the rise in cost in private insurance and that would be to remove the burden of medicare, medicaid, on them. mr. akin: nord, are you saying -- in other words, are you saying that the private medical insurance people that are writing medical insurance plans are subsidizing medicare and medicaid? mr. fleming: absolutely. if i can give you an example in my own practice, the typical medicare or medicaid reimbursement is under my cost. i have to see probably twice as many privately insured people to make it up. as the mix of medicare and medicaid grows, again that's single payer, government -- so-called public plan that exists today, as that percentage grows, their chance of growing out -- of going out of business grows as well. mr. akin: what's going on then

is in order to fix the part of health care the government's already meddling in, which is, in terms of medical payments overall, the government handles half the money that's going through health care if you take medicare and medicaid, that's about half of the total of all money spent. we already got the government meddling in half of it. now we're asking the privates to support all this public stuff, right? mr. fleming: yes. mr. akin: that's adding to the cost of everything. tennessee just about crashed their economy trying to do the same thing is that correct? mr. fleming texas spast correct. mr. akin: it isn't like all these proms -- promises that this is such a wonderful health insurance, the thing that strikes me, say somebody said to you, it sounds like -- what they're selling sounds good, the government will give you free health insurance, free health coverage, not just insurance but health care

access. if somebody said would you like the government to give you a free home? we'd be crazy to say no. of course i'd like to a free home. then they follow it up, would you want to live in government housing? that's a different question. isn't that the parallel. we're going to give you free medical insurance, except you have to wait longer and it's going to be more expensive. i like the idea of free medical insurance, but is that what we're getting? it didn't work in massachusetts or tennessee. we're joined by another doctor, a good friend of mine, it's interesting that doctors are coming out to talk about this plan. we've got dr. broun from georgia, another medical doctor, has a great reputation and is bold in just lay leying things out, telling it like it is, it's terrible english but it's a good freas. dr. broun, please join us.

mr. broun: i just walked in a moment ago. i wanted to bring out something that you may or may not have talked about, but the american people need to understand something. they've been promised that if they like the private health insurance that they have today, they can keep it. mr. akin: i heard a congresswoman from this chamber on television this morning walking past the tv set in the gym of all places, and she is saying if you like what you have, you can keep it. and yet we had copies of the bill that was proposed, the democrat plan on the floor and it didn't say that, did it? mr. broun: no, in fact, that's what i wanted to bring up, if you like what you have today, you're going to lose it. as dr. fleming, thank you, dr. fleming for giving me this chart. if you like what you have today, the american people will lose it. the reason that they're going to lose it -- mr. akin: today you've got

insurance, you've got a doctor you like if you like that, what the democrats said is, you can keep it. what the bill says is you're going to lose it. that's a radical difference. mr. broun: the reason that people are going to lose their private health insurance that they have today is because the bill requires the health care czar, they call it a commissioner in the bill, is going to set the health care plan for every single individual in this country. it's going -- mr. akin: you're saying there's a high-level government bureaucrat, they call him a czar or commissioner? mr. broun: they call him a commissioner in the plan. but this fits the pattern of the czars that the president has established. he's -- the funny thing is, this president set up more czars than russia did throughout its history. through 200 years. we have more czars in the last six months than russia has ever

had. but -- mr. akin: but this is not a czar, it's a commissioner. but -- maybe call him a come sar. -- a commisar. mr. broun: he fits the pattern of the health care czar. he is not confirm by the senate he has no one to answer to but the president of the united states. the congress has no control over what he does or what -- mr. akin: he's independent. he can do whatever he wants. mr. broun: exactly. mr. acain: what does this say? mr. broun: sounds like a dictatorship. mr. akin: does this contradict what i just heard a congresswoman saying? mr. broun: what it's going to do is the health care commissioner, i won't use the word czar, but that's what he's going to be, but this health care commissioner is going to set every single private plan in this country.

the employer is not going to have a choice about it. neither is the employee. if the employee doesn't want that plan, the set by this health care commissioner, established by the president, appointed by the president, then that individual is going to be fined through the tax code and they're going to be fined by having to pay higher taxes for just not accepting the mandated coverage that this health care commissioner than administration is going to put on them. mr. akin: so what you're saying is this bill literally says at the end of the five-year period, a group health plan must meet the minimum benefit requirement. in other words, what we're saying is that you could have a plan you might like now, you've got private health insurance, but if it doesn't meet the government plan, then at the end of five years at the longest, you can't have it youmple plan has to be exactly like the federal one.

or at least has to have all the things the federal one has. mr. broun: let me point out a specific here. particularly with this administration, which is the most pro-abortion administration we've ever seen. obviously what this plan is going to include, if barack obama has anything to say bt it, is taxpayer-funded abortions. and people are not going to have a choice. they're going to have to be buying a plan and help support a plan, even if they disagree with abortions, that will pay for abortions. and it may be, there's a very high potential that that plan to cover everybody within an employee of a particular business, it may be that a single male will have to pay for o.b. coverage. it may be that a person who is past -- a couple, for instance,

who work for a particular company who is past the childbearing ages will have to pay for o.b. coverages. because this health care commissioner is going to mandate to every sine business, every single private insurance company, whether it's individually purchased or purchased through the company, that they work for, this health care commissioner is going to mandate coverage to every single human being in america. mr. akin: i'd like to stop for a minute, just as i started out this evening, doctors, the whole secret of bringing somebody to the -- something to the floor, really fast, do it at 3:00 in the morning, get the 300-page amendment they haven't gotten the bill put together, quick, quick, vote on it before anybody puts it together, that's great strategy if you're trying to hide stuff in the bill. what i'd like to do is take a moment and just go around and start thinking about the people

that if they understood this bill which you're going to have to be pretty smart -- this is an organization chart of the bill. let's talk about the people who might want to vote against it, if they knew what were in here. the promise is, it's all free, you can keep what you have, except it's all free except, what? a couple trillion dollars or if you cheacht with the numbers, a trm dollars. you can keep what you have, except you can't keep what you have, and you're supposedly going to get good health insurance and good coverage. there's a difference between insurance and coverage. but i'd like to make a list -- i'd like to start categorizing who are the people that if they were us would be voting no and by golly, darn it all we don't want it, no, no, no. who is going to vote no on this thing? i think as we look at this, we'll see that there's a lot of hidden stuff here and there's a lot of people that have good reason to encourage every one of us to vote no on it.

let's start talking about some of the groups and you brought the first one up, dr. broun, that's the people who are, let's say, they're pro life. in america, you have constituents, i have constituents, we have some pro-life and some who believe in abortion, that people should have a right to abortion. those are deeply held views. but what is going to happen in this bill and in -- if this were not going to happen there could be an amendment to make sure it doesn't happen, the government plan is going to include that you can get free abortions. we did that for a while in america. we had subsidized abortions. if you're pro-life, and if you -- or if let's say you're pro-abortion but it's unfair to make people who have deep religious convictions that think killing the unborn is the wrong thing to do, are you going to make them pay taxes to fund something you think is fundamentally wrong? if you're pro-life you're not going to vote for this thing unless there's an amendment

that says, we want a guarantee that this doesn't give people a the right on government money to abort a kid. that's one group that's going to say no, i think. go ahead, dr. broun. mr. broun: the american people need to understand that, that this plan, though it's silent on abortions, amendments to the plan have been presented to make sure that the plan does not make taxpayers pay for abortions. mr. akin: amendments were offered where? in committees? mr. broun: it's been offered in committees. those amendments have been defeated. in other words, the democrat, and it's been pretty much party line. mr. akin: party line vote. democrats saying they don't want the amendment that says you can't get a free abrorgs. if you're pro-lifest that's one group of people if this weren't in the dark of night and wull were known about the bill, certainly the pro-lifers wouldn't vote for it. i'd like to go that to the doctor fleming.

do you have a ooth group? dr. fleming: physicians. mr. akin: two doctors here. mr. fleming: you heard the democrats talk about how the a.m.a. has come out in support of this that's true and not true. what happened was, last month the rank and file physicians across the country met with the a.m.a. and voted not to support it. mr. akin: the doctors voted no about supporting this you guys are both doctors and the other doctors said, no, this isn't a good idea. mr. fleming: exactly. then, again, one of those behind the scene, in the back rooms deal a deal was cut over the sustained growth rate, the s.g.r., that would be cast aside if a.m.a. would sign on to it so without consulting physicians, the board of trustees of the a.m.a. cut the deal with the president, in the wee hour os of night, and then sent them a let never support. thus far, 18 chapters, state

chapters of the a.m.a., and a growing number, have come out saying they do not support this and i would really -- i think i would say with confidence, the majority of physicians across this cubtry do not support government takeover. mr. akin: first of all if you're pro life i'm not going to like this bill. the doctors don't like the bill, even though the a.m.a. cut some deal their membership said we don't support this mr. fleming: exactly. mr. akin: dr. broun? mr. broun: there have been two other group this is a endorsed obamacare. the american college of surgeons and the american college of obstetrics and gynecology. the american college of obstetrics and gynecology, they have been promoting abortion. go back to your pro-life group. they wouldn't sign on to a plan if we didn't pay with taxpayer funds abortions.

that's one thing. secondly, back to the a.m.a., i don't think they represent but about 20% of doctors here in this country. mr. akin: the a.m.a. doesn't represent all doctors, just 20%. and that 20% wasn't in favor. mr. broun: the a.m.a. represents very few doctors in this country. i'm a member of the association of american physicians and surgeons. we have been ardently opposing a government takeover of health care for years and years and looking to the marketplace and has presented ideas about how to lower the cost of health care for everybody in this country to make it more affordable. but, the liberals in congress won't hear of that type of philosophy. so the a.m.a. endorsing this plan, actually, i think they've been shortsighted because as dr. fleming said, they cut a

backroom deal by just a little handful of the leadership in the a.m.a., they didn't consult any doctor here in congress i can find, neither did the other two group, didn't consult any of us who served here in congress and cut these backroom deals on the -- on the s.g.r., sustained growth rate, or what we call doc figs here. they're being shortsighted because the taxes for all those doctors is going to go up above what they have been promised to be given in not cutting their fees, so net income for the doctors is actually going to go down and the doctors ought to understand that the a.m.a. has sold them out. . mr. aiken: the doctors don't like this thing. we have two doctors here don't like it. i want to bring up another category when i wake up in the

morning some i'm feeling a little older and achier. i just hit 62. i want to talk about old geezers like me, seniors. if you were a senior citizen in america, what do you think about the government running health care? do you think you're going to like that idea very much? mr. fleming: if the gentleman would yield. i would say for two reasons they will not like this. first of all you heard me just say part of this plan is to cut medicare to a great extent. which the elderly depend on. medicare is already going bankrupt in less than 10 years and is heavily subsidized by private insurance. so what we are looking at is taking away this subsidy and -- mr. akin: if you are a senior you are not going to like gutting medicare. mr. fleming: if i could add one other problem is this comparative effectiveness committee that's being created -- mr. akin: there is a committee somewhere in this chart that's a comparative effectiveness committee. what's it going to do?

mr. phlegm -- mr. fleming: it's tasked with the job of who deserves what or what is really too expensive for whom and what sort of diseases. if you look at the other countries that do this already, the united kingdom, canada, and others the elderly are the first ones counted out under this program. mr. akin: let's say are you a smart bureaucrat and you got an awful lot of money being spent on health care in america and the budget is going bust and you're thinking, oh, my goodness. how aim going to fix this? you find that the old 80-20 rule is working just fine right here in health care. that is that 20% of the people have 80% of the cost. guess people who have 80% of the cost? geezers like me. we are going to need to regulate this system so we are going to deny care. so in other words what we are going to do is, we are going to say that the doctor and patient don't make the call, we are going to say some bureaucrat in

washington, d.c., decides whether you get treatment or not. that may seem pretty outlandish or harsh, the fact of the matter is that's what's going on in canada. this is personal to me because i got a bad hip and people keep saying akin how come you are limping? i fell on ice a year ago. the reason i'm limping is i'm postponing getting a hip replacement. in canada if you're my age at 62 you can't get a hip replacement. if you're later 50's in canada you can't get a him replacement. guess where you get it? in the good old u.s.a. if you are an old person there will be rationing of care and you are not going to get taken care of because the bureaucrats say you're too old. it's not a good financial investment. we'll give you painkillers. if you are an old person, first of all you're going to have medicare will get taken. the second thing is you got the problem of someone coming between you and your doctor, and that's the bureaucrat from d.c. if i'm an older person i would say if i'm a senior, i sure

don't want to touch this thing. i want to yield to my friend from georgia. mr. broun: thank you, mr. akin. i just want to talk a little more about something dr. fleming brought up is this comparative effectiveness research that was funded through the stimulus bill. got a ton of money to set up this commission or studdy -- study group to look at compirive effectiveness research. age is one of the parameters. what happens in canada today if you need coronary bypass surgery, you go on a waiting list and stay there until you die. if you're past a certain age. if you're diabetic and develop renal failure and need dialysis, i think the age is 55, i'm not certain of the age up there. great britain the same way, that's fine. we'll put you on the list. for renal transplant. or even for dialysis. you never get off the list. you just die there.

very quickly -- mr. akin: i yield to my good friend who is joining us at this time not a medical doctor, but known for his seniority on the intelligence committee. we have a guy who is intelligent, please. congressman hoekstra. mr. hoekstra: i thank my colleague for yielding. i hate to correct my colleagues, but that's not what happens to everybody in canada. being a border state we know another thing that happens in canada. that when a canadian goes to their doctor or their hospital or it is determined they need treatment, and that they are going to be down the list, instead of hoping to someday go to the hospital, in canada when you get sick, a lot of people go to the airport or go to the bridge or they go to the tunnel or they go to the border crossing. in michigan they go to the bridge or tunnel. they come from windsor and other places in canada because they

come to the united states for excellent health care. so they do have another option. it's called american health care. mr. broun: would the gentleman yield? you're not going against what i was saying. in canada happens that way. but they have a relief valve that's called the united states. and the excellent quality of care they can get here on demand. but in the canadian system, in the british system if they stayed there, they just die. they don't get the care that they need to save their lives. and so you and i agree, and you in michigan have seen that first and foremost in your communities where places like university of michigan in ann arbor -- mr. hoekstra: where? it is ann arbor? -- it is ann arbor. reclaiming my time. if we implement this kind of national health care plan my

colleague will have an advantage. mr. broun: how's that? mr. hoekstra: america's escape valve will become cuba. you are closer to cuba than we are. mr. akin: we have had a guy who is a top guy in intelligence and two doctors, i don't know what i'm doing in this conversation at all. i know one thing, i have had some experience with health care in the sense that i'm a cancer survivor. i was one of those guys in my early 50's i came to congress bulletproof and i had a very lousy insurance plan provided by the state of missouri and i hadn't had a physical for a long time. but i know i was bulletproof, i thought somebody told me, when you get to be over 50, you need to go get yourself a physical checkup. so i waltz down to the doctor's office right here in this capitol building run by the navy doctors, they said, yeah. todd, you are bulletproof and doing great except one detail. you have cancer. you have prostate cancer. i'm going, oh, my goodness. let me tell you that doctor, as

you know, that gets your attention when they use the big c word. let's take a look at what happens if you happen to be -- we have talked about people who are pro-life. they are going to hate this bill. we have talked about older people because their care is going to be rationed. they are going to hate this bill because medicare is going to be decimated and they lose their insurance. in spite of the promises the bill says everybody's insurance is going to be government insurance. let's talk about somebody who gets cancer. now, if you go over to the united kingdom, they've got this kind of socialized medicine. and let's take a look at the united states. the survival rate for cancer in men, that's got my attention, 62.9% in america. in the united kick come -- kingdom, 44.8. you have an 18% greater probability you are going to die in the u.k. because of their socialized medicine. if you are a woman it's a little better. cancer survivors in women in the u.s. 66.3%.

they are doing bert than the men. and in the u.k. a little better, still 14% greater chance are you going to die over there. so if arrest' cancer person, you don't want -- you're a cancer person u. don't want this plan. if you're pro-life, you don't want this. older person, you don't want this thing. mr. broun: i want to point out a chart that dr. fleming pulled up. this is about the one that mr. akin's looking at here is about all cancers. but if you look at prostate cancer, if you look at prostate cancer and breast cancer, it's absolutely phenomenal the difference in the rate. for instance, in the u.s. which is the purple bar here -- mr. akin: that's breast on that side. i can tell a breast from a prostate. mr. broun: i was looking at the word prostate. breast cancer actually with the

new technology we have of imaging and the diagnosis, to try to diagnose as early as well as some of the new drugs coming out on the market today that will all be denied actually under care because it's not cost-effective, but five year survival rate for women is way over 90% in the united states. but look in england it's hard to tell but it's much lower. mr. akin: can i see the chart maybe bert than you can, gentlemen, from where i'm standing. the purple is the united states, prostate cancer i'm seeing somewhere between 90 and 100% survival rate. and i'm seeing the sort of greenish, bluish color is england i'm seeing something about the 50% or 40% survival rate. you're saying this generalized

cancer statement, it's a lot different with prostate. it's almost two to one difference. in other words, in canada you got -- it's a flip of a coin whether you are going to live. whereas the united states it's a good chance you're going to live fine. i yield. mr. hoekstra: let's personalize this. those are the statistics. mr. akin: it's personal to me. it was my prostate. mr. hoekstra: i called one of my constituents today and we were talking about different issues. then he shared with me that his daughter was just diagnosed with cancer. mr. akin: breast cancer? mr. hoekstra: no. i think it was the prostate cancer. mr. broun: not his daughter. mr. hoekstra: i don't know. mr. akin: you have doctors here. mr. hoekstra: what he told me is they have taken her to mayo and the survival cancer is -- the

survival rate is pretty good. mr. broun: almost 100%, five years. what hoekstra: what he said is i'm thankful that in the united states i can take my daughter to a place like mayo. because mayo, they are always testing. they are always improving because that's the vision i think we as republicans have. this is not going to the lowest common denominator. we believe that america, we ought to have high quality health care for everybody. that's symbolized by mayo because they always do the research and they do these time studies over people. mr. akin: isn't america really known for innovation in health care? mr. hoekstra: people from all over the world go to mayo clinic, cleveland clinic, they come to the united states because of the excellence in health care. mr. akin: don't we have a lot of new drugs developed in america? mr. hoekstra: absolutely.

mr. akin: new procedures as well, doctors? mr. broun: prostate cancer, yeah. mr. hoekstra: what i found interesting, i chaired it with him, the next time you go to mayo, give one of the administrators a hug and write them a check for the work they do there. because the mayo clinic recognizes what this is going to do to them. they came out foursquare opposed to this plan. mr. akin: not just doctors now, but the mayo clinic is opposed to this scheme that we have seen concocted here? mr. hoekstra: i think what they recognize is the scheme up there will take a mayo and rather than allowing mayo to continue to lead the world along with these other institutions of the united states to provide quality, excellence, innovation, and research in treatments that are are then shared with doctors and hospitals around the country and around the world, i think what

they say is, well, that threatens us at mayo and we are not -- we are no longer going to be able to provide that. i think we need to make it real clear. what republicans are for and against. we are against that, that chart up there. we are for high quality health care. mr. akin: that's a very strong point. i was just starting out our discussion, gentlemen, this evening talking about why in the world would you bring up something at 3:00 in the morning, a bill hasn't even been read, and you want to push it through in a great big hurry? the reason is you don't want people to know what's in the bill because it's easier to pass it. we are starting to talk -- mr. hoekstra: i need to correct my earlier statement. colon. she has colon cancer. mr. broun: would the gentleman yield? i'd like to go back to what governor hoekstra, pete hoekstra, our friend has said from michigan. about mayo clinic and the innovative techniques they are

developing. they are being developed at the medical college of georgia, in augusta, georgia, i represent. they are being innovative techniques developed all over this country for all sorts of health problems. . but now, mr. akin work the cancer you have, prostate cancer, it's the most common cancer in men. with the new techniquese've done, the stereotactic surgery and some of the thing this is a go on today, we've developed techniques, surgical techniques to take care of prostate cancer that by and large will prevent men who have prostate cancer from having what in medicine we term incontinence, which means their urine leeks out -- leaks out and they don't have control of the urine, they have to wear, a catheter with a bag on their leg to catch the urine

because they can't control it. that is almost a thing of the past because of these new technique that was been developed. in the past -- mr. akin: it's practical for people. mr. broun: and in the past, people who had prostate cancer, have many of them, following that surgery were sexually impotent and could not perform sexually. with the new technique, we've developed these new surgeries that prevent the impotence, prevent the incontinence, but the types of research and the innovative efforts that doctors make in this country today are going to be totally -- mr. akin: those different technologies and developments, were those a product of the government coming up with those things? mr. broun: the government does fund some research through n.i.h. and other entities. mr. akin: but isn't it the private sector that comes up

with these? mr. broun: it's the private sector and doctors all over the country. but when we go to rationing care, what we're going to do is demand the lowest quality of care for everybody. mr. akin: it would be nice if the government gave you a free home, but you don't want to live in government housing. mr. broun: those techniques will not continue to be developed. mr. akin: let's talk about people against this bill. we've said people who are pro life are not going to like it. if you're an older person, you don't want medicare savaged financially. if you think it's important to have innovation and new technologies if you're a cancer person or someone else, you're going to want that new technology marching along to hopefully protect you there, so those are people that are not going to want this whole government takeover of health care. let's talk about people in this country, we all have constituents.

don't you have some of your constituent this is a don't like illegal imgragration? mr. broun: absolutely. mr. akin: isn't this going to give illegal immigrants health care? mr. fleming: approximately 10 million illegal immigrants are in the united states today. and they, of course, are here working, many of them, most of them, but there's nothing that the government derives to pay for the social services, education, health care for them. of course that's 10 million people that either should be here legally and then paying into the system and paying their way, or they should go back home because they're here illegally to begin with and that would not be a cost or burden. mr. akin: if you came to america before, and we had some coming in with drug traffic and they smuggled individuals into our country through illegal immigration if before we had trouble with people coming here

illegally, if we give them free health insurance and health coverage, that's going to make it more attractive for them to come. if yao don't like illegal immigration, you're not going to like this bill either are you? mr. fleming: exactly. mr. iakin: i'm trying to think of who will vote no. mr. broun. mr. brun: they're not immigrant, they're criminals. they not only come here illegally which means they're criminally, but virtual all of them have forged documents, they're guilty of many law infractions, but this health care plan, obamacare is going to give every single one of those aliens in this country free health insurance at the cost of taxpayers. what that means is, as we ration care to everybody in this country, that means

american citizens, american taxpayers, are going to have lescare provided to them because we're funding the illegal aliens. when we hear the number that 47 million people don't have health insurance, they say don't have health care, everybody has health care, they have access to health care in this country today. everybody has access. that 47 million people don't have health insurance. of that, there's at least 10, if dr. fleming is right, could be 15 million or 20 million illegal aliens in this country. so it's a huge part of the 45 million or 47 million that don't have insurance. mr. akin: part of the reason for doing this bill, supposedly, other than the uncontrollable desire for the government to run everything, but aside from that, there are 40 million people who don't have health insurance and this is supposed to help fix the problem. but 10 million of those 40 million are illegal and the way

the bill is set up, there's nothing that says the illegals don't get free health insurance. mr. broun: they will get it. mr. akin: if yao don't like that you'll pay for illegal immigrants' health insurance, you won't like this mr. broun: let me bring up another category of folks. employees. if you work for a company you shouldn't like this. the reason for that is that mandated coverage, directed by the health commissioner -- mr. akin: or was it the czar? mr. broun: the health commissioner that is going to mandate to the employees' employer what kind of care they're given, it's going to do two things, at least, to the employee and maybe even more. number one, the employee has to

accept the insurance provided by the employer. now of the 47 million people who are not insured today, some of those are eligible for insurance through their employer. but they just choose not to take it. but they're going to be mandated to take the insurance through their employer and if they don't, they're going to be fined through the tax system. it's a 2% tax or fine for them not taking the employer-mandated cat fwoir. mr. akin: if you're an employee in the country and not taking that particular insurance, you're going to be forced to do it. you're not going to like the bill because it's going to force you to do something you don't want to do. mr. broun: that's correct. and the other thing is, because the employer is going to be taxed or have to pay more for the plan, a lot of companies are saying already, it would be better for them to just pay the 8% tax on those employers than

it is to continue to give them the insurance, so it's going to force the employees off of their private health insurance that the employer's giving and force them on the so-called public option, the socialized medicine, the medicaid light or medicare light that already has huge problems, and a lot of them won't want to do that either. mr. akin: we know that people who have a private plan they like are going to lose that. if off private plan you like, certainly you don't like this. mr. broun: that's correct. mr. akin: if you're an employee and don't have a plan the employer offers because you don't like it, you're going to be forced into ta plan. how about the employer? mr. hoekstra: i've got another category that i think may not be on your list. i just had the opportunity to watch the president deliver his speech on health care and then answer some questions.

and i found it very interesting that the plan that the president was describing is not the plan that we find in the house of representatives today. and -- mr. broun: or the senate? mr. hoekstra: or the senate. then the president, in the questions or whatever, the president said, let me tell you about the new areas where we have agreement. again, this was agreement among the democrats, not the republicans. and i think you know the energy and commerce committee is going to go back to work tomorrow marking up the bill, this health care bill. but it looks like there are now massive changes that are being negotiated that are being feverishly written into law tonight and over this coming weekend because this house is on a mad dash because there's an artificial deadline, it has to be done by august 1. mr. akin: by august 1, we're going to take 20% of the u.s. economy and turn it over the some czar or commissioner or

commissar, or something, ands the flow chart of what's going to happen. mr. hoekstra that's the flow chart today. tomorrow there's a different one. so the other people that won't like this, because the flow chart is changing as we speak, the other people who won't -- mr. akin: it's already giving me a headache. mr. heekstra: the people who won't like this are saying, it's 16% to 20% of the economy, let's go through this in a professional way as we write this legislation, let's make sure that we deliberate it, let's make sure we understand these consequences that just magically appear today and give us some time to digest this because at the same time the president is saying this group likes it, this group supports it, all of a sudden it's a whole new plan. so by tomorrow afternoon, you -- there will be, i expect, a new plan on the floor of the energy and commerce committee that nobody in the committee will know what's in it except

for maybe one or two people system of people who believe that we shouldn't rush into messing around with their health care and with our doctors and our hospitals and that we ought to be very deliberate and that they would like us to know what's in a bill before we vote on it and they would like to know what's in a bill so they can call us and tell whause they like. mr. akin: are you telling us our constituents want us to read the bill before we vote on it? mr. hoekstra: i did a town hall tonight, there were two questions, where are the jobs. i live in a state with 15.2% unemployment. they see we've spent $800 billion, they're saying, pete, where are the job, where are the jobs, where are the jobs? because of the impact it's having on their family, their kids, those kinds of things. the second category was, don't mess with my health care or don't mess with my health care until i have an opportunity to

review it and see what it's going to do to my health care and, you know, don't vote on anything you haven't had the opportunity to read and review and to explain to us what it will do to us. mr. akin: going back to the whole premise if you do it really fast and nobody knows what's in it, you don't have as many people saying don't vote for this thing. because they don't know what's there. we've been joined by another fantastic congressman from louisiana, a man who has not spent that much time in the house, has distinguished himself already for being articulate and a penetrating questioner of some of these different schemes we see, my good friend congressman scalise from louisiana. mr. scalise: i want to thank my friend from akin from missouri for yielding and for hosting this hour to talk about health care. earlier tonight we heard president obama talking about the latest rendition of his story to the american people

about what this bill does and doesn't do. i think what you're seeing across the cubtry, though, is people have now started to see the details of the bill. i serve on the energy and commerce committee, where we've been debating this bill for a few weeks now. we finally got the text of the bill just a few days ago. in fact we had a hearing with the congressional budget office last week, the day after the chairman of the committee released to the public the debails of the bill. when we were talking to thed of the c.b.o. about what the cost is to the american people. the head of the c.b.o. acknowledge head didn't have the opportunity to read the bill, but as he started to go through it -- mr. akin: would the gentleman yield? mr. scalise: i'd be happy to. mr. hoekstra: do you think that's the bill you'll be voting on tomorrow? mr. scalise: what's not

necessarily changing are the details, but it's the rhetoric. they try to say something to appease the american people. when the american people look at the details of the bill they realize, this bill gives a government bureaucrat this new health care czar they're creating, we're not talking about a cabinet secretary post, somebody who is actually confirmed by the senate, but a federal bureaucrat, a health care czar, gives the health care czar the ability to take away your insurance if you like it system of the president will give a speech and say, if you like what you have, you can keep it. the problem is, his bill gives the bureaucrat the ability to take your health care away. if you -- their bill allow this is health care czar to ration health care on americans. so american people are looking at this and small business people, you know, i talk to small businesspeople all the time, just talked to one a little while ago who watched the president's speech who said, one of the things we're sick and tired of is all the new taxes they keep adding on to the backs of working people

and all the new mandates government keeps adding on to the backs of people that are taking away their right, taking away their health care and they see it in this bill and they can give all the speeches they want and all the assurance, be the problem is, in the bill, they take away those rights. mr. hoekstra: i think the gentleman hits it right on the nose. the alternative to that chart is freedom. is freedom by the american public to be involved in their health care and if we vote in this massive health care, what we are doing is giving up exactly what the gentleman described. we are giving up our freedom and we are turning it over to this town, to this building, and to that bureaucracy. . mr. akin: you said you were talking to your constituents. a powerful tool we have is have a computerer call our constituents where we sit and have a conversation for an hour or two.

what i heard about was the jobs. you know who is not going to like the program. people looking for jobs. let me connect the dots here. where do 80% of the new jobs in america come from? they come from small business. that is 500 or less employees. 500 or less employees. that's where we make 80% of our new jobs. who is going to pay for this mess? guess what? small business. you take their money away so they can't invest in new buildings, new spices -- supposes of machinery, guess what happens? they don't make the jobs. if you are unemployed, are you not going to like this very well. mr. broun: even if you're employed you won't like this bill because what's going to happen is millions of people will be put out of work. they are going to lose their job because of this obamacare plan. mr. akin: the reason for that is? mr. broun: because of the increased taxes and burden on their employer. mr. akin: you put more burden on the small business man, and

guess what happens? you start to lose jobs. mr. broun: it's going to lose millions of jobs. those that are working are going to have a lower take-home pay. mr. awkin: because of the cost. mr. broun: and the mandates on the individual as well as on the business. incomes literally are going to go down if you're employed and you keep your job, but there are millions of americans that are going to literally lose their jobs because of obamacare. mr. akin: this is interesting. our constituents have been telling us jobs are a problem. unemployment is a be problem. we have set some records. in the last six months we have lost more jobs than ever in any time period since the great depression in america. we have lost more jobs in the last six months than have ever been lost since the great depression. so this is a serious thing. i want to yield to my friend, dr. fleming. we haven't heard from you. mr. fleming: -- the speaker pro tempore: the

gentleman's time has expired. under the speaker's announced policy of january 6, 2009, the chair recognizes the gentleman from iowa, mr. king, for 60 minutes. mr. king: i thank the gentlelady, the speaker, for yielding to me. i anticipate we are going to have a seamless transition here this evening. it looks as though there wasn't anybody from the other side to appear down here to defend themselves or advocate for this policy. i'm wondering if some of the people haven't gone underground that have advocated for this national health care plan. but as the gentleman from missouri had said, we lost more jobs in the last six months since the great depression. i think there's something here to illustrate -- mr. hoekstra: if the gentleman would yield for a second. mr. king: i would make my point

and then yield. this is direct contradiction to what the gentleman from missouri has said. this is the white house chief of staff, rahm emanuel, who said, we rescued the economy. rahm emanuel said we rescued the economy. mr. akin: i hope they don't rescue it much more. mr. king: that's the gentleman i intended to yield to. if we rescued the economy, lost more jobs in six months than we have since the great depression. unemployment has 4 1/2, 4.7 million people unemployed. there are another 5.8 million people looking for a job that have exhausted their unemployment benefits that no longer qualify under the definition of unemployed which takes us up over 20 million people in america that are looking for work. according to a study that was done by one of the lead thinkers in this that went to 25 million effectively unemployed because many have had their hours cut down so they are no longer truly

a full-time employment. rescued the economy? i don't think so. let's hope they don't rescue health care. the gentleman from michigan. mr. hoekstra: just before you took over and joined us in this special order, my colleague was saying that the -- this doesn't do much for the unemployed. i think we have to recognize it does. for those people that are in the unfortunate circumstance today of being unemployed, one of the things that they are concerned about is that they don't have access to health care. that plan may provide it, but the other thing that i think has been pointed out, this plan will hurt the economy and hurt more jobs. what these people want is they want the opportunity to get back to work. i think under the republican proposals that we have out there, we have ways for people who are in that unfortunate situation of being unemployed, through a tax credit or whatever to be able to go out and to buy and to have the freedom to

choose a health care plan. i think that's now becoming a selling point of this new plan. if you're unemployed -- they are creating a loft them. we are going to be able to provide you health care. the republican plan will do the same thing because we do believe it's important that everybody have the -- the security of having access to health insurance. we just don't think you have to create this bureaucracy to do it. let's not forget about the people that are hurting who are unemployed but just because they are unemployed doesn't mean this system is what they need. there are better alternatives. mr. broun: would the gentleman yield? i'd like to tell you, my dear friend from michigan, that, mr. hoekstra, everybody in this country has access to health care. today. everybody whether they are employed or unemployed. the reason they have access to health care is because anybody can walk into any emergency room anywhere in this country and can get evaluation or treatment for

any problem that they have. i used to work full-time as a director of emergency services at georgia baptist hospital. anybody that walked in the door, any problem, was evaluated and treated. whether they had health insurance or not. that's true all over the country. so everybody in this country, whether they have health insurance, whether they are employed, whether they are unemployed, whether they are legal immigrants, whether they are illegal aliens, american citizens, whether they are taxpayers or nontaxpayers, everybody in this country today has access to the health care system. the thing that they don't have, the 45 million or 47 million is they don't have a health insurance card, policy in their pocket to pay for it. mr. hoekstra: we want to be able to provide them with that opportunity because we believe that is a more effective and more cost efficient way and a better way to get health care to americans.

so that is one proposal to do it. but republicans also have a proposal in ways to make that available that move away from this extraordinaryly expensive and job killing bureaucracy. mr. broun: you're exactly right. we have been as republicans by our democratic colleagues have been described as the party of no,-n-o. the real is we are the party of now, -- know, k-n-o with. even though the obamacare plan, the director of the c.b.o. said even in 10 years there is still going to be millions and millions of people uninsured even under the obama plan. so we do have -- we are the party of no to know how to solve these problems. to put people back to work, to give them lower cost for

insurance, all of it -- we have multiple plans on our side. mr. king: reclaiming my time. i'd like to pose a question here that's at the bottom of this. there are a loft different numbers out there. we know this is a moving tarring e we are trying to shoot at a moving target because we know once it's concluded it's going to come through here like a lightning bolt and it will be over. i'm seeing numbers that show this has high as a $2 trillion propose a can i see c.b.o. numbers that come to about $1.2 trillion. i can see tax increase that is are in the area of $00 billion to $900 billion and deficits about $239.1 billion. now, whatever these numbers are, we know that the calculations and predictions are different than what it's actually going to be. programs always cost more money than -- in reality than they do when they are estimated. here's the point. president obama has said we can't fix the economy unless we first fix health care. health care is broken.

well, if you have a company that's broken, you don't go out and borrow more money and lower your revenue stream and increase your deficit. if health care costs too much money, why do we have have to add $1 trillion or $2 trillion to it to fix the program? that's the rhetorical question i ask. hopefully we'll be able to get to that. i yield to the chairman of the appropriations committee who came down here to do business. >> i thank the gentleman for yielding. the speaker pro tempore: for what purpose does the gentleman from wisconsin rise? mr. obey: by direction of the committee on appropriations i present a privileged report for filing under the rule. the speaker pro tempore: the clerk will report the title. the clerk: report to accompany h.r. 3293, a bill making appropriations for the departments of labor, health and human services and education, and related agencies for the fiscal year ending september 30, 20, 10, and for other purposes. the speaker pro tempore: referred to e union calendar

and ordered printed. pursuant to clause 1 of rule 21, points of order are reserved. mr. obey: i thank the gentleman. the speaker pro tempore: the gentleman from iowa may continue. mr. king: i was glad to yield to the chairman of the appropriations committee. i see the gentleman from louisiana was leaning forward. i would be happy to yield to the gentleman from louisiana, mr. scalise. mr. scalise: i thank my friend for yielding. when we really talk about the numbers, there are lots of big numbers being thrown around. billions and billions of dollars. the c.b.o., congressional budget office, has already said that the promises of savings that president obama has promised lots of savings, as he's read the bill, he said the promises of savings don't exist. so you hear the president talking about, we are going to squeeze all these savings out. the problem is the bill doesn't yield any savings. what it yields is an increase in federal spending to the tune of hundreds of billions of dollars, over $800 billion in new taxes. but this is the bureaucracy that they create. think when you really start talking about why the american

people as they are looking at this plan are turning against this government takeover of health care, this is what really i think offends the american people. this is an organizational chart of president obama and speaker pelosi's proposal to have a government takeover of health care. and i think what frightens people the most, and there are a loft things about this bill that frighten people across america, the fact that you would have a government bureaucrat being able to ration care, i think what is the most offensive even above the tax increases and above the hundreds of billions of dollars in spending of money that we don't have is the fact that they are proposing in their bill, this is the doctor and this is the patient. look at all of the bureaucracy that their bill is placing in between you, the consumer, the patient and your doctor. we have two doctors here tonight joining us from georgia and louisiana. when you look at this

organizational chart of president obama and speaker pelosi's proposal to have a government takeover of health care, what offends people the most is the fact that they are placing all of these new federal bureaucracies, including a health care czar, in between you and your doctor and people know when you look at canada, when you look at england, people know what that led to and in fact just monday of this week, monday of this week a tragic story. a 22-year-old man, 22-year-old man in england died because england's government-run health care system, very similar to this proposal, denied the ability for that 22-year-old to get a liver transplant. his 44-year-old mother testified how horrible this system is that they have in england. a system that would allow a 22-year-old man to die because they denied him treatment. this is the exact same structure. all these federal bureaucrats

un-elected here in washington, d.c., coming in between you, the patient, and your doctor. this is offensive. this is why this is such a horrible idea. we need reforms. but we surely don't need this. i yield back. mr. akin: there are different categories of people who aren't going to like this bill, but there are some people who just hate government red tape. i happen to be genetically, i don't like government red tape. can you picture trying to get a health care decision and something is messed up and you got a wife or kid that needs health care and you got to deal with this? to try to get health care. and these people are going to tell you whether or not you can get it. the one thing in my telephone town hall meeting people say they want more than anything else, they want health care decisions made between the doctor and the patient. and we offered that amendment in committee and it was voted down on a party line vote. the democrats saying they want the red tape bureaucrats to make

health care decisions and they voted against an amendment that said that the doctor and the patient should make the health care decisions. . that's not where the mainstream of america is and that's not why you're practicing medicine is to have a bureaucrat tell you how to practice medicine. it gets me upset. mr. king: reclaiming my time and letting the gentleman relax a minute from missouri. i wanted to bring this up. when we see the flow charts that are today in color and when you look at the color flow charts, those that are in white are the old existing programs that are there. and those in color are the new programs that are laid on top of the existing bureaucracy. this flow chart, this is the hillary care flow chart from back in 1993. and this is the flow chart that is, i believe, a replica of what hung on the office of my construction office throughout that entire decade in probably past the change of the

millennium. and it hung there because it scared the living daylights out of me as an employer who was providing health insurance for my employees and of course my family as well and when i looked at this chart, i had an aversion to anybody that's ever been in business has an aversion to red tape. this was the red tape chart, this chart being put up back in 1993 was enough, i think, that added enough weight on that it sunk hillary care because the people in this country did not want to create all of this bureaucracy and give all of this control and authority over to the government. they wanted to maintain their own independence, their own freedom and in the end, it was a freedom argument that won out, that killed hillary care. now we have obama care. the difference is, it's in color, it probably takes not quite as much freedom as this one might have, but i would point out the gentleman's chart, let me see, i have a handy one right here and the part that concerns me the most are these two purple circles down here in the bottom.

the white square is the existing private health insurance. traditional health insurance. all of those insurance policies have those 1,300 or so insurance companies that are competing right now for the dollar for health insurance would have to flow flew and become qualified health insurance plans. they would only be qualified if right here the health insurance czar decided that he had written the regulations in such a way that the newly created public health benefits plan, the federal health insurance plan that's designed to compete against the private sector, so that they could stay in business. so they will set the regulations and establish the mandates a determine what these private health insurance policies offer and then when they rank those standards, then they'd be competing directly against the public and at some point public swallows up private. this is where it gobbles it up, right here. this is where you lose your freedom, this is where president obama cannot make the promise that if you like your health insurance plan you can keep it.

you don't get to keep it. you don't get to keep it because the people that make the, those that are employers that are providing health insurance are going to look at the premium that's here, the rules that are set by the government, and they will decide whether you keep it. will you not if you're a happenpy employee. i yield to the gentleman from georgia who has a statement to make. mr. broun: i'm glad you brought this up because the american people have been promised by this president over and over again, he's saying, if you like your insurance, you can keep it. but nothing could be further from the truth. it's not factual, it's just totally falsehood. if you like the policy that you have today you will not be able to keep it under obamacare. and the other thing that you're talking about there, let me just tell you what happens to me as a physician with medicare patients. mr. akin: before you go there, can i just add a point?

>> because there will be some people who will keep their health insurance who will that be? mr. broun: congress. >> it will be federal employees and congress. congressmen and senators will keep their health care because i believe in the senate there was a proposal, there was an amendment that was voted on and i hope that we have the opportunity to vote on this in the house, because in the senate there was a vote that said we're going to put all federal employees, including members of congress, into the public health plan. the plan that we will force millions -- what was the number, 73 million in the first five years or something? that we will force -- mr. broun: over 100 million, actually. mr. hoekstra: we're going to force them into the public health plan but when the vote came up and i'm not sure if they had one in energy and commerce on this amendment yet but i think it's coming, when that vote was held in the senate, the senate said, we're not going into the public health plan.

we're going to keep what we have. and so it's fascinating to say, we're ready to -- for the senate to say, we're ready to force 100 million people -- 100 million people in the public into the public health plan, but we ain't going there. that tells you what the senate thinks of what will be the public health plan. i thank my colleague for yielding. mr. broun: let me tell you where i was going to begin with. if i see a medicare patient and decide, say a patient comes in with with some chest pain and i decide that they need an x-ray of their chest or an m.r.i. of their chest, i have to call a federal bureaucrat to get permission for that patient to have those studies done. right now today. and in fact, even with a lot of the h.m.o.'s that are privately administered, if i prescribe an antihypertens, something to

control blood pressure, i have to call a pharmacy benefits manager to get permission and approval to prescribe a medication. which i'm totally against that. and i have -- we're writing in our office a health care reform plan that will put patients in a position where they make the decision, not a pharmacy benefits manager, not a federal bureaucrat. and this is one of the plan's that's going to be offered as a bill. but right now today that federal bureaucrat tells me as a doctor what kind of x-rays that i can do on my patients if they're on government plans. medicare and medicaid. and it's already a broken system. it's already being rationed, care is being rationed in the government-supplied insurance programs today. in medicare and medicaid. it's going to get a lot worse under obamacare.

a lot worse. we'll have more rationing of care, more denial of care, there will be longer waiting periods. i heard about a guy -- mr. akin: just a moment now. because you're making, i think, a point. the democrats were here about an hour and a half ago and they were saying, hey, we don't like the idea that an insurance company rations your care and the insurance companies gets between a doctor and a patient. as a republican, i don't like that idea either. but the solution isn't to put an even bigger bureaucrat in the way, the solution is to get back to the doctor-patient relationship which is why you practice medicine. mr. broun: that's exactly right. mr. hoekstra:ky give my colleagues a little history lesson? i'm not sure any of you were here in 2001? prosecute any of you? one. you know what this reminds me of? remember we passed a bill, and i'm thankful i voted against it, no child left behind. mr. akin: i voted no on that, too. mr. hoekstra: and why did we

vote no? because what it did is it put the -- put the department of education between a parent and their local school and their local administrators. and that thing passed with all of this promise because the promise was we're not going to leave a single child behind. well you and i felt passionately, that's absolutely, we don't want to leave a child behind, but the way to fix that isn't to put a government bureaucracy in charge of that kid's education and guess what? we are now eight years later and who now agrees with us? a lot of folks on the other side of the aisle and most of the folks on this side of the aisle who voted for that bill now recognize that no child left behind was a huge mistake because what it did is it took local control, parental control of your child's education, away from parents, away from local administrators and moved it here to washington and we're leaving more kids behind even though

we're spending more money than ever and if we think, you know, so a lesson from history, from those of us that that no child left behind wasn't going to work, this is a monstrosity that is ten times -- 10 times bigger and will have 10 times more impact than no child left behind will because no child left behind only impacted our kids. this will impact every single one of us and it is the same model of moving away from the concept of freedom, which my colleague talked about earlier, the concept of freedom, freedom to raise our kids, freedom to choose our health care, freedom to make our own health care decisions, moving them to federal bureaucracies and bureaucrats who don't know the names of our kids, who don't know the names of our drrs and who don't know the hospitals -- doctors and who don't know the hospitals that we want to go to. that's the problem with the approach we're seeing today. mr. king: reclaiming my time. as the gentleman raises the issue about who will be making the decisions on health care,

whether it will be the doctor or the patient or the bureaucrat, we have on record before the committee in the markup two days ago, an amendment that was offered by a respect -- by republicans, and i believe it was dr. gingrey from georgia, and i have the text of it here handy and this is this, nothing in this section shall be construed to allow any federal employee or political appointee to dictate how a medical provider practices medicine. that was a simple amendment that preserved the doctor-patient relationship. cut the bureaucrat out of it. mr. hoekstra: that passed, right? mr. king: it failed and it failed on a party line vote, save one. only one democrat would defend the doctor-patient relationship in the entire committee and it was shot down as a partisan vote and that would be a clear principle that you would think democrats and republicans could agree upon. mr. akin: and yet every republican standing here tonight, we all stand behind that doctor-patient relationship. that's the heart of freedom. that's what medical care should be about.

and yet we had that, that was a straight party line vote with the exception of only one democrat. mr. king: that's correct. mr. broun: will the gentleman yield? i'd like to tell you a story that i just recently heard about a patient that actually helped my friend from michigan's economy, mr. hoekstra, you might be very interested in this because it actually provided some funds into your state from what i understand. there was a patient in canada, had severe knee pain. such severe knee pain that he required narcotics. went to see his family doctor, the gate keeper to the health system up there. the doctor told him that he's just going to treat him with some physical therapy and give him nar cot. this went on for a year. over a year. before he could get in to see an orthopedic surgeon. took him over a year to get on the list to see an orthopedic surgeon for the evaluation of this severe knee pain. when he finally got to see the

orthopedic surgeon, after a year, of course here in this country if a family doctor wants to get a patient to the orthopedic surgeon, we can do it in a matter of days or certainly weeks if our orthopedist is busy. but took him over a year to see one that was mandated, the orthopedic surgeon was mandated by the government. that he to see this particular one. and it took him over a year to see him. the orthopedic surgeon finally did some x-rays on him and told the patient, yes, you've got such and such a condition in your knee and you need an operation. this patient said, fine. let's go to the hospital. i want to get rid of this pain. i want to get off the narcotics. the doctor -- the orthopedic surgeon says, no, no, we'll have to put you on the list. the waiting list. to get in the hospital for your surgery. the patient says, well how long is that going to take? we don't know is what he was told. so the patient left canada, came to the united states, i think to

michigan, to get his much-needed simple knee surgery. that was denied immediate care, may even may have made him a narcotic addict because he was put on narcotics that he had to take because of this severe pain and he had to deal with that too because the government delayed his evaluation and his treatment. and that's exactly what's going to happen to people here in america. thunderstorm plan that's being presented by the democrats. mrs. bachmann: if the gentleman would yield. mr. king: to the gentlelady from minnesota. mrs. bachmann: it's very interesting, i think the gentlemen that are here in the chamber tonight, i think probably everyone here considers themselves pro-life and you remember during all of the arguments and debates there's been on this issue of women making a decision about whether or not to have an abortion, one of the main arguments that was proffered is no government should get between a woman and her doctor.

government should not get between the woman and her doctor. when she comes to making that decision. and yet it's so curious, when you look at these 33 new bureaucracies that are created, when it comes to that decision about an abortion, you've got 33 new bureaucracies now that are created and i recognize those who are here probably are pro-life in this chamber but for those women who aren't pro-life, that's something they need to consider very seriously. that government is going to be between them and their doctor in a quhole new way, a big way, 33 bureaucracies' way. that's one thing women understand. women consume health care, they purchase most of the health care in this country, they take care of their elderly parents and women will be the ones that are stuck filling out the paperwork, making call after call after call. we all know what it's like if you call the department of motor vehicles and you have a problem or you call some other problem -- some other government department you have a problem.

you know what it goes through. we still have gentlemen who serve valiantly in world war i who still can't get medals. they're still trying to get through to get access. and now we're looking at women having the hassle factor of having to get through to a bureaucrat. one thing i wanted to mention, i just finish watching president obama on his press conference. he was talking to the nation about his health care reform and his health care proposal. i listened to every question that was asked by all the reporters. i found it very curious, president obama was adamant, he said his health plan, his government takeover, will not add to the deficit in the next 10 years. he made it as a guarantee, as a promise, he will not add to the deficit in the next 10 years. not one reporter that asked a question brought up the independent congressional budget office, the testimony by doug, where he stated unequivocally that we will see rising costs

and a rise in deficit if president obama's plan goes into effect. not one question by the reporters. not one question contradicted president obama's statement. the other thing that surprised me, president obama hasn't given to the public what every previous president before gives out and that's in midjuly there's a budget update about where the budget is at. well, guess what? president obama said he's going to delay putting that midbudget assessment out until midaugust when all of the members of congress are back home, presumably after we take this vote on health care. is this the most transparent presidency that we've had? that's the claim. this is transparent. mr. broun: no. mrs. bachmann: but he doesn't even want to us see the budget numbers, he doesn't want to be asked about the c.b.o. estimate and he said, where are we going to find the money and how is this not going to cost more by adding millions more? he said it's from waste. we're going to ring waste out of

the system. well, if that's so, why don't we have a chart equal to this one showing all the specifics of how they're going to take waste out of the system? let's go aheaded a start with that. let's start getting these hundreds of billions of dollars out of the system by ringing out waste. it's because he knows, he knows what's going to happen. doctors are going to turn into gs-15's, government employees. doctors are going to take drastic reductions in payments. nurses are will take drastic reductions in payments, hospitals will take drastic reductions in payments. what does that mean for the american people? drastic reductions in quality of care. . mr. king: president obama might have told the truth tonight when he said he wasn't going to increase the deficit with his national health care plan. we already know there are $800 billion or $900 billion in tax increases written into this and there are only about $239

billion by one set of measure, might be more. so all they really need to do is raise taxes another $239 billion and exceptp the estimates they have and a they might have already arrived and he simply uses his rhetorical trick of giving you a definition that, giving america a definition, that people hear what they want to hear and he speaks in a way that people hear what they want to hear again. i think that's the deal. i yield to the gentleman from louisiana. mr. scalise: there is one other thing the president will do with his government takeover of health care if he truly does want to make it revenue neutral, which it's not. right now this bill adds hundreds of billions of dollars to the deficit. and the number grows every day. the numbers in the $200 billion range right now. we know by the end of this week it's probably going to be higher. what the president will do is ration care. in this bill he's got this health care czar with the power.

it's in his bill. the power to ration care. so if he says, he's going to control costs to make sure that it doesn't cost anymore of, we know he added about $800 billion in taxes, so every american family, every small businessperson knows they are going to see massive tax increases. that's bad enough. that's going to lead to millions of jobs lost in this country. but even with all of that, his bill costs so much over $1 trillion that he still doesn't have enough money to make the two ends meet. if he truly lives up to his word, then the way he does that, is by the same way that canada, england, any other country that has a government-run system does t they ration care. mrs. bachmann: talk about what rationing is. mr. hoekstra: the other thing i used to be in the private sector and i used to be in the marketing world. we all know that these forecasts , these aren't actual numbers, they are predictions. one of the things we have learned from these predictions

is that what does government forecast conservatively? meaning if everything goes bad we are going to be $800 billion short. no, the government forecasts optimistically. i think it's safe to say if you take a look at the assumptions and predictions that the deficit or the amount that this program will add to the deficit over this period of time is probably at least double. mr. broun: tell me it's not so. mr. hoekstra: the other thing that it is based on, it is based on reimbursements to the states. to get people in. so states to buy off on medicaid reimbursements, what they do is they bump them up in the first three, four years of this program. and then they cut them dramatically. and we all know that those cuts will never take place in future years. so the deficit most likely of this proposal will be

significantly higher than the numbers we see today. i think that's been true -- mr. akin: i would like to talk a little bit about the president's ability to predict the future. in terms of his numbers. as i recall just three months ago we were taking a look at what was supposed to be called a stimulus bill, some of us called it a porkulus bill. it was about a tremendous amount of spending. i think it was $787 billion in spending. and the president gave us a number that we could take to the bank. he said, look, if you guys do not pass this stimulus bill, we might have unemployment as high as 8% in america. so we passed this tremendous spending bill and let's see what is our unemployment now? 9.5%. mr. broun: it's almost 14% in many of my counties in georgia. mr. hoekstra: i hate to take the

lead on that. we are at 15.2%. mr. akin: when the president says this bill isn't going to cost anything and the congressional budget office first comes out and says it's $2 trillion and then they whittle some numbers by some little fancy stuff and it comes down to $1 trillion, he says it's going to help the economy. not going to cost anything, that's a little like his promise that said listen to me now. he said, if you're making under $250,000 there won't be any tax on you. except we've got this little deal when you flip a light switch you're going to get taxed. mrs. bachmann: by president obama's own estimates t. will cost this health care plan will cost nearly five million jobs. his porkulus bill has cost us two million jobs. the takeover of g.m.-chrysler cost another 150,000 jobs. the energy bill you talked about is 2.5 million jobs every year. this alone is five million jobs. so it's already a huge cost in

terms of job loss out of the united states. mr. king: the original question again, when the president says that the economy is a disaster and we can't fix the economy unless we first fix the broken health care system in america, and the only way you can fix the broken health care system in america is to add to the spending by $1 trillion or $2 trillion depending how you want to evaluate the proposal and add to the taxes by $800 billion or more, and we end up with a huge deficit of $200 billion or $800 billion created in all that, if something is broken and you have to fix it, how can it be if we are spending too much money on health care today that we are going to spend more on health care tomorrow and add to the deficit and unemployment and fix a problem? we are talking about this proposal exacerbates the problem. that's the flaw in the president's logic. this is similar to things that came out a couple generations ago in another continent.

you repeat the same thing over and over again. after a while if people are afraid to challenge y that some begin to believe it's true. it can't be true. first the gentleman from georgia then back over to louisiana. mr. broun: i want to bring up -- we hear all these grandiose promises from the president. i want to remind my colleagues here on the house and the speaker, i can't speak to the american people, but if i could speak to them i would remind them, too, that the president just recently said that his nonstimulus bill is working just like he thought it wofment we have more people out of work today and the promises made have been broken. and i was coming to that very point. the chief of staff of the president, rahm emanuel, who used to be a member here in this house -- mr. king: could we direct the attention down here to the chief of staff to the white house. we rescued the economy, said today. rahm emanuel. mrs. bachmann: the president

said that tonight, too. mr. broun: the point being is the president and his administration give us all these grandiose promises. and they use all the sleight of hand shell game of words to try to tell people what they want to hear. but the reality is what they say is not factual. absolutely not factual. the american people need to understand that. mrs. bachmann: the president did say something perhaps we should listen to. he said tonight in his press conference that the united states spends about $6,000 more per person on health care. he wants to reduce that. so we need to listen to that now. he wants to reduce that by about $3,000 per person. how is he going to do that? let's take him at his word. if he's going to reduce health care expenses $3,000 per person, that goes back to how we define rationing. rationing means if your baby daughter was born with a heart condition would she get the pace maker? if your 85-year-old mother has a

problem with her hip, will she get a replacement? or if perhaps your daughter has kidney problems, will she get the help? that's the way you reduce the costs by something as dramatic as by half per person. let's face it. president obama's plan for americans is we are getting less health care not more. mr. king: somehow i can't imagine under president obama's health care proposal ladies waiting in line to get an abortion. i can't imagine they are going to do that. mr. akin: i try to picture you get a free c-section as long as you're willing to wait a year for it. that's going to be helpful. mr. king: the gentleman from louisiana, patiently waiting. mr. scalise: there are a loft statements that have been made by the administration, all of which contradict each other. the american people are catching on to the fact that they go and the administration has these focus groups and they say things people want to hear. vice president biden last week

said, we have to go spend money to keep from going bankrupt. any american that balances their budget, which is every american family, knows that's a ludicrous statement. it's the way they are governing and the way this bill approaches this. in fact, as we have been talking about how much will this bill cost? how much will this government takeover cost? in committee, energy and commerce earlier this week, they had amendments to the bill to actually add even more costs? what are those costs? what is that additional spending that the vice president talks about that they need to do to keep from going bankrupt? they added another $250 million, one amendment, a member offered of the committee on the democratic side, that would create a program that would allow the federal government through this government takeover of health care, to allow, to create a new program, to allow for individual organizations like planned parenthood, we asked if planned parenthood, groups like acorn, would be able

to access this program, they said yes. it would allow groups like planned parenthood to have access to $250 million in a new federal program, money we don't have, to teach teenage girls how to use condoms. allow teenage girls -- by the way without the permission of their parents. so imagine if you are looking at this budget deficit, spiraling out of control, spending in washington, spiraling out of control. the president bringing this government takeover in health care and saying we are not going to pass a bill that doesn't control costs. yet there was an amendment that they passed, not one republican voted for this amendment. those of us that are pro-life were highly offended by it. but the amendment passed. it's in the bill. it creates a separate $250 million taxpayer funded program to allow groups like planned parenthood to teach your daughter without your permission how to use condoms. it's in their bill to take over the government, to take over health care. that's what's going on with this

bill. the american people are seeing this. that's why they are trying to ram this bill through by the end of next week without the american people being able to read the bill. they know when people read this stuff they are going to revolt and they should because this is a horrible idea. i yield back. mr. akin: that's the whole point of doing these things at 3:00 in the morning, with 300-page amendments that there's not even a copy of the bill on the floor. why do you want to do it in the dark? how many americans are going to vote to spend $250 million to teach your daughters how condoms work? there are not too many american people want to vote for that. that's why you want to do it in the dark of night. and the other thing they don't want you to do is start to understand the difference. they want to say our health care system is so bad. hey, there's problems. take a look at it compared to this socialized mess over in england or canada take a look for people like me that's a cancer survivor. take a look at your survival rate with cancer for men, 18%

better in the united states. we want to trash our system to go to something that has worse numbers? it doesn't make sense. i yield back. mr. king: reclaiming my time. recognizing there are folks that are lined up to speak. the gentleman from louisiana mentioned acorn as one of the huge machines that drives the democrat turn out the vote effort that has produced over 400,000 fraudulent voter registration forms, that seems to be behind a loft things going on pushing the hard core left wing agenda. by the way they are registered as, i have it as a 503-c-3 not for profit, nonpartisan organization. this is a picture of their headquarters at 2609 canal street, new orleans. i get that right, dr. fleming? and there i stood across the street right before the fourth of july, put my little camera up there and here's a picture of the window at the headquarters of new orleans where there are at least 174 corporations affiliated with acorn, and here

are the obama posters inside the glass. this is your not-for-profit organization. here's the acorn logo hanging on the flag outside. . there's the get out and vote machine that's funded by your federal tax dollars. funding planned parenthood and acorn with your tax dollars, funding abortions with your tax dollars. mrs. bachmann: and it's good times for acorn. they received $53 million in direct federal grants since 1994. but now they've hit it big. the slot machine is paying off now. because now they have access to $8.5 billion, billion, $53 million was chump change for acorn. now they have potentially access to $8.5 billion. mr. king: i'd like to kick this over to louisiana. i gave the bait for new orleans here. i yield to the doctor from louisiana. mr. fleming: i just wanted to mention think a know gentlemen and lady know that the president spoke on this very subject

tonight while we were actually talking ourselves and i just got some input. some interesting things he said here. number one, he said, he acknowledges that the people of america are becoming skeptical because there haven't been any laws lately that have positively affected them. i think that's an understatement from our president. also, he makes the claim that there's no bureaucracy, there will be no gap between the patient and the doctor, the sacred dr.-patient relationship -- doctor-patient relationship. well, we've seen slide after slide of these, if the camera can show here, with what mr. akin has, that there are so many steps between the doctor and the patient. there's many now. but now it really goes crazy. when we get into this system. and then finally he was asked, you may recall that we submitted house resolution 651 -- 15 that say -- 615 that says if you vote

for government takeover of health care that you're willing to sign up for it and forego a waiver which is built into these bills that doesn't put knew this automatically that you can stay in your private health plans. and the president was asked this question tonight and he basically gave no answer to the question, he dwodged the question altogether which we know he's so skillful to do. so it's pretty obvious that, if this gets passed, that we're looking at a situation where the average american out there, the average working american, will be subject to all the bureaucracy of a government-run system, just like in england and canada and the only ones who will be exempt, as mr. hoekstra mentioned a moment ago, will be the ruling elite, congress, senate and the president and perhaps some wealthy, the rockefellers and the bill gates and families such as that. i just thought these were some interesting comments that were

going on while we were holding this session tonight. mr. king: i thank the informed gentleman from louisiana and yield to the gentleman from michigan. >> we've had some pretty good discussion about, people want to help. this is hard. but, you know, what's the real motive for moving this all under a government health care? and the gentlelady from minnesota helped point out, you know this moves $250 million into acorn, because what it does is, when you move all of this spending from the private sector to government we have control. that bureaucracy has control. the president has control. to direct policy and what many of us would think is personal policy, that is between me and my doctor, our family and our doctor and all of those kinds of things and what we're doing when we move that amount of money and remember we're moving basically

20% of the economy with one vote we're going to move it from the private sector where we each have some influence and we'd all like more control, that's what the republican proposals do, is give us more control in that equation. but instead of us having more control we're going to give it up or there are people in here who -- the american people i don't think know they're giving it up, but there are people in this house, in this senate and in this town who are willing to take it and want to take it because they want that kind of control over social policy, health care policy, economic policy in this country because they don't trust the american people to make those decisions for thems is -- themselves. they believe that the economy, they believe that everything begins in washington. and as republicans we know and we believe that it begins with the people at the grassroots. they are the ones that drive america, they're the ones that drive our communities, our

states and our country, not this town and not our state capitals and that's our fundamental difference. we're uncomfortable taking that responsibility or moving that responsibility to washington. we're only uncomfortable with it, we think it's wrong. mr. king: reclaiming my time -- mr. hoekstra: my democratic colleagues think it's right, it's appropriate and it's necessary. mr. king: the gentleman from michigan is absolutely correct and the people that generate these kind of flow charts, they are liberal elitist ewe taupianists. they believe they're smarter than your average person. this he don't believe the average person is capable of taking care of themselves, they believe they can device the perfect flow chart that will make everything work out perfectly and the only thing that gets in the way of all that is because there are some people in the world that try to give people their freedom. and they will always trade off american freedom for security. it's happened in western european. i took a trip down to cuba here a few years ago, a legal trip to cuba and this is what occurs to

my mind as i listen to mr. hoekstra speak, how in the world do we ever balance a budget if we swallow up the private sector by growing government to eat up the private secter? eight huge entities have been swalode up and nationalized by president obama. a large percentage of our g.d.p. is now run by the government, by the white house, some of it directly, some by rahm emanuel. if the federal government continues to take over huge sections of the economy like this 17% or whatever that number is, i know how you balance a budget, you do like they do in cuba, you just take a cut out of all commerce because castro has investment in all things. and that's where this nation is heading if we don't get a grip and get our freedom back. i yield to the gentleman. mr. akin: i'd like to jump in a little bit about this idea about our trust for different bureaucracy. let's take a look at the track record of how well -- you know, we're talking about a health care system that's going to have the good heart of the i.r.s. and the efficient is -- efficiency of the postal system. you know, let's take a look at some of these different

government agencies and how much do we really -- do we really want to trust them with our personal health care? let's think a little bit about the department of energy. the department of energy was chartered with a mission. the mission of the department of energy was that we are going to make sure that we're not dependent on foreign sources of energy. now, we've had a lot of employees and we're more dependence on -- dependent on foreign energy than we've ever been. let's talk about the department of education. there was a presidential commission studying the department of education. they came to the conclusion that if a foreign country had done to us what the department of education has done we'd consider it an act of war. but we have a lot of faith in government bureaucracies. let's talk about your favorite bureaucracy, i shouldn't pick on your pet, the c.i.a., we go into gulf war i and they give us this intelligence, they say, look, iraq is 10 years away from making a nuclear device. we get in there, they're a year and a half away. so we go to gulf war ii, they say they're a year and half

away, we get in there, they're 10 years away. why do we have so much faith in these government -- i guess fema did a wonderful job on hurricane katrina and yet we want to turn our personal health care to these government agencies. i don't get it. it doesn't seem to make any sense at all. mr. king: the best thing we have going for us is these government bureaucrats aren't always on the job. sometimes they're on the job, but they're not always paying attention to the job. this is the president's economic advisor, larry summers, who back about the turn of the administration, which seems eons ago, around january 20 of this year, made the statement that, what we needed to do to bring the economy back around was, everybody has to go out and spend, spend, spend and some of us, myself included, said, wait a minute, saving this economy is about increasing our production, you can't spend your way into pros tert -- prosperity. you have to go out and produce something that has value and market it and then you can earn your way into prosperity. well, just this week this gentleman woke up and said, we

need to plow now. the spending era is over. it's time to produce. i don't know if he went back to sleep or not but he was right the second time, not the first time. i yield to the gentlelady from minnesota. mrs. bachmann: the gentleman from iowa was talking recently just a few moments ago but how much the federal government is getting more and more control over our private economy. two weeks ago there's a front page story in "the washington times" written by an economist from arizona state university and he said this, i found it astounding, he said, since bailout nation began, since the inception just at the end of 2008, with the united states going in, owning banks, a.i.g., mortgage companies, chrysler and g.m. and the various things that have been nationalized, just since that time, we're talking a matter of months, today the federal government, the economist said, either owns or controls 30% of the american economy. 30%. so if you take that 30% and then do what president obama hopes to

accomplish, have the federal government take over 17% of the wealth in this country that is created by private health care, that's the federal government taking over nearly half of the american economy. either through owning it or through controlling it. how do we remain a free market capitalist country? this is the deconstruction of free market capitalism and the president's only been in office about six months and we're already looking potentially at half of our economy owned or controlled by the federal government. how do we ever get it back again? this is nothing more than an all-out war against private wealth creation and not only a war against private wealth creation but an all-out war and assault against retaining and owning the private wealth that we created. at that point we lose the incentives. at that point we lose the american dream.

why would we want to do that? why would we want to encourage the next generation of 19 year olds and 20-year-olds to go out and succeed, take risks and sacrifice, work hard in medical school. are we going to see the best and brightest go to medical school? we have the best and brightest here, dr. broun, we have numerous doctors here, the best and brightest. will we see that in this country? those are all questions we have to answer. mr. king: 20 years ago this coming november 9, the wall in berlin came crashing down. it was literally the iron curtain crashing down and when it crashed down, within a few short months, almost with bloodlessly, freedom echoed across eastern europe and all the way to the pacific ocean. we all knew what that was. that was free enterprise capitalism destroying a managed economy. the soviet union couldn't keep up. ronald reagan kept raising the stakes, antying up more and more and the question was, will the soviet union checkmate us militarily before we bankrupt them economically?

thaffers the equation and no one wondered in 1990, 1991, 1992 what was the dominant economy, what had proven was the most powerful civilization in the world based on free market economics and here we are just 20 years, not quite 20 years later, the stock market takes a dip and the people over here on the democrat side of the aisle begin the chant, that proves capitalism has failed. really? mr. hoekstra: we know that markets are imperfect and that markets are tough, but that markets correct themselves. and that they do that because people are provided with freedom to innovate and to be creative. i think, you know, one little last lesson from no child left behind. in 2001 when that passed it said we're going to measure this year's third graders versus last year's third graders in the same school.

and you kind of say, that makes no sense. but, you know in 2001 that was the measurement tool that they were going to use. it's now eight years later and for eight years, for the last five or six years, people said, that doesn't make any sense because this group of kids this year could be very different than the group of kids last year. so why measure the performance of those kids? we have the tools to measure the individual achievement of every child every year. and that's what we should be measuring. from the first day of school to the last day of school, how much learning took place. but because it's in a bureaucracy and to change that we have to pass a law. we have to pass a law through the house and the senate and the president has to sign it to change that. so our schools and our local communities are still being judged as to being what? they are a failing school, that's the label that the federal government puts on them, a failing school because we are using a failed measurement which everybody understands is a failed measurement but we can't

change it. in a market system, in a market dynamic, it would have changed a long time ago. mr. king: dr. broun. mr. broun: i'd like to come back to something that my friend, mr. hoekstra from michigan, was just saying about the government bureaucracy and i want to remind all of my colleagues that mr. hoekstra was talking about that putting the bureaucrats in charge of this gives us more power. but we won't have any control because the commissioner, the health czar, is going to be making these decisions and we won't as members of congress, as the dual elected representatives of each of our directs -- districts, won't have any say whatsoever on what that commissioner does. and coming back to what my friend was talking about, we've got a clear picture of what's going on here, about taking over the economy by this president. because he's doing exactly the same thing that his marxist

buddy, hugo chavez, is doing in venezuela. . we have a picture of where that leads. that leads to another one of our president's good buddies, fidel castro, has done to cuba. we headed down that same road. the american people can look at cuba at their health care system, economic system and see that that's exactly the direction that this administration is taking us. i yield back. mr. king: reclaiming my time. i thank the gentleman from georgia. i point out as i saw our president stand next to hugo chavez in that photo-op, that double handshake that took place down there, it occurred to me in the last month our president had nationalized far more businesses than hugo chavez had. he had only taken out one rice processing plant in the previous 30 days. president obama took over billions of our national economy in the same period of time. they are going to the same place. if anybody would like to know what the strategy is, they need to go to dsausa.org.

democratic socialists of america,.-- dot org. they'll tell you their arm is the progressive caucus here in the house of representatives, 75 members, they say on their website we want to nationalize the major corporations in america. it's happening under our very nose. the last minute i yield to the gentleman from missouri. mr. akin: i was thinking about that berlin wall example. we think about the soviet union and what was their basic theory. the theory is the government is going to basically give you food. the government's going to give you housing. the government will give you education. the government's going to give you health care. and let's see what are we doing in america? the government will give you an education. food, a place to live. the government's going to give you health care. we didn't seem to learn a whole lot. thank you very much, yes. mr. king: reclaiming my time just briefly conclude. i would like to thank all the members who have come here tonight and made this two-hour special order primarily on health care on this national

health care plan. this socialized medicine plan and our budget and our economy. you are leaders in this congress and all to be commended. madam speaker, i thank you. i yield back the balance of my time. the speaker pro tempore: is there a motion to adjourn in mr. king: madam speaker, i move the house do now adjourn. the speaker pro tempore: the question is on the motion to adjourn. so many as are in favor say aye. those opposed, no. the ayes have it. the motion is agreed to. accordingly,

>> coming up tonight, president obama's news conference on health care. then more on health care with mitch mcconnell and john boehner. then senator baucus and kent conrad. later, a house appropriations committee hearing on the fiscal year 2010 defense spending bill. now, president obama talks about health care legislation at his fifth official news conference after taking office. states.

>> good evening. please be seated. before i take your questions, i want to talk for a few minutes about the progress we are making on health insurance reform and where it fits into our a broader economic strategy for the six months ago i took office amid the worst recession in half a century. we were losing an average of 700,000 jobs per month and our financial system was on the verge of collapse. as a result of the actions we took in those first weeks, we have been able to pull our economy back from the brank. we took steps to stabilize our financial institutions and our housing market and we passed the recovery act that has already saved jobs and created new ones, delivered billions in tax relief to families and small businesses and extended unemployment insurance and health insurance to those who have been laid off. of course we still have a long way to go. the recovery act will continue

to create more jobs over the next two years just like it was designed to do. i realize this is no comfort to those americans who are currently out of court and i will be honest with you. the new hiring is always one of the last things to bounce back after a recession. the fact is even before this crisis hit, we had an economy that was creating a good deal of wealth for those folks of the very top of not a lot of good-paying jobs for the rest of america. it is an onomy that simply wasn't ready to compete in the 21st century and one where we have been slow to invest in clean energy technologies that have created new jobs and industries in other countries where we have watched our graduation lag behind and where we spent much more on health care than any other nation but aren't any healthier for it. that is why i have said even as we rescue this economy from a full-blown crisis, we must rebuild it stronger than before and health insurance reform is central to that effort. this is not just about the

47 million americans who don't have any health insurance at all. reform is about every american who has ever feared they may lose their coverage if they become too sick or lose their job or change their job. it is about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. it is about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of medicare and medicaid. let me be clear. if we do not control these costs, we will not be able to control our deficit. if we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket. if we don't act, 14,000 americans will continue to lose their health insurance every single day. these are the consequences of inaction. these are the stakes of the debate we are having right now. i realize that with all the charges and criticisms being

thrown around in washington, a lot of americans may be wondering what is in this for me? how does my family stand to benefit from health insurance reform? tonight i want to answer those questions because even though congress is still working through a few key issues we already have gruff agreement on the following areas. if you have health insurance, the reform we are proposing will provide more security and more stability and will keep government out of health care decisions, giving you the option to keep your insurance if you are happy with it. it will prevent insurance companies from dropping your coverage if you get too sick and it will give you the security of knowing that if you lose your job, if you move or change your job you will still be able to have coverage. it will limit the amount your insurance company can force you to pay for medical costs out of your own pocket and will cover preventive care like check-ups and mammograms that save lives and money. now, if you don't have health

insurance or you are a small business looking to cover your employees you will be able to choose a quality, affordable health plan through health insurance exchange, a marketplace that promotes choice and competition. finally, no insurance company will be allowed to deny you coverage because of a preexisting medical condition. i have also pledged reform will not add toward deficit over the next decade and i mean it. in the past eight years we saw the enactment of to tax cuts, primarily for the wealthiest americans and the medicare prescription program, none of which were paid for and that is partly why i inherited a $1.3 trillion deficit. that will not happen with health insurance reform. it will be paid for. already we have estimated two-thirds of the cost of reform can be paid for by reallocating money that is simply being wasted in federal health care programs. this includes over $100 billion on wanted subsidies that go to insurance companies part of

medicare, subsidies that do nothing to improve care for seniors and i am pleased that congress has already embraced these proposals. well there currently working to a proposal to finance the remaining costs i continue to insist that health reform not be paid for on the backs of middle-class families. in addition to making sure this plan doesn't add to the deficit in the short term, the bill einstein must also slow the growth of health care costs in the long run. our proposals will change the senate's of doctors and nurses are free to give patients the best care, just not the most expensive care. that is why the nation's largest organizations representing doctors and nurses have embraced our plan. we also want to create an independent group of doctors and experts who are empowered to eliminate waste and inefficiency in medicare on an annual basis, a proposal that could save even more money and ensure long-term financial health for medicare. overall, our proposals will

improve the quality of care for our seniors and save them thousands of dollars on prescription drugs, which is why the aarp has read-- endorsed our efforts. not all the measures i mentioned were contained in congress is drafting legislation that we are now seeing broad agreement thanks to the work that has been done over the last few days so even though we have a few issues to work out, what is remarkable at this point is not how far we have left to go, it is how far we have already come. i understand how easy it is for this town to become consumed in the name of politics, to turn every issue into running tally of who's up and who's down. i have heard the one republican strategist tell us party even though they may want to pollack-- to go for the kill. another republican senator that defeating health care reform is about breaking me. so let me be clear. this is about me. i have great health insurance and so does every member of congress. if this debate is about the letters i read when i sit in

oval office every day and the stories i hear at town hall meetings. this is about the woman in colorado who pays $700 a month to her insurance company only to find out that when pay a dime for cancer treatment it had used up her retirement funds to save her own life. it is about the middle-class college graduate from maryland his health insurance expired 20 change jobs and woke up from the emergency surgery that he required with $10,000 worth of debt. this is about every family, every business and every taxpayer who continues to shoulder the burden of a problem that washington has failed to solve for decades. this debate is not a game for these americans and can afford to wait any longer for reform. they are counting on us to get this done other looking to us for leadership and we can't let them down. we will pass reform that lowers cost, promotes choice and provides coverage every american can count on and we will do it this year. with that i will take your

questions. and, we are going to start off with the then feller with "associated press." >> thank you mr. president. congress as you alluded to is trying to figure out how to pay for all of this reform. have you told house and senate leaders which of their ideas are acceptable to you? if so are you willing to share that standard with the american people and if you haven't given that kind of direction to congressional leaders, are you willing to, are you willing to explain why do you are not stepping in to get a deal done since you are the ones setting the deadline? >> well, before we talk about how to pay for it, let's talk about what exactly needs to be done, and the reason i want to emphasize this is because there has been a lot of misinformation out there. right now premiums for families that have health insurance have doubled over the last ten years. they have gone up three times faster than wages so what we

know is that if the current trends continue, more and more families will lose health care, more and more families are going to be in a position where they keep their health care but it takes a bigger bite out of their budget. employers are going to put more cost on the employee or just stop providing health care altogether. we also know what health care inflation on the curve it is on we are guaranteed to see medicare and medicaid basically break the federal budget. and, we know we are spending on average, we hear in the united states are spending about $6,000 more than other advanced countries, where they are just as healthy, and i have said this before. if you found out that your neighbor had gotten the same car for $6,000 less, you would want to figure out how to get that deal. and that is what reform is all about, how can we make sure that we are getting the best bang for health care dollar?

2/3 of the reform which includes coverage for people that do not have it, making it more affordable for people that do, making sure that we are creating the kinds of systems where prevention and wellness and information technologies make the system more efficient. that the entire cost has to be paid for and it has to be deficit neutral. . . spent right now, so taxpayers are already putting this money into the kitty. the problem is they are not getting a deal for the money they are spending. that takes care of two-thirds of the cost. the remaining one-third is what the argument has been about of late. what i have said is that there may be a number of different ways to raise money. i put forward what i thought was the best proposal, which was to limit the deductions, the

itemized deductions for the wealthiest americans, people wealthiest americans, people like myself could take percentage deduction that middle-class families do, and that would raise sufficient funds for the final one-third. now, so far, we haven't seen any bills a top that. there are other ideas that are out there. i continue to think my idea is the best one, but i am not foreclosing some of these other ideas as the committees are working them through. the one commitment i have been clear about is, i don't want that final one-third of the cost of health care to be completely shouldered on the backs of middle-class families who are already struggling in a difficult economy, and so if i see a proposal that is primarily funded through taxing, middle-class families, i am going to be opposed to that because i think there are better ideas to do it.

now, i have not yet seen what the senate finance committee is producing productive than the number of ideas that we have not seen the final draft. the house suggested a surcharge on wealthy americans, and my understanding although i have not seen the final versions, there is talk about making that basically only apply to families whose joint income is $1 million. to me, that meets my principle that it has not been shouldered by families who are already having a tough time. what i want to do is to see what emerges from these committees, continuing to work to find more savings because i actually think it is possible for us to fund more of this process to identifying waste in the system, try to narrow as much as possible the revenue needed on the front end and then see how we can piece this thing together in a way that is acceptable to both democrats and i hope republicans. absolutely it is my job.

i am the president, and i think this has to get done. just a broader point, if somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next ten years, that is guaranteed to result in more americans losing their health care, and that is by far the biggest contributor to our federal deficit, i think most people would be opposed to it. that is the status quo. that is what we have right now, so if we don't change, we can expect a different result. that is why i think this is so important, not only for those families out there who are struggling and you need some protection from abuses of the insurance company or need some protection from skyrocketing

costs, but it is also important for our economy and by the way it is important for families wages and incomes. one of the things that does not yet talked about is the fact that when premiums are going up and the cost to empyers are going up, that is money that could be going into people's wages and incomes and over the last decade we basically saw middle-class families, their incomes and wages flatlined. part of the reason is because health care costs are gobbling that up and that is why i say, even if we don't reduce our health care costs by the $6,000 that we are paying more than any other country on earth, if we just reduced it by two or 3,000 that would mean money in people's pockets and that is possible to do, but we are going to have to make some changes. we have got to change how health care is delivered into the health care dissolute-- so that doctors are being paid for the quality of care and not the

quantity of care. we have got to make information technology more effective. we have got to have the medical system work in teams so that people don't go through five different tests. those are all critical to do and we can do them. i understand people are feeling uncertain about this. they feel anxious partly because we have become so cynical about what government can accomplish. people's attitudes are, you know, even though i don't like this, at least i know it and i would like to have more that i don't know so folks are skeptical. that is entirely legitimate because they have not seen a lot of laws coming out of washington lately that have helped them. but, my hope is, and i am confident that when people look at the cost of doing nothing, they are going to say we can make this happen. we have made big changes before that and up resulting in a

better life for the american people. david alexander of reuters. >> thank you mr. president. you have been pushing congress to pass health care reform by august. why the rush? are you worried that if you don't, there is a delay until the fall, the whole effort will collapse? >> a couple of points. number one, i am rushed because i get letters every day from families that are being clobbered by health care costs. and they ask me, can you help. i have got a middle-aged couple that will write me and they say our daughter just found out she is that leukemia, and if i don't do something soon, we just r.e. they are going to go bankrupt or we are not going to be able to provide their daughter with the care that she needs. and, in a country like ours, that is not right.

so that is part of my rush. the second thing is the fact that, if you don't set deadlines in this town, things don't happen. the default position is inertia, because doing something always creates some people who are unhappy. there is always going to be some interest out there that decides, you know what? the status quo is working for me a little bit better, and the fact that we have made so much progress, where we have got doctors, nurses, hospitals, even the pharmaceutical industry, aarp, saying that this makes sense to do, i think means that the stars are lined and we need to take advantage of that. now, i do think it is important to get this right. and, if at the end of the day i

do not yet see that we have it right, then i am not going to sign a bill that for example ed store deficit. i won't sign a bill that doesn't reduce health care inflation, so that families as well as government are saving money. i am not going to sign a bill that i don't think will work, and my measure of whether things work or not our listening to the american people but also listening to health care experts, who have shown that in some communities, health care is cheaper and delivers a better result. i think we can achieve it so i am confident that if we just keep at it, we keep working, we are diligent, we are on this, if we take criticisms that are out there, and modify whatever plans are already working through congress so that it meets those

concerns and those criticisms, that we can arrive at a bill that is going to improve the lives of the american people. i will give you one specific example. i think there was legitimate concern that we have not incorporated all of the measures that could reduce health care inflation over the long term. in some of the versions of health care reform that were coming out of committee. over the last week, working with not only health care experts but also members of congress who are concerned about this, we actually have now got a commitment to incorporate an idea that has a panel of doctors and health care experts advising on how we can get a better value for our money in medicare. and, every expert out there says this can be a valuable tool to start reducing inflation over the long term.

so, can i say this though? if we hadn't had any kind of deadline, that change probably wod have never surfaced until who knows when. and, so, i want to do this right, but the american people need some relief. chuck todd. >> thank you our. where just talking on that question about reducing health care inflation, reducing costs. can you explain how you are going to expand coverage? is it fair to say, is this bill going to cover all 47 million americans who are uninsured or is it going to take a mandate? is this something, your bill is probably not going to get it all the way there and if it is not going to get all the way there, how far is enough? 20 million mark, i can sign that, 10 million more i can't. >> now, the truth is that unless

you have what is called a single-payer system in which everybody is automatically covered, then you are probably not going to reach every single individual because there is always going to be somebody out there who thinks they are indestructible and doesn't want to get health care, doesn't bother getting health care and then unfortunately when they get hit by a bus and end up in the emergency room, the rest of us have to pay for it. that is not the overwhelming majority of americans. the overwhelming majority of americans want health care but millions of them can afford it, so the plan that has been, that i put forward and that we are seeing in congress would cover the estimates are at least 97 to 98% of americans. there might still be people left out there who, even though there is an individual mandate, even though they are required to purchase health insurance, might still not getting it, war

despite a lot of subsidies are still in such dire straits and that it is still hard for them to afford it and we may end up giving them some sort of hardship exemption. i am sorry, go ahead. so, i think that's the basic idea should be that in this country, if you want health care you should be able to get affordable health care, and given the ways that is already in the system right now, if we just to redesign certain elements of health care, then we can pay for it. we can pay for it in the short term but we can also pay for it in along term and in fact there is going to be a whole lot of savings that we obtain from that because for example, the average american family is paying thousands of dollars in hidden costs in their insurance premiums to pay for what is called uncompensated care. people the show up at the emergency room because they

don't have a primary care physician. if we can get those people insured, and instead of having a foot amputation because of advanced diabetes, they are getting a nutritionist who was working with them to make sure that they are keeping their diet where it needs to be. that is going to save us all money in the long term. >> you mentioned to republicans in your opening statement, but you have 60 democratic seats, healthy majority in the house for goeth you don't get this, isn't this a fight inside the democratic party and republicans really aren't playing? you can't blame the republicans for this one. >> first of all, you have not seen me out there blaming the republicans. i have been a little frustrated by some of the misinformation that has been coming out of the republicans, but that has to do with as you pointed out,

politics. if you have got somebody out there saying, not let's get the best bill possible but instead says, let's try to beat this so we can gain political of advantage, well, that is not i think what the american people expect. i am very appreciative that people like chuck grassley on the finance committee in the senate, people like mike enzi, people like alexius know have been serious and engaging democrats in trying to figure out how do we action get a system that works, and even in those committees were you did not see republican votes we have seen republican ideas so for example in the health committee in the senate, 160 republican amendments were adopted into the bill because they have got good ideas to contribute so the politics may dictate that they don't vote for health care reform because they think you know, it will make obama more

vulnerable. but, they have got a good idea we will still take it and in terms of democrats, the fact of the matter is that, because this is a big issue i think that a lot of democrats have a lot of different ideas. some of them have to do with regional disparities. for example you have got some democrats who are concerned that the medicare reimbursement rates and their communities are too low, so they would like to see the bill incorporates higher rates for doctors and providers in rural communities to incentivize good care and those communities. that is a legitimate concern but the minute you bring up that concern, that adds money which means we then have to find additional dollars. so, this is part of the normal give-and-take of the legislative process. i am confident in the end we will have a bill that democrats and some republicans support.

jake. >> thank you mr. president. you said earlier that you want to tell the american people what is in it for them, how will their families benefit from health care reform but experts say in addition to the benefits you were pushing, there is going to have to be some sacrifice in order for there to be true cost-cutting measures such as americans giving up tasks, referrals, choice and end of life care. when you describe health care reform you don't understandably, you don't talk about the sacrifices americans have to make. do you accept the premise that, other than some tax increases on the wealthiest americans, the american people are going to have to give anything up in order for this to happen? >> they are going to have to give up paying for things that don't make them healthier. and, speaking as an american i think that is the kind of change you want.

look, if right now hospitals and doctors aren't coordinating and of to have you just take one test when you come in because of an illness, but instead have you take one test, then you go to another specialist and take a another test, then you take a third test and nobody is bothering to send the first test, the same test, to the next doctors. you are wasting money. you may not see it because if you have health insurance right now, it is just being sent to the insurance company but that is raising your premiums, that is raising everybody's premiums. that money one way or another is coming out of your pocket, although we are also subsidizing some of that because there are tax breaks for health care. so, not only is it costing you money in terms of higher premiums, it is also costing you as a taxpayer. i want to change that. every american should want to change that.

why would we want to pay for things that don't work that are not making us healthier? and come here is what i am confident about. if doctors and patients have the best information about what works and what doesn't, then they are going to want to pay for what works. if there is a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that is going to make you well? the system right now doesn't incentivize that. those are the changes that are going to be needed, that we are going to need to make inside the system. it will require i think patients to, as well as doctors, as well as hospitals, to be more discriminating consumers. but i think that is a good

thing, because ultimately we can't afford this. we just can't afford what we are doing right now. and, just to raise a broader issue, that i think has how we look at health care reform, let me just talk about deficit and debt, because part of what has been happening in this debate is the american people are understandably queasy about the huge deficits and debt we are facing right now. and, the feeling is, alright, we have the bank bailout. we have the recovery package. we have the supplemental. we have got the budget. we ours the numbers, trillionth here in trillionth there's a legitimately people are saying look, we are in recession. i am having to give up things and yet all they see as

government spending more and more money. that argument i think it's been used effectively by people who don't want to change health care, to suggest that somehow this is one more government programs so i just want to address that point very quickly. first of all, let's understand that when i came in, we had a $1.3 trillion deficit, annual deficit, that we had already inherited. we had to immediately move forward with a stimulus package because the american economy had lost trillions of dollars of wealth. consumers have lost their their 401(k)'s, through their home values, you name it, they have lost trillions of dlars. that all just went away. that was the day i was sworn in, it was already happening.

we had 700,000 dolleck-- 700,000 jobs being lost. we felt it was important put together a recovery package that would help stabilize the economy. then we passed the budget by law, and our budget at a ten year projection, and i just want everybody to be clear about this, if we had done nothing, if you have the same old budget as opposed to the changes we made in our budget he would have been $9.3 trillion deficit over the next ten years. because of the changes we have made, it is going to be 7.1 trillion. that is not good, but it is $2.2 trillion less than it would have then if we have the same policies in place when we came in. so, the reason i point this out is to say that the debt and the

deficit our deep concern of mine. i am very worried about federal spending. and, the steps that we have taken so far have reduce federal spending over the next ten years by $2.2 trillion. it is not enough, but in order for us to do more, we are not only going to have to eliminate waste in the system and by the way we have a big victory yesterday by eliminating a weapons program, the f-22 that the pentagon had repeatedly said we didn't need so we are going to have to eliminate waste there. we are going to have to eliminate no-bid contracts. we are going to have to do all kinds of reforms in our budget but we are also going to have to change health care. otherwise we can't close that $7.1 trillion gap in the way the american people want it to change. so, to everybody who is out there who has been ginned up about this idea that the obama administration wants to spend and spend and spend the fact of

the matter is that we inherited an enormous deficit, enormous long-term debt projections. we have not reduced it as much as we need to end as i would like to, but health care reform is not going to add to that deficit. it is designed to lower it. that is part of the reason why it is so important to do and to do now. chipper read. >> thank you mr. president. on medicare, they are obviously millions of americans who depend on medicare, and when you talk about ending the long term cost them or when you talk about cuts in the current proposal on capitol hill, you talk about cuts in medicare or they talk about cuts in medicare but there never many specifics. specifically what kind of thing, what kind of sacrifice are you calling on beneficiaries to make and even if not right away our future beneficiaries going to be

getting less generous benefits than today? and what you think about taking it out of the political realm and giving it to an outside body of experts to take it out of health care? >> that is what our proposal is. it is called the medpac program. by the way it was originally a republican idea. i want to give credit where credit is due. the republican congress passed a bill that created a panel of health care experts to make recommendations to congress on how we could get better quality, lower costs. the problem is every year it would just go on the shelf and nobody would act on it, so what we have said is, let's give that body some power. let's require congress to vote on the proposals they are making every year. congress can still reject it, so does not completely removing it from politics, but they have to

reject or accept it as a package and that i think what incentivize and empower important changes, but here's the thing i want to emphasize. it is not going to reduce medicare benefits. what is going to do is to change of those benefits are delivered, so that they are more efficient. let me give you a theories that the example. you have heard that there is a consequence of our efforts of reform, the pharmaceutical industry has already said they are willing to put $80 billion on the table. why is that? the reason is, is because there is probably more waste than $80 billion in terms of how the drug plan and medicare is administered. we might be able to get $100 billion of debt or more, but the pharmaceutical industry voluntarily said here the $80 billion. do you know what that means? that mean senior citizens who right now have a so-called donut

hole in their plan, where after spending a certain amount on prescription drugs, suddenly they drop off the cliff and they have got to pocket the entire cost. so they half of that is filled. that is a hard commitment that we already have, so that is the change in how we are delivering medicare, but do you know what? it turns out it means out-of-pocket savings for seniors. that is why aarp has endorsed us. christie parson. >> you promised health care negotiations would take place on c-span and that has not happened. nord ministries and recently turned down a request from a watchdog group seeking a list of health care executives who visited the white us to talk about health care reform. also, the t.a.r.p. inspector general recently said your white house of withhold and to much information on the bank bailout so my question for you is are

you fulfilling a promise of transparency and the white house? >> on the list of health care executives who visited us, most of the time you guys have been in there taking pictures though it has not been a secret and my understanding is we sent a letter out providing a full list of all the executives, but frankly these have mostly been at least photos phrase for you could see who was participating. with respect to while the negotiations not being on c-span, you will recall in this very room that our kickoff event was here on c-span, and at a certain point, you know you start getting into all kinds of different meetings, the senate finance is having a meeting, the house is having a meeting. if they want this to be on c-span, then i would welcome it. i don't think there are a lot of secrets going on in there. and, the last question with respect to t.a.r.p..

let me take a look at what exactly they say we have not provided. i think that we have provided much greater transparency then existed prior to our administration coming in. it is a big program. i don't know exactly what has been requested. i will find out and i will have answered for you. >> thank you mr. president. you have said the recent bank profits indicate there has been no sense of remorse on wall street for risky behavior and we haven't seen a change in culture there. do you think that your administration needs to be taking a harder line with wall street and also, would you consider going a step further than your regulatory reform proposals and supporting a fee on risky activities that go beyond traditional lending?

>> we were on the verge of a complete financial meltdown. and, the reason was because wall street took extraordinary risks with other people's money. they were peddling loans that they knew could never be paid back. they were flipping those loans and leveraging those loans and higher and higher mountains of debt were being built on loans that were fundamentally unsound. and, all of us now are paying the price. now, i believe it was the right thing to do. as unpopular as it is, it was the right thing for us to do to step in to make sure that the financial system did not collapse, because things would be even worse today that the steps not been taken. it originated under the bush administration. we continue it, because, with

your on the left of the right if you talk to economists, they said that this could have the kinds of consequences that would drop this into a deep depression and not simply a very severe recession. now, one of these success stories of the past six months is that we really have seen a stabilization in the financial system. it is not where it needs to be, but people are no longer talking about the financial system falling off a cliff. we have stepped away from the brink and that is important because what it means is there are a lot of companies right now that can go into the marketplace and borrow money to fund inventory from payroll and that will help the economy grow as a whole. the problem is, now that the financial system has bounced back, what you are saying is banks are starting to make profits again. some of them have paid back the

t.a.r.p. money that they received, the bank bailout money that they have received and we expect more of them to pay this back. that is a good thing and we also think it is a good thing that their profitable because of their profitable that means they have reserves in place and they can lend. this is america, so if you are profitable in the free market system, then you benefit. but, what we haven't seen i think it's the kind of change in behavior and practices on wall street that would ensure that we don't find ourselves in the fix again where we have got to bailout these folks and while they are taking huge risks, and taking huge bonuses. so, what do i think we need to do? we have got to pass the financial regulatory reform, and you know this is an example of where folks say, should the obama administration be taking

on too much? the fact of the matter is that if we don't pass financial regulatory reform, then banks are going to go back to the same things that they were doing before. in some ways it could be worse because now they know that the federal government may think they are too big to fail, so if they are unconstrained they can take even more risks. so, there are a number of elements of financial regulatory reform. with respect to compensation i would like to think that people would feel a little remorse and feel embarrassed and would not get multimillion-dollar bonuses, but if shane does not work, then i think one proposal that i put forward is to make sure at least shareholders of these companies know what their executives are being compensated, and that may force some reductions. for banks that are still receiving taxpayer assistance,

we have a set of rules that give sessom control on reducing the unwarranted compensation and in terms of the last point you made, which is the possibility of these four transactions that we want to discourage, that one of the ideas that is going to be working its way through the process. i think it minimum, what we want to do is to make sure that, to the extent the federal government is going to have to be a backstop, just like the federal deposit insurance corp., everybody is familiar with the fdic, when you put your deposit in your bank you have confidence that they are insured, that is paid for by bank fees. we need to make sure that there's a similar mechanism in place for some of these other far out transactions, so if you guys want to do them, then you have got to put something into the kitty to make sure that if

you screw up is not taxpayer dollars that have to pay for it, but dollars coming out of your pockets. steve kaufman of the cleveland plain view. >> thank you. to follow up on jake's question earlier star. so many americans are concerned that this plan particularly the public option which lead to reduced benefits are reduced coverage, to questions. one, can you guarantee this legislation wheel lock again, so the government will never deny any services that will be decided by the doctor and patient, the government will then not deny coverage and secondarily can you as the symbolic gestures say that you and the congress will abide by the same benefits and the public option? >> well, number one, not only the public option but the insurance regulation that we want to put into place will largely matched up with what members of congress are getting through the federal employee

plan. that is a good example of what we are trying to build for the american people. the same thing that congress enjoys, which is they go, there is a marketplace of different plans that they can access, depending on what is best for their families. one of the plan that we have talked about is a public option in part of the reason we want to have a public option is to help keep the insurance companies on the speak with the insurance companies are providing good care and as it is they are going to be more regulated so they can't deny you care because of a preexisting condition or because you change jobs or they decided you were too sick and not a good risk. with regulation, there is already going to be improvement in the insurance industry. but, having a public plan out there that also shows that maybe if you take some of the profit motive out, maybe if you are reducing some of the administrative cost that you can get an even better deal, that is going to incentivize the private

sector to do even better and that is a good thing. that is a good thing. you know, there have been reports in just over the last couple of days of insurance companies making record profits right now, at a time when everyone is getting hammered. they are making record profits and premiums are going up. what is the constraint on them? how can you ensure that those costs aren't being passed on to employers or passed on to employees? the american people, ordinary middle-class families and the way that overtime is going to make them broke? part of the ways to make sure there is some competition now there's so that is the idea. now come to get your original question, can i guarantee that they are going to be no changes in the health care delivery system? no. the whole point of this is to try to encourage changes that

work for the american people and make them healthier. the government already is making some of these decisions. more importantly, insurance companies right now are making those decisions in part of what we want to do is make sure those decisions are being made by doctors and medical experts based on evidence, based on what works because that is not how it is working right now. that is not have this working now. right now doctors a lot of times are forced to make decisions based on the fee payment schedule that is out there, so if they are looking and you come in and you have got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, i make a lot more money if i take this kids tonsils out. that may be the right thing to do. but, i would rather have that

doctor making those decisions just based on whether you really need your kids tonsils out whether it might make more sense just to change, maybe they have allergies, and maybe they have something else that would make a difference. partum webley want to do is to free doctors, patients, hospitals to make decisions based on what is best for patient care and that is the whole idea behind mayo. that is the whole idea behind the cleveland clinic. i am going to be visiting your hometown's mall to go to the cleveland clinic, to show why their system works so well in part of the reason it works well is because they have set up a system where patient care is the number one concern, not bureaucracy, what forms have to be filled up, what do we get reimbursed for. those are changes i think the american people want to see. [inaudible]

>> you know, i would be happy to abide by the same benefit package. i will be honest with you. i am the president of the united states so i have a doctor following me every minute, which is why i say this is not about me. i have got the best health care in the world. i am trying to make sure that everybody has good health care and they don't right now. lynn sweet. [laughter] i said steve, but he just stood up. that is not fair. shame on you. gideon there real quick. >> i appreciate that. you cited the mayo clinic in the cleveland clinic's as models for the delivery of health care. the mayo clinic though has problems with house proposals, saying they don't focus enough on patients and results. what to expect to achieve

tomorrow by going to the cleveland clinic and r.e. expecting some form of the endorsement from the cleveland clinic? >> i am not expecting an endorsement. the cleveland clinic is simply a role model for some of the kinds of changes that we want to see. i think it is important to note that the mayo clinic was initially critical and concerned about whether there were and of changes in the delivery system and cost-saving measures in the original house bill. after they found out we had put forward very specific mechanisms for this medpac idea, this idea of experts getting the politics out of health care in making decisions based on the best evidence out there, they wrote in their blog the very next day that we actually think this would make a difference. alright, i try to make that short savitt lynn sweet would last question in. >> thank you mr. president a we usually professor henry jr. was

arrested at his home in cambridge. what this that incident say to you and what does it say about race relations in america? >> i should say at the outset that skip gates is a friend, so i may be little biased here. i don't know all the facts. what has been reported though is that the guy forgot his keys. he jimmy his way to get into the house. there was a report called then to the police station that there might be a burglary taking place. so far, so good. if i was trying to-- i did guess this is my house now. [laughter] let's say my old house in chicago. here i would get shot. [laughter] but, so far so good. they are reporting, the police are doing what they should and

there's a call in date investigate what happens. my understanding is, at that point, professor gates is already in his house. the police officer comes then. i am sure there is some exchange of words, but my understanding is that professor gates then shows his id to showbiz is his house. let that point he gets arrested for disorderly conduct, the charges which are later dropped. now, i don't know, not having been there and not seeing all the facts, what role phrase played in that, but i think it's fair to say no. one any of us would be pretty angry. number two, that the cambridge police acted stupidly in arresting somebody when there was already proved that they were in their own home. and number three, what i think we know separate and apart from

this incident is that there is a long history in this country of african-americans and latinos being stopped by law enforcement disproportionately. that is just the fact. as you know liane, when i was in the state legislature in illinois we worked on the racial profiling bill because there was indisputable evidence that blacks and hispanics were being stopped disproportionately, and that is a sign, an example of how you know, the race remains a factor in this society. that does not lessen the incredible progress that has been made. i am standing here as testimony to the progress that has been made and yet, the fact of the matter is that this still haunts us, and even when they are honest misunderstandings, the facts that blacks and hispanics are picked up more frequently

and often time for no cause, casts suspicion even when there is good cause and that is why i think the more we are working with local law enforcement to improve policing techniques so that we are eliminating pote [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> brunn >> coming up thursday, a recap of the present's news conference. then congressman eric kanter, the deputy minority leader, gives reaction to preston's remarks. we would hear of the government spending of tarp funds from

kevin, the debt the special ig. later, in the covers to the eyes of two freshmen members. "washington journal" take your calls and e-mails live starting at 7:00 p.m. eastern here on c- span. >> on america and the courts, reporters discuss the last term in the cases the felt me the greatest impact. it see it saturday at 7:00 p.m. eastern here on c-span. >> join the conversation on civil rights and race relations with npr and fox news analyst, juan williams, live in two weeks. >> republican leaders in the house and senate spoke out against the health care bill being debated.

the committee is charged coming up with the way to pay with health care and are in the negotiating phase. this briefing with senate republican leader mcconnell and john boehner is 15 minutes. >> good afternoon. it seems like every day is health care. it certainly stood -- should be the subject. i have continued to your suggestions that members of the republican conference are not for health care. i cannot find a single member who was not for trying to improve america's health-care system. most all of us agree with the american people overwhelmingly say in polls that they like the quality of the year concerned about the cost and access and those are related issues.

the administration does continue to mention these unnamed people who seem not to want to make progress on this. i have been unable to find anyone. not a single soul is in favor of a no action. what we do think is that we ought to target the problems. there are ways to do that that could be achieved, i think, on a large-a bipartisan basis. why should we any longer tolerate lawsuits against doctors and hospitals? why will we not want to incentivize plans like the safeway plan that has demonstrated you can capt. the cost of health insurance by incentivizing your employees who go after the preventable causes of health care problems in this country?

smoking, obesity, high blood pressure, a lack of exercise -- they have demonstrated that by incentivizing their employees they can have an impact. we know that one of the reasons we have such a large number of uninsured is because if you are an individual, it is not deductible on your tax return, but if you are a company is providing it for you and it is deductible. why we not want to equalize the tax treatment for individuals and corporations? these are the kinds of things that would have a positive impact on improving the cost issue and axes. i noticed that the ceo -- cbo director was called to the white house as today. it strikes me as somewhat achene the owner the teen coming up -- i can to the owner of the team coming up to the umpires

box. they are not players in this game. i do not think we ought to be tampering with an organization that is arguably controlled by the majority here in congress but tries to function as an independent arbiter and estimator of the cost of what we do. we look forward to being able to move a health care proposal this year on a truly bipartisan basis, one that is not increasing deficits, when it is up with the government in charge of our health care, one that does not produce that in the end delays care and organize care and. i do not think the american people want any of that. let me call my friend and colleague. >> i want to thank you senator

mcconnell for your work over in the senate. and your work earlier with republican colleagues in the house on dealing with the issues better coming at us like a machine gun. the american people want us to work together to reform health care in america so that it costs less. i think that americans looked at what they see the big government takeover of health care that is on the table and a plan that they do not support. tonight we will hear the president like the say some of the messiest and repeating over the last several months he will say you like your plan you can keep it. clearly, under the cbo estimates, 23 million americans will be forced out of their private health insurance and into a government-run plan.

a consulting firm estimates that number could be as high as a 114 million people. he will say it to reduce health- care costs in america. it is pretty clear that the director of the budget office says the healthcare curve and not only will not decrease, but the curve will increase. at a time when we are trying to get the cost out of the system, there is nothing in that proposal that will reduce costs in our health-care system. i do not know how you can spend $1.60 trillion over the next 10- years and say that we went to spend less on health care. he is likely to say that any plan that passes will not add to the deficit. the cbo has made clear that the planet is on the table in the house will increase the size of the deficit by $239 billion over the next 10-years.

the white house chief of staff this morning said that president -- he was reviewing the president's speech -- when he said that -- i like to ask my friends and ohio where the unemployment rate is at 11.2% whether they have been rescued by the economy. if they try to fix their health care system like they tried to rescue our economy, i think we are in really big trouble. it is time for the president to scrap the plan they have been working on. it is time to bring both parties together to several health care reform that will reduce the cost of the system, will reduce health-insurance costs, and provide better access. >> [inaudible]

>> as i said earlier, i am unaware of a single member of congress who is not in favor of doing health care reform. in a very positive way. there are plans that are around. we want to do the right thing here. this is not about the president. i think there are some that think everything is about the president. this is about the country. it is about a huge issue that affects all our lives, our health, and is 16% of our economy. in a country of 300 million people, the representatives may have a point did you the best

way to fix the problem. this is not about any individual. it is about the issue and taking the time to get it right. we had an experience with rushing a major bill earlier this year. i said we had to get the stimulus through yesterday. with interest, that will be about $1 trillion. we are spending $100 million a day in interest on it. it was sold to those enthusiastically embraced it as a way to keep unemployment from going above 8%. now decided to 10%. in conduct. in kentucky, it is tim 0.9%. -- in kentucky, it is 10.9%. we need to take our time and do it right. >> [inaudible] >> i hate to repeat what we just said, but it is about getting the policy right. it is about getting the policy

right. we do not wish anyone ill. we want to get the policy right. >> [inaudible] >> we have plenty of discussions, but in the end the question will be how bipartisan is the product. we have had plenty of interaction with the president. he is a good man. the test of whether or not this is a bipartisan product will be the product itself. >> [inaudible] >> i do not know whether she has been votes or not. she knows that. it is very clear they will rush ahead and put this risky scheme on the floor as early as next

when you begin to look at the pieces of this puzzle. -- pieces of this puzzle, this is a giant government bureaucracy. yesterday i pointed out this little section in the bill that requires after five years all employer provided health care plans are going to have to be approved by the department of labor and the health care choices czar. their approval will be based on whether these employer provided plans meet federal standards before high quality plans. are you kidding me? most employers in america are one to look up and go, whoa, this is, i will pay a surta thed my employees contend for themselves. that will push tens of millions of people out of their health

care provided by employers. >> [inaudible] >> i do not fault the cbo for attending the meeting. i'm not quite sure what the purpose of the meeting or occasion was. you will have to ask the white house that question. you bring up an employee report in thought. the two and a $39 billion deficit -- $239 billion deficit is only for 35 years. it'll take five years for this plan to be put in place. it is going to be hot war -- a whole lot more than that. the cbo pointed out that when you get out into the year seven and nine, u of annual costs for this plan over $200 billion a year.

in the year nine or 10 is $230 billion per year. that is in today's dollars. can you imagine what it is really going to cost will we get out there? you are probably talking of $300 billion a year in additional outlays. the tax increases that they have are bad enough. it will not be anywhere close enough to cover the real cost. >> [inaudible] >> to do what? >> [inaudible] >> before we get to the issue of how to pay for, we need to see what we are doing. as far as i know, other than the health committee bill which was on paid for, the district to the

bill and let the pay for the senate. i'm not prepared to do it until i see the product. >> thank you. >> max baucus spoke to reporters wednesday about negotiations on health care legislation after senator baucus, senator conrad makes remarks. this is 15 minutes. >> we are still making progress. today we talked quite a bit about coverage within the exchange and who is qualified for the subsidies.