W. Akin

Mr. AKIN

Mr. AKIN. That strikes me a little bit as, first of all, you run over them with a car and then back over them to say you're sorry. I mean, you're getting them coming and going. First of all, they're doing what we would say is the right thing as a responsible citizen--having a job, buying health insurance, and trying to take care of their own bills--and now you're going to tax them for doing the very thing that you wanted them to do in the first place. There's a basic rule of economics, and that is what you tax, you get less of, and what you pay for, you get more of. The more people you pay for free medical care, you're going to get more and more people signed up for it. And the more you tax people who are working and paying for their own health care, you're going to get less of it. So why in the world would we want to adopt a policy like that? The interesting thing is, gentleman, this proposal, the Pelosi health care proposal, in spite of the fact that a lot of major media is pushing it and the President is pushing it and all kinds of people like that are pushing it, the American public is not buying this thing. And I was just kind of thinking in my mind, Who would be against this? Why is it that the polling data shows that this is not popular with the American public? And I'm thinking, well, it's almost like politics, in a way. How many groups of people does this Pelosi plan antagonize? Well, let's see. First of all, if you're on Medicare, you're going to take $500 billion out of Medicare. Well, the people who are on Medicare are thinking, I don't want you to take $500 million out of the place where I'm getting my health. So the older people--who are pretty regular voters, by the way--they don't like this thing. Well, then you've got other people. Gentleman, you were a successful owner of a small business. Well, the small business guys are going to get soaked to have to pay for this plan, so they're not too enthused about it. Then you have some other people. They call themselves pro- lifers. They don't like this plan very well either because there was an amendment offered in committee making it clear that we weren't going to use this government socialized money to pay for free abortions. That amendment was defeated in committee. It is very clear that this money is going to go for abortions, and that's why National Right to Life says, This is the biggest threat in the pro-life area since Roe v. Wade. So the pro-life people don't like this, small business people don't like it, older people don't like it. Then you have got the 100 million people that have their insurance, doctors that they like and a system that's giving them good health care, and basically you're creating something that's going to destroy that, and they're going to have to change to a government system within some number of years, so they're not liking this. After you start adding those people together, it starts to make sense why people don't like this. And particularly, most Americans at a fundamental level understand that good health care has to start with a patient-doctor relationship. It has to start with the doctor and the patient deciding what is the right health care alternative. We don't like it when some big insurance company sticks their nose in that relationship, and we like it a whole lot less when it's going to be a government bureaucrat.

Mr. AKIN. Gentleman, the truth of the matter is we're not standing here defending everything about the American health care system. There's things that need to be changed, and we've talked about those things. You have mentioned on the floor that tort reform has to be a big part of it because tort reform is just using up a whole lot of money that doesn't need to be spent, which could be spent on good medicine. So that's one item. But there's some other things that I think almost any American, if you heard about it, would say, Oh, yeah, that's right. For instance, there are some people in America who get to buy their health insurance using pretax dollars; whereas, small business men and self-insured people have to use the money they pay after they've paid taxes on the money. So that's not just justice. People are not equal before the law. We say we're a Nation of laws, but that's not a just solution. What we should do is that everybody should use the same equation. I think you and I would agree that we just pay for health insurance with pretax dollars. That would be making everybody consistent. There's a second thing that we could do. Another thing is the idea of a medical savings account. You could allow people with pretax dollars to set money aside. They could use that money to buy health insurance or to pay medical bills. And if they don't use it, they can keep it earning interest in an uninsured account. If they up and die, they can pass it on to their kids. That makes sense, too. That allows us to allow Americans having their own money, buying health care, and that equation starts to get people to shop for prices. So that's another good idea. And there are quite a number of other ones that we've proposed. You mentioned another one which makes a whole lot of sense. People say, Oh, well, you're trying to help the big insurance companies. No. What we want is reasonable competition. And that idea of being able to shop for health insurance across State lines is a very effective and competitive mechanism, because if one State has got laws that allow the insurance to be purchased at a lower price, then why can't a citizen, particularly where we have a big metropolitan area that bridges two different areas, get their health insurance from places less expensive? So there's another idea that's been proposed. And there are other ones. I don't want to run too long on your time, gentlemen, but there are a number of things that we can do to make medicine better in our country. Let me tell you. You know who votes with their feet? You get some sheik in Bahrain or some other place or some other part of the world that's loaded with millions of dollars and they get sick, guess where they come to get their medical care? They come to the good old USA. That's because our medical system is not bad. It's producing very good results. It's just that there's a lot of cost shifting going on. Here's an idea, gentlemen. I just toss this out for you to think about it. Somebody summarized, if there is a problem with American health care, the problem is this: that is that one-third of Americans are paying nothing for it and the other two-thirds are paying for it, and that that cost shift is the problem, that one-third are paying nothing. And that's part of what's causing our cost shift problem. I'd yield.

Mr. AKIN. So what we're doing, gentleman, is we're saying we're going to scrap the whole system, have the government take it over, because of that little 4 percent thing. I came from the engineering world, and there's one thing about solving a problem. There's another one to have a solution to just try to force your solution on something that doesn't make sense. It appears to me that the solution is we want the government to run everything. We want the government running health care, so we're going to force a government solution just because of that little red--that isn't even a decent piece of pie. You couldn't even gain any weight on that amount.

Mr. AKIN. Now, who is it that should allow the Federal Government to tell American citizens whether they're spending their money in the right place? Isn't that kind of this Big Government top-down mindset that comes up with something as dumb as that? If you're sick, you're going to spend as much money as you need to try and get well. Who's to tell you you spent too much or too little? Even the very sniff of that speaks of this Big Government mindset.

Mr. AKIN. I'm afraid that America is probably less healthy under the results of the Pelosi Congress. If you were to judge in economic terms, you would be talking in trillion-dollar measurements of less healthy. You would be talking about excessive spending and excessive government control. I think sometimes history is so close to us we fail to grasp the significance. Did you ever stop to think that the President of the United States fired the President of General Motors? That is an incredible intrusion that our forefathers would say, What? I can't believe that. And now we are talking about this isn't just a sort of semi-benign Lyndon Baines Johnson war on poverty. He figured out there were people that were hungry out there, so he decides to hand out some food stamps, which has turned out to be a very corrupt program. So he decides to hand out some food stamps, which has turned out to be a very corrupt program, but he didn't try to have the government take over every supermarket and every farm in America. You've got 100 million people that have got good health insurance, good relations with their doctors and hospitals, getting good medical treatment, and for what he started saying, 30 million, and then your chart I see coming up is going to explain about how small this is. So we're going to basically have the government take over the entire system and mess everything up for 100 million people in order to try and help 15 million? I mean, just the common sense of this. And you're talking about the Pelosi Congress. I will tell you, the patient is a lot sicker than they were 6 months ago, my friend.

Mr. AKIN. It's my pleasure to join my good friend. And as you talk a little bit about freedom, you have spoken in somewhat general terms about the effects of the government taking over paying the doctors and what that would do. But I would like to get a little bit more into the details, because I think we have to remember the results of what that freedom has done in the area of medicine. The level of innovation that has occurred in medicine in a free society such as ours is just incredible. And it is America that drives all of these new developments of various drugs. It is America that is driving all of these things like laser surgery for eyes. We see examples now of something that was considered a very risky and strange procedure that wasn't covered by insurance company, called Lasik surgery for your eyes, which now is tremendously common. My wife had some 10 years ago, and her vision was terrible. It's much better than mine now because of the fact we had this innovation. We have innovation in terms of heart surgery and the way that we deal with that. My dad just had a seven-way heart bypass. That was something that wasn't available 30, 40 years ago. And he is surviving and doing well at 88 years old. There are so many different kinds of innovations, use of radiation which is now focused in a very, very tiny area to be able to destroy cancer, and different types of drugs and things. All of this innovation is the product of freedom, because as people take risks and try new ideas, new and better ways to do things are born. It struck me, my good friend from Iowa, that it was said that it wasn't until about the First World War that when you got sick and went to a doctor that you came out ahead. In other words, if you went to see a doctor before World War I, it was certainly after the Civil War, but if you got sick and went to see a doctor, at least 50 percent of the time you would leave the doctor worse than where you started. And that is, of course, kind of a grim situation to be very sick and have to see a doctor knowing you have got less than a 50 percent chance to do better than when you started.

Mr. AKIN

Mr. AKIN. I very much appreciate your taking some time to join with us. This is such an important discussion. Your experience in California with the great amendments that you offered both in California but now, I understand, in committee are making it clear that the promise, we are not going to spend one dime of deficit, and yet it gets defeated on a straight party-line vote. It took some courage to offer that amendment, but at least it defined where we are in this entire situation. And I'm very thankful that you came out and joined with us today on a very important discussion. The talk is that sometime in the next couple of weeks, this whole thing may come down to a vote. Once again, I go back to my own personal experience with having been a survivor of cancer, coming into this very building, having medical doctors tell me, Congressman Akin, you are fit as a fiddle except for the fact you have cancer. That's a sobering kind of thing. So what had happened to me was the insurance companies had discouraged my getting a physical. I should have. If I had been smart, I would have forced myself to get a physical and line up and wait for it all, but I didn't do it until I got here in Congress. Well, here's what happens, one step worse than an insurance company getting between you and your doctor, and that's when the Federal Government gets in between and starts to ration and dictate what's going to happen. We have this experience in the United Kingdom with what happens in cancer there, and in Italy and Spain. Then you take a look at the U.S. results, and in spite of the complaints about American health care, if you're some well-to-do sheik from Bahrain and you have got unlimited billions of dollars or millions of dollars to spend and you're sick, guess where you come. You come to the good old USA for our health care because we still have a lot of good things going on with the level of services we provide. There are changes that need to be made, but the change doesn't need to be socialized medicine. It doesn't need to be a government system which will crowd out all of the privates. It doesn't need to be a system which is going to create an incentive for private companies to dump their employees on the government. It doesn't need to be a system which is going to take $500 billion of Medicare funds away from people who are on Medicare. It doesn't need to be a system that basically guarantees that illegals can get health care at the public trough. It doesn't need to be a system that says that we're going to use Federal money to provide free abortions for anybody who wants those. And it doesn't need to be, above all, a system that is driven by bureaucrats getting between the patient and the doctor. Those are things that we don't need in America. Americans, in spite of the fact that a great preponderance of media have not been giving all the facts and pointing out that these quotations are not true, in spite of that fact, Americans across the board, whether they're liberal or conservative or whatever, they're saying, Please, don't take our one-fifth of the economy and completely redesign it to fit 15 million people who may not have insurance when 100 million people are comfortable with what they have. We need some reforms. We need some changes, and there are some very good things we can do. We haven't even mentioned tort reform, the high cost of defensive medicine. That's one thing that's needed to be fixed for a long time. That will drive health care costs down. We haven't even mentioned here today the fact that people that work for big companies or the government get to buy their health insurance with pretax dollars; whereas, a small business or self-employed person has to pay for their health insurance with after-tax dollars. That is not just. It should not stand. We should not tolerate this. There are changes we need to make, but socialized medicine is certainly not one of them. All you need is a little common sense to look at the foreign countries or the two States in America that tried this Pelosi-type plan and you will see that this is not the direction we need to go.

Mr. AKIN. That's the other thing that's interesting. America, such a great country, and we have these fifty States. And the States, to some degree, were like little laboratories. People could try stuff in the States and see how it worked. And then, if it worked really well, perhaps you might want to bring it to the Federal level. But why would we want to repeat the failed experiment of Massachusetts and Tennessee?

Mr. AKIN. You know, that's the thing that I find hard, the amount of faith that's required, when you take a look at the performance of government agencies, to turn our physical bodies over to those government agencies to take care of us. It's kind of a hard thing to swallow. As you say, the compassion of the IRS, the efficiency of the post office. FEMA, we've seen that--legendary. But we've got other ones. You've got the Department of Energy. Do you know why the Department of Energy was created? To make sure we weren't dependent on foreign oil. Aren't you glad that we've got all those employees making sure we're not dependent on foreign oil? And then you've got the CIA; the cloak and dagger stuff. Well, that would be great, but they're the ones that gave us a report in Gulf War I that the Iraqis were 10 years away from making a bomb, a nuclear device. When we got in there, they were about a year to a year and a half away from making it in Gulf War I. So we go to Gulf War II, they tell us, Oh, within a year, year and a half, they'll have a bomb. We get in there, and they weren't doing anything. And we want to trust our health care to these agencies? It's one thing if it's the post office or something, a letter gets missed. What happens--that's what I'm asking you my friend--what happens when we get the call and somebody says, Congressman McClintock, they're not letting my mom get the heart bypass, and I don't have any other alternative. How are we going to deal with that? How can we explain that?

Mr. AKIN. It's interesting that we seem to--as a political party system, the Democrats seem to be wedded to trying to copy what did not work well in the United Kingdom or in Canada. You can take a look at these cancer statistics and other measures of quality and they're really bad. If you look overall at cancer in the United Kingdom, you're looking at a 50 percent survival rate. Whereas in America, the numbers are so much higher. So why do we want to repeat something that doesn't work? Why do we want to mess up something that 100 million Americans have got a good system going, and we want to just turn it over to the government? It's almost like we've got these blinders on. Regardless, we know the government should do it all. And so half the Democrats want to go that way, the other half are kind of dragging their feet--and I'm thankful for them.

Mr. AKIN. Against the law federally?

Mr. AKIN. Why would that be, gentleman?

Mr. AKIN. Or you might not able to afford.

Mr. AKIN. And the way that works is that of course you've got different States that have their own requirements for health care, but if a plan meets the requirements of a given State, and that company wants to sell their health plan to someone over a State line, now you've got a chance for shoppers to get a better price on their product. And it tends to break up the monopolies that an insurance company can generate in a particular State market. I picture, gentleman, that that's going to be particularly effective where you've got basically large metropolitan areas that span several States. You can go back and forth and kind of shop for what's better for you. Is that your impression?

Mr. AKIN. That makes a whole lot of sense, doesn't it?

Mr. AKIN. You just don't buy your groceries in California. You can go across State lines to buy groceries.

Mr. AKIN. Gentleman, what you're talking about is you're talking about one of a whole series of different Republican proposals of what can be done to health care. Our position in being very critical of socialized medicine is not to say that there aren't things that are constructive or positive that should be done with our current health care system. In fact, a lot of the problems in our health care system were put there because we already have the government with its big nose in about half of it. But there are some things that can be done. As you say, one of the things is you own your own health care policy. People sometimes use the word ``portability.'' That is, if you own it, you can take it with you as you go from job to job. It also means if you're insured, you're not going to get uninsurable because you already have the health care plan.

Mr. AKIN. That's called freedom, isn't it?

Mr. AKIN. That's something about freedom, isn't it?

Mr. AKIN. So the government wouldn't have to run the whole thing at all.

Mr. AKIN. Well, Congressman McClintock, you just brought up a little bit of a tender subject for me. Just about 6 or maybe it was 8 weeks ago, my father, who's 88, in the State of Missouri, went to a new heart doctor. His new heart doctor took a look at the medicines his previous doctor had prescribed and said, What did the doctor do for your heart? My dad said, Well, I don't know what you mean. He just gave me these medicines. So you can see this troubled look in his new doctor. The new doctor says, Well, you need to come in tomorrow, and we're going to give you a chemical stress test. I don't know how exactly that works, but it's like a stress test of being on a treadmill, except it's for older people. They do it chemically, somehow. He didn't go very far and the doctor said, Stop, that's good enough. He said, You need to come in the beginning of next week for this heart catheterization, or whatever it is. So he comes in and they put him out and they take a camera and go up through his leg and look at his heart. He wakes up--and they said they might put some stents in or something--and they said, Well, we didn't do anything. And I was at the meeting with the doctor. The doctor said, Your heart is in too bad a shape to put in stents. You need open heart surgery. This is, mind you, about a week and a half elapsed, or so. So I'm at the meeting on Monday and he says, Here's the numbers. First of all, if you have open heart surgery at 88 years old, because it should have been done earlier, you've got about a 10 percent chance of a major complication. But if you don't get it this next year, you've got a 50 percent chance of a major heart attack. So you take a look at the numbers and you go, Okay, he explained it so I understand it. So the doctor said, Well, you can come in tomorrow or Thursday. It's Monday. My father goes in Tuesday, has a seven-way heart bypass and by Saturday he's back home again, and he's doing well now. Now people want to say that the American health care system is broken, but I would suggest that that being done in less than 3 weeks, a seven-way heart bypass and the technology involved in that, that's the kind of thing that you're never going to see with a government-run health care system.

Mr. AKIN. Are those all U.S. citizens now?

Mr. AKIN. Winning the lottery.

Mr. AKIN. I think The Wall Street Journal had another guy--I remember, because he was in his late fifties--and the Canadian system said, Sorry; you're too old. You can't get a hip replacement. Well, I'm 62 and my hip has been giving me trouble. I'm probably going to have to get a hip replacement. I fell on some ice when I was jogging 10 years ago. They basically tell me, Take some aspirin and suck it in, buddy, because you're not allowed to have that.

Mr. AKIN. I'm sure that you've gotten phone calls from your constituents and they're saying, Hey, Congressman, I'm having trouble with this, that, or the other part of the Federal Government, I'm trying to get my passport or this or that. And you or your office goes to bat for those people trying to talk to different Federal agencies to help them with their problem. Now, I'm just trying to picture in my mind. Let's say that the Democrats jam this thing down everybody's throats. Can you picture getting a call from somebody from your district and they say, The bureaucrat that you're in charge of in that Federal Government just told my mom she couldn't have a heart bypass. How are you going to deal with a constituent like that?