Phil Roe

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I would agree with that. I think the biggest problem you have when you don't have enough resources in the system to develop new medications and new technologies, new treatments, new pieces of equipment, there's no question that you freeze in time where you are. I recall it wasn't a day that I would go to the operating room that I wouldn't see somebody back in the seventies getting operated on for an ulcer, bleeding ulcer. It's almost unheard of now because of medical treatments and other endoscopic treatment. You have almost eliminated that very invasive surgery. We certainly don't want this to slow down. One of the things that I think we value in America--I know we do--is we value every human life. Every life has great value here. And that's one of the things that I've seen in my practice. Whether you are rich or you are poor, you are valuable to the American people and to the health care system. And we're going to take care of you. Dr. Broun, Madam Speaker, one of the things that's an untold problem in the health care system is the availability of care--the accessibility of it, I should say. In the next 10 years, 50 percent of our registered nurses are able to retire. Fifty percent. We need a million more nurses by 2016. That's only 7 years from now. So we need to be encouraging young people to go into these very needed specialties in medicine and as physicians. We're already behind the curve. In the next 10 years we will have more physicians retiring or dying than we're producing in this country. And the population is growing and the baby boomers are going to need more care. And guess what we're doing? We're living longer than we've ever lived in the history of the world. So we have a multiprong problem. It's not just that; it's do we have access. Am I going to be able to find a nurse and a doctor to take care of me. I yield to the gentleman.

Mr. ROE of Tennessee. Will the gentleman yield?

Mr. ROE of Tennessee. I think, Madam Speaker, what we need to do is look at the problem we're faced with. What are people concerned with? Well, affordability. Certainly, we've got to deal with this. Number two is accessibility. We have talked about that somewhat. Thirdly, when we have a job, our health insurance is tied to our job. So we're concerned if I lose my employment, I lose my job. Do you need an entire government takeover of medicine to address those issues? No, you don't. When you look at portability, that's certainly one thing that I think can be done with very minimal government involvement. I will give you another quick example. Many of us have children. And today is a very poor work environment. So when you see young people come out of college or out of high school today, it's very difficult for them in this market to find a job. But guess what happens to them when they graduate from East Tennessee State University or the University of Georgia, wherever, and there's no job available? They lose their health insurance coverage. Why not just leave them on their parents' plan until they're 25 years old? It wouldn't cost the government a nickel. Do you know how many people that would cover, estimated, in this country? Seven million young people. And I know for all three of my children, when they got out of school, they all needed help with their health insurance coverage. I had to go out and buy a private health insurance plan, which was not tax deductible. Another example I'll give you is myself. Last year, when I worked in my medical practice, I provided health benefits. That was one of the benefits we have for our employees and for me. I retired from my medical practice to run for Congress. The next day, my health premiums went up 33 percent because they were no longer deductible. That's not expensive for the government to do. Simply allow individuals out there who want to purchase their own private health insurance plan--if you're a farmer or small business person, let them deduct that exactly like GE does, or any other large business

Mr. ROE of Tennessee. Yes.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Madam Speaker, I rise today to congratulate Sycamore Shoals State Historic Area on their play ``Liberty!'' being recognized by the Tennessee General Assembly as the official outdoor drama of the State of Tennessee. ``Liberty!'' has been performed annually during the month of July for 31 consecutive years. ``Liberty!'' tells the story of Tennessee's frontier beginnings by portraying the relationships between the American settlers and the native Cherokee Indians. Hundreds of gifted local volunteers come together at the location where these historic events actually occurred and celebrate the lives of the people and depict important episodes that helped shape the heritage of this great state and country. I want to congratulate and sincerely thank all of the volunteers that contribute their time and efforts to ``Liberty!'' for honoring our great state of Tennessee.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Chairman, I rise in support of the Paulsen amendment to give special consideration to SBIR funding for medical technology. The underlying legislation prioritizes projects that are related to energy and infectious diseases, and there is no question that these are deserving areas. But I believe the Paulsen amendment adds an important priority category that is left out, medical technology. The fact is, because of our health care system, we lead the world in medical technology advances. It's a huge competitive edge we hold and one I do not want to lose. As a physician, I was able to take advantage of this technology over the course of my career, and I can give numerous examples of how care was improved for my patients. Prioritizing SBIR funding for medical technology projects is one step to help us maintain our edge. While this amendment will take steps toward creating a fertile environment for medical technology advances, it is important not to take two steps back by creating a government-run health care system. A major problem with care that is managed by Washington bureaucrats instead of patients and doctors is that bureaucrats are focused on cost rather than advancing care, and they inevitably require the use of older, less expensive technology because of its comparative effectiveness. If the health care system refuses to use new technology until older technology is proven ineffective, we eliminate much, if not all, of the incentive for new medical technology developments and rob future generations of the chance to find cures for cancer, Alzheimer's, Parkinson's, and diabetes, just to name a few. I urge adoption of the Paulsen amendment, which to me is just common sense, and hope this Congress does all it can to keep the health care system that rewards medical research and development.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Madam Speaker, I rise in opposition to this rule and the underlying legislation. I've only been here 6 months, but this is the worst piece of legislation that has come out of the House yet. It defies logic that at a time of economic recession we would impose a regressive national energy tax that many have predicted will result in a net job loss. Supporters of this legislation only want to talk about the so-called ``green'' jobs that will be created, but they conveniently ignore that some studies indicate that for every one job created, two are eliminated. Worse, we are creating a costly, confusing program of carbon credits. Let me make one prediction: the only certainty under this bill is Wall Street traders sophisticated enough to understand how these credits are traded will make millions. I offered an amendment yesterday at the Rules Committee stating that at least bring it to a level playing field between the U.S., China, and India. My feeling is that if Congress is going to pass this legislation, we should require India and China--two enormous and growing resources of greenhouse emissions--to abide by the same standards. My amendment would have required the U.S. to come to agreement with these two countries on emission reductions before implementing any provision within this bill. This rule is a sham. It pales in comparison to how awful the bill is. I urge the Members to demand a return to the democratic process and defeat this bill that will certainly exacerbate our economic recession.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. I thank the gentlewoman for yielding. Madam Speaker, I strongly urge opposition to this undemocratic rule. The majority is apparently unwilling at best or afraid at worst of debating whether the Environmental Protection Agency should have the authority to change the Clean Air Act without congressional opinion. I went to the Rules Committee last night and asked them to make in order my amendment that would prohibit the EPA from using funding to implement or enforce its Notice of Proposed Rulemaking finding six greenhouse gases constitute a threat to the public's health and welfare. On April 24, 2009, the EPA issued a proposed rulemaking that it had found six greenhouse gases--carbon dioxide, methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons, and sulfur hexafluoride-- pose a significant threat to the public's health and welfare. This endangerment finding is a precursor for the EPA to regulate these gases' emission, with or without explicit authority from Congress to do so. My amendment would have simply returned this explicit authority to Congress to regulate greenhouse gases. Without this amendment, the EPA could threaten sweeping changes without giving any consideration whatsoever to its effects on the economy since the EPA's mandate is environmental and public health. Passing this amendment could have removed a threat so that we can consider climate change legislation in an open, deliberative process. If the majority's national energy tax scheduled for debate later this week gets signed into law, eventually the EPA can move forward on enforcing this explicit action by Congress. But there has been no action taken yet. Rather, the courts have decided the EPA has the authority to make such a determination, which is hardly what Congress intended when it passed the Clean Air Act. Unfortunately, the Rules Committee blocked this amendment. Furthermore, Congressman Lewis and Congressman Blackburn had similar amendments, and the Rules Committee denied all three. If we had an open rule, we could not be debating all three of our amendments. We would be debating one. Unfortunately, because of the Democrats' unprecedented lockdown rule, we don't get a chance to debate at all. This is a travesty for democracy. I urge all Members to reject the Democratic leadership's attempt to stifle debate and impose its will on the House by defeating this embarrassing rule.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, yesterday on the House floor, I offered an amendment to fully fund President Obama's budget request for the Federal prison system, and it was called a ``draconian cut.'' I'm sure President Obama would be surprised to learn his recommended level would be greeted by such hostility by his own party, considering he proposed spending $384 million more in fiscal year 2009, an increase of 6.8 percent. Only in Washington, DC, is a 6.8 percent increase called a ``draconian cut.'' Back in Johnson City, where I was mayor, we had a very simple philosophy. We spent less than we took in. When I arrived in Washington, DC, I learned the President's philosophy was to borrow more than you take in and then spend all of that. Apparently, congressional Democratic philosophy is borrow even more than the President and then spend that. I hope it's apparent that we are addicted to spending. I hope we adopt my amendment today and send a message, a small message, that this Congress is not entirely tone deaf to the fact that we have record deficits and runaway spending.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I demand a recorded vote.

Mr. ROE of Tennessee

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

Mr. ROE of Tennessee. Mr. Chairman, I demand a recorded vote.

Mr. ROE of Tennessee. Mr. Chairman, I have an amendment at the desk.

Mr. ROE of Tennessee. I yield myself 2\1/2\ minutes. Mr. Chairman, I believe the level of spending in this bill is irresponsible in light of our deficits, but I also know my view is in the minority. This is about priorities and it is about morals. This year, we are going to pass $1.8 trillion in new debt on to our children's generation. I would argue that passing this level of debt on to our next generation is immoral. So far, there has been not one iota of interest in setting priorities from the majority. Instead, they've chosen to fund everything generously and call that priority setting. That's their prerogative. They won the election, and they are entitled to run our Nation's credit card well past its limit to never-before- seen levels. When it comes to spending in budgets, it is clear from debates that there is no interest in adopting Republican ideas by my friends on the other side of the aisle, so I went to a source you might not think a Republican would look at: President Obama's budget. The President has requested nearly $6 billion for the Federal prison system. The Democratic Congress has increased that by $97.4 million. We are trying to support the President and show a little bit of fiscal restraint by adopting the President's budgeted level. In percentage terms, this means we are growing at 6.8 percent instead of 8.6 percent. If it passes, the amendment's impact will not be huge, but it sends a message, however small, that this Congress is not completely tone deaf to the concerns about the deficit of runaway spending. It is important to note this is not a vote on whether to cut the program. It is a vote on whether to provide the program the President's proposed increase or to provide it the Democratic leadership's proposed increase. Mr. Chairman, I reserve the balance of my time.

Mr. ROE of Tennessee. Mr. Chairman, I yield myself 1 minute. I certainly understand the budget constraints. I've been a mayor, had a jail system under my supervision, and I also know that around this Nation there are cities and States that are dealing with budget deficits never before seen, and here is the only place in the world I have ever seen where we raise it almost 9 percent and then give the President exactly what he wanted and call that a draconian cut. It is not. We should show some fiscal restraint here in the House as an example to the people around this country, families and cities and municipalities and States, that are working hard to balance their budget. In my own hometown they're doing that by making real cuts, not making huge increases and reducing it somewhat. This is a very minimal cut, and not a cut actually but a reduction, and exactly what the President of the United States asked for. Mr. Chairman, I reserve the balance of my time.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, I rise in opposition to this bill. I wanted to come down to the House floor to let the troops know I support them and how much I appreciate the work they're doing around the world. I have been to Afghanistan and to Guantanamo Bay this year to see the work they're doing, and it is tremendous. We should all be proud of their effort. Unfortunately, today's vote misuses critical funding for our troops to push through billions in foreign spending. People in east Tennessee question why we're giving $5 billion and over $100 billion in loan guarantees to the International Monetary Fund to bail out other countries when we have so many needs right here at home. Additionally, because this legislation designates everything as ``emergency'' spending, this spending is not offset and breaks the already-inflated spending caps. The way I see it, the only emergency I see is that a month has passed and the Democrats haven't added a few billion to our already record deficit in new spending. I urge members to defeat this bill and force the Democratic Leadership to bring us back a clean supplemental that supports the troops.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Good points about the private versus the public sector. The private sector will always be more efficient and more responsive. And you have heard this story before, but when I began practice and when you did, Dr. Gingrey and Dr. Fleming also, when a patient came to me, and I took care of nothing but women, and when they came to me with breast cancer--which I unfortunately saw way too much of and our practice diagnosed about a case a week. It was that common or is that common. And we just had a relay this weekend. In 1977 or so, the 5-year survival rate was about 50 percent, maybe a little bit better, but about 50 percent. And the big argument came: Do you do a disfiguring operation of a radical mastectomy or a lumpectomy? Because the survival rates were the same. So what has happened over that time is that now a patient can come to you or me or any of our colleagues and we can tell them that because of early detection, because of education, because of mammography, you're going to have a 98 percent survival rate in new medications. That is a wonderful story to tell. And I know no matter how tough the times are for that patient, you can look at them and say, You're going to be okay. In the English system, they quit doing routine mammography. And why did they quit doing that? Screening mammograms aren't done anymore. Why? Well, because it costs more than the biopsies. Sometimes a test will tell us we have something when we don't have it. That's called a false positive. And the phone call that I love to make is to my patients to say, You do not have cancer. So this is one where they quit doing that because the cost of the biopsies was more than the screening. The best rates they had were 78 percent survivals, and those are going to go down if you use that technique.

Mr. ROE of Tennessee. It was. And I think the discussion, as I recall--and Dr. Fleming is absolutely right, there are not that many disagreements, it's who is controlling these health care decisions; is it a bureaucrat or is it the patient and a doctor? And I think that is where the big discussion is. Now, as I recall, when the Medicare part D discussion came up, the problem was going to be--the argument I heard the other side make was that without this public option there wouldn't be enough competition, and therefore prices would go up. But was what happened in part D--and I'm not saying part D certainly is perfect, it's not--but what happened was, with a competitive market out there, that actually came in lower without the public option when you had the private option competing in the open market. And I believe the discussion among the Democrats was that without this public option, that wouldn't happen. Well, just the opposite happened. And again, we have seen what happened in Tennessee, I don't want to go over it again. But I can assure you that it will be a plan that promises more than it can deliver for the funds that are available, and there will be two options. And you know what those options are, and that's long waits--and I just don't think the American people are interested, I know I'm not interested in that.

Mr. ROE of Tennessee. Just a couple of comments. Our colleague from California made great points. And I am going to ask the two of you who have been here for a while to discuss this Medicare part D discussion in just a moment. But he is correct. What happened was, when we created the TennCare plan in Tennessee, we are surrounded by eight States in the State of Tennessee, and we had a plan much richer than the surrounding States. So guess what happened? People came into the State. First of all, when we first put the plan out, all you had to have was a post office box. Well, there were a lot of post offices boxes that occurred, and a lot of people came into the State of Tennessee to get care. The way the Governor handled that--and remember that government-run plans--and I want people to understand, this is a very important point--in Tennessee, when it was about to break the State, our Governor, along with the legislature, made some very tough decisions. They cut the rolls. They limited the number of people that were on the TennCare plan. In a plan in England or in Canada or other single-payer systems, what happens is you ration care, you create waits. For example, in Canada--and this is the head of the Canadian Medical Association, not Phil Roe saying this--but he said you could get your dog's hip replaced in a week in Canada, but it takes 2 to 3 years for a person to get their hip replaced in Canada. And I think you made that point this morning during 1 minutes.

Mr. ROE of Tennessee. Just a point right here. You were making an excellent point, Dr. Gingrey, about why you don't want the Federal Government to come between a patient and a doctor. A veteran can go to an emergency room, have an electronic medical record at the VA, can show up somewhere in an emergency room, let's say, in our area we have a VA Hospital in Johnson City, and let's say he lives in Mountain City, Tennessee. He shows up there and the doctor in the emergency room at Mountain City does not have access to his VA record, to his electronic record that they have at the VA. Now, I think we can do better than that, and that's going on right now. So that veteran who's up there with, maybe he's an elderly veteran, a World War II veteran with a very complicated medical history, that emergency room doctor is flying by the seat of his or her pants, and I think we can do better. And again, the health care decisions should be made between a patient and a doctor. And I don't want to let the private insurers off the hook here. You and I know this, and Dr. Fleming, also. I remember one of the last cases I did in practice before I retired to run for Congress, I spent almost as much time on the phone with a private insurer trying to get the case approved as I did actually doing a major surgical procedure. Now, that's the ridiculous item of the day when you do that, when you're not providing care to someone, you're arguing with a bureaucrat at the private health insurer. I yield back.

Mr. ROE of Tennessee. Would the gentleman yield?

Mr. ROE of Tennessee. Thank you, Dr. Gingrey and also Madam Speaker. It is good to be here tonight to discuss a very important, and I believe, Dr. Gingrey and Madam Speaker, probably from a social standpoint, the most important issue that we will discuss, and probably this health care debate is the most important one since the mid-sixties when Medicare was voted on. Just to give you a little background, I am a native Tennessean, practiced medicine in Johnson City, Tennessee, in that region for 31 years, and really saw a tremendous change in the health care delivery system from 1970 when I graduated from medical school until the current. I really marvel myself at the miracles that occurred. I recall when I was in medical school when St. Jude's Children's Hospital had just opened, it hadn't been there long, and the death rate among childhood cancers was 80-plus percent. Today, over 80 percent of those children survive and live and thrive. We are having a debate on what kind of system best fits America and its personality, and I will share with you some things we have learned in Tennessee about a public and a private system. What I hear when I am out talking to people is that, number one, they are worried about the cost of care. They are worried about the availability of it. And there is another whole discussion that we haven't had, which is accessibility. As we age, as the medical population and caregivers age, there is going to be a huge problem of accessibility in this country. We are already seeing it in our own communities, where in the next 7 years we will need 1 million more registered nurses in America. In the next 8 to 10 years there will be more physicians retiring and dying than we are producing in this country. Well, you know, that is not sustainable. You cannot maintain the quality of care that we have grown to expect and the medical advances we have grown to expect without practitioners. That is an entirely different issue, not part of this debate, but indeed very much a part of this debate. In Tennessee, about 14 or 15 years ago we had Medicaid. We got a waiver to try a managed care system. Back in the eighties and nineties, managed care was going to be how we were going to control the ever- escalating health care costs. So it was a wonderful idea to try to provide care to as many Tennesseans as we could at as low a cost as we could. What we did was we hastily put a plan together, as we are doing right here in this Congress right now. The most astounding thing I have ever heard in my life is in 60 days, or less than that, we are going to vote on a health care plan that affects every American citizen, 300 million of us. And your health care choices, as you know, are very personal choices. They are between you and your physician and your family. So the plan was a managed care plan, and it was a very rich plan. It provided a lot of care for not much money, and for some people no money. What happened was that people made very logical choices. About 45 percent of the people who ended up on TennCare actually had private health insurance, but dropped it. Why did they drop their care? Well, you had a plan, this TennCare plan, which was cheaper, but provided more coverage, so therefore people made again a very conscious decision. The problem with the plan is, as with every public plan so far, is it does not pay the cost of the care. That cost has been shifted over to the private sector. So when you look at your health insurance costs going up each year, you are paying or supplementing, a tax really, on your private health insurance premiums caused by the increased usage of the public plan. In Tennessee, for instance, the TennCare plan covered about 60 percent of the cost of actually providing the care. If everyone in Tennessee had the TennCare plan, most providers would lock the door, throw the key away and walk away because they couldn't pay their bills. Medicare, another plan that we have, pays about 90 percent of the cost, and our uninsured pay somewhere in between. Now, what I think will happen with this public plan is that once again, because politicians are involved in designing the plan, what will happen is more and more and more things will be promised about what will be covered in the plan, but when it comes to paying for it, and if we have time we can get in and discuss the Massachusetts plan a little bit, what will happen is you will have a Medicaid plan that doesn't pay the cost, you will have a Medicare plan that doesn't pay the cost, and you will have a public funded ``competitive'' plan that is subsidized by government but doesn't pay the full cost of the care, meaning more and more costs will be shifted on to the private payers. Well, what will happen over time, I think, is that, again, individuals first, small businesses, 20, 30, 40, 50 in the business will say, We just can't afford this private continually escalating cost of private health insurance. And what will happen then is more will be shifted to the public plan, and over time you'll end up with a single- payer system. And a lot would say, and I've heard it argued here on the House floor, Well, so what? What's wrong with that? We have a government-run, one-payer health care system. What's the problem with that? Everybody has coverage. Well, everybody has a health insurance card, but that doesn't necessarily mean you can get health care. Don't confuse a plastic card that says you have coverage with actually getting care. Well, what do I mean by that? Well, let me give you an example. When President Clinton had his heart attack, he went to the hospital, had a heart attack. He was operated on several days later, I think 3 or 4 days, and probably the reason, in my opinion, he probably got a blood thinner that took a few days to get out of his system. And he was operated on and went home. Had he had that heart attack in Canada, they would have said, Mr. Clinton, you can go home and in 117 days, that's the average amount of time it takes to get a bypass operation in Canada, you can come back and get your bypass operation. Two weeks ago, I was in Morristown, Tennessee, talking to a physician there who is Canadian. His father began to have chest pain. I won't go through all the details about how long it took him to get a treadmill, how long it took him to see a cardiologist. Anyway, 11 months later, the man got--his left anterior descending coronary artery was 90 percent blocked, and he finally survived and got a bypass operation. I do not believe the American people are going to put up with that type of health care system. We are not. The other thing that I think that's been so astonishing to me, and I know Dr. Gingrey and Dr. Fleming, you have seen this, and Dr. Broun also, are the medical advances. When I graduated from medical school, we had one cephalosporin antibiotic, one. That's a type of antibiotic we use in infection. There probably are 50 today. There were about five antihypertensives, high blood pressure medicines, three of which caused severe side effects. I mean, it was almost better to have the high blood pressure than take this medicine. Today there are over 50, and the side effects have been reduced dramatically. People do so much better. So there are a lot of reasons, and we can go to it, and I'm going to yield back some time now, Dr. Gingrey and Dr. Fleming, for comments. And I have some other comments about a single-payer system. It's a good idea, as you pointed out a moment ago, to try to cover as many people as we can in this Nation as inexpensively as we can, and I agree with that. I yield back.

Mr. ROE of Tennessee. Will the gentleman yield?

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Mr. Speaker, it's time we address the crisis in health care. We can ensure every American can get the care they need, protect individuals from costs that can bankrupt them, and make health insurance portable so they can move or change jobs without losing health insurance coverage. We can also stop insurance companies from avoiding sick patients by reforming the system to pay when people become healthier. Enacting a public plan will not bring about this type of change. If you think you won't be affected by a public plan, consider this: a recent analysis by the respected independent firm The Lewin Group estimated that 70 percent of individuals who have health care coverage through their employer would lose those benefits in favor of a public option. This plan could very easily be a Medicaid-like plan. In fact, Senator Kennedy is proposing expanding Medicaid to families making up to $110,000 a year in legislation he dropped yesterday. When supporters of a public plan say they want a public plan to compete with private plans, the facts show that what they're really saying is they want a Washington bureaucrat to take over health care decisionmaking. Buyer beware.

Mr. ROE of Tennessee

Mr. ROE of Tennessee. Yes.