adjourn. the speaker pro tempore: the question is on the motion to adjourn. those in favor say aye. those op there is still time to get your copy of the 2009 congressional directory, with information on the cabinet, supreme court

justices, and the nation's governors, plus the district maps and how to contact caucuses. it is $16.95 at c- span.org/products. >> policies and funded? >> through donations. >> they get it from the government. >> maybe sponsors? >> it might get some government funding. >> 30 years ago, america's cable companies created c-span as a public service, a private business initiatives, no government mandate. no government money. >> next on c-span, and house hearing on health care and questions for health and human services secretary kathleen civilians. that hearing is followed by a americans for tax reform. they held a forum with the

coalition that opposes the white house plan. now that hearing. we will hear first from committee chairman, henry waxman. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> then february, president obama called upon congress to enact legislation to reform america's health-care system. in april, governor kathleen

sibelius was sworn in as secretary of health and human services. her department has the lead responsibility for improving the health of the american people. last friday, i joined with the chairman rangel and chairman miller to propose a discussion draft on health reform. this morning, we have the honor of hearing secretary sibelius' present the administration's views on the discussion draft. based on her contributions today and on what we will hear and learn from, the 50 state holders appearing before the said committee this week, and on the input from the members, we will revise the discussion draft and introduce a bill for consideration by the three committees. our legislation will reduce health-care costs. it will cover all americans. it'll improve the quality of care. it will be fully paid for.

the lead sponsor, all there, will be the chairman of this committee who is faithfully carried on his father's legacy as an undisputed leader in the struggle for health reform. i want to emphasize a few important points about the discussion draft. it is just that, a draft for legislation and for discussion for the legislation. we are seeking input for the administration and others, because we want to approve the draft before introducing legislation. second, the draft of builds on what works and our uniquely american system. it builds on the employer base system for providing health coverage to workers and their dependents. it relies on and improves medicare as the source of health coverage for the elderly and the disabled. it builds upon medicaid to extend coverage to low-income

americans. third, it fixes what is broken. it fixes the broken individual health insurance market by creating a new insurance exchange through which uninsured americans can enroll in their choice of health care plans. those who cannot afford to purchase the coverage available in the exchange will receive a -- assistance. a public opinion -- excuse men -- a public auction will be available within the extern exchange to give consumers an alternative to private health insurance for their help for a bridge for their coverage. this public auction will be self supporting, will not receive ongoing subsidies from the federal government's. the public auction will compete. and no one is obligated to sign up for the public auction.

no provider is obligated to provide medical services under the public auction. the public auction will provide competition so that we can make the market work and keep everybody honest. it contains provisions to contain ethnic disparities and treatment. the draft that is a broken medicare physician payment system and prevents cuts that are scheduled under current law from going into effect. the draft takes the steps necessary to fix the shortage of primary-care practitioners and addresses and other providers. finally, at the drafting chores that people have a choice. a choice of doctors, benefit packages, and a choice among insurance plans. this approach builds on what works and fixes what is broken and make sure that people have

choices that are pragmatic. it will produce the results of the nation's health care system so desperately need. it will lower costs, broader coverage, and better quality. today we will continue on a journey that began over 100 years ago to provide health insurance for all americans. some of our greatest presidents of the 20th century, teddy roosevelt, franklin roosevelt, and harry truman, or advocate for health insurance for all americans. president clinton fought hard for the administration proposal. those initiatives may have failed, but the hope that inspired them was never defeated. the time has finally come to redeem that and to deliver true health reform. in my conversations with colleagues, i am getting the sense there is now a willingness to tackle this issue and to resolve the problems and bring forward a much better health

care system for all americans. with president obama and the white house, we now have the best opportunity ever to enact health reform. i'm determined that we not let this opportunity slip from our grasp. i look forward to this morning's testimony and continue with urgent, pragmatism, to send help reform legislation to the president for his signature this year. i want to recognize the ranking republican member of the committee. >> thank you. >> we both attended summit this year. in both those summits, i said that the republicans in the house and on this committee were very ready am very willing to work with the president and with you and other members of the

majority to create a new health care system for america. there is no member of congress on either side of the aisle that is opposed to the improvement in reforms in our current health care system. we were ready to work. you told me repeatedly that you are ready to work with myself and other republicans. having said that, actions speak louder than words. while you and i have had several meetings, personal meetings, we had one with ranking members of the subcommittee, we agree to work together -- the brown bag lunch that was supposed to occur because of that was scheduled and rescheduled and finally, last week, we are supposed to have had last friday at noon. we were called the afternoon before in said that the brown bag lunch on a bipartisan basis could not be scheduled.

you were attending a press conference to deal with democratic health care bill. that is not by partisanship. that is not inclusiveness. it sure made me feel like a young woman who was being wooed by a young man and a young man kept promising to take her out on a date in the filing calder and said, well i know we have one tomorrow, the fed -- i cannot do because i'm getting married to someone else. i guess some people do both. [laughter] luckily, you are not one of them. i am not see there. it is what it is. we now have a bill. yet the secretary of health and human services here that probably wax eloquent. i bet the testimony will be supportive. i have not read it. the good news is that we are

going to have a series of hearings and we will at some point in time go to mark f. hope springs eternal on our side that some of our ideas may be included. the bill in its current form i have not read all 852 pages -- i'm not going to fit about that -- i have seen some rays. it is a massive government involvement in to the american health care. it is hugely -- i've seen estimates as high as $3 trillion. i am told that the word shall mention over 1300 times. there are 38 new mandates. there are dozens of new properties. i listened to your opening statement and heard you said no one has to take a plan that does not want it.

that may be too technical, but if you put so many mandates on private insurance the becomes cost prohibitive and if you raise the medicaid eligibility to 400%, there are going to be millions of americans that lose their coverage because private businesses that offered cannot afford it and they are going to be not warning to pay a monthly premium of x dollars let him go on medicaid and pay little or nothing. the short of it is that if your bill were to become law, we would not have much of a private health care system in america. put me down as undecided, mr. chairman. we will work with you. we have a number of amendments. we have a republican alternative that is private

sector based. it was the individuals maintain their choice. we do some of the things that you do in your bill. we do have a permanent physician reimbursement fixed. we do have a tax credits, a reimbursable tax credit, for low-income americans. the big difference between the republican bill and the democratic bill is that on the republican side, we still believe in the marketplace. we do not have all the mandate. we do not force americans into a government plan that we think is not very good for america. with that, i'll submit the rest of my statement for the record i look forward to these hearings. >> thank you. i am sincere in saying that i want to work with the. i will sherri brown bag lunch with you. >> thank you. >> this bill is a draft. i want to recognize the chairman of this committee.

he is the champion of health care reform. he is the man that shall be the first time on the legislation. mr. dingell's? >> first, thank you for holding this important hearing. thank you for your remarkable leadership on moving forward toward resolution of the health care problems we have. i am grateful and proud. i am appreciative of the words he said about my dad. on behalf of my dad, i want to thank you for your kind words and for your friendship. i also want to do something on a personal factor. that is to welcome secretary sibelius. your father was a bible member of this committee. he said in his room for a number of years. we are always proud to have you here. your father and all was a bible member of the house, as you will recall. -- a valuable member of the

house, as you will recall. this week marks the beginning of a historic process. it is an opportunity to fill our economic obligations, to provide quality and affordable health care coverage for all americans. the current system is not working. my dad started on this years ago and it was a matter of humanitarian concern. americans were dying for lack of health care. healthcare was not available to most americans. today that is still true to one degree or another. but it is now an economic necessity, something which must be done to enable the united states to continue to compete in the world market place. our industries are being killed by the lack of this kind of support in a fiercely competitive world economy.

47 million americans are currently without health care. this is an upward of 86 million will be allowed out healthcare at some point in during this year. more and more americans are being forced to make decisions they never should be forced to make. do they pay their monthly health insurance premium if they can get health insurance policy board do they pay the utility bill, mortgage, or do they buy food for the family? american business owners are facing a tough decision as to whether to meet monthly payroll or to pay health insurance contributions toward their employees. if you look at the american automobile, it has $750 million worth of steel in it. foreign competitors do not have this problem. the federal budgets and no longer sustain our current health care spending. the health care costs grow and

the cost to the country will be more than 20% of the gdp on health by 2018. the discussion draft, i stress the word draft, we are considering it is a uniquely american solution to this crisis. it does in a privilege for me to work with you, mr. chairman, on putting a strapped together. i want to commend all of those, including the subcommittee who worked so hard to bring about unprecedented ordination that went into producing a single discussion draft for the three committees of jurisdiction. i want to make something clear. the discussion draft will not be a single payer system. it will not raise care. it will not attempt to destroy

the private market system or the system of employer sponsor healthcare many americans enjoy today. anybody who says otherwise simply has not read the bill or is not being truthful with himself or anyone else. that being said, each of us has our own vision of what i do health care reform looks like. while the specifics may be different, we all share some common goals. first, we must pass legislation that reduces the cost of health care for families, businesses, and government. second, we must pass legislation that makes quality affordable health care available to all americans. we must pay for this legislation. we must pass legislation now. the choices we make over the coming months are going to be historically significant and they will bring with the passage

of social security and medicare. if we are courageous and in that comprehensive health care reform, our products will meet the test of history. i would in note as with medicare and social security, medicare was mentioned on the editorial page on sunday of "to the new york times." it is only a short of the flag in his popularity. we are not courageous, we will have a field of this generation and generations to come. the country will suffer for it. i am certain we will pass comprehensive health care reform that will build on the existing system, keep intact that which is working, and give people a piece of mind that no matter what they face, they will always have access to health insurance.

the american people deserve nothing less. thank you, mr. chairman. >> thank you, mr. dingell. he gave his opening statement yesterday. he did not have that opportunity. i was by unanimous consent, that everyone had the opportunity to submit a written statement for the record. >> thank you. thank you for holding this hearing and a series of panels today and tomorrow. i want to welcome all the witnesses who are joining us, especially to express my appreciation and welcome to dr. todd williamson, who is the president of the georgia medical association. as we consider this drafted this week, hearing from the witnesses is important. i think we have reached consensus that reforms are necessary, but we differ with respect to the right method of reform which will yield cost and

higher quality savings and the decisions that should be left to doctors and patients. not before bureaucrats as they make choices about health care for our people. more government is simply not the answer. the draft before us seems to think that it is the answer. as far as the republicans are concerned, we have seen an attempt to approach health care reform in a bipartisan fashion and it has resulted in what we consider to be a partisan proposal. it refuses to address the concerns of members on our side of the aisle. but friday, we received an 852 page reform that is nearly one legislative day before the committee began its hearings of. we are concerned about the costs. the office has yet to weigh in on the cost. early analysis by mr. stve and who testified yesterday, scores

of legislation at a whopping $3.50 trillion. we need to come up with real solutions to improve healthcare that american families can afford. the promise of the obama administration and the leadership here on the hill has been that if you have -- if you like what you have then you can keep it. that is a play on words. it is drafted does what i think it will do, it will destroy that private health insurance market and will ultimately lead to what i consider a one size fits all government's plan. if we focus on reforming the health care delivery system with the benefit of the american people in mind, we should not focus our efforts on things that will destroy the private insurance market. i believe we should be encouraging physicians to enter into the field of medicine as the demand for health care related services will continue to grow. with the proposal before us today, which benchmarks' public

plan reimbursements to medicare, on that in itself continues to drive providers out of the system. i believe we will fall short of the objective that all of a share. that is having a system that encourages doctors to enter and allows everyone to gain access to health care coverage. mr. chairman, we all agree that changes to our health care delivery system had the potential to yield significant savings and improvement of efficiency and delivery of care, but we must ensure that reports that we put into place promote competition and transparency. as to move forward, i hope we will get that cbo score. i think it is important to the deliberations ally before us. i want to reiterate again that those of us on our side the i'll look forward to working in a bipartisan fashion. we hope amendments will be suggested. thank you again to our witness,

our secretary, and thanks all the witnesses will make of the panels that will follow. i yield back. >> thank you very much. it is my pleasure to welcome kathleen silliest to our committee for the first time as our nation's secretary of health and human services. it is highly appropriate that the first testimony is on the reforming of the nation's health-care system. that is the president's highest priority. it is a subject of which brings a bread -- in which she brings a breadth of its experience. she has essentially valuable experience. she is implemented health care reform. before that, shed eight years in the kansas house some reason it is. i want to welcome you. we look forward to welcoming you. your full prepared statement will be in the record. we would like to recognize you

to proceed. there is a button on the base of the microphone. he should pull closer to you. >> thank you, chairman waxman. thank you for this opportunity to join me for critical conversation about health reform in america. as the chairman has already recognized, my father did serve on this committee. he was here when medicare was passed. i feel privileged to be part of this historic conversation and a delighted to have the chance to work with you on this critical issue. no question that your release of the discussion draft with your colleagues from education and labor represents a historic moment in this debate. we not only appreciate the hard

work if you already done, but we are grateful for the work you are about to do as we work together to at long last enact reform. help treat form constitutes one of our most important domestic priorities. we know the cost of doing nothing is simply too high. as the president has said, unless we fix what is broken in our system, everyone's health care is in jeopardy. reform is not a luxury, it is a necessity. today in america we have the most expensive health system in the world. we spend 50% more per person than the average developed country, spending more on health care than housing or food. health insurance premiums have doubled since 2000. the high cost of care is crippling businesses who are struggling to provide care to their employees and stay competitive in this global world. small businesses and their workers, the backbone of the american economy, are suffering.

as recently as 16 years ago, 61% a small businesses offered health care to their employees. today, only 38% do. last week i was ivisiting business owners in new jersey who met with me the sacrifices they have had to make in their company to provide health benefits to their employees. even then, some of their employees cannot afford the care they need. we spend more on health care than any other nation but are not any healthier. only three developed countries in the world have higher infant mortality rates. our nation ranks 24th in the life expectancy among developed country. more than 1/3 vs are obese. we know that 75% of our health costs are spent on chronic disease. without reform, these problems only get worse.

in 2008, we spent an estimated $2.40 trillion on health care. if we do nothing, by 2018, we will spend $4.40 trillion. today we spend about 18% of our gdp on health costs. doing nothing, those cost reach 34% gdp by 2040 and 72 americans will be -- sidney 2 million americans of the uninsured. the cbo has estimated that by 202525% of americans economic output will be tied in the health system, limiting all our other investment and priorities. there are many problems with the whole system today. there is also a reason for optimism. across this country, there are a lot of examples of hospitals and providers enter using new technology, cutting costs, and

improving the quality of care. two weeks ago, i was an oin omaha, neb. at one the nation's first fully digital hospital. i saw how technology can help doctors and patients. health care providers like the kaiser system in california and the mayo clinic have lowered costs and have more importantly improve outcomes for their patients. i have spoken to community health center providers from ohio and pennsylvania who helped outline how information technology has helped them save resources and provide better care. our challenge is how to take the best practices and spread them across the entire country. i have every confidence that we can meet this challenge and its cheek -- meet our goals. protecting people choices of doctors and health plans and ensure