David Schweikert

Mr. SCHWEIKERT

Mr. SCHWEIKERT. You are very kind, and I thank you for the colloquy. Look, many of us just want to solve the problems. I have the best little girl in the world sitting in the back right now. She is 3 years old. What does her future get to be like? We have a demographic crisis. It is just math. We are getting older very quickly. If we don't grow the economy, if we don't have lots of labor force participation, and if we don't use trade and tax policy and innovation, we need these things to grow. But instead, Madam Speaker, if you listen to the speeches that often end up behind these microphones, it is an absurdity that is partisan because we care about power more than actually doing those things that are so important for our future of this society. So I want to give you one last, ultimate thought experiment. I am still just stunned this article hasn't gotten more coverage around the country, but it is going to require many of us to actually deal with some of our political constituencies that have lots of folklore built into their belief systems. About 6 weeks ago, an article came out. University of Illinois U.S. Agricultural Research Service published a paper saying--now, you all remember your high school or your first botany class or when you were actually learning about cell biology--there is actually a weird inefficiency in plant cells on how they grab a carbon molecule or oxygen molecule--we won't geek out too much--but they found a way through a bit of genetic engineering to make the cell wall superefficient. They basically believe that they have broken the Holy Grail that plants, commodity crops--right now they did it on tobacco plants, because the reason they do research on tobacco plants is we have known the genome of tobacco plants for quite a while now--40 percent increase in efficiency. We have got to think this through. Now, there is a really disruptive side of that. Forty percent, tomorrow if you could plant a corn seed or wheat or something else, and it had 40 percent more yield, what does that mean to feeding the world 50 years from now? Yay. What does that mean to commodity prices? Scary. But you need functionally now 40 percent less land, 40 percent less water, 40 percent less fuel, and we actually have some data here from the IPCC 2014 report which is from the United Nations that just a little under one-quarter of all the human emissions, functionally greenhouse gases, come from agriculture. If you do the math--think about this--this 40 percent increase in yield for agriculture would functionally equal removing every car off the face of the Earth. Think about the conversations we have here talking about the environment. Here is a miracle. And the reality we know from other disruptions in seeds that it can be rolled into society very quickly as these new seed stocks, except we are going to have to deal with our brothers and sisters saying: well, that is a genetically modified seed. Yes, but it has this amazing disruption in the world. If you truly care about greenhouse gases, if that is your fixation, just moving to this new disruptive technology that I hope is real, I hope the research continues to demonstrate a 40 percent production increase, this here could be the fastest, biggest disruption in greenhouse gases in the world because you could actually adopt these seed crops within just a few years. That is an example of technology not just bringing a small improvement or even a disruption, in many ways it is a major disruption, but you have to deal with the politics of belief systems. It is genetically modified, but it is not a genetically modified seed stock to deal with pests or this and that, they just dealt with the inefficiency of the cell wall. It is a miracle. If it is true, it is a miracle. Think about it, though, but understand the disruptions that are going to roll through our society. What happens to the value of agricultural land? What happens to the ability of nations to ultimately feed themselves if all of a sudden they had a 40 percent increase in productivity? But also what happens in our world if I come to you right now, Madam Speaker, and say that agriculture produces functionally, by my math, a bit more than 2\1/2\ times the amount of emissions of every car on the Earth? So this technology would be as if you just removed every car off the Earth. How come we don't have these types of conversations here on the floor? It is because it doesn't fit our political folklore model of what has become just a stunningly partisan gotcha weaponized body. As we go through our five pillars for the future one more time, the reason for the fixation on this, we have 74 million of our brothers and sisters who are baby boomers, the last baby boomer hits 65 in 9 years, many of the things we should have done we should have done a decade or two decades ago, and we didn't have the political appetite. We have to deal with the reality that we have this population bubble that is getting older and our birthrates have substantially collapsed. If we are going to keep our promises to those folks who have worked their entire lives who will be moving into their benefit years, we have to think disruptively. We have to be willing to do everything from tax policy, trade policy, and regulatory policy that we have talked about here using technology, to labor force participation, encouraging people all up and down the spectrum to actually enter the labor force. We have to be willing to talk about redesigning some of the programs to incentivize, if you wish to work, you get to work. We are going to have to actually also embrace the miracle of these disruptive technologies and not be scared of them. But this body is going to also have to deal with something that is very difficult for a political body, and that is a lot of our friends are going to either have to change their economic models and a lot of our States are going to have to change their regulatory models just as we will. But it is these disruptions that give us the economic robustness to actually keep our promises over the next 30 years. Madam Speaker, I yield back the balance of my time.

Mr. SCHWEIKERT. It is actually a tax credit according to the amount of tonnage you produce of ACO2.

Mr. SCHWEIKERT. Madam Speaker, what we are going to do right now is, and we are going to hopefully only take about a half an hour, actually walk through sort of the continuing theme of how at least our math--and particularly in our office, we have been trying to put together sort of a unified theory of how do we deal with the reality of what is happening in our country with our demographics. We are getting older much faster, and our birthrate has fallen dramatically. Repeatedly, we have come up here with other boards that basically show, over the next 30 years, the greatest threat to our economy, to our society, to our country's priorities, is the fact that our interest, Social Security, Medicare, healthcare entitlement costs consume everything. The rest of the budget is functionally imbalanced. I know this is uncomfortable because it is one of those things that is hard for us to talk about. It is not Republican or Democratic. It is demographics. It is math. Part of that baseline, to understand 2008 to 2028, take those 20 years, 91 percent of the spending increase here in Washington, if you remove interest, 91 percent of the spending increase is--actually, I think it does include interest--interest, Social Security, healthcare entitlements. We need to understand the basic math. And now, how do you actually deal with it? How do you maximize economic growth? How do you maximize labor force participation? How do you encourage people, if we built the incentives, to actually stay in the labor force longer? How do you actually embrace technology, particularly disruptive technology that crashes the prices and makes our society healthier and more efficient? And then, how do we have an honest conversation of those earned benefits and build them so they have incentives in there that, if you are fit and healthy and happy, you are willing to stay in the labor force longer? Are there certain spiffs and benefits we can design into these? So those are sort of our five pillars. Today, we are going to do something that is fun. We just grabbed a handful of concepts that are about technology, and the tough part--when you start talking about disruptive technology--it makes you sort of giddy for what the future is and the opportunities. But there is this thing we call incumbency, particularly in economics--incumbency: the incumbent business; the incumbent medical provider; the incumbent over here. These technologies are going to be a real challenge. The running joke in our office is how many of us went to Blockbuster Video last weekend. We sort of woke up one night and all decided to go home and hit a button called HBO Go, Netflix, those things. We no longer stood in line and got movie suggestions and went home with a little shiny disc. We are going to walk through, first, some of the healthcare IT and why this is so important. I want you to first think about some of the technologies that are starting to roll out. If you got to take home or had in the back of the office or we had on the back of the floor here something that looked like a gigantic kazoo that you could blow into and it told you whether you had the flu or whether you had a bacterial infection and, instantly, it could ping your medical records that you are carrying around both on your phone or in the cloud and instantly order your antivirals and they were delivered to your house, did we just crash parts of the price of healthcare? Of course we did. Did we just make a lot of incumbent businesses? We are challenging part of their business model because you used this technology instead of going to the urgent care center or going to the emergency room or going to the hospital or even going to the pharmacy. But we have to be willing to think about these things. These types of technologies are rolling out all around us. An Israeli company--the picture over in the far corner--actually has, and I guess it is being certified all across Europe right now, a desktop blood test that actually does a whole plethora of different blood tests with just a few drops. Remember, we talked about this 10 years ago. It turns out the technology now actually exists. In a couple of blog posts, even the concept of going into an autonomous healthcare center--and we actually have about 10 of these up in the Phoenix area where you go in and sign up on an iPad. You take a picture of your driver's license and a picture of your insurance card. You go into a booth alone. You put your arm in this thing. It does blood pressure and does a number of readings. You pick up this particular tool, and an avatar on the screen says: Can you shine this down your throat? Can you bend? Can you turn? Now do your ears, your eyes. It actually does algorithmic healthcare. What if that few-drop blood test--actually, as a couple of blog posts talked about, you put your hand on something and it pricks your finger. It takes the blood test right there, and before you walk out the door, 5 minutes later, it is giving you a full blood workup. What did you just do using technology to disrupt parts of healthcare costs? These things are real. They are rolling out right now. There are amazing technologies in almost everything you can think of. But we are going to have to think about both the ecosystem and the complications of how it is paid for--are these things that Medicare, Medicaid, and other insurers will pay for?--and how we do it. Also, the data. What happens in a society where you are now going to be walking around with certain wearables? You have the fancy watch that helps you manage your hypertension, the patch that does your blood oxygen, the port that helps you actually manage your blood sugar. There is lots of data coming off of those wearables. We, in our office, call them digiceuticals. How does that all tie into the rest of the ecosystem? And that data, how do you actually get that data so a doctor or the algorithm can see, when you open your pill bottle--because the pill bottle has a sensor in it, we know when you took your pill, and 15 minutes later we see this on your EKG that is coming from your watch, we see this reaction, can that data become incredibly usable? Can that data be blinded from your own personal information and help all of society get healthier because we gained more data in those algorithms? This is cutting edge, but it is not utopianism. We actually have those things right now today. If you start to think about it, you can actually go to Amazon, or I am sure others online, and see that it exists today. For under a couple of thousand dollars, you can buy a handheld ultrasound. Think about that. Apparently, there are other versions, faster, better, even ones coming in the future where the algorithm will actually read the ultrasound. You hold it up on your iPhone, and as you are using this handheld ultrasound to look at the picture, the algorithm is also going to help you interpret it. What did an ultrasound system cost a few years ago? You can buy this online today. It exists, and we are doing experiments with it right now in a VA, I believe, just right here in Maryland. Apparently, they are having terrific outcomes because the doctor can walk up and check something. These technologies exist. How do we start to have these technologies start to disrupt the price of healthcare? Because to be absolutely intellectually honest, if you actually look at the Affordable Care Act, ObamaCare, or Republican alternatives, we have spent a couple of decades in this body having a debate on who pays, not how to disrupt. With the ACA, we are going to have government pay a lot more. Over here, in our version, we are going to try to create incentives to have individuals actually get market competition. They have been debates on paying. We have almost never stepped up and said: What are our barriers at the State level? What are our barriers at the regulatory level? What are the barriers at the HHS levels that actually prevent the adoption of disruptive technologies? These things do exist today. We need to actually embrace the concept of rapid disruptive adoption of these technologies because, remember our five pillars, if we do not have a disruption in the cost of healthcare as we are getting older very quickly as a society, remember, in only 9 years, we have two workers for every one person in retirement. In 9 years, if you pull interest out, half the spending here coming out of Washington, D.C., will be to those 65 and older, and it is, substantially, healthcare. We all carry around these smartphones. Should our health records be on those? Of course they should be, because they should be portable with us because health data, health records are going to become something dramatically different than the record that is sitting there at the hospital. It is going to be living. How many of you ever use something like Waze or a crowdsource on your phone? You are going to be having these things on your body, or the pill bottle that knows when you opened it. That data should be living with you so you are constantly managing. There is a debate going on with those folks who build these algorithms. The fact that you had a surgery 7 years ago that is sitting on your health record or the health data that is coming off your wearables from the last 48 hours, which one is actually more valuable to your healthcare? The living data has incredible value in keeping you healthy. We need to find a way to embrace this and build this ecosystem. This next one I put up, even though there are a dozen, we are going to show a couple of versions of this just for the fun of it. Think about the debates we are having here in Washington, D.C., and for those of us on the Ways and Means Committee in regard to drug pricing. We need to fix many of the incentives. We need to actually deal with the fact that some of the games that are played on patents and other things--okay. That is an honest debate. But understand, the data says that half the pharmaceuticals that will be picked up at pharmacies today or delivered in the mail today, half of them will either not be used or will not be used properly. Think about that just conceptually. Half of the pharmaceuticals that will be taken home today aren't going to be used properly. Is there a data solution? We have everything from just the pill bottle top that lets us know that you opened it and when it opened and would tag your healthcare record, hopefully, be portable with you on your phone so we know that you actually took it, to actually, now, for those who may be on the severely mentally ill side who have certain maintenance medications that are providing miracles--they actually have a super small tiny chip that is actually in the pill itself that we can actually read that we know you are digesting it, that we know you took your meds. Think about it. We need to embrace these types of technologies, even down to this type of pill dispenser for someone who may have a little more complicated issue where they take some of their pharmaceuticals either at multiple times during the day or they have certain complications. Here is one that was shown at the Consumer Electronics Show in Las Vegas about 6 weeks ago. You put your cup under it and it automatically dispenses at a certain time and tells us what pharmaceuticals were delivered to you. It is technology dealing with the fact that we have documented that half the pharmaceuticals aren't properly used or used at all. It turns out the data that will flow off of these things actually will help us. When you have a wisdom tooth taken out, do you really need 30 pills or do you need 3? It turns out, the data from this may actually help us dramatically change the way we do prescriptions in the first place. So I am making the argument, it turns out that data and technology are also one of the solutions as we talk about pharmaceutical pricing. Now we are actually going to move on to something else we, as a body--and this is going to take my brothers and sisters on the Democratic side and Republican side. We need to have a very, hopefully, math-based, honest conversation about how we are going to finance miracles that are coming, and some of them are going to be here before the end of this year. We just put up this slide as part of the thought experiment. In America, we have about 8,000 Americans who have hemophilia A. The price range, we have actually found some documents that say the blood clotting factors and those things may be a half million dollars a year to keep that American stable. What happens this November or December--which we are actually very hopeful is about to happen--when a single shot cures hemophilia A? How do we pay for it? What are we willing to pay for it? How do you value that in society? It is a single shot of a very small population so it is not like the next day there is going to be a competitor drug in the pipeline like we had with other drugs. In this case, it is a single- shot cure. But we actually know that over 50 percent of all of our healthcare expense is to 5 percent of our brothers and sisters who have chronic conditions. What happens when we start having miracle drugs like a genomic biological like this that is curing diseases that are part of our brothers and sisters, that 5 percent who actually have the chronic conditions that consume over half of our healthcare dollars? We are actually, as an office, proposing ideas of a type of healthcare bond so you can actually finance the adoption of the distribution of these disruptive, revolutionary drugs and then pay for it using some of what would have been the future costs, pull those forward so you get the disruption of the future savings. These individuals are out of that chronic condition, but we are going to have to have a very tricky conversation. How do you price it? What is the value of a pharmaceutical that is functionally a miracle that cures something like hemophilia A? How do you price it? There is only going to be one producer of it, would be my guess, because there is such a small population. There are only 8,000 Americans with hemophilia A. Is it worth $1.5 million an injection? There is actually a math way to get there dealing with the reality of this is a population that costs us a quarter of a million dollars a year to keep them healthy, and this is the life expectancy. What was the research cost, because we want these miracle drugs as part of our society to help us have that disruption as part of the holistic theory of technology, these new miracle drugs that are coming, to disrupt the future healthcare costs. Now, I want you to take this concept a bit further and spread it beyond healthcare. Think of some of the crazy debates we have actually had here on the floor in regards to--forgive me--environment. I want to argue with you that there is a technology disruption that can make our environment cleaner but we don't actually hurt the economy. We can actually help it grow. So here is my first thought experiment. This has been a fixation of mine for a few years here. Think of the community you live in. What if tomorrow, instead of today's current model--you want to open up a paint shop or you want to open up a bakery or this and that. You go out and fill out forms. You send them down to the local environmental regulator. You may also file them with the State. If you are doing certain types of volatile organics, you may have to file with the EPA. You are basically filling up file cabinets. Do filled-up file cabinets make the environment, the air quality in your community cleaner? It is an honest concept because we functionally have a 1938 regulatory model of file--lots and lots of paper--maybe even do quarterly audits, maybe annual audits, fill out more paper, and fill up file cabinets full of paper that functionally a lawyer gets to come and look at a couple years later. Does that make the environment in your community cleaner? What would happen if you had a few hundred or a few thousand people traveling around in your community that actually just had the little sensor traveling with them that they were collecting data on hydrocarbons, on volatile organics, and on ozone, and you could actually see the map of your community? If all of a sudden you had a hot spot over here because you find out you have clowns painting cars in the backyard of their house, you would know about it instantly, and the environmental regulator, instead of putting paper in file cabinets, they would get in, hopefully, their electric vehicle, and go over and actually stop the clowns from painting cars in their backyard. Which made the environment cleaner? The trade-off here is actually very elegant because I don't need you to file lots of paperwork. I don't need you to actually be doing quarterlies and annuals because if you screw up, we catch you instantly. What made the economy grow, what reduced the bureaucratic burden in our society, and what actually made our communities healthier and cleaner? It is just technology.

Mr. SCHWEIKERT. I yield to the gentleman from Florida.

Mr. SCHWEIKERT. Will the gentleman enter into a colloquy?

Mr. SCHWEIKERT. The gentleman is one of my buddies from Florida. He actually gets this, but he also knows I actually love the technology disruptions, because none of us has figured out if it is Republican or Democrat yet, which actually makes it possible for us to do it. Now, eventually, we will break it into partisan because everything has become weaponized and partisan around this body. But, right now, think of this: this is a natural gas electric facility. It can power 5,000 homes. It is up and running outside Houston. It doesn't have a smokestack. All the ACO2, so all the carbon is captured. They actually came up with this brilliant technology that the carbon actually flows through. My understanding of the engineering is it helps spin the turbines, and then the excess carbon that is generated is safe and sold. We actually have a tax credit that we adjusted that hopefully made it more robust as we did tax reform that if you want to take some of that carbon you can put it in concrete, or a piece of plastic, or do it for certain types of oil recovery.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Mr. Chairman, I rise in opposition to the amendment.

Mr. SCHWEIKERT. Mr. Chair, wishes and hopes and optimism are not public policy. Be careful what you are asking for here. There are real- life examples across our country with what this did to our democracy. Understand the damage you are about to do. Mr. Chair, I yield back the balance of my time.

Mr. SCHWEIKERT. Mr. Chair, I accept this as--and I don't mean this in a mean fashion, but I accept this as one of the tenets of faith on the Democratic side. The gentleman from Maryland--wonderfully articulate--that isn't what happened. I mean, you have 25 years in other States and other communities, particularly in legislative bodies. I thought the same thing. But the fact of the matter is, what you do in this fashion is the person who is part of a certain leftist group, right group: I just need these folks to write me enough checks so that I get enough matching, or a good direct mail vendor who hits the ideological extreme so I get those dollars. Those aren't the facts. And on occasion, we have to take a step back and take a look at sort of the incubators of democracy and experience, which is our State legislatures, and understand the reality of what has happened. I am a conservative. It worked out fine for my view of the world, but understand--at least in my State legislature--within 4 years, this type of plan completely changed the character of the population that was representing the people in Arizona. Mr. Chair, I reserve the balance of my time.

Mr. SCHWEIKERT. Mr. Chair, I reserve the balance of my time.

Mr. SCHWEIKERT. Mr. Chair, how much time is remaining?

Mr. SCHWEIKERT. Mr. Chair, I actually appreciate the study mechanisms, but this is actually one a little bit broader. How many of us are from States that have actually had public funding or public matching of our State legislatures? I am from Arizona; I have actually lived this experience. And do understand, we used to--in Arizona--refer to it as the ``no new moderates'' piece of legislation. If you actually look at what happened to Arizona--and my understanding is this happened in other States--personal experience: I was 28 years old when I got elected to the Arizona Legislature. I was there. You had to go knock on a door. You had to ask someone for a couple hundred dollars. You had to listen to them. They would look you in the eye, and if they thought you weren't worthy, you walked out the door without anything. It turns out asking for money is part of the vetting process. Well, a few years later--so we have had it for 25 years in Arizona-- here is what happened: You are part of the group over here on the right or you are part of this group on the left. In Arizona, you get a couple hundred people to write you a $5 contribution, and you get elected. Within two election cycles, we wiped out half of Democrats, half of Republicans, maybe one- third of the body who were in the moderates. So when I was in that State legislature for 4 years, half the Republicans were conservatives, half the Republicans were moderate; same thing on the Democratic side. After just functionally 4 years of public funding or public match, they were gone. I appreciate the study of saying: Hey, this amendment is really about knowing, you know, do the dollars match, do the mechanisms match? And I don't know if the FEC is the right place to go to say: Are we about to try to finance the bipolar--the extremisms on both ends? In many ways, this piece of legislation--at least this mechanic right here--you have got to understand what you are doing. You are going to wipe out the middle. This is, in many ways, the ``no new moderates'' piece of legislation. Mr. Chair, I reserve the balance of my time.

Mr. SCHWEIKERT. Mr. Chair, I rise in opposition to the amendment.

Mr. SCHWEIKERT. Mr. Chairman, having been here for a little while, be careful--good intentions--and when people often bring those issues and bring those--be careful. You may have good intentions. And the intentions of often those who bring us a thought or an issue, until we have vetted whether they have particular potential economic interests-- I am just sharing my concern--the amendment, just as it is designed right now, our side is going to have to vote no because we create a fourth level. We don't create enough definitions. We hand so much power to the executive director. Mr. Chairman, I would love to talk to the gentlewoman about election encryption and my personal fixation on blockchain technology. But for this one, I think we may miss the mark. Mr. Chairman, I yield back the balance of my time.

Mr. SCHWEIKERT. Mr. Chairman, how much time do I have remaining?

Mr. SCHWEIKERT. Mr. Chairman, I appreciate and I love the concepts of technology. I am really concerned. This should actually be a bipartisan concern, because at some point is that executive director going to be one party or another, or demonstrate certain political bias? But if you hand sole authority to the executive director to appoint a 15-member commission that is going to establish saying, here is how we are going to review these grants and what sort of grants and direction, I am sorry, but you are creating all sorts of both policy leakage here, potentially a favoritism to certain either technologies or securities or firms. I don't have a problem with the attention. I think it is actually an authority that should have been given to one of the other committees instead of creating a fourth one, because we have this tendency, as Members of Congress, to sort of create bureaucracies on top of bureaucracies. But please understand--and I am being as genuine as I can--I fear that it may not happen now, it may not happen for a few years, but you are creating, as technology changes, as there will be a time in our future where I may be voting through a blockchain technology on my phone, have you just created the very commission that actually said: Hey, here is the security mechanics. Oh, by the way, our security mechanics favor the seven people who actually have a relationship to this particular security encryption who have a friend who is a friend? I am sorry; it is just not designed with enough comfort when this is about our voting system. Mr. Chairman, I reserve the balance of my time.

Mr. SCHWEIKERT. Mr. Chairman, having read over the amendment, there are a couple of concerns I want to walk you through. And please understand, I am one of those--I co-chair the Blockchain Caucus. I have a fascination with could we ever move to encrypted blockchain security of these levels of information. But if you actually walk through this amendment, it is a little hollow in its details. The executive director gets to appoint a 15- member, we will call it, committee. Tell me that those 15 members in this amendment can't have relationships with a certain security firm, or with a certain vendor, or with certain things. I will argue that you are creating now functionally a fourth committee within the commission and handing an awful lot of power to the executive director without a lot of guidelines, that should actually, in many ways, make both Democrats and Republicans a bit nervous. Mr. Chairman, I reserve the balance of my time.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Madam Speaker, I move that the House do now adjourn.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Madam Speaker, and to my friend, thank you for stalling. What we are doing tonight--and we will try to do it somewhat efficiently so you don't have to spend too much time in the Chair--is every week we have been taking a half an hour or so--tonight we may do something less--and sort of walking through what we believe is actually an idea that actually saves this country. And not to be too melodramatic, but let's actually walk through some of the mathematical realities. We have 74 million baby boomers moving into retirement. The peak of the baby boom is just a couple years away from retirement. So baby boom, 74 million over an 18-year period. If you look at Federal spending, the growth in Federal spending from 2008 to 2028 as CBO has calculated--2008 to 2028--91 percent of all the growth in Federal spending is interest, Social Security, healthcare entitlement. I know this doesn't sort of fit the mantra that you so often hear around here from Republicans and Democrats, but it is math. We have a demographic issue. We are getting old much faster than almost anytime--anytime, I think--in our society, and our birth rates have substantially collapsed. So one of the things we have come to is saying: How do you maximize economic vitality in our society so we can keep our promises, those promises of earned benefits like Social Security or promises such as earned benefits of Medicare? We believe we have five pillars, so we always start with this chart, and you can do them in any fashion you want. Last week, we actually did 30 minutes--which I am sure was riveting for anyone who was willing to watch--on labor force participation, but it is important. If you go back over the last couple years and look at some of the CBO reports, repeatedly there are sections in there that talk about: What is the barrier to economic expansion in our country? They will often talk about two things: capital stock, basically, savings rates, money to be lent into the economy to multiply, to build things, to grow things; and the second thing is population, labor force availability. Well, it turns out, since tax reform, the capital stock numbers have been much better than almost any of us had expected in the modeling. So our restraint on economic expansion turns out to be substantially labor force. Okay. So that is what we talked about last week. How do you draw in millennial males? How do you add incentives to those who are older to stay in the labor force? So that was last week. We have also actually talked about what we will have to do--and every week we are going to do one of these--dealing with the earned benefits. Are there things we can do in those earned benefits to add some competition for when someone is buying their medical benefits through Medicare? Can we add certain incentives? Say I am healthy. I wish to work longer. Can we give you certain incentives to either of those programs in the Tax Code to stay in the labor force as long as you are healthy? And we actually see other societies around the world--you know, look at Japan and others--who are actually having to work through this concept as their demographics get older. How do they actually keep as much of their population still within the labor force so the economy continues to stay stable and grow? Economic growth, we are going to do a whole presentation on everything you do from designing a Tax Code that stays competitive in the world, somewhat like we did a year-plus ago, that incentivizes capital formation, incentivizes investment in plant and equipment and technology, because we had gone functionally almost two decades with very little productivity growth. Do you want to pay Americans more? Well, what is the formula? Do we all remember our high school economics class? What are the two elements that go into typical growth in someone's salary? Well, it is inflation. If you get an inflation adjustment, you are not getting any further ahead. You are just sort of holding steady. It is productivity. When we look at the formulas that end up organically, systematically thought through, when businesses pay their workers more, here is the inflation adjustment. By the way, we bought a new plant; we bought new equipment; we bought new technology. We are able to make this many more widgets now. Our productivity has gone up. We can pay more. That is the key reason. We functionally have gone a couple decades with very little wage growth because we didn't have productivity growth. As we start to talk about economic growth, it is going to be everything from designing a Tax Code that maximizes that type of growth, to trade policy that maximizes economic expansion in our country, all the way down to how you design a rational regulatory environment. Some people like to come behind these microphones and talk about deregulation or re-regulation. I want to make the argument that we should be, as a society, talking about smart regulation. You have a supercomputer in your pocket or your purse, that phone you have. Why aren't we using much more technology to be the driver of our regulatory environment? A simple example: What would happen if you could crowd source data on the environment? You could have a few thousand people. If you are in a large urban area or other areas that have a sensor on your phone that says, hey, I am going to help crowd source ozone, or crowd source volatile organics, or whatever, our environmental regulator is no longer a file cabinet of paperwork where we put paper and document more, document more. Instead, it is almost like a quick reaction for us of: Hey, the sensors are saying there is a hotspot over here. Let's go deal with it. I think it is time we revolutionize what we consider financial, environmental, health types of regulations, realizing we have technology today that would make us healthier, more prosperous, our financial markets much more stable, and the time between a bad act and something getting fixed could be minutes, not years. An example is, if you had certain types of technology, a Bernie Madoff could never happen because you would instantly know his accounts don't match his bank accounts. The other one we are going to do next week is technology disruption. What happens if you could go home and, at home, you have this thing that looks like a large kazoo? You could blow into it, and it instantly tells you if you have the flu or not and then instantly could order your antivirals. A couple hours later, those antivirals could be delivered to your home. How much healthier would you be? We are going to bring in a whole series of healthcare technologies that is a true disruption because, remember, part of our premise is, if you look at the cost curves, so much of it is Medicare. The fact is, we do not have the resources set aside to keep our promises right now. That technology, if we do the adoption, if we remove the barriers, could be an amazing disruption in the price of healthcare because this body--let's be brutally honest--for a decade, we have been having the wrong debate. We have the ACA over here, which, functionally, just moved around who got to pay. We had many of our Republican alternatives that we believed would add some competition and those things, but it was, substantially, who got to pay. It is time the Republicans and Democrats got together to understand there is a technology revolution out there that could be, that can be, that will be the price disrupter on healthcare, if this body is willing to remove those barriers to that technology. Imagine being able to have certain wearables, whether you are the type of person who walks around with a smartwatch or the type of person who has the patch that can read your blood oxygen and these types of things, or the autonomous healthcare clinics that are being experimented with in the Phoenix-Scottsdale market. There is a revolution happening out there. We need more of it. We need to adopt it faster. We need to remove the barriers and stop having these crazy conversations of little, incremental changes. We need the disruption. As we walk through, part of the premise is, if you look at this slide, and I brought this slide in previous discussions, 91 percent of the spending growth between 2008 and 2028, interest, Social Security, healthcare, and functionally the healthcare entitlements. When you look at that, you start to realize these other colors you see here are functionally the other portions of the budget. Nondefense is green. Yellow is defense. Their percentage of the growth and spending is substantially flat. A little growth here, a little growth there, but the explosion in the curve, where you see those lines going up, is interest, Social Security, and healthcare entitlements. Why doesn't this place, why don't we as Members of Congress, have the honest conversation that, if you care about the debt, if you care about retirement security, if you care about these things, this is the honest conversation? Take a look at this slide. Between 2018 and 2048, a 30-year period, and this slide is not adjusted for inflation, you see the little green bar on the far end? That is the rest of the Federal budget. That is the non-Social Security, non-Medicare. It is actually $16 trillion to the positive. How do you end up with $84 trillion in the negative over those 30 years? It is functionally the interest and the spending on Social Security, the interest and the spending on Medicare. I believe we have a moral obligation to protect these earned entitlements. But you aren't protecting them by avoiding the subject, and that is what this place has become famous for doing. Let's talk about this concept we refer to in our office as sort of population stability. Remember, this is just one of our five pillars. In 9 years, our society, and its driven by demographics, will have two workers for every one person in retirement. Think about that for a moment. Programs like Social Security and Medicare, there were four or five, five-plus workers for every one in their benefits. In 9 years, we moved 2-to-1. What also happens in 9 years? It is the end of the baby-boom cycle, so the end of the spiked years. If this slide doesn't make you go ``wow, maybe we should take this seriously,'' because we should have taken it seriously a couple of decades ago because we knew people were going to turn 65 from the baby boom for how many years? Nine years, two workers, one person in retirement. This is absolutely critical, and this is what is coming to us. What are the solutions on this particular pillar we call population stability? We need to be honest and work hard for policies that maximize family formation. I don't even know if I have them here--I hope I do--some of the charts that show you what is happening in the birth rates around the country. You do understand, as a nation, we are now well below replacement rates in our population. This one I particularly like because it is from my home State of Arizona, but the trendline is almost identical. We will go through some of that. If I asked you right now which State had the largest fall in birth rates, how many of you would have said Arizona? It turns out Arizona had the largest fall in birth rates. It is a little complicated. You have to read through the data, but Native Americans and Hispanics, their birth rates fell substantially and are looking much more like the mean of the rest of our society. Apparently, the demographers say, that is wonderful. What it means is, even though this place sometimes spends a lot of our politics keeping us apart, the actual demographics say, when we are all having babies like each other, it is a symbol that the melting pot is working, that we are all starting to have similar education, live in the same neighborhoods, have similar job descriptions. Now our family formations are starting to look very, very similar. That is wonderful. The melting pot is working. But understand what that means in the future, having enough workers to participate in keeping the economy growing and stable. These pay-as-you-go programs, which are Social Security and Medicare, have that vitality, and this is a real threat when you start to see these sorts of numbers and understand what that means. How do you reach a level of population stability? This is a brand-new slide for us. We are going to do a little more on what is happening population-wise. Once you substantially look at, we will call it the green line, the second one down, do you see that precipitous fall? If we are right here, that was sort of our last time of being in the positive, a bit before 2010. Since then, we have continued to fall, and fall, and fall. Now our demographers are coming back and saying, yeah, this is sort of the new normal, because it is not just the United States. Apparently, this trend is all over the industrialized world. A lot of the great writers and thinkers on demographics are saying the next prized asset in the world isn't going to be lithium for batteries or petroleum products. It is going to be people, smart people. You are starting to see that around the world where other countries right now are even starting to change some of their immigration rules to say, if you have talent, you are given a much faster path to enter our country. We are going to have to have that very honest conversation of a major change in our immigration system. The last slide here, and then we are going to talk about some of the solutions in this, this is just sort of fun to understand that it is a trend. We have one or two States that are still bucking the trend of having positive population growth, and that is through birth rates. But the rest of the country is substantially collapsing. What do you do for population stability? Okay, back to family formation. Are there things we can do that will work? We have spent about a year in our office reading literature from around the world, what they have done in Scandinavia, what they are doing right now in Hungary, what has been done in a province in Canada, trying to promote native births. Small, incremental changes--no one has found the magic formula. Maybe we as a society have to have this discussion. What works? What can we do? Is it something you do in the Tax Code? Is it something you do in family friendly policies? What do we do to maximize family formation in our country? Right now, when you start to look at the cost, I have only one beautiful little girl, and you realize, children are the greatest thing that ever happened to my wife and I, but it is expensive. The second part of that population stability discussion is, if you are over here working on family formation and making sure society understands the blessing of children in our society, are there immigration policies that if you are bringing in populations into the United States that maximize the economic vitality? So part of this thought experiment, based on the actual numbers in the last 10 years, the U.S. fall in birthrates functionally equals 4 million children that we expected that with the fallen birthrates will not be part of our society. You do realize that over 10 years that is functionally 4 full years of legal immigration. So let's say we actually were effective in being serious about family formation here, and we actually started to have an honest discussion of as a society do we start to do the things such as New Zealand, Great Britain, Australia, Canada, and others are doing where substantially it is a talent-based immigration system? Why do you want to fixate on that? It is an immigration system that actually has the elegance of we don't care about your gender, we don't care about your religion, and we don't care about your race. But what we care about as a society is we care about the vitality, the energy, and the talent you bring to our society to maximize the economic growth so we can keep our promises, particularly on Social Security and Medicare. Remember, demographics are really the biggest issue we as a society are facing, except it is really hard to talk about it because the math is complex. So are we as a body willing to take on complex issues and understand you can't just do one of them? There was a time here a decade ago or so people would come to the microphone and say: Well, if we do entitlement reform, then we get this. We have missed that window. Now my argument to this country, to my brothers and sisters here in Congress, is we have to actually reach out to at least the five pillars we have laid out of maximizing economic growth, and that is everything from tax policy to trade policy to regulatory policy, and labor force participation. How do you design programs, everything from Social Security Disability to TANF to food stamps to this and that, saying we want you in the labor force? What can we do so you have your safety net, but we have got to get you into the labor force? What do you do for population stability as we have talked about right now? What do you do for dramatic disruptive technology adoption, particularly for healthcare, but it can also be for environment? We are going to actually do that in the coming weeks. Then we will have to step up and have an honest conversation of as the promised earned benefits, we call entitlements, how can we adjust and refine them so they incentivize to stay in the labor force, but they incentivize efficiencies of how healthcare is purchased? We need to do this as an entire society. Once again, remember, in 9 years, two workers, one person in retirement, one person 65. Over the 20-year period, 2008 to 2028, 91 percent of all the growth in spending will be interest, Social Security, and healthcare entitlements. In 9 years--the CBO report that came out last month has a beautiful graph in there--in 9 years, 50 percent of all the noninterest spending coming from Washington, D.C. will be for those who are 65 and older. So if you care about keeping our promises, if you care about this country being able to maintain its place in the world, it is math. It is demographics. There is a path for us to succeed, but it no longer works. The math no longer works by just doing one thing or these little, incremental, petty things I see happening around here on this floor where it is political power grabs instead of the things that stabilize and grow our country and protect my 3-year-old daughter and her economic future and her opportunity to actually live the American Dream. Madam Speaker, I yield back the balance of my time.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Madam Speaker, many of us really appreciate when you stay here and listen to us because we know a lot of folks out there don't appreciate it. It is sort of a gift of your time to be with us. When we were in the majority, I spent much of my freshman term sitting in that chair. What we are going to do tonight is this sort of a continuation of a theme. We have already heard tonight, and over the last couple weeks, discussions of debt, discussions of what is happening in Medicare, and, actually, I want to come here behind this microphone and talk about what I believe is a solution. I genuinely believe over the last few years, we have put together at least the backbone of enough math to talk about the reality. But let's first sort of set up the discussion if you haven't watched some of our other floor presentations since the beginning of this session. Every week, every other week, we try to take a half an hour and walk through our five pillars of what we believe saves us. Understand, in 9 years, 50 percent of all of the noninterest spending that this Congress will do will be to those 65 and over. Understand, in 9 years, the 74 million baby boomers will actually be in their benefit cycle. They will be 65 and up. In 9 years, two workers for one retiree. And when you start to look at the future of our debt, understand--and this is hard because so many don't want to hear it, and it is not Republican or Democrat, it is demographics. If you look at our society, we are getting older very fast; our birth rates have substantially collapsed. Family formation, we have some real issues out there. So what do you do as a society? We have promises that have been made, earned entitlements out there, your Social Security, your Medicare, and you have earned those. That is part of your societal contract with this government, but we don't have the cash to pay over the next 30 years. How do we get there? I am going to tell you. I am still optimistic there is a path. I see some of these slides and these boards through the eyes of my daughter. I have a 3-year-old daughter. Best little girl ever. We actually have a coffee mug at home that says that. Doesn't she have the right to live as well as the generations that have gone before her? Doesn't she have the right to have that sort of optimistic opportunity? I actually believe that is not lost in our society. But as you even saw on the floor today, we do political theater here because complex policy is hard. It actually requires math, and Congress is substantially a math-free zone. So we always start with this chart. Understand, I believe there are five pillars, and you can mix them up any way you want to. Immigration. How do you design an immigration system in the future that maximizes talent importation to the Nation? Because you need to maximize economic philosophy as soon as possible. That is what the rest of the world has done. Australia, Great Britain, New Zealand, and Canada have moved to talent-based systems because they figured out that there is something elegant about that model. Now, let's be honest. I don't care what gender you are. I don't care your religion. I don't care your race. I don't care who you cuddle with. I don't care about those things. We care about the talent you bring to our society to maximize economic growth. I actually think it is a much more elegant model than we use today in immigration. Economic growth. We must hunker down and embrace tax policy, regulatory policy, and trade policy that maximizes economic vitality. The velocity of the size of this economy must continue to grow, and grow at a fairly substantial rate. If you look at the data, 91 percent of the spending increases from this government from 2008 to 2028 are functionally three things: interest, Social Security, and healthcare entitlements. So we are all going to talk about debt. It is a threat to our society. When we are going to have the honest conversation, it is substantially driven by our demographics and our healthcare costs. The next one we are going to talk about is labor force participation. We are going to spend time tonight on that. I know it is a dry subject, but this is actually trying to be intellectually honest. This is a moment where if you are going to call our office and say we want solutions, we are working through it. But it is not trite. My father used to have a saying. We were just talking about it over in the corner. For every complex problem, there is a simple solution that is absolutely wrong. It turns out, complex problems require complex solutions. We are going to talk tonight about labor force participation. How do we get as many Americans across the board to participate in the economic vitality? It turns out that has an amazing effect; everything from our healthcare costs, to tax collections, to just the economic growth. The next two, there is a technology revolution about to happen in healthcare. It is also happening in environment. In the next couple of weeks we are going to come here and show some of the amazing technologies that are out there that actually make some of the environmental discussion seem sort of passe when you understand the technology that is on the cusp of rolling out. Let's talk about healthcare right now. I have come here to the floor over the last couple of weeks and shown things like--we nicknamed it in our office the flu kazoo--something a material science professor has developed; you blow into it, and it instantly tells you if you have a viral infection, and in the backbone, it could automatically order your antivirals. Start thinking about the revolution that would happen in the cost curve of healthcare if we had substantial change in autonomous healthcare. In the Phoenix area, we have an organization that now, I believe, has seven of these autonomous healthcare clinics where you go in, you sign up on an iPad, you take a picture of your insurance card, your driver's license, you go in and you put your arm in, you pick this up, you shine it in your throat, your ear, and your nose, and the algorithm is able to do amazingly accurate calculations of your health. Think about that type of technology when it is in your pocket. You have all seen the pocket size, the size of your smartphone that is now an ultrasound. It is completely portable. We must, as a body--and this is at our State legislature, but particularly this body--we must break down these barriers to the technology disruption that could be a revolution in lowering healthcare costs. You have got to be intellectually honest. The ACA, the Republican alternatives, in much of the discussion, we are not actually having a discussion about lowering healthcare costs. We are having discussions about who gets to pay. It is time that we embrace and truly draw in the technology that can be that very disruption. We have a running joke in our office: Did you go to Blockbuster Video last weekend? We all live it. It is now time that we understand that our future healthcare costs are an Achilles' heel to this society because of our demographics and just where the costs are going. There is another part of that. We are going to actually do a floor presentation, probably at the end of the month. There are incredible disrupters coming in the pharmaceutical world. We just had some information and we think, actually by the end of this year, there may be a single shot cure for hemophilia A. That is only about 8,000 of our brothers and sisters in the country, and it is going to be really expensive, but it cures. What happens as we continue to see these biological, genomic pharmaceuticals rolling out that actually cure? Or the one that we were reading about today, that stabilizes our populations who have ALS? What does that mean to the cost curve of the 50 percent of healthcare spending that is to the 5 percent of our population that have chronic conditions? The last one I am going to give you is, it is time to rethink the incentives--and this one will always be tough--in Social Security, in Medicare. How do we encourage an individual to stay in the labor force? Are there things we can do to encourage waiting to take benefits? And these are math. It is just actuarial science. So today we are going to talk about labor force participation. Isn't that exciting? The first slide I have already mentioned, this is from the CBO report 3 weeks ago, and I was shocked it didn't get much press or discussion in this body because it is math. But if you look at this chart, what it is trying to say is, in functionally 9 years, half of the spending of this body--if you remove interest--half of the spending will be to those 65 and older. It is just demographics. We got older as a society. In 9 years it is the end of the baby boomers, because they have moved into being 65 and older. But if you had seen this chart and then matched it up to where you start to see the debt and spending curves move up, you understand they are in sync: if you care about the debt, if you care about spending, if you care about opportunity in our society, understand the demographic headwinds and what we must do to face that. So one of the reasons for this slide, and I know these are a little tough to watch, but what I want you to sort of see is this is 2000. At that time, actually over 67 percent of our population was in the labor force. It functionally collapsed after 2008 and never returned. The blessing is this last year we have had a little bit of a blip. There were these really smart economists who said: Hey, you are never going to get back up to 62, 63 percent of labor force participation. I believe we are now around 61 or 62. We actually need to find a way to get back to that 67 percent of our brothers and sisters all up and down our society being in the labor force, having the honor, the elegance of working. There were some amazing numbers last December, if you actually broke into what was in those statistics, of the number of organizations, the number of companies that were actually reaching out to the handicapped community and making accommodations and hiring. There are actually--and we are going to touch on this--some parts of our society are moving into the labor force, particularly in the millennials, and we are seeing parts that are not. Countries like Japan that actually have faced this, are facing it, have actually been trying to design incentives and programs for even those who are older, who are healthy, who are capable, who are desirous to be welcomed to stay or enter back into the labor force. It is a barbell. We have a problem with part of our younger population, and then, obviously, our older population--which we have so much talent--that are retiring. We are going to have to have an honest incentives discussion design to maintain this labor force philosophy. If you actually look at what is going on in our society right now, if I had come to you 2 years ago and said: Hey, we are going to see all sorts of quartiles in our society have some of the lowest unemployment in modern history, I think I would have just gotten blank stares. But it is happening. And with that incredible, almost full-employment society, we are actually seeing--and particularly in markets like Arizona--we are actually now seeing wages really starting to move. This is wonderful. This is something we needed, functionally, for a decade or two. We can do a much more complicated discussion of some of the incentives that were built in the tax reform last year that encouraged investment in plant and equipment to push up productivity. Productivity allows you to be able to pay people more. But those are the sorts of things you talk about. How do you maintain economic vitality? When we actually look at some of the unemployment numbers, there is something missing. Understand, when we look at unemployment numbers, we are looking at people who are actively looking, actively searching for employment. We actually have a real problem in parts of millennial males and others, so how do we reach out and design incentives to stay in? We are also going to go to some of the other tougher questions, and that is: Is it time to rethink things like Social Security disability and say, hey, if you earn $24,000, or you hit this point, you hit a cliff. Your benefits disappear. If you are on other safety-net programs, if you earn a certain amount, you hit a cliff, and it disappears. We need to have a brutally honest conversation of, is that incentive of that cliff an incentive not to enter the labor force? What would happen if we would work out the math so it was a much more gradual glide slope to draw those individuals into labor participation? Because if we are almost a full-employment society but we still had millions and millions of Americans who are choosing not to participate in the economy and we really need them in our economy, we have got to look to what are the disincentives. It is about time that we actually start to have those social entitlement conversations. I know for both Republicans and Democrats, these are tough because it requires math. It requires us to work through certain ideological folklore. But if you want the wholistic solution to make it through the next 30 years, this labor force participation is one of those five pillars. The reason I actually did this slide is--this one is a little geeky-- but it is actually trying to walk through what has been happening. I am not going to walk through all the detail, but we recently had this wonderful pop of sort of in the population of 25 to 34 females entering the workforce. That was one of the great things that we actually saw last December. Great. We need to understand why millennial women are entering the workforce in these sorts of numbers, what we learn from that, and what we do now for the millions of millennial males who are still dramatically underrepresented in the economy. Data shows millennial women dominating the current job market. Look at this separation right here and why this is so important. Remember how I was just saying something has been happening in the last couple quarters where millennial females are entering, but millennial males is the lower line. This is a conceptual problem, but it is real math. Remember we talked about our barbell? We have those who are older. How do we create incentives to enter and stay in the labor force? How do we reach out to our younger population, get them, incentivize them, and work with them to get them into the labor force? Functionally, we just do not have a choice. Let me grab another slide. We will put these up in our office. Remember, this sort of presentation is for those who really care about digging in to the actual math of policy. So often, what we end up doing on the floor is political theater and folklore. If you look at some of these lines--and I know this is a long time ago--but if you and I were to step back to 1967 and look at the data for males, we had 97 percent of working-age males in the labor force. Today, if we did that same thing, I think we are at about 88. It falls, 87, 88. One of the big things that helped us grow the economy is female participation in the economy. But we need to find a way to get this back up. We are just talking a few points, but those few points of a few more million stepping back into the labor market have substantial economic impact. I want to talk about a story from Arizona. I have had this discussion with a couple of my Democratic friends. Within that, we have talked about incarceration rates and some of the other things that end up becoming impairments for young males to be in the labor force. In Arizona right now, we have such a shortage of skilled trades-- electricians and carpenters--that a number of the businesses in Arizona--actually, I approached our Governor, Governor Ducey, and said: Help us. We are willing to take our own money and go into Arizona correctional facilities and do a training program that is, when someone is going to be on parole in just a few months, we will train them, and we will guarantee that we will hire them. It doesn't mean a guarantee that they will keep them. So last year, we brought this young man out from Arizona. We brought him to the Ways and Means Committee. He sat down in this beautiful room. The Ways and Means Committee room, it is just very big and very ornate. He didn't look like our typical witness, with a number of piercings and a number of tattoos around the neck. He looked up when it was his turn to tell his story, and he hesitated for a moment and started with: I am a three-time convicted felon. He went on to tell his story of how he was an addict and the other times he had gotten out of prison, he had relapsed. He had lost his family. He had lost everything. He had lost contact with his child. He was a few months from his opportunity to go on probation and leave the correctional facility, and he saw this flyer that said: We are doing training for electricians. We guarantee we will hire you--it doesn't mean we are going to keep you--if you pass this very basic course. He said: Why not? He took this electrician course while in prison, while it was paid for by private industry because the job market is so tight they are willing to take risks on all sorts of populations to get them back into the work environment. He graduated. He started at just a little over minimum wage. A year later, he was making, I think, $23-something an hour. He said he hadn't relapsed because he is working too much. He said he is back with his family. He gets to see his child. There are these incredibly human stories. If we are in a society right now that is almost at full employment for those looking for employment, how do we reach out to those whom our society gave up on or who gave up on themselves? How do we as policymakers design those incentives, design the social entitlement programs, and design our society where we want everyone to have this opportunity within our communities and our society? It was one of the most touching and amazing hearings, because when you looked at those of us sitting up on the dais, there were actually tears hearing his story and realizing there is hope, that this economic vitality provides opportunity and hope. We turn it into a political football because it is not our side that wants to get credit, or their side wants to get credit. We need to get beyond that, because if we don't get this math right, my 3-year-old little girl won't have the same type of future I have had. There is a path to make this work and continue to have an economy, a nation, that grows and provides opportunities. Understand, when the United States grows, the world benefits. But we have those five pillars. Is this body capable of stepping up and doing things that are complex without a simple solution? Madam Speaker, I so desperately hope so. With that, I yield back the balance of my time.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Madam Speaker, I move that the House do now adjourn.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Mr. Speaker, what we are doing today is sort of a continuation of the theme that since the beginning of this Congress we have been walking through. So let's put this sort of in context. This is probably our fourth or fifth time to come to the floor and do part of this theme. The first time we did this we took almost an hour and we actually sort of walked through what is happening in our society, when you actually do the math of the massive unfunded liabilities in Medicare; the issues with the fact that in 9 years, 50 percent of the noninterest spending of this government in 9 years will be to those 65 and over. So it is important to understand what is happening to us demographically. Much of that difficulty that is coming toward us is about healthcare costs. One of my passions has been trying to get an understanding of this. There are a number of things we can do to actually deal with the fact that we are getting older as a society. We are seeing what is happening on our birth rates. The fact of the matter is, those of us who are baby boomers--there are 74 million of us--and in 9 years, all of the baby boomers will be functionally 65 and older. It is a demographic bubble moving through our society, and there are benefits that we as a society have been promised. So what do you do? How do you make sure you have a vibrant enough economy to keep our promises? How do you make sure we have a vibrant enough economy not to crush the young in their opportunities? We have been laying out five little legs. We will call them our proposals, everything from an immigration system that is talent based so you maximize economic vitality; policies, such as tax, regulatory, trade, that maximize economic growth; policies that are all up and down, whether it be our programs within the social safety net, or just incentives within Social Security, and Medicare; other programs to stay in the workforce or enter the workforce because labor force participation is crucial. We had a good number last month where we broke over 63 percent labor force participation. I know this sounds a little geeky, but it is crucial. The fifth one--and we will come back to the fourth--the fifth one is looking at our retirement entitlements and how we design them to incentivize everything from being a good consumer to staying in the labor market longer. But the fourth one that we keep talking about over and over and over again is technology. Once again, I put up this slide right here just to understand the scale. In a decade, you and your partner, if you have jobs, there will be two people working for every one person in retirement in 10 years: two workers, one retiree. And understand Medicare and Social Security are functioning right now as pay-as-you-go programs because we are using today's income to pay today's retirees. The next slide is just to emphasize the scale of the unfunded liability. When you look at this slide, you will see up on the top that this is the 30-year projection. It is not adjusted for inflation. So if you want to adjust it for inflation, you can remove a third of the value. But, functionally, over the next 30 years, you have an $84 trillion unfunded liability when you add in the cost of the programs and the interest related, $84 trillion over the next 30 years. But if you take a really close look, almost all of that comes from Social Security and Medicare. The rest of the budget has about a $16 trillion on the positive side, so you have got an $84 trillion shortfall. So what do you do as far as solutions? Well, we are going to show some slides of some creative ideas. Remember, we are working on that. We have five piers. Right now we are going to talk about our technology pier. Just, once again, to sort of get your head around these numbers, from 2008 to 2028, the calculation is 91 percent of the increased spending of this Federal Government will be interest, Social Security, and healthcare benefits. Your government is functionally an insurance company with an Army. So how do you have a revolution in healthcare costs? We have lots of proposals around here, and if you listen to them--and we have got to be brutally honest--think about the ACA, many know it as ObamaCare, or some of our alternatives; we are often having a debate of who gets to pay. Those don't have a revolutionary--they don't have a disruptive nature in the cost of healthcare services. We are just moving around saying: we want more government subsidies. No, we want more nongovernmental private-sector competition, but we are often moving around who gets to pay. Our argument is we are in the middle of a technology revolution. How many of you have a watch that helps you manage your blood pressure? How many of you have seen the patch that helps you manage your blood oxygen? There are a number of these sorts of things--we call them digiceuticals--that are coming onto the market. We as a body need to drag technology into this debate so technology brings us a disruption in the cost. I say this over and over and over, but it is a good visual. When was the last time you went to Blockbuster video? Didn't it feel like almost overnight from going down and getting the little silver disk and getting a movie recommendation to now you go home and hit a button? We are living in a society that is having an amazing technological revolution. What happens when this supercomputer in your pocket is functionally your primary-care physician? It turns out that that technology is here today, but we as a body need to talk more about who gets to pay and more about lowering the price of healthcare. I will argue that the elegance of dragging this technology, removing the barriers, removing our inequities in the compensation for using this healthcare IT is we will be healthier. We will deal with our issues much faster, particularly for those of us who have very busy lives, instead of waiting for that appointment. So I want to just show some of the revolution that is already out there. These things are already out there in our society. This next slide shows a handheld ultrasound. It is basically the size of your phone. You plug it into your Bluetooth, or you plug it into whatever, iPhone--at least I think this one is an iPhone in this picture--and it is a handheld ultrasound. What happened to the days when you used to have to go to a medical clinic that had the specialty equipment? You would sit there and find out that you had a bone chip in your heel. Now, you are at your office, your nurse's office, your company's office. You can actually buy this as an individual. You can actually see, and we are reading articles that are saying very soon you won't actually look at the picture. You will use this handheld ultrasound and the algorithm will actually tell you what it is seeing. This is a revolution. Right now, I think you can buy one of these on Amazon for under $2,000. Conceptually something that used to be a large piece of equipment is in the palm of your hand. That is a revolution. We are about to have a series of discussions about drug pricing. Drug pricing is a huge component of what we do to have a revolution in the cost of healthcare. Here is a quick thought experiment. What if I came to you and said: 50 percent of the pharmaceutical prescriptions that will be written this year will not be properly used or used at all. So just as a thought experiment, half the pharmaceutical prescriptions written this year just won't be used at all, or will be misused. Well, right there--it is absurd to say if we would fix this problem we would have a 50 percent reduction in the need to pay for pharmaceuticals, but it could be a huge impact. This has less to do with fighting over the formularies, the mechanisms over here. Will we have enough money for healthcare research? This is just about proper utilization. So what would happen if I would come to you right now and say: I have a relative who has some dementia issues or did you take your hypertension medicine this morning? Turns out, we can actually put on a bottle cap that actually would talk to your phone saying: Hey, you did not take your pill today. Hey, you did not take your pill in the time prescribed that you are supposed to take it. Something like this, as simple as this, is a technology solution to an issue where we know we have lots and lots of seniors that don't take their medicines on time or in the proper fashion. We even have more complicated ones that are in the same vein. What if you are someone who has multiple pills that you take? This one was particularly designed for seniors with some memory issues combined. This is a dispensary that was just shown at the Consumer Electronics Show in Las Vegas 3 weeks ago. At a certain time, it notifies you and drops the prescribed combination of pills into a little cup for you. It is a technology solution for drug utilization where we know that 50 percent of pharmaceuticals are not being properly used. Mr. Speaker, I beg of us as a body, we need to get out of our rhetoric sounding like it is the late 1990s. There is a technology revolution around us. Let's drag that creative thought, creative design into our debate and say, this is more than the continuing debate of who pays, who doesn't pay. It is: we need a revolution in how we stay healthy. Is this Republican or Democrat? I am making the argument it is technology. Now, as we joke in our office, eventually, we will figure out that one party will take a side so we can fuss at each other. But at least right now, the discussion of dragging technology into our own personal healthcare is not partisan. It is a solution. Let's go on to the next slide. About 2 years ago I had a situation where I was cooking. It was a Sunday evening. I love to cook, and I almost chopped off my pinky. So I am at the emergency room in Scottsdale, Arizona, and I am bleeding like crazy. The wonderful person who is on the intake side in the emergency room, as I am bleeding down my arm, is saying: David, do we have your medical records? Are you allergic to anything? And I am going: I am bleeding. Well, the absurdity is my medical records were in the office that was closed because it was a Sunday evening. I should have my medical records with me and you should have your medical records with you. It is not that hard. It turns out others agree. This technology is out there. Now, I had the blessing of being the co-chair of the Congressional Blockchain Caucus. I actually believe there is a really elegant way of using an encrypted, what we call, blockchain, a distributive ledger, with levels of permission. So it is more than just my medical records, because, as we are going to show in a couple more slides, this is actually just the beginning. If I can carry my medical records with me on this, why can't I have that wearable that helps me manage my diabetes, also doing 24 hours, 7 days a week data; the thing that actually helps me deal with my heart arrhythmia, 7 days a week, 24 hours every day. That type of algorithmic data is also attached to my medical files; instead of thinking that my medical professional is going to find out I have an issue in that 15 minutes I am in their office. This is more than a medical record concept. If I am able to have digiceuticals--wearables--that will help me manage my healthcare and help me manage my chronic condition, will I be healthier? Mr. Speaker, it is like the contact lens that actually helps manage your blood glucose talking to your pump, so you don't crash if you are diabetic, it helps maintain you. You already see some of that technology on a number of people's shoulders today where it is actually Bluetoothing into the pump. The revolution is already around us using these technologies. We, as a body, need to have a very honest conversation of how do we remove barriers--and we will need our friends at the State and local level to also remove some of their regulatory barriers--to allow the adoption of these types of technologies. The thought experiment goes a little further. In the Scottsdale area--I think we now have five or six, maybe seven of them up--there are functionally autonomous healthcare clinics. It is a crazy thought. You walk in, you sign up on an iPad, and you take a picture of your insurance card. You go into a booth, and the avatar on the screen talks to you and says: Can you shine this in your nose? Can you turn it right, turn it left? It will show you. This avatar bends the device, and then says, put it in your ear, turn it, and down your throat, turn it, turn it. It is autonomous. Think about the cost savings. The algorithm does a calculation and says: we are actually calculating you have the flu. It turns out that algorithm is remarkably accurate. Now, in today's world, at the very end of the consult, a doctor comes on to the screen and talks to you. A doctor can choose to hit the button and accept that algorithm. But, conceptually, think about that. What if that type of technology wasn't just sitting in an autonomous healthcare clinic, but was at your school nurses' office, your office? How about if it got small enough, compact enough, and inexpensive enough so it was at your home? How many of us have had the occasion where we have the cold or the flu, we suffer with it for a couple days, and then we start saying: Can I go to the urgent care center? Maybe I can get an appointment with my doctor. By the time you show up at your doctor's appointment, Mr. Speaker, you are actually already on the mend. I have a picture on my phone of something that looks like a large kazoo, and here is the final part. You blow into this, Mr. Speaker, and it is able to tell you if you have a viral infection--the flu--or a bacterial infection like a cold. What would happen if that large kazoo you could have sitting at home, you blow into it, it says that you have the flu, we are ordering your antivirals, and they are going to be delivered--let's say by a drone or an autonomous vehicle, if we are going to be really techno-utopian--and it is delivered to your home a couple of hours later. How much healthier did our society get? The fact you didn't go to work and infect everyone; that you were able to deal with this almost immediately; that the time between actually getting your pharmaceutical to actually manage this infection and the moment you were feeling sick it is now hours. How much cost did you just save out of the medical system? So I need us all to be creative here and think this issue through. If 50 percent--actually more than 50 percent of our healthcare cost is 5 percent of our brothers and sisters with chronic conditions; we already know these types of technologies are helping us manage individuals' needs and issues who have chronic conditions. We saw the pill bottles to make sure that--is there a way that the 50 percent of pharmaceuticals that are not being properly used or used at all are being properly managed? Our ability to manage our data is going to be coming from all these healthcare devices. So my thesis is very, very simple. As we have the arguments about drug prices and as we have the arguments about healthcare costs, we need to have the discussion of it is time for a technology revolution, and we need to drag that technology solution into the debate in how we regulate, how we incentivize, and how we compensate. Because, Mr. Speaker, I will make you the argument: this is the moment that--if you remember, the first couple slides were the healthcare costs that we have committed to as a society that functionally consume almost every incremental dollar of our future. What would our future look like if we were able to bend that cost curve because we actually found and embraced the technology disruption that is on our doorstep? Wouldn't this be a much more elegant debate and a much more optimistic conversation? That is what I have for today. But we are going to do the next phase of this next week and the week after that to sort of walk through these pillars of, there is a path where we can make this work. Mr. Speaker, I yield back the balance of my time.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Mr. Speaker, I am going to try to do a couple of things tonight, and some of this is actually to answer some correspondence we had into our office when we did part of our, we will call it, unified theory presentation a couple weeks ago on what we see happening. I have two key points I really want to try to drill home tonight. I am going to say them over and over, and I am going to use a number of different slides to talk about them. Mr. Speaker, one is, it is obvious. You see what is happening in our mandatory spending, but that mandatory spending is substantially driven by our demographics. We are getting older as a society, and we need to just deal with that. That is not Republican or Democratic; it is basically math. Those of us from the baby boom--there are 74 million of us--the peak of the baby boom, I believe, right now, is about 63 years old. A lot of the reforms should have happened a decade ago. Now it is almost too late. So how do we deal with the fact of the matter? We are going to see a number of slides of what is about to happen in our mandatory spending curve and what that means to the financial impact of our debt and our economic growth in our society, because much of the debate you will see behind these microphones, I believe, is actually missing the point. We joke in our office that D.C. is substantially a math-free zone. We are going to try to actually do some math. The reason we put up this slide is very, very simple: just to visualize it. It is about a year old. This new CBO report update came out today. We are grinding through it. We have a couple slides here from that. But just to visualize, this is 1965, and that is 2018. Mr. Speaker, do you see the red area on the 2018? That is to give you a sense that we don't vote on that. That is on autopilot. The blue area is actually the defense spending; that is about 15 percent. The green is basically everything else. So remember, 70 to 75 percent of all of the spending around here is on autopilot. I am going to show you, Mr. Speaker, in a number of these slides how much of that is actually really based on our demographics. This slide is very powerful--and I am going to bend it just a bit to try to understand. Now, this is done by the Manhattan Institute. It was done about a year ago. So we are going to try to get the numbers updated. Now, this is not adjusted for inflation. So when it says what is causing an $84 trillion deficit, functionally, over the next 29, 30 years, you can take off about one-third if you want to do the inflation adjustment in your head. But when you look at it, the point is up here. You see the first bar; that is Social Security. The middle bar there is Medicare, and the third bar is everything else. Mr. Speaker, you will notice everything else over the 30 years is actually positive in its impact on revenues, but Social Security and Medicare are the vast, functionally, almost all of that $84 trillion of debt. It is demographics, it is math, and we need to deal with it, because as a society and as a government, we have an obligation to keep our promises. These are earned benefits. But how do we do it? We are going to talk about how we keep our promises in the last part of these slides. But, once again, I am trying to make the point that the scale of the problem, if you have a political person, an academician--anyone--and they are talking about the future of this country, if they are not talking about what is happening to us demographically and our entitlement promises, then they are not telling you the truth, Mr. Speaker, because this is going to drive all policy around it. Now, I will have lots of conversations with folks back home in Arizona--which is just beautiful; I think it was 74 degrees today in Scottsdale--and I will get: Well, I paid into the program. And you did, and we have a social contract with you on those benefits, but we do need to understand some of the actual math. This is sort of the average person who will be moving into retirement over this decade. For Social Security, you will have paid in about $540,000 in Social Security taxes. You are going to get about $616,000 back out. Those two are fairly in balance, even though all that money that went to the trust fund then is loaned to the Federal Government, and then the Federal Government--actually, Treasury--puts special T-notes. The last time I checked, they were paying like 3 percent, so they had a reasonable rate of return. But the one that causes most of the deficit over the next decade, two decades, three decades, you look at Medicare. The average person will have paid about $140,000 in Medicare taxes. They are going to get $422,000. So 140 in, 422 out. When you see that number, it is an understanding that we need to do the things that would bring price disruption to the delivery of those health services. If not, think of this: 74 million baby boomers--74 million baby boomers--and, on average, we will have put in $140,000 in Medicare taxes, and we are going to get $400-some thousand in benefits back out. The math is just devastating for our economic future. This is a brand-new slide. This is in today's CBO report. The reason I had this one printed is to understand, in 9 years, according to today's CBO report--9 years--50 percent of all Federal spending, not counting interest, just 50 percent of all Federal spending, will be to seniors. Just understand what that means. I believe, in the early 1970s, for every dollar that went to seniors, $4 to $5 went to our children. It has, obviously, more than doubled in the other direction. It is just demographics. We are getting older. Birth rates have substantially collapsed in the country. But this is in today's CBO report, just to get our heads around it. The dark brown you see on top, that is those who are 65 and older. What is more of a rust color, those are 20 to 64, just to give you an idea of the population differences. Yet, the brown part, in 9 years, is 50 percent of all Federal spending. We need to understand that it is demographics. Another slide, just to sort of make the point here, if you were to go from 2008 to 2028, take those years, 91 percent--91 percent--of the increased spending of the Federal Government is, functionally, interest, Social Security, and the healthcare--we will call it healthcare entitlements, healthcare delivery. That can be Social Security. It can be Medicare. It could be Indian Health Service. Think of that. Ninety-one percent of all the spending growth from 2008 to 2028, over those 20 years: Social Security, interest, healthcare entitlements. Ninety-one percent. It gives you a sense of where the spending is. Yet, we will have hours and hours of debate on this floor over this coming year on trivial issues, because this is really difficult. This is hard. No one really wants to talk about it because the math is difficult. There are lots of zeroes. The elements of it mean some very difficult things for someone like me who believes one of the greatest issues of our time is retirement security. Yet, 91 percent of the increased spending from this Federal Government over that 20-year period: Social Security, interest, healthcare entitlements. Now, this is a brand-new slide. We are going to, over the next couple weeks, come back and do some more analysis on the CBO report today, the Congressional Budget Office report, and what it is telling us. This is a little awkward. We have never printed one this direction. I hope it works. This is directly from today's information, the budgetary policy release. See those lines? The only reason I put that up is to understand, whether it be what you all think of as the Social Security trust fund, the Social Security disability trust fund, or the Medicare trust fund, you will notice, in the next couple years, all of them go below zero. We need to understand the impacts, that demographics spending promises have now caught up with us, and we are emptying out those trust funds. This one is a good one. If you are like I am--and I know I am blessed to have some folks who correspond with me after we do these presentations. They have a fixation on: Well, what is the spending as a percentage of the size of the economy? In many ways, when you have someone throw out a debt number, the number that is most important to most economists, actually, is: How much is that dollar amount as a percentage of the size of the economy? That is why there is this fixation for many of us here that we have to grow the size of this economy, because that is how we can digest the amounts of debt that are, demographically, about to come to us. Do you see this number out here, that 15.1? Understand that is, functionally, 9 budget years from now. That is saying, 15.1--and this is from, I believe, today's CBO report. It is saying, in 9 years, 15.1 percent of the entire economy will be Federal Government mandatory spending and 5 percent will be discretionary. Remember, discretionary is things like the military, parks, healthcare research. All those things will be 5 percent, and 3 percent of the entire economy's value will be what we are spending just to cover interest. Add those together, and you start to understand: In 9 years, Federal spending, we are over 23 percent of the entire GDP. What should blow off this page to you: In 9 years, over 15 percent of the entire Nation's economy is just covering the mandatory spending here. That is under today's policies. Now, in the next couple weeks, we will do more of this, and I am going to find a way to print some boards that become more digestible, because I will get calls that will say: Well, David, just do this. Lift the caps on Social Security. Well, let's look at some of those numbers. If we come over here and start to say to eliminate FICA caps from the 15 percent payroll tax, so just lift the caps, you have to understand that it covers 0.78 percent of the 6-plus percent of GDP shortfall. These are all the pop solutions that I hear often from my friends on the left. You start to add them up, and they cover only fractions of the avalanche of debt and spending that are coming at us. We will do some more breakdowns on these over the next couple weeks, just to understand where the real math is, because we have a classic problem around here. Our rhetoric doesn't actually fit our calculators. Let's walk through some of the other things that are going on. I have repeatedly come behind this microphone and talked about something we in our office refer to as the unified theory. I believe there are, functionally, five things out there we have to do to sustain the future and survive, those of us who are baby boomers, and our earned promises, our entitlements. The first one we talk about is: What are you going to do to maximize economic growth? What are you going to do to keep people in the labor force? This one here that I put up, this is a chart of what we call labor force participation. We were all joyful when we found out in December that we crossed over 63 percent participation. But, remember, it was only like a decade ago that we were close to 67 percent of our population participating in the labor force, working. There is a great article today, if you have a chance to look at it, in the Wall Street Journal, talking about, in this incredibly robust job market we have today, where we have, functionally, hundreds of thousands--millions, if you actually do the average out--of positions looking for workers, that we are starting to see something that is really good for society. Those who have had a rough time are moving into the labor force. Those who have designations of having handicaps, maybe on Social Security disability, others, are moving into the labor force. I am fixated on this particular slide because we have to do better. I ask every policymaker, whether you are on the left or the right, to think about how we design these programs that are meant to be our safety net. How do we design them to encourage work, to encourage that participation in the labor force? We have to have that on this end, if we are going to have the resources on the other end to keep our promises. We are going to go through all five things that I believe, optimistically, can get us there. This one I put up just because it is from Arizona. A bit of trivia: You saw the numbers a few months ago talking about the collapse, functionally, in U.S. birthrates, you know, down to 1.67. Do you know what State had the largest fall of birthrates? It was actually my home State of Arizona. You start to see this and understand the scale we are at. We are substantially below replacement rate right now. When you see this slide, you immediately should start thinking about what we can do as incentives in our society for family formation with children, but also what are the levers within immigration that would help us move to certain types of population stability. Before we go to the next slide--let's hold off on that one--let's walk through sort of an optimistic vision of what we can do. It is big; it is complicated; and it is going to require a lot of us to explain really difficult things to constituencies that have heard politicians for decades now saying: Well, if we just take care of waste and fraud. You understand, there are problems out there. It needs to be fixed. I believe there are technology solutions to stop the waste and fraud. It is a fraction of a percent of what is actually happening out there. So let's walk through our five. We have to grow our economy. That is why we did tax reform. That is why we also now have to fix our trade situation. That also is why we have to continue the proper types of education in our society. There is a series of things you do as a society to maximize economic expansion, because we are talking more than just this year, next year, the next decade. We really need to have a window that goes out at least 30 years. Remember our baby boom population of 74 million with the peak being 63 years old? We need to be thinking at least 30 years out of what we do to maximize economic expansion over that time. A lot of it is going to be tax, regulatory, education, trade, those types of things that we have the levers on that can maximize that expansion. The next thing we were just talking about is labor force participation. Let's fixate on that. As we start to go through these, what do you also do within the incentives? You are 65. You are healthy. What could we do as incentives within Medicare, Social Security, certain of our tax rules, to encourage someone to stay in the labor force? If you have an interest in this, read some of the articles about things Japan has been doing to try to create some labor force participation stability, even though their population is aging out very, very quickly. The next slide I want to go to is one of my favorites, just conceptually. That is, much of the explosion in the costs, you see, is in the Medicare area. The debates that happen on this floor about healthcare, if you take a step backward and can strip your mind a little bit from being a Democrat or a Republican, you do understand that much of the debate around here is not about what changes the cost, but it is about who gets to pay. The ACA created a world where we are saying: Okay. We are going to create all these government subsidies; we will move it this way. But it didn't remove any costs. Then we will actually do things that are saying: Well, we believe this will actually get more participation in the marketplace, and that will actually create actuarial stability. But, ultimately, if you actually take a step backwards and think about, in society, what do any of these do to actually remove costs? And I want to argue there is a technology disruption revolution about to hit in healthcare. The poster next to me actually is a handheld ultrasound. Think about an ultrasound that is the size of your phone. You take it, you actually plug it into your phone, and you have an ultrasound; something that, just a few years ago, was really expensive, you can have in your pocket. It is under a couple of thousand dollars, and, apparently, the prices are crashing because there are now multiple competitors in this technology because of the development of new types of sensors. Think about a world where it is much more than you are wearing a smartwatch that helps you with your heart arrhythmia, but think about something where you can blow into it, and it tells you if you have the flu and automatically could order your antivirals. Well, it turns out that is actually in testing right now. How many of you went to Blockbuster video last weekend? Of course not. There was a technology revolution--feels like it happened overnight--where we used to go stand in line, get a little box with a little disc in it, get movie recommendations from the person behind the counter. Today, we go home, we hit a button, and it is HBO Go, it is Netflix, Hulu, whatever you ultimately watch. We were quite willing to accept that technology in our homes almost overnight. I am going to continue to ask Congress, the regulators, the people in our society, think about what we could do to disrupt the costs of the delivery of healthcare, and I will argue with you that it is technology. There is an experiment going on in Arizona right now where I think they are up to five little clinics that are substantially autonomous. It is a powerful thought experiment. You will hear people; Members of Congress talk about telemedicine. I will argue with you, some of the research we have been doing out of our office, telemedicine now is already out of date. There is now algorithmic, where it can read these sensors that you wear on your body. It can actually read with the thing you blow into, and the algorithm is amazingly accurate. Would that concept help us in our issues in rural healthcare, but also in our ability to have the cost collapse that technology potentially brings? And I know it is uncomfortable because we are used to the system we have, but we can't afford the system we have. You have seen it in the chart. You see what is coming at us. Then the last thing of the five is we are going to have to have an honest conversation about the way Medicare, the way Social Security, the way many of these programs are designed. Do we need to look out into the future and build a shock absorber into them that has to do with life expectancy? What would happen tomorrow if we were blessed to have a cure to Alzheimer's and life expectancy suddenly--what is the term? Like a punctuated equilibrium, we had a sudden pop of a few years in life expectancy, what would that mean to actuarial tables? Do we need to start designing in shock absorbers policy-wise today, the incentives to actually stay and work so we have the labor force participation, but, also, can we build some spiffs, some incentives? So if you start to look at everything from fixating on the growing of the economy, fixating on participation in the labor force, fixating on the adoption of technology as a price disrupter, and then the actual structure we use on the delivery of entitlements, and we understand the scale and how fast this is coming at us, I will argue with you, it is something we need to do almost immediately. My goal is, over the next few months, every week, every other week to come behind this podium, and we are going to start to get more granular in how the policies would work and what drives them. So my point, once again, is understanding it is mandatory spending. It is substantially, remember, 91 percent, delivered by our demographics, and demographics isn't political. It is just what we are as a society. So what do we do? Last bit, because I skipped it, and I want to come back to it. Immigration; designing an immigration system that substantially promotes a talent-based model. Why? If everything we do policy-wise has a fixation on economic expansion, on economic growth, so we actually have the resources to keep our promise as a society, you actually have to think about, even immigration, and a model within that both looks at population stability--because you saw what was happening to our birth rates--but a talent-based system so you get the maximum multiplier effect of economic growth. When we do the math in our office, we see a way to stabilize the debt. It doesn't go away. It keeps growing, but the economy grows so that percentage of debt to GDP actually keeps us so our interest rates don't explode off the charts because no one will take the risk on our debt, but think of the number of policy decisions I am asking this body to make. There is a path. It is going to be hard. We are going to have to explain a lot of very difficult mechanics of why we need to do what we are going to do, but it is the path that saves our country. I have a 3-year-old little girl, best little girl ever. I want her to have the same opportunities I have had. And the way our demographics pile up our debt over the next 30 years, she won't have the same opportunities I have had, and that just isn't fair. That is not fair to anyone. We have got to find a way to keep our promises and have the next couple of generations also have the same opportunities. Mr. Speaker, I yield back the balance of my time.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Mr. Speaker, this is one of those opportunities, now that we have the new session of Congress up and running, to come up here and sort of walk through some of the math and the reality. And, look, it is always fascinating when we hear, you know, the discussion of, well, there is $5 billion for security and the barriers, but I just want to say to everyone, before we sort of go into the presentation of the actual math of what is going on in our society, you do realize the total amount that is being discussed as the plus-up for the border security is less than we borrow in 2 days. It is less than 2 days of borrowing. I mean, we live in this world of absurdity where the politics actually have outstripped sort of the reality and the math. And, look, I accept that there is part of our society that so desperately doesn't want the White House to ever get any of its priorities, they will burn the place down, but come on. Being from a border State, you know, come and see the fentanyl, the heroin, the human exploitation that is happening not only across the country, but particularly for those of us that are from border States. But that isn't why I had reserved tonight's time. I actually want to make sure that once we get beyond this partial shutdown and we maybe get back to the business of governing, we actually start to have some understanding of the reality of what our society is up against. In the first chart I have brought I am going to try to make an argument that our greatest difficulty we have as a society, as a country, is actually demographics. This is something we often don't talk about, because it is not something we really can do a lot about, but the reality of it is, as a society, we are getting older very fast. There was an article just last week saying we are growing older the fastest in 80 years. You have seen the crash in our birth rates. I mean, you do realize that our birth rates are nowhere near what we call replacement rates as a society. We are down to, what is it? What do they say? 1.76 births, when you need to be up around 2.1 just for population stability. What does that actually mean? Well, we are going to walk through a number of these boards and start to understand what that fiscal impact means if you want to keep our society's promises on things such as Social Security, Medicare, and how we deal with it. I actually want to give sort of an optimistic idea. We believe we have sort of a five-point idea, but it is going to require my brothers and sisters on the left, my friends on the right, and people in between to pull out their calculators and think. The fact of the matter is I often feel like I work in a math-free zone. Just a bit of trivia. In 11 years, you and your partner, so two people, will be supporting one retiree. In 11 years, two workers for every one person in retirement. Think about that. No matter what you think about politics and who pays and who doesn't pay, just think about that structurally as a society: two workers for every one person in retirement, and that happens in 11 years. It is hard to talk about because, let's face it, we are Members of Congress. We often like talking about the shiny object, the thing that when we walk out these doors, the reporter is going to stick the microphone in our face, and it is going to be the shiny object of the day instead of the structural reality of what threatens our Republic. The first slide here, all I want to be absorbed is this is 1965, a long time ago, 50-some years. Do you see the red? That is what we call mandatory spending. Those are things that are on autopilot. The most elegant way I think to describe that is that you have Social Security and Medicare. Those are earned entitlements. You worked a certain number of quarters; you paid in; and you get those benefits. There are other entitlements that fall under this. If you are part of a certain Tribal population, we have a treaty obligation. Or if you fall under a certain income, you get these benefits. But they are mandatory. They are built into the base. We don't vote on them. They are on autopilot. In last year's budget, actually, well over 70 percent of all the spending was on autopilot. It is what, ultimately, is consuming the budget. We are going to do a couple of these slides, just to try to get our heads around this. Let's swap to the next one. This is just to sort of help the breakout. My understanding is that in this coming budget year--you need to think about this--defense spending in the 2019 cycle will basically be the same as Medicare. How many of us, when we go home to talk to our constituents, somehow think defense is two-thirds, a third of the budget? Basically, as you start to look at the charts here, you will actually see--and these are the 2018 numbers. As you walk through, you see the blue. We will call that the sea foam blue. That is Social Security. That is 24 percent of all our spending. If you come over here, national defense is this rust. That is 15. Last year, Medicare was actually a little over 14-point-something. This year, Medicare and defense are almost the same. With our demographics--remember the baby boom, 74 million of our brothers and sisters who were born in that 18-year period who are baby boomers--the peak of the baby boom right now is about 62, 63 years old. They are just starting to move into the years where they will receive those earned benefits. Then you come over here to Medicaid and other income programs, net interest--remember, interest is a mandatory. You have to pay it to protect the sanctity and full faith and credit of U.S. debt. You start to realize, the amount that we, as Members of Congress, actually get to work on starts being about a quarter of all the spending. It is not driven, really, by current policy. These are previous policies. It is driven by our demographics. We are getting older very fast. This is the slide that is the most devastating to get your head around. Yes, I have not adjusted this for inflation, so these are stagnant dollars. When you use a 30-year time window, you can deduct about a third. Eventually, I will get this slide up, and I will do the interest deduction. But think of this: Over the next 30 years--2018 to 2048, a 30-year window--what is causing an $84 trillion budget deficit? It is substantially interest, the shortfalls in Social Security, and the shortfalls in Medicare. The rest of the budget has about a $16 trillion surplus in what we calculated as revenues to spending. That is really important to get our heads around. It is fascinating that, when you show these numbers, I will get people who will protest the math. It is not Republican math; it is not Democratic math; it is just math. The reality of it is that we have these massive, unfunded liabilities that are basically in two programs, Social Security and Medicare, and we have a moral obligation to keep our promises as a society. So how do we get there? The next one, I am just going to put this one up so it helps reemphasize the way this works. Think of this: From 2008 to 2028--so that 20-year window--91 percent of the increased spending in this body comes from three things: interest, the growth in Social Security, and the growth in spending in healthcare entitlements. When you see my kind come behind these microphones, and we speak as eloquently as we can, unless we are telling the truth about the demographics, we are actually not telling the truth of what is really going on. I know it is hard. It is math with lots and lots of zeroes. But this is the reality. When you look at the charts, things like defense, nondefense discretionary, even some of what we call the other entitlements, they are substantially flat over that 20-year period. We are getting older very fast as a society, and our birth rates as a society have collapsed. We don't have enough children right now, over the last decade, to even be at replacement rates. We are basically following the trend of the rest of the industrialized world. You have to think that through. What does that mean for our ability to promise Americans, as they move into their senior years, that retirement security? That, I think, both Republicans and Democrats all agree we must have, but, yet, then we do everything we can to avoid the actual math. The next slide I want to go to is to, once again, reemphasize the reality of what is happening in our society population-wise. For this next chart, I am using Arizona, because that is my home. But guess which State appears to have the biggest fall in birth rates? Arizona. Now, please be merciful on me. I am going to try to explain something with a lack of sort of elegant language. I have had multiple conversations with a couple of folks who make their living just fixated on demographic numbers, and they, partially, are giddy about this for one thing in society. They sort of come back and say: Look, in previous demographic modeling, we thought parts of our Hispanic populations, parts of our LDS populations, and parts of others were going to continue to have very high birth rates, and that was going to provide some population stability. But the fact of the matter is the melting pot, apparently, is actually working in our society. In our country, the melting pot is working. One of the ways that demographers refer to it is say: Look, we are all not having children like each other. The likelihood you will have a similar education, live in the same neighborhood, and now also not have children like each other, you see it in the math. So, on one hand, yes, the melting pot is working. That is great for our country. We are Americans. We are a diverse lot, but we are Americans. Now we need to deal with the social entitlement problem. That is, in 11 years, if I have two workers for every one person that is retired, and my birth rates are continuing to fall, how do you make the math work? How do you keep your promises? Remember my first quip when first coming up to the podium: We are having this dispute over an additional $5 billion of border security and the effects that has on humanitarian aid. But the absurdity is that it is less than 2 days of borrowing right now, and almost all that borrowing is driven by--you saw it on the previous slide--our allocation to cover our interest costs, Social Security, and the healthcare entitlements, where almost all the spending growth is. This is a reality, but it is fascinating. The beginning of this is 2000. In 2000, we were basically about 3.1 in birth rates. Fertility rates have collapsed. When you actually start to do the mean nationwide, we are now down to--what is it?--1.67. We need to actually couple that in with the massive unfunded liabilities we have and start to understand that the greatest threat to our country right now is massive entitlement promises and the lack of resources to cover them. I have done it before, and I am going to do this about every week. I am going to bring in different boards. I have a series of boards that show almost every idea that gets quipped out of: ``Well, we will raise tax rates to this, or we will do this.'' None of them come anywhere close to actually covering the scale of our obligations. Right now, I want to do one or two things that I actually believe are optimistic. I am going to give you sort of a five-point idea. This is something I have been talking about in Arizona and partially around the country and other places. I need us to think about, okay, this is the math reality. We have these massive unfunded liabilities that are basically driven by two programs and our interest obligations. How do we fix it? Let's actually walk through a list and understand it. I call this the unified theory because we have to do all of them. We have to do all of them at the same time, and we have to fixate on the growth aspects they all bring. The first one I want to talk about is immigration. As we go through, partially, the political theater, as this body has been doing with regard to immigration, let's actually take a step backward and say: What immigration policy maximizes economic growth for the country so that growth helps us pay our promises, so people will receive their Social Security and Medicare? We will have to move to a talent-based immigration system, because, as the rest of the world has done, whether it be New Zealand, Great Britain, Canada, or Australia, the rest of the world has basically moved to a talent-based system because they figured out it maximizes economic growth. In our case, hopefully, we would move to a substantially talent-based system. You still are going to have compassion. There will still be types of visas for our brothers and sisters around the world that meet our standards of compassion. But with that, I believe, you also are going to have to put in math shock absorbers that deal with the fact that we are going through a cycle right now with birth rates falling. Would you adjust certain portions of that talent-based immigration population to deal with something we call population stability for the future? Remember, this is about maximizing economic growth, so we can keep our promises as a society. The slide I have next to me is sort of as we deal with the next couple issues. So I believe a major reform in the immigration system can maximize economic expansion. The next thing is a fixation on growth. When we did tax reform, as we get together and start to realize this supercomputer we carry in our pocket, oddly enough, could be the greatest regulator in our society because it can crowd source information. I have done presentations on this in the past. Instead of building bureaucratic models, where we make people fill out lots of pieces of paper and shove them in file cabinets, how about moving to a modern system? As a simple example, how many of you use Waze as a way you drove to your office, or to work, or to pick up the kids? That is a crowd source model that gives you information. It turns out that same concept can actually be a way to regulate air quality and know that we are safe without building a bureaucratic model. It can be so many things. We need to fixate on what maximizes economic growth in our society, and that is Tax Code; that is regulatory code; that is removing barriers, removing the barriers at the State, local, and Federal level that encourage risk-taking entrepreneurship, the things that create the economic disruptions, so we grow. The third thing, and that is what that chart is about, we call it labor force participation. We got the report last week that was actually in some ways wonderful and in some ways it is heartbreaking. We are giddy that we broke 63 percent labor force participation. We hit 63.1. I can show you a stack of articles from the last decade from really smart economists, mostly on the left side. They said we are never going to get back to 63 percent labor force participation because we are getting older as a society, we have so many worn-out workers, or whatever the current pop cultural term is. Well, we broke through 63.1 last month in December. But understand, it was only a decade ago we were pushing around 67 percent labor force participation. What does that mean? It means we have substantial portions of our population who, for lots of reasons, whether it be drugs, whether it be certain educational aspects, whether it be societal expectations, are not in the labor force. I have actually done it before, and we will do it again over the next couple of months. I will do some charts where it is actually a really interesting sort of barbell-type curve where we have lots of young people--mostly males--who are not in the workforce, and then older parts of our population who are choosing maybe the rational thing, to retire. How do you build a society that encourages a person to stay or to enter the workforce? So as we have debates around here where the left wants to talk about certain types of income assistance, we in the right will talk about: How do you take that and make it a reward to work? We need more of our population to work. If we could go right now from that 63 percent labor force participation and get back to that 67 that we were at just a decade ago, it is amazing how it helps. So the third thing I am going to give you is we need to have everything, whether it be from the discussion of SNAP--food stamps--to incentives in Social Security and Medicare, to encourage someone to stay in the workforce longer, to a young person in their student loans to actually enter the workforce and begin that process. Every program we as a government, as a society, participate in, we should maximize the incentive to work because we need it if we are going to keep our promises. Remember, this is a loop. Everything here we talk about is, if we are going to keep our promises on Social Security and Medicare, we have got to have the economic expansion that provides the resources. The next one I am going to give you is the one that I am most optimistic about. And let's put that board up. But this one is a little harder to talk about, so I will beg you to bear with me. When we have had debates around here on the ACA--some people know it as ObamaCare--or our Republican alternative, or this healthcare debate, I need everyone intellectually to strip away our partisanship and take a step backwards. Almost all of the debates have been about who gets to pay. The ACA just shifted lots and lots of the spending onto the government. Some of our alternatives were actually trying to spread the cost out more across the private payer populations. But we have done almost nothing to disrupt the cost curve. So part of the thought experiment I want us all to engage in is: How many of us went to Blockbuster Video last weekend? I know it is a little starky, but think about it. Didn't it feel like almost overnight you no longer stood in line at the local retail strip center at Blockbuster Video to get the little silver disk that you were going to take home and shove into your Blu-ray player? You would now go home and you hit a button and you get Netflix, or HBO Go, or Hulu, or whatever you are watching. That is what we call a disruption. Almost overnight, society figured out, hey, this is cheaper, faster, better. How do we take that sort of concept of disruption and make it part of healthcare? How do you say, instead of playing this game that we have played over and over of just trying to move around who gets to pay, we are going to engage technology in such a fashion that we disrupt the cost curve of healthcare delivery? The fact of the matter is there is so much technology rolling out, this is about to become your primary care physician. How many of you have seen the articles of something that looks like a kazoo, a large kazoo that you blow into and it tells you if you have the flu virus. The article from last week, something a little bigger, a cone over your nose and mouth, you blow into it and it tells you if you have a bacteria. There is the Apple Watch that will help you manage your arrhythmia. There is all of this technology rolling out. There are things, I am told, right now at the Consumer Electronics Show, a couple of hundred items being shown at this moment that are all technology--we like to refer to them as digiceuticals in our office--that will disrupt the cost of healthcare if we can break down the regulatory legal barriers, whether it be on how we pay for them or the fact that many of them provide a level of autonomous healthcare. Our system as it is regulated and compensated today does not, was not designed for a level of autonomous. We have a company in Scottsdale that now has four or five locations up. I guess they used to be Theranos booths. I think they are at Safeways, if I am allowed to say such a thing. You go in and you functionally fill out your information in an iPad. You go into a private booth. There is an avatar on the screen. You grab the scope--and forgive me, I am not a medical person--and you shove it down your throat, in your ear, in your nose. It tells you how to move it. It tells you what they need. You put your hand on something. It can do a pulse and the temperatures and other things. And an algorithm does the calculations. Apparently, the algorithm is amazingly accurate. What would happen if that type of healthcare became available to all of us? We crash the price. We dramatically change the availability. And, yes, these things are scary because it is a disruption of technology into our economy, but we don't have a choice. You saw the charts before. The greatest fragility in our society is promises we have made that we have no money. And almost every solution gets us nowhere close to the types of resources needed. We must have a disruption in the cost of delivery. And part of the thought experiment, it has been a year or two, but we have seen things like the contact lens that can calculate your blood glucose, that talks to your insulin pump. Because we do know that more than half of our healthcare costs in this country are for the 5 percent of our brothers and sisters who have chronic conditions, what happens when those digiceuticals help manage those chronic conditions to prevent the crashing? How about the pill bottle that makes sure that--we know that 50 percent of pharmaceuticals are not used properly. The solution becomes a technology one when all of a sudden your phone rings. The beeper goes off. You haven't taken your hypertension medicine that morning. We desperately need this body to start to understand this. And is that Republican or Democratic? It is technology. Now, I am sure, eventually, we will break down and it will become a Republican issue or a Democratic issue, whether it be because which lobbyists go where, but for right now, it is just a solution. The last one I will give you of my five is when we do all of this progrowth, this ability to crash the cost of delivery of healthcare, we are going to then have to have a really honest conversation of what we must do, particularly in Medicare, to modernize the design, deal with the reality that life expectancies for those who make it into retirement are going up. Many of us will spend a third of our life in retirement. Do we need to change the incentives within those individual programs on how we take our benefits? How we manage those costs? How we participate in them? We have some really interesting ideas: Would you make adjustments for folks who may have the ability to carry previous healthcare options with them? But I truly believe we need to do all five of these, and we need to do them almost immediately because every day we wait, another 10,300 of our brothers and sisters, Americans, reach 65 and start to move into their benefits. And every day we wait, we avoid the reality of math. I guess there are a couple of smart people out there who many years ago said: Tell me your demographics and I will tell you your destiny. I have just told you our demographics. I have just shared with you the scale that is off the charts on the promises we have made and our lack of resources, and I believe I have actually begun to give an approach of a unified theory of how we make it work and how we make it through, functionally, our 74 million baby boomers who are moving into retirement and how we move through that population bubble so someone like my 3-year-old daughter also has the economic opportunities that I have had. Mr. Speaker, I yield back the balance of my time.

Mr. SCHWEIKERT

Mr. SCHWEIKERT. Mr. Speaker, I move that the House do now adjourn.