[Congressional Record (Bound Edition), Volume 156 (2010), Part 3]
[House]
[Pages 4073-4074]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   TEXAS SAYS ``NO'' TO HEALTH REFORM

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Burgess) is recognized for 5 minutes as the 
designee of the minority leader.
  Mr. BURGESS. I came to the floor of the House tonight because I want 
to share with the House a letter I received from the Texas Medical 
Association.
  The letter says, ``On behalf of the nearly 45,000 physician and 
medical student members of the Texas Medical Association--and on behalf 
of our 25 million patients--we are writing to express our opposition to 
the health reform bill (H.R. 3590) that will be before the U.S. House 
of Representatives this weekend. Please vote `NO.'
  ``Unlike the American Medical Association, we do not believe that 
passage of H.R. 3590 and the accompanying reconciliation bill are steps 
in the right direction. Our position on health reform remains 
steadfast: Keep what's good in the health care system and fix only 
what's broken.
  ``To repeat what we said in December when the U.S. Senate passed this 
bill, the bill is bad medicine for our patients, and TMA cannot support 
it. The legislation:
  ``Does nothing to correct the flawed Medicare payment formula that 
Congress created in 1997.''
  The legislation ``would increase the cost of health insurance for our 
patients and deliver even less in return.''
  It ``would dramatically enhance Federal Government interference.''
  It ``would create incentives for patients to pay a fine for not 
having insurance rather than to pay an unrealistic amount for insurance 
coverage.''
  It ``would not protect Texas' liability reforms and does even less to 
expand those protections to patients and physicians in other States.''
  It ``would impose untested and arbitrary treatment standards that do 
not improve the quality of patient care.
  ``In addition, this bill could be a budget buster for Texas. 
According to the Texas Health and Human Services Commission, the 
current proposal would cost the State of Texas up to an additional $24 
billion in increased Medicaid spending over the first 10 years of its 
implementation.
  ``Please note that our position is not based solely on the personal 
opinions of the TMA leadership. In a recent survey of nearly 3,300 TMA 
members, almost 70 percent said if a new health care bill becomes law, 
it will make the U.S. health care system worse than it is now in the 
long run. Six out of 10 said the quality of patient care will get 
worse, patients' cost for care will go up, and patients' health care 
coverage will go down if a new bill becomes law.
  ``Please work with your Texas colleagues on both sides of the aisle 
to develop and pass a rational Medicare physician payment system that 
automatically keeps up with the cost of running a practice and is 
backed by a fair, stable funding formula. No more Band-Aids. It's time 
for a permanent Medicare fix.
  ``Thank you for your consideration of our requests.''
  And I will insert the letter from the Texas Medical Association into 
the Record.


                                    Texas Medical Association,

                                                   March 19, 2010.
       Dear Member of Texas' Congressional Delegation: On behalf 
     of the nearly 45,000 physician and medical student members of 
     the Texas Medical Association--and on behalf of our 25 
     million patients--we are writing to express our opposition to 
     the health reform bill (HR 3590) that will be before the U.S. 
     House of Representatives this weekend. Please vote ``NO.''
       Unlike the American Medical Association, we do not believe 
     that passage of HR 3590 and the accompanying reconciliation 
     bill are steps in the right direction. Our position on health 
     reform remains steadfast: Keep what's good in the health care 
     system and fix only what's broken.
       To repeat what we said in December when the U.S. Senate 
     passed HR 3590, this bill is bad medicine for our patients, 
     and TMA cannot support it. The legislation:
       Does nothing to correct the flawed Medicare payment formula 
     that Congress created in 1997. That formula is directly 
     responsible for the slow erosion of access to care for 
     seniors and the poor.
       Would increase the cost of health insurance for our 
     patients and deliver even less in return.
       Would dramatically enhance federal government interference, 
     bureaucracy, and red tape for patients and physicians.
       Would create incentives for patients to pay a fine for not 
     having insurance rather than pay an unrealistic amount for 
     insurance coverage.
       Would not protect Texas' liability reforms and does even 
     less to expand those protections to patients and physicians 
     in other states.
       Would impose untested and arbitrary treatment standards 
     that do not improve the quality of patient care.
       In addition, this bill could be a budget buster for Texas. 
     According to the Texas

[[Page 4074]]

     Health and Human Services Commission, the current proposal 
     could cost the State of Texas up to an additional $24 billion 
     in increased Medicaid spending over the first 10 years of its 
     implementation.
       Please note that our position is not based solely on the 
     personal opinions of the TMA leadership. In a recent survey 
     of nearly 3,300 TMA members, almost 70 percent said if a new 
     health care bill becomes law, it will make the U.S. health 
     care system worse than it is now in the long run. Six out of 
     10 said quality of patient care will get worse, patients' 
     cost for care will go up, and patients' health care coverage 
     will go down if a new health care bill becomes law.
       Finally, regardless of whether HR 3590 becomes law, we 
     strongly urge you to take swift action to stop the implosion 
     of our Medicare system. Since its inception, the Sustainable 
     Growth Rate Formula (SGR) has not worked. Annually, it has 
     forced physicians to limit access for our patients, pushing 
     patients into higher-cost areas like emergency rooms. Every 
     year for a decade, we have faced steep cuts that jeopardize 
     our ability to care for patients. You and your colleagues 
     have recognized this glaring problem--this gaping wound in 
     our health care system--but have been willing to address it 
     only with Band-Aids. We need more than Band-Aids. We need 
     more than sutures. We need a complete transplant. Congress 
     created this disease, and only you, as a current member of 
     Congress, can cure it.
       We note that HR 3590 creates a physician payment board--
     independent of and not answerable to Congress--with the 
     authority to unilaterally determine physicians' Medicare 
     payments. Even if Congress were to fix the flawed SGR 
     formula, your action could be, and likely would be, ignored 
     by this board.
       Please work with your Texas colleagues on both sides of the 
     aisle to develop and pass a rational Medicare physician 
     payment system that automatically keeps up with the cost of 
     running a practice and is backed by a fair, stable funding 
     formula. No more Band-Aids. It's time for a permanent 
     Medicare fix.
       Thank you for your consideration of our requests. Please 
     feel free to contact us at any time if we can be of any 
     assistance in this process.
           Sincerely,
     William H. Fleming III, MD,
       President, Texas Medical Asociation.
     Susan Rudd Bailey, MD,
       President-Elect, Texas Medical Association, Chair, Texas 
     Delegation to the AMA.

  I also want to share a letter I received from the American College of 
Surgeons. Again, this is similar language.
  ``On behalf of the more than 75,000 members of the American College 
of Surgeons, I write to restate that the College shares your commitment 
to make quality health care more accessible to all Americans. Over the 
past year and a half, the College has consistently sought to serve as a 
constructive voice of reform, guided by the College's principles of 
providing quality and safety, improving patient access to surgical 
care, while enacting meaningful liability reform, and reducing health 
care costs.''
  ``The College's principles underscore our commitment to health care 
reform that will extend coverage and improve access to quality health 
care for more Americans. Without addressing these fundamental concerns, 
the College believes that H.R. 3590 will undermine quality and threaten 
patient access to surgical care. Therefore, the College opposes the 
Patient Protection and Affordable Care Act of 2009.'' But we do 
``remain steadfast in our role as champions for meaningful health care 
reform that is in the best interest of patients.''
  I also have a letter from the Texas Association of Home Care & 
Hospice. They conclude by saying, ``The Texas Association for Home Care 
& Hospice again respectfully requests that Congress reject the notion 
that reductions in Medicare home health and hospice reimbursement rates 
equates to health care reform and long-term cost containment and ask 
that you vote no on the current health care proposal.''
  I also wanted to share some insights from the Texas Attorney General 
regarding the constitutionality of the individual mandate.
  According to Greg Abbott, ``The individual mandate is 
constitutionally suspect because it does not fall within any'' of the 
normal categories. ``The mandate provision of H.R. 3590 attempts to 
regulate a nonactivity. The legislation actually imposes a financial 
penalty upon Americans who choose not to engage in interstate 
commerce--because they choose not to enter into a contract for health 
insurance.
  ``In other words, the proposed mandate would compel nearly every 
American to engage in commerce by forcing them to purchase insurance, 
and then use that coerced transaction as the basis for claiming 
authority under the commerce clause.''
  Seems a little tortuous to get to that point.
  Finally, a letter from the Governor of the State of Texas, Rick 
Perry, who also delineates concerns about the cost of the program. He 
ends up, ``While Washington argues, Texans wait for real reform that 
results in everyone to have the opportunity to live a healthier life 
without adding trillions of dollars of debt that we and our children 
will'' end up having to pay.
  Thank you for the consideration.

                          ____________________