John Fleming

Mr. FLEMING

Mr. FLEMING. Yes, versus Europe, which is 47.3 percent.

Mr. FLEMING. Absolutely.

Mr. FLEMING. Well, I thank the gentleman, Mr. Akin, for the question. Of course, I, among all of our Republican colleagues and our Democrat colleagues, was here to hear the President make these statements, and it's very interesting when he said not one dime would be spent, and yet I don't know of anyone in America who agrees with that. Even the CBO, who is led by someone who was actually appointed by him, says that even with all of the razzle dazzle and the sleight of hand and pulling rabbits out of the hat, still there's $256 billion that's not covered, and that's after the $500 billion that's being gutted from Medicare, as you adroitly pointed out.

Mr. FLEMING. Well, it is a two-step situation. About $350 billion.

Mr. FLEMING. That is the first step. The second step is nearly another $200 billion that comes out of Medicare Advantage. So the total comes to something well over $500 billion, half a trillion dollars.

Mr. FLEMING. Well, $350 billion would be from the so-called fraud, waste and abuse. The other $150 or so billion, almost $200 billion, would be to directly tear down, dismantle, if you will Medicare Advantage.

Mr. FLEMING. It seems to me that it is easy to do on paper, but this program is over 40 years old. And every politician that has come along has promised to do away with fraud, waste and abuse. Not one has been able to do it, and our President nor our colleagues on the other side of the aisle have even hinted how that would be accomplished.

Mr. FLEMING. A point you raised, Mr. Akin, is a very important one that is often left out of the debate, and that is that Medicare and Medicaid are paying such low rates, far below cost in many cases, that it is only the private insurance market that is making up the difference, that keeps doctors solvent and keeps their offices open. If you look at the increase in private insurance premiums and the fact, and the President points this out frequently, the rate of increases is higher than inflation, well, what is causing that is the government-run health care that we already have which is being subsidized by the private market.

Mr. FLEMING. Well, I will just briefly comment, because I know we have got other speakers here who are anxious to get on the record tonight. The whole concept behind SGR, sustained growth rate, is that the government in its infinite wisdom said, Well, out in the future someplace, we're going to spend no more than this many dollars, and the doctors are going to have to get together amongst themselves--the hundreds of thousands of them--and decide how they're going to do that. Of course the obvious thing occurred. How in the world are doctors and hospitals going to be able to do that? Anybody under part B.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, it was recently reported that the Centers for Medicare and Medicaid Services has issued a gag order on private insurance companies to prevent them from providing information to their beneficiaries regarding the administration's proposed cuts to Medicare Advantage and how the Democrat health reform could take away their current coverage. The CBO, by the way, agrees with this. That is a fact that coverage is being taken away. However, the one entity not being affected by this gag order is the AARP, which has been a prime advocate of the Democrats' government takeover of health care. Even as AARP advocates for cutting Medicare Advantage plans by more than $150 billion, an analysis of the organization's operation reveals that it stands to receive tens of millions of dollars at the expense of seniors' medical care. Under the Democrats' plan, seniors are going to have to fund kickbacks to AARP- sponsored plans, and there isn't a single provision attempting to impose any new restrictions on AARP policies. Did CMS somehow forget to include AARP among the organizations whose First Amendment rights to inform seniors of harmful Medicare provisions were restricted, or did the administration only wish to silence its critics?

Mr. FLEMING

Mr. FLEMING. Madam Speaker, as we debate health care reform, little attention has been paid to the impact that our Nation's broken medical liability system has on rising medical costs. There are 125,000 lawsuits against physicians at any given time; 75 percent of the suits are closed without payment to the plaintiff, and in 83 percent of the cases going to trial, physicians are cleared. This means there is very little correlation between lawsuits and actual malpractice. More than that, the current system pushes doctors to overtest and overtreat to avoid being hauled into the courtroom, costing Americans billions of dollars in taxes and higher premiums. In a few cases in which there is a judgment, much of the money goes to pay lawyers, not the aggrieved patient. Furthermore, the current system is driving physicians out of needed specialties. Recent studies show that one in seven obstetricians no longer delivers babies, and 49 percent of American counties don't even have an OB, largely because of high malpractice costs. If the President and Democrats are serious about controlling high health care costs, they must call on trial lawyers to share in the sacrifice and to reform the medical liability system.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, the President has claimed that his policies are going to reduce the skyrocketing national deficit, but I would like to spend just a moment to debunk this myth. Rather than reducing the deficit, the President's budget calls for a $9 trillion deficit over the next 10 years, 6 trillion higher than the CBO predicted just in January when he took office. Even according to the White House, the national debt will more than double in 10 years. The President's own numbers showed that the national debt will be 107 percent of GDP by 2019. In the month of August, there were 14.92 million unemployed individuals looking for work, the highest number in history. Since February, when the Democrats passed their stimulus, 2.46 million people have lost their jobs. And while the President promised that billions of dollars would go into shovel-ready construction projects that would help rebuild infrastructure and employ hundreds of thousands, transportation spending from the stimulus has only trickled out at a snail's pace. Given this administration's track record, why wouldn't the American people be skeptical about $1.6 trillion for health care reform?

Mr. FLEMING

Mr. FLEMING. Yes.

Mr. FLEMING. Will the gentleman yield just for a moment?

Mr. FLEMING. According to our President and to our colleagues on the Democratic side, they suggest this government option will be sort of an anecdote to the problem we have in insurance today, which is that there's not enough competition. Again, I don't know of any economic textbook or of any economic model that suggests that the way to create more competition in the workplace or in the business world is to create artificial pricing, which is what this does. So what artificial pricing does, particularly when it's backed up with taxpayer dollars, is it, in effect, creates a situation where insurance companies will be put out of business, and that will, of course, cave the entire insurance industry.

Mr. FLEMING. Well, that's a bait and switch. What the polls actually show is a majority of Americans favor health insurance reform. However, when you ask them specifically about the public option, as you point out in your poster, only 42 percent of Americans approve and 52 percent disapprove. So we have a 10 percent gap. Most Americans do not approve of a public insurance option or what we call government takeover. And you really see this in the town halls. I don't know about you, Congressman Gingrey, but in my town halls, I did a number of town halls in my district during August. And overwhelmingly, I would say by a factor of about 95 to 98 percent, were against any sort of government-run insurance and only a handful suggested they were for it in any way. And, really, other polling that we have done suggest similar statistics. And the other thing that you don't see here is intensity. The intensity level against government-run health care is far stronger than those who are in favor of it.

Mr. FLEMING. Yes. Yes, I remember him saying this and shaking his finger while he was doing it, and we have been totally unable to find anyone who can agree with this statement. The cost of the bill will be anywhere from $1.6 trillion to over $2 trillion. The President says that the savings will either come from-- well, really from a combination of raising taxes and then savings. If I could digress for a moment, he is talking about savings. You alluded to this a little bit, Congressman Gingrey, about his gutting Medicare and Medicaid $500 billion--$190 billion by killing off Medicare Advantage-- and then the rest would come out directly. You know, I was born at night, but I wasn't born last night, and I happen to know that I and many of my physician colleagues, who have been dealing with Medicare reimbursement for many years, all know that we are currently being reimbursed under Medicaid and Medicare well below our costs. We make it up on the private insurance, which is what is driving the private insurance cost up. It is the existing government-run programs that are running those costs up. To say that you can take $500 billion out and it's not going to affect services just is not true. It is plainly false to say that. Even with the best estimates, we come out with at least, as you say on your poster, $239 billion of deficit over 10 years. So there is nothing at all that supports that statement, sir.

Mr. FLEMING. Yes, please.

Mr. FLEMING. Yes, sir. Well, you know, if you look in the four corners of the bill, itself, there is no statement that says that it will change the coverage or the doctor you have. However, remember that it's the impact of the law that really dictates the outcome. First of all, you just mentioned that 25 percent of Medicare recipients are on Medicare Advantage, which is the privatization part of Medicare in general where they're able to get more services through private insurance than they can on regular Medicare. Well, the financing for that program will be killed off, so that's 25 percent of Medicare recipients. We'll lose Medicare Advantage, so whatever doctors and whatever services they're getting will definitely be changed.

Mr. FLEMING. I thank the gentleman. To follow up on H.R. 3400, which I am also an original cosponsor of, you know, the President last night talked about a lot of laudable goals such as doing away with the whole idea of preexisting illness that would deny care, denying care to someone who developed a disease while on insurance. The ability, if you lose your job, to keep your insurance. Well, you know what, this bill provides for all of that. These are all structural problems that are easily fixable. Our insurance system that we have today for health care was developed in the 1940s when insurance was only a catastrophic umbrella coverage. It is not what it is today. And, so, really, through some very simple things, tearing down the walls between States, so that any American can buy any insurance policy within the borders of the United States, that would create the kind of healthy, robust competition we need to lift service and to reduce cost, to simply pass a law, a very simple law that says you can't deny coverage as a result. You can't even ask what preexisting illnesses you have had in the past. It's like a friend of mine who had a routine colonoscopy as a preventive tool, and he was found to have a couple of benign polyps. I can tell you, Dr. Gingrey, that man may die in bed at 100, he may get run over by a bus, but he will never die of cancer of the colon. However, that's the reason why he lost his insurance, because polyps were found on an examination that he well should have had. These atrocities should not occur, and H.R. 3400 will resolve those issues. And it also has tort reform, which you talked about, which H.R. 3200, the Democrat bill does not have. So, really, all of the problems we have, virtually all of them, all of the solutions are found within H.R. 3400. And yet and still, you mention about participating in the process, the President said last night, and I will quote him, ``I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.'' Well, on May 13 the House Republicans wrote him a letter asking for that. We are yet to hear a response. He's never commented. As far as I know, he's never read H.R. 3400. So, again, I think it's disingenuous. I think we have something better to offer and certainly something that could offer tremendous amendments to the bill already before us.

Mr. FLEMING. I thank my friend from Georgia, Dr. Congressman Gingrey for having this debate this afternoon. I think this is an appropriate time, after, I guess, the climax of all speeches by our President on this topic, health care. I believe last night's speech was his 28th major speech with health care reform as its topic. Before we get into the meat of this, which will deal with some of the statements that were made last night, I want to comment on the speech that our President made, things that struck me during the speech and then afterwards. And first of all, let me say that, as a physician practicing for over 30 years, business owner, still owning businesses and employing hundreds of people in my businesses, providing health care insurance for them, I came to Congress hoping to work in a reform environment. I want health care reform. Wanted it before I was elected, but seeking to achieve that through private means, through capitalism, through the things that have made America great, not through socialistic government take-over means. So I came to this discussion last night, sat very close to where I am at this moment, hoping that the President would, after a very difficult August recess for many of our friends on the other side of the aisle, running into disgruntled Americans who are unhappy with the idea of government take over of health care, would come in a nonpartisan way, wanting finally to reach across the aisle to share some of our ideas, to allow us to participate in the debate as well. But I noticed four things that I want to point out real quickly. Number one was his partisan tone. I really felt that his tone was hyperpartisan, was really unexpected to me. Again, he's my President. He's President of everyone in this Chamber today. And I think it's his responsibility to rise above partisanship. And I had expected that, to be honest, but I was disappointed. I noticed a condescending tone, his lecturing us on how to achieve capitalistic ideals, free-market ideals using socialistic principles. Again, I've been a physician for many years in private practice. I've owned businesses for a number of years, and know of no economic model in which creating socialistic or governmental entities will make capitalism or the free market better. Thirdly, an accusatory tone, suggesting and, in fact, coming outright and saying, in effect, we Republicans are lying about many parts of H.R. 3200, the Democratic bill. I really take personal umbrage over that because everything that I've spoken about and everything I hear from my colleagues is backed up through facts, and while we may disagree at times even over those facts, I don't think that it's appropriate for us to accuse each other of lying. Then, finally, the unsupported claims themselves, which we're going to get into in a moment, making statements that cannot be in any way supported. So, on the one hand, every statement that I know of that I and my colleagues have made can be supported very clearly, not necessarily with what's directly in the bill but with facts that surround the bill. Then there is our President coming to us, making statement after statement and repeating them, which can't be supported in any way, shape or form either in the bill or outside of the bill.

Mr. FLEMING. Absolutely. Secondly, as I described before, Medicare and Medicaid, the current government-run programs, only survive today because of the tremendous subsidy that's going on from private insurance, and even that will run out of money in 8 years, so we haven't even solved that problem. But if you look at the fact that the current government-run programs are, themselves, being subsidized by private insurance, once you create this government option, which will cost employers 8 percent of their payroll, it will begin to pull people out of private insurance and onto the rolls of the single-payer, government-run system. Little by little--well, in fact, quite rapidly--the cost of insurance premiums of private insurance will begin to dramatically rise. The disparity of the differential between the 8 percent of payroll that they will be required under the government option and the 15 or 20 percent of whatever it is going to end up being with private insurance will be so large that employers will have to be put in a position--will be forced--to dump their employees into the government option, the government-run system. As you point out there, the Lewin study shows that as many as 114 million Americans will be the ones dumped into the system.

Mr. FLEMING

Mr. FLEMING. Yes, to kind of summarize, I think that there were, I was personally offended last night when our President insinuated, if not coming out right and condescendingly saying that somehow we've been lying about what we've been saying about these health care bills. But the fact is, if you look at the details, if you look at the truth, you find that what we've been saying we can back up with facts, whether it is taxpayer-funded abortions, which is definitely covered in all versions of the bill on the Democrat side, coverage of illegal immigrants, definitely covered, and then of course the cost of this monstrosity, which is going to start at $1.6 trillion, and after about 10 years it's going to go up from there, never bending the cost curve down. So, again, I would like to suggest that rather than being called out for so-called myths, I think we should really get to the bottom and the real truth of this matter.

Mr. FLEMING. I thank my friend, Mr. Bishop from Utah, for letting me speak. I enjoy serving on Natural Resources and certainly this is an important topic; but I do want to bring up what happened on this very floor last night with regards to health care. The Congressional Research Service, which, as you know, are experts when it comes to whatever happens in terms of academics in Congress, came out with a report this morning on the controversial topic of does ObamaCare, or H.R. 3200, or whichever Democrat version of the bill we're talking about, does it cover illegal immigrants. And let me give you a quote from the CRS. It says: ``Under H.R. 3200, an insurance exchange would begin operation in 2013 and would offer private plans alongside a public option. H.R. 3200 does not contain any restrictions on noncitizens, whether legally or illegally present or in the United States.'' So it's very clear that despite the fact that our President claims that this does not cover illegal immigrants, it absolutely does. In fact, in the SCHIP bill earlier this year, we tried, on our side of the aisle, to get language that was specific to require some sort of proof before someone could sign up for coverage under SCHIP that would show that they were not illegal immigrants. And, of course, that tougher language was removed. Also, with regard to $900-or-so billion that our President mentioned last night, cost of the health plan, which really most believe is more like $1.6 trillion, he talked about savings that would come as a result of removal of fraud, waste, and abuse. Now, these programs, Medicare and Medicaid, which are government-run programs, have been in existence for around 45 years. What have we learned recently that we haven't known for all of these years that we can now remove fraud, waste, and abuse that we couldn't for 45 years? In a 48-minute speech last night, the President did not bring up one new idea, any new strategy or techniques that would allow us to remove fraud, waste and abuse any better than we have been able to for all these years. The truth of the matter is that in order to reduce what we already have as waste in the system, we would have to create even another level or two of extremely expensive bureaucracy that would cost even more than what we would recover. The fact of the matter is that a government system, whether it's running Cash for Clunkers, or the post office, is inept at controlling fraud, waste and abuse. It creates many new bureaucracies, in this case 53 new bureaucracies in the health care system; and, consequently, without moving to a private industrial form this wouldn't be possible.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, the President's speech in this Chamber last night was the 28th speech about the same old tired plan, and it totally ignored the facts. Rhetoric and empty promises are not going to solve the health care challenges Americans face. Americans have spoken in number and force against the same proposals the President endorsed last night. Americans want health care reform that will not expand government intrusion into health care or undermine what works in our health care system today. Contrary to the President's claim that Republicans have no solutions, I support H.R. 3400, the Republican solution: health reform that will expand coverage to those who need it regardless of preexisting conditions. It also expands insurance pools across State lines and encourages young, healthy people to buy insurance to bring down costs for everyone. Individuals and small businesses can be encouraged to band together to purchase group health coverage for themselves or their employees, and we can save billions by limiting frivolous lawsuits against physicians that have driven many out of business altogether.