Tim Ryan

Mr. RYAN of Ohio

Mr. RYAN of Ohio. One percent of cost. And there is no real way to quantify--reclaiming my time--no real way to quantify this number. But when you're talking about billions and billions and billions of dollars, again, that's to my point, is that the Republican plan is to just kind of nibble around the edges and maybe we'll try to do this a little bit here and a little bit there, but at the end of the day here's the reality. Since we have gotten in office and with President Obama, but before that, we took on the banks and yanked them out of the student loan business because they had a sweetheart deal. As you said, with Medicare part D, where all of this money is going to the pharmaceutical companies, we are reforming that provision as well. Now we're taking on the insurance companies. With the energy bill, we took on the oil companies, where they're getting subsidies. And just a couple of years ago we spent $115 or $120 billion dollars in escorting ExxonMobil ships in and out of the Middle East so that they would be safe to further supplement and subsidize the oil industry. We took on the oil industry. Increased minimum wage, increased Pell Grants. We made steps to make investments. But the bottom line is this health care reform bill is about economic development in the United States of America.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, there has been a lot of talk about freedom and liberty over the last couple days in Washington, DC, but the question really is: The person who is sick and can't get health care, are they really free? If you keep getting sick because you can't access a doctor, you can't get better, so you can't go to work, so you can't make money, is that person really free? In 2009, we need to redefine freedom. Freedom in America in 2009 means being healthy and having access to a health care system that isn't just for the elite, but it's for everybody. Now, our people are going to get a 15, 20, 30 percent increase. Businesses are going to get a 30 percent increase right now. This is what we're trying to prevent, an $1,800 increase for the average family of four if we do absolutely nothing. We're going to wake up in a few weeks in America, no more denials because of preexisting conditions; no more people in America or families in America will go bankrupt. We're going to fix this health care crisis that we have in this country.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. There are a lot of issues here. Earlier in the evening, I was watching someone, one of our friends on the other side, in the Rules Committee explain the Republican plan. And one of the questions from one of the committee members was, Does your plan cover everybody? And after dodging that question for quite some time, the answer is no. And then he went on to say that, Well, our plan is incremental. And that's the slow walk that our friends on the other side want to do here. They want to kill this and go back to the original political memo that was given: How do we kill health care reform? How do we not give Barack Obama a victory on health care? And that's all this is is playing the politics of it and to say, Well, our plan doesn't cover everybody. Our plan doesn't bring down costs. Our plan is not going to reduce costs for small business by allowing them to go in and do all this negotiation. I mean, think about what our friends on the other side of the aisle are going to vote against when we take this vote in the next couple of days. They're going to vote against everyone in America being protected from being denied insurance because of a preexisting condition. They're going to vote against that. They're going to vote against our saying that no one in America will ever go bankrupt again because of a health catastrophe in their family. Our friends are going to vote against that. Subsidies to help middle class families afford health care, they're going to vote against that. Extending COBRA until the exchange gets set up, they're going to vote against that. Increasing the age to 27 years old so that people can stay on their parents' insurance, they're going to vote against that. And giving small business people an opportunity, instead of swimming with the sharks in the current insurance market, to go in and negotiate with hundreds of thousands, if not millions, of other people to drive costs down, they're going to vote against it. So we are sitting here telling you, Mr. Murphy, here is what we are for: the exchange, competition, choice, the public option, eliminate preexisting conditions, no more bankruptcies, stay on your parents' insurance until you are 27, here are some subsidies, close the doughnut hole on Medicare part D so our seniors can have consistent prescription drug coverage. They are going to vote against it. We are here saying, this is what we are for, this is what is going to pass, and this is what is going to help the American people. You can call it whatever you want. Our friends like the socialized transportation system we have here when they fly into Reagan Airport and back to their own airports. They like socialized Medicare for their parents. They like socialized public schools. They like socialized roads, socialized ports, and socialized defense. They like all that. But the one thing that is not socialized, they try to label it as being socialized. It doesn't make any sense.

Mr. RYAN of Ohio. I thank the gentlelady, and I think that is a perfect articulation of what has happened and why that tomorrow and this weekend has become such a monumental day. I know our friends on the other side have been trying their best to try to undermine and scare. I just was hanging in my office just answering the phone with people calling in with complete misinformation about what this bill is going to do. This is very, very simple. When you look at what happened with Medicare, there was a gap in the capitalistic system. Insurance companies couldn't make money off of insuring our grandparents and older parents because there was no money to be made there. So the government had to come in and establish the Medicare program, which I am sure our friends on the other side of the aisle would not want to get rid of right now, and now they are actually sticking up for all the slowing of the growth and all the changes we are making. But the bottom line is this: We have two issues here. We have an economic issue where health care will bankrupt our country if we do not start reining in the spending. In the next 10 years, one of every five dollars in our economy will be spent on health care. In 30 years, one of every three dollars will be spent. If we do absolutely nothing, which up until two days ago our Republican friends wanted us to do, but now they know something is going to pass so they have to hurry up and hustle and get some plan together, but if we do absolutely nothing, the average family in our country will pay $1,800 more a year next year in their health care costs. That is if we do nothing. And keep projecting that out, $1,800 the following year, $1,800 the following year. Compounding is a very powerful thing. So we must for economic reasons get our health care house in order, and this bill does it. It reins in the spending for Medicare and makes it stronger and more efficient by closing the doughnut hole. In addition to that, we have human rights issues that we are dealing with in this country. American people who are sick, who go to the insurance company and get denied coverage, as we heard the other day at our press conference, because of infertility. You get denied coverage. Then the kicker was that spousal infertility was a reason to deny coverage and diabetes and cancer and all of these issues that insurance companies use to deny coverage. To me, that's a human rights issue; and we cannot, as a country, look ourselves in the mirror anymore as of tomorrow, hopefully, and at the end of this year and not say, Health care is a right in the United States of America. If we all collectively, through investments in NIH and private investments and premiums and money, have come up with ways to make someone healthy, but we, as a society, say, You know what, sorry, you can't afford this one, and just those of us in the club are going to be able to afford it, you can't. So, you know, you're going to have to get sicker faster, and you are going to have to die earlier than everyone else because you can't afford it. That is unacceptable. I yield to my friend who has been such an instrumental part--I just watched you in the Rules Committee--and continue to defend what we're trying to do here. To explain to the American people how important this is, I yield to my friend from New Jersey.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, the Republicans controlled this Chamber from 1993 until 2006, they controlled the Presidency until 2008; and now, 11 months into a national health care debate, they are just figuring out that we have a health care crisis in this country. How long will it take them to shake the grip of the insurance industry before they even come up with a realistic plan? Let's look at what our friends on the other side of the aisle are going to vote against. They're going to vote against us increasing the age to 27 where kids can stay on their parents' insurance. They're going to vote against citizens of the United States not being denied health care coverage because of a preexisting condition. They're going to vote against us saying that no one in America will ever go bankrupt again because of a health care catastrophe in their family. That's what they are going to vote against. It's very simple: once again the Republican Party is going to be on the wrong side of the vote, on the wrong side of health care reform, and on the wrong side of history.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, it is with deep sadness that I inform the House of the death of Mr. David W. Troutman of Akron, Ohio. David (Dave) William Troutman, 67, passed away on October 26, 2009. Dave was born on February 16, 1942 in Wooster, Ohio to George and Ruth Troutman. Most important to Dave was his beloved family. He is survived by his lovely wife of 40 years, Janet L. Troutman. He was a loving and devoted father to Michael (Danielle) Troutman and DeAnna (Thomas) Donaldson; a doting grandfather to his precious grandchildren, Luke Donaldson and MacIntyre Troutman. He is also survived by his sisters, Hannah Onderack and Florence (James) Castner through whom his family legacy extends through his nieces and nephews, Alicia, Nicholas, Jennifer, Daniel, Katie, Chelsea, Aleem, and Sufia. Dave's life was dedicated to serving his community, state and country. His accomplished career in law enforcement spanned over 40 years. He served as a soldier in the U.S. Army Reserve, Summit County Sheriff Deputy for 10 years, Barberton Chief Probation Officer for seven years, Summit County Sheriff for 14 years and finally served as U.S. Marshall for nine years at the request of then President Bill Clinton. From his early years attending high school in Barberton, Ohio and college at Miami (Ohio) University, Dave was committed to serving his community and helping others. Throughout his lifetime, he served in numerous appointed and elected public offices to include Coventry Township Trustee, Coventry Country Parks and Recreation Board Member, Summit County Sheriff, OPOTA Council Member, Ohio Organized Crime Commission Member, Ohio Athletic Commission Member and Kiwanis to name but a few. His leadership role in so many offices was not for public recognition as is typical of so many, but for his belief that he could serve others from such a position and lead others to public service. Because of his generosity and outstanding servitude, an exhaustive list of recognition and awards were bestowed upon him including the Cliff Skeen Award and Sheriff of the Year. To have known Dave was to know a man of integrity, honesty and service. His love for people and community was shown daily as he always helped others when often no one else would. To say Dave personally touched the lives of thousands would be an understatement. His legacy of service and love for others and his lifelong example of honesty and integrity is priceless and inspiring to so many. How would Dave have us honor such a lifetime of example? By following that example and becoming great through helping others. Dave will be missed, loved and never forgotten. Ohio has truly lost one of its most beloved sons. We love and miss you Dave!

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Just to continue on as you were saying, one of the key components of this legislation is to help small business people, and I think in the long term this is going to be part of long-term strategies in the United States. We are working on the stimulus package and other job- type programs, but if we don't have and put in place long-term, systemic changes to health care, we are going to continue to impede long-term growth in the United States. What we are saying here is, why are all of these small businesses putting so much of their budgets into health care when that money should be going back into buying new machines, hiring new employees, paying their employees more? It is because the cost of insurance keeps eating up more and more of their budget, so wages have been stagnant. So what we need to do is continue to reinvest back into these companies, and that is what this bill is all about. Over the course of the last couple of days, we heard our friends on the other side, Mr. Speaker, time and time again continue to talk about we are removing choice. That couldn't be further from the truth. We are trying to increase choice. The idea of the public option is to increase choice. Our friends on the other side, boy, if it came to a trade agreement, if you would pull up the Congressional Record and you would listen to these folks talk about trade, choice, increased competition, lower prices, it will have all these great effects throughout the market. But now when we say we want to introduce choice into the health insurance reform package, giving more options, maybe even a public option, a Medicare-style option for people to be able to go into and buy into, all of a sudden they are against it, Mr. Murphy. They are against choice. The fact of the matter is that this bill in the long term has a human rights component to it, as you stated, with eliminating preexisting conditions, making sure that people don't go bankrupt. I think those two in and of themselves would be transformational reforms to the health insurance program. Our friends yesterday in their long line of speakers, they were all talking about being scared. I think at the end of the day, our friends on the other side are going to be most scared when in November or maybe even early December we have a vote on health care for America, and when they are really going to be scared is when they vote against health insurance reform and they wake up the next morning and they look in the mirror and they say, I just voted against eliminating preexisting conditions; I just voted against having a cap on how much an American can spend per year as a percent of their income so they don't go bankrupt. I voted against it. I voted against subsidies to make sure that people could afford health insurance. That is not going to be a good holiday season for a lot of folks, waking up realizing they did that. I think it sounds good now to be against this and appeal to the radical fringe of the Republican Party, to appeal to the tea baggers, to appeal to those people who are completely anti-government. It may sound good. It may be comfortable right now to be in that position. But at the end of the day, history will look back and say who was pushing this reform to make health care more affordable and to address these human issues, and there are going to be folks on the wrong side of that.

Mr. RYAN of Ohio. I love when our friends on the other side, oh, my God, they're going to start rationing care. Like, are you breathing in 2009 and hearing and seeing what's going on with the current private insurance market? It's unbelievable the rationing that's going on. And what we're saying to the insurance companies is no longer will you be able to tell an American citizen you can't cover them because they have a preexisting condition. Now, that is a transformational step in the private insurance markets. But right now we have our friends on the other side of the aisle and across the dome saying that somehow this system is okay. And you know what? This will be a Democratic bill when it passes, and we're all going to have to live with the consequences. But I will tell you, I'd much rather be in Niles, Ohio, in December telling my constituents that they will never be denied because of a preexisting condition, the 1,600 families that went bankrupt in the 17th Congressional District in Ohio, that that won't happen anymore. That's a pretty good holiday gift, a pretty good Christmas gift for a lot of people in my district. And to go to a small business person and look them dead in the eye and say, You know what? Last year your insurance went up 15 percent and now they're projected to go up another 15 or 20 percent as far as the eye can see. And that's the thing we forget to talk about is this isn't, Oh, my insurance went up 15 percent in the last 5 years. No. It went up 15 percent a year every year for the last 5 years, or whatever the case may be, and the projections are, in 30 years, $1 of every $3 in the United States of America will be spent on health care. Now, to me, we have a responsibility to do something. And when folks say, well, you're going to bust the budget, we're not going to do anything. The budget is on its way to getting busted. We're trying to fix it. That's what this is all about. And when you have 45 million people a year without health insurance, and the numbers can be disputed, 10 million, 15, 20, 30, 40, we all hear, there are millions of people in the United States of America who go into an emergency room and call that their health care plan. And then you follow in after with your insurance card and you wonder why you're paying $10 for an aspirin. Well, because three people just walked in and didn't pay anything for an aspirin, so you've got to pay for it, and the people with insurance. So those costs get pushed off. That is unsustainable. Let's get these people in the tent, get them preventative coverage. We can give them a $20 prescription, Mr. Altmire, instead of letting them 2 weeks later show up in the emergency room and spend a week in the hospital costing us $10,000 or $15,000. Now, this is not rocket science, but the trick is taking on the special interests that have controlled this town over the past 8 years and trying to wrestle control away from them and trying to give it back to the American people. Now, just think about it. Since the Democrats have taken over, we've taken on the oil industry. We've taken on the banking industry and got them out of the student loan business. Now we're taking on the insurance industry. Whose side are you on? These are the people we're taking on, and the American people, I think, once they hear the story, are on our team, recognizing we're taking on these big interests.

Mr. RYAN of Ohio. And the idea with Medicare, as well, is now we have in many areas across the country where people are 55 or 60 years old. They lose their job. They don't have health insurance, or they don't have very good health insurance. So I hear a lot from people in northeast Ohio that say, Well, I'm going to wait until I get into Medicare. I'm not going to get anything now. I will get some real basic coverage, if anything at all. I'll wait until I get into Medicare. So we have people who now basically don't have insurance that are 60 years old and wait years before they go into the Medicare program who end up with very small problems not getting addressed and they become very big problems, and sometimes chronic problems by the time they get into Medicare, which is very, very expensive. But if everybody has health insurance, then you will get the kind of preventative care, the kind of screenings that you need, the kind of preventative treatments that you need to prevent you from going into Medicare and costing a lot more money. So, overall, when we talk about slowing the rate of growth to Medicare, it's because there will be a healthier consumer, a healthier patient going into the Medicare program, which is going to have significant savings over time. But that's not brain surgery. That's just a smart way to run it. I mean, I think that if you would ask somebody to draw up the worst possible health care system for costs and efficiency, they'd say, Well, let's wait until you get really, really, really sick and then you go to the emergency room and get in line with everybody else who waited until they got really, really sick or had a major accident and you get in line with them. That's the worst way to do it. So we're trying to fix that.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, it is with deep sadness that I inform the House of the death of Mr. Joseph A. Manente of Girard, Ohio. GIRARD--Joseph A. Manente, 74, died Sunday, Sept. 20, 2009, at St. Elizabeth Health Center in Youngstown. He was born June 13, 1935, in Girard, a son of Carmen and Gabriella Carson Manente. He was a veteran of the U.S. Army and a member of St. Rose Church, Girard. He retired from the Girard Post Office. He is survived by his wife, Betty Miller Manente; two children, Lisa Manente Leschinsky of Girard and Greg of Hartford; two brothers, Anthony Manente of Austintown and Sam Manente of Mineral Ridge, and three grandchildren. He was preceded in death by five brothers and sisters. Calling hours will be from 5 to 8 p.m. Wednesday at McClurkin Funeral Home, Girard. A Mass of Christian Burial will be held at 11 a.m. Thursday at St. Rose Church with prayers at 10:30 at the funeral home. Interment will be at Girard City Cemetery.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Madam Speaker, it is with deep sadness that I inform the House of the death of Mr. Michael J. Bonasera of Warren, Ohio. Michael J. Bonasera Sr. was born April 13, 1915 in Buffington, Pa., the son of Pasquale and Ninfa Danca Bonasera. Michael was a 1934 graduate of Hickory High School and came to Warren in 1942 from Sharon, Pa., where he had lived since 1920. He was a veteran of WWII, having served in the Army Transportation Corps., and attaining the rank of Sergeant. His military service included tours of duty in England and the Philippines. Michael retired in 1980 from American Welding, where he was a machine operator for 32 years. He was an award-winning machinist, and was one of the first machinists to machine parts for jet and rocket engines. He was a great teacher and was able to pass on his vast knowledge to future generations of machinists. He was a member of St. Mary's Church, and enjoyed traveling, golf, tending to his garden, and music, and had taught accordion lessons for 45 years. Most of all, he enjoyed spending time with his grandchildren and great-grandchildren. Survivors include his wife of 67 years, Lena R. Maggiano Bonasera, whom he married Oct. 10, 1942; a daughter, Janet M. (Charles) Richards of Warren; two sons, Michael J. (Susan) Bonasera Jr. of Seattle and Atty. Thomas J. (Julie) Bonasera of Columbus; 14 grandchildren; seven great-grandchildren; and a son-in-law, Dan Matthews of Coos Bay, Ore. He was preceded in death by a daughter, Mary Lee Matthews; a brother, Charles Bonasera; and his sisters, Constance LaMagro, Grace Ciolfi, Sunda Sebastian, Josephine Roman, Rose Russo and Mary Welch. Calling hours were yesterday from 4 to 7 p.m. and this morning from 9 to 9:30 a.m. at the Peter Rossi & Son Memorial Chapel. Burial will be at All Souls Cemetery. The family requests that memorial contributions be made to the Susan G. Komen Breast Cancer Foundation, 26210 Emery Road, Suite 307, Cleveland, OH 44128.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. I thank the gentleman. I would like to also thank the ranking member. This is a good conference report. This is a good piece of legislation. I think there are some sound investments in here. I wish some were more, but I think given the stimulus and everything, we are moving in the right direction. We send about $750 billion a year to oil-producing countries. A couple of years ago the Department of Defense spent about $115 billion escorting big oil ships in and out of the Persian Gulf. We have got to get away from our dependency on foreign oil. We have got to get away from our dependency on these foreign countries that get us into all of these political entanglements. I think the investments that are made here on solar energy ($225 million), biofuels, vehicle technology, hydrogen technology, energy- efficient buildings--for those of us who represent manufacturing States in the Midwest, this green economy is opportunity for us. We have manufacturing. We have great research and development institutions. This is an opportunity for us to revive the middle class in the United States of America through these green jobs. There was a report that was just done for the Midwest Governors meeting that is coming up, and it says, ``Regional Report Endorses Clean-Energy Economy for the Midwest.'' ``Midwestern States should use their abundant natural resources and manufacturing base to build an economy based on clean energy.'' And we have the opportunity to do that if we continue investing in research and development, especially coal. There is one last point that I would like to mention. I hope that next year we can continue to push these energy hubs. Secretary Chu has made this a top priority. They're modeled after the old Bell Laboratories. A variety of different universities are going to be involved in the research. They're going to be able to collaborate and focus on the technologies that are working, not focusing on just getting money so you can have a budget for next year. So I hope as we continue to move, we continue to push, these energy hubs are going to be nothing but opportunity for us to get into the commercialization and continue to create jobs. Again, this is a good piece of legislation. I want to thank the chairman. I would also like to thank the staff. I know a lot of work went into it.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. I thank you, Mr. Speaker. This is our traditional 30-something hour. We will be talking about health care and try to rebut some of the claims that have been made earlier here tonight. But before we do this, we have had several situations going on in the Pacific, and we wanted to yield as much time as the gentlelady from Guam may consume to talk about the circumstances that are going on in her district. I gladly yield to Ms. Bordallo. Tsunami in American Samoa

Mr. RYAN of Ohio. Reclaiming my time, I thank the gentleman and extend the condolences from the people of my district in Ohio and the rest of the House. Tsunamis and hurricanes and all of the natural disasters that we watch on TV, I think it's important that the Representatives come here today and share with us kind of the human side of it, and we realize that these are human beings that have been hurt and families that have been displaced. And we want to just extend our condolences to the gentleman and the gentlewoman and also the gentleman who couldn't make it here from American Samoa. Our hour tonight, Mr. Speaker, what is left of the hour, is to talk about an issue that is pressing for the country. It has been the topic of conversation here in the United States Congress for several months. It's been a topic in the country for decades going back to Teddy Roosevelt, Franklin Roosevelt, upward and onward to Truman and Johnson and as of late, in recent history, President Clinton in the early 1990s and now President Obama to try to deal with the situation of health care in the United States of America. This is an issue that we hear as elected Representatives day in and day out where we get letters from constituents who have problems with the insurance industry, who have been hurt, displaced, not covered. The coverage that they have doesn't necessarily work. I think this whole debate breaks down into two separate categories. There's the financial aspect of health care reform and bending the cost curve and making sure that our country doesn't go belly up because we keep going down the same road and we don't muster up the courage to have change. And then the other track is the social justice track, the idea that the way that human beings, the way that American citizens are now getting treated by insurance companies is unfair, not right, cruel, and something that needs to stop. So collectively as a country in the past election, the country overwhelmingly voted for change, and they overwhelmingly voted for health care change. And one of the major planks in President Obama's platform was health care, health care reform, bringing some justice to the system, and helping to bend the cost curve in the system. I think everybody recognizes the social justice side. I think everyone has heard stories. It has happened to them. It has happened to family members. It may happen to somebody that they know where someone is denied coverage because they have a preexisting condition or a family goes bankrupt because of a health care catastrophe in their family. And what this reform does is it eliminates those two major problems that we have in our health care system, where we are collectively as a country saying it is not right for a human being, a United States citizen to have to file for bankruptcy because they got sick or someone in their immediate family got sick. Now, I hope we can all agree upon that. When some of our friends on the other side talk about liberty and freedom and they cue up the patriotic music to try to destroy health care reform in the United States, I would like to ask the question, How free is the person that just had to file bankruptcy because they got sick? How liberated is the person who has to file bankruptcy because they got sick? Is that their idea of freedom, Mr. Speaker? Is that the TEA baggers' idea of liberty, Mr. Speaker? I don't believe that it is. But that is the great debate we are having in this country. There are people in this country who will end up on one side of that fence or the other. And the side that President Obama and the Democrats have been pushing is to say that when you go bankrupt because you got sick or someone in your family got sick, you are less free. You have fewer options. There are others who are trying to kill health care reform, who say if you go bankrupt, tough luck. We'd rather have the concept of liberty, the concept of freedom. But our job when we come to Washington and make laws and reforms is to actually take these ideas that the Founding Fathers have given us that are written all over these buildings, all over Washington, D.C., in State capitals all over the country, and that our kids read about in the history books and on the computer that when they are implemented, those definitions mean something. And this health care reform will make American citizens more free. It will allow them more opportunity, more options. It's bad enough you've got to deal with being sick and you're sick enough that you have to spend so much money that you go bankrupt; then you've got to be bankrupt, which is not a pretty process. It strangles your ability to be free. So I have to laugh, if it wasn't so sad, when we hear about people in this debate talk about liberty and freedom. You're doggone right it is. And we are trying to enhance liberty, enhance freedom, actually make it work for people. In my congressional district, if we do nothing, we will have 1,600 families go bankrupt because of health care concerns, 1,600 just in my district. Half of the bankruptcies in the United States of America are because of health care issues. Now, to me that doesn't sound like the principal of freedom. And we're going to fix it. The same with preexisting conditions. So you're in a job and you have health care and you or your spouse has some kind of condition that you know if you get out of the current pool that you're in, you're going to end up in the shark tank, basically, right now and you're not going to be able to get health care coverage. So you want to start a business or you want to go somewhere else where maybe you could make more money or you could express more of your talent, more of your ability. You could grow. You could learn new things and maybe provide more for your family. But you don't do it because you know if you leave your job that you won't be able to get health insurance. Now, I ask my friends who talk about freedom and liberty, is that person more free? Is that person liberated to pursue happiness? I don't think they are. So I will have the debate all day long, Mr. Speaker, with the TEA bag groups and the TEA baggers and everybody else who wants to have this debate about freedom and liberty because this reform bill and the insurance reform components of this are about increasing people's freedom. It's about protecting them in a market in which they need some consumer protections in order for them not to be strangled, not to be strapped, not to be forced to go bankrupt. I yield to my friend from right across the border in Pennsylvania.

Mr. RYAN of Ohio. Mr. Speaker, we also have the Representative here from the Northern Mariana Islands, Mr. Sablan. I yield to the gentleman.

Mr. RYAN of Ohio. If the gentleman would yield. The issue coming from the other side is interesting, because just a couple of years ago, our friends had control of the entire government. They had control of the House, and they had control of the Senate. Your class came in, and we had a great year. But prior to 2006, there were 6 years that President Bush, the Senate and the House were all Republican. They could have implemented some kind of health care reform. It didn't have to be necessarily what we are doing, but really, not to do anything to try to bring some justice to the system and, in the process, spend $2.5 trillion over 10 years on the Bush tax cuts that went to primarily the top 1 percent of the people in the country. Now we're talking about a bill here that is deficit neutral, that will be paid for, that is $900 billion over 10 years, a little more than a third of what they spent on tax cuts, and we'll start bending the cost curve and bring some justice to end these stories. I think it's important to talk about that, because we all run into the business person you talk to who says they don't have health care any more, from the example you used earlier. So let's track those 12 families. Now they are out, and they are swimming with the sharks. Hopefully no one has a preexisting condition so when they go out now on their own, out of the plan that they were in, and they try to get some coverage, hopefully they don't have a preexisting condition. But what if they do? And I bet that there is somebody in that group, some family, some spouse, some worker there that probably does, and they are not going to be able to get insurance or they are going to have insurance that is going to cost so much that it is going to be really not helpful. And so they may go without. Now, not having gotten any treatments, they may go 1 year, they may go 2 years, but now all of a sudden a very small problem turns into a very, very big problem, so that at some point, this person ends up in the emergency room. If they are older they end up in the Medicare program. In both instances, they cost us a heck of a lot more money than they would have if they were able to stay in that plan, get preventative care and get consistent treatment. They could have dealt with a sickness that they may have had so it doesn't become chronic and costly. That's what's happening all over the country. Our friends are scratching their heads saying, How in the heck does this get so expensive? Well, it happens every day. We see these situations happening all the time. A lady called in to one of my telephone town halls about a month ago. She is 60 years old. She makes $32,000 a year. She works. And her company, same situation, just dropped her health care. She basically said on the call, I may just wait until I get into Medicare. So here you have someone that is working, 60 years old, and can't get health care in the United States of America. That is a whole other topic of how bad and wrong and cruel that is, but just from the sheer numbers standpoint, this person is going to go 5 years without health care? And then when she goes into the Medicare program, she will have how many different problems that could have been prevented in those 5 years? You wonder why Medicare is going to go belly up. Well, part of the reform is to make sure that those people that are that age, all Americans, but people that age will have some basic level of health care.

Mr. RYAN of Ohio. And how do our friends who talk about freedom and liberty want to deny the ability to basically buy into a Medicare-type program? That seems to me like it's limiting the consumers' choice, limiting freedom. And what we're saying is they have all got to compete. They have all got to be there. We're going to help you pay for it because we know if you don't get insurance you're going to go cost us a heck of a lot more money in the emergency room and this is all about choice. And you know, if you like what you have, you keep it. That's fine. So you know, this is good. I think about the 1,600 families in my district that go bankrupt because of health care. I think of the people that will have opportunity and options because of what we're trying to set up here and reform this system. But as we close, Mr. Speaker, I would just like to say, if you look at what we have tried to do and what we have done over the course of the last 7 or 8 months, we've taken on the oil industry; we're taking on the insurance industry. Since we've been here, we've raised the minimum wage, increased money for Pell Grants, taken the banks out of student loans so that people can afford to go to college, make investments back into the middle class, infrastructure money, stimulus money, thousands of teachers are at school right now because of stimulus money that is coming out, invested in the green technologies, green energy. If you look, issue by issue by issue by issue, everything that we have done has been sticking up for the middle class and taking on the special interests that have been driving down wages, driving up health care costs, making it difficult for small businesses, making it difficult to go to college, cutting every business in on the deal, no matter what; and it's important to recognize that this reform proposal and this reform bill is all about giving the middle class consumer protections, choice, and affordable health care in a system that has justice. So I want to thank my friend from Connecticut, I want to thank our friend from Pittsburgh, western PA, who was here. And, again, our condolences out to people in the Pacific who are going through a very, very difficult time who shared with us earlier in the hour. With that, we yield back the balance of our time.

Mr. RYAN of Ohio. And why do the programs even exist? Because you can't make money off of sick people. I mean, how disingenuous to walk around saying, boy, look how expensive Medicare is. No kidding. Everybody is 65 and older. Yes, that's expensive, but no one was doing it. So we decided as a country that it may be a good idea to protect those senior citizens and provide them a little bit of dignity.

Mr. RYAN of Ohio. Well, you think about how a game started like basketball or football or just of any sport; right? At some point, you know, Naismith puts up the peach basket and starts throwing a ball and they decide, well, we'll cut a hole and the ball will fall through. That will be good. But then you start getting teams, and at some point someone threw an elbow at somebody's face and hit them with an elbow in the face and they couldn't play anymore. And the people organizing the game said, you know what, that's not really fair. That's not what the game is. So that's illegal because here's the game. You each get five people. You put it in the thing, but whatever the rules are, and then rules consistently evolve to make the game more fair. And so here we are in the United States, well, we're saying that government is not going in to run anything. What we're going to do is create new rules, and one of the rules is you can't be denied for a preexisting condition because it's unfair. We are all agreeing as a country, and our friends on the other side, we will see how they vote when they have an opportunity to vote for this, because it's unfair. Going bankrupt in the United States for a health care reason is unfair. We want to change that rule. That rule no longer applies. And so what we're trying to do is make the game of health care more fair. But there's a point that I wanted to just touch on for a minute. One of the points I wanted to touch base on that Mr. Murphy just made is how the insurance industry has acknowledged that this will be a level playing field for all the different insurance companies, and if we do preexisting condition, making sure that no one can pay any more than a certain percentage of their income out of pocket per year to prevent bankruptcies, those kinds of things. There's an important point that I think we need to acknowledge and talk about more. If insurance companies have to cover everyone, if they can't play the game that they're playing now--the game now is how do I get sick people off of my rolls so they don't cause me a medical loss and how do I not get people on my rolls that I know are going to cost me money, and those people are going to be diabetics and heart disease and cancer patients. And I had one cancer patient come to a roundtable I had who said, you know, she had cancer and then she lost her job and then was out with another job trying to get insurance on her own. She was denied. Her cancer had been gone for years and years, but it hadn't been gone 10 years, so insurance companies would continue to deny her coverage. And so what we're saying here, if everybody is covered, if insurance companies can't deny anybody coverage, they will have to take you. There is a new business model that will be created within the insurance industry, because the game of keeping people off your rolls, or getting sick people off your rolls, is over. The new game for the insurance company is going to be how do we keep the people that are in our pool under our coverage healthy. So you are going to see them investing money into wellness, prevention. They're going to be very interested in what the kids are eating at schools. They're going to be very interested in the pesticides that we're putting on our food that may cause cancer. They're going to be very, very interested in obesity rates. They're going to be very interested in what physical education programs look like in our schools. We can have a real ally among the insurance industry to partner with us, with nutritionists, with dietitians, with, you know, preventative and wellness groups. We will now have an ally. Instead, the insurance companies are now the enemy because they don't want to make these investments. Now they're slowly starting to because I think they're reading the tea leaves here is that they're going to be slapped down and they're going to have to cover everybody, and because of that, they are going to be able to make investments, and I think it's going to end up being a very, very good thing.

Mr. RYAN of Ohio. And so you go to this exchange that's going to be-- there will be an essential benefits package that will be set by the Surgeon General and a group of experts who will decide what the essential benefits package would be, you know, dental, maternity, hospital, all the basics, and every insurance company that goes into this exchange, that will be the bare minimum. So there won't be any of this, I'm paying a lot of money out of pocket but my coverage is terrible, or, I don't have any to begin with. There will be this essential benefits package which will be the baseline coverage for every single private insurer that comes to the exchange. Then they can build on that with premium plans, Cadillac plans, however high they want to go, so people who have a lot of money, there are still going to be plans up there because insurance companies will be making money. What we're asking here in the House side now is, in addition to all of these private insurers, we put in, basically, a Medicare program, a Medicare program that will compete with all of the other private insurers. Everyone, 80 percent of the people who have Medicare like it. Sixty-five percent of the American people say this is a good idea. But that Medicare that would be in the exchange with all the other insurance companies would compete with all of them, but they wouldn't have to put money into marketing. They wouldn't have to pay a CEO $100 kajillion a year or, turns out, like $200,000 a minute or an hour, whatever it is nowadays and would compete. And by not having to put all that money into advertising and all those other things could help bring costs down, and everyone else in the exchange would now have to compete with that. So you want to talk about choice, that public option and the way we're setting up the exchange is all about choice. And if you're a family of four making less than $89,000 a year, you're going to qualify for some health care credits, some subsidies. So you will get the subsidy from the government based on your income, and then you go to the exchange and pick any plan you want. No government bureaucrat's telling you what--no, you've got to pick this plan; no, I mean that one; you pick this one. There's none of that. You get the credit and then you go to the exchange. And if you want the public option, you could pick it. If you don't want it, you don't have to pick it.

Mr. RYAN of Ohio

Mr. RYAN of Ohio. Mr. Speaker, I appreciate the opportunity to be here. I will be joined shortly by a colleague of mine from Ohio (Mr. Boccieri) and maybe several others to talk about a variety of issues that I think are pressing the country right now and that we want to inform our constituents about and speak to the House of Representatives about. You know, I think it's important for us--and I think every time I've been on the floor in the past year or two, I follow some of our Republican colleagues, and I feel the need to just kind of clarify the record as to how we ended up getting to the spot we're at now. I realize that in a democracy like this, we always have the opportunity to criticize each other, and I think that the beautiful thing about this democracy is that, you know, we do have the opportunity to come to the floor of the House of Representatives and speak directly to the American people, live on TV, live to all of our other colleagues, and speak in a way that is pretty straightforward. That's a beautiful thing about this country. But if we look at where we are today, and if we look at where we were just 7 or 8 months ago, our economy was on the brink of collapse. Unemployment rates were climbing at unprecedented rates, where we were losing 600,000, 700,000 jobs a month. The stock market had crashed. The housing market had crashed. Our budget deficit just ballooned. And all of this was because of the policies, Mr. Speaker, that we had in this country from 2000 to 2008. And if it weren't for an election in 2006, we would have went further over the cliff. Those are the facts of the matter, and the facts of the matter are that during that time, the House, the Senate, the White House were all controlled by Republicans. And we got the Milton Friedman, supply-side, Ronald Reagan, cut taxes for the wealthiest 1 percent of the people in the country and hope that health care would get fixed, energy would get fixed, and the economy would get fixed, and then people would get jobs at some point. Well, it's important for all of us to recognize that we don't have to go to some theoretical schoolbook to figure out if the supply side Republican neoconservative domestic and foreign policy program works. It has been implemented, and it has been an absolute failure on all accounts, by all measures. Our friends on the Republican side now who say, Oh, my God, this health care bill that the Democrats are trying to push is going to cost $800 billion, $900 billion over 10 years. But it's important for us to recognize that it was the Bush tax cuts, that went to primarily the top 1 percent of the people in the country, that cost $2.5 trillion over 10 years. So don't come to us about a health care bill that costs $800 billion or $900 billion, that would end up saving the country a bunch of money in the long run, end up fixing the health care problem, because you were the ones and they were the ones, Mr. Speaker, who were walking in lockstep, following George Bush right over the cliff, $2.5 trillion in tax cuts, primarily to the top 1 percent over 10 years, bankrupted the country. Now all of a sudden everybody's concerned about the budget deficit. All of a sudden, everyone's concerned about borrowing money from China. What we're saying is, the investments that we are going to make are going to stop health care projections from growing at 9 percent a year and try to bring some justice to the system so that average people can afford health care, so that average people don't get sick and then try to go get health care and an insurance company says, We can't cover you. You have cancer. But my cancer's fixed, the patient says. But it hasn't been gone for 10 years, so we can't cover you. Or when we attempt to change the energy policy in this country--which my friend Mr. Boccieri has become an expert on because of his position in the military and his recognition of this as a national security issue--when we send $750 billion a year from the United States of America to Middle Eastern countries and foreign countries to buy oil-- countries who don't traditionally support our views, our values or our Democratic principles--we send this every year to them, money that goes out of our economy into these OPEC countries. Then a couple of years ago, Mr. Boccieri, we spent $115 billion or $120 billion out of our defense bill to escort Exxon-Mobil ships and big oil ships, coming into and out of the Persian Gulf. So all these tea baggers who want to stand up like they're the most patriotic people in the United States of America are saying, We shouldn't change our energy policy, We should just continue sending $115 billion a year out of our defense budget to escort these big oil ships in and out of the Persian Gulf. Is that pro-American? I don't believe it is. Is it pro-American to allow health care to grow at 9 percent when our GDP grows at 3 percent so that insurance companies can make money hand over fist and deny American citizens coverage? I'm going to ask you a question: Where are the family values there, Mr. Speaker? That we want the government out. The only entity left to protect people who are getting screwed to the wall by the insurance companies is the government. We need to make rules to make sure that these people, these insurance companies stop hurting people. They're hurting people. Now I'm sorry, but we had to listen all August about all this nonsense that's going on. In Ohio's 17th Congressional District, we will have 1,600 families go bankrupt next year if we do absolutely nothing about health care. Now I'm sorry. That's not right. And if we have to act and maybe take on the insurance companies, then so be it. Let's clean this up, what's happened in this Congress and with this new President over the last 7 or 8 months, let's clean this whole thing up. We've taken on the big oil companies. We're taking on the big insurance companies. We're taking on the big pharmaceutical companies. Today we extended unemployment benefits for another 13 weeks so that average people who can't find a job will have a little peace of mind for 13 more weeks. That's what we've been doing. Our policies have been clear, Mr. Boccieri. We're not hiding behind them. We're trying to reduce our dependency on foreign oil, bring that investment back to the United States, take money out of the hands of the insurance companies, bring it back to the average people so that they have better health care, and transform our country, get us ready to go. We recognize that there are going to be some powerful interests that aren't going to be for this. But tough. Tough. You can't make money on the backs of human beings, of American citizens, and think it's okay because it's not. And we are going to do something about it. You can scream and yell. I want to just ask one question. These people talk about, where's our liberty, where's our freedom? Well, first of all, we're giving you more choice in your health care. But where's our liberty? Where's the liberty and where's the freedom of the United States citizen that's sick and can't get health care? How free of a citizen are you? You're not free at all because you're sick. You're in your home. You're in a hospital. You're in a nursing home. There's no freedom there. So you can talk freedom all you want. I stood at the Canfield Fair, the biggest fair in Ohio, for 4 hours. For 4 hours I talked to every single person that came by that wanted to chat, and I had two people in 4 hours tell me they were against health care reform. Some wanted some clarification, some wanted to know exactly what was going on. But the people were for it. If we pass this, the people are going to recognize that we wanted the reform, the people voted for the reform, and the people got the reform. I yield to my friend from Canton, home of the Football Hall of Fame, the National First Ladies' Library.

Mr. RYAN of Ohio. Reclaiming my time, I think it's important because we tell our seniors and they hear that there are going to be all of these cuts in Medicare. There's going to be savings in Medicare. There's actually going to be an increase in the benefits. I want to say two things, one about part D, which is the drug program. Right now if you qualify for Medicare and then you get part D up to like about $2,700, you're covered, and then coverage for your prescription drugs completely falls off and then it picks back up at $5,000 or so. I got a letter from a doctor in Warren or Howland that said, I have a patient. She used up all her $2,700. She now fell into the doughnut hole, so they had to change the drug that she had. I think it was diabetes. It was a diabetes drug. They had to change the prescription. They changed it after she got into the doughnut hole because they had to go to a cheaper drug. There was a reaction because of the change. They changed it again, changed it again. She ends up in the hospital. So what we're trying to say is by filling in this doughnut hole and paying just in this one instance, this woman, covering her for another thousand dollars or two would have saved the Medicare program thousands of dollars because she went from not qualifying anymore for part D, falling into the doughnut hole, to into the hospital. Now, let's use, as my grandmother used to say, our ``medulla abingatta,'' the Italian version. But let's use our brains. This makes no sense what we're doing here. It makes no sense and it's hurtful to the patient and it wastes money. But one of the main ways how we're going to save money and start to bend the cost curve on Medicare is in areas especially like ours in northeast Ohio, Pennsylvania, Indiana, Michigan, the older industrial States, we have people 50, 55 years old and they lose their job. So they lose their health care or they just lost their health care and they keep their job. We had a lady on one of our telephone town halls who kept her job and lost her health care, 60 years old. So when you're 60 or 55, you start saying, I don't know if I can really get insurance or afford it, so I'm going to wait this sucker out. I'm going to wait until I get into Medicare because they'll pay for it and then I'll be good. I can maybe get a supplemental, but most of it will be covered. So we have a population of Americans who are getting into the Medicare program sicker than they need to be and sometimes chronically, which is really driving up the cost of Medicare. So what we're saying is we're paying for these people anyway because they're going into the Medicare program. But if we want to save money, wouldn't it be smarter to make sure that these people have some basic health care before they get into Medicare, because it will save us money because they'll get preventative care. They may not have cancer as bad. They may catch breast cancer early or cervical cancer early or prostate cancer early as opposed to letting it develop and then getting dumped into the Medicare program and costing everybody a bunch of money. This is basic ounce of prevention is worth a pound of cure.

Mr. RYAN of Ohio. Can I make a point on your second P there? When you talk to people, when you talk to educators that are talking to our kids that are going to high school, going to college, guidance counselors, what they tell these kids today is that you are going to have seven, eight, nine, ten different jobs throughout the course of your life. You need to have skills that are mobile because it's not going to be like the 1960s where you're going to go to a General Motors factory or you're going to go to Youngstown Sheet and Tube and you're going to work there for 40 years, get a retirement and you're done. It's over. You work for one employer your whole life. Our educators are telling our kids how many different jobs they're going to have to have. So does it make any sense to have a health care system that locks people into their employment because they have a spouse or they have a condition that some insurance company, some jerk that a doctor calls up to try to get coverage and the person at the insurance company says, Nope, sorry, we don't cover that? Well, it's in my policy. Sorry, we don't cover that. You are preventing people from going out and starting businesses because they're afraid they can't get any health care coverage. You're locking people into work that they may not like or enjoy when they have another opportunity elsewhere but they know they can't move because of this. The health care system needs to reflect the dynamism of the economy, and it doesn't now. So it's stifling creativity at a time where we need people to be out creating jobs and creating work.

Mr. RYAN of Ohio. Exactly. And right now we spend four cents of every health care dollar on prevention when we know that's the big saver. But there's a point that we all need to remember. We are fighting for the public option and whatever. Some people are for it, some aren't. I don't know if it will be in. Who knows. But we have to remember that if we have everybody covered and everybody is going to be covered by primarily private insurance, then the whole dynamic of the system changes. So we say to the insurance companies, as you said, and I like that analogy that we set the ground rules basically. And States regulate insurance now, so we're going to say, Here's the goal line. Here's the end zone. Here are the goalposts. Here are the rules. And the rules that we want to change are that you can't be denied because you have a preexisting condition. If you have diabetes, heart disease, the insurance company has still got to cover you. There will be a cap on how much you can spend a year so you're not going to go bankrupt over a health care crisis. But the dynamic that changes when every single person can have health care insurance and the insurance companies have to cover you where they can't shake you any more, because now the insurance companies are spending money saying let me see what you've got, and I shouldn't have called somebody a jerk because they are just trying to make a living, and so I apologize for that. But you call up and the game now is the insurance company tells you, sorry, you have a preexisting condition. They spend money hiring bureaucrats within their organization to deny people coverage. But this all changes if now I am the insurance company and I have to cover you. So now all of a sudden it is in my interest to make you well. So I'm going to spend money and time and energy and effort working with your employer, creating incentives for you to go work out, stop smoking, do things that are going to reduce your stress level, because I know stress is a killer. I am going to do things from an insurance company perspective to make you healthier. That is something that we have failed to talk about. Once everybody is covered and we all get married to our insurance company and they can't get rid of us, their incentive changes from denying you coverage and getting rid of you to making you healthy. That is part of this whole preventive thing that you are talking about.

Mr. RYAN of Ohio. Keep talking.