Bill Cassidy

Mr. CASSIDY

Mr. CASSIDY. Mr. Speaker, I am a physician. I still see uninsured patients at the public hospital where I've worked for 20 years. Now, to give uninsured patients access to private health care, we've got to lower costs. But lowering health costs is more than just access; it's also about a stronger economy. According to the White House Council on Economic Advisers, they had a study that explained that lowering health care costs lowers unemployment, raises the standard of living, and prevents disastrous budgetary consequences. Unfortunately, neither the House nor Senate bill lowers costs. The Congressional Budget Office says that each will more than double costs over the next decade. Yesterday, the President released a new proposal combining the House and the Senate bill. But combining two bills that don't lower costs results in a third bill which certainly doesn't lower costs. If you don't lower costs, access and quality suffer, our economy suffers, people lose their jobs. The American people--Republicans, Democrats, and Independents--want health care reform but they want reform which controls costs in reality, not just in rhetoric. They know that their health care, economy, and jobs depend upon it.

Mr. CASSIDY

Mr. CASSIDY. Dr. Boozman just pointed out that the price controls upon insurance policies is the ultimate in a top-down, bureaucratic, doesn't matter what the market says, we're going to control your costs from Washington. It never has worked. On the other hand, the Republican approach is patient-centered. You and I know as physicians--and I am still seeing patients. I see them about once every 2 weeks in my practice. I work in a public hospital treating the uninsured. If you involve the patient in her care, she typically is healthier, she saves money, and the system saves money. Health savings accounts, Dr. Broun, I know you know this, but for the audience, a patient will put, with pretax dollars, before you are taxed on it, will fund a bank account, and that bank account is used to pay for medical care. As it turns out, with traditional insurance, say a family of four puts up $12,000, and then a year later they put up another $12,000, and then a year later they put up another $12,000. With a health savings account, if you don't use the money, it rolls over to the next year. And some families will continue to accumulate until the amount they have to put in is zero because they have been so wise with how they spend their money. A good example of this, I am sorry Dr. Fleming left, because he talks about how his medical practice went to HSAs for all the employees. And he has an employee who was smoking. And she complained, because before the insurance paid for inhalers--the smoking had given her asthma--and now she had to pay for it out of her own pocket. So before she was cost-insensitive, and now, because it is out of her bank account so to speak, she is aware of it. And Dr. Fleming said to her, Well, you know, if you stopped smoking, you wouldn't need that inhaler. And she goes, Really? He goes, Yes. She stopped smoking, her health is better, she no longer pays for inhalers, and we are controlling costs overall. So by involving somebody in her care, her health is better, the system saves money, and she has more money in her pocket. And, by the way, one last thing before I yield back, the Kaiser Family Foundation has a study. They found that a family of four with a health savings account, that that policy is 30 percent less expensive than a traditional insurance policy for a family of four; that the family with the health savings account and the catastrophic policy on top, not only is that policy 30 percent cheaper, but they use preventive services as frequently as a family with a traditional insurance policy. Now, if our goal is to give high quality care to all at an affordable cost, well, what we just found out is with the HSA you lower the cost by 30 percent. Okay. That is one of your goals. And they are using preventive services as frequently. So they have access to quality care. As it turns out, because it is lower cost, 27 percent of people in this study who had a health savings account with a catastrophic policy were previously uninsured. About 50 percent had a family income of $50,000 or less, and about 60 percent had a family income of $70,000 or less. So again, by lowering costs 30 percent, people who were formerly uninsured now have access to quality care. That is a patient-centered approach, far different from the bureaucratic approach that is being offered by the Senate and House bills. But from our experience as practicing health care providers, I think we can say it is the right approach. I yield back.

Mr. CASSIDY. I will.

Mr. CASSIDY. That is correct. It is kind of a crazy thing where if an HSA is used for a generic price on an over-the-counter drug, which is what we are describing here----

Mr. CASSIDY. Which lowers cost, it's not available for an over-the- counter medicine. And so that $20 prescription is actually over-the- counter medicine, and we're talking about ulcer medicine. So in this way, the patient reacts so as to take care of her health and to lower her cost. And in millions of those interactions across the Nation, not from Washington, D.C., but rather from the exam rooms themselves is how the system saves costs. You recall, Dr. Broun and Mr. Speaker, how we spoke of the HSAs being 30 percent cheaper. Well, that's why they're 30 percent cheaper because patients are incentivized to control their cost. One last thing I will say. When you ask a crowded room who is most responsible for each person's health, we all know that it is that person in particular. So what the Health Savings Account does, the patient-centered approach does, it says that the patient is most responsible for his or her care, and in so doing, we trust that the patient, with her physician, will make the right decisions. And the story of Health Savings Accounts is that that is true, that is a well placed trust.

Mr. CASSIDY. You know, it is interesting because we can see from the Republican administration of Richard Nixon, the Democratic administration of Jimmy Carter on oil and gas, that when you try to artificially control price with regulation, it doesn't work. You have to address the fundamentals. So let me give an alternative between this top-down bureaucratic means of control and a patient-centered approach. I was speaking about HSAs and patient-centered approaches with a constituent, and he says, you know, doc, I take a pill for my ulcer. Now, I have an HSA. My physician wrote a prescription and I said, physician, I know from experience that this pill is going to cost me $159--he didn't say $160, he said $159. He said, I have an HSA, I pay for this out of pocket, can you do me something different? And the physician said, oh, you have an HSA? Tore it up and wrote a prescription for generic and it cost him $20. The system just saved $139. I have another patient who called me--I am a liver specialist--called me up, and she says, Dr. Cassidy, I have a bad heart. My doctor over here said I needed this test because of my bad liver, not my heart, but rather my liver. And I said, from a liver perspective, you don't need it. She said, well, I will pay for it if I need it, I have an HSA, but I will pay for it if I need it. I said, no, ma'am, you do not need it. The system saved $1,000. Because she had an HSA, she was motivated, she was motivated to find out how much it cost and then to see if she really needed it.

Mr. CASSIDY. Dr. Boustany will be at the summit meeting.

Mr. CASSIDY. Clearly, I think we can all agree on what are the goals of health care reform. We want access to quality care at an affordable price. And it kind of gives us a nice way to judge each of these. I am struck. Medicare is going bankrupt in 7 years. Medicaid is bankrupting States, and we're about to create a third entitlement to rescue the first two. And a third entitlement that is going to be based upon the House bill and the Senate bill. The Congressional Budget Office has said of both the House bill and Senate bill that they more than double costs within 10 years. So we're going to go from a status quo which may double costs in 10 years, to a reform which more than doubles costs in 10 years. Folks ask me how do I like my first year in Washington, D.C. I say, it's a crazy place. We pass a reform to control costs which is more expensive than the status quo--and that is important because the American people since August have been saying, Mr. Speaker, that we need to control costs. They understand that you can give everyone access, but soon our costs are out of control and access is gone. You can give everybody the highest quality, but unless you control costs, again you break the bank. So the American people since August, and with the Senate election in Massachusetts putting an exclamation mark behind the sentence, are saying, Control costs. Now as it turns out, the proposals before the President, the Senate bill, again, according to Congressional Budget Office, more than doubles costs in 10 years, and the President's proposal will be a hundred billion dollars more expensive than that. Now, the President is billing this as a tax cut to the American people, but really it's a shell game. Some folks will have their taxes simultaneously raised and their subsidies increased. Now, that's a crazy thing, but on the other hand, if you're going to subsidize here, you must tax there. And because some of the things being taxed are insurance policies--insurance policies owned by union folks, for example, who negotiated this through their wages--there will be a tax on folks who most consider middle income. What are the alternatives? You mentioned something earlier, Dr. Broun. I said, man, you can tell the guy's a family physician. You talked about empowering patients. I think the fundamental difference between the Republican proposal and the Democratic proposal is that the Democratic proposal is a top-down, control costs from Washington, D.C., type approach.

Mr. CASSIDY

Mr. CASSIDY. Mr. Speaker, Americans are asking, where are the jobs? Now, to create jobs there must be affordable energy. As it turns out, creating energy creates jobs. First, let me compliment the President. Last week, he announced a commitment to developing new power plants in the United States. It's a great step in the right direction because domestic energy production means more jobs, with good benefits, lower energy prices, and greater energy security. Now, although moving forward with nuclear energy, the administration has effectively banned, through delays, new natural gas and oil production. The National Association of Utility Commissioners recently reported that the administration's current delay on natural gas and oil production eliminates 13 million jobs, $2.35 trillion in lower energy costs, and $2.36 trillion in economic growth. By the way, it also eliminates royalty payments and billions of dollars to cash-strapped States. Now I applaud the President for advancing nuclear energy. Let's do the same with domestic oil and gas. We know where the jobs could be. They're in oil and gas. Mr. President, allow their creation.

Mr. CASSIDY

Mr. CASSIDY. Mr. Speaker, on rollcall No. 48, I was unavoidably detained. Had I been present, I would have voted ``nay.''

Mr. CASSIDY

Mr. CASSIDY. Mr. Speaker, this may be the last address given on the floor of the House of Representatives this year. It is fitting that it is a tribute to Michael Cote, a specialist who gave his life while fighting to defend us in Iraq. Specialist Cote was from Denham Springs, Louisiana. After graduating from Denham Springs High School, he met his wife, Ashlee, when the two were in basic training. They passed notes back and forth during their training and snuck off to church services to be together on weekends. Just days after basic training ended, the two soldiers were married. Michael was serving in Iraq when their daughter, Brooke, was born in March, but he found a way to be on the phone with Ashlee during the delivery. She delivered in Baton Rouge. Ashlee tells me that Michael liked to fish and hunt. She says he was an all-around country boy who liked to goof around but always knew when it was time to be a soldier. Michael was serving as a crew chief when his Black Hawk helicopter went down in Balad, Iraq, in September. On the day of his memorial service, the people of Denham Springs lined the streets to wave American flags as the procession went by. Families brought their children and grandchildren out to honor Specialist Cote, a tribute to a man friends and family in Denham Springs say they knew would grow up to be a soldier. His mother, Carol Bass, tells me that she visits the grave daily. Mr. Speaker, we mourn with Ashlee, Brooke, and Mrs. Bass the loss of Specialist Cote, but let us celebrate his patriotism, his dedication to country, his sacrifice on behalf of our security. We are forever indebted to the men and women of our armed services, soldiers like Michael Cote, who put themselves in harm's way so that we may live freely and in peace.

Mr. CASSIDY

Mr. CASSIDY. Mr. Speaker, on rollcall No. 973, I was unavoidably detained. Had I been present, I would have voted ``aye.''

Mr. CASSIDY

Mr. CASSIDY. Madam Speaker, I rise today in honor of Sergeant Benton Thames from the Town of Springfield in Louisiana's Sixth's Congressional District. It gives me great pleasure to extend to Sergeant Thames immense gratitude and appreciation for his exemplary service to our country as Commander of the Relief at the Tomb of the Unknown Soldier at Arlington National Cemetery. Sergeant Thames has dutifully guarded the Tomb of the Unknown Soldier for over two years. His responsibilities include changing of the guard and laying of the wreath at the Tomb. Sergeant Thames strives to make this ceremony special for the thousands of veterans and Americans who visit this sacred landmark annually. Sergeant Thames' dedicated service and commitment to our brave and courageous veterans and fallen heroes is truly admirable. Sergeant Thames is a graduate of Springfield High School, and a former resident of Louisiana's Sixth Congressional District. In his spare time, Sergeant Thames volunteers with the Louisiana Honor Air program which aides World War II veterans in a variety of ways. I am honored by Sergeant Thames' service to our country and wish him continued success as Commander of the Relief at the Tomb of the Unknown Soldier.

Mr. CASSIDY

Mr. CASSIDY. Madam Speaker, I rise today in honor of St. James Episcopal Day School, located in the City of Baton Rouge in Louisiana's Sixth Congressional District. It gives me great pleasure to announce that St. James Episcopal Day School has been designated as a ``Blue Ribbon School of Excellence'' by the United States Department of Education. The administration, faculty, staff, students, and parents of St. James Episcopal Day School have successfully demonstrated academic excellence in standardized test scores, curriculum, technology, instructional methods, professional development, and school leadership. St. James Episcopal Day School is a Pre-Kindergarten through Fifth grade elementary school that was founded in 1948. At St. James, students are challenged to reach their full potential; to be active in faith; to be responsible for their learning; and to be accountable for their actions, thus preparing these students to be leaders in facing the demands of their future. With this honor, I can only hope that the school's next sixty years will be even more successful than its first.

Mr. CASSIDY

Mr. CASSIDY. I think that people are waking up. Again, if we're going to achieve our goals of reform for all, health care accessible and at affordable costs, you can't have it with a program which drives up costs and drives up costs despite the high taxes and the loss of jobs. So we're not through yet. The American people still have time to weigh in on this, to weigh in as the bill goes through the Senate side and then comes back to conference. But what I challenge the American people to do is to do as they did in August, to contact those Representatives that voted for this bill and express their concern regarding the cost, the taxes, the loss of jobs, but also to contact their Senators and to say that they want reform, but they want reform that doesn't kill jobs, raise taxes, or deprive us of personal freedom. I think in that way we can have a bill which serves the American people without sacrificing our values.

Mr. CASSIDY. I think the point just hit upon, we all want reform and we know the goals of reform are to control cost and to expand access to quality care. Now, there are some who think that to do that you have to sacrifice freedoms, you have to raise taxes, kill jobs and still not control costs. But you and I know from our practice and our life experience that you can do it differently. You can actually increase freedom by giving that person the ability to control her account that she can use to spend or not spend, to seek value. In so doing, you lower the administrative costs. You kind of cut the insurance company out of the deal because now she has her own account, and she doesn't have to submit a payment claim. She just pays for it with a debit card. You can control costs in a patient-centered way, one that incentivizes a healthy lifestyle. And in so doing, the patient becomes healthier; and by becoming healthier, you control costs, not by 111 different bureaucracies, boards, and commissions. It stays with conservative values of individual responsibility, limited government, and free enterprise. It actually works in this segment of our economy as it does in every other segment. I yield.

Mr. CASSIDY. We have spoken about the irony, about how the bill we have to pass in order to control costs is more expensive than status quo. We spoke about the irony about the bill we had to pass to rescue jobs will cost 5.5 million American jobs. There is another irony here. Medicare, a great program but going bankrupt in 7 years, according to the folks that run it; Medicaid, another Federal program which is bankrupting States, is now going to be rescued by a third public program which is based upon the one and expands the other. So two going bankrupt or bankrupting will be saved by a third which builds upon those first two. To go back to Scripture, you are building a house upon a foundation of sand. In this case, it is a fiscal foundation of sand which should concern us, as it concerns newspapers like the Post and the Times which wonder if it does enough to control costs.

Mr. CASSIDY. I think people back home are concerned that in this Chamber we are too partisan. That is why I am trying to make it a point to not speak from a Republican viewpoint, but to quote The Washington Post and The New York Times, which says that this bill does not do enough to control costs. To quote the Centers for Medicare & Medicaid Services, which is a Federal agency: In aggregate, we estimate that for the calendar years 2010 through 2019, national health expenditures will increase by almost $290 billion. Most of the provisions in H.R. 3962 that were designed in part to reduce the rate of growth and health care costs would have relatively small savings. Again, some of my colleagues, Democrats, said: I fear this bill will not reduce long-term costs and our debt and deficits will suffer and balloon in the years ahead. Another Democrat colleague: My primary concerns have been that the legislation does little to bring down out-of-control health care costs, which is what burdens families and small businesses and also leads to our skyrocketing budget deficits. The Congressional Budget Office, an independent agency, says that the cost has grown at about 8 percent per year, which more than doubles cost. If you compound 8 percent per year, when the President says the cost of doing nothing is that the cost will double, in this case the cost of doing this something, costs will more than double, according to the Congressional Budget Office. On balance, during the decade following the 10-year period, the bill would increase Federal outlays for health care and the Federal budgetary commitment to health care relative to the current amount. That does not include the State dollars that we have been referring to.

Mr. CASSIDY. Reclaiming my time, just for those watching who are not familiar with Medicaid, Medicaid is the program where States put up some money and the Federal Government puts up other money and it covers the poor. Right now in many States they are either having to raise taxes to cover the cost of it or cut back services to the poor. And yet what this bill does is says that you shall, the States shall increase the percent of their population that they are paying for medical services with Medicaid. The Federal Government will pay for a portion of that, but not all, and the State taxpayer has to pay the rest. In our State, Louisiana, it is estimated that will cost $610 million extra State dollars that will come out of roads and highways and schools. I think Schwarzenegger in California said $6 billion for California.

Mr. CASSIDY. I think that was the message from the town hall meetings in August. In August, the people spoke. They came out in droves to say we want reform, but we want reform that doesn't concentrate power in Washington, DC, doesn't raise taxes by $737 billion and still does not do enough to control costs, doesn't kill 5.5 million jobs. No, we want something which you and I would call patient centered, something which recognizes there is a heck of a lot of money in the system now. If we just create the economic model in which people are incentivized, as your employee was, to live a healthier lifestyle, thereby saving her and the system money, thereby saving small businesses money, we can accomplish something. So I think the American people spoke loudly and clearly in August. The only question is will they be heard. I will compliment my Democratic colleagues. Thirty-nine of them heard and joined with Republicans voting against this bill which sacrifices personal freedom, which increases taxes by $737 billion, which is estimated to cost 5.5 million jobs and still does not control costs. So I think the American people are, frankly, where you and I are.

Mr. CASSIDY. There are a couple of ironies here. One irony is that we were told we had to do this to control costs, yet we see it does not do enough to control costs. The GDP amount going to health care will be more under this bill. The other irony, we were told we had to do this to preserve jobs, yet it is estimated that we will lose 5.5 million jobs related to the $730 billion in taxes in this bill.

Mr. CASSIDY. I see we've been joined by Congressman Scalise. I will yield to the gentleman from Louisiana. Before doing so, I'll say we have been discussing costs; how the Washington Post, New York Times, the Chinese Government, Centers for Medicare & Medicaid Services have all expressed doubts that this bill will control costs. And frankly in fairness there were 39 Democrats that voted against this bill. Some of them also expressed concerns regarding this cost. I'd like to yield to you for your thoughts, please.

Mr. CASSIDY. That is a trifecta of disaster.

Mr. CASSIDY. So there's mandates on businesses and individuals, there is a loss of freedom; there's $730 billion in new taxes, and there's 5.5 million American jobs lost.

Mr. CASSIDY. So lay people off. It is projected, I see, using the methodology of the White House Council on Economic Advisors, that the tax hike, $730 billion in tax hikes to address this cost--which, by the way, inadequately addresses it--would kill 5.5 million American jobs.