Charles Boustany

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, at this time, I yield 3 minutes to the gentleman from Texas (Mr. Sam Johnson), a distinguished member of the Committee on Ways and Means.

Mr. BOUSTANY. Mr. Speaker, I now yield 2 minutes to the gentleman from Illinois (Mr. Roskam), a distinguished member of the Ways and Means Committee.

Mr. BOUSTANY. Mr. Speaker, I yield myself such time as I might consume. (Mr. BOUSTANY asked and was given permission to revise and extend his remarks.)

Mr. BOUSTANY. Mr. Speaker, as I stated earlier, this legislation contains provisions that will make April 15 easier for American taxpayers, and so I intend to vote for the bill. Simplifying the treatment of cell phones used by employees, eliminating the 20 percent down payment requirement for offers in compromise, notifying taxpayers of suspected identity theft, and studying whether there are more efficient ways to get tax refunds into people's hands all makes sense and will make a positive difference in people's lives. But it's also important to recognize what's not this in this bill: Repeal of health care mandates and taxes, protecting taxpayers from automatic tax increases scheduled to go into effect next year, and finding a permanent solution to the ticking time bomb known as the AMT. Hopefully, the majority will listen to the American people and move forward on those priorities so that taxpayers will have an easier time on future tax days. Mr. Speaker, I urge my colleagues to vote for this bill, and I yield back the balance of my time.

Mr. BOUSTANY

Mr. BOUSTANY. Madam Speaker, I thank Ranking Member Camp for yielding me this time. We are talking about jobs, and this bill purports to be a job- creation bill, but I have deep reservations about one of the pay-fors in the bill. It is in section 301. It raises $7.7 billion in taxes, and where do these taxes come from? Where does this tax increase come from? Well, it comes from U.S. companies who happen to be headquartered overseas. What does that mean? These are companies that employ U.S. workers. These are companies that are in every one of our communities that also stimulate business activity that help create jobs in other businesses that affiliate with these and do business with them. So what are we doing here? We are basically hurting U.S. job growth. We are hurting U.S. workers. Furthermore, this provision would basically abrogate some 60 bilateral tax treaties that we currently have. We know that the Senate has opposed these types of provisions in the past. So why are we doing this? Secondly, in the course of the hearing, we had the Deputy Assistant Secretary for Tax Policy and she had questions about this approach and said that this was not the preferred approach of the administration and also expressed concerns that this could invite retaliation upon U.S. companies doing business overseas, further hurting U.S. jobs. Now if we are going to create jobs, let's try to be sensible and make sure that our tax policy is coordinated with trying to create jobs. What do we know about these jobs in the U.S. by these U.S. companies who happen to be headquartered overseas? Well, they pay better wages. In fact, their compensation packages are roughly one-third more. These are high-skilled jobs so why on the one hand do we want to say we are going to create jobs and on the other hand focus on policies that will kill jobs? I just don't understand the logic here, and for those reasons I oppose this bill.

Mr. BOUSTANY. I want to respond to what was just said about these tax provisions, and that is, the previous administration actually wanted to work through these treaties and recognized that there were some problems but did not just simply want to abrogate 60 tax treaties.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, we all have compassion for families struggling, those who have lost jobs, those who lack access to health care. We all want to do what's right for our country. We all want to solve these problems. But as I look at this massive, complex and partisan bill, I see premiums continuing to rise for families and abject failure to control health care costs for families and businesses. I see huge tax increases coupled with irresponsible cuts to Medicare services, all to expand new coverage entitlements where physician access will worsen, continuing to burden our strapped emergency rooms. Mr. Speaker, frankly, I see a sequel to the modern Greek fiscal tragedy unfolding before us with a potential for default. We have a duty to reform health care, but an obligation to get it right.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, I had the great privilege of practicing medicine for 20 years in Louisiana. I was a heart surgeon. I did open heart surgery, critical lung surgery, and I took care of many patients during very difficult times in their lives. And I got to see the wonderful innovation in technology that we were able to use to save so many lives during that time. As we face a Sunday vote, here we are Friday night, and I have to say that I am deeply saddened because I really fear what is going to happen to health care in the United States if this bill passes. I have heard from many Americans across the country, given my status as a physician in Congress, many, many Americans from all over the country have contacted me and have basically rejected this bill. They are concerned. They are concerned because they will see their premiums rise. Let me explain. The Senate Democrat bill will increase health insurance premiums for families by up to 13 percent by 2016. What does this mean? For an individual with the lowest cost basic plan, it would cost $300 more in 2016 than if Congress did nothing at all. How about for a family? Families are struggling right now. Well, for a family who got the lowest cost basic plan, it would cost $2,100 more in 2016 than if Congress did nothing at all. Premiums are going to rise. We don't need an expensive bill to start bringing health care premiums down. All it would take is competition and choice, things that Republicans have promoted. We have written bills that would expand health savings accounts. We would allow folks to buy insurance across State lines, create transparency, and allow small businesses to pool together to get greater purchasing power, just like unions and large corporations do. That wouldn't cost trillions of dollars to do. Let's just do this. It's easy. What is going to happen with this plan? Well, it raids the Medicare program by a half a trillion dollars and uses that money to create a whole new entitlement, just like it basically raises taxes by over a half a trillion dollars to create this new entitlement program. What happens with these taxes? These are taxes on businesses and families. These are taxes on innovation in health care. And so the United States may end up losing its innovative edge if we allow this to go forward. If you look at what's happened over the past 50 years in health care, folks, doctors, nurses have come from all over the world to train in the United States because of our advanced education in health care and in medicine and our advanced technology. Patients come from all over the world because of this great innovation, this great ability to save lives. And if we tax this, well, we will lose that competitive edge. There is no question about it. So what happens with this big massive entitlement that is going to be expanded? Well, $434 billion will be used to expand Medicaid coverage. Now, as a physician I know that Medicaid is a deeply flawed program. There are serious problems with this. First of all, it is breaking States' budgets. Secondly, it is a strain on the Federal budget. But what does this really mean for families? Well, families who have Medicaid right now are having a very difficult time getting access to a doctor because the Medicaid reimbursements don't even come close in many instances to meeting the costs. So doctors are not seeing these patients until late in their conditions. They are having to go to the emergency room, when care is much more expensive, they are sicker. And it is just the wrong way to do this. It is not fair for these individuals, these families who are having to do this. So what does this bill do? It expands Medicaid. Well, I have a problem with this. I think there is a better way to do it. We can expand coverage, meaningful coverage, by increasing competition, as I mentioned earlier, so that folks afford health care insurance. The last thing we want to do is drive up the cost of health insurance. And that is what this bill does. The other thing this bill does is it increases taxes across the board. I mentioned new taxes on innovation, on pharmaceuticals, on devices that surgeons use in the hospital. You know, your knee replacement, your hip replacement. This is going to hurt innovation, as I mentioned. But there are also new taxes across the board on businesses. We are going to see new Medicare taxes, $210 billion in new Medicare taxes, new taxes on health care benefits, new taxes on employers, and an individual mandate, an individual mandate that is going to have the IRS in everybody's business. Mr. Speaker, we have a duty to do health care reform, but we have an obligation to get this right.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, tomorrow Ambassador Kirk will meet behind closed doors with the House Ways and Means Committee. While I appreciate the meeting, why do congressional Democrats refuse to talk in the open about creating jobs through international trade? I am encouraged by the administration's newfound openness to promoting American goods and services overseas, but the current situation is bleak. Nearly one in 10 Americans who want work cannot find a job. The recent economic downturn erased the certainty many families came to rely on, and now they turn to Washington for solutions. Unfortunately, a health care overhaul with new mandates, energy taxes that will drive up input costs, and a massive Tax Code full of quirks and loopholes add to their doubts. To truly grow American jobs, entrepreneurs and businesses need new markets where they can compete to sell their products. We must restore American competitiveness to create new jobs and a prosperous future. With 95 percent of the world's consumers living outside the United States, our ability to compete fairly and successfully in these markets is vital to our long-term economic growth and security. As the President said last week, ``We need to compete for those customers because other nations are competing for them.'' Today almost one in five U.S. jobs is supported by international trade. I welcome President Obama's lofty goal of doubling U.S. exports in the next 5 years through his National Export Initiative, and I look forward to discussing his plans with Ambassador Kirk. As our economy continues to struggle, it is evident Americans will not be able to consume their way out of this recession, so we must focus on getting our products and services to emerging markets around the world. American ingenuity, creativity, and innovation can spur new jobs and new factories all right here at home. According to the Obama administration, increasing trade by merely 1 percent would create 250,000 jobs, a significant start to helping Americans find work. Passing the Colombia, Panama, and South Korea Free Trade Agreements would accomplish just that, increasing our trade exports by 1 percent and creating an estimated 250,000 Americans jobs. These free trade agreements put American workers on a fair footing with workers in those countries instead of alienating our global trading partners through narrow-minded policies such as Buy American. Now American-produced goods face substantial tariffs in Colombia, Panama, and South Korea, while many goods produced in those countries have no tariff at all when sold to the U.S. The President's goal is ambitious, so passing these three free trade agreements is an important first step to restoring American competitiveness in global markets. The last time the U.S. doubled its exports, it took nearly 10 years: final implementation of the North American Free Trade Agreement, nine bilateral free trade agreements, and the successful conclusion of the Uruguay Round. Since 1994, Louisiana has increased its exports to NAFTA countries by 271 percent. As a result, thousands of Louisiana workers have job stability, but we can do much more. Trade creates good-paying jobs for millions of Americans, and leveling the playing field abroad increases our opportunities. Truly supporting American workers and creating new jobs will not be accomplished by closing our doors to the rest of the world while they continue to strike new deals and expand their exports. Now is the time to reach and to work with our allies and major trading partners. American leadership is in jeopardy, not because of a rising power but because of a shrinking level of American engagement. The world will not wait for us to wake up and realize the opportunities out there. That is why we need to act on expanding these trade agreements.

Mr. BOUSTANY

Mr. BOUSTANY. Madam Speaker, now I would like to yield such time as he may consume to the gentleman from Texas (Mr. McCaul) in whose district this tragic event occurred.

Mr. BOUSTANY. Madam Speaker, I have no further requests for time, and I yield back the balance of my time.

Mr. BOUSTANY. Madam Speaker, I yield myself such time as I might consume. (Mr. BOUSTANY asked and was given permission to revise and extend his remarks.)

Mr. BOUSTANY. Like all my colleagues here in the House of Representatives, I was shocked and horrified by the tragedy that occurred at the IRS office in Austin, Texas, on February 18. I especially want to offer my condolences to the family of Vernon Hunter, who lost his life in this senseless attack. Mr. Hunter dedicated his life to serving his country, including 20 years in the U.S. Army and two tours in Vietnam. I stand with my colleagues today to honor his service and his memory. We should also recognize the courage and heroism of those men and women, including IRS employees, first responders, and others, who responded to the attack to ensure that our country did not suffer even greater losses. I would like to associate myself with the words of President Obama to the employees of the IRS when he said, and I quote, ``I am thankful for your dedication, courage, and professionalism as we rebuild in Austin. And as you continue your work, we will do what is needed to ensure your safety. We are grateful for your service to this country. May God bless you and the United States of America.'' Madam Speaker, I reserve the balance of my time.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, I thank my friend and colleague Mr. Cao for giving me time and for bringing this resolution to the floor which I wholeheartedly support, congratulating the New Orleans Saints for winning Super Bowl XLIV and bringing this long overdue NFL championship to south Louisiana. You know, I was talking to some businessmen back home in my district who told me after the victory that they're starting to see out-of-state business opportunities come up as a result of the new-found spirit that's come about following this great Super Bowl victory, and it's a wonderful thing for Louisiana. After 43 years without reaching the Super Bowl, the Saints did it. They finally did it, and it's been a great victory for all of us. It's great for our State. Leading that charge was Super Bowl MVP quarterback Drew Brees, who completed 32 out of 39 pass attempts for 288 yards, two touchdowns. And Louisiana native Tracy Porter, whose 74-yard interception returned for a touchdown sealed this game. But I am really especially proud of one player from my district. He is a graduate of Opelousas High School, wide receiver Devery Henderson. He is in his sixth season with the Saints. He caught 68 passes for 867 yards this year and four touchdowns, and he played a key role on offense in the Super Bowl, catching seven important passes for a total of 63 yards. This is truly a very special occasion for the Who Dat Nation, all of our Saints fans in Louisiana and around this great country. We want to honor Sean Payton for his genius and what he has brought to the Saints organization, and for the entire Saints family, the organization, for what they've done for New Orleans and the rest of the Saints. We are exceedingly proud of what has happened. We commend the families and the players, the coaches and the support staff and the loudest and most loyal fans of all, the Who Dat Nation.

Mr. BOUSTANY

Mr. BOUSTANY. Madam Speaker, I rise today in support of LSU and its many achievements over the last 150 years. As a graduate of LSU medical school, I can attest to the excellence and professionalism of the faculty and to the spirited campus atmosphere that is rivaled by few in the world. LSU continues capturing the hearts of its students just as it was since it first opened its doors in 1860. It is a place with a unique culture, rich in tradition and quality. Originally serving as a war college, LSU has grown into the flagship university of Louisiana. Through its seven institutions of higher learning, as well as its distinguished faculty, LSU prepares countless students for the careers of distinction in Louisiana and around the world. LSU also celebrates a number of athletic achievements, including football, baseball, and track and field national championships. In addition to its academic and athletic successes, the LSU system goes above and beyond to serve the people of Louisiana. From its tireless efforts in the aftermath of the 2005 hurricanes to its various community outreach programs, LSU makes a great deal of difference in the many communities it serves. Throughout the years, LSU has persevered to become one of the leading educational institutions in the country. It continues to uphold excellence at every level and sets a very worthy goal of reaching the upper level of national prominence by the end of 2010. It is my pleasure to recognize Louisiana State University and join with the thousands of current students and alumni to celebrate 150 years of excellence. Geaux Tigers!

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, this week debate continues in the Senate over a massive health care overhaul. What's at stake for seniors? Many seniors will probably see their benefits cut or higher premiums. The Senate bill cuts more than $135 billion from hospitals serving seniors. It cuts $40 billion from home health agencies, $15 billion from nursing homes, and nearly $8 billion from hospices--an all-important service our seniors depends on. Seniors deserve to know how Washington Democrats are going to pay for their massive new government-run bureaucracy because cuts like these will affect their care. As a heart surgeon, I know that we can do better. We need to work together to strengthen Medicare, putting it on sound footing to ensure that it will be there when seniors need help with their health care costs. We need to lower health care costs for seniors and all Americans by increasing competition in the insurance marketplace, promoting wellness programs, and limiting frivolous lawsuits in medicine. We can accomplish these commonsense solutions if we work together. Let's protect seniors. Let's protect Medicare.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, I rise today to express my deep concern about gulf coast disaster relief left out of this bill. Yesterday I offered an amendment at the Rules Committee to extend important tax provisions, tax relief provisions, to help gulf coast residents rebuild after the 2005 hurricanes. It's disappointing yet again that the majority is bringing this bill to the floor under another closed rule, prohibiting amendments to be debated. The economic downturn complicated gulf coast recovery and jeopardized the effectiveness of Katrina and Rita aid. Residents need more time to fully utilize existing disaster assistance programs before they expire. Congress should extend the GO Zone low-income housing tax credit for an additional year. At risk, currently at risk, are nearly 70 affordable rental housing projects encompassing over 6,000 units along the gulf coast. These projects take time, and this important extension will give investors and developers the confidence to move forward on these very important projects. Congress should also make disaster-related low-income housing tax credits eligible for the new exchange grant program. This will provide immediate relief to disaster-impacted States as the market for housing tax credits rebounds. The bill also cuts short tax incentives for businesses to invest in the hardest-hit areas along the gulf coast through the special depreciation rules that promote economic development. My amendment would extend the GO Zone 50 percent first-year bonus depreciation through 2010, bringing new capital to communities struggling to recover. They were hit twice, I mean, hit basically by hurricanes and now the economic downturn. Look, gulf coast residents are resilient. They are working hard to rebuild, and Congress shouldn't pull the plug on existing disaster programs just as they are starting to make a difference. What folks need is certainty. Businesses need certainty, and what they are seeing is nothing but uncertainty coming out of Washington. This is not the way to stimulate a recovery, whether it's from hurricanes or from this economic disaster we are facing. We need certainty.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, as a physician I know directly about access problems that our seniors are having. Clearly we must protect seniors' access to physicians of their choice. I also know directly about the flawed formula for physician reimbursement. We all want to deal with it. What we need to do is repeal the flawed SGR formula and replace it with a more equitable reimbursement for physicians that is paid for. This bill ignores over $200 billion in added deficit spending. It continues the same price-controlled formula for physicians. And it does not eliminate--let me repeat--it does not eliminate the tendency for physician cuts. Instead of providing a realistic, long-term solution, this bill spends borrowed money and basically increases the Medicare shortfall by $1.9 trillion. I urge my colleagues, let's get real about this. I urge my colleagues to vote ``no'' on this bill. Let's support a real solution that protects patient access to a physician of their choice. Let's support a real solution that's honest with physicians and treats them fairly, and a solution that avoids massive debt passed on to our children and grandchildren. Vote ``no'' on this bill.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, today we will have a vote on a flawed, massive, and irresponsible health care takeover by government, pushed by Speaker Pelosi and House Democrats, that will cost more than $1 trillion. This bill will increase health care costs for most Americans, increase taxes while Americans struggle to find work, and hurt seniors' quality care. Mr. Speaker, as a heart surgeon, I saw the amazing innovation in my 20 years in practice in our system. In fact, in the early 1950s, an American surgeon, hopelessly observing the death of a patient from blood clots to the lungs, was inspired and invented the first heart- lung machine that made open heart surgery possible. Many thousands of patients worldwide have benefited from this innovation, this innovation right here in the United States, innovation that will be stifled by the Pelosi health care bill. There is another way. We can do better. House Republicans have solutions that will lower costs by creating real choice and competition. We will help those with preexisting conditions to get meaningful health care coverage, we will preserve U.S. leadership in medical innovation and education, and we will reduce frivolous lawsuits in medicine that needlessly drive up the costs for families. As a heart surgeon, I know that we can achieve real health care reforms to bring down costs. But the Democrats' current bill will only lead to higher costs for millions of Americans and destroy what is currently working in our system. There is a better way. There is a different way. There is a way to lower health care costs, help more people achieve a high quality doctor-patient relationship in this country and improve health care for all Americans. Vote down this bill and support the Republican plan.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, the Democratic leadership in Congress continues to push a flawed, massive government takeover of health care that is going to cost more than $1 trillion. What's more, their health care overhaul will drive up health care costs for families and small business, and it will disrupt the doctor-patient relationship. States already straining under runaway budgets will be forced to cut services or to raise taxes when they're forced to raise Medicaid eligibility. As a doctor, I saw the problems with our current health care system, and I saw the amazing innovation which makes the U.S. the envy of the world. Let's build on what works. We can achieve commonsense solutions in a bipartisan way, but the Pelosi health care bill focuses on where we disagree. House Republicans put forward a commonsense plan to revitalize the American health care system--to lower costs for families and businesses and to improve quality. Our plan puts patients first, and it puts doctors and patients back in control of decisionmaking. Our plan makes health care more affordable and more accessible, with patients being able to see the doctors of their choice. We can do better. Adopt the Republican plan.

Mr. BOUSTANY

Mr. BOUSTANY. Mr. Speaker, I strongly support our Armed Forces and veterans and fully realize the debt of gratitude that our nation owes the men and women who defend our country. Mindful of this commitment, I thank the World War II veterans for their commitment and unselfish service to America. I would especially like to thank the Louisiana HonorAir organization for their hard work and dedication to these veterans and recognize October 24, 2009 as ``Louisiana HonorAir Day.'' In 2007, Louisiana HonorAir began flying WWII veterans three hours on a chartered flight from Louisiana to our nation's Capital free of charge. In Washington, D.C., the groups toured the WWII Memorial, Korean Memorial and Vietnam Memorial and attended wreath laying ceremonies at the Tomb of the Unknown Soldier at Arlington National Cemetery. Then, as quickly as they came, the groups returned home to a hero's welcome in Louisiana where family and friends gathered to show their appreciation one more time. For many veterans, it was their first time to tour the WWII Memorial because of its recent construction, while for others it was their only chance to see these sights dedicated to the great service they provided to our nation. Having met many of these groups in Washington, I continue to be awestruck by the reactions of these brave men and women who stood up to tyranny in Europe and Asia. Many rarely talk about their service, instead, looking to happier times. However, in the company of others who nobly served, they are able to frankly discuss their experiences, share tearful stories and remember comrades missing or killed in action. I am grateful to have worked with Louisiana HonorAir and I salute them, as well as the courageous men and women who stood to protect America. Today, I ask my colleagues to join me in remembering the brave men and women who defended America and in commending Louisiana HonorAir by recognizing October 24, 2009 as ``Louisiana HonorAir Day.''

Mr. BOUSTANY

Mr. BOUSTANY. I thank my friend for yielding. I'm really glad that you brought up Health Savings Accounts. First of all, Health Savings Accounts were created by a Republican Congress, so that was one of the things that Republicans did when we were in control of the Congress, among a few other things in health care; but one of the problems we've had with Health Savings Accounts, that I've heard, is that a lot of families can't put enough money into them to really make them meaningful. You know, I introduced a bill that actually, really, raises the amount of money that you can put into one so that you actually, really, do save money year in and year out and do build savings. Secondly, when you get to be a senior and when you go on Medicare, you can keep that Health Savings Account and can continue to fund it and can use it for things that Medicare currently doesn't cover. So many seniors have to buy supplemental insurance. You could use your Health Savings Account to fund that. So now you're using pretax dollars rather than really hard-earned, after-tax dollars for that health need. There are a number of other things that families could use these for. Finally, upon death, you can pass your Health Savings Account on to your family without a tax consequence, and now you're really building savings across generations to take care of our health problems, putting families back in control of their health care destinies rather than, again, a big government, one-size-fits-all-kind of a program, such as what we see with the Pelosi health plan. I yield back.

Mr. BOUSTANY. Well, I thank my friend. I am amazed at all the reading you have done already with this bill and the scholarship that you have put in today. It says a lot about your character as a judge and a lawyer, having dug into the details of this. Here we are, talking about the Pelosi health care plan just released today, all just under 2,000 pages of it. I commend my colleague for shedding some light on just a couple of the provisions in this. There are so many unintended consequences, most likely, in this bill, and I have not had the kind of time to go through it that even my colleague has had so far, but we will be reading this bill and going through it very carefully. Let me just say, before coming to Congress, I practiced medicine for about 20 years. I did open heart surgery, lung surgery, oftentimes doing three and four operations a day, caring for anybody who needed surgical care in my practice, whether they could pay or not. We're dealing with health care, one-sixth of the entire U.S. economy, something that affects every man, woman and child in this country. This is a kitchen table issue, if there ever was one, a very important issue. What gives me great distress is that we're on the wrong path. We're not going to lower the cost of health care for families and for small business owners. In fact, there is nothing in this bill that is going to actually drive down the cost of health inflation. Those increases in premiums, double-digit increases in premiums year after year that families and small business owners are seeing, there is nothing in there that will do this. The sad thing is, I think Republicans and Democrats could agree on a number of areas where we could work together that would actually make a difference and bring those costs down, yet the decision was made by the leadership to ignore these things. The whole idea was to create a new government plan, sort of modeled after Medicare, based on the same faulty financial footing that Medicare is currently struggling with today, and now we're going to double the liability to the Federal taxpayer based on all this. This is a huge problem. What we see in this bill are increased taxes for families. The Pelosi health care bill, it's an increase in taxes on families and small businesses. It's an increase in taxes on health plans. It's an increase in taxes on all the research and innovation that have made American health care as great as it is today. Let's face it, we know health care is expensive. It's too expensive. We know there is waste in the system, and those things can be corrected. But we also know that we have the finest doctors, the finest nurses and the best hospitals, teaching hospitals and training facilities in the entire world. Patients come from all over the world to be treated in the United States, if they're lucky enough to be able to get here. Doctors from all over the world come here to train, to learn the latest techniques. All of that innovation and technology is at risk because of the tax provisions and the punitive approaches taken in these health care proposals. This is going to be a major step backwards. I can talk about many, many instances where a new technology came out or a new pharmaceutical came out that made a huge difference in quality of life. Initially it was expensive, but with time, the costs went down. There are many, many examples of this. I will give an example. When I was in medical school, preparing to undertake a surgical career, I remember one of the operations we used to do the most was this big operation for ulcers. If you had an ulcer, a lot of times you had complications from that ulcer, either bleeding or you got obstructed in your intestinal tract or you had severe pain or even an ulcer perforated and caused you to get very, very sick, requiring emergency surgery. These were very devastating conditions. We had nothing to treat that, other than to do a massive operation, a major surgery under general anesthesia where you had to take out almost half the stomach and reconstruct all of it. Patients had all kinds of problems afterwards. I will never forget early on in my surgical training when a new drug came out, and everybody thought, Oh, my gosh. This is going to be great. This drug was called Tagamet. The generic name was Cimetidine. Now you can buy it over the counter, but back then it was expensive. Almost immediately upon the release of this drug, we quit doing most of those big stomach operations. We didn't have to do them anymore, except under extraordinary circumstances. So countless numbers of patients avoided surgery and had a much higher quality of life. Now we've seen several other generations of these drugs come about that have made a tremendous difference for individuals, and it's cut the cost of health care. But the Congressional Budget Office doesn't recognize that because it works in an artificial 5-year window. It doesn't work based on the real world, which deals with the lengthy process of doing research and development to get these new technologies and these new pharmaceuticals out. Think of coronary stents. Back when I started off, oftentimes when someone had a heart attack, they died. We had very little in the way of pharmaceutical treatments for heart disease. If you had blockage, there was nothing we could do about it. Then open heart surgery developed with coronary artery bypasses, and it was a big operation. Then it became more routine and less expensive over time, and patients have done very well following those operations. Then the advent of stents, where you go in, you have a stent put in a blocked coronary, you go home the same day, and you are feeling much better. We can actually stop a heart attack in progress by inserting a stent in a timely manner. Those advancements here in the United States are now being adopted abroad. They've made a huge difference. That innovation is at risk. This bill taxes businesses, taxes families, taxes innovation, taxes insurance plans. What happens when you tax insurance plans? Premiums go up. The CBO and other actuaries have said that on average, premiums for Americans are going to double and in some cases, triple. What's going to happen? That's going to put more of these insurance companies in a bind because their products would become untenable, and we're going to move to a single-payer health care system, run by the Federal Government with all the bureaucracy and the lack of innovation. And that's the goal here. I can tell you, it is very distressing, as a physician who practiced for 20 years and saw the great things that we could do in health care, but I have also seen the problems. I can tell you, I, myself, have had health problems. I would still be doing open heart surgery and not standing here giving a speech tonight to the United States Congress if I didn't have a health problem. I developed a form of arthritis that basically ended my surgical career early. When I closed my practice down, we had a health plan. I tried to shift from the plan that we had with the same insurance company. We tried to shift from an employer- based plan to a family plan within the same insurance company. They knew everything about my history and records and everything else. Guess what: They denied my entire family and myself coverage, but because I knew how to negotiate within the health care system, I called the insurance company. They said, You have a preexisting condition. I said, I understand that. You have already been helping to treat that, and this is a continuous process. So why not just exclude my condition and at least insure my family? And after a lot of vigorous going back and forth with the insurance company, I convinced them to do that. Americans should not be denied coverage based on preexisting conditions. Republicans have ideas where we can get the cost of that kind of insurance down for all Americans by creating competition and choice in the insurance marketplace, which this bill does not do. It will limit competition and choice. We can keep those costs down. We can make insurance much more accessible, and at the same time, take what I think our colleague from Texas mentioned earlier, take this kind of an incremental step-by-step approach so that we don't create unintended consequences--we know what we're getting into--and build a system that's comprehensive that Americans can be proud of. As my colleague said earlier, we have over 40 bills that move us in that direction. And how many hearings have we had on the Republican bills in the House Ways and Means Committee where I serve? None. None. These ideas have not been discussed, they have not been vetted, and furthermore, a lot of the ideas in this bill have not been thoroughly vetted. That's a problem. That's legislative malpractice in my mind. It's wrong, and the American public deserves better. This health care problem has been going on for too long, and there is a lot that we can do to solve it if we put our heads together. I know there are some well-meaning friends across the aisle who want to work together on it, and I think that's what the American people want us to do, instead of an ideologically driven approach to a single- payer health care system, run by the Federal Government, which we know is going to run up massive deficits for this country, which we already are seeing now. It's going to stifle job growth, and it's going to hurt the American economy. With that, I will yield back to my friend.

Mr. BOUSTANY

Mr. BOUSTANY. Very briefly, I would say my friend from Texas is absolutely right. This is about growing U.S. jobs and creating job opportunities for our small businesses. As these export markets open up and that greater connectivity is created between our country and our trading partners, the standard of living goes up in those countries and those markets expand. It creates more opportunities for our small businesses to create jobs here and to continue to export. So, at a time where we are having these discussions, when this country is seeing high unemployment, we are coming out of a recession, we should be vigorously pursuing these types of agreements. And what are we hearing now from this White House? Silence. Silence. It makes no sense.

Mr. BOUSTANY. Here we are. If we want to grow small business jobs, the best way to do it is to expand our exports and that will help us also expand our manufacturing capacity. Actually, the world is moving forward and we're sitting still here. If you look at the TransPacific Partnership, everybody's waiting on the United States to move forward with this agreement. It's a critically important agreement to work out with Chile, Peru, Singapore, Australia, New Zealand, and Brunei. We're also looking at the Asia-Pacific Economic Cooperation. This is where we need to be engaged with China and these Eastern countries, because we have huge, huge trade opportunities and job growth opportunities by expanding these agreements. So I think it's clear that this administration needs to come forward with a comprehensive trade policy to Congress and let's get to work on creating this liberalized trade order because that is the element of soft power that you were emphasizing earlier. And it is probably our most important instrument of power as we move on the global stage. With that, I will yield back.