[Congressional Record (Bound Edition), Volume 156 (2010), Part 3]
[House]
[Pages 3865-3871]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  2015
                           HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Louisiana (Mr. Fleming) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. FLEMING. Mr. Speaker, I am going to be starting this hour on 
behalf of my colleagues from the GOP Doctors Caucus. Congressmen and 
Drs. Murphy and Gingrey are our two cochairmen. We make up a group of 
10 M.D.s and 4 other professional health care workers, including a 
dentist, a psychologist, an optometrist. We have been meeting on a very 
regular basis throughout this debate. Perhaps this weekend we will have 
a culmination of quite a debate. And what a debate it has been all 
year.
  As I tell folks often, I ran in my election in 2008, my first 
election, on health care reform. I am a physician, a family physician 
of 30 years. I have enjoyed the practice of medicine. I still practice 
medicine when I go back to my district. And for this 30-year period I 
have learned a lot about the economics of health care, things that are 
so important. I have been through all phases. In the early days of 
Medicare, when we didn't have a lot of the restrictions and restraints 
that we have today; during the HMO days, where we had capitated care 
and the so-called gatekeeper; during the days when the CLIA laws came 
out that more or less outlawed laboratories for doctors' offices; of 
course the SGR days, sustained growth rate that we have been dealing 
with for the last 10 years. I have seen it all, and so have my 
colleagues. In fact, among us we have over 400 years of clinical 
experience. I would include our two physicians from the Senate in that 
group.
  What I want to talk about this evening is a little bit of background, 
and also we will kind of get into where we are with the latest 
situation. One of the observations that I made early in my practice was 
that oftentimes economics actually controlled the decision-making more 
than the actual health care itself.
  I will give you a good example. I had a patient who required monthly 
blood tests to check his clotting factor because he was on anticlotting 
drugs because of chronic deep venous thrombosis. And I could not for 
the life of me get him to get those blood tests on a regular basis, not 
because he was afraid of needles, but simply he didn't want to pay the 
price. However, once we were brought under an HMO, health maintenance 
organization, and all of a sudden he didn't have nearly the out-of-
pocket expenses that he would have had, not only did he want to have 
the blood tests, but he wanted to have many other tests as well, things 
far beyond anything that I could conceive would be a benefit to him. So 
for him it was a value issue. Since he wasn't paying and somebody else 
was paying, well, let's utilize as much as we can so I get my money's 
worth for what I am getting.
  One of the things I like to tell people when I speak to groups is 
think of health care consumption like a credit card. If I were to give 
you a credit card that has a limit of $10,000 on it and I said to you, 
buy whatever you need, but nothing that you just want. I often ask the 
crowd, ``What would you buy?'' And of course people come back with, 
well, I would buy probably a new shotgun to go hunting, or camo, or 
perhaps some physical fitness equipment, or a treadmill, something of 
that nature. Things that maybe I am not willing to pay out of pocket 
for, but if it's your money, then I'm willing to pay it.
  This, Mr. Speaker, is really the core of the problem when it comes to 
cost. There are two areas of our economy in which cost has gone up more 
rapidly than inflation. One is education and the other is health care. 
And it just happens that those are the two areas in which a third 
party, in the case of education it is the government who pays for that, 
and in the case of health care it is both government and private 
insurance that pays the main balance of the bills.
  So from that I have observed that if ever we are going to deal with 
increasing coverage, which is really what this is all about, how do we 
increase coverage, in order to do that we are going to have to find a 
way to lower the cost. I have agreement among all of my colleagues on 
the Republican side to just that. In order to have more coverage, we 
have got to lower the cost. And we have to do it fundamentally.
  This bill that is before us that we may vote on within the next 3 
days, it has a lot of things in it. It has 3,000 pages, it has over a 
hundred mandates and boards. It has three specific boards of unelected 
bureaucrats who make decisions about what doctors are going to be paid, 
what is going to be in your insurance policy, many things about your 
life that you would otherwise have control of. But the one thing it 
does not do, Mr. Speaker, is it does not address cost.
  And so I can say to you that fundamentally if we are going to at some 
point in time address cost in health care, there is one of two ways: 
either we look at it on the doctor-patient level, where the doctor and 
the patient, who make the majority of decisions that impact cost, we 
either give them incentives and we also give them some responsibility, 
some accountability for cost, in which case if that cost is lowered as 
a result of accountability for them, then it lowers it for the entire 
system. That has been proven to work time after time.
  For instance, as soon as health care insurance began to cover more 
and more out-of-pocket expenses, we began to see over the years the 
cost of insurance going up far faster than the inflation rate. In 
recent years, we have come up with a tool to counteract that, and that 
is health savings accounts. I instituted that with my small businesses, 
which are apart from my medical practice, approximately 6 years ago. 
And it was considered to be sort of revolutionary. And there was a 
little angst among employees, what is this going to be like? Because 
our deductible is going to go up. But I committed to them that the 
incremental increase in what the policy costs would be, I am going to 
put it in their tax-free account which they can use for any health care 
purchase they like.
  Despite their reticence at first, they quickly came on because what 
they found is that now instead of being free utilizers of health care 
and running costs up because it's a use-it-or-lose-it proposition, now 
they have money in the bank; and if they make good, wise, savvy 
consumer decisions, they can choose generic drugs instead of brand name 
and save hundreds of dollars. They can shop around costs for certain 
procedures, certain doctors. It works very effectively. In fact, I 
would love to see that in health care reform at some point. It is not 
contained in this bill.
  We could even do that for Medicare and for Medicaid, put money in the 
bank on their behalf. Not out of pocket, mind you, but it is the 
insurance money or the Medicare money that goes in there to be spent on 
their behalf. Because if they are saving money for themselves, they are 
saving it for the system at large.

[[Page 3866]]

  What we are going to see here with this bill if it comes to law is 
just the opposite. Nothing to commit the doctor and the patient into 
controlling cost. In fact, in many ways it lowers the out-of-pocket 
expenses to a point where the patient behavior, the consumer behavior 
is unaffected by cost. And yet the consumer and the doctor are making 
those choices.
  Now, there will be, of course, layers and layers and layers of 
bureaucrats who will be controlling from Washington how things are 
paid. No question about it. And they will be attempting to control 
people's lives, what they eat, how they eat, what they weigh, whether 
they smoke or whatever. But unfortunately, there is no way that 
Washington, D.C. can micromanage human behavior. Attempts will be made 
with this bill, there is no question about it, but it will not work.
  So then there will have to be plan B. How will we save money? And 
what we found in every case, whether it is Tennessee, which attempted 
this some years ago, Massachusetts, which has attempted this much more 
recently, Canada, the United Kingdom, most Western European countries, 
Australia, every one of them, this is what has happened. The plan works 
nicely at first. People get less out-of-pocket cost. They can go to the 
doctor they want. Everything works beautifully. But then all of a 
sudden the costs begin to explode and they go far beyond anything that 
has been predicted or budgeted.
  And then what happens? Somewhere costs have to be controlled. And how 
do they do that? They do that through rationing and long lines. Every 
single case. Just the other day TennCare cut its Medicaid visits from 
unlimited down to eight visits a year. That is exactly the way it 
happens every time. Massachusetts, they are way over what their budget 
is. And as a result of that, they have come to a point now where they 
are actually reaching out to the Federal Government to control that.
  So just to kind of conclude this discussion about cost itself, either 
you start with lowering costs by using commonsense methodologies of the 
free market, with transparency and with turning the patient into a 
savvy consumer who has all the choices before him or her and can make 
the best choices for quality and for cost, therefore improving the 
quality and lowering the cost, or you can go to a top-down, government-
run, government takeover system in which a Federal bureaucrat will be 
walking with you every step of the way.
  I have been joined here tonight by one of my colleagues, again as I 
alluded to a little earlier, Congressman Dr. Phil Gingrey from Georgia, 
a cochair of the GOP Doctors Caucus. In fact, it was his leadership 
that led us here tonight for one of many doctor caucus discussions and 
debates. He ran a little bit late because he had a tele-town hall back 
to his district. But he has now joined us.
  So I am going to yield to the gentleman, the obstetrician of many 
years from Georgia.
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman, my 
colleague from Louisiana, Dr. Fleming, for not only yielding a little 
time to me but also for being here on the floor to control the time. 
Mr. Speaker, as you know, each side of the aisle gets a leadership 
hour, and it seems that maybe our Democratic friends who had the 
previous hour and only took 35 minutes came to the conclusion that the 
less said the better about this health care bill. That seems to be the 
way things have been going, Mr. Speaker, in regard to how much we know 
about what is in the bill. We will be talking about that a good little 
bit tonight. I can assure you, Mr. Speaker, on our side of the aisle, 
we've got a lot to say. I think the more said the better.
  The American people need to know. They need to be informed. Indeed 
they know already a lot, know enough to say, as 70 percent of them do, 
that they don't want this bill. Not this bill. As Dr. Fleming said, Mr. 
Speaker, I was doing a tele-town hall meeting to my constituents in the 
11th of Georgia, northwest Georgia, the nine counties that I represent, 
the 700,000 people, salt-of-the-earth folks, just as Dr. Fleming 
represents the same kind of folks in Louisiana. Suffering folks, 
unemployed folks, struggling folks.
  I did a poll question on this tele-town hall call that probably went 
out maybe to 25,000 households. And a lot of them were on the line and 
listening and asking questions and staying in the queue for the whole 
hour and 30 minutes, I think we went.
  Mr. Speaker, the poll question was, if your greatest concern about 
this bill, the so-called Patient Protection and Health Accountability 
Act or whatever it is called, H.R. 3590, the Senate bill that is going 
to be deemed passed if the Democratic majority has their way, what's 
your greatest concern? If it's the economy, the effect that this bill 
will have on the economy, push ``1'' on your keypad. If your greatest 
concern is the effect it will have on your health or the health of your 
immediate family, press ``2.'' If your number one concern about this 
bill is the devastating effect that it will have on the Medicare 
program and our senior citizens, you, your parents, your grandparents, 
press ``3'' on the keypad. If your concern is all of the above, press 
``4.''
  Well, I am going to tell you, 65 percent of them, Representative 
Fleming, 65 percent of them, Mr. Speaker, pressed ``4.'' That is what I 
would have pressed, too. It was equal, 10, 12 percent equally divided 
among the other three.
  People are outraged, Mr. Speaker. It is just unbelievable to me. 
Let's refer to the first slide, this poster that I have got to my 
right, your left. What Americans Want. I wasn't surprised at all by the 
poll that I took tonight because the American people have been saying 
this for months and months. The first bullet point on the slide, 73 
percent of Americans want Congress to start over on health care reform, 
or if they are unwilling to do that, this is a situation where it's 
better to do nothing. They don't believe we should do something even if 
it's wrong. No, if it's wrong, do nothing. Second bullet point, 56 
percent of people want the Congress to tackle health care reform on a 
step-by-step basis, not a wholesale government takeover.

                              {time}  2030

  Mr. Speaker, when Senator Lamar Alexander a couple weeks ago at the 
Blair House went to the health care summit, when he could finally get a 
word in edgewise after our President finished filibustering, said the 
same thing. Said, Look, we can solve the problem. We can actually lower 
the cost of health insurance and, indeed, the cost of health care if we 
do it in an incremental, commonsense way.
  And then when Coburn got to speak, Senator Coburn, Mr. Speaker, he 
said, Mr. President, let me just make it brief here. I know you're not 
going to give me a lot of time, and you're controlling the clock and 
who gets to speak. And you took already twice the time that we did in 
your opening statement. But that is okay. You're the President. But 
give me a couple of minutes. I will make two points. One, let's 
eliminate waste, fraud, and abuse. And Dr. Coburn had some great 
suggestions about that.
  And then he went on to say--and, Mr. Speaker, this is almost 
unbelievable to us, to the physicians that serve in this House of 
Representatives, to the members of the GOP Doctor Caucus in the House 
and to our physician friends, Dr. Coburn and Dr. Barrasso in the 
Senate--the President said to the American Medical Society last summer, 
at the annual meeting--they invited him to be the keynote speaker--and 
when they asked, Mr. President, you want us to endorse, and the AMA 
went on and did endorse based on the President's promise that there 
would be reform of medical liability, so-called tort reform, ending 
frivolous lawsuits and ending the necessity for doctors to protect 
themselves and their practices by ordering all of these tons of tests, 
expensive tests, sometimes even, Mr. Speaker, dangerous tests, just to 
cover their back so that some slick expert witness in a court of law 
wouldn't say that, oh, you know, you didn't order a fizzle phosphate 
level on this patient? That's below the standard of care in Louisiana 
or in Georgia, in Marietta or Athens.

[[Page 3867]]

That is the kind of thing we're dealing with.
  And to just complete the slide, Mr. Speaker, I refer back to this 
first poster, the last bullet point. Sixty percent of Americans think 
the Slaughter solution is unfair. I'm going to let my colleagues, if 
they want to--or maybe when they come back to me I will talk about 
that--but there are other Members, other physician members, Mr. 
Speaker, that are here; and I want to yield time to them.
  The gentleman from Louisiana was so kind to control the time in my 
absence. I yield back to him so that he can yield back to other 
Members. And I yield back to my good friend, Dr. Fleming.
  Mr. FLEMING. I thank the gentleman. Great comments.
  And my experience, Dr. Gingrey, is the same as yours. The teletown 
halls that I have done on this subject in the last 6 months started out 
that 85 percent of my constituents were against this. Now it's up to 92 
percent. Unbelievable.
  Let me just touch again on economics, and then I'm going to pitch 
this back. We have been joined by Congressman Broun also from Georgia.
  But first let me mention, let us talk about Medicare just for a 
moment.
  We hear the other side of the aisle continuing to complain that 
you're seeing this catastrophic increase in insurance rates, private 
insurance, and it has been going on for years. And, yes, it has been. 
It has been faster than inflation. No question about it. But if you 
look within that, what you find is that because Medicare pays well 
below break-even for a physician or a hospital and Medicaid pays even 
half of that, that you have tremendous cost shifting. So you have to 
raise something; something is going to have to go up to offset the 
costs that are not being paid.
  So, Mr. Speaker, in light of all of that, what we have in this bill 
is we're going to have a dramatic increase in Medicare and especially 
in Medicaid which is going to make those rates go up, that is, private 
insurance, even faster.
  But let's look for a moment at what are the economics of Medicare in 
this bill.
  This bill, at least the version we think we are talking about this 
evening, because we have not even seen the final draft of it and yet we 
are soon to vote on it, where does it raise revenue? It raises revenue 
first by taking a half trillion dollars out of Medicare. Speaker Pelosi 
today said--the way she was asked, How do you do that? And her answer 
was very simple: You get rid of fraud, waste, and abuse. We've had this 
program for 40 years and nobody has been able to figure out how to get 
any dollars out of fraud, waste, and abuse, much less a half a trillion 
dollars. So I don't believe that is going to happen.
  Number two, the $500 billion that we're talking about is earmarked to 
extend the life of Medicare which is going to run out of money in 2017. 
That is really 7 years from now. But it's also going to be used to help 
subsidize private insurance.
  The CBO wrote a letter last week saying, You're counting the same 
half trillion dollars twice, and to get it, you've got to take it out 
of something you can't take it out of. So really we're tripling down on 
the same money, which gives us an error of $1 trillion.
  So the economics, Mr. Speaker, of this are crazy. They're smoke and 
mirrors. They don't add up, and there are many other parts of this that 
we can get into as we go forward. But that is the fundamental problem, 
as I talked before. Utilization is going to skyrocket, which is not 
even measured for by the CBO. And then you've got the same dollars 
counted not once, not twice, but three times.
  So with that, I would like to welcome Dr. Broun, also a physician, a 
fellow family physician from the great State of Georgia, and I yield to 
the gentleman
  Mr. BROUN of Georgia. Thank you, Dr. Fleming. I've listened to you 
talk about this economic game that they're playing. I call that zombie 
economics because you have to be a dead man walking around with no soul 
to believe the economic parameters and the games that the Democrats 
have played with CBO.
  And people need to understand that when CBO, Congressional Budget 
Office, scores a bill, they can only score the bill according to the 
parameters that whoever writes that bill give them to score it on.
  So all of these things where you're having double counting of money, 
it's just a good example of that zombie economics that the Democrats 
utilize and force CBO to use in scoring the bill so it doesn't look as 
bad as it really is going to be. And there is nothing about the marked 
cuts in doctors' reimbursement, how much the government under Medicaid, 
as well as Medicare, is going to be reimbursing the doctors.
  And what's going to happen--and I think the American people need to 
understand this very firmly--they may give a government insurance 
policy card to people that they can stick in their pockets, but they're 
not going to be able to find a doctor that will accept that card and 
accept that insurance. So the American people need to understand that 
the access to a doctor is actually going to go down, in my opinion. And 
in fact, that card for many, many Americans is going to be as worthless 
as a Confederate dollar was after the War Between the States. It's 
going to be useless. We're going to have more people who have less 
access to doctors, less access to care, if ObamaCare is passed.
  Another thing that policy after policy has shown is that the American 
people continue to overwhelmingly reject this government takeover of 
health care. Yet Speaker Pelosi has declared that a government takeover 
of health care should become the law of this land without even taking a 
vote on the bill. Well, that is unconstitutional.
  I, as well as, I know, Dr. Gingrey, as I know Dr. Fleming, carry a 
copy of the Constitution. I believe in this document as it was intended 
by our Founding Fathers. We have absolutely no constitutional authority 
for the Federal Government to take over health care. None. We have no 
constitutional authority to even do this deem and pass Slaughter rule. 
Deem and pass. That sounds like an old western movie. Deem and pass. 
The only people who are going to be ambushed are the American taxpayers 
and small businesses in this country. That is exactly what's going to 
happen. Deem and pass is being set up by our Democratic colleagues who 
want to raid small business's coffers and people's coffers.
  In fact, we've got a lot of taxes on small business. A lot of taxes 
on individuals. The Ways and Means Committee just today has put out a 
report on this bill. We hear from the President if you make $250,000 
and above, you have to pay extra taxes for the bill. And anybody making 
less than $250,000 will not be taxed. But the Ways and Means Committee 
just today set out the parameters on the taxes. Half of the new 
individual mandate taxes will be paid by Americans earning less than 
$66,150 for a family of four. Let me say that again: half of the 
individual mandate taxes are going to fall on the shoulders--not of the 
rich people; I don't think a family of four making $66,000 a year is 
rich--but half of those individual mandate taxes are going to fall on 
the shoulders of families making $66,000 a year or less.
  And also the IRS is going to be markedly expanded. And, in fact, it's 
going to be up to the IRS to get all of these new taxes.
  And I have got a little slide here. Because the IRS is going to be 
running ObamaCare. The IRS agents in this country are going to verify 
whether you have acceptable health care coverage. Now, who determines 
what's acceptable health care coverage? Well, it's a panel here in 
Washington, D.C., that is going to mandate every single insurance 
policy in this country.
  So if you have health insurance today and you like it? Forget it. 
Forget it. That is another distortion, something that is not true 
that's been touted by our Democratic colleagues.
  And the IRS agents in this country are going to be prying into your 
health care insurance, into your life, to see if you have acceptable 
coverage.

[[Page 3868]]

  Also, the IRS is going to have to hire new agents to do all of this 
new work that they're being given by ObamaCare: 16,500 new IRS agents. 
There are going to be more audits of people's income taxes because the 
IRS is going to be in charge of making sure that individuals have this 
acceptable health care coverage that is mandated by the Federal 
Government.
  The IRS can even confiscate your tax refund. And the IRS can fine you 
up to $2,250 or 2 percent of your income, whichever is greater, if you 
don't have the minimal, essential coverage. Again, the Federal 
Government is going to determine what that minimal coverage is. So 
forget your current insurance policy. The Federal Government is going 
to mandate it.
  Mr. GINGREY of Georgia. Will the gentleman yield for a minute?
  Mr. BROUN of Georgia. Absolutely.
  Mr. GINGREY of Georgia. I appreciate my colleague for yielding 
because the gentleman points out an accurate statement in regard to the 
expansion of the IRS because there absolutely would be those that would 
be going through with a fine-tooth comb every tax return. And we're not 
too far from that date where people, if they don't put down and verify 
that they have that health insurance policy--and the gentleman was 
probably going to say this, but I will go ahead and say this--not just 
that they have a health insurance policy, but the type of policy.

                              {time}  2045

  In other words, a young person, a young, healthy person who exercises 
and takes care of himself, doesn't smoke, doesn't drink, runs 
marathons, and so he wants a health insurance policy that he can 
afford. He is just out of high school or just out of college. He is 
paying back student loans, trying to buy a car, trying to save up to 
get an engagement ring for his fiancee, whatever, paying for an 
apartment, yet he wants to have coverage. He wants to have catastrophic 
coverage, but he can't afford first dollar coverage, so he buys these 
high deductible but very low monthly premium--probably one-fourth of 
what the IRS and this bill is going to demand that they have. If he 
doesn't have it, he is going to jail.
  Mr. BROUN of Georgia. That's right.
  Mr. GINGREY of Georgia. It's just unbelievable. And very quickly, 
before yielding back to my colleague, I want to say this.
  If we were in charge, Mr. Speaker, I think the three of us on the 
floor right now, we would eliminate the IRS. We wouldn't add to them 
and add to that bureaucracy. We would get rid of the IRS and the 
Federal income tax, and we would replace that with a flat tax or a fair 
tax, a national retail sales tax that our colleague from Georgia, John 
Linder, has been such a strong proponent of.
  Mr. BROUN of Georgia. I thank you for yielding back.
  In fact, I want to point out something else that is going to happen 
with this bill the way it's set up. The tax-writing committee, the Ways 
and Means Committee, tells us an additional $10 billion is going to be 
needed to pay for this marked expansion of the Internal Revenue 
Service. And, Dr. Gingrey, I'm like you. I would like to totally get 
rid of the Internal Revenue Service. You and many people know I have 
been a very ardent supporter of the fair tax.
  But it doesn't matter--well, it does matter how they get our taxes. 
The bottom line is that we have just got to stop this outrageous 
spending here in Washington, and we are going to increase spending of 
the Internal Revenue Service by $10 billion.
  But something else the American people need to know is: Guess who has 
been left out? Guess who is not going to have all these mandates? 
Illegal aliens. That's what our Democratic colleagues have put in 
place. The illegal aliens in this country are going to get free 
taxpayer-funded health insurance, and they are not going to get all 
these fines. They are not going to be bothered by the Internal Revenue 
Service. It's just the American citizens and legal residents in this 
country that are going to be bothered by these folks.
  Now, they are going to say, and I've heard them say over and over 
again, illegal aliens can't get free government health insurance, but 
Dr. Gingrey was in the Energy and Commerce Committee. Over and over 
again, Dr. Gingrey and many others fought to make sure that illegal 
aliens would not get free government health insurance by making the 
Federal Government verify the citizenship and the legal presence of 
these people here.
  Mr. GINGREY of Georgia. If the gentleman would yield just for a 
second, he may want to yield back to Dr. Fleming who is controlling the 
time. It is our colleague from our great State of Georgia, Congressman 
Nathan Deal, the ranking member on the Health Subcommittee of Energy 
and Commerce where this bill, by the way, originated as H.R. 3200, Mr. 
Speaker. We all remember that. But it was Congressman Deal, Nathan 
Deal, 17 years, this is his 18th year, in fact, in this body, had the 
amendment to stop that, to make sure that people had to give adequate 
verification, just like they do for the Medicaid program in our States 
and the SCHIP program. It's called PeachCare in Georgia. It was 
Congressman Nathan Deal--who, by the way, I think is going to be the 
next Governor of Georgia--who very strongly advocated for that. But 
unfortunately, as all Republican amendments, if they get heard at all, 
they get voted down on straight party lines, good commonsense 
amendments.
  Mr. BROUN of Georgia. I want to go to Congressman Deal, too. He has 
been fighting for a long time to stop this birthright citizenship here 
in this Nation, which is actually a ruling by the Federal court system. 
It is an improper ruling on the 14th Amendment. It's an 
unconstitutional, actually, ruling on the 14th Amendment that we're 
giving birthright citizenship to these children who are born to illegal 
aliens in this country, and they are going to go on the Medicaid 
system. And we're going to have a magnet, a magnet to draw more of 
those illegal aliens in this country because they are going to get free 
government health care because of this ObamaCare bill that we're going 
to be voting on just in the next day or two.
  I just want to say before I yield back, Congressman Nathan Deal, I 
hope he is our next Governor, and he has been right on the front line 
fighting this illegal alien problem that we have in this country. He 
lives in Gainesville, Georgia, and he has seen them there in Hall 
County, Georgia, how it's been a tremendous drain on the local economy 
and the local government for goods and services and things. And so he 
has been an ardent, ardent fighter to try to make these illegal aliens, 
who are criminals, to go home. Now we are going to give them free 
health care.
  And the American people need to just say ``no'' to our Democratic 
colleagues, because it's just going to be disastrous. We are going to 
have an influx of illegal aliens just to come and have those anchor 
babies to get on Medicaid. We've already seen that happening, and that 
is one reason Nathan Deal has been doing it.
  I yield back to Dr. Fleming.
  Mr. FLEMING. I thank the gentleman. I thank both gentlemen from 
Georgia for your comments and, again, your many years of experience as 
physicians.
  I would like to change the topic slightly, and that is to talk about 
process for a moment. Now, what I would really describe, this situation 
is one in which, as this debate continued, Mr. Speaker, as this debate 
continued through the year, it began to lose momentum almost 
immediately. We began to see the polls. At first, it was 50/50. Half 
America wanted this health care reform but didn't know much about it, 
the other half really didn't want it.
  As this debate has gone on and on and on and the news gets out, the 
acceptance of this has dropped. In fact, today it is at its lowest 
point that it's been. I think we are up to now 55 percent of Americans 
are against it and down in the 30s are actually for it. In fact, a CNN 
poll--and I'm sure that CNN wouldn't be considered as an extreme right-
wing media outlet--shows that--they asked a question a little different 
way. What should we do with

[[Page 3869]]

this bill? Seventy-five percent of Americans said either scrap it 
altogether and forget about it or start over again. And that's exactly 
where we are. We would like to start over again and pass commonsense 
reforms without the government takeover of health care.
  Well, anyway, as this thing has been losing steam, it has caused more 
and more difficulty for the other side of the aisle to get things 
passed, vote after vote. And we saw that there was such a reaction 
across the country that our good friend, Scott Brown, was elected to, 
believe it or not, Senator Kennedy's seat, something that no one could 
have imagined this time a year ago. And while he is an excellent 
candidate, something else had to be in play there, and we know what it 
is, and that is health care. Also, through the process to get it 
through the Senate, even with the 60 votes that already were there, it 
took special deals. I will just name them real quickly.
  The Louisiana purchase; $300 million to go to my State of Louisiana, 
which would seem ostensibly to be a good thing, but by signing this 
bill, the President would actually cause costs that would be far 
greater than the $300 million that we would receive. So the net result 
is money lost, not money gained.
  The Nebraska kickback, which everyone has hated. And, in fact, what 
it is going to do is probably it will pass in this reconciliation, if 
it is passed, will actually extend the same benefit to all States which 
is going to drive up taxes and cost.
  A $10 million earmark for a Connecticut hospital for Chris Dodd, our 
Senator, and certainly Gator aid, where every State will lose its 
Medicare Advantage except for the State of Florida.
  But if that wasn't enough, Mr. Speaker, now that we're in the House, 
we've got another situation. We're talking about reconciliation; that 
is, instead of sending it to the Senate in the final form and have it 
passed and get past the cloture rules over there, they want to slide it 
in under reconciliation, a mere 51 votes. But all of that being as bad 
as it is, now we're talking about the Slaughter solution.
  And I will pitch back to my friend, Dr. Broun, for his comments.
  Mr. BROUN of Georgia. Thank you, Dr. Fleming. I appreciate your 
yielding.
  In fact, I've wondered, and I'm sure the American people are 
wondering, why is it that Democrats don't want to have a vote on a 
bill? Well, you're just telling them right now today in this Special 
Order why the Democrats don't want to have a vote on the bill--because 
they don't want to face the fact. They don't want to face the voters 
that they are doing all these special deals, sweetheart deals.
  You didn't mention the ones in there for the unions on their Cadillac 
plans. The unions have just cut a special deal, too, with the 
administration, with the leadership here in Washington. But why 
wouldn't they want an up-or-down vote? We've heard the President say 
over and over again this should have an up-or-down vote.
  Well, just today, just today, as my colleagues know, the Democrats 
voted down, through a procedural method, voted down--what we are trying 
to do is to have an up-or-down vote on the bill, but they don't want 
their yeas and nays to be recorded as is required by the Constitution 
of the United States. Article 1, section 7, the second paragraph says 
that for a bill to be passed into law, it has to be voted on by both 
Houses. It has to be the very same bill, and then it has to be signed 
by the President or a veto has to be overridden, and the yeas and nays 
must be recorded. So it is totally unconstitutional what the leadership 
is doing.
  And I have one question for the Speaker. If Democrats are confident 
that the American people want this new multitrillion dollar program, 
why are they avoiding a simple up-or-down vote? Well, the simple truth 
is that the House Democrats just don't want that because they don't 
want to face the voters. They don't want to face their constituents 
about these special deals. They don't want to face the zombi economics 
that they're using. But the jig is up for the Democrats trying to pull 
the wool over the eyes of Americans, because Americans get it. They 
understand that this is going to be disastrous.
  As I mentioned before, we are going to have costs go out of the roof 
for everybody. And, in fact, experts tell us that people who have 
private insurance, private insurance today for a family, their 
insurance premiums are going to go up $2,100 a year because of 
ObamaCare if this is passed into law.
  Mr. FLEMING. Those are all great. I appreciate your adding some of 
the things I left out. This list is getting so long of all the special 
deals. And the way that the Democrats are attempting to bypass the 
Constitution is just really unbelievable, and it's making Americans 
awfully mad. The emails I'm getting are really showing me either people 
are extremely mad or extremely terrified.
  Now I would like to turn to the other gentleman from Georgia, Dr. 
Gingrey, and see, do you have other comments about the process?
  And by the way, I must say that the President, Nancy Pelosi, and even 
Harry Reid say the process doesn't count, that the American people 
don't care about the process, only the finished product. Well, that 
tells me that the ends justify the means, and I just don't agree with 
that.
  What say you, sir?
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman for 
yielding to me.
  I agree with my colleagues that process does matter. We, physician 
Members in particular, are concerned mostly about the policy, and we 
are emphasizing policy tonight, and we will continue to do that. But 
the American people definitely care about process.
  I want to go back, Mr. Speaker, to what my colleague from Georgia was 
just saying in regard to the insurance premiums are going to go up for 
those in the private market. There is no question about that. The CBO 
has said as much. And, Mr. Speaker, you wonder, maybe the American 
people wonder, if that's true, if the whole purpose of this reform plan 
was to lower the cost of insurance so more of the uninsured would have 
insurance, those that are not eligible for Medicaid and just don't 
realize it, that we have to lower the cost or they can't, we've wasted 
our time. We've spent $1 trillion and we have accomplished nothing.
  But, Mr. Speaker, I would suggest that this may be intentional. This 
may, indeed, be intentional. If what you want, Mr. Speaker, ultimately 
is a socialized national health insurance system like other countries 
have, where rationing is commonplace and denial is commonplace and old 
people get thrown under the bus, if that is ultimately what you want, 
you want the Federal Government, and your mindset, your mentality is 
more government is better government, more control is better because 
the people are too dumb to run their own lives so we want to take over, 
we want to take over one-sixth of the economy, so you drive up the cost 
of health insurance in the 40 percent of the market that's private, 
eventually there is no private market. And everybody morphs into these 
public plans. That's why the Democratic majority insisted on a public 
option. They didn't get it, but that's coming next. That's coming next.
  And I will yield back to the gentleman controlling the time to yield 
to Dr. Broun.

                              {time}  2100

  Mr. FLEMING. Thank you, Dr. Gingrey. Let me add a couple points and 
then I will yield to the other gentleman.
  You know, we have got two bills right now. We have the Senate bill 
which has all of these ugly, sleazy deals in them that even the Members 
on the other side don't want their fingerprints on, and that is why we 
are going through this deemed process, because they want to pass it 
without voting for it. Crazy.
  Anyway, the reconciliation part, the so-called correcting bill that 
they are wanting to vote on is going to do this: It is going to 
increase taxes by $155.8 billion on top of the Senate bill. So it is 
increasing taxes. It also takes over the student loan program. So what?

[[Page 3870]]

 Well, this is the so-what. It is a job killer. It is going to take all 
the profits from the private industries that have been loaning this 
money, it is going to unemploy 35,000 Americans, and it is going to 
skim that profit to dump into this to go down the sinkhole.
  Mr. GINGREY of Georgia. On this point about the job killer, this 
student loan--Federal Government, once again, the Federal Government 
taking over the student loan program. Well, I don't know. Ten, 15 years 
ago they took over half of it, and that wasn't enough. Although that 
killed about 50,000 jobs, I say to my colleague from Louisiana, Dr. 
Fleming. And now, as he points out, now they want it all, and that is 
going to kill another 30,000.
  So, Mr. Speaker, we are talking about 80,000 jobs in the private 
market so that the Federal Government can have a 4-percent spread, 
borrowing money at 2.5 percent, lending it out to the students at 6.5 
percent, 7 percent, and taking in $60 billion so this majority party 
can spend it on more social welfare programs. That is what we are 
talking about. And I yield back to my colleague.
  Mr. FLEMING. Reclaiming my time. And then one other deal that just 
slipped in on the House side is the North Dakota deal. There are carve-
outs there.
  So the sweet deals have not stopped even though the Senate bill is 
complete. I understand that there have been in fact ambassadorships, 
like an ambassadorship to NATO has been offered for a ``yes'' vote. We 
have Members of Congress being carted around in Air Force One and 
certainly asked out to dinner and all sorts of things like that.
  Look, this is one-sixth of the economy. This is the future of our 
Nation for a century. Are we so lack of character that we are willing 
to sell our souls for just about nothing? I yield to the gentleman from 
Georgia.
  Mr. BROUN of Georgia. I thank you, Dr. Fleming, for yielding. We are 
here talking tonight amongst ourselves during this Special Order period 
that Dr. Fleming is controlling--very well, thank you--and I am just 
honored to joining him and Dr. Gingrey here.
  But the American people are asking, what can they do? They are 
asking, is this a done deal? In fact, I have talked to a lot of people 
not only in my district but around the State of Georgia and even some 
from other States, and the American people are saying, ``What can we 
do? Is this a done deal? Is this going to pass?''
  I don't think it is a done deal. And it is up to the American people 
whether it passes or not, because the Democrats don't want their 
fingerprints on the Senate bill, they don't want their fingerprints on 
all the increase in the Internal Revenue Service and the increased 
taxes, the health care insurance police that is going to be put in 
place. They don't want their fingerprints on the increased costs; in 
fact, they are even denying the increased costs. Why? Because the 
Democrats know this is a bum deal. They know that.
  In fact, I have talked to just in the last 2 or 3 days several 
Democrats, and I have been told by the Democrats that every one of them 
know it is going to raise premiums. Every one of them know that it is 
going to increase the cost of health care above doing nothing. Every 
one of them know that this is a government takeover of the health care 
system. And what do they do? They come down here and say we are in 
favor of the big insurance companies.
  I don't like the big insurance companies. As a medical doctor, I have 
been fighting them through almost four decades of practicing medicine. 
I been fighting them for my patients. But they know that.
  And we hear the President say, well, if the American people 
understood his plan, they would accept it and embrace it. Hogwash. The 
American people do understand his plan, and they reject it 
overwhelmingly. And I would yield back.
  Mr. FLEMING. Reclaiming my time. I am sure that my other colleague 
from Georgia has a few choice comments as well.
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman for 
yielding, because I just happen to have a slide. I think my colleague 
from Louisiana noticed that slide. Maybe my good friend from Athens 
can't see it, but this is ``Notable Quotable.''
  Look, Mr. Speaker, I respect the Speaker of the House of 
Representatives. We all do, of course. And anybody can misspeak and 
make a bad quote. But, gee, whiz, for the Speaker of the House to say--
here is the quote: ``We have to pass the bill so that you can find out 
what is in it.'' I have got to repeat that for you, Mr. Speaker, in 
case you didn't hear and my colleagues, both sides of the aisle. The 
Speaker of the House just a couple, a few days ago. Here is the quote: 
``We have to pass the bill so that you can find out what is in it.''
  Now, that is why the American people are outraged. They know that. 
2,700 pages, and then they come here with this reconciliation package. 
And, oh, they are going to give us 72 hours to study it. And then, as 
my friend from Georgia was talking about, the Scheme and Deem or the 
Slaughter solution.
  Mr. Speaker, I am telling you, the majority party, if they do that, 
if they pass this bill, this Senate bill without really voting on it to 
trick the American people so they don't have to go home and face the 
irate voters, they are going to get slaughtered in November.
  I yield back to the gentleman controlling the time.
  Mr. FLEMING. Reclaiming my time. In the last few moments that we have 
in our discussion, which I think has been a great discussion, and once 
again I thank the gentlemen for joining me this evening.
  You know, we are in the final hours of this, it would appear. And we 
don't know if it is going to pass or not. I suspect that if the votes 
were there, we would be voting on it today. So I do think that the 
American people still have an opportunity to reach out to those who 
have not committed, and even those who have.
  You know, we don't have even one single Republican that has voted for 
any of this except for one, and even he is not going to vote for it 
this time.
  So this is not a bipartisan bill except to the extent of its 
opposition. We have the Republicans, we have a good group of Democrats, 
and also particularly pro-life Democrats, and the American people. But, 
unfortunately, we have a big enough group, a large enough group, if you 
will, of Democrats who feel through their arrogance they can still 
trump the American people and those others.
  And, you know, when you are talking about monumental legislation, Mr. 
Speaker, we are not talking about a small little bill that maybe it is 
a financial bill and maybe there are some little deals that have to be 
made in the back so that we can pull a couple more votes. We are 
talking about a fundamental bill, perhaps the most important that has 
been voted on in more than 40 years that affects every American in the 
most intimate way. Yet we are in the situation with this where we are 
still up to sleazy deals. Anyway we can get it done, even if you hate 
the bill, get it done. We can fix it later. That is the craziest thing 
I have ever heard of.
  And I would be happy to yield to the gentleman, Dr. Broun.
  Mr. BROUN of Georgia. Well, it is the craziest thing because they are 
not going to fix taxpayer-funded abortions in reconciliation. We have 
got, I think it is, 41 Democrats that claim to be pro-life. They have 
whittled it down to 12. Those other 29 so-called pro-life Democrats 
cannot ever, ever again claim to be pro-life, because if they vote for 
this bill, they are going to be voting for taxpayers to fund killing 
unborn children.
  Mr. FLEMING. And if you would yield back for one moment. This will be 
the biggest increase in abortions since Roe v. Wade. And I yield back.
  Mr. BROUN of Georgia. And it is going to be a big boom for Planned 
Parenthood, which is the largest abortion provider in this country and 
in the world. So those 29 pro-life Democrats can never, ever claim to 
be pro-life again if they vote for the rule. If they vote for the rule, 
they can never, ever claim to be pro-life again because they are voting 
for abortion.

[[Page 3871]]

  Also, the American people are smarter than what our Democratic 
colleagues evidently give them credit for, because the American people 
will know when we vote on the rule, which is what I think we are going 
to see on Sunday, a vote on the rule, whenever it is. When we vote on 
that rule, they are going to be voting for the Senate bill with all the 
special deals, with abortion funded by taxpayer dollars, for cutouts so 
the illegal aliens won't be fined and taxed like American citizens will 
be, so that all of the bad things that are in the Senate bill that the 
American public overwhelmingly have rejected--when they vote for that 
rule, the American people need to take note, because they are going to 
be voting for the greatest government takeover of our economy ever in 
the history of this Nation because they have put in place a mechanism 
to socialize the health care system.
  In the 1930s, the Socialist party of the United States said the 
fastest way to destroy freedom in America, the fastest way to change 
America from being a free Nation with free people into a Socialist 
Nation with government control, central control from Washington, D.C., 
is a government takeover of the American health care system.
  The American people need to contact their Democratic members and say: 
``No. Or, we are going to say `no' to you.''
  Mr. FLEMING. We have got only 1 or 2 minutes remaining, and I am 
going to turn the remainder of this over to Dr. Gingrey.
  Mr. GINGREY of Georgia. I thank the gentleman for yielding. As we 
conclude, I have got one last slide I want to share with my colleagues. 
The title of it, the Slaughter solution. My colleagues have already 
mentioned it. But it would indeed let Speaker Pelosi send the Senate 
bill to President Obama without an up-or-down vote. It would just be 
deemed passage when they vote for the rule.
  Americans deserve an up-or-down vote. And listen to these quotes as 
we conclude our hour.
  President Obama: ``I believe Congress owes the American people a 
final up-or-down vote.''
  The Democratic National Committee chairman, his quote: ``There is 
going to be a vote, and it's going to be an up-or-down vote. Everybody 
is going to be up or down on the record and be accountable either for a 
`yes' vote or a `no' vote.''
  Have the intestinal fortitude, Mr. Speaker, to stand up and be 
counted. Stand up and be counted. That is all we are asking. And I 
yield back to the gentleman from Louisiana.
  Mr. FLEMING. I thank you gentlemen for joining me this evening. I 
thank our audience. This has been again another productive discussion 
about health care. I ask that everyone going forward in the next 3 days 
pray for us. And I yield to the gentleman.
  Mr. BROUN of Georgia. One final word.
  The American people can kill this bill by contacting their Democratic 
Congressmen and saying ``no'' to this government takeover of health 
care system that is going to ruin our economy.

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