[Congressional Record (Bound Edition), Volume 156 (2010), Part 2]
[House]
[Pages 1939-1940]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     HEALTH CARE SUMMIT--Continued

  The SPEAKER pro tempore. The gentleman from Texas may resume.
  Mr. BURGESS. Reclaiming my time, let me just run through a little 
bit.
  We heard right at the end of the 6-hour discussion down at Blair 
House today, the President and I believe the Speaker of the House said 
that the time for incrementalism has passed. I felt like I had stepped 
back in time. I heard that very same argument in 1993 and 1994 when the 
then-Clinton health care plan was before the House of Representatives.
  I never will forget the day that Mike Synar, a Representative from 
Oklahoma, a Member of this House of Representatives, was down in 
Dallas. He was talking to a group of us who were American Medical 
Association members, and he was going to talk to us about this bill. 
Many people had questions at the time--believe it or not, I was so shy 
I was scared to say anything--but toward the end, someone asked Mr. 
Synar, wouldn't it be better to tackle some of these problems on an 
individual basis and not try to do all of this all at once because it 
did appear to be frightening people. And Mr. Synar made a very emphatic 
statement that the time for incrementalism is over, we must have this 
bill and we must have it this year. Sounds familiar. That was over 15 
years ago.
  Of course they didn't get the bill passed, life went on, the health 
care system in this country improved. We developed the State Children's 
Health Insurance Program under a Republican Congress with a Democratic 
President. We established medical savings accounts. We then, several 
years later, improved them with health savings accounts. We provided a 
prescription drug benefit in Medicare. For better or for worse, we 
passed the HIPAA law in 1996. But there was a lot of work that went on 
in health care.
  Health care is an evolutionary process. Medicine is an evolutionary 
process because the knowledge base changes. The science changes over 
time. It is not a static event like law, or physics perhaps. But 
medicine is constantly evolving. In fact, many times we say that's why 
we refer to it as both an art and a science.
  Well, what do the people think about doing this all at once or 
perhaps taking off some smaller pieces that might be actually doable? 
Americans agree with Republicans and want a fresh start on health care 
reform. A CNN poll--now, CNN is not always friendly to conservative 
principles--in a CNN poll, 73 percent of Americans say lawmakers

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should work on an entirely new bill or stop working on health care 
altogether. This was from February 24, 2010. Another poll, 79 percent 
of independents want Congress to start work on a new bill or stop all 
work, again from the same time frame.
  So maybe it is reasonable that we start over with these small, 
incremental changes and solve some of the problems that bedevil 
Americans right now, but not turn the entire system on its head in 
order to help that smaller percentage that is having difficulty right 
now.
  Starting over does not mean that we have no bill to pass. It doesn't 
mean that we start into another year-long debate. As I began this hour, 
I outlined to you, Mr. Speaker, several bills that are already out 
there, already written, could be called up, could go to committee, 
could be worked on, marked up, amended, and come to this House to be 
voted on up or down. We could pass a bill on preexisting conditions 
before we go home for the Easter recess. It would really be that 
simple. Instead, what we may get is the Senate bill being passed by the 
House of Representatives--under great duress for some Members of the 
House of Representatives--and then when that bill is passed by the 
House, it goes down to the President for his signature, and then good 
luck undoing all of the problems that are contained within that bill. 
It would be far better, since no help is coming for 4 years anyway, to 
take a little time and do this correctly.
  The gentleman from Pennsylvania brought up the problems in 
Pennsylvania with medical liability. Texas, of course, in 2003 did 
change their medical liability laws and passed a bill that would allow 
a cap on noneconomic damages. It is a more generous cap than was passed 
in California in 1975 under the Medical Injury Compensation Reform Act 
of 1975, but nevertheless, it has worked well over the last several 
years and has now solved a lot of the problems that we were 
encountering in the earlier part of this decade.
  Just some statistics to share with you; before the reform, one in 
seven obstetricians no longer delivered babies, 49 percent of counties 
didn't have an OB/GYN, 75 percent of neurosurgeons would no longer 
operate on children. Since passing that reform in Texas, it has really 
dramatically changed things. We had, in the 2 years before the reform 
passed, 99 Texas counties--Texas has 254 counties, and 99 counties lost 
at least one high-risk specialist. With the passage of what was then 
called Proposition 12, which was a constitutional amendment to provide 
caps on noneconomic damages and lawsuits, 125 counties added at least 
one high-risk specialist, including the counties I represent, Denton, 
Tarrant and Cooke Counties. And you can see of course there are some 
areas that are still needing to add specialists.
  One of the remarkable things about the passage of this law is the 
number of counties that did not have an obstetrician previously but now 
do, and the number of counties that did not have an emergency room 
doctor but now do. Twenty-six counties that previously had no emergency 
room doctor, 10 that had no obstetrician, and seven that had no 
orthopedic surgeon, now at least have at least one of those 
specialists. Charity care rendered by Texas hospitals has increased 24 
percent, nearly $600 million since the passage of this legislation. And 
Texas physicians have saved well over $500 million in liability 
insurance premiums.
  Now, people will argue that passing tort reform does not immediately 
result in lower cost. Defensive medicine is learned behavior. Defensive 
medicine is oftentimes learned over a lifetime of practicing medicine. 
And it does take a while to begin to walk back from that. But as anyone 
will tell you, the journey of a thousand miles starts with the first 
step, and Texas has taken that first step. In fact, in Texas, one of 
our bigger problems now is licensing all of the doctors who want to 
move to the State. The State Board of Medical Examiners cannot keep up 
with the demand. It is a good problem to have because we had many 
counties that were underserved. And now, with the passage of this 
legislation at the State level, almost 100 percent of Texans live 
within 20 miles of a physician. That is a remarkable change from even 
just a decade ago.
  One of the last things I want to bring up tonight before we leave, 
we've talked a lot about cost, and during the course of the discussion 
down at the Blair House the debate on cost was lengthy and sometimes it 
became contentious, but just a few points that Representative Paul Ryan 
from Wisconsin made today. He pointed out correctly that Medicare has 
an unfunded liability of $38 trillion over the next 75 years. This is a 
huge, huge budget pitfall that is facing not just Members of Congress, 
but every citizen of the United States over the next 75 years.
  While Federal Medicaid spending grows at 23 percent this year, the 
program continues to suffocate State budgets. And this bill does not 
control costs. Mr. Biden talked about if we don't bend the cost curve, 
we're in trouble. I will submit that we are in trouble because we have 
bent the cost curve, but we are bending it in the wrong direction.

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