Phil Gingrey

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Mr. Speaker, on that I demand the yeas and nays.

Mr. GINGREY of Georgia. Mr. Speaker, I'm trying to confine my remarks to the point of order.

Mr. GINGREY of Georgia. Mr. Speaker, I will proceed. To make matters worse, and contrary to the assertions of this majority, this bill does not fix our physician reimbursement problem, but it simply replaces one flawed system for another. So, Mr. Speaker, my motion to recommit ensures that physicians are reimbursed fairly and that this reimbursement is fully paid for and would add not one cent to the deficit.

Mr. GINGREY of Georgia. Allow me to explain, Mr. Speaker. This motion to recommit will provide physicians with a 2 percent Medicare payment rate increase in each of the next 4 years. The motion to recommit would erase the scheduled 21 percent cut in 2010----

Mr. GINGREY of Georgia. Mr. Speaker, I rise today as an OB/GYN physician who knows very well the challenges that our doctors face with the current SGR system. I can say with 100 percent confidence as a physician Member of Congress that this bill, H.R. 3961, is a bad deal. It's a bad deal for doctors, it's a bad deal for patients, and it's a bad deal for the American people upon whom this majority seems content to simply pile another $210 billion worth of debt.

Mr. GINGREY of Georgia. Mr. Speaker, during his meeting earlier this week with Chinese President Hu Jintao, I hope that President Obama asked for that $210 billion, because that's how the majority plans to pay for this bill, by borrowing more money from the Chinese.

Mr. GINGREY of Georgia. Mr. Speaker, am I allowed to continue?

Mr. GINGREY of Georgia. Mr. Speaker, the gentleman from California reserved a point of order. Does that not allow me the opportunity to speak to the point of order?

Mr. GINGREY of Georgia. Mr. Speaker, I have a motion to recommit at the desk.

Mr. GINGREY of Georgia. In its present form, I am.

Mr. GINGREY of Georgia. Parliamentary inquiry, Mr. Speaker.

Mr. GINGREY of Georgia. Mr. Speaker, I rise today as a medical practitioner, one of 13 on the Republican side, in strong opposition to H.R. 3961. H.R. 3961 does not fix our physician reimbursement problem. It simply replaces one system of cuts with another. The bill, however, would add more than $200 billion to the Federal deficit at a time when our patients are struggling to find or keep the jobs they have today. Mr. Speaker, if the details of this bill are not bad enough, the political reality is even worse. The Senate tried a similar sham of a bill last month, and 13 Senate Democrats sided with every Republican to reject it; however, House Democrats don't seem to be listening. The time for empty promises has long since passed. We as a Nation can no longer afford to walk blindly down this path of fiscal irresponsibility. As mentioned, with $12 trillion in debt, I, for one, refuse to add another quarter trillion dollars to that debt. I urge my colleagues to vote against this empty promise.

Mr. GINGREY of Georgia. Mr. Speaker, the motion to recommit would erase the scheduled 21 percent cut in 2010 and the estimated 5 percent cuts in 2011, 2012, and 2013. The Democratic bill would only provide eight-tenths of 1 percent payment rate increase.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Representative Broun, Dr. Broun, I thank you very much. Before we move on, Mr. Speaker, to another subject that's hugely important, indeed, what we took up here today on the floor of our great House of Representatives, I just want to make one closing comment in regard to this issue of rationing of care and in particular in regard to this new recommendation to dumb down the care, indeed, the screening, for breast cancer. I don't know how to put it any other way than to say that it dumbs down that care and that opportunity for early detection and lives saved. Mr. Speaker, there are female Members of this body, great, great Members on both sides of the aisle, women that represent their districts all across this country that serve in this 435-Member House of Representatives. And, unfortunately, a number of them, a number of them have been stricken with breast cancer. In fact, Mr. Speaker, it may have even been before you were here that a Member on our side, a wonderful, wonderful Member from Virginia, struggled with her breast cancer for several years with great, great courage and fortitude and hopefulness and faithfulness, and God called her home. She died from the spread of that breast cancer. And it was such a sad day. And then I think of Members, Mr. Speaker, on your side of the aisle that at a young age, in their early 40s, have been stricken with breast cancer, women with beautiful young toddler children. I've seen them walking down the Hall of the Cannon Building, you know, a great Member, a great friend, but I'm very thankful for her that early detection occurred because of, I don't know, probably a combination of breast self-exam but maybe it was mammography, and we hope and pray and really feel very confident that our colleague has a complete cure. So when we bring up a subject like this, it's not to be morbid and not to scare people, Mr. Speaker, but just to inform in the reality and the unintended consequences sometimes of the things that we do. Particularly when we draft 2,000-page bills that you don't bring everybody together on both sides of the aisle in a bipartisan way and utilize the doctors, the doctors, not just the leadership and people that have been on these committees of jurisdiction for 30 years who write these bills in the dark of night and then just throw them out there in front of us and say you've got 24 hours to read it and vote up or down and, oh, by the way, you can't amend, it's a closed rule. It's wrong. It's wrong but it also is dangerous. Mr. Speaker, in the time that I have remaining, I want to shift gears a little bit because today on the floor of the House the main thing that we dealt with was a bill called H.R. 3961. Now, the number is insignificant really except to look it up on the Internet, but let's call it what most people would recognize it as, certainly most physicians, all physicians across the country would understand, the ``doc fix'' bill. The ``doc fix'' bill. Our physicians for the last 15-or-so years, maybe more, maybe closer to 20 years, but there is a flawed formula for calculating how much they are reimbursed for the procedures that are done under the Medicare program. And for the last at least 6 or 7 years when you calculate that formula--we'll call it for abbreviation purposes the SGR formula, sustainable growth rate--and every year for the last 6 or 7, the calculation says you doctors who are just barely breaking even, maybe not even breaking even, maybe losing money, seeing Medicare patients out of the goodness and compassion of your heart, for which we commend you, are going to have to take next year a 5 percent cut, and then we calculate it and then the next year a 4\1/2\ percent cut, and on and on and on. Well, each year over the last several years, we have come in and passed a law that would say we're going to mitigate that cut for this year, and we're going to let you get reimbursed on the basis of what you got last year and we're going to bump it up 1 percent or .5 percent or whatever, and we're going to do that for a couple of years. We literally are going to kick the can, kick the can down the road, Mr. Speaker. You know that expression. Because that's what we're doing. Maybe we kick it soccer style. But the problem doesn't really go away. So the next time in the aggregate, instead of a 5 percent cut, you've got a 10 percent cut or a 15 percent cut. Indeed, January 1, 2010, in the aggregate that cut will be 21 percent if we don't do something about it. Well, Mr. Speaker, what the Democratic majority and what President Obama said to the American Medical Association way back in June is in this bill, this health reform act that we're going to pass that we're going to totally reform one-fifth of our economy, we're going to have in there a permanent fix for the doctors. We're going to solve the problem. And, doctors, also we know you have another concern. Mr. Speaker, you're aware of this. My colleagues, I know are aware of it. You doctors have this concern over medical malpractice and this need to defend yourself against these frivolous lawsuits by ordering all these tests on patients that are not only unnecessary but indeed could be downright dangerous to the patient, but yet you keep doing them because you don't want to be dragged into a court of law and have some slick attorney or some expert witness hired by some very capable, smart attorney saying, Oh, yes, this doctor practiced below the standard of care because he didn't order a fizzle phosphate level, whatever the heck that is. So I was so thrilled when Mr. President said to the AMA, Mr. Speaker, that there would be medical liability reform. We would solve the low payment based on that flawed formula, SGR, and we would at last have medical liability reform. This bill, 3962, that we passed last Saturday night had none of that in there, and the Democratic majority just took out the ``doc fix'' because, guess what. To do it costs about $290 billion, Mr. Speaker, and would push the cost of this massive monstrosity of a bill over the $900 billion, which the President had put a cap on, a ceiling, and said he wouldn't sign anything that cost more than $900 billion. I say even if you pay for something that costs $900 billion, if the final result is an Edsel, you have not accomplished very much. But, indeed, the bill was pulled out and the President and Ms. Pelosi said, basically, not to worry, not to worry. We're going to come and we're going to introduce this bill as a stand-alone, and indeed that's what we did today, 3961, and we're going to pass it. But you know what? It ain't paid for. And whether it costs $210 billion, $230 billion, $275 billion, I'm not sure of the exact figure, but it's north of $200 billion, and my Georgia Tech math tells me that that's about a quarter of a trillion dollars. It's going to cost that much money and we're not going to pay for it. The debt now is something like $12 trillion. So we're going to add another quarter-trillion dollars to the debt. In fact, we're going to even have to add to the debt ceiling because we're going beyond what the law allows us to do. So, Mr. Speaker, my side of the aisle looked at this very carefully, particularly the physician Members, the 13 of us that form the GOP Doctors House Caucus. And we said, you know, we want to do right by our doctors and we want to do right by our patients and we want to do right by the country, and we can fix this and we can pay for it. So we had one opportunity today to offer a motion to recommit with our design of how we pay the doctors a 2 percent increase every year for the next 4 years under Medicare and we pay for it. And the way we pay for it, Mr. Speaker, in that motion to recommit, is to have that medical liability reform in the bill among a couple of other things to generate revenue, and it's revenue that the CBO says is at least $54 billion. So our motion to recommit, our bill, on ``doc fix'' is paid for. It's a real ``doc fix.'' But you know what, Mr. Speaker? You were here. All my colleagues were here. We got ruled out of order. The Chair said our motion to recommit was nongermane because H.R. 3961, the Democrats' ``doc fix'' bill, the $290 billion not-paid-for bill, well, we weren't consistent with that because we paid for our bill; therefore, it was nongermane. Now, what can kind of idiocy, what kind of idiocy is that, Mr. Speaker and my colleagues? This is something the American people need to understand, and certainly I think the doctors understand. We had an opportunity to do this and do it right, and we were denied even to vote on that motion to recommit. It was tremendously disappointing to me because, Mr. Speaker, I had the opportunity, the privilege, the distinction of offering that motion to recommit, and I wanted to explain to my colleagues exactly what our bill does. And the chairman of the Energy and Commerce Committee denied me the opportunity even to speak, getting the Chair to rule that our motion to recommit was nongermane. So every time I tried to speak, I was gaveled down. Mr. Speaker, that's not what the American people want. If we were in the leadership, they would be appalled. I think they're appalled tonight with your party in the leadership. The American people don't want that. They want Members to have an opportunity to represent their districts, to represent their principles, and to represent and fight for this country and not be silenced. And that's what happened on this floor today. And it's got to stop, Mr. Speaker. It's got to stop. And we will continue to fight. This bill that was passed here today, there was not--I think there may have been one Republican that voted for it, and there were 9 Democrats that voted against it. So there was bipartisan opposition. But your party, Mr. Speaker, had the votes, and you passed it. But it's a sham of a bill, and you know it, because the Senate, 3 weeks ago, totally rejected the bill with 14 Democratic Senators voting no. They couldn't even get a cloture vote. That bill is dead on arrival when it gets to the Senate. Our bill had an opportunity to pass and get to the President's desk and give the doctors relief for the next 4 years, at least. But, no. We had to do it the same old same old way of forcing things on the American people. It's not right, Mr. Speaker, and it's not going to stand. I appreciate the opportunity, as I said at the outset, to come and to talk about this with my colleagues, because I only had 5 minutes to speak about our motion to recommit this afternoon. Five minutes to explain, not hyperbole, not harsh rhetoric, just to explain what our bill did in contrast to 3961, the majority bill, which, as I say, is not going anywhere and the Democratic leadership knows it's not going anywhere. So it is a sham. It's not a ``Doc Fix,'' it's a ``Doc Trick.'' And I want to be, as I move to wrap up, I want my colleagues to just look at this one chart, one poster that I have to show. And this is my depiction of a Trojan horse. And you might not can read this writing, but on the Trojan horse is a saddle, and it says, the Democratic ``Doc Fix'' Bill, H.R. 3961. But on the back of the horse you see the overall health care reform act, the Pelosi Health reform act of 2009, yes, with the $500 billion cuts to our precious seniors under the Medicare program, kind of slipping right on in there. That Trojan horse is this democratic ``Doc Fix.'' But when they, and if they, and I hope and pray to God, Mr. Speaker, that it doesn't pass, but if it does, this is what's going to happen to the American people, not only to our doctors, but to our patients and especially to our seniors. With that, Mr. Speaker, I want to yield a little time to my great friend from Texas, Judge Louie Gohmert.

Mr. GINGREY of Georgia. I thank the gentleman from east Texas so much for being with me tonight. Mr. Speaker, as I bring this to a conclusion, let me just say that we hear the term all the time in the military about collateral damage, and we worry about it. Every time we fire a rocket or use a predator drone to get the really bad guys, we worry about collateral damage. Well, we should be just as worried about collateral damage in the social programs that we are enacting up here as the representatives of the people, especially when it's dealing with health care, because in both instances, both in the military and socially, the collateral damage can result in lost lives. We're talking serious business here. We will continue to fight for the right thing. With that, Mr. Speaker, I yield back the balance of my time.

Mr. GINGREY of Georgia. I think Mr. Reagan said it right. ``Trust but verify.'' The verification is yet to come.

Mr. GINGREY of Georgia. If the gentleman would yield. Is that similar to a triple-dog dare?

Mr. GINGREY of Georgia. I thank my colleagues. And they're well on target, of course. We're just, Mr. Speaker, trying to make sure that all of our colleagues, all of our colleagues and their constituents understand that we on this side of the aisle, the Republican Party, we feel that we have the best health care system in the world. We think doing routine screening mammograms starting at age 40 and emphasizing and recommending breast self-examination, screening young African American children for sickle cell anemia, doing routine screening of hearing and vision in preschool for all of our children, we think all of these things are good. We have a great health care system, and it's not perfect. We know that there are things that can and should be done. But in an incremental way, Mr. Speaker. Not spending $1.5 trillion, not spending $900 billion. I guess the Senate got a score of $785 billion, and they're just elated. Mr. Speaker, when you spend $250 billion--when you spend $100,000, for that matter, on something that is bad for the American people, you have done them a grave disservice--and especially all of the spending at a time when our unemployment rate is 10.2 percent. Some of us have members of our own family who have children who have lost their jobs-- 16 million across this country. And we have this situation in Afghanistan where a four-star general, Mr. Speaker, a commander who was put there by President Obama, says to his Commander in Chief, ``Mr. President, I need help. We can win. I need help.'' Well, how can that not be a higher priority than totally reforming our health care system, throwing the baby out with the bath water, spending a trillion dollars, or $2 trillion, or $2\1/2\ trillion? How can that be more important than putting people back to work? The President, Mr. Speaker, was just over there on a 9-day trip. I wish he had been right here inside the Beltway in the Oval Office working on this issue and this economy. But I hope while he was over there that he got some advantage out of it, Mr. Speaker, and maybe asked Hu Jintao, the Chinese President, to write him a check for $210 billion so he can bring it back and pay for this Trojan horse that we just passed here on the floor of the House today in the name of H.R. 3961. I want to yield to my good friend from Texas, Judge Gohmert.

Mr. GINGREY of Georgia. I have heard it said, ``I'm here from the government. Trust me. I'm here to help you.''

Mr. GINGREY of Georgia. After we don't pay.

Mr. GINGREY of Georgia. Reclaiming just for a second on this point. The gentleman from Texas, Mr. Speaker, is so right. And to do this, of course, now they're going to have--they're going to go over the current debt ceiling by law. They're within, I think, $70 billion of the current debt ceiling, so they're going to have to, in the next couple of weeks, before Christmas, they're going to have to increase the debt ceiling once again. And you know what? That's not going to be a stand-alone bill, because they don't want that, the light of day to shine on that. That's going to be embedded in something else, is it not, my friend?

Mr. GINGREY of Georgia. Mr. Speaker, reclaiming my time, the gentleman from Texas is dead on. He's absolutely right. This 3961, the so-called ``Doc Fix,'' and Representative Gohmert and I agree, it's a ``Doc Trick.'' It mitigates the 21 percent cut that's coming due January 1st. And it gives a positive update, I think, of 1 percent for 1 year. But then after that, Mr. Speaker, here comes the trick that Judge Gohmert was talking about. There's going to be a formula, a new formula, not the SGR, but this new formula, based on GDP. So if you're a primary doc and you're doing examinations, histories and physicals in your office, so-called ``evaluation and management,'' you get GDP plus 2 percent. But if you're a specialist, like I was, an OB-GYN or, say, a urologist or general surgeon, it's going to be GDP plus 1 percent. Well, if the GDP is a negative number, then here again the doctors have no confidence that they're going to get paid a decent reimbursement for their services. So indeed, it is a trick. It is not a fix. Mr. Speaker, I want to take an opportunity--we've been joined by our good friend from Missouri, who has been with us on a number of occasions on health care and other issues, and I want to yield to him some time. And I'll yield to the gentleman, Representative Todd Akin from Missouri.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. If the gentleman from Missouri would yield.

Mr. GINGREY of Georgia. On this issue, as the gentleman from Pennsylvania just said, the actuaries of CMS, Medicare and Medicaid Services, just said exactly what he said, that over a 10-year period of time, the amount of Medicare expenditures are going to go up by something like $289 billion. Look, colleagues, Madam Speaker, we are going to face something on this floor tomorrow, something called ``doc fix.'' I think the bill number is H.R. 3961. And I want to use my reference to my last chart to bring this home to our colleagues that this is nothing but a Trojan horse. Here's the Trojan horse with this 3961. I know, my colleagues and Madam Speaker, it's hard to see this, but it says ``Democrat doc fix,'' but what's inside that Trojan horse, of course, is the $500 billion cut to the Medicare program that the gentleman from Pennsylvania was just talking about. And also it says H.R. 3200. We now know with the Pelosi health reform act, as H.R. 3962, the poor horse is back because it's gone from a thousand pages to 2,000 pages. But that's what's inside this Trojan horse. Make no mistake about it, my colleagues. Members back home and, yes, your physician constituents, your physician constituents are going to recognize this Trojan horse because they were promised in this massive bill, H.R. 3962, that there would be this permanent ``doc fix'' in there. But the leadership and the President got together and said, oh, no, that's going to make the cost go over $900 billion, and I promised not one dime more than $900 billion. So let's pull the doctor fix out and then we'll bring it forward as a stand-alone bill. But guess what, colleagues? It's not paid for. And the gentleman from Pennsylvania, I know that he knows this. That adds another $250 billion to the deficit. Don't vote for this Trojan horse tomorrow, 3961.

Mr. GINGREY of Georgia. I said ``doc fix,'' Madam Speaker. But I probably misspoke. I think the gentleman from Missouri is absolutely on target. Doc trick. Amen.