Sander Levin

Mr. LEVIN

Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, on that I demand the yeas and nays.

Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I continue to reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I yield myself the balance of my time. There is no one that questions the importance of this industry--no one. This country has been in the forefront in terms of creating medical devices. There has been innovation and there has been enterprise, and it has impacted the lives of millions of people. That is not the issue here. The issue is this. A number of industries and a number of providers participated in creating the Health Care Reform Act. Essentially, I am not sure it is the industry as much as some Members are essentially coming here and saying: Give this industry a free ride in terms of their participation, while others are doing their part. That isn't fair; it isn't workable; and it is also fiscally irresponsible. I would like to talk to the CEOs of any of these companies and ask them if they think it is fiscally responsible to repeal this provision costing well over $20 billion, unpaid for, made permanent. Indeed, this is industry joined with others in the healthcare world in this country in a letter of May 11, 2009, to the President: Dear Mr. President, We believe that all Americans should have access to affordable, high-quality healthcare services. Thus, we applaud your strong commitment to reforming our Nation's healthcare system. The times demand and the Nation expects that we, as healthcare leaders, work with you to reform the healthcare system. And it concludes with this paragraph: We, as stakeholder representatives, are committed to doing our part to make reform a reality in order to make the system more affordable and effective for patients and purchasers. We stand ready to work with you to accomplish this goal. And it was signed by a number of representatives--the AMA; America's Health Insurance Plans, their leadership; the Pharmaceutical Research and Manufacturers; et cetera, and also signed by the president and CEO of the Advanced Medical Technology Association. So now people are coming here and saying what was essentially committed to in 2009 should essentially be ripped out of ACA in 2015. I just want to read from a report by the National Center for Health Research. And I refer, for example, to the chart on the number of employees at the 12 largest U.S.-based device companies. All of them show an increase in employment of the 12 largest, except two, and in one case, the reduction was from 10,800 to 10,500. One company did have a larger loss, but it wasn't anything close to catastrophic. Then the number of employees at the small, publicly traded device companies--one, two, three, four, five, six, seven, eight, nine--of those, only seven show a reduction in the number of employees from 2012 to 2014. In one of them, there was a reduction of one, and the other, a reduction of four employees. And then there is another with a reduction of four, and another, a reduction of six. The others had increases in their employment, and two of them, one went from 230 to 320, and another from 244 to 303. These are the smallest. Let me also refer in this document to stock prices for the 12 largest U.S.-based device companies. When you look down at the profit margin, all of their profits went up except one, which had a reduction of 1.6 percent from the close of January 2, 2013, to the close of January 2, 2015. That reduction was tiny. The others had a very substantial reduction, some in the twenties, one in the thirties, and the average was a 13.8 percent increase in the profit margin. Also, this report reads: Similarly, the report on 2013 employment, released by a financial analysis news service, EP Vantage, showed that 11 of the top 15 device makers expanded their workforce after the device tax went into effect. I think what is happening here is that a few of my colleagues are coming here and are using a few examples--and I don't deny, in a capitalist system, there are some losers as well as winners. Everybody isn't necessarily a winner, and there was a recession in this country during some of these years, but to come here and to use those examples that really are refuted by the overall data, I think, is essentially saying that we ought to begin, on this point, to rip apart the ACA because, in every case, there hasn't been an improvement for every company. In terms of research and development, the Ernst & Young report makes it very clear that spending by the industry increased by 6 percent in the same year. I am just asking everybody who cares about healthcare reform and who cares about the overall picture here in the United States to resist the temptation to take several examples, perhaps, from their own districts, to draw conclusions about what really has happened in the medical device industry and to, essentially, come forth because of those relatively few examples and say that we should now, essentially, repeal this provision, costing well over $20 billion--unpaid for--permanently. That is not only contrary to the letter I read, but it is contrary to fairness within the healthcare industry, and it is really unfair to the millions of people who have benefited from the ACA when the motive, really, of so many of the Republicans who come here is not to simply repeal this tax, but it is part of an effort to, essentially, repeal the ACA altogether. We should resist that. The people of this country do not want that repeal, so let's vote ``no''--and a resounding ``no''--on this proposal. May 11, 2009. The President, The White House, Washington, DC. Dear Mr. President: We believe that all Americans should have access to affordable, high quality health care services. Thus, we applaud your strong commitment to reforming our nation's health care system. The times demand and the nation expects that we, as health care leaders, work with you to reform the health care system. The annual growth in national health expenditures-- including public and private spending--is projected by government actuaries to average 6.2% through the next decade. At that rate, the percent of gross domestic product spent on health care would increase from 17.6% this year to 20.3% in 2018--higher than any other country in the world. We are determined to work together to provide quality, affordable coverage and access for every American. It is critical, however, that health reform also enhance quality, improve the overall health of the population, and reduce cost growth. We believe that the proper approach to achieve and sustain reduced cost growth is one that will: improve the population's health; continuously improve quality; encourage the advancement of medical treatments, approaches, and science; streamline administration; and encourage efficient care delivery based on evidence and best practice. To achieve all of these goals, we have joined together in an unprecedented effort, as private sector stakeholders-- physicians, hospitals, other health care workers, payors, suppliers, manufacturers, and organized labor--to offer concrete initiatives that will transform the health care system. As restructuring takes hold and the population's health improves over the coming decade, we will do our part to achieve your Administration's goal of decreasing by 1.5 percentage points the annual health care spending growth rate--saving $2 trillion or more. This represents more than a 20% reduction in the projected rate of growth. We believe this approach can be highly successful and can help the nation to achieve the reform goals we all share. To respond to this challenge, we are developing consensus proposals to reduce the rate of increase in future health and insurance costs through changes made in all sectors of the health care system. We are committed to taking action in public-private partnership to create a more stable and sustainable health care system that will achieve billions in savings through: Implementing proposals in all sectors of the health care system, focusing on administrative simplification, standardization, and transparency that supports effective markets; Reducing over-use and under-use of health care by aligning quality and efficiency incentives among providers across the continuum of care so that physicians, hospitals, and other health care providers are encouraged and enabled to work together towards the highest standards of quality and efficiency; Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies; and, Reducing the cost of doing business by addressing cost drivers in each sector and through common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms. These and other reforms will make our health care system stronger and more sustainable. However, there are many important factors driving health care costs that are beyond the control of the delivery system alone. Billions in savings can be achieved through a large-scale national effort of health promotion and disease prevention to reduce the prevalence of chronic disease and poor health status, which leads to unnecessary sickness and higher health costs. Reform should include a specific focus on obesity prevention commensurate with the scale of the problem. These initiatives are crucial to transform health care in America and to achieve our goal of reducing the rate of growth in health costs. We, as stakeholder representatives, are committed to doing our part to make reform a reality in order to make the system more affordable and effective for patients and purchasers. We stand ready to work with you to accomplish this goal. Sincerely, Stephen J. Ubl, President and CEO, Advanced Medical Technology Association. Karen Ignagni, President and CEO, America's Health Insurance Plans. Rich Umbdenstock, President and CEO, American Hospital Association. J. James Rohack, MD, President-elect American Medical Association. Billy Tauzin, President and CEO, Pharmaceutical Research and Manufacturers of America. Dennis Rivera, Chair, SEIU Healthcare, Service Employees International Union.

Mr. LEVIN. I yield back the balance of my time.

Mr. LEVIN

Mr. LEVIN. Mr. Speaker, I yield 1 minute to the gentleman from Rhode Island (Mr. Cicilline).

Mr. LEVIN. I yield 1 minute to the gentleman from Minnesota (Mr. Ellison).

Mr. LEVIN

Mr. LEVIN. Mr. Speaker, I demand a recorded vote.

Mr. LEVIN. Mr. Speaker, I demand a recorded vote.

Mr. LEVIN. Mr. Speaker, could the Clerk read what the motion is?

Mr. LEVIN. Mr. Speaker, I demand a recorded vote.

Mr. LEVIN

Mr. LEVIN. Mr. Speaker, I demand a recorded vote.

Mr. LEVIN

Mr. LEVIN. Mr. Speaker, I reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I yield myself such time as I may consume. I have worked in all my years here to expand trade in ways that spread its benefits to the many, not just to the few. Charlie Rangel and I led the fight to include strong and enforceable labor and environmental positions and to strike the right balance between innovation and access to medicines in the historic May 10 agreement of 2007. The trouble with this TPA is that it means no meaningful provisions whatsoever in TPP on currency manipulation, which has destroyed millions of middle class American jobs and allows investors to challenge American health and environmental regulations and others, not through the American legal system but through unregulated arbitration panels. It is about a TPP going in the wrong direction in access to medicines and, in some important ways, on environmental protections; and it is about countries like Mexico that deny their workers basic labor rights to gain an uncompetitive advantage over our companies and workers. It is about Vietnam and Malaysia, which stand in clear violation of the May 10 provisions on international workers' rights, with no plan we know of. In that sense, it is secret of a TPP to change that, far from a progressive trade agreement. On this and every other area of the TPP, there are only vague negotiating objectives left to be determined whether they were met by those who did the negotiating. I just want to say these negotiating objectives are so vague that they are meaningless, and to hold them up as something that holds USTR to action is simply a mirage. Instead of passing this bill, which gives a blank check to the administration to finish up TPP negotiations where they are now and leaves Congress with only an up-or-down vote at the end, we should be using our leverage to impact the negotiations. This bill does not do that. We in Congress, despite all of the rhetoric, will be in the back seat, not in the falsely claimed driver's seat. That is what this is all about, not protectionism versus free trade, not reflective opposition as is sometimes claimed to expanded trade. I have worked for expanded trade. It is quite the opposite. I want a TPP that is worthy of broad bipartisan support. As to TAA and proponents of TPA, they are the ones who have linked the two together in a single bill. TAA should not be a bargaining chip to get a deeply flawed TPA across the finish line, and that is how this has been set up. This TPA should stand on its own feet. Even in its best form, TAA was a modest program, and I was one of the authors supporting it, but this TAA bill includes a number of shortcomings compared to the high watermark of the program. Despite the fact that the need in this country is growing and trade is expanding, the truth of the matter is we need to do far more to train and educate our workers and to invest in our future in order to compete in a global economy. A ``no'' vote will give us another opportunity to improve TAA and TPA and to achieve our ultimate goal for which I and others have been working for months and months and months and months, and that is the goal: a strong TPP agreement that can gain broad, bipartisan support. I reserve the balance of my time.

Mr. LEVIN. Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Doggett).

Mr. LEVIN. Mr. Speaker, I yield 2 minutes to the gentleman from Wisconsin (Mr. Kind), a member of our committee.

Mr. LEVIN

Mr. LEVIN. Mr. Speaker, it is now my pleasure to yield 1\1/2\ minutes to the gentleman from Georgia (Mr. Lewis), a member of our committee, the most distinguished Member from Georgia--or I should say the very distinguished Member.

Mr. LEVIN. I yield the gentleman an additional 15 seconds.

Mr. LEVIN. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Illinois (Mr. Danny K. Davis), a member of our committee.

Mr. LEVIN. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman from California (Ms. Linda T. Sanchez), another valued member of our committee.