the speaker pro tempore: on this

the speaker pro tempore: on this vote the yeas are 419. the nays are zero. 2/3 of those voting having responded in the affirmative, the rules are suspended, the bill is passed, and without objection the motion to reconsider is laid upon the

the chair lays before the house the following communication. the clerk: the honorable the speaker, house of representatives. madam, pursuant to section 4 of the ronald reagan centennial commission act public law 111-25, i am pleased to appoint mr. elton gallegly of california as a member of the to the commission. mr. gallegly has expressed interest in serving in this capacity and i'm pleased to fulfill his request. signed, sincerely, john a. boehner, republican leader. the speaker pro tempore: the chair will entertain requests for one-minute speeches. for what purpose does the gentleman from illinois rise? >> i ask unanimous consent to suspend the rules, to address the house for one minute. the speaker pro tempore: without objection. the gentleman is recognized for one minute.

>> madam speaker, i rise today to discuss our relationship with our neighbor to the south. >> the house is not in order. the speaker pro tempore: the house will be in order. >> thank you, madam speaker. i rise today to discuss our relationship with our neighbor to the south, cuba. i applaud president obama for his plan to re-engage cuba in a constructive dialogue and support his first steps toward that end, but i must ask, what has cuba done? improving relationship between the united states and cuba is something i strongly support, but i do not support this partnership at any cost. i must asked, what has cuba done? cuba still imprisons political dissidents, cuba still denies gay and lesbian citizens basic rights.

they still ban travel outside the country. we cannot tacitly reward this behavior by restoring normal relations with cuba without asking what has cuba done? our ultimate progress is up to cuba and our shared diplomacy must be be a two-way street. thank you. the speaker pro tempore: is there any other member who would seek recognition for one-minute speech? for what purpose does the gentleman from pennsylvania rise? mr. thompson: request unanimous consent to address the house for one minute. revise and extend. the speaker pro tempore: without objection. mr. thompson: thank you. madam speaker, i rise today to honor a constituent who has been invaluable to pennsylvania agriculture and served with distinction at penn state university. dr. robert steel has been dean of the university's college of agricultural sciences since july 1, 1997. dr. steele has been in charge of penn state's agricultural program which includes 12 academic departments serving

more than 3,000 students. under dr. steele's leadership, penn state has performed significant agricultural research, and i'm dwrafle for the support -- grateful for the support congress has shown over the years for this important work. specific programs at penn state i'm proudly support include sagging a urel entrepreneurial alternatives, dairy farm profitablity, improved dairy management practices, and milk safety. he's stepping down as dean and returning to the classroom. thank you for your many years of service and your dedication to agriculture and higher education. i thank you, dr. steele, for your service and leadership. pennsylvania agriculture is stronger for it. madam speaker, i yield back the balance of my time. the speaker pro tempore: are there further requests for one-minute speeches? for what purpose does the gentleman from texas rise? mr. burgess: to address the house for one minute. revise and extend my remarks. the speaker pro tempore: without objection. mr. burgess: thank you, madam

speaker. we have a problem today in that many patients enrolled in medicaid really face a tough time finding a doctor who will accept their coverage. a recent article in my hometown paper, the "dallas morning news," highlighted the troubles of a young girl in north texas covered by medicaid. she couldn't find a doctor to treat her stating that due -- because of the lack of medicaid doctors. medicaid patients often grow sicker while hunting for a doctor. madam speaker, we have an obligation to ensure americans covered under medicaid who also happen some of our poorest and neediest patients, children and pregnant women can see the doctor they need to see when they need to. expanding the number of americans who qualify for medicaid without first making certain that there are enough doctors to see those medicaid patients is irresponsible and a disservice to these individuals. to avoid this crisis, i propose that the federal government undertake the changes necessary to address the barriers of access to a doctor for any government program. throwing more americans on to

the rolls of government-run health care without first ensuring there will be a doctor to see them is wrong. coverage should equal access to a doctor and must be part of the national health care debate. i encourage people to go to my website, www.healthcaucus.org. i yield back the balance of my time. the speaker pro tempore: are there further one-minute requests? for what purpose does the gentleman from minnesota rise? >> unanimous consent to address the house for one minute. revise and extend. the speaker pro tempore: without objection. mr. paulsen: madam speaker, the cost of defensive medicine is a major factor for skyrocketing health care prices for american families. studies reveal some alarming facts. defensive medicine costs united states $170 billion per year, a third of orthopedist, obstetricians, trauma surgeons, emergency room doctors, and plastic surgeons can expect to be sued in a given year.

liability concerns have driven 7% to 8% of all ob/gyn's to stop practicing all together. data for 2006 shows that 71% of all cases are either dropped or dismissed and only 1% results in a verdict for the plaintiff. yet it still costs an average of $25,000 just to defend a lawsuit even if no payment is awarded. the results are higher premiums, less access to treatments, and physicians shortages in certain specialties. any real health care plan must include long overdue medical liability reform. without it patients and doctors alike will suffer and the cost of health care for all americans will continue to go up. i yield back. the speaker pro tempore: for what purpose does the gentleman from georgia rise? >> request permission to address the house for one minute. revise and extend. the speaker pro tempore: without objection. mr. kingston: thank you, madam speaker. zoras, russia.

czarist rush russia, 1,800 yards over a period of time. czarist obama nation, america, 33 czars in seven months. 33 czars who are running policy from guantanamo bay to energy to a $790 billion stimulus package to a myriad of other things, and yet none of them have gone before the united states senate for confirmation. even though article 2, section 2 of the constitution says that the president should seek consent and advice from the u.s. senate before appointing important policy people to his cabinet. now, we do appoint and have the senate confirm subcabinet members, deputy cabinet members, a myriad of judges, hundreds if not thousands of people, 33 people at a salary of $172,000 each are running a parallel

government without consent and approval of the senate. we need to stop this. i yield back the balance of my time. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from texas rise? mr. gohmert: i ask to address the house for one minute. the speaker pro tempore: without objection. mr. gohmert: thank you, madam speaker. of course we had heard our president say, we are not a christian nation. people can decide for themselves. but i thought it was worth pointing out when the washington monument right down the mall from us was dedicated, they put an aluminum capstone on it, four sides, there is a writing on all four sides, but on the side that faced the capitol were the latin words, praise be to god. now, the reason they put that facing the capitol was so that every day when the first rays of god's sun hit the very first thing in this nation's capital,

it was the words, praise be to god. every morning the first rays of god's sun hit the first thing in the capitol that is praise be to god. just thought you ought to know. thank you, madam speaker. i yield back. the speaker pro tempore: for what purpose does the gentlewoman from texas rise? ms. jackson lee: to address the house for one minute. revise and extend. the speaker pro tempore: without objection. ms. jackson lee: thank you. thank you very much, madam speaker. i rise today because we had a very important step in the history of america today. a house leadership announced a major initiative on health care reform. the 47 million-plus and growing number of uninsured americans, the small businesses who get up every day and create the economic engine, the hardworking laborers who work every day, the children of america, just plain america is looking forward to a

health reform package that gives a robust and vigorous public option without decreasing quality. that says to hardworking americans no pre-existing disease or ail n-your farmer will break you again. that will allow for the strength and integrity of the federal government to be a partner in working with those who wish to choose their own insurance which they already have. it is a fair balance and it is paid for. and so as we begin this debate, i am excited to be able to announce that there will be savings, the elimination of fraud and abuse, the opportunity for real health care reform. i yield back. the speaker pro tempore: for what purpose does the gentleman from texas rise? mr. culberson: to address the house for one minute. revise and extend. the speaker pro tempore: without objection. mr. culberson: madam speaker, this is a historic day, but not for the reasons my colleague just specified. today is the first day in american history the national

deficit has reached $1 trillion. we in this congress have an obligation to do everything we can to preserve the financial integrity of this nation for future generations, and as a texan, i know the solution is very simple. it's one that is embodied in these wonderful stars which were born by soldiers in the army of the republican of texas. this is a star worn by a young man who served in the marine corps of the republic of texas. the lone star symbolizes for texans that the solution is to our problem as a nation, leave us alone, let texas run texas. stick to the constitution. the very -- the federal government needs to stick to the very limited powers set out in the constitution and otherwise leave us alone. stay away from my bank account, my pocket, get off my back, out of my way. stay away from my home, family, kids, job, church, synagogue. let texans run texas. let ohio run ohio. that's what these young men were fighting for in the army of the republic of texas.

that's what we as fiscal conservatives are fighting for here today. . the speaker pro tempore: are there any further requests for one minutes? for what purpose does the gentleman from texas rise? the chair lays before the house the following personal requests. the clerk: leaves of absence requested for ms. guinea brown-waite of florida for monday, july -- ms. ginny brown-waite of florida for monday, july 13, 2009. mr. upton for july 13. the speaker pro tempore: without objection, the requests are granted. for what purpose does the gentleman from texas rise?

mr. poe: madam speaker, i ask unanimous consent that today following legislative business and any special orders heretofore entered into the following members may be permitted to address the house, revise and extend their remarks and include therein extraneous material. myself, mr. poe, for july 20 and 21. mr. jones, july 20 and 21. mr. pence for today. mr. english for today. mr. bill ralkis for today. -- mr. bilirakis for today. mr. gingrey for today. mr. fortenberry for today. mrs. bachmann for today. the speaker pro tempore: for what purpose does the gentlewoman from california rise? ms. woolsey: madam speaker, i ask unanimous consent that today following legislative business and any special orders heretofore entered into the following members may be permitted to address the house for five minutes, to revise and extend their remarks and include therein extraneous material. ms. woolsey, california.

mr. mcmahon, new york. ms. kaptur, ohio. mr. defazio, oregon. mr. spratt, south carolina. mr. delahunt, massachusetts. mr. brady, pennsylvania. the speaker pro tempore: without objection. under the speaker's announced policy of january 6, 2009, and under a previous order of the house, the following members are recognized for five minutes each. ms. woolsey, california. ms. woolsey: madam speaker, president obama has said that our nation's policy in afghanistan rests on a three-legged stool. the three legs are, one, security, which means more troops. two, economic development. and, three, helping the afghan government to do a better job of serving the needs of the afghan people. last week national security

advisor james l. jones gave a frank assessment about the strategy. he made it clear that the most important leg of the strategy is economic development. this is what he said. and i quote him. this war will not be won by the military alone. we tried that for years. the peace of our strategy -- the piece of our strategy that has to work in the next year is economic development. if that is not done right, there are not enough troops in the world to succeed, end of his quote. madam speaker, i welcome jones' comments and agree with him, agree with him completely about the importance of economic development. the administration must commit more to the economic strategy. look at the splull funding bill for -- the supplemental funding bill for afghanistan which congress passed last month and

which i voted against and you will see we have our priorities wrong. 90% of the bill's funding goes toward purely military operations while only 10% goes to support smart power, which includes economic development, humanitarian aid, and diplomacy. madam speaker, a 90-10 split favoring the military option is a doomed strategy that has virtually no chance of succeeding. to win the battle for afghanistan, we must show the afghan people that the united states is helping them, helping them build better lives for themselves. but after seven years of occupation, the afghan people don't see enough evidence that their lives are better now than they were before we arrived. in fact, in some ways their lives have worsened. that's because we've relied almost exclusively on the military leg of the stool, and

ignored economic development and the other elements of smart power. as a result, some afghans now join the taliban out of a sense of resentment and frustration. some support the taliban simply because they are poor and the taliban will pay them. mariam, a former senior advisor to the afghan american chamber of commerce and an activist for afghan women recently was asked what advice she would give president obama, and here's what she said, and i quote her. i would tell him to direct more money into economic development and creation of jobs. to end the violence, the money needs to reach the villages. if the money doesn't get to the village itself, there is no chance -- and the young men are left without support -- no --

there's no change and the young men are left without support and they become foughter for the taliban, end of quote. madam speaker, we must redirect our mission in afghanistan. we must shift our resources toward a civilian surge, saurge of experts and workers who -- a surge of experts and workers who can help the afghan people develop their economy and our military forces could actually be redirected to support these efforts. we must also have a diplomatic surge, a surge that engages all of afghan's neighbors in an effort to assist the afghan people and to shore up the central government. in addition, we must develop a series of rigorous metrics to evaluate the progress of these efforts and report the results to the congress of the united states and to the american people which will then send the message that our involvement in afghanistan is not open-ended. we can also use this process to

develop a timeline for the full redeployment of our troops and military contractors out of afghanistan. and finally, madam speaker, the government of kabul must eliminate corruption. they must respect the rule of law and show that it is working on behalf of the afghan people. madam speaker, the previous administration failed in afghanistan because it did not understand the importance of smart power. president obama does. that's an important step forward. but our next step is to put smart power to work, which will bring peace to afghanistan and it will strengthen america's national security. i yield back. the speaker pro tempore: the gentlewoman yields back. mr. poe of texas. mr. poe: request permission to address the house for five minutes. the speaker pro tempore:

without objection, the gentleman from texas is recognized for five minutes. mr. poe: thank you, madam speaker. the tax owe kratts are at it again, -- the taxocrats are at it again. this time they want to raise taxes on small businesses. the so-called rich the taxocrats are targeting are america's entrepreneurs, the engine of the american economy. madam speaker, the taxes are the root of all federal mischief. businesses with less than 500 employees produce half of america's gross national product and account for the majority of our jobs. the taxocrats wants them to buy health insurance for all their employees whether they can aforward it or not and if not they have to pay stiff fines. and, of course, they will lose jobs. the taxocrats wants to take taxes out of small businesses to pay for their health care boondoggle. small businesses need a tax break, not a tax hike. madam speaker, it's been the

american entrepreneurial spirit that has helped new ones opening up. today more are closing than opening. by the end of may, commercial bankruptcies were up 52% this year compared with the first five months of last year. eva christian owns a popular european style restaurant called cafe boulevard in dayton, ohio. she's one of the 8,300 businesses that have already filed for bankruptcy protection this year. eva is trying to keep her cafe open and her workers employed while she's trying to work things out with the creditors. she said the cost of rising health care and food is making her not afford health care for her employees. and her ability to bounce back will be smothered by the taxocrats new taxes on small businesses.

so she will just close up. making matters worse, the high cost of energy is making everything cost more. the taxocrats refuse to expand the drilling for oil and natural gas here at home that will bring not only prices down but create millions of american jobs and not send them to saudi arabia. they want to kill the coal industry that supplies most of our electricity. they don't want to build more nuclear power plants that provide limitless clean energy, and their solution is to tax energy consumption on all americans. all that will do is decrease the energy supply and cost -- cause energy costs to go up. there is no transition for fuel and no energy source to transition to for at least 10 more years. that's not going to power industries or fill anybody's gas tank so they can get to work. when the government took over general motors and put it into bankruptcy, the small businesses nationwide that supply the auto industry took a big hit. seat belt manufacturers,

rearview mirror manufacturers, and elect trickal manufacturers, all of the parts and pieces that come together to make automobiles were losing jobs. when big business files for bankruptcy it affects small businesses that supply them. small businesses, as you may recall, madam speaker, that got no bailout, they weren't important enough to keep from failing or politically influential with this administration so they just went out of business. when the new government motors put hundreds of their dealerships out of business it hurt local strip malls, sandwich shops, gas stations and on and on and that causes financial struggles for these industries that supply small businesses. madam speaker, america's small business offers the best hope for job creation. the government needs to get out of their way, stop sucking the oxygen out of the economy with higher taxes and higher energy costs. let america's entrepreneurs keep more of their own money to pull this country out of this mess.

that says it in a nutshell. let them keep more of their own money. taxocrats want to control america's economic engine, however. they want to seize the wealth created in this country and spend it on their special friends and special interest groups. america's economy doesn't work that way. no economy ever has. if the government seizes the wealth it created that -- that these businesses created, however, it kills any incentive to create wealth. just ask the former soviet union. that's why they went out of business. why would someone build the company from scratch and then send their fruits of labor over to the government? governments don't create anything. they just seize it. they create taxpayer programs. america's economy is the most successful in the history of the world, and the reason is easy to figure out. freedom. freedom to create and grow an idea into a company, a dream to make it a multinational corporation. it makes no sense at all to kill the greatest economy on

god's green earth along with the freedom and little bit that created it. you cannot help the poor by economically killing the rich. and it's been said you don't make the poor rich by making the rich poor. madam speaker, taxes are the root of all federal mischief and that's just the way it is. the speaker pro tempore: the chair recognizes mr. mcmahon. for what purpose does the gentleman from new york rise? mr. mcmahon: i ask unanimous consent to address the house and revise and extend my remarks for five minutes. the speaker pro tempore: without objection. mr. mcmahon: thank you, madam speaker. late thursday, madam speaker, the house stood in support of our friend, israel, and the greater global community by providing $2.2 billion towards israel's regional security and counterterrorism efforts. more importantly, this appropriation bill takes a firm stand fwens the active state sponsorship of terror by iran

by cutting off u.s. expert companies to companies that help refine products to the islamic republic of iran. now, i stand by the administration's decision to engage iran to negotiations. however, the united states must have something concrete to negotiate with first. . i strongly advocate the use of sanctions to wean iran away from its nuclear ambitions. as for israel it is our fellow democracy, our tried and true ally. supporting it is essential to the stability and future not only of the middle east but of the world. and any democracy nation that has chosen to treat israel as a suspect state, to impose on israel embargoes and daunting deadlines for peace agreement, should know that its actions ultimately do damage to the shared values that all

democracies espouse. our alliance with ourure peaian partner should be held in high rereguard and it is. we must consistently work to maintain this relationpship. yet a recent decision by the united kingdom to revoke a number of arms export licenses to israel following the gaza war may trigger similar decisions by other e.u. nations. and comes at a crucial time for israel's security. following the failed iranian elections in june, the iranian regime has had its legitimacy wounded and its paranoia increased. many observers expect the regime to take a posture of increased repression at home and antagonism abroad. in that dangerous environment, israel's leaders have every right to be concerned for their country's safety. while hope still exists for a free iran, europe, israel, and the united states must

undoubtedly prepare for a more dangerous iranian regime in the near term. we must be ready for the possibility that iran will intensify its pursuit of nuclear weapons, to overcome the embarrassment of their resent elections. -- recent elections. incredibly there seems to be uncertainty in the community that iran poses no threat. they test add 1,200-mile range missile and displayed the video footage to the world, a group of experts at the east-west institute released a report on iranian capabilities that made this astounding statement and i quote. there is no reliable information at present on the state of iran's efforts to develop solidpropelant rockets. and their motors and therefore no basis to make this assessment. it is this is very shocking failure to prepare that puts israel and the entire

international community at risk. in this light our european allies' decision to place an arms embargo on israel does not merely represent a double standard, it is decidedly harmful to democracy faced with the very real prospect of a destructive nuclear neighbor. madam speaker, i urge this congress and the united states to make the iranian regime pay a higher cost for its nuclear weapons pursuit. if we needed any further reminder, the protest in the streets of tehran have made clear that the words and actions mean very little to ayatollah khomeini. the threat from iran demands an effective policy response and our european allies are well placed to formulate one with us. you see even though iran is an oil exporter, its economy is in fact highly dependent on imported gasoline and other refined petroleum products. we need to embargo this trade.

european companies are heavily involved in iranian gasoline business, policymakers need to stop this trade, to end this nuclear threat. if the iranian regime faced damaging economic pressure from significant reduction in gasoline supplies, it may indeed change its course. and an ever-present threat to israel and to global security may be alleviated. i think we are all encouraged by the joint statement that came from the g-8 summit in italy expressing concern over iran's belligerence and i hope by the next g-8 summit in september the deadline set by the world leaders, our european allies included, will see real international collaboration to curb the threats of tehran. nothing endangers peace more than a refusal to face facts. and even as we set deadlines for when discussions with iran might begin, let's remember they

continue to enrich uranium and a deadline with real consequences must be considered along with engagement. otherwise engagement will be manipulated as a mere tactic for delay. i am glad this house chose to face iran and face israel with its vote on thursday and i have high hopesp the international community will do the same. we must support and defend israel and end the nuclear threat of iran. thank you, madam speaker. i yield the remainder of my time. the speaker pro tempore: the ntleman yields back the balance of his time. mr. jones of north carolina. for what purpose does does the gentleman from north carolina rise? mr. jones: to address the house for five minutes. the speaker pro tempore: without objection. mr. jones: i'm pleased to report that 304 of my colleagues in the house from both parties have joined me as co-sponsors of h.r. 24, legislation to redesignate the department of navy to be known as the department of navy and marine corps. i am grateful to chairman ike skelton who included the

language of h.r. 24 in the national defense authorization act which passed the full house last month. this is the eighth year in a row that language to properly recognize the marine corps has been included in the house version of the bill. unfortunately each year the language has been stripped in the senate. this year i'm grateful to have the support of senator pat roberts, a former marine, who introduced the same bill in the senate, s. 504. with his help i'm hopeful this will be the year the senate supports the house position and joins in bringing proper respect to the fighting team of the navy and marine corps. madam speaker, some people might ask why is the change so important? is it renaming department just symbolic? what's in a name? well, madam speaker, the name of the marine corps represents more than two centuries of service alongside the navy. what's in the name? the flag raising at iwo jima?

what's in the name, honor, courage, and commitment, and semper fi. what's in a name? more than 1,000 marines who have given their lives serving in iraq and afghanistan. as symbolic as a change in the name might be, this is a matter of respect and gratitude to the marine corps. the marines do not serve beneath the navy, they are one fighting team. that is the marine corps and the navy as co-equal partners. this legislation is not about changing the responsibilities of the secretary of the department, reallocated resources, or altering missions. general carl mundy, the 30th commandant of the marine corps summed up the need for this change when he said, and i quote, this action will accurately ally the secretary's title with his present day authority and responsibilities as is the title is confusing. it is inconsistent with the status of the four armed services in the department of defense, and it acknowledges

only 2/3 of the uniform service members in the department. close quote. over the course of the marine corps history including their present day service around the world, those three words, and marine corps, have been earned through blood and sacrifice. when the department of the navy writes the families of marines who have been killed, their family deserves to receive the letter from the department of the navy and marine corps. madam speaker, the marines are fighting today deserve this recognition and those who are part of the history of the marine corps deserve that recognition as well. madam speaker, i want to close my comments by first saying, to those in iraq and afghanistan, i ask god to please bless our men and women in uniform. i ask god to please bless the families of our men and women in uniform. even i ask god in his loving arms to hold the families who have given a child dying for freedom in afghanistan and iraq.

madam speaker, i close three times by asking god, please, god, please, god, please, god continue to bless america. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. ms. kaptur of ohio. >> madam speaker, i ask unanimous consent to take my time now. the speaker pro tempore: without objection. the gentleman is recognized for five minutes. >> madam speaker, i rise today so that my colleagues in the house of representatives can join me in recognizing the cape cod baseball league of massachusetts on its 125th anniversary. recognized as the -- the summer collegiate league in the nation. the cape cod baseball league today consists of 10 franchises in two five-team divisions. in its early years, during world

war i and world war ii, the league was populated largely by young g.i.'s, fresh from their service. the modern era of the league began in 1963 when it was officially sanctioned by the ncaa. throughout its existence the league has promoted to bigtime, the bigs, several cy young and most valuable player award winners, as well as major leaguers who achieved hall of fame status. as well as decorated scouts and managers. all of whom got their start on the fields of dreams on cape cod.

entering its 125th season, the league continues to offer the most talented baseball players from across the country, the opportunity to demonstrate their skills in front of major league scouts. as the pioneer among the nation's summer leagues, including, by the way, the use of wooden bats, the cape cod baseball league is truly america's league. young players learn the importance of sportsmanship and teamwork, not only on the diamond and in the dugout, but also through the generosity of cape cod families who open their homes to host these young men during the summer season. at a time when the integrity of

the game is at risk, the cape cod baseball league continues to embody the golden american tradition of wholesome entertainment. our national pastime has been kept alive in its most pure state owing to the efforts of this volunteer organization which enables fans to enjoy games at no expense, where visions of stripped socks, crackerjacks, and lemonade evoke feelings of nostalgia for the bygone days of america's favorite sport. the cape cod baseball league stands out as a national treasure that can captivate any spectator through an exciting, competitive, nine-inning baseball game. on this historic occasion i am

proud to honor the cape cod baseball league for its 125 years of success. and for its well established, beloved reputation among the cape cod family, both residents and tourists alike. congratulations to the players and to the volunteers in that organization and may you forever be where the stars of tomorrow shine tonight. with that i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. >> madam speaker, i yield back. the speaker pro tempore: mr. burton of indiana. for what purpose does the gentleman from florida rise? >> unanimous consent to give my special order at this time. the speaker pro tempore: the gentleman from florida is recognized. without objection. mr. bilirakis: thank you, madam speaker. i rise today to honor mr. jack

h. jones, who was recently elected imperial potentate of shriners international way which makes him the highest ranking shriner in the world. i want to share with my colleagues many of whom may be be unfamiliar with the work of the shriners what they all are all about. shriners international is a fraternity based on fun, fellowship, and the masonic principles of brotherly love, relief, and truth. there are approximately 375,000 members from the 191 temples or chapters in the united states, canada, mexico, and panama. i'm proud to be a shriner and support their ongoing charitable efforts. shriners international supports shriners hospitals for children, one of a kind international health care system of 22 hospitals dedicated to improving the lives of children, providing

special pediatric care, innovative research, and outstanding teaching programs. . shriners hospitals for children have significantly improved the lives of 865,000 children. mr. jones has been involved with shriners for more than 30 years. he's served as part of the body that governs the shriners. prior to his election to that position, he served on the elected devon of egypt shriners in tampa, florida. his masonic affiliations includes hillsboro lodge 125, f and a.m., red cross of constantine, royal order of justers and national sole

jorners. he's a 33rd degree scottish right mason. mr. jones has received many awards, including the benjamin franklin award from the grand lodge of pennsylvania, the henry prince medal from the grand lodge of massachusetts, and the andrew jackson medal from the grand lodge of tennessee. in 2006, he was presented the imperial award of merit which is the highest honor in the shriner's fraternity. in his new position, he will serve as chairman of the board of directors for shriners international and shriners hospitals for children. i'm assured that his immeasurable talent and experience will greatly help the shriners and the many people who benefit from their work. madam speaker, i encourage all of our colleagues to congratulate mr. jones on his election as imperial potentay

and recognize the contributions that shriners make for the betterment of our world. thank you, madam speaker. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. mr. defazio of oregon. mr. pence of indiana. mr. gingrey: madam speaker, i ask unanimous consent to speak out of turn for mr. pence. the speaker pro tempore: without objection, the gentleman is recognized for five minutes. mr. gingrey: thank you, madam speaker. madam speaker, after losing an additional $467 -- 467,000 jobs last month, our nation's unemployment rate reached a 25-year high of 9.5%. it is time for the administration and the democratic majority to admit what the american people know all too well, the vaunted democratic stimulus bill has failed to stimulate anything other than a few federal bureaucrats and the chinese who are loaning us, with hefty

interest, i might add, with stimulus dollars. when president obama and the democratic leadership ran the 1,073-page stimulus bill through congress without giving representatives on either side of the aisle, much less voters back home, a chance to actually read it, they promised that the $1 trillion price tag would go to saving or creating 3.5 million jobs. well, madam speaker, i must ask the question, where are the jobs? to make matters worse, the house passed the pelosi global warming tax two weeks ago that will only make it harder for businesses and families to survive by piling an additional $3,000 on to every household's energy bill. this cap and tax, they call it cap and trade, but it's a cap and tax policy that will impose artificial emission standards on companies and producers,

increasing the costs to do business and forcinging them to cede market shares to overseas competitors who do not have limits -- subject to these limits on carbon dioxide emissions. i'm talking about china and india. and now the same people who turned general motors into government motors have set their sights on a government-controlled health care system that gives power to bureaucrats rather than doctors, like myself, to make decisions about your care. as we have seen in great britain and in canada, the end result will be the virtual elimination of private health insurance, and the creation of a one-size-fits-all government health plan that would ration care by limiting the types of treatment patients can receive. madam speaker, instead of another government takeover, we need real solutions which will

make health care more affordable and more accessible while leaving critical choices and decisions about the health where they belong, in the hands of patients and their physicians. and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. mr. spratt from south carolina. mr. moran from kansas. mr. brady from pennsylvania. mr. fortenberry. the gentleman is recognized for five minutes. mr. fortenberry: madam speaker, recently the secretary of state appeared before the house foreign affairs committee and confirmed that it is the administration's goal to include abortion as an integral element of reproductive health

care provided by the united states overseas. this hearing came on the heels of the secretary's words of praise for margaret sanger as a personal hair win. she was a -- heroine. she advocated for policies to eliminate persons she deemed inferior and not well to live, namely the immigrant, the black child. while the secretary at the hearing did rightly deplore the comments attributeable to margaret sanger, the administration's policies regrettably continue to champion abortion here and abroad. this continues despite the fact that more and more americans oppose the practice, let alone using taxpayer dollars to fund it or imposing it on persons across the world who may be weak and vulnerable. margaret sanger's world views should shock the conscience and

have equal condemnation from thoughtful persons on both sides of the aisle. and, madam speaker, for this reason i was stunned to learn that in a july 12 interview in "the new york times" supreme court justice ruth bader ginsberg echoed the sentiments of sanger while explaying the outcome of harris vs. mccray in the 1980 supreme court ruling which disallows medicaid funding for abortions, justice ginsberg said this, and i quote, frankly i have thought that at the time roe was decided there was concern about population growth and particularly growth in populations that we don't want to have too many of. madam speaker, did you hear those words? justice ginsberg, i repeat, actually said this. quote, there was concern about population growth and

particularly growth in populations that we don't want to have too many of. madam speaker, to whom was justice ginsberg referring? who would justice ginsberg prefer to not have live? it is unfathomable that in this day and age a justice of the united states supreme court would aiculate such a patently genocidal sentiment. this is more of the same. discredited, amoral philosophy of social engineering that offers no comfort, no vision of the common bond of all humanity, particularly for those who are weak and vulnerable among us. madam speaker, it is with a very heavy heart that i have to say such things. i know we have come much further than this in our society. millions of americans believe that we are big enough and loving enough as a nation to

embrace the mother and her unborn child and truly care for life. we can do better. we must do better. women deserve better than abortion and america deserves better from its leaders. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. mrs. bachmann. for what purpose does gentlewoman -- does the gentlewoman rise? mrs. bachmann: to address the house and to revise and extend. the speaker pro tempore: without objection, the gentlewoman is recognized for five minutes. mrs. bachmann: madam speaker, thank you. two days after independence day, the remaining g.m. dealers in the united states received a letter from the general motors national dealer council letting the dealers know that the national dealer council strongly opposes the automobile dealer economic rights restoration act of 2009. it's also called h.r. 2743.

the letter urged all remaining g.m. dealers to sign the letter immediately by no later than 5:00 p.m. on tuesday, july 7. they urged the dealers to fax it back to the national dealer council urging that they do not support passage of the restoration of economic rights. i have nothing personally against g.m. or chrysler, madam speaker. these are great american companies. but what i do object to is the federal government effectively taking over these once great companies. last friday, g.m. emerged from bankruptcy. madam speaker, but do the american people even realize that they own a majority share in this company effectively 61%, which is why many people now call it government motors? do they know that 3,400 privately owned dealerships were given pink slips

essentially by the federal government? 3,400 dealerships were closed down all across america, not because these dealers were failing. hardly. in my district, dealers were experiencing some of their best months ever for sales. high customer satisfaction and terrific service. perplexed and bewildered, 3,400 automobile dealers across the united states were given pink slips essentially by the obama auto task force. 154,000 jobs are estimated to be at risk of vanishing by this move, and with these jobs goes a part of the american dream for private property owners and business in our country. the remaining g.m. dealers carved up the spoils. now, let me be perfectly clear, i thought none of these existing remaining -- fought none of these existing remaining g.m. dealers. these were not their fought. our fear government running these companies is that politics will control g.m.

remaining decisions, not business. now with this letter it seems that politics is prevailing. they're urged by go m. to work against restoring economic rights to the dealers who saw their business' go from them overnight. how can current g.m. dealers possibly stand up against g.m. when g.m. is the federal government? again, dealers are urged to sign a letter that will disadvantage their disenfranchised former competitors? this is a bad business, madam speaker, and it perfectly illustrates why we don't want government to own or operate or control private businesses? and i yield back. the speaker pro tempore: the gentlewoman yields back. mr. broun of georgia. for what purpose does the gentleman from illinois rise? mr. shimkus: i ask unanimous consent to address the house and to revise and extend. the speaker pro tempore: the gentleman is recognized for

five minutes, without objection. mr. shimkus: thank you, madam speaker. i appreciate the time to come down to the floor and talk about the bill that recently passed the house, the cap and trade, cap and tax, national energy tax bill, which has a basic premise. the basic premise says there's too much carbon dioxide in the atmosphere. the solution is to make sure that the emission of carbon dioxide is charged more, and that charge will decrease our reliance on that by forcing people not to use fossil fuels. sounds simple. it's not that simple. fossil fuels is the basic foundational fuel for a thriving economy. and in this economy that we have today, the last thing we want to do is slow that engine

by raising costs. energy is a component in the cost of everything we do. here in this chamber we appreciate the lights being on. that currently is possible by fossil fuels, whether that's coal or natural gas, fossil fuels help create that electricity. as we drive back and forth maybe to our districts, the cost of gasoline, a fossil fuel. if we're flying back to our districts, the jet fuel is a fossil fuel. if we add a cost on the use of fossil fuels, the cost for everything increases. from the clothes that you wear to the food thaw consume, to the houses that you build. and the last time we went through legislation, environmental legislation that dealt with the clean air act, there was great devastation of jobs throughout the midwest.

an example is this poster that i bring to the floor numerous times of united mine worker members from peabody number 10 in cane cade, illinois. when the last clean air act amendment was adopted, 1,200 mine workers in this mine alone lost their jobs. there is an effect by the legislation that we passed here on the floor of this house. and not only did it affect these individual miners but it affected all of the communities from which they come from because that was the major job creator in this county was those who operated this mine. . they not only lost their jobs but in southern illinois, 14,000 other workers lost their jobs. this is very similar to what happened throughout the rest of the midwestern states. the one that's poignant because the head of the ohio coal

association, the ohio mining association came before before our committee and said after the 1990 clean air act amendments, 35,000 coal mine workers lost their jobs. so that's why those of us from coal producing areas and those of us who want low cost fuel have come to the floor and we thought so diligently in opposition to the national energy tax. if we want to move on the national energy tax and if we want to limit the amount of carbon dioxide because the atmosphere has too much, wouldn't it be important to ensure that the rest of the countries that are developing would also comply? but the bill that passed the house had no provision, had no trigger to ensure the number one emitter of carbon dioxide would have to comply in a regime, and that's china. another major emitter of carbon

dioxide is india. they are not involved and responsible for moving to limit their emissions. so for the united states to go into and disarm ourselves by raising our energy cost against countries that compete with us because they can pay their employees more, they don't comply with environmental standards, now we are going to allow them to have cheaper energy, it is just a foolish proposition. so what have republicans done? we have come to the floor to talk about what are the really energy demands we have in this country? we need to decrease our reliance on imported crude oil. the cap and tax bill does nothing to decrease our reliance on crude oil. what we propose is make sure we take access of the outer continental shelf. the royalties then are used not to continue to bring additional taxes on the american people, the royalties are used to expand

wind and solar power that is now developing throughout this country which we support because we want to diversify our energy portfolio. we want to make sure we use our most identify fishent, cheapest source we have which is coal. we want to use it for electricity legislation. we also want to use that to produce liquid fuel so we have a competitor. that is where we decrease our reliance on impropertied crude oil. thank you. the speaker pro tempore: the gentleman's time has expired. for what purpose does the gentleman from connecticut rise? >> unanimous consent to address the house for five minutes. the speaker pro tempore: without objection, so ordered. the gentleman is recognized. >> thank you, i rise to address the house this afternoon because like so many members of this body i am engaged in a terribly important exercise of working to think through the next generation of regulation that

will oversee the stability and health of our financial services sector. this is a terribly important and challenging thing that we do. we need to make sure that we do what is necessary to have a vibrant, innovative, thriving financial services sector that employs the people of connecticut and the people of this nation. that pays taxes in connecticut and to this nation, but that we tow the line in such a way that we never find ourselves in the position that we are in today of tens and hundreds of billions of taxpayer dollars being brought to the table to bail out a private industry that took too many risks. and i rise this evening because i'm concerned by the conclusion being drawn by some of the members of this house.

because our regulatory apparatus, which let's face it was crafted in the 1930's, failed in many respects, and boy did it fail in some spectacular aspects, the conclusion seems to be drawn that government cannot regulate. that we should get out of the business. that we should leave the financial services sector entirely to its own devices, but somehow individual responsibility alone will creat a stable and vibrant financial services sector. so i want to harken back to the history of this body and this government crafting smart regulation. think back 110, 120 years ago. american families eight rotten food, they bought snake oil in the guise of pharmaceuticals, they worked in factories that burned down and killed hundreds.

they lived in cities that were unsanitary, and over 120 years, 110 years, maybe starting with the fine republican teddy roosevelt, this nation said, we can do better. we can put in place smart regulation that protects our citizens and that adds to the quality of life of every american family. and in fact that is what happened. and we haven't gotten it quite right. there have been spectacular failures. but over that 120 years the efforts of this government to craft smart, efficient regulation hasn't destroyed the economy, the economic growth in this country over that period of time has been nothing short of spectacular. but it has protected american families. very few families anymore buy snake oil, buy securities that would put madoff securities to shame, find themselves working

in factories that burned down and nobody gets out because the doors are locked. 110 years, 120 years of success, not unadulterated success, there have been failures, but over time the efforts of this country to put in place smart and efficient regulation have helped this economy and have helped the quality of life of american families. and that is what we must do. we must not shrink from the task just because the s.e.c. blew it on the madoff case or because other regulators weren't watching new and dangerous markets closely enough, we must not shrink from the task of thinking through what new round of financial regulation allows that industry to thrive, allows that industry to provide credit to american families, to small businesses, to allow our economy to grow, but which never, ever puts us in the kind of risky position that we are working so

hard to dig ourselves out of right now. we can do this. there is a century-long tradition ever our working constructively in that direction. i know we can do this. the answer is smart, efficient, modern regulation for the benefit of everyone and the benet of this economy. mr. speaker, thank you. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. under the speaker's announced policy of january 6, 2009, the gentleman from kentucky, mr. yarmuth, is recognized for 60 minutes as the designee of the majority leader. mr. yarmuth: thank you, mr. speaker. it's a great honor for me to be here tonight to lead a discussion about the most pressing and the most significant problem to most americans and that is the question of health care. i'm here with members of the class of 2006, we call ourselves

the majority makers, frimmed we are here to address smatters of great national import with you. but this is a very special topic for the class of 2006. i remember very well when i began my campaign for congress back then, in 2006 when many of the headlines of our nation's newspapers and our television news operations were all about the iraq war, and people would say to me, i guess everyone's talking about the iraq war to you. i said, no. nobody's talking about the iraq war. it's health care, health care, health care. everywhere i went. neighborhood picnics, catholic picnics on friday night, festivals, businesses, schools. wherever i went i heard story after story about how americans were fed up with a health care system that was not serving them. in fact it was in many cases killing them.

well, here we are three years later and while health care may not have been on the front pages of the newspapers up until now, because we have a severe economic decline and many challenges we are dealing with, this congress is ready to put health care back on the front pages. and president obama has already indicated that this is his top priority and his first term in offers. the reasons that is so are not hard to determine. it's pretty easy to look around us, look at the numbers and see while we have to take significant, decisive action to improve, to change our health care system. just a few weeks ago dr. christine roemer who heads the white house's economic team testified before the house budget committee that if we don't make significant steps to reform health care, to get a

handle on cost, to bring prices down, that health care which now comprises 17% of our economy, by 2040 would make up 35% of our economy. well, you don't have to be an economist or a health care expert to know that if health care takes up 35% of our economy, it's going to squeeze out most of everything else. in short, it is an unsustainable number. and we can go on and talk about the dramatic impact of medicare and those types of expenses on the federal budget as well as on the general economy, but what most people are concerned about is not the big picture, not the macroeconomic picture, it's the kitchen table picture. it's what happens in your house 40e8d. -- household. what happens to individuals. those people we meet in all segments of our society from one

coast to the other, who have had significant difficulties with their health care system. they are small businesspeople who have seen their premiums rise 15%, 20%, 25% every year despite the fact they have healthy people. we have seen story after story of individuals who at 55 years of age lose their job. they can't get cobra for very long period of time. they don't qualify for medicare. they try to go out in the private market and buy insurance , but at 55 most everybody's going to have some kind of pre-existing condition that makes them under current, the current system uninsurable. we heard from a couple yesterday in that exact same position. they came to testify to congress. woman has had epilepsy since she was 5 years old. her husband lost his job.

now they go out and try to shop for insurance in the private market, but because she has epilepsy, something totally beyond her control, obviously, the only insurance policy she could get cost $2,600 a month. how many people in this country can afford $$2,600 a month for health insurance? $30,000 a year. not very many. these are stories that are repeated time after time after time. i have to tell one was a personal experience of mine, and then i'm going to let my colleagues from the class of 2006 contribute not just their stories about where health care needs to be fixed, but also what this congress is proposing to do to set america on a sounder course for health care. back during my 2006 campaign, we had a young worker, young woman in her mid 20's, was a volunteer

in our campaign, she was severely disabled, so severely disabled she was wheelchair bound and she told me if she were not covered bye s.s.i. she would have spent -- had to spend $3,000 a month just on they are prescription medications. because of s.s.i. she was able to manage her health care problems. now, she had, and i hope she still has, a boyfriend. and they wanted to get married. her boyfriend worked at a supermarket company. he was making $11 an hour, which to them was great salary. but they couldn't get married. because if they got married she would lose her disability coverage and the company where her boyfriend was employed could not -- would not put her on the policy because she was so expensive to cover. so what we have here is two

people in love wanting to get married, wanting to start a family, wanting to do what so many americans want to do and because of a health care coverage issue they could not get married. . in this country there's no excuse for that situation. but time after time all of us run into situations in which people are having to make important life decisions based on whether there's the availability of health care coverage. somebody who wants to leave a company and start a small business of their own not able to do it because of coverage. somebody who wants to leave a situation in which he or she has coverage to go back to school, to further their education and advance their prospects can't do it because of insurance coverage. we all know these scenarios all too well. so this congress, this president, has set out to change the health care system in this

country, to make sure that every american has peace of mind and security where his or her health care is concerned. that's what we're about and that's why we are going to put health care back on the front pages and back as the lead story on america's newscasts over the next few weeks because we're going to do for the american people what we know they want us to do and need us to do. and with that i'd like to yield to my good friend and colleague from maryland, mr. sarbanes. mr. sarbanes: thank you. i want to thank my colleague from kentucky for organizing this very important discussion today and we've got some terrific members who have been very engaged in this health care topic for a long time and i say a long time because even though these are folks that came to this chamber in january of 2007, all of them are people who have been working on this issue for many, many years. and so this is going to be an

important discussion tonight. i think a stimulating one and one that will be enlightening to all of those folks who are very concerned about where we are right now. today was an incredible day because today was introduced in this chamber, the health reform act, that i think is going to form the basis of moving us forward in a very meaningful and significant way in this country. this is a long time coming, this day. we ran on this issue in 2006, not because we made it up out of thin air but because everywhere we went we heard from constituents and members of the public who were saying this was their number one issue. we ran on it again in 2008 because that was the number one issue that people brought to our attention and the stories like the one that john jar muth just told -- yarmuth just told. there's legions of that story

that we've heard. this was the number one issue in 2006 and 2008. there are some other the -- on the other side and there are even some in the public who are saying we're moving too fast on this, slow down, we need to take more time to deliberate. and it's a fair point but only to a point because the people that we were elected by and the people that we hear every weekend when we go home to our districts have been clamoring for this kind of reform for decades. and they really can't wait to change the situation that they're in right now. so this is a great day because we're finally at this moment, after decades of struggle, after the past few years where the call for this kind of change has reached a fever pitch, we're finally at the point where we are putting legislation on the

table that's going to make a difference. and i want to yield soon to my colleagues that are here, but let me just mention a couple things, dispense with some myths. you know, before we began this exchange, i heard a few folks who are critical of the proposal saying we don't need a government takeover. well this bill couldn't be further from a government takeover. what this is doing, in a very american way, is offering more choices out there. too many americans feel that they have been shackled by a private health insurance industry that was more interested in seizing profits for themselves than really providing high quality and accessible care to most americans. and folks are fed up with that. so we're not talking about a government takeover, we're talking about trying to get out from under the takeover that the private health insurance industry has had for so many

years. that's what this is about. second thing, this bill invests in primary care and preventive care. it does the kinds of commonsense things that the american people have been calling for with respect to their health care coverage for so many years. let's treat people on the front end and keep them from getting sick in the first place rather than waiting for them to get sick on the back end. that makes common sense. and the other thing is, investing in our health workforce. if we're going to presume as we should to cover everyone in this country and provide them with health care coverage, we got to make sure that there are enough care givers to deliver that care to them. and let me close with this observation, which to me is what -- this is what i think most americans are thinking to themselves, they're thinking, if america could have accomplished all the things that we've

managed to accomplish over the last few decades, even as we were care -- carrying this broken health care system around on our backs, imagine what we can accomplish as a society, as individuals, if we can fix this health care system. imagine if your mother who goes to work and leaves a child at home whose got a fever of 100 degrees, but you don't have to worry because you know that your family has decent health care coverage, imagine how much more productive you're going to be at work that day, imagine if you're a small business that wants to do the right thing for your employees but could never afford to do it before but now you can, imagine if you're a large business that's trying it to compete with competitors overseas that have more of a

shared obligation, public and private sector, to help them with the cost of health care. imagine how much more productive and competitive you can be. so given that america's been as successful as we've been all these years even with this monkey we've been carrying around on our back, just think, just think, just manage the heights we're going -- imagine the heights we're going to reach as a nation and as individuals if we can fix this health care system and that's what this bill is all about. so i want to thank you, john, my colleague from kentucky, for convening us today to talk about this very, very important issue. i yield my time back to you. mr. yarmuth: i thank the gentleman and he raises a point that i think it's appropriate to make at this time and we will hear a lot over the few weeks that we're going to be actively engaged in this issue and trying to bring a bill to the floor and passing it before august 1 and you'll hear a lot about the

canadian system and you'll hear a lot of fear tactics being thrown ought the debate because -- at the debate because right now those people who are opposing what we're trying to do really have nothing but fear tactics to throw at it. and it's interesting because we had a hearing in ways and means several weeks ago and a gentleman was there who was arguing against our public option, the public option part of the proposal, which basically is a government-run plan that would compete with private insurers and compete for your business, for the business of the american people. and he kept saying, we don't want canada, we don't want canada, we don't want canada this, they're long lines and all these things -- their long lines and all these things around the canadian system and i asked him if he knew how many countries in the world, how many industrialized nations, had national health insurance system and he said, all of them except

the united states, how many of them have universal coverage? all of them except the united states. how many have a blend of public and private, where you have a basic level of coverage provided by the government but people can buy private insurance to enhance their position? and he said, well, all of them except canada. and i said, so you've chosen the one country in the world that is an outliar and used that to undermine the arguments for an american plan when we haven't copied anything from canada in this country that i know of except hockey? and he really didn't have a response to that, but the point is, you'll hear a lot of these myths thrown out and they really don't relate to what we're doing or trying to do which is to create a uniquely american solution to a uniquely american problem. with that i'd like to yield time to my colleague from

massachusetts, congresswoman tsongas. ms. tsongas: i want to thank my colleague from kentucky and it was a historic day to be here discussing the issue of health care. you were talking about how many in our class campaigned on the very important issue of health care and i came in midterm a year, maybe 10 months after you all had been elected as part of a special election process, in which the issue of expanding coverage for children under the children's health insurance program was the defining issue and i ran on a campaign as many of my class did to expand children's health coverage and finally we have been successful this year with president obama signing that most important legislation into law. i also happen to be running at a time when the new massachusetts system which was designed to provide guaranteed access to affordable health care for massachusetts residents was coming into play. and we had many, many questions around the potential it had, the difficulties it might present,

the costs it might impose, and in fact since we began that most important system, 439,000 residents of our state are now covered with quality affordable health care and this legislation created a mechanism not unlike the exchange that we are talking about in the legislation that was being proposed today that created a place for people to go to assess the different possibilities of health care and make sensible choices that make sense for them. what i learned from that -- from the massachusetts experiment, which has become very successful, is that while we talk very much about what the role of government is, in massachusetts, the role of government was to be the architect of the system that brought everybody to the table. the employer, the individual and government, to sort out how best each player should play its role. and because we had that cooperative approach which i

think we see in the legislation that has come to the table today and the successes that that has generated, i think it's a remarkable model that says there is a role for government, but everybody has to play its most important part. so i think this is really a very exciting day for our country, it's a beginning of a process. i look forward to reaching out to my constituents who will have slightly different perspectives because of their experience under the massachusetts model, to get their input as we go forward with the most important debate that we're just beginning and i thank you for beginning that today. i apologize for not staying longer, but the women of the house are playing a softball gamer later this evening and i don't want to be -- game later this evening and i don't want to be too late even though i'm just cheering. i don't want to be in the hospital as a result of my poor game playing talent. thank you for beginning this discussion. mr. yarmuth: i thank the gentlelady and i intend to be at

the game myself in a supportive role. i'd like now to introduce one of the physicians of the house, not too long ago there was an article in "the new york times" that talked about the number of physicians here and they make an extraordinary contribution to our efforts in this field and many others, so it gives me great pleasure to yield to my good friend from wisconsin, dr. kagen. mr. kagen: thank you, congressman yarm you get. i appreciate the opportunity to -- yarmuth. i appreciate the opportunity to join with you and the other members of the class of 2006, the difference make, majority makers, who brought a message of positive change here to washington in january of 2007. and what happened is we had another election in 2008 and we returned. because we haven't finished the job yet. and there's an inheritance that our president, boehm, has taken on. i can't -- barack obama, has taken on. i can't imagine when another president has inherited so much in crisis.

a housing crisis where housing construction and prices were falling through the floor. a financial crisis where the credit markets completely froze up, went into a medical coma, money wasn't being transferred between banks. he inherited a lot. he also inherited $3.7 -- 3.7 million people who had lost their jobs during the year. this economic recession began under the watch of the previous president and we have a lot of fixing to do. it's going to need a doctor in the house to get things going. but we do have -- we do have hope now because we have a new way of looking at things. we're taking a positive approach and we brought forward today a bill that begins the process of heal our fractured health care system. now, when i ran for congress and when i got re-elected, i put together a health care advisory team in my district, in northeast wisconsin, composed of physicians, of medical people involved in hospital administration, insurance people, nurses, everybody that's

involved in health care. and we came up with 10 essential elements that should be included in a successful piece of federal legislation. the first and most important element was no discrimination. we sought to apply our constitutional rights to protect us against discrimination to the health care industry, to guarantee that no one would suffer from discrimination, not on the basis of the color of their skin, but the chemistry of their skin or in the case that you mentioned, the patient with epilepsy. we shall not discriminate against any citizen or legal resident -- based upon pre-existing medical conditions and that's in this bill that was submitted today for our contribution. now the bill may not be perfect. it certainly hasn't been read all the way through yet. but it does have within it no discrimination against any citizen or legal resident due to pre-existing medical conditions. . the second element was that we

needed a standard plan. a health care benefit plan that's standardized such that each and every insurance company would offer in the marketplace by openly disclosing the price a standard plan. that's in this bill. and the idea is to create competition that doesn't exist today. create open and transparent markets that don't exist today because you can't call up an insurance company and ask for the price. they just don't know what to charge until they find out how to cherry pick you out or boost up your price. so no discrimination and a standard plan are in this bill. when we do that, when we have an open marketplace where the standard policy that's being sold in a very competitive fashion, i believe we can drive down the price of your insurance premiums by about 22%. that's a lot of money when the average cost today is $1,200 to $1,400 a month for a family of four. the third element, transparency.

it's in the bill. incentives. the fourth element. incentives, financial incentives to begin to root out waste in the system. i believe as many people here in congress and across the country believe that we are spending enough money across this country now on health care. it just needs to find a better home. 47% is the overall overhead of the private insurance industry. for small business. that means when a small business sends a dollar into an insurance company, 47 cents in my view is wasted. it's wasted on the bureaucracy within that insurance industry. we can and must do better. we must drive that overhead down to 15%. when we do, we'll save america $39 billion a year that will go right back into our economy. i'm absolutely convinced as are many members here that when we reduce the cost of health care for everyone by using the marketplace to leverage things down, leverage the price down, we are going to stimulate our

economy. because there are two big overheads right now for any small business, it's called health care and energy. if you are in farming in small business on main street or the side streets, you got an overhead, that's health care number one, and energy number two. i'm very pleased to see that these essential elements are in this bill and it's a great day for america. it's a very hopeful day. i yield back.  mr. yarmuth: i thank dr. kagen for his expert contribution and as we move forward we will rely more and more on those people who have been in the trenches. for someone who has been in the trenches and knows the problems that face his patients and his colleagues, the medical profession, we will be able to craft a much better piece of legislation. i thank him for his contribution tonight. now it ges me great pleasure to introduce another individual who has been focused on health care throughout his political career.

he's a good friend from memphis, tennessee, mr. cohen. i yield to mr. cohen. mr. cohen: i appreciate mr. yarmuth bringing this topic and joining dr. kagen and my colleague, mr. sarbanes, and miss tsongas who was with us. i look at the encryption over the speaker's chair here in the united states capitol, it's daniel webster. daniel webster says, let us bring the resources of our nation, our institutions together and may we do something here that is worth remembering and something worthwhile that may be remembered. i can't think of anything that would be more worthwhile than daniel webster's spirit that we could do to have people remember this 111th congress than to provide health care that's been sought for so many generations. i think back to harry truman who really had this original concept and wanted to see national health care. you think about what mr. yarmuth talked about, the only industrialized nation on the earth that does not have health care for its people. it's the greatest country on the

face of the earth, but we don't provide health care. that's somehow an omission that this country has overlooked. dr. king would certainly be in feafer of such a bill because this is a nation that has forgotten so many for so long and we cannot continue to do that and be considered the greatest country on the face of the earth. this bill that president obama talked about today and anne has gotten through the committees with mr. miller, mr. rangel, and mr. waxman who have worked so hard on it and speaker pelosi and a comparable bill in the senate will see to it that we save money, $500 billion over the next 10 years in medicare. securing for our seniors a medicare system that will be affordable and available and offer quality care. it will see to it that we ferret out fraud and waste from the system and make savings that will help reduce our deficit that we are presently experiencing. so there is a fiscal mechanism

to this bill as well. and it will see the pre-existing conditions can be used to deprive people of health care insurance. there are advertisements on television, profits for insurance companies, and tremendous salaries and profits that are there, and they need to be wrung out of the system. one way we are going to do it is by having this public option plan to compete and force insurance companies if they intend to remain active in the market to compete with a national system that does not have those same costs and will keep costs down. this will be more quality at a cheaper cost and more people covered. there's a tax that we already have in america. when you have 47 million people, maybe 50 million at this point without health insurance, and 14,000 more people each month

who lose their health insurance, when those people get sick, they still get care at someplace, some time. but it's paid for by higher insurance premiums. , it's paid for by higher taxes where there are community hospitals, they go to emergency rooms. you pay for it the most expensive care possible in the emergency room which wouldn't be there if the people had insurance because they could go to their doctors and it's paid for through property taxes by citizens. and expensive manner. this will be eliminated. for all those cities including mine, where we have a community hospital, trauma center that treats a lot of people that don't have insurance at an expensive fashion in the emergency room, those people will have insurance and they won't be coming to the emergency room which won't cost our taxpayers as much and means that that trauma certainty will be available for trauma care as it was intended. in case there is a disaster it will be available as well and that trauma center can survive.

there won't be this tax put on everybody for taking care of the uninsured in uncompensated care which hospitals do and just charge it to you at a higher bill you get from your physician or health care provider. we are paying for it but without any controls. and so the system is really out of control. it needs to be restrained. now, mr. yarmuth talked about canada. and i know that we probably don't want to compare anything we are doing here except for hockey to canada. but i was with a canadian minister yesterday in memphis, not a minister in the clerical sense, but a government official. and he told me that a lot of people compare our system to yours. he said but you know our people live to an average of 81 years of age and you people live to 78. he said the increase in inflation in our health care system is 1% a year and in your system it's 10% a year. he mentioned some other figures, and this was his perspective,

won't trade our system for yours for anything. our system is the most expensive health care on the face of the earth, but it's not the best. and we are paying for it. and that's wrong. and not enough people get health care. i'm happy to be a part of this congress to support this bill with a strong public plan that will see to it that we can compete with the insurance industry to keep their costs down and to see that everybody has access to health care as this plan will. i'd like to yield to my wisconsin namesake, steve, and as my father was a doctor, a fine doctor, mr. kagen, from wisconsin. mr. kagen: i want to thank you for your kind words about what we are going to do together. let's agree we are not canada we are going to have a uniquely american health care solution. don't think anybody in this body, don't think anyone in the legislature here, i don't think anyone watching tonight across america would argue with getting

a menu. my son works at a pizza rea, he's a darn good cook. this is appleton's first and finest pizzaria. it's frank's pizza palace. if we go there together and order a sausage 12-inch medium pizza, it's $12.50. and it says it right here. now, if you order that same pizza, what are you going to pay? $12.50. health care shouldn't be much more complicated than that. the price is openly disclosed at the pizzaria and they don't great against anybody. and just like in health care they are only as good as their last performance. they have to compete for business. they compete with the italian place down the street or the greek restaurant or the chinese restaurant or just your home cooking. what we are suggesting here is that we use the leverage of the marketplace, that we have an open and transparent and competitive medical marketplace

and guarantee universal access as we will do. the power ever no discrimination , the power of equality it is after all the foundation of our country and our culture. it is equality that we seek not of outcomes but equality of opportunity. and i think it's time to apply that no discrimination theme not just to the insurance world of saying no you can't cherry pick and vate against -- discriminate against someone because of a pre-existing condition, it's time to take that to the level of pharmacy counter. as a doctor can i tell you that is where the rubber meets the road. if i write a prescription for a patient and they can't fill it because they can't afford it, if it's not on their list, we haven't done a thing. we haven't improved that patient as -- patient's health. we have to make certain when you go to the pharmacy counter you are going to pay the lowest price they accept as payment in full from anybody.

i'll use just one other example then i'll yield back. our veterans. everywhere i go in wisconsin, we subscribe, we volunteer, but our veterans didn't go into combat and didn't serve our country for themselves. they served for our entire nation. they didn't serve just for themselves. yet they are the one that is have the v.a. benefit of that discount for the prescription drug. i think it's time that the soldier's wife or husband had that same benefit of that low cost prescription drug. and their children. while we are at it, what about their next door neighbor? what about their community? what about the whole country? if we could use the power, the purchasing power of these united states together in leveraging down prices for everybody, we could have affordable prescription drugs once again. that would bring equality to the pharmacy counter. it's something that needs to be defined very clearly in this piece of legislation. it isn't there yet. but we are going to work

together and hopefully get that to be. -- get that done, i yield back. mr. cohen: i'd like to ask two questions. what's going to happen with the doughnut hole? the seniors are very concerned about the doughnut hole. will we be working on that? mr. kagen: yes, we can. and yes, we will. by working together we can close the doughnut hole. but it's going to take the opportunity and the power and the legality of leveraging down the price by using the government purchasing power. when we the people ban together in a purchasing pool to lower prices for prescription drugs, we can get that price down. if you are the owner after drug company selling a pill in mexico city for $1, thank you for openly disclosing that product and that price. that's the price it should be in new york state all the way through to california and the territories. show me your price and give

every citizen and legal resident that same lowest price that you accept as payment in full. that's the power of the marketplace and that is equality brought to the pharmacy. mr. cohen: before i yield back to mr. yarmuth, i would like to ask him a question. if you have an insurance policy now you like, can you keep it? mr. yarmuth: absolutely. i think that's the uniquely american element of this plan that is most important to stress. no one is forced to do anything in this plan. if you like your coverage, if you have employer sponsored insurance that you're happy with, you get to keep it. no change is necessary. no change is mandated. you get to keep your choice of doctors. you get to choose your hospital. these are the fundamental elements that we considered extremely critical to this legislation because we know many americans are satisfied with their health coverage and we don't want to change their situation. we want to make sure that

everyone is satisfied with their coverage, that everyone has coverage, and through the competitive american spirit that we think we are building, creating this legislation that we will be able to provide the type of environment where people who like what they have can keepp it. people who don't like what they have can shop for something that better suits their family's needs. that's what the entire purpose of this great legislation is. . mr. cohen: and if you keep it you're probably going to get it cheaper because you won't be paying for them through that hidden tax. mr. yarmuth: that's the most essential part of this legislation. if we can't control costs in the health care system, if we can't see to it that people get what they need at a lower price, then we know for instance, that if we don't have reform it's projected that the average family's cost

will increase $1,800 per year for the foreseeable future. that's unsustainable. we know that. so cost control through competition is the critical and through changes we hope that we can incentivize in the way medicine is delivered, health care's delivered and practiced in this country, that we can make affordable, quality health care available to every american. mr. cohen: thank you, sir. mr. yarmuth: i thank you. and, you know, this is supposed to be a conversation of the class of 2006, but occasionally we adopt members from other classes because we know he that they share the values that brought to us congress and it's now my great pleasure to introduce one of those colleagues, mr. ryan from ohio. mr. ryan: i thank the gentleman and, you know, just as all of you do, i feel this is such a critical issue for our country and we started coming to the floor in 2002, congressman meek from florida and i, with the 30-something hour and we were

talking about at that point social security privatization and just a reminder of what the world would look like today if we had privatized social security and we weren't here, democrats weren't here to prevent that from happening, where we would be now. with what's going on in my districts in akron and youngstown, ohio, very industrial and a bit north from my friend in kentucky, and when you look at what the problems that communities and families are having to deal with there, an example of steel companies that have closed, people have -- their pensions have gone to the pbgc, some lost their pensions altogether, some lost their health care altogether. now we're dealing with, as the new g.m. moves forward, a lot of the old delphi folks weren't included in the new deal so now they're left on the outside whether they're union workers or salaried workers that had put just as much time, effort and intellectual into developing delphi and general motors and

now they're finding themselves left behind with a $14,000 or $15,000 health care bill. and so what we're talking about here, why you're coming to the floor, why i'm coming to the floor, why president obama is so forceful -- in persuading the american people that this needs to happen now, why speaker pelosi and senator reid are all on this issue is because this is an issue that the american people want. they know that they are paying too much for their health care. they experience the fear of having a pre-existing condition and trying to go out into the market and try to get somebody to cover them. they deal with these every day. so i don't want to get too much into the weeds because i think over the course of the next three weeks, as you come down here and the 30-somethings come down here and we all get ratcheted up and lean on the doctor here to tell us how this works once it hits the ground, but i think it's important to know that some of the principles here are that no one, once you get your health care that with

these new plans that you'll be able to get into, your health care situation will not bankrupt your family. your health care system, your health care plan, will not bankrupt your bills. you will have coverage, you will have someplace to go. now that to me doesn't seem like too big of an ask in america today. with all the money that is in this system, and i think that's the beauty. looking at the draft plan and knowing that it has to go into all the different committees and get workthrough, i think the magic of what's happening here is that a lot of the costs are going to be squeezed out of the current system that has been inflated because everyone gets their little piece of the action. and we're saying we squeeze it and reinvest that money and in many ways we look, we have some kind of universal coverage now, but it's through the emergency rooms. no way to administer health care, doc.

no way to do it. it's more expensive. so what we're saying is, with the preventative proposals that are in here, is that there's no cost sharing to go check up, there's no cost share to participate in any kind of the preventative measures that specific plans may have. that's going to make you healthier, that's going to make sure that you get a prescription instead of end up in the emergency room a week later and cost the whole system $100,000, when it could have been taken care of for a $20 prescription. that's what we're talking about here. and i'm sure that's going to be a lot of tv ads, i'd be happy to yield to my friend. >> if i understand you correctly you're saying if you're a citizen you're going to be in, if it's in your body it's going to be covered? and would you also agree that much like we had a systemic financial riss wisconsin our financial meltdown, isn't -- risk with our financial meltdown,en the the it also true with the crisis in health care and the impossible cost for everyone, it prests a systemic risk to our economy and if we do

not confront it our economy may be in shambles? mr. ryan: there's no we about it and our economy is in shambles now in part because of the burden that's placed a lot on -- on a lot of the businesses. i remember about a year ago i was in room full of 15 or 20 businesses, prime manufacturing businesses in ohio and we were talking about health care and they were all talking about how their health care costs went up 15%, 20%, 30%, depending on the situation of the people that work at the factory. and when asked if they would somehow be willing to pay more and get health care off their books completely, would they be willing to do that? they were all like, sign me up right now. you mean i don't have to deal with this anymore? i can focus on making this product that i make? and part of what we're trying to do here is to say, get all this waste out of the system, put it on the front end where we can have prevention, let's stop all this stupidness of saying you

don't get any health care because whatever reason and you end up in the emergency room, put it up front, let's squeeze the fat, bring in farma and take some of the savings from there and help fill that doughnut hole that you were talking about, the gentleman from tennessee was talking about earlier, and let's get ourselves healthy. and i yield back to my friend. mr. yarmuth: i thank the gentleman for his very important contribution and someone else who has been very much engaged in the development of the legislation that was introduced today, the gentleman from kentucky who is a member of the energy and commerce committee, so i yield to mr. murphy from kentucky. mr. murphy: thank you very much. my friend tim ryan back wearing a path in a familiar spot on the house floor, speaking truth to the american people. listen, we're talking about -- what we're talking about is this invisible cost to the health care system that we kind of pretend doesn't exist. you know, we didn't get to 17%

of our gross domestic product by accident. we did that by ignoring some fundamental problems in our health care system. and the fact is, we kind of just, you know, boxed our ears and shut our eyes and tried to sort of wish this problem away. well, you know, every employee has started to feel this crunch, right? the percentage of their income that is devoted to health care has inched up and inched up every single year. but a lot of the cost they don't see. because employers out there are eating it and are paying these 12% or 12% or 15% increases they're getting every year and instead of passing the cost of that in its entirety over to the employee, they just don't give as big a wage increase as they might have that year. or maybe they don't give any wage increase. maybe they actually fur low

folks one day a month. these health care costs that companies are taking on are causing wages to remain flat. right? that's what we've seen over the last 10 years. g.d.p. in this country is growing, i mean, we're making more stuff if you look at the 10-year window. obviously in the last two years that has not been the case. but over the last 10 years g.d.p. is growing but we just are staying right here. there are a lot of reasons for that. some people up at the real high end of the income spectrum are, you know, pretty fat and happy but a lot of that is because all of the extra money that companies are making are going to pay health care rather than going to their employees. so that's one way in which the costs of our health care system are sometimes invisible. because employees just assume that they don't get wage increases because their company didn't make as many widgets that year or didn't sell as many pieces of product line. no, a lot of the reason is that they sold more this year, they

just took all that extra profit and paid for health care. second thing is what you guys i'm sure have been talking about already today. it's that, you know, goat a system of universal health care in this country, it's just the worst, most backwards, most inhumane, most encon shenble system of health care in the world. we basically say to people, we will guarantee you health care, our federal law guarantees health care, but only when you get so disastrously sick that you show up to the emergency room. a woman in connecticut came and testified before one of our state legislative committees and she told a real simple story and i've told it on this floor before. had a pain in her foot had, no insurance, worked for a living, did everything she was supposed to, just didn't have insurance. she knew she had some sort of infection so she knew what she was going to have to pay for it. she was going to the doctor, probably pay $100 for that visit and get an antibiotics or some medication. that was going to be a couple more hundred dollars. she didn't have it. she knew she didn't have it. so she decided to just live with the pain.

finally one night it was unbearable. she had to go to the emergency room. so she showed up to the emergency room and it was too late. that foot was infected so badly it had to be amputated. that's a terrible, terrible outcome for that woman. changes her life for the rest of her time. but it cost the system the thousands of dollars that that surgery and all of that follow-up care required, first the couple hundred bucks we could have gotten in preventive care up front. we're paying for that. you never met that woman and you never see the thousands like her who end up showing up in the emergency rooms with crisis care that could have been prevented. that's more invisible costs but it's all there. one last point, mr. ryan, mr. yarmuth, people are going to sort of hear the cost of these bills when they come out, right? they're going to see that the cost of the bill from the house is, you know, x billion dollars, the cost of the bill in the senate is x plus y billion dollars. here's what you have to do. you have to look at that cost

versus the cost of doing nothing. and every credible survey, every credible examination is going to tell you this, that the cost of the bill that we produce is going to be half of the cost of sitting and accepting the status quo. that's why we have to pass health care reform, mr. yarmuth. mr. yarmuth: i thank the gentleman and because he talks so much about the higher level of carat the emergency room, most of which is uncompensated for those providers or shifted to the private pay customers, i know there are estimates out there that indicate that there is somewhere around $100 billion a year that's actually care administered in the emergency rooms to people by hospitals who do it as part of charity work, but it's all being shifted to the people who are covered. so, when we talk about health reform plan that's going to cost roughly $100 billion a year for

10 years, we're already spending that $100 billion. so the not money new to the system, which is, i think, an example of we have plenty of money spent in this country on health care right now. i yield to the gentleman from ohio. mr. ryan: just for example, with medicare advantage. 14% overpayment on average for medicare advantage. that is over what medicare pays. that is wasting the taxpayers' dollars. that's the money we're talking about that we can shift from that current program into what mr. murphy was talking about earlier, this kind of cost savings that we need. mr. yarmuth: yeah. i yield to the gentleman from wisconsin. mr. kagen: i'm glad you brought this subject of medicare advantage plans because not every medicare advantage plan is identical and not every community is identical as well. and there are some areas of the

country where medicare advantage plans like in some regions of new york state and some regions of wisconsin are very advantageous. they have a lot of prevention planned into them and they're not really overcharging at all, they're bringing about all of the evolution in our health care system that you'd like to see. squeezing out the waste. and emphasis on prevention and primary care. but no legislation is perfect. and nothing that we codify in law here that the president will sign will instill better judgment in every patient that is going to exist. is it still comes down to personal responsibility -- it still comes down to personal responsibility. we can't instill all the government judgment into our children, don't you know? we have to have an understanding of what our limitations are in terms of government. we have to set up the table and set up the rules of engagement where we can have an open and transparent medical marketplace. allow the marketplace to do what it does best, bring down prices to be everybody and increase access but begins, it begins with this piece of legislation that we had submitted today,

with no discrimination against anyone due to pre-existing conditions and a standard planned, a plan that guarantees if you get sick you'll be in your house, not the poor house, i yield to mr. cohen. mr. cohen: thank you, doctor. i was thinking of an old saying and you might know where it comes from, the old ounce of prevention is worth a pound of cure and what was the origin of that? does that not apply to the idea of having wellness programs and -- mr. kagen: i thought it was my grandmother. mr. cohen: i thought it was, too. but doesn't that apply to this program where we have wellness programs now and if you can pay for wellness programs and preventative care you don't have to pay for that emergency room care? it's as simple as a traditional slogan like that, a saying that comes from "the saturday evening post." that's where we're going to save a lot of money. mr. kagen: but the idea that was common place up until this point in time is to divide and conquer.

that's what the insurance industry did. they cherry picked an separated neighbor from neighbor based on pre-existing conditions. they went so far is to -- as to separate a husband and a wife based on medical conditions, sometimes even a mother from a child. we're going to have to go back to community. community-based ratings, where we work across the aisle to save the complex programs -- problems. i'm glad that this class of 2006, and our recent adoptee from ohio, is taking on health care and energy and education. these are the three problems the president has been leading us on. >> if i could just add something, mr. kagen brings up energy policy, we're right now engaged in the muck of trying to change the health care system, i think it's wovert reminding everyone out there how hard it's

going to be to try to reform a health care system where, as mr. ryan said, a lot of money is being wasted. but that money being wasted, it's not like you're wasting heat in your house, and it escapes into the atmosphere. when we talk about wasting money, it ends up in people's pockets. it makes them rich and creates fortunes. when we talk about saving money in the health care system, that involves taking on pretty powerful institutions around this city of washington, d.c. and around this country that are going to have to live with a little bit less to get average americans a little bit more. i think people are going to read all these stories in the paper about how long it's taken to pass health care reform and how tough it is to get the senate and house to agree. when you're taking on 1/7 of the economy and when you're taking on the industry which by years of republican neglect allowed for big players in the health care industry to make their fortunes off the fact that some people can't afford it, it's

going to take some time, it's going to take heavy lifting that's going to fix it for a long time. that's why energy is hard to do, it's taking on similar interests. it's not just a nice, powerful policy discussion amongst peers, this is about vested interest. mr. ryan: i think this is roughly correct, the insurance industry had increased their employment by maybe 5% or 6% or 7% and they decreased the amount of services they were provide big like 25% or 30% system of they were taking this money, hiring people to knock people off the rolls. to not cover, to make them jump through these hopes, i called i got denied, i'm sick, i've got to know, maybe eventually we get a call, we make a call, who knows what happens. to your point, mr. murphy, that

person who is hiring people, growing their business, at the expense of all these other people, is not the way this is going to keep going because america is better when all of these people together are healthier and more productive and participating in the system. i want to yield to my friend from tennessee, because he caught me before my friend from wisconsin, but there was an article yesterday brought to our attention about people in technology businesses that, for whatever reason, want to go out and start their own business but can't because someone in their family or they have a pre-existing condition so they need to stay in their current job because they don't have the coverage, when they could be out in the market, using what's best in america, the entrepreneurship, creating employment. mr. cohen: i want to thank you for bringing up the issue of bankruptcies.

i chair the subcommittee on judiciary, we're going to have a hearing on bankruptcies and health care. health care is the major cause of bankruptcy in this country. when people go bankrupt because of high medical bills, people lose out because they don't get paid. merchants don't get paid because of that. that's another cost of not having a health care system. i yield back to mr. ryan or mr. yarborough. mr. kagen: i'd like to say that mr. ryan from ohio pointed out the difference between health insurance and health care. what we're talking about in this bill is health care. getting the care you need. you have the choice, you've got the coverage and you've got the cost coming down. that's exactly what this bill aims to do mr. yarmuth: i appreciate the comments from my colleagues, i'd like to close by reading a letter from a 10-year-old

constituent of mine. it says, dear mr. yarmuth, i'm a 10-year-old living in kentucky. i have a younger brother with autism, i want you to sponsor the autism education act. i would appreciate you co-sponsoring the bill to end insurance discrimination. my parents spend $50,000 a year on ce. it seems patients have to pay unnecessary conditions because their child is different. it's just not fair and this is a fair country and everybody, no matter who they are, should be treated equally. there you have it, a 10-year-old understands the essential unfairness of the system we have now, the fact that so many people are uninsured, the fact that so many people pay too much for the insurance they have,

have to make life decisions based on whether they can get insurance or not, and that's what this congress is determined to correct. we have a historic opportunity here to create a just, fair health care system, one that is affordable and sustainable for this country and which will make sure that every american citizen has the health care he or she needs for their families well into the future. with that, mr. speaker, i yield the balance of our time. the speaker pro tempore: the gentleman yields back. under the speaker's announced policy of january 8, 2009, the gentleman from missouri plrning akin, is recognized for 60 minutes as designee of the minority leader.

mr. akin: good evening, mr. speaker, and my friends. we have just heard from the democrats talking about their new to ray into solving all the problem -- new foray into solving all the problems with health care. it sounds good. the promises, essentially what i was hearing talk about is first of all, costs are coming down, you're going to get free medical care and the quality of the care

is going to go up and gosh, if you were given a proposal like that, i don't see why anybody wouldn't say, let's just march ahead with socialized medicine, let the government run it because they're going to bring the costs down, they're going to give you freed medical care, and you'll get better coverage than you get now. i also was hearing the fact that they talked about the muck of our health care system and how bad the health care is and how if we don't immediately pass this legislation, that things are going to get even worse and so -- but what we have in front of us is this absolutely euphoric view of a great health care system. first thing that strikes me is a little bit of problem with common sense. the first is that if our health care system were so bad, then it would seem like to me that americans would be going to some foreign country to get their health care. but what i'm observing is that if i got sick, and i have been

sick, the place i'd like to be treated is in good old u.s.a. i don't want to go to canada, i don't want to go to great britain or france or sweden or russia, no, i'd like to be sick right here in this country. it strikes me that a health care system that most people, even around the world, recognize as probably the most sophisticated and the best quality health care system in the world, we're saying that it's full of muck and the system has to be completely changed around. so it's ok if you want to believe these promises that what's going to happen when the government takes over the health care system is that it's going to cost less money. the trouble is, the congressional budget office doesn't say that. the estimates of the costs don't say that. and the states that have tried using the same approach that's being proposed here nationally don't say that either. those states are almost bankrupt for trying to do this kind of system.

yet we're going to try to copy those bad examples. we are just -- actually, a few weeks, a couple or three weeks away from dealing with the other big problem the administration has iidentified, the fact that the climate and the earth is going to get worse and worse, hotter and hotter, and we're going to melt down so we have to deal with the problem of global warping by, of course, what would you expect, a large tax increase, the largest tabblings increase in our country, about $787 billion. that was the largest tax increase we've done. we did that. it was 1,100 page bill brought to the floor and then at 3:00 in the morning, in a special committee hearing, another 300 pages of extra text were added to the 1,100 pages and the 300 pages being in the form of amendments to had to be collated and put into the 1,100 pages.

as we were debating this wonderful bill on the floor, they were busy trying to collate this amendment that had been passed, 300-page amendment at 3:00 in the morning. they're busy trying to collate that. as we're debating it here on the floor, about to vote on it, there isn't a copy of the bill we're going to vote on. here we go again, not having -- perhaps we did learn from our last experience that it's easier to pass something that people don't know what it is. so here we go now, with about 1,000 pages of bill in terms of what we're going to do to have the government take over 20% of the u.s. economy. the health care business is about 20% of the money that's spent in america. it's about 20%, or close to it, of our economy, and now we're going of the government take, well if you take a look at it,

about half of it the government is already running with medicare an medicaid. we've had some experience with the government running these programs, medicaid program, of course is noted for the tremendous amount of fraud and abuse that it has, but if you add the medicaid and medicare money if you look at the total amount we spend on health care, the government is doing about half of it right now. we're talking about having the government do the rest of it. that's where we're going. i think we need to take a look at that. when the government does take over various things, what tends to happen is not noted for its efficiency. usually what happens is you get the tremendous excess in amount of spending, you get a will the of -- a will the of bureaucratic rationing, these are typical things in government programs, there's an inefficiency and degraded quality. those are the kinds of things history tell us happens when the government takes something over. that's what's being proposed

here. what's being proposed is the government is going to take over the health care system. that has left people with this particular equipment, you think health care is expensive now, wait until it gets to be free. -- with this particular quip, you think health care is expensive now, wait until it gets to be free. let's take a look at how well this has worked in the past. that's one way to decide whether to make a move, is to look at other people who tried the same thing. the state of massachusetts decided in 2006 they were going to require universal health care coverage, very much like the current democrat plan, where people are required to purchase specific levels of health insurance. here's what happened. health care costs have risen 42% since 2006. 42% increase. we were just hearing from the democrat this is a this thing isn't going to hardly cost anything, it's going to be a break even because there's so

much efficiency. what sort of efficient is -- efficiency is a 42% increase? yet health care access is down and the patients have to wait more than two months to try to get to see a doctor. so is this the kind of thing we think is going to improve what most people think is a best health care system in the world? and health care costs now, up in massachusett they're 133% of the national average. that doesn't seem to me to be producing these glorious results i i'm hearing the democrats talk about. i don't think these people may have gotten over their euphoria from just managing to put 1,100 pages with 300 page this is a nobody could read or no know -- or know what it was -- what it was and pass that within a day of the 3:00 in the morning when they made the amendments. here we go again, let's see if we can't pass another, going to 1,000 or 2,000 page bill this week or next week, and it's a

lot easier to pass them when people don't read them. i'm joined here this evening by some very, very good friends of mine and some people who have done a number of years of study on the health care issue. i think that we need to take a -- talk a little bit about this before we go racing off to make some snap decisions, i think we need to do that. i'm joined by a number of my colleagues, i guess i'll start -- would you like to -- yes, i would yield to the gentleman, if you'd like, if you want some charts, help yourself, or you've got some over here. this is congressman shadegg from arizona. do you want to talk from the well? let me help you, i'll put some charts up, you can talk.

mr. shadegg: i want to thank the gentleman for yielding and hopefully we can do this where we are all in a conversation and no one of us talks in a monologue that's interesting, but i want to thank the gentleman for standing up. i like he watched the democrats in their special order that just preceded us and i thought some things were very interesting. on the one hand, i think there are some things we agree on. our democratic colleague said it's tragic when someone has a preexisting condition or chronic illness and because of that preexisting condition or chronic illness they can't get care. that's why we as republicans thinks the health care system in america needs to be reformed and the health care bill put forward by every republican that i know of says we need to make sure that every american with a preexisting condition or a chronic illness can get health care costs at roughly

the same price as americans who are healthy. indeed, i introduced and the congress passed a number of years ago a bill called the state high-risk insurance bill that encouraged all 50 states in america to create high-risk pools so that for someone for whom they have an illness and that illness or that chronic condition has caused their health care cost to rise and they either can't get health care at all or they can only get health care at an extraordinarily high price, they have the option of going into a state high-risk pool and getting health care at the same cost. that's not an issue that divides us. that's an issue that we agree on. in addition, they expressed concern those who are not insured in america. a bill i co-sponsored and i see gentlemen and gentleladies that co-sponsored it with me

provides health care insurance for every single american. it says we are going to provide care for everyone. and our democrat colleagues say, yeah, we think everyone american should get care. there's another issue where we agree with our democratic colleagues. but where we don't agree is how they propose to do it because they want a topdown government controlled one plan fits all you're just one little doing in a very large wheel plan, and that's what the bill they introduced today will do. i have to ask a question. i think that the biggest issue in the health care debate is cost. most americans are pretty satisfied with their health insurance. 83% say they're happy, but every american is concerned about cost. now i listened when the democrats introduced their bill today and the chairman of my committee, mr. waxman, said the big issue is cost and so the democrats are going to fix that cost. now, i don't quite understand

how they're going to fix that cost by raising taxes $1.5 trillion to create a massive new government one-size-fits-all government health care plan. but i have this burning question for any american that can answer it, anyone in the room that can answer it, any of my democratic colleagues that can aner it. please show me the last time when we got government involved and took over a private sector activity that the cost of something went down. mr. akin: i think you asked me an absolutely great question because we just heard an hour from the democrats. that's their whole point. their point is we are going to somehow make the costs go down which is hard to reconcile with a $1.5 trillion estimate, and we saw, what was it, three weeks ago, we crammed through the biggest tax increase in the history of the country.

what was it, $787 billion tax on energy to anybody that flips the light switch is going to get taxed and that's just a drop in the bucket compared to what we want to spend and somehow this is supposed to be efficiency. boy, that really stretches on the conscience. we have a number of medical doctors here today. i was thinking, dr. roe, who is from tennessee, did you put a program similar to this in tennessee and did you really find that it helped the economy of your state snid' like to yield a little bit of time and i am going to go to the doctor from georgia as well in just a moment. mr. roe: i want want to take -- i don't want to take credit for putting that in. what happened in tennessee is we had a lot of uninsured in tennessee and it was a very noble goal of trying to cover as many people we could and we had a standard medicare plan like most states do now. we had a medicare waiver from h.h.s., department of health and human services, to develop a managed care for the state.

what happened was there was a plan very rich in benefits, much like what you're seeing from this plan that we heard discussed the last hour, provide a lot of benefits but not much access, we found out. and what happened was this plan, this public plan paid only about 60%. now pays less than, i found out the other day, less than 60% of the costs of actually providing the care. medicare pays about 90%, so businesses and individuals made a perfectly logical decision. they dropped their private coverage and about 45% of the people who are on tin care had private health coverage but chose to drop it. that was fine until we got the bill in the state. what happened was the bills kept piling up, consumed more of the state budget than education did. mr. akin: just reclaiming my time for a minute. one of the trouble with doctors is you guys are smart. you go pretty fast. you have to slow down a little

bit. the state government said we are going to give you medical insurance and so a bunch of people signed up for it. then the companies that had the private insurance, they dropped theirs because you could go get the freebie stuff from the government. then guess what happened, the government stuff got really expensive and now the state's in trouble. we have another congresswoman that i greatly respect, congresswoman blackburn from tennessee. you have some more fax? i mean, you lived with it. i yield. mrs. blackburn: i thank the gentleman for yielding. and dr. roe is exactly right. he was a physician practicing medicine or trying to practice medicine under the impact of tin care. i was a legislature trying to figure out -- legislator trying to figure out how to pay for it. as a member of the tennessee state senate -- mr. akin: the democrats said it's going to be really cheap. it's not hard to pay for. mrs. blackburn: that's an interesting thing. the tennessee plan was put in place in 1994 as the test case for public option, government funded, government delivered

health care. the interesting thing now is the white house doesn't want to talk about it because it is an experiment that was not successful. it failed. even our democrat governor has said it has been a disaster. and that was in an a.p. article. mr. akin: reclaiming my time. the governor of the state said it was a disaster in tennessee? mrs. blackburn: yes. and one of the things we need to realize is this. tin care was put in place as an executive order program of the office of the governor. it was an 1115 waiver from c.m.s. the state house and the state senate got the bill of paying for it. what happened after about five years of this program being in place and you had consent decrees and court orders and you had companies that were dropping insurance, 55% of the unrollees on the program were people that were not supposed to be there. they had previously had

insurance, and you had a program that was insuring or covering, gold plated program covering 25% of the state's residents. then the costs start to bloom. you see cost shifting onto those who have private insurance. you have restricted access by doctors and hospitals because they are not being paid by the program because there's not enough money to go around. and the costs are absorbing every single new revenue dollar that is coming into the state of tennessee and ends up being 36% of the state's budget. mr. shadegg: will the gentlelady yield? mrs. blackburn: i'll yield. mr. shadegg: costs are going up too fast, the president said it's unsustainable. in tennessee they put in a government-run plan, got the government involved, substituted the private market and costs did not go down?

mrs. blackburn: costs skyrocketed, and we saw the costs go up every single year. as dr. roe can tell you, having been a physician trying to handle this issue, every single year the cost went up on the public option, the access was restricted, the quality of care was diminished, and those with private insurance saw their rates go up 10%, 15%, some companies even 100%. mr. akin: what you're depicting what sounds to me is one of the things they used to do, they charged people money -- they'd get a railroad track with two huge steam locomotives. it's a classic train wreck. what happened was a government engineered a train wreck on health insurance. dr. roe, you're a medical doctor. i assume you got into the doctoring business because you wanted to take care of people. what was it like to be there?

i'd yield. mr. roe: one of the things i got to congress here and i began to hear the plan that was. i said, we tried that already in the state of tennessee. this is nothing new. it failed. and can you say failed? it was a disaster, and the governor ran in 2002, our democratic governor, his platform was fixing tin care, fixing what six, eight years later was a mess in the state of tennessee. now, there are -- there are good parts of this plan, as we pointed out, things we will agree on. i do want to show the public one thing. i almost broke my printer in the office this afternoon, but this is the bill that came out this afternoon just to give you an idea that we are going to talk about in the next couple of days. mr. akin: i believe it's 1,100 pages long? mr. roe: yes. mr. shadegg: they do what they did on cap and trade it will explode on the day of the vote to, what, 1,400 pages with a last-minute 300-page amendment?

mr. roe: the devil is in the details here. mr. broun: will the gentleman yield? mr. roe: yes. mr. broun: it's interesting after our last series of votes i was walking to my office as i went in the cannon house office building, there's a democrat who's engaged in this process -- mr. akin: reclaiming my time for a minute. i want to introduce the gentleman. you got in the business for practicing medicine. you are not from tennessee. you are from georgia. dr. broun is an expert in the area of health ce because you've been doing this all your life. i would like you to continue commenting where we are because this is an important discussion. mr. broun: well, thank you, mr. akin. it was humorous to me, actually sad to me because this democrat , she said to me that all they're going to do is cover those who are not insured with this public option and give them the opportunity to buy

into this public option if they don't have insurance. and i told her, how are you going to keep companies from canceling their insurance and from people being shifted over? that's going to increase the cost of insurance for everybody else. so you're going to see a continual shifting. isn't that, dr. roe, mrs. blackburn, isn't that what you saw in tennessee? mrs. blackburn: will the gentleman yield? mr. akin: i'll yield, yes. mrs. blackburn: i know that dr. roe will want to comment on it. it's good that we can talk from the perspective of a state senator who was charged with holding that program accountable even though it was set up without the permission, without the permission of either the state house or the state senate in the state of tennessee. and dr. roe was charged with keeping his oath and making certain that he was providing care to those that were in his care.

but what we saw, again, was the cost shifting that was taking place, the cost of insurance to those in the private markets going through the roof. i have employers in my state senate district and now in my congressional district who've seen over a three-year period of time their health insurance cost go up 100%. we also saw delayed care, and as the gentleman from arizona knows, delayed care might as well be denied care because it -- i do yield. mr. shadegg: will the gentlelady yield just on that point? our colleagues are saying, we ought to do a canadian-style system, something that gets the government more involved. we know that canada has a single-payer system. those want to create a single-payer system but they want to transition to it. i think it's very important. you know, you said the -- right to access to care is not the right to care. actually, that's exactly what

the supreme court of canada ruled about their single-payer system. this is on this chart next to me, which i think the gentleman -- i thank the gentleman for allowing me to put up. the chief justice of the canadian supreme court said in an opinion issued in 2005, access to a waiting list is not access to health care. in an opinion in which the supreme court of canada ruled that you couldn't be forced to stay in their system. you had to be given the right to get outside of the government program and get the care you need. access to the point the gentlelady was making, act ss to a waiting list is not access to health care. mr. akin: this supreme court justice, she was no right-wing conservative. mr. shadegg: she was no right-wing conservative. a very liberal justice.

mr. akin: yet she's saying the socialized medicine system doesn't work. you can have a free c-section but it if you have to wait 12 months for it, it doesn't do much good. mr. shadegg: if you have to wait 12 months for a free c-section, it doesn't do you much good at all. we don't want to give americans access to a government waiting list we want to give them access to real health care. mr. akin: i yield to congressman broun from georgia, i think you had the floor for a moment there and i'll go to congressman gingrey, another medical doctor we have joining us, we have a lot of doctors here tonight, i'm thankful for your expertise. mr. broun: i want to come back to something my dear friend john shadegg said, where he's talking about cost.

i want to just inject here something that happened in my medical practice when i was practicing in southwest georgia and what i'm fixing to say is going to point out the government -- that government intrusion in the health care system is what's driven up the cost for everybody, whether they're private insurers or public insurers on schip or medicaid. back a number of years ago, i was in private practice, had a one-man office with several employees and i had a fully automated lab in my office. patient would come in to see me with a red sore throat, running a fever, aching all over, coughing, runny nose, white patches on their throat. i would in my fully automated lab would do a c.b.c. a complete blood count. i could do it in five minutes, charged $12. congress passed a bill called the clinical laboratory improvement act, or clea.

it -- or clia. it shut down every lab in the country, hospital labs had to get a waiver. mr. akin: let me get this right, laws passed here in congress shut down your lab? mr. broun: to do any testing. mr. akin: they shut it down? mr. broun: they shut it down. shut every lab in the country down. i would do a c.b.c. to see if they had a bacterial infection, if they needed antibiotics or if they had a viral infection. they look exactly the same. a viral infection is not treated the same as bacterial infection. doctors were told in medical school not to overprescribe medication and if people have

viral infections, they don't need antibiotics. i do a c.b.c., 12 bucks, five minutes. clia shut my lab down. i had to send patients across to the hospital, it took two to three hours and $75 for one test. it markedly increased the cost. congress passed hipaa, the health insurance portability and privacy act, that's cost the health care industry, thus insurance, and all of us billions of dollars, and has not paid for the first aspirin to treat the headaches it's created. it was totally unneeded legislation. totally unneeded. because we could have done something to make insurance portable without going that route. so government intrusion into the health care system and medicare policy is what has driven up the

cost for everybody. it comes back to what mr. shadegg was saying about asking a question, could any of us answer a question -- the question about has government being involved in any area decreased the cost? the answer is no. it has increased the cost markedly for the health insurance and everybody el. it's going to in this too. mr. akin: reclaiming my time, i think you've given us several concrete examples in the health care business where the government involvement has basically run the cost of health care up. that's not a big surprise, is it? we look at the regular marketplace. i think one example would be the idea of lacic surgery for eyes. that's one thing government didn't get its big figures into meddling. what used to cost thousands for a procedure is now done for hundreds of dollars. we've seen a dramatic decrease in the cost of good quality care because the government wasn't tampering in it.

yet every time we see this the government get its fingers into things, the costs invariably go up. i'd like to get over to congressman gingrey from georgia, another medical doctor, joining us, many years of medical practice, also a former senator from georgia and a great colleague. i yield time. mr. gingrey: i thank my colleague for yielding, it's a pleasure to be on the floor with my colleagues, talking about this bill that was finally, as we all know, introduced by speaker pelosi at a press conference this afternoon. hearing our colleagues from tennessee talk about really the ultimate pilot project, we're always in medicare, any time they're trying to do something to improve a situation we start with a pilot project. which makes sense. this was the ultimate pilot project, i think, this tencare that congresswoman blackburn and dr. roe, congressman roe have described to us and as is their

democratic governor said, it was a complete, abysmal failure and yet -- mr. akin: we're going to repeat this? please, continue. mr. gingrey: if the gentleman will continue to yield. yet we're going to repeat this now on a grand national scale. i want to take a few minutes to talk about what the blue dog democrats said in a letter sent to the honorable nancy pelosi and the honorable steny hoyer, the majority leader of the democrats. 40 -- i think there are 52 members of the blue dog coalition of democrats, those member whors a little more conservative than the typical -- the typical moderates to liberal democrats and basically these 40 members, 40 of 52, in their -- and there are a number of things

in their letter but i want to go over a couple, but one of the provisions they say is absolutely needed fixing in this bill before they could support it, small business protections. here's what it says. any additional requirements for employers must be carefully considered and done so within the context of what is currently offered. small business owners and their employees lack coverage because of high and unstable cost, not because of any unwillingness to provide or purchase it. we cannot support a bill that further exacerbates the challenges faced by small businesses. now, look, my colleagues. look what this bill says. it just came out today. this is the burden, the additional burden that will be put on small businesses. payroll -- if the payroll of a

business does not exceed $250,000, then there's no surtax, but if the payroll exceeds $250,000 to $300,000, there's a 2% sur fax. if the -- surtax. if the payroll exceeds $3,000 but does not exceed $400,000, there's a 4% surtax. there can be an 8% surtax on the small businesses. these small business they don't -- they're not subchapter -- c-corp.s, they're subchamenter s or sole proprietors and they pay as an individual. this is on top of the fact that president obama is going to let the tax cuts expire that president bush put in place in

2001 and 2003 -- mr. akin: reclaiming my time, what you brought up is a critical point, it's part of how they're going to try to pay for this humdinger bill. what you're saying is they're going after small business. a lot of us know if you take small businesses, 500 employees or less, that's 80% of the new jobs created, typically, in the economy. if you target small business, now you're going to drive down employment. that's significant. the gentleman from arizona, i yield him time. mr. shadegg: i am shocked. i've got to tell you, i'm absolutely shocked. i understand the gentleman from georgia was reading from the bill just now. reading provisions of the bill? mr. gingrey: reading directly from that provision. mr. shadegg: you have read a portion of this bill. mr. gingrey: i have read a portion of it. mr. shadegg: and you read from a letter from the blue dog

democrats to their leadership expressing concerns about the bill, the so-called tricommittee discussion draft are you telling me that blue dog democrats have read portions of the bill? mr. gingrey: the gentleman from arizona is absolutely right. one of the provisions that they stated in the letter is this. finally, any health care reform legislation that comes to the floor must be available to all members and to the public for sufficient amount of time before we are asked to vote for it. mr. shadegg: i am stunned. i have here beside me a quote from the house majority leader, which suggests it's not appropriate in america for us to expect members of congress to read bills. the majority leader said, if every member pledged to not vote for it, it being this health care bill if they hadn't read it in its entirety, i think we would have very few votes.

he said last week he laughed out loud at the notion that members might actually read a bill. i suppose if you've done what he kid, -- what he did, which son the cap and trade bill, introduce at 3:04 in the morning, introduce a 309-page amendment, making it impossible far single member to read the bill before it was voted on by 4:00 p.m. that afternoon, then you have to say, i don't want members to read the bill. soif to say, you are reading the bill snand the blue dog democrats are reading this bill? mr. gingrey: if i can respond, absolutely. again in this letter, too short of a review period sun acceptable and only undermines congress' ability to pass responsible health care reform that works for all americans. our colleague from tennessee, dr. roe, just held up that 1,100

page bill. i wonder when they're going to get around to reading it. i yield back. mr. akin: i would like to yield time to congresswoman blackburn from tennessee. i think you had a point and also the stack of that that's just the beginning of the bill and it's already giving my eyes a headache. what do you have nine or 10 inches of paper stacked up there, doctor? that's where we are now. we haven't done the amendments at 3:00 in the morning yet. i do yield to the gentlelady from -- mrs. blackburn: what we see in this stack of a bill, the 1,100 pages that are there in that bill, 1,683 times, it gives you the directive of you shall do -- individuals shall do this. let me explain what this means. when you're a mother, many times you will tell your children, well, you can go out and play if you want to, you can do this if you want to, but when you really make a point, you say, you are

going to go to time out or you are going to do your homework, no question, no options. in legislative parlance, that is what shall means. you have to do this. now, 47 times it uses the word must, you must do this and that. and 495 times it uses the word require. all of these are new mandates on the american people. to make it worse, 172 times it talks about taxes, taxpayer, taxable activity. 172 times. and 99 times it uses penalties. the democrats have become the party of punishment, and they are going to punish americans severely in this health care bill. and to the gentleman from georgia, i loved the fact that

he talked about the taxes. that portion that he so beautifully articulated would create $300 billion in new revenue for the government. that means taxes out of pocket that you are taking out of your pocket and handing it to the tax man. $300 billion. mr. akin: reclaiming my time. i heard promises that it doesn't cost that much. from the congressional budget office it was $3.5 trillion and now they've got it down to $1.5 trillion. and if you are talking about $300 billion and we did the biggest tax increase in the history of our country on energy taxes which is going to put our productivity and that's only not even $800 billion, we're not even there yet. i yield. mrs. blackburn: you're exactly right. what the gentleman has is one small portion of that bill. i'd add before i yield back that his own economic advisor from the president's economic

advisor estimates that that amount of taxes in this legislation would cost us 4.7 million new jobs. and i yield back. mr. shadegg: if the gentlelady would yield briefly. all those numbers show that you are very much in the process of reading this bill, your staff is in the process of reading this bill. i said facetiously to the gentleman yesterday that i am stunned that people are reading this bill. the majority leader said members are not expected to read the bill. i know i won't vote for this bill until i've read over it. i commend the gentlelady for pouring over this bill. i commend the gentleman from georgia for obviously reading portions of the bill. and i think the american people expect us to read the bill. >> will the gentleman yield? mr. shadegg: i was only being facetious that we might be stunned and shocked that we might read a bill.

i'd be happy to yield. mr. broun: i just signed a pledge to the american people that i would not vote for this bill until i read it. i don't sign pledges. mr. shadegg: i hope our colleagues on the other side to do the same. mr. broun: i hope so. i hope the blue dogs don't hold their breath because they'll tie from hypoxia. i want to turn to something that dr. gingrey was talking about and mrs. blackburn brought up clearly. this tax increase on small business is going to cost jobs. not one or two, not 10 or 20, not hundreds but thousands of jobs because small businesses all across this country are not going to be able to pay for the increased taxes that the democrats are going to put on the back of small business men and women around this country.

so many people are going to be out of work, and it's going to shift them over to the public plan. they're going to get free health care. we've heard several of our colleagues say, if you think herk is expensive now, -- health care is expensive now, wait until you get it for free. it's going to be very expensive. mr. akin: reclaiming my time. i want to go back to doctor. you were there in tennessee. you saw this experiment. even the democratic governor said it was a failure. i'd like you to finish. we have just a few minutes left. if you can finish. mr. roe: let me say why it's important for the public and our patients and as physicians for our patients to understand this. what we're concerned about if this plan becomes a public option, that's the only option and the way that occurs is i've explained when the cost to the public plan does not pay for the cost of the care, more costs are shifted to your private health insurers meaning they'll eventually drop the plan. having a single-payer system

like canada or england, is that necessarily bad? i would say that's bad for america. the reason is it's going to limit choices. i know it was brought up a moment ago by the gentleman from arizona about costs, and i'm going to share with you just a -- just a family practitioner in my own district the other day called me up and said, phil, he said, i have had one lawsuit in my career. very young woman had a serious problem, probably not preventable. he had -- he had a grade by the insurance companies of what a good doctor he was and top third always. after this lawsuit, one lawsuit and nowhere is medical malpractice is mentioned here, his referral to specialists in one year went up 350%. his lab ordering went up 550%. this is not him saying this. this is a grade he got from the insurance companies. so there's the cost side. we were talking about earlier. who knows when you extrapolate that across the country how much that must be.

i got this letter from c.b.o. to chairman rangel, 14th of july, today. and in this it says another significant feature of the insurance exchanges it they will include a public plan that pays medicare-based rates for medical goods and services. c.b.o. estimates that the premiums for that plan would generally be lower for premiums for private insurance. but on average the public plan will be about 10% cheaper than the typical private plan offered in exchanges. and therefore, they're saying right here in this document that that's what's going to happen. the other thing about this i found interesting was this plan doesn't start until 2013, and what you're seeing here is only in the last six years, this $1.1 trillion plan, it actually is $150 billion per year is what it amounts to. it's not what they're currently saying, $1 trillion over 10 years. it's really $1 trillion-plus over six years. i yield back.

mr. gingrey: if the gentleman from missouri would yield. mr. akin: i told congressman shadegg he would get in. i have a couple of points and then get right over to you. i yield to the gentleman from arizona. mr. shadegg: i thank the gentleman for yielding and i'll try to be as brief as i can. the democratic bill was not the only bill introduced today. as my colleagues know we introduced the improving health care for all americans act today. it's a bill that reforms health care, not top down government mandate. it reforms american health care bottom up. it controls costs by empowering americans, and it has some key points. it says if you like it, you can keep it. it provides coverage for every single american and choice for every single american. it provides new pooling mechanisms so you can be an insurance pool other than your employer's pool. it says the rotary international or daughters of the american ref united nations

or your alumni association of your college or university could sponsor your plan. so you could pick many pools to get into. it says we are going to cover preexisting conditions or chronic conditions at the same rate as everyone else across subsidizization and high-risk pools. i have two quick points very quickly. and i'd invite everybody else who speaks in the limited time we have left to comment on those because i think they're so important. the president has said over and over and over again, if you like it you can keep it. i think that's so important because polls show ruffle -- roughly 83% of americans, 83% of americans like the health care they have. so if the president stands forth and says if you like it you can keep it, ladies and gentlemen, i wish it were true. this is the language of the bill, which was introduced today. it's been revised and renumbered.

this came from the working draft, but the same language is in the bill. it says, by the end of the five-year period -- following introduction of the bill -- group health insurance plans, every health insurance group plan, must meet the minimum benefit requirements under section 121. section 121 creates a new federal entity called the health care advisory committee which will rewrite the minimum benefits for every health care plan in america. that means every health care plan in america under their bill will change within five years. some will change immediately. everyone will change within five years. mr. akin: reclaiming my time. so what you're saying is if you like it you won't be able to keep it? mr. shadegg: if you like it, like the headline says, if you like it, if you like your care, if you're one of the 83% of americans, be prepared to lose it because you're going to lose it under their bill. not just by competition from the public plan. their bill says you'll lose it.

in five years every plan has to change. i'll conclude very briefly on an issue that i know that's near and dear to the gentleman who sponsored this special hour tonight -- special order tonight, mr. akin, who is a cancer survivor. the american people i hope will slow down this sprose. i hope they'll say -- this process. i hope they'll slow down this process. we are being told to switch to a system similar to what exists in canada, europe and england. those are the parallels. but i would suggest to my colleagues and to every american, there are two things that scare every american, those two things are cancer. for men it's prostrate cancer. for women it's breast cancer. and these are hard facts. this chart shows you that the five-year survival rate in the united states for prostrate cancer is dramatically better

than canada. it is stunningly better than europe, and it is shockingly better than in england. so if you have prostrate cancer in america your chance of surviving in five years is dramatically better in the united states than in the system the democrats are telling us we ought to adopt. but that's not enough. because every woman in america goes to bed each night worrying about breast cancer, and i would suggest every husband in america goes to bed worrying about what breast cancer can do. here are the facts. if you look at five-year survival rates for breast cancer, once again, the united states, the system they want to throw out, you have a dramatically better -- significantly better chance of surviving than canada. even more dramatically better chance of surviving five years than if you live in europe. and even better than that of

surviving five years than if you lived in england. before we adopt a canadian, a european or a british system of health care, we better know that the survival rates for these cancers, the cancers that scare most americans more than any other are significantly worse in those countries than in the united states. mr. broun: will the gentleman yield? mr. akin: i promised i'd yield over to the gentleman from michigan, my good friend, mr. hoekstra, and i'll come over to you, doctor. mr. broun: ok. i'd like to speak to mr. shadegg's point there before he leaves if he could stick around for a second. mr. hoekstra: i thank the gentleman for yielding and i'd thank my colleagues for allowing me to be part of this discussion for a few minutes. it's interesting as my colleague from arizona is pointing out the differences between the u.s. system, the canadian system, and the british system. and i think one of the things that you see there in america

you have competition. so the hospitals are all working to improve their survival rates. if you get a certain type of disease or illness, you know, people will check the various performance rates by hospitals, by clinics as to where it's working. this bill now is 1,000 pages. it's over 1,000. we just went through a massive cap and trade and tax bill. but i just opened it up and one of the things that people say, don't worry. there will still be improvement and competition to get excellence. you know what job i want? start on page 40 -- or 84. i want to be the commissioner. the commissioner shall specify the benefits. the next page, the commissioner shall establish the following standards. you go to page 87. the commissioner shall establish a permissible range. if the state has entered into an arrangement satisfactory to

the commissioner. page 88, the commissioner shall -- the commissioner shall. i mean, it's like -- and this is in two minutes of looking at this bill and it's like, well, it looks like the commissioner knows what to do. and if the commissioner's going to do all of this, what's there left for me? it looks like the commissioner is going to take over my health care. mr. akin: are you sure it's not saying czar? mr. hoekstra: coming from michigan, we've had enough of czars. we've had enough of car czars running our automobile industry or making a decision which car company will survive, how they will survive, who will manage the companies, who will be on the board of directors, what dealers will survive. i mean -- mr. akin: reclaiming my time. we are talking about the president of the united states firing the president of general motors. we got ourselves in the insurance business, in the banking business,