we can 
give them a certain medication or not, how long they can stay in the 
hospital, what kind of care we can give. So there is already control, 
particularly with the Medicare patients of health care.
  The problems that Medicare has today are going to be exacerbated, or 
made worse, by what this administration is doing and by what the 
leadership in this House and in the Senate are doing. It's not only 
going to destroy the quality of health care, but it's going to destroy 
the budgets of States, of local communities and, most especially, of 
small business and of people who are working class Americans.
  The reason it is going to do that is that the cost of health care is 
going up. It's going to go up for everybody. It doesn't contain costs 
at all. We've been told by the President that this--and in fact, they 
claim on the White House Web site that this is going to help the 
Federal deficit by $100 billion. Well, the reason for that is they are 
going to markedly raise taxes--over half a trillion dollars in 
increased taxes. Those taxes are going to be on everybody.
  We hear from the President that he doesn't want to tax anybody but 
the upper 5 percent of the population, 5 percent of the income, but 
that's not factual. Everybody is going to be taxed because of the 
mandates. We have been told over and over again that, if you like your 
health insurance, you can keep it. Nothing can be further from the 
truth.
  Folks, Mr. Speaker, if you like your health insurance, you can't keep 
it, because even this new ObamaCare 2.0, the second version, has so 
many mandates and requirements on private health insurance that it 
appears to me that what our administration is doing is they are putting 
up a system that is going to force everybody onto the public exchange.
  Well, the President told us a couple of months ago that he sees the 
public option--or in the Senate, it's the public option lite. They call 
it a public exchange. That is what is in the President's current 
proposal. It's just the first step towards Federal bureaucrats' 
controlling every health care decision in this country. Federal 
bureaucrats are going to run the health care system for everybody.
  The playing field has been laid, in this latest proposal by the 
President, that it is going to put the squeeze on everybody in this 
country, not only on the insurance companies--and I'm not a friend of 
the health insurance companies. I fight them all the time as a health 
care provider, as a medical doctor--but it's going to put the squeeze 
on everybody to force them off of private insurance into a public 
exchange or into a public option.
  The President told us just a few months ago that his game plan, his 
purpose of all this, is to try to force everybody into a government-
controlled health care system, and that's exactly the direction that he 
is going.

                              {time}  2145

  Now, frankly, I think this proposal of a bipartisan meeting on 
Thursday, the 25th of February, is nothing but a ruse. It's nothing but 
a dog and pony show either to try to make the Republican Party and 
Republicans to be a party that has no ideas, which the Democrats over 
and over claim, or to be an obstructionist party, that just want to be 
the party of ``no.''
  Mr. Speaker, the American public needs to understand the Republican 
Party is the party of k-n-o-w. We are the party of ``know'' because we 
know how to lower the cost of health care. We know how to lower the 
cost of energy, to seek energy exploration here in America so that 
we're less dependent upon energy sources from countries that hate us 
and want to destroy us. We are the party of k-n-o-w, ``know,'' because 
we know how to create jobs. And we do that through stimulating small 
business, by giving them tax breaks to leave dollars in the hands of 
small business men and women so that they can hire new employees, so 
that they can expand their business, so that they can buy new 
inventory. We're the party of k-n-o-w because we know how to give 
individuals money in their pockets so they can be good consumers again.
  Mr. Brady of, Texas in his 5-minute speech, talked about the folks 
that he talked to just recently there in Texas, and these are small 
business men and women that said that we need to get the fear out of 
the system. We need to give assurance.
  Mr. Speaker, I am here tonight as a medical doctor to try to give 
some assurance to the American people that there are people here on the 
Republican side that are fighting against this

[[Page 1681]]

government takeover of the health care system.
  Mr. Speaker, the American people have spoken very loudly. A recent 
poll showed that 70 percent of Americans either want us to scrap the 
ObamaCare plans, the House plan and the Senate plan, and it would 
include his new plan because it's the two plans put together, or do 
nothing. Well, frankly, as a medical doctor, I don't want to do 
nothing. I have introduced my own health care finance overhaul plan, 
H.R. 3889, which is a comprehensive overhaul of the health care system. 
It's a little over 100 pages. It would put patients in charge of health 
care decisions, along with their doctors. And even Medicare patients. 
It would stop this government control of health care dollars and would 
put those decisions back in the hands of the patients and the families 
where they should be. So Republicans are the party of k-n-o-w, 
``know.'' We've tried real hard.
  But the President has proposed this bipartisan summit. But a senior 
White House official said Thursday the Democrat negotiators, talking 
about this summit that is going to occur this Thursday, the Democratic 
negotiators are resolving final differences in House and Senate health 
bills. That's what we saw just this week in the Obama administration's 
proposal that's on the White House Web site right now, 11 pages, no 
bill, no legislative language. We do not have a bill. All we have are 
bullet points and ideas that they have now resolved the differences and 
have one bill that passed last year with virtually no Republican help.
  Our leadership went over to the White House and said, We'll be glad 
to come. We'll be glad to try to solve this problem for the American 
people. Our leadership, our Republican leadership, has offered a hand 
out to the White House and said to the White House, We want to find 
some commonsense solutions. It's good for patients, good for small 
business, good for America. We need to start all over again. Let's find 
some areas of mutual agreement. Let's find where we can agree on 
issues, where we can pass something to lower the cost of health care 
for all Americans. Let's try to find some solutions to help those who 
are struggling to pay their bills and can't buy health insurance by 
making it more affordable. Let's find solutions to those who are 
uninsurable because of preexisting conditions.
  What was the answer from the White House? The White House's answer 
was, No, we will not do that. You have to accept our plan. We're going 
to start there. We will talk about our plan and we will see where we go 
from there. We're not going to start over. We're not going to try to 
find some common ground. You have to accept things that you do not 
like. That was the answer from the White House.
  Our leadership said, Well, at least do this: Let's take the ramrod 
out. The ramrod has to do with the rule over on the Senate side that's 
called ``budget reconciliation,'' and it's a way of trying to ram 
things through the Senate.
  The White House says, No, we won't do that. We're going to ram it 
down the throats of the American people whether they like it or not, 
and we will do it without your help. We will do it solely with 
Democrats doing this. And we don't care what you say. We don't care 
what you believe. We don't care what you bring to the table. We're not 
going to consider your proposals. We're not going to consider anything 
that you're offering. We're going to do it our way, like it or lump it. 
That's what the White House told our leadership.
  Is that what the American people want? I don't think so. I don't 
think so at all. That's what the White House has said. Now, that was in 
a private meeting.
  They've suggested that we have this open bipartisan meeting 
televised, and, frankly, I think it's just nothing but political 
theater to try to force down the throats of the American people a 
government takeover of health care so that government bureaucrats here 
in Washington, D.C., make your health care decision if you're out there 
in America; that's going to tell doctors, patients, and families 
whether they can get care or not, whether they can have a medication 
that may be even a lifesaving medication or not. And the cost is going 
to go up. What's that going to do? Because the costs are going to go 
up, it's going to hurt small business. It's going to hurt workers. It's 
going to hurt the middle class. We're told one thing by the President, 
but the President says one thing and does something else.
  It's a sad day. It's really a sad day. It's a sad day for my 
patients. It's a sad day for working men and women in America. It's a 
sad day for those people who are struggling to make ends meet. It's a 
sad day for those people who are on government assistance today. It's a 
sad day for America because I think this dog and pony show, this 
charade, this ruse that the White House has put together for Thursday 
is nothing but something to try to pull the wool over Americans' eyes.
  The good news is, though, America, I don't think, is going to buy it 
because the American people get it.
  The President recently said he's just not articulated well enough 
about ObamaCare to allow the American people to understand how they 
need this government takeover of the health care system. He didn't call 
it a government takeover of the health care system. He said ``my 
plans.'' ``My,'' ``I''--all his focus is on himself. But the American 
people do get it. They understand very firmly that this is not what 
they want. This is not the change that they thought they were getting. 
This is not the hope and change that was promised.
  I have been joined tonight by several of our Doctors Caucus members, 
a couple freshmen and then a longstanding Member of the House that have 
come tonight to talk to the American people, Mr. Speaker, through this 
Special Order about ObamaCare to let people know that Republicans are 
the party of ``know.''
  To begin with, I would like to welcome and yield to a freshman, 
another family doctor from the State of Louisiana, from Shreveport, 
Louisiana, Dr. John Fleming.
  Mr. FLEMING. I thank the gentleman from Georgia, Paul Broun, a fellow 
family physician, a fellow conservative who has been a great 
inspiration for me, a great Member, and under whose leadership many of 
these issues have been very valuable to me.
  Mr. Speaker, what I'm going to do is just touch very lightly, just 
highlights, on where we started with this and where we are today and 
certainly yield back for others to weigh in on this.
  It's been slightly less than a year ago that we began to see a strong 
movement towards the passage of health care reform in Congress. Quite 
frankly, I ran on health care reform as a physician, and I'm sure Dr. 
Broun sees many of the things that can be fixed in our system that are 
problems. Having said that, we have the best health care system in the 
world. How do I know this? Well, just one of many empiric facts is a 
gentleman--I believe his name is Mr. Williams--who is Premier of 
Newfoundland, who needed heart surgery, and the type of heart surgery 
he needed was simply not available in Canada. So he came to the U.S. of 
A., the good old U.S. of A., to have that heart surgery because that's 
where the cutting edge is for health care. If you really need health 
care, the best of health care, and you have the resources, the U.S. of 
A. is the place to get it, but we need to be sure that good health care 
is available to all.
  Less than a year ago, there was launched, by both the House and the 
Senate, efforts to pass health care reform, which really turned out to 
be, in my view, nothing more than a government takeover of health care.

                              {time}  2200

  Both bills are very similar. Both passed, of course, each House. The 
one or two major differences would include the House bill has a 
government option. The taxation is heavy in both. The financing is 
heavy in both, but very similar.
  But, to cut to the chase, it cuts out a half-trillion dollars from 
Medicare. It taxes people $800 billion, and it does not bend the cost 
curve down. Even the CBO says that.
  Now, we have a situation, despite the fact that all of us here who 
are speaking tonight have been working very

[[Page 1682]]

hard for many months, day after day, night after night, attempting to 
drive a wooden stake in the heart of this vampire, the government 
takeover of health care. And it seems, even when it's dead, it seems to 
be rising again.
  Now, you know, it started out with a slight approval rating in the 
early days. I mean, who wouldn't be for health care reform? It sounds 
like a wonderful idea. But as people began to learn about it, and 
certainly when we got to the August recess where there were town hall 
meetings, we saw situations where people became so angry they were 
almost, I would say, out of control at times, very angry at many of 
their representatives across the country who would dare want the 
government to take over the most intimate part of our society, and that 
is health care.
  And so, little by little, and maybe not so little by little, but 
perhaps even rapidly, we saw the approval rating of the government 
takeover of health care drop. And today, 2 to 1 Americans are against 
this. And those of us who were against it, it doesn't matter what party 
you're in--it doesn't matter. I mean, the only thing bipartisan about 
these bills we can actually say is that there are people on both sides 
of the aisle who are against it. But the bottom line here is that 
Americans do not want this.
  I perceive us today, at this point in time, to be two touchdowns 
ahead, and 2 minutes left in the fourth quarter. The debate is over 
among the American people.
  Yet and still, we have the President and Members of the House and the 
Senate, Democrat Party, who still want to find a way to cram it 
through. And one of the things they've come out with is just the 
release, less than 24 hours ago perhaps, maybe a little more than 24 
hours ago, of a compiled version of the two bills. And here is what we 
have. The bill is most like the Senate bill, that is, the Obama 2.0 
that Dr. Broun refers to is most like the Senate bill, but it increases 
spending by $100 billion. It increases premiums that are already going 
to increase by $2,100 per family per year. And it does something 
unbelievable, unprecedented. It actually begins to tax, by a factor of 
2.9 percent, unearned income. That's the capital gains tax, interest 
income. These are all things that come to people who, in many cases, 
have fixed incomes. And of course, yes, it is the people who make over 
$200,000 a year.
  But you know what? Where are we today with the AMT tax? It was never 
indexed for inflation, and now we have middle class people paying it. 
This is not indexed either, so sooner or later, middle class taxpayers 
will be paying those taxes.
  Mr. BROUN of Georgia. Will the gentleman yield a second?
  Mr. FLEMING. Yeah, sure.
  Mr. BROUN of Georgia. I want to point out something too so that we 
understand. We keep hearing from the President, we want to tax the 
rich. Most small businesses in this country file their income taxes 
individually because they're sub S corporations, which means that their 
income taxes are filed individually, as a person or as a couple. And 
over half of those people that make over $200,000, which is in the 
President's current proposal, are small businessmen and women, and it's 
taxes on their business. So, by taxing folks making over $200,000 or 
over $250,000, what it's going to do is it's going to take money out of 
small businesses so that they can't expand, so that they cannot give 
their employees the kind of salary that their employees deserve.
  And I've talked to a lot of small businessmen and -women in Georgia 
who are going to have to let people go. So this is going to cost a lot 
of jobs. In fact, millions of jobs all over this country are going to 
be lost because of this tax, so-called tax on the rich, because it's 
really a small business tax. It's a tax on small business that's going 
to cost millions of people their jobs in this country. They're going to 
be out of work, and so we're going to have more joblessness in this 
country if this monstrosity gets passed into law. I thank you. I yield 
back.
  Mr. FLEMING. Yes. I appreciate the gentleman, Dr. Broun. Absolutely, 
that's the working capital for small businesses. You add to that that 
there will be as much as an 8 percent payroll tax for businesses that 
heretofore could not afford health care insurance, and they'll have to 
pay the insurance without getting that. And then their employees, who 
will not be able to afford to buy insurance, will be--instead of paying 
$750 per person under the Senate version, it'll be $2,000. So we have 
many things that are going to be job-killers out of this bill.
  And last but not least, just when we thought all of those bad deals 
that really got this thing in trouble to begin with were going away, we 
find the Louisiana Purchase, the $300 million for Medicaid to 
Louisiana, which--Louisiana needs money to offset a FMAP problem, no 
doubt about it. But the problem is, if this bill goes to signature, 
that $300 million will be swallowed by a billion dollars of additional 
cost down the road that Medicaid is going to cost. So no real benefit 
to the State of Louisiana.
  The Yukon deal--Senator Dodd added $100 million for a hospital that 
he liked for his State.
  Gatorade--Ben Nelson secured extra benefits for Medicare Advantage 
beneficiaries. The handout, the Montana, the North Dakota Senators 
deal, Hawaii got a special exemption for higher Medicaid DSH, or 
``Dish'' payments. On and on and on, there are all sorts of deals still 
in this bill that have not been cut out.
  And so I agree with the gentleman. As we go into this summit, health 
care summit on Thursday, there's no doubt about it. The American people 
need to understand that this is not about a true negotiation. The 
Republicans have been locked out of negotiations. We've been locked out 
of amendments.
  Despite what I hear my Democrat colleagues say, we do not agree with 
80 percent of this bill, not by any stretch of the imagination.
  And so why now would we have this summit in front of the cameras? The 
reason is, as I said, is because this bill is nearly dead. It's trying 
to be revived, and now this is time for the Hail Mary. The President's 
going to jump in there and try to revive this somehow at the last 
minute.
  And so I submit, Mr. Speaker, that it's time to kill this once and 
for all. Let's go on to true health care reform, stand-alone bills, 
starting with the low-hanging fruit, one at a time, attacking the 
things that we know we can all agree on: Preexisting illnesses, 
aggregating employees into large buying pools, purchase of insurance 
across State lines, tort reform--these things are straightforward. We 
could improve health care and lower the cost overnight by doing these 
things. And then get back to the people's work, and that is creating 
jobs for this country. I thank you and I yield back.
  Mr. BROUN of Georgia. Thank you, Dr. Fleming. I appreciate it. Now 
want to yield some time to another great member of our Doctors Caucus, 
Dr. John Boozman from Arkansas. And Dr. Boozman, before you start, I 
want to say that just to kind of tag on to what Dr. Fleming just said 
about the Louisiana purchase. He's from Louisiana. But this new 
proposal that President Obama has put forward is going to extend the 
Louisiana Purchase to every State. Now, the governors are going to love 
that, and the State legislatures are going to love that, because what 
it's going to do is it's going to take some of the financial burden off 
them for health care costs that are skyrocketing because of the Federal 
Government. But what it's going to also do is it's going to put a heavy 
burden on all the taxpayers in this country. So the taxpayers are going 
to hate the Louisiana Purchase. And it's just a cost shifting, 
basically, from a State level to a Federal level, and again, it's a 
Federal takeover of the health care system, and to get the States, as 
well as private insurance, out of the health care system, so--Louisiana 
Purchase. So I appreciate Dr. Fleming bringing up the Louisiana 
Purchase.
  Dr. Boozman, I yield to you whatever time you may consume.

                              {time}  2210

  Mr. BOOZMAN. Thank you very much.
  I agree. That sounds good in the sense of taking an additional role 
by

[[Page 1683]]

the Federal Government paying for these things. The problem is, we've 
got a proposed budget by the administration of $3.8 trillion. Almost 
half of that money is borrowed from people like Saudi Arabia, China--
people that don't like us very much. And the American public knows it 
just doesn't work. These things sound good but at some point, you have 
got to pay your bills, and we've got to start paying our bills.
  The President outlined his plan, and the reality is he's not hearing 
the concerns of the American people. He is not hearing the concerns of 
the people of Arkansas. What he is doing is he is telling us what 
health care coverage we can have as opposed to what the American people 
want.
  The American people now in overwhelming majority have said, ``No. 
This is not the bill we want.'' Right now, we're spending more than any 
other country in the world by far with our health care system. The 
proposal that we have will spend almost another trillion dollars and 
yet costs will continue to rise.
  So, again, instead of trying to do something in the free market way 
to lower costs, what the bill actually does is basically say we're 
going to do that by setting price controls. And price controls don't 
work. What we're going to do is have rationing, and we will have 
decreased quality of care.
  Another real concern I've got is the abortion coverage. The Hyde 
amendment has always said that we're not going to pay for abortions 
with taxpayer funding, and yet this bill leaves that wide open.
  The Medicare payroll tax. The administration is talking about putting 
a 2.9 percent tax on non-wage income, and I don't think the American 
public understands yet that that is in there or being talked about, the 
ramifications about that. But when you start taxing dividends, when you 
start taxing interest, capital gains, things like that, those are the 
kinds of things that are creating jobs.
  My frustration is instead of coming out with things that are job 
creators in this economy, we continue to have these things thrust upon 
us that are really job killers.
  The group that he is not talking about--and we were discussing this 
earlier, and I will yield to my colleague here--are the health care 
providers.
  Tomorrow, Thursday, there is going to be the meeting, and there is 
probably 17, 18, 19, 20 Members of Congress that are health care 
providers, and none of those are over there actually talking about 
what's going on.
  Mr. BROUN of Georgia. Let me reclaim my time here.
  Let's say that again so we understand. The American people say, 
``What? You're not including doctors who are taking care of patients? 
How are you going to form a health care system?''
  Dr. Boozman, please say that again very clearly so the Speaker and 
anybody watching tonight can understand.
  Mr. BOOZMAN. Again, and this is not a Republican or Democrat thing. I 
am just saying health care providers amongst all of us. When you add 
the experience up, the years of practice and things, you would think 
that this is the group that you would call on first to get over and 
give you good advice.
  Mr. BROUN of Georgia. Reclaiming my time, I agree with you. In fact, 
I introduced H.R. 3889, a comprehensive bill, a little over a hundred 
pages, that totally would change health care financing in America and 
it would give patients the power to make the decisions along with their 
doctor.
  I wrote the President. He said, If you have any ideas, my door is 
always open. But I've been knocking on that door over and over again, 
and it is slammed shut, locked, and I've been trying to open that door 
that he said was open and it's not been opened.
  I know other members on our side, Dr. Price from Georgia, another 
physician, orthopedic surgeon, has introduced the Republican Study 
Committee Bill, H.R. 3400. Dr. Price has offered to talk with the 
administration. The door is locked. Bolted. Closed shut. Republicans Go 
Away is the sign on the door. And we're not being included in this so-
called summit, bipartisan summit, on Thursday.
  Why don't they want us there? Because we know about health care. 
They're not interested in what we, as physicians, know. They're not 
interested in our ideas. They're not interested in any Republican 
ideas.
  This is a ruse. It's a show. Nothing but a dog-and-pony show to try 
to boost the President's approval ratings or try to make him look as if 
he is reaching out a hand of bipartisanship trying to find solutions 
for the American people. Actually, it's a fist that he is showing us, 
and it's a closed fist. It's a closed, locked door, and it's nothing 
but a show or a charade to try to look to be something different than 
it is.
  Thank you, Dr. Boozman.
  We are also joined tonight with another colleague. Louisiana is 
blessed by having three physician members of the Republican delegation 
here. We heard from Dr. John Fleming just a moment ago. We have Dr. 
Charley Boustany from Lafayette, Louisiana. Lafayette is one of my 
favorite towns. I've got some great Cajun buddies that I duck-hunt with 
down there. In fact, I talked to one today about he's coming to Georgia 
and wants to go turkey hunting. Shelly Deshotels from Lafayette, 
Louisiana is a good friend and a turkey hunting buddy. And Shelly 
Deshotels told me today, ``Keep fighting.'' He doesn't want to see this 
health care bill passed anyway.
  We've got another physician, Dr. Bill Cassidy, who's joined us today.
  Louisiana is like Georgia. We have three physicians from Georgia in 
the Republican delegation, and we have three physicians from Louisiana 
in their delegation.
  I want to welcome and yield to Dr. Bill Cassidy for such time as he 
may consume.
  Mr. CASSIDY. Dr. Boustany will be at the summit meeting.
  Mr. BROUN of Georgia. Oh, really? That is news. Hallelujah. Praise 
the Lord.
  Mr. CASSIDY. Clearly, I think we can all agree on what are the goals 
of health care reform. We want access to quality care at an affordable 
price. And it kind of gives us a nice way to judge each of these.
  I am struck. Medicare is going bankrupt in 7 years. Medicaid is 
bankrupting States, and we're about to create a third entitlement to 
rescue the first two. And a third entitlement that is going to be based 
upon the House bill and the Senate bill. The Congressional Budget 
Office has said of both the House bill and Senate bill that they more 
than double costs within 10 years.
  So we're going to go from a status quo which may double costs in 10 
years, to a reform which more than doubles costs in 10 years.
  Folks ask me how do I like my first year in Washington, D.C. I say, 
it's a crazy place. We pass a reform to control costs which is more 
expensive than the status quo--and that is important because the 
American people since August have been saying, Mr. Speaker, that we 
need to control costs. They understand that you can give everyone 
access, but soon our costs are out of control and access is gone. You 
can give everybody the highest quality, but unless you control costs, 
again you break the bank.
  So the American people since August, and with the Senate election in 
Massachusetts putting an exclamation mark behind the sentence, are 
saying, Control costs.
  Now as it turns out, the proposals before the President, the Senate 
bill, again, according to Congressional Budget Office, more than 
doubles costs in 10 years, and the President's proposal will be a 
hundred billion dollars more expensive than that.
  Now, the President is billing this as a tax cut to the American 
people, but really it's a shell game. Some folks will have their taxes 
simultaneously raised and their subsidies increased. Now, that's a 
crazy thing, but on the other hand, if you're going to subsidize here, 
you must tax there. And because some of the things being taxed are 
insurance policies--insurance policies owned by union folks, for 
example, who negotiated this through their wages--there will be a tax 
on folks who most consider middle income.
  What are the alternatives? You mentioned something earlier, Dr. 
Broun. I

[[Page 1684]]

said, man, you can tell the guy's a family physician. You talked about 
empowering patients. I think the fundamental difference between the 
Republican proposal and the Democratic proposal is that the Democratic 
proposal is a top-down, control costs from Washington, D.C., type 
approach.
  Mr. BROUN of Georgia. That doesn't control costs.
  Mr. CASSIDY. Dr. Boozman just pointed out that the price controls 
upon insurance policies is the ultimate in a top-down, bureaucratic, 
doesn't matter what the market says, we're going to control your costs 
from Washington. It never has worked.
  On the other hand, the Republican approach is patient-centered. You 
and I know as physicians--and I am still seeing patients. I see them 
about once every 2 weeks in my practice. I work in a public hospital 
treating the uninsured. If you involve the patient in her care, she 
typically is healthier, she saves money, and the system saves money.

                              {time}  2220

  Health savings accounts, Dr. Broun, I know you know this, but for the 
audience, a patient will put, with pretax dollars, before you are taxed 
on it, will fund a bank account, and that bank account is used to pay 
for medical care.
  As it turns out, with traditional insurance, say a family of four 
puts up $12,000, and then a year later they put up another $12,000, and 
then a year later they put up another $12,000. With a health savings 
account, if you don't use the money, it rolls over to the next year. 
And some families will continue to accumulate until the amount they 
have to put in is zero because they have been so wise with how they 
spend their money.
  A good example of this, I am sorry Dr. Fleming left, because he talks 
about how his medical practice went to HSAs for all the employees. And 
he has an employee who was smoking. And she complained, because before 
the insurance paid for inhalers--the smoking had given her asthma--and 
now she had to pay for it out of her own pocket. So before she was 
cost-insensitive, and now, because it is out of her bank account so to 
speak, she is aware of it.
  And Dr. Fleming said to her, Well, you know, if you stopped smoking, 
you wouldn't need that inhaler.
  And she goes, Really?
  He goes, Yes.
  She stopped smoking, her health is better, she no longer pays for 
inhalers, and we are controlling costs overall. So by involving 
somebody in her care, her health is better, the system saves money, and 
she has more money in her pocket.
  And, by the way, one last thing before I yield back, the Kaiser 
Family Foundation has a study. They found that a family of four with a 
health savings account, that that policy is 30 percent less expensive 
than a traditional insurance policy for a family of four; that the 
family with the health savings account and the catastrophic policy on 
top, not only is that policy 30 percent cheaper, but they use 
preventive services as frequently as a family with a traditional 
insurance policy.
  Now, if our goal is to give high quality care to all at an affordable 
cost, well, what we just found out is with the HSA you lower the cost 
by 30 percent. Okay. That is one of your goals. And they are using 
preventive services as frequently. So they have access to quality care. 
As it turns out, because it is lower cost, 27 percent of people in this 
study who had a health savings account with a catastrophic policy were 
previously uninsured. About 50 percent had a family income of $50,000 
or less, and about 60 percent had a family income of $70,000 or less.
  So again, by lowering costs 30 percent, people who were formerly 
uninsured now have access to quality care. That is a patient-centered 
approach, far different from the bureaucratic approach that is being 
offered by the Senate and House bills. But from our experience as 
practicing health care providers, I think we can say it is the right 
approach.
  I yield back.
  Mr. BROUN of Georgia. Thank you, Dr. Cassidy.
  One other thing that I want to add, too; not only is it less 
expensive, people can afford to buy insurance where before they had not 
been able to. They use more preventative services, but they take care 
of themselves better. So they are healthier. Diabetics control their 
blood sugar better. People who have high blood pressure control that 
better. Folks with high cholesterol tend to get their cholesterol 
lowered. They have less heart attacks, strokes. So they are healthier. 
They live longer. They are more productive. They are happier. They feel 
better, have more energy. So it actually promotes wellness.
  If you really think about it, in the health care system today, we are 
not taking care of healthy folks, for the most part. We take care of 
sick people. That is what doctors do. That is what hospitals do, take 
care of sick people. Some people say we have a sick care system. Well, 
the system is sick because of the government.
  Before I go back to Dr. Boozman, I want to tell a couple of stories 
about my practice and how government intrusion in the health care 
system has driven the cost of health care up for everybody. Back 
several years ago, I was practicing medicine down in rural southwest 
Georgia. Congress passed a bill called CLIA, the Clinical Laboratory 
Improvement Act, and what this did is it shut down every single 
doctor's lab in this country.
  Prior to CLIA, I had a fully automated, quality controlled lab in my 
office. And when patients came in to see me with a red, sore throat, 
running a fever, coughing, runny nose, I would do a CBC, or complete 
blood count, to see if they had bacterial infection and, thus, needed 
antibiotics, needed that expense, needed the exposure to the 
antibiotics and problems that may come from that, or whether they had a 
viral infection that is not helped by antibiotics at all. They don't 
need to spend that money. They don't need the exposure to the 
antibiotics. Less chance of having anybody have allergic reactions, 
less chance of developing the superinfections in this country.
  I do that test, a CBC in my office, in 5 minutes. It costs $12. That 
is what I charged. That is what I charged Medicare and Medicaid as well 
as the patients. So this was a tool that I could use in my office, 
fully quality controlled. But Congress, in its supposedly infinite 
wisdom, in fact, Mr. Waxman, who is right in the middle of trying to 
push forward this government control of health care, was the one who 
pushed through CLIA--one of the ones.
  After CLIA shut down my lab and every lab in doctors' offices across 
the country, to do that same test I had to send my patients across the 
way to the hospital. So they had to leave my office, go over there, 
spend 2 to 3 hours doing what I could do in 5 minutes, $75 for one 
test. Twelve dollars to $75. Five minutes to 2 to 3 hours for the 
patient.
  Now, what do you think that did to the cost of everybody's health 
insurance in this country? What do you think it did to the cost that 
Medicare has to pay for lab services? It rose the cost of health care 
markedly all across this country. And that is with one government 
intrusion, CLIA. We have hundreds.
  Not long ago Congress passed HIPAA. HIPAA has cost the health care 
industry billions of dollars. It is totally unneeded regulation. It has 
cost the health care industry billions of dollars and has not paid for 
the first aspirin to treat the headaches it has created. What does that 
do to my insurance costs and the American people's insurance costs? It 
drives it up markedly. Somebody has to pay that billions of dollars for 
that one government regulation that was put in place by Congress and 
the President signed into law. It has cost the health care industry. It 
costs all of us a tremendous amount of money.
  So it is government regulation, government intrusion in the health 
care system that has raised the costs for me and for my patients. And 
here we go with another government bill, another government takeover 
that is going to put cost controls, that is going to put taxes out the 
wazoo for everybody in

[[Page 1685]]

this country. So it is going to cost everybody. And I believe it is 
totally designed, to go back to what the President said just a couple 
of months ago, that he wants to go to a government-controlled, 
centrally run health care system, socialized medicine run from 
Washington, D.C.
  Before, Dr. Boozman, I go to you, I just want to point out a couple 
things on this chart. What is in the new bill? It is just more of the 
same. It is the worst of the House bill, worst of the Senate bill put 
together. It is more of the same. It is a government takeover of health 
care. There is no question about it. There are price controls, as Dr. 
Boozman was talking about. There are a lot of individual and employer 
mandates.
  So if you have health insurance and you like it today, it is going to 
go away, because the Federal Government and the Federal bureaucracy in 
Washington, D.C., is going to put mandates on your health insurance to 
the point that it is going to go away.

                              {time}  2230

  In fact, I believe it is geared up to try to put all health insurance 
companies out of business so that there is only one health insurer in 
America, and that is the U.S. Federal Government.
  There is no medical liability reform. The President talked about he 
wanted to have medical liability reform. It is not in any of the 
Democrat bills, the House bill, the Senate bill, nor is it in ObamaCare 
II. It still puts Washington bureaucrats in charge of defining what is 
quality health care. In fact, in the stimulus bill, the nonstimulus 
bill--the failed stimulus bill--the Democrats put in something that's 
called--what was it called? I'm having a brain freeze here. It's called 
an Effectiveness Research Council, or Comparative Effectiveness 
Research is what it's called. What that is geared to do is physicians 
look at the comparative effectiveness of different treatments, whether 
if you have cancer, whether surgery, or chemotherapy, or radiation 
therapy--or a combination of all three is better. That's what we do in 
medicine.
  The comparative effectiveness that the Democrats have put in place 
actually is geared towards how to spend dollars. It is the comparative 
effectiveness of spending $1 on a 40-year-old versus a 65- or 70-year-
old. And so the way the whole system is set up, it means that the 
Medicare recipients are going to get thrown in the stick. Senior 
citizens, under the comparative effectiveness, are not going to get the 
care; they are going to be denied it by the Federal Government.
  Cuts Medicare Advantage. It still raises taxes. There is over a half 
of a trillion dollars of increase in taxes, and this is the only way 
that they can even get it anywhere close to the kind of numbers that 
the President promised. And he and his administration have used what I 
call ``voodoo economics.'' The reason I call it voodoo economics is 
because you have to be a dead man walking around with no soul to 
believe the economic parameters of the economic issues that they've put 
in place. But this Obamacare raises taxes and will raise taxes on 
virtually everybody.
  And it still gives the government-run plan a beachhead to eliminate 
private insurance. And I think this is the bottom line. This is the 
purpose that Henry Waxman and Charlie Rangel and Ted Kennedy and Nancy 
Pelosi and George Miller and a lot of people have been pushing, the 
government takeover. They're very open and frank about it, and I 
congratulate them for being at least halfway honest. But the whole 
purpose of the Pelosi bill in the House, the Reid bill in the Senate, 
both ObamaCare and now the proposals that the President put forth 
yesterday morning, is a government takeover of health care, to tell the 
American people the kind of care that they can get.
  Whether they can get it or not, it is going to take the 
decisionmaking process out of the hands of patients and families, out 
of the doctor's hands, and it is going to put it in--all those 
decisions are going to be made by government bureaucrats here in 
Washington, D.C.
  So with that, I yield to Dr. Boozman.
  Mr. BOOZMAN. Well, again, I would add that I was a health care 
provider, but I was also a small business person in the sense that we 
had about 85 employees that we had to meet payroll with. And always our 
biggest cost of doing business, our biggest expense was health care 
insurance for our employees. Every year the guys would come along and 
they would say, well, your premium is going up 10, 15, 20 percent, 
whatever it is. The major problem that we have going on right now is 
increased cost. And as was discussed earlier by my colleague, you know, 
things like health savings accounts, those are free market reforms. It 
is a free market reform that lowers cost. Associated health plans, 
allowing my barber with his two or three employees to team with maybe 
thousands of barbers to get a much lower rate. And then lastly, 
controlling the nuisance lawsuits. Those are free market reforms that 
would lower costs, which we desperately need. The problem is--and 
again, I don't know who the President is listening to--but those types 
of things are not included in the bill that we see.
  The only thing I would say though is, instead, there is no control of 
cost, and what we have is in the fine-print wage and price controls 
that they're just saying, well, we are going to dictate the cost. And 
again, as my colleague said earlier, that just doesn't work. That has 
been proven with several administrations in the past that it is going 
to lead to rationing and decreased quality of care.
  I yield to you.
  Mr. CASSIDY. You know, it is interesting because we can see from the 
Republican administration of Richard Nixon, the Democratic 
administration of Jimmy Carter on oil and gas, that when you try to 
artificially control price with regulation, it doesn't work. You have 
to address the fundamentals.
  So let me give an alternative between this top-down bureaucratic 
means of control and a patient-centered approach. I was speaking about 
HSAs and patient-centered approaches with a constituent, and he says, 
you know, doc, I take a pill for my ulcer. Now, I have an HSA. My 
physician wrote a prescription and I said, physician, I know from 
experience that this pill is going to cost me $159--he didn't say $160, 
he said $159. He said, I have an HSA, I pay for this out of pocket, can 
you do me something different? And the physician said, oh, you have an 
HSA? Tore it up and wrote a prescription for generic and it cost him 
$20. The system just saved $139.
  I have another patient who called me--I am a liver specialist--called 
me up, and she says, Dr. Cassidy, I have a bad heart. My doctor over 
here said I needed this test because of my bad liver, not my heart, but 
rather my liver. And I said, from a liver perspective, you don't need 
it. She said, well, I will pay for it if I need it, I have an HSA, but 
I will pay for it if I need it. I said, no, ma'am, you do not need it. 
The system saved $1,000. Because she had an HSA, she was motivated, she 
was motivated to find out how much it cost and then to see if she 
really needed it.
  Mr. BOOZMAN. Will the gentleman yield?
  Mr. CASSIDY. I will.
  Mr. BOOZMAN. Under these plans, the generic is not covered in the 
HSA; is that not correct? Can you comment on that?
  Mr. CASSIDY. That is correct. It is kind of a crazy thing where if an 
HSA is used for a generic price on an over-the-counter drug, which is 
what we are describing here----
  Mr. BOOZMAN. Which lowers cost.
  Mr. CASSIDY. Which lowers cost, it's not available for an over-the-
counter medicine. And so that $20 prescription is actually over-the-
counter medicine, and we're talking about ulcer medicine. So in this 
way, the patient reacts so as to take care of her health and to lower 
her cost. And in millions of those interactions across the Nation, not 
from Washington, D.C., but rather from the exam rooms themselves is how 
the system saves costs.
  You recall, Dr. Broun and Mr. Speaker, how we spoke of the HSAs being 
30 percent cheaper. Well, that's why they're 30 percent cheaper because 
patients are incentivized to control their cost.

[[Page 1686]]

  One last thing I will say. When you ask a crowded room who is most 
responsible for each person's health, we all know that it is that 
person in particular. So what the Health Savings Account does, the 
patient-centered approach does, it says that the patient is most 
responsible for his or her care, and in so doing, we trust that the 
patient, with her physician, will make the right decisions. And the 
story of Health Savings Accounts is that that is true, that is a well 
placed trust.
  Mr. BROUN of Georgia. Well, I will reclaim my time, and I thank you, 
Dr. Cassidy.
  In fact, my health care overhaul bill, H.R. 3889, expands health 
savings accounts, creates Medicare health savings accounts. So it puts 
Medicare patients in charge of their own dollars, and they own those 
dollars. And those dollars, if they're not expended, would roll into 
their estates so that their heirs would get them.
  We pay our Medicare taxes to the Federal Government, and we should 
get it back. I am an original intent constitutionalist, and I 
understand that some people would say, well, Dr. Broun, an HSA is not 
constitutional under Medicare, but we've got to fix Medicare. And it is 
a bridge to help Medicare patients start controlling their own costs 
and controlling their own money and controlling their own health care 
decisions. That is exactly what my bill, H.R. 3889, would do.
  But I wanted to go back to this summit just in the last few minutes 
that we have. Actually, the mainstream media has written some articles 
that just came out today, and I wanted to read a couple of things from 
the mainstream media. The President has talked about he wants to reach 
out in a bipartisan way. The Wall Street Journal wrote today, Democrats 
have decided to give the voters what they don't want anyway. A San 
Francisco Examiner editorial said, Republicans publicly wondered if 
Obama's proposal represented a refreshing new attempt by the Chief 
Executive to display genuine bipartisanship and whether they should 
trust him to come to the summit with a truly open mind. And that is 
what we had hoped.
  Going on with what they said: We now know the answer to both 
questions is a resounding ``no.''
  The Washington Post said, President Obama's opening bid on health 
reform is not designed to entice Republicans to join the game.
  And as we said earlier, I don't believe the President wants 
Republicans to join the game, he doesn't want the Governors to join the 
game. He doesn't want anyone to join the game because he has set the 
game rules himself, tilted towards just what he wants and what nobody 
else wants. It is just the leadership meeting in secret behind closed 
doors, with no input actually from our Democratic colleagues nor our 
Republican colleagues, nor Governors, nor health care providers, 
anybody except just the leadership has brought forth ObamaCare II.
  And even in his hometown newspaper, The Chicago Tribune--not known to 
be a conservative newspaper--said this: Obama wants Republicans to 
approach the summit in a spirit of compromise. Too bad he's not leading 
by example.
  So, Mr. Speaker, we've spent an hour with my colleagues talking about 
health care. Republicans are the party of k-n-o-w, know. We can lower 
the cost of health care. We can empower patients and doctors to make 
the decisions and start health care reform, health care financing 
reform, that makes sense economically, that will cover those that are 
uninsured, that will cover those who have preexisting conditions that 
can't get insurance today. We can do those things if the President and 
the leadership of this House and the leadership of the Senate would 
just listen to some of the proposals that we have put forward. Doctors 
have not been enjoined in this process. The American people have not 
been in this process. And the American people need to say no to 
ObamaCare.

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