John Garamendi

Mr. GARAMENDI

Mr. GARAMENDI. Please.

Mr. GARAMENDI. That has not been discussed. In every part of America, people need to know about the enormous increase in the community clinics that will be available. That's in the legislation. It costs money, but it saves money because, once again, people will be able to get care early.

Mr. GARAMENDI. Let's just continue on here. We talked about prescription drugs. It's not only the doughnut hole, but there are certain kinds of generic prescription drugs that would also benefit as a result of this legislation and, of course, the doughnut hole issue, which we've discussed here in some detail. The doughnut hole is squeezed shut, and initially, this last year, $250. Now, I don't imagine the repeal would force the seniors to refund the $250 check they had. Nonetheless, that doughnut hole would remain wide open if the repeal were to take place. We've talked about the improvement of the quality of senior care, and both of my colleagues here have spoken to this, I think, very correctly. Preventative care. Now, we talked a moment ago about high blood pressure--clearly, the silent killer and a major problem for seniors. Okay. You're going to get, free of charge, an annual blood pressure test. You know, it's very simple, very cheap, and the drugs to treat high blood pressure are cheap also, but the cost of not treating it is extraordinary. There is another one that affects not only seniors but others around this Nation, and that is diabetes. This is an enormous cost. It can be treated. It can be taken care of, but if you ignore it, you are in for a world of harm and a very, very great expense to all of the people, including, in this case, to the taxpayers. This is an interesting one. Primary care doctors. Nobody has really talked about this much on the floor, but in the legislation, there is a significant increase in medical education opportunities, not only for doctors but also for others in primary care--nurse practitioners, physician assistants, and nurses. There is an enormous increase. This one happens to be really, really important to me. Our daughter graduated from medical school just 3 days ago, and we go, Yes. She says, I want to do primary care. I'm going, Terrific. How about geriatric care?--my wife and I are looking to the future here. This is really important. She has an opportunity under this piece of legislation, as do all other primary care doctors who choose to serve in underserved areas--and she may very well decide to do that--to have their medical loans reduced as they provide service in underserved areas, and some of those underserved areas are in our urban communities. Now, that brought Mr. Cohen to his feet and Mr. Pallone, so please share, gentlemen.

Mr. GARAMENDI. If you will yield for a moment, there is a place where the bill can be read, the Web site www.healthcare.gov. It gives the bill. It gives a detailed description of every item in the bill. We have only talked about maybe one-third of the bill here today, and maybe we will go into some of the other parts. It also talks about the timeline in which the various elements of the bill will go into effect. For example, the senior population: The doughnut hole begins to close. Last year a $250 rebate check to those seniors who are in the doughnut hole, and then, in the next 8 years, that doughnut hole is squeezed shut. And, as Mr. Pallone said earlier, seniors would then have all of their prescriptions covered. It also shrinks the cost of prescription drugs. That wasn't talked about here earlier today. And if they want to read the bill, they can talk about the coverage options in every part of America--in California, Tennessee, New Jersey, wherever--and specific detail about seniors, about women, those kinds of pieces of information: www.healthcare.gov. You want to read the bill? You want to understand it? I would suggest that our colleagues on the other side, the Republicans, take a look at the bill, itself, and what it does. Please continue, Mr. Cohen.

Mr. GARAMENDI. You are quite correct. It is some very simple things which I think all Americans understand. Blood pressure, high blood pressure, the silent killer, people don't know that they have high blood pressure until they get the stroke. And then if they survive, they may very well be paralyzed or incapacitated the rest of their life and take an enormous expenditure every day, every month, every year caring for them in a nursing home or in an extended care situation. That is a very simple thing to understand. And this piece of legislation provides free preventive care for seniors. Is that what they really want to repeal, that free preventive care for seniors where most high blood pressure cases are found and where most strokes are found? It is a preventive cost.

Mr. GARAMENDI. In Tennessee, the property tax base. In California, the general tax base and the Federal Government. Here is the clincher: every health insurance policy in the Nation pays for the uninsured. So we have health care coverage. In fact, this law requires that the three of us and all 435 Members of Congress and 100 Members of the Senate will get the exact same kind of insurance that every American gets. We don't get a special deal. In fact, we get to pay for part of it ourselves. That is a fact. So what about those people that are out there uninsured that get sick. We get to pay for it through our health insurance policies because that cost is shifted over to us, the taxpayer. There is no free lunch here. The question we have is should everybody participate in this insurance pool. I think it is only fair to say that we all participate. I don't know what I said, Mr. Pallone, that made you come to your feet, but please proceed.

Mr. GARAMENDI. Mr. Cohen, thank you very much. You pointed out the nature of the debate taking place on the floor. I listened to much of the debate this afternoon as it was going on, and tomorrow it is probably going to be the same. Like you, I was surprised and in many cases disappointed with the rhetoric that I heard. It simply wasn't based on fact. They talked about the government takeover of health care. You used the word ``big lie.'' Well, in fact it is not going to happen. This is not the government takeover of health care. There are many who said we simply should take Medicare and expand it to all. Now that is a program that is government collection of the money, but the services are provided by individual doctors, hospitals, and other provider groups. It is not a government takeover; it is a government finance program. You mentioned the uninsured. Actually, it is about 42 million uninsured in America. They get sick. Who pays for them when they go to the emergency room? They don't have an insurance policy. They are certainly not going to be able to afford the cost of an emergency room and any procedure. Those people who are uninsured do get sick. They do go to the emergency room, and they do get medical care. And who pays, the taxpayer.

Mr. GARAMENDI. That is similar in every district, Republican or Democrat, across the Nation. The number of small businesses may vary district to district, but the point is that every small business has an opportunity to reduce by more than one-third the cost of health care by simply providing health care. And that will grow to 50 percent in just 3 years. It climbs up 35 and then 50 percent in 2014. And in 2014, every State will have an exchange, an insurance marketplace, where small businesses, individuals, can buy health insurance on a marketplace that talks about the quality and the cost so there is competition. Once again, why would you want to repeal that, where individuals can shop for health insurance in a competitive market? We talk about competition here. Well, let's let it happen. Right now it doesn't really occur because many insurance companies don't compete. There are many, many aspects of this. I notice that our friend from the great State of Tennessee has joined us. Mr. Cohen, if you will, what is going on in Tennessee? Do they want to repeal this? Do they really want to do away with the patients' bill of rights? The preventative care that seniors are able to get under this bill? The closing of the doughnut hole? Is that what the Tennessee folks want?

Mr. GARAMENDI. Thank you very much, Mr. Pallone. If it's about jobs, then why are we doing all of this? It's interesting to note, and I heard this debate earlier on the floor here, that this is a job crusher, to be politically correct now, and that businesses are going to lose jobs, when in fact since the bill became law, over 932,000 private sector jobs have been created. So there's no evidence in the large job market that this legislation, the health care reform, has harmed jobs, crushed jobs. It hasn't happened. In fact nearly a million new jobs have been created; 932,000. In addition to that, this is an extremely important bill for small businesses. This bill, as you said, actually subsidizes the cost of health care for small businesses. If you have less than 50 employees, you can get a subsidy, up to 35 percent, for buying health care for your employees. And if you don't want to buy health care, you don't have to if you have less than 50 employees. I don't understand this debate about small businesses being harmed. In fact, the Kaiser Family Foundation has shown that in the last year, probably as a result of this bill--that's their conclusion--the number of small businesses providing health insurance has grown from 46 percent to 59 percent.

Mr. GARAMENDI. Crush. Crush jobs.

Mr. GARAMENDI. Mr. Speaker, thank you for this opportunity to discuss health care this evening. But before I get to health care, I was notified early this afternoon that a unique, iconic American had died today; Sargent Shriver is no longer with us. This individual has had an impact on America and the world around us that will last for centuries. He literally created the United States Peace Corps. The idea was developed by him and his brother-in-law, JFK, and put into effect in the first year of the Jack Kennedy administration. Thousands, indeed over nearly 200,000 Americans, have joined the Peace Corps in the ensuing years. For my wife and I, it changed our life; it changed the path upon which we have traveled. We were the third iteration of the Peace Corps back in the 1960s. We were sent to Ethiopia. We served in a village out in the boondocks of southwestern Ethiopia, and it put in place in our lives the vision that we could and should continue to serve. We are not alone. Thousands upon thousands of Americans, those that were in the Peace Corps and those that were affected by the Peace Corps here in this Nation, found that same mission of being a life of service. In the 1990s, Sargent Shriver returned once again to assist the Peace Corps as the Clinton administration undertook the rebuilding and expansion of the Peace Corps. My wife was then working at the Peace Corps as the associate director, and together they and the other staff opened the Peace Corps to the former Soviet Union nations, Eastern Europe and beyond and also to South Africa. It was a period of growth, and once again it was a period in which the Shriver enthusiasm and the Shriver determination to reach out to everyone in this world so that they could have a better life created these opportunities. We mourn his passage. Our prayers go out to his family and to remind all of us that we too in any way possible should be serving our fellow man. Sergeant Shriver, we miss you and we know that America and millions of people around the world that were affected by your programs will miss you also. Let me now turn to another issue that affects every American, their well being, their lives, their ability to get the care that they need when they have health care problems. On this floor today we began the debate of the repeal of the Affordable Health Care Act, an extraordinary law that will affect each and every one of us in this Nation; and as it affects us, it will also affect people around the world because this law will help America finally join the other industrialized nations in the world and provide health care to all of our people, not just those who are fortunate enough to be employed by an employer who has found it useful, wise or even correct to provide health care for their employees, but for those individuals that are not so fortunate to be with an employer that does not provide health care, and for those who are unemployed. This is an extremely important debate going on here on the floor of the House. It's a debate about all of our lives. It was estimated before this law went into effect that some 30,000 to 40,000 Americans every year lost their lives because they did not have health care. It was too late for them to get their blood pressure under control. It was too late for them to deal with their diabetic situation or their cancer had run its course so that it was not treatable, 30,000 to 40,000 Americans every year. That is not the way America should be. We should be providing insurance to all Americans. On the floor today, the debate commenced, and I was pleased and a bit curious to hear my colleagues on the Republican side talk about repeal and replace. And as they talked about what they would replace, I began to say, Excuse me. Wait a minute. What you're replacing is already the law in America. The health care bill that became law this year deals with every American from birth through their school years, through their years of building a family, in their employment and through their retirement. It deals with the entire cycle of life by providing the opportunity for health insurance, improved health insurance, at every stage of life. Let me show you how that works. It's the Patient's Bill of Rights, which apparently our Republican colleagues want to repeal. The Patient's Bill of Rights is a fundamental reform of the insurance industry. I was insurance commissioner for 8 years in California, and I understand the insurance industry very, very well. And it's about profit. All too often, the health insurance industry puts profit before people. In doing so, they deny coverage. The Patient's Bill of Rights goes directly to this issue of insurance companies putting profit before people. Let me show you where this works. Children. My very first speech here on the floor as the health care debate came up in 2009, in November of 2009, I spoke to an individual, a friend of ours who lives here in Washington, whose child was born with a very serious kidney problem. The mother was covered by insurance through the pregnancy and through the delivery. The moment it was discovered that that child had this preexisting kidney ailment, they dropped the coverage on the child. The family struggled and continues to struggle to provide care for that child, limping along trying to get the money together for the next procedure to provide the services that are necessary--the transplant. All of those things should have been covered by insurance, but with the insurance company putting profit before people, they denied that child coverage. The Patient's Bill of Rights stops that and says that every child has a right to coverage, no longer the kind of discrimination that took place here with my friend's family. Secondly, young adults. I happen to have had six young adults. All of them have passed through the age 23, and that period where their coverage stopped was the scary time for us in our family, and it is for every other family in America. At the age of 23, insurance companies were allowed to drop patients' coverage. And if you're a 23-year-old and you have any kind of a preexisting condition, you're out of luck. The Patient's Bill of Rights guarantees that that young woman or man will be able to get coverage until the age of 26. And if they have a preexisting condition, that can no longer be a reason to deny coverage. The Patient's Bill of Rights would be repealed by the piece of legislation that will be brought to this floor tomorrow. If you are a woman, you have a preexisting condition. It is called being a female. And routinely--and I've seen this during my tenure as insurance commissioner. Routinely, the insurance companies would deny coverage because you are a woman and you might get pregnant or you might have any number of conditions. That will no longer be the case. If you happen to have cancer, you cannot be denied coverage. The Patient's Bill of Rights protects every single American when it comes to getting insurance and keeping insurance. Many other provisions are in this bill, and I find it astounding that our colleagues on the Republican side would repeal the Patient's Bill of Rights and literally open every single American up to the gross discrimination that the insurance companies have foisted upon Americans for decades putting profits before people. There are many other parts of the Patient's Bill of Rights, but I want to just take a moment and invite to this conversation my colleague from the great State of New Jersey, Frank Pallone, who has been fighting this fight for decades both as a Member of Congress and as a concerned citizen. Mr. Pallone, if you will join with us, share with us your thoughts and your experiences, and we will continue on with this discussion. I yield.

Mr. GARAMENDI. So it pushes it back to 2023.

Mr. GARAMENDI. Well, I will do my best, and along the way, if my colleagues would join in on any one of these issues, I'd appreciate it. Health care reform means security and stability for America's seniors. First of all, despite all the rhetoric on the floor, this legislation actually improves the financial status of Medicare. It extends the solvency of Medicare, I think, by almost a decade.

Mr. GARAMENDI. Mr. Pallone.

Mr. GARAMENDI. Last week, on this floor, many of us tried to put an amendment on this piece of legislation that would read: If the repeal occurs, then every Member of Congress would lose his health care, keeping in mind that 31 million Americans will not have health insurance if the repeal takes place. So, 435 of us. If the bill is repealed, we should join the 31 million Americans who will not have health insurance if the bill is repealed. It seems to be the least we could do. If we want to harm 31 million Americans, if we want to take away the insurance from 31 million Americans, then, surely, 435 of us should be willing to go without insurance also. It turns out that not one Republican voted for that amendment. I wonder why. They want something that they are going to deny to 31 million Americans.

Mr. GARAMENDI. Mr. Cohen.

Mr. GARAMENDI

Mr. GARAMENDI. Madam Speaker, this is the most remarkable of all Chambers where discussions take place, because in this Chamber if you say something that is not true, often enough somebody will believe that it's actually true. What I have heard today on the floor I am just going, well, that's a marvelous thing, when in fact our colleagues on the Republican side want to enact reforms that are already in place. Already in place is the Patients' Bill of Rights. No rescisions. No preexisting conditions. Children being able to stay, or young adults being able to stay on their parents' policies until the age of 26. They say they want it--it's already the law of America. Wow. What are we going to repeal? You are going to repeal that? You want small businesses to be well taken care of? Well, so do we. That's why, if you employ less than 50 people as a small business you don't have any requirements at all. But if you want to provide health insurance to your employees, wow, the government's going to give you a subsidy, 35 percent now, building to 50 percent in the years ahead. What's wrong with that? Where's the harm to small business? What in the world are our colleagues talking about here? I don't get it. It's in the law already. Everything I have heard here in the last half hour is the law of America. So why are you repealing it? So you can have the insurance companies get another shot at taking over the care of patients, which is exactly what they do, and exactly what I know because I was the insurance commissioner for 8 years in California, and I know what the insurance companies do. They are the ones that make the decisions. We don't want that to happen. That's why the Patients' Bill of Rights is the law in America today. The Patients' Bill of Rights would be repealed by this H.R. 2. Not good for Americans. Not good. Some 30 million people would lose their opportunity for insurance.

Mr. GARAMENDI

Mr. GARAMENDI. Madam Speaker, on behalf of the men and women of the 10th Congressional District, I rise in support of this resolution and bring to this floor their condolences and prayers for the six who were murdered in Tucson and for Gabby and for her speedy recovery. Patti and I send along our own special prayers and condolences. For those of us that have had the privilege of working with Gabrielle, I add my own special thoughts. I came to the Committee on Science and Technology where she was the chairwoman of the Subcommittee on Space and immediately saw her incredible intelligence, her charm and wit as she conducted numerous hearings, and came to understand her commitment to America's science and technology and space as she led our committee to the reauthorization of the NASA programs. I look forward to her speedy recovery and her return to this floor, where she can once again provide her talents and her leadership as she would once again lead us in our efforts to bring about a better understanding, not only of the space and this role of our planet in the cosmos, but also our own personal understanding to each other and to our constituents. It was a sad day on Saturday, and it will be a bright future when Gabrielle returns to this floor.

Mr. GARAMENDI

Mr. GARAMENDI. Thank you. There is a lot of talk here on the floor about job killers. Actually this bill, the affordable health care bill, creates some 400,000 jobs. The repeal of it is actually a killer of human beings. Some 40,000 Americans die every year for lack of health insurance. That's the reality. Repeal this bill and you're going to find more Americans dying. Also, you're doing away, with this repeal of the Affordable Health Care Act, of the patients' bill of rights. I was the insurance commissioner in California. I know exactly what the insurance companies will do if this repeal goes forward. They will continue to rescind policies. They will continue to deny coverage. They will continue to make sure that those 23-year-old children that have graduated from college will no longer be able to be on their parents' policies. This repeal is perhaps the worst thing you can do to Americans in their health care. Besides that, you will significantly increase the deficit, by $230 billion.

Mr. GARAMENDI

Mr. GARAMENDI. We are going to wrap this one up. I see the gentleman from Kentucky is here and he will probably carry on with health insurance. Maybe a couple of us will be asked to join him. We have really today focused on a broad range of issues: The patients' bill of rights; the way in which the repeal would harm individuals who have preexisting conditions; young children from infancy; the 23- to 26-year-old coverage. We also discussed a little bit about how this affects business and, of course, we went into some detail about senior citizens. All of these are critically important issues. We will be discussing these in the days ahead. I do hope the American public will really pay attention, because this next week, particularly as we move towards Wednesday, is going to be absolutely critical to the American people. It's a question about will all of us in America be able to get health care coverage that is affordable and provides us with the opportunity to have the health care that we need. Mr. Speaker, I yield back the balance of my time.

Mr. GARAMENDI. We have about, maybe 3 minutes, 4 minutes, and I am going to turn now to the gentleman from Tennessee (Mr. Cohen).

Mr. GARAMENDI. The other countries of the world don't look at it that way. They look at it as a right for their citizens to have access to health care, and they provide the health insurance. There are different ways of doing it. Germany, France, Britain, Canada all do it differently, but they all do it. Incidentally, the health statistics in all of those countries are considerably better than America, and America is placed at the bottom of the industrialized countries in terms of our health care, how healthy we are, how long we live, how sick we get. We are at the bottom. In fact, we are often with developing countries in the statistics. We spend almost twice as much as any of those other countries. So the Affordable Health Care Act goes after many, many things beyond the Patients Bill of Rights and the senior issues. Thank you so very much for raising that issue. We have about maybe 10 more minutes. Mr. Pallone.

Mr. GARAMENDI. Well, I think you are asking me a rhetorical question, because you know the answer and I think most Americans know the answer, that all the industrialized nations--we are not talking about China, but we are talking about Korea, Japan, the European countries, the European Union. All of those countries provide universal health insurance coverage. Universal. Everyone, including tourists who happen to show up--and this I know from one of my daughters who fell off a stair at the Leaning Tower of Pisa. She fell, went into an emergency room, they took an MRI, bandaged her up, and said, ``Get out of here.'' And she said, ``Well, I haven't paid.'' ``Well, you are covered.'' That was in Italy.

Mr. GARAMENDI. Well, I'm not sure I heard your question, so please say it again.

Mr. GARAMENDI. You mentioned the doughnut hole, the prescription drug doughnut hole. Every senior that was in the prescription drug doughnut hole last year, 2010, received a $250 check to help them pay for their drugs. In going forward, the doughnut hole will be lessened and lessened, and eventually, 9 years from now, will disappear. There will be no doughnut hole. You talked about the quality of care. Extremely important, quality of care. Thank you for bringing that up. More primary doctors, more geriatric care from nurses and doctors, an extraordinary important part of the legislation, not just only for seniors. You also mentioned the community-based and of course the preventative care. All of these things are there, and all of them will disappear if the Republicans are successful with their legislation next Wednesday that will be brought to this floor without one hearing to discuss any of these issues in a relevant policy committee. Mr. Cohen, please join us.