we're just going to help students get a lower interest rate. that was the nose of the camel in the tent, the toe in the door, to the point now where if this bill would pass the senate, where you've got the government now in the student loan business system of now let's fast forward. why, then, how does that parallel our concern on health care? our concern is, you put a public option in, the government starts with that, it seems like just a little thing. then pretty soon you say, every insurance policy in the country has to be the same in the government's which is what the legislation says, and pretty soon, guess what, you've got one provider, the federal government and the government has now taken over all of the health care. . the congressman from georgia has a distinguished record here in the house but also is a medical doctor which we don't hold against him. i be would be delighted to recognize my good friend, dr. gingrey. mr. gingrey: i thank the gentleman for yielding, mr. speaker. i hope my patients don't hold it

against me as well. i just wanted for you to yield me time so i could ask our good friend from north carolina, ms. foxx, a question with regard to this. you're right. she's a member on our side of the aisle, rules committee, does a great job handling the rules for us and apparently does all the education bills that come before the floor. there was some discussion, representative foxx, about how many jobs, in this time of losing jobs they keep saying, 14,000 people a day lose their health insurance, we know why, because they are losing their jobs, but in this particular instance as far as that private sector, can you give us a number on that? ms. foxx: we have an estimate between 30,000 and 40,000 jobs in the private sector will be lost as a result of that education bill. and that again makes the statement that mr. miller from california made so astounding because it's likes the statement

that president obama has made about the health care bill. mr. miller said, this will not cost the citizens of this country one single dime. and -- mr. akin: you're starting to blow my circus. you're saying a congressman on this floor, the head of the education committee now, says that this government loan program is not going to cost us a dime. ms. foxx: the complete takeover is not going to cost us a dime. mr. akin: the federal government is going to go in, take over all these student loans, it's not going to cost a dime. you know what you would have to prove to prove that true? would you have to say every single loan is going to be made good. that's what you have to say almost to make that happen. that's beyond credible. ms. foxx: it also is beyond credible when we know that there are 30,000 to 40,000 people in the private sector servicing the existing loans. it's incomprehensible to me. mr. akin: 30,000 or 40,000?

jobs lost? ms. foxx: jobs lost, and they believe that people in the department of education are going to absorb the program into the department without adding any personnel. now, that's beyond belief for anybody in this country, i believe, to think that you add responsibilities to people who work in the federal government and they are not going to ask for additional personnel. mr. akin: there's kind of an overused phrase down here, people of faith. i think we are talking about people of faith that can make statements like that with a straight face almost. i would like to just shift a little bit to my good friend from georgia. and he in a way to me is a hero because he has done something which i think is a tremendous educational tool for the people of the united states. on this house floor, we are denied many, many times any kind of amendment that we can offer because it might be embarrassing to have to vote on something.

but in committee we have -- still have the freedom to be able to offer amendments. and a third point of some considerable contention on health care is the question of rationing. is it going to end up that the government is going to -- instead of an insurance agent getting between you and your doctor, which we don't like, even worse a bureaucrat telling the doctor and the patient sorry you can't go there. give them some aspirin and send them home. that's something that's been a concern. so my good friend the doctor from georgia offered an amendment in committee on this very point. i think -- i don't think this has received nearly enough attention, dr. gingrey, but i want to review the simple sentence that you put in, because i think this really busts wide open this entire question about whether we are going to have rationing of health care. nothing in this section shall be construed to allow any federal

employee or political appointee, that is bureaucrat, to dictate how medical provider practices medicine. in other words, i think -- my understanding what you're saying, doctor, is that that doctor-patient relationship which we all consider to be the backbone of good medical care, is sacrosanct, and we are not going to put bureaucrats in charge of doctor-patient and medical decisionmaking. was that your point? and tell me about your amendment? mr. gingrey: mr. speaker, i thank the gentleman from missouri for yielding. that essentially is the amendment that we proposed. there were a number of others, but on that particular one early on, back on july 30 i believe when we were working up into the wee hours of the night, and the big concern was when you look at the chart, this massive bureaucracy that was created between the patient here and the

provider, there was all these government bureaucrats who had the authority under this bill, h.r. 3200, mr. speaker -- mr. akin: was that fantastic colored flow chart we saw that had all these boxes and arrows? mr. gingrey: mr. speaker, the gentleman was right. i was able to hold that up when we were marking up the bill in energy and commerce. of course c-span cameras were there and showed the morass of bureaucrats in a chart depiction , but i think people got it, mr. speaker. they could see -- mr. akin: that's your point. you don't want bureaucrats getting in the way of medical decisions. mr. gingrey: absolutely. mr. akin: how did it go? tell me about the votes. mr. gingrey: the vote on everything -- mr. akin: it passed without any question, right? everybody agrees to doctor-patient relationship, right? mr. gingrey: mr. speaker, the

gentleman asked that question. the answer to that if you ask every doctor and if you ask every patient the answer would be we don't want some government bureaucrat coming in this exam room telling either one of us not to do. this is a sacred relationship, really between -- mr. akin:00 i agree. mao -- mr. akin: i agree. how did the committee vote? mr. gingrey: they voted it down. they voted a lot of great amendments down. mr. akin: i got here in my notes t. says the democrats, 32 voted against it. one voted for it. republicans, 23 voted for it, none of them voted against it. straight party-line vote? mr. gingrey: mr. speaker, there was maybe one or two exceptions in the vote. they have 36 members on the energy and commerce committee. i say they, mr. speaker, your party, majority party. they were assigned to that committee by the speaker of the house, ms. pelosi. we have 23 republicans. so it's a 36-23 and unless we --

mr. akin: your amendment failed. as did all the other amendments. you mr. gingrey: you might say, mr. speaker, the deck was stacked against us. mr. akin: when it failed, what does that say to us if you are worried about bureaucrats making decisions? does that give you comfort? mr. gingrey: the question does that give you any sense of comfort that bureaucrats won't come between the doctor and his or her patient, it gives you total discomfort is the answer to that question. otherwise we would have had almost a preponderance of members both democrats and republicans voting in favor of that amendment. surely some more than one or two felt that way, but they didn't vote that way. mr. akin: i really appreciate, doctor, your offering this amendment. because i think this is, if there's any indication of where this health care is going and why the american public is concerned about it, this would be one of those things, because

we are talking about promises on one hand that you can keep what you have and your doctor-patient relationship is good and don't worry about that, 100 million people in america have their own insurance and doctors and providers and they feel like they are getting pretty good health care, yet here this amendment says -- we are joined by a fantastic congresswoman, congresswoman lieu miss -- lummis. mrs. lummis: i was sitting in my office in the longworth building listening to this discussion, and my fellow freshmen colleague, the physician from louisiana, was talking earlier about medicare and the effects of $350 billion of waste, fraud, and abuse coming out of medicare to magically fund a big portion of the proposed health care bill that ms. pelosi and her

colleagues have prepared for us. mr. akin: what part of medicare did that come out of? did you happen to notice that? is there any line item that says waste, fraud, and abuse in medicare that you just take money out of? how do we do that? mrs. lummis: there certainly isn't. the most amazing thing to me about listening to that discussion is when i was home for the august work period i met with the physicians and administrators at wyoming medical center in casper, wyoming. they told me that they are currently reimbursed at 37 cents on the dollar for their actual out-of-pocket costs of treating a medicare patient. mr. akin: that's an incredible number. in other words, we have a doctor like dr. gingrey, dr. fleming and they accept a patient on medicare, it costs them $1 to provide some type of medical care, they are getting reimbursed how much?

$1.50? $1? how much? mrs. lummis: 37 cents. mr. akin: they are losing money on a medicare -- mrs. lummis: they are losing roughly 2/3 of every dollar that they spent spend -- mr. akin: so we are going to cut half -- $500 billion out of medicare and expect doctors to continue to do that? i don't understand how that's supposed to work. mrs. lummis: it is a stunning departure from rational thinking. mr. akin: i think that's a great phrase, a stunning departure from rational thinking. you're such a nice person. that's a nice way to say being stupid, isn't it? missouri, we are not very good at explaining things -- i wish i was as politically correct as you are. i see my good friend, congressman king, over here he's

having way too much fun from iowa. i think we got to let steve have a chance chatting with us a minute. congressman king, somebody who is known for calling things plain and straight talk, i appreciate your western perspective. please join us. mr. king: all those compliments i might argue are a stunning departure from rational thinking, mr. akin. i'm glad i came over here just to hear that exchange between you and cynthia lumis -- lumis tonight. there is a great huge philosophical divide going on in this congress. and the people on the left side the philosophical spectrum and level side of the aisle seem to believe somehow they can generate all of this government, all of this government oversight, and take on a huge operation of the job that's being done now by a lot, by the private sector, punish the health insurance companies, replace them with federal health insurance companies, and somehow the incentive that is there

today that has allowed some profit for doctors to get back, their huge investment in their education and training and internships, and in our nursing and all of the expenses that it takes to -- up front-loaded education, somehow there's going to be a incentive there to have more doctors and more nurses when we know it's going to be less. cut the funding to medicare by half a trillion dollars. and argue that it's waste, fraud, and abuse and somehow the president makes the argument that, let's see, he can find this savings that's already -- that's there because of waste, fraud, and abuse, but the quid pro quo is we don't get to save the wasted money unless we take on the socialized medicine part of his package. mr. akin: i would like -- we have two medical doctors here, dr. fleming, dr. gingrey and we have been really leaning on our medical doctors. i guess the question i have is, i have been here nine years and over this period we passed some bill, don't know how many years ago, which says we are going keep ratcheting down how much

money we are spending on medicare, and it obviously isn't working if you look at medicare growth and costs. every year we do the medicare patch so the doctors aren't going to go bankrupt all the time or at least they'll keep taking medicare patients. it seems like to me when we do the patch we are putting more money into medicare and now we are talking about taking out $500 billion out of it. this thing somehow -- dr. beginningry, do you want to address that for a minute? mr. gingrey: i would be glad to take some time to the gentleman from missouri then i would be glad to yield back to him so he can let the gentleman from louisiana our family practitioner, dr. fleming, also speak on this issue. yes, this sustainable growth rate formula, and it's very complicated, i have had six courses of calculus at georgia tech and i still can't quite figure out how they come up with these numbers, but it's flawed. everybody knows it's flawed. and needs to be doneway with. you can't fix something that

badly flawed. for the last five, six years when they calculated that formula that the doctors end up taking a cut in something that already is underweighing them, mr. speaker. it doesn't cover their basic expenses. it's calculated far different from the way hospitals are reimbursed. mr. akin: every year we are patching that, aren't we? mr. gingrey: the gentleman, mr. speaker, is right. every year we are patching it. . that's no way to run a bank. you patch it, then you take the cut for that year and the patch you removed. 5% from the patch and 5% from the current year. january 1 of 2010, the doctors said if we don't do something about it, we're going to take a 20% cut. i want to yield back. mr. akin: how many years could you practice medicine -- say

our salaries were cut 20% every year, how long could we keep doing this? we keep adding money to keep that cut from taking place, now we're going to take more out of medicare and it's going to work fine? dr. fleming, what do you think? mr. fleming: i'll keep it brief, the whole concept behind sustained growth rate, s.g.r., is that the government in its wisdom, its infinite wisdom, the government said, out in the future someplace, we're going to spend no more than this many dollars and the doctors have to get together among themselves and decide how to do that. the obvious thing occurred, how are doctors and hospitals going to be able to do that, anybody under part b. mr. akin: this is a conference call in mr. fleming: as far as i know, i was never invited to a

conference call, never received an email, i went along practicing medicine. then we're told, all of a sudden, we're spending above the s.g.r. level. we can pick and choose a number out there that's going to be a goal and we're going to practice and spend less than that amount. that does not affect the day-to-day behavior inside the exam room, which is again why our bill, h.r. 3400, is so important, because it gets to the behavior and the decision making between the doctor and the patient. that is where the money is saved, not in some concept yule decision made out in the future that we're going to spend only this many billions of dollars next year or the coming years. that's why the s.g.r. is an abysmal failure. we all know it's a joke. we do a patch every year. but it never would work and never will work. mr. akin: i appreciate your

response as a medical professional on that and the fact that it's going to be awfully hard, if year after year we're putting more money into medicare to try to prop it up and as dr. gingrey said, that's no way to run a ship, that's true, but we're constantly putting more money in it and we're being told by the president he's going to take $500 billion out of it and put it into this program, there's not going to be a nickel of deficit involved in that. another claim the president made and i've been sticking a little bit on the theme of, there's a lot of debate on what's true, america is arguing about this stuff. what our objective is to try to add some colonel of truth to -- some kernel of truth to this. if you're among the hundreds of millions of americans who already have health insurance through your job, medicare, medicaid or the v.a., nothing in this plan will require you or your employer to change the coverage or the doctor you

have. we have heard this over and over from the president, from different democrat congressmen claiming this. yet this isn't really true from what we're seeing as we take a good, closer look at it. and the first thing that strikes me is, if you are among the hundreds of millions of americans who already have health insurance. you've got 100 million americans who already have health insurance and you like it you like your doctor-patient relationship. you're say, just leave me alone. what's the object snive the objective is to find some other number of people who don't have health insurance and so, how many is that in we have an expert on that here in congressman king. lets be very liberal. let's say the president who said originally it was 46 million, he took it down to 30 million and it's probably less than that. even say it's 30 million who didn't have health insurance and you have hundreds that have, why scrap the hundreds off the bat to deal with the 30

million? >> would the gentleman yield? mr. akin: yes. mr. king: there have been flawed premises under the foundation of this health care debate from the beginning. one is we spend too much on health care. that's not been adjusted for a number of reasons. the other is we have too many uninsure the number that's most consistent is 47 million uninsured. when you start subtracting from that, those that are here illegally, which the@decided now that he doesn't want to fund those, those that are here legally are under the five-year bar, those that make over $75,000 a year and can presumably pay their own premium those that qualify for an employer plan or a plan like medicaid but don't bostonner to sign up, once you take $47 million and sub -- from that 47 million you end up with 12.1 million who are americans without affordable options.

>> when you read this, hundreds of millions who already have health insurance and you're going to tamper with all of this to deal with 12 million. mr. king: to deal with less than 4% 12rk.1 million. mr. akin:less than 4%, we're going to redo the whole system to deal with 4%. even on the surface, it doesn't seem intuitively obvious that that's the way to deal with this thing. congresswoman foxx. ms. foxx: i thank the gentleman for yielding. i wanted to speak to what you started out talking about tonight, along with this comment, is what are we to believe on all of these issues? there are lots of numbers being thrown around, lots of comments being made, and i think it's important, first of all, let me give a statistic i know of, 89% of those people you talk about are happy with their health insurance. mr. akin: of americans in yen,

89% are saying, we're pretty comfortable with what we've got. ms. foxx: right, the ones who have health care coverage. but the point i want to make tonight is what's been coming out in the last day or two about what's happening in term of informing the american public. mr. king: this is the area that's sacred to american, the idea of free speech, you can have your opinion, disagree with a family member or neighbor, we can have this debate and not hide information. ms. foxx: that's right. there's an organization called humana, which provides health care benefits to -- health insurance to -- primarily to medicare advantage program to seniors all over this country. mr. akin: humana, it's a health insurance company provider, particularly working with medicare money and packaging that money into more of like a private medical plan type.

ms. foxx: correct, the medicare advantage program. the humana organization sent a letter out to the people who participate in that program saying, we want you to be aware of what's happening in this health care debate, we'd like you to send back a card so we can send you information about what's happening. we do want you to know that the current bill under consideration, they don't name h.r. 3200, but we assume that's the bill they're talking about, will be cutting funding for this program. that is absolutely true. anyone who reads that bill will see that it's true. but what happens is -- mr. akin: spefpkly the bill being proposed by nancy pelosi and indirectly by the president will cut medicare, specifically it's going to cut medicare advantage and humana works with that. i want to make sure we're

getting this down. ms. foxx: sure. this is a program that seniors like very much. where the rub comes in is, suddenly, the organization, the centers for medicare and medicaid services, doesn't like the fact that humana is exercising its free speech options. mr. akin: or educating -- ms. foxx: and educating people being covered by its program, writes to them and says, you cannot do this anymore. you can't write letters to the people participating in your program. and it says, we are instructing you to immediately discontinue all such mailings to beneficiaries and to remove any related materials directed to medicare enrollees from your website. this is -- mr. akin: wait, wait, stop again. i feel like i've blasted off and gone to some other country or some other planet.

ms. foxx: you're living in "1984." mr. akin: you're saying we have a private company who is insuring people. they write a letter to people buying their product and say to them essentially, you're being targeted by this nancy pelosi health care bill system of they are a constituency, they're a group of americans that have a right to have an opinion. obviously they're somewhat predisposed to like it because they wouldn't be in the program if they didn't like it. they're being told, the program you like in medicare is going to be canceled. they're warning their people that are buying their product, look out, you're about to lose something, if you like it, you'll have to say something about it. now the government is threatening humana for communicating? ms. foxx: that's absolutely true. mr. akin: i'm not sure if we have a first amendment anymore. ms. foxx: mr. speaker, i would like to enter into the record tonight the letter from humana to its enrollees and the letter

from c.m.s. and the c.m.s. press release that was sent out related to that into the record of this discussion tonight. mr. akin: i appreciate you sharing that. i guess i appreciate it. i think it's a little bit chilling. the president said something like calling us out. that sounds like something my principal did to me all the time when i was talking or chewing gum. ms. foxx: would the gentleman from missouri yield? the speaker pro tempore: without objection, so ordered. ms. foxx: thank you, mr. speaker. mr. akin: i was going to go to dr. gingrey. have you heard about this situation? it's spooky, you can't send the letter to people in america? mr. gingrey: i have heard about it. it's amazing, isn't it, that what we hear from the leadership of the majority

party and from 1600 pennsylvania avenue is that everybody that is questioning h.r. 3200 or the bill that came out of the health committee in the senate and has great concerns about whether illegal immigrants are going to be covered, whether the general taxpayer, whether they're pro-life or pro-choice will have to pay for subsidies that low-income people get through the exchange if they choose to a plan, the government plan or private plan, that offers abortion services, and it's in the bill. it's clear language and yet we're just getting all wee weed up according to certain sources. it's like the only people telling the truth is the white house and the democratic majority party. everybody else is lying. you know. it's absolutely insulting. mr. speaker, that's why the people at the town hall

meetings were so wee-weed up, they're tired of being insulted by these people who have all the power, the people at the white house and both chambers of congress. mr. akin: i'm still coming back to, you're a business and you're writing a letter to your -- the people that you're providing a product to and the government tells you you can't send it to them. is this 1984, george orwell or something? i find the whole pattern here to be upsetting. i do. my gentleman friend from iowa are you running away from us? i was just about to recognize you. did you want to jump in on this? i think -- mr. king: if the gentleman would yield, i appreciate him doing system of there are a number of things that jump out in my mind. that is, yes, this subject matter gets me all animated. i don't know how to pick that up with mid western vernacular,

but i wanted to point out the president's vernacular. we have to be careful and listen closely to this president, he's a master of casting ambiguities that couch things in terms where he's not confined by the definition of language. right there. nothing in this plan will require you or your employer to change the coverage of the doctor you have. remember, for months he said if you like your plan, you get to keep it. and john shadegg said if you like your plan, get ready to lose it, that's the reality. now in his address before congress, i'll point it was september 8 of 2009, the president changed the language to read what's down there, nothing in this plan will require you or your employer to change the coverage or the doctor you have. except you may not be able to access the coverage or doctor you have because the plan might bring about a change in premiums, disqualify the policy, might disqualify the health insurance company. nothing in the plan might

require you to change, but you may not have the option to keep the one you have because it may not exist anymore. mr. akin: this is the president's claim. what's the balancing counterclaim? here's one. this is this poor guy from m.i.t. who wish he is hadn't said it. he was attacked for making this statement. with or without reform, that won't be true, about this statement. he said that won't be true. his point is that the government is not going to force you to give up what you have, but that's not to say other circumstances won't make that happen. so in other words, he can say you can keep what you've got, but in fact, what happens, just like in higher -- in the funding for higher education, the government comes in, changes everything, and no, you don't have access to it anymore. please, the gentleman from iowa. mr. king: listen to the words the president says. here's a little bit different

subject he said after the blowup on that night of september 8, in the joint presentation to congress, on the issue about funding illegals through this, the president came back and said, i want to be clear, if someone is here illegally, they won't be covered covered under this plan. in other words, he's going to oppose any language that's ambiguous that would allow illegals to be covered. however, a few days later he went before an open borders organization, which i recall to be lara sa and he said we need -- la rah sa, and he said we need to move forward on legalizing people who are here legally. so this language that says, if someone is here illegally, they won't be covered under the plan, but if you legalize everybody here, this language becomes moot. listen carefully to the ambiguities the president threads into his language and you might find out well after the fact that it's a little late to raise the issue. .

mr. gingrey: thank you, mr. speaker. i want to respond to my good friend from iowa, because he's absolutely right. the president did make that comment that, hey, this problem would go away. all we have to do is grant amnesty to 12 million illegals and then we won't have this problem and they'll be eligible for government subsidies under the government plan or exchange or whatever. but he did say, mr. speaker, he did say emphatically that there should abprovision in h.r. 3200 if that happened to be the bill and i hope it won't be, but he said that he agreeed that there ought to be an absolute provision that specifically states that before a person is eligible for any of these government subsidies, that they have to have proof of their legality, not citizenship, but they are in this country legally. and that proof, he said, the

thing speaks for itself. i'm paraphrasing what the president said. he was pretty emphatic. i yield. mr. akin: this is the august 8 speech. there are those who claim that our reform effort will insure illegal immigrants. this, too, is false. he's saying people are saying things that are false. that's pretty close to calling them something else. they are saying things that are false. the reforms i'm proposing would not apply to those who are here illegally. this is a statement he made. is it true or not? one of the ways you can check it out is to take a look at the bill. another way you can do it is you can hire a group of legal scholars who work for congress called the congressional research service. they are not republicans, they are not democrats. they look into this statement. and this is what did they find? under 3200, this is pelosi's health care bill, health insurance exchange would begin operation in 2013 and would

offer private plans alongside public option. then it goes on, 3200 does not contain any restrictions on noncitizens whether legally or illegally present, or in the united states temporarily or permanently. in other words, in spite of the fact that the bill says, this shouldn't apply. there's language it shouldn't apply to illegals n. practice when you turn the bill on, there's no screening mechanism which is what congressional research service -- mr. gingrey: don't take that poster down. i notice on that, gentleman, mr. speaker, on that poster that is dated august 25, 2009, and energy and commerce committee, h.r. 3200, passed committee on july 30, 2009. this is an opinion rendered by c.r.s. almost a month after that bill passed committee. mr. akin: i do yield. mr. fleming: there was also

attempts by my friends, dr. gingrey and others, to actually say, well, ok if this is fudsy language -- fuzzy language f. we are going to debate this and say it's ambiguous, let's just settle it by putting an amendment into the bill that will settle that for good. mr. akin: reclaiming my time. if the objective is that we are not going to cover illegals, if that's the objective, you're saying let's make it clear to everybody, we'll put a simple couple sentences in the bill, make it clear we are not going to cover illegals, and that's offered as an amendment? mr. fleming: yes. mr. akin: was that amendment passed? i assume it was passed. mr. fleming: my understanding is the amendment failed according to party line vote. mr. akin: so we have the president saying we are not going to be covering illegal immigrants. the bill from a completely unbiased source says there's nothing in it to protect against

that, and the amendment to specifically prohibit is defeated on a party-line vote. that's why there's some tension, isn't there, on this subject? one person things something. i do yield. mr. gingrey: on that very point, dr. fleming made, mr. speaker, in regard to the amendment. that amendment back in july, on that two, three days of markup, was offered by my colleague from georgia, the ranking member, ranking member with 17 years experience on the health subcommittee of energy and commerce, he offered that very same amendment and it was rejected. mr. akin: reclaiming my time. and i appreciate doctors, your help. we've got just a couple minutes before i have to close. i would like to correct one other thing. it's assumption that's been kind of hidden in this debate over the months. that is that american health care is really cruddy and terrible and has to be totally

torn down and rebuilt. this summer while we were debating this, my dear father, who is 88 years old, went to a heart doctor. his original heart doctor had been diagnosed with cancer and he retired. he goes to a new heart doctor. heart doctor says what's the doctor done for your heart? dad says getting these medicines. what did you do? and he said, come on in for a stress test. came in for the stress test. within a couple days he's scheduled angioplasty. my father is put under anesthetic. they looked around with their camera. he comes back out. they hadn't done anything. they call us in the office. i was with my dad on monday. and the doctor says, you need open heart surgery, 88 years old. you need open heart surgery. what are the numbers? the numbers are these, 10% chance for major complication in open heart surgery. if you don't get it, 50% chance you're going to have a major heart attack. so i'm sitting there with my dad, mom in the office. the doctor says, when can we

schedule surgery? he said, tuesday or thursday? that is tomorrow or two days. so we scheduled surgery, my dad had a seven-way heart bypass, was home from the hospital on saturday, the whole process took about two weeks, 2 1/2 weeks. that's the -- he's doing fine. that's the miracle of american medicine. let me explain one thing, and that is if you are some cheek with unlimited money, where do you want to go for health care? good ole u.s.a. i say to you doctors hats off for the great health care you provide. there are some things we can do to improve it, but it doesn't mean we have to burn the entire barn down. i do yield. mr. fleming: some might say that's anecdotal. for all cancers, 66.3% of american men and 63.9% of women survive. in europe hasegawa 47.3 and 55.8. so we are not talking about just

a single story like you gave, which i think is representative. we are talking about across the word statistically significant differences in cancer survival rates in the u.s. versus canada. mr. akin: do that statistic one more time. we'll probably have to close up with that. in the u.s. your survival rate is 60-something percent? mr. fleming: all cancers, 66.3 men, 63.9, women. mr. akin: this is over five years. you got -- ok. mr. fleming: versus europe, 47.3. mr. akin: if you got cancer you want to be in the good ole u.s.a. then. i very much appreciate you-all joining us tonight. i thank my colleagues, the american public for continuing this discussion on health care. god bless you all, thank you. the speaker pro tempore: the gentleman's time has expired. under the speaker's announced policy of january 6, 2009, the

gentleman from connecticut, mr. murphy, is recognized for 60 minutes as the designee of the majority leader. mr. murphy: i thank the speaker. for granting us this time on the house floor this evening. i hope to be joined very shortly by a few other of our colleagues, both from the 30-something working group, which as our colleagues know comes down to this floor on a regular basis to talk about the issues that matter not just to our constituents, to the american people, but in particular to young families out there. also be joined this evening by a few other members who care deeply about this congress' commitment to health care reform. this is the defining subject of this moment in congress. it is the defining issue for our constituents when we are back home. and rightly so. mr. speaker, my colleagues, when i was home for august, i went

out there and talked to the people that i represent in every form possible. i spent early mornings in the dew of village greens. i did town halls in the evenings, set up a card table outside supermarkets. talked to health care professionals, nurses, and doctors and patients. and listen, we certainly saw in connecticut the disagreement over the solution just as we saw all over this country. but we had an agreement that something had to be done. that the current system is unsustainable. now, there's not that kind of agreement here in washington. i hear too many of my colleagues on the other side of the aisle and groups that are affiliated with that party talking about the system being ok as is. talking about the lack of need for any real reform. well n. connecticut the very least, we understand the need for reform. we saw it plainly, plainly

earlier this year when the states' major insurer that covers over 50% of individuals in connecticut proposed a 30% increase on individuals and small businesses. now, thanks to government, thanks to the state of connecticut's regulatory system, looks like we are going to be able to push that increase down to 20%. but think of that. think of the impact of a 20% one-year increase in health insurance premiums for individuals in connecticut who are struggling to get by, the fact is is that most people in my state and across the nation that don't have health care insurance today, those that are purchasing on the individual market, frankly are struggling to get by. these are folks that are either running their own business that are self-employed, or that work for an employer that doesn't provide health care benefits. those folks can't take a 20%

increase. neither can the small businesses that are being charged those premiums as well. study after study shows us that small businesses bear the brunt of cost in our health care system. on average a small business is paying 18% more in health care premiums than large businesses are. it's simple economics. i didn't get past ecom 101 in college, but i learned enough to know if you are a small business, purchasing anything, staples, paper, or health care on behalf of only five, or 10, or 20 employees you are not going to get the same deal as a company that's purchasing that on behalf of 100 or 1,000 or 10,000 employees. it's the small businesses in today's marketplace that are getting hurt the most. just as individuals are getting hurt the most. so in connecticut i think we are representative of most folks, most businesses across this nation that know this current system just doesn't work for people.

that we are not talking about tinkering around the edges. we are talking about comprehensive bottom-up reform to make this market work again for families, for individuals, and for businesses. in connecticut we have seen over the last 10 years an increase of 120% in the premiums that small businesses have been paying. during that same time, wages for their employees have only gone up about 30%. that's not coincidence. the fact is is that the costs of our health care system are sometimes invisible to employees and to workers. because it results in a lack of wage increases. it results in a contraction of pay for those employees. when the business is making a little bit extra money in one year, too much of that additional income is going simply to pay those 10% or 20% increases in health care premiums. and so the result is is that the workers of those businesses get

a zero% pay increase or 1% or 2% pay increase. all the extra money the companies are making is going to health care. that's not sustainable, either. and on the other end, we got to ask what we are getting for all of this money. it would be one thing if we were paying in for the most expensive health care system in the world, and it's the most expensive health care system in the world not by 5%, 20%, by 100%. we are paying twice as much for health care in this country as any other industrialized nation in this world, it would be one thing if we were getting the added quality. . maybe, my friends on the other side of the aisle, the republicans who are so complimentary of the current system, if all this money they're so proud we're spending on health care today got us better results. but the fact is, it doesn't.

yes, if you have access to the best health care centers in this country, to the best doctors and hospitals, you can absolutely, absolutely get better care. you can absolutely get the best health care in the world. i don't deny for a second that are there -- that there are people from all over this worldcoming to those top centers of care in this country. but the fact is, not enough people have access to those centers of excellence. there are too many people who can't get into the best of our health care system. it means when a group like the world health organization surveys the quality of health care in the united states and all of our economic competitors across the globe, we turn out to be in the middle of the pack. any health care indicator you look at, life expectancy, hospitalization rates, infant mortality, infection rates, we rank 10%, 15%, 20%, for all of

the money we're spending in this country, we should be at the top of the list regarding outcomes. our health care system should be the best in the world. and this debate around health care reform has to encompass all those problems. this debate has to start with cost. about how we get at making sure that never again do people in my district see a 20% or 30% increase in health care costs in one given year. this debate has to get to a paint where businesses can make extra pun in -- money in one particular year and pass that extra income on to their employees, rather than to insurance companies. this debate has to address the quality gap between those who have access to the best of our system and those that can't get there. we should be at the top of those lists at the world health organization puts out, not the middle of the -- middle or the bottom.

that's why band-aids aren't going to work. in the energy and commerce committee, my republican friends today unveiled maybe what is one of their first detailed proposals for an alternate to the effort that the president and his -- and this congress are putting forth. it was nothing but a series of band-aid fixes on our current system. slight tweaks to the system of private insurance that has gotten us in the problem that we're in today. the republicans had control of this house for 12 years. and during those 12 years, that's stre the strategy they employed, empower the private market. tweak and change the current private health care system here and there. the jury is in on that approach. the evidence is set. during that time that our republican friends controlled

this house, insurance premiums skyrocketed. the number of people without insurance increased. our health system got more broken. it's time to dramatically alter the rules by which insurance companies play by. that's what we're talking about here today. no more incremental changes to our health care system that have proven to be ineffective but serious reform that protects what we like about our health care system but fixes what is broken. so i hope that that's the debate we will have here. in this chamber and in committees throughout this congress. that's what we need. that's what businesses in my district need, that's what the constituents in my district need. and let's have a real debate a debate on the facts, not based on innuendo, not based on distortions, not based on

outright fabrications in this bill. i listened to our republican colleagues who had the previous hour talk about this issue regarding the access that illegal immigrants will have to the new health care system that we hope to build here. they talked about an amendment in the energy and commerce committee, which i sit on, that would, in their mind, restrict it, the access to the health insurance exchange or the subsidies included in the bill for lower income people so that it wouldn't accrue to illegal aliens. they failed to mention that we passed that amendment. the space amendment passed. check it out. thomas.gov online. passed by the house energy and commerce committee, which states in as plain english as you can make it, and i get it a lot of amendments and bills we pass here are pretty hard to understand, whether you're watching congress or in

congress, but this thing was about as plain as you could make it, that nothing in this bill shall allow people who are in this country illegally to access subsidies, to access government programs like medicare or medicaid. the existing law which requires verification of citizenship remains the same. not a lot of talk. i'll yield for a moment, certainly. mr. king: the amendment with the general language says nothing in this bill may have been an amendment that was adopted but the amendment mr. gingrey referred to was the deal amendment that would have required proof of citizenship, it failed 29-28, not exactly a party line vote. mr. murphy: reclaiming my time, i tharninge the gentleman. my point is, you don't hear a lot about the amendment that did pass, that's attached to that bill today that states

what the law is and which i think is one of the things that leads the president when he appears before groups out in the public or before this chamber that the law is clear. i wish we had a more honest discussion of the entire debate in the energy and commerce committee which included passage of a clear and restrictive amendment on that case. this is, i think, and i thank the gentleman. this is one example of many in which we've got to start matching the facts of this proposal and this debate to the rhetoric that's out there today. irning if we can do that, i think if we can get by the political jibs and jabs of this debate, there's real substance here. representative -- i want to yield to my friend from pennsylvania in a moment but i'll close on this. representative boustany in response to the president's speech of several weeks ago

talked about the fact that there is and can be agreement on a lot more than there's disagreement over. thing many of us who went home for the break found that amongst our constituents that folks out there were arguing around the margins of this bill. but on the guts of it, whether or not we have an only gailings in some form or fashion to try to help people who don't have insurance today get insurance, whether or not we have an obligation to start holding insurance companies accountable for their actions, whether or not we have a responsibility to try to stimulate a competitive health care market that is in the majority of states today not competitive, i think there's agreement on a lot of that. so if we can start talking about what's really in the bill, talking about amendments that passed, not just those that didn't pass, start talking about what the words in the bill say, rather than the words of political pundits on the evening cable news show say, i

think we can find some agreement here. i'm glad your leadership, mr. altmire here in the house, has reengaged the minority side. i'm hopeful that the president is absolutely sincere in his intention to bring republicans to the table. you see in the senate democrats and republicans talking to each other about how they can forge compromise here between the two sides. there are absolutely going to be disagreements. maybe in the end we can't all come together on something. but if we listen to our constituents, if we listen to how very broken the health care system is in their eyes, small businesses, individuals, and families, i think our mandate is not to put a band-aid on the current system, but to make major reforms that correct years of health care neglect from this body and this government. i'd be glad to yield to my friend.

>> i really appreciate the opportunity to be able to participate tonight. we could stand here and discuss the merits of the bill, and we will. the bill that has come before congress already and the bills that we're trying to mold together to what we expect the end result to be, we can have a discussion on the need for health care reform in this country and the merits of the system that we have, what we can do better, we're going to have that discussion. but i did want to come down to agree with the gentleman. i watched some of the previous hour and members who i consider to be friends and i work with and certainly don't question intent, but we did hear a lot of rhetoric that does not in any way match up with the facts of the issues that we're discussing. i did not vote for the bill. i am not here to defend the bill. but when i hear members come to the floor and talk about things that are not in the bill as though they are and hear them reference portions of the bill

and greatly take out of context what they're talking about in that bill, i don't think that's a legitimate discussion on health care reform in this country. i am someone who wants to pass a health care reform bill. i want to find a way to make it work. i thought the house bill that was before us could have been better. i'm hopeful we're going to make it better. i don't want to engage in a discussion and talk about how somehow we are in the process of putting together a bill that's going to lead to illegal immigrants getting health care or death panels or some of the other things that we heard over the course of the recess. that's rhetoric that is misplaced. i think, as the gentleman said, we do have the best health care system anywhere in the world, if you have access to it. our medical innovation, our technology, our research exceeds anything available

anywhere else in the world, that's true. we want to preserve what works in our current system, no question about that but there are things we can do better. i don't know how many people there are on the other side that think we shouldn't do any reform. i would suspect not beter -- not many. but we should be able to agree on the fact that in large segments of society, people who have insurance have access to the best health care system in the world. that's in the to say we can't do better. i want to engage in a dialogue on how we can improve upon the bill that was put forward. what can we do to achieve consensus. in america that's where we end up. we start with an idea and we build to consensus. and we get something done. that's how legislation is passed. so it offends me when i hear rhetoric put forth that is just not consistent with the facts. of what's in the legislation.

again, i'm not here to defend that bill, but i understand that some of the things we heard are not legitimate concerns. i had, when we talk about what's the need for reform, i had an august where i went around and talked to rotary clubs and physician groups and hospital boards and went to all the fairs and had town hall meetings, theavering other members of this house did and one of the things that stuck out in my mind, i had at a rotary club i was speaking at, a small business owner come up to me and hand me his statements from his previous four years, his rate increases, annual statement from the insurance company. the lowest increase he had over a four -- over an annual period for four years was 28% increase. that was the lowest in the four years. he said to me, and he clearly was upset about it, that he was going to be unable to offer health care to his employees because he couldn't sustain this increase. four straight years of at least

a 28% increase he had to drop coverage. these are things that we can't allow to happen in this country. when you have the best health care system in the world, you want everyone to have access to it. we want small businesses to be able to offer coverage. if you're a small business owner who can't offer health care to your employees, it's not because you're a bad person or you don't want to. it's because you can't. you can't afford to do it. so we need to bring the costs down for small businesses. every family in america has had a similar discussion around the dinner table, to talk about the increased cost of health care and the impact that's having on their family. some of them have to make difficult decision on what they can afford and what they can't do to the keep health care. everyone understands the costs are going up at an unsustainable rate. we all know the impact it has on government budgets, whether it be the federal budget, but