Phil Gingrey

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. If the gentleman would yield for a clarification.

Mr. GINGREY of Georgia. Mr. Speaker, the gentleman is right in his comment, that every year we're patching it. And that's no way to run a bank. That's no way to do business. You patch it, and yet then the next year you take the cut for that year plus the patch that you removed. So you essentially have 5 percent for the patch and 5 percent for the current year. In fact, on January 1, 2010, the doctors, if we don't do something about it, will take a 20 percent cut.

Mr. GINGREY of Georgia. Absolutely it did, as did all the other amendments. You might say, Mr. Speaker, that the deck is pretty well stacked against us.

Mr. GINGREY of Georgia. Mr. Speaker, I will be glad to take some time from the gentleman from Missouri, and then I will be glad to yield back to him so he can let our family practitioner, the gentleman from Louisiana, Dr. Fleming, also speak on this issue. But yes, this sustainable growth rate formula--and it's very complicated. I've had six courses of calculus at Georgia Tech, and I still can't quite figure out how they come up with these numbers--is flawed, and everybody knows it's flawed and needs to be done away with. You can't fix something so badly flawed. For the last, I would say, 5, 6 years when they calculated that formula, the doctors end up taking a cut in something that already is underpaying them. It doesn't cover their basic expenses. It's calculated far differently from the way hospitals are reimbursed.

Mr. GINGREY of Georgia. If the gentleman would yield, don't take that poster down just yet. If you'll notice, Mr. Speaker, on that poster, it is dated August 25, 2009. In the Energy and Commerce Committee, H.R. 3200 passed committee on July 30, 2009. So this is an opinion rendered by CRS almost a month after that bill passed committee.

Mr. GINGREY of Georgia. Mr. Speaker, there was maybe one or two exceptions in the vote. They have 36 members on the Energy and Commerce Committee. I say ``they,'' Mr. Speaker. The majority party. They were assigned to that committee by the Speaker of the House, Ms. Pelosi. And we have 23 Republicans. So it is 36-23.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Mr. Speaker, I thank you, and I thank the minority leader, John Boehner of Ohio; the minority whip, Eric Cantor of Virginia; and the minority conference chairman, Mike Pence from Indiana--our leadership--for giving me the opportunity to take this hour this afternoon as the designee of the Republican Party, the minority party. Like my colleagues on the other side of the aisle, the Democratic majority that you've just heard from concerning health care reform, my hour also will be spent discussing this topic of tremendous importance to the American people. Certainly, we were home during the August recess for almost 5\1/2\ weeks, and I think, for each and every Member on both sides of the aisle, if they didn't know health care was the number one issue when they went home to their districts, they found out pretty quickly. I think, Mr. Speaker, you would agree with me on that. Certainly, it was all over the television news--cable news and the networks. So we are in a time of this 111th Congress where we're dealing with something that is just as important as almost anything that you can think of. There are other issues, of course, that are on people's minds, issues which are equally as concerning. One of those, Mr. Speaker, is the economy. The economy has been pretty rough, and we all know it. For the last year and a half, we've been in a pretty deep recession, and it seems like no matter what we do that we're not able to pull ourselves out of that ditch. So I would say to my colleagues on both sides of the aisle, while the health care reform issue is important--and it is important that we lower the cost of health insurance so that everybody in this country can have affordable, accessible health insurance plans and can have the opportunity to see physicians when they need to--there are other great concerns. One of those great concerns, of course, is the economy. I looked at some polls earlier today, and when 1,000 people were asked to list in the order of their own priorities what their greatest concerns were, 44 percent of them said, My greatest concern is the economy. In second place was reforming health care at 14 percent of the respondents, and our national defense tied in third place when 14 percent also said that was their greatest concern. It is important that we keep this issue as high a priority as it has, and as important as it is to people in this country, that the economy is the number one issue. Mr. Speaker, I think it was President Clinton that said, It's the economy, stupid. Or maybe somebody said to President Clinton, remember, that it is the economy. And it is. There is no question about it. When you are looking at an unemployment rate bumping up to 10 percent, and people losing jobs since February, when we passed the economic stimulus act, Mr. Speaker, $787 billion, I believe, of borrowed money, a third of that money borrowed from the Chinese government. That was going to stem the tide; we were going to make sure that unemployment did not get worse than 8.5 percent, and that we stopped the hemorrhaging of jobs and, indeed, began to grow jobs. Well, now, here we are, some 6 months later in the process. We haven't spent it all, but appropriated that much money again, $787 billion, to try to get things going to stimulate the economy. We have lost another 2 million jobs, and the unemployment rate is approaching 10 percent. I think that one thing that I wanted to share with my colleagues this afternoon, Mr. Speaker, is the revision of our health care system. The revision of our health insurance system, while important, and important to our economy, it's not the number one issue. The number one issue is to get people back to work and start creating some jobs and do something about the homebuilding industry, where sales are down. Prices of homes are down 40 percent, probably, in some parts of the country. Jobs are lost in that industry, and there are so many things we could be doing, should be doing, to stimulate this economy. Yet the President's attention has been diverted so much that he is going all across the country, doing his own town hall meetings, almost like in a campaign mode, lobbying for this idea of a comprehensive, total reform of our health care system such that the government has more involvement. Maybe not total involvement, but from my perspective, Mr. Speaker, and those of us on the Republican side of the aisle, we have great fear that these plans--my colleagues that spoke in the aisle before were comparing the Senate version versus the House version. I would say, Mr. Speaker, that I have concern about both versions, about both versions leading to a total takeover of the health care system by our government. Ms. Woolsey and Mr. Ellison are very good people, compassionate Members, as we all know, and you could tell from hearing them speak, that they have good hearts. But if you ask them, or, and I have heard, actually--I am not going to put words in their mouths, but I have talked to a number of the members of the Progressive Caucus, of which they are a part, Mr. Speaker, and what many of them have said, and don't deny it, is that they are not going to be satisfied until the Federal government completely takes over the health care system in this country. That is similar, if not identical, to the Canadian system, or the UK system, a nationalized, socialized medicine, is actually what we are talking about. And so we feel, on the Republican side of the aisle, first of all, that's not desirable. The people don't want it. The town hall meetings told us that they don't want it. The recent polling tells us that they don't want it. They clearly want lower prices for health insurance, they want us to do something about that, and they want to make that opportunity to have health insurance more accessible to each and every one of them and the members of their families. But they don't want a government takeover, Mr. Speaker. I say to my colleagues, look, the President, in the joint session of the Congress, where our colleagues on the House side, our Chamber, were obviously here. Our colleagues on the other body, United States Senate, were here. Cabinet members, Supreme Court justices were here as the President addressed the Nation in prime time. You know, you can't have a better bully pulpit than that opportunity for the President to make his case. During that 45-minute speech, another great speech by President Obama, he said one thing that I agreed with, well, probably several things that I agree with, many things that I don't agree with, like a public option, which is a euphemism for a government takeover of our health care system. But President Obama did say that one thing, one area of reform that he has not yet seen in any bill is medical liability reform, and that he felt that that would bring down the cost and that he was willing to listen, Mr. Speaker, to ideas presented to him. His door was open--I don't know about those three or four levels of gates before you get to the door--but I am really hopeful, Mr. Speaker, that his door is open to Republicans and Democrats, and rank and file, leadership, to every Member of this body. In fact, even, it would be great if his doors were open to the citizens of this country that have great ideas and where we get most of our great ideas, if the truth be known. But this, this idea of medical liability reform, I have sent him a letter based on what he said in that speech. He also, Mr. Speaker, said the same thing to the American Medical Association annual meeting in his hometown of Chicago this past June. Mr. Speaker, I know you know this, but some of my colleagues may not know that in my prior life, before I came to this body 7 years ago--I am now serving in my fourth term--I spent 31 years practicing medicine, 26 as an OB/GYN specialist in my 11th District of Georgia, where I still live and will spend my entire life. It's a wonderful, wonderful community in northwest Georgia. This issue of health care--I am as compassionate about it as anybody, just as compassionate as my friends on the Democratic side that had the previous hour. This idea of doing something about medical liability reform--I am so glad that the President said to the American Medical Association at that annual meeting, Yes, in response to a question from one of the doctors, We do need to do something, and I will take that into consideration. Now, he wasn't specific, just like the other night he wasn't specific in regard to what he would be amenable to in regard to liability reform. Mr. Speaker, tonight, I am going to spend some time talking about a bill that I have introduced every year since 2003, that was the 108th Congress. I have been a Member of the 108th, 109th, 110th and 111th and hope to be a Member, Mr. Speaker, of many more Congresses to come. I love this place. I love this body, I love my colleagues on both sides of the aisle. But each year I have introduced the bill called the HEALTH Act, and it is about medical liability reform. The bill number, for those of you who would like to look it up--and I hope you will, because I have got about 60 cosponsors right now, Mr. Speaker. I want cosponsors on both sides of the aisle, because I want this to be a bipartisan effort. I think that's the only way we can really accomplish things that the people will be happy with. But H.R. 1086 is called the HEALTH Act, and it's modeled after a bill that was passed in California. California, with its 35 million people, passed a bill back in 1978. The acronym for the bill is MICRA. The most important aspect of that bill, Mr. Speaker, was to put a cap on awards from a jury to a plaintiff for pain and suffering. Now, when a medical case is brought before a jury, and there is alleged malpractice, and the patient has been harmed or injured in some way, there is all kinds of evidence given to the jury in regard to what the patient has lost, how much they are disabled and whether or not they can continue to work, and if they can't continue to work over a lifetime, you know, maybe 25 more years, that they expected to work. How much is that worth? That's called compensatory damages, and those awards can be in the millions of dollars and sometimes are. In most of those cases, I would say, bravo, Mr. Speaker, that the patient was injured by some physician or some hospital practicing below the standard of care, and they have got just compensation. We call it a redress of their grievances. Maybe it doesn't make them whole, but it helps. Well, this bill, though, doesn't say anything about that, doesn't take away one scintilla of their right to redress of those grievances. It simply says that if it's a minor situation, a minimal injury or even, in some cases, where the jury says we know, based on 2 weeks of the attorneys, the plaintiff's attorneys and the attorney defending the physician, that the doctor didn't do anything wrong, that this was really just an unfortunate outcome; the doctor followed all of the standard practices, best practices in the community. But, golly, you know, we just feel sorry for the patient and, after all, the doctor is not really going to pay this. He or she pays a high malpractice premium to be insured, but it's that old insurance company, and we are just going to go ahead and award $4 million for pain and suffering. Well, that's what drives up the cost of health insurance, Mr. Speaker, for everybody else. And it is estimated that if we limit that kind of opportunity, just out of compassion, not based on any factual evidence, that these sort of runaway jury awards are given, if we limit that, then we could save, in this health care system of ours, Mr. Speaker, up to $120 billion a year, $120 billion a year, that estimate by the RAND Corporation. It just seems to me, Mr. Speaker, that if we go in this direction, that we wouldn't have to say to the American people, we are going to pay for health care reform by taxing the so-called wealthy an additional $800 billion a year. My friends, we are talking about, well, it's okay if you had a lot of money, why not give to the poor and the downtrodden and follow the Good Book. That's fine. I mean, I understand. But there is another perspective on that. You teach a man to fish, you feed him for life. You give a man a fish, you just give him one meal. And many of these people, these so-called rich that are going to be taxed in the House bill that they were praising so much, I think the number is H.R. 3200, there's a surtax on people with a combined income, I forget, something like $250,000. Well, many of those people, Mr. Speaker, are small business men and women who pay their taxes just like an individual, like a small business, sole proprietor. And when you add that surtax on top of their marginal rate and on top of their State and local taxes and FICA, they are paying 52 percent, more than half of their income, in taxes. So many of them will just simply say, you know, this little company that we started years ago, this little roofing company, this sheet metal company, this real estate shop, and we created these 10, 15, 20, 25 jobs, and we have been good to our employees and provided them health insurance, we are now in our fifties and we have been prudent and frugal and saved back and we planned on working another 10-15 years and keeping this company going and maybe turning it over to our children or grandchildren, but this is crazy. We are not working for ourselves or employees, we are working for the Federal Government so they can totally reform health care and turn it into a socialized medicine system. Well, we are just not going to do it and we are going to close the doors, and we are going to have that many more people on the unemployment rolls and that many more people without health insurance. I have been hearing my colleagues talk about, and I think President Obama, Mr. Speaker, said it just last week in his speech, this is a crisis; 14,000 people every day, 14,000 people every day are losing their health insurance, and we have to do something about it. Mr. Speaker, 14,000 people are losing their health insurance every day not because of the cost of health insurance. They are losing it because they lost their job, 6 million of them in the last couple of years, 2 million since February when we passed the so-called economic stimulus bill. So we have to put all of these things in proper perspective. So this bill that my colleagues were praising, H.R. 3200, I am on the committee, I have read the bill, the 1,100 pages. The pay-for of $1.5 trillion over 10 years, and that is a very conservative estimate as told to us by, as they said, the nonpartisan Congressional Budget Office, $1.5 trillion, $8 billion coming from taxation on those small business men and women, that job-killing taxation and another $500 billion, Mr. Speaker, taken out of what, the Medicare program. Do you think, my colleagues, that we can afford to cut Medicare by $500 billion when we have already been told by the trustees that by 2017 there will be less money coming in from Medicare FICA than is going out in benefits to our 45 million, I think there are, Medicare beneficiaries? And that the long-term unfunded liability of Medicare out to the year 2075 is $35 trillion, and that is with a ``T,'' $35 trillion. So we say, oh, well, we need the money because the President said we are not going to do this bill, either the Senate bill or the House bill, whatever is the one that is ultimately chosen, we are not going to spend one dime, no, I think he even said one penny, I think he said one penny. We are not going to spend one penny of Federal money; it is all going to be paid for. So that's the pay-for, the $800 billion worth of taxes and the $500 billion cut to Medicare. Mr. Speaker, $500 billion over 10 years. I heard someone from AARP say that is a small cut. Well, in 2008 we spent $480 billion on the Medicare program. So if we cut it $500 billion over 10 years, that, my colleagues, is $50 billion a year. Divide 500 by 10, $50 billion a year. Well, $50 billion as a numerator over $480 billion as the denominator, I believe that is more than 10 percent a year. Mr. Speaker, cutting Medicare when it is about to go broke by the year 2017, over 10 percent a year for the next 10 years, you tell me that makes sense, so we can guarantee insurance for another 5 percent of our population, many of whom don't want it but yet we are going to force them to take it, to buy it. Certainly it is not going to be free. But what happens to our Medicare recipients, our moms and dads and grandparents who are let's say on Medicare Advantage. Medicare Advantage is that option that you have under Medicare, you have to pay a little bit more, but it covers prevention and wellness and you get to go to the doctor and have an annual physical and Medicare pays for it. And you have screening for a lot of dreaded diseases, and Medicare pays for it. And a nurse calls you back, maybe a week after your appointment, to make sure that you got your prescriptions filled or that your fever went down or that you checked your blood pressure and it is okay. All of that is provided under Medicare Advantage that is not available to the 80 percent who get Medicare as traditional fee-for- service. It doesn't pay for a physical except the entry physical to Medicare when you first turn 65, but you need one when you are 68. You need one when you are 72, and then you might need one every year thereafter. So Medicare Advantage, my colleagues, we may be paying too much and we may need to sharpen our pencil. I'm not saying that we don't look at everything very, very closely. We should do that on everything, every dime. As the President said, Mr. Speaker, every penny of taxpayer dollars that we spend should be well spent, and we should be sure that we are not overpaying the insurance companies that provide the Medicare Advantage option. But it must be pretty popular, Mr. Speaker, because 11 percent of those seniors pick Medicare Advantage. Well, to pay for that $500 billion out of Medicare, guess where the biggest chunk comes from? It comes from Medicare Advantage to the tune of about $170 billion. It literally guts Medicare Advantage. It literally guts Medicare Advantage. So when the President says, Mr. Speaker, you and I and all of our colleagues have heard him say it many times, if you like what you've got in regard to your health care, nothing will change. If you like what you have, you can keep it. Well, try to convince those 10-11 million people, senior citizens, precious senior citizens who are on Medicare Advantage. They may want to keep it, but if the providers of the Medicare Advantage are losing money on the programs--and they will if you cut 17 percent of their reimbursement--they will simply say, look, I have other business lines. I sell property and casualty. I sell automobile, homeowners, catastrophic, I sell life insurance; but I'm out of this. There is no way. So that is 11 million people, potentially, not all of them, but a large number of them who will lose their health insurance, what they like; they wanted to keep it, but they didn't get to. So it is an indirect taking it away from them. When you talk about, well, this is a way we are going to pay for it and not spend one extra dime, it is very important. It is just very important that people understand what the pay-for is. That is why I say in regard to medical liability reform, the current system of the runaway awards given to patients for pain and suffering, there are a couple of other provisions in my bill, the provision of course that we cap the award for pain and suffering at $250,000. Several States have done that. Several States have actually done that and expanded that number to $350,000. And it has worked fine. My mind is open in regard to some changes because the bill, H.R. 1086 that I am talking about, is based on a California law that was passed 30 years ago. So, you know, to say today, well, $350,000, I think is a reasonable thing. And I would be willing in a heartbeat to talk to the President about that, to talk to the leadership of the Democratic majority party about that. Mr. Speaker, there are a couple of other things about medical liability tort law that I think our colleagues need to understand. There is something called joint and several liability. So here's the scenario. A patient suffers an injury and the plaintiff's lawyer names everybody that had anything to do with that patient during a hospital stay. Let's say it is a patient that is scheduled for surgery on Monday, a routine operation. And the doctor who is going to perform the surgery says to her partner, I'm going to be at church Sunday morning with my family. Do you mind when you are making rounds seeing your patients, would you stop in and see Mr. Smith and just make sure that everything is okay and tell him that I will come by this afternoon and check on him and see if he has any last minute questions before the surgery? So the doctor's partner does that. He kind of sticks his head in the door and says hello, and your doctor will be by this afternoon. Well, that doctor could, under current law, be just as liable of any adverse outcome of that next day surgery as the operating surgeon. The way the current law says, if that doctor who all he did was say hello, I'm your doctor's partner and I just wanted to stop in and tell you that she will be by this afternoon, if he has the most coverage, maybe he bought a more expensive malpractice policy, Mr. Speaker, and he has--well, you have heard the expression, he has the deepest pockets, then in a lawsuit, he could be liable for everything, although he never even laid a hand on the patient. Well, that's wrong and that ought to be corrected. That's why we need to eliminate this policy. It is called joint and several liability. In other words, everybody who is named is equally liable. Clearly, as that analogy I just presented shows, that's not the case. It ought to be very specific, and it ought to be proportioned. I would think, Mr. Speaker, that would be plain as the nose on your face. There is another provision of H.R. 1086, the Health Act. It is called collateral source disclosure. I mentioned earlier, Mr. Speaker, about the evidence that is presented to a jury so they can figure out what award, if any, is appropriate for a patient who is injured by a physician or a hospital, medical facility, that has practiced below the standard of care, and it is a very scientific approach. If the patient had to come back in the hospital and stay for another 2 weeks or month, if the patient had to have another surgical procedure done, if the patient had to be put to sleep and had to have the services of an anesthesiologist, if the patient went home and had to have a specialized wheelchair, if the patient had to have an assistant to help them with daily living, all of that stuff is--and I'm sorry, Mr. Speaker, I use the word ``stuff.'' That is improper. But all of those things, items of cost, are used to calculate what the total amount of a judgment should be if in fact it is determined that what the doctor did led to this terrible, unfortunate outcome. Well, if the patient has disability income insurance, and when the injury occurred they were 30 years old, that disability income compensates them for 80 percent of their salary for the rest of their life. If the patient has health insurance that covers anything else that had to be done, that information should be known to the jury because, if not, we're looking at a situation we sometimes call double dipping. All of these things, Mr. Speaker, drive up the cost of health care and health insurance for everybody else. For everybody else. So, Mr. Speaker, that's why I was so pleased to hear the President say that he acknowledges that and something ought to be done about it. His mind is open. And I will say to him and to my colleagues in this body and in the Senate that my mind is open as well. And we should sit down, if necessary, Mr. Speaker, with a blank sheet of paper and just say, Look, certain things in Representative Gingrey's bill, H.R. 1086, we don't agree with, but here are some other sections that we think are very good. And, by the way, we have some ideas here--the majority certainly, because it would be their bill--and would say, Look, let's put this in and that in, and let's get to a point where we can all agree. If we take this attitude, Mr. Speaker, on every aspect of health care reform and health insurance reform, I can name, and, in fact, I would like to name, several things that I just know that there would be bipartisan agreement on in regard to how the insurance companies treat their clients. We, on my side of the aisle, we Republicans absolutely would prohibit insurance companies from canceling or rescinding a person's health insurance coverage after the fact by saying, Oh, you know, 5 years ago when you took out the policy, you didn't answer every question just right. You had a lab test that you didn't tell us about or you had hepatitis when you were 16 years old in playing high school football and you completely recovered, but still, you didn't tell us about it and so now you're 45 and you have to have your gall bladder taken out and, lo and behold, that $20,000 bill, estimate of benefits that you got, we're not paying a dime of it. You're paying all of it. That's got to stop. That absolutely has to stop. We are in total agreement that insurance companies should not be allowed to deny coverage for preexisting conditions. We are in agreement that setting up exchanges, insurance exchanges in every State where a person who doesn't have insurance or works for a small company that doesn't offer it can shop. And you've got multiple insurance companies. There are 1,300 of them, I think, across the country, that offer health insurance products that they can compete and that a person could go online and know exactly what is covered, what the deductible is, what the copay is, who the doctors are in the provider network. Even go online and check and find out if the doctors have a good record, if they're cost-effective, and make a decision. If their income is lower than 300 percent of the Federal poverty level--for a family of four, that's about $65,000 a year--then to supplement them so that they can afford to buy those policies. We're in agreement with that, Mr. Speaker. My colleagues, we don't disagree. We have compassion, too. The two Democrats who were here earlier may be two of the most compassionate Members of this body, but we have a heart as well, and we want to help people. We want to help the downtrodden. But we don't want to, as I said at the outset, to just simply say we can't solve this problem. Golly, we put a man on the Moon in 1969. It took us about 8 years to do it. We caught Russia and passed them because we had the determination, the will to do that. And you tell me now, 50 years later, that we can't solve this problem without just saying, Look, we throw up our hands. We can't do it. The Federal Government, you take it over and run our health care system and let's have everybody on Medicare or Medicaid. No. We have a lot of things that we can work together on, and we need to do that. This idea of medical liability reform and the savings that it brings, certainly it should be on the table, and heretofore it has not been. There's not one section in any of the three bills that came through the House or the two bills that came through the Senate. We need that, just as we need, Mr. Speaker, a comprehensive electronic medical records system. That's another cost saver of maybe $150 billion a year. Yes, there's some upfront costs. Indeed, I think the President put $19 billion into the economic stimulus package to make sure the government continues its efforts to set the standards so that all these computer systems, hardware, software, for every specialty and every subspecialty, can talk to the Medicare system, can talk to the Medicaid system, can talk to the VA, can talk to the military, can talk to every private insurance company across this country. So if you go on vacation and if you have a little card about the size of a VISA card or American Express card that's got your identification in there, very secure and encrypted, and you're at the South Pole, for goodness sakes, and you fall and hit your head on the ice and you're in a coma and they take you to the emergency room, somebody can reach in your back pocket, get your wallet out, swipe that card and know exactly what your medical history is, what medications you're on; if you're taking Plavix, not inadvertently give you Coumadin and kill you. So electronic medical records is something that we can, should, and I think do agree on. Mr. Speaker, I think that if we put the bickering, as the President said, try to put the bickering aside and listen, and the majority party allows the minority party in the room, we can do this. We can do this. And I think the American people would be proud of it. There's one other thing that I have been proposing and my colleagues on this side of aisle, this idea of why is it that people can only buy health insurance in their own State. Their own State may have passed all kinds of mandates on health insurance that require a test for this, a test for that, coverage for this, coverage for that. All of these things that sound nice when you propose them, but they are part of a basic policy, and so every policy that's sold in the State has to include all those things. Well, these people can't afford health insurance in that particular State. Maybe it's my own State of Georgia, or Alabama, Louisiana, or Florida, Massachusetts. But yet, they are forced to buy insurance in their own State--and many of them don't because they can't afford it. Well, let's let them go online and shop in a neighboring State or anywhere in the country that they want to look and see. Just like on Medicare part D, the prescription drug plan, you will see that the competition in the free market will keep those prices down and make them competitive and that an individual can pick a policy that's almost tailor-made for him or her, just as they do in the prescription drug plan. In the prescription drug plan, part D of Medicare, my mom goes online and she makes a list of the six medications that she's on and she gives her Social Security number, she gives her zip code so that she would know which pharmacies are close to her and what plans are available, and she looks and sees how much the different plans charge for the medications that she's on. She doesn't care what they charge for something that she's not taking. That doesn't matter to her. It's the uniqueness of her that allows her to shop in that way and get the best price. We can do that with these health plans through these exchanges. We can set up these high-risk pools so that people that have birth defects or they come down early in life with type 1 diabetes or they have osteoporosis or multiple diseases, they can become part of a high-risk pool in each State. And we can say to the insurance companies once again, You have to participate and you can't charge more than 1\1/2\ percent--1\1/2\ times what the standard rates are. Again, I started out the hour specifically talking about medical liability reform and the significant savings. I think I even referred to it as a silver bullet worth of savings. And I think that that is something that certainly ought to be--if we pass health reform this year, that certainly should be a major provision; electronic medical records, of course, as well, and many of the things that I mentioned. But to just throw up your hands and say, We can't do it. We have got 435 of the best and brightest people in this country serving this Congress. All walks of life, all educational levels, all previous professions, and we can't do this? We have to just literally toss up our hands and say, Let's let the Federal Government do it? There yet is not one word in this Constitution that talks about health care and the requirement of the Federal Government providing health care, not one word, and I look at it often, my colleagues. I look at the glossary often. I look at things like: Arms, the right to bear; assembly, the right of; counsel, the right to; grievances--we talked about that earlier, didn't we--redress of; petition the government, the right to; the press, freedom of; religion, freedom of; speech, freedom of. But not one word about health care. I want to just close by saying to my colleagues, we don't want to let the Federal Government take over our health care system. There's an art to medicine. It's not an exact science, and we don't need bureaucrats getting between our doctors and our patients. The American people are telling us that. And I say woe be unto us if we turn our back on them and force a government-run health care system down the throats of the American people by some parliamentary trickery. I hope, Mr. Speaker, that my colleagues are smarter than that. I know they are. I know they are. In the final analysis, we're going to do the right thing, and I hope and pray that we do it in a bipartisan way.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Madam Speaker, experts have predicted that meaningful liability reform can save our health care system $126 billion annually. What does $126 billion in annual savings mean? We would not have to cut $500 billion from our seniors' Medicare program over the next 10 years. We would not have to levy $800 billion in job- killing taxes on our economy. We would not have to ask every American to give up their liberty because of a government edict to purchase government insurance that they may not be able to afford. My colleagues, meaningful liability reform is the silver bullet in this debate. It can stop the practice of defensive medicine, save our health care system over $100 billion a year, and protect the American people from the occasional greedy lawyer seeking a windfall. As an OB/GYN who practiced medicine for over 30 years, I know how dire the consequences are if we continue our failure to act. It is time to put partisan politics aside and stand up for the American people. Meaningful liability change cannot wait. It must be included in any health care reform bill.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Mr. Speaker, I rise today to express my strongest support for H. Res. 679, a bill that recognizes American Legion Day and commends the exemplary service of the veterans of the United States Armed Services. The American Legion was granted a charter by this body on September 16, 1919, and since that time the Legion has remained active on the local, state, and national level as a volunteer service organization for our nation's veterans. Today, it is an honor to express my deep sense of gratitude to the thousands of veterans who are members of the American Legion. The American Legion provides many volunteer opportunities for our nation's troops when they retire from the Armed Services. Some of these include donating millions of man hours to the medical facilities of the Veterans Administration, sponsoring Boy Scouts of America troops all around the country, and awarding millions of dollars for college scholarships. These incredible volunteers give back to the very communities that they have already sacrificed so much for throughout their careers. Community involvement is only one aspect of the American Legion. These Legionnaires also provide an extraordinary amount of support for troops returning from war in Iraq and Afghanistan. Legion Posts all around the nation have been involved with providing financial assistance to veterans displaced by natural disasters or families of veterans that are struggling to pay for basic needs such as housing. The American Legion has a Family Support Network that provides much needed assistance to families of members of the Armed Services, and the organization focuses on reintegrating troops returning from deployment into the workforce in the United States. It is appropriate that we take a moment to recognize and say thank you to the active duty members of our Armed Forces for their dedication, sacrifice, and honor. Each and every day, they keep this great nation safe and protect the freedoms that we enjoy. We are proud of all of our servicemen and women and are eternally grateful for their efforts in the Global War on Terror. Furthermore, let us not forgot those who have paid the ultimate sacrifice, and let us say a gracious thank you to them for their willingness to make the ultimate sacrifice for liberty. The families of those who serve our country on the front lines also deserve the admiration and appreciation of each and every citizen. These family members often watch their loved ones travel to far away lands in support of a cause and an ideal so much greater than any one individual. Indeed, our democratic form of government is a testament to the courage and valor of our Armed Forces. The support given to our servicemen and women by their loved ones is irreplaceable, as it is the foundation for the bravery inherent in those who labor steadfastly in the defense of liberty. Mr. Speaker, I believe that the brave men and women who sacrifice-- and have sacrificed in the past--for our present freedoms deserve our fullest support. Our nation's servicemen and women represent the best our country has to offer, and they must be treated with the respect and honor they deserve. Recognizing American Legion Day in 2009 is just one small reminder of the invaluable contributions made by our troops at home and abroad, and it is my hope that we will continue to do all we can and more for the veterans of our Armed Forces. The American Legion is an exceptional organization for veterans and communities all around the nation, and we now reaffirm our commitment to these heroes by recognizing this day. Mr. Speaker, I urge all of my colleagues to support this resolution.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Mr. Speaker, I rise today to honor the tremendous achievements of 17-year-old American tennis player Melanie Oudin. Melanie was born on September 23, 1991, in Marietta, Georgia, where I reside; and she captured the heart of America with her inspiring performance at the 2009 United States Open. Melanie entered the United States Open as the youngest player in the top 100, numbered 67--the number three American behind Serena and Venus Williams. This was Melanie's second U.S. Open, and she played incredibly well. Melanie ousted the number four seed, the number 13 seed and the number 29 seed before losing in the quarterfinals to the number nine player. This series of wins comes on the back of her performance at Wimbledon this summer where she made the fourth round. Melanie's sneakers, pink and yellow with the word ``believe'' stamped on the heel, sum up her attitude about life and sports, and she has shown all of us what can be achieved if you only work hard enough. I know that I and the other residents of Marietta, Georgia, are proud to call her one of our own; and we look forward to watching her continued rise in the sport of tennis and in life.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Well, and, again, in regard to the facts, when we went home for the August recess, President Obama, his overall approval rating--and, let's face it, politicians pay attention to polls, and, certainly, our Commander in Chief and the highest politician in the country is the President of the United States, and he pays attention to his approval rating, and it dropped over 10 percent in a 5-week period of time and 57 percent of the people in the country when we left here the first of August were in favor of this health reform plan, but now it's down to 42 percent. So, again, that fact check, I think, is very important. My colleagues, the point we are getting to is this, based on the speech that the President gave last night, it's pretty clear to me, it's pretty clear to this Member, to this physician Member, that the President has not listened. He may be listening to Ms. Pelosi, the Speaker of the House, he may be listening to Mr. Reid, the majority leader of the Senate; he may be listening to Charlie Rangel, who chairs the Ways and Means Committee. Possibly he is listening to Henry Waxman, the chairman of the committee that I serve on, Energy and Commerce; or maybe his friend from California, George Miller, who chairs the Education and Labor Committee in the House; and maybe he is listening to Chris Dodd, the Senator from Connecticut, who chairs the Health, Education, Labor, & Pensions Committee, the health committee in the United States Senate. But he is not listening to the American people. We have come to not expect, my colleagues, him to listen to the loyal minority and to give the minority truly an opportunity to participate on the front end of having input in these very important bills. We are talking about 17 percent of our economy is health care. And John Fleming and Phil Gingrey, together, probably have 70 years of clinical experience, Mr. Speaker, in the practice of medicine. And I am talking about where you see patients. I am not talking about writing papers or teaching at some ivory tower medical facility, I am talking about in urban and rural America, seeing patients across all aspects, financial, socioeconomic, ethnicity, with all kinds of problems. And our specialties are different. And yet we have got these 70 years of clinical experience that we should have, could have, would have brought to the table. And not once were we invited. So the President is listening to somebody, but he is not listening to some experts that could help him, and he is sure not listening to the American people. The American people said very clearly, and, again, when I wasn't holding town hall meetings, I was watching them. I was a C-SPAN junkie. You know, I was an insomniac. I'm a senior citizen, so I don't sleep a lot. And the people were saying, Mr. President, no government-run health care, don't cut senior care to pay for this health reform. We don't need to remodel the kitchen. We just need to fix the ice maker. Don't raise the deficit. We just heard that your guy, Mr. Orszag, the director of the Office of Management and Budget at the White House, your man, you put him there, he is a brilliant economist, and he just said that over the next 10 years your deficit spending, your red ink is going to total $9 trillion. Now, ladies and gentlemen, my colleagues, we are currently $11 trillion in debt in this country, 11 plus 9 is 20. That's about $45,000 worth of debt for every man, woman and child. And we are going to do this massive health reform change and spend another $1.5 trillion when, yes, 14,000 people every day are losing their jobs and something like 5 million have lost their jobs since February when we passed the economic spendulus and Recovery Act that was going to stop unemployment at 8.5 percent and start growing jobs. Unemployment now is 10 percent, and we haven't grown a job yet. The American people said don't raise the deficit. The American people said health care choices, not government dictates. The American people said bipartisan compromise. Mr. President, you are not listening. Well, just a few additional points to be made, Mr. Speaker, and my colleagues. The truth behind the Democrats' health care proposal, 5.5 million more jobs will be destroyed just by the business tax proposals in this plan. As I pointed out, 114 million Americans could lose their current health insurance, so much for if you like what you have you can keep it; $500 billion in Medicare cuts, 20 percent increase in seniors' Medicare prescription drug premiums, $800 billion in new tax hikes, and that's just the beginning. Now, my colleagues, many times on the majority side of the aisle, you have said, the Republicans are the Party of No. Well, at first I took umbrage to that. It's almost like a member of our side of the aisle in a moment of passion made a statement last night that he regretted and apologized to the President, when this issue of whether or not this new health care benefit and these subsidies would be going to illegal immigrants. That invokes a lot of passion in a lot of people in this country, including Members of this body. And when I hear the Democrat majority say we are the Party of No, I get upset about that, or at least I used to. And now I realize that maybe we are the Party of No, Mr. Speaker, but it's spelled k-n-o-w. And we do know. We do have a plan. We do have a second opinion, if you want to put it in medical parlance. We have a second opinion on everything that comes through this Congress. We had a second opinion on energy reform, Mr. Speaker. We reject the cap-and-tax, cap-and-trade scheme that would cost every family at least $2,500 a year more in electricity costs when China and India with their 2.5 billion people get off scot free because they are a so-called developing nation. They are developing all right, they are eating our lunch, that's what they are doing. And they are taking away all of our manufacturing jobs. Mr. Speaker, we have an idea, we have a second opinion on energy, we have a second opinion on how to reform health care. No, it's not 1,100 pages, it's 260 pages. It's called the Empowering Patients First Act. It's not H.R. 3200. It's H.R. 3400. And this is just one of four, or maybe five Republican bills that are alternatives, second opinions, that can solve this problem in a bipartisan way without breaking the bank. But do you think we get an opportunity to have a hearing on these bills? Do you think we have an opportunity to have our amendments vetted? Do you think when whatever comes before this floor so that all the Members can vote on it, that any Republican will have an opportunity to either offer a bill or even an amendment? I have as part of this bill an amendment on liability reform that every year that we Republicans controlled the House, it would pass. And it probably would save the cost of health care $150 billion a year, because doctors wouldn't be doing all these unnecessary, defensive tests, which can be downright dangerous to patients. So, yes, this is a second opinion. And yet you won't hear much about it, except from us, an opportunity like this, my colleagues, and we take this opportunity. Maybe when some of our Members have already, you know, headed for the airport and can't wait to get home to their families and their children and grandchildren, I certainly can't blame them for that. But this is our only opportunity, Mr. Speaker. That's why Dr. Fleming and I are here to make sure that you understand that we are not the Party of No. We are the Party of K-n-o- w. I would like at this point to hear from my friend from Louisiana.

Mr. GINGREY of Georgia. I thought we could go to the next fact then. Again, I'm quoting from our President last night. ``Not a dollar of the Medicare trust fund will be used to pay for this plan.'' I think he spoke the truth there because I don't think there's any money left in the Medicare trust fund. I think past Congresses for many years have spent that money like crazy. As we all agree, I think, every Member, every constituent, certainly every Medicare recipient would say that that trust fund ought to be lockboxed and that it should not be touched for any Federal expenditure except for the solvency of the Medicare plan. So, yes, I agree with him, that not a dollar of the Medicare trust fund will be used to pay for this plan. The fact, of course, is not just the trust fund. He's taking money right out of the hide of the Medicare program, not the fat but the muscle and the sinew and the cartilage and the bone; $500 billion out of Medicare. Then he went on to say that he promised that, if his bill does not save money, more cuts will come. Hear me, Members, who might happen to be on Medicare--and your constituents surely are--more cuts will come. Now, the next fact: The President earlier in the speech said this-- and I wondered if he was listening. I don't know what he was listening to during the month of August, but this is his quote from his speech last night to this joint session and to the television audience--to all of the Americans. ``A strong majority of Americans still favor a public insurance option.'' What's the fact, Dr. Fleming?

Mr. GINGREY of Georgia. I thank you for those comments, and I certainly agree with you. The President did say that. He said if you've got a good idea, bring it to me. And I would say this to the President because we do, as John Fleming said, we do have some good ideas, not just the two of us but Members on both sides of the aisle. The more conservative Members on the Democratic side, the Blue Dog Coalition of 52 members, they need to be heard, and I think thus far they've been heard, but they've been ignored at the same time. And what I would say to the President as we wrap up this hour, Mr. Speaker, this is what I would suggest to the President. We've all heard the expression around here--in fact, I think the late Senator Kennedy was famous for this; maybe he coined the phrase--``Don't let the perfect be the enemy of the good.'' Now, if President Obama thinks that H.R. 3200, the big bill with the public plan in it, is perfect but the American people, in a very resounding way, have said, ``Mr. President, we don't want the public plan because we fear that that's just a Trojan horse and it's two steps towards a single-payer national health insurance where you have rationing such as they do in Canada and the UK,'' then the President could--and I wish he had last night said to us--``Well, we can't pass what I think is the perfect, because American people are afraid of it. I feel that they're wrong. I fear that they've been scared. I fear that they've gotten misinformation. But nevertheless, they've spoken pretty clearly, and the Members on both sides of the aisle have heard because they came back to Washington and they told me, and I'm just going to have to pull that public plan option out and let's get together with the Republicans in the Senate and in the House and let's draw up a new bill and let's do the `not perfect but the good.' '' And Dr. Fleming, Representative Fleming mentioned a couple of things. Equalize the tax treatment so that everybody gets discounted health care. Absolutely put in the subsidy for people who are not poor enough to qualify for our safety net programs like Medicaid but they don't have enough income to purchase health insurance for them and for their children. They get government subsidies based on a sliding scale. Make the insurance companies accept people with preexisting conditions. Don't let them put caps on how much coverage you get in any one year. If you get real sick in any one year, whatever the bill is, the insurance company should pay it after you paid your copay and your deductible. Maybe the next 5 years they won't have to pay anything and you won't have any claims. And let's create these high-risk pools across each and every State where people with multiple illnesses can get coverage at a reasonable rate and, yes indeed, help those who need help with subsidies both from the State and from the Federal Government. Just a few--let people purchase health insurance across State lines where maybe they're cheaper. If you live in--as I did for a long time-- in Augusta, Georgia, it was just a half a mile across the river to North Augusta, South Carolina. Why can't people go across State lines and purchase health insurance? They can do it to buy a gun or a television set. So again, all of these provisions are in the bill H.R. 3200, which I showed you just a second ago. Here it is. So, Mr. President, in your opinion--not in ours--but in your opinion, this may not be the perfect, but I tell you what, it's darn good. And if we can get together in a bipartisan way for the American people and let's get this done and then let November 2, 2010, take care of itself. And as far as your political future, Mr. President, let's let 2012 take care of itself. Let the American people be the judge. But let's get this done in a bipartisan way and let's, for once, listen to the American people. With that, Mr. Speaker, I will yield back.

Mr. GINGREY of Georgia. Well, again, reclaiming my time, this is a point that I made earlier, Mr. Speaker. Again, I want to repeat it to our colleagues, this business about, if you like what you have, that you can keep it--you may want to keep it. As an example, we'll use Medicare Advantage. But you may be prohibited from keeping it because it's not offered anymore. It's the same thing with regard to, if you work for an employer, Mr. Speaker, and if that employer says, Look, you know, we've got a menu. That's the way it works. That's the way it works for the Federal Employee Benefit Plan. For those of us who work for the Federal Government, you have choices of five or six things that you might want--a high option, a low option, a standard option. You might want dental coverage. You might not. You might want eye coverage. You might not. You might, indeed, want a low premium, a very low monthly premium with a high deductible combined with a Health Savings Account. A lot of Federal employees choose that. A lot of employees for these large companies choose that, whether we're talking about Wal-Mart, Coca-Cola, Lockheed, whatever. They have those as their choices. But the Federal Government is under this massive new bureaucracy with, I think, 53 different agencies making decisions under the Department of Health and Human Services. Mr. Speaker, the ones with the strongest voices would be these health choices administrators who could say--now, there will be a grace period up till--what?--about 2013, I think, Dr. Fleming.

Mr. GINGREY of Georgia. But at that point, they could say to a company, Gosh, I notice that you've got a lot of your employees who have picked the high deductible-low premium plan, these young workers who are just out of college or just out of high school. Well, you know what, Mr. Employer? We're not going to approve that because we have decided that nobody can spend that much money out-of-pocket in any one year. That's one of our requirements. So you're going to have to come up with something entirely different and, yes, more expensive. That's what Representative Fleming was saying, Mr. Speaker, that the employer is going to say, You know what? It's not worth it to me. Heck, I'll just pay the 8 percent fine for each of these employees, and I'll let them go into this government plan. So you're talking about, if you like what you've got, you can keep it. You can keep it until you can't keep it, and that's going to be in 2013.

Mr. GINGREY of Georgia.--you mentioned a fact check, Dr. Fleming, and I have a number of those facts here on the poster board, on the easel. I think what I'll do is uncover the first one, and I'll let you comment in regard to the first fact that he mentioned last night. My colleagues, you may not be able to see that well nor may Dr. Fleming, but here is what it says. This is a quote from our President. ``I will not sign a plan that adds one dime to our deficits--either now or in the future.'' Congressman, can you see the true fact on that?

Mr. GINGREY of Georgia. If my colleague will yield just for a minute----

Mr. GINGREY of Georgia. Reclaiming my time, I certainly agree with you. The President talked about not spending one penny to add to the deficit, and this $239 billion shortfall in the pay-for is after cutting Medicare by $500 billion, as you have heard from me and from Dr. Fleming, and after taxing the rich, whoever they are. I think, unfortunately, the rich are a lot of small business men and women who create most of the jobs in this country. They're taxing them anywhere from 1 to 5 percent, and are trying to raise an additional $800 billion. So, even with the $800 billion worth of new taxes and the $500 billion cut to the Medicare program, especially to Medicare Advantage-- and Dr. Fleming would, I'm sure, verify this--fully 20 percent of Medicare recipients today, my colleagues, choose the Medicare Advantage program as the delivery system because they get more care. Dental care is covered. Hearing aids are covered. Annual physicals are covered. There is a catastrophic cap. None of that is true under traditional fee-for-service Medicare unless, maybe, if you have an expensive supplemental policy. So that was the first fact. Congressman, if you will let me unveil, if you will, fact number two. My colleagues, this fact-check is this--and again, we're quoting from the President's speech last night, not 12 hours ago: Nothing in this plan will require you to change the coverage or the doctor that you have. Now let me repeat that because this is an important fact check: Nothing in this plan will require you to change the coverage or the doctor that you have. Congressman.

Mr. GINGREY of Georgia. Reclaiming my time, even if they wanted to keep it, it would no longer be there for them because if you cut it to the bone--and this cut in Medicare Advantage is like 17 percent a year--the insurance companies that offer that product will just simply say, I'm sorry. We're shutting our doors, and you're going to have to go find yourself a doctor who will accept you under Medicare fee for service.

Mr. GINGREY of Georgia. Mr. Speaker, thank you for the opportunity to spend the next hour as the designee of the minority leader on the Republican side to talk about what we heard here in this Chamber last night beginning about 8:15 in prime time from the President of the United States regarding health care reform. I am pleased to be joined by at least one of my colleagues, and there may be others that come during the hour. Congressman John Fleming from the great State of Louisiana will be joining me and we will be talking about what went on last night. We may even want to address some of the comments that our Democratic colleagues have just made on this House floor during the previous hour in regard to their enthusiasm for a public plan, indeed their enthusiasm for a single-payer system, national health insurance, if you will. So this gives us a great opportunity. That is what makes this body so great, that we can agree to disagree in a respectful way. The three members of the Democratic majority that were just speaking to our colleagues are good friends that I have great respect for, the gentlewoman from California, the gentleman from Minnesota, the distinguished gentleman from Michigan. We just happen to totally disagree on this issue. That is why we are here. That is what this is all about, is to take an opportunity to point and counterpoint, folks remember that, Crossfire and things we see on television. You are from the right, you are from the left; you are Republican, you are Democrat; you are conservative, you are liberal. Your viewpoints on what is best for the country are going to vary. Sometimes they are going to be 180 degrees apart, and, surprisingly enough, there are occasions on which we agree on issues almost 100 percent. But on this issue, there is serious disagreement. I want to just talk a little bit about how the President started his address to this joint session of Congress, and, of course, in prime time to the Nation, on H.R. 3200, the bill that has passed the committees in the House, not passed the whole House, but also the bill that passed the Senate Health Committee. The President talked about that last night. Typically when the President comes before a joint session of Congress, it is going to be in this Chamber, because this is the bigger Chamber, as our colleagues know. The Cabinet members come in, and there are additional chairs put out here down front for them, for members of the Supreme Court, for any retired Members of Congress who may want to come. Of course, the galleries were completely full last night. Madam First Lady was sitting over here on this side, and it was quite a setting. I don't think any of us really knew, except maybe the Democratic leadership and some of the Democratic majority party, knew ahead of time what the President was going to say. Sometimes we get a draft of the speech, and on this particular occasion we didn't. When we sat down in our seats and the magic hour was approaching, at just after 8 p.m. last night these cards, these laminated cards, were passed out by the clerks of the House. I want my colleagues to notice, and, of course, you did see it last night, but there is some script on the front, but there is nothing on the back. So it is not really a two- pager. It is a one-sider, if you will. The bottom line, it is just a thumbnail sketch of what the President was going to say to us. We typically have, when we sit down, a copy of the speech, and not just a draft, the very speech that the President is going to make right here standing behind that podium as he reads that off of his teleprompters so we can follow word by word, and, indeed, if he is speaking slower by necessity, so we can read ahead and in a typical situation know what he is going to say maybe a page ahead or a page and a half ahead. Not last night. You absolutely did not know what to expect. I know what I hoped to hear him say, and many people asked me about that, both before and after the speech. But what did you expect, Congressman Gingrey? You are a doctor. You practiced OB/GYN medicine for 26 years in your district in northwest Georgia, Cobb County and Marietta. You delivered 5,200 babies. You have been in the practice of medicine for 31 years. You have been up here now seven. You sit on the Energy and Commerce Committee where this bill, this H.R. 3200, my colleagues, I just happen to have it, a fresh copy of it, I think 1,100 pages, pretty thick, kind of hard for me even to hold. You know, what do you think about the bill? After the August recess, when everybody went home, this bill passed the Energy and Commerce Committee. It passed the Ways and Means Committee, and it passed the Education and Labor Committee, very narrowly, strictly upon party lines, and we went home for the August recess. That is when things really got exciting. Typically, during the month of August, Members are in their district. They are seeing constituents, maybe one on one, more typically in a townhall meeting setting. On a busy, day you might see 50 people or 75, and rarely 100 if the weather is perfect. Well, during this August recess, which lasted about 5\1/2\ weeks, all across the country congressional Members, Senators, Members of the House, Republicans, Democrats, Independents that held these townhall meetings were seeing 10 times the attendance that they would normally see. So instead of 50, I was seeing 500. Instead of 100, I was seeing 1,000. And this was true, I think, in every district. My colleagues, you know that your constituents were either going to those townhall meetings, trying to talk to their Members, or they were watching on C-SPAN or they were watching on CNN or Fox News and they were seeing what was going on. And it was clear, it was clear that most of the people at those townhall meetings were our senior citizens. The ones I held, six or eight or nine, there were a few scatterings of young people, but maybe they were off working or at ball games or it wasn't on their mind like it was senior citizens. But those senior citizens were there because they were very concerned about how this new bill, this big one, H.R. 3200, it is called the America's Affordable Health Choices Act of 2009, what it was going to do to their health care coverage. And in particular, their concern was a provision in that bill, a provision in that bill that calls for the creation of an exchange, where people who do not have health insurance, maybe they have lost their job and in so doing, have lost the health insurance, or possibly they work for a company. The bottom line is that those seniors that were showing up are very concerned about how you pay for this bill and why the need for the Federal Government to sell health insurance and compete with the private marketplace for the business of these people that don't have insurance. The bill calls for setting up these exchanges where people can go in their State, online typically, and shop for a health insurance policy, and several companies you can think of, my colleagues think of Blue Cross/Blue Shield, or Wellpoint or Cigna or Aetna or any of the insurance companies that have health insurance as part of that product line, and look and see what they offer, what your needs are in regard to your health, what medications you need to be on, and what the coverage is, and who the doctors are, in fact, that accept that particular policy. You know in a community who you want to go to, who you want your wife to go to for obstetrical care, who you want your children to go to for pediatric care, and so you pick and choose. And also you look at the doctors. Do you know them or do they have a good reputation? What they charge for standard obstetrical care or for the removal of an appendix, or for the repair of a fracture. Are they competitive? And that system, ladies and gentlemen, my colleagues in the Chamber, would work very well. And it has worked very well in regard to the prescription drug plan that our Medicare beneficiaries receive now under the prescription drug plan that we passed back in December of 2003, without government interference, without government setting the price control, because if you let the government participate as a competitor on the field--and yet at the same time, they are the referee, they set all the standards in regard to what has to be covered, not just by them, but every insurance offering that's competing in that exchange and what they can charge. So the Federal Government gets a tremendous unfair advantage and eventually what will happen is what the President has promised us repeatedly would not happen. What the President has promised is that if you like the insurance that you have, if you like the health insurance that you have, you can keep it and nobody can take it away from you. Now, that's a pretty bold promise that the President has made. But the fact is in this exchange, where you have a government plan competing, and then you have an administrator of all this called the Health Choices Administrator, not unlike the Social Security Administrator, a very, very powerful new bureaucrat comes along and says to Corporate America, what you are offering in the way of health insurance to your employees, even though they're very happy with it, is not adequate because we have made a decision that it needs to cover X and it needs to cover Y, and it needs to cover Z, and you don't cover one of those three, or you don't cover two of those three. Or this Health Choices Administrator could also say, we have decided that nobody in any one year is going to pay more than a certain amount of deductible or copay, or in the aggregate, out-of-pocket expenses. And we notice, Mr. Employer, that even though the people that work for you are very happy with what they have, many of them have signed up for a very low monthly premium with a fairly high deductible, maybe $4,500, maybe $5,000 a year, but they have this catastrophic coverage so that if they get run over by a truck, or get hurt on their motorcycle, then this catastrophic picks up and they do not end up in bankruptcy. A lot of young people, my colleagues, a lot of young Americans who are healthy; who may be working in their very first job; who are trying to pay for a car; who are paying off a student loan that could be as much as $125,000; who are trying to rent an apartment; who, indeed, may be just trying to pay down on an engagement ring for their fiance, and they are healthy, they take care of themselves, they don't smoke, they don't drink, they exercise, they run marathons, their parents are in great health, no family history of cancer, no family history of diabetes, heart disease, both sets of grandparents are now well into their 90s, they have the Methuselah gene, and we're going to say to them, the Federal Government is going to say to them, this plan that you have that works so well for you is not adequate according to what we have determined. We, Uncle Sugar, we've made a determination that your plan is not adequate, Mr. Employer, and you're just going to have to either put in a whole new policy for these workers or you're going to have to pay a fine of 8 percent of their salary into this exchange. So what happens then eventually all of these people, the Lewin Group estimates that as many as 110 million could lose their coverage even though they like it, and they can end up in this exchange; and pretty soon the government, which is competing in that exchange, will force all of the other competitors out, and you will have that many more people in a government-run Medicare/Medicaid-like program. Now, if that's getting to keep what you like, then maybe you can sell me some oceanfront property in Arizona. My colleagues, it clearly is not what the American people want. And that's what they told us so clearly during these townhall meetings. I mean, I don't know what the President, my colleagues, I don't know what the President was doing during the August break. Maybe he and his family took a little vacation. I hope they did. But I expect that he was watching a little television, but maybe not. Maybe he was himself giving speeches and listening to his own speeches, but not watching these other townhall meetings and seeing these ladies and gentlemen with a little gray around their temple saying what are you about to do to our Medicaid program? What's this business we hear about you cutting Medicaid $500 billion? Mr. President, last year we spent 480 billion on Medicaid. If you're going to cut it 500 billion over the next 10 years, isn't that more than 10 percent a year cut? And under Medicare right now, we know it's a good program, but it doesn't cover catastrophic care; it doesn't give us coverage as far as annual physicals. We have to be sick to go in and get our claim honored under Medicare, unless of course we signed up for Medicare Advantage, which 20 percent of us did. And, oh, by the way, what is this $170 billion cut to Medicare Advantage, a 17 percent per year cut in a very popular program to pay for this idea of insuring everybody when those who are chronically uninsured only amount, my colleagues, to about 5 percent of our total population? Even the President is beginning to admit that. And it would be like saying, you know, I've just found out that the ice maker in my refrigerator has gone on the blink. And I got a little estimate and I went by Sears or Home Depot, and I found out that it's going to cost me about $350 to replace that ice maker. So you know what I think I'll do? I think I'll spend tens of thousands of dollars remodeling my kitchen. I mean, that makes a lot of sense doesn't it? It's kind of like the old adage of throwing the baby out with the bath water. The bottom line is there are so many things that we can do to reform our health care system without going to this single-payer national health insurance program. The President, Mr. Speaker and my colleagues, last night, in the very first few minutes of his speech, he lamented the fact that since the days of Theodore Roosevelt, the early 1900s, that we have not passed meaningful health care reform. And then he referenced who? He referenced two distinguished Members of this body, former Member John Dingell, Sr. from Michigan, current Member John Dingell, who has served in this body for over 50 years, a great Member, former chairman of the Energy and Commerce Committee, now emeritus chairman of the Energy and Commerce Committee. And he said, you know, these two gentlemen, father and son, in every Congress for the last 45 years, I think he said, have introduced this bill to reform our health care system. Well, my colleagues, the President was expressing his great regret that that bill had not passed, and that bill was a single- payer national health insurance program just like Canada, just like the UK. Uncle Sam government bureaucrats running everything. And that's what the President was disappointed in, the fact that we had not passed that. I say thank God we have not passed it, even though we have great respect for these Members. Congressman John Conyers, long-serving Member from Michigan was just on the floor a few minutes ago talking about a very similar bill that he introduces in every Congress. So that's what we're talking about. These are the things that I wanted to discuss with my colleagues this evening. I want to take a little time now to pass the gavel, the mike, if you will, to my friend from Louisiana, Dr. Fleming, and we're going to continue over this hour to discuss this hugely, hugely important issue to the American people. And I yield to Dr. Fleming.

Mr. GINGREY of Georgia. Of course I'll yield.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Madam Speaker, I thank the gentleman from Texas for yielding. It pains me in a way to be on the floor tonight to join with Representative Carter and Representative Westmoreland, my colleague from Georgia who just spoke, and Representative Virginia Foxx, a great Member on our side of the aisle from North Carolina, and the gentleman from Texas, another gentleman from Texas, another judge from Texas, which we will be hearing from in a few minutes. But as painful as it is, Madam Speaker, to discuss a subject of this manner and this magnitude, I think it is important that we do it. I think it is important that we have the courage to do it, because I think the American people are watching what we do. I think that this recent district work period, the month of August, the traditional time when Members are back in the district meeting with their constituents holding these town hall meetings, and this is something that didn't just happen this August, by the way, Madam Speaker, it has been a tradition probably, I don't know, for 100 years. People this year though, while we might typically have 25 or 50 or on a really good day 75 people, it was 500 and 1,000 and 1,500 and it was unbelievable how engaged the American people are now, who want desperately to be heard. Madam Speaker, this business of ``being out of control'' and ``being a gang'' and ``being a mob,'' no, no. They are patriots, is what they are, Madam Speaker. They are mostly seniors who are worried about losing their coverage under Medicare. When they hear, particularly if they are on Medicare Advantage, that that program is going to be cut about 17 percent per year over the next 10 years, I think $170 billion taken out of that one program, where 20 percent of seniors, by the way, like that so much that that is what they choose to receive their health care is Medicare Advantage and not Medicare fee-for-service. So the point I am making is people are outraged. They are so frustrated that powerful Members of Congress are not listening to them. And it is not always their Member, but it is the leadership. It is the committee chairs that have control over significant pieces of legislation, such as the America's Affordable Health Choices Act of 2009, H.R. 3200. They know that Mr. Waxman is chairman of the Energy and Commerce Committee, where most of the bill was written. They know that Representative Charles Rangel from New York, a long-serving Member since 1971, chairs the most powerful Ways and Means Committee. They know that George Miller, the gentleman from California, a long-serving senior Member, chairs the Education and Labor Committee. So they are very frustrated and want to be heard. So here we are talking tonight about grave concerns that we fellow Members have in regard to the ethical standards and behavior of people in this body who are in the highest positions. My goodness, the two most powerful standing committees of the House of Representatives are probably the Appropriations Committee and the Ways and Means Committee. On the one hand, the Appropriations Committee is charged with spending the $3 trillion or so a year in the Federal budget, and the Ways and Means Committee, led by the chairman, is charged with raising the money to fund all these Federal Government programs. People are getting a little concerned and upset with $787 billion stimulus packages and deficit spending in the year 2009 of $1.8 trillion, and a deficit that is calculated, not by me, not by my Republican colleagues, but by the Office of Management and Budget, which is the number cruncher, the Ph.D. economists hired by and who are part of the Obama administration, that says that over the next 10 years there is going to be $9 trillion of deficit in the aggregate, that much more debt, $20 trillion worth of debt at the end of the next 10 years. So people are very concerned about the integrity, the honesty and the fair play of these powerful Members. Our colleague from North Carolina (Ms. Foxx) is so outstanding, and she was talking just a few minutes ago about the Old Testament and Moses and the commands, and she can turn a phrase better than I think most every Member in this body. But, I was reading recently in the Old Testament in the Book of Deuteronomy, and Moses was saying to the Jewish people, look, God gave me these laws to give to you. These are not suggestions, these are commands, and you are not to add to them and you are not to take away from them. You are to follow them exactly as God has commanded and has given that command to me to give to you. Well, you know, that is pretty sacred stuff, the ultimate sacred stuff, I should say. But here in the House of Representatives, the rules of behavior, the standards of official conduct, indeed, the House Committee on Standards of Official Conduct, are pretty darn sacred too, Madam Speaker. And they are not suggestions. They are really there so that every Member is treated fairly, from the least to the greatest, from the freshman Member to the Member that has served 35 years and is chairing one of the most powerful committees in this House of Representatives. So when we see things like this and what Representative Carter has brought out in regard to these new findings of, oops, I just overlooked $600,000 worth of income, it was a stock account that I had forgotten about, well, you know, you don't forget about things like that. You don't forget about it. To make sure, Madam Speaker, that everybody understands, when we have to fill out these financial disclosure reports on an annual basis as required by the standards of official conduct, my chief of staff will come to me and say, Congressman, we need to go through this 401(k), this IRA that you have had when you were working as a physician, and, of course, it is kind of frozen now because you are not continuing to put any money into it, but we have to look at every mutual fund and go through each one and see on each individual stock within a mutual fund, and you may have six or eight or ten different mutual funds in a 401(k) or an IRA, and my chief of staff says to me, Congressman, every stock in this, you have to list whether it gained money or lost money, whether something was bought or something was sold. It is very time-consuming and rather painful, but it is for a good purpose, because the American people want to know, they want to be able to look in a very transparent way. They want to know who are the wealthiest Members of Congress, and they also want to know who are those who have absolutely no assets, no wealth other than their annual salary they receive from the taxpayer from this House of Representatives. It's a point for a lot of people to try to understand that, to follow the dollar and see where maybe influences are applied and why people vote in the way--or if there's any suggestion that someone might cast their vote based on contributions or anything of that sort and that no one is in here enriching themselves at the expense of John Q. Public who is struggling every day just to maintain a job and to feed his family and support his children and hope that they get to go to college some day. And unfortunately, in this deep recession that we're in, some 6 million have lost their jobs over the last couple of years. So this is a very, very serious issue that Judge Carter, Madam Speaker, brings before us, and I think that the gentleman from New York who chairs this powerful committee should step aside while the House Committee on Standards of Official Conduct is doing its investigation. Now, to his credit, he asked the committee to look into this over a year ago. But, Madam Speaker, I feel that he should have stepped aside at that point. But now here we are a year later and all of a sudden this additional ``Oops, I forgot.'' Well, you know, if he won't voluntarily do this, then I think it's the responsibility of the leadership, and ultimately the leadership of this body, Madam Speaker, as you know, is the Speaker whose seat you're sitting in right now as her designee this evening. And she will be there tomorrow night sitting right beside the President of the Senate, the gentleman from Delaware, Mr. Biden, and of course we will be hearing from President Obama. We don't want this body, this House, this Chamber to be tainted. And I think it's time for the gentleman from New York to be strong. Maybe he will be found to have not violated any ethical rules of this Chamber. We're not certainly putting him on trial here tonight, and I'm sure my colleagues would agree with that, but I think it's the right thing to do. I think it's courageous for Judge Carter to bring this forward. And none of us are perfect, but every one of us needs to be honest with the American people and explain our actions or have others who are officially designated to do that look into it and let's get to the bottom of it. With that, I will yield back to my friend from Texas.

Mr. GINGREY of Georgia. If the gentleman would yield for just a second.

Mr. GINGREY of Georgia. You've hit on a point I've got to address. The President spoke to the American schoolchildren today, and I think the President did a fine job. The speech, I know early on there may have been concerns about curriculum recommendations, that sort of thing, but I heard the Secretary of Education over the weekend, Secretary Arne Duncan, talk about this upcoming speech, and I couldn't agree more with what he said on Sunday morning; very logical, made sense to me. And the President, of course, gave a very powerful speech to America's schoolchildren and taught just what Judge Carter just mentioned about personal responsibility and doing the right thing even when it's tough, even when it's hard to do that. And golly, if our leaders in the highest positions of our country can't do that, how can we expect kids in the fifth grade to do it? How can I expect my 11-year-old twin granddaughters who are in the fourth grade--and I talk to them all the time about the personal responsibility of going a little beyond what's required, doing more, getting up earlier if you need to to do your homework, turn that television off at night or that video game. The President said the same thing, and I commend him for that. But he's talking to all of us, Madam Speaker, about personal responsibility and doing the right thing. You know, I don't know--and I will yield back quickly, Judge. But it may be that the gentleman from New York, the chairman of the Ways and Means Committee, wishes his boss, the Speaker of this House, would ask him to temporarily step aside while this investigation was ongoing. Maybe he doesn't want to do it himself. He's a World War II veteran, a Korean war veteran, in fact, a hero. I read part of his book. As has been mentioned here earlier, he's a very likable individual, without question. You can understand how he keeps getting reelected with such overwhelming majorities. But he may, as a soldier, as a hero, he may feel that, gosh, you know, I don't want to be the one to step aside, but I sure wish my boss would tell me to step aside. So, as you point out, there are two people here that have a responsibility. And I'm glad you brought that up, because that's--I mean, you know, it was Harry Truman, a Democratic President, back in 1948 or so, who says, Hey the buck stops on my desk. Well, the buck stops on the Speaker of the House of Representatives' desk in regard to this issue. I yield back.

Mr. GINGREY of Georgia

Mr. GINGREY of Georgia. Madam Speaker, I submit the following: [From the Marietta Daily Journal, July 28, 2009] What Happened to Medical Charity of Years Past? (By Cecil Toole, MD (Ret.)) Re Bill Kinney column, ``Cobb's sick getting well, thanks to Good Samaritan,'' July 19 MDJ In 1961 or 1962, I met the original ``Good Samaritans'' of Marietta and Cobb County, when I joined their group as a visiting resident in obstetrics from Piedmont Hospital in Atlanta. All of them were on the staff of a forgotten Kennestone Hospital in Marietta, where they conducted many free pre-natal clinics, free medicines for eligible patients, and free deliveries for those same patients in a hospital that agreed to not charge ``clinic patients'' for hospital service. Those mysterious and economically foolish services were done by charitable doctors such as Dr. Meaders, Dr. Reilly, Drs. George and Murl Hagood, Dr. Remer Clark, Dr. Colquitt, Dr. Mussara, Dr. Pete Inglis, Dr. Mainor, Dr. Parker, Dr. W.H. Perkinson, Dr. Looper, Dr. Clingbell, Dr. Stafford, Dr. Mitchell, Dr. McClure and Dr. Clonts, to name a few, without ever sending a bill to their ``clinic patient.'' Ineligible patients might be sent a bill through a collection agency. (And by the way: the IRS never-ever allowed such ``charity'' done by those same doctors, to be deducted.'') I was fascinated to learn how those doctors survived Economics 101 when none of their clinic patients needed, or carried, ``affordable health insurance.'' At Piedmont Hospital where I was a resident, the hospital took care of all of the hospital expenses of the unwed mothers from the Florence Crittenden Home. I was also told that none of them had ``health-insurance.'' I can tell you this. As far as the TLC (Tender Loving Care) given to the ``clinic-patients'' and the ``private patients,'' the treatment from the staff and the nurses was identical. The care was always excellent. I hope if you ever get to meet the genius who invented ``affordable health care,'' that you will remember to ask this question, ``Does charity have a place in today's health- care?'' The ``Obama Bidens'' don't want, or need, your charity. They insist on asking everybody, including the jobless, the helpless and the hopeless, to pay cash for their own ``health-care'' even if the cash has to be a personal loan from the government. Just to show their good intentions, if those indigent groups can't repay their ``medical care'' loans, the great socialist government will identify and prosecute them, for the crime of ``unpaid debts.'' Aren't medical science and ``health-care,'' when mixed with Socialism, wonderful?