W. Akin

Mr. AKIN

Mr. AKIN. Mr. Speaker, when people get into the details of health care, I think they sometimes miss seeing the very big picture. The big picture here is that the Pelosi and the Democrat health care plan has this final destination, which is that it's going to be run by some czar or commissar in the Federal Government. I guess the question I have is: On what sense of faith is this decision made? Is it the efficiency of the Post Office, perhaps, that inspires them or the compassion of the IRS, or is it, perhaps, the Department of Energy that was created to make sure we wouldn't be dependent on foreign oil or, perhaps, the Department of Education, which was studied some years ago, and it was determined in the study that, if a foreign power had done what the Department of Education has done to America, it would be considered an act of war? Why do we want to destroy the health care system that 100 million Americans enjoy in order to just simply socialize it and to turn it over to some czar in Washington, D.C.? That's an act of faith that's just too hard to follow.

Mr. AKIN

Mr. AKIN. If you push this button, it'll make the whole thing go, I think.

Mr. AKIN. Go ahead.

Mr. AKIN. Just reclaiming my time. Gentleman, you're talking about a situation, you're 30 years old, bullet proof, but you say, yeah, it's possible. If I got the really bad part of the statistic, I could get something I couldn't afford to pay for so I'm going to get that catastrophic plan that fits me in my situation. I don't need OB-GYN coverage because I'm a guy, and so I don't need that part of the plan. I'm just going to get this catastrophic thing and take the rest of my money and I'm going to put it into my small business because I've got a dream.

Mr. AKIN. I do yield.

Mr. AKIN. So basically what you're really saying is one of the things that's going to be lost, one of the big things that's going to be lost is the person who's sick having some say over the direction of which way they're going. I think this big blue button here, this is the nerve center. And if you want to be in the right place in health care, you want to be this health care--I don't know if this is a czar or not.

Mr. AKIN. Madam Speaker, it's a treat to be able to join my colleagues today here on the floor of the U.S. Congress talking, once again, about a subject that has absorbed the attention and energies of Americans now for a number of months, the subject of American health care. This is a big subject. It involves 18 percent of our entire gross domestic product. If you take a look at the hospitals, health care providers and doctors and all, you're looking at 18 percent of the U.S. economy. So from an economic point of view, it's a big deal. But we know it's a bigger deal than just that. We know it's a big deal because it's dealing with our personal bodies. It's a personal issue. And it's something that has to be done, and it has to be done the right way. There are many different ways of looking at and talking about the subject of health care, and I'm going to be going through those. I anticipate being joined by some of my colleagues and friends here talking about this issue, but I thought I might start a little bit differently this week than I have in some past weeks on health care and read excerpts from a letter that I have received from a lady I have known for a good number of years. It turns out that she works in Europe, Eastern and Western Europe, has had a family over there for more than 10 years and has had access to the health care in a number of different Eastern and Western European countries. So I thought I would share some of her comments as she hears about our debate here in the United States on the subject of health care and has shared some of her personal experiences from having lived there. She starts by saying, The first thing I note about the system of health care is that people who want really good health care travel to the U.S. if they can at all. It's interesting, isn't it? People in Eastern Europe or Western Europe, if they want really good health care, they travel to the U.S. So regardless of what we say may be broken about our system, certainly they prefer to do that if they can. In fact, some of the immigration to our Nation is based upon older people wanting better health care. And when you observe that with government-regulated health care, older people can get two free cancer treatments, and then they must consent to go home and prepare to die, you understand why the world envies our tradition of health care in America. She continues: My family have had surgeries, transplants, various tests and medical maintenance checkups in facilities in a number of countries where medicine has long been regulated by the government. My first introduction to this was hearing a national friend express her joy, and others, by this statement: God has been so good to my mother. She got in a hospital where the staff mops the floors and changes the sheets. For an American used to even community health clinics that surpass some of the westernized, that is, these European specialized clinics, that I have seen in Europe, this was a shocking first revelation that government-run health care was not all that it had been cracked up to be. Then she goes on and talks about some different people that might be getting health care. The first category she talks about is the elderly. She goes on: Later as I became a regular visitor in middle-class hospitals, I saw firsthand how very fortunate we are in America. I speak here of hospitals and clinics to speak of care for the elderly as almost too sad to describe, she says. But I can tell you that whereas once I was incensed by a low-budget nursing home my aunt was placed in--now she says in America she had an aunt that was placed in a low- budget nursing home. She was very upset about that kind of care in America. Now that I have ministered to elderly people lying in narrow beds in the back corner of dingy two-room apartments because nursing homes or assisted-living programs are beyond the hopes of the people who supposedly have free access to their nation's health care system, I think of my aunt and am grateful she had a comparatively luxurious environment. So much for the elderly. Let's talk a little bit about children. As for the care of children in a government-regulated system, let me give one example. As a public school teacher in a capital city, I was not allowed to help the orphan girl who lived with me to get glasses, though she obviously needed them. According to the school nurse in charge of the health of the children in that school, she did not qualify. Unfortunately, I did not realize then that this was my cue as caregiver to offer the nurse financial incentive to write the recommendation to request an eye exam at the government clinic. In other words, here is a little girl in a school that can't see properly, and you have to bribe someone in order to get an eye exam. So much for government care for children. Here's one for women. This is from her own personal example: No woman enjoys her gynecological annual checkup. I would ask American women to imagine a scene where in one of the best clinics you sit in a stark, icy cold room, naked from the waist up as folks walk in and out until you learn to bring your own cover-up when awaiting a mammogram. Imagine that one of the best clinics in your city cannot give you more sophisticated testing for a suspicious spot, and after seeking a clinic in a neighboring country, you end up in another stark clinic where attitudes and expectations are demeaning to any woman's dignity. Eventually, you are sent where for reliable testing? To America. These are just some of the impressions of someone that in a number of countries has dealt with government-run health care systems. And they are not very pretty pictures. That's what we're going to talk about once again, and that is, what happens when our government tries to do too much, when the government decides that we are going to take over 18 percent of the economy. Now, there are those who are going to tell you that what's being proposed by the Democrats is not a government takeover of health care. Well, it all depends on what version you're looking at. But in essence, most of the versions of the Democrat-proposed health care plans have the idea that the government is going to get into the business of bidding for government health insurance. And so if you have the government get into the business to start with, what happens is typically that the government tends, over time, to take the thing over. We've seen the same thing in student loans. There were government- assisted student loans a number of years ago, but there were a lot of private people offering student loans. Now after a bill that was just passed, essentially the Federal Government, while it just had its toe in the door before, now it has 80 percent of all the student loans in America. And so what happens if the government does too much? It goes beyond what it's effective at doing. Well, we have seen some of these kind of things--inefficient allocation of resources, bureaucratic rationing, degraded quality and excessive expense. This has led people to quip in the case of health care, ``If you think health care is expensive now, just wait till it's free.'' And so let's take a look at some of these areas and see this if there is real cause for concern. The first chart that I have here is an attempt to try to put on a flowchart the proposal that Nancy Pelosi has set forth in the House plan. And it's about a 1,000-page bill, so this chart, to try to reproduce 1,000 pages, what they're doing is all of these colored boxes are new agencies or some new structure which is going to start taking over this 18 percent of our economy. This is the House Democratic health plan. There are several others in the Senate. But this is the House picture. And what you see here, in a sense is, if you're a consumer, if you're ill, you're over here, you've got doctors on the other side and you've got to somehow get through this maze. I was thinking about creating a cartoon with all these little paths and you would find that, unfortunately for many people, there is no path through this morass of government bureaucracy. Now there are some people who have a tremendous faith in Federal Government, have a lot of faith in government in general, and feel the government could run this process better. But when you think about it, it's your body. And if you're sick, do you really think the government is going to provide you with a level of care? So the first thing here is there is a complexity. It's very hard for the government to reproduce our free enterprise system of health care. And so this gives you a picture as to what the Democratic bill would look like. Now what I would suggest to you is that if you take a look at American health care, there is a lot of talk about it being so bad. And yet foreigners, if you're sick, if you're a multimillionaire sheikh from Bahrain and you're sick, guess where you're going to go with your money to get your health taken care of? You're going to come to the good old U.S.A. So in America, we realize that there are some problems in health care, but we also realize that we still have the best health care in the world. So the idea that we just have to have change, let's change it to make it like all these other countries, doesn't make a whole lot of sense. What is broken about American health care? If you stand way, way back and look at it from a distance, what you see is that it's not so much the care that is being provided for people, although there is always ways you can improve that, what is more broken is the way we pay for it. That is the more complicated question. And the reason that's complicated is because about one-third of Americans don't pay anything for health care, and the other two-thirds have to pay for the one-third that aren't paying. So that's part of the nature of the problem. But the question is, is the solution to that problem to have the government take it all over, either directly or de facto by getting into the business of selling health care until nobody else sells it except for the government? That's what this proposal would suggest. Now there are other problems as we have seen. Excessive expense is one of the things you have to worry about when the government takes over something. Do we have any reason or basis for being concerned about an aggressive government takeover of the medical area? Well, take a look here at three of the large, large entitlement programs created some many years ago. One you know is Social Security, which is not so much medical. But Medicare and Medicaid are. If you take a look at the projected growth, particularly in Medicare here over a period of time, you realize that the government is not doing a good job of controlling cost. It's almost impossible, in fact, for the government to try to control the cost. They've written the program, written all of this law, and the law just ticks away and people collect their benefits. It's called an entitlement program. These entitlement programs--these graphs are agreed-to numbers by liberals and conservatives alike--are showing that these programs are financially out of control. In fact, if you really want to take a look at understanding the real challenges to the American economy and the biggest challenges to the solvency of our government, certainly the major component parts are the tremendously ballooning increases of Medicare, Medicaid and Social Security. Now, this red line here is about what the historical average of tax revenues are. You think, well, shoot, if these things go up, we just raise taxes more and everything will be okay. But that doesn't necessarily work, because what happens when you raise taxes too high, you kill the economy. You may have a very high rate of taxes, but the amount of money that the government takes in is not very good. That may seem strange to you, but if you really think about it, let's say you are king for a day and your job is to raise taxes by taxing a loaf of bread. And you think to yourself, well, I could charge a penny a loaf and make some tax revenue on that. Then you think, ha, maybe I could charge $100 a loaf on bread. But maybe people wouldn't buy so much bread then. Somewhere between a penny and $100 there is some optimum level of taxing where you are going to get the most tax revenues. What we found historically, when the Federal Government runs its taxes too high, it just kills the economy and we end up not making too much money. So you can't fix this problem by constantly taxing people more and more. So, with this experience, this would give us a lot of confidence to say we want the government running our health care. I would suggest now that that is an optimistic way of looking at things, if you want the government to do that. This is a statement made by our President. ``Most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse.'' It is as though we had some government document in our ledger books that said ``waste and abuse,'' and we can just subtract some money out of waste and abuse and we have all this extra money in here. Well, where was it he was going to go to get all of this ``waste and abuse''? Well, he was going to go to Medicare. And how much money was he going to take out of Medicare? Oh, at one time the estimate was $500 billion being taken out of Medicare, particularly the Medicare Advantage program which is enjoyed by many seniors all over this country. So here he says, ``Most of this plan can be paid for by finding savings within the existing health care system.'' What sort of savings? Taking it out of Medicare. That is one of the reasons why these health care proposals have been not too popular. The senior population enjoys Medicare Advantage and other parts of Medicare, and they are not so sure that this is the way to pay for socialized medicine. Another statement by our President: ``Here is what you need to know. First, I will not sign a plan that adds one dime to our deficits, either now or in the future. Period.'' Very emphatically. I am not going to add one dime to our deficit, says the President; yet, if we take a look at the last 6 months, we kind of wonder whether he is really very serious, or maybe whether he was joking. Because if you take a look the Wall Street bailout, $250 billion we spent; economic stimulus, which was really an expansion of welfare and a lot of other programs, $787 billion; SCHIP, another $66 billion; another $410 billion for appropriations in the IMF bailout here. When you get all done, we are looking at a spending of $3.6 trillion, which we don't have. In fact, by the time we got to about March or April of this year, we had spent all the money that was coming in in taxes. In other words, it would be like you and your family budget, and you are sitting there, you have one year you are supposed to make your budget over, and you get through the first 4 months and you have spent all the money for the year. That is what happened here federally with the trillions of dollars of debt and deficit that is being piled up under the Pelosi and Obama leadership. We were told that George Bush spent too much money, and he did. That is why I voted against a bunch of his proposals even though I am a Republican. But he is a mere piker when it comes to spending. So when we say we are not going to add one dime for a health care plan that isn't paid for, this record that has been established over the last 9 months certainly is one that leads us to be just a little bit skeptical about that promise. We have had some other promises from the President. Here is one: ``If you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid or the VA, nothing in this bill will require you or your employer to change the coverage or the doctor you have.'' Boy, I am sure glad to hear that. One thing, if I knew the Congress were going to be having the government take over health care, if they told me I could kind of keep the program I have and the doctors that I am comfortable with, I would think that is a good promise. I really like that. But is it true? Is it true? Let's take a look at what other evidence there is to see if this is true or not. This is an MIT health economist. ``If you like it, you can keep it?'' with a question mark. Is that really true? If you like your health insurance today, can you keep it? Here is what Jonathan Gruber said. ``With or without reform, that won't be true,'' said Gruber. So he is basically saying the President is wrong, it is not true. His point is that the government is not going to force you to give up what you have, but that is not to say other circumstances won't make that happen. So, what you have going on here is that by having the government involved in health care, what is going to happen is the government will continuously exert an influence. It will change the way that the private insurance companies write their health care, and you will not be able to continue with the care that you currently have. So this is another promise which is a bit misleading. One of the things that is particularly important I think for most Americans in health care overall, and that is they want that doctor- patient relationship protected. When you go to see your doctor, most of the people who practice medicine do so because they like to heal people, they like to help people, and they will take time with you. They will try and diagnose what is wrong with you, and they are going to say, you know what I think you should do, you ought to do this, this and this. They are going to make a recommendation. You may or may not choose to take their advice. You may get a second or third opinion if it is something that is very serious, but you are going to check it out. Then, when you and the doctor eventually come up with a plan as to what you are going to do if you have a problem, you don't really want somebody in an insurance company telling you, No, you can't do that. You want to be able to have the doctor-patient relationship to be intact and that you can proceed on that track. You certainly don't want somebody that works for an insurance company getting in the way. But there is one thing worse than some big insurance company getting their nose in the relationship between you and your doctor, and it is much worse, and that is when a bureaucrat gets his nose in and says, Sorry, you are not qualified to get that care. You see, there is nothing about the way the bureaucrat is going to figure out who is going to get care, because this is basically a law of supply and demand. It is a basic law like the law of physics, and that is, if you have an unlimited demand and a limited supply, things aren't going to work. So you have everybody in the country wanting absolutely free health care and you have got a limited number of hospitals and doctors, something has got to give. So what is the solution? Well, the government bureaucrats are going to get these big old calculators and they are going to figure out whether you are the right age to get this particular health care or not, or maybe use other parameters to determine do you get service or do you not. It is called bureaucratic rationing. You know, the trouble with their calculators, those big old calculators, they don't know anything about health care. They are just counting dollars. So, if you are the wrong age, too bad. You get a bottle of aspirin and get to go home and just wait to die. Anyway, one of the things that is very important to Americans is the idea that you and your doctor's decisions about health care should be protected and final. So this is something that never can happen here on the floor of the House, because people wouldn't want an embarrassing vote to happen here on the floor. But they do allow amendments in committees. Here was an amendment that was offered by a good friend of mine, Dr. Gingrey from Georgia, an amendment in a committee. Here is what the amendment says: ``Nothing in this section shall be construed to allow any Federal employee,'' you can translate that bureaucrat, ``or political appointee,'' an appointed bureaucrat, ``to dictate how a medical provider practices medicine.'' That is, we want to leave the doctor-patient relationship intact. That is what this is about. This is kind of a simple little amendment. You may think we pass thousand-page bills on the floor here that we haven't had read or printed. That is true. We don't like it. We have a bill to try to fix it. That does happen. This isn't any 1,000 pages. This is a simple little sentence. You can read it off this chart. This amendment was offered in committee, and guess what? This amendment failed. People voted on it. Do you like this? Do you want to keep the doctor-patient relationship sacrosanct? Here is the votes. The Republicans, 23 of them, voted for this amendment that Dr. Gingrey proposed. The Democrats, 32 of them, voted against it, and one voted for it. So it was almost a straight party- line vote, and this amendment failed. This amendment failed. So if we start talking about some bureaucrat dictating whether you are going to get care or rationing of health care, don't be surprised. A lot of politicians say a lot of things. This here is a written sentence in English, and this here is an historic vote total. People can have opinions, but they don't have the right to their own set of facts. This is a fact. This is what happened in committee, and this should give you some concern if you don't want the government rationing your health care. Here is another statement by our President: ``There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false. The reforms I am proposing would not apply to those who are here illegally.'' Well, I am glad to know that the people who are paying for health care in America wouldn't be having to pay for people that aren't even American citizens. And that is what the President is assuring us of. We are not going to be paying for people who are here illegally. Well, again, like a lot of these other statements, instead of just taking it at face value, you probably better take a look at the fine print to see if he is telling the truth, because the last couple of statements he made, I don't believe him at all. Do we have any reason to believe this statement? Let's take a look and see. This is an amendment that was offered by Congressman Heller, and it is going to clarify this question. This is an amendment that is going to go on to the Democrat health care bill. It was tried in committee. What he wanted to do was, Congressman Heller, who is a Republican, he wanted to take Obama up right on this promise right here that he made that no illegal immigrants are going to be getting any of this government-paid-for health care; translated, that means you and I pay for it. So, he says, well, fine. If that is what you mean, we are not going to have illegal immigrants getting health care, what I am going to do is write up a sentence here just to make that absolutely clear. Here is the sentence: In order to utilize the public health insurance option, an individual must have had his or her eligibility determined and approved under the Income and Eligibility Verification System, IEVS, and the Systemic Alien Verification for Entitlements, SAVE, program. In other words, using other parts of our government law, you have to prove that you are here legally if you are going to get any of this health care provided courtesy of the U.S. Government, provided courtesy of the U.S. taxpayer. So here is an amendment that just makes clear that what the President was saying is true. And how did this amendment go in terms of voting in committee? Well, here we have it again. The Republicans voted 100 percent; that is, 15 of them voted for this amendment. They said, yeah, we don't want illegal immigrants getting this socialized health care. And the Democrats voted 100 percent, that is 26 noes, and they don't want this in the bill. Now, does that give you a sense of confidence that what the President said is really true? If we didn't want illegal immigrants to be getting this health insurance from the government, wouldn't the President say, hey, Democrats, vote for this amendment so we can make it clear to the public that we don't have any illegal immigrants getting this? No. Of course, this is voted. So we hear one thing from the President, and yet, in fact, when we actually put an amendment up in committee, we find a straight party- line vote. Some people say there is no difference between Republicans and Democrats. If you worked down here, my friends, you would know there is a very big difference. A very big difference indeed. I am joined by a good friend of mine, Congressman Hoekstra, and you have joined us before as we have talked about health care, just kind of running through a whole series of different aspects of what is involved in this huge debate that is taking place. Apparently, at some period of time there is going to be a big vote on this subject. I don't know if we will get a copy of the bill or not, but there is going to be a big vote. I would yield time to my good friend from Michigan to let us know what your thoughts are.

Mr. AKIN. Thank you, Madam Speaker.

Mr. AKIN. And ``poor outcomes,'' that's doctor's talk for you're going to die, isn't it?

Mr. AKIN. So you have rationed care. Rationed care means you've got to wait longer in line. Waiting with cancer is not a good deal.

Mr. AKIN. In our last minute or two, what I might do is share something personal because I came to this Congress 9 years ago, and they have a little medical clinic that's downstairs, and the medical clinic gives you--if you want to spend about $400, you can get a test, you can get a physical. I hadn't had a physical in years because I had some sort of State HMO policy. I never could see my primary care doctor. I don't even think he existed. I could never get an appointment. So I go down there and find out I was bulletproof, as I thought, except for one detail. I had cancer. So when you use the ``cancer'' word around me, my ears pick up a little bit. I take a look at how does it work when these governments run and deal with cancer. Here's your survival rate for men in the United Kingdom, 44.8 percent. It jumps up here quite a number percent to 62.9 among men in the United States. And we want to go over and make ours like that? I don't think so. I yield to my friend from Georgia, last minute.

Mr. AKIN. I do yield, yes.

Mr. AKIN. So we've been talking a little bit bad about these Democrat proposals. This is something that Congressman Lungren's been hitting, and that is it reduces health choices. Freedom is about increasing health choices, not reducing them. It raises premiums as long as there's even going to be premiums, it delays and denies care, $500 billion in Medicare cuts.

Mr. AKIN. I just hit 62, and I was just reading that in Canada--I've got a bad hip--I wouldn't be able to get that hip replacement that Dan got because I am too old, I'm an old geezer now, and it's not worth it for a government bureaucrat to pay me to get my hip fixed.

Mr. AKIN. Now you're getting off to preaching and getting on to meddling a little bit.

Mr. AKIN. Not to mention $500 billion out of Medicare, taxing small business when we already have close to 10 percent unemployment.

Mr. AKIN. That's the end goal.

Mr. AKIN. I do yield.

Mr. AKIN. None. So we don't have any malpractice reform. We don't allow the competition of--of course, they don't need to worry about that in their bill because their plan is, they're not going to have any private insurance companies in a period of time because the government is going to run it all.

Mr. AKIN. Do you know if that is included in any of the Democrat bills at all?

Mr. AKIN. So if you have some insurance companies that may have a little bit of a monopoly in one part of a market and you allow people to buy insurance across State lines, you're breaking up monopolies, allowing prices to come down and giving people more choice, which is more freedom. Is that right?

Mr. AKIN. More choices equals freedom, doesn't it, gentlemen?

Mr. AKIN. We've got just about maybe 5 or 6 minutes to go. We've been accused, as Republicans, as not having any ideas. You started by saying, Yeah, we sure do. You want to take a look at one thing, you can avoid getting into this kind of mess. If you're worried about the cost of medicine, you can deal with tort reform. That's one piece. The lady who was here from the district before, Ms. Foxx, talked about the idea of treating pools of people, small businesses coming together and getting a better buy on their insurance. She talked about portability, so that when you leave one job, you can take your insurance along with you. All of these things are things that we talked about that we agreed to. And there are a couple of other things.

Mr. AKIN. Yes, I yield.

Mr. AKIN

Mr. AKIN. Madam Speaker, it is a common refrain today that ``we are losing good manufacturing jobs'' in the United States; that manufacturing anything in the United States is becoming more and more difficult. As a former steel executive, I share the concerns of our manufacturing community and blame, in no small part, the onerous regulatory burden with which this government has saddled our manufacturers for that decline. But, despite what seems to be the best efforts of some in Congress and our regulatory agencies, there are manufacturing companies in this country who are succeeding and without government intervention. One such company is O'Fallon Casting; located in my district, they will celebrate their 6-year anniversary on Friday October 23. Once a division of Hitchiner Manufacturing, Co. O'Fallon Casting has roots dating back 40 years in Missouri. But today it has shed its traditional past and transformed itself into a modern, high tech industry leader positioned for growth in the future. Proving that despite an increasingly competitive world economy, innovative U.S. manufacturers can and do successfully compete in the global market. With the support of ownership, O'Fallon's management team has incorporated modern automation of the material handling and production systems. Additionally, compression straightening of castings has been implemented with four workstations feeding to a single, custom, 500-ton press. The company's goal is to provide their customers with access to cutting edge technologies. Employing 169 people in O'Fallon, Missouri, over the past six years the company has also pursued a number of environmentally friendly initiatives including high-efficiency lighting and in-house recycling of water, wax and metal. In 2004, O'Fallon Casting was recognized by the State of Missouri with a prestigious Gold Award for its water recycling and waste treatment efforts. The City of O'Fallon named the company ``Manufacturer of the Year'' in 2005. Throughout my tenure in Congress I have fought to reduce the tax and regulatory burden this government places on American business and manufacturing as a way to encourage companies, like O'Fallon Casting, who are responsible for creating the jobs that employ all our constituents. I'm honored to represent the company and its 169 employees in this House, and congratulate them on their sixth anniversary. I pray I will be able to celebrate many more such days with them for many years to come.