Phil Roe

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I want to just comment on that right now before I have to go on blood pressure medication.

Mr. ROE of Tennessee. Which is brought on by the bill. Here we have something as ridiculous as hiring 16,000 IRS agents to check a box to see whether you have bought health insurance, where if you took that $10 billion right there, you could solve the uninsured, and our TennCare problems in the State of Tennessee could actually provide the care. Now, that's absurd when you hire government bureaucrats to check a box when you could actually provide care for pregnant women, for the elderly on Medicaid, for young people. The gentleman from Pennsylvania brings up a great point on rural hospitals. Typically, if you look at the demographics--and I live in a rural area in Tennessee--if you look at the demographics, they tend to be older and less affluent. And those smaller hospitals that don't get the more affluent people have a higher percentage of Medicaid and Medicare patients, meaning there's more pressure on them. You lower those reimbursements and there's a very real chance they will be in financial trouble. I yield back.

Mr. ROE of Tennessee. Sixty.

Mr. ROE of Tennessee. You bring up a very, very pertinent point, which is, this year in America, as of the last number I saw, we were training a whopping total of 600 primary care physicians.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Madam Speaker, I rise today to commend the United Way volunteers of Washington County, Jonesborough, and Johnson City for their service to East Tennessee. I am proud of the example these fine volunteers set and for all they give back to the great state of Tennessee. Nearly 125 volunteers will be attending the annual Volunteer Breakfast on April 23, 2010. With approximately 150 volunteers of their own, United Way of Washington County partners with many other organizations and thousands of other volunteers to change the lives of people in East Tennessee. I sincerely thank the United Way of Washington County and all partnering organizations for all they do for the Volunteer State.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I yield myself as much time as I may consume. Mr. Speaker, I rise today in support of House Resolution 1206, remembering the victims of the attack on the Alfred P. Murrah Federal Building in Oklahoma City, Oklahoma. Fifteen years ago, domestic terrorists set off a truck bomb in front of the Alfred P. Murrah Federal Building in Oklahoma City in what would become one of the worst terrorist attacks to happen on American soil. In a matter of moments, the lives of 168 people, including 19 children, were cruelly brought to an end. In the aftermath, we learned that more than 850 people were injured, and 30 children were orphaned; 219 children lost at least one parent in the tragedy. To those there, it seemed as if no one in Oklahoma escaped unscathed. Indeed, it has been said that ``at 9:02 a.m. on April 19, 1995, every American became an Oklahoman.'' The outpouring of support for the people of Oklahoma in the hours, days, weeks and months following this attack revealed the depth of character of the citizens of this great Nation. Many of those killed and injured were Federal employees or the families of Federal employees. It is important that we take time to remember the civil servants who served our country honorably and perished in this tragedy. All of these employees' service to our country deserve recognition and distinction. I want to extend my sincerest gratitude to local, State and Federal law enforcement, firefighters and emergency response teams from Oklahoma and across the United States; the servicemen and -women, the medical personnel, and the thousands of volunteers who donated their time to help save lives and assist the injured and provide meals to those that came to help the people of Oklahoma. Without these brave men and women, countless more lives may have been lost that day. Oklahomans have demonstrated the depth of their own character by rebuilding in the wake of the bombing. This tragedy could have devastated the future of Oklahoma City; but in the 15 years since the bombing, the city and all Oklahomans have undergone profound healing. I commend them for their strength and for the continued commitment to triumph over such senseless violence, and I stand with them as they persevere. Rather than allowing fear to hinder them, the people of Oklahoma City determined to continue the city's growth while keeping alive the memory of those lost. Nowhere is that determination more beautifully exhibited than at the Oklahoma City National Memorial and Museum. This facility has attracted hundreds of thousands of visitors from all over the world each year since its opening. It serves as a reminder of not only the tragic event that took place 15 years ago, but also the way that all Americans came together to pick up the pieces and move on. It provides Oklahomans and all Americans with a sense of hope that we truly are able to rise from the ashes of terrorism and come out a stronger community and Nation. The Memorial Institute for the Prevention of Terrorism was also created to help educate the Nation's emergency responders and law enforcement about preventing and mitigating the effects of terrorist attacks. Before I close, I will quote the inscription on the wall of the memorial which sums up the lessons learned from this senseless tragedy. It reads: ``We come here to remember those who were killed, those who survived, and those who changed forever. May all who leave here know the impact of violence. May this memorial offer comfort, strength, peace, hope and serenity.'' As we near the 15th anniversary of the bombing of the Murrah Federal Building in Oklahoma City, I hope we will keep those impacted by this in our minds and heed these important words. I am proud to be a cosponsor of this resolution, and I urge all of my colleagues to support this resolution. And, Mr. Speaker, I think this speaks volumes about what we are as a Nation. We're not a Nation of political parties. We're all Americans, and we come together in a tragedy like this to help heal. And I extend my condolences from the great State of Tennessee to Oklahoma. And I thank my friend from Virginia here today for helping us commemorate this. I yield back the balance of my time.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in support of House Resolution 1198, congratulating Lock Haven University of Pennsylvania for 140 years of excellence in higher education. On the banks of the Susquehanna River in central Pennsylvania is a university where students receive excellent career preparation, develop lifelong friendships, and never feel like they are just another number. Lock Haven University prides itself on having a small college lifestyle with a big university education. With an enrollment of 5,000 students, classes are student centered and there are unlimited opportunities to be become involved. Lock Haven University was founded in 1870 as the Central State Normal School. By 1927, it was known as the State Teachers College of Lock Haven; and in 1960 the name was changed to Lock Haven State College. In 1983, the school joined with the Pennsylvania State System of Higher Education and became known as Lock Haven University of Pennsylvania. The Clearfield campus in Clearfield, Pennsylvania, was established in 1989. LHU has more than 60 undergraduate programs and three graduate programs. The student-to-faculty ratio is 19:1. Its athletics department offers eight women's Division II teams as well as seven men's Division II programs. Division I men's wrestling and women's field hockey programs round out the athletic offerings. LHU has an outstanding international mission, offering exchange programs on six continents. It has approximately 580 full-time employees, which includes 270 full-time instructional faculty. There are more than 120 clubs, activities and organizations on campus. And it is also one of the few public institutions in the United States to require laptop computers of freshmen and transfer students. The requirement is complemented by a wireless technology infrastructure that will encompass virtually the entire campus in the near future. LHU's students have numerous opportunities to learn outside of the classroom through internships and field placement. In addition, LHU students can study abroad a semester in England, France, Japan, Australia or one of 24 other countries. Armed with the tools to succeed, 97 percent of recent graduates are either employed or continuing their education. Today, we honor Lock Haven University for 140 years of excellence in higher education. Congratulations to its president, Dr. Keith Miller, and the faculty of one of the most noble endeavors, preparing future leaders for every sector of our society. I would also like to congratulate the students and staff as well. I support this resolution, and ask my colleagues to do the same. I yield back the balance of my time.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume. Just a quick comment. We do these suspensions and we talk about them and vote on them and so forth, but there's a real lesson in college athletics that I think Congressman Minnick brought up that's very important. Not just a resolution congratulating a football team but young athletes, and I know I certainly learned these lessons, as an athlete, you learn to show up on time, you learn to be a team player, and you learn to give your very best. And if you take those attributes into the world of business and your life, you are going to have a pretty successful life if you take those lessons that you have learned. So congratulations once again. I would like to associate my comments. We just saw in the last week one of the greatest athletic events in this Nation, which was the NCAA basketball tournament. We saw what happened there, and a football team should be allowed the same opportunity. Mr. Speaker, I yield back the balance of my time.

Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in support of House Resolution 1042, commending the Boise State University Broncos football team for winning the 2010 Fiesta Bowl. The Boise State University Broncos won the 2010 Tostitos Fiesta Bowl against the Texas Christian University's Horned Frogs on January 4, 2010. The game was very competitive with a final score of 17-10. With less than 10 minutes left in the game, Head Coach Chris Petersen called a gutsy fake punt play that led to the game-winning touchdown. The Broncos finished their 2009 season with an undefeated 14-0 record. Sophomore quarterback Kellen Moore threw 39 total touchdown passes during the season, setting the single-season school record. Coach Petersen received the Paul ``Bear'' Bryant Award, recognizing the best college football coach in the Nation, for the second time in 4 years. The team could not have had such an outstanding season without his excellent coaching. The Broncos football team has been a consistent winner, particularly on their signature home blue turf. In 2008, the Broncos' only loss was a one-point loss to Texas Christian University. In 2007, Boise State was victorious in the Fiesta Bowl with an historic 56-7 win. I stand before the House today to recognize the significant achievements of the players, coaches, and students whose dedication and hard work have led to the success of the Boise State University Broncos football team and congratulate them on their victory in the 2010 Fiesta Bowl. I ask my colleagues to support this resolution. Also, to my good friend Congressman Minnick, being a huge SEC fan, you do play some football in Idaho now. Mr. Speaker, I reserve the balance of my time.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I yield back the balance of my time.

Mr. ROE of Tennessee. I yield myself such time as I may consume. Mr. Speaker, I rise today in support of House Resolution 1041, congratulating and commending the University of Idaho's football team for winning the 2009 Humanitarian Bowl in Boise, Idaho. On December 30, 2009, the University of Idaho's football team won the 2009 Humanitarian Bowl in Boise. The University of Idaho Vandals ended their outstanding season with a victory over Bowling Green State University. The Vandals won the game in the closing seconds to take a 43-42 victory for their second Humanitarian Bowl. Head coach Robb Akey led the team to victory and to its first winning season since 1999. Senior guard Mike Iupati--and Mike, I apologize if I mess that up since he is an Outland Trophy finalist--was named to the Senior Bowl and was named an All-American and Outland Trophy finalist. The contributions of this outstanding player and coach were a large part of the Vandals' success this past season. While athletic success is what brings us here today, we should take time to highlight academics as well. The University of Idaho was founded in 1889, and it is the State of Idaho's flagship institution. Located in Moscow, Idaho, it is the State's oldest public university and the State's land-grant university. University programs are organized into 10 different colleges, which have graduated Olympic medalists, NFL coaches, CEOs of Fortune 500 companies, and, of course, Congressmen. I extend my congratulations to University of Idaho president Duane Nellis, athletic director Dr. Rob Spear, head coach Robb Akey and his staff, the hardworking players, and the fans. I wish all continued success, and I ask my colleagues to support this resolution. I reserve the balance of my time.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I yield back the balance of my time.

Mr. ROE of Tennessee. I yield myself such time as I may consume. Mr. Speaker, I rise today in support of House Resolution 1222, supporting the goals and ideals of National Library Week. I also would like to associate my remarks with the gentlewoman from California. First sponsored in 1958, National Library Week is a national observance sponsored by the American Library Association and libraries across the country each year in April. It is a time to celebrate the contributions of our Nation's libraries and librarians and to promote library use and support. In 1957, the National Book Committee developed a plan for National Library Week based on the idea that, once people were motivated to read, they would support and use libraries. With cooperation from various organizations, the first National Library Week was observed in 1958 with the theme ``Wake Up and Read!'' Libraries play a vital role in supporting the quality of life in their communities. The digital divide has narrowed because libraries provide no-fee public computer and Internet access to meet the growing need for access to digital and online information, including eGovernment, continuing education and employment opportunities. Libraries help us discover a world of knowledge, both in person and online, and are a key player in the national discourse on intellectual freedom and equity of access. According to the National Center for Education Statistics' December 2008 report, library use was up to 1.4 billion visits nationwide among all types of library users, continuing a long-term trend of increased library usage. By recognizing National Library Week, we show our appreciation to libraries, librarians, and staff across America. I am honored to support this resolution, and I ask my colleagues to join me. Just as an aside, Mr. Speaker, I would like to encourage everyone, whether they are parents, aunts, uncles, or just mentors, to take children to a library and to read and mentor them. It's a great place to do it. It's a great place to meet, to learn, and to educate yourself. I would like to thank Congressman Vernon Ehlers for introducing this. I reserve the balance of my time.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I thank the gentleman for yielding. Just some real-world experience, not textbook and not in academia. I'm talking about out in my office practicing. The last year I was in practice--and something strange happened over 31 years. My patients got older with me, and they started developing things. I saw 15 breast cancers myself the last year I was in my medical practice. I could feel one of them. The rest of them were picked up on. I could not palpate the mass. They were picked up on screening mammograms. Now, that's something that will be done--and you know if you find that disease that early--it's one of the great stories, Dr. Gingrey, that I like to tell. When I began practice--and all of us here are pretty close to the same vintage. When I began practice, 50 percent of the patients with breast cancer had a 50 percent 5-year survival rate. Today, an early diagnosed breast cancer like that has a 95 percent survival rate. It's a wonderful story to tell. There is no reason for us to go backwards. I mean, it would be a tragedy of unbelievable proportions if we did that.

Mr. ROE of Tennessee. I thank the gentleman for yielding. I think the comment is a government large enough to give you anything you want is powerful enough to take away everything you have. Just briefly on jobs before I go on with health care, three counties at least in my district of 12 have unemployment rates of 16 percent. I left one yesterday, spending the day there before I came back last night. And 87 percent of the people in the First Congressional District of Tennessee don't think the stimulus package has done them any good, and the reason they don't think it's done them any good is it hasn't done them any good. Their own view of it is it hasn't helped them, and I think they're right. I know that we had a lot of discussions and a lot of jokes were made about death panels and so on. There is a provision--I would encourage my colleagues to read this bill, and I've already introduced legislation already. There is a panel. In this Senate bill--not in the House bill. The House did not pass this. But the Senate bill did in reconciliation. It's basically the Senate bill with a few tweaks is what got to the President for his signature. There is a panel in Medicare called an Independent Payment Advisory Board. And before--you know, in this particular plan, the way we fund this, we're cutting $500 billion out of the Medicare plan over the next 10 years. And during the next 10 years, beginning next year, the baby boomers hit Medicare age. We're going to add 3 million baby boomers per year for the next 20 years. Actually, 78 million are estimated to be at Medicare age in the next 20 years. So in 10 years, about 35 million people will reach that age with 500 billion less dollars. And what we did as a Congress was we gave up our purse strings, our control of the purse strings on how Medicare dollars are spent for this Independent Payment Advisory Board. Well, let me tell you what happens. When you have 35 million more people chasing 500 billion less dollars, this panel will use something called comparative effectiveness research. And we know what that is. We've already seen just the beginnings of it when we talk about, Well, you really don't need to have your mammogram until age 50. Let me look the camera in the eye and tell people, Dr. Gingrey--and Dr. Broun knows this very well--I cannot tell you how many patients I have seen over the past years less than 40 years of age with no family history with breast cancer. And right now we begin screening mammograms at age 35, and almost every insurance company in the world pays for screening mammograms at age 35 and repeated at 40 and so on. If you have a family history, you get them more than that. That's what they're going to begin using, and that's what's done in England right now, because they can't afford to pay for the screening mammograms. And you and I both know that we can feel a lump in a breast when it gets about 2 centimeters. And for those of you who don't deal in metric, that is about three-fourths of an inch. You can palpate that. Once a lump gets that big, some of those have actually spread. So that's a panel that will decide whether you get a hip replacement, whether you have heart bypass surgery when you reach a certain age. We need to relook at that very seriously. And that's something that's not known to almost anyone, but I've already introduced legislation to repeal this. And, by the way, there was a letter with 50 Democrats on this that also agreed with this before this bill was passed, and I urge my colleagues on the other side of the aisle to help us to replace this current piece of legislation. I yield back.

Mr. ROE of Tennessee. Dr. Gingrey, thank you, and it is good to be back. I, as you, enjoyed being with family, as I am sure most of our Members on both sides of the aisle did. And I also got the opportunity to view one of the greatest basketball games that has ever been, which is the Final Four in Indianapolis, and my hat's off to the Duke Blue Devils and to the Butler team that played such a great basketball game. One of the reasons I had for running for Congress, I was very happy in a medical practice in Tennessee. I was mayor of our local community, the largest one, Johnson City, Tennessee, the largest community in our district. But I knew that this health care debate was going to occur, and I wanted to be part of that debate. Unfortunately, none of us on the Republican side were consulted, so we were only in the debate in a peripheral way. And the reason that I wanted to be a part of the debate was to share some experiences that we had had in Tennessee over the past 17 years or so in our attempt to not only manage health care costs but to cover more of our people. Tennessee is not a wealthy State. We certainly have one of the lower per capita incomes in the country, and we have a lot of uninsured people. So there was a good reason to try to do something for this. We have several major medical centers in our State both in Memphis and Nashville, Knoxville, and the Tri-Cities area, where I live; and the idea was that we were going to have a plan in Tennessee that was going to have a competition, much like we heard in the public option, which this plan does not have, where various insurance companies would compete for your business, and when they would compete for your business, this would help drive costs down. Well, what we did was we actually provided a massive expansion of a Medicaid plan. TennCare is our exemption for Medicaid. What this current health care bill does is massively expand Medicaid. Now, remember, Medicare is a plan that has premiums which fund it. So there are premium dollars that a recipient gets now who has paid in just like you would for any other insurance plan, whereas Medicaid is not. It's an entitlement. So we massively expanded our entitlements. And how did we do that? We had about eight plans that would compete for your business. In 1993, we had about a $2.6 billion program in our State. Ten budget years later, that has exploded to an $8 billion program; and in our State that was at that point taking up in 2004 about 35 percent of the State budget. Now, since that time, everyone realized that we couldn't continue on this pathway. Here we were in a plan that we would have been happy with 17 percent of our budget. It was 35 percent of our State budget. So what did the governor and the legislature do? And, by the way, our governor is Governor Phil Bredesen, who is a Democrat. He has dealt with this. He has a business background and also has been in the health care business himself. What we did initially was cut the rolls. We cut about 200,000 people from the rolls of TennCare. And when that didn't prove enough, this particular year during this recession, we have had to resort to some more drastic measures. It hasn't been completely worked out yet. But we also found out, Dr. Gingrey, that during this time--and I am going to, during this hour, predict what I believe will happen with this plan that we've just passed. I have seen it happen in Tennessee, and I believe it will happen again with this plan. What happened was 45 percent of the people who ended up on TennCare had private health care insurance and dropped it and got on TennCare. Why did they do that? Why did they go on the government entitlement? Well, it was a perfectly logical reason why they did that. They did it because it was cheaper and it offered first-dollar coverage. It offered prescription drug coverage, unlimited doctor visits. And what did we get for spending this much money? We got the highest prescription drug use in America, number one in prescription drugs and 47th in health outcomes. So if we had spent the money and had gotten better health outcomes and better usage of those dollars, I would have supported it in a heartbeat. The other thing that's not known and never discussed, you never hear it discussed on this House floor, are the pay-fors. And as you as a physician know this, and we're willing to do this especially in OBGYN because pregnancy is one of those things that you either are or you're not. So we accepted TennCare in our practice and always did because the patients needed the care and had to go somewhere. What happened was that at the point that it started, it paid the providers, that is, the hospitals and the doctors, about 60 percent of the cost of actually providing the care. So those other costs, that other 40 percent was shifted to private insurers. An example I will give you is, I don't know, 8 or 10, 12 years ago, our local hospital put an implantable defibrillator in. You know that's where if you have a heart irregularity and you have an arrest, this will restart your heart. The TennCare plan paid, I think, $800 to the hospital, and the device costs $40,000, just the piece itself, not the care to put it in, the doctors and so forth. So those costs were shifted. What I predict will happen with this plan when you massively expand the Medicaid entitlement and those costs are not paid, those costs are going to be shifted to private insurers, and over time those costs will be so expensive that the private insurers are going to say, look, we can't pay that, we're going to have to drop it, drop private health insurance. And you're going to hear the other side say, see, we told you so. We need to take over the whole plan. That is exactly what is going to happen. This particular plan right here is designed to fail, and it will fail financially. Now, will there be some good out of it? Sure, there will be. I mean, you can't spend a trillion dollars and not do some good. The question is, is this the right way to do it? And I believe that is the discussion that we have had this year. And as you well know, the bipartisan vote on this bill was ``no.'' There were 34 of our Democratic colleagues who elected to vote against this bill and all of the Republicans voted against this bill. And it's not that Republicans don't have ideas. I came here, you came here, Dr. Broun, who has joined us, came with numerous ideas. The problem was we never got to share those ideas with anyone.

Mr. ROE of Tennessee. I think what we were told--and you saw lots of manipulations during this particular, incredibly complex bill about the pay-fors and how this is going to be budget neutral. Well, let's just go over some history of these estimates by the government. Number one, when Medicare was established in 1965, it was a $3 billion program. It was estimated by the government--there was no CBO then--but it was estimated by the government that in 25 years it would be a $15 billion program. The real number, $90 billion, and today, over $500 billion. Some of the pay-fors are the CLASS Act. I think this would make Bernie Madoff grin from ear to ear, and he probably is right now. The CLASS Act, unless you exempt yourself out of it, it is a payroll deduction to pay for long-term health care services, maybe a nurse in your home or assisted living or that type thing. Probably not a bad idea. And over the next 10 years, this bucket of money will be about $70 billion. What this plan pays for is it is--have you heard this before? You are going to borrow the money out and spend it on health care, have a $70 billion liability out here that you call an asset, and leave that liability for future generations. We are also doing that with about $54 billion in Social Security. No money there. It is all spent. But my grandchild, who will be 17 in 10 years, will get the bill for that. The student loan program; it was touted as a savings. And let me just take a minute, because I don't have much time, to let people know why is the student loan program in the health care bill? I mean, you should ask that question. Well, the Federal Government took over the student loan program. There were two programs, of which 80 percent used the private sector. In the private sector, Dr. Gingrey, 80 percent of the loans were made for students. Eighty percent. I talked to the chancellor at Vanderbilt University in Nashville, Tennessee, a great university. He much preferred the private program, but it has been taken over by the Federal program. They are going to borrow the money at 2.8 percent, lend it to our students at 6.8, call this interest that they make a savings, spend that on health care. They are not doing that to lower the costs for students to make their education less expensive. In Tennessee, it is going to cost our students about $1,600 to $1,800 over the duration of the loan in more interest payments.

Mr. ROE of Tennessee. I thank the gentleman for yielding. And I think what we need to do, Dr. Gingrey and Dr. Broun, is, why is that a concern? You formed this very well. Why are we concerned about this? And as I said, I believe this is designed to fail because we saw what it did to our local private insurers in the State of Tennessee, where we had about $1,800 per year shifted in costs. So those costs, it's a hidden tax. What will happen is businesses now are struggling. And you know that the number one issue in this Nation right now should be jobs; number two, jobs; and, number three, jobs. Everywhere I went in the district this weekend people were fearful and worried about losing their jobs. They were underemployed or either not employed whatsoever. So we have a system, when this Medicaid expansion occurs, what will happen is private businesses will get, not in addition to all of the taxes that are in here we'll talk about later; but this is absolutely designed to fail. And we're worried about it for what reason? As physicians we're worried about rationing care. I attended a conference at East Tennessee State University College of Medicine while I was home, and we had a look at the Canadian health care system, we had a look at the English health care system, we had a look at the VA, and we had a look at our system. All have plusses, all have minuses, all have problems. One of the things that I listened and summarized in that is that our concern as a physician is that you will eventually, when you have this many dollars and you have more demand for services than you have dollars to pay for it, there is no other option but rationing care. It's happened in every system around the world, and it will happen here. And my prediction is by 2020 is when we're going to really hit, about 10 years because this plan is phased in, if we don't repeal it and replace it, it's phased in over a period of years. And the reason I believe this is that's what I've seen in Tennessee. The other part of this plan that's so similar that we've tried also is in Massachusetts. We have no preexisting conditions, and the Republicans had a perfectly good way to solve that problem. It isn't even difficult if you do this. Preexisting conditions are only a problem for the small group market, small business market and an individual. And when I retired from my medical practice, I had a single insurance plan. If it had been tax deductible, it would have been 35 percent cheaper for me to own health insurance coverage; and high-risk pools, and let you go across State lines and form large groups. You can solve the preexisting conditions without mandates. In Massachusetts they have a mandate, and there's a tax for a fine if you don't purchase health insurance. And without subsidies, without Federal subsidies, that plan in Massachusetts would be in terrible problems, terrible shape. So what have we done? We have taken the Tennessee plan, which hasn't worked. And by the way, this year, Dr. Gingrey, we're going to limit patient visits to eight doctor visits per year in the State because that's all we can pay for. And all the TennCare plan will pay for your hospitalization is $10,000. I don't care what the bill is. So you've got both. We're already rationing care with that system. You've got the Massachusetts plan that's also doing exactly the same thing. And those two together. One other thing I want to mention before we get Dr. Broun in, actually two things----

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Madam Speaker, I rise today to commend the city of Kingsport, Tennessee for observing the National Day of Prayer on May 6, 2010. Since the first call to prayer in 1775, when the Continental Congress asked the colonies to pray for wisdom in forming a nation, the call to prayer has continued through our history. In 1952, a joint resolution by Congress, signed by President Truman, declared an annual national day of prayer. In 1988, the law was amended and signed by President Reagan, permanently setting the day as the first Thursday of every May. I am very proud of Mayor Phillips and the city of Kingsport for observing this important day.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. It is a fair assessment. And now, countrywide, 40 percent of our primary care physicians choose not to see a Medicaid patient, and 60 percent of specialists. It's estimated that it will be, when this plan goes into effect, 60 percent of primary care physicians won't see these patients and 80 percent of specialists won't see these patients.

Mr. ROE of Tennessee. In our State right now, let me just give you some real-world experience as to what's going on in our State-run plan, TennCare, which is the State Medicaid plan. Right now, we're discussing limiting patient visits to eight per year, no matter how many times you may need to go to the doctor. Number 2, the State's considering paying only $10,000 in total for a patient visit to the hospital, no matter what the cost is, meaning that those costs are going to get shifted to private insurers. And over time, if that occurs, and we expand massively the Medicaid system around the country, you're going to shift more and more cost to the private insurers, and when that happens, eventually they're going to fail. And I think that may be the purpose here. The other thing is that I had a friend of mine visit this week from home, and right now, to get an orthopedic surgeon to see you, you're going to have to drive 100 miles to see this orthopedic surgeon. The State of Tennessee, as of the 1st of July of this year, will no longer cover rehabilitative services for a patient who's operated on or any rehabilitative services for an injury. That's what we have now. And we're asking our State to take on more and more cost. And what concerns me--it's not about the good things that are in this bill, and there are some things I agree with very much. But the other things are how do we pay for it, and how do we then find someone to pay for the care? The other little caveat is that these plans never pay for the cost of the care. TennCare, right now, pays about 60 percent of the cost and going down. Medicare, as you know, pays about 80 to 90 percent of physician cost.

Mr. ROE of Tennessee. Madam Speaker, a recent news article posed a question that gets at the heart of this debate: Will the law as the Democrats have planned spur economic growth by lowering health care costs and allowing companies to expand and hire new employees or, as many business advocates have argued, will the opposite occur? It's a good question. It is a fair question. So let's look at the evidence that we have. In Massachusetts, they passed a plan with broad mandates and an exchange-like health care marketplace. The plan has resulted in the highest insurance premiums in America, rising faster than anywhere else in America as a percent, and a large number of individuals forego insurance until they get sick, then they show up and get the care and pay a relatively low penalty. In Tennessee, where we've expanded our State's Medicaid program, we saw employers shift the cost to the public sector and then watch as our program tripled in costs. Now, before any of these expansions go into law, our State's being forced to limit enrollment and ration care. And nothing in this bill helps control costs like tort reform, and it's nowhere to be seen. And trust me, as an OB-GYN doctor, one of the things you could do for our patients is to work on this very needed bill, apart from this bill, and we could do it separately, and yet we haven't done that. What's being proposed now is combining the worst part of both State systems, and I think the evidence clearly shows that costs will be higher and with the decreased access and lower quality. The American people deserve to know that this bill flies in the face of real-world experience and it deserves to be defeated. Another comment, Madam Speaker, I'd like to make is that, in my years of experience, I have not seen a patient's health care denied or a preexisting condition because of a miscarriage. I have personally not seen that, and I'd like to see reference to that if I could.

Mr. ROE of Tennessee. Thank you for yielding. One of the things that is disturbing, and I have taught medical school and taught medical students, only 2 percent of our graduates now are going into primary care. And I'm in a group with 70 primary care doctors. I was in a group until I came to Congress. And we can't get our best and brightest to go into primary care. And it's a real quality issue, because what concerns me about our Medicare plan is this: At the time I came up here, I was having problems finding primary care doctors, internists, family practice to see my patients that I'd operated on.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, today we debate and vote on the most important piece of social legislation in decades, a massive expansion of government unparalleled in our Nation's history, with the potential to bankrupt future generations by lowering the standard of living for our children and grandchildren. For the past 30 years, I haven't been a politician, but a physician, treating patients and delivering babies in rural east Tennessee. And I can say without hesitation that we have in this country the highest quality of health care in the world. But I will also say that this care is too expensive for an increasing number of people. Health care should not be a partisan issue. I have never operated on a Republican or a Democrat cancer in my life. We have heard about how this is going to save money and reduce the budget deficit. Seventeen years ago in Tennessee we tried a plan called TennCare. It was an idea where different companies were going to compete and we were going to cut costs. What happened in that? Just 10 budget years later, our costs had tripled and we had to cut the rolls in Tennessee because the State was literally going bankrupt. And this year for the first time, we have had to limit patients' visits to 8 doctor visits per year, and this plan will only pay $10,000, I don't care what the cost of the care is, and those costs are shifted to private insurers. Also the physicians are not taking TennCare because it pays them less than 60 percent of their costs of actually providing the care. That approach, which is pretty much the same approach we are voting on here today, failed, and I know because I am a physician who worked in that system. Mr. Speaker, I have one question for every Member of this body: If we have seen how this Big Government scheme doesn't work, why would you vote for it again? Well, the States know. They are already well ahead of the Federal Government. Thirty-seven States, including Tennessee, are now proposing legislation to opt out if the ObamaCare plan should pass. So the States get it because they can't afford it. The seniors get it because they understand $500 billion will be cut from this program. And let me tell you, in the next 10 years we are going to add 35 million people to the Medicare rolls in this country when the baby boomers hit. Three things will happen when that occurs: you will decrease access; you will decrease quality because you can't see your doctor; and costs will go up. So seniors get it. The doctors get it. They are going to work harder and get paid less. Also, there is no meaningful tort reform, and without that, you cannot reduce the cost of care. The American people get this. The people of Tennessee don't want this plan. The people of the United States don't want this plan; but the politicians who vote for it are not listening. I choose to listen to the American people and vote ``no,'' and urge my colleagues to do the same.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Madam Speaker, I know that I am just a country doctor from Tennessee, but the fact that we can't have a true up-or- down vote on one of the most important pieces of legislation this body will ever consider just flat out confounds me. I decided to do a little research on the issue, and just since the time I've been here, the House has recorded votes on whether to congratulate two college football teams, a college basketball team. There was a vote on a college quarterback. We've even held votes on honoring 10 colleges and universities and named 30 post offices. The House held a recorded vote on whether to pay tribute to Homeland Security Department employees, and just this week, we actually voted on whether or not to congratulate Vancouver on hosting the Winter Olympics. Heck, we've even asked Members of Congress to go on record about the 2,560th birthday of Confucius. We can vote on all of these matters, but we can't have a vote on health care. Madam Speaker, if anyone can explain this to me, my phone line is open.