John Fleming

Mr. FLEMING

Mr. FLEMING. I thank the gentleman, Dr. Roe, for his very insightful comments. And we're beginning to pull the cover back on what some of the solutions are. I will point out this evening that, you know, it's interesting the way physicians are trained. We're trained to be problem solvers. We're trained to look for solutions. And sometimes it's like mixing oil and water up here in Washington because there are a lot of people who've been up here a long time who don't think in terms of solutions. So we're committed, all of us, our physician colleagues and nurses, psychologists, dentists, to continue to apply the pressure to move forward in solving problems for the American people. I'd now like to yield to another physician from Louisiana. He's actually a hepatologist. And I know that some who may be hearing me speak right now may not know what that is. It's basically a specialist, a physician specialist in liver disease, and also a gastroenterologist as well. With that, I will recognize the gentleman from Louisiana, Bill Cassidy.

Mr. FLEMING. This is the only graph I have.

Mr. FLEMING. If the gentleman will yield.

Mr. FLEMING. Just to reiterate, we in Congress, despite what a lot of people think, we don't have any kind of special health care plan. We have the same plan as all other Federal workers, and that is simply to go on a Web site or in a booklet and choose from hundreds of excellent health plans that are competing with each other for our business. We pay part of the premium; our employer, the Federal Government, pays the other part, and that is precisely what we want for everyone in America to have. But in order to do that, you've got to take down the walls from one State to another, the State borders, when it comes to insurance. You've got to make sure that all of these providers of services--doctors, hospitals, insurance companies--are competing with each other, driving up the quality and driving down the cost. With that, I would like to recognize one of our freshman members who's really come on fast, again another physician, a family physician, Mr. DesJarlais from the State of Tennessee.

Mr. FLEMING. I thank the gentleman. Did you hear that? Did you hear what the gentleman said? The gentleman said that he's never treated a patient that was either a Republican or a Democrat. It doesn't matter to us who we're providing care to. We've got three wonderful nurses here, and we all appreciate what nurses do. Often times, the nurse is the first health care worker you encounter when you open your eyes after whatever has happened to you. So we appreciate our angels so much. But again, we providers, we don't care, we don't ask whether you're a Democrat or a Republican. All we care about is that you have a need. I would now like to recognize Congresswoman Ann Marie Buerkle from the great State of New York. We're actually moving above the Mason- Dixon line this evening, and we're talking to folks from New York.

Mr. FLEMING. I thank the gentlelady from New York. I would now like to yield to another gentlelady, to a person with whom I've become good friends, who is also from New York State. She is a person who has a vision for America. Not only that, she is someone who has been taking care of the vision of other people as well. She is an ophthalmologist, and she has come to Washington to apply her vision to what she feels--and we agree with her--the future of health care should be like as well as many other things in life. With that, I yield to the gentlelady from New York, Nan Hayworth.

Mr. FLEMING. I thank the gentlelady from New York, Nan Hayworth, for all of her contributions both here in Washington and certainly back home. We've saved the best for last here. We have Dr. Benishek, the gentleman from Michigan, who actually managed the time for our last Special Order and did a great job. As I understand it, he is a wonderful surgeon. So I would like to yield to the gentleman in the last few minutes that we have tonight.

Mr. FLEMING. I thank the gentleman from Michigan, the physician. In the closing moments here, what have we learned? We've learned that we have a Medicare system that's highly bureaucratic, highly expensive and, as the graph showed, is going to be insolvent as early as 2016. That's 4 years away. And we desperately need a solution to that. We've got this side of the aisle which has already come up with a solution, a premium support plan that basically offers to Americans the same opportunity we, in Congress, have, an excellent health care plan. And then we have got this side of the aisle, Democrats, who absolutely have come up with no solution. As the gentleman says, they bury their heads in the sand and offer nothing. I would submit to you, Mr. Speaker, that we can't continue going this way. We have got to move forward. We've got to find solutions by, again, putting health care providers in the arena, having them compete with each other, always doing that. If it's a level playing field--and that's our responsibility in government--the quality of care goes up while the cost goes down. I want to thank my colleagues here tonight. We have had a great discussion, and I look forward to doing this again very soon. With that, I yield back the balance of my time.

Mr. FLEMING

Mr. FLEMING. I thank the gentleman, Dr. Benishek. That was an unexpected recognition there. I thank you, sir, for that. I'm just going to give a brief top-level overview of where we started with health care in this Nation and why we are here today. I have to take you back to post-World War II, where we began to have the indication of a crisis protection form of insurance; that is, insurance that is there just to keep the family from going bankrupt over medical bills. That seemed to be well received. Over time, it became obvious that there were other people, the people who were poor, people who were elderly, who could not get coverage in the normal marketplace of insurance. As a result, Congress in the mid- 1960s, created Medicaid, health care coverage for the poor, and Medicare, health care coverage for those who are 65 and over. That was all well and good; however, this was the first real foray of the government managing health care, that is, the financing of health care. The promises were great to the doctors to get them to go along with it. The promises were great to the patients. It has rocked along for a while pretty well. People who receive Medicare benefits enjoy them. The problem is that we know in government that the cost has risen and risen and risen, and now what we have is a situation where Americans who are on Medicare enjoy very good health care benefits, but the explosion in cost and the pressure it is putting on the rest of the health care system is becoming unsustainable. In fact, if left alone, Medicare will totally displace all discretionary spending in the government today; therefore, something has to be done about it. We got about halfway through government-run health care, and our friends on the other side of the aisle have had this vision for many years of having government totally control health care for everyone. They attempted to do that with the passage of ObamaCare, which took us, I would say, to about 95 percent complete government control of health care. What was the promise? The promise was that your insurance rates would go down, your coverage would go up, that your choices would go up, and things would be fine and dandy. What have we found thus far? And it hasn't even been nearly fully implemented. That is that the cost of insurance premiums have gone up. We now have a board called IPAB, which is 15 bureaucrats who will be appointed by the President, not necessarily health care workers. Everything that may affect you in your life with regard to health care may well rest in the hands of this 15, even usurping Congress itself when it comes to decisions such as what doctors you can see, what it will cost you, and certainly what the health care system itself will be paid. What I would submit to you tonight is that any time government runs a system of economy--which certainly it has done in education, and we see the failures in secondary and primary education there, and now in health care--that costs skyrocket. They become very inefficient and they become unsustainable. Remember that when it comes to Medicare that, for every $1 that a recipient puts into the system in the way of premiums, they get $3 in benefits. That means that even the very wealthy--even the Warren Buffetts of the world--actually get subsidized health care. We just simply can't afford it. We'd love for our recipients--our voters--to get this, but we can't afford it. So now what do we have? We have ObamaCare, which is a fixed top of Medicare and Medicaid, and we have nearly a 100 percent government-run system. You just heard my colleague from Georgia talk about the fact that one of the ways to fund it is by this CLASS Act, which is long-term health care. It's unsustainable. It will collapse. Actuaries tell us it's not going to work, so we're in the process of repealing it. We know that there is an amazing number of taxes that go with this--a tax on the sale of your home as an investment--and many other pieces. Another big piece toward funding it is by taking out a half a trillion dollars from Medicare, which only makes Medicare go out of business even faster. Right now, we're looking at about 10 years for that to happen; and our friends on the other side of the aisle, the Democrats, have no solution for that whatsoever. So I would say, Mr. Speaker, that we have gone from the frying pan into the fire when it comes to health care by way of government. There are those who say, Well then, what is your solution? Mr. Speaker, our solution is very simple. Our solution is: Let's re-invoke the marketplace, the forces of the market--economic freedom and patient choice--back into the system, and let's get government out. Government has a role. Government's role is to protect its citizens and to ensure there is an even playing field. Yet we know that no way will costs go down in any open economy, in any free economy, unless there is robust competition. But we do not have that today, not among insurance companies, not among large, vertically integrated governmental systems. It's not there--it never will be--and we will continue to have waste. No matter what any politician says that he's going to do to get rid of fraud, waste, and abuse in the system, he is incapable of doing that. Only a free market can do that. I will refer you back to Paul Ryan's budget, which actually gives Medicare recipients a free market choice, which is the same kind of choice that we in Congress have today. That is: We can go to a Web site or we can go to a book, and we can choose from one of hundreds of excellent health care systems out there by which we can be covered. Why can't Medicare recipients and why can't Medicaid recipients have exactly the same thing? Why can't we tear down the State walls that exist that make, in most cases, one insurance company totally control the market in an entire State? Why can't we do this? The answer is: This body right here has not allowed that to happen. Mr. Speaker, that is what I submit to you this evening: Should we repeal ObamaCare? I am convinced now that we will; that perhaps it will be H.R. 1 in 2013, the full repeal of ObamaCare; that we will quickly replace it with piecemeal pieces of legislation that do many things, including reforming liability insurance, re-invoking the free marketplace, patient choice; and that we will get on with making this a much more efficient system, one that is much more user friendly and one that we can all be proud of. I thank the gentleman, and I thank my fellow physicians in the GOP Doctors Caucus. It is always an honor to serve with these ladies and gentlemen. It's not only physicians, but nurses and other types of health care workers. There are truly great things that are happening in this body.

Mr. FLEMING. I thank the gentleman. I will just briefly respond to that. The point I would like to make on that very question is that coverage is not the same thing as access. There are countries around the world that have 100 percent coverage, yet they have no access to care. And I'm not just talking about communist or socialist countries. Look at Canada today. It takes a year to get a CT scan; but yet everybody's covered. So that's the fine point that we need to understand and take away. I will also add in response to the gentleman just a moment ago talking about the Independent Payment Advisory Board is that it will have more power than Congress itself. It will take a two-thirds vote from both bodies to overturn their decisions, and I don't think that Americans are ready to put all of that power in the hands of 15 bureaucrats who may or may not be physicians.

Mr. FLEMING

Mr. FLEMING. I thank the gentleman, Mr. Smith, not just for the introduction, but for the fine work you've done for so many years, sir, as well as Joe Pitts, our good friend and colleague. Mr. Speaker, I speak to you this evening as a physician of over 30 years, a father, and a grandfather. And I have delivered, myself, many hundred babies and have found that that is one of the most important and intimate times in a person's life is taking part of and in some way delivering a baby. Nonetheless, we have today a problem since Roe v. Wade that we are in great grievance about. You heard Mr. Walberg so eloquently talk about the passages from the Bible that describe about knitting me in the womb and knowing me even before being born. But do you realize that the DNA of every conceived life is unique in history? There will never be another like it. In my opinion, that is God's opinion, that that is a separate and distinct human being and a person upon itself. Let me share some facts with you. Do you realize that the heart begins beating at 23 days after conception, that the fetus begins to feel pain as early as 20 weeks and maybe even earlier? We are still waiting for some studies on that. Certainly any abortion that is committed in the middle or third trimester is obviously extreme agony for any type of fetus. Some other important facts. While there were approximately 744,000 abortions in 1973, the time of Roe v. Wade, that actually peaked in 1990 at 1.6 million. It has come down. It has come down today to 1.2 million. Not nearly low enough. Do you realize also that over $487 million of taxpayer money is used each year to go to Planned Parenthood, which is the number one provider of abortions in this country, committing over 320,000 innocent lives to death each year? There are things we are doing that are effective. You heard me say that we are down from a peak of 1.6 million down to 1.2 million. What are some of the things that we can do and have done? My home State, Louisiana, which was chosen by AUL to be number one in abortion law, has done the following: A mother-to-be must wait at least 24 hours after notification to actually have an abortion; she must be provided with information so she can read about this and have a cooling-off period before making that final decision; she must receive information about fetal pain, what I mentioned just a moment ago; and that she must be allowed, if she chooses, to view a sonogram to see what that fetus actually looks like, her potential baby. And Louisiana has declared that the unborn child is a human being and is therefore a person. Mr. Speaker, there is a lot that we have done. There is a lot more we can do. Although I want to see Roe v. Wade overturned, there are still many good laws that we can produce that I think--certainly defunding of organizations that provide these abortions that can sharply lower these numbers. There is much more we can do. We shouldn't just hold out for overturning Roe v. Wade. We should act today.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, as a family physician for more than 30 years, I've had the privilege of delivering hundreds of babies. I have witnessed the miracle of life itself firsthand, and I believe that every human life at any stage is unique and fully deserving of my protection as a physician. The authority of our government should stand behind the protection of human life. I am proud to be from Louisiana, a State recently ranked number one on life issues by Americans United for Life. Louisiana has implemented some commonsense protections, including a requirement that any woman seeking an abortion must understand how that unborn child is developing, the pain her child will experience during the abortion, and the facts about risks and the alternatives to abortion. Louisiana has banned partial birth abortion and prohibits abortion providers from getting taxpayer dollars to pay for abortion services. We are making progress. But abortion still happens. In the last 39 years, there have been more than 54 million babies terminated. This is a heart-breaking number, and it is past time to end this scourge and protect human life from conception to natural death.

Mr. FLEMING

Mr. FLEMING. I thank the gentleman, and I thank the Speaker. The reason why we're here today is because of the Balanced Budget Act of last year, which was a flawed bill, one which I voted against. Why? It set spending limits way too high. It guts defense by $1 trillion in a time when the world is becoming even more dangerous than ever. It cut funding to Medicare providers in a time when patients out there need access to their physicians and hospitals. And it finally creates a sham, this resolution that we're debating today, which is just that, a sham. All the President has to do is veto our vote of disapproval and it automatically goes into effect. We just basically handed the President, in a time when we have crossed that threshold, $15 trillion of debt more than our GDP, our gross domestic product, which puts us up there with Greece. We have now handed the President a gift of another spending of $1.2 trillion, which now brings him increasing the national debt.

Mr. FLEMING. This brings the President from a point which all Presidents, all the way through George Bush 43, bringing us to $10.6 trillion, increasing that national debt by 70 percent, just in one term under President Obama. I urge my colleagues to vote for the disapproval.

Mr. FLEMING

Mr. FLEMING. I thank my friend, the gentleman, Mr. Camp, for giving me time to speak. I just want to say, Mr. Speaker, that this boils down to one of two choices here today. We're going to be either voting for a 2-month extension of the payroll tax or a 1-year extension of the payroll tax. We'll either be voting for a 2-month fix for reimbursement for physicians, health care providers in general, or we'll be voting for a 1-year fix. Now, for my money, it should be 1 year versus 2 months. I don't understand really what the problem is. But having said that, let me also mention to you that this affects me and many of my friends back home in this way, and that is: I'm a physician myself, have many friends in the health profession. They're asking me: John, why in the world do you keep us upset like this all of the time? Why is it that we can't predict what our reimbursement rates are going to be from one month to another? They're desperately begging for us not only to extend that for a year, but for 2 years and even beyond that. They're desperately asking for a fix. And we've been promising them that we would try. So that's a lot behind what we're here today about, and that is to have a long-term solution to physicians. I also come from the small business sector, and I can tell you that when you do your tax deferrals or the income tax for your employees, that's usually done on a quarterly basis. In fact, it's always done on a quarterly basis. Well, how do you do it on quarterly basis when you only have an extension for 2 months? So we have the Associated Builders and Contractors and many, Mr. Speaker, that say that this is just absolutely, flatly untenable. So I encourage that both Chambers vote today to be in favor of sending this back to the Senate, have the conferees get together. Let's do it the way the Constitution asks us to do it.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, nearly 3 years ago, the President of the United States stood in this Chamber and said we need health care reform to address ``the crushing cost of health care'' and to ``strengthen Medicare for years to come.'' Well, we got the President's type of health care reform. Seniors had to help pay for it, however, by removing $500 billion--a half trillion dollars--from Medicare in order to subsidize ObamaCare. But guess what. That has made Medicare even weaker. Today we're trying to find billions of dollars to pay for another temporary fix to Medicare reimbursement rates to ensure access by patients to their physicians. Last year it cost $19 billion, and it will cost more in future years. ObamaCare did not bend the cost curve down as it was promised; it just pushed the issue down the road. Republicans are committed to getting the doc fix done and finding a permanent solution; but Medicare is running out of money, and these fixes are getting more expensive. It's time to repeal ObamaCare and replace it with reforms that truly strengthen Medicare for years to come.

Mr. FLEMING

Mr. FLEMING. I thank the gentleman. Dr. Gingrey serves on the House Energy and Commerce Committee, a committee that has oversight and jurisdiction in this area, very important, looking at a lot of legislation. Next, I want to turn to another of our freshmen. We've had a wonderful cadre of freshmen we appreciate so much and a wealth of physicians and dentists as well bringing in their years of experience, training, and education. Next I would like to recognize Dr. Hayworth, Nan Hayworth from New York, and would be very interested to hear what you have to say this evening.

Mr. FLEMING. If the gentlelady would yield, I think Dr. Gingrey has something he would like to add.

Mr. FLEMING. Thank you, Mr. Speaker. I come before this House tonight to talk about a very important issue--it's been important for years, and it's going to be increasingly important and increasingly a part of the debate--and that is health care, and particularly health care for our seniors. We've got lots going on. ObamaCare, of course, was passed in 2010, and we're running into all sorts of problems. Of course, I and my Republican colleagues here tonight voted against it. I'm joined tonight, by the way, by two of my colleagues, Dr. Phil Roe, an obstetrician from the great State of Tennessee, and Dr. Scott DesJarlais, who is, like me, a family physician. I thought I would just give a brief introduction about Medicare and how that fits into the budget. I know that Dr. Roe is going to talk in more detail about that. No speaker would be complete without a chart, and I have several tonight. This is one I think that's important for everybody to understand. This pie chart breaks up spending for the Federal budget. If you will notice, the vast majority of this pie is in what we call permanent mandatory or so-called entitlement spending and interest. What makes up a large part of mandatory spending is Social Security, Medicare, and Medicaid. The size of this pie, this section of the pie, is growing. In fact, if you recall, back in the nineties we actually balanced the budget. The last time we balanced it, I think was in the late nineties. It was a lot easier to do back then because entitlement spending, permanent spending, was not in place to the extent that it is today. It was growing, but not as big. What is the difference between mandatory spending and discretionary spending, which is the other two pieces of this pie? Mandatory means that if you qualify for a certain type of service or payment, whether you're on Medicare, Medicaid, whether you earned it or not, if you qualify for it, the government must pay. No matter who shows up or how many people show up, the government must pay. So, therefore, the government cannot per se control that cost. Discretionary cost, on the other hand, is split into two: defense, which is around $600 billion to $700 billion a year; and nondefense discretionary, which is what we run the government on. That we can adjust, although we've not done a good job in controlling this. In fact, that's increased probably 25 percent just in the last 2 years under President Obama. But I want to illustrate for you what the problem is, and that is that the entitlement spending, which we don't control, with an aging population and the fact that it's dependent on government spending, is growing at a much faster rate than our revenues and inflation. This is a chart that outlines where we are today with Social Security, Medicaid and Medicare, the part of entitlement spending. Now, let me say, first of all, Social Security is down here in the purple, and you notice that it slants upward and then it flattens out. Social Security is not our problem. Let me repeat that: Social Security is not our problem. And people who are on it or will be on it, in my opinion, have nothing to worry about. Now, we may have to tweak it, we may have to adjust it, but you'll notice that the cost really rises relatively slowly, and that's just a matter of demographics. And we can adjust this, as we have in the past, and make this sustainable. There are other ways to do it, in terms of allowing Social Security recipients to invest some of their money and so forth, but that's beyond the scope of discussion tonight. The next group in green is Medicaid and other health care. You'll notice it's going up faster. And Medicaid is health care for the poor. And then finally in red you see Medicare, and you see how that explodes and it goes up continuously. Medicare alone will completely displace all the budgetary spending eventually if we don't bring that under control. And that would mean we'd have to give up on government itself, we'd have to give up on a national defense--everything--unless we begin to control that. Now, at the rate things are going, Medicare will run out of money, become insolvent by 2020. And that is straight from the CBO, the Congressional Budget Office. Another way to look at it is that our spending is now equal to 15 percent of the total Federal spending is Medicare, blowing out of control. What has made this worse is ObamaCare actually cut $500 billion, that is, half a trillion dollars, out of Medicare to use for subsidies for middle class health care plans. So let me repeat: Medicare is running out of money; it's exploding through the roof. And what does ObamaCare do, the Members who voted for it, it actually cuts money out of it and depletes it of money in the future so that it becomes insolvent. And here's where the cuts are: $135 billion for Medicare Advantage, which is the private health care version of Medicare, $112 billion, which was taken from hospitals, $39.7 billion from home health, $14.6 billion from nursing homes, and $6.8 billion from hospice care. These are very real cuts. And the only explanation that the other side gave us, our Democrat friends, is that somehow we'll cut out fraud, waste and abuse. Well, let me warn you, any time a politician tells you he's capable of doing that, watch out, because I've never seen it done and I don't expect to see it done in the future. Because, you see, in order to cut out the massive fraud, waste and abuse, you have to spend even more money to find all the bad actors. The best way to do away with fraud, waste and abuse is to make the system much smaller, perhaps even privatize it, and make the system accountable rather than a Big Government bureaucracy, which wastes money, whether we're talking about the Department of Defense or Medicare. So that should give you kind of a beginning of where we are with Medicare. Let me just close my opening remarks by saying that there's basically two options when it comes to making Medicare again solvent and available for us in the future. There is a Republican plan, which would allow you, if you are currently on Medicare or 10 years from becoming on Medicare, to keep Medicare as it is. And it is sustainable, as far as the CBO tells us, indefinitely. However, we would have to reform that for younger adults today who will be senior citizens by opening up the insurance system, creating a marketplace for seniors to buy insurance, and then let government help them with what we call ``premium support,'' and allowing competition in private care to drive the cost down and raise the level of service. In fact, what we in Congress have today is the very same thing. The Democrats, their plan is this: goose egg, no plan whatsoever. Under their plan--or non-plan--Medicare runs out of money in 8 years. And they've failed to present an idea, much less a bill, as we have, that would even solve that. Well, that gives you an idea of some of our opening discussion. First tonight, I want to introduce my good friend, Phil Roe. Dr. Phil Roe, as I said, is an obstetrician. I think he has some comments about the financing of Medicare and other things as well.

Mr. FLEMING. I thank the gentleman. We have also been joined, in addition to Dr. Scott DesJarlais, by Dr. Phil Gingrey, also an OB-GYN; Nurse Ann Marie Buerkle; and Nan Hayworth, an ophthalmologist from New York. So we've got a full cadre. If anybody here has a headache or, certainly, a heart attack, I think they would be very well taken care of on the floor of the House. With that, I'm going to ask Dr. DesJarlais to talk to us a little bit. I think you have an interest in some of this discussion on IPAB and perhaps other things, so I'd love to hear what you have to say, sir, on that.

Mr. FLEMING. If the gentleman will yield on that point, I want to be sure that that's not missed, and that may be the most important statement made tonight. I believe you said that, through a lifetime, a Medicare recipient will pay in an average of 100,000 or so dollars but will take out, on average, $300,000. So what we really have with Medicare is somewhat of a subsidy system which does not subsidize according, necessarily, to need. My point in saying that is: Warren Buffett, today, because he's over 65, qualifies for Medicare, and if he gets care, I assume would get the same subsidized care, subsidized by whom? Taxpayers--middle-class, working- class people who pay the private insurance rates. In some ways, Medicare has become not just help for the poor and the elderly, but just subsidy for people over 65. And so we're going to have to look at: Is there a way in the future that we can even this out, where we're not necessarily subsidizing for those who are capable of paying some of their own costs?

Mr. FLEMING. Absolutely. I thank you for the wisdom of your experience, Dr. DesJarlais. I'd like to turn to Dr. Gingrey here. He's joined us and, of course, has conducted a number--I can't even count the number that I've participated in with Dr. Gingrey with respect to Special Orders that we've had. And before doing that, just to follow up on what Dr. DesJarlais said about the 100,000 in, 300,000 back, I can recall one day in my own practice sitting there and thinking about the three patients that I just saw. In Room 1, I saw a little lady who's on Medicare who could barely scrape by by the end of the month, and she's on Medicare and getting the benefits of Medicare, and God bless her, she was getting them. And then I thought about the second room where there was a gentleman who's a multimillionaire. But you know what? My charge to both of them and what Medicare did for both of them was precisely the same. I just couldn't quite understand that, especially when I thought about the little mother in Room 3 who's on private insurance, two- paycheck family, baby, barely scraping by, paying far more in their premiums than someone in Medicare and having to raise children. It was her insurance premiums that were subsidizing both the little old lady who was poor and the multimillionaire. We're going to have to do something about that to make the economics of this system work. It is unsustainable, as we know. Dr. Gingrey, I would like to ask you if you could give us a few words, sage wisdom on what your perspective of where we are with health care, ObamaCare, Medicare, and all the other cares that we're talking about.

Mr. FLEMING. Since we are beginning to run a little short on time-- and I want to make sure we get to all of our doctors and nurses--I'm going to recognize Ms. Buerkle, a very excellent nurse and a wonderful addition to our freshman class.

Mr. FLEMING. I thank the gentlelady for a very compelling discussion, both as a health care provider and nurse, but also as a daughter of an elderly mother. Those words are very heartfelt, and obviously it means as much to you that we protect Medicare and health care in general as it would anybody. There's no reason why, just because you're a Member of Congress, that you would love your mother any less, so I think those are important words. We're going to move now from a nurse to a surgeon. Dr. Benishek from Michigan has joined us this evening, and let's hear from you, Doctor, and see what you have to tell us.

Mr. FLEMING. I thank the gentleman from Michigan. Again, we're getting a world of experience here tonight, all the way from OB-GYNs, ophthalmologists, family physicians, nurses, so much in the way of words of wisdom, and we have so much on our side of the aisle with Republicans, as my friend points out, a dearth of available physicians, health care workers on the other side of the aisle. It seems a shame that we were completely closed out of the creation of and passage of the health care reform act, which certainly suggests that we need to go back and do it. We also are joined tonight by our colleague from Arizona, Dr. Gosar, who is a dentist and a very valued member, as well, of the conference. I would love to hear from you this evening.