so iould say that the 98,000 figure at this point is low and has been probably upped by every paent and government study that has looked into it since. >> so your testimony is that every adverse event is a medical malpractice issue? >> i'm looking at the studies and how they define it, and in for example the hhs study, they found one in seven medicare patients are the victim of an adverse event and 44% are preventible. >> again, are you saying that -- >> preventible errors -- >> isn't adverse, in your eyes, is an adverse event medical malpractice? >> a preventible adverse event is. >> the other thing i wanted to know is, i know who dr. hoven is representing and i know who dr. weinstein's representing, but i couldn't find in ur documentation where the justice, center for democracy and justice gets its funding. could you provide the committee

with a list of your fellow and associate members so we have an accurate understanding of the point of view which you are represting, and also, you mentioned the demo projes and they are going to get grant funding. are you or anybody associated with the center for justice and democracy able to apply for those grants? >> apply for which grants? >> the ones for the research that you were speaking about earlier. >> well, we are tiny. we have about five people on our staff. we are not a high budget operation. so we don't really have the staff to do research projects like that. we he other people would do that. >> again, i would like to know, like your fellow and associate members, are they going to be applying for those grants? >> our associate members, i would have no information about any of that. i don't know. those grants were already -- that process has already taken

place. hhs has already granted the money in new york, for example, it granted $3 million to the office of court administration in conjunction with the department of health that is looking at a specific proposal that was presented to them. so actually, i know a lot about that proposal. i know about a few of the others, but that has already happened. >> are you aware, and this goes to all three of you and i think dr. weinstein and dr. hoven have said this and i want to make sure you are aware, also, there are certain professions in the medical field that have stopped practicing because they can't see enough patients in order to cover their insurance cost. just the cost alone, not because they have done anything wrong, but they cannot see enough patients to cov their malpractice insurance cost. >> well, i hope that also you're aware that since 2006, we have been in a soft insurance market.

that's why you don't hear any longer about doctors picketing on state legislatures and capitals andrauma centers, et cetera, that we did in the early part of the 200s when we were in a hard insurance market, when rates were going up 100%, 200% for doctors. this is a cyclical industry. this has happened in the past 30 years when rates have shot up like this. to believe the legal system has anything to do with it, you would have to believe juries engineered large awards in 1975, then stopped for ten years, then did it again from 1986 to 1988, then stopped for 17 years, and then started up again in 2001. of course, that's never been true. the claims have always been steady and stable, so what's driving insurance, rate hikes is the insurance and accounting practices of the insurance industry. the solutions to that probl lie with the insurance industry. they should not be solved on the backs of injured patients.

>> i see my time has expired. >> thank y, miss adams. the gentlewoman from texas, miss jackson-lee, is regnized for her questions. >> thank you. let me thank all the witnesse for their presence here today. i want you to know that each of your presentatio are particularly respected and admired. i want to start with the representative from dr. hoven, from the american medical association, and coming from houston, i think many of you are aware, proudly so, for me, that we have one of the greatest medical centers in the world, the texas medical center. i'm very proud of recent $150 million private donation just recently received by the texas -- by m.d. anderson so i have a great familiarity with a lot of physicians and applaud

their work and thank them for some of the life-savi research they have been engaged in. but building on the presen national law which is, of course, the patient protection and the affordable care act, dr. hoven, one of your peers, one of your colleagues who happened to serve in this body, senator fritz, indicated that that law was a fundamental platform upon which we could now base our desire to go forward, to have additional provisions, so i just want to get a clear understanding. it's my understanding the american medical association supported the bill. is that correct? >> the american medical association supported parts of the bill. we believe that access to care covering the uninsured, decreasing costs and improving quality are very, very important first sts. >> so you would not -- you're telling me doctors would not support eliminating the

pre-existing cditions and allowing children to stay on their surance until age 26? >> we do support that. >> so i think a great part of the bill, you did and you probly would -- i'm not sure, maybe because you're before a large group that you don't want to say that the ama supported it, but it was my understanding that they did. i see someone shaking their head behind you. do you support the bill? did the ama support the bill? >> the ama did support the bill. we recogzed it is an imperfect bill. >> you are absolutely right. i will assure you, those of us who are lawyers as well agree with you, because it is very difficult to write a perfect bill, but as dr. fritz said, this is a bill that is the law of the land. he even said he would have voted for it. i want to clear the record that this is a bill that really does answer a lot of questions but we can always do better. let me indicate to miss doroshow, if i have it correctly, in the process of

hearings, we have witnesses that represent the majority view, majority is represented by republicans, chaired by mr. smith and we have a right to have a witness that maybe has a different perspective. so t inquire of your fundinger on whether you're getting grants, every hearing, we will find that we will have witnesses that will agree with the predominant view by the majority but we'll also have in this democracy, the right to have a different view. i suppose you have a different view from the health act that is before us. is tt correct? there is a bill that you have a slightly different view, is that my understanding, between this question dealing with tort reform or medical malpractice? >> i certainly have a different view from the other witnesses, yes. >> yes. that's the point i'm making. >> yes. >> let me inquire and as i do that, i think the point that i wanted to engage with dr. hoven was to say that i want to find every way that we can wor with physicians. i want their doors to be open, i

want them to be in community health clinics, i want them to have their own private practice, i want them to be og-gyn. in fact, dr. natalie carroll daly, former president of the national medical association, i count her as a very dear friend but also someone who counsels me. let me be very clear. answer these two questions. what is the reality of how many frivolous lawsuits we have? you have a notation of the ho harvard school of public health. number two, insurance companies, isn't that the crux of the problem? are patients the ones charging doctors $120,000 for insurance or is it the insurance companies who have documented that they will not lower costs even if there is a low count of medic malpractice lawsuits in that doctor aa, in that doctor's office and in that state? isn't that true? >> absolutely. >> would you just comment very

quickly? let me as i say that, say to you my mother had a pacemaker for 20 years. she had a procedure to give her a new one. the next day she was dead. i would like you to be able to answer my questions if th chairman would indulge your answer, please. >> in terms of the harvard study, this is important because this is the study that gets i think misrepresented often and figures about 40% of cases are frivolous. actually, the harvard study found the exact opposite. in fact, i will read the quote from the author of that study, the leadoff. some critics have suggested that the malpractice system is inundated with groundless lawsuits and that whether a plaintiff recovers money is like a random lottery, virtually unrelated to whether the claim has merit. these findings, the harvard school of public health findings, casts doubt on that view by showing that most malpractice claims involve medical error and serious injury, and that the claims with merit are far more likely to be paid than claims without merit.

there is a lot of extensive search done on that study and the headline of harvard press release was study casts doubt on claims that medical malpractice system is plagued by frivolous lawsuits. >> you didn't -- the gentlewoman's time has expired. thank you, miss doroshow. we will recognize the gentleman from virginia, mr. forbes, for his questions. >> thank you, mr. chairman. i want to thank all of our witnesses. i truly believe all three of you are here to do what you think is in the best interest of our patients and of the united states. i feel the same way about the members that we have up here, but we all have specific constituencie constituencies. as much as i love the chairman, i know there are times that he's from texas and he has a texas constituency. the gentleman from arkansas has an arkansas constituency. gentlewoman from florida has a florida constituency. that's what we tell everybody, the gentleman from florida, the gentleman from arkansas. i think it's important that we know when you're testifying who your constituencies are and two

of our witnesses have set that forward an the congresswoman adams asked what i think is a fair question to miss doroshow, and that is, if sheould just be willing to give us your sources of public funding and your membership, would you make those publico we know who those constituencies are? >> well, we're a501c-3 tax exempt organization and we do not release the names and information about our donors. i will say that we get different kinds of funding. we get foundation grants, for example. in fact, i started the organization in 1998 and it was just myself, sort of sitting there writing letters to the editor with a little bit of money om a friend of mine, and i got a large grant from the stern family fund -- >> miss doroshow, i only have five minutes. the answer is that you won't let us know who your membership is and your sources of funding?

>> absolutely not. >> okay. then we'll take that into account. let me just say that sometimes, this is not as complex as we try to make it. the reality is that everybody at home who watches these hearings and who looks at these issues, they know when you're talking about not changing tort reform, who the true beneficiaries of that are. i mean, th're the trial lawyers and the trial lawyers are the ones that put the dollars behind i the trial lawyers are the ones that will sit here and tell us if we don't do this, we're going to be impacted and we could be losing our jobs. on the other hand, we know who some of the major beneficiaries are if we do tort reform and that's some of our doctors and they tell us hey, if we don't do this, we could be losing our jobs. one of the interesting things, i can tell you, andell this committee, i have never in my entire career, had a single constituent walk in to me and say i am worried because i can't

find a trial lawyer out there. but i have been over and oer coming to me now, truly worried that they cannot find doctors to represent them. secondly, when i hear people lk about the 2% or 3% of bad doctors, that sometimes falls on hollow ground because the same people that will point and say oh, yeah we can't do malpractice reformecause it's 2% or 3% of bad doctors fight us every time we try to get rid of the 2% or 3% of bad doctors, the same way they try to do when we try to get rid of the 2% or 3% of bad teachers. so my question to you is this. all three of you. i am a firm believer in modeling and simulaon. we use it in the armed services committee to try to model for us our most difficult weapons systems, our military strategies. we are so confident in it, although we know it has some flaws, that we put the entire

defense of the united states sometimes on modeling and simulation that we can do. do we have any efforts at modeling and simulation that would help show us what the health care world would be like if we did tort reform and if we got rid of some of the litigation and whether it would benefit us or not, and if we don't, what can we do to help you move forward in that? dr. weinein? >> if i can address that question, i think you have a model out there existing already. that's the most recent texas reform. you also have california which has a longer history. the texas reform obviously showed lowering premiums but increasing numbers of critical care specialists, particularly in underserved counties. that included also pediatricians, emergency physicians, et cetera. if i might, could i come back to the issue of the frivolous lauits? >> absolutely. >> congresswoman adams asked about this and i think the issues are the data would be that 64% of suits are either withdrn, dropped or dismissed

because they lack merit. less than 1% are actually decided for the plaintiff. when you come to the new york study which is called the harvd study, which looked at new york data, you're talking about extrapolation of 280 cases of error. and in that study, errors could be someone falling in the hallway walking and that was lumped together with someone having a significant surgical error. the study has been flawed as was pointed out -- >> dr. weinstein, my time is up. i don't mean to cut you off. i just wanted to say the point you made about having california and texas is so accurate. we hear over and over we're going to do these demonstration projects, but you have two monstrous demonstration projects and if we are going to ignore those, we are certainly going to ignore the other demonstration projects. doctor, i don't have time for you to give me your answer but if you could submit it to us in writing or miss doroshow, we would love to have it on the modeling simulation part. i yield back. >> thank you, mr. forbes.

the gentleman from north carolina, mr. watt, is recognized for his questions. >> thank you, mr. chairman. let me first apologize to the witnesses. i had to leave to go to a meeting and didn't hear anything other than a small part of the first witness' testimony. i assure you i will read it. i didn't come back to ask questions about what you said because i didn't hea what you said. i came back really to make sure that a perspective that i have on this issue gets into the record. because this is where i differ with a lot of my colleagues who have thought that this is an appropriate issue for us to deal with in the u.s. house judicry

committee. i'm kind of a states rights, old school guy on this. i have always believed that tort law was a matter of state law. i concede that we have the authority to write tort standards for medicare recipients and for the range of people that we do, but general tortlaw, from my perspective, has always been a matter of state law. i happen to live in charlotte, north carolina, and that is right on the south carolina line, but ive never seen a hospital that straddles the line.

they don't operate -- i've never seen a medical procedure take place in interstate commerce. i concede they use stuff that comes through interstate commerce. everything we do comes through interstate commerce. but i just think that this is an issue that my conservative colleagues, the states rightsers, have lost their way on. and were i a member of the north carolina state legislature, perhaps i would listen very intently to whether we need to in north carolina do tort reform, and th have at the state legislature level in north carolina. i happen to think that they are

as intelligent and bright in the state legislature of north carolina as we happen to be here in the congress of the united states. we don't have any monopoly on knowledge on this issue. it is a state issue. it has histically been a state issue. i think my conservative colleagues have lost their way trying to make this a federal issue. so i want that in the record. they say i used to be the chair of the states rights caucus on this committee. maybe this is one of those times that i got that reputation as being the chair of the states rights caucus. but we can debate whether state by state, states ought to be doing this. we could even debate whether we ought to be applying some

different standards for medicare recipients or medicaid recipients. but i just think as a general proposition, having a debate about doing general tort law reform in the congress of the united states offends that constitution that we read the first day of this session on the floor. so that's my perspective. i appreciate you all being here as witnesses, and -- but i didn't want to miss the opportunity to put that perspective in the record in public. not that i haven't done it before. if you go back to the 111th congress, the 110th congress, the 109th congress and you go all the way back to when i started, whatever congress that was, i think i have given my perspective on this over and

over and over again, because we have been talng about this for the 18 years that i've been here, and my position on it hasn't changed. we don't do malpractice interstate and if a doctor's operating on somebody that lives in another state, th can get into federal court and apply whatever state law it is that plied in that jurisdiction. that's my story. i'm sticking to it. i appreciate -- >> would the gentman yield? >> i don't have any time left. >> the gentleman's time has expired. let me say to the gentleman we appreciate his consistency over the years and being for states rights and appreciate his being an original founder of the states rights caucus on the judiciarcommittee. we will now go to the gentleman from arkansas, mr. griffin, for his questions. >> thank you, mr. chairman. dr. weinstein, i am particularly

interested in the gallop poll that came out in february 2010, over the last year or so i talked to a lot of doctors in my district who are advocates for some sort of medical liability reform, and during the last year, this poll came out and i was struck by the numbers, and i saw that you referenced this gallop poll in your statement. the first question i have for you is the data in this poll, the one that came out in february, is it consistent with other data that you've seen, particularly the point that physicians attributed 26% of overall health care costs to the practice of defensive medicine, and then secondly, that 73% of the physicians agreed they had practiced some form of defensive

medicine in the past 12 months. so my first question is whether that data in the gallop poll is consistent with data that you have seen elsewhere. >> mr. griffin, i think the data on the cost of defensive medicine vary considerably from low estimates of $56 billion over ten years to this was the largest estimate of $650 billion. you can go back to studies like kesler, mcclellan and others who looked at it and the costs of defensiv medicine are astr astronomic. it is not going away. a very well-known study done not by doctors, but lawyers, the harvard group, shows 90% of physicians in the state of pennsylvania practice defensive medicine. when they surveyed residents, doctors in training across all residencies in pennsylvania, they found 81% felt they couldn't be honest with patients. they viewed every patient as a potential lawsuit and the most depressing statistic of all was

28% of residents across the spectrum in pennsylvania regretted their choice of becoming a doctor because of the liability crisis. >> with regard to the pennsylvania data that you're discussing, have you turned that data over to the committee? >> yessir, that's in the writtetestimony. >> what procedures, could you give usome specifics on the procedures that are usually subject to the practice of defensive medicine? >> sure. defensive medicine breaks down, two areas. one is assurance behavior. you need to assure yourself you haven't missed something. as has been pointed out by dr. hoven,n medical school you're trained to take a history, do a physical examination and try and put this puzzle together. occasionally you'll need one test, a lab test, or imaging study, and then you will take an orderly progression, but the climate of fear that exists from the medical standpoint is such, you need to keep taking that

progression, that orderly progression, to the very end from the beginning, because should you miss something, your life and your ability to practice medicine and your craft is over. so that's the assurance behavior. avoidance behavior is most medical students come out of medical school, in our school, over $100,000 in debt, so when they choose a career, they come out of our orthopedic surgery residency able to take care of anybody who is brought in off the highway who has had a traumatic injury and put them together again, but the majority of them don't want to do that. they don't want to cover the emergency room because that's a high risk environment. so you avoid things that are high risk. you avoid ob, if you're a neurosurgeon, you don't take care of children's head injuries. doctor doe't do vaginal deliveries or any deliveries at all. that's how the avoidance behavior affects the american public. >> so getting down to the specific medical procedures that are usually subject to that, you

mentioned head injuries, you mentioned ob-gyn. can you get even more specific in terms of the actual procedures? >> i think just head injuries in children, there are very few neurosurgeons willing to take care of a head injury in a child. at one time in this town, 40% of ob-gyns weren't doing deliveries. this was a few years ago. one in seven no longer deliver babies. they now get out, on average of obstetrics at age 48 which would be a mid-career point. you are just reaching your peak. you have another 20 years of practice. but now ob-gyns stop practicing obstetrics at age 48 because of the liability risk. >> if you have a number of tests that are being conducted using equipment and using resources and in some instances they are not necessary, they are more to assure or to avoid, can yo comment on that crowding out

tests that need to be conducted that are necessary? >> yeah. i think that when you crowd a system with i won't say that they're unnecessary tests. the gentleman earlier sort of implying that these tests are illegal, that you're doing, you're defrauding medicare. i think that's not the truth. but basically as i mentioned, when you progress to solve a puzzle in taking care of a patient, you follow an orderly progression. if this doesn't work, then we'll do this study, we'll do a ct scan or myelogram or mri but we can't afford to do that anymore. so what happens is you use valuable resources, imaging resources in particular, to do defensive medicine, to take that step number ten and bring it down to step number two, and you deprive someone who actually needs that resource from the use of it. >> so if a young child who has a head injury comes into the

emergency room, in an ideal situation, you're saying a doctor would look at that child and say well, i'm going to start at step one, and if i think i need to go to step two, on my way to ten, then i'll do that progressively but in the current environment, they see the child and they automatically say we got to do one through ten? >> i think if there is a pediatric neurosurgeon or neurosurgeon willing to take care of that injury at that hospital, because i think three-quarters oour emergency oms are at risk because of the availability or lack of availability of on-call specialists, that doctor will proceed with the entire battery from step one. >> and not progressively? >> not necessarily in an orderly progressive fashion which you learned in medical school. >> thank you, mr. griffin. appreciate those questions. the gentleman from georgia, mr. johnson, is recognized, who had the advantage of going to law school in texas. he's recognized for his questions. >> thank you, mr. chairman. dr. weinstein, it's a fact, is

it not, that doctors are human beings? >> yes, sir, they are. >> and it's also a fact that human beings are not perfect. isn't that true? >> absolutely. >> so doctors, just like human beings, make mistakes. would you disagree with that, dr. hoven? >> errors occur. >> errors occur. mistakes can be made, isn't that true? >> they can. >> by doctors. correct? >> that's true. >> and so now, when a doctor makes a mistake, it can cause a death or it can cause a diminished quality of life in the victim. would anybody disagree with

that? hearing no objection or hearing nothing, i will assume that you agree with me on that. now, that diminished life of a victim of what i ll refer to as medical negligence, it has a value that a jury puts on it, and we call that non-economic loss what? lawyer doroshow, what do we call that, non-economic loss, recovery for? >> permanent disability, blindness, disfigurement, mutilation -- >> pain and suffering for whatever may arise as a result

of the doctors' negligence. pain and suffering. non-economic loss. that is worth something, don't you think? now, the question is how much is pain and suffering worth. that might be a little different for cornesha scott who, back in little rock, arkansas, in 2007, 29-year-old went for a partial thyroidectomy to remove a goiter and 12 hours ter, she began to develop a shortness of breath and began feeling her neck tighten, despite complaints to the nurses, her condition was not appropriately monitored or reported to a physician. she went into respiratory arrest and suffered severe brain

damage. it was later discovered that she had a hematoma at the site of the surgery. she is now bedridden and tally dependent on her mother for care. now, that's pain and suffering. do you think that pain and suffering is worth more than an arbitrary cap of $250,000? if you d i disagree with you. if you think that laurenlalini out in denver should be limited to $25000 for pain and suffering, she went to a denver hospital for kidney stone surgery in february of 2009. six weeks later, her health began to deteriorate, with feelings of exhaustion and a loss of appetite. after a week of her illness, she became jaundiced and had an inflamed liver. the doctors at an urgent care

clinic diagnosed her with hepatitis c. 35 other patients became infected with hepatitis c at that hospital at the same time. a state investigation revealed that the outbreak began with a hospital staff person who used hospital syringes and painkillers during drug use. and miss lalini is now convicted and sentenced to a lifetime of pain and suffering. how much is that worth? is that worth $250,000? no. it's worth a whole lot more than that. and what this legislation does is puts an arbitrary cap of $250,000 on non-economiclosses,

pain and suffering. it is actually an affront to the united states constitution, the seventh amendment which guarantees people a right to a jury trial when the amount in controversy is in excess of $20. so on one hand we're talking about eliminating health care for everybody and now we're talking about one day later, we're talking about denying access the courts for people who have -- who have been hurt and that's about all i got to say. thank you. >> thank you. the gentleman's time has expired. next, the chair recognizes mr. ross from florida for five minutes. >> thank you, mr. chairman. you know, being from florida, it's interesting, we did a little bit of research and saw that for an internal medicine physician, they pay as much as

$57,000 for medical malpractice but yet in minnesota, they pay just a little bit more than $3,000 which makes you wonder whether the injuries are more severe in florida than they are in minnesota, or whether it's a result of the litigation environment. what i would like to do is step away from the substantive part and not talk about damages but let's talk about procedure. for example, in my practice i would probably say the vast majority of my cases have resolved at the mediation level, whether it be court ordered or voluntary mediation seems to work. i guess, miss doroshow, i would ask you would you not agree that dispute resolution as opposed to actual trial is more efficient, more effective in getting the needed benefits to the injured parties? >> 90% of cases do settle but it's because of the threat of a jury trial, the possibility of a jury trial, that that happens. when you take away the jury trial option, that won't happen. >> well, i'm not saying take away the jury trial. i'm saying when you're in the dispute resolution a lot of

factors come into play whether you want to settle the case. in some cases it's the burden of proof, is it not? >> well, the cases -- the studies i have looked at, at least, show the cases that settle, there is negligence, there is error, there is injury. the cases that end up, the small number of cases that end up going to trial are the ones where it's a littleore unclear and they need a trial to resolve it. so i think the system as it is rit now is very efficient, because most cases do settle and that really -- that's a system that really shouldn't be played around with. it's working now. but in terms of burdens of proof, different jurisdictions have like scintilla of evidence compared to clear and convincing. would you not agree burden of proof would be a factor that would come into play? >> for example, in texas, for emergency room injuries, they made the burden of proof so incredibly difficult that it's knocked out all -- every single emergency room negligence case.

so what has hapned there is the state of care in emergency rooms has become much more unsafe, and that's sort of what's happened there. yeah, it does vary and state law does determine that. >> dr. hoven, with the ama, are there not practice protocols that physicians groups, specialties, subscribe to in the performance of their duties? >> yes, thank you for that question. yes. the ama has been up front going forward for many years, in fact, since the mid '90s in terms of measures, development, quality guidelines, outcome objectives. we have had a major role in this and it's been applicable and it is now standard of care. these guidelines are extremely useful in allowg us for evidence-based care. >> not only extremely essential, but they also sometimes le to the practice of defensive medicine. in other words, if your practice protocol requires if this diagnosis is made, then this form of treatment is required,

sometis physicians may do that even though they may not need to just to stay within the realms of the practice protocols? >> that correct. in fact, legislation needs to be out there that gives me, using my clinical judgment and my clinical knowledge, the ability to provide the best care for that patient at that particular point in time. >> dr. weinstein, wouldn't you agree that if we had established practice protocols and we require by way of the funding of medicaid or medicare that it's contingent, receipt is contingent upon established practice protocols in each jurisdiction and those practice protocols are followed, and the burden of proof would then have to shift from the physician to the plaintiff to show that by way of either a clear and convincing evidence that they deviated from the practice protocols, or committed egregious error, would that in and of itself provide a substantial reduction in the amount of litigation and the amount of awards out there? >> i think that first of all,

all medical groups, including the ama and others, have been working on guidelines, appropriateness criteria, to help physicns establish a safer method of practice. but all patients don't fit in every sngle guideline. patients are individuals, they have different co-morbidities so they provide a general framework in which to start. but it's not a one size fit all. medicine is not a cookbook that you follow this step and go to this step. it has to be a physician interacting using their clinical skills to determine wether that guideline fits that particular patient or that appropriateness criteria needs to deviate for that -- >> in those cases, where practice protocols areemployed, should not the practicing physician have at least the defense that the burden of proof would now shift to - the doctor has established that he did the following protocols that were required of that particular

specialty annow there must be a showing by a greater weight of the evidence, clear and convincing evidence, that then the physician deviated from or committed egregious error? >> i think again, i'm not a lawyer. i can only speak from a physician's standpoint that the guidelines and appropriateness criteria are very good foundations for me as a practitioner to follow or to look at when i see an individual patient. but i to use my skill and judgment acquired over, in my case, 35 years of practicing dicine, to decide if my patienfits exactly that paradigm. otherwise i need to have the ability to not have my hands tied. otherwise i'm going to hurt my patient. >> thank you. >> the gentleman's time has expire the gentleman from south carolina. recognized for five minutes. >> thank you, mr. chairman. miss doroshow, i will ask you a series of what i hope are narrowly tailored questions in hopes of an equally narrowly tailored answer, okay? do you support any toughening of rule 11 sanctions for frivolous lawsuits, lawsuits that are

dismissed or lawsuits where summary judgment is granted? >> i mean, i think rule 11 is probably sufficient enough but -- >> so you do not -- >> i would prefer that to ever taking away the rights of victims. >> i may not have phrased my question well. forgive me for that. do you support a toughening of rule 11 sanctions for frivolous lawsuits? >> i think obvious i would have to see the provision. i don't have a problem with that. >> so the answer is you don't have a problem with that? >> i don't have a problem with that. >> you could support that? >> provided i looked at what you were asking me to support. >> how about this. how about -- >> reasonable request. >> how about joint and several liability reform. do you support that or not? >> absolutely not. >> do you support a higher quantum of proof for emergency care? >> absolutely not. >> do you support any tort

reform? >> i support provisions that would repeal tort reforms currently in existence in states. absolutely. >> do you support any tort reform? >> for example? >> well, i just gave you four of them. we were 0 for 4. >> i support a law that would prohibit confidential settlements where there are public health and safety issues involved. i would support that tort reform. >> dr. hoven many of us oppose the current health care law because in our judgment, individual mandate is beginning to make the commerce clause so elastic as to be amorphous. for those of us who want to support tort reform, draw the nexus for us, draw the connection where it's a appropriate use of congressional power to supplant state tort laws and while you're doing it, do we also surrender the states

determining scope of practice issues if you federalize tor reform? >> there's a role for both. the law we're talking about, the health act, in fact, supports states in what they have already done and proffered and what they're putting into place. in states that don't have it such as mine, kentucky, we desperately need the federal regulation, the federal legislation, to get us to a different place. for all of the reasons i've talk about before which have got to do with access and cost. so there's a role for both but the health act recognizes that i believe, and would achieve what we're looking for in the global topic of medical liability reform >> when you say the health act recognizes that, you're referring specifically to the state flexibility provision that -- >> that's correct. >> -- doesn't supplant current state law? >> that's correct. >> is there any concern on behalf of physicians that if you allow congressional encroachment, if you will, into this area, that congress will also want to decide scope of

practice issues between optometrists, nurses and other traditional state issues? >> no, these are state issues. we fully recognize scope of practice issues. we have been doing that for years and years. >> you don't thk we lower the bar the commerce clause at all by federalizing tort reform? >> i trust you. >> i'm a lawyer. don't. final question. implicit, actually, more than imicit in some of the questions that have been asked this morning, has been very thinly veiled accusations of health care fraud, medicare fraud, medicaid fraud, for what we consider to be defensive medicine. would you take a crack at explaining the predicament physicians find themselves in with this culture of litigation and defensive medicine? and defensive medicine? >> as i outlined before, as a physician you have skills, history, physical examination, you put laboratory tests or

imaging studies tether to come and solve a puzzle for what's wrong with your patient or how to treat them, and there's an orderly progression. if this turns out this way, i might go in this direction or another direction. if you have this progression of multiple steps to get to the end, you don't stop at square one and say, let's see how it works. how des this treatment work? if they're not getting better we'll do something else. from the diagnostic standpoint you do everything because of fear of an adverse outcome or something happens, then you're at risk. what happens is the patient gets everything out there under the sun as opposed to just a stepwise progression toward an orderly diagnosis or management plan. >> i'd like to thank all three panelists and thank mr. chairman. >> thank you to the gentleman from arizona, mr. quail, is recognized for five minutes. >> thank you, mr. clarm. thanks to all of you for showing up.

this is a very important topic if we're going to address and take control of our health care costs going forward. it's important to have access to quality care. my first question is t. wine steen. you say doctors have faced the brunt of abusive lawsuits. while some insurance premiums have leveled off recently or decreased slightly in some areas, theyremain a serious burden for many doctors across the country. moreover with the implementation of the new health care bill,e may discover this has been a brief lull before the storm. can you expand on what you mean by the brief lull before the storm and why the insurance premiums may have gone off in a lull for a short amount of time? >> i think we're in a lull, if you will, until we see how te heth care reform act plays out and wh happens here in this body and across the way. i think that rht now we nee to look at the provisions of that and what actually becomes law, what actually is

implemented to see whether other avenues. just in the state of massachusetts recently the supreme court, i think, reinstituted a suit against a physician who had prescribed high blood pressure medication for his patient. now the physician is sued for treating the hypertension. there's avenues to be spur sued by a trial bamplt this is a very fertile area. a front page article in "the new york times" show how hedge funds investigate in liability lawsuit. this is big money and big business. it's unfortunate. with the new healt care law we have to e how things unfold and what avenues are opened by that. >> staying on that with the high-risk specialties and if you look at the doctor -- the aging doctor population that's happening, you don't have many people going into the profession and especially in high-risk

specialties, if we cannot control the liability insurance costs, how will that affect the quality of care for these different areas of expertise? >> when you lose high risk specialties, i think every american is in danger when they have a problem, let's say, in your state, arizona. that was witnessed several weeks ago unfortunately, but if you don't have the specialists available and have level one trauma centers available in a recent distance, men nits matter. ij the american public now can no longer expect that they can be traling along a highway, have an accident and go to an emergency room and be saved. that will an unreistic expection because of the shortage of hih-risk specialists but the unwillingness to put themselves at risk by taking on high-risk cases. >> do you know the average? from talking to people in the ob/gyn profession it's over

$1,000 just to turn on lights, what's the aench in high-risk specialties? >> it depends on the state. in some areas even in high-risk spine surgery, for example, physicians pay high liability premiums. they're very high. >> doctor, i was wondering, there was enormous financial toll on doctors when they have to defend frivolous lawsuits. what is the emotional toll, and how does that affect the doctor/patient relationship for that doctor going forward? >>t's very traumatic. doctors want to heal, provide care and take the best possible care. when all of a sudden you're confronted with a lawsuit over which you have no control or you were part of something else in the suit process, it devastates you. i was sued. i tried to talk about that a little bit ago. i was sued for five years after that, and this goes to the issue of practicg defensive medicine. i refuse to see any -- add any

new patients to my practice. i've found myself constantly thinking what have i missed? what have i missed? even though i knew i was bringing the best potential care there. this affects the physician's headlight and their family's health and most importantly it begins to affect the relationship between the patients and the doctor. all of a sudn that threat, that fear of threat and trauma is out there. i consider myself a very good physician. yet, in that process i felt that i was damaged by the process. >> okay. thank you very much. mr. chairman, i yield back. thank you. >> the chair would recognize the chairman from the subcommittee that has jurisdiction over this issue, mr. franks from arizona for five minutes. >> thank you, mr. chairman. doctor winestein, opponents of

medical liability reform often argue, as you know, that reforming the medical liability system especially through limits noneconomic and punitive damages will lead to the practice of medicine itself being less safe. i think that's a pretty critical, important question to answer. based on your experiences, do you believe that placing limits on noneconomic and punitive damages will affect whether doctors practice high quality medicine or not? >> no, i don't, sir. >> it shouldn't. >> it's pretty clearhat the current system we have neither protects patients who are injud nor does it make the system safer. we are not a country of infinite resources, and when you talk about economic damages, those can be quantified. when you talk about noneconomic damages, there's no way those are quantifiable, and without infinite resources, i think it does not affect the quality of care in a system such as that.

>> do you have anything to add to that? >> i would also add that in this era in the last 10 to 15 years, medicine, physicians have taken huge leadership roles following the iom report, for example, in moving medicine to a different place. improving quality and improvg systems, diminishing errors. so this discussion about physician responsibility and liability in this setting is difficult beuse we, in fact, have made maj, major strides in improving health care throughout this couldn't. >> dr. weinstein, i thought one of the most striking pieces your written testimony is about doctors entering specialties or treats high-risk patients. how could legal reform similar

to calornia's mrcia or the health act that passed the house 2003 here positively affect doctors' decisions to practice in high risk specialties or treat high risk patients? >> i think with reasonable reform physician culture will change. physicians will then feel it's worth the risk. there's always a risk when you talk about high-risk medicine, but it's worth the risk to use th skills that you leard in your medical school and residency training and fellowship training to help restore function, alleviate pain and restore life to individuals. unless a reform such as those previous ones you've outlined is implemented, that just won't happen. >> dr. hoeven, i have to tell you i'm extremely grateful to the medical community because of having them have a tremendous impact in my own life.

i had major surgeries starting out at birth, and so i think that, you know, the importance of allowing doctors to pursue that calling that they have to try to help heal their fellow human beings is a profound significance in our society. if i could ask sort of a hypothetical or ask you to reach out, if you could do one thing -- dr. weinstein, i'll put you on deck, too, to answer it. if you could do one thing in terms of public policy we might pass that would strengthen the doctor/patient relationship, that would allow you as a doctor to work better with your patients and would also deliver the best care possible where you would protect both the patient and doctor and the entire medical process in terms of liability reform, what's one thing you would do? what's the one priority you've dealt with us? if you could only have one.

>> thank you for your comments. the answer to that is stabilation. the medical liabilitsituation must be stabilized, and that stabilization includes addressing economic and noneconomic payments. it also has to remove from us in that stabilization the culture of fear. and when somebody is looking over our shoulder all of the time. that will improve and ntinue to enhance the patient/physician relationship. it will stabilize care in this country. it will improve access to care, and it will improve quality. >> thank you. >> i would say we need a rational solution to this situation, because right now it's irrational. nobody has benefitted from it. unless we have some type of stability, injured patients will not get compensated appropriately and the system will never get better because system errors require a system

of transparency. you can only have a system of transpency when you have a stable situation where everyone can work together towards the same end of making a safer health care system. >> thank you all for coming. thank you mr. chairman. >> the gentleman's time has expired. the gentleman from virginia is recogned. >> i'd like to follow-up on a question asked by the gentlemen fromouth carolina, mr. goudy. one of the questions he asked you reeltded to whether or not you would support a higher proof of negligence or substandard care for emergency care. you said not just no, but absolutely not. so if we have -- all of us have at some time or another been in a theater, a sporting event, a stadium where somebody becomes injured or ill, and the first question is is there a doctor in the house? now, you expect that doctor to identify themselves and come forward and help that individual

if they know very little about the circumstances, don't know what this patient's medical records are previous to the treatment, what they might be allergic to, to try to save their life? you wouldn't provide a higher standard of protection for that doctor under those circumstances? >> the standard is already pretty high? you're not finding lots of emergency room cases moving forward in this country. when you do that, first of all, the emergency room according to -- >> you would support a higher standard of -- >> no. >> that's the question he asked you. higher standard of negligence for somebody in an emergency situation? >> the emergency rooms are the most unsafe and dangerous parts of a hospital. that's according to the institute of medicine. it's where many people go who don't have insurance. >> how about a theater or a sporting event or somebody injured in an accident on the highway where a doctor happens to be coming by to provide

assistance? >> i believe that the civil justice system that exists in this country is able to handle cases that go frward based on the state common law that exists that has been developed by the state. if the state common law and frankly if the state decides -- >> reclaiming my time, most states have specific statutory liability provisions. >> exactly. look at texas. what has happened in texas is they have made the standard of liability for emergency room malpractice so high that it is has knocked out virtually all cases. you have a situation where a woman was in an emergency room, was misdiagnosed. as a result of that her legs have been cut off.

she cannot get an attorney because of tht. >> you're again avoiding my questi. >> i'm saying. i'm saying i don't agree with you. >> what about on the highway, at the theater, out in public away from a medical facility if a doctor provides care, volunteers that care under those circumstances, very different than emeency rooms. i agree emergency rooms shod be different than other standards of care as well, but in an emergency itself, should the doctor have greater protection? yes or no? >> i believe that the law should be what the state common law is. >> i'm going on to another question. thank you. dr. hoeven, some argue that lowering a doctor's malpractice liability insurance bill does not really lower health care costs in a way that benefits patients. i don't agree with that. what are your views on that? >> i disagree with na statement as well. it's clear that our liability costs have to be something we can budget for and build into our costs of running a practice or a clinic.

money that i don't have to spend on liability insurance i can and do turn back into a practice to retain a nurse to provide care to 100 diabetic patients so that our costs are lowered. i think we have to be very careful in this phraseology, but in actuality if i can budget, i know what my monies are going to be. they're not out of sight. i can improve care and quality and access to my patients. >> thank you. dr. weinstein, "news week" reported that younger physicians are especially frustrated with practicing defensive medicine betweening rising insurance rates and the legislation and bureaucracy in the new health care law. are you concerned that in the future fewer of our best young students will pursue medical career science. >> yes, i think the evidence is very clear. this is born out in the study done by the harvard group and the columbia university legal

team which showed that physicians in all residencies are just discouraged, number one, to be doctors. 28% regretted choosing medicine as a career, and that 81% viewed every patient they encountered as a potential lawsuit. i think this is a terrible state of affairs, so there's no question that the younger geration is profoundly affected in the career choices and practice locatns. the context in which they practice. in other words, what they cut down their skill set to and what they offer their community in which they live. >> they can spend a lot of years and hundreds of thousands of dollars to receive a license to practice medicine, and the cost then of liability insurancend the risk if they have to make a claim against that insurance or more than one claim against that insurance to their future as a physician, what is that risk?

>> i think the issue here is there are plenty of people that need good, medical care that aren't necessarily high risk. if you feel you can have a satisfactory practice without putting your life and your family at risk by unnecessary liability, many younger physicians are taking that route. >> and that is indeed the crux of the problem. the quality of medical care and availability of medical care is very much affected by the perception of the medical profession and the reality to the medical profession of the current standards with regard to medical liability? >> there's no question that access and quality of care are profoundly affected by the current situation. >> thank you. thank you, mr. chairman. >> thank you very much. i yield myself five minutes. i come to is like everybody else does as a product of my experience. my dad was a doctor a board

certified cardiologist and internist from long beach, calirnia. i was his wayward son that went to law school, but i snt five years doing medical malpractice defense, although i did some plaintiffs' cases in southern california. my practice bracketed the time before micra and after. for anybody to suggest that micra didn't make a difference, you weren't there. i happened to be a young attorney at the time, and i had some classmates from high school and college that went to medical school, and they were about ready to enter the practice of medicine. a number of of them left the state of california because the insurance rates were so hichlt i remember a good friend of mine who is an anesthesiologist left the state. some ob/gyns left the state. some doctors involved in brain surgery left the state because of the high costs.

i don't knowhereou get these figures that it wasn't until '88 we saw any progress, because the absolute increase on a yearly basis of the premiums paid for by the tdoctors leveled off aftr we passed micra. it was interesting to hear the gentleman from georgia talk about noneconomic damages. it puts a limit on noneconomic damages, pain and suffering. why? that's the most potentially abused part of the system. i can prove losses for future earnings. i can prove what the costs are, the direct costs. pain and suffering, if you think about t, if before an instant you were to ask somebody, how much would it be worth to you to lose your arm or leg? they'd say you couldn't pay me

enough money to do that. after the fact when you talk about pain a suffering, it's a very difficult figure to determine. so you make a rational judgment by the legislature or the people as to what that limit would be, because otherwise it has an adverse effect on the potential for people having access to medical care. i mean, it's not a perfect system. never has been a perfect system. so i'll just say from my standpoint as someone who was there when we passed it in california, i saw a tremendous diffence. when people talk about frivolous lawsuit, let's talk about the real world. when a plaintiff's attorney begins the lawsuit, he or she sues everybody in sight because he or she can't be sure who was responsible. by the time you get to trial, you ought to know as the plaintiff, plaintiff's attorney who you thk really is

responsible. you ought to let out the other people. if you don't, we ought to have a very simple, modified loser's pay provision so that at the time of trial you can present to the judge and say, if they have no case or they get less than what i am offering now, all attorney fees and costs should be borne by the plaintiff. i was in settlement conferences where the judge would say to me, i know your hospital or i know dr. c doesn't have any liability, but the cost of defense will be $10,000 so throw in $10,000. that was considered a quote-unquote settlement. in every case i'm aware of you have that dilemma, and so when you're talking about even real cases of malpractice, a lot of other people are involved in the case and they may settle out but

there was no real liability. unless you sort of change that dynamic, you're going to have this situation. i have to overcome my reluctance to do this on a federal level, because i thought california, we were ahead of the rest of country when we passed what we did. you probably couldn't have passed micra on the federal level at that time. i'm sorry my friend from north carolina is not here, because he said very clearly to me that health care is not covered by the commerce clause. i would hope that he'll make that presentation before the courts that are considering the lawsuits right now. so i'm sorry i don't have any questions for you. just listening to everything, i have to put it into my sense of -- no, he said someone is not taking care of across a state border. they're in a hospital here, a hospital there. it's not in interstate commerce.

that's what he said. having heard all of this, it brings me back to the argument that is we were making in california in 1974-1975. we made a reasonable judgment in california, frankly i think it has worked very, very well and is a model for the rest of the country. i don't think there's any doubt that the specialties that are available in california are available in larger numbers today thanhey would have been had we not passed micra. so there's no perfect system. i think we all recognize it it. what we're trying to do is find that which will give us the best overall response to a continuing challenge. how do we provide health care for the people of the united states? last note is i take my hat off to the medical community because i had major kidney surgery when i was four, i've had five knee surgeries and i have a new hip and knee, you repaired my

achilles tendon a while ago. i'm a walking example of what medical care can do for people in the united states. my wife said you're getting older, but i said i'm getting new parts. there is hope. i'd like to thank our witnesses for testimony today. they have five days to submit the chair additional written questions for the witnesses which we will forward and ask you to respond to those, please, as quickly as you could so we could make your answers a part of the record. if we send them to you, there will be serious questions for members, some who weren't able to attend, some who had to leave, some who have more questions for you. i would thank if you you seriously consider that, all three of you. without objection all have legislative days to submit additional materials for inclusion in the record. i'd like to thank the witnesses. i know this is an imposition on your time and we have to run off and vote and so forth and you sit here. we thank you very much for your testimony. it is very, very

>> this is a fiscal house of cards and it is a health-care house of cards. has any family in america act, any single mother, any spouse, any child, and the grandparent met a more bureaucratic system than the health insurance system? >> watch this week's health care debate any time on line with the congressional chronicle. see what your representative said amtrak time lines and read

transcripts. c-span.org/congress. >> in 45 minutes, a discussion on the agenda of the house oversight and government reform committee. after that, today's house debate on the future of health care legislation. on washington journal tomorrow morning, we will talk about president obama's first two years in office with bill adair. ignagni joins us on the health-care debate. and chad hart. "washington journal" is live on

on c-span at 7:00 a.m. eastern. >> historians discuss the first age of terror. domestic terrorism of the late 19th and early 20th-century. turn-of-the-century old traditions of preparing for a horse-drawn funeral and howard university professor of african studies explains how slaves escape and started new lives. all weekend, every weekend. see the complete schedule online where you can press the c-span abroad button and have our schedules e-mail to you. -- e-mail to you. >> eric kantor and steny hoyer on the schedule. they discuss proposals to cut the federal budget and deficit. this is 45 minutes.

the speaker pro tempore: the house will be in order. for what purpose does the gentleman from maryland, the distinguished minority whip, rise? mr. hoyer: mr. speaker, i thank the speeblinger -- thank the speaker for recognition and i ask to speak out the of order for one minute to inquire of the schedule for the coming week. the speaker pro tempore: without objection. mr. hoyer: i thank the speaker and i yield to my friend, the gentleman from virginia, mr. cantor. mr. cantor: mr. speaker, i thank the gentleman from maryland, the democratic whip, for yielding. on monday the house will meet at noon for morning hour and 2:00 p.m. for legislative business with votes postponed until 6:30 p.m. on tuesday the house will meet at 10:00 a.m. for morning hour debate and noon for legislative business. the house will recess no later than 5:00 p.m. to allow a security sweep of the house chamber prior to the president's state of the union address. the house will meet again at

approximately 8:35 p.m. in a joint session with the senate for the purpose of receiving an address from the president of the united states. on wednesday the house will meet at 10:00 a.m. for legislative business. during the week the house will consider at least one bill under suspension of the rules which will be announced by close of business tomorrow. in addition we will consider h.res. 38, a resolution reducing nonsecurity spending to fiscal year 2008 levels or less and a bill of the public's choosing via the youcut program to reduce federal spending in the deficit by terminating taxpayer financing of presidential election campaigns and party conventions. saving taxpayers $520 million in mandatory spending according to c.b.o.'s estimate last year. mr. speaker, i yield back. . mr. hoyer: i thank the gentleman for informing us of the schedule for the week to come. i want to thank at the outset

not only the gentleman but the speaker as well for the respect and consideration they have given during this current tragic situation that's confronted us in tucson and the critical injury sustained by our colleague, gabby giffords. i want to thank mr. cantor in particular for his very strong statement as well as the speaker's very strong statement that an attack on any individual who serves is an attack on all of us irrespective of party or philosophy. and i think that we all have raised prayers for the victims who lost their lives, the families, prayers who are either in the process of recovering or now out of danger. and of course for our beloved colleague, congresswoman giffords, as well.

i want to thank the gentleman for his leadership and the speaker's leadership and join with our leader and myself in leading the house in what i thought was a very appropriate and united response to that tragedy. we are heartened by the progress that congressman giffords is making and we look forward to her quick return. mr. cantor, if i can, next week we are scheduled to leave on wednesday. i know that there has been an articulation of an intent to try to get out by noon on the day that is we leave. would your -- would you expect that to be the case next week? mr. cantor: i thank the gentleman. first of all i'd like to thank him for his kind statements regarding the expressions of grief and support that i think all members of this body have

expressed to gabby giffords, her family, her staff. our thoughts and prayers remain with all of them and certainly to the victims and their families. and hope that they all know that we are thinking of them. mr. speaker, as far as the schedule's concerned, if you recall, the commitment on our schedule was the last day that we are here the finishing time would be 3:00 p.m. on the last day we are here and we specifically had indicated that january is going to be a little different and an exception due to the organizing process, state of the union, etc. the expectation is to begin that in february as was originally expressed although we do intend to try and be as expeditious as possible on wednesday, the exact timing of our departure and finishing up

depends on the actual rule coming from the rules committee, including the amendment debate, structure for the presidential election fund bill. and so we expect an announcement by the rules committee chairman later today on that. i yield back. mr. hoyer: i thank the gentleman for his comment. given that response, can i ask the gentleman what -- would he expect there to be an open rule with respect to that bill? i yield to my friend. mr. cantor: the gentleman understands as the rules committee chairman presides over the rules committee and entertains the submission of amendments as to exactly -- i can't answer that right now and that will be determined by the rules committee. mr. hoyer: not only do i recall that as being a fact, i also recall it as an answer i used to give the gentleman on a regular basis. i thank the gentleman for his response. but i'm certainly hopeful as he was hopeful, but given the

representations of transparency and openness that there would be opportunities to amend, i know that mr. van hollen spoke to that in the rules committee, and i would hope that we could see that policy which has been expressed by your side pursued in this instance as well as future instances. i thank the gentleman for his response. let me ask the gentleman there was some criticism raised when we passed a budget enforcement resolution that we hadn't passed a full budget. in that budget enforcement resolution as you recall, a, we articulate add specific number, and b, that number was voted on by the entire house. it's my understanding that the proposition that will be put before the house next week will provide and give unilateral authority to the chairman of the budget committee to set a

number. that that number will not be voted upon by the house pursuant to the authority granted in that resolution. is that an accurate reading of that resolution? i yield to my friend. mr. cantor: mr. speaker, i thank the gentleman. to be clear once the house adopts the resolution next week, the resolution will then instruct chairman ryan to cap nonsecurity discretionary spending for the remainder of fiscal year 2011 at fiscal year 2008 levels. that is the purpose of our adopting the resolution. acting as the house as a whole, instructing chairman ryan to cap nonsecurity discretionary spending at 2008 levels for the remainder of this fiscal year. and again, mr. speaker, i say to the gentleman, i know he shares with me the realization that people across this country, families, businesses are having to face some tough choices. we started this congress i think together committed to

demonstrating that we are willing to make those tough choices. thus the resolution for next week. i yield back. mr. hoyer: i thank the gentleman for his response. i do not want to be argumentative, i just received your amended copy of the resolution and as i read it on your second page it says, remainder of fiscal year 2011 that assumes nonsecurity spending at fiscal year 2008 levels or less. the implication is that it seems to me is that mr. ryan unilaterally can set a number which has not been agreed to by the house but would be under the power granted in this resolution would bind the house to a number to which it had never agreed. in addition to that, -- let me yield on that. is that an at crack reading of that? could in fact under this resolution mr. ryan set a

number that is less than, as your resolution says, 2008 numbers? mr. cantor: mr. speaker, i say to the gentleman that the resolution provides the capping of spending levels at 2008 levels. the gentleman also knows that the speaker has been very consistent in his statement saying that we are going to have open rule process when it comes to spending bills. in fact that's what we said during the last campaign season in the pledge to america. so that is in working with that commitment, the -- as well as the language of this resolution, the budget chairman, mr. ryan, will be instructed to enter into the record a cap of spending levels for the remainder of the fiscal year to be placed at 2008 levels. i yield back. mr. hoyer: i thank the

gentleman. would it be, therefore, accurate that the or less is superfluous and is not intended to give mr. ryan the authority to set a figure at less than 2008 levels? i yield to my friend. mr. cantor: i would tell the gentleman i disagree with that characterization of the language, or less, and just say that, again, the speaker's committed to an open process on spending bills and i assume that we will see coming to the floor every attempt and effort to try and maintain some sense that this congress is going to be a cut and grow congress. we are about trying to find savings everywhere we can so that we can get this country back on to a trajectory of fiscal sustainability. i say to the gentleman, no. this is not something that we intend to be meaningless. that we are serious.

the cap is consistent with our commitment to the people of this country that the levels of spending for the remainder of the fear -- fiscal year will not exceed 2008ment it is our hope that we will continue to find additional savings so that, yes, we could even find ourselves below 2008 levels. but the cap is 2008 levels. i yield back. mr. hoyer:00 i thank -- mr. hoyer: i thank the gentleman for yielding. the point i was trying to make perhaps not as clearly as i need, what we are in that resolution giving is to one person, one person, in this congress, the authority without consideration by this house to set the number without hearings on what we will cap, as you articulate, cap spending levels at for fiscal year 2011. as i understand there have been no hearings by the budget committee. no hearings by the

appropriations committee. no hearing by the ways and means committee or any other committee involved in fiscal matters what the ramifications of that cap will be to individual programs or individual americans. i share the gentleman's view and have voted consistently as i voted for the balanced budget amendment as the gentleman knows last we considered it, to bring our fiscal house into order. i think neither party can necessarily take sole responsibility for doing so or not doing so when it comes to fiscal balance. but i do tell my friend that with respect to transparency and openness, and to inclusion of all the members of the body, it is, i think, not consistent with that objective to give to one person, however brilliant that person is, and i have great respect as the gentleman knows and have said so publicly in the press for mr. ryan, who

i think is a very positive, effective, and important member of this body, but i'm not forgiving any one person in this body the authority to unilaterally set the number at which we will fund america's government for the next seven months. i yield back to my friend to see if i might have a response to that because in his responses to me, i have -- i understand the cap. but at any number below that at 2007, 2006, 2005 levels it seems to me this resolution authorizes mr. ryan to set such figures as he unilaterally determines is an appropriate figure. in his mind that may be an appropriate figure but it is not necessarily the same figure that this body voting in a transparent, open way might select. i yield back to my friend. mr. cantor: mr. speaker, i just respond to the gentleman by saying we are in the position we are in because the majority

that he participated in the last congress failed to live up to its obligation in passing a budget and in even passing any appropriations bills short of a continuing resolution. that's why we are here today is because there is a mess that's been created from the last majority and we are trying to clean that up. now, we have committed to a transparent and open process and i have said to the gentleman that when the c.r. comes to the floor, we will see members on both sides of the aisle have an opportunity to amend the continuing resolution according to the way they think that we ought to be saving taxpayer dollars. so, again, i disagree with the gentleman's assertion that somehow there is a lack of transparency here. we have said all along the cap on our spending will be 2008 levels for the remainder of the fiscal year. if this house works its will and if members on either side are able to gain a majority of

votes in this house to achieve even more spending below the 2008 levels, then that will be the will of this house. and so, again, the gentleman understands well why we are where we are and we look forward to working together to go and produce a spending resolution here that begins to address the mess that was left before. i yield back. the speaker pro tempore: i the gentleman the gentleman for yielding. -- i thank the gentleman for yielding. will -- mr. hoyer: i jiang that the for yielding. is the gentleman representing to me this resolution will result in 2008 levels of expenditure so that members who are being asked to vote on this will have a certitude of the number on which they are voting? that's my only question. so that they will know on what authorization they are giving, what budget direction they are giving to the members of the appropriations committee?

mr. cantor: i thank the gentleman. the budget directive is 2008 levels or less. as the gentleman well knows. the intention is to allow the budget committee, the appropriations committee to do its work to report a bill to the floor, resolution to the floor, the body will work its will according to the insistence of the majority and speaker that we have an open process on spending bills. it is our hope that we can work to achieve even greater savings for the taxpayers of this country. i yield back. mr. hoyer: i understand that. i thank the gentleman. i know that he has indicated we are going to be considering what i believe to be a $52 million cut. that's important money. . of course she will take approximately 50 years to get to $100 million. if we consider one every week

that we're in session. my presumption is that you will be informing us of those opportunities to cut as well, giving us opportunities on our side and there may well be members on our side who want to join in making sure that we spend our money as effectively and efficiently as possible. but we also know in the commissions that -- and the commissions that have reported know that while these types of expenditures are important to review, and i don't know there thank there have been any hearings on this youcut, i know that this has been in response to the web page question that you have -- webpage question, i don't know how many responses you received to that, but are you intending to have hearings in relevant committees on future

propositions to cut? i yield to the gentleman. mr. cantor: i'd say, mr. speaker, i'd say to the gentleman, first of all, as far as the $520 million, not $52 million, is concern, as he knows, that is mandatory spending that is not discretionary spending and would be different and apart from the commitment that we just spoke about at 2008 levels. i would also say to the gentleman from, we -- to the gentleman, we will be glad to have hearings once the committee is organized. as the gentleman knows, it's been a little bit slow in upstart, just given the transition of leadership, etc. but we are waiting for your side in some instances. i hear from committee chairmen that things are working well. so we hope that committees will be up and organized to have hearings. but to -- in order for us to deliver our commitment that we are going to bring up a spending cut bill every week, this body will be considering a bill providing for cutting the

presidential election fund that has been in existence for some time. as the gentleman well knows, this tends to be of some controversy in some corridors. there are those who believe that this is an attempt to drive this country towards a public finance system for campaigns. obviously there are those in this country who believe that's what should happen. but knowing full well the controversy, i'm sure we'll have a robust debate and i am looking forward, mr. speaker, to as many cuts to this fund as the gentleman's side may offer and look forward to a robust debate on the issue. and i yield back. mr. hoyer: i thank the gentleman. let me ask again, because -- does the gentleman intend, once the committees are up and running, i understand in a transition it takes some time, that the cuts that you're going

to propose on a weekly basis will have been subjected to committee oversight and hearings with the public having an opportunity to testify on the consequences of those cuts? i yield to my friend. mr. cantor: i say to the gentleman again, yes, it is our intention to have as full and open debate on all of these issues. as the gentleman recalls, this process began last june or spring or so that we said we were going to redirect the focus to make sure that we are in line with the will of the people and that is trying to do everything we can to remind all of us of the import of cutting spending and therefore this process begins. but, yes, to the gentleman's question about hearings, we welcome that and would expect that. i yield back. mr. hoyer: good. i appreciate that response. lastly, i ask my friend, one of the significant issues that will be confronting us in the coming months will be the extension of

the debt limit, to ensure that america continues to pay the bills that it has incurred and therefore maintain fiscal stability. not only in this country but throughout the world. mr. speaker, and you have both made, i think, very positive comments on the fact that as unwanted as such a vote may be it is nevertheless, as the speaker pointed out, an adult vote, i took that to mean a responsible vote, to ensure that fiscal stability of our country. does the gentleman anticipate a clean up or down d vote on that issue -- up or down vote on that issue when it becomes timely to vote on that issue sometime in march or april? and i yield to my friend. mr. cantor: mr. speaker, i thank the gentleman and i would begin by saying to the gentleman, as he knows, it's unclear when the

federal government will actually hit the debt ceiling and we will be closely monitoring that date. but before we reach that date it is very, very important that we prove that this congress is willing to cut spending. and the house, as discussion today indicates, will be taking those necessary steps each week that we are here leading up to an eventual vote. and in fact i will call on the leader on the other side of the capitol, mr. reid, to follow suit. the continuing resolution vote gives us the first opportunity, real opportunity, to demonstrate our commitment to cutting spending. the debt limit will be another opportunity for this congress to cut spending. and as i think the gentleman knows, i have said repeatedly that we will not accept an increase in the debt limit without serious spending cuts and reforms. and i look forward to joining

with the gentleman, debate on this house floor, hopefully we can have the senate join us as well as the president towards that end. i yield back. mr. hoyer: i thank the gentleman. it's my understanding from the gentleman's response that if in the eyes of you or mr. boehner or your side of the aisle that serious spending cuts have not been affected, that would you oppose the extension of the debt limit, is that what i hear you saying? i yield back. mr. cantor: i say to the gentleman this, we have been charged with an obligation by the people of this country to get our fiscal house in order. we intend to be very deliberate and focused on cutting spending while making sure we're doing all we can to grow the economy and the private sector jobs. and it is our intent to prove that this house and this congress, hopefully leader reid will follow suit, that we'll deliver on that commitment.

the public, as the gentleman knows all too well, is tired of business as usual. they don't want to see this country to continue to incur debt as it has in the past without some indication that things are changing, without some indication that serious spending cuts have been implemented and reforms affected and that would be our intent. i yield back. mr. hoyer: i thank the gentleman for that response. but i hate to keep pressing him. if his hopes are not realized and i don't know the answer as to whether they will be, but if at some point in time we'll be confronted with an alternative on whatever the facts may be with respect to what we're payable able to pass for this house, the senate -- able to pass for this house and the senate, signed by the president, we will be confronted with the consequences of our past behavior and i underline our, o-u-r. spending that we have incurred.

i don't want to go through the tired debate that you and always -- you and i always go through so i won't do it but we will be confronted with an adult moment as to whether or not we will in light of the consequences of past behavior take actions necessary to preclude america from defaulting on its debts and i simply ask the gentleman, will we have the opportunity to have an up or down vote on that issue under the circumstances where we have reached, as the gentleman points out, we don't know the exact date, the extent of present authority? mr. cantor: i'd say to the gentleman, mr. speaker, that the vote on the debt limit comes within the context of our demonstrating a commitment to cut spending, to affect reforms and the president as well as the gentleman's side here in this house has said both that they would like to see and join us in

cutting spending. this debt limit vote comes in the context of all that we're going to be able to do over the next several months and we've got to be demonstrating that or frankly the public will not want us to accept any notion that we're going to continue business as usual unless we've demonstrated that things are changing and that's why i continue to say to the gentleman, we will not accept an increase in the debt limit without serious spending cuts in reforms. i yield back. mr. hoyer: i thank the gentleman. and i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. for what purpose does the majority leader rise? mr. cantor: i ask unanimous consent that when the house adjourns today it adjourn to meet at noon on monday next for morning hour debate and 2:00 p.m. for legislative business. the speaker pro tempore: without objection, the majority leader. mr. cantor: mr. speaker, i send to the desk a privileged

concurrent resolution and ask for its immediate consideration. the speaker pro tempore: the clerk will report the resolution. the clerk: house concurrent resolution 10, resolved that the two houses of congress assemble in the hall of the house of representatives on tuesday, january 25, 2011, at 9:00 p.m. for the purpose of receiving such communication as the president of the united states shall be pleased to make them. the speaker pro tempore: without objection, the regulationlusion is agreed to and the motion to re-- resolution is agreed to and the motion to reconsider is laid upon the table. for what purpose does the gentleman from texas rise? >> mr. speaker, i ask unanimous consent that today following legislative business and any special orders heretofore entered into, the following members may be permitted to address the house for five minutes, to revise and extend

their remarks and include therein extraneous material. mr. hinojosa: mr. hoyer for five minutes. mr. van hollen from maryland for five minutes. ms. delauro from connecticut for five minutes. ms. woolsey from california for five minutes. mr. mcdermott from washington for five minutes. ms. kaptur from ohio for five minutes. the speaker pro tempore: without objection. for what purpose does the gentleman from michigan, mr. kildee, rise? without objection. mr. kildee: mr. speaker, today we will be saying farewell to the pages who have served this house so well, they're standing in back of the chambers here now, and we wish to thank you for your service.

i've been on the page board for about 30 years. speaker tip o'neill appointed me to this board and this has been a tremendous group of pages. you've worked hard, yufpke worked well and you've worked -- you've worked well and you've worked honorably. you've seen history. you've seen a change of party control of this house. you've seen our joyce -- joys and our sorrows. you witnessed the sorrow we all experienced and you experienced when a member of this house was attacked back in her district. there is a program called close up where people come to washington, people your age, to observe the congress. and they learn a lot. it's a great program. but no one sees the congress as

close up as you do. and we appreciate the fact that you recognize that as a great responsibility and a great honor. and you'll go back home and tell others about this congress. i think you can tell them that everyone who serves in this congress, even though we may have differences, sometimes very sharp differences, the one thing that does bind us together is that everyone here in this congress loves this country. go back and tell them that we are imperfect people trying to make a more perfect republic. i'd like to yield, mr. speaker, to my colleague on the page board, the gentleman from utah,

mr. bishop. mr. bishop: mr. speaker, thank you. mr. kildee, i appreciate it. the young men and women who are standing behind the bar at the back of our chamber here today are great young men and women who have served us well over this past. we appreciate you. this is probably the best behaved group of pages we've ever had. i don't know if you want to take it further than that, but you've done a great job and we appreciate you. mr. speaker, i ask unanimous consent to have placed in the record the names of those pages who have served us for this last semester, the fall class of 2010. the speaker pro tempore: without objection, so ordered. mr. bishop: thank you. i yield back. the speaker pro tempore: the gentleman from michigan. mr. kildee: thank you very much and i want to thank mr. bishop and ms. foxx also who served on this committee. we have enjoyed our work and you've made our work very enjoyable. mr. speaker, i yield back the balance of my time. .

the speaker pro tempore: the gentleman yields back. for what purpose does the gentleman from texas seek recognition? >> take my five minutes at this time. the speaker pro tempore: the gentleman will suspend. the chair will entertain one-minute speeches. for what purpose does the gentleman from rhode island approach? without objection, the gentleman is recognized. mr. cicilline: thank you, mr. speaker. even as i speak the lan slides continue to ravage the country. this national disaster, ongoing for several months now, has taken more than 300 lives and damaged or destroyed more than 2,000 homes. in total more than two million victims have been affected by the flooding and some reports are calling this the worst natural disaster in colombia's

history. my district in northern rhode island is home to many wonderful colombian families. in fact colombians make up the fourth largest latino group in rhode island, most of whom have loved ones in the affected areas. so on behalf of the people of the first district of rhode island i extend my sympathies. we remember those who have died to those who have lost loved ones, injured, or lost their homes as a result of this destruction. i express my wishes for a rapid reconstruction of the damage to areas and return to safety for the families affected by this tragic natural disaster. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back. are there further one-minute requests?

the chair leaves before the house the following personal requests. the clerk: leave of absence requested for mr. ruppersberger of maryland for today. the speaker pro tempore: without objection, the request is granted. under the speaker's announced policy of january 5, 2011, and under a previous order of the house, the following members are recognized for five minutes each. mr. poe from texas. mr. paul: i ask to take my five minutes at this time. the speaker pro tempore: the gentleman from texas is recognized for five minutes. mr. paul: thank you, mr. speaker. mr. speaker, perpetual war is expensive. we have been militarily

involved in the persian gulf region now for 20 years. experts have predicted that the cost of this continuous and expanding war will reach $6 trillion. the hostilities in our overt involvement in iraq can be dated back to january 16, 1991, when the defensive operation desert shield became the offensive operation desert storm. though the end of the persian gulf war was declared on april 6, 1991, with a u.s. military victory, the 20-year war was just beginning. the u.s. and britain have had an intense interest in controlling the oil of the middle east dating back to the overthrow of the ottoman empire during world war i. this interest expanded during world war ii with f.d.r.'s promise to protect the puppet government in the persian gulf region, especially saudi arabia. though this arrangement never set well with the citizens in the region, a fairly decent relationship remained between the arab people and the

american public. but animosity continued to build with our ever present military involvement in iraq. our military assistance to the mugea had a dean in the 1980's, now the taliban, help the muslim defenders, one of whom was osama bin laden, oust the soviets from afghanistan. at that time we were still not seen as occupiers and the radical muslims encouraged by the u.s. were expected to direct all their efforts toward the munist threat. that all changed with the breakup of the soviet system and the end of the cold war , when as the lone superpower left standing, we named ourselves the world policemen. it was then that the resentment by arabs and muslims became directed toward the united states now seen as an invader and occupier. continuous bombing and crippling sanctions against iraq during the 1990's, the

appearance that the u.s. did not care about the plight of the palestinians, and our military bases in saudi arabia led to attention getting attacks against the united states. the 1998 embassy attacks in kenya and tanzania and the attack of the u.s. cole in the year 2000 were warning that the war was far from over. the horrible tragedy of 9/11 shouldn't have been a surprise and many believe it was preventable. currently the war has morphed into a huge battle for control of the persian gulf region and central asia. this involves iraq, afghanistan, pakistan, yemen, somalia, and iran. foolish policies lead to foolhardy conflicts. foolhardy conflicts lead to unsustainable costs and a multitude of unintended consequences. to name a few we have spent trillions of dollars based on the false pretense of defending freedom and our constitution.

the notion has been further solidified that war no longer needs to be declared by congress and can be pursued as a prerogative of the president. we are now seen by the world not as a peacemaker but rather a troublemaker and aggressor. thousands of american service members have been killed and tens of thousands wounded with a sharp increase in service connected suicide. over 500,000 veterans are seeking medical treatment and disability benefits. millions of citizens have been killed, wounded, and displaced in the countries on the receiving end of our bombs, droughns, sanctions, and occupation. the region has suffered huge environmental damage as a consequence of our military occupation. christians from iraq have suffered the worst route in the history of christian done. iron and iraq are now better allies than ever with strong

anti-american sentiment. iraqi political stability is a joke. ending hostilities in afghanistan is a dream. china and iran have been drawn into a closer alliance against the united states. america's uncontrolled deficits are senselessly fueled by needless militarism. we are now much poorer and less safe. there was no al qaeda in iraq before we invaded in 2003. today there is. no weapons of mass destruction were ever found in iraq. war always leads to government growth and the sacrifice of civil liberties. in the past 10 years this has been particularly costly to us with the acceptance of military tribunals, torture, assassination, abuse of habeas corpus, and patriot act-type legislation. senseless war and senseless destruction and death should not be rationalized as providing a great service in protecting our freedoms. our constitution or maintaining

peace. the only value that can come of this is to recognize our policies are flawed and they need to be changed. without this history will record the sacrifices were all in vain. the speaker pro tempore: mr. hoyer of maryland. mr. hoyer: thank you, mr. speaker. i ask unanimous consent to revise and extend my remarks. the speaker pro tempore: without objection. mr. hoyer: mr. speaker, i rise to honor the great american. my friend, sargent shriver. a son of maryland who passed away this week at the age of 95. he was a public servant who lived a full life dedicated to promoting justice an opportunity in america and indeed throughout the world. as the first director of the peace corps, mr. shriver skillfully launched an organization that has strengthened respect for america across the world and has for half a century exposed a generation of americans to

the world beyond their borders. sargent shriver also made his mark as the director of the important anti-poverty programs and is the leader of the special olympics movement. a movement that he joined his extraordinary bride, eunice kennedy shave, in heading. -- shriver in heading. in the words of his biographer, i quote, often the things that sargent shriver accomplished, starting the peace corps, or getting 500,000 kids into head start programs, its first summer when the experts said that 10,000 kids was the maximum feasible, were things that everyone before him had said were not realistic or were down right impossible. he did. he had a gift for what one of the old war on poverty colleagues called, and i quote, expanding the horizons of the possible.

i'm reminded of robert kennedy's quote that he used so often that some men see things as they are and say why. robert kennedy said i dream things that never were and ask why not? sarge shriver mirrored that quote. may we all learn from his example. may we honor his legacy of public service by expanding our own horizons of the possible. by caring for those who need our help. here and around the world. sargent shriver brought to american life a singular commitment to service. his good work and his historic examples will long outlive

the backs every morning, it is "washington journal." connecting you with policymakers and journalists. weeknights, congressional hearings and policy forms. also, supreme court oral arguments. you can see our signature interview programs. on saturdays, "the communit cators". you can watch our programming any time at c-span.org and is searchable through our video library. a public service greeted by america's cable companies. >> this new law is a fiscal house of cards, and is a health care house of cards. has any family in america, any single mother, any spouse, any child, and the grandparent met a more bureaucratic system than the american health insurance

system? >> watch this week's health care debate from the house floor on line with the congressional chronicle. track daily time lines and read transcripts. congressional chronicle at c- span.org/congress. >> tuesday, president obama delivers the state of the union address. live coverage begins at 8:00 p.m. eastern with our preview program followed by the speech tonight. the republican response and your phone calls. live on c-span, c-span radio, and online. you can watch the president's address on c-span2, followed by reaction by members of congress. >> more about the republican agenda in congress. this segment focused on plans for the health oversight and reform committee. this is half an hour.

host: meet congressman jason chaffetz of utah. he represents the third district in utah. we just announced he has a new job. he will be chairing the subcommittee on national security and homeland defense. what you want to do with that panel? guest: there is a lot to do. we have hundreds of millions of dollars going out the door in the war effort. we have people from every corner of this country fighting to defend the country. quite frankly, we do not have enough discussion about the fact that we are in a war. we have a duty and a responsibility to not only work with the president, but also be the check and the balance. there's a lot to look at. also, i want to look closely at the csa and what is happening at

the airports. i have been an outspoken critic of the way they are conducting the search is at the airport, and the southwest border. i'm very concerned. everyone says border security is imperative. but, is it really happening? we just heard the secretary scuttling a billion-dollar plus effort to come up with a virtual defense. i think we have a duty to give some oversight and look at what is happening at the border. host: the restructuring, do you think that has been a plus in making it more secure? guest: i think we need to evaluate that. i also serve on judiciary with lamar smith. we asked for a review on how those agencies work together. we have this huge array. i do not know that they're working closely together. one area i am concerned about

is immigration and customs enforcement. they have duties and responsibilities dealing with anything that happens on the internet over our borders. they do not necessarily have the time and resources to take on that mission as well. in utah, we have 29 counties. we have 22 officers. they are not spending any time been looking at this salacious internet sex crimes and things are happening. if these are questions we need answers on. host: we have when half-hour with the congressman. will put the phone numbers on the screen. we also have an e-mail address and a twitter account. there has been a great deal of discussion about the tone and direction of the committee overall with chairman darrell issa have been the devil. i am wondering if you could let people know -- have been the gavel, what direction do you see

that he is going to be taking president.ttee? it is not our job to be the lap dog. we are supposed d to challenge e administration. i think we are supposed to do it in the way it speaker john boehner outline. we may disagree, but we do not need to be disagreeable. it is nothing personal -- personal about the president or any personality within the administration. but, we, as representatives of the people, if need to dive deep into those issues and items that will percolate up. there is no need to go on a witch hunt. there are plenty of items to look at that have been in the news and things that investigators have highlighted. we have special investigators in

iraq and afghanistan. we have a disaster in afghanistan with that general who recently left the post. we have the overseer of cartel will be on capitol hill today. we should not be making it personally. the investigator general for the tarp program, yes. host: let me jump on one other thing. that may use part of what you said before launching the discussion about civility. you have the one member of congress who has a concealed carry permit. what are you thinking about congressional security? guest: on capitol hill, i think they do it and exceptional job. there is a virtual army and great security and intelligence.

at home, it is a little bit of a mixed bag. i feel much more comfortable, it is not that i live in fear, or that i'm scared, but the reality is we have to do offices and we represent close to 900,000 people. there are a few people that deserve deeper investigation. while the capitol hill police and sergeant of arms have done a great and wonderful job, unfortunately, as we saw with what happened in tucson, a lot of people are on edge. i am hoping that as threats come in, because all members get threats, that we dive deeper in exploring those, particularly those that cannot distinguish reality -- those need to be taken more seriously. it is important not to react. i am comfortable carrying a gun. if it is a personal issue with me.

i do not want anyone to run out and suddenly go get a concealed carry permit in the wake of what happened on that saturday morning. we have to be careful not to overreact. host: what would overreaction look like? guest: if someone decided to arm their staff. there are a lot of things. i also do not believe congress should come up with new laws or rules that are special for members of congress. there were a couple of proposals that came out when day or two after the horrific events. if i do not think we necessarily need that. i am not advocating any gun law changes. take a deep breath. understand that this maniac is an isolated case. learn from it, but let's not overreact. host: how frequently do you get threats that concern you? guest: pretty much on a monthly basis.

almost everyone i talked to has had some degree of threat. a lot of this happens over the internet. a lot of people say and do things on the internet they would never do it in person. it happens on a regular basis. we had somebody two weeks before the shooting who showed up in our office and does something that said they wanted to kill jews. i happen to be of jewish heritage. i take that personally. you work about that that bridge you worry about that. host: waldo, florida. frank, you're on. caller: on the health-care issue, the democrats are just trying to push through or keep 10 pages of that health-care bill. they have a lot of other things in there that no one knows anything about. it is like paying for abortion, and i have heard of a few other

things, but i have not seen the bill. i would like to get a copy of the bill or have someone read the whole thing. anyway, my point is that i would like to see them repeal the whole thing, and then go back into it, and put in parts that they want to keep, and drop out all of the other garbage that is just going to increase taxes and everything else. host: thank you, frank. guest: i happen to agree. that is all we saw as republicans across the country. there are parts that we like. and by and large, it was a bad bill. republicans had a mandate, a duty, and an obligation to retail lead built. there are parts that i like, but the -- repeal that bill. there are parts that are a lot that i like -- there are parts

that i like it if there was an easy answer, it would have been done before. i do not think there is anyone who understands how so-called obama-care is actually going to work. when nancy pelosi stood up and actually set out loud, and i am glad she did, "we are going to have to pass the bill to find out what is in the" -- in its" that was very true. a lot of conservatives were concerned that a kid to much unilateral control to the secretary and others. host: harkening back to the discussion about oversight -- this week. -- this tweet.

guest: i am not in favor of the contractors or a post. there is a balance. it particularly in afghanistan or iraq, there was a good inc.rt called warlords thi that looked at the trucking contracts that go into afghanistan. we spend over two billion dollars a year on those trucking contract. are those actually fueling the war in afghanistan? is that money ultimately making its way to the taliban and in power in them to continue the fight? if you think about them -- and it's in powering them to continue to fight? if you think about that, as long as there are conflicts, they will need to hire more contractors. it was a very good bipartisan

report. it got into that issue. it is something our committee will dive into. host: mr. chaffetz, next call is tom, a democrat. caller: if you want to see some waste, you ought to investigate all of the spending that the local people laugh about. host: on border security? caller: you might call it border security. host: why is it wasteful? caller: anyone with half a brain can see all the stuff they purchase that is not being used. they have a parking lot of trucks that are not used. if they have a truck for everyone in the government. there is a tremendous waste of money in that department. the local people talk about that and laugh about it.

guest: tom, thank you. it is definitely something we need to look at. not only on the southern border, but the northern border as well, we are throwing billions and billions of dollars into this. what is happening with abuse. is it effective? you cannot go one week without hearing of all border violence that is spilling over into the united states. part of this was started in the bush administration. asked if you look at what is happening with cyber security and all the things i've are supposed to happen, there is a lot of concern because it does not work. i do not understand. after a decade of deep concern, we are still not able to secure borders. to hear about what is happening in michigan, that there are just laughing, that is something our committee should look at.

host: our guest has a dancer's degree from brigham young. -- bachelor's degree from brigham young. he served as a chief of staff for the governor after first being a campaign communications director and a campaign manager. he beat and the -- and incumbent gop member in that state. why did you become a republican? guest: i like to joke that i learned to read and write. i got my degree. i got married. i got a job. i just found out internally the diet a conservative person. i believe i can't -- that i am a conservative person. i believe i can work with anyone. i believe in limited government, accountability, and strong national defense. as i look at all of those components, i just recognize the

republican party offered me a lot more. i had an opportunity as a young man to meet ronald reagan. it was impeccable. i was with him for a few days. i had conversations with him. i have been a republican for quite a while. host: ronald reagan is on the cover of "usa today." the 100th anniversary of his birth is coming up february 6. there are many commemorations that the get ronald reagan's legacy. susan page is the author of the peace. next, brad, and independent. -- an independent. caller: my first comments are

since republicans came into office, they are always saying about the american people -- the polls before the election said the american people did not really like the health-care bill, but the more they understand it, most americans prefer the health-care bill -- the health care law. i want to know why republicans do not say -- i want to note the polls right now are showing american people want this plan. host: there is a new poll that says the public is evenly split , 39/39. guest: i appreciate the call and the concern. i believe it is important that any public official be guided by principle and not by polls. we do a poll on everything, and

probably too many. the principle for me not as concerned about health care is who is in control taxed i came to washington, d.c., in part because i want to shift the responsibility, the control and the power out of washington d.c., back to the states. i believe that it should not be the states that have this one- size fits all. that is philosophically my approach. it is the way i approach the department of transportation, the department of education. is there a role and responsibility for us to be involved? yes. but, it will not be a bureaucrat in washington, d.c. it will be what is happening in utah. utah happens to be one of the most effective and efficient deliverers of health care in the nation. we ought to be able to propel

them forward at the state level. point, let's not take a gauge of nicole. it is fundamentally wrong. host: hall is utah's economy? -- how is utah's economy? guest: we have been rated by a lot of magazines by one of the most impressive paces to do business. hello tax rate. we are one of the fastest- growing states. we have an educated workforce. we have lower taxes. we did the difficult lifting and challenges of our retirement program. we have a balanced budget. we do not have the massive debt to other states do. consequently, we can't ride.

-- we can authorize. host: ken, republican line. caller: i have three issues i would like to discuss. what is the issue i have currently -- we still have a huge deficit and our economy is not growing nationwide. all over the country, guess which are steadily going up. we know things like the american public paying for the bp spill. second, i am in total agreement with the congressman on the government taking over the health care. i do not believe the government should control our health care in any form, or education. however, at the same time, with that health-care bill, no one has seemed to say they read

this, but it is available online. no one is bringing up the fact that everyone will be able to -- required to take the chip under this bill, which is dangerous. the third thing, on your border security, which we are letting illegal immigrants coming here every day with drugs, guns. illegal immigrants are taking over our health-care system. we even find out that we have senior citizens from latin america that are getting social security. what is our government truly doing? are they doing anything at all? guest: good morning in missouri. i appreciate that. let me try to tackle that. the debt and the deficit -- that is one of the main reasons i came to washington, d.c. when i was running in 2008, i

was concerned our debt was coined to be nine trillion. now it is over $14 trillion. the reality is we cannot sustain this. when you have 25 cents of every dollar in this country being spent by the federal government, that is too much. we are paying more than $600 million a day in interest. we do not get anything for that. i looked at the state budget for the state of europe -- state of .tah we have to cut spending. i have only been here 24 months. what has been so disconcerting to me is that we have not cut anything. everything from a 1 million -- billion dollars subsidy, all the way up to big things like social security reform and the entitlement reform. these are things are congress needs guts to get tested.

i am proud of the fact that republicans are committed to bring up these cuts. we have massive cutting to do in order to get to where we are. to the second point about energy prices, which to me is also a discussion about how you thrive and grow jobs -- one, we need certainty in the marketplace. we have exacerbated the uncertainty. we will never balance our budget until we get a thriving business economy. we will help more people with health care if they have a job. that is what everything needs to be about. how'd you get the economy booming again? for me, it is getting the government out of the way. incentivize to hire employees, not incentivized to not hire employees. those are more than just bumper stickers to me. it night -- it needs to not just be live service. we have not done anything to cut

the debt. host: health care and a limit from it illegal immigrants -- and a limp -- and illegal immigrants access to it? guest: in the state of utah, we have the very good health care delivery system. i went to our largest provider and and i asked how much more do i pay then someone to cover all of the people? we pay 70% higher rates to cover those people -- 17% higher rates to cover the people that are not full participants in the system. that is the burden put upon those said are responsible. that is a deep concern. host: that is the argument behind mandatory purchase.

guest: this is where the government goes too far. i do not support the idea that the federal government will force you to pay for a service. host: square those two issues. guest: is what we are doing in the state of utah. the way we look at that the equation is to say we have a high risk insurance pool. we have people with pre-existing conditions. we have young people who have cancer. how will they get insurance? no matter what your situation is you can pay into the system. they need to pay into the system. i do not think the federal government should force you. that is a line i will not cross. is it important that we offer those types of products and services? we do already in the state of utah, but i do not think the federal government should be forcing that. it goes against the principles that i believe. host: just a couple of minutes

left. indianapolis, michael, good morning. sick call i think the stock -- caller: my colleagues on security. it seems to me the chinese no longer need any espionage against us because if you look at any of these deals with boeing or general electric, or binary of our technology, the chinese term is indigenous convention, which means you give us your technology if you want to sell products in our country. the recent example is the general electric deal. basically, the chinese will build their own claims. they are after the avionics. i am not an expert, but it is clear there after that portion of the technology, yet it does

not mean that anyone is doing anything about the fact that we spend and give tax credits to these companies. we are giving them billions of dollars. if it takes us five years to 10 years to develop this technology, what are we doing to stop that? guest: we are not doing enough. that is one of the deep concerns. here, we are competing with china on the global marketplace. they have bought nearly $1 trillion of our debt along the way. yet, we are still giving china a. we take tax payer money, and we are still giving aid to china. it is frustrating with such a huge debt. i am on the intellectual property subcommittee. it is something we will look at. the roles are not fair. they are not balanced. we are giving china all kinds of

access to the american market. we want and need them to have that access, but when you take u.s. companies such as microsoft, and they are trying to do business in china, they do not have the same sort of intellectual property enforcement, nor do i think they have those desires to put mechanisms in place. microsoft could collect the royalties. they joked we are the largest provider of products in china, but we have only sold one product. we have to get much more serious with the chinese in enforcing that intellectual property and making sure that it is fair and balanced. right now it is so upside-down. host: what did you think of the tone of the meeting with the two leaders? guest: it was cordial and polite. the ambassador to china was my

former boss. he speaks exceptional man during parity as a diplomat -- h exceptional mandarin. he is a diplomat in every sense .f the world i applaud the president. host: did you have a chance to catch up with the ambassador? what is up with his political future? guest: he is still a young guy. he brings a unique conversation of been a very successful, a popular governor, but also the international experience been the ambassador in singapore and china, his work in taiwan, his work with the u.s. trade representative --

>> i have to practice staying alive and preparing to die at the same time. >> sunday, our guest is christopher hichens. >> this is a strange time to have cancer. there are treatments that are out of my reach probably which is both encouraging and annoying. >> this sunday on c-span. this weekend on american history television, historian's discuss the first age of terror, domestic terror of the late 19th and early 20th centuries. learn the traditions of preparing for a horse-drawn

funeral. -- explains how slaves survived and had new lives. see the complete schedule online at c-span.org/history >> in a few moments, the house debate on the future of health care legislation. in about an hour and a house -- and about a hour and a half, the white house briefing. then a hearing on the relationship between medical mack truck -- medical malpractice liability and insurance costs. a couple of life events to tell you about tomorrow. house democrats are meeting in cambridge, maryland. we will have their news conference. shortly after that, you also

have the annual meeting of the u.s. conference of mayors. the housing secretary and the trade representative will be there. >> tuesday, but president obama delivers the state of the union address to both sessions of congress. there will then be the republican response and your phone calls. you can also watched the address on c-span-2 followed by reactions from members of congress. >> we provide cover to politics, coverage affairs, nonfiction books, and american history. this is all available to you on television, radio, on line, and social networking sites. we take c-span on the road with our local content of vehicle,

bringing our resources to our community. the c-span networks, available in more than 100 million homes. >> one day after voting to repeal the health care law, house republicans introduced a resolution drafted committees to come up with new proposals. the debate included an amendment dealing with the payment discrepancies for doctors treating medicare patients. this is an hour and a half. resolution 26, i call up h.res. 9 and ask for its immediate consideration. the speaker pro tempore: the clerk will port the title of the resolution. the clerk: house calendar number one, house resolution 9, instructing certain committees to research legislation prere-placing the job-killing health care law. the speaker pro tempore: pursuant thouse resolution 26, the resolution is debatable for

one hour equally divided between the chair and ranking membeof the committee on rules or their designees. the amendment printed in part b of house rort 112-2 is offered by the gentleman mr. matheson or his designee shall be considered read and shall be separately debatable for 10 minutes equally dided and controlled by the proponent and an opponent. the chair recognizes the gentleman from california. . mr. dreier: i yield myself such time as i may consume. implementing health care reform is what we begin today. this resolution, h.res. 9, initialates the second step of a two-part process which as we all know with the vote last night saw repeal of the health care bill. having ten that action to wipe the slate clean, we are now moving on to the far more

challenging task of crafting real solutions for the american people to ensure that we can drive down the cost of health insurance and health care. this resolution instructs the four committees of jurisdiction to draft legislation that brings about meaningful health care reforms. furthermore, this resoluti lays out 12 clear guidelines that deline what real reform is. some of these guidelines are simply commonsense principles such as the need for reform spending. if there is one overarching principle for reform is we cannot pick winners and losers. real reform must be accessible to every american. if a family is forced to give up a health plan that is working for them, can we call that reform? if a small business must lay off employees to comply with

new mandates, can we call that reform? if a doctor is forced to close her family practice because the cost of malpractice insurance is prohibitive, can we call that reform? if government bureaucrats make decisions that should be left to dtors and patients, can we call that reform, madam speaker? obviously not. our al is to increase access to quality health care for every single american, cluding those with pre-existing conditions. h.res. 9 that we are going to be considering here today puts us on the path to do just that. as i said at the outset, this is a tremendous challenge. achieving the goal of meaningful health care reform which we all share will demand an open d collaborative process. the four committees of jurisdiction have a great deal of work ahead of them.

this is a process in which we all must contribute, docrats and republicans alike. we have good ideas that are coming from both sides of the aisle and i believe that they will be considered through this deliberative process. these ideas must be shared, analyzed, and debated. if we all participate in -- if we all participate in this open and transparent process, i believe that we can address the health care challenges that we face in an effective and meaningful way. ultimately we all hope to arrive at the same place. we all share the same goal. that is access, access to quality care for all. that's what house republicans want a cheeve and that's what my democratic colleagues want to achieve as well. and that's whapresident obama wants to achieve. we all have our own views on

how we get there. in this body alone we have 435 views on the best way to reform our health care system. we owe the american people nothing short of a rigorous and thorough debate. but if we conduct that debate in good faith, madam speaker, grounded in the recognition that we all hope to achieve the same outcome, i believe that we in a bipartisan way, democrats and republicans together, can come up with real solutions. now, we saw the day before yesterday that the president said that he is willing and eager to work with republicans on the issue of health care. that's the sentiment that i and i know my colleagues on this side of the aisle share wholeheartedly. this resolution, h.res. 9, puts us on a path towards doing just that. it will begin this critically important process. so i hope very much that we'll have strong bipartisan support

for this resolution and we'll say that we have an amendment that will be coming forward, a democratic amendment, that the rules committee has made in order. i'm happy to say will add to that list that our friend, mr. matheson, has provided, and i will also say that contrary to the argument that has been put out there, that we don't have solutions, there are a wide range of proposals that exist and we look forward to having this committee process vigorously pursue just that. with that, madam speaker, i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from massachusetts. mr. mcgovern: thank you, madam speaker. i yield myself four minutes. the speaker pro tempore: the gentleman is recognized for four minutes. mr. mcgovern: i rise in very strong opposition to this resolution and very strong opposition to the very closed process in which we are discussing this resolution. once again i am deeply disappointed that instead of working to create jobs and strengthening the economy, the new republican majority continues to focus on reopening old wounds and fighting old battles.

the resolution before us today is allegedly the replace component of the republicans repeal and replacetrategy. i say allegedly, madam speaker, because this resolution not a serious legislative effort. it is a series of talking points. it is a press release. what this resolution does is ask the committees of jurisdiction to hopefully, maybe someday, if they would be so kind, to report legislation to the house that meets certain vage goals. -- vague goals. instead of repeal and replace, this is repeal and relax. trust the republicans to do the right thing. no thank you, madam speaker. yesterday this house voted without a single hearing or markup, without a single amendment to eliminate the affordable care act in its entirety. the members who voted for that bill voted to return to the days when insurance companies could discriminate against people based on pre-existing conditions. they voted to eliminate the ban

on annual and lifetime limits on care. they voted to eliminate the ability for young people to stay on thei parents' insurance plan up to the age of 26. they voted to reopen the doughnut hole in medicare, basically they voted for a tax crease on senior tizens who need prescription drugs. they voted to eliminate tax credits for small businesses who want to do the right thing and provide health insurance for their workers. all of that, madam speaker, would have the force of law. all of that was done with real legislative language. but not the resolution before us today. instead of real language that would provide real benefits to real americans, this resolution is simply a collection of empty promises. and the ironic thing is that most of the provisions included in the resolution were actually addressed in the affordable care act. according to this resolution, we should, quote, lower health care premiums through increased competition and choice. well, the affordable care act

already does that. many of us argued for a public option which would have lowered premiums even further with increased competition and choice, but my republican friends didn't want to have anything to do with that. this resolution -- the resolution before us today says we should, quote, preserve our patient's ain't to keep his or her health plan if he or she likes it. well, the affordable care act already does that. increase the number of insured americs, well, we did that by 30 million people. protect the doctor-patient relationship, we did that, and so on and so on. on the critical issue of people with pre-existing conditions, however, it's interesting to see the language my republican friends use in this press release that they call a resolution. they say, they support, and i quote, provide people with pre-existing conditions access to affordable health coverage, end quote. that sounds nice. but what we did in the affordable care act was to actually ban insurance companies from discriminating

against those people. i'll be very interested to see how my republican friends handle that critical issue and how much influence the big insurance lobby has around here now that they are in charge. and the doughnut hole? the resolution absolutely silentn the doughnut hole. madam speaker, health care is a vital importance to every single american. it is a big deal. and to treat health i shurens reform as just another -- insurance reform as just another opportunity for happy talk and wishful thinking is not the way to do business in the people's house. i urge my colleagues to reject this resolution. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from california. mr. dreier: madam speaker, i yield myself 15 seconds and i do so to say to my friend that i appreciate his very consill torrey -- conciliatory remarks. everyone has acknowledged this is flawed. we have had he courts already throw the mandate out. we need to deal with the

problem even before this measure is being implemented. so it seems to me -- the speaker pro tempore: the gentleman's time has expired. mr. dreier: we proceed with this work. with that i'm happy to yield two minutes to a hdworking memb of our rules committee, the gentleman from lawrenceville, georgia, mr. woodall. the speaker pro tempore: the gentleman from georgia is recognized for two minutes. mr. woodall: thank you, mr. chairman. madam speaker. i have been a memb of this body for two weeks and two days and i could not be prouder to be on the house floor today in support of the chairman's resolution. for the entire last year in my district, we have been focus the on one thing and one thing only, since march of 2010, and that is the repeal of the president's health care bill. before march of 2010, my district cared about health care reform. we talked about tort reform. we talked about putting patients back in charge of decisions. we talked about ending the tax preference businesses get so we can purchase insurance on our own and own those policies.

but the moment this bill was signed into law, the moment the president's bill was sign into law, that discussion stopped. and the repeal discussion began. and with the repeal yesterday, we now begin anew the discussion of how properly to reform the system. i'm anxious to have that discussion. we learned a lot in our time in the minority. one of those things we learned is that bringing simple straightforward resolutions to the floor is better for the process, better for the american people. the speaker's made that commitment. we continue that commitment today with these instructions to go back to the drawing board and bring things forward one at a time. i sat through 10 hours of hearings in the rules committee where folks came forward and said, go ahead and repeal the bill but save this one provision. let's have this one provision. keep this other one provision. we now have that opportunity. we have now repealed the bill here in the house and we have the opportunity to bring those

provisions forward one by one. i'll tell you what. i'm not going to like those provisions. some will pass the house. and that's the way it ought to be. you shouldn't have a one-size-fits all take it or leave it kind of system. you ought to be able to have that discussion on both sides of the aisle. and i have no doubt that provisions are going to come forward from our committee that i'm going to vote no on, but my colleagues on the left and right are both going to vote yes on and it's going to pass. that's the way the process ought to be. one provision at a time. one idea at a time. the speaker pro tempore: the gentleman's time has expired. mr. woodall: insurance reform. putting patients back in charge of those decisions. the speaker pro tempore: the gentleman's time has expired. the gentleman from massachusetts. mrmcgovern:00 madam speaker -- mr. mcgovern: madam speaker, i yield myself 15 seconds. the speaker pro tempore: the gentleman is recognized. mr. mcgovern: madam speaker, i think our objection is not with the idea of having a serious debate on these issues. there are areas we can come together and hopefully make this bill better. our objection is the fact my

friends on the other side voted to repeal everything. voted to allow insurance companies to once again discriminate against people with pre-existing conditions. i yield 15 seconds. they voted to take away the been fit for senior citizens that we put in there to help try to close the doughnut hole in the prescription drug bill. and what do they do in terms of replacing it? they come not with an alternative a press release. that's not serious legislating. that's politics as usual. madam speaker, i yield two minutes to the gentleman from new jersey, mr. pallone. the speaker pro tempore: the gentleman from new jersey is recognized for two minutes. mr. pallone: thank you, madam speaker. i'amazed, i listened to the gentleman from georgia who just spoke, and he said that in his district all of the focus is o health care and health care repeal. i don't know, when i go home all i hear in my district is jobs and the economy. people are concerned about the economy. they wanted us to create jobs. they want us to focus mostly on that issue. not on repeal of health ca. the other problem i have with the gentleman from georgia's

comments is because he seems to think because the house passed this repeal yesterday that the health reform is repealed. let me tell everyone, it's not. and this is just a ruse. this bill -- this health reform wasn't repealed. the senate isn't even going to take it up. the president has said he would never sign a repeal bill. so the republicans are just waing their time rather than focusing on what we should be focusing on is the jobs and economy. they keep talking about this false repeal that is never going to happen. now, i also wanted to say something about what mr. dreier said before. he talked about increasing access, increased choices. that's not what goes on if this bill was ever repealed. the choices now for people who have pre-existing conditions, they can't get insurance. they can't -- they have to pay more if they try to get it. or the kids on the policies that would be taken off if we have repeal, or the people that would again face lifetime caps. you don't have choices under

the old system because you were denied care through the insurance companies' discrination. the only way you have choice and access is under the health reform that this house and this country put into law where you're guaranteed you get insurance even if you have a pre-existing qun. you don't have to worry about lifetime caps. you can put your kids on the policies. don't talk to me about choices and aess. people don't have choices and access with those discriminatory policies that would be put back in place by the inrance companies as they continue to raise premiums, more and more people will not have access to health care and have access to health insurance. the only way you have access and choices is if we keep the health reform in place. . the speaker pro tempore: the gentleman's time has expired. the gentleman from california. mr. dreier: i'm pleased to yield two minutes to the dean of our delegation, mr. lewis. the speaker pro tempore: the gentleman is recognized for two minutes. mr. lewis: i appreciate my colleague yielding, and madam

speaker, i think the entire public knows that america has had in place, for a long time, one of the finest health care delivery systems in the world. it's the envy of many. that's not to say it's perfect. that's not to say we don't have major challenges, like pre-existing conditions and questions of portability. but indeed if the people who put in place a health care plan last year had their way, they would have taken the next step, to have a centralized, government-run health care system. that's the pattern of their future. at this moment, great britain, which has had such a thing in place for some time is attempting to back off their system and have more relationships between physicians and their patients. indeed, they're ing that because their system does not work. it's very important that we not allow the former majority to take their next step, that is, to have government-run health care and with that, yesterday we passed a repeal that will take us to conference with the senate and in turn, today, we're

beginning the process of examine re-examining where we have been to make certain we put in place health care that is positive for all americans, not health care run by the i.r.s. i yield back the balance of my time. the speaker pro tempore: the gentleman from massachusetts. >> i yield two minutes to the gentleman from new jersey, mr. andrews. the speaker pro tempore: the gentleman is recognized for two minutes. mr. drews: thank you, madam speaker. i thank my friend from massachusetts, well, we could have a bill on the floor today that expands fair trade for american companies, but we don't. we could have a bill on the floor today that finds ways to stop sending a billion dollars to the middle east to buy oil every day and instead create jobs producing energy in america. but we don't. we could have a bill on the floor today talking about ways to regenerate our real estate market and get people buying and selling houses again. but we don. what we have is an empty promise.

that someday, somehow, the new majority will come to our floor with a bill that will fix the health care problem. and i quote, insteadf focusing on new health care mandates that will increase costs and employers and swell the ranks of the uninsured, senate democrats should focus on providing access to health insurance for the 39 million americans who remain without health coverage. this should be our first priority. i'm quoting from speaker john boehner. he said this on june 18, 2002. so at a time when the republicans had a majority in this house, a president in the white house, and for most of the time, the majority in the senate, their first priority, which was to deal with the health care problem, they didn't do. that's the standard against which we should measure today's promise. doesn't leave for much --

doesn't leave room for much optimism. i would say instead of focusing on yet another empty promise, let's focus on putting americans back to work. i yield back. the speaker pro tempore: the gentleman from california. mr. dreier: i yield myself 30 seconds. the speaker pro tempor the gentleman is recognized. mr. dreier: everyoneas acknowledged that the legislation that has passed is flawed. everyone has acknowledged that. the president of the united states, when he said that the 1099 issue imposing mandates on small businesses, needed to be rectified, in his first news conference after the election, recognized there are problems. we had, day before yesterday, the distinguished assistant majority leader, the former majority whip, mr. clyburn say, he believes republicans and democrats should work together to improve this bill. 've already had a federal court determine it is unconstitutional to impose this mandate. madam speaker, we need to work together to resolve the very, very great challenges that we have ahead of us. with that, i reserve the balance

of my time. the speaker pro tempore: the gentleman from massachusetts. mr. mcgovern: i yield two minutes to the gentleman from texas, mr. doggett. the spear pro tempore: the gentleman is recognized for two minutes. mr. doggett: with last year's important health insurance reformaw, we provided real guarantees to american families against insurance monopoly abuses. today, republicans tell these families, forget the binding guarantees. we have 12 platitudes for you. this isn't a republican prescription, this is a placebo and for the american middle class, it's a very tter pill indeed. yesterday, house republicans in a remarkable measure, with one vote, decided to increase the national debt, reduce the solvency of the medicare trust fund, raise insurance premiums and charge seniors more fo their health care. during the last 12 years that these republicans were in charge, six of them with nea

total come domination of government here in washingto under the bush-cheney administration, they failed to enact one of these 12 platitudes in this flimsy, two-page excuse of a bill. 12 health care platitudes, missing in inaction for 12 years. they're broad platitudes that propose something they apparently kept hidden under bushel for the last 16 years and now will unveil. i think it'll just be the same old tired rejected, retread, republican proposals to get more -- give more income tax breaks to those at the top and if you believe they've got something new to offer to genuinely reform the health care system in a way that will help middle class americans instead of health insurance monopolies, i think you'll want to buy some of that republican iceream that helps you lose weight. our families don't need republicanlatitudes they need real help. i think the tea party types are right about one thing.

there are dangers from soaring debts, dangers they forgot for a decade. there are dangers from big government. but you know, that's not the only threat our families face. they face threats from big banks. from big insurance monopolies. do you have another minute or half a minute? mr. mcgovern: i yield the gentleman an additional minute. the speaker pro tempore: the gentleman is recognized for an additional minute. mr. doggett: our families face challenges from big pharmaceutical companies that charge more than any place in the world from the giant inrance monopolies and sometimes our families need government to come down on our side because otherwise those giant economic forces will take advantage of our families. by writing out the very protection the sick and injured need the most, protection they write into the fine print of an insurance poli that no ordinary person can understand, where they are told that they're not covered anymore. that they have a pre-existing

condition. that you have reached your policy limits and cannot get the care that your doctor says is vital to sustain your life. that this policy just doesn't cover sick people or that it can be rescinded. i say we need to provide people genuine protection. th's what we did last year. that's what theyant to eliminate this year. let's side on the side of the people, not the 12 republican platitud to benefit the insunce monopoly. i yield back. the speaker pro tempore: the gentleman's time has expired. the gentleman from california. mr. dreier: madam speaker, with that, i'm happy to yield one minute to one of the hardworking members of this brand new class that's come in carrying a strong message, the gentleman from columbus, ohio, mr. stivers. the speakepro tempore: the gentlen is recognized for one minute. mr. stivers: thank you, madam speaker. i thank the gentleman for yielding. i voted for the repeal of health

care bill yesterday because think doing otherwise would have been supporting the status quo and that's unacceptable. i believe there are some good ideas that were in the original health care bill that can be used and improved but, you know, some of those ideas are in h.res. 9 today. that instructs the committees on next steps on health care. however, there is one idea that i think we need to be -- need to add to that list. i think weeed to add the allowing of young folks to stay on their parents' insurance to h.res. 9. in this tough economy, many students are unable to find jobs right out of school. as a member of the state senate, i sponsored a bill that would allow those up to age to stay on their parents' plan and i just heard from a constituent whose 23-year-old son justin is back on his parents' insurance. moving forward, i'm committed to working with my colleagues in a bipartisan manner to support reforms we agree on like allowing young adults to stay on their parents' plan.

this was included in the republican alternative last year and should be included in the replacement bill this year. the speaker pro tempore: the gentleman from massachusetts. mr. mcgovern: i want to thank the gentleman for his comments in recognizing the fact that the provision that allows children -- parents to keep their children on their insurance is a good idea but he voted yesterday along with all the republicans to take that away. this press release they're now saying is a bill on the house floor doesn't address that issue. i wish the gentleman would have actually voted the way he -- with his convictions yesterday and voted against repeal. because what he did, if this bill becomes law, will take no i will -- it will deny parents to be able to keep their their kids on their insurance uil they're 26. i yield two minutes to the gentlewoman from florida, ms. wasserman schultz. the speaker pro tempore: the gentlewoman is recognized for two minutes. ms. wasserman schultz: i rise to

oppose the republican cynical attempts to place the health care reform law. yesterday's decision to repeal the affordable care act was dangerous to the american people, but today's actions to tout these provisions as republican ideas, is baffling. this these were the republicans' priorities, they would have left the affordable care act intact because all these provisions exist in the current law. if we all agree on the importance of keeping young adults on their parent's insurance, prohibiting insurance companies from dropping coverage for the sick and strengthening medicare this spectacle is a colossal waste of time we don't have. if they want to guarantee consume brother texts for the american people, they would not stage partisan antics. even when republicans had control of the entire government for six year, they did nothing to reform our nation's health care system. and during that time, premiums skyrocketed, the number of uninsured americans grew to 47 million and those with insurance

saw their benefits decimated. of course it would have been great to have the republicans as willing partners in the last two years as we work hard to pass the patient protection and affordable care act. no i will not yield. unfortunately, they insisted on being the party of no. even as we incorporated so many of their party's ideas into the law. rather than roll back the hard fought consumer protections and freedoms that unshackles americans from the whims of private insurance companies, as former republican senate majority leader bill frist said, republicans should be working with us to build on and improve the health care system. not to mention every potential minute spent in committee focusing on redundant legislation is another minute wire not spending working to get out of this recession. unfortunately, the republican majority's hasty vote to repeal the affordable care act failed on all such counts. the american people deservednd got real reform.

this vague resolution stating so-called republican principles on health care reform is like giving the american people a wish sandwich. there's nothing between the bread but we wisthere was. thank you and i yield back. the speaker pro tempore: the gentleman's -- gentlewoman's time has expired. the gentleman from california. mr. dreier: the fact of the matter stherk republicans sent associated health plans to make sure small businesses could drive the cost of health insurance down to the senate and our friends in the other party killed that measure. we put in place access for affordable prescription drugs so we have worked dill jebtly to make this happy. i'm mape to yield a minute to my good friend from fort myers florida, mr. mack. the speaker pro tempore: the gentleman is recognized for one minute. mr. mack: i thank you, madam speaker. yesterday was a great day for democracy and freedom in this country. yesterday, the republican-led congress voted to repeal a

health care law that was passed by the democrats that would maate, that would force people to buy something, even if they didn't want to. it's unconstitutional, it's un-american, it is not what this country stands for. now we're hearing a lot of our colleagues on the other side talk about how we want to strip away this and we want to strip away that and we're playing games d this resolution is a game. let me remind you that it was -- the present of the united states in his state of the union talked about tort reform, which was not included in obamacare. we intend to include tort reform in the next -- in this congress. we also believe that association health plans are very important to ensure that more people have access to health care, something your side of the aisle failed to do. there is real ways to do common sense reforms. it is not by having government it is not by having government mandate what you have to buy as